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Iwamoto T, Kajiwara Y, Kawada K, Takabatake D, Miyoshi Y, Kubo S, Suzuki Y, Yamamoto M, Ogasawara Y, Hatono M, Yoshitomi S, Hara K, Sasahara A, Ohsumi S, Ikeda M, Doihara H, Mizota Y, Yamamoto S, Taira N. Long-Term Physical Activity and Body Composition After Exercise and Educational Programs for Breast Cancer: A Randomized Controlled Trial From the Setouchi Breast Project-10. Clin Breast Cancer 2024; 24:27-35.e8. [PMID: 37852895 DOI: 10.1016/j.clbc.2023.09.008] [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: 04/20/2023] [Revised: 07/17/2023] [Accepted: 09/11/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND It is unclear what interventions can sustain long-term higher physical activity (PA) to improve breast cancer outcomes. Thus, this study aimed to evaluate the long-term effects of interventions on PA after breast cancer treatment. METHODS This was a prospective randomized controlled trial for patients with stage 0 to III breast cancer evaluating the efficacy of exercise and educational programs on long-term PA compared with usual care. The primary endpoint was proportion of patients with recreational PA (RPA) ≥5 metabolic equivalents (METs)/week at 1 year after registration. RESULTS From March 16, 2016, to March 15, 2020, breast cancer patients were registered in the control (n = 120), education (n = 121), or exercise (n = 115) group. There were no significant differences in proportion of RPA ≥5 METs/week at 1 year between the exercise and control groups (54% and 53%, P = .492) and between the education and control groups (62% and 53%, P = .126). Significant difference in reductions from baseline at 1 year were noted on body weight (P = .0083), BMI (P = .0034), and body fat percentage (P = .0027) between education and control groups. Similarly, the exercise group showed significant difference in reduction in body fat percentage (P = .0038) compared to control group. CONCLUSION Although there were no significant effects on RPA 1 year after exercise and educational programs for breast cancer survivors, both interventions reduced body composition. Future studies on PA should investigate appropriate interventions to improve overall survival.
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Affiliation(s)
- Takayuki Iwamoto
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan; Breast and Thyroid Surgery, Kawasaki Medical School Hospital, Kurashiki, Japan.
| | - Yukiko Kajiwara
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan; Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Hospital, Okayama, Japan
| | - Kengo Kawada
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Daisuke Takabatake
- Breast and Thyroid Surgery, Kochi Health Science Center, Kochi, Japan; Breast Oncology, NHO Shikoku Cancer Center, Matsuyama, Japan
| | | | - Shinichiro Kubo
- Department of Breast and Thyroid Surgery, Fukuyama Citizens Hospital, Fukuyama, Japan
| | - Yoko Suzuki
- Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Hospital, Okayama, Japan
| | - Mari Yamamoto
- Department of Breast and Thyroid Surgery, Fukuyama Citizens Hospital, Fukuyama, Japan
| | - Yutaka Ogasawara
- Department of Breast Endocrine Surgery, Kagawa Prefectural Center Hospital, Takamatsu, Japan
| | - Minami Hatono
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Seiji Yoshitomi
- Department of Breast and Endocrine Surgery, Red Cross Okayama Hospital, Okayama, Japan
| | - Kyoko Hara
- Department of Breast and Endocrine Surgery, Red Cross Okayama Hospital, Okayama, Japan
| | - Asako Sasahara
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Shozo Ohsumi
- Breast Oncology, NHO Shikoku Cancer Center, Matsuyama, Japan
| | - Masahiko Ikeda
- Department of Breast and Thyroid Surgery, Fukuyama Citizens Hospital, Fukuyama, Japan
| | - Hiroyoshi Doihara
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan; Department of Breast Surgery, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Yuri Mizota
- Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | | | - Naruto Taira
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan; Breast and Thyroid Surgery, Kawasaki Medical School Hospital, Kurashiki, Japan
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Nakamoto S, Shien T, Itoh M, Yamamoto Y, Ohsumi S, Yoshitomi S, Hikino H, Miyoshi K, Notsu A, Taira N, Doihara H, Ikeda M. Systemic immunity markers are associated with clinical outcomes of atezolizumab treatment in patients with triple-negative advanced breast cancer: a retrospective multicenter observational study. Clin Exp Med 2023; 23:5129-5138. [PMID: 37904008 DOI: 10.1007/s10238-023-01230-x] [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: 09/21/2023] [Accepted: 10/19/2023] [Indexed: 11/01/2023]
Abstract
Immune checkpoint inhibitors (ICI) are reportedly efficacious against triple-negative breast cancer (TNBC) and are now recommended as first-line therapy. Systemic immunity markers, the absolute lymphocyte count (ALC) and the neutrophil-to-lymphocyte ratio (NLR), have been identified as predict ICI efficacy in patients with various cancers. We retrospectively enrolled 36 TNBC patients who received atezolizumab treatment between September 2019 and May 2021 at eight Japanese medical institutions. We evaluated systemic immunity markers, including dynamic changes in these markers, as predictors of survival benefit derived from atezolizumab treatment. Median time-to-treatment failure (TTF) and overall survival (OS) were 116 days and "not reached", respectively. Patients with low NLR at baseline and decreased NLR at the start of the second cycle (SO2nd) had significantly longer OS than those with high NLR at baseline and increased NLR (SO2nd) (log-rank P < 0.001 and log-rank P = 0.049, respectively). Multivariate analyses identified high ALC at baseline and decreased NLR (SO2nd) as independent predictive markers for longer TTF (P = 0.043 and P = 0.002, respectively), and low NLR at baseline and decreased NLR (SO2nd) as independent predictive markers for longer OS (P < 0.001 and P = 0.013, respectively). The safety profile was consistent with those of previous trials. This retrospective multicenter observational study showed the clinical efficacy and safety of atezolizumab treatment. Furthermore, systemic immunity markers, including their dynamic changes, were found to be associated with clinical outcomes of atezolizumab treatment in patients with advanced or metastatic TNBC.
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Affiliation(s)
- Shogo Nakamoto
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Mitsuya Itoh
- Department of Breast Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Yutaka Yamamoto
- Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Shozo Ohsumi
- Department of Breast Oncology, NHO Shikoku Cancer Center, Matsuyama, Japan
| | - Seiji Yoshitomi
- Department of Breast and Endocrine Surgery, Red Cross Okayama Hospital, Okayama, Japan
| | - Hajime Hikino
- Department of Breast Surgery, Matsue Red Cross Hospital, Matsue, Japan
| | - Kazuya Miyoshi
- Department of Breast and Endocrine Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan
| | - Akifumi Notsu
- Clinical Research Center, Shizuoka Cancer Center, Nagaizumi-cho, Japan
| | - Naruto Taira
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
- Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Hiroyoshi Doihara
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
- Department of Surgery, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Masahiko Ikeda
- Department of Breast and Thyroid Surgery, Fukuyama Citizens Hospital, Fukuyama, Japan
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Ohsumi S. Reply to "Is venous thromboembolism a time-dependent event in breast cancer patients taking tamoxifen?". Breast Cancer 2023; 30:1106. [PMID: 37603254 DOI: 10.1007/s12282-023-01495-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/12/2023] [Indexed: 08/22/2023]
Affiliation(s)
- Shozo Ohsumi
- Department of Surgery, Matsuyama Shimin Hospital, 2-6-5 Otemachi, Matsuyama, Ehime, 790-0067, Japan.
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Takayama T, Muguruma N, Igarashi M, Ohsumi S, Oka S, Kakuta F, Kubo Y, Kumagai H, Sasaki M, Sugai T, Sugano K, Takeda Y, Doyama H, Banno K, Fukahori S, Furukawa Y, Horimatsu T, Ishikawa H, Iwama T, Okazaki Y, Saito Y, Matsuura N, Mutoh M, Tomita N, Akiyama T, Yamamoto T, Ishida H, Nakayama Y. Clinical Guidelines for Diagnosis and Management of Cowden Syndrome/PTEN Hamartoma Tumor Syndrome in Children and Adults-Secondary Publication. J Anus Rectum Colon 2023; 7:284-300. [PMID: 37900693 PMCID: PMC10600266 DOI: 10.23922/jarc.2023-028] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 10/31/2023] Open
Abstract
Cowden syndrome (CS)/PTEN hamartoma tumor syndrome (PHTS) is a rare autosomal dominantly inherited condition caused by germline pathogenesis. It is associated with multiple hamartomatous lesions occurring in various organs and tissues, including the gastrointestinal tract, skin, mucous membranes, breast, thyroid, endometrium, and brain. Macrocephaly or multiple characteristic mucocutaneous lesions commonly develop in individuals in their 20s. This syndrome is occasionally diagnosed in childhood due to the occurrence of multiple gastrointestinal polyps, autism spectrum disorders, and intellectual disability. CS/PHTS can be diagnosed taking the opportunity of multigene panel testing in patients with cancer. Appropriate surveillance for early diagnosis of associated cancers is required because patients have a high risk of cancers including breast, thyroid, colorectal, endometrial, and renal cancers. Under these circumstances, there is growing concern regarding the management of CS/PHTS in Japan, but there are no available practice guidelines. To address this situation, the guideline committee, which included specialists from multiple academic societies, was organized by the Research Group on Rare and Intractable Diseases granted by the Ministry of Health, Labour, and Welfare, Japan. The present clinical guidelines explain the principles in the diagnosis and management of CS/PHTS, together with four clinical questions and the corresponding recommendations, incorporating the concept of the Grading of Recommendations Assessment, Development, and Evaluation system. Herein, we present an English version of the guideline, some of which have been updated, to promote seamless implementation of accurate diagnosis and appropriate management of pediatric, adolescent, and adult patients with CS/PHTS.
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Affiliation(s)
- Tetsuji Takayama
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Naoki Muguruma
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masahiro Igarashi
- Department of Lower GI Medicine, Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - Shozo Ohsumi
- Department of Breast Oncology, NHO Shikoku Cancer Center, Matsuyama, Japan
| | - Shiro Oka
- Department of Gastroenterology, Hiroshima University Hospital, Hiroshima, Japan
| | - Fumihiko Kakuta
- Division of General Pediatrics and Gastroenterology, Miyagi Children's Hospital, Sendai, Japan
| | - Yoshiaki Kubo
- Department of Dermatology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hideki Kumagai
- Department of Pediatrics, Jichi Medical University, Shimotsuke, Japan
| | - Mika Sasaki
- Department of Pediatrics, National Hospital Organization Morioka Medical Center, Morioka, Japan
| | - Tamotsu Sugai
- Department of Molecular Diagnostic Pathology, Iwate Medical University, Morioka, Japan
| | - Kokichi Sugano
- Oncogene Res Unit, Cancer Prevention Unit Tochigi Cancer Center Research Institute, Cancer Prevention, Genetic Counseling Clinic, Genome Center, Tochigi Cancer Center, Utsunomiya, Japan
- Department of Genetic Medicine, Sasaki Foundation, Kyoundo Hospital, Tokyo, Japan
| | - Yuko Takeda
- Faculty of Nursing and Medical Care, Graduate School of Health Management, Keio University, Tokyo, Japan
| | - Hisashi Doyama
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Kouji Banno
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoichi Furukawa
- Division of Clinical Genome Research, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Takahiro Horimatsu
- Department of Real World Data Research and Development, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideki Ishikawa
- Department of Molecular-Targeting Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Ishikawa Gastroenterology Clinic, Osaka, Japan
| | - Takeo Iwama
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Yasushi Okazaki
- Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | | | - Michihiro Mutoh
- Department of Molecular-Targeting Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naohiro Tomita
- Cancer Treatment Center, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Takashi Akiyama
- Department of Pediatric Surgery, Chuden Hospital, Hiroshima, Japan
| | - Toshiki Yamamoto
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Hideyuki Ishida
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Yoshiko Nakayama
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
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Ohsumi S, Watanabe K, Kondo N, Kosaka Y, Ishikawa T, Kitahara M, Kubo S, Oba MS, Kimura T, Takita A, Mukai H. Venous thromboembolism in Japanese patients with breast cancer: subgroup analysis of the Cancer-VTE Registry. Breast Cancer 2023; 30:607-616. [PMID: 37069366 PMCID: PMC10284999 DOI: 10.1007/s12282-023-01452-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/07/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND This subgroup analysis of the Cancer-VTE Registry, a nationwide, large-scale, multicenter observational study with a 1-year follow-up, assessed real-world data on venous thromboembolism (VTE) among Japanese patients with breast cancer. METHODS Patients with stage II-IV pretreatment breast cancer screened for VTE at enrollment were included. During the 1-year follow-up period, incidences of VTE, bleeding, and all-cause death, and background factors associated with VTE risk were examined. RESULTS Of 9,630 patients in the Cancer-VTE Registry analysis set, 993 (10.3%) had breast cancer (973 [98.0%] did not have and 20 [2.0%] had VTE at baseline). The mean age was 58.4 years, 73.4% of patients had stage II cancer, and 94.8% had an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0. Risk factors for VTE at baseline by univariable analysis were age ≥ 65 years, ECOG PS of 2, VTE history, and D-dimer > 1.2 μg/mL. During follow-up, the incidence of symptomatic VTE was 0.4%; incidental VTE requiring treatment, 0.1%; composite VTE (symptomatic VTE and incidental VTE requiring treatment), 0.5%; bleeding, 0.2%; cerebral infarction/transient ischemic attack/systemic embolic event, 0.2%; and all-cause death, 2.1%. One patient with symptomatic VTE developed pulmonary embolism (PE) and died. Incidences of VTE and all-cause death were higher in patients with VTE vs without VTE at baseline. CONCLUSIONS In Japanese patients with breast cancer, VTE screening before initiating cancer treatment revealed a 2.0% prevalence of VTE. During follow-up, one patient had a fatal outcome due to PE, but the incidences of VTE were low. CLINICAL TRIAL REGISTRATION UMIN000024942; UMIN Clinical Trials Registry: https://www.umin.ac.jp/ctr/ .
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Affiliation(s)
- Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, Ehime, 791-0280, Japan.
| | - Kenichi Watanabe
- Department of Breast Surgery, National Hospital Organization Hokkaido Cancer Center, Sapporo, Hokkaido, Japan
| | - Naoto Kondo
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Yoshimasa Kosaka
- Department of Breast and Endocrine Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
- Department of Breast Surgery, Japanese Red Cross Sagamihara Hospital, Sagamihara, Kanagawa, Japan
| | - Takashi Ishikawa
- Department of Breast Oncology and Surgery, Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan
| | - Miyuki Kitahara
- Department of Breast Surgery, Ibaraki Prefectural Central Hospital, Ibaraki Cancer Center, Kasama, Ibaraki, Japan
| | - Shinichiro Kubo
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Fukuyama, Hiroshima, Japan
| | - Mari S Oba
- Department of Medical Statistics, Toho University, Ota-ku, Tokyo, Japan
- Department of Clinical Data Science, Clinical Research and Education Promotion Division, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Tetsuya Kimura
- Primary Medical Science Department, Daiichi Sankyo Co., Ltd., Chuo-ku, Tokyo, Japan
| | - Atsushi Takita
- Data Intelligence Department, Daiichi Sankyo Co., Ltd., Shinagawa-ku, Tokyo, Japan
| | - Hirofumi Mukai
- Division of Medical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
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Makita K, Kanzaki H, Hamamoto Y, Nagasaki K, Kataoka M, Kido T, Ohsumi S. Prognostic assessment of patients who receive radiotherapy for bone metastases from breast cancer. Oncol Lett 2023; 25:188. [PMID: 37065784 PMCID: PMC10091177 DOI: 10.3892/ol.2023.13775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
For prognostic assessment in women who receive radiotherapy (RT) for bone metastases (BMs) from breast cancer (BC), prognostic factors specific for BMs from BC were investigated in the present study. The prognostic assessment was performed by retrospectively reviewing 143 women who received first-time RT for BMs from BC between January 2007 and June 2018. The median follow-up time and median overall survival (OS) time from the first-time RT for BMs were 22 and 18 months, respectively. In the multivariate analysis, nuclear grade 3 (NG 3) [hazard ratio, 2.18; 95% confidence interval (CI), 1.34-3.53], brain metastases (hazard ratio, 1.96; 95% CI, 1.01-3.81), liver metastases (hazard ratio, 1.75; 95% CI, 1.17-2.63), performance status (PS) (hazard ratio, 1.63; 95% CI, 1.10-2.41) and previous systemic therapy (hazard ratio, 1.58; 95% CI, 1.03-2.42) were significant factors for OS, whereas age, hormone-receptor/human epidermal growth factor receptor 2 status, number of BMs and synchronous lung metastases were not significant factors. When points according to risk levels [unfavorable points (UFPs)] were assigned to each risk factor (1.5 points for NG 3 and brain metastases; and 1 point for PS ≥2, previous systemic therapy and liver metastases), the median OS times of patients with a total number of UFPs ≤1 (n=45), 1.5-3 (n=55) and ≥3.5 (n=43) were 36, 17 and 6 months, respectively. Overall, in patients who received first-time RT for BMs from BC, NG 3, brain/liver metastases, poor PS and previous systemic therapy were unfavorable prognostic factors. Comprehensive prognostic assessment using these factors seemed to be useful for the prediction of prognoses in patients with BMs from BC.
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Akezaki Y, Nakata E, Kikuuchi M, Tominaga R, Kurokawa H, Okamoto M, Ozaki T, Aogi K, Ohsumi S, Sugihara S. Characteristics of Postoperative Patients with Breast Cancer Aged 65 Years and Older. Curr Oncol 2023; 30:673-680. [PMID: 36661701 PMCID: PMC9858311 DOI: 10.3390/curroncol30010052] [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: 11/04/2022] [Revised: 12/22/2022] [Accepted: 01/03/2023] [Indexed: 01/07/2023] Open
Abstract
Objective: This study aimed to compare postoperative patients with breast cancer aged ≥65 years with those aged <65 years and clarify the characteristics of postoperative patients with breast cancer aged ≥65. Methods: In total, 376 patients in whom we were able to evaluate survey items one month after surgery were included in the study. Comorbidity, including diabetes mellitus and hypertension, shoulder range of motion (ROM), upper-limb function, and psychological problems, was evaluated. Results: Hypertension and diabetes mellitus were significantly higher in patients aged ≥65 years (the elderly group) than in those aged <65 years (the non-elderly group) (p < 0.05). Preoperative shoulder flexion ROM was significantly restricted in the elderly group compared with the non-elderly group (p < 0.05). Preoperative shoulder abduction ROM was significantly restricted in the elderly group compared with the non-elderly group (p < 0.05). At one month after surgery, upper-limb function was more impaired in the non-elderly group than in the elderly group (p < 0.05). In both groups, both ROM and upper-limb function were significantly impaired one month after surgery compared with before surgery (p < 0.05). Conclusions: Postoperative patients with breast cancer aged ≥65 years should be careful about risk management and intervention during rehabilitation. Preoperative evaluation of shoulder ROM should be performed because patients aged ≥65 years have limited ROM before surgery.
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Affiliation(s)
- Yoshiteru Akezaki
- Division of Physical Therapy, Kochi Professional University of Rehabilitation, Kochi 781-1102, Japan
| | - Eiji Nakata
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama 700-8558, Japan
| | - Masato Kikuuchi
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan
| | - Ritsuko Tominaga
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan
| | - Hideaki Kurokawa
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan
| | - Masaki Okamoto
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama 700-8558, Japan
| | - Kenjiro Aogi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama 791-0280, Japan
| | - Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama 791-0280, Japan
| | - Shinsuke Sugihara
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan
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Ohsumi S, Nishimura R, Masuda N, Akashi-Tanaka S, Suemasu K, Yamauchi H, Tokunaga E, Ikeda T, Nishi T, Hayashi H, Iino Y, Takatsuka Y, Ohashi Y, Inaji H. A prospective analysis of two studies that used the 5-mm interval slices and 5-mm margin-free method for ipsilateral breast tumor recurrence after breast-conserving surgery without radiotherapy. Breast Cancer 2023; 30:131-138. [PMID: 36175750 DOI: 10.1007/s12282-022-01406-5] [Citation(s) in RCA: 1] [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: 05/09/2022] [Accepted: 09/18/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Breast-conserving surgery with radiotherapy is one of standard treatments for early breast cancer. However, it is regarded as an option to treat elderly patients with small hormone receptor-positive breast cancer with breast-conserving surgery and hormone therapy without radiotherapy. We conducted two sequential prospective studies to examine the feasibility of breast-conserving surgery without radiotherapy since 2002 and present the results. PATIENTS AND METHODS Primary female breast cancer patients who fulfilled the strict eligibility criteria were prospectively enrolled in two sequential studies named WORTH 1 and 2. The surgical materials were sliced in 5-mm intervals and all slices were examined microscopically. Postoperative radiotherapy was not allowed, but tamoxifen or anastrozole was administered for 5 years. Ipsilateral breast tumor recurrence (IBTR)-free survival was the primary outcome. RESULTS The data of the two studies were combined (N = 321). The median follow-up period for IBTR was 94 months (4-192 months). Only three patients were treated with adjuvant chemotherapy. The 5- and 10-year IBTR-free rates were 97.0% and 90.5%, respectively. The age at operation and PR status affected IBTR rates independently. When we calculated IBTR-free rates of patients who were 65 years of age or older at the time of surgery and had PR-positive tumors, the 5- and 10-year IBTR rates were both 98.4%. CONCLUSIONS Our "5-mm-thick slice and 5-mm free-margin" method may be effective to select patients who can be treated by breast-conserving surgery and hormone therapy without radiotherapy.
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Affiliation(s)
- Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, Ehime, 791-0280, Japan.
| | - Reiki Nishimura
- Department of Breast Oncology, Kumamoto Shinto General Hospital, Kumamoto, Kumamoto, Japan
| | - Norikazu Masuda
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Sadako Akashi-Tanaka
- Department of Breast Surgical Oncology, Show University School of Medicine, Tokyo, Japan
| | | | - Hideko Yamauchi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Eriko Tokunaga
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Fukuoka, Japan
| | - Tadashi Ikeda
- Department of Surgery, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | | | - Hiroto Hayashi
- Department of Surgery, National Hospital Organization Kanmon Medical Center, Shimonoseki, Yamaguchi, Japan
| | - Yuichi Iino
- Department of Breast and Thyroid Surgery, Kusunoki Hospital, Fujioka, Gunma, Japan
| | - Yuichi Takatsuka
- Department of Breast Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan
| | - Yasuo Ohashi
- Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Hideo Inaji
- Department of Breast Surgery, Kaizuka City Hospital, Kaizuka, Osaka, Japan
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9
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Okazawa-Sakai M, Yamamoto Y, Futagawa M, Okamura M, Miyawaki S, Nishina T, Takehara K, Kozuki T, Tomida S, Hyodo I, Ohsumi S, Hirasawa A. Handling of Germline Findings in Clinical Comprehensive Cancer Genomic Profiling. Acta Med Okayama 2022; 76:673-678. [PMID: 36549769 DOI: 10.18926/amo/64117] [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] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Patients found to have presumed germline pathogenic variants (PGPVs) during comprehensive genomic profiling (CGP) require genetic counseling (GC) referrals. We retrospectively investigated the outcomes of patients with PGPVs. Among 159 patients who underwent CGP, we recommended GC for the 16 patients with PGPVs (3 with [FG group] and 13 without [G Group] a family/personal history of hereditary cancer) as well as for the 8 patients with no PGPVs, but a history (F group); 2 (67%), 5 (38%), and 3 (38%) patients received GC in the FG, G, and F groups, respectively. Germline testing results were positive in 1 and 2 patients of the FG and G groups, respectively. Among the patients recommended for GC, 58% did not receive GC due to lack of interest, poor performance status, or death. CGP contributes to the identification of germline variants in patients without a history of hereditary cancer. However, the proportion of patients who undergo GC should be improved.
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Affiliation(s)
- Mika Okazawa-Sakai
- Department of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.,Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center.,Department of Cancer Genomic Medicine, National Hospital Organization Shikoku Cancer Center
| | - Yasuko Yamamoto
- Department of Cancer Genomic Medicine, National Hospital Organization Shikoku Cancer Center.,Department of Hereditary Tumors, National Hospital Organization Shikoku Cancer Center
| | - Mashu Futagawa
- Department of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Miki Okamura
- Department of Hereditary Tumors, National Hospital Organization Shikoku Cancer Center
| | - Satoko Miyawaki
- Department of Cancer Genomic Medicine, National Hospital Organization Shikoku Cancer Center.,Department of Hereditary Tumors, National Hospital Organization Shikoku Cancer Center
| | - Tomohiro Nishina
- Department of Cancer Genomic Medicine, National Hospital Organization Shikoku Cancer Center.,Department of Hereditary Tumors, National Hospital Organization Shikoku Cancer Center
| | - Kazuhiro Takehara
- Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center.,Department of Hereditary Tumors, National Hospital Organization Shikoku Cancer Center
| | - Toshiyuki Kozuki
- Department of Clinical Research Center, National Hospital Organization Shikoku Cancer Center
| | - Shuta Tomida
- Center for Comprehensive Genomic Medicine, Okayama University Hospital
| | - Ichinosuke Hyodo
- Department of Cancer Genomic Medicine, National Hospital Organization Shikoku Cancer Center
| | - Shozo Ohsumi
- Department of Hereditary Tumors, National Hospital Organization Shikoku Cancer Center
| | - Akira Hirasawa
- Department of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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10
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Mori T, Okamoto Y, Mu A, Ide Y, Yoshimura A, Senda N, Inagaki‐Kawata Y, Kawashima M, Kitao H, Tokunaga E, Miyoshi Y, Ohsumi S, Tsugawa K, Ohta T, Katagiri T, Ohtsuru S, Koike K, Ogawa S, Toi M, Iwata H, Nakamura S, Matsuo K, Takata M. Lack of impact of the
ALDH2
rs671 variant on breast cancer development in Japanese
BRCA1
/2‐mutation carriers. Cancer Med 2022; 12:6594-6602. [PMID: 36345163 PMCID: PMC10067083 DOI: 10.1002/cam4.5430] [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] [Received: 05/12/2022] [Revised: 09/19/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022] Open
Abstract
The aldehyde degrading function of the ALDH2 enzyme is impaired by Glu504Lys polymorphisms (rs671, termed A allele), which causes alcohol flushing in east Asians, and elevates the risk of esophageal cancer among habitual drinkers. Recent studies suggested that the ALDH2 variant may lead to higher levels of DNA damage caused by endogenously generated aldehydes. This can be a threat to genome stability and/or cell viability in a synthetic manner in DNA repair-defective settings such as Fanconi anemia (FA). FA is an inherited bone marrow failure syndrome caused by defects in any one of so far identified 22 FANC genes including hereditary breast and ovarian cancer (HBOC) genes BRCA1 and BRCA2. We have previously reported that the progression of FA phenotypes is accelerated with the ALDH2 rs671 genotype. Individuals with HBOC are heterozygously mutated in either BRCA1 or BRCA2, and the cancer-initiating cells in these patients usually undergo loss of the wild-type BRCA1/2 allele, leading to homologous recombination defects. Therefore, we hypothesized that the ALDH2 genotypes may impact breast cancer development in BRCA1/2 mutant carriers. We genotyped ALDH2 in 103 HBOC patients recruited from multiple cancer centers in Japan. However, we were not able to detect any significant differences in clinical stages, histopathological classification, or age at clinical diagnosis across the ALDH2 genotypes. Unlike the effects in hematopoietic cells of FA, our current data suggest that there is no impact of the loss of ALDH2 function in cancer initiation and development in breast epithelium of HBOC patients.
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Affiliation(s)
- Tomoharu Mori
- Laboratory of DNA Damage Signaling, Department of Late Effects Studies Radiation Biology Center Graduate School of Biostudies, Kyoto University Kyoto Japan
- Department of Primary Care and Emergency Medicine Graduate School of Medicine, Kyoto University Kyoto Japan
| | - Yusuke Okamoto
- Laboratory of DNA Damage Signaling, Department of Late Effects Studies Radiation Biology Center Graduate School of Biostudies, Kyoto University Kyoto Japan
| | - Anfeng Mu
- Laboratory of DNA Damage Signaling, Department of Late Effects Studies Radiation Biology Center Graduate School of Biostudies, Kyoto University Kyoto Japan
| | - Yoshimi Ide
- Division of Breast Surgical Oncology Showa University School of Medicine Tokyo Japan
- Department of Breast Surgery Kikuna Memorial Hospital Yokohama Japan
| | - Akiyo Yoshimura
- Department of Breast Oncology Aichi Cancer Center Hospital Nagoya Japan
| | - Noriko Senda
- Department of Breast Surgery Graduate School of Medicine Kyoto University Kyoto Japan
| | - Yukiko Inagaki‐Kawata
- Department of Breast Surgery Graduate School of Medicine Kyoto University Kyoto Japan
| | - Masahiro Kawashima
- Department of Breast Surgery Graduate School of Medicine Kyoto University Kyoto Japan
| | - Hiroyuki Kitao
- Department of Molecular Cancer Biology Graduate School of Pharmaceutical Sciences, Kyushu University Fukuoka Japan
| | - Eriko Tokunaga
- Department of Breast Oncology National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Yasuo Miyoshi
- Division of Breast and Endocrine Surgery Department of Surgery, Hyogo College of Medicine Hyogo Japan
| | - Shozo Ohsumi
- Department of Breast Oncology National Hospital Organization Shikoku Cancer Center Matsuyama Ehime Japan
| | - Koichiro Tsugawa
- Division of Breast and Endocrine Surgery, Department of Surgery St. Marianna University School of Medicine Kawasaki Kanagawa Japan
| | - Tomohiko Ohta
- Department of Translational Oncology St. Marianna University Graduate School of Medicine Kawasaki Kanagawa Japan
| | - Toyomasa Katagiri
- Division of Genome Medicine Institute of Advanced Medical Sciences Tokushima University Tokushima Japan
| | - Shigeru Ohtsuru
- Department of Primary Care and Emergency Medicine Graduate School of Medicine, Kyoto University Kyoto Japan
| | - Kaoru Koike
- Department of Primary Care and Emergency Medicine Graduate School of Medicine, Kyoto University Kyoto Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology Graduate School of Medicine Kyoto University Kyoto Japan
- Department of Medicine Center for Hematology and Regenerative Medicine Karolinska Institute Solna Sweden
- Institute for the Advanced Study of Human Biology (WPI‐ASHBi) Kyoto University Kyoto Japan
| | - Masakazu Toi
- Department of Breast Surgery Graduate School of Medicine Kyoto University Kyoto Japan
| | - Hiroji Iwata
- Department of Breast Oncology Aichi Cancer Center Hospital Nagoya Japan
| | - Seigo Nakamura
- Department of Breast Surgery Kikuna Memorial Hospital Yokohama Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention Aichi Cancer Center Research Institute Nagoya Aichi Japan
- Division of Cancer Epidemiology Nagoya University Graduate School of Medicine Nagoya Aichi Japan
| | - Minoru Takata
- Laboratory of DNA Damage Signaling, Department of Late Effects Studies Radiation Biology Center Graduate School of Biostudies, Kyoto University Kyoto Japan
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11
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Nakamoto S, Taira N, Kawada K, Takabatake D, Miyoshi Y, Kubo S, Suzuki Y, Yamamoto M, Ogasawara Y, Yoshitomi S, Hara K, Shien T, Iwamoto T, Ohsumi S, Ikeda M, Mizota Y, Yamamoto S, Doihara H. 176P The effectiveness of long-term physical activity after exercise and educational programs on breast cancer-related lymphoedema: Secondary analyses from a randomized controlled trial: The Setouchi Breast Project 10. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.211] [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: 11/16/2022] Open
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12
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Ohsumi S, Nakamura S, Miyata H, Watanabe C, Den H, Arai M. Risk-reducing mastectomy for women with hereditary breast and ovarian cancer (HBOC): analytical results of data from the Japanese Organization of HBOC. Jpn J Clin Oncol 2022; 52:1265-1269. [PMID: 35905458 DOI: 10.1093/jjco/hyac120] [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: 04/13/2021] [Accepted: 07/09/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Risk-reducing mastectomy is one option for women with hereditary breast and ovarian cancer to reduce the risk of breast cancer. PATIENTS AND METHODS We analyzed data of the Japanese Organization of Hereditary Breast and Ovarian Cancer on women who were diagnosed as hereditary breast and ovarian cancer by BRCA germline genetic testing between 2010 and 2019 to reveal the rate and likelihood of risk-reducing mastectomy. RESULTS There were 412 women with BRCA1, 271 with BRCA2 and 4 with both female pathogenic variants. Ninety (13.1%) received risk-reducing mastectomy. The rates of risk-reducing mastectomy were statistically significantly higher in women with BRCA1 pathogenic variants than BRCA2, in women who had breast cancer than those who did not, in women with a breast cancer family history than in those without, in mothers than in those without children, in women who were receiving surveillance with MRI than those who were not and in women who received risk-reducing salpingo-oophorectomy than in those who did not on univariate analyses. The ages when they received the genetic testing were statistically significantly younger in the women receiving risk-reducing mastectomy than those who did not receive it. The women with BRCA1 pathogenic variants, personal history of breast cancer, mothers, those receiving MRI surveillance and younger women were independently significantly more likely to receive risk-reducing mastectomy based on multivariate analysis. CONCLUSIONS The rate of risk-reducing mastectomy was not high in Japan; however, risk-reducing surgery was approved by the Japanese National Medical Insurance for hereditary breast and ovarian cancer patients with breast and/or ovarian cancer in 2020, so this rate will increase.
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Affiliation(s)
- Shozo Ohsumi
- Department of Breast Oncology, NHO Shikoku Cancer Center, Matsuyama, Japan
| | - Seigo Nakamura
- Division of Breast Surgical Oncology, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Hiroaki Miyata
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Chie Watanabe
- School of Nursing and Rehabilitation Sciences, Showa University, Tokyo, Japan
| | - Hiroki Den
- Department of Hygiene, Public Health, and Preventative Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Masami Arai
- Department of Clinical Genetics, Juntendo University, Graduate School of Medicine, Tokyo, Japan
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13
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Saji S, Ohsumi S, Ito M, Hayashi N, Kobayashi K, Masuda N, Niikura N, Yamashita T, Kiyama K, Hasegawa A, Nakagawa S, Hattori M. Subgroup analysis of Japanese patients in a phase III randomized, controlled study of neoadjuvant atezolizumab or placebo, combined with nab-paclitaxel and anthracycline-based chemotherapy in early triple-negative breast cancer (IMpassion031). Jpn J Clin Oncol 2022; 52:1124-1133. [PMID: 35750038 PMCID: PMC9538755 DOI: 10.1093/jjco/hyac098] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/27/2022] [Indexed: 11/29/2022] Open
Abstract
Background In the global phase III IMpassion031 study, neoadjuvant atezolizumab plus nab-paclitaxel/anthracycline-based chemotherapy improved pathological complete response in patients with early stage triple-negative breast cancer. Here, we report primary analysis results from a subgroup of Japanese patients. Methods Patients with histologically documented, previously untreated, stage cT2–cT4, cN0–cN3, cM0 triple-negative breast cancer were randomized 1:1 to receive intravenous atezolizumab 840 mg or placebo every 2 weeks in combination with chemotherapy consisting of nab-paclitaxel intravenous 125 mg/m2 once a week, followed by doxorubicin intravenous 60 mg/m2 and cyclophosphamide intravenous 600 mg/m2 every 2 weeks. Patients then underwent surgery. Pathological complete response (ypT0/is ypN0) in the intention-to-treat and PD-L1-positive (≥1% PD-L1-expressing tumor-infiltrating immune cells) populations were co-primary endpoints. Results This subanalysis (data cutoff: 3 April 2020) included 36 patients from Japan (intention-to-treat; atezolizumab arm, n = 17; placebo arm, n = 19). Pathological complete response occurred in 41% (n = 7; 95% confidence interval, 18–67) of patients in the atezolizumab arm and 37% (n = 7; 95% confidence interval, 16–62) in the placebo arm. In the PD-L1-positive population, pathological complete response occurred in 50% (n = 5; 95% confidence interval, 19–81) of patients in the atezolizumab arm and 45% (n = 5; 95% confidence interval, 17–77) in the placebo arm. Treatment-related grade 3–4 adverse events occurred in 71% and 68% of patients in the respective arms. Conclusion Atezolizumab added to neoadjuvant chemotherapy numerically improved pathological complete response versus placebo in this small exploratory analysis of Japanese patients with early stage triple-negative breast cancer, a trend directionally consistent with the global study results. No new safety signals were identified.
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Affiliation(s)
- Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Mitsuya Ito
- Department of Breast Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Naoki Hayashi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Kokoro Kobayashi
- Department of Medical Oncology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Norikazu Masuda
- Department of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Naoki Niikura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Toshinari Yamashita
- Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, Kanagawa, Japan
| | | | | | | | - Masaya Hattori
- Department of Breast Oncology, Aichi Cancer Center Hospital, Aichi, Japan
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14
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Tsuda H, Kurosumi M, Akiyama F, Ohno S, Saji S, Masuda N, Shimomura A, Sato N, Takao S, Ohsumi S, Tokuda Y, Inaji H, Watanabe T. Correction to: Validation of a nuclear grading system for resected stage I-IIIA, high-risk, node-negative invasive breast carcinoma in the N·SAS-BC 01 trial. Breast Cancer 2022; 29:730. [PMID: 35499664 PMCID: PMC9225968 DOI: 10.1007/s12282-022-01367-9] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - Futoshi Akiyama
- Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinji Ohno
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | - Norikazu Masuda
- Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | | | | | | | - Yutaka Tokuda
- Tokai University School of Medicine, Kanagawa, Japan
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15
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Tsuda H, Kurosumi M, Akiyama F, Ohno S, Saji S, Masuda N, Shimomura A, Sato N, Takao S, Ohsumi S, Tokuda Y, Inaji H, Watanabe T. Validation of a nuclear grading system for resected stage I-IIIA, high-risk, node-negative invasive breast carcinoma in the N·SAS-BC 01 trial. Breast Cancer 2022; 29:720-729. [PMID: 35435571 PMCID: PMC9225977 DOI: 10.1007/s12282-022-01350-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND This retrospective observational study validated nuclear grading criteria developed to identify a high-risk group with recurrence rate ≥20-30% and local pathology diagnosis used in a previous multi-institutional randomized N·SAS-BC 01 trial, where the efficacy of adjuvant chemotherapy regimens was evaluated in 733 high-risk node-negative invasive breast cancer patients. METHODS Of 545 patients with long-term follow-up data (median 12.1 years), pathology slides, and local pathology diagnosis, 530 eligible patients were subjected to central pathology review (CPR) for histological type and nuclear grade (NG). Concordance in NGs was compared with local diagnosis. The 10/15-year recurrence-free survival (RFS) and overall survival (OS) rates stratified by NG and histological type were calculated. RESULTS Local diagnoses were invasive ductal carcinoma (IDC)-NG2, IDC-NG3, invasive lobular carcinoma (ILC), and metaplastic carcinoma (MC) in 158/327/38/7 patients, respectively. The 10/15-year RFS rates were 87.2/82.6% for IDC-NG2 and 81.8/75.0% for IDC-NG3 (p = 0.061), and OS rates were 95.0/92.8% for IDC-NG2 and 90.8/85.7% for IDC-NG3 (p = 0.042). CPR graded 485 locally diagnosed IDCs as IDC-NG1/NG2/NG3/unknown in 98/116/267/4 patients, respectively. No significant difference was found among survival curves for the three NG groups. Although the agreement level between local and CPR diagnoses was low (κ = 0.311), both diagnoses identified a patient group with a 15-year recurrence rate ≥ 20%. The 10/15-year RFS rates were 79.4/63.5% for ILC and 68.6%/unknown for MC. CONCLUSIONS The N·SAS grading system identified a patient group with high-risk node-negative invasive breast cancer, suggesting that local diagnosis was performed efficiently in the N·SAS-BC 01 trial. TRIAL REGISTRATION NUMBER UMIN000022571. Date of registration: June 1, 2016.
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Affiliation(s)
| | | | - Futoshi Akiyama
- Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinji Ohno
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | - Norikazu Masuda
- National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | | | | | | | - Yutaka Tokuda
- Tokai University School of Medicine, Kanagawa, Japan
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16
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Takaoka M, Ohsumi S, Ikejiri H, Shidahara T, Miyoshi Y, Takahashi M, Takashima S, Aogi K. Pathological Complete Response Patients after Neoadjuvant Chemotherapy in Breast Cancer. Acta Med Okayama 2022; 76:105-111. [PMID: 35503437 DOI: 10.18926/amo/63403] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Cases of breast cancer metastasis after achieving a pathological complete response (pCR) with neoadjuvant chemotherapy (NAC) are sometimes encountered in clinical practice. We investigated the prognostic factors for pCR in patients with breast cancer after NAC. This retrospective cohort study included patients with localized breast cancer who underwent NAC followed by surgery between 2004 and 2020 and achieved a pCR. The associations between clinical factors and distant metastasis-free survival rate were statistically analyzed. We analyzed data for 127 patients. Twelve patients (9.4%) had distant metastases, and seven (5.5%) died. For estrogen receptor (ER)-positive patients, the distant metastasis-free survival rate was 94.6% for both 5 and 8 years. In contrast, ER-negative patients had a distant metastasis-free survival rate of 87.6% and 85.4% for 5 and 8 years (p=0.094), respectively. In cT0-2 patients, the distant metastasis-free survival rate was 92.4% for 5 years and 90.5% for 8 years, whereas in cT3-4 patients, the distant metastasis-free survival rate was 83.5% for 5 years and 83.5% for 8 years (p=0.301). This study suggested that patients with ER-negative, pre-NAC cT3 or T4 breast cancer who had achieved a pCR after NAC tended to have a worse prognosis.
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Affiliation(s)
- Megumi Takaoka
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center
| | - Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center
| | - Haruka Ikejiri
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center
| | - Tomohiro Shidahara
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center
| | - Yuichiro Miyoshi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center
| | - Mina Takahashi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center
| | - Seiki Takashima
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center
| | - Kenjiro Aogi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center
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17
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Takaoka M, Ohsumi S, Miyoshi Y, Takahashi M, Takashima S, Aogi K, Shimizu T, Teramoto N, Yamamoto Y, Okamura M. Four magnetic resonance imaging surveillance-detected breast cancer cases in cancer-free BRCA1/2 mutation carriers. Surg Case Rep 2021; 7:228. [PMID: 34674065 PMCID: PMC8531180 DOI: 10.1186/s40792-021-01313-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Hereditary breast and ovarian cancer (HBOC) syndrome is a susceptibility syndrome for cancers, such as breast and ovarian cancer, and BRCA1/2 are its causative genes. Annual breast-enhanced magnetic resonance imaging (MRI) is recommended for BRCA1/2 mutation carriers aged over 25 years as a secondary prevention of breast cancer. However, breast MRI surveillance is rarely performed in Japan, and only four cases of breast cancer diagnosis triggered by MRI surveillance have been reported. Case presentation At our hospital, MRI triggered the diagnosis of breast cancer in four cancer-free BRCA1/2 mutation carriers. In one of our four cases, although MRI showed only a 3-mm focus, we could diagnose breast cancer by shortening the surveillance interval considering the patient’s high-risk for developing breast cancer. Conclusions Image-guided biopsy, including MRI-guided biopsy, depending on the size of the lesion, and shorter surveillance intervals are useful when there are potentially malignant findings on breast MRI surveillance for cancer-free patients with HBOC.
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Affiliation(s)
- Megumi Takaoka
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umenomoto-machi, Matsuyama, 791-0280, Japan.
| | - Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umenomoto-machi, Matsuyama, 791-0280, Japan
| | - Yuichiro Miyoshi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umenomoto-machi, Matsuyama, 791-0280, Japan
| | - Mina Takahashi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umenomoto-machi, Matsuyama, 791-0280, Japan
| | - Seiki Takashima
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umenomoto-machi, Matsuyama, 791-0280, Japan
| | - Kenjiro Aogi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umenomoto-machi, Matsuyama, 791-0280, Japan
| | - Teruhiko Shimizu
- Department of Radiology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umenomoto-machi, Matsuyama, 791-0280, Japan
| | - Norihiro Teramoto
- Department of Pathology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umenomoto-machi, Matsuyama, 791-0280, Japan
| | - Yasuko Yamamoto
- Department of Familial Tumor, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umenomoto-machi, Matsuyama, 791-0280, Japan
| | - Miki Okamura
- Department of Familial Tumor, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umenomoto-machi, Matsuyama, 791-0280, Japan
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18
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Tsukamoto F, Arihiro K, Takahashi M, Ito KI, Ohsumi S, Takashima S, Oba T, Yoshida M, Kishi K, Yamagishi K, Kinoshita T. Multicenter retrospective study on the use of Curebest™ 95GC Breast for estrogen receptor-positive and node-negative early breast cancer. BMC Cancer 2021; 21:1077. [PMID: 34610807 PMCID: PMC8493674 DOI: 10.1186/s12885-021-08778-5] [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: 12/10/2020] [Accepted: 09/13/2021] [Indexed: 12/30/2022] Open
Abstract
Background The benefits of postoperative chemotherapy in patients with estrogen receptor (ER)-positive breast cancer remain unclear. The use of tumor grade, Ki-67, or ER expression failed to provide an accurate prognosis of the risk of relapse after surgery in patients. This study aimed to evaluate whether a multigene assay Curebest™ 95GC Breast (95GC) can identify the risk of recurrence and provide more insights into the requirements for chemotherapy in patients. Methods This single-arm retrospective multicenter joint study included patients with ER-positive, node-negative breast cancer who were treated at five facilities in Japan and had received endocrine therapy alone as adjuvant therapy. The primary lesion specimens obtained during surgery were analyzed using the 95GC breast cancer multigene assay. Based on the 95GC results, patients were classified into low-risk (95GC-L) and high-risk (95GC-H) groups. Results The 10-year relapse-free survival rates were 88.4 and 59.6% for the 95GC-L and 95GC-H groups, respectively. Histologic grade, Ki-67, and PAM50 exhibited a significant relationship with the 95GC results. The segregation into 95GC-L and 95GC-H groups within established clinical factors can identify subgroups of patients using histologic grade or PAM50 classification with good prognosis without receiving chemotherapy. Conclusions Based on the results of our retrospective study, 95GC could be used to evaluate the long-term prognosis of ER-positive, node-negative breast cancer. Even though further prospective validation is necessary, the inclusion of 95GC in clinical practice could help to select optimal treatments for breast cancer patients and identify those who do not benefit from the addition of chemotherapy, thus avoiding unnecessary treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08778-5.
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Affiliation(s)
- Fumine Tsukamoto
- Department of Breast and Endocrine Surgery, Japan Community Health care Organization Osaka Hospital, Osaka, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Mina Takahashi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Ken-Ichi Ito
- Department of Surgery, Division of Breast and Endocrine Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Seiki Takashima
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Takaaki Oba
- Department of Surgery, Division of Breast and Endocrine Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masayuki Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | | | | | - Takayuki Kinoshita
- Division of Breast Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
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Koh SJ, Ohsumi S, Takahashi M, Fukuma E, Jung KH, Ishida T, Dai MS, Chang CH, Dalvi T, Walker G, Bennett J, O'Shaughnessy J, Balmaña J. Correction to: Prevalence of mutations in BRCA and homologous recombination repair genes and real-world standard of care of Asian patients with HER2-negative metastatic breast cancer starting first-line systemic cytotoxic chemotherapy: subgroup analysis of the global BREAKOUT study. Breast Cancer 2021; 29:189-190. [PMID: 34562259 PMCID: PMC8732975 DOI: 10.1007/s12282-021-01299-w] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Su-Jin Koh
- Department of Hematology and Oncology, Ulsan University Hospital, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 877, Korea.
| | - Shozo Ohsumi
- Department of Breast Oncology, NHO Shikoku Cancer Center, Ehime, Japan
| | - Masato Takahashi
- Department of Breast Surgery, NHO Hokkaido Cancer Center, Hokkaido, Japan
| | | | - Kyung Hae Jung
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Takanori Ishida
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Hospital, Miyagi, Japan
| | | | | | | | | | | | | | - Judith Balmaña
- Hospital Universitari Vall d'Hebron, Barcelona, Cataluña, Spain
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Akezaki Y, Nakata E, Kikuuchi M, Tominaga R, Kurokawa H, Hamada M, Aogi K, Ohsumi S, Sugihara S. Factors associated with return to work of breast cancer patients following axillary lymph node dissection. Work 2021; 70:271-277. [PMID: 34511470 DOI: 10.3233/wor-213571] [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] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The identification of factors that are related to return to work after surgery for breast cancer could help healthcare professionals accurately identify patients at risk of return to work-related difficulties in order to provide them with appropriate support during breast cancer management. OBJECTIVE The aim of this study was to identify factors related to return to work in breast cancer patients three months after axillary lymph node dissection. METHODS Seventy-three women who were working before the surgery were evaluated. Age, body mass index, level of lymph node dissection, marital status, children, co-resident household members, preoperative chemotherapy, postoperative chemotherapy, postoperative hormonal therapy, postoperative radiotherapy, shoulder range of motion, upper limb function (Disabilities of the Arm, Shoulder and Hand; DASH), and work were evaluated. Patients who had returned to work constituted the return to work group, and those who had not returned to work constituted the no return to work group. RESULTS Of the patients, 36 returned to work at three months. Logistic regression analysis including the five variables showed that shoulder flexion range of motion and DASH were significantly associated with return to work (p < 0.05). CONCLUSIONS The observation that the symptoms and limitations of upper limb function and shoulder flexion range of motion affect return to work may indicate the importance of postoperative rehabilitation in breast cancer patients following axillary lymph node dissection.
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Affiliation(s)
- Yoshiteru Akezaki
- Division of Physical Therapy, Kochi Professional University of Rehabilitation, Takaoka-Machi, Tosa, Kochi, Japan
| | - Eiji Nakata
- Department of Orthopaedic Surgery, Okayama University Hospital, Kita Ward, Okayama, Japan
| | - Masato Kikuuchi
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Ritsuko Tominaga
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Hideaki Kurokawa
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Makiko Hamada
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Kenjiro Aogi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Shinsuke Sugihara
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
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21
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Shidahara T, Ohsumi S, Miyoshi Y, Takahashi M, Takashima S, Aogi K, Teramoto N. A Case of Multiple Liver Metastases after Surgery in Elderly HER2-Positive Breast Cancer in Which Anastrozole + Trastuzumab Was Ineffective but T-DM1 Was Effective. Case Rep Oncol 2021; 14:1632-1637. [PMID: 34950008 PMCID: PMC8647049 DOI: 10.1159/000520357] [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: 10/07/2021] [Accepted: 10/19/2021] [Indexed: 11/23/2022] Open
Abstract
Chemotherapy is often difficult to treat human epidermal growth factor receptor 2 (HER2)-positive metastatic recurrent breast cancer in the elderly, and no standard treatment has been established at this point. We experienced a case in which trastuzumab (Tmab) + anastrozole (ANA) was ineffective (progressive disease; PD) in elderly HER2-positive breast cancer with postoperative multiple liver metastases, but T-DM1 was significantly effective (complete response; CR), and treatment could be continued safely. An 82-year-old woman was referred to our department with a right breast mass. A close examination revealed right breast cancer cT1bN0M0 cStage I, and total mastectomy and sentinel lymph node biopsy were performed. The postoperative pathological result was pT1bN0M0 pStage I (luminal HER2 type). The patient was elderly and had no adjuvant treatment after the operation. Approximately 2 years after the operation, multiple liver metastases were observed, and treatment with ANA and Tmab was started. Four months later, MRI showed that the number of multiple liver metastases increased. The patient was diagnosed with PD, and the anti-HER2 drug was changed from trastuzumab to trastuzumab emtansine (T-DM1). The dose was reduced due to vomiting (grade 3). Two months later, MRI showed that the multiple liver metastases shrank and became obscure after 5 months. After that, T-DM1 was continued, and the disease did not worsen. In elderly people with difficulty in administering chemotherapy, T-DM1 may have a safe and sufficient therapeutic effect by adjusting the dose and managing side effects appropriately.
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Affiliation(s)
- Tomohiro Shidahara
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Yuichiro Miyoshi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Mina Takahashi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Seiki Takashima
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Kenjiro Aogi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Norihiro Teramoto
- Departments of Pathology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
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22
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Akezaki Y, Nakata E, Kikuuchi M, Tominaga R, Kurokawa H, Okamoto M, Hamada M, Aogi K, Ohsumi S, Sugihara S. Investigation of Factors Affecting Early Quality of Life of Patients after Breast Cancer Surgery. Healthcare (Basel) 2021; 9:healthcare9020213. [PMID: 33669376 PMCID: PMC7920245 DOI: 10.3390/healthcare9020213] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/15/2021] [Accepted: 02/15/2021] [Indexed: 11/27/2022] Open
Abstract
Objective: The purpose of this study was to investigate factors related to early quality of life (QOL) three months after surgery in breast cancer patients with axillary lymph node dissection. Methods: The subjects of this study were 195 consecutive patients who underwent axillary lymph node dissection for breast cancer. Age, body mass index, level of lymph node dissection, marriage, children, co-resident household members, neoadjuvant chemotherapy, postoperative chemotherapy, postoperative hormonal therapy, postoperative radiotherapy, upper limb function (disabilities of the arm, shoulder, and hand (DASH)), and QOL (European Organization for the Treatment and Research of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)) were evaluated. For each item of the EORTC QLQ-C30, compared with preoperative status and three months after surgery, those who improved or remained unchanged in the three months after surgery were classified as the maintenance and improved groups, and those with worsening status were classified as the worsened group. Results: Age, level of lymph node dissection, DASH, neoadjuvant chemotherapy, postoperative chemotherapy, and postoperative radiotherapy were significantly associated with QOL (p < 0.05). Conclusions: The early QOL of postoperative patients with breast cancer is affected by multiple factors, such as upper limb function and postoperative chemotherapy, and thus comprehensive intervention is required.
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Affiliation(s)
- Yoshiteru Akezaki
- Division of Physical Therapy, Kochi Professional University of Rehabilitation, Kochi 781-1102, Japan;
| | - Eiji Nakata
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama 700-8558, Japan
- Correspondence:
| | - Masato Kikuuchi
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan; (M.K.); (R.T.); (H.K.); (M.O.); (M.H.); (S.S.)
| | - Ritsuko Tominaga
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan; (M.K.); (R.T.); (H.K.); (M.O.); (M.H.); (S.S.)
| | - Hideaki Kurokawa
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan; (M.K.); (R.T.); (H.K.); (M.O.); (M.H.); (S.S.)
| | - Masaki Okamoto
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan; (M.K.); (R.T.); (H.K.); (M.O.); (M.H.); (S.S.)
| | - Makiko Hamada
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan; (M.K.); (R.T.); (H.K.); (M.O.); (M.H.); (S.S.)
| | - Kenjiro Aogi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan; (K.A.); (S.O.)
| | - Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan; (K.A.); (S.O.)
| | - Shinsuke Sugihara
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime 791-0280, Japan; (M.K.); (R.T.); (H.K.); (M.O.); (M.H.); (S.S.)
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Masuda N, Ohsumi S, Nishimura R, Akashi-Tanaka S, Suemasu K, Yamauchi H, Tokunaga E, Ikeda T, Nishi T, Hayashi H, Iino Y, Takatsuka Y, Inaji H. Abstract PS1-01: Combined analysis of the WORTH 1 and WORTH 2 studies of ipsilateral breast tumor recurrence after breast conservative surgery without radiotherapyusing the “5-mm thick slice and 5-mm free margin method”. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps1-01] [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: 11/16/2022]
Abstract
Abstract
Background: Breast conserving surgery with radiotherapy is one of the standard treatment methods for early breast cancer. However, it is regarded as an option to treat elderly patients with small hormone receptor positive breast cancer with breast conserving surgery and hormone therapy without radiotherapy. Two sequential prospective studies were conducted to examine the efficacy of breast conserving surgery without radiotherapy from 2002. Patients and Methods: Primary breast cancer patients were divided into the WORTH 1 (n=123) group (Oct. 2002 and Mar. 2005) and the WORTH 2 (n=198) group (Dec. 2006 and Nov. 2011) and the data was retrospectively combined and analyzed. The eligibility criteria of the two sequential studies were a tumor ≥3cm determined by palpation, pathologically node negative by axillary dissection or sentinel node biopsy and M0, no preoperative treatment, postmenopausal patients ≥50 years of age at surgery, no tumor cells within 5 mm from the margins, no lymphatic invasion around the primary tumor, and estrogen receptor positive. The surgical specimens were sliced at 5 mm intervals and all the slices were examined microscopically. Postoperative radiotherapy was not conducted and adjuvant chemotherapy was optional. The patients were treated with tamoxifen or anastrozole in WORTH 1 and anastrozole in WORTH 2 for 5 years. Ipsilateral breast tumor recurrence (IBTR)-free survival and distant relapse-free survival (DRFS) were recorded as the interval from initial surgery until IRTR or distant relapse. The factors related to IBTR were evaluated using the proportional hazard model. Patients who did not develop IBTR or distant relapse were statistically censored at the time of the last follow-up or death. Survival rates were calculated using the Kaplan-Mayer method. Statistical analyses were conducted using the log rank test. Values < 0.05 were considered statistically significant. Results: The median age at surgery was 65 (range 50-84). The median tumor size was 1.5 cm (range 0-4.0 cm). The median follow-up period for IBTR was 95 months (range 4-192 months). Only 3 patients were treated with adjuvant chemotherapy. The 5- and 10-year overall survival rates were 98.7% and 95.1%, respectively and the 5- and 10-year distant DRFS rates were 99.3% and 96.3%, respectively. The 5- and 10-year IBTR free rates were 97.0% and 89.7%, respectively. Older patients had significantly less IBTR rates (5-year IBTR free rates: 95.8% for ≤64 vs. 98.1% for ≥65, p=0.019). There was no difference in IBTR rates between the large and small tumors (5-year IBTR free rates: 96.9% ≤1.4 cm vs. 96.8% for ≥1.5 cm, p=0.094). PR positivity had a significantly lower IBTR free rates (5-year IBTR free rates: 98.3% for PR positive vs. 91.5% for PR negative, p=0.009). The age at surgery (≤64, p=0.017, Hazard ratio 3.07, 95% CI 1.22-7.70) and the PR status (PR negative, p=0.024, Hazard ratio 2.54, 95% Cl 1.13-5.69) independently affected the IBTR rates. Both the 5- and 10-year IBTR free rates of the patients who were ≥65 at surgery and had PR positive tumors (n=136) were 98.4%. Conclusions: The findings suggest that the “5-mm thick slice and 5-mm free margin” method may be effective in selecting patients who can be treated with breast conserving surgery and hormone therapy without radiotherapy.
Citation Format: Norikazu Masuda, Shozo Ohsumi, Reiki Nishimura, Sadako Akashi-Tanaka, Kimito Suemasu, Hideko Yamauchi, Eriko Tokunaga, Tadashi Ikeda, Tsunehiro Nishi, Hiroto Hayashi, Yuichi Iino, Yuichi Takatsuka, Hideo Inaji. Combined analysis of the WORTH 1 and WORTH 2 studies of ipsilateral breast tumor recurrence after breast conservative surgery without radiotherapyusing the “5-mm thick slice and 5-mm free margin method” [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS1-01.
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Affiliation(s)
- Norikazu Masuda
- 1National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Shozo Ohsumi
- 2National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | | | | | | | | | - Eriko Tokunaga
- 7National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Tadashi Ikeda
- 8Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | | | - Hiroto Hayashi
- 10National Hospital Organization Kanmon Medical Center, Shimonoseki, Japan
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Ohno S, Saji S, Masuda N, Tsuda H, Akiyama F, Kurosumi M, Shimomura A, Sato N, Takao S, Ohsumi S, Tokuda Y, Inaji H, Watanabe T, Ohashi Y. Relationships between pathological factors and long-term outcomes in patients enrolled in two prospective randomized controlled trials comparing the efficacy of oral tegafur-uracil with CMF (N·SAS-BC 01 trial and CUBC trial). Breast Cancer Res Treat 2020; 186:135-147. [PMID: 33259001 PMCID: PMC7940338 DOI: 10.1007/s10549-020-06018-1] [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: 09/02/2020] [Accepted: 11/12/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE To evaluate the efficacies of cyclophosphamide, methotrexate, and fluorouracil (CMF) and tegafur-uracil (UFT) as adjuvant therapy in patients with resected stage I-IIIA breast cancer by immunohistochemistry (IHC)-based subtype and to determine the relationships between clinicopathological factors and long-term outcomes. METHODS A pooled analysis of the randomized controlled N·SAS-BC 01 and CUBC studies was conducted. Expression of hormone receptors (HRs; estrogen and progesterone receptors), human epidermal growth factor receptor 2 (HER2), and Ki67were assessed by IHC. Tumor-infiltrating lymphocytes (TILs) and nuclear/histological grades were determined by hematoxylin and eosin staining. Relapse-free survival (RFS) and overall survival (OS) were estimated by Kaplan-Meier analysis and hazard ratios were determined by Cox model adjusted for baseline tumor size and nodal status. RESULTS A total of 689 patients (342 CMF and 347 UFT) were included in the analyses with a median follow-up of 11.1 years. There was no significant difference in RFS or OS between the two cohorts (RFS: 0.96 [95% confidence interval: 0.71-1.30], log-rank test p = 0.80; OS: 0.93 [0.64-1.35], p = 0.70). There was no difference in RFS or OS between the two cohorts for HR+/HER2- and HR+/HER2+ subtypes. RFS was significantly longer in patients treated with UFT compared with CMF in patients with HR-/HER2+ subtype (0.30 [0.10-0.88], p = 0.03). A high TILs level was associated with a better OS compared with low TILs level (p = 0.02). CONCLUSIONS This long-term follow-up study showed that RFS and OS were similar in patients with luminal-type breast cancer treated with CMF and UFT.
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Affiliation(s)
- Shinji Ohno
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
| | | | - Norikazu Masuda
- National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | - Futoshi Akiyama
- Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | | | | | | | | | - Yutaka Tokuda
- Tokai University School of Medicine, Kanagawa, Japan
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O'Shaughnessy J, Brezden-Masley C, Cazzaniga M, Dalvi T, Walker G, Bennett J, Ohsumi S. Prevalence of germline BRCA mutations in HER2-negative metastatic breast cancer: global results from the real-world, observational BREAKOUT study. Breast Cancer Res 2020; 22:114. [PMID: 33109210 PMCID: PMC7590609 DOI: 10.1186/s13058-020-01349-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 10/05/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The global observational BREAKOUT study investigated germline BRCA mutation (gBRCAm) prevalence in a population of patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC). METHODS Eligible patients had initiated first-line cytotoxic chemotherapy for HER2-negative MBC within 90 days prior to enrollment. Hormone receptor (HR)-positive patients had experienced disease progression on or after prior endocrine therapy, or endocrine therapy was considered unsuitable. gBRCAm status was determined using baseline blood samples or prior germline test results. For patients with a negative gBRCAm test, archival tissue was tested for somatic BRCAm and homologous recombination repair mutations (HRRm). Details of first-line cytotoxic chemotherapy were also collected. RESULTS Between March 2017 and April 2018, 384 patients from 14 countries were screened and consented to study enrollment; 341 patients were included in the full analysis set (median [range] age at enrollment: 56 [25-89] years; 256 (75.3%) postmenopausal). Overall, 33 patients (9.7%) had a gBRCAm (16 [4.7%] in gBRCA1 only, 12 [3.5%] in gBRCA2 only, and 5 [1.5%] in both gBRCA1 and gBRCA2). gBRCAm prevalence was similar in HR-positive and HR-negative patients. gBRCAm prevalence was 9.0% in European patients and 10.6% in Asian patients and was higher in patients aged ≤ 50 years at initial breast cancer (BC) diagnosis (12.9%) than patients aged > 50 years (5.4%). In patients with any risk factor for having a gBRCAm (family history of BC and/or ovarian cancer, aged ≤ 50 years at initial BC diagnosis, or triple-negative BC), prevalence was 10.4%, versus 5.8% in patients without these risk factors. HRRm prevalence was 14.1% (n = 9/64) in patients with germline BRCA wildtype. CONCLUSIONS Patient demographic and disease characteristics supported the association of a gBRCAm with younger age at initial BC diagnosis and family history of BC and/or ovarian cancer. gBRCAm prevalence in this cohort, not selected on the basis of risk factors for gBRCAm, was slightly higher than previous results suggested. gBRCAm prevalence among patients without a traditional risk factor for harboring a gBRCAm (5.8%) supports current guideline recommendations of routine gBRCAm testing in HER2-negative MBC, as these patients may benefit from poly(ADP-ribose) polymerase (PARP) inhibitor therapy. TRIAL REGISTRATION NCT03078036 .
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Affiliation(s)
- Joyce O'Shaughnessy
- Baylor University Medical Center, Texas Oncology and US Oncology, Dallas, TX, USA.
| | | | | | - Tapashi Dalvi
- AstraZeneca Pharmaceuticals, LP, Gaithersburg, MD, USA
| | | | | | - Shozo Ohsumi
- NHO Shikoku Cancer Center, Matsuyama-shi, Ehime-Ken, Japan
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Ohsumi S, Mukai H, Takahashi M, Hozumi Y, Akabane H, Park Y, Tokunaga E, Takashima T, Watanabe T, Sagara Y, Kaneko T, Ohashi Y. Factors affecting enrollment in randomized controlled trials conducted for patients with metastatic breast cancer. Jpn J Clin Oncol 2020; 50:873-881. [PMID: 32463090 DOI: 10.1093/jjco/hyaa065] [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: 02/02/2020] [Revised: 03/20/2020] [Accepted: 04/26/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is critical to obtain informed consent from eligible patients to complete clinical trials. We investigated the factors that affect the participation rates of eligible patients. PATIENTS AND METHODS Patients with metastatic breast cancer who were eligible for SELECT BC or SELECT BC-CONFIRM trials, randomized controlled trials conducted for patients with chemotherapy-naive metastatic breast cancer were recruited to prospective studies, SELECT BC-FEEL and SELECT BC-FEEL II, respectively. SELECT BC FEEL and SELECT BC-FEEL II were conducted to identify the factors affecting the rates at which informed consent was obtained, using a self-administered questionnaire we developed. RESULTS In total, 232 patients participated in the studies. The patients who agreed to take part in the randomized trials were more likely than the refusers to answer that they decided to participate because: 'My doctor wanted me to participate in this trial' (P = 0.00000), ' My family or friends wanted me to participate in this trial' (P = 0.00000), 'Both treatment regimens used in the trial are suitable to me' (P = 0.00383), 'I know that the trial is conducted to determine which is a better treatment' (P = 0.01196), and ' I think that my participation in the trial will contribute to the benefit to future patients with the same disease' (P = 0.00756). CONCLUSIONS To enhance the consent rate in randomized trials of metastatic breast cancer patients, concepts of the trials must be considered important and acceptable not only by patients but also by doctors and their families.
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Affiliation(s)
- Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama 791-0280, Japan
| | - Hirofumi Mukai
- Department of Breast and Medical Oncology, National Cancer Center Hospital East, Kashiwa
| | - Masato Takahashi
- Department of Breast Surgery, National Hospital Organization Hokkaido Cancer Center, Sapporo
| | - Yasuo Hozumi
- Department of Breast Surgery, Ibaraki Prefectural Central Hospital, Kasama
| | | | - Youngjin Park
- Department of Breast and Endocrine Surgery, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai
| | - Eriko Tokunaga
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka
| | - Tsutomu Takashima
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka
| | - Takanori Watanabe
- Department of Breast Surgery, National Hospital Organization Sendai Medical Center, Sendai
| | - Yoshiaki Sagara
- Department of Breast Oncology, Hakuaikai Medical Corp Sagara Hospital, Kagoshima
| | - Tetsuji Kaneko
- Department of Clinical Research, Tokyo Metropolitan Children's Medical Center, Fuchu
| | - Yasuo Ohashi
- Faculty of Science and Engineering, Chuo University, Tokyo
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Akezaki Y, Tominaga R, Kikuuchi M, Kurokawa H, Hamada M, Aogi K, Ohsumi S, Tsuji T, Kawamura S, Sugihara S. Risk Factors for Lymphedema in Breast Cancer Survivors Following Axillary Lymph Node Dissection. Prog Rehabil Med 2020; 4:20190021. [PMID: 32789268 DOI: 10.2490/prm.20190021] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/14/2019] [Indexed: 12/30/2022] Open
Abstract
Objective The aim of the current study was to assess the risk factors for developing lymphedema following breast cancer treatment. Methods The subjects of this study were 238 consecutive patients who underwent axillary lymph node dissection for breast cancer at Shikoku Cancer Center. The study variables were the occurrence of lymphedema, the body mass index, the follow-up period, the drain removal time, the level of lymph node dissection, the presence or absence of co-resident household members, radiation therapy, neoadjuvant chemotherapy, and adjuvant chemotherapy. Results We observed lymphedema in 23.9% of patients after axillary lymph node dissection for breast cancer. Neoadjuvant chemotherapy and adjuvant chemotherapy using docetaxel and cyclophosphamide increased the risk of developing lymphedema (P <0.05). Conclusions Those patients treated with neoadjuvant chemotherapy and adjuvant chemotherapy using docetaxel and cyclophosphamide should be observed closely after axillary lymph node dissection, and appropriate intervention should be considered from an early stage.
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Affiliation(s)
- Yoshiteru Akezaki
- Division of Physical Therapy, Kochi Professional University of Rehabilitation, Kochi, Japan
| | - Ritsuko Tominaga
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Masato Kikuuchi
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Hideaki Kurokawa
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Makiko Hamada
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Kenjiro Aogi
- Department of Breast Surgery, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Shozo Ohsumi
- Department of Breast Surgery, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University Hospital, Tokyo, Japan
| | - Susumu Kawamura
- Department of Plastic and Reconstructive Surgery, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Shinsuke Sugihara
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ehime, Japan.,Department of Orthopaedic Oncology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
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Kaneyasu T, Mori S, Yamauchi H, Ohsumi S, Ohno S, Aoki D, Baba S, Kawano J, Miki Y, Matsumoto N, Nagasaki M, Yoshida R, Akashi-Tanaka S, Iwase T, Kitagawa D, Masuda K, Hirasawa A, Arai M, Takei J, Ide Y, Gotoh O, Yaguchi N, Nishi M, Kaneko K, Matsuyama Y, Okawa M, Suzuki M, Nezu A, Yokoyama S, Amino S, Inuzuka M, Noda T, Nakamura S. Prevalence of disease-causing genes in Japanese patients with BRCA1/2-wildtype hereditary breast and ovarian cancer syndrome. NPJ Breast Cancer 2020; 6:25. [PMID: 32566746 PMCID: PMC7293299 DOI: 10.1038/s41523-020-0163-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 04/30/2020] [Indexed: 12/30/2022] Open
Abstract
Panel sequencing of susceptibility genes for hereditary breast and ovarian cancer (HBOC) syndrome has uncovered numerous germline variants; however, their pathogenic relevance and ethnic diversity remain unclear. Here, we examined the prevalence of germline variants among 568 Japanese patients with BRCA1/2-wildtype HBOC syndrome and a strong family history. Pathogenic or likely pathogenic variants were identified on 12 causal genes for 37 cases (6.5%), with recurrence for 4 SNVs/indels and 1 CNV. Comparisons with non-cancer east-Asian populations and European familial breast cancer cohorts revealed significant enrichment of PALB2, BARD1, and BLM mutations. Younger onset was associated with but not predictive of these mutations. Significant somatic loss-of-function alterations were confirmed on the wildtype alleles of genes with germline mutations, including PALB2 additional somatic truncations. This study highlights Japanese-associated germline mutations among patients with BRCA1/2 wildtype HBOC syndrome and a strong family history, and provides evidence for the medical care of this high-risk population.
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Affiliation(s)
- Tomoko Kaneyasu
- Project for Development of Innovative Research on Cancer Therapeutics, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Seiichi Mori
- Project for Development of Innovative Research on Cancer Therapeutics, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Hideko Yamauchi
- Department of Breast Surgical Oncology, St. Luke’s International Hospital, 10-1 Akashi-cho, Chuo-ku Tokyo, Japan
| | - Shozo Ohsumi
- National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-machi, Matsuyama, Ehime Japan
| | - Shinji Ohno
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Daisuke Aoki
- Department of Obstetrics & Gynecology, Keio University School of Medicine, 35 Shinano-cho, Shinjuku-ku Tokyo, Japan
| | - Shinichi Baba
- Sagara Hospital, 3-31 Matsubara-cho, Kagoshima, Japan
| | - Junko Kawano
- Sagara Hospital, 3-31 Matsubara-cho, Kagoshima, Japan
| | - Yoshio Miki
- Project for Development of Innovative Research on Cancer Therapeutics, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Fukuura 3-9, Kanazawa-ku Yokohama, Japan
| | - Masao Nagasaki
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi Japan
| | - Reiko Yoshida
- Department of Clinical Genetic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Sadako Akashi-Tanaka
- Division of Breast Surgical Oncology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku Tokyo, Japan
| | - Takuji Iwase
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Dai Kitagawa
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Kenta Masuda
- Department of Obstetrics & Gynecology, Keio University School of Medicine, 35 Shinano-cho, Shinjuku-ku Tokyo, Japan
| | - Akira Hirasawa
- Department of Obstetrics & Gynecology, Keio University School of Medicine, 35 Shinano-cho, Shinjuku-ku Tokyo, Japan
| | - Masami Arai
- Department of Clinical Genetic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Junko Takei
- Department of Breast Surgical Oncology, St. Luke’s International Hospital, 10-1 Akashi-cho, Chuo-ku Tokyo, Japan
| | - Yoshimi Ide
- Division of Breast Surgical Oncology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku Tokyo, Japan
| | - Osamu Gotoh
- Project for Development of Innovative Research on Cancer Therapeutics, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Noriko Yaguchi
- Project for Development of Innovative Research on Cancer Therapeutics, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Mitsuyo Nishi
- Sagara Hospital, 3-31 Matsubara-cho, Kagoshima, Japan
| | - Keika Kaneko
- National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-machi, Matsuyama, Ehime Japan
| | - Yumi Matsuyama
- National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-machi, Matsuyama, Ehime Japan
| | - Megumi Okawa
- Department of Breast Surgical Oncology, St. Luke’s International Hospital, 10-1 Akashi-cho, Chuo-ku Tokyo, Japan
| | - Misato Suzuki
- Department of Breast Surgical Oncology, St. Luke’s International Hospital, 10-1 Akashi-cho, Chuo-ku Tokyo, Japan
| | - Aya Nezu
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Shiro Yokoyama
- Division of Breast Surgical Oncology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku Tokyo, Japan
| | - Sayuri Amino
- Project for Development of Innovative Research on Cancer Therapeutics, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Mayuko Inuzuka
- Division of Breast Surgical Oncology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku Tokyo, Japan
| | - Tetsuo Noda
- Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku Tokyo, Japan
| | - Seigo Nakamura
- Division of Breast Surgical Oncology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku Tokyo, Japan
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Kikuuchi M, Akezaki Y, Nakata E, Yamashita N, Tominaga R, Kurokawa H, Hamada M, Aogi K, Ohsumi S, Tsuji T, Sugihara S. Risk factors of impairment of shoulder function after axillary dissection for breast cancer. Support Care Cancer 2020; 29:771-778. [PMID: 32468131 DOI: 10.1007/s00520-020-05533-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/14/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Postoperative shoulder joint dysfunction has been observed at a certain rate after breast cancer surgery with axillary lymph node dissection. The purposes of this study were to verify the feasibility and effects of home-based exercise using a DVD and clarify the target of intensive intervention with physiotherapy by identifying the factors that cause postoperative shoulder dysfunction. METHODS The study comprised 237 female patients who underwent breast cancer surgery with axillary lymph node dissection, whose data were acquired until 3 months postoperatively. All patients were instructed to exercise at home using a DVD. Range of motion (ROM) of shoulder flexion and abduction and the disability of the arm, shoulder, and hand (DASH) score were measured before surgery, 1 week and 1, 2, and 3 months after surgery. As factors influencing the recovery of shoulder ROM at 3 months after surgery, the presence or absence of radiation and factors up to 1 month after surgery (age, body mass index, the relationship between operated side and dominant side of the hand, treatment modalities, and complications). RESULTS Shoulder ROM and DASH scores had gradually recovered from 1 week to 3 months postoperatively. As the results of the multivariate analysis, the factors that were associated with the recovery of ROM of shoulder flexion at 3 months were the side of surgery corresponding to the dominant hand (negative factor) and the presence of paresthesia at 1 week postoperatively (positive factor) (p < 0.05). Radiation therapy and the side of surgery corresponding to the dominant hand were negative factors for the recovery of shoulder abduction (p < 0.01). Regarding the feasibility of the home exercise, 214/229 (93.4%), 172/210 (81.9%), and 139/206 (67.5%) of patients performed exercise at least once a day at 1, 2, and 3 months after surgery, respectively. CONCLUSION Our result indicated that the side of surgery corresponding to the dominant hand was the inhibiting factor for recovery for both shoulder flexion and abduction at 3 months after surgery. Home-based exercise with DVD was considered feasible. For the verification of this effectiveness, a randomized control study should be planned in the future.
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Affiliation(s)
- Masato Kikuuchi
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ko-160, Minamiumemoto-cho, Matsuyama City, 7910280, Japan
| | - Yoshiteru Akezaki
- Division of Physical Therapy, Kochi Professional University of Rehabilitation, Kochi, Japan
| | - Eiji Nakata
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama, Japan
| | - Natsumi Yamashita
- Division of Clinical Biostatistics, Clinical Research Center, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Ritsuko Tominaga
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ko-160, Minamiumemoto-cho, Matsuyama City, 7910280, Japan
| | - Hideaki Kurokawa
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ko-160, Minamiumemoto-cho, Matsuyama City, 7910280, Japan
| | - Makiko Hamada
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ko-160, Minamiumemoto-cho, Matsuyama City, 7910280, Japan
| | - Kenjiro Aogi
- Department of Breast Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Shozo Ohsumi
- Department of Breast Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shinsuke Sugihara
- Department of Rehabilitation Medicine, National Hospital Organization Shikoku Cancer Center, Ko-160, Minamiumemoto-cho, Matsuyama City, 7910280, Japan.
- Department of Orthopaedic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.
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Ohsumi S, Kiyoto S, Takahashi M, Hara F, Takashima S, Aogi K, Matsuda M, Yamamura N, Doi M. Scalp cooling for hair loss prevention in female Japanese breast cancer patients receiving (neo)adjuvant chemotherapy. Support Care Cancer 2020; 29:437-443. [PMID: 32388615 DOI: 10.1007/s00520-020-05506-w] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/30/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Scalp cooling during chemotherapy infusion has been recently reported to have moderate efficacy in the mitigation of chemotherapy-induced alopecia; however, there are few reports on Asian patients. We aimed to clarify the effects of scalp cooling in Japanese women. PATIENTS AND METHODS Female Japanese breast cancer patients who planned to receive (neo)adjuvant chemotherapy participated in this prospective study on the efficacy of scalp cooling using the Paxman Scalp Cooling System for alopecia prevention. The primary outcomes were the rates of patients with Grade 3 alopecia (defined as hair loss of > 50%) and the rates of patients who used a wig or hat to conceal hair loss 1 month after the last infusion of chemotherapy. The subjects were given a brief questionnaire regarding headaches, bad mood, fatigue, and chills shortly after each cooling. RESULTS One hundred and forty-three patients participated in the study and used the cooling cap at least once. The mean and median ages of the subjects were 50.6 and 50, respectively (age range 28-76). One hundred and twenty-nine patients completed the planned chemotherapy of 4 to 8 cycles. Among them (7 patients were not evaluable), 74 patients (60.7%) had Grade 3 alopecia 1 month after chemotherapy. Of 80 patients who used the scalp cooling system throughout the planned chemotherapy (1 patient was not evaluable), 36 patients (45.6%) experienced Grade 3 alopecia. CONCLUSION The efficacy of scalp cooling during chemotherapy infusion for hair loss mitigation in Asian women is similar to that in Caucasian women.
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Affiliation(s)
- Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, Ehime, 791-0280, Japan.
| | - Sachiko Kiyoto
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, Ehime, 791-0280, Japan
| | - Mina Takahashi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, Ehime, 791-0280, Japan
| | - Fumikata Hara
- Department of Breast Medical Oncology, Breast Oncology Center, Cancer Institute Hospital for JFCR, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
| | - Seiki Takashima
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, Ehime, 791-0280, Japan
| | - Kenjiro Aogi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, Ehime, 791-0280, Japan
| | - Miwa Matsuda
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, Ehime, 791-0280, Japan
| | - Naomi Yamamura
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, Ehime, 791-0280, Japan
| | - Miyuki Doi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama, Ehime, 791-0280, Japan
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31
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Mukai H, Yamaguchi T, Takahashi M, Hozumi Y, Fujisawa T, Ohsumi S, Akabane H, Nishimura R, Takashima T, Park Y, Sagara Y, Toyama T, Imoto S, Mizuno T, Yamashita S, Fujii S, Uemura Y. Ki-67 response-guided preoperative chemotherapy for HER2-positive breast cancer: results of a randomised Phase 2 study. Br J Cancer 2020; 122:1747-1753. [PMID: 32238920 PMCID: PMC7283228 DOI: 10.1038/s41416-020-0815-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 05/21/2019] [Revised: 01/15/2020] [Accepted: 03/12/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The effectiveness of a therapeutic strategy that switches chemotherapy, based on Ki-67 tumour expression after initial therapy, relative to that of standard chemotherapy, has not been evaluated. METHODS Patients were randomly assigned to the control arm or the Ki-67 response-guided arm (Ki-67 arm). Primary tumour biopsies were obtained before treatment, and after three once-weekly doses of paclitaxel and trastuzumab to assess the interim Ki-67 index. In the control arm, paclitaxel and trastuzumab were continued for a total of 12 doses, regardless of the interim Ki-67 index. In the Ki-67 arm, subsequent treatment was based on the interim Ki-67 index. Ki-67 early responder is defined as the absolute Ki-67 value that was <10%, and the percentage of Ki-67-positive tumour cells was reduced by >30% compared with before treatment. Early Ki-67 responders continued to receive the same treatment, while early Ki-67 non-responders were switched to epirubicin plus cyclophosphamide. The primary endpoint was the pathological complete response (pCR) rate. RESULTS A total of 237 patients were randomised. There was almost linear correlation between the Ki-67 reduction rate at interim assessment and the pCR rate. The pCR rate in Ki-67 early non-responders in the Ki-67 arm was inferior to that in the control arm (44.1%; 31.4-56.7; P = 0.025). CONCLUSIONS The standard chemotherapy protocol remains as the recommended strategy for patients with HER2-positive breast cancer. CLINICAL TRIAL REGISTRATION Clinical Trial Registration: UMIN-CTR as UMIN000007074.
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Affiliation(s)
- Hirofumi Mukai
- National Cancer Center Hospital East, Kashiwa, Chiba, 277-8577, Japan.
| | | | - Masato Takahashi
- National Hospital Organization Hokkaido Cancer Center, Sapporo, Hokkaido, 003-0804, Japan
| | - Yasuo Hozumi
- University of Tsukuba Hospital, Tsukuba, Ibaraki, 305-8576, Japan
| | - Tomomi Fujisawa
- Gunma Prefectural Cancer Center, Ota, Gunma, 373-0828, Japan
| | - Shozo Ohsumi
- National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, 791-0245, Japan
| | | | - Reiki Nishimura
- Kumamoto Shinto General Hospital, Chuo Ward, Kumamoto, 862-8655, Japan
| | - Tsutomu Takashima
- Osaka City University Graduate School of Medicine, Sumiyoshi Ward, Osaka, 558-0022, Japan
| | - Youngjin Park
- Tohoku Medical and Pharmaceutical University Hospital, Sendai, Miyagi, 981-8558, Japan
| | - Yasuaki Sagara
- Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan
| | - Tatsuya Toyama
- Nagoya City University Graduate School of Medical Sciences, Aichi, Nagoya, 467-8601, Japan
| | - Shigeru Imoto
- Kyorin University Hospital, Mitaka, Tokyo, 181-8611, Japan
| | | | - Satoshi Yamashita
- National Cancer Center Research Institute, Chuo-ku, Tokyo, 104-0045, Japan
| | - Satoshi Fujii
- Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, 277-8577, Japan
| | - Yukari Uemura
- National Center for Global Health and Medicine, Tokyo, Japan
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Ohsumi S, Kiyoto S, Miyoshi Y, Takahashi M, Takashima S, Aogi K, Shimizu S, Doi M. Abstract P5-14-21: Prospective study of hair recovery after (neo)adjuvant chemotherapy with scalp cooling in Japanese breast cancer patients. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p5-14-21] [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: 11/16/2022]
Abstract
Abstract
Introduction
Scalp cooling during chemotherapy infusion to mitigate hair loss for breast cancer patients is becoming popular in European and North American countries. But there is little prospective data regarding hair recovery after chemotherapy with scalp cooling. We reported on the results of hair loss prevention with scalp cooling during (neo)adjuvant chemotherapy with anthracyclines and/or taxanes for 122 Japanese breast cancer patients at the 2018 San Antonio Breast Cancer Symposium. Now we report on the prospective data of hair recovery of our 122 patients.
Patients and Methods
One hundred and twenty two Japanese breast cancer female patients who completed planned (neo)adjuvant chemotherapy used Paxman Scalp Cooling System for alopecia prevention and were evaluable for hair loss prevention in our prospective study. The scalp cooling was done 30 minutes prior to and during and 90 minutes after each chemotherapy infusion. We evaluated their hair recovery 1, 4, 7, 10, and 13 months after completion of the chemotherapy. We took photographs of the heads of the patients from 5 directions, namely front, back, both sides, and top and asked the patients about the use of a wig or hat to conceal the hair loss using a questionnaire at the times mentioned above. Primary outcomes were grades of alopecia judged by two investigators (defined as Grade 0: 0% of hair loss, G1: 1~25 %, G2: 26~50%, G3: > 50%)(objective grade) and patients' answers to the questionnaire (defined as Grade 0: not at all, G1: sometimes, G2: almost always)(subjective grade). Among 122 patients 79 completed scalp cooling during the whole planned chemotherapy cycles, but 43 discontinued it mostly after the first cycle due to several reasons. We compared the objective and subjective grades of hair loss between the patients who had completed the scalp cooling (79 patients: Group A) and those who had discontinued it (43 patients: Group B).
Results
Objective grades 1 month after completion of the chemotherapy were Grade 0 in 6 patients (4.9 %), G1 in 13, G2 in 29, and G3 in 74, and subjective grades at 1 month were Grade 0 in 3 patients (2.5 %), G1 in 13, G2 in 105, and unknown in 1. The changes over time in objective grades were as follows; 4 months: G0 55 (47.0 %), G1 52, G2 9, G3 1, unknown 5, 7 months: G0 99 (85.3 %), G1 15, G2 1, G3 1, unknown 6, 10 months: G0 105 (89.7 %), G1 10, G2 1, G3 1, unknown 5, 13 months: G0 104 (92.0 %), G1 7, G2 1, G3 1, unknown 9. On the other hand, the changes in subjective grades were as follows; 4 months: G0 12 (10.3 %), G1 29, G2 76, unknown 5, 7 months: G0 53 (45.7 %), G1 22, G2 41, unknown 6, 10 months: G0 80 (68.4 %), G1 15, G2 22, unknown 5, 13 months: G0 93 (82.3%), G1 7, G2 13, unknown 9. When we compared Group A with Group B, the rates of objective G0 were statistically significantly higher in Group A than Group B, at 4, 10, and 13 months (4 months: 55.7% vs. 28.9%, P = 0.010, 10 months: 96.1% vs. 78.0%, P = 0.006, 13 months: 97.3% vs. 81.6%, P = 0.011) and the rate of subjective G0 was also statistically significantly higher in Group A than Group B at 7 months (53.2 % vs. 30.8 %, P = 0.022). When we restricted the data to those with objective Grade 3 at 1 month, Group A showed tendency of faster hair recovery in the objective grades than Group B.
Conclusion
It is concluded that scalp cooling during chemotherapy infusion for Japanese breast cancer patients made their hair recovery faster.
Citation Format: Shozo Ohsumi, Sachiko Kiyoto, Yuichiro Miyoshi, Mina Takahashi, Seiki Takashima, Kenjiro Aogi, Sachie Shimizu, Miyuki Doi. Prospective study of hair recovery after (neo)adjuvant chemotherapy with scalp cooling in Japanese breast cancer patients [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-14-21.
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Affiliation(s)
| | | | | | | | | | | | | | - Miyuki Doi
- NHO Shikoku Cancer Center, Matsuyama, Japan
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Saji S, Ohno S, Masuda N, Tsuda H, Akiyama F, Kurosumi M, Shimomura A, Sato N, Takao S, Ohsumi S, Tokuda Y, Inaji H, Watanabe T, Ohashi Y. Abstract P2-14-17: Pooled analysis of long-term outcome of patients enrolled in two trials comparing the efficacy of oral tegafur-uracil with CMF (N-SAS-BC01 and CUBC trials). Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p2-14-17] [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: 11/16/2022]
Abstract
Abstract
Background: Two randomized controlled trials comparing the efficacy of oral tegafur-uracil (UFT) (2 years) with that of classical cyclophosphamide, methotrexate, and fluorouracil (CMF) (6 courses) were conducted in patients with resected early breast cancer (N-SAS-BC01 trial [Watanabe et al, J Clin Oncol 2009] and CUBC trial [Park et al, Br J Cancer 2009]). Pooled analysis of these two randomized controlled trials using individual patient data has been published (Ohashi et al, Breast Cancer Res Treat 2010) and long-term follow-up data has also been reported (Yonemori et al, SABCS 2018). However, because the pathological factors evaluated in those studies are insufficient and based on old criteria, a re-evaluation using the current standard pathological factors is requited to use the data in the clinical practice.
Methods: Paraffin-embedded sections of surgically excised tumor tissue were available for patients with resected stage I-IIIA breast cancer. The expression of estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2) and the Ki67 labeling index were assessed by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), and the grades of TILs were evaluated by hematoxylin and eosin (H&E) staining by pathology central review. The relationship of these pathological factors to relapse free survival (RFS) and overall survival (OS) was evaluated using long-term follow-up data. Hazard ratios were determined using the Cox model adjusted for clinical characteristics, namely tumor size and nodal status. Survival curves were estimated by the Kaplan-Meier method. This study is registered with the University Hospital Medical Information Network (UMIN), Japan (UMIN000022571).
Results: Paraffin-embedded sections were available from 689 of the total of 1,057 (65.2%) patients (CMF, n=342; UFT n=347). The median follow-up time was 11.1 years (12.1 years in the N-SAS-BC 01 trial and 8.3 years in the CUBC trial). Baseline characteristics were similar in each group. The 10-year RFS and OS was 79.9%, 87.7% in the CMF arm, and 77.1%, 88.8% in the UFT arm, respectively. The hazard ratio (UFT vs. CMF) was 0.962 (95% CI 0.712-1.300) for RFS and 0.929 (95% CI 0.639-1.350) for OS. Table 1 shows the 10-year RFS and OS in each IHC-defined breast cancer subtype. 10-year OS in UFT arm and in CMF arm were similar in Hormone receptor (HR) + groups. Although this is not expected, there is a positive signal of benefit of UFT in HR-HER2+ group (RFS; hazard ratio 0.296 (95% CI 0.100-0.878)). High TILs were associated with better prognosis in all patient group (vs. low TILs: hazard ratio 0.347 (95% CI 0.140-0.855)), however in HR+ HER2- group, there was no association between TIL status and prognosis (High vs. low: hazard ratio 0.787 (95% CI 0.240-2.581)). TILs status could not predict the benefit of UFT in the subset analysis of all patient group and of each subtype group.
Conclusion: This long-term follow-up study using randomized controlled trials shows that RFS and OS are similar in luminal type patients treated with UFT and CMF.
Funding: Taiho Pharmaceutical CO., LTD.
Table 1. 10-year RFS and OS in each IHC-defined breast cancer subtypeUFT (%)CMF (%)hazard ratio (UFT vs. CMF)10-year RFSHormone receptor (HR)+ HER2-76.7 (n=210)81.2 (n=210)1.034 (95%CI: 0.705-1.517)HR+ HER2+71.4 (n=26)73.7 (n=42)1.237 (0.499-3.069)HR- HER2+81.2 (n=29)68.4 (n=29)0.296 (0.100-0.878)HR- HER2-78.2 (n=73)84.7 (n=59)1.263 (0.596-2.675)10-year OSHR+ HER2-91.0 (n=210)89.5 (n=210)0.907 (0.551-1.491)HR+ HER2+83.9 (n=26)82.6 (n=42)0.993 (0.345-2.856)HR- HER2+90.9 (n=29)78.9 (n=29)0.335 (0.081-1.394)HR- HER2-84.6 (n=73)89.4 (n=59)1.455 (0.628-3.367)
Citation Format: Shigehira Saji, Shinji Ohno, Norikazu Masuda, Hitoshi Tsuda, Futoshi Akiyama, Masafumi Kurosumi, Akihiko Shimomura, Nobuaki Sato, Shintaro Takao, Shozo Ohsumi, Yutaka Tokuda, Hideo Inaji, Toru Watanabe, Yasuo Ohashi. Pooled analysis of long-term outcome of patients enrolled in two trials comparing the efficacy of oral tegafur-uracil with CMF (N-SAS-BC01 and CUBC trials) [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-14-17.
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Affiliation(s)
| | - Shinji Ohno
- 2Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Norikazu Masuda
- 3National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | - Futoshi Akiyama
- 2Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | | | | | | | - Shozo Ohsumi
- 9National Hospital Organization Shikoku Cancer Center, Ehima, Japan
| | - Yutaka Tokuda
- 10Tokai University School of Medicine, Kanagawa, Japan
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Hozumi Y, Ohsumi S, Mukai H, Takahashi M, Akabane H, Park Y, Tokunaga E, Takashima T, Watanabe T, Sagara Y, Kaneko T, Ohashi Y. Abstract P1-21-01: Factors affecting enrolment in randomised controlled trials of Japanese patients with metastatic breast cancer. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p1-21-01] [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: 11/16/2022]
Abstract
Abstract
Background: It is critical that a large proportion of eligible patients should participate in clinical trials. However, recruitment into clinical trials requires informed consent and involves some difficult and complex problems. Therefore, it is important to know what factors affect the participation of eligible patients in clinical trials.
Patients and Methods: Patients with metastatic breast cancer (MBC) who were eligible to participate in the SELECT BC or SELECT BC-CONFIRM trials were recruited to a prospective study accompanying them named SELECT BCFEEL. The SELECT BC and SELECT BC-CONFIRM trials were randomised controlled trials (RCTs) that compared taxanes or anthracyclines, respectively, with the oral regimen of S-1 in the first line setting for Japanese patients with MBC. The SELECT BC FEEL was conducted to identify factors affecting the rates at which informed consent was obtained, using a self-administered questionnaire we developed. The questionnaire included the following items: Physician recommendation, family or friend recommendation, satisfaction with the explanation about the trial, both from the doctor or clinical research coordinator and from printed matter, regimens used, understanding of the concept of the trial, benefit to future patients, relationship with the doctor, attitude toward random assignment, concerns about privacy, burden on the patient, and potential adverse effects. We also asked the patients their age, whether they received prior chemotherapy, and about the time needed to decide whether or not to participate, communication with their doctor or other patients, potential adverse effects they were concerned about, and other people's opinions that affected their decision. The patients were asked to answer most of the questions in 5-point Likert scales. To investigate the associations between patients’ decision regarding whether or not to participate in the RCTs and their responses to each question, the Chi-square test, the Mann-Whitney U test, and the t-test were used. P values of < 0.05 were considered statistically significant.
Results: Two hundred and thirty-two patients participated in the present study. Data were missing for 3 patients, and they were excluded from the analyses. One hundred and eighty five participated in the RCT, but 44 did not. The patients who chose to participate in these RCTs were more likely to answer that they decided to participate because "My doctor wanted me to participate in this trial" (69.2% vs. 25.6%; P <0.001), "My family or friends wanted me to participate in this trial" (46.7% vs. 9.3%; P< 0.001), "Both treatment regimens used in the trial are suitable for me" (48.4% vs. 23.8%; P = 0.004), "I know that the trial is conducted to determine which is a better treatment" (91.9% vs. 76.8%; P = 0.012), and "I think that my participation in the trial will contribute to the benefit of future patients with the same disease" (96.2% vs. 84.1%; P = 0.008), and spent fewer days making a decision (P =0.017) in comparison with those who declined to participate. The answering direction was reversed in only one question: those who answered "I am worried about the fact that I cannot choose which treatment to receive if I participate in the trial" were less likely to participate (46.4% vs. 67.4%; P = 0.010). The persons who had the greatest influence on the decision also differed significantly between the two groups (P = 0.005). Those who chose to participate were more likely to answer that "their doctors" were most influential (66.1% vs. 39.5%), but those who declined answered "their family" (22.8% vs. 46.5%) more frequently than the participants.
Conclusions: To enhance the consent rate in randomised trials of Japanese breast cancer patients, the concepts of the trials must be considered important and acceptable by the doctors and families of the patients.
Citation Format: Yasuo Hozumi, Shozo Ohsumi, Hirofumi Mukai, Masato Takahashi, Hiromitsu Akabane, Youngjin Park, Eriko Tokunaga, Tsutomu Takashima, Takanori Watanabe, Yoshiaki Sagara, Tetsuji Kaneko, Yasuo Ohashi. Factors affecting enrolment in randomised controlled trials of Japanese patients with metastatic breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-21-01.
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Affiliation(s)
- Yasuo Hozumi
- 1University of Tsukuba Hospital/Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Shozo Ohsumi
- 2National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | | | - Masato Takahashi
- 4National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | | | - Youngjin Park
- 6Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Eriko Tokunaga
- 7National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | | | - Takanori Watanabe
- 9National Hospital Organization Sendai Medical Center, Sendai, Japan
| | | | - Tetsuji Kaneko
- 11Tokyo Metropolitan Children's Medical Center, Fuchu, Japan
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Ohsumi S. Present issues regarding BRCA genetic testing and genetic counseling in medical care for HBOC patients in Japan. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz342.002] [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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Ohsumi S, Kiyoto S, Takahashi M, Hara F, Takashima S, Aogi K, Matsuda M, Yamamura N, Matsuda A, Yamauchi T, Doi M. Abstract P4-16-13: Prospective study of scalp cooling for hair loss prevention in Japanese breast cancer women receiving (neo)adjuvant chemotherapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-16-13] [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: 11/16/2022]
Abstract
Abstract
Introduction
Recently scalp cooling during chemotherapy infusion has been reported to be quite effective to mitigate chemotherapy-induced alopecia. But data in Asian patients are quite limited.
Patients and methods
Japanese breast cancer female patients who planned to receive (neo)adjuvant chemotherapy were offered to participate in this prospective study of scalp cooling with Paxman Scalp Cooling System for alopecia prevention. The scalp cooling was done 30 minutes prior to and during and 90 minutes after each chemotherapy infusion. Photographs of the head of the participants were taken from 5 directions, namely front, back, both sides, and top, on the day of chemotherapy infusion and 1 month after the last infusion. Two investigators consisting of a physician and a nurse judged the grade of alopecia by looking at the photographs according to the WHO classification. The primary outcomes were the rates of patients with Grade 3 alopecia (defined as hair loss of > 50%) and the rates of patients who used a wig or hat to conceal the hair loss one month after the last infusion of chemotherapy. This paper reports on the former outcome mainly. They were asked to answer a brief questionnaire regarding headache, fatigue, chill etc. shortly after each cooling. They could use the cooling cap for free on the first cycle of chemotherapy. But they were required to purchase it (about 1,130 US$) for the scalp cooling of the following cycles.
Results
One hundred forty three patients participated in the study and actually used the cooling cap at least once. The mean and median age of them are 50.6 and 50, respectively (28 - 76). One hundred twenty nine patients completed the planned chemotherapy of 4 to 8 cycles (89 Pts 4 cycles, 1 Pt 6 cycles, 39 Pts 8 cycles). Among them (7 patients were not evaluable), 74 patients (60.7 %) had Grade 3 alopecia 1 month after chemotherapy. In 80 patients who used the scalp cooling system throughout the planned chemotherapy (1 patient was not evaluable), 36 patients (45.6 %) experienced Grade 3 alopecia. On the other hand, among 49 patients who discontinued the cooling mostly after the 1st cycle (6 were not evaluable), 38 (88.3 %) had Grade 3 alopecia. When we restrict them to 33 (5 were not evaluable) who decided to discontinue the cooling by day10 of the first cycle of chemotherapy to exclude the patients who discontinued it because of less effect on alopecia prevention than they expected, 25 (89.3 %) experienced Grade 3 alopecia. Comparing the results of those who completed the cooling and patients who decided to discontinue it by day10 of the first cycle, the rates of Grade 3 alopecia (45.6 % vs. 89.3 %) were statistically significantly different in favor of the former (P = 0.0001). Most patients complained of some headache, chill, and pain of the jaw.
Conclusion
Scalp cooling with Paxman Scalp Cooling System during chemotherapy infusion in Asian women seems as effective for hair loss mitigation as in Caucasian women.
Citation Format: Ohsumi S, Kiyoto S, Takahashi M, Hara F, Takashima S, Aogi K, Matsuda M, Yamamura N, Matsuda A, Yamauchi T, Doi M. Prospective study of scalp cooling for hair loss prevention in Japanese breast cancer women receiving (neo)adjuvant chemotherapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-16-13.
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Affiliation(s)
- S Ohsumi
- NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - S Kiyoto
- NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - M Takahashi
- NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - F Hara
- NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - S Takashima
- NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - K Aogi
- NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - M Matsuda
- NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - N Yamamura
- NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - A Matsuda
- NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - T Yamauchi
- NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - M Doi
- NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan
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Yonemori K, Ohsumi S, Takao S, Tokuda Y, Ito Y, Nakagami K, Takahashi M, Yoshidome K, Nakayama T, Yamaguchi Y, Ohashi Y, Inaji H, Watanabe T. Abstract P1-13-09: Long-term follow-up of two randomized controlled trials (N-SAS-BC01 trial and CUBC trial) comparing oral tegafur-uracil (UFT) versus classical cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) as adjuvant therapy in early breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-13-09] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Two randomized controlled trials comparing the efficacy of oral tegafur-uracil (UFT) (2 years) with that of classical cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) (6 courses) were conducted in patients with resected early breast cancer. UFT is an oral fluoropyrimidine that combines tegafur, a prodrug of 5-fluorouracil, with uracil in a 1:4 molar ratio. One study was the N-SAS-BC01 trial (Watanabe et al, J Clin Oncol 2009), which was conducted in patients with high-risk node-negative breast cancer (n=733). The other was the CUBC trial (Park et al, Br J Cancer 2009), which was performed in patients with node-positive breast cancer (n=377). We reported the pooled analysis of these two randomized control trials using individual patient data (Ohashi et al, Breast Cancer Res Treat 2010). This pooled analysis showed that UFT was non-inferior to CMF in terms of inhibiting recurrence of estrogen receptor (ER)-positive early breast cancer. In addition, an exploratory subgroup analysis showed that UFT may be more effective in ER-positive patients who were 50 years or older. The present study was conducted to investigate the long-term efficacy of UFT or CMF in patients with early breast cancer.
Methods: Long-term follow-up data for disease recurrence and survival were collected. Hazard ratios (HR) were determined using the Cox model stratified by study and adjusted for clinical characteristics, namely age, tumor size, nodal status, histological type, ER, and progesterone receptor (PgR). Survival curves were estimated by the Kaplan-Meier method. Hochberg multiplicity adjustment was applied in the previous pooled analysis, and non-inferiority of UFT versus CMF was shown in terms of relapse-free survival (RFS) in the ER-positive patient group. We investigated the non-inferiority of UFT in the same patient group with updated data. Restricted mean survival time (RMST) was calculated to consider the relative efficacy of UFT. This study is registered with JapicCTI-163321.
Results: In total, 1,057 patients were analyzed (CMF, n=528; UFT n=529). The median follow-up time was 11.1 years (12.1 years in the N-SAS-BC 01 trial and 8.3 years in the CUBC trial). Table 1 shows the 10-year RFS and overall survival (OS) in all patients and ER-positive patients. The difference in RMST between arms at 20 years in terms of RFS was -2.7 months in all patients and 3.4 months in ER-positive patients. Table 2 shows the HR for RFS according to ER status and age.
UFT (%)CMF (%)UFT to CMF; HR (95% CI)10-year RFSall patients74.477.11.02 (0.81–1.30)ER-positive patients75.075.10.91 (0.66–1.27)10-year OSall patients86.886.90.98 (0.72–1.34)ER-positive patients89.987.90.86 (0.54–1.37)
Age <50 yearsAge ≥50 yearsER negative1.76 (0.95–3.26)0.93 (0.58–1.51)ER positive1.29 (0.74–2.23)0.76 (0.50–1.16)
Conclusion: This study shows that UFT was shown to be non-inferior to CMF in terms of RFS in ER-positive early breast cancer. This result is similar to that of the previous pooled analysis.
Sponsor: Taiho Pharmaceutical Co., LTD
Citation Format: Yonemori K, Ohsumi S, Takao S, Tokuda Y, Ito Y, Nakagami K, Takahashi M, Yoshidome K, Nakayama T, Yamaguchi Y, Ohashi Y, Inaji H, Watanabe T. Long-term follow-up of two randomized controlled trials (N-SAS-BC01 trial and CUBC trial) comparing oral tegafur-uracil (UFT) versus classical cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) as adjuvant therapy in early breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-13-09.
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Affiliation(s)
- K Yonemori
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - S Ohsumi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - S Takao
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Tokuda
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Ito
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - K Nakagami
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - M Takahashi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - K Yoshidome
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - T Nakayama
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Yamaguchi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Ohashi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - H Inaji
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - T Watanabe
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
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Takabatake D, Kajiwara Y, Ohtani S, Itano Y, Yamamoto M, Kubo S, Ikeda M, Takahashi M, Hara F, Aogi K, Ohsumi S, Ogasawara Y, Nishiyama Y, Hikino H, Matsuoka K, Takahashi Y, Shien T, Taira N, Doihara H. The efficacy and feasibility of dose-dense sequential chemotherapy for Japanese patients with breast cancer. Breast Cancer 2018; 25:717-722. [PMID: 29948957 DOI: 10.1007/s12282-018-0877-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 06/04/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Perioperative dose-dense chemotherapy (DDCT) with granulocyte-colony stimulating factor (G-CSF) prophylaxis is a standard treatment for patients with high-risk breast cancer. The approval of this approach in Japan led to the widespread adoption of DDCT, despite limited efficacy and safety data among Japanese patients. We evaluated the efficacy and safety of neoadjuvant DDCT for Japanese patients with breast cancer. METHODS This prospective, multicenter, phase II study evaluated 52 women with operable human epidermal growth factor receptor 2-negative breast cancer and axillary lymph node metastasis. Neoadjuvant DDCT (adriamycin plus cyclophosphamide or epirubicin plus cyclophosphamide followed by paclitaxel) was administrated every 2 weeks with G-CSF support. The study endpoints were the rates of pathological complete response (pCR), febrile neutropenia, treatment completion, toxicities, and the relative dose intensity (RDI). RESULTS The pCR rate was 21.9% (9/41) and the triple-negative (TN) subtype was significantly associated with a high pCR rate (triple-negative: 53.3% vs. luminal A: 7.7% and luminal B: 0%; p = 0.003). The treatment completion rate was 80.8% (42/52) and the average RDI was 98.9%. Most adverse events were manageable and tolerable. Six patients (11.5%) developed febrile neutropenia. Grade 3-4 adverse events were slightly more common among older patients (57%) with a low protocol completion rate (≥ 65 years: 42.9% vs. <65 years: 86.7%, p = 0.0062). CONCLUSION The pCR rate for DDCT was similar to that of standard chemotherapy, although it was remarkably effective for the TN subtype. DDCT may be feasible for Japanese patients with breast cancer although caution is needed for older patients.
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Affiliation(s)
- Daisuke Takabatake
- Department of Breast surgery, Kochi Health Science Center, 2125-1 Ike, Kochi, Japan.
| | - Yukiko Kajiwara
- Hiroshima Citizens Hospital, 7-33 Nakaku, Motomachi, Hiroshima, Japan
| | - Shoichiro Ohtani
- Hiroshima Citizens Hospital, 7-33 Nakaku, Motomachi, Hiroshima, Japan
| | - Yoko Itano
- Fukuyama Citizens Hospital, 5-23-1 Zaoh, Fukuyama, Japan
| | - Mari Yamamoto
- Fukuyama Citizens Hospital, 5-23-1 Zaoh, Fukuyama, Japan
| | | | - Masahiko Ikeda
- Fukuyama Citizens Hospital, 5-23-1 Zaoh, Fukuyama, Japan
| | | | - Fumikata Hara
- Shikoku Cancer Center, 160 Umemoto, Matsuyama, Japan
| | - Kenjiro Aogi
- Shikoku Cancer Center, 160 Umemoto, Matsuyama, Japan
| | - Shozo Ohsumi
- Shikoku Cancer Center, 160 Umemoto, Matsuyama, Japan
| | - Yutaka Ogasawara
- Kagawa Prefectural Center Hospital, 1-2-1 Asahimachi, Takamatsu, Japan
| | | | - Hajime Hikino
- Matsue Red Cross General Hospital, 200 Omoicho, Matsue, Japan
| | - Kinya Matsuoka
- Ehime Prefectural Central Hospital, 83 Kasugacho, Matsuyama, Japan
| | - Yuko Takahashi
- Okayama University Hospital, 2-5-1 Shikata, Kitaku, Okayama, Japan
| | - Tadahiko Shien
- Okayama University Hospital, 2-5-1 Shikata, Kitaku, Okayama, Japan
| | - Naruto Taira
- Okayama University Hospital, 2-5-1 Shikata, Kitaku, Okayama, Japan
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Valachis A, Mamounas EP, Mittendorf EA, Hayashi N, Ishitobi M, Natoli C, Fitzal F, Rubio IT, Tiezzi DG, Shin HC, Anderson SJ, Hunt KK, Matsuda N, Ohsumi S, Totomi A, Nilsson C. Risk factors for locoregional disease recurrence after breast-conserving therapy in patients with breast cancer treated with neoadjuvant chemotherapy: An international collaboration and individual patient meta-analysis. Cancer 2018; 124:2923-2930. [DOI: 10.1002/cncr.31518] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/05/2018] [Accepted: 03/18/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Antonios Valachis
- Centre for Clinical Research Sormland; Uppsala University; Uppsala Sweden
| | - Eleftherios P. Mamounas
- Comprehensive Breast Program; University of Florida Health Cancer Center-Orlando Health; Orlando Florida
| | - Elizabeth A. Mittendorf
- Department of Breast Surgical Oncology; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Naoki Hayashi
- Department of Breast Surgery; St. Luke's International Hospital; Tokyo Japan
| | - Makoto Ishitobi
- Department of Breast Surgery; Osaka International Cancer Institute; Osaka Japan
- Department of Endocrine Surgery; Osaka International Cancer Institute; Osaka Japan
| | - Clara Natoli
- Department of Oral, Medical and Biotechnological Sciences; University G. D'Annunzio; Chieti-Pescara Italy
| | - Florian Fitzal
- Department of Surgery, Breast Health Center; Medical University Vienna; Vienna Austria
| | - Isabel T. Rubio
- Breast Surgical Oncology, Breast Cancer Center; University Hospital VAll d'Hebron; Barcelona Spain
| | - Daniel G. Tiezzi
- Breast Disease Division, Department of Gynecology and Obstetrics, Ribeirao Preto Medical School; University of Sao Paulo; Sao Paulo Brazil
| | - Hee-Chul Shin
- Department of Surgery; Chung-Ang University Hospital; Seoul South Korea
| | - Stewart J. Anderson
- National Surgical Adjuvant Breast and Bowel Project Biostatistical Center, Department of Biostatistics, University of Pittsburgh Graduate School of Public Health; University of Pittsburgh; Pittsburgh Pennsylvania
| | - Kelly K. Hunt
- Department of Breast Surgical Oncology; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Naoko Matsuda
- Department of Breast Surgery; St. Luke's International Hospital; Tokyo Japan
| | - Shozo Ohsumi
- Department of Breast Oncology; NHO Shikoku Cancer Center; Matsuyama Japan
| | - Athina Totomi
- Centre for Clinical Research Sormland; Uppsala University; Uppsala Sweden
| | - Cecilia Nilsson
- Centre for Clinical Research; Vastmanlands County Hospital; Vasteras Sweden
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Shiroiwa T, Fukuda T, Shimozuma K, Mouri M, Hagiwara Y, Kawahara T, Ohsumi S, Hozumi Y, Sagara Y, Ohashi Y, Mukai H. Cost-effectiveness analysis of the introduction of S-1 therapy for first-line metastatic breast cancer treatment in Japan: results from the randomized phase III SELECT BC trial. BMC Cancer 2017; 17:773. [PMID: 29149882 PMCID: PMC5693567 DOI: 10.1186/s12885-017-3774-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 06/19/2017] [Accepted: 11/13/2017] [Indexed: 11/12/2022] Open
Abstract
Background This study evaluated the cost-effectiveness of replacing standard intravenous therapy (taxane) with oral S-1 therapy for first-line metastatic breast cancer treatment. Methods This cost-effectiveness analysis was based on data from a randomized phase III trial (SELECT BC). As cost-effectiveness was a secondary endpoint of the SELECT BC trial, some of the randomized patients participated in an EQ-5D survey (N = 391) and health economic survey (N = 146). The EQ-5D responses, claims, and prescription data were collected for as long as possible until death. The expected quality-adjusted life years (QALY) obtained from each treatment were calculated using patient-level EQ-5D data, and the expected cost was calculated using patient-level claim data. The analysis was performed from the perspective of public healthcare payers. Results The estimated EQ-5D least-square means and 95% CI up to 48 months were 0.764 (95% CI, 0.741–0.782) and 0.742 (95% CI, 0.720–0.764) in the S-1 and taxane arms, respectively. The expected QALY was 2.11 for the S-1 arm and 2.04 for the taxane arm, with expected costs of JPY 5.13 million (USD 46,600) and JPY 5.56 million (USD 50,500), respectively. These results show that S-1 is cost-saving. According to probabilistic sensitivity analysis, S-1 was dominant with a probability of 63%. When the willingness to pay (WTP) value was JPY 5 million (USD 45,500) per QALY, the probability of being cost-effective was 92%. Conclusions Our results show that the introduction of oral S-1 therapy for metastatic breast cancer is highly likely to be cost-effective. Trial registration UMIN CTR C000000416. Registered on May 10, 2006.
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Affiliation(s)
- Takeru Shiroiwa
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - Takashi Fukuda
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - Kojiro Shimozuma
- Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Mitsuko Mouri
- Kanagawa Academy of Science and Technology (KAST), 3-2-1 Sakado, Takatsu-ku, Kawasaki, Kanagawa, 213-0012, Japan
| | - Yasuhiro Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Takuya Kawahara
- Department of Biostatistics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Biostatistics Division, Clinical Research Support Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-machi, Matsuyama, Ehime, 791-0280, Japan
| | - Yasuo Hozumi
- Department of Breast and Endocrine Surgery, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.,Department of Breast Surgery, Ibaraki Prefectural Central Hospital, 6528 Koibuchi, Kasama, Ibaraki, 309-1793, Japan
| | - Yoshiaki Sagara
- Breast Surgery Department, Social Medical Corporation Hakuaikai Sagara Hospital, Matsubara-cho 3-31, Kagoshima, 892-0833, Japan
| | - Yasuo Ohashi
- Department of Integrated Science and Engineering, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, Tokyo, 112-8551, Japan
| | - Hirofumi Mukai
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
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Kinoshita T, Aogi K, Takahashi M, Ito KI, Oba T, Shiroma N, Arihiro K, Tsukamoto F, Shiino S, Yoshida M, Ohsumi S. The first report of multicenter validation study of 95-gene classifier, a multi-gene prognostic assay of estrogen receptor positive and node negative breast cancer patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.035] [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: 11/14/2022] Open
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42
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Watanabe J, Ito Y, Ohsumi S, Mizutani M, Tashiro H, Sakurai K, Takahashi M, Saito T, Tsurutani J, Mukai H, Yoshinami T, Takao S, Yamamoto Y, Matsuoka T, Iwase H, Iwata H, Nakamura S, Saeki T. Safety and effectiveness of eribulin in Japanese patients with locally advanced or metastatic breast cancer: a post-marketing observational study. Invest New Drugs 2017; 35:791-799. [PMID: 28660549 PMCID: PMC5694520 DOI: 10.1007/s10637-017-0486-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 06/20/2017] [Indexed: 12/03/2022]
Abstract
Background This large-scale study was conducted to evaluate the safety and effectiveness of eribulin for the treatment of inoperable or recurrent breast cancer in real-world settings in Japan. Methods Between July and December 2011, eligible patients with inoperable or recurrent breast cancer receiving eribulin for the first time were centrally registered and observed for 1 year. Eribulin was administered intravenously (1.4 mg/m2) on days 1 and 8 of every 3-week cycle. The primary endpoint was the frequency and intensity of adverse drug reactions (ADRs). Secondary endpoints included overall response rate (ORR) and time to treatment failure (TTF). Results Of 968 patients registered at 325 institutions, 951 and 671 were included in the safety and effectiveness analyses, respectively. In the safety population, ADRs were observed in 841 patients (88.4%). The most common (≥15% incidence) were neutropenia (66.6%), leukopenia (62.4%), lymphopenia (18.4%), and peripheral neuropathy (16.8%). The most common grade ≥ 3 ADRs (>5% incidence) were neutropenia (59.8%), leukopenia (50.5%), lymphopenia (16.1%), and febrile neutropenia (7.7%). In the effectiveness population, ORR was 16.5% (95% confidence interval: 13.7, 19.4). The median TTF was 127 days (95% confidence interval: 120, 134). Conclusions The safety and effectiveness profile of eribulin was consistent with prior studies. Eribulin had a favorable risk-benefit balance when used in real-world clinical settings.
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Affiliation(s)
- Junichiro Watanabe
- Division of Breast Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
| | - Yoshinori Ito
- Department of Breast Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization, Shikoku Cancer Center, 160, Minamiumemotomachikou, Matsuyamashi, Ehime, 791-0280, Japan
| | - Mitsuhiro Mizutani
- Mikawa Breast Cancer Clinic, 39-6, Koita, Sasame-cho, Anjo, Aichi, 446-0073, Japan
| | - Hideya Tashiro
- Department of Surgery, Oita Prefectural Hospital, 476, Bunyou, Oita, Oita, 870-8511, Japan
| | - Kenichi Sakurai
- Department of Breast Surgery, Nihon University School of Medicine, 30-1, Ohyaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Masato Takahashi
- Department of Breast Surgery, National Hospital Organization, Hokkaido Cancer Center, 2-3-54, Kikusuishijo, Shiroishi-ku, Sapporo, Hokkaido, 003-0804, Japan
| | - Tsuyoshi Saito
- Breast Surgery Unit, Japanese Red Cross Saitama Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, Saitama, 330-8553, Japan
| | - Junji Tsurutani
- Department of Medical Oncology, Kinki University Faculty of Medicine, 377-2, Onohigashi, Osaka-sayama, Osaka, 589-8511, Japan
| | - Hirofumi Mukai
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Tetsuhiro Yoshinami
- Department of Clinical Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3, Nakamichi, Higashinari-ku, Osaka, Osaka, 537-8511, Japan
| | - Shintaro Takao
- Department of Breast Surgery, Hyogo Cancer Center, 13-70, Kitaojicho, Akashi, Hyogo, 673-8558, Japan
| | - Yasuhisa Yamamoto
- Department of Surgery, Oomoto Hospital, 1-1-5, Oomoto, Kita-ku, Okayama, Okayama, 700-0924, Japan
| | - Toshiyuki Matsuoka
- Oncology PMS Section, Oncology Medical Department, Medical Division, Eisai Co., Ltd., 4-6-10 Koishikawa, Bunkyo-ku, Tokyo, 112-8088, Japan
| | - Hirotaka Iwase
- Department of Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto, 860-8556, Japan
| | - Hiroji Iwata
- Division of Immunology, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku Nagoya, Aichi, 464-8681, Japan
| | - Seigo Nakamura
- Division of Breast Surgical Oncology, Department of Surgery, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Toshiaki Saeki
- Department of Breast Oncology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
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Ito KI, Oba T, Aogi K, Ohsumi S, Takahashi M, Shiroma N, Oda M, Arihiro K, Tsukamoto F, Shiino S, Yoshida M, Kishi K, Kinoshita T. The first report of multicenter validation study on curebest 95GC breast, a multi-gene assay to predict prognosis of node negative and ER positive breast cancer patients. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e12107] [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
e12107 Background: Curebest™ 95GC Breast (95GC) is one of the multi-gene assays to predict prognosis of node negative and estrogen receptor (ER) - positive breast cancer patients, developed using 95 gene-set without overlap with that used in Oncotype DXⓇ(ref 1). It has been shown to have the capability to classify the “intermediate” patients determined using Recurrence Online (microarray-based simulation model for Oncotype DXⓇ) but was validated only using the data from single institute and public database. Here we report the result of the first multi-center validation study for this multi-gene assay. Methods: ER-positive and T1-2/N0/M0 breast cancer patients who received adjuvant hormonal therapy were enrolled retrospectively. Fresh frozen tissues were applied to the assay, resulting classification into “L” and “H”, which was used for the validation on 5 year recurrence free survival (5Y-RFS) data of each patient. Results: 73 cases out of 150 enrolled cases were eligible and analyzed. 46 patients were classified as “L” whose 5Y-RFS was 96.5% (95%CI:89.5-98.9) while 27 patients were classified as “H” whose 5Y-RFS was 79.0% (95%CI:63.6-88.5). There was a statistically significant difference between RFS of “L” and “H” group by Log-Rank test (p = 0.0016). Significant association with 95GC were seen in histological grade (p = 0.0012), Recurrence Online (p < 0.001) and PAM50 (p < 0.001). The assay could classify the patients of histological grade 2, intermediate group by Recurrence Online (RS > 17, RS < 31) and Luminal B patients into “L” and “H”. Conclusions: Curebest™ 95GC Breast was well validated by this first multi-centered retrospective study on 5Y-RFS of the ER positive, node-negative patients who received only hormonal therapy in adjuvant setting. This result indicates the usefulness of 95GC as a novel multi-gene assay, as it can classify target patients into 2 groups, “H” and “L” according to predicted prognosis of 5Y-RFS. Reference: 1. Naoi et al. Breast Cancer Res Treat (2011) 128:632-641
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Affiliation(s)
- Ken-ichi Ito
- Division of Breast, Endocrine, and Respiratory Surgery, Department of Surgery (II), Shinshu University School of Medicine, Matsumoto, Japan
| | - Takaaki Oba
- Division of Breast, Endocrine, and Respiratory Surgery, Department of Surgery (II), Shinshu University School of Medicine, Matsumoto, Japan
| | - Kenjiro Aogi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Mina Takahashi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Okayama, Japan
| | - Noriyuki Shiroma
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Miyo Oda
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Fumine Tsukamoto
- Department of Breast and Endocrine Surgery, Japan Community Health Care Organization (JCHO) Osaka Hospital, Osaka, Japan
| | - Sho Shiino
- Department of Breast Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Masayuki Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuki Kishi
- LS Business Unit, Sysmex Corporation, Kobe, Japan
| | - Takayuki Kinoshita
- Department of Breast Surgery, National Cancer Center Hospital, Tokyo, Japan
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Shien T, Ikeda M, Ohtani S, Hara F, Takahashi M, Tuji H, Yoshitomi S, Matsuoka K, Ogasawara Y, Taira N, Doihara H, Ohsumi S. 134P Safety and efficacy of eribulin and trastuzumab in anti-HER2 therapy pretreated patients with HER2-positive metastatic breast cancer: A Japanese multicenter phase 2 study (SBP-04 study). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw577.017] [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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Hara F, Mukai H, Ohsumi S, Yotsumoto D, Takashima T, Hozumi Y, Watanabe T, Saito T, Watanabe KI, Tsurutani J, Toyama T, Akabane H, Nishimura R, Taira N, Uemura Y, Ohashi Y. Biomarker analysis of S-1 in SELECT-BC: A randomized phase III study of taxane versus S-1 as the first-line chemotherapy for metastatic breast cancer (SELECT-BC EURECA). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e23274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - Daisuke Yotsumoto
- Sagara Hospital, Social Medical Corporation Hakuaikai, Kagoshima, Japan
| | | | - Yasuo Hozumi
- Department of Breast and Endocrine Surgery, University of Tsukuba Hospital/ Department of Breast Surgery, Ibaraki Prefectural Central Hospital, Tsukuba, Japan
| | | | - Tsuyoshi Saito
- Department of Breast Surgery, Saitama Red Cross Hospital, Saitama, Japan
| | | | | | | | - Hiromitsu Akabane
- Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | | | | | - Yukari Uemura
- Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Yasuo Ohashi
- Department of Integrated Science and Engineering, Chuo University, Tokyo, Japan
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Ohsumi S. [Hereditary Breast and Ovarian Cancer--From the Gynecological Viewpoint]. Gan To Kagaku Ryoho 2016; 43:189-192. [PMID: 27093729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Yoshitomi S, Tsuji H, Ikeda M, Ito M, Ohtani S, Higaki K, Sagawa T, Matsuoka K, Kawai H, Takabatake D, Doihara H, Shien T, Taira N, Ohtawa Y, Maruyama S, Hikino H, Fujii S, Yamamoto Y, Ohsumi S, Hara F. Safety and efficacy of gemcitabine and trastuzumab in HER2-directed therapy pretreated patients with HER2-positive metastatic breast cancer: SBP-01 study. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.28_suppl.142] [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
142 Background: Prognosis of HER2-positive metastatic breast cancer (MBC) has been dramatically improved by trastuzumab (Tmab). More recently, newer anti-HER2 agents such as lapatinib, pertuzumab and T-DM1 have prolonged survival. Despite the efficacy of these drugs, most patients develop progressive disease during or after treatment, and alternative anti-HER2 agents plus chemotherapies are required in subsequent lines of treatment. However, there are few evidence on efficacy of Tmab-containing regimens after disease progression. Gemcitabine (GEM) is non-cross resistant to anthracycline and taxane. Preclinical studies have shown that the combination of Tmab and GEM has synergistic effect against HER2-positive breast cancer cell lines. SBP-01 study assessed the efficacy and safety of the combination of Tamb and GEM in patients with HER2-positive MBC previously treated with anti-HER2 therapy. Methods: SBP-01 study included patients treated with one or more anti-HER2 directed regimens for MBC. Patients were administered with GEM 1250 mg/m2 on days 1 and 8 of each 21-day cycle and Tmab 4mg/kg loading dose and then 2mg/kg weekly. The primary endpoint was objective response rate (ORR). Secondary endpoints included progression free survival (PFS), overall survival, and safety. Results: Between June 2011 and June 2014, 35 patients were enrolled. Patients had ER positive tumor (37.1%), a median of 2 metastatic organ sites, visceral metastasis (80.0%), prior (neo) adjuvant Tmab (22.9%) and a median of 2 prior chemotherapy regimens for MBC. Previous HER2-directed drugs included Tmab (94.3%), lapatinib (37.1%), T-DM1 (8.6%) and pertuzumab (2.9%). ORR was 22.9% (95% CI, 8.6%-36.8%). Median PFS was 146 days. Patients with stable disease response received a median of 7 cycles (6-28 cycles) of treatment. Grade3/4 leukopenia (20.0%) and neutropenia (48.6%) were observed. All non-hematological toxicities were less than grade3. Conclusions: The Combination Tmab and GEM is effective and well-tolerated regimen for patients previously treated with HER2-directed therapy, and appears to make disease stable for long time period. Clinical trial information: UMIN000005881.
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Affiliation(s)
| | | | | | | | | | | | - Teiri Sagawa
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | | | - Hiroshi Kawai
- Japan Labour Health and Welfare Organization Okayama Rosai Hospital, Okayama, Japan
| | | | | | | | | | | | | | | | - Sayaka Fujii
- Kawasaki Medical School Hospital, Kurashiki, Japan
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Naito Y, Ohashi Y, Yokota I, Watanabe T, Iwata H, Ohsumi S, Ohno S, Hozumi Y, Yamamoto S, Takahashi M, Aihara T, Mukai H. Impact of BMI on survival and toxicity in early breast cancer: An exploratory analysis of prospective randomized phase III study N-SAS BC02 and 03. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.11102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Yoichi Naito
- National Cancer Center Hospital East, Chiba, Japan
| | - Yasuo Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan
| | - Isao Yokota
- Department of Biostatistics, The University of Tokyo, Tokyo, Japan
| | | | | | - Shozo Ohsumi
- NHO Shikoku Cancer Center, Department of Breast Oncology, Matsuyama, Japan
| | - Shinji Ohno
- Clinical Research Institute, National Kyushu Cancer Center, Fukuoka, Japan
| | | | | | - Masato Takahashi
- National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
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Naito Y, Ohashi Y, Yokota I, Watanabe T, Iwata H, Ohsumi S, Ohno S, Hozumi Y, Yamamoto S, Takahashi M, Aihara T, Mukai H. Abstract P6-08-21: Low body mass index (BMI) is associated with poor survival in Japanese patients with early breast cancer; an exploratory analysis of prospective randomized phase III trials N-SAS BC02 and 03. Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-p6-08-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Obesity is reported to be associated with worse prognosis in early breast cancer. However, there is little data regarding the impact of low BMI on survival in patients with breast cancer. As obesity is rare and low BMI is relatively common in Japanese population compared to Caucasians, Japanese cohort is suitable to assess the impact of low BMI on survival in patients with early breast cancer. Recently an exploratory analysis of a small Japanese randomized phase II trial (JFMC 34-0601) suggested that low BMI was associated with a decreased overall response rate to neoadjuvant endocrine therapy with exemestane. We further explored the impact of low BMI on survival in patients with early breast cancer using a dataset of randomized phase III trials in Japan.
Methods: Patients included in prospective randomized phase III trial N-SAS BC02 and BC03 were retrospectively analyzed. N-SAS BC02 investigated four arms of adjuvant chemotherapy consisted of taxane alone or in combination with anthracycline-containing regimen (median follow up of 6.1 years). NSAS BC03 compared anastorozole with tamoxifen as adjuvant endocrine therapy (median follow up of 6.4 years). The correlation of BMI and overall survival was exploratory analyzed. This study was supported by the Public Health Research Center Foundation CSPOR.
Results: A total of 1726 patients were included in our study. Median age was 56 (24 – 82) years, 71.2% of tumors were ER positive, and 9.7% were HER2 overexpressed. Lymph node metastases were observed in 76% of patients. Mean value of BMI was 23.3 and only 4.6% of patients had BMI over 30. 33.1% of patients had BMI under 22 and 4.8% had BMI under 18.5. In the univariate Cox proportional hazard model, lower BMI was significantly associated with worse prognosis (BMI<27 vs >27, HR 0.55, 95% CI 0.32 – 0.93, p = 0.025). The same trend was observed in multivariate analysis (HR 0.61, p = 0.064).
Conclusion: We confirmed that obese patients were relatively rare in Japanese patients with early breast cancer. In this non-obese population, lower BMI was correlated with worse prognosis. However these results should be cautiously interpreted. Our findings suggest that there may be an optimal BMI in patients with early breast cancer and it should be confirmed by another cohort.
Citation Format: Yoichi Naito, Yasuo Ohashi, Isao Yokota, Toru Watanabe, Hiroji Iwata, Shozo Ohsumi, Shinji Ohno, Yasuo Hozumi, Seiichiro Yamamoto, Masato Takahashi, Tomohiko Aihara, Hirofumi Mukai. Low body mass index (BMI) is associated with poor survival in Japanese patients with early breast cancer; an exploratory analysis of prospective randomized phase III trials N-SAS BC02 and 03 [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P6-08-21.
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Affiliation(s)
| | | | | | | | | | - Shozo Ohsumi
- 6National Hospital Organization Shikoku Cancer Center
| | - Shinji Ohno
- 7National Hospital Organization Kyushu Cancer Center
| | | | - Seiichiro Yamamoto
- 9National Cancer Center Research Center for Cancer Prevention and Screening
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Taira N, Akiyama I, Ishihara S, Ishibe Y, Kawasaki K, Saito M, Shien T, Nomura T, Hara F, Mizoo T, Mizota Y, Yamamoto S, Ohsumi S, Doihara H. Impact of modifiable lifestyle factors on outcomes after breast cancer diagnosis: the Setouchi Breast Cancer Cohort Study. Jpn J Clin Oncol 2015; 45:600-2. [PMID: 25770837 DOI: 10.1093/jjco/hyv033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 11/28/2014] [Accepted: 02/17/2015] [Indexed: 11/15/2022] Open
Abstract
The primary purpose of this large cohort study is to investigate the effects on breast cancer outcomes of modifiable lifestyle factors after breast cancer diagnosis. These factors include physical activity, smoking, alcohol consumption, obesity and weight gain after diagnosis, alternative medicine and dietary factors. Women diagnosed with Stage 0 to III breast cancer are eligible for participation to this study. Lifestyle, use of alternative medicine, psychosocial factors, reproductive factors and health-related quality of life will be assessed using a questionnaire at the time of breast cancer diagnosis (baseline), and 1, 2, 3 and 5 years after diagnosis. Clinical information and breast cancer outcomes will be obtained from a breast cancer database. The primary endpoint will be disease-free survival. Secondary endpoints are overall survival, health-related quality of life, breast cancer-related symptoms and adverse events. Patient recruitment commenced in February 2013. Enrollment of 2000 breast cancer patients is planned during the 5-year recruitment period. The concept of the study is described in this article.
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Affiliation(s)
- Naruto Taira
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama
| | | | - Setsuko Ishihara
- Department of Radiology, Okayama Saiseikai General Hospital, Okayama
| | - Youichi Ishibe
- Department of Surgery, Mizushima Kyodo Hospital, Okayama
| | - Kensuke Kawasaki
- Department of Surgery, Kagawa Prefectural Central Hospital, Kagawa
| | - Makoto Saito
- Department of Surgery, Yashima General Hospital, Kagawa
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama
| | - Tsunehisa Nomura
- Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital, Okayama
| | - Fumikata Hara
- Department of Breast Oncology, Shikoku Cancer Center, Ehime
| | - Taeko Mizoo
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama
| | - Yuri Mizota
- Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Seiichiro Yamamoto
- Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Shozo Ohsumi
- Department of Breast Oncology, Shikoku Cancer Center, Ehime
| | - Hiroyoshi Doihara
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama
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