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Takeuchi E, Ogino H, Kondo K, Okano Y, Ichihara S, Kunishige M, Kadota N, Machida H, Hatakeyama N, Naruse K, Nokihara H, Shinohara T, Nishioka Y. An increased relative eosinophil count as a predictive dynamic biomarker in non-small cell lung cancer patients treated with immune checkpoint inhibitors. Thorac Cancer 2024; 15:248-257. [PMID: 38087769 PMCID: PMC10803223 DOI: 10.1111/1759-7714.15191] [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: 09/13/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND An increased relative eosinophil count (REC) has potential as a predictive biomarker for a beneficial clinical response and outcome to cancer immunotherapies. Therefore, the present study investigated the impact of an increased posttreatment REC on the prognosis of non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs). METHODS We retrospectively reviewed all 151 patients diagnosed with NSCLC and treated with ICI monotherapy and blood test data between March 2016 and August 2021 at National Hospital Organization Kochi Hospital and Tokushima University. RESULTS A total of 151 patients with a mean age of 69 years were included. REC after 4 weeks of initial ICI monotherapy was higher than pretreatment REC in 87 patients but not in 64. REC after 4 weeks of the ICI treatment with and without an increased REC were 4.4 and 1.8%, respectively (p < 0.001). Disease control rates (DCR) were significantly higher in patients with than in those without an increased REC (84% vs. 47%, p < 0.001). The median overall survival (OS) of lung cancer patients with or without an increased REC were 674 and 234 days, respectively. A Kaplan-Meier univariate analysis revealed a significant difference in OS between the two groups (p < 0.001). A Cox proportional regression analysis identified an increased REC as an independent predictor of OS (p = 0.003). CONCLUSION ICI-treated NSCLC patients with an increased REC after 4 weeks of treatment had a better DCR and prognosis than the other patients examined.
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Affiliation(s)
- Eiji Takeuchi
- Department of Clinical InvestigationNational Hospital Organization Kochi HospitalKochiJapan
| | - Hirokazu Ogino
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Kensuke Kondo
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Yoshio Okano
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Seiya Ichihara
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Michihiro Kunishige
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Naoki Kadota
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Hisanori Machida
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Nobuo Hatakeyama
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Keishi Naruse
- Department of PathologyNational Hospital Organization Kochi HospitalKochiJapan
| | - Hiroshi Nokihara
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Tsutomu Shinohara
- Department of Community Medicine for RespirologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Yasuhiko Nishioka
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
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Atagi S, Daimon T, Okishio K, Komuta K, Okano Y, Minato K, Kim YH, Usui R, Tabata C, Tamura A, Kawahara M. A randomized phase III study of docetaxel alone versus docetaxel plus S-1 in patients with previously treated non-small cell lung cancer: JMTO LC09-01. Thorac Cancer 2023; 14:2941-2949. [PMID: 37609677 PMCID: PMC10569902 DOI: 10.1111/1759-7714.15080] [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: 05/30/2023] [Revised: 08/02/2023] [Accepted: 08/05/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND This study evaluated the efficacy and safety of the combination chemotherapy of docetaxel plus S-1 in patients with previously treated non-small cell lung cancer (NSCLC) compared to docetaxel alone. METHODS Patients with previously treated NSCLC were randomly assigned to docetaxel alone (arm A) or a combination of docetaxel and S-1 (arm B) for a maximum of four cycles. The primary endpoint was overall survival (OS). RESULTS The study was terminated early because of poor accrual. The number of patients evaluated were 74 and 77 in arm A and arm B, respectively. The median OS was 9.8 months (95% confidence interval [CI]: 6.8-15.2) and 12.3 months (95% CI: 9.2-14.5) in arms A and B, respectively. In arms A and B, the median progression-free survival was 3.5 months (95% CI: 2.7-4.0) and 4.1 months (95% CI: 3.2-4.7), respectively. No statistically significant difference was observed in OS (hazard ratio [HR]: 0.984, 95% CI: 0.682-1.419, p = 0.4569) or progression-free survival (HR: 0.823, 95% CI: 0.528-1.282, p = 0.0953). The major toxicity was myelosuppression. The incidence of grade 3 or more neutropenia was higher in arm A than in arm B (44.6% vs. 35.1%). However, the incidence of grade 3 or more febrile neutropenia and infection with neutropenia (12.2% vs. 22.1%) was more frequently observed in arm B. CONCLUSIONS The prematurely terminated study did not show the benefit of two cytotoxic agents over single-agent therapy for previously treated NSCLC patients.
