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Ueno M, Morizane C, Ikeda M, Ozaka M, Nagashima F, Kataoka T, Mizusawa J, Ohba A, Kobayashi S, Imaoka H, Kasuga A, Okano N, Nagasaka Y, K. Kurishita, Tomatsuri S, Sasaki M, Shibata T, Nakamura K, Furuse J, Okusaka T. 64P Phase I/II study of nivolumab plus lenvatinib for advanced biliary tract cancer (JCOG1808/NCCH1817, SNIPE). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.092] [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: 11/01/2022] Open
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Morizane C, Okusaka T, Mizusawa J, Katayama H, Ueno M, Ikeda M, Ozaka M, Okano N, Sugimori K, Fukutomi A, Hara H, Mizuno N, Yanagimoto H, Wada K, Tobimatsu K, Yane K, Nakamori S, Yamaguchi H, Asagi A, Yukisawa S, Kojima Y, Kawabe K, Kawamoto Y, Sugimoto R, Iwai T, Nakamura K, Miyakawa H, Yamashita T, Hosokawa A, Ioka T, Kato N, Shioji K, Shimizu K, Nakagohri T, Kamata K, Ishii H, Furuse J. Combination gemcitabine plus S-1 versus gemcitabine plus cisplatin for advanced/recurrent biliary tract cancer: the FUGA-BT (JCOG1113) randomized phase III clinical trial. Ann Oncol 2019; 30:1950-1958. [PMID: 31566666 DOI: 10.1093/annonc/mdz402] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [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] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Gemcitabine plus cisplatin (GC) is the standard treatment of advanced biliary tract cancer (BTC); however, it causes nausea, vomiting, and anorexia, and requires hydration. Gemcitabine plus S-1 (GS) reportedly has equal to, or better, efficacy and an acceptable toxicity profile. We aimed to confirm the non-inferiority of GS to GC for patients with advanced/recurrent BTC in terms of overall survival (OS). PATIENTS AND METHODS We undertook a phase III randomized trial in 33 institutions in Japan. Eligibility criteria included chemotherapy-naïve patients with recurrent or unresectable BTC, an Eastern Cooperative Oncology Group Performance Status of 0 - 1, and adequate organ function. The calculated sample size was 350 with a one-sided α of 5%, a power of 80%, and non-inferiority margin hazard ratio (HR) of 1.155. The primary end point was OS, while the secondary end points included progression-free survival (PFS), response rate (RR), adverse events (AEs), and clinically significant AEs defined as grade ≥2 fatigue, anorexia, nausea, vomiting, oral mucositis, or diarrhea. RESULTS Between May 2013 and March 2016, 354 patients were enrolled. GS was found to be non-inferior to GC [median OS: 13.4 months with GC and 15.1 months with GS, HR, 0.945; 90% confidence interval (CI), 0.78-1.15; P = 0.046 for non-inferiority]. The median PFS was 5.8 months with GC and 6.8 months with GS (HR 0.86; 95% CI 0.70-1.07). The RR was 32.4% with GC and 29.8% with GS. Both treatments were generally well-tolerated. Clinically significant AEs were observed in 35.1% of patients in the GC arm and 29.9% in the GS arm. CONCLUSIONS GS, which does not require hydration, should be considered a new, convenient standard of care option for patients with advanced/recurrent BTC. CLINICAL TRIAL NUMBER This trial has been registered with the UMIN Clinical Trials Registry (http://www.umin.ac.jp/ctr/index.htm), number UMIN000010667.
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Affiliation(s)
- C Morizane
- Department of Hepatobiliary and Pancreatic Oncology, Tokyo.
| | - T Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, Tokyo
| | - J Mizusawa
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - H Katayama
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - M Ueno
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama
| | - M Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa
| | - M Ozaka
- Hepato-Biliary-Pancreatic Medicine Department, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
| | - N Okano
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo
| | - K Sugimori
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama
| | - A Fukutomi
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka
| | - H Hara
- Department of Gastroenterology, Saitama Cancer Center, Saitama
| | - N Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya
| | - H Yanagimoto
- Department of Surgery, Kansai Medical University Hospital, Hirakata
| | - K Wada
- Department of Surgery, Teikyo University School of Medicine, Tokyo
| | - K Tobimatsu
- Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine, Kobe
| | - K Yane
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo
| | - S Nakamori
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka
| | - H Yamaguchi
- Department of Clinical Oncology, Jichi Medical University, Shimotsuke
| | - A Asagi
- Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama
| | - S Yukisawa
- Department of Medical Oncology, Tochigi Cancer Center, Utsunomiya
| | - Y Kojima
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo
| | - K Kawabe
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Y Kawamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo
| | - R Sugimoto
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka
| | - T Iwai
- Department of Gastroenterology, Kitasato University Hospital, Sagamihara
| | - K Nakamura
- Division of Gastroenterology, Chiba Cancer Center, Chiba
| | - H Miyakawa
- Department of Bilio-Pancreatology, Sapporo Kousei General Hospital, Sapporo
| | - T Yamashita
- Department of Gastroenterology, Kanazawa University, Kanazawa
| | - A Hosokawa
- Department of Gastroenterology and Hematology, University of Toyama, Faculty of Medicine, Toyama
| | - T Ioka
- Department of Cancer Survey and Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka
| | - N Kato
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba
| | - K Shioji
- Department of Internal medicine, Niigata Cancer Center Hospital, Niigata
| | - K Shimizu
- Department of Gastroenterology, Tokyo Women's Medical University, Tokyo
| | - T Nakagohri
- Gastroenterological Surgery, Tokai University School of Medicine, Isehara
| | - K Kamata
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka
| | - H Ishii
- Clinical Research Center, Chiba Cancer Center, Chiba, Japan
| | - J Furuse
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo
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Ioka T, Nakamori S, Sugimori K, Kanai M, Ikeda M, Ozaka M, Furukawa M, Okusaka T, Kawabe K, Furuse J, Komatsu Y, Sato A, Shimizu S, Chugh P, Tang R, Ueno M. Liposomal irinotecan (nal-IRI) plus 5-fluorouracil/levoleucovorin (5 FU/LV) vs 5-FU/LV in Japanese patients (pts) with gemcitabine-refractory metastatic pancreatic cancer (mPAC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz422.010] [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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Okano N, Ueno M, Morizane C, Yamanaka T, Ojima H, Ozaka M, Sasaki M, Takahara N, Kobayashi S, Morimoto M, Hosoi H, Nakai Y, Ikeda M, Maeno S, Nagashima F, Okusaka T, Furuse J. Multicenter phase II trial of axitinib monotherapy for advanced biliary tract cancer refractory to gemcitabine-based chemotherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.064] [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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Ozaka M, Kobayashi S, Ikeda M, Ueno M. Multicenter retrospective study of gemcitabine plus nab-paclitaxel for elderly patients with advanced pancreatic cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.032] [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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Fukutomi A, Mizusawa J, Katayama H, Okusaka T, Ito T, Okano N, Mizuno N, Ikeda M, Ueno M, Shioji K, Ozaka M, Shimizu S, Sakamoto Y, Kondo S, Kawabe K, Eba J, Ishii H, Fukuda H, Furuse J. Randomized phase II study of modified FOLFIRINOX versus gemcitabine plus nab-paclitaxel combination therapy for locally advanced pancreatic cancer: Japan Clinical Oncology Group Study (JCOG1407). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kurokawa Y, Doi T, Sawaki A, Komatsu Y, Ozaka M, Takahashi T, Naito Y, Okubo S, Nishida T. Phase II study of TAS-116, an oral inhibitor of heat shock protein 90 (HSP90), in metastatic or unresectable gastrointestinal stromal tumor refractory to imatinib, sunitinib and regorafenib. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx387.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sasaki M, Ueno H, Omae K, Goto T, Murohisa G, Mizuno N, Ozaka M, Kobayashi S, Uesugi K, Kobayashi N, Hayashi H, Sudo K, Okano N, Horita Y, Kamei K, Hosokawa T, Henmi T, Kobayashi M, Todaka A, Fukutomi A. Risk factors for febrile neutropenia (FN) in unresectable/recurrent pancreatic cancer(PC) patients(pts) receiving FOLFIRINOX (FFX) from JASPAC06 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shirasu H, Omae K, Fujii H, Mizuno N, Ozaka M, Ueno H, Kobayashi S, Uesugi K, Kobayashi N, Hayashi H, Sudo K, Okano N, Horita Y, Kamei K, Seigo Y, Takafumi H, Henmi T, Kobayashi M, Todaka A, Fukutomi A. The impact of UGT1A1 genetic polymorphism on safety in unresectable pancreatic cancer patients receiving FOLFIRINOX therapy: A subset analysis of JASPAC 06 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.123] [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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Mizuno N, Todaka A, Mori K, Boku N, Ozaka M, Ueno H, Kobayashi S, Uesugi K, Kobayashi N, Hayashi H, Sudo K, Okano N, Horita Y, Kamei K, Yukisawa S, Nakamori S, Yachi Y, Henmi T, Kobayashi M, Fukutomi A. Observational study of FOLFIRINOX (FFX) for unresectable/recurrent pancreatic cancer (PC) in Japanese patients (pts)(JASPAC 06): final results. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.70] [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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Ioka T, Fukutomi A, Mizusawa J, Katayama H, Nakamura S, Ito Y, Hiraoka N, Ueno M, Ikeda M, Sugimori K, Shimizu K, Okusaka T, Ozaka M, Yanagimoto H, Nakamori S, Azuma T, Hosokawa A, Sata N, Mine T, Furuse J. Randomized phase II study of S-1 and concurrent radiotherapy with versus without induction chemotherapy of gemcitabine for locally advanced pancreatic cancer (LAPC): Final analysis of JCOG1106. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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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Nakayama I, Shinozaki E, Azuma T, Wakatsuki T, Ogura M, Ichimura T, Ozaka M, Takahari D, Chin K, Mizunuma N. 164P Does patient selection according to RAS/PIK3CA/BRAF mutational status enrich the efficacy of adjuvant chemotherapy for Stage IV CRC after R0 resection? Ann Oncol 2015. [DOI: 10.1093/annonc/mdv523.25] [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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Nakayama I, Shinozaki E, Wakatsuki T, Ogura M, Ozaka M, Suenaga M, Mizunuma N. P-262 The impact of variations in KRAS codon 12 and 13 point mutation on the efficacy of cytotoxic chemotherapy for metastatic colorectal cancer (CRC). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.259] [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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Shinozaki E, Miki Y, Ueno M, Igarashi M, Nakayama I, Osumi H, Suenaga M, Chin K, Ogura M, Ozaka M, Matsusaka S, Takahari D, Takashi I, Wakatsuki T, Yamaguchi T, Mizunuma N. P-203 KRAS mutational variations and characteristics in colorectal cancer(CRC): Analysis of over 1600 patients in single institute. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.201] [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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Osumi H, Shinozaki E, Suenaga M, Kumekawa Y, Ozaka M, Ogura M, Matsusaka S, Chin K, Ueno M, Saiura A, Okumura S, Mizunuma N, Miki Y, Yamaguchi T. P-231 All RAS mutation predict for poor clinical outcomes after metastasectomy in patients with metastatic colorectal cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Osumi H, Ozaka M, Ishii H, Sasahira N. Severe ischemic colitis after treatment of bile-duct cancer using gemcitabine and cisplatin. Jpn J Clin Oncol 2015; 45:402-3. [DOI: 10.1093/jjco/hyv038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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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Inoue D, Ozaka M, Matsuyama M, Yamada I, Takano K, Saiura A, Ishii H. Prognostic value of neutrophil-lymphocyte ratio and level of C-reactive protein in a large cohort of pancreatic cancer patients: a retrospective study in a single institute in Japan. Jpn J Clin Oncol 2014; 45:61-6. [DOI: 10.1093/jjco/hyu159] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Suenaga M, Mizunuma N, Matsusaka S, Shinozaki E, Ozaka M, Ogura M, Chin K, Yamaguchi T. A Phase I/II Study of Bi-Weekly Xeliri with Capecitabine 1,000 Mg/M2 Twice Daily and Irinotecan 180 Mg/M2 Plus Bevacizumab(Bv) for Patient with Metastatic Colorectal Cancer As Second-Line Chemotherapy (Bixer Study). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.30] [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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Suenaga M, Matsusaka S, Shinozaki E, Ozaka M, Ogura M, Chin K, Hatake K, Mizunuma N, Yamaguchi T. A Phase I/II Study of BI-Weekly Xeliri Plus Bevacizumab for Patient with Metastatic Colorectal Cancer as Second-Line Chemotherapy (Bixer Study): Reports of Interim Analysis of Phase II Part. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32376-0] [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: 11/26/2022] Open
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Omuro Y, Ikari T, Ishii H, Ozaka M, Suyama M, Matsumura Y, Itoi T, Egawa N, Yano S, Hanada K, Kimura Y, Ukita T, Ishida Y, Tani M, Ohoka S, Hirose Y, Hijioka S, Watanabe R, Ikeda T, Nakajima T. A randomized phase II study of gemcitabine plus S-1 versus gemcitabine alone in patients with unresectable pancreatic cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4029] [Citation(s) in RCA: 3] [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: 11/20/2022] Open
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Horikawa Y, Tsuchiya N, Yuasa K, Narita S, Saito M, Takayama K, Nara T, Tsuruta H, Obara T, Numakura K, Satoh S, Habuchi T, Hu X, Guo J, Lin Z, Sun L, Xu Z, Cang C, Wang G, Kanda T, Sakamoto K, Matsuki A, Ohashi R, Hirota S, Fujimori Y, Matsuda Y, Yajima K, Kosugi S, Hatakeyama K, Kitahara K, Watanabe M, Nakazono S, Wada N, Kakizaki H, Li J, Gong FJ, Sun PN, Shen L, Li Q, Li N, Qiu M, Liu J, Yi C, Luo D, Li Z, Gou H, Yang Y, Cao D, Shen Y, Wang X, Xu F, Bi F, Li Q, Zhang X, Li N, Wei W, Luo HY, Wang ZQ, Wang FH, Qiu MZ, Teng KY, Ruan DY, He YJ, Li YH, Xu RH, Matsusaka S, Mizunuma N, Suenaga M, Shinozaki E, Mishima Y, Terui Y, Hatake K, Nara E, Kodaira M, Mishima Y, Yokoyama M, Saotome T, Terui Y, Takahashi S, Hatake K, Nishimura N, Nakano K, Kodaira M, Ueda K, Yamada S, Mishima Y, Yokoyama M, Saotome T, Takahashi S, Terui Y, Hatake K, Nozawa M, Mochida Y, Nishigaki K, Nagae S, Uemura H, Oh SY, Jeong CY, Hong SC, Lee WS, Kim HG, Lee GW, Hwang IG, Jang JS, Kwon HC, Kang JH, Ozaka M, Ogura M, Matsusaka S, Shinozaki E, Suenaga M, Chin K, Mizunuma N, Hatake K, Pua PF, Ganzon D, Chan V, Sailaja K, Vishnupriya S, Raghunadharao D, Markandeya G, Reddy PRK, Reddanna P, Praveen D, Sakamoto K, Kanda T, Matsuki A, Takano T, Hanyu T, Yajima K, Kosugi S, Hirota S, Hatakeyama K, Shigekawa T, Ijichi N, Takayama S, Tsuda H, Ikeda K, Horie K, Osaki A, Saeki T, Inoue S, Subhashini J, Rajesh B, Rajesh I, Ravindran P, Takagi K, Chin K, Oba M, Kuboki Y, Ichimura T, Oto M, Kawazoe Y, Watanabe T, Ozaka M, Ogura M, Suenaga M, Shinozaki E, Matsusaka S, Mizunuma N, Hatake K, Ueda K, Saotome T, Yamada S, Nishimura N, Nara E, Nakano K, Kodaira M, Katsube A, Mishima Y, Terui Y, Yokoyama M, Takahashi S, Hatake K, Yao X, Yang Q, Li C, Diao L, Chen X, Yu Z, Zuo W, Wang Y, He Y, Zhang X, Cai S, Wang Z, Xu J, Zhan W, Zhang YF, Misumi M, Takeuchi H, Nakamiya N, Shigekawa T, Matsuura K, Fujiuchi N, Osaki A, Saeki T. CLINICAL OUTCOMES. Jpn J Clin Oncol 2011. [DOI: 10.1093/jjco/hyq254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Matsusaka S, Chin K, Mizunuma N, Ogura M, Suenaga M, Ozaka M, Takagi K, Oba M, Mishima Y, Hatake K. Use of circulating tumor cells to predict response to chemotherapy in patients with advanced gastric cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.43] [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
43 Background: The purpose of this study was to quantify circulating tumor cells (CTCs) in advanced gastric cancer (AGC) patients, and to demonstrate the role of CTCs in cancer therapy. The purpose of this study was to identify CTC threshold proposal for determining response to chemotherapy in AGC. Methods: From November 2007 to June 2009, fifty-two patients with AGC were enrolled into a prospective study. All patients were enrolled using institutional review board-approved protocols at the Cancer Institute Hospital and provided informed consent. The study population consisted of patients of aged 18 years or older with histologically proven AGC. Other inclusion criteria were Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 2; adequate organ function. The subjects were five patients treated with S-1 (40 mg/m2, twice daily, days 1-28, repeated every 6 weeks), twenty-six patients treated with S-1 plus CDDP (S-1 40 mg/m2, twice daily, days 1-21, CDDP 60 mg/m2, day 8, repeated every 5 weeks), and twenty-one patients treated with paclitaxel (80 mg/m2, weekly). CTCs of whole blood at baseline, two weeks and four weeks after initiation of chemotherapy, were isolated and enumerated using immunomagnetics. Results: Patients with ≥4 CTCs at two-week points and four-week points had a shorter median PFS (1.4, 1.4 months, respectively), than those with the median PFS of <4 CTCs (4.9, 5.0 months, respectively) (p<0.001, p<0.001, respectively). Patients with ≥4 CTCs at two-week points and four-week points had shorter median OS (3.5, 4.0 months, respectively) than those with the median PFS of <4 CTCs (11.7, 11.4 months, respectively) (p<0.001, p=0.001, respectively). In univariate analysis, PS, treatment regimen, Line of chemotherapy, and CTC levels at 2 weeks and 4 weeks predicted PFS and OS. In order to evaluate the independent predictive effect of chemotherapy, multivariate Cox regression analysis was carried out. CTC levels at 2 weeks and 4 weeks were the strongest predictors. Conclusions: A threshold of lower than 4 CTC/7.5 ml at 2 weeks and 4 weeks was a significant predictor of the outcome for AGC patients treated with S-1 based regimen or paclitaxel regimen. No significant financial relationships to disclose.
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Affiliation(s)
- S. Matsusaka
- Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan; Cancer Institute Hospital, Tokyo, Japan; Cancer Chemotherapy Center, Clinical Chemotherapy, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - K. Chin
- Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan; Cancer Institute Hospital, Tokyo, Japan; Cancer Chemotherapy Center, Clinical Chemotherapy, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - N. Mizunuma
- Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan; Cancer Institute Hospital, Tokyo, Japan; Cancer Chemotherapy Center, Clinical Chemotherapy, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - M. Ogura
- Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan; Cancer Institute Hospital, Tokyo, Japan; Cancer Chemotherapy Center, Clinical Chemotherapy, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - M. Suenaga
- Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan; Cancer Institute Hospital, Tokyo, Japan; Cancer Chemotherapy Center, Clinical Chemotherapy, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - M. Ozaka
- Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan; Cancer Institute Hospital, Tokyo, Japan; Cancer Chemotherapy Center, Clinical Chemotherapy, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - K. Takagi
- Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan; Cancer Institute Hospital, Tokyo, Japan; Cancer Chemotherapy Center, Clinical Chemotherapy, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - M. Oba
- Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan; Cancer Institute Hospital, Tokyo, Japan; Cancer Chemotherapy Center, Clinical Chemotherapy, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Y. Mishima
- Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan; Cancer Institute Hospital, Tokyo, Japan; Cancer Chemotherapy Center, Clinical Chemotherapy, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - K. Hatake
- Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan; Cancer Institute Hospital, Tokyo, Japan; Cancer Chemotherapy Center, Clinical Chemotherapy, Japanese Foundation for Cancer Research, Tokyo, Japan
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Suenaga M, Mizunuma N, Matsusaka S, Shinozaki E, Ogura M, Kuboki Y, Watanabe T, Ozaka M, Chin K, Hatake K. Effect of the addition of bevacizumab to first-line FOLFOX on efficacy, including response rate, progression-free survival, and overall survival, in patients with metastatic colorectal cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.588] [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
588 Background: Bevacizumab (BV) is a recombinant, humanized monoclonal antibody against vascular endothelial growth factor. Used in combination with chemotherapy, BV has been shown to improve survival in both first- and second-line treatment for metastatic colorectal cancer (mCRC). However, it was reported that addition of BV to FOLFOX conferred only little survival benefit (Saltz et al. JCO2008). The aim of this study was to assess the efficacy of addition of BV to FOLFOX in first-line treatment for patients with mCRC. Methods: Bevacizumab was approved for mCRC in July 2007 in Japan. This study was conducted at a single institution and comprised 217 consecutive patients receiving first-line treatment for mCRC between 2005 and 2009. The primary objective was to compare survival benefit in patients treated with FOLFOX4 (FF) between 2005 and 2007 with that in patients receiving FOLFOX4+BV 5 mg/kg (FF+BV) between 2007 and 2009. Results: Total number of patients in the FF and FF+BV groups was 132 and 85, respectively. Characteristics of patients were as follows (FF vs. FF+B): median age, 62 yrs (range 28-76 yrs) vs. 60 yrs (range16-74 yrs); ECOG PS0, 98.8% vs. 81.8%; and median follow-up time, 20.8 months vs. 24.4 months. Median progression-free survival (PFS) in the FF and FF+BV groups was 10 months (95% CI, 8.7-11.3) and 17 months (95% CI, 10.2-14.1), while median overall survival (OS) was 21 months (95% CI, 17.9-24.1) and not reached, respectively. Response rate was 46% (95% CI, 37- 54) in FF, and 62% (95% CI, 51-73) in FF+BV. Addition of BV to FOLFOX4 significantly improved PFS (p=0.002) and OS (p<0.001). Conclusions: The additive effect of BV for first-line FOLFOX was reconfirmed. These data indicate potential survival benefits from the addition of BV to FOLFOX in first-line treatment of mCRC. In addition, PFS may be a sensitive indicator of outcome prior to post-treatment. No significant financial relationships to disclose.
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Affiliation(s)
- M. Suenaga
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - N. Mizunuma
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - S. Matsusaka
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - E. Shinozaki
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - M. Ogura
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Y. Kuboki
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - T. Watanabe
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - M. Ozaka
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - K. Chin
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - K. Hatake
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
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Suenaga M, Matsusaka S, Watanabe T, Takagi K, Kuboki Y, Ozaka M, Shinozaki E, Chin K, Mizunuma N, Hatake K. Coagulo-fibrinolytic activity as a predictor of efficacy in bevacizumab-combined chemotherapy in metastatic colorectal cancer patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.533] [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
533 Background: The combination of bevacizumab (BV) and chemotherapy in the first-line and second-line treatment of metastatic colorectal cancer (mCRC) has been shown to improve survival. Bevacizumab is a recombinant, humanized monoclonal antibody against vascular endothelial growth factor. However, the relationship between coagulo-fibrinolytic activity factors and treatment efficacy remains to be clarified. The aim of this study was to determine potential coagulo-fibrinolytic activity markers impacting survival. Methods: Among 119 consecutive patients included in the study, 85 received first-line FOLFOX4 plus BV 5 mg/kg and 34 received second-line FOLFIRI plus BV 5 mg/kg until progression of disease or unmanageable toxicity occurred. Coagulo-fibrinolytic activity factors, including D-dimer, thrombin antithrombin complex (TAT) and carbohydrate antigen 125 (CA125) encoded by the MUC16 mucin gene were evaluated as candidate predictors of outcome. Results: In first-line treatment, overall response, median progression-free survival (PFS) and two-year survival rate were 61.9%, 518 days and 67.3%, respectively. In second-line treatment, overall response, median PFS and median overall survival (OS) were 23.5%, 248 days and 651 days, respectively. The outcomes of the univariate analysis were as follows: normal D-dimer and CA125 levels at baseline were associated with better PFS and OS in first-line treatment; normal TAT and CA125 levels at baseline were associated with better PFS and OS in second-line treatment. According to the results of the multivariate analysis, normal D-dimer level was associated with longer PFS in first-line treatment, and only CA125 level at baseline was an independent predictor of both PFS and OS in second-line treatment. Conclusions: The results suggest that coagulo-fibrinolytic activity factors such as TAT, D-dimer or CA125 may be useful predictors of outcome in mCRC patients receiving BV in combination with chemotherapy. No significant financial relationships to disclose.
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Affiliation(s)
- M. Suenaga
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - S. Matsusaka
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - T. Watanabe
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - K. Takagi
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Y. Kuboki
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - M. Ozaka
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - E. Shinozaki
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - K. Chin
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - N. Mizunuma
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - K. Hatake
- Cancer Institute Hospital, Tokyo, Japan; Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
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Ozaka M, Shinozaki E, Suenaga M, Matuzaka S, Chin K, Mizunuma N, Hatake K. A retrospective analysis of patients with complete response (CR) after FOLFOX4: Single institute experience. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15100] [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: 11/20/2022] Open
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