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Ido M, Fujii K, Mishima H, Kubo A, Saito M, Banno H, Ito Y, Goto M, Ando T, Mouri Y, Kousaka J, Imai T, Nakano S. Comprehensive genomic evaluation of advanced and recurrent breast cancer patients for tailored precision treatments. BMC Cancer 2024; 24:85. [PMID: 38229073 DOI: 10.1186/s12885-023-11442-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/25/2023] [Indexed: 01/18/2024] Open
Abstract
AIM The aim of this study was to investigate genetic alterations within breast cancer in the setting of recurrent or de novo stage IV disease. PATIENTS AND METHODS This study included 22 patients with recurrent breast cancer (n = 19) and inoperable de novo stage IV breast cancer (n = 3). For next generation sequencing, FoundationOneCDx (F1CDx) (Foundation Medicine Inc., Cambridge, MA, USA) was performed in 21 patients and FoundationOneLiquid CDx was performed in 1 patient. RESULTS Median age was 62.9 years (range, 33.4-82.1). Pathological diagnoses of specimens included invasive ductal carcinoma (n = 19), invasive lobular carcinoma (n = 2), and invasive micropapillary carcinoma (n = 1). F1CDx detected a median of 4.5 variants (range, 1-11). The most commonly altered gene were PIK3CA (n = 9), followed by TP53 (n = 7), MYC (n = 4), PTEN (n = 3), and CDH1 (n = 3). For hormone receptor-positive patients with PIK3CA mutations, hormonal treatment plus a phosphoinositide 3-kinase inhibitor was recommended as the treatment of choice. Patients in the hormone receptor-negative and no human epidermal growth factor receptor 2 expression group had significantly higher tumor mutational burden than patients in the hormone receptor-positive group. A BRCA2 reversion mutation was revealed by F1CDx in a patient with a deleterious germline BRCA2 mutation during poly ADP ribose polymerase inhibitor treatment. CONCLUSION Guidance on tailored precision therapy with consideration of genomic mutations was possible for some patients with information provided by F1CDx. Clinicians should consider using F1CDx at turning points in the course of the disease.
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Affiliation(s)
- Mirai Ido
- Department of Surgery, Division of Breast and Endocrine Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute city, 480-1195, Japan
| | - Kimihito Fujii
- Department of Surgery, Division of Breast and Endocrine Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute city, 480-1195, Japan.
| | - Hideyuki Mishima
- Cancer Center, Aichi Medical University Hospital, Nagakute city, Japan
| | - Akihito Kubo
- Cancer Center, Aichi Medical University Hospital, Nagakute city, Japan
| | - Masayuki Saito
- Department of Surgery, Division of Breast and Endocrine Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute city, 480-1195, Japan
| | - Hirona Banno
- Department of Surgery, Division of Breast and Endocrine Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute city, 480-1195, Japan
| | - Yukie Ito
- Department of Surgery, Division of Breast and Endocrine Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute city, 480-1195, Japan
| | - Manami Goto
- Department of Surgery, Division of Breast and Endocrine Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute city, 480-1195, Japan
| | - Takahito Ando
- Department of Surgery, Division of Breast and Endocrine Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute city, 480-1195, Japan
| | - Yukako Mouri
- Department of Surgery, Division of Breast and Endocrine Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute city, 480-1195, Japan
| | - Junko Kousaka
- Department of Surgery, Division of Breast and Endocrine Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute city, 480-1195, Japan
| | - Tsuneo Imai
- Department of Surgery, Division of Breast and Endocrine Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute city, 480-1195, Japan
| | - Shogo Nakano
- Department of Surgery, Division of Breast and Endocrine Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute city, 480-1195, Japan
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Inada R, Nagasaka T, Shimokawa M, Ojima H, Noura S, Tanioka H, Munemoto Y, Shimada Y, Ishibashi K, Shindo Y, Mishima H, Okajima M, Yamaguchi Y. Phase 3 trial of sequential versus combination treatment in colorectal cancer: The C-cubed study. Eur J Cancer 2022; 169:166-178. [DOI: 10.1016/j.ejca.2022.04.009] [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] [Received: 01/30/2022] [Revised: 03/18/2022] [Accepted: 04/03/2022] [Indexed: 11/03/2022]
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Watanabe J, Maeda H, Nagasaka T, Yokota M, Hirata K, Akazawa N, Kagawa Y, Yamada T, Shiozawa M, Ando T, Kato T, Mishima H, Sakamoto J, Oba K, Nagata N. Multicenter, single-arm, phase II study of the continuous use of panitumumab in combination with FOLFIRI after FOLFOX for RAS wild-type metastatic colorectal cancer - Exploratory sequential examination of acquired mutations in circulating cell-free DNA. Int J Cancer 2022; 151:2172-2181. [PMID: 35723084 DOI: 10.1002/ijc.34184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 11/11/2022]
Abstract
This multicenter single-arm, phase II study evaluated the efficacy and safety of uninterrupted panitumumab usage combined with cytotoxic doublets for unresectable/metastatic colorectal cancer (mCRC). Additionally, clinical value of the RAS/BRAF mutation status in circulating cell-free DNA (ccfDNA) was evaluated; this evaluation was measured independently of the protocol treatment. Eligible patients with RAS wild-type mCRC who had received the first-line panitumumab plus FOLFOX treatment were recruited and administered continuous panitumumab combined with FOLFIRI. Progression-free survival (PFS) at 6 months was the primary endpoint, with threshold and expected values of 35% and 50%, respectively. In total, 54 patients were enrolled between October 2017 and October 2019. The crude 6-month PFS rate was 37.0%, with a 4.8-month median PFS. The response rate and disease control rate were 16.7 % and 50.0%, respectively. Notably, of the 54 participants, 17 showed RAS/BRAF mutations until the end of the protocol treatment, and of the 22 patients with progressive disease as their best response, 10 possessed RAS/BRAF mutations in their plasma ccfDNA at baseline. The median PFS significantly differed among patients harboring tumors with BRAF and RAS mutations and those with wild-type tumors. In conclusion, this study failed to show the expected efficacy of the continuous panitumumab use in the second-line treatment. Liquid biopsy discriminated the duration of PFS according to the mutation status. The effectiveness of continuous treatment with panitumumab should be evaluated in patients with RAS/BRAF wild-type mCRC determined by liquid biopsy at the start of the second-line treatment.
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Affiliation(s)
- Jun Watanabe
- Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Hiromichi Maeda
- Department of Surgery, Kochi Medical School Hospital, Kochi, Japan
| | - Takeshi Nagasaka
- Department of Clinical Oncology, Kawasaki Medical School, Okayama, Japan
| | - Mitsuru Yokota
- Department of Surgery, Kurashiki Central Hospital (Ohara Healthcare Foundation) Okayama, Japan
| | - Keiji Hirata
- Department of Surgery 1, University of Occupational and Environmental Health, Kitakyusyu, Japan
| | - Naoya Akazawa
- Department of Digestive Surgery, Sendai City Medical Center Sendai Open Hospital, Sendai, Japan
| | - Yoshinori Kagawa
- Department of Gastrointestinal Surgery, Kansai Rosai Hospital, Hyogo, Japan
| | - Takeshi Yamada
- Department of Digestive Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Manabu Shiozawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Takayuki Ando
- Third Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Takeshi Kato
- Department of Gastrointestinal Surgery, National Hospital Organization Osaka, National Hospital, Osaka, Japan
| | | | | | - Koji Oba
- Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoki Nagata
- Department of Surgery, Kitakyusyu General Hospital, Kitakyusyu, Japan
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Ishihara M, Kitano S, Kageyama S, Miyahara Y, Yamamoto N, Kato H, Mishima H, Hattori H, Funakoshi T, Kojima T, Sasada T, Sato E, Okamoto S, Tomura D, Nukaya I, Chono H, Mineno J, Kairi MF, Diem Hoang Nguyen P, Simoni Y, Nardin A, Newell E, Fehlings M, Ikeda H, Watanabe T, Shiku H. NY-ESO-1-specific redirected T cells with endogenous TCR knockdown mediate tumor response and cytokine release syndrome. J Immunother Cancer 2022; 10:jitc-2021-003811. [PMID: 35768164 PMCID: PMC9244667 DOI: 10.1136/jitc-2021-003811] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [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] [Accepted: 06/02/2022] [Indexed: 11/08/2022] Open
Abstract
Background Because of the shortage of ideal cell surface antigens, the development of T-cell receptor (TCR)-engineered T cells (TCR-T) that target intracellular antigens such as NY-ESO-1 is a promising approach for treating patients with solid tumors. However, endogenous TCRs in vector-transduced T cells have been suggested to impair cell-surface expression of transduced TCR while generating mispaired TCRs that can become self-reactive. Methods We conducted a first-in-human phase I clinical trial with the TCR-transduced T-cell product (TBI-1301) in patients with NY-ESO-1-expressing solid tumors. In manufacturing TCR-T cells, we used a novel affinity-enhanced NY-ESO-1-specific TCR that was transduced by a retroviral vector that enables siRNA (small interfering RNA)-mediated silencing of endogenous TCR. The patients were divided into two cohorts. Cohort 1 was given a dose of 5×108 cells (whole cells including TCR-T cells) preconditioned with 1500 mg/m2 cyclophosphamide. Cohort 2 was given 5× 109 cells preconditioned with 1500 mg/m2 cyclophosphamide. Results In vitro study showed that both the CD8+ and CD4+ T fractions of TCR-T cells exhibited cytotoxic effects against NY-ESO-1-expressing tumor cells. Three patients and six patients were allocated to cohort 1 and cohort 2, respectively. Three of the six patients who received 5×109 cells showed tumor response, while three patients developed early-onset cytokine release syndrome (CRS). One of the patients developed a grade 3 lung injury associated with the infiltration of the TCR-T cells. No siRNA-related adverse events other than CRS were observed. Cytokines including interleukin 6 I and monocyte chemotactic protein-1/chemokine (C-C motif) ligand (CCL2) increased in the sera of patients with CRS. In vitro analysis showed these cytokines were not secreted from the T cells infused. A significant fraction of the manufactured T cells in patients with CRS was found to express either CD244, CD39, or both at high levels. Conclusions The trial showed that endogenous TCR-silenced and affinity-enhanced NY-ESO-1 TCR-T cells were safely administered except for grade 3 lung injury. The TCR-T cell infusion exhibited significant tumor response and early-onset CRS in patients with tumors that express NY-ESO-1 at high levels. The differentiation properties of the manufactured T cells may be prognostic for TCR-T-related CRS. Trial registration number NCT02366546.
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Affiliation(s)
| | - Shigehisa Kitano
- Division of Cancer Immunotherapy Development, Advanced Medical Development Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Experimental Therapeutics, National Cancer Institue Hospital, Tokyo, Japan
| | - Shinichi Kageyama
- Departments of Immuno-Gene Therapy and Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshihiro Miyahara
- Departments of Immuno-Gene Therapy and Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Institue Hospital, Tokyo, Japan
| | - Hidefumi Kato
- Department of Transfusion Medicine, Aichi Medical University, Nagakute, Japan
| | | | - Hiroyoshi Hattori
- Laboratory of Advanced Therapy, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Takeru Funakoshi
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Kojima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tetsuro Sasada
- Division of Cancer Immunotherapy, Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Eiichi Sato
- Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | | | | | | | | | | | | | | | | | | | | | | | - Hiroaki Ikeda
- Department of Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takashi Watanabe
- Departments of Immuno-Gene Therapy and Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroshi Shiku
- Departments of Immuno-Gene Therapy and Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Japan
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Noura S, Inada R, Ojima H, Nagasaka T, Tanioka H, Munemoto Y, Shimada Y, Ishibashi K, Shindo Y, Shimokawa M, Mishima H, Yamaguchi Y, Okajima M. QoL analysis: A randomized phase 3 study of sequential versus combination treatment in first-line chemotherapy for metastatic colorectal cancer—The C-cubed study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.4_suppl.102] [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
102 Background: The C-cubed (C3) study demonstrated a sequential approach start from fluoropyrimidines (FP) plus bevacizumab (Bmab) followed by oxaliplatin (OX) adding significantly improved a median Treatment failure of strategy (TFS) for a combination approach start from FP+OX+Bmab [15.2 months vs. 7.6 months, HR, 0.475; 95% CI, 0.362 to 0.623; p < 0.0001] in first-line metastatic colorectal cancer (mCRC). In this congress, we focus on the quality of life (QOL) assessments as a pre-planned analysis. (Study information: UMIN000015405). Methods: The C3 study was a randomized phase III study which evaluated the time to discontinuation of OX-containing therapy (sequential approach [Capecitabine/5-FU (FP)+Bmab followed by OX-FP+Bmab] vs. combination approach [OX-FP+Bmab]. The primary endpoint was TFS and secondary endpoints were ORR, OS, PFS, Safety and QoL. QOL assessments included European Organisation for Research and Treatment of Cancer (EORTC) quality-of-life questionnaire for cancer (QLQ-C30) (EORTC QLQ C-30), EuroQol 5D 5L (EQ5D) and the Patient Neurotoxicity Questionnaire (PNQ) in both arm as a pre-planned analysis. Each questionnaire was collected at the time of enrolment, 6, 12, 18 months and end of treatment. QOL scores were compared using a mixed-effects models for repeated measures (MMRM). Results: A total 292 patients participated in QoL part (arm A: n =148; arm B: n =144). The returned questionnaire sheets were 292 (reply rate: 97%), 206 (68%), 199 (65%), 61 (20%) at baseline, 6, 12, 18 months, respectively. Sequential approach was statistically improved than combination approach as follows: Physical functioning (p<0.001), Cognitive functioning (p=0.012), Social functioning (p=0.0004), and Fatigue (p=0.013) in EORTC QLQ C-30. In addition, at 6 months (after which attrition in the combination arm was more than 50%) after randomization, the mean change rate from baseline of EQ5D score in the sequential approach versus combination approach were: –1.91 (SD 27.57) versus –9.62 (29.60). In contract, PNQ sensory score showed that sequential approach was not statistically improved for combination approach (0.22 [SD: 0.89] vs. 0.61 [SD: 0.95], p=0.115). Conclusions: The further clarification of patients’ characteristics are needed, but this sequential approach can be advocated as a valuable treatment option in first-line mCRC for current guideline based on these QoLs and main efficacy data.