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Affiliation(s)
- Shinji Atagi
- Health Management CenterJapan Community Health care Organization Yamatokoriyama HospitalYamatokoriyamaJapan
| | - Takashi Daimon
- Department of BiostatisticsHyogo College of MedicineNishinomiyaJapan
| | - Kyoichi Okishio
- Department of Clinical Research CenterNational Hospital Organization Kinki‐Chuo Chest Medical CenterSakaiJapan
| | - Kiyoshi Komuta
- Internal MedicineOsaka Anti‐Tuberculosis Association Osaka Fukujuji HospitalOsakaJapan
| | - Yoshio Okano
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Koichi Minato
- Division of Respiratory MedicineGunma Prefectural Cancer CenterOtaJapan
| | - Young Hak Kim
- Department of Respiratory MedicineGraduate School of Medicine, Kyoto UniversityKyotoJapan
| | - Ryo Usui
- Department of Respiratory MedicineTokyo Metropolitan Bokutoh HospitalTokyoJapan
| | | | - Atsuhisa Tamura
- Center for Pulmonary DiseasesNational Hospital Organization Tokyo National HospitalTokyoJapan
| | - Masaaki Kawahara
- Operations OfficeThe Japan‐Multinational Trial OrganizationNagoyaJapan
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Takeuchi E, Kondo K, Okano Y, Ichihara S, Kunishige M, Kadota N, Machida H, Hatakeyama N, Naruse K, Ogino H, Nokihara H, Shinohara T, Nishioka Y. Pretreatment eosinophil counts as a predictive biomarker in non-small cell lung cancer patients treated with immune checkpoint inhibitors. Thorac Cancer 2023; 14:3042-3050. [PMID: 37669914 PMCID: PMC10599974 DOI: 10.1111/1759-7714.15100] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 07/21/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND The peripheral blood eosinophil count prior to treatment has potential as a predictive biomarker for a beneficial clinical response to cancer immunotherapies. Therefore, the present study investigated the impact of the eosinophil count on overall survival (OS) in non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICI). METHODS We retrospectively reviewed all patients diagnosed with NSCLC and treated with ICI monotherapy between March 2016 and August 2021 at National Hospital Organization Kochi Hospital and Tokushima University. RESULTS A total of 166 patients were included. Fifty-five patients had an eosinophil count of less than 100 cells/μL (Eo < 100). Nighty-eight patients had an eosinophil count of 100 cells/μL or more, but less than 500 cells/μL (100 ≤ Eo < 500). Thirteen patients had an eosinophil count of 500 cells/μL or more (Eo ≥500). The median OS of all lung cancer patients was 476 days. The median OS of lung cancer patients with Eo <100, 100 ≤ Eo <500, and Eo ≥500 was 339, 667, and 143 days, respectively. A Kaplan-Meier univariate analysis showed a significant difference in OS between these three groups (p < 0.001). A Cox proportional regression analysis identified 100 ≤ Eo <500 (p = 0.04), ECOG PS score ≥ 2 (p = 0.02), tumor size ≥5 cm (p = 0.02), and PD-L1 ≥ 1% (p = 0.01) as independent predictors of OS. CONCLUSION OS was significantly longer in ICI-treated NSCLC patients with a pretreatment eosinophil count of 100 ≤ Eo <500 than in the other patients and, thus, has potential as a new predictive biomarker.
