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Hotta K, Saeki S, Yamaguchi M, Harada D, Bessho A, Tanaka K, Inoue K, Gemba K, Shiojiri M, Kato Y, Ninomiya T, Kubo T, Kishimoto J, Shioyama Y, Katsui K, Sasaki J, Kiura K, Sugio K. Gefitinib induction followed by chemoradiotherapy in EGFR-mutant, locally advanced non-small-cell lung cancer: LOGIK0902/OLCSG0905 phase II study. ESMO Open 2021; 6:100191. [PMID: 34153652 PMCID: PMC8233144 DOI: 10.1016/j.esmoop.2021.100191] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/13/2021] [Accepted: 05/26/2021] [Indexed: 12/02/2022] Open
Abstract
Background The role of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) induction coupled with standard concurrent chemoradiotherapy (CRT) is unclear in unresectable, stage III, EGFR-mutant non-small-cell lung cancer (NSCLC). Therefore, a phase II trial was conducted to evaluate the efficacy and safety of gefitinib induction followed by CRT in this disease setting. Patients and methods Patients with unresectable, EGFR-mutant, stage III NSCLC were administered gefitinib monotherapy (250 mg/day) for 8 weeks. Subsequently, patients without disease progression during induction therapy were administered cisplatin and docetaxel (40 mg/m2 each) on days 1, 8, 29, and 36 with concurrent radiotherapy at a total dose of 60 Gy. The primary endpoint was the 2-year overall survival (OS) rate, which was hypothesized to reach 85%, with a threshold of the lower limit of 60%. Results Twenty patients (median age: 66 years; male/female: 9/11; histology: 20 adenocarcinoma; stage IIIA/IIIB: 9/11; and exon 19/21: 10/10) were enrolled. The 2-year OS rate was 90% (90% confidence interval: 71.4% to 96.8%), indicating that this trial met the primary objective. The overall response rate and 1- and 2-year progression-free survival rates were 85.0%, 58.1%, and 36.9%, respectively. Grade ≥3 adverse events (>10%) included hepatic toxicity during the induction phase and neutropenia and febrile neutropenia in the CRT phase. Radiation pneumonitis grade ≥3 or treatment-related death did not occur. Conclusions This is the first prospective study to demonstrate the favorable efficacy and safety of EGFR-TKI induction followed by standard CRT in EGFR-mutant, stage III NSCLC. Further confirmatory studies are needed. This is the first prospective study evaluating gefitinib induction followed by CRT in EGFR-mutated, locally advanced NSCLC. The 2-year OS rate was 90% (90% confidence interval: 71.4% to 96.8%), indicating that this trial met the primary objective. The objective response rate throughout the treatment protocol was 85.0% (17 of 20). The safety findings were consistent with the known safety profiles of all agents administered. Our results might raise a critical point that needs to be evaluated in further studies to improve the cure rate.
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Affiliation(s)
- K Hotta
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan; Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan.
| | - S Saeki
- Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - M Yamaguchi
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Kyushu, Japan
| | - D Harada
- Department of Thoracic Oncology, National Hospital Organization Shikoku Cancer Center, Shikoku, Japan
| | - A Bessho
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - K Tanaka
- Department of Respiratory Medicine, Kyushu University Hospital, Kyushu, Japan
| | - K Inoue
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - K Gemba
- Department of Respiratory Medicine, Chugoku Central Hospital, Chugoku, Japan
| | - M Shiojiri
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan; Department of Respiratory Medicine, Ehime Prefectural Central Hospital, Ehime, Japan
| | - Y Kato
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan; Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - T Ninomiya
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan; Department of Thoracic Oncology, National Hospital Organization Shikoku Cancer Center, Shikoku, Japan
| | - T Kubo
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - J Kishimoto
- Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu, Japan
| | - Y Shioyama
- Clinical Radiology, Radiology Informatics and Network, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
| | - K Katsui
- Department of Proton Beam Therapy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - J Sasaki
- Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Kitasato, Japan
| | - K Kiura
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - K Sugio
- Department of Thoracic and Breast Surgery, Oita University, Oita, Japan
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Noro R, Igawa S, Bessho A, Hirose T, Tsuneo S, Nakashima M, MInato K, Seki N, Tokito T, Harada T, Sasada S, Miyamoto S, Tanaka Y, Furuya N, Kaburagi T, Hayashi H, Iihara H, Naoki K, Okamoto H, Kubota K. 1365P A prospective, phase II trial of low-dose afatinib monotherapy for patients with EGFR, mutation-positive, non-small cell lung cancer (TORG1632). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Kubo T, Nogami N, Bessho A, Morita A, Ikeo S, Yokoyama T, Ishihara M, Honda T, Fujimoto N, Murakami S, Kaira K, Harada T, Nakamura K, Iwasawa S, Shimokawa T, Kiura K, Yamashita N, Okamoto H. Phase II trial of carboplatin, nab-paclitaxel and bevacizumab for advanced non-squamous non-small cell lung cancer (CARNAVAL study; TORG1424/OLCSG1402). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz437.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Saeki S, Hotta K, Yamaguchi M, Harada D, Bessho A, Tanaka K, Inoue K, Gemba K, Inoue K, Ichihara E, Kishimoto J, Sasaki T, Shioyama Y, Katsui K, Sasaki J, Kiura K, Sugio K. Induction gefitinib followed by standard chemoradiotherapy in locally advanced (LA) non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) activating mutations: The LOGIK0902/OLCSG0905 intergroup phase II study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Kunimasa K, Ito K, Yamanaka T, Fujimoto D, Mori M, Maeno K, Tomomatsu K, Tamura A, Tanaka H, Watanabe S, Teraoka S, Hataji O, Suzuki K, Hontsu S, Hara S, Bessho A, Kubo A, Okuno M, Nakagawa K, Yamamoto N. The safety assessment of crizotinib and alectinib from real-world data of 840 ALK-inhibitor naïve patients with NSCLC harboring ALK-rearrangement (WJOG9516L). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tanaka K, Morita S, Ando M, Yokoyama T, Nakamura A, Yoshioka H, Ishiguro T, Miura S, Toyozawa R, Oguri T, Daga H, Ko R, Bessho A, Tachihara M, Iwamoto Y, Hirano K, Nakanishi Y, Nakagawa K, Yamamoto N, Okamoto I. MA13.06 Ph3 Study of Maintenance Therapy with S-1 vs BSC After Induction Therapy with Carboplatin + S-1 for Advanced Squamous Cell Lung Cancer (WJOG7512L). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Otani S, Yamada K, Miyamoto S, Azuma K, Ishii H, Bessho A, Hosokawa S, Kunitoh H, Miyazaki K, Tanaka H, Miura S, Aono H, Nakahara Y, Kusaka K, Hosomi Y, Hamada A, Okamoto H. MA21.11 A Multicenter Phase II Study of Low-Dose Erlotinib in Frail Patients with EGFR Mutation-Positive, Non-Small Cell Lung Cancer: TORG1425. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Yokoyama T, Ninomiya K, Oze I, Hata T, Tanaka A, Bessho A, Hosokawa S, Kuyama S, Kudo K, Kozuki T, Harada D, Yasugi M, Murakami T, Nakanishi M, Takigawa N, Katsui K, Maeda Y, Hotta K, Kiura K. A randomized trial of sodium alginate prevention of radiation-induced esophagitis in patients with locally advanced NSCLC receiving concurrent chemoradiotherapy: OLCSG1401. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ninomiya T, Nogami N, Kozuki T, Harada D, Kubo T, Ohashi K, Kuyama S, Kudo K, Bessho A, Fujimoto N, Aoe K, Shibayama T, Minami D, Sugimoto K, Ochi N, Takigawa N, Hotta K, Kiura K. Updated analysis of a phase I trial of afatinib (Afa) and bevacizumab (Bev) in chemo-naïve patients (pts) with advanced non-small cell lung cancer (NSCLC) harboring EGFR-mutations: OLCSG1404. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Miyamoto S, Tokkito T, Bessho A, Fukamatsu N, Kunitoh H, Ishii M, Tanaka H, Aono H, Fukui T, Kusaka K, Hosomi Y, Hamada A, Yamada K, Okamoto H. ABCB1 genetic polymorphism and pharmacokinetic analysis of low dose erlotinib in frail patients with EGFR mutation (mt)-positive, non-small cell lung cancer: TORG1425. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hosokawa S, Otani S, Sasaki J, Fukui T, Nakahara Y, Bessho A, Fukamatsu N, Nakamura Y, Kasai T, Sugiyama T, Tokitho T, Seki N, Hamada A, Masuda N, Okamoto H. P3.01-37 Phase II Study of Amrubicin Plus Erlotinib in Previously Treated, Advanced Non-Small Cell Lung Cancer Patients with Wild-Type EGFR: TORG 1320. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ito K, Hataji O, Tanzawa S, Harada T, Fujimoto N, Bessho A, Takamura K, Takahashi K, Shinkai T, Kozuki T, Satouchi M, Kato T, Seki N, Shukuya T, Yamashita N. P1.01-40 Randomized Phase II Study of Docetaxel Plus Bevacizumab or Pemetrexed Plus Bevacizumab for Elderly pts with Untreated Advanced NSCLC: TORG1323. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bessho A, Ochi N, Kuyama S, Umeno T, Ikeda G, Harada D, Nogami N, Ninomiya K, Kishino D, Chikamori K, Fujimoto N, Hotta K, Takigawa N, Kiura K. A phase II trial of carboplatin plus S-1 for elderly patients with advanced non-small cell lung cancer with wild-type EGFR: The Okayama Lung Cancer Study Group Trial 1202 (OLCSG1202). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx671.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hayashi H, Akamatsu H, Koh Y, Morita S, Fujimoto D, Okamoto I, Bessho A, Azuma K, Nakagawa K, Yamamoto N. P2.03-045 Updated Results of Phase II, Liquid Biopsy Study in EGFR Mutated NSCLC Patients Treated with Afatinib (WJOG 8114LTR). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Harada D, Nogami N, Kozuki T, Ninomiya T, Bessho A, Kuyama S, Fujimoto N, Sugimoto K, Aoe K, Ochi N, Minami D, Fukamatsu N, Kudo K, Kiura K. A phase I trial of afatinib (Afa) and bevacizumab (Bev) in chemo-naïve patients (pts) with advanced non-small-cell lung cancer (NSCLC) harboring EGFR-mutations: OLCSG1404. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx671.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kudo K, Kuyama S, Harada D, Kozuki T, Bessho A, Hotta K, Yoshioka H, Gemba K, Takigawa N, Oze I, Kiura K. P2.01-034 Phase I/II Trial of Weekly Nab-Paclitaxel as 2nd or 3rd Line Treatment in NSCLC Without Driver Mutations. (OLCSG1303). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kenmotsu H, Iwama E, Goto Y, Harada T, Tsumura S, Sakashita H, Mori Y, Nakagaki N, Fujita Y, Seike M, Bessho A, Ono M, Okazaki A, Akamatsu H, Morinaga R, Ushijima S, Shimose T, Tokunaga S, Hamada A, Yamamoto N, Nakanishi Y, Sugio K, Okamoto I. P1.03-004 Alectinib for Patients with ALK Rearrangement–Positive Non–Small Cell Lung Cancer and a Poor Performance Status. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tanaka T, Yoshioka H, Bessho A, Ishikawa N, Yamasaki M, Shibayama T, Aoe K, Kozuki T, Fujimoto N, Genba K, Ueda Y, Inoue M, Murakami T, Kuyama S, Kawai H, Fujitaka K, Inoue K, Takata M, Yanai H, Kiura K. A large prospective cohort study of the clinical features of advanced lung cancer harboring HER2 aberrations (HER2-CS STUDY). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ninomiya T, Hotta K, Ohashi K, Kubo T, Harada D, Kozuki T, Nogami N, Oze I, Hosokawa S, Bessho A, Yoshioka H, Kudo K, Kuyama S, Harita S, Takata I, Fujimoto N, Moritaka T, Ichikawa H, Takigawa N, Kiura K. Phase I/II trial of weekly nab-paclitaxel as 2nd or 3rd line treatment in NSCLC without driver mutations. (OLCSG1303). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bessho A, Hosokawa S, Hotta K, Kudo K, Nogami N, Kuyama S, Gemba K, Inoue K, Okada T, Takigawa N, Tanimoto M, Kiura K. 453P Development of skin rash within the first week is a potential surrogate marker of effect in afatinib for EGFR mutant NSCLC: Okayama Lung Cancer Study Group Experience. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv532.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Isozaki H, Ichihara E, Takigawa N, Ohashi K, Ochi N, Yasugi M, Ninomiya T, Yamane H, Minami D, Kubo T, Sato A, Hotta K, Sakai K, Matsumoto K, Hosokawa S, Bessho A, Sendo T, Tanimoto M, Kiura K. 2PD Crizotinib could overcome acquired resistance to alectinib caused by HGF autocrine in ALK rearranged non-small cell lung cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv517.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Obata K, Nishimoto M, Fuke S, Sato T, Sakukawa R, Bessho A, Takahashi T, Ujike Y. Postural change does not affect autonomic nerve activity in patients with heart failure during early rehabilitation. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.2014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Nogami N, Ichihara E, Kozuki T, Kubo T, Kishino D, Kuyama S, Bessho A, Fujii M, Takigawa N, Chikamori K, Aoe K, Nagata T, Fujimoto N, Hosokawa S, Harita S, Kamei H, Ueoka H, Hotta K, Tanimoto M, Kiura K. A Phase Ii Trial of Gefitinib in Combination with Bevacizumab As First-Line Therapy for Advanced Non-Small-Cell Lung Cancer with Activating Egfr Gene Mutations: Olcsg 1001. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yoshioka H, Hayashi H, Kiura K, Takigawa N, Hotta K, Harita S, Kamei H, Bessho A, Tabata M, Tanimoto M. A phase II trial of erlotinib monotherapy in pretreated patients (pts) with non-small cell lung cancer (NSCLC) who do not possess active EGFR mutations. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8067 Background: Efficacy of gefitinib therapy strongly depends on the presence of active EGFR mutations in Asian NSCLC pts, with objective response rates (ORR) of 71.2% and only 1.1% in active mutant-positive (EGFRmt+) and -negative (EGFRmt-) tumors, respectively [Mok T, ESMO2008]. Recently, the survival advantage of erlotinib, another TKI, is observed even in pts with EGFRmt- tumors (HR=0.74, p=0.09 [Zhu C, JCO2008]), indicating such subpopulation might also benefit from this TKI. The aim of this trial was to evaluate its efficacy and toxicity in Japanese pts with relapsedEGFRmt- tumors. Methods: Primary endpoint was ORR. Patients with EGFRmt--NSCLC previously treated with one to three chemotherapy regimens were enrolled in this trial. The mutation status was assessed by the PCR clamp methods. Erlotinib was administered at a dose of 150mg/day until disease progression or unacceptable toxicities. Results: Thirty pts were enrolled between Jan and Dec 2008. Median duration of erlotinib treatment was 60 days. All pts were assessable for efficacy and safety. Demographics of the pts were as follows: M/F:24/6, Ad/others:20/10, ECOG-PS 0/1/2:7/19/4, and smoker/non-smoker:22/8. Platinum-based regimens were commonly used as the prior chemotherapy. Objective response was obtained in one pt (3.3%; RECIST). Seventeen pts obtained SD (56.7%). Toxicity profiles were almost tolerable with the treatment interruption in 11 pts (median duration; 10 days). Skin rash was common (grades 1, 2 and 3 in 7, 15, and 7 pts, respectively; NCI-CTCAE ver3). One pt developed grade 4 pulmonary embolism, but it seemed due to disease progression. Other 2 pts developed interstitial lung disease (grades 2 and 3 in one pt each). No treatment-related deaths (TRD) occurred. With a median follow-up time of 6.4 months, MST and MPFS time were 8.6 and 2.1 months, respectively. Conclusions: This is a first prospective biomarker study showing that erlotinib therapy for pretreated pts with EGFRmt- tumors seems as almost effective and safe as the standard docetaxel therapy (PR: 5.8%, SD: 42.7%, MST: 7.0 months, MTTP: 2.5 months and TRD: 4.9% [Shepherd JCO2000]). No significant financial relationships to disclose.
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Affiliation(s)
- H. Yoshioka
- Kurashiki Central Hospital, Okayama, Japan; Okayama University Hospital, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; Sumitomo Besshi Hospital, Niihama, Japan; NHO Iwakuni Medical Center, Iwakuni, Japan
| | - H. Hayashi
- Kurashiki Central Hospital, Okayama, Japan; Okayama University Hospital, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; Sumitomo Besshi Hospital, Niihama, Japan; NHO Iwakuni Medical Center, Iwakuni, Japan
| | - K. Kiura
- Kurashiki Central Hospital, Okayama, Japan; Okayama University Hospital, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; Sumitomo Besshi Hospital, Niihama, Japan; NHO Iwakuni Medical Center, Iwakuni, Japan
| | - N. Takigawa
- Kurashiki Central Hospital, Okayama, Japan; Okayama University Hospital, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; Sumitomo Besshi Hospital, Niihama, Japan; NHO Iwakuni Medical Center, Iwakuni, Japan
| | - K. Hotta
- Kurashiki Central Hospital, Okayama, Japan; Okayama University Hospital, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; Sumitomo Besshi Hospital, Niihama, Japan; NHO Iwakuni Medical Center, Iwakuni, Japan
| | - S. Harita
- Kurashiki Central Hospital, Okayama, Japan; Okayama University Hospital, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; Sumitomo Besshi Hospital, Niihama, Japan; NHO Iwakuni Medical Center, Iwakuni, Japan
| | - H. Kamei
- Kurashiki Central Hospital, Okayama, Japan; Okayama University Hospital, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; Sumitomo Besshi Hospital, Niihama, Japan; NHO Iwakuni Medical Center, Iwakuni, Japan
| | - A. Bessho
- Kurashiki Central Hospital, Okayama, Japan; Okayama University Hospital, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; Sumitomo Besshi Hospital, Niihama, Japan; NHO Iwakuni Medical Center, Iwakuni, Japan
| | - M. Tabata
- Kurashiki Central Hospital, Okayama, Japan; Okayama University Hospital, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; Sumitomo Besshi Hospital, Niihama, Japan; NHO Iwakuni Medical Center, Iwakuni, Japan
| | - M. Tanimoto
- Kurashiki Central Hospital, Okayama, Japan; Okayama University Hospital, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; Sumitomo Besshi Hospital, Niihama, Japan; NHO Iwakuni Medical Center, Iwakuni, Japan
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Hotta K, Matsuo K, Ueoka H, Kiura K, Tabata M, Harita S, Gemba K, Yonei T, Bessho A, Tanimoto M. Continued gefitinib treatment after disease stabilisation prolongs survival of Japanese patients with non-small-cell lung cancer: Okayama Lung Cancer Study Group experience. Ann Oncol 2005; 16:1817-23. [PMID: 16157622 DOI: 10.1093/annonc/mdi369] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND This study aimed to investigate the survival outcome of patients with non-small-cell lung cancer (NSCLC) who had obtained disease stabilisation with gefitinib treatment and to clarify the effect of continued treatment with gefitinib on prognosis. PATIENTS AND METHODS We reviewed the clinical records of 365 Japanese patients with NSCLC who received gefitinib (250 mg/day). RESULTS Of 324 (89%) patients assessable for response, 147 (45%) obtained disease stabilisation and 71 (22%) patients achieved an objective response. Overall survival in patients obtaining disease stabilisation was significantly longer than in patients with progressive disease (median survival time 12.1 versus 4.4 months; P <0.0001). In patients obtaining disease stabilisation, those who continued gefitinib treatment until disease progression tended to have longer overall and progression-free survival compared with those discontinuing gefitinib treatment (1-year survival rate 52.1% versus 36.6%, P = 0.08; 1-year progression-free survival rate 31.8% versus 5.2%, P = 0.001). Multivariate analysis showed discontinuing gefitinib was an independent risk factor for progression-free survival (hazard ratio 1.66; 95% confidence interval 1.07-2.56; P = 0.022) but not for overall survival. CONCLUSIONS Our findings indicate the importance of achieving disease stabilisation with gefitinib treatment and continued gefitinib treatment in Japanese patients with disease stabilisation, although further studies are required to confirm these findings.
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Affiliation(s)
- K Hotta
- Department of Medicine II, Okayama University Medical School, Okayama.
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Hotta K, Matsuo K, Ueoka H, Kiura K, Tabata M, Harita S, Gemba K, Yonei T, Bessho A, Tanimoto M. Continued gefitinib treatment after disease stabilization prolongs survival of patients with advanced non-small-cell lung cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- K. Hotta
- Okayama Univ, Okayama, Japan; Aichi Cancer Ctr Research Inst, Nagoya, Japan; Okayama Univ Medcl Sch, Okayama, Japan; Chugoku Central Hosp, Fukuyama, Japan; Okayama Rousai Hosp, Okayama, Japan; National Hosp Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan
| | - K. Matsuo
- Okayama Univ, Okayama, Japan; Aichi Cancer Ctr Research Inst, Nagoya, Japan; Okayama Univ Medcl Sch, Okayama, Japan; Chugoku Central Hosp, Fukuyama, Japan; Okayama Rousai Hosp, Okayama, Japan; National Hosp Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan
| | - H. Ueoka
- Okayama Univ, Okayama, Japan; Aichi Cancer Ctr Research Inst, Nagoya, Japan; Okayama Univ Medcl Sch, Okayama, Japan; Chugoku Central Hosp, Fukuyama, Japan; Okayama Rousai Hosp, Okayama, Japan; National Hosp Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan
| | - K. Kiura
- Okayama Univ, Okayama, Japan; Aichi Cancer Ctr Research Inst, Nagoya, Japan; Okayama Univ Medcl Sch, Okayama, Japan; Chugoku Central Hosp, Fukuyama, Japan; Okayama Rousai Hosp, Okayama, Japan; National Hosp Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan
| | - M. Tabata
- Okayama Univ, Okayama, Japan; Aichi Cancer Ctr Research Inst, Nagoya, Japan; Okayama Univ Medcl Sch, Okayama, Japan; Chugoku Central Hosp, Fukuyama, Japan; Okayama Rousai Hosp, Okayama, Japan; National Hosp Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan
| | - S. Harita
- Okayama Univ, Okayama, Japan; Aichi Cancer Ctr Research Inst, Nagoya, Japan; Okayama Univ Medcl Sch, Okayama, Japan; Chugoku Central Hosp, Fukuyama, Japan; Okayama Rousai Hosp, Okayama, Japan; National Hosp Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan
| | - K. Gemba
- Okayama Univ, Okayama, Japan; Aichi Cancer Ctr Research Inst, Nagoya, Japan; Okayama Univ Medcl Sch, Okayama, Japan; Chugoku Central Hosp, Fukuyama, Japan; Okayama Rousai Hosp, Okayama, Japan; National Hosp Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan
| | - T. Yonei
- Okayama Univ, Okayama, Japan; Aichi Cancer Ctr Research Inst, Nagoya, Japan; Okayama Univ Medcl Sch, Okayama, Japan; Chugoku Central Hosp, Fukuyama, Japan; Okayama Rousai Hosp, Okayama, Japan; National Hosp Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan
| | - A. Bessho
- Okayama Univ, Okayama, Japan; Aichi Cancer Ctr Research Inst, Nagoya, Japan; Okayama Univ Medcl Sch, Okayama, Japan; Chugoku Central Hosp, Fukuyama, Japan; Okayama Rousai Hosp, Okayama, Japan; National Hosp Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan
| | - M. Tanimoto
- Okayama Univ, Okayama, Japan; Aichi Cancer Ctr Research Inst, Nagoya, Japan; Okayama Univ Medcl Sch, Okayama, Japan; Chugoku Central Hosp, Fukuyama, Japan; Okayama Rousai Hosp, Okayama, Japan; National Hosp Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan
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Kiura K, Hotta K, Takigawa N, Bessho A, Harita S, Umemura S, Ogino A, Tabata M, Ueoka H, Tanimoto M. Phase I study of irinotecan and amrubicin in patients with advanced non-small-cell lung cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- K. Kiura
- Okayama Univ Hosp, Okayama, Japan; Okayama Univ, Okayama, Japan; National Hosp Minami-Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan; Chugoku Central Hosp, Fukuyama, Japan
| | - K. Hotta
- Okayama Univ Hosp, Okayama, Japan; Okayama Univ, Okayama, Japan; National Hosp Minami-Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan; Chugoku Central Hosp, Fukuyama, Japan
| | - N. Takigawa
- Okayama Univ Hosp, Okayama, Japan; Okayama Univ, Okayama, Japan; National Hosp Minami-Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan; Chugoku Central Hosp, Fukuyama, Japan
| | - A. Bessho
- Okayama Univ Hosp, Okayama, Japan; Okayama Univ, Okayama, Japan; National Hosp Minami-Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan; Chugoku Central Hosp, Fukuyama, Japan
| | - S. Harita
- Okayama Univ Hosp, Okayama, Japan; Okayama Univ, Okayama, Japan; National Hosp Minami-Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan; Chugoku Central Hosp, Fukuyama, Japan
| | - S. Umemura
- Okayama Univ Hosp, Okayama, Japan; Okayama Univ, Okayama, Japan; National Hosp Minami-Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan; Chugoku Central Hosp, Fukuyama, Japan
| | - A. Ogino
- Okayama Univ Hosp, Okayama, Japan; Okayama Univ, Okayama, Japan; National Hosp Minami-Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan; Chugoku Central Hosp, Fukuyama, Japan
| | - M. Tabata
- Okayama Univ Hosp, Okayama, Japan; Okayama Univ, Okayama, Japan; National Hosp Minami-Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan; Chugoku Central Hosp, Fukuyama, Japan
| | - H. Ueoka
- Okayama Univ Hosp, Okayama, Japan; Okayama Univ, Okayama, Japan; National Hosp Minami-Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan; Chugoku Central Hosp, Fukuyama, Japan
| | - M. Tanimoto
- Okayama Univ Hosp, Okayama, Japan; Okayama Univ, Okayama, Japan; National Hosp Minami-Okayama Medcl Ctr, Okayama, Japan; National Shikoku Cancer Ctr Hosp, Matsuyama, Japan; Chugoku Central Hosp, Fukuyama, Japan
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Umemura S, Kiura K, Segawa Y, Tabata M, Bessho A, Aoe M, Gemba K, Shinkai T, Ueoka H, Tanimoto M. Lung cancer in patients ≤30 years of age. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S. Umemura
- Okayama University Graduate School, Okayama, Japan; Okayama University Hospital, Okayama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; Okayama Rosai Hospital, Okayama, Japan
| | - K. Kiura
- Okayama University Graduate School, Okayama, Japan; Okayama University Hospital, Okayama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; Okayama Rosai Hospital, Okayama, Japan
| | - Y. Segawa
- Okayama University Graduate School, Okayama, Japan; Okayama University Hospital, Okayama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; Okayama Rosai Hospital, Okayama, Japan
| | - M. Tabata
- Okayama University Graduate School, Okayama, Japan; Okayama University Hospital, Okayama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; Okayama Rosai Hospital, Okayama, Japan
| | - A. Bessho
- Okayama University Graduate School, Okayama, Japan; Okayama University Hospital, Okayama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; Okayama Rosai Hospital, Okayama, Japan
| | - M. Aoe
- Okayama University Graduate School, Okayama, Japan; Okayama University Hospital, Okayama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; Okayama Rosai Hospital, Okayama, Japan
| | - K. Gemba
- Okayama University Graduate School, Okayama, Japan; Okayama University Hospital, Okayama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; Okayama Rosai Hospital, Okayama, Japan
| | - T. Shinkai
- Okayama University Graduate School, Okayama, Japan; Okayama University Hospital, Okayama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; Okayama Rosai Hospital, Okayama, Japan
| | - H. Ueoka
- Okayama University Graduate School, Okayama, Japan; Okayama University Hospital, Okayama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; Okayama Rosai Hospital, Okayama, Japan
| | - M. Tanimoto
- Okayama University Graduate School, Okayama, Japan; Okayama University Hospital, Okayama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; Okayama Rosai Hospital, Okayama, Japan
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Hotta K, Harita S, Bessho A, Yonei T, Gemba K, Aoe K, Tabata M, Kiura K, Ueoka H, Tanimoto M. Interstitial lung disease (ILD) during gefitinib treatment in Japanese patients with non-small cell lung cancer (NSCLC): Okayama Lung Cancer Study Group. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- K. Hotta
- Okayama University Medical School, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; National Okayama Medical Center, Okayama, Japan; Okayama Rousai Hospital, Okayama, Japan; National Sanyo Hospital, Ube, Japan
| | - S. Harita
- Okayama University Medical School, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; National Okayama Medical Center, Okayama, Japan; Okayama Rousai Hospital, Okayama, Japan; National Sanyo Hospital, Ube, Japan
| | - A. Bessho
- Okayama University Medical School, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; National Okayama Medical Center, Okayama, Japan; Okayama Rousai Hospital, Okayama, Japan; National Sanyo Hospital, Ube, Japan
| | - T. Yonei
- Okayama University Medical School, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; National Okayama Medical Center, Okayama, Japan; Okayama Rousai Hospital, Okayama, Japan; National Sanyo Hospital, Ube, Japan
| | - K. Gemba
- Okayama University Medical School, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; National Okayama Medical Center, Okayama, Japan; Okayama Rousai Hospital, Okayama, Japan; National Sanyo Hospital, Ube, Japan
| | - K. Aoe
- Okayama University Medical School, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; National Okayama Medical Center, Okayama, Japan; Okayama Rousai Hospital, Okayama, Japan; National Sanyo Hospital, Ube, Japan
| | - M. Tabata
- Okayama University Medical School, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; National Okayama Medical Center, Okayama, Japan; Okayama Rousai Hospital, Okayama, Japan; National Sanyo Hospital, Ube, Japan
| | - K. Kiura
- Okayama University Medical School, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; National Okayama Medical Center, Okayama, Japan; Okayama Rousai Hospital, Okayama, Japan; National Sanyo Hospital, Ube, Japan
| | - H. Ueoka
- Okayama University Medical School, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; National Okayama Medical Center, Okayama, Japan; Okayama Rousai Hospital, Okayama, Japan; National Sanyo Hospital, Ube, Japan
| | - M. Tanimoto
- Okayama University Medical School, Okayama, Japan; Chugoku Central Hospital, Fukuyama, Japan; National Shikoku Cancer Center Hospital, Matsuyama, Japan; National Okayama Medical Center, Okayama, Japan; Okayama Rousai Hospital, Okayama, Japan; National Sanyo Hospital, Ube, Japan
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Kiura K, Ueoka H, Segawa Y, Tabata M, Kamei H, Takigawa N, Hiraki S, Watanabe Y, Bessho A, Eguchi K, Okimoto N, Harita S, Takemoto M, Hiraki Y, Harada M, Tanimoto M. Phase I/II study of docetaxel and cisplatin with concurrent thoracic radiation therapy for locally advanced non-small-cell lung cancer. Br J Cancer 2003; 89:795-802. [PMID: 12942107 PMCID: PMC2394466 DOI: 10.1038/sj.bjc.6601217] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Recent studies have suggested the superiority of concomitant over sequential administration of chemotherapy and radiotherapy. Docetaxel and cisplatin have demonstrated efficacy in advanced non-small-cell lung cancer (NSCLC). This study evaluated the safety, toxicity, and antitumour activity of docetaxel/cisplatin with concurrent thoracic radiotherapy for patients with locally advanced NSCLC. Patients with locally advanced NSCLC (stage IIIA or IIIB), good performance status, age <or=75 years, and adequate organ function were eligible. Both docetaxel and cisplatin were given on days 1, 8, 29, and 36. Doses of docetaxel/cisplatin (mg m(-2)) in the phase I study portion were escalated as follows: 20/30, 25/30, 30/30, 30/35, 30/40, 35/40, 40/40, and 45/40. Beginning on day 1 of chemotherapy, thoracic radiotherapy was given at a total dose of 60 Gy with 2 Gy per fraction over 6 weeks. In the phase I portion, the maximum tolerated doses (MTD) among 33 patients were docetaxel 45 mg m(-2) and cisplatin 40 mg m(-2). The major dose-limiting toxicity (DLT) was radiation oesophagitis. The recommended doses (RDs) for the phase II study were docetaxel 40 mg m(-2) and cisplatin 40 mg m(-2). A total of 42 patients were entered in the phase II portion. Common toxicities were leukopenia, granulocytopenia, anaemia, and radiation oesophagitis, with frequencies of grade >or=3 toxicities of 71, 60, 24, and 19%, respectively. Toxicity was significant, but manageable according to the dose and schedule modifications. Dose intensities of docetaxel and cisplatin were 86 and 87%, respectively. Radiotherapy was completed without a delay in 67% of 42 patients. The overall response rate was 79% (95% confidence interval (CI), 66-91%). The median survival time was 23.4+ months with an overall survival rate of 76% at 1 year and 54% at 2 years. In conclusion, chemotherapy with cisplatin plus docetaxel given on days 1, 8, 29, and 36 and concurrent thoracic radiotherapy is efficacious and tolerated in patients with locally advanced NSCLC and should be evaluated in a phase III study.
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Affiliation(s)
- K Kiura
- Second Department of Internal Medicine, Okayama University Medical School, Okayama, Japan.
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Ohke M, Bessho A, Haraoka K, Ohgou T, Ozaki S, Kishimoto T. Percutaneous balloon pericardiotomy by the use of Inoue balloon for the management of recurrent cardiac tamponade in a patient with lung cancer. Intern Med 2000; 39:1071-4. [PMID: 11197793 DOI: 10.2169/internalmedicine.39.1071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 32-year-old man with lung cancer involving pericarditis carcinomatosa underwent pericardiotomy, using an Inoue balloon dilating catheter, to create a non-surgical pericardial window. The procedure was performed from the thoracic wall to the left pleural effusion and parietal pericardium under local anesthesia. The effects of non-surgical pericardial window had been maintained until this patient died from his primary disease. It is concluded that percutaneous balloon pericardiotomy is helpful in the management of massive pericardial effusions particularly in patients with malignancies and poor clinical condition
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Affiliation(s)
- M Ohke
- Department of Internal Medicine, Okayama Rousai Hospital
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Fujimoto N, Hiraki A, Ueoka H, Kiura K, Bessho A, Takata I, Hiramatsu Y, Ikeda K, Harada M. Intramedullary spinal cord recurrence after high-dose chemotherapy and autologous peripheral blood progenitor cell transplantation for limited-disease small cell lung cancer. Lung Cancer 2000; 30:145-8. [PMID: 11086208 DOI: 10.1016/s0169-5002(00)00147-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Intramedullary spinal cord metastasis is very rare in small-cell lung cancer (SCLC), and develops in only 2% of neurological disorders associated with SCLC according to previous reports. We describe here a patient with SCLC who developed intramedullary spinal cord recurrence after high-dose chemotherapy (HDCT) followed by autologous blood progenitor cell transplantation (ABPCT). A 59-year-old Japanese male was referred to us for diagnosis and treatment of an abnormal shadow on a chest radiograph. Based on transbronchial biopsy and staging procedures, he was diagnosed with limited-disease (LD)-SCLC. He received concurrent chemoradiotherapy followed by late intensification with HDCT supported by ABPCT. He achieved complete response and was discharged after receiving prophylactic cranial irradiation (PCI). However 6 months later, he noticed rapidly progressive weakness of the left lower extremity and bowel/bladder dysfunction. Magnetic resonance imaging (MRI) of the spinal cord disclosed an intramedullary tumor exhibiting an enhancement effect with Gd-DTPA at the 11-12th level of the thoracic vertebra. Immediately, radiotherapy to the spinal cord metastasis was given at a dose of 30 Gy, and his neurological disorders were completely resolved. At this time of reporting, he is doing well without recurrence. This case indicates that intramedullary spinal cord is one of the recurrence sites implicated after HDCT and PCI in LD-SCLC.
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Affiliation(s)
- N Fujimoto
- Department of Internal Medicine II, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
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Bessho A, Tabata M, Kiura K, Takata I, Nagata T, Fujimoto N, Kunisada K, Ueoka H, Harada M. Detection of occult tumor cells in peripheral blood from patients with small cell lung cancer by reverse transcriptase-polymerase chain reaction. Anticancer Res 2000; 20:1149-54. [PMID: 10810412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The reverse transcriptase-polymerase chain reaction (RT-PCR) of tumor-specific or -associated genes is a sensitive assay for detecting a minimal number of tumor cells in peripheral blood (PB) or bone marrow (BM). In this study, we determined whether mRNA of bombesin receptors is detectable in PB or peripheral blood progenitor cell (PBPC) samples from patients with small cell lung cancer. Among three bombesin-like peptide receptors, we used the neuromedin B receptor (NMB-R) gene as a target, because of the most frequent expression on SCLC cell lines. The lower limit of detection was one tumor cell in one million normal PB cells and there was no detection in normal PB or BM cells unlike a cytokeratin 19 gene. The NMB-R gene was detected in 14 (31.8%) of 44 PB samples from patients with SCLC at diagnosis and 2 (15.4%) of 13 samples of PBPC collected during a recovery phase after chemotherapy followed by administration of G-CSF (filgrastim). At diagnosis, patients whose PB was positive for the NMB-R gene had a significantly shorter survival than those who were negative. Our observation suggests that this assay may be useful in diagnosing metastatic disease and monitoring minimal residual disease in patients with SCLC.
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MESH Headings
- Aged
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Bone Marrow/pathology
- Carcinoma, Small Cell/blood
- Carcinoma, Small Cell/drug therapy
- Carcinoma, Small Cell/mortality
- Carcinoma, Small Cell/pathology
- Female
- Filgrastim
- Granulocyte Colony-Stimulating Factor/therapeutic use
- Humans
- Lung Neoplasms/blood
- Lung Neoplasms/drug therapy
- Lung Neoplasms/mortality
- Lung Neoplasms/pathology
- Male
- Middle Aged
- Neoplasm, Residual
- Receptors, Bombesin/analysis
- Receptors, Bombesin/genetics
- Recombinant Proteins
- Reverse Transcriptase Polymerase Chain Reaction/methods
- Sensitivity and Specificity
- Survival Analysis
- Tumor Cells, Cultured
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Affiliation(s)
- A Bessho
- Second Department of Internal Medicine, Okayama University Medical School, Japan
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Yamane H, Bessho A, Kiura K, Tabata M, Katayama Y, Motoda K, Tsuchida T, Nogami N, Hiraki A, Ueoka H, Harada M. Double high-dose chemotherapy supported by autologous transplantation of peripheral blood stem cells for treatment of an elderly patient with small-cell lung cancer. Intern Med 1999; 38:892-5. [PMID: 10563752 DOI: 10.2169/internalmedicine.38.892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report a 62-year-old male with extensive disease small-cell lung cancer (SCLC) who was successfully treated with double high-dose chemotherapy supported by autologous peripheral blood stem cell transplantation (auto-PBSCT). This patient achieved a partial response with 3 cycles of induction chemotherapy. After the peripheral blood stem cell mobilization, two cycles of high-dose ICE regimen (ifosfamide 3,000 mg/m2 at days 1 to 5, carboplatin 400 mg/m2 at days 1, 3, 5, and etoposide 500 mg/m2 at days 1, 3, 5) could be given with further regression of the tumor and acceptable toxicities. This successful case suggests the feasibility of double high-dose ICE with auto-PBSCT in elderly patients with SCLC.
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Affiliation(s)
- H Yamane
- Second Department of Medicine, Okayama University Medical School
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Bessho A, Ueoka H, Kiura K, Tabata M, Sunami K, Katayama Y, Yamane H, Hiraki A, Harada M. High-dose ifosfamide, carboplatin and etoposide with autologous peripheral blood progenitor cell transplantation for small-cell lung cancer. Anticancer Res 1999; 19:693-8. [PMID: 10216478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND We investigated the feasibility and efficacy of high-dose chemotherapy consisting of ifosfamide, carboplatin and etoposide (HD-ICE) facilitated by autologous peripheral blood progenitor cell transplantation (ABPCT) for the treatment of small-cell lung cancer (SCLC). PATIENTS AND METHODS Eleven patients aged 44 to 63 years old (5 with extensive disease [ED] and 6 with limited disease [LD]) were entered into this study. Induction chemotherapy consisted of 3 to 4 cycles of cisplatin and irinotecan for ED-SCLC, and cisplatin and etoposide for LD-SCLC. Patients with LD-SCLC received concurrent chest radiotherapy along with the first cycle of induction chemotherapy. After induction therapy, peripheral blood progenitor cells (PBPC) were collected following G-CSF administration during a recovery phase from high-dose etoposide (1,500 mg/m2). Eight patients (4 with ED and 4 with LD) with adequate organ function were treated with HD-ICE (15 g/m2 ifosfamide, 1,200 mg/m2 carboplatin and 1,500 mg/m2 etoposide) followed by ABPCT. RESULTS Hematologic recovery was rapid and non-hematological toxicities were acceptable without treatment-related mortality. In ED-SCLC, all of the 4 patients achieved complete response (CR) or near CR but developed a relapse of the disease. In LD-SCLC, 2 of 4 patients with LD-SCLC are alive in continuous CR for 18 and 21 months after the beginning of induction therapy. CONCLUSIONS Despite a limited number of patients and short follow-up time, these preliminary results indicate that marrow-ablative therapy (HD-ICE) supported by ABPCT is feasible in the treatment of elderly patients with LD- and ED-SCLC.
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Affiliation(s)
- A Bessho
- Second Department of Internal Medicine, Okayama University Medical School, Japan
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Hiraki A, Ueoka H, Yoshino T, Chikamori K, Onishi K, Kiura K, Bessho A, Mimoto J, Date H, Ando A, Shimizu N, Harada M. Synchronous primary lung cancer presenting with small cell carcinoma and non-small cell carcinoma: diagnosis and treatment. Oncol Rep 1999. [DOI: 10.3892/or.6.1.75] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Hiraki A, Ueoka H, Yoshino T, Chikamori K, Onishi K, Kiura K, Bessho A, Mimoto J, Date H, Ando A, Shimizu N, Harada M. Synchronous primary lung cancer presenting with small cell carcinoma and non-small cell carcinoma: diagnosis and treatment. Oncol Rep 1999; 6:75-80. [PMID: 9864405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Synchronous primary lung cancer (SPLC) occurs in up to 0.5% of patients with lung cancer. Among SPLC cases, coexistence of small cell carcinoma (SCLC) and non-small cell carcinoma has been reported in a very small fraction. Futhermore, there have been no reports discussing treatment and prognosis of SPLC presenting with SCLC and NSCLC. We report on two cases of SPLC presenting SCLC in limited stage and operable NSCLC. One patient developed synchronously SCLC and adenocarcinoma of the lung, while the other SCLC and squamous cell carcinoma of the lung. The clonal origin of these synchronous lung cancers was evaluated using immunohistochemical and polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analyses. Both of the patients were diagnosed based on transbronchial lung biopsy (TBLB) and mediastinoscopic biopsy. They were successfully treated with chemoradiotherapy and adjuvant surgery, and are now doing well without any signs of tumor progression for about one year. In both cases, a response of mediastinal lymph node for concurrent chemoradiotherapy was quite different from that of the mass in the lung field. In case 2, p53 mutation was observed in the SCLC tissue, but not in the NSCLC tissue by PCR-SSCP. In both cases, carcinoembryonic antigen was documented in the NSCLC tissue, but not in the SCLC tissue by immunohistochemical staining. This report indicates the importance of the accurate diagnosis of SPLC by employing TBLB and/or media-stinoscopy for the optimal treatment of patients having SPLC presenting with SCLC and NSCLC. Diagnostic criteria and standard treatment of this disease should be established.
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MESH Headings
- Adenocarcinoma/chemistry
- Adenocarcinoma/diagnosis
- Adenocarcinoma/drug therapy
- Adenocarcinoma/pathology
- Adenocarcinoma/radiotherapy
- Adenocarcinoma/surgery
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biopsy
- Bronchoscopy
- Carcinoembryonic Antigen/analysis
- Carcinoma, Small Cell/chemistry
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/drug therapy
- Carcinoma, Small Cell/pathology
- Carcinoma, Small Cell/radiotherapy
- Carcinoma, Small Cell/surgery
- Carcinoma, Squamous Cell/chemistry
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/radiotherapy
- Carcinoma, Squamous Cell/surgery
- Cisplatin/administration & dosage
- Combined Modality Therapy
- Etoposide/administration & dosage
- Fatal Outcome
- Genes, p53
- Humans
- Keratins/analysis
- Lung Neoplasms/chemistry
- Lung Neoplasms/diagnosis
- Lung Neoplasms/drug therapy
- Lung Neoplasms/pathology
- Lung Neoplasms/radiotherapy
- Lung Neoplasms/surgery
- Male
- Mediastinoscopy
- Middle Aged
- Neoplasm Proteins/analysis
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/radiotherapy
- Neoplasms, Multiple Primary/surgery
- Polymerase Chain Reaction
- Polymorphism, Single-Stranded Conformational
- Protein Isoforms/analysis
- Remission Induction
- Tumor Suppressor Protein p53/analysis
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Affiliation(s)
- A Hiraki
- Second Department of Medicine, Okayama University Medical School, Okayama 700-8558, Japan
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Abstract
Biloma is an extraductular collection of bile within a defined capsular space. Prior reports have documented an association between biloma and abdominal trauma, and between biloma and iatrogenic injury resulting from abdominal surgery, percutaneous catheter drainage, or transhepatic cholangiogram. To our knowledge, bilomas have not previously been associated with lung cancer. We report a case of spontaneous biloma that developed as a complication of small cell lung cancer.
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Affiliation(s)
- A Hiraki
- Second Department of Medicine, Okayama University Medical School, Japan
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Yamane H, Kiura K, Tabata M, Bessho A, Tsuchida T, Motoda K, Hiraki A, Ueoka H, Harada M. Small cell lung cancer can express CD34 antigen. Anticancer Res 1997; 17:3627-32. [PMID: 9413215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In humans CD34 is a valid and reliable marker for hematopoletic stem and progenitor cells. In general, solid tumors, with the exception of endothelial cancers, do not express CD34. Accordingly, immunological selection of CD34+ hematopoietic stem/progenitor cells can be used to remove CD34- malignant cells in the setting of autotransplantation. To rule out CD34 expression on tumor cells from small cell lung cancer (SCLC), eleven SCLC cell lines were analyzed by flow cytometry. Interestingly, two of these were positive for CD34 and their expression of full-length CD34 was further confirmed by reverse transcriptase and polymerase chain reaction (RT-PCR). This finding indicates that prior to subjecting SCLC patients to the above treatment modality, preparing CD34+ hematopoietic stem/progenitor cells from SCLC patients for autotransplantation, CD34 expression on their tumor cells should be screened using immunohistochemistry and/or flow cytometry.
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Affiliation(s)
- H Yamane
- Second Department of Medicine, Okayama University Medical School, Japan
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Teshima T, Sunami K, Bessho A, Shinagawa K, Omoto E, Ueoka H, Harada M, Ohno Y, Miyoshi T, Miyamoto T, Higuchi M. Circulating immature cell counts on the harvest day predict the yields of CD34+ cells collected after granulocyte colony-stimulating factor plus chemotherapy-induced mobilization of peripheral blood stem cell. Blood 1997; 89:4660-1. [PMID: 9192794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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41
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Katayama Y, Yano T, Bessho A, Deguchi S, Sunami K, Mahmut N, Shinagawa K, Omoto E, Makino S, Miyamoto T, Mizuno S, Fukuda T, Eto T, Fujisaki T, Ohno Y, Inaba S, Niho Y, Harada M. The effects of a simplified method for cryopreservation and thawing procedures on peripheral blood stem cells. Bone Marrow Transplant 1997; 19:283-7. [PMID: 9028559 DOI: 10.1038/sj.bmt.1700644] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A simplified method for cryopreservation at -80 degrees C of peripheral blood stem cells (PBSC) has been increasingly used for autologous PBSC transplantation in Japan. Although this method, using 6% hydroxyethyl starch (HES) and 5% dimethyl sulfoxide (DMSO) as a cryoprotectant without rate-controlled freezing, has several advantages over the conventional method using 10% DMSO with rate-controlled freezing, little is known about effects of long-term cryopreservation for years and thawing process on hematopoietic progenitors. We examined the recovery rates of BFU-E and CFU-GM in sample tubes cryopreserved by the simplified method under various conditions as follows: (1) long-term storage for 1-5 years; (2) DMSO exposure for 1 h after rapid thawing; and (3) thawing at a lower temperature other than 37 degrees C. In our study, we found that the recovery rates of BFU-E and CFU-GM were not affected by the length of cryopreservation period; they remained at more than 70% on average for 16-61 months. In our hands, a 1-h exposure to DMSO after rapid thawing was not toxic for hematopoietic progenitors. Furthermore, there was no significant difference in the recovery rates of BFU-E and CFU-GM between thawing at 37 degrees C and 20 degrees C. These observations indicate that PBSC cryopreserved for at least 5 years by the simplified method can be used clinically without losing hematopoietic activity, and suggest that hematopoietic activity of the thawed PBSC may be unaffected when PBSC are infused slowly within 60 min or even when PBSC are thawed gradually at room temperature.
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Affiliation(s)
- Y Katayama
- Second Department of Internal Medicine, Okayama University Medical School, Japan
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Ueoka H, Kiura K, Tabata M, Bessho A, Matsushita A, Chikamori K, Yamane H, Harada M, Kimura I, Ohnoshi T. [Chemotherapy for small-cell lung cancer]. Nihon Kyobu Shikkan Gakkai Zasshi 1996; 34 Suppl:87-91. [PMID: 9216192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Here we review the current treatments for small-cell lung cancer. Cisplatin and etoposide, combined with concurrent or alternating thoracic irradiation, have been considered to be the standard therapy for patients with limited disease. Dose-intensive weekly chemotherapy and high-dose chemotherapy with autologous stem cell transplantation have failed to increase survival in patients with extensive disease. Promising new drugs such as irinotecan and taxol may improve survival in patients with extensive disease.
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Affiliation(s)
- H Ueoka
- Department of Medicine, Okayama University Medical School
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