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Affiliation(s)
- Shingo Noura
- Department of Surgery, Osaka Rosai Hospital, Sakai, Japan
| | - Ryo Inada
- Department of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi, Japan
| | - Hitoshi Ojima
- Gastrointestinal Surgery, Gunma Prefectural Cancer Center, Gunma, Japan
| | - Takeshi Nagasaka
- Department of Gastroenterological Surgery, Okayama University Hospital, Okayama, Japan
| | - Hiroaki Tanioka
- Department of Gastroenterological Surgery, Okayama University Hospital, Okayama, Japan
| | | | - Yasuhiro Shimada
- Clinical Oncology Division, Kochi Health Sciences Center, Kochi, Japan
| | - Keiichiro Ishibashi
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Yoshiaki Shindo
- Gastroenterological Surgery, Nakadori General Hospital, Akita, Japan
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | | | - Yoshiyuki Yamaguchi
- Department of Clinical Oncology, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Masazumi Okajima
- Department of Surgery, Hiroshima City Hospital, Hiroshima, Japan
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Aoyama T, Morita S, Kono T, Hata T, Mishima H, Sakamoto J. Effects of Goshajinkigan (TJ-107) for oxaliplatin-induced peripheral neurotoxicity using the functional assessment of cancer therapy/gynecologic oncology group 12-item neurotoxicity questionnaire in a Phase II, multicenter, randomized, double-blind, placebo-controlled trial. J Cancer Res Ther 2021; 17:1473-1478. [PMID: 34916380 DOI: 10.4103/jcrt.jcrt_1123_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The aim of the present study was to evaluate the efficacy of TJ-107 for oxaliplatin-induced peripheral neurotoxicity in prospective, multi-institutional, randomized, double-blind, placebo-controlled Phase II trials using the functional assessment of cancer therapy/gynecologic oncology group 12-item neurotoxicity questionnaire (FACT-GOG-NTX-12). Patients and Methods The patients who were registered to the Goshajinkigan oxaliplatin neurotoxicity evaluation study (UMIN000002211) were analyzed. A NTX-12 from the validated FACT/GOG-NTX-12 was assessed before treatment and at the end of every 2 cycles. Results The comparisons of the median scores for TJ-107 and the placebo at 8 and 26 weeks were as follows: numbness or tingling in the hands (P = 0.5820), numbness or tingling in the feet (P = 0.3236), feeling of discomfort in the hands (P = 0.8219), feeling of discomfort in the feet (P = 0.5361), joint pain or muscle cramps (P = 0.1974), feeling weak all over (P = 0.2771), trouble hearing (P = 0.2832), ringing or buzzing in ears (P = 0.1031), trouble buttoning buttons (P = 0.1653), trouble feeling the shape of small objects when held in hand (P = 0.2919), trouble walking (P = 0.5406), and pain in the hands or feet when exposed to cold temperatures (P = 0.1872). Conclusion There might be no clinically significant difference between the use of TJ-107 and the severity and quality of life for patients treated with oxaliplatin.
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Affiliation(s)
- Toru Aoyama
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toru Kono
- Advanced Surgery Center, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Taishi Hata
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | | | - Junichi Sakamoto
- Director of a Hospital, Tokai Central Hospital, Kakamigahara, Japan
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Usuda K, Hayashi K, Ishikawa T, Aizawa Y, Kato T, Kusayama T, Tsuda T, Usui S, Sakata K, Kawashiri M, Mishima H, Yoshiura K, Makita N, Takamura M. Novel variant of the glycerol-3-phosphate dehydrogenase-1 Like (GPD1-L) gene in Japanese Brugada syndrome patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0640] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The incidence of Brugada syndrome (BrS) varies among racial groups. Several studies reported Glycerol-3-Phosphate Dehydrogenase 1-Like (GPD1-L) gene is associated with BrS. However, most of these studies were reported from Western countries, so the evidence about GPD1-L mutation is limited especially among Asian BrS patients. This study aimed to search for rare variants in GPD1-L among Japanese BrS patients and to investigate the pathogenicity.
Method
We performed whole-exome sequencing for patients with Brugada type 1 ECG pattern from Japanese multicenter BrS cohort consisting of SCN5A-negative BrS probands (n=288) and controls (n=372). We conducted patch-clamp study in human embryonic kidney (HEK) 293 cells cotransfected with the wild-type sodium channel (SCN5A) and wild-type or mutant GPD1-L expression plasmid.
Results
We identified a rare variant in GPD1-L, p.D262N (c.784g>a) in 2 of 288 BrS probands, which was not identified in 372 controls. The minor allele frequency of the variant is 0.0014% in the Genome Aggregation Database. One proband was a 49-year-old man and the other was 34-year-old man who both developed a ventricular fibrillation. ECGs of both probands showed Brugada Type 1 pattern after administration of the pilsicainide. In functional study, coexpression of D262N GPD1-L with SCN5A in HEK293 cells significantly reduced inward sodium currents compared with wild-type GPD1-L. Additionally, inward sodium currents with D262N were similar to those with A280V GPD1-L, which was associated with BrS in previous reports (Figure). Also, several pathogenicity prediction programs, such as SIFT (score: 0.031) and PolyPhen2 (score: 0.937) predicted deleterious effects of GPD1-L D262N.
Conclusion
We identified a rare variant in GPD1-L at the rate of 0.7% in Japanese BrS patients without SCN5A mutations. GPD1-L, p.D262N reduces inward sodium currents and may be a novel susceptible variant for BrS in the Japanese population.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Current–voltage curve
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Affiliation(s)
- K Usuda
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - K Hayashi
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - T Ishikawa
- National Cerebral and Cardiovascular Center Hospital, Omics Research Center, Osaka, Japan
| | - Y Aizawa
- International University of Health and Welfare, Department of Cardiovascular Medicine, Tochigi, Japan
| | - T Kato
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - T Kusayama
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - T Tsuda
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - S Usui
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - K Sakata
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - M Kawashiri
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - H Mishima
- Nagasaki University, Department of Human Genetics, Nagasaki, Japan
| | - K Yoshiura
- Nagasaki University, Department of Human Genetics, Nagasaki, Japan
| | - N Makita
- National Cerebral and Cardiovascular Center Hospital, Omics Research Center, Osaka, Japan
| | - M Takamura
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
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Asai M, Koike Y, Kuwatsuka Y, Yagi Y, Kashiyama K, Tanaka K, Mishima H, Yoshiura K, Utani A, Murota H. Multifaceted array-based keloidal gene expression profiling reveals specific MDFI upregulation in keloid lesions. Clin Exp Dermatol 2021; 46:1255-1261. [PMID: 33899950 DOI: 10.1111/ced.14698] [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] [Accepted: 04/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Keloid lesions are characterized by mesenchymal cell proliferation and excessive extracellular matrix deposition. Previous microarray analyses have been performed to investigate the mechanism of keloid development. However, the molecular pathology that contributes to keloid development remains obscure. AIM To explore the underlying essential molecules of keloids using microarrays. METHODS We performed microarray analyses of keloid and nonlesional skin tissues both in vivo and in vitro. Gene expression levels were compared between tissues and cells. Quantitative reverse transcription (qRT)-PCR and immunohistochemical staining were used to determine the expression levels of molecules of interest in keloid tissues. RESULTS Several common molecules were upregulated in both keloid tissues and keloid-lesional fibroblasts. PTPRD and NTM were upregulated both in vivo and in vitro. The genes MDFI and ITGA4 were located at the centre of the gene coexpression network analysis using keloid tissues. qRT-PCR revealed significant expression levels of PTPRD and MDFI in keloid tissues. Immunopathological staining revealed that MDFI-positive cells, which have fibroblast characteristics, were located in the keloid-associated lymphoid tissue (KALT) portion of the keloid tissue. CONCLUSION Our gene expression profiles of keloids could distinguish the difference between lesional tissue and cultured lesional fibroblasts, and MDFI was found to be commonly expressed in both tissues and cells. Thus, MDFI-positive cells, which were located in the KALT, may play an important role in keloid pathogenesis and thus might be useful for in vitro keloid studies.
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Affiliation(s)
- M Asai
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Y Koike
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Y Kuwatsuka
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Y Yagi
- Department of Dermatology, Osaka Red Cross Hospital, Osaka, Japan
| | - K Kashiyama
- Department of Plastic and Reconstructive Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - K Tanaka
- Department of Plastic and Reconstructive Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - H Mishima
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - K Yoshiura
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - A Utani
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - H Murota
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Ishibashi K, Aoyama T, Kotaka M, Satake H, Tsuji Y, Kataoka M, Nakamura M, Nagata N, Sakamoto J, Oba K, Mishima H. Phase II study of an oxaliplatin-based regimen for relapsed colon cancer patients treated with oxaliplatin-based adjuvant chemotherapy (INSPIRE study). Cancer Chemother Pharmacol 2021; 87:665-672. [PMID: 33555359 PMCID: PMC8026470 DOI: 10.1007/s00280-021-04232-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/03/2020] [Accepted: 01/12/2021] [Indexed: 11/12/2022]
Abstract
Background The aim of this study was to evaluate the efficacy and safety of first-line chemotherapy with re-introduction of oxaliplatin (OX) more than 6 months after adjuvant chemotherapy including OX. Methods Stage II/III colon cancer patients with neuropathies of grade ≤ 1 who relapsed more than 6 months after adjuvant chemotherapy including OX were considered eligible. Eligible patients were treated with 5-fluorouracil, l-leucovorin and OX plus molecularly targeted agents or capecitabine and OX plus bevacizumab (BV) or S-1 and OX plus BV. The primary endpoint was the progression-free survival (PFS), and the secondary endpoints were the overall survival (OS), response rate (RR) and toxicity. Results A total of 50 patients were enrolled between September 2013 and May 2019. Twelve patients received 5-fluorouracil, l-leucovorin and OX (FOLFOX) plus BV, 21 patients received capecitabine and OX plus BV, 10 patients received S-1 and OX plus BV and 7 patients received FOLFOX plus cetuximab or panitumumab. The median PFS was 11.5 months (95% confidence interval [CI] 8.3–16.0), the median OS was 45.4 months (95% CI 37.4–NA), and the RR was 56.0% (95% CI 42.3–68.8). Adverse events of grade ≥ 3 that occurred in ≥ 5% of cases were neutropenia in 6 patients (12%), peripheral sensory neuropathy in 5 patients (10%), diarrhea in 4 patients (8%), hypertension in 4 patients (8%), anorexia in 3 patients (6%) and allergic reactions in 3 patients (6%). Conclusions First-line chemotherapy with re-introduction of OX more than 6 months after adjuvant chemotherapy including OX can be used safely with expected efficacy for relapsed colon cancer patients.
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Affiliation(s)
- Keiichiro Ishibashi
- Department of Digestive Tract and General Surgery Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Toru Aoyama
- Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 2360004, Japan.
| | - Masahito Kotaka
- Department of Gastrointestinal Cancer Center, Sano Hospital, Kobe, Japan
| | - Hironaga Satake
- Cancer Treatment Center, Kansai Medical University Hospital, Hirakata, Japan
| | - Yasushi Tsuji
- Department of Medical Oncology, KKR Tonan Hospital, Sapporo, Japan
| | - Masato Kataoka
- Department of Surgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Masato Nakamura
- Department of Chemotherapy Comprehensive Cancer Center, Aizawa Hospital, Nagano, Japan
| | | | | | - Koji Oba
- Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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10
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Saito T, Iwamoto S, Murotani K, Hashimoto A, Kurahashi S, Fukami Y, Komatsu S, Kaneko K, Mishima H, Sano T. Efficacy of celecoxib as preemptive analgesia for patients undergoing laparoscopic inguinal hernia repair: a randomized trial. Surg Today 2021; 51:1118-1125. [PMID: 33389189 DOI: 10.1007/s00595-020-02199-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/07/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the efficacy and safety of preemptive analgesia with a transversus abdominis plane (TAP) block versus celecoxib for patients undergoing laparoscopic transabdominal preperitoneal inguinal hernia repair (LTAPP). METHODS Sixty patients scheduled for LTAPP were randomized into three groups: a celecoxib group, given 200 mg celecoxib 2 h before surgery; a celecoxib/diclofenac group, given 200 mg celecoxib 2 h before surgery and 50 mg rectal diclofenac sodium on recovery from general anesthesia; and a block group, given a TAP block with 60 mL 0.25% levobupivacaine after general anesthesia. We assessed the numerical rating scale (NRS) scores for pain at rest and with movement 24 h after surgery. Postoperative analgesia use and adverse events were also evaluated. RESULTS The NRS scores for pain at rest and with movement were lower in the celecoxib group than in the block group, 24 h postoperatively. The time to first request for analgesia tended to be longer in the block group than in the celecoxib group. No significant between-group differences were noted in analgesic use or adverse events. CONCLUSIONS Celecoxib was not inferior to the TAP block as preemptive analgesia. Thus, celecoxib could be given as simple preemptive analgesia for LTAPP by considering a multimodal analgesic strategy in the early postoperative period.
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Affiliation(s)
- Takuya Saito
- Division of Gastroenterological Surgery, Department of Surgery, Aichi Medical University, 1-1 Karimata-Yazako, Nagakute, Aichi, 480-1195, Japan.
| | - Shigeyoshi Iwamoto
- Cancer Center, Aichi Medical University, 1-1 Karimata-Yazako, Nagakute, Aichi, 480-1195, Japan
| | - Kenta Murotani
- Biostatistics Center, Graduate School of Medicine, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Atsushi Hashimoto
- Department of Anesthesiology, Aichi Medical University, 1-1 Karimata-Yazako, Nagakute, Aichi, 480-1195, Japan
| | - Shintaro Kurahashi
- Division of Gastroenterological Surgery, Department of Surgery, Aichi Medical University, 1-1 Karimata-Yazako, Nagakute, Aichi, 480-1195, Japan
| | - Yasuyuki Fukami
- Division of Gastroenterological Surgery, Department of Surgery, Aichi Medical University, 1-1 Karimata-Yazako, Nagakute, Aichi, 480-1195, Japan
| | - Shunichiro Komatsu
- Division of Gastroenterological Surgery, Department of Surgery, Aichi Medical University, 1-1 Karimata-Yazako, Nagakute, Aichi, 480-1195, Japan
| | - Kenitiro Kaneko
- Division of Gastroenterological Surgery, Department of Surgery, Aichi Medical University, 1-1 Karimata-Yazako, Nagakute, Aichi, 480-1195, Japan
| | - Hideyuki Mishima
- Cancer Center, Aichi Medical University, 1-1 Karimata-Yazako, Nagakute, Aichi, 480-1195, Japan
| | - Tsuyoshi Sano
- Division of Gastroenterological Surgery, Department of Surgery, Aichi Medical University, 1-1 Karimata-Yazako, Nagakute, Aichi, 480-1195, Japan
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11
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Ejiri M, Kurose Y, Kasugai Y, Kondo M, Iwata T, Iwamoto S, Ohnishi M, Mishima H. [A Study on the Status of End-of-Life Chemotherapy for Solid Cancer after the Introduction of New Anti-Cancer Drugs]. Gan To Kagaku Ryoho 2020; 47:2236-2238. [PMID: 33468919] [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: 06/12/2023]
Abstract
BACKGROUND In recent years, the decision to discontinue chemotherapy has become more difficult, and there is a tendency for chemotherapy to continue until just before death. We investigated the current state of end-of-life(EOL)chemotherapy for solid cancer patients. METHODS Patients who died of cancer during hospitalization between January and November 2018 were included. Patients were divided into 2 groups, those who received EOL chemotherapy within 30 days of death(Near group: NG)and those who did not receive it(Far group: FG). The contents of each treatment were compared retrospectively. RESULTS The number of patients were 46(32%)in the NG and 96(68%)in the FG. As EOL chemotherapy, the number of patients received cytotoxic drugs were 27(59%)and 68(71%), molecular targeted drugs were 6(13%)and 16(16%), immune-checkpoint inhibitors were 8(18%)and 12(12%), and hormone drugs were 0(0%)and 5(5%)in patients with NG and FG respectively(p<0.05). DISCUSSION Minimally invasive drugs were often selected for EOL chemotherapy. It was suggested that the advent of new drugs has expanded the options for EOL chemotherapy.
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12
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Satake H, Kotaka M, Ishibashi K, Tsuji Y, Kataoka M, Nakamura M, Nagata N, Sakamoto J, Oba K, Mishima H. 460P Update analysis of phase II study of oxaliplatin based regimen in relapsed colorectal cancer patients treated with oxaliplatin based adjuvant chemotherapy: INSPIRE study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.571] [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: 11/25/2022] Open
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13
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Yamada Y, Muro K, Takahashi K, Baba H, Komatsu Y, Satoh T, Goto M, Mishima H, Watanabe M, Sakata Y, Morita S, Shimada Y, Takenaka N, Hirooka T, Sugihara K. Impact of sex and histology on the therapeutic effects of fluoropyrimidines and oxaliplatin plus bevacizumab for patients with metastatic colorectal cancer in the SOFT trial. Glob Health Med 2020; 2:240-246. [PMID: 33330814 DOI: 10.35772/ghm.2020.01050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/06/2020] [Accepted: 08/18/2020] [Indexed: 12/20/2022]
Abstract
Mechanisms accounting for sex differences in the incidence of adverse events caused by fluoropyrimidine treatments, and histologic differences in efficacy are insufficiently understood. We determined differences between the sexes in terms of the safety of S-1 plus oxaliplatin (SOX)/bevacizumab-versus-l-leucovorin, 5-fluorouracil (5-FU) and oxaliplatin (FOLFOX)/bevacizumab, and the impact of histology on their therapeutic effects, in 512 unresectable metastatic colorectal cancer patients from the SOFT phase III study. Nausea (OR: 2.88, P < 0.001) and vomiting (OR: 3.04, P = 0.005) occurred more frequently in females than males treated with SOX/bevacizumab, while nausea (OR: 2.12, P = 0.006), vomiting (OR: 3.26, P = 0.004), leukopenia (OR: 2.61, P < 0.001), neutropenia (OR: 2.92, P < 0.001), and alopecia (OR: 4.13, P < 0.001) were higher in females on FOLFOX/bevacizumab. Mean relative dose intensities (RDIs) of S-1 during all cycles of SOX/bevacizumab were significantly lower in females (73.9%) than males (81.5%) (P < 0.001), while RDIs of continuous infusion of 5-FU in the FOLFOX/bevacizumab regimen were 75.0% in females and 80.5% in males (P = 0.005). No significant differences in efficacy with regard to overall survival (OS) and progression-free survival (PFS) were identified between the sexes for either SOX/bevacizumab or FOLFOX/bevacizumab treatment. Patients with poorly-differentiated adenocarcinoma had significantly worse OS (HR: 2.72, 95% CI: 1.67-4.44, P < 0.0001) and PFS (HR: 1.89, 95% CI: 1.18-3.02, P = 0.0079) than patients with well- or moderately-differentiated adenocarcinoma. Female patients experienced more frequent and severe adverse reactions to SOX/bevacizumab and FOLFOX/bevacizumab and a worse prognosis for poorly-differentiated adenocarcinoma were confirmed in this phase III study. This warrants further translational research to identify the responsible mechanisms.
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Affiliation(s)
- Yasuhide Yamada
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Keiichi Takahashi
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan
| | - Yoshito Komatsu
- Cancer Center, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Taroh Satoh
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University, Osaka, Japan
| | - Masahiro Goto
- Cancer Center, Osaka Medical College Hospital, Osaka, Japan
| | | | | | - Yuh Sakata
- Misawa City Hospital, Misawa, Aomori, Japan
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14
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Satake H, Kato T, Oba K, Kotaka M, Kagawa Y, Yasui H, Nakamura M, Watanabe T, Matsumoto T, Kii T, Terazawa T, Makiyama A, Takano N, Yokota M, Okita Y, Matoba K, Hasegawa H, Tsuji A, Komatsu Y, Yoshino T, Yamazaki K, Mishima H, Oki E, Nagata N, Sakamoto J. Phase Ib/II Study of Biweekly TAS-102 in Combination with Bevacizumab for Patients with Metastatic Colorectal Cancer Refractory to Standard Therapies (BiTS Study). Oncologist 2020; 25:e1855-e1863. [PMID: 32666647 PMCID: PMC8108052 DOI: 10.1634/theoncologist.2020-0643] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/28/2020] [Indexed: 11/20/2022] Open
Abstract
Lessons Learned A biweekly TAS‐102 plus BEV schedule in patients with heavily pretreated mCRC showed equivalent efficacy with less toxicity compared with the current schedule of TAS‐102 plus BEV combination. Biweekly TAS‐102 plus BEV combination could reduce unnecessary dose reduction of TAS‐102, maintain higher doses, and possibly be effective even in cases without chemotherapy‐induced neutropenia (CIN). The prespecified subgroup analysis of this study showed an obvious association between CIN within the first two cycles and prognosis of biweekly TAS‐102 plus BEV.
Background TAS‐102 (trifluridine/tipiracil) plus bevacizumab (BEV) combination therapy has shown promising activity in patients with metastatic colorectal cancer (mCRC). However, the previously reported dose and schedule for the TAS‐102 (70 mg/m2/day on days 1–5 and 8–12, every 4 weeks) plus BEV (5 mg/kg on day 1, every 2 weeks) regimen is complicated by severe hematological toxicities and difficult administration schedules. Here, we evaluated the efficacy and safety of a more convenient biweekly TAS‐102 plus BEV combination. Methods Patients with mCRC who were refractory or intolerant to standard chemotherapies were enrolled. Patients received biweekly TAS‐102 (twice daily on days 1–5, every 2 weeks) with BEV (5mg/kg on day 1, every 2 weeks). The primary endpoint was progression‐free survival rate at 16 weeks (16‐w PFS rate). Results From October 2017 to January 2018, 46 patients were enrolled. The recommended phase II dose was determined to be TAS‐102 (70 mg/m2/day). Of the 44 eligible patients, the 16‐w PFS rate was 40.9% (95% confidence interval, 26.3%–56.8%), and the null hypothesis was rejected (p < .0001). Median progression‐free survival (PFS) and overall survival were 4.29 months and 10.86 months, respectively. Disease control rate was 59.1%. Common grade 3 or higher adverse events were hypertension (40.9%), neutropenia (15.9%), and leucopenia (15.9%). Conclusion Biweekly TAS‐102 plus BEV showed promising antitumor activity with safety.
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Affiliation(s)
- Hironaga Satake
- Cancer Treatment Center, Kansai Medical University HospitalOsakaJapan
- Department of Medical Oncology, Kobe City Medical Center General HospitalKobeJapan
| | - Takeshi Kato
- Department of Surgery, National Hospital Organization Osaka National HospitalOsakaJapan
| | - Koji Oba
- Department of Biostatistics, The University of TokyoTokyoJapan
| | - Masahito Kotaka
- Department of Gastrointestinal Cancer Center, Sano HospitalKobeJapan
| | - Yoshinori Kagawa
- Department of Gastrointestinal Surgery, Kansai Rosai HospitalAmagasakiJapan
| | - Hisateru Yasui
- Department of Medical Oncology, Kobe City Medical Center General HospitalKobeJapan
| | | | | | - Toshihiko Matsumoto
- Department of Medical Oncology, Kobe City Medical Center General HospitalKobeJapan
- Department of Medical Oncology, Himeji Red Cross HospitalHimejiJapan
| | - Takayuki Kii
- Cancer Chemotherapy Center, Osaka Medical College HospitalTakatsukiJapan
| | - Tetsuji Terazawa
- Cancer Chemotherapy Center, Osaka Medical College HospitalTakatsukiJapan
| | - Akitaka Makiyama
- Department of Hematology/Oncology, Japan Community Healthcare Organization Kyushu HospitalKitakyushuJapan
- Cancer Center, Gifu University HospitalGifuJapan
| | - Nao Takano
- Department of Surgery, Tokai Central HospitalKakamigaharaJapan
| | - Mitsuru Yokota
- Department of Surgery, Kurashiki Central HospitalKurashikiJapan
| | - Yoshihiro Okita
- Department of Clinical Oncology, Faculty of Medicine, Kagawa UniversityKagawaJapan
| | - Koreatsu Matoba
- Department of Gastrointestinal Medicine, Kobe Rosai HospitalKobeJapan
| | - Hiroko Hasegawa
- Department of Gastroenterology and Hepatology, National Hospital Organization Osaka National HospitalOsakaJapan
| | - Akihito Tsuji
- Department of Clinical Oncology, Faculty of Medicine, Kagawa UniversityKagawaJapan
| | - Yoshito Komatsu
- Division of Cancer Chemotherapy, Hokkaido University Hospital Cancer CenterSapporoJapan
| | - Takayuki Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital EastKashiwaJapan
| | - Kentaro Yamazaki
- Department of Gastrointestinal Oncology, Shizuoka Cancer CenterShizuokaJapan
| | | | - Eiji Oki
- Department of Surgery, Graduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
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15
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Kotaka M, Ishibashi K, Satake H, Tsuji Y, Kataoka M, Nakamura M, Nagata N, Sakamoto J, Oba K, Mishima H. P-37 phase II study of oxaliplatin-based regimen in relapsed colon cancer patients treated with oxaliplatin-based adjuvant chemotherapy: INSPIRE study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.119] [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] Open
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16
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Ohta T, Kato T, Kawakami H, Miyake Y, Goto M, Iwamoto S, Otsuji T, Nakamura M, Sugimoto N, Okamura S, Kotaka M, Tsujie M, Tokunaga Y, Mishima H, Hata T, Shimokawa T, Kurokawa Y, Satoh T. Phase II study of 5-fluorouracil-leucovorin plus bevacizumab for chemotherapy-naïve older or frail patients with metastatic colorectal cancer (OGSG 0802). Int J Clin Oncol 2020; 25:1291-1298. [PMID: 32219630 DOI: 10.1007/s10147-020-01656-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 03/08/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Older or frail patients are often underrepresented in clinical trials for metastatic colorectal cancer (mCRC). We here assessed the efficacy and safety of 5-fluorouracil (5-FU)-leucovorin plus bevacizumab in such patients. METHODS The study (OGSG 0802) was designed as a single-arm, open-label, multicenter phase II trial. Eligible patients had mCRC and at least one of the following: an age of ≥ 65 years, an Eastern Cooperative Oncology Group performance status of 1 or 2, a serum albumin level of ≤ 3.5 g/dL, incompatibility with oxaliplatin or irinotecan, and a history of abdominal or pelvic radiotherapy. Patients received 5-FU (600 mg/m2) and l-leucovorin (200 mg/m2) on days 1, 8, and 15 together with bevacizumab (5 mg/kg) on days 1 and 15 every 4 weeks. The primary end point was objective response rate (ORR), and secondary end points were progression-free survival (PFS), overall survival (OS), and safety. RESULTS Forty-one patients were enrolled and eligible. Median age was 76 years (range 56-90 years), and 51% of patients had a performance status of 0. The ORR was 36.6% [95% confidence interval (CI) 22.1-53.1%], median PFS was 9.4 months (95% CI 7.4-17.7 months), and median OS was 24.0 months (95% CI 19.9 months-not reached). The most common treatment-related adverse events of grade ≥ 3 were neutropenia (24%), anorexia (10%), leukopenia (7%), and mucositis/stomatitis (7%). There were no treatment-related deaths. CONCLUSION Weekly 5-FU-leucovorin with biweekly bevacizumab may be a tolerable and effective treatment option for older or frail patients with mCRC.
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Affiliation(s)
- Takashi Ohta
- Department of Clinical Oncology, Kansai Rosai Hospital, Amagasaki, Japan
| | - Takeshi Kato
- Department of Surgery, Osaka National Hospital, Osaka, Japan
| | - Hisato Kawakami
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
| | - Yasuhiro Miyake
- Department of Surgery, Osaka Minato Central Hospital, Osaka, Japan
| | - Masahiro Goto
- Cancer Chemotherapy Center, Osaka Medical College, Takatsuki, Japan
| | | | - Toshio Otsuji
- Department of Internal Medicine, Dongo Hospital, Yamatotakada, Japan
| | - Masato Nakamura
- Comprehensive Cancer Center, Aizawa Hospital, Matsumoto, Japan
| | - Naotoshi Sugimoto
- Department of Clinical Oncology, Osaka International Center Institute, Osaka, Japan
| | - Shu Okamura
- Department of Surgery, Suita Municipal Hospital, Suita, Japan
| | | | - Masaki Tsujie
- Department of Surgery, Tondabayashi Hospital, Tondabayashi, Japan
| | - Yukihiko Tokunaga
- Department of Surgery, Japan Post Kyoto Teishin Hospital, Kyoto, Japan
| | | | - Taishi Hata
- Department of Surgery, Kansai Rosai Hospital, Amagasaki, Japan
| | - Toshio Shimokawa
- Department of Clinical Study Support Center, Wakayama Medical University, Wakayama, Japan
| | - Yukinori Kurokawa
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Taroh Satoh
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
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17
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Yabe D, Kuwata H, Fujiwara Y, Sakaguchi M, Moyama S, Makabe N, Murotani K, Asano H, Ito S, Mishima H, Takase H, Ota N, Seino Y, Hamamoto Y, Kurose T, Seino Y. Dietary instructions focusing on meal-sequence and nutritional balance for prediabetes subjects: An exploratory, cluster-randomized, prospective, open-label, clinical trial. J Diabetes Complications 2019; 33:107450. [PMID: 31648850 DOI: 10.1016/j.jdiacomp.2019.107450] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Received: 08/07/2019] [Revised: 09/10/2019] [Accepted: 09/10/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although lifestyle modifications are known to be effective in type 2 diabetes (T2D) as well as in prediabetes, adherence to a healthy diet is difficult for some, and interventions of lifestyle modifications need to be revised occasionally. Meal sequence has been gaining attention as a part of a healthy diet among T2D individuals to improve glycemia and body weight. In addition, a dietary instruction program, SMART Washoku®, which can help individuals to consume a more nutritionally balanced diet, has been developed. METHODS The current exploratory trial was designed to examine the effects of dietary instructions focusing on meal sequence and nutritional balance in individuals with prediabetes in the Japanese national health check-up and guidance program. Participants were cluster-randomized into three groups: Group A, receiving a conventional health guidance program (n = 11); Group B, receiving health guidance with dietary instructions focusing on meal sequence (n = 18); and Group C, receiving health guidance with dietary instructions focusing on nutritional balance (n = 13). Participants received health guidance education and various measurements before and 6 months after the instructions. RESULTS Body weight in Group B was significantly reduced compared to that in Group A, with similar adherence, while the effects on glycemia were similar between the two Groups. Body weight reduction was greater in Group C compared to that in Group A, although adherence in Group C was significantly lower than that in Group A. CONCLUSION The group receiving health guidance with dietary instructions focusing on meal sequence exhibited similar adherence and greater reduction in body weight than the group receiving conventional health guidance.
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Affiliation(s)
- Daisuke Yabe
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe, Japan; Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, Gifu, Japan; Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan; Division of Molecular and Metabolic Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Hitoshi Kuwata
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe, Japan; Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka, Japan; Center for Metabolism and Clinical Nutrition, Kansai Electric Power Hospital, Osaka, Japan
| | - Yuuka Fujiwara
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe, Japan
| | - Mayuka Sakaguchi
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe, Japan; Center for Metabolism and Clinical Nutrition, Kansai Electric Power Hospital, Osaka, Japan
| | - Shota Moyama
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe, Japan; Center for Metabolism and Clinical Nutrition, Kansai Electric Power Hospital, Osaka, Japan
| | - Noboru Makabe
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe, Japan; Center for Metabolism and Clinical Nutrition, Kansai Electric Power Hospital, Osaka, Japan
| | - Kenta Murotani
- Biostatistics Center, Graduate School of Medicine, Kurume University, Fukuoka, Japan
| | | | - Sanae Ito
- Kansaimedicalnet Co., Ltd., Kyoto, Japan
| | | | | | | | - Yusuke Seino
- Department of Endocrinology and Metabolism, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yoshiyuki Hamamoto
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe, Japan; Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka, Japan
| | - Takeshi Kurose
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe, Japan; Nakanoshima clinic, Osaka, Japan
| | - Yutaka Seino
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe, Japan; Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka, Japan.
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18
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Maeda H, Hazama S, Iwamoto S, Oba K, Tsunedomi R, Okayama N, Suehiro Y, Yamasaki T, Nakagami Y, Suzuki N, Nagano H, Sakamoto J, Mishima H, Nagata N. Association between polymorphisms in EGFR and tumor response during cetuximab and oxaliplatin-based combination therapy in metastatic colorectal cancer: Analysis of data from two clinical trials. Oncol Lett 2019; 18:4555-4562. [PMID: 31611963 PMCID: PMC6781779 DOI: 10.3892/ol.2019.10787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 12/17/2018] [Accepted: 07/17/2019] [Indexed: 12/13/2022] Open
Abstract
Predicting tumor response prior to starting anti-epidermal growth factor receptor (EGFR) antibody therapy would benefit patients with advanced/metastatic colorectal cancer (mCRC). The present study investigated the association between efficacy of cetuximab treatment and gene polymorphisms of fragment C γ receptor (FcγR) 2A, FcγR3A and EGFR in patients with extended RAS/BRAF wild-type mCRC. Clinical data and specimens were obtained from 90 patients who participated in either of two clinical studies evaluating the first-line, cetuximab plus oxaliplatin-based treatment. It was hypothesized that polymorphisms H/H of FcγR2A, V/V of FcγR3A, K/K of EGFR and <36 CA repeats in the EGFR gene may be associated with a favorable tumor response. Multivariate analysis demonstrated that patients with the H/H polymorphism tended to have an improved tumor response compared with the non-H/H population, although the result was not significant [odds ratio, 2.25; 95% confidence interval (CI), 0.89–5.66; P=0.09]. Univariate analysis revealed increased tumor shrinkage in patients with the K/K polymorphism of EGFR compared with the other polymorphisms (mean ± standard deviation, −55.3±28.4 vs. −39.6±40.8%; P=0.04). Subsequent multivariate analysis confirmed that the K/K polymorphism of EGFR predicted greater tumor shrinkage (multiple linear regression analysis estimate, −19.3; 95% CI, −35.5 to 3.0; P=0.02), with the tendency toward a preferable response in patients with <36 CA EGFR gene repeats (estimate, −16.9; 95% CI; −34.4 to 0.6; P=0.06). However, other polymorphisms and clinical variables did not predict tumor shrinkage. In conclusion, the present study demonstrated that polymorphisms of EGFR, FcγR2A and FcγR3A may differentiate the patients that obtain the maximum benefit from cetuximab treatment.
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Affiliation(s)
- Hiromichi Maeda
- Cancer Treatment Center, Kochi Medical School Hospital, Kochi University, Nankoku, Kochi 783-8505, Japan
| | - Shoichi Hazama
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan.,Department of Translational Research and Developmental Therapeutics Against Cancer, Yamaguchi University School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Shigeyoshi Iwamoto
- Cancer Center, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
| | - Koji Oba
- Department of Biostatistics, Graduate School of Medicine, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
| | - Ryouichi Tsunedomi
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Naoko Okayama
- Division of Laboratory, Yamaguchi University Hospital, Ube, Yamaguchi 755-8505, Japan
| | - Yutaka Suehiro
- Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Takahiro Yamasaki
- Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Yuki Nakagami
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan.,Department of Translational Research and Developmental Therapeutics Against Cancer, Yamaguchi University School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Nobuaki Suzuki
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | | | - Hideyuki Mishima
- Cancer Center, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
| | - Naoki Nagata
- Kitakyushu General Hospital, Kitakyushu, Fukuoka 802-8517, Japan
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Nagasaka T, Inada R, Ojima H, Noura S, Tanioka H, Munemoto Y, Shimada Y, Ishibashi K, Shindo Y, Kagawa Y, Tomibayashi A, Okamoto K, Tsuji A, Tsuji Y, Yamaguchi S, Sawaki A, Mishima H, Shimokawa M, Okajima M, Yamaguchi Y. Randomized phase III study of sequential treatment with capecitabine or 5-fluorouracil (FP) plus bevacizumab (BEV) followed by the addition with oxaliplatin (OX) versus initial combination with OX+FP+ BEV in the first-line chemotherapy for metastatic colorectal cancer: The C-cubed study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.048] [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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20
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Hattori H, Ishihara M, Kitano S, Miyahara Y, Kato H, Mishima H, Yamamoto N, Funakoshi T, Kojima T, Sasada T, Sato E, Okamoto S, Tomura D, Chono H, Nukaya I, Mineno J, Ikeda H, Watanabe T, Kageyama S, Shiku H. A novel affinity-enhanced NY-ESO-1-targeting TCR-redirected T cell transfer exhibited early-onset cytokine release syndrome and subsequent tumour responses in synovial sarcoma patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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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21
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Iwata T, Ando K, Mishima H. [A Case of an Elderly Patient with Multiple Lung Metastases of Postoperative Pancreatic Cancer in Whom Lung Metastases Were Controlled by Biweekly Dose-Down Administration of Gemcitabine]. Gan To Kagaku Ryoho 2019; 46:1453-1455. [PMID: 31530789] [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: 06/10/2023]
Abstract
An 80-year-old woman was diagnosed with pancreatic head cancer, and pancreaticoduodenectomy was performed. Twelve months after the operation, chest CT scans showed the presence ofmultiple nodules in both the lungs. Because ofthe potential negative side effects of anti-cancer drugs, the patient underwent chemotherapy with dose-down biweekly adminis- tration ofgemcitabine (1,000mg/day/body≒750mg/m2. Chest CT examination every 2-3 months revealed no rapid increase in multiple tumors. Nineteen months after starting gemcitabine therapy, there was an elevation in tumor marker and a gradual increase in lung metastases. We performed combination chemotherapy with nab-paclitaxel. However, owing to side effects, only 2 courses of nab-paclitaxel were administered, and the therapy was switched to only gemcitabine administration. Later, respiratory distress accompanied by pleural effusion developed, and the patient died of the original disease 27 months after recurrence. Here, we report a case ofan elderly patient with multiple lung metastases ofpancreatic cancer in whom lung metastases were controlled by biweekly dose-down administration of gemcitabine.
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22
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Ishihara M, Kitano S, Hattori H, Miyahara Y, Kato H, Mishima H, Yamamoto N, Funakoshi T, Kojima T, Sasada T, Sato E, Okamoto S, Tomura D, Chono H, Nukaya I, Mineno J, Ikeda H, Watanabe T, Kageyama S, Shiku H. Tumor responses and early onset cytokine release syndrome in synovial sarcoma patients treated with a novel affinity-enhanced NY-ESO-1-targeting TCR-redirected T cell transfer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.2530] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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
2530 Background: Adoptive transfer of TCR-redirected T cells has been reported to exhibit efficacy in some of melanoma and sarcoma patients. However, there have not been well known about cytokine release syndrome (CRS) or its relations to tumor responses. This study evaluates clinical responses in association with the cell kinetics and CRSs after transfer of high-affinity NY-ESO-1 TCR-gene transduced T cells in NY-ESO-1-expressiong cancer patients (NCT02366546). Methods: We developed a novel-type affinity-enhanced NY-ESO-1-specific TCR and an originally-developed retrovirus vector that encodes siRNA to silence endogenous TCR creation. The NY-ESO-1/TCR sequence is mutated for high affinity with replacements of G50A and A51E in CDR2 region. This is a first-in-man clinical trial of the novel NY-ESO-1-specfic TCR-T cell transfer to evaluate the safety, in vivo cell kinetics and clinical responses. It was designed as a cell-dose escalation from 5 x108 to 5 x109 cells. NY-ESO-1-expressing refractory cancer patients were enrolled, with 3+3 cohort design. Cyclophosphamide (1,500mg/m2) were administered prior to the TCR-T cell transfer as pre-conditioning. Results: 9 patients were treated with the NY-ESO-1/TCR-T cell transfer. The TCR-T cells expanded in peripheral blood with a dose-dependent manner, associated with rapid proliferation within 5 days after the cell transfer. 3 patients receiving 5x109 cells developed early-onset CRSs, with elevations of serum IL-6, IFN-γ. The CRSs developed on day1 or 2 after the cell transfer. They were well managed with tocilizumab treatment. 3 synovial sarcoma patients exhibited tumor shrinkages of partial responses, and they all had high-expression of NY-ESO-1 in the tumor samples, namely, 75% or more. Exploratory analysis revealed that multiple chemotactic cytokines including CCL2 and CCL7, and IL-3 increased in the serum from the patients with CRS. The proportions of effector-memory phenotype T cells in the infused cell-product were significantly associated with CRS development. Conclusions: The affinity-enhanced NY-ESO-1/TCR-T cell transfer exhibited early-onset CRS in association with in vivo cell proliferation and sequential tumor responses in the patients with high-NY-ESO-1-expressing synovial sarcoma. Clinical trial information: NCT02366546.
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Affiliation(s)
| | - Shigehisa Kitano
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | | | | | | | | | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
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23
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Hakoda H, Sekine Y, Ichimura H, Ueda K, Aoki S, Mishima H, Sako A, Kobayashi K, Sakata A, Sato Y. Hepatectomy for rapidly growing solitary liver metastasis from non-small cell lung cancer: a case report. Surg Case Rep 2019; 5:71. [PMID: 31049732 PMCID: PMC6497696 DOI: 10.1186/s40792-019-0633-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 02/20/2019] [Accepted: 04/24/2019] [Indexed: 01/08/2023] Open
Abstract
Background Patients with liver metastasis from non-small lung cancer (NSCLC) usually have multiple metastases at other sites and thus rarely undergo liver surgery. We present a case involving successful resection of rapidly growing liver metastasis from squamous cell carcinoma of the lung. Case presentation A 74-year-old man had undergone left lower lobectomy for squamous cell carcinoma of the lung, which was diagnosed pathologically as stage IA. A computed tomography (CT) scan that was taken 12 months after lung resection showed an irregularly shaped mass lesion (size, 8.3 cm) in segment five of the liver. Retrospectively, the mass was identifiable on CT 6 months before this initial recognition. Although the lesion showed rapid growth, positron emission tomography and brain magnetic resonance imaging ruled out the possibility of other metastatic lesions. Therefore, we performed right hepatectomy 14 months after the initial lung surgery. The patient was pathologically diagnosed with liver metastasis from lung cancer and has remained free from recurrence 41 months after the liver surgery, without receiving any adjuvant chemotherapy. Conclusions Although there is no reliable clinical indicator for selecting oligo-recurrence, hepatectomy could be an option for solitary liver metastasis from NSCLC for patients who are in good health.
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Affiliation(s)
- Hiroyuki Hakoda
- Department of Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Yasuharu Sekine
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Hideo Ichimura
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Japan. .,Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. .,Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Hitachi Medical Education and Research Center, 2-1-1 Jyounan, Hitachi, Ibaraki, 317-0077, Japan.
| | - Kazumitsu Ueda
- Department of Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Shigeo Aoki
- Department of Surgery, Hitachi General Hospital, Hitachi, Japan
| | | | - Akihiro Sako
- Department of Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Keisuke Kobayashi
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Akiko Sakata
- Department of Pathology, Hitachi General Hospital, Hitachi, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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24
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Nagata N, Maeda H, Ishibashi K, Hirata K, Makiyama A, Iwamoto S, Takemoto H, Imasato M, Yoshida Y, Munemoto Y, Tanaka C, Morita Y, Hotta Y, Toyofuku A, Nagasaka T, Morita S, Sakamoto J, Mishima H. Multicenter open-label randomized phase II study of second-line panitumumab and irinotecan with or without fluoropyrimidines in patients with KRAS wild-type metastatic colorectal cancer (PACIFIC study). Med Oncol 2019; 36:46. [PMID: 31020480 DOI: 10.1007/s12032-019-1254-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 02/11/2019] [Indexed: 12/29/2022]
Abstract
This phase II clinical trial compared the efficacy and safety of second-line irinotecan and panitumumab treatment (IRI + Pmab) with that of irinotecan, fluoropyrimidines and panitumumab treatment (control) in patients with KRAS wild-type mCRC. The primary endpoint was progression-free survival. In addition, early predictive markers of treatment efficacy were explored. Eighty patients were planned to be recruited. Due to a slow accrual rate, only 48 patients were recruited from 2012 to 2016, of which 23 were allocated to the control group and 25 were allocated to the IRI + Pmab group. The median progression-free survival was 254 days (95% confidence interval, 159-306) for control, and 190 days (95% confidence interval, 159-213) for IRI + Pmab (log-rank test, P = 0.26). The response rate without confirmation was 21.7% (5/23) for control and 40.0% (10/25) for IRI + Pmab. Neutropenia, leukopenia, and anorexia were the most common Grade 3/4 adverse events, and several early drop-outs from the treatment protocol were observed in the control group. As for the biomarkers, carcinoembryonic antigen and lactate dehydrogenase (LDH) smoothly declined immediately after the initial dosing in patients with a partial response or stable disease. After starting treatment, LDH-1 and - 2 increased, while LDH-4 and - 5 decreased, irrespective of tumor response. However, exceptions were frequent. In conclusion, this study failed to prove the safety and efficacy of irinotecan and panitumumab treatment due to insufficient patient accrual. Although LDH and its isozymes changed after initiation of treatment, their ability to predict the tumor response may not surpass that of carcinoembryonic antigen levels.The University Hospital Medical Information Network Clinical Trial Registry: UMIN000007658.
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Affiliation(s)
- Naoki Nagata
- Department of Gastroenterological Surgery, Kitakyushu General Hospital, Kitakyushu, Japan
| | - Hiromichi Maeda
- Cancer Treatment Center, Kochi Medical School Hospital, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.
| | - Keiichiro Ishibashi
- Department of Digestive Tract and General Surgery Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Keiji Hirata
- Department of Surgery 1, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Akitaka Makiyama
- Department of Hematology and Oncology, JCHO Kyushu Hospital, Kitakyushu, Japan
| | | | | | - Mitsunobu Imasato
- Department of Gastroenterological Surgery, Osaka Police Hospital, Osaka, Japan
| | - Yoichiro Yoshida
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | | | - Chihiro Tanaka
- Department of Surgery, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Yoshitaka Morita
- Department of Radiology, Kenporen Osaka Central Hospital, Osaka, Japan
| | - Yoshihiro Hotta
- Department of Surgery, Tokai Central Hospital, Kakamigahara, Japan
| | - Atsushi Toyofuku
- Department of Surgery, National Hospital Organization Kokura Medical Center, Kitakyushu, Japan
| | - Takeshi Nagasaka
- Department of Clinical Oncology, Kawasaki Medical School, Kurashiki, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
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25
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Tanioka H, Honda M, Tanaka C, Morita Y, Ishibashi K, Kato T, Matsuda C, Kataoka M, Satake H, Munemoto Y, Kobayashi K, Takahashi M, Nakata K, Sakamoto J, Oba K, Mishima H. Biweekly S-1 plus oxaliplatin (SOX) reintroduction in previously treated metastatic colorectal cancer patients (ORION 2 study): a phase II study to evaluate the efficacy and safety. Int J Clin Oncol 2019; 24:836-841. [DOI: 10.1007/s10147-019-01414-0] [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] [Received: 11/01/2018] [Accepted: 02/06/2019] [Indexed: 11/29/2022]
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26
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Iwamoto S, Maeda H, Hazama S, Oba K, Okayama N, Suehiro Y, Yamasaki T, Suzuki N, Nagano H, Sakamoto J, Mishima H, Nagata N. Efficacy of CapeOX plus Cetuximab Treatment as a First-Line Therapy for Patients with Extended RAS/BRAF/PIK3CA Wild-Type Advanced or Metastatic Colorectal Cancer. J Cancer 2018; 9:4092-4098. [PMID: 30519308 PMCID: PMC6277612 DOI: 10.7150/jca.26840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/23/2018] [Accepted: 07/25/2018] [Indexed: 11/23/2022] Open
Abstract
Background: Oxaliplatin and capecitabine (CapeOX) combined with cetuximab is rarely used to treat advanced and metastatic colorectal cancer (mCRC). The present study aimed to clarify the clinical benefits of this treatment regimen when used as a first-line therapy in patients with expanded RAS/BRAF/PIK3CA wild-type mCRC, using the data and tumor specimens from two previously published Phase II clinical trials. Methods: The gene mutation status and clinical data of 102 patients with KRAS wild-type mCRC, who received either of CapeOX + cetuximab or FOLFOX + cetuximab, were analyzed. The primary endpoint was response rate (RR) of CapeOX + cetuximab treatment in patients with extended RAS/BRAF/PIK3CA wild-type mCRC. RR comparisons and maximum tumor size changes between different treatment regimens and gene mutation status were set as key secondary endpoints. Results: We identified 88 patients with extended RAS/BRAF/PIK3CA wild-type mCRC. Those treated with CapeOX + cetuximab (n = 52) had a 61.5% RR (95% CI, 47.0-74.7%), while those treated with FOLFOX + cetuximab (n = 36) had a 66.7% RR (95% CI, 49.0-81.4%). Patients with any mutation (n = 14) had a 42.9% RR (95% CI, 17.1-71.1%). There were no significant differences between these three groups (P = 0.298). The disease control rate was 86.5% (95% CI, 74.2-94.4%) in the CapeOX + cetuximab group, and 88.9% (95% CI, 73.9-96.9%) in the FOLFOX + cetuximab group. Maximum tumor size changes were largest in patients with wild-type mCRC treated with FOLFOX + cetuximab followed by patients with wild-type mCRC treated with CapeOX + cetuximab, and then by those with any mutation (-63.2%, -52.6%, and -27.3%, respectively; P = 0.035). Conclusions: Patients with RAS/BRAF/PIK3CA wild-type mCRC had a sufficient RR following first-line treatment with CapeOX + cetuximab. These results suggest that this combination therapy should be considered as a treatment option for patients with advanced mCRC.
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Affiliation(s)
| | - Hiromichi Maeda
- Cancer Treatment Center, Kochi Medical School Hospital, Kochi University, Nankoku, Japan
| | - Shoichi Hazama
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.,Department of Translational Research and Developmental Therapeutics against Cancer, Yamaguchi University School of Medicine, Ube, Japan
| | - Koji Oba
- Department of Biostatistics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoko Okayama
- Division of Laboratory, Yamaguchi University Hospital, Ube, Japan
| | - Yutaka Suehiro
- Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takahiro Yamasaki
- Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Nobuaki Suzuki
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
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27
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Maeda H, Nagata N, Nagasaka T, Oba K, Mishima H, Kato T, Yoshida K, Muro K, Sakamoto J. A multicenter single-arm Phase II clinical trial of second-line FOLFIRI plus panitumumab after first-line treatment with FOLFOX plus panitumumab for initial RAS wild-type colorectal cancer with evaluation of circulating tumor DNA: A protocol study. Oncol Lett 2018; 17:1980-1985. [PMID: 30675264 DOI: 10.3892/ol.2018.9763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 03/23/2018] [Indexed: 12/25/2022] Open
Abstract
The efficacy and safety of the continuous use of panitumumab in first- and second-line treatments for colorectal cancer (CRC) have yet to be determined. Liquid biopsy of circulating tumor DNA is capable of assessing the gene mutation status at several time-points, and could predict the efficacy of ongoing panitumumab treatment. To address these two points, a multicenter single-arm Phase II clinical trial will be conducted by evaluating the effect of FOLFIRI with panitumumab as second-line chemotherapy in patients with CRC, after failure or intolerance of first-line treatment with FOLFOX with panitumumab. The primary endpoint is the 6-month progression-free survival rate. Gene mutation status using circulating tumor DNA will be assessed at multiple time-points during the study period as one of the secondary endpoints. The observed 6-month PFS rate will be compared with the threshold 6-month PFS rate of 35% with a one-sided significance level of 10% using the binomial exact test. The target number of cases in this study is 55 patients. The study protocol was approved by the Institutional Review Board of the Epidemiological and Clinical Research Information Network (17-0601-1) and will be conducted after approval by the Institutional Review Board of each participating institute. This study is registered in UMIN (UMIN000026817, March 31, 2017). The results of the present study will be presented at related international congresses, and will be disseminated in peer-reviewed journals.
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Affiliation(s)
- Hiromichi Maeda
- Cancer Treatment Center, Kochi Medical School Hospital, Kochi University, Nankoku, Kochi 783-8505, Japan
| | - Naoki Nagata
- Kitakyushu General Hospital, Kitakyushu, Fukuoka 802-8517, Japan
| | - Takeshi Nagasaka
- Department of Gastroenterological Surgery Transplant and Surgical Oncology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama 700-8530, Japan
| | - Koji Oba
- Department of Biostatistics, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Hideyuki Mishima
- Cancer Center, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
| | - Takeshi Kato
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Osaka 540-0006, Japan
| | - Kazuhiro Yoshida
- Second Department of Surgery, Gifu University, Gifu, Gifu 501-1194, Japan
| | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
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Masuishi T, Taniguchi H, Eto T, Komori A, Mitani S, Hasegawa H, Narita Y, Ishihara M, Tanaka T, Kadowaki S, Ura T, Ando M, Tajika M, Nomura M, Sato Y, Mishima H, Muro K. Morphologic Response and Tumor Shrinkage as Early Predictive Markers in Unresectable Colorectal Liver Metastases. Anticancer Res 2018; 38:6501-6506. [PMID: 30396978 DOI: 10.21873/anticanres.13014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/01/2018] [Accepted: 10/02/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND/AIM Anti-EGFR antibodies or bevacizumab comprise first-line treatment for patients with RAS wild-type colorectal liver metastases (CLM). Which marker better predicts efficacy, early tumor shrinkage or morphologic response, still remains unclear. PATIENTS AND METHODS We retrospectively evaluated 155 patients with KRAS exon 2 wild-type CLM treated with bevacizumab (BEV group) or anti-EGFR antibodies (EGFR group). Three radiologists independently assessed early tumor shrinkage (ETS) and early optimal morphologic response (EOMR) from baseline and first follow-up CT scan. RESULTS Patients with ETS had longer progression-free survival (PFS) than those without ETS [hazard ratio (HR)=0.69] and ETS tended to be observed in the EGFR group, while patients with EOMR had longer PFS than those without EOMR (HR=0.64) and EOMR tended to be observed in the BEV group. CONCLUSION Among patients with KRAS exon 2 wild-type CLM, EOMR and ETS may predict better PFS, especially in patients treated with bevacizumab and anti-EGFR antibodies, respectively.
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Affiliation(s)
- Toshiki Masuishi
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroya Taniguchi
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Tetsuya Eto
- Department of Gastroenterology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Azusa Komori
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Seiichiro Mitani
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroko Hasegawa
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yukiya Narita
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Makoto Ishihara
- Department of Gastroenterology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Tsutomu Tanaka
- Department of Gastroenterology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Shigenori Kadowaki
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takashi Ura
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masashi Ando
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masahiro Tajika
- Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Motoo Nomura
- Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yozo Sato
- Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya, Japan
| | | | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
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Kagawa Y, Satake H, Kato T, Oba K, Yasui H, Nakamura M, Watanabe T, Hirata K, Muro K, Komatsu Y, Yoshino T, Yamazaki K, Mishima H, Kotaka M, Tsuji A, Kakeji Y, Oki E, Nagata N, Junichi S. Phase Ib/II study of biweekly TAS-102 with bevacizumab combination for patients with metastatic colorectal cancer refractory to standard therapies (BiTS study): Phase Ib results. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy431.021] [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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Ishibashi K, Nagasaka T, Sawaki A, Mishima H, Tsuji A, Tsuji Y, Munemoto Y, Yamaguchi S, Shimokawa M, Shibata M, Sugiyama Y, Suzuki H, Okajima M, Yamaguchi Y. A phase III trial of Cape/5-FU+Bmab followed by CapeOX/mFOLFOX6+Bmab vs. CapeOX/mFOLFOX6+Bmab in mCRC: C-Cubed(C3) study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy375.008] [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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31
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Honda M, Matsuda C, Tanaka C, Kondo K, Takahashi T, Kosugi C, Tokunaga Y, Takemoto H, Kim H, Sakamoto J, Oba K, Mishima H. A phase II study of bevacizumab and irinotecan plus alternate-day S-1 as a second-line therapy for colorectal cancer: The AIRS study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.027] [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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32
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Hakoda H, Mishima H, Habu T, Murai S, Maeno R, Yokomizo Y, Inagaki Y, Maruyama T, Matsui Y, Sako A. Laparoscopic treatment of a vesicointestinal fistula due to a Meckel's diverticulum: a case report and review of the literature. Clin J Gastroenterol 2018; 11:476-480. [PMID: 29915984 DOI: 10.1007/s12328-018-0878-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/09/2018] [Indexed: 11/26/2022]
Abstract
While there have been numerous reports about colovesical fistulas and ruptured intestinal diverticula, there have been far fewer reports about vesicointestinal fistulas caused by Meckel's diverticula. Most Meckel's diverticula are asymptomatic. Furthermore, they seldom cause vesicointestinal fistulas, and the associated complications are non-specific. Thus, their preoperative diagnosis is difficult. We experienced a case in which a vesicointestinal fistula was caused by a Meckel's diverticulum and was treated with laparoscopic surgery. A 46-year-old male was referred to our hospital after exhibiting hematuria. Cystoscopy revealed a fistula between the small intestine and bladder. Contrast-enhanced computed tomography and magnetic resonance imaging showed a diverticulum in the ileum and a fistula between the ileum and bladder, which passed through the diverticulum. A Meckel's diverticulum was suspected. We conducted a laparoscopic operation. We dissected the Meckel's diverticulum with an automatic suturing device and removed it together with part of the ileum. The patient's postoperative course was good. We experienced a case in which a vesicointestinal fistula was caused by a Meckel's diverticulum and was successfully treated with laparoscopic surgery. In selected cases of Meckel's diverticulum, the dissection of the diverticulum with an automatic suturing device is appropriate.
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Affiliation(s)
- Hiroyuki Hakoda
- Department of Surgery, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki, 317-0077, Japan.
| | - Hideyuki Mishima
- Department of Surgery, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki, 317-0077, Japan
| | - Takumi Habu
- Department of Surgery, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki, 317-0077, Japan
| | - Shin Murai
- Department of Surgery, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki, 317-0077, Japan
| | - Ryohei Maeno
- Department of Surgery, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki, 317-0077, Japan
| | - Yuriko Yokomizo
- Department of Surgery, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki, 317-0077, Japan
| | - Yuki Inagaki
- Department of Surgery, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki, 317-0077, Japan
| | - Takehito Maruyama
- Department of Surgery, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki, 317-0077, Japan
| | - Yuichi Matsui
- Department of Surgery, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki, 317-0077, Japan
| | - Akihiro Sako
- Department of Surgery, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki, 317-0077, Japan
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Takahashi M, Munemoto Y, Nakamura M, Kotaka M, Kuroda H, Kato T, Minagawa N, Noura S, Fukunaga M, Kuramochi H, Touyama T, Takahashi T, Akagi Y, Satake H, Kurosawa S, Miura T, Mishima H, Sakamoto J, Oba K, Nagata N. SAPPHIRE: A randomized phase II study of oxaliplatin discontinuation after 6 cycles of mFOLFOX6 + panitumumab therapy in patients with colorectal cancer: Final analysis of efficacy and safety results. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.010] [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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34
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Kato T, Satake H, Oba K, Kagawa Y, Yasui H, Nakamura M, Watanabe T, Matsumoto T, Hirata K, Muro K, Komatsu Y, Yoshino T, Yamazaki K, Mishima H, Kotaka M, Tsuji A, Kakeji Y, Oki E, Nagata N, Sakamoto J. Multicenter phase Ib/II study of biweekly TAS-102 with bevacizumab combination for patients with metastatic colorectal cancer refractory to standard therapies (BiTS study) - Trial in progress. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.293] [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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35
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Nishikawa K, Aoyama T, Oba MS, Yoshikawa T, Matsuda C, Munemoto Y, Takiguchi N, Tanabe K, Nagata N, Imano M, Oshiro M, Fukushima R, Kataoka M, Morita S, Tsuburaya A, Mishima H, Kono T, Sakamoto J. The clinical impact of Hangeshashinto (TJ-14) in the treatment of chemotherapy-induced oral mucositis in gastric cancer and colorectal cancer: Analyses of pooled data from two phase II randomized clinical trials (HANGESHA-G and HANGESHA-C). J Cancer 2018; 9:1725-1730. [PMID: 29805697 PMCID: PMC5968759 DOI: 10.7150/jca.24733] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/04/2018] [Indexed: 11/06/2022] Open
Abstract
Background: The current pooled analysis evaluated the efficacy of Hangeshashinto (TJ-14) in the prevention and/or treatment of chemotherapy-induced oral mucositis (COM) in gastric cancer and colorectal cancer using two prospective, multi-institutional, randomized, double-blind, placebo-controlled phase II trials. Patients and Methods: HANGESHA-G and HANGESHA-C randomly assigned patients with gastric cancer or colorectal cancer who developed moderate to severe COM (grade ≥1) during any cycle of chemotherapy to receive either TJ-14 or a placebo as a double-blind trial. The patients received a placebo or TJ-14 for four to six weeks, according to the chemotherapy regimen, from the start of their next course of chemotherapy. The primary endpoint was the incidence of grade ≥2 COM in the protocol treatment course, and the secondary endpoints were the time to disappearance of COM and the incidence of adverse events. Results: The pooled population included 181 patients. The incidence of grade ≥2 COM in the TJ-14 group was 55.7% (49 patients), while that in the placebo group was 53.8% (50 patients); there was no significant difference between the two groups (p=0.796). The median time to remission of grade ≥2 COM to grade <1 was 8 days in the TJ-14 group and 15 days in the placebo group (p= 0.072). The hazard ratio was 1.54 [1.02 to 2.31] in favor of TJ-14. Treatment with TJ-14 was associated with marginally significant reduction in the duration of severe grade ≥2 COM in comparison to patients receiving placebo indicating the effect of TJ-14 in reducing the severity of COM. Conclusion: The present-pooled analysis showed that TJ-14 had a treatment effect in gastric cancer and colorectal cancer patients with COM in comparison to a placebo. Further phase III studies with a larger sample size are needed to clarify the protective effects of TJ-14 against COM.
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Affiliation(s)
| | - Toru Aoyama
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center
| | - Mari S Oba
- Department of Biostatistics and Epidemiology, Yokohama City University
| | | | - Chu Matsuda
- Department of Gastrointestinal Surgery, Osaka University
| | | | | | - Kazuaki Tanabe
- Department of Gastroenterological and Transplant Surgery, Hiroshima University
| | | | | | | | | | | | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University
| | | | | | - Toru Kono
- Department of Surgery, Asahikawa Medical University
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36
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Matsuda C, Honda M, Tanaka C, Kondo K, Takahashi T, Kosugi C, Tokunaga Y, Takemoto H, Kim HM, Sakamoto J, Oba K, Mishima H. A phase II study of bevacizumab and irinotecan plus alternate-day S-1 as a second-line therapy in patients with metastatic colorectal cancer: the AIRS study. Cancer Chemother Pharmacol 2018; 81:1035-1041. [PMID: 29644459 DOI: 10.1007/s00280-018-3568-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 03/22/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND The aim of this single-arm phase II clinical trial was to evaluate whether the alternate-day administration of S-1 plus irinotecan would reduce the incidence of severe diarrhea in comparison to consecutive-day S-1 administration (standard IRIS regimen) in second-line treatment for patients with metastatic colorectal cancer. METHODS Patients with metastatic colorectal cancer after failure with first-line treatment of oxaliplatin and fluoropyrimidine were enrolled. Irinotecan (150 mg/m2) and bevacizumab (5 mg/kg) were given intravenously on day 1. Oral S-1 was administered on alternate days at a dose of 40-60 mg twice a day. Cycles were repeated every 2 weeks. The primary endpoint was the incidence of grade ≥ 3 diarrhea. Our hypothesis set 21% as a threshold incidence and 10% as an expected incidence from previous studies with one-sided alpha 0.05. The secondary endpoints included the relative dose intensity, progression-free survival, overall survival and other adverse events. RESULTS A total of 51 patients were enrolled. The incidence of grade ≥ 3 diarrhea was 15.7% (8/51). Other common grade ≥ 3 adverse events were neutropenia, anemia, thrombocytopenia and fatigue were 13.7% (7/51), 5.9% (3/51), 2.0% (1/51) and 5.9% (3/51), respectively. The relative dose intensities of irinotecan, bevacizumab, and S-1 were 80.0, 86.8, and 77.7%, respectively. The median progression-free survival and overall survival were 8.4 months (5.8-9.8) and 17.1 months (11.8-22.3). CONCLUSIONS The alternate-day S-1 administration does not have significant effectiveness to reduce diarrhea in patients who received second-line treatment for metastatic colorectal cancer.
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Affiliation(s)
- Chu Matsuda
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Michitaka Honda
- Department of Disaster and Comprehensive Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan.
| | | | - Ken Kondo
- Nagoya Medical Center, Nagoya, Japan
| | - Takao Takahashi
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | | | | | | | - Ho Min Kim
- Department of Surgery, Rinku General Medical Center, Izumisano, Japan
| | | | - Koji Oba
- Department of Biostatistics, School of Public Health, University of Tokyo, Tokyo, Japan
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Nakamura M, Munemoto Y, Takahashi M, Kotaka M, Kuroda H, Kato T, Minagawa N, Noura S, Fukunaga M, Kuramochi H, Touyama T, Takahashi T, Akagi Y, Satake H, Kurosawa S, Miura T, Mishima H, Sakamoto J, Oba K, Nagata N. SAPPHIRE: A randomized phase II study of mFOLFOX6 + panitumumab versus 5-FU/LV + panitumumab after 6 cycles of frontline mFOLFOX6 + panitumumab in patients with colorectal cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.729] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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
729 Background: FOLFOX therapy, an infusion of 5-fluorouracil (5-FU) with leucovorin in combination with oxaliplatin (OXA), is a common first-line chemotherapy regimen for unresectable, advanced or recurrent colorectal carcinoma (CRC). However, long-term administration of OXA is associated with peripheral neuropathy (PN); decreasing treatment length of OXA may be beneficial without reducing its efficacy. Methods: Chemotherapy-naïve pts aged ≥20 yrs with RAS wild-type advanced/recurrent CRC were enrolled to receive 6 cycles of panitumumab (Pmab) + mFOLFOX6 once every 2 wks. Pts who completed 6 cycles of Pmab + mFOLFOX6 and confirmed no progressive disease were subsequently randomized 1:1 to continue to receive Pmab + mFOLFOX6 (arm 1) or Pmab + 5-FU/LV (arm 2). The primary endpoint was progression-free survival (PFS) rate at 9 mos after randomization. The threshold PFS rate was defined as 30%, and the expected rate was set at 50%, with a 90% power and a 1-sided alpha value of 0.10. In the primary analysis, a binomial test was conducted separately for each arm. This study was designed as a phase II randomized screening comparison study which does not use direct comparison for the primary analysis. Results: Of 164 enrolled pts who received initial Pmab + mFOLFOX6 treatment, 56 were randomized to arm 1 and 57 to arm 2. PFS rates at 9 mos after randomization were significantly higher than the defined threshold at 44.6% (80% CI, 36.4–53.2) in arm 1 and 47.4% (39.1–55.8) in arm 2. Median PFS after randomization was 9.1 (8.6–11.2) and 9.3 (6.0–13.0) mos, respectively. Grade ≥2 PNs occurred in 6 (10.7%) and 1 (1.8%) pts in arms 1 and 2, respectively. Serious AEs occurred in 14 (25.0%) pts in arm 1 and in 9 (16.7%) pts in arm 2. Conclusions: The results of this trial suggest that Pmab + 5-FU/LV after 6 fixed-cycles of Pmab + mFOLFOX6 may be a treatment option in pts with RAS wild type chemotherapy-naïve advanced/recurrent CRC. Pts treated with Pmab + 5-FU/LV had a lower occurrence of grade ≥2 PNs compared with Pmab + mFOLFOX6. Clinical trial information: NCT02337946.
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Affiliation(s)
| | | | | | | | | | - Takeshi Kato
- National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Noritaka Minagawa
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | | | - Hidekazu Kuramochi
- Tokyo Woman's Medical University, Yachiyo Medical Center, Yachiyo, Japan
| | | | | | | | | | | | - Tomoko Miura
- Takeda Pharmaceutical Company Limited, Chuo-Ku, Japan
| | | | | | - Koji Oba
- University of Tokyo, Tokyo, Japan
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Maeda H, Nagata N, Nagasaka T, Oba K, Mishima H, Kato T, Yoshida K, Muro K, Sakamoto J. Trial in progress: A phase II study of second-line FOLFIRI plus panitumumab after first-line FOLFOX plus panitumumab for RAS wild-type colorectal cancer with evaluation of circulating tumor DNA. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.tps886] [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
TPS886 Background: The mechanisms underlying the acquired resistance of metastatic colorectal cancer (mCRC) against panitumumab treatment is not fully understood. The efficacy and safety of FOLFIRI with panitumumab as the second-line chemotherapy after failure of FOLFOX with panitumumab treatment has yet to be determined. To address these two points, a multicenter single-arm Phase II clinical trial is being conducted with evaluation of circulating tumor DNA (ctDNA). Methods: The major inclusion criterion is that the patient has refractory measurable tumor that has progressed after the first-line therapy with FOLFOX plus panitumumab. After registration, treatment with the FOLFIRI and panitumumab will be continued in 2-week cycles until disease progression, unacceptable toxicity and/or patients’ refusal. The primary endpoint for this study is six-month progression-free survival (PFS) rate, a simple surrogate endpoint of PFS. According to a clinical trial revealing the median PFS of 4.6 months for FOLFIRI alone and 6.4 months for panitumumab plus FOLFIRI treatment in RAS wild-type patients (Peeters et al. Clin Cancer Res. 2015; 21: 5469-79), we assume the threshold and expected 6-month PFS rate as 35% and 50%, respectively. Under the settings of one-sided alpha = 0.10 and power = 80%, the required sample size is 53 patients. The target number of cases in this study is 55 patients, considering a dropout rate of 5%. The secondary endpoint includes the tumor-related gene mutation status assessed by liquid biopsy. Primary tumor and/or metastatic site tissue samples will be collected by formalin-fixed paraffin-embedded specimens at the time of registration. Blood samples will be collected at 3 time-points: (1) before second-line treatment, (2) at 6 ± 2 weeks after initiation of the treatment protocol, and (3) after confirmation of acquired resistance to this second-line therapy. The multiple evaluation of ctDNA will provide the meaningful information concerning relationship between the tumor resistance against treatment and alterations in gene mutation status. Clinical trial information: UMIN000026817.
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Affiliation(s)
| | | | - Takeshi Nagasaka
- Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Koji Oba
- University of Tokyo, Tokyo, Japan
| | | | | | | | - Kei Muro
- Aichi Cancer Center Hospital, Nagoya, Japan
| | - Junichi Sakamoto
- Japanese Foundation for Multidisciplinary Treatment of Cancer, Tokyo, Japan
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Ojima H, Mishima H, Sawaki A, Nagasaka T, Shimokawa M, Inukai M, Shinozaki K, Tanioka H, Nasu J, Nishina T, Hazama S, Okajima M, Tsuji A, Tsuji Y, Munemoto Y, Yamaguchi S, Yamaguchi Y. A randomized phase III clinical trial of sequential capecitabine or 5-FU plus bevacizumab (Cape/5-FU+Bmab) followed by Cape/5-FU plus oxaliplatin plus Bmab (CapeOX/mFOLFOX6+Bmab) versus combination CapeOX/mFOLFOX6+Bmab in advanced colorectal cancer: The C-cubed (C 3) study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.tps872] [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
TPS872 Background: Less intensive regimens, focusing on survival and disease control, may be better first-line treatments in unresectable metastatic colorectal cancer (mCRC). Several randomized trials suggested that sequential cytotoxic agents in mCRC may improve overall survival compared with combination chemotherapy. This study investigated whether sequential treatment with Bmab-based first-line therapy with oxaliplatin has superior efficacy to combination treatment for unresectable mCRC. Methods: This study is a two-arm, multicenter, open-label, randomized phase III trial in Japan, comparing the efficacy and safety of sequential Cape/5-FU+Bmab with escalation to CapeOX/mFOLFOX6+Bmab versus combination CapeOX/mFOLFOX6+Bmab as the first-line treatment of mCRC. The primary endpoint is Time to failure of strategy (TFS). In the sequential arm (Arm A: oxaliplatin ‘wait-and-go’), treatment escalation from Cape/5-FU+Bmab to CapeOX/mFOLFOX6+Bmab is recommended for progressive disease. In the combination arm (Arm B: oxaliplatin ‘stop-and-go’), de-escalation from CapeOX/mFOLFOX6+Bmab to Cape/5-FU+Bmab is possible after 12 weeks of treatment. Re-escalation to CapeOX/mFOLFOX6+Bmab after progressive disease is considered only for patients who received de-escalation of oxaliplatin, not caused by oxaliplatin-associated toxicity, after 12 weeks of treatment. A target sample size of 304 evaluable patients is considered sufficient to detect a hazard ratio of 0.69 for the TFS of the sequential ‘wait-and-go’ approach compared with the combination ‘stop-and go’ approach with 80% power and a 2-sided significance level of 5%. From December 2014 to September 2016, 311 patients were enrolled across 81 centers in Japan. The follow-up period is until March 2018, and results are expected in 2019, and results are expected in 2019. Clinical trial information: 000015405.
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Affiliation(s)
| | | | | | - Takeshi Nagasaka
- Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | | | | | | | | | | | | | - Shoichi Hazama
- Yamaguchi University Graduate School of Medicine, Ube, Japan
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Iwata T, Murotani K, Komatsu S, Mishima H, Arikawa T. Surgical outcome of laparoscopic hepatic resection for hepatocellular carcinoma: A matched case-control study with propensity score matching. J Minim Access Surg 2018; 14:277-284. [PMID: 29226881 PMCID: PMC6130181 DOI: 10.4103/jmas.jmas_116_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Although the number of reports on laparoscopic hepatic resection (LHR) has increased, studies of long-term outcomes regarding tumor recurrence and patient survival compared to the conventional open approach are limited. We evaluated the long-term survival and feasibility of LHR in patients with hepatocellular carcinoma (HCC). Patients and Methods: A retrospective analysis was performed on the clinical data of patients who underwent hepatic resection for primary HCC between August 2000 and December 2013. The patients were divided into the LHR or open hepatic resection (OHR) groups. To control for selection bias in the two groups, propensity score matching was used at a 1:1 ratio based on the following covariates: Child–Pugh grade, tumour size, tumour number and tumour location. Following propensity score matching, thirty patients were included in the LHR group and thirty were included in the OHR group. Results: The respective disease-free survival rates at 1 year, 3 years and 5 years were 78.4%, 61.1% and 38.9%, respectively, for the LHR group, and 89.3%, 57.5% and 47.9%, respectively, for the OHR group (P = 0.89). Also, the overall survival rates at 1 year, 3 years and 5 years were 96.4%, 68.2% and 62.5%, respectively, for the LHR group and 100.0%, 95.8% and 72.3%, respectively, for the OHR group (P = 0.44). Conclusions: According to our study, using propensity score matching, LHR for HCC is safe, feasible and comparative, with good oncologic results.
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Affiliation(s)
- Tsutomu Iwata
- Department of Gastroenterological Surgery, Aichi Medical University School of Medicine, Aichi, Japan
| | - Kenta Murotani
- Department of Center for Clinical Research, Aichi Medical University School of Medicine, Aichi, Japan
| | - Shunichiro Komatsu
- Department of Gastroenterological Surgery, Aichi Medical University School of Medicine, Aichi, Japan
| | - Hideyuki Mishima
- Department of Center for Clinical Research, Aichi Medical University School of Medicine, Aichi, Japan
| | - Takashi Arikawa
- Department of Gastroenterological Surgery, Aichi Medical University School of Medicine, Aichi, Japan
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Masuishi T, Kadowaki S, Kondo M, Komori A, Sugiyama K, Mitani S, Honda K, Narita Y, Taniguchi H, Ura T, Ando M, Mishima H, Muro K. FOLFOX as First-line Therapy for Gastric Cancer with Severe Peritoneal Metastasis. Anticancer Res 2017; 37:7037-7042. [PMID: 29187492 DOI: 10.21873/anticanres.12174] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 09/27/2017] [Accepted: 09/28/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Severe peritoneal metastasis (PM) from advanced gastric cancer (AGC) causes massive ascites and inadequate oral intake. Because patients with severe PM are often not included in clinical trials, little is known regarding the efficacy and safety of oxaliplatin with l-leucovorin and bolus/continuous infusion of 5-fluorouracil (FOLFOX) for them. PATIENTS AND METHODS We retrospectively studied AGC patients with massive ascites and/or inadequate oral intake due to severe PM treated with FOLFOX as the first-line treatment. RESULTS Only 39 (10%) of 378 AGC patients had severe PM; 10 received FOLFOX. The median progression-free and overall survivals were 7.5 and 13.2 months, respectively. Ascites decreased in seven of nine patients with ascites, and oral intake improved in four of seven patients with an inadequate oral intake. Common grade 3-4 adverse events included neutropenia and anemia. CONCLUSION This study suggests that FOLFOX is effective and manageable for AGC patients with severe PM.
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Affiliation(s)
- Toshiki Masuishi
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shigenori Kadowaki
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Mayumi Kondo
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Azusa Komori
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Keiji Sugiyama
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Seiichiro Mitani
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kazunori Honda
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yukiya Narita
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroya Taniguchi
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takashi Ura
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masashi Ando
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | | | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
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Morikawa T, Inada R, Nagasaka T, Mori Y, Kishimoto H, Kawai T, Umeda Y, Mishima H, Goel A, Fujiwara T. BRAF V600E mutation is a predictive indicator of upfront chemotherapy for stage IV colorectal cancer. Oncol Lett 2017; 15:2195-2201. [PMID: 29434925 PMCID: PMC5776948 DOI: 10.3892/ol.2017.7553] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 03/15/2016] [Accepted: 02/07/2017] [Indexed: 12/16/2022] Open
Abstract
In stage IV colorectal cancer (CRC), initial resection of the primary tumor is considered to be an important strategy for improving disease outcome. However, there is no consensus on the timing as to when the surgical intervention of the primary tumor should occur. The present study hypothesizes that genetic profiles in CRC may indicate the appropriate treatment strategies for patients with stage IV CRC, and a cohort of 113 patients with stage IV CRC resected primary lesions at various periods were analyzed for the presence of mutations in the KRAS, exon 2, and BRAF genes, exon 15, and for the microsatellite instability status of the tumor. These data were additionally correlated with various clinicopathological features. Although BRAF-mutant was revealed to be an independent negative prognostic factor in stage IV CRC (HR, 8.42; 95% confidence interval, 2.72–26.02), BRAF-mutant samples exhibited better prognoses if they were treated with chemotherapy prior to tumor resection. Thus, the presence of BRAF mutations provides a compelling rationale for the establishment of intensive upfront chemotherapy to improve survival in stage IV CRC.
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Affiliation(s)
- Tatsuya Morikawa
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Chūgoku 700-8558, Japan
| | - Ryo Inada
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Chūgoku 700-8558, Japan
| | - Takeshi Nagasaka
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Chūgoku 700-8558, Japan
| | - Yoshiko Mori
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Chūgoku 700-8558, Japan
| | - Hiroyuki Kishimoto
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Chūgoku 700-8558, Japan
| | - Takashi Kawai
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Chūgoku 700-8558, Japan
| | - Yuzo Umeda
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Chūgoku 700-8558, Japan
| | - Hideyuki Mishima
- Cancer Center, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
| | - Ajay Goel
- Center for Gastrointestinal Research and Translational Genomics and Oncology, Baylor Scott & White Research Institute and Charles A Sammons Cancer Center, Baylor University Medical Center, Dallas, TX 75246, USA
| | - Toshiyoshi Fujiwara
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Chūgoku 700-8558, Japan
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Li J, Xu R, Xu J, Denda T, Ikejiri K, Shen L, Toh Y, Shimada K, Kato T, Sakai K, Yamamoto M, Mishima H, Wang J, Baba H. Phase II study of S-1 plus leucovorin in patients with metastatic colorectal cancer: Regimen of 1 week on, 1 week off. Cancer Sci 2017; 108:2045-2051. [PMID: 28763145 PMCID: PMC5623741 DOI: 10.1111/cas.13335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 03/08/2017] [Revised: 07/04/2017] [Accepted: 07/15/2017] [Indexed: 12/03/2022] Open
Abstract
A phase II study of S‐1 plus leucovorin (LV) given in a 4‐week schedule (2 weeks’ administration followed by 2 weeks’ rest) for patients with untreated metastatic colorectal cancer (mCRC) showed that the combination was effective, but grade 3 toxicities (diarrhea, stomatitis and anorexia) occurred at a relatively high rate. In this phase II study, we evaluated the efficacy and safety of a 2‐week schedule of S‐1 plus LV. Patients with mCRC received oral S‐1 (40–60 mg) and LV (25 mg) twice daily for 1 week, followed by 1 week's rest. Treatment was repeated until disease progression or unacceptable toxicity. The primary endpoint was response rate. The pharmacokinetics of S‐1 and LV in Chinese patients were evaluated on day 1 of the first cycle. Seventy‐three patients were enrolled in Japan and China. Of 71 eligible patients, the response rate was 53.5%, and the disease control rate was 83.1%. Median progression‐free survival and median overall survival were 6.5 and 24.3 months, respectively. The incidences of grade 3 toxicities were diarrhea 8.3%, stomatitis 8.3%, anorexia 2.8% and neutropenia 9.7%. There were no treatment‐related deaths. The pharmacokinetics profiles of S‐1 plus LV in Chinese patients were similar to those in Japanese patients. This 2‐week schedule of S‐1 plus LV showed good efficacy and better tolerability than the 4‐week schedule. This therapy will be the base regimen for mCRC to be added by other cytotoxic or molecular‐targeted drugs. The optimized treatment schedule for S‐1 plus LV was 1 week on and 1 week off.
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Affiliation(s)
- Jin Li
- Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Ruihua Xu
- Division of Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China
| | - Jianming Xu
- No. 4 Division of Oncology, People's Liberation Army No. 307 Hospital, Beijing, China
| | - Tadamichi Denda
- Division of Gastroenterology, Chiba Cancer Center, Chiba City, Japan
| | - Koji Ikejiri
- Department of Surgery, Gastroenterology Center, National Hospital Organization Kyushu Medical Center, Fukuoka City, Japan
| | - Lin Shen
- Digestive System Medicine Department, Beijing Cancer Hospital, Beijing, China
| | - Yasushi Toh
- Department of Gastroenterological Surgery, National Hospital Organization, National Kyushu Cancer Center, Fukuoka City, Japan
| | - Ken Shimada
- Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama City, Japan
| | - Takeshi Kato
- Department of Surgery, Minoh City Hospital, Minoh City, Japan
| | - Kenji Sakai
- Department of Medical Oncology, Saiseikai Kumamoto Hospital, Kumamoto City, Japan
| | - Manabu Yamamoto
- Department of Surgery, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima City, Japan
| | - Hideyuki Mishima
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka City, Japan
| | - Jinwan Wang
- Division of Oncology, Chinese Institute & Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Hideo Baba
- Gastroenterological Surgery, Kumamoto University Hospital, Kumamoto City, Japan
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Suto T, Ishiguro M, Hamada C, Kunieda K, Masuko H, Kondo K, Ishida H, Nishimura G, Sasaki K, Morita T, Hazama S, Maeda K, Mishima H, Ike H, Sadahiro S, Sugihara K, Okajima M, Saji S, Sakamoto J, Tomita N. Erratum to: Preplanned safety analysis of the JFMC37-0801 trial: a randomized phase III study of six months versus twelve months of capecitabine as adjuvant chemotherapy for stage III colon cancer. Int J Clin Oncol 2017; 22:805-806. [PMID: 28608229 DOI: 10.1007/s10147-017-1146-6] [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: 11/28/2022]
Affiliation(s)
- Takeshi Suto
- Department of Gastroenterological Surgery, Yamagata Prefectural Central Hospital, 1800 Aoyagi, Yamagata-shi, Yamagata, 990-2214, Japan
| | - Megumi Ishiguro
- Department of Translational Oncology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Chikuma Hamada
- Graduate School of Engineering, Tokyo University of Science, 6-3-1 Niijuku, Katsushika-ku, Tokyo, 125-8585, Japan
| | - Katsuyuki Kunieda
- Department of Surgery, Gifu Prefectural General Medical Center, 4-6-1 Noishiki, Gifu-shi, Gifu, 500-8717, Japan
| | - Hiroyuki Masuko
- Department of Surgery, Nikko Memorial Hospital, 1-5-13 Shintomi-cho, Muroran-shi, Hokkaido, 051-8501, Japan
| | - Ken Kondo
- Department of Surgery, National Hospital Organization Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya-shi, Aichi, 460-0001, Japan
| | - Hideyuki Ishida
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, 350-8550, Japan
| | - Genichi Nishimura
- Department of Surgery, Kanazawa Red Cross Hospital, 2-251 Mimma, Kanazawa-shi, Ishikawa, 921-8162, Japan
| | - Kazuaki Sasaki
- Department of Surgery, Otaru Ekisaikai Hospital, 1-10-17 Ironai, Otaru-shi, Hokkaido, 047-0031, Japan
| | - Takayuki Morita
- Department of Surgery, Aomori Prefectural Central Hospital, 2-1-1 Higashitsukurimichi, Aomori-shi, Aomori, 030-8553, Japan
| | - Shoichi Hazama
- Department of Digestive Surgery and Surgical Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube-shi, Yamaguchi, 755-8505, Japan
| | - Koutarou Maeda
- Department of Lower Gastrointestinal Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake-shi, Aichi, 470-1192, Japan
| | - Hideyuki Mishima
- Cancer Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute-shi, Aichi, 480-1195, Japan
| | - Hideyuki Ike
- Department of Surgery, Saiseikai Yokohama Southern Hospital, 3-2-10 Konandai, Konan-ku, Yokohama-shi, Kanagawa, 234-8503, Japan
| | - Sotaro Sadahiro
- Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara-shi, Kanagawa, 259-1193, Japan
| | - Kenichi Sugihara
- Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Masazumi Okajima
- The Second Department of Surgery, Hiroshima University School of Medicine, 7-33 Motomachi, Naka-ku, Hiroshima-shi, Hiroshima, 730-8518, Japan
| | - Shigetoyo Saji
- Japanese Foundation for Multidisciplinary Treatment of Cancer, 1-28-6 Kameido, Koto-ku, Tokyo, 136-0071, Japan
| | - Junichi Sakamoto
- Japanese Foundation for Multidisciplinary Treatment of Cancer, 1-28-6 Kameido, Koto-ku, Tokyo, 136-0071, Japan
| | - Naohiro Tomita
- Division of Lower Gastrointestinal Surgery, Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya-shi, Hyogo, 663-8501, Japan.
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Ishibashi K, Nakamura M, Tsuji A, Takinishi Y, Shindo Y, Aoyama T, Sakamoto J, Oba K, Mishima H. Randomized phase II study of cetuximab vs. irinotecan and cetuximab in patients with chemo-refractory KRAS codon G13D metastatic colorectal cancer (G13D-study): Compared with ICECREAM study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx261.311] [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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Baba H, Yamada Y, Takahari D, Matsumoto H, Yoshida K, Nakamura M, Yoshida M, Iwamoto S, Shimada K, Komatsu Y, Sasaki Y, Satoh T, Takahashi K, Mishima H, Muro K, Watanabe M, Sakata Y, Morita S, Shimada Y, Sugihara K. S-1 and oxaliplatin (SOX) plus bevacizumab versus mFOLFOX6 plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer: updated overall survival analyses of the open-label, non-inferiority, randomised phase III: SOFT study. ESMO Open 2017; 2:e000135. [PMID: 28761727 PMCID: PMC5519807 DOI: 10.1136/esmoopen-2016-000135] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 11/30/2016] [Revised: 12/12/2016] [Accepted: 12/23/2016] [Indexed: 12/22/2022] Open
Abstract
Objective The SOFT study previously demonstrated that S-1 and oxaliplatin (SOX) plus bevacizumab was non-inferior to l-leucovorin, fluorouracil and oxaliplatin (mFOLFOX6) plus bevacizumab in terms of the primary end point of progression-free survival (PFS) as first-line chemotherapy for metastatic colorectal cancer (mCRC). The overall survival (OS) data were immature at the time of the primary analysis. Methods A total of 512 patients were enrolled and randomly assigned to receive either mFOLFOX6 plus bevacizumab (5 mg/kg of bevacizumab, followed by 200 mg/m2 of l-leucovorin given simultaneously with 85 mg/m2 of oxaliplatin, followed by a 400 mg/m2 bolus of 5-FU on day 1 and then 2400 mg/m2 of 5-FU as an intravenous infusion over the course of 46 hours, every 2 weeks) or SOX plus bevacizumab (7.5 mg/kg of bevacizumab, 130 mg/m2 of oxaliplatin on day 1 and 40–60 mg of S-1 two times per day for 2 weeks, followed by a 1-week rest). The primary end point was PFS. After the primary analysis, the follow-up survey was cut-off on 30 September 2013, and the final OS data were analysed. Results With a median follow-up of 37.7 months, the median survival time (MST) was 29.7 months with mFOLFOX6 plus bevacizumab and 29.6 months with SOX plus bevacizumab (HR, 1.018; 95% CI 0.823 to 1.258). Median PFS was 11.7 months in the mFOLFOX6 plus bevacizumab group and 12.2 months in the SOX plus bevacizumab group (HR, 1.051; 95% CI 0.876 to 1.262; pnon-inferiority=0.0115). Conclusion Our results reconfirmed that SOX plus bevacizumab is non-inferior to mFOLFOX6 plus bevacizumab in terms of PFS. MST did not differ between the groups. SOX plus bevacizumab is considered an effective regimen for first-line chemotherapy in patients with mCRC and can be used instead of mFOLFOX6 plus bevacizumab. Trial registration number JapicCTI-090699.
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Affiliation(s)
- Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasuhide Yamada
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Daisuke Takahari
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroshi Matsumoto
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kazuhiro Yoshida
- Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan
| | - Masato Nakamura
- Aizawa Comprehensive Cancer Center, Aizawa Hospital, Matsumoto, Japan
| | - Motoki Yoshida
- Cancer Chemotherapy Center, Osaka Medical College Hospital, Takatsuki, Japan
| | - Shigeyoshi Iwamoto
- Department of Surgery, Kansai Medical University Hospital, Hirakata, Japan
| | - Ken Shimada
- Department of Internal Medicine, Division of Medical Oncology, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yoshito Komatsu
- Department of Cancer Center, Hokkaido University Hospital, Sapporo, Japan
| | - Yasutsuna Sasaki
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Taroh Satoh
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University, Suita, Japan
| | - Keiichi Takahashi
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masahiko Watanabe
- Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | | | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University, Kyoto, Japan
| | - Yasuhiro Shimada
- Department of Clinical Oncology, Kochi Health Sciences Center, Kochi, Japan
| | - Kenichi Sugihara
- Tokyo Medical and Dental University, Graduate School, Tokyo, Japan
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Nagata N, Mishima H, Kurosawa S, Oba K, Sakamoto J. mFOLFOX6 Plus Panitumumab Versus 5-FU/LV Plus Panitumumab After Six Cycles of Frontline mFOLFOX6 Plus Panitumumab: A Randomized Phase II Study of Patients With Unresectable or Advanced/Recurrent, RAS Wild-type Colorectal Carcinoma (SAPPHIRE)-Study Design and Rationale. Clin Colorectal Cancer 2017; 16:154-157.e1. [PMID: 28284575 DOI: 10.1016/j.clcc.2017.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND In Japan, oxaliplatin (OXA)/5-fluorouracil (5-FU)/leucovorin (LV)-the mFOLFOX6 regimen-is the most frequently used first-line chemotherapy backbone for metastatic colorectal cancer. However, peripheral nerve disorders caused by OXA during mFOLFOX6 therapy can decrease patients' quality of life. OXA can be safely discontinued from a FOLFOX regimen after 6 cycles during first-line therapy. Also, for patients who discontinue OXA without having experienced peripheral nerve disorders, reintroducing OXA in the later stages of treatment could remain an option. PATIENTS AND METHODS The study is a phase II, multicenter, open-label, parallel-group, randomized, controlled exploratory study comparing the efficacy and safety of mFOLFOX6 plus panitumumab and 5-FU/LV plus panitumumab in patients with chemotherapy-naïve, unresectable, advanced or recurrent colorectal carcinoma of RAS wild-type (SAPPHIRE; ClinicalTrials.gov identifier, NCT02337946). Eligible patients will receive 6 cycles of mFOLFOX6 plus panitumumab combination therapy, followed by 1:1 randomization to either further treatment with mFOLFOX6 plus panitumumab or discontinuation of OXA and treatment with 5-FU/LV plus panitumumab. Up to 100 randomized patients will receive treatment for approximately 12 months or until any of the criteria for treatment discontinuation have been met. The primary endpoint is progression-free survival rate at 9 months after the day of randomization. The secondary endpoints are progression-free survival, overall survival, response rate, and interval to treatment failure. Safety will be evaluated according to the incidence and severity of adverse events, including the incidence of peripheral nerve and skin disorders. Additional endpoints will include maintenance of performance status, continuation of OXA in the mFOLFOX6 plus panitumumab group, and continuation of panitumumab in both groups.
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Affiliation(s)
| | | | | | - Koji Oba
- The University of Tokyo, Tokyo, Japan
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Suto T, Ishiguro M, Hamada C, Kunieda K, Masuko H, Kondo K, Ishida H, Nishimura G, Sasaki K, Morita T, Hazama S, Maeda K, Mishima H, Ike H, Sadahiro S, Sugihara K, Okajima M, Saji S, Sakamoto J, Tomita N. Preplanned safety analysis of the JFMC37-0801 trial: a randomized phase III study of six months versus twelve months of capecitabine as adjuvant chemotherapy for stage III colon cancer. Int J Clin Oncol 2017; 22:494-504. [PMID: 28078540 PMCID: PMC5486458 DOI: 10.1007/s10147-016-1083-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 11/02/2016] [Accepted: 12/23/2016] [Indexed: 12/01/2022]
Abstract
Background Six months of adjuvant chemotherapy is regarded as the standard of care for patients with stage III colon cancer. However, whether longer treatment can improve prognosis has not been fully investigated. We conducted a phase III study comparing 6 and 12 months of adjuvant capecitabine chemotherapy for stage III colon cancer, and report here the results of our preplanned safety analysis. Methods Patients aged 20–79 years with curatively resected stage III colon cancer were randomly assigned to receive 8 cycles (6 months) or 16 cycles (12 months) of capecitabine (2500 mg/m2/day on days 1–14 of each 21-day cycle). Treatment exposure and adverse events (AEs) were evaluated. Results A total of 1304 patients (642 and 636 in the 6-month and 12-month groups, respectively) were analyzed. The most common AE was hand-foot syndrome (HFS). HFS, leukocytopenia, neutropenia, and hyperbilirubinemia (any grade) occurred more frequently in the 12-month group than in the 6-month group. HFS was the only grade ≥3 AE to have a significantly higher incidence in the 12-month group (23 vs 17%, p = 0.011). The completion rate for 8 cycles was 72% in both groups, while that for 16 cycles was 46% in the 12-month group. HFS was the most common AE requiring dose reduction and treatment discontinuation. Conclusions Twelve months of adjuvant capecitabine demonstrated a higher cumulative incidence of HFS compared to the standard 6-month treatment period, while toxicities after 12 months of capecitabine were clinically acceptable. Trial registration UMIN-CTR, UMIN000001367.
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Affiliation(s)
- Takeshi Suto
- Department of Gastroenterological Surgery, Yamagata Prefectural Central Hospital, 1800 Aoyagi, Yamagata-shi, Yamagata, 990-2214, Japan
| | - Megumi Ishiguro
- Department of Translational Oncology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Chikuma Hamada
- Graduate School of Engineering, Tokyo University of Science, 6-3-1 Niijuku, Katsushika-ku, Tokyo, 125-8585, Japan
| | - Katsuyuki Kunieda
- Department of Surgery, Gifu Prefectural General Medical Center, 4-6-1 Noishiki, Gifu-shi, Gifu, 500-8717, Japan
| | - Hiroyuki Masuko
- Department of Surgery, Nikko Memorial Hospital, 1-5-13 Shintomi-cho, Muroran-shi, Hokkaido, 051-8501, Japan
| | - Ken Kondo
- Department of Surgery, National Hospital Organization Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya-shi, Aichi, 460-0001, Japan
| | - Hideyuki Ishida
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, 350-8550, Japan
| | - Genichi Nishimura
- Department of Surgery, Kanazawa Red Cross Hospital, 2-251 Mimma, Kanazawa-shi, Ishikawa, 921-8162, Japan
| | - Kazuaki Sasaki
- Department of Surgery, Otaru Ekisaikai Hospital, 1-10-17 Ironai, Otaru-shi, Hokkaido, 047-0031, Japan
| | - Takayuki Morita
- Department of Surgery, Aomori Prefectural Central Hospital, 2-1-1 Higashitsukurimichi, Aomori-shi, Aomori, 030-8553, Japan
| | - Shoichi Hazama
- Department of Digestive Surgery and Surgical Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube-shi, Yamaguchi, 755-8505, Japan
| | - Koutarou Maeda
- Department of Lower Gastrointestinal Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake-shi, Aichi, 470-1192, Japan
| | - Hideyuki Mishima
- Cancer Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute-shi, Aichi, 480-1195, Japan
| | - Hideyuki Ike
- Department of Surgery, Saiseikai Yokohama Southern Hospital, 3-2-10 Konandai, Konan-ku, Yokohama-shi, Kanagawa, 234-8503, Japan
| | - Sotaro Sadahiro
- Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara-shi, Kanagawa, 259-1193, Japan
| | - Kenichi Sugihara
- Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Masazumi Okajima
- The Second Department of Surgery, Hiroshima University School of Medicine, 7-33 Motomachi, Naka-ku, Hiroshima-shi, Hiroshima, 730-8518, Japan
| | - Shigetoyo Saji
- Japanese Foundation for Multidisciplinary Treatment of Cancer, 1-28-6 Kameido, Koto-ku, Tokyo, 136-0071, Japan
| | - Junichi Sakamoto
- Japanese Foundation for Multidisciplinary Treatment of Cancer, 1-28-6 Kameido, Koto-ku, Tokyo, 136-0071, Japan
| | - Naohiro Tomita
- Division of Lower Gastrointestinal Surgery, Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya-shi, Hyogo, 663-8501, Japan.
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Denda T, Kanda M, Morita Y, Kim HM, Kashiwada T, Matsuda C, Fujieda S, Nakata K, Murotani K, Oba K, Sakamoto J, Mishima H. Pharmacokinetic dose adjustment of 5-FU in modified FOLFOX7 plus bevacizumab for metastatic colorectal cancer in Japanese patients: a-JUST phase II clinical trial. Cancer Chemother Pharmacol 2016; 78:1253-1261. [PMID: 27807652 DOI: 10.1007/s00280-016-3184-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 10/25/2016] [Indexed: 01/27/2023]
Abstract
PURPOSE Dose adjustment of 5-fluorouracil (FU) based on pharmacokinetic monitoring has been shown to reduce toxicities and increase efficacy compared with dosing based on body surface area in patients with metastatic colorectal cancer (mCRC). We evaluated the efficacy and safety of pharmacokinetic dose adjustment of FU in a modified FOLFOX7 (mFOLFOX7) plus bevacizumab regimen in Japanese patients with previously untreated mCRC. METHODS This single-arm, multicenter phase II trial enrolled 48 patients with mCRC. Treatment consisted of 5 mg/kg intravenous bevacizumab followed by mFOLFOX7 (oxaliplatin 85 mg/m2 on day 1, infused leucovorin 200 mg/m2, followed by a 2400 mg/m2 infusion of FU for 46 h starting on day 1), repeated every 2 weeks. FU concentrations were measured by immunoassay between 18 and 36 h after the start of continuous FU infusion, and the FU dose was then adjusted if required in subsequent cycles. The primary endpoint was response rate. RESULTS The median initial area under the concentration-time curve for FU was 23 mg h/L. Twenty-nine patients (60%) achieved the target concentration at the first cycle, and all 48 achieved it within the fourth cycle. The overall frequency of grade 3/4 adverse effects was 38%, with no significant difference between patients who did and not require dose adjustments. The overall response rate was 48% (95% confidence intervals = 34-62%). The median progression-free and overall survival rates were 11.3 and 24.1 months, respectively. CONCLUSIONS Pharmacokinetic dose adjustment of FU in mFOLFOX7 plus bevacizumab can optimize FU concentrations promptly and is safe in Japanese patients with mCRC.
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Affiliation(s)
- Tadamichi Denda
- Division of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - Mitsuro Kanda
- Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | | | - Ho Min Kim
- Department of Surgery, Rinku General Medical Center, Izumisano, Japan
| | - Tomomi Kashiwada
- Division of Cancer Center, Saga University Hospital, Saga, Japan
| | - Chu Matsuda
- Department of Surgery, Osaka General Medical Center, Osaka, Japan
| | - Shinji Fujieda
- Division of Gastroenterology, Ibaraki Prefectural Hospital, Kasama, Japan
| | - Ken Nakata
- Department of Surgery, Sakai City Hospital, Sakai, Japan
| | - Kenta Murotani
- Clinical Research Center, Aichi Medical University Hospital, Nagakute, Japan
| | - Koji Oba
- Department of Biostatistics, School of Public Health, Tokyo University Graduate School of Medicine, Tokyo, Japan.,Interfaculty Initiative in Information Studies, Tokyo University, Tokyo, Japan
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Yamaguchi S, Kunieda K, Sato T, Naramoto Y, Kobayashi M, Ogata Y, Furuhata T, Takii Y, Kusunoki M, Maehara Y, Koda K, Okuno K, Ohno M, Mishima H, Sadahiro S, Hamada C, Sakamoto J, Saji S, Tomita N. Phase III trial of 24 weeks vs. 48 weeks capecitabine adjuvant chemotherapy for patients with stage III colon cancer: Final results of JFMC37-0801. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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