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Affiliation(s)
- Eiji Takeuchi
- Department of Clinical InvestigationNational Hospital Organization Kochi HospitalKochiJapan
| | - Kensuke Kondo
- Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical SciencesTokushima UniversityTokushimaJapan
| | - Yoshio Okano
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Seiya Ichihara
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Michihiro Kunishige
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Naoki Kadota
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Hisanori Machida
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Nobuo Hatakeyama
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Keishi Naruse
- Department of PathologyNational Hospital Organization Kochi HospitalKochiJapan
| | - Hirokazu Ogino
- Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical SciencesTokushima UniversityTokushimaJapan
| | - Hiroshi Nokihara
- Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical SciencesTokushima UniversityTokushimaJapan
| | - Tsutomu Shinohara
- Department of Community Medicine for Respirology, Graduate School of Biomedical SciencesTokushima UniversityTokushimaJapan
| | - Yasuhiko Nishioka
- Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical SciencesTokushima UniversityTokushimaJapan
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Shimokawa M, Kanazu M, Saito R, Mori M, Tamura A, Okano Y, Fujita Y, Endo T, Motegi M, Takata S, Kita T, Sukoh N, Mizuki F, Takenoyama M, Atagi S. Clinical benefit of platinum doublet combination therapy in older adults with advanced non-small cell lung cancer: A prospective multicenter study by the National Hospital Organization in Japan. Thorac Cancer 2023. [PMID: 37073452 PMCID: PMC10260489 DOI: 10.1111/1759-7714.14904] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Previous trials suggest that older adults with non-small cell lung cancer (NSCLC) derive benefit from platinum doublet combination therapy, but its superiority is controversial. Although geriatric assessment variables are used to assess the individual risk of severe toxicity and clinical outcomes in older patients, the standard first-line treatment is still debated. Therefore, we aimed to identify the risk factors for clinical outcomes in older patients with NSCLC. METHODS Patients aged ≥75 years with advanced NSCLC treated at any of 24 National Hospital Organization institutions completed a pre-first-line chemotherapy assessment, including patient characteristics, treatment variables, laboratory test values, and geriatric assessment variables. We evaluated whether these variables were the risk factors for progression-free survival (PFS) and overall survival (OS). RESULTS A total of 148 patients with advanced NSCLC were treated with combination therapy (n = 90) or monotherapy (n = 58). Median PFS was 5.3 months and OS was 13.6 months. We identified that hypoalbuminemia (hazard ratio [HR] 2.570, 95% confidence interval [CI]: 1.117-5.913, p = 0.0264) was a risk factor for PFS and monotherapy (HR 1.590, 95% CI: 1.070-2.361, p = 0.0217), lactate dehydrogenase (HR 3.682, 95% CI: 1.013-13.39, p = 0.0478), and high C-reactive protein (HR 2.038, 95% CI: 1.141-3.642, p = 0.0161) were risk factors for OS. The median OS was significantly longer in patients treated with combination therapy than in those who received monotherapy (16.5 months vs. 10.3 months; HR 0.684, 95% CI: 0.470-0.995, p = 0.0453). DISCUSSION Platinum doublet combination therapy may be beneficial in older patients with NSCLC. Identification of risk factors will assist in the development of a personalized treatment strategy.
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Affiliation(s)
- Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
- Clinical Research Institute, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masaki Kanazu
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka, Japan
| | - Ryusei Saito
- Division of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Masahide Mori
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka, Japan
| | - Atsuhisa Tamura
- Department of Respiratory Diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Yoshio Okano
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Yuka Fujita
- Department of Respiratory Medicine, National Hospital Organization Asahikawa Medical Center, Asahikawa, Japan
| | - Takeo Endo
- Department of Respiratory Medicine, National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | - Mitsuru Motegi
- Department of Respiratory Medicine, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan
| | - Shohei Takata
- Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Toshiyuki Kita
- Department of Respiratory Medicine, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - Noriaki Sukoh
- Department of Respiratory Medicine, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Fumitaka Mizuki
- Center for Clinical Research, Yamaguchi University Hospital, Yamaguchi, Japan
| | - Mitsuhiro Takenoyama
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Shinji Atagi
- Department of Thoracic Oncology, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
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Kunishige M, Ichihara S, Kadota N, Okano Y, Machida H, Hatakeyama N, Naruse K, Shinohara T, Takeuchi E. Non-small cell lung cancer with EGFR (L858R and E709X) and CNNB1 mutations responded to afatinib. Thorac Cancer 2022; 14:423-426. [PMID: 36519636 PMCID: PMC9891858 DOI: 10.1111/1759-7714.14775] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Lung cancer with complex epidermal growth factor receptor (EGFR) and CTNNB1 comutations is rare, and the efficacy of tyrosine kinase inhibitors (TKIs) is generally poor. Here, we encountered a lung cancer patient with complex EGFR (L858R and E709X) and CTNNB1 comutations who successfully responded to afatinib. A 78-year-old woman visited our hospital with a cough and bloody sputum that had worsened over the past year. She had multiple mass shadows in both lungs and nodular shadows in the bronchi. The patient was diagnosed with lung adenocarcinoma cT4N3M1c stage IVB. A genetic analysis of the primary tumor using the Oncomine Dx target test multi-CDx system revealed positivity for EGFR (L858R and E709X) and CTNNB1 mutations. The expression of programmed death ligand 1 (22C3 clones) in tumor cells was negative by immunostaining. The patient was treated with afatinib as first-line therapy and achieved clinical improvement and a partial response and is continuing treatment 1 year later. Case reports of lung cancer patients with EGFR/CTNNB1 comutations are rare, and TKIs are not considered to be effective. We herein present the first case report of lung cancer with the co-occurrence of uncommon and complex EGFR (L858R and E709X) and CTNNB1 mutations that was successfully treated with afatinib.
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Affiliation(s)
- Michihiro Kunishige
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochi cityKochiJapan
| | - Seiya Ichihara
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochi cityKochiJapan
| | - Naoki Kadota
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochi cityKochiJapan
| | - Yoshio Okano
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochi cityKochiJapan
| | - Hisanori Machida
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochi cityKochiJapan
| | - Nobuo Hatakeyama
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochi cityKochiJapan
| | - Keishi Naruse
- Department of PathologyNational Hospital Organization Kochi HospitalKochi cityKochiJapan
| | - Tsutomu Shinohara
- Department of Community Medicine for Respirology, Graduate School of Biomedical SciencesTokushima UniversityTokushimaJapan
| | - Eiji Takeuchi
- Department of Clinical InvestigationNational Hospital Organization Kochi HospitalKochi cityKochiJapan
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Ichihara S, Kunishige M, Kadota N, Okano Y, Machida H, Hatakeyama N, Naruse K, Shinohara T, Takeuchi E. Late-onset acute type 1 diabetes mellitus 7 months after discontinuation of pembrolizumab against lung cancer. Thorac Cancer 2022; 14:81-84. [PMID: 36411591 PMCID: PMC9807438 DOI: 10.1111/1759-7714.14736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/23/2022] Open
Abstract
Immune-related adverse events (irAEs) occur in rare cases, even after the completion of immune checkpoint inhibitor (ICI) therapy. We encountered a lung cancer patient diagnosed with acute-onset type 1 diabetes mellitus (DM) 7 months after the cessation of ICI. A 68-year-old woman was referred to our hospital for chest abnormalities. She was diagnosed with lung adenocarcinoma cT4N2M1c, stage IVB. Immunostaining showed that the expression of programmed death ligand 1 in tumor cells was negative. A genetic analysis using the Oncomine Dx Target Test Multi-CDx System revealed that the primary tumor was positive for ERBB2. Combined immunotherapy with carboplatin, pemetrexed, and pembrolizumab was performed as first-line therapy, followed by maintenance therapy with pemetrexed plus pembrolizumab, which was successful. After the seventh course, maintenance therapy was stopped because only the primary tumor showed local enlargement. Local chest radiotherapy (66 Gy/33 Fr) was performed, and the patient was followed up. HbA1c was 4.9% 3 months after the completion of pembrolizumab, and dry mouth and polyuria occurred after 5 months. Seven months later, the patient developed diabetic ketoacidosis with a blood glucose of 348 mg/dL and an HbA1c of 11.3%. Antiglutamic acid decarboxylase antibodies were negative and urinary C-peptide was 9.3 μg/day. The patient was diagnosed with acute-onset type 1 diabetes and received insulin therapy. There has been no case report of type 1 diabetes diagnosed 7 months after the last administration of an ICI. These results indicate that irAE needs to be considered even after the cessation of ICI.
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Affiliation(s)
- Seiya Ichihara
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Michihiro Kunishige
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Naoki Kadota
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Yoshio Okano
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Hisanori Machida
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Nobuo Hatakeyama
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochiJapan
| | - Keishi Naruse
- Department of PathologyNational Hospital Organization Kochi HospitalKochiJapan
| | - Tsutomu Shinohara
- Department of Community Medicine for RespirologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Eiji Takeuchi
- Department of Clinical InvestigationNational Hospital Organization Kochi HospitalKochiJapan
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Kanazu M, Shimokawa M, Saito R, Mori M, Tamura A, Okano Y, Fujita Y, Endo T, Motegi M, Takata S, Kita T, Sukoh N, Takenoyama M, Atagi S. Predicting systemic therapy toxicity in older adult patients with advanced non-small cell lung cancer: A prospective multicenter study of National Hospital Organization in Japan. J Geriatr Oncol 2022; 13:1216-1222. [PMID: 36008273 DOI: 10.1016/j.jgo.2022.07.011] [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: 04/14/2022] [Revised: 07/20/2022] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Previous studies have developed risk stratification schemas to assess systemic therapy toxicity. However, it is controversial which geriatric assessment variables should be used to assess the individual risk of severe treatment-associated toxicity in older adult patients. MATERIALS AND METHODS Patients aged ≥70 years with advanced non-small cell lung cancer (NSCLC) treated at 24 National Hospital Organization institutions completed a pre-first-line systemic therapy assessment, including patient characteristics, treatment variables, laboratory test values, and geriatric assessment variables. Patients were followed through one cycle of systemic therapy to assess grade 3 (severe) to grade 5 (death) adverse events according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. RESULTS In total, 348 advanced NSCLC patients with a median age of 76 years (range, 70 to 95 years) joined this prospective study. Severe adverse events ≥grade 3 occurred in 136 patients (39.1%). Predictors of hematologic toxicity were treatment variables, body mass index, body weight loss, and limitation in daily living due to dementia. These predictors provided the predictive model of hematologic toxicity ≥grade 3; 0 point (22.2%), 1 point (33.8%), 2 points (59.6%), ≥3 points (73.3%). Sex, daily living independence level, and lactate dehydrogenase levels were associated with non-hematologic toxicity ≥grade 3 in multivariate analysis. A scoring system using these predictors distinguished the risk levels of non-hematologic toxicity ≥grade 3; 0 point (6.6%), 1 point (12.2%), 2 points (39.0%), 3 points (75.0%). DISCUSSION A stratification using individual extracted risk factors may be useful to predict the vulnerability to systemic therapy in older adult NSCLC patients.
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Affiliation(s)
- Masaki Kanazu
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Japan.
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Japan; Clinical Research Institute, National Hospital Organization Kyusyu Cancer Center, Japan
| | - Ryusei Saito
- Division of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Japan
| | - Masahide Mori
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Japan
| | - Atsuhisa Tamura
- Department of Respiratory Diseases, National Hospital Organization Tokyo National Hospital, Japan
| | - Yoshio Okano
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Japan
| | - Yuka Fujita
- Department of Respiratory Medicine, National Hospital Organization Asahikiwa Medical Center, Japan
| | - Takeo Endo
- Department of Respiratory Medicine, National Hospital Organization Mito Medical Center, Japan
| | - Mitsuru Motegi
- Department of Respiratory Medicine, National Hospital Organization Takasaki General Medical Center, Japan
| | - Shohei Takata
- Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, Japan
| | - Toshiyuki Kita
- Department of Respiratory Medicine, National Hospital Organization Kanazawa Medical Center, Japan
| | - Noriaki Sukoh
- Department of Respiratory Medicine, National Hospital Organization Hokkaido Medical Center, Japan
| | - Mitsuhiro Takenoyama
- Department of Thoracic Oncology, National Hospital Organization Kyusyu Cancer Center, Japan
| | - Shinji Atagi
- Department of Thoracic Oncology, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan
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Hino H, Shinohara S, Okano Y, Naruse K, Takeuchi E, Sakiyama S, Shinohara T. Solitary Ground-Glass Nodule Mimicking Lung Cancer due to Focal Progression of Usual Interstitial Pneumonia. Int J Surg Pathol 2022:10668969221117984. [PMID: 35946121 DOI: 10.1177/10668969221117984] [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: 11/17/2022]
Abstract
Idiopathic pulmonary fibrosis is often associated with lung cancer, but early malignant lesions mixed with fibrous lesions are not always easy to diagnose. A 78-year-old woman was referred to our hospital due to a ground-glass nodule in the left upper lobe detected on chest high resolution computed tomography during follow-up of chronic idiopathic interstitial pneumonia. Pathological examination of the resected specimen revealed that the ground-glass nodule was locally progressed usual interstitial pneumonia (UIP). It should be noted that focal progression of UIP may occur and present with ground-glass nodule mimicking lung cancer, even if lesions in other areas remain unchanged. Moreover, in such cases, recognition of nodular lesions by the gross findings on the pleural surface and palpation during surgical resection are difficult and require precise marking.
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Affiliation(s)
- Hiroyuki Hino
- Division of Thoracic Surgery, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Shizuka Shinohara
- Division of Internal Medicine, Japan Community Health Care Organization Kochi West Hospital, Kochi, Japan
| | - Yoshio Okano
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Keishi Naruse
- Division of Pathology, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Eiji Takeuchi
- Department of Clinical Investigation, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Shoji Sakiyama
- Division of Thoracic Surgery, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Tsutomu Shinohara
- Department of Community Medicine for Respirology, 118112Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
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9
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Takeuchi E, Kondo K, Okano Y, Kunishige M, Kondo Y, Kadota N, Machida H, Hatakeyama N, Naruse K, Ogino H, Nokihara H, Shinohara T, Nishioka Y. Early mortality factors in immune checkpoint inhibitor monotherapy for advanced or metastatic non-small cell lung cancer. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04215-7. [DOI: 10.1007/s00432-022-04215-7] [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: 04/06/2022] [Accepted: 07/15/2022] [Indexed: 11/24/2022]
Abstract
Abstract
Purpose
Immune checkpoint inhibitors (ICI) are a promising treatment, but may cause hyperprogressive disease and early death. The present study investigated early mortality factors in ICI monotherapy for lung cancer.
Patients and methods
We retrospectively reviewed all patients diagnosed with advanced or metastatic non-small cell lung cancer (NSCLC) and treated with ICI monotherapy (nivolumab, pembrolizumab, and atezolizumab) between March 2016 and August 2021 at National Hospital Organization Kochi Hospital and Tokushima University. Early death was defined as patients who died within 60 days of ICI treatment.
Results
A total of 166 patients were included. The majority of patients (87%) had an Eastern cooperative oncology group (ECOG) Performance status (PS) of 0/1. There were 21 early deaths. Significant differences were observed in ECOG PS, the histological type, liver metastasis, tumor size, the white blood cell count, neutrophils (%), lymphocytes (%), the neutrophil-to-lymphocyte ratio in serum (sNLR), C-reactive protein (CRP), and albumin between the groups with or without early death. Univariate logistic regression analyses identified ECOG PS score ≥ 2, liver metastasis, tumor size ≥ 5 cm, neutrophils ≥ 69%, lymphocytes < 22%, sNLR ≥ 4, CRP ≥ 1 mg/dl, and albumin < 3.58 g/dl as significant risk factors for early death. A multivariate logistic regression analysis revealed that liver metastasis (Odds ratio [OR], 10.3; p = 0.008), ECOG PS score ≥ 2 (OR, 8.0; p = 0.007), and a smoking history (OR, 0.1; p = 0.03) were significant risk factors for early death.
Conclusion
Liver metastases, ECOG PS score ≥ 2, and a non-smoking history are early mortality factors in ICI monotherapy for advanced or metastatic NSCLC.
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Okano Y, Morishita A, Naruse K, Takeuchi E. Positron Emission Tomography/Computed Tomography Findings of Granulocyte Colony-stimulating Factor-producing Lung Cancer. Intern Med 2022; 61:2241-2242. [PMID: 34980799 PMCID: PMC9381352 DOI: 10.2169/internalmedicine.8777-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yoshio Okano
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Japan
| | - Atsushi Morishita
- Department of Thoracic Surgery, National Hospital Organization Kochi Hospital, Japan
| | - Keishi Naruse
- Department of Pathology, National Hospital Organization Kochi Hospital, Japan
| | - Eiji Takeuchi
- Department of Clinical Investigation, National Hospital Organization Kochi Hospital, Japan
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Shimada T, Higashida-Konishi M, Izumi K, Hama S, Oshige T, Oshima H, Okano Y. POS1423 CHARACTERISTICS OF CYTOMEGALOVIRUS-POSITIVE VERSUS NEGATIVE, AND CYTOMEGALOVIRUS-TREATED VERSUS UNTREATED PATIENTS DURING IMMUNOSUPPRESSIVE THERAPY FOR RHEUMATIC DISEASES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2193] [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] [Indexed: 11/04/2022]
Abstract
BackgroundImmunosuppressive treatment is a common cause of cytomegalovirus (CMV) reactivation.ObjectivesTo elucidate the characteristics of CMV-positive and negative patients during the treatment for rheumatic diseases.MethodsWe retrospectively evaluated consecutive patients admitted to our department from January 2006 to October 2021 whose C7-HRP antigen were measured. We collected their age, sex, primary problem and its lesion, and test results within 3 months before C7-HRP measurement. We also investigated the use of immunosuppressants, and maximum and cumulative dose of administered prednisolone within 6 months before C7-HRP measurement. Maximum and cumulative dose of prednisolone contained methylprednisolone pulse, which was converted into prednisolone equivalent. We investigated the characteristics of CMV-positive and negative patients, and those of CMV-positive patients with or without anti-CMV drug use.ResultsOf a total of 472 patients, 85 were positive and 387 were negative for C7-HRP. The average age was 71.2 vs. 64.4 (p=0.0021). Their male-to-female ratio was 20/65 vs. 120/267 (p=0.0290). The following diseases were significantly common among CMV-positive patients: microscopic polyangiitis (21.2% vs. 3.9%, p<0.0001), adult-onset Still’s disease (7.1% vs. 1.3%, p=0.0002), and systemic sclerosis (4.7% vs. 2.1%, p=0.0273). Significantly common comorbidities of CMV-positive patients were interstitial lung disease (35.3% vs. 16.0%, p<0.0001), nephritis (23.5% vs. 11.6%, p=0.0005), peripheral nervous system disorders (11.8% vs. 5.7%, p=0.0070), alveolar hemorrhage (5.9% vs. 0.8%, p=0.0001), and peripheral circulatory disorders (4.7% vs. 1.6%, p=0.0111). Average neutrophil counts (7720 /μL vs. 6440 /μL, p=0.0001), serum creatinine (1.0 mg/dL vs. 0.9 mg/dL, p=0.0104), and hemoglobin A1c (6.3% vs. 5.7%, p=0.0030) were significantly higher among CMV-positive patients, whereas hemoglobin (10.1 g/dL vs. 11.1 g/dL, p<0.0001), lymphocyte counts (820 /μL vs. 1190 /μL, p<0.0001), platelet counts (233000 /μL vs. 259000 /μL, p<0.0001), and serum albumin (2.9 g/dL vs. 3.4 g/dL, p<0.0001) were lower. Higher maximum dose of prednisolone (534.9 mg/day vs. 135.5 mg/day, p<0.0001), intravenous cyclophosphamide (27.1% vs. 11.4%, p<0.0001), rituximab (9.4% vs. 2.1%, p<0.0001), azathioprine (23.5% vs. 14.2%, p=0.0053), cyclosporin (8.2% vs. 3.6%, p=0.0101) were significantly more often used among CMV-positive patients. Average cumulative dose of prednisolone was 3022.6 mg vs. 1408.7 mg (p<0.0001). We also performed multivariate analysis, including the patients’ age, sex, maximum and cumulative dose of prednisolone, and the use of intravenous cyclophosphamide, rituximab, azathioprine, and cyclosporin. Elderly (p=0.0006), female (p=0.0293), high cumulative dose of prednisolone (p=0.0155), and the use of cyclosporin (p=0.0479) were significantly associated with CMV-positivity. Anti-CMV drug was administered to 63.5% of CMV-positive patients. The average age was significantly higher in anti-CMV-drug-treated patients than untreated patients (73.7 vs. 67.1, p=0.0492). The CMV-treated patients had significantly higher neutrophil counts (8540 /μL vs. 6280 /μL, p<0.0001), erythrocyte sedimentation rate (57.6 mm/h vs. 40.5 mm/h, p<0.0001), and C-reactive protein (5.3 mg/dL vs. 2.6 mg/dL, p<0.0001) than the untreated patients while the other data such as complete blood counts and serum chemistry revealed no significant difference. Average maximum dose of prednisolone was significantly higher in CMV-treated patients (617.1 mg/day vs. 391.1 mg/day, p=0.0261) while average cumulative dose of prednisolone and the use of any other immunosuppressants revealed no significant difference.ConclusionIntense immunosuppression, especially with higher dose of glucocorticoids, seemed to be the major risk factor of CMV reactivation. These medications may often require anti-CMV therapy.Disclosure of InterestsNone declared
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Higashida-Konishi M, Izumi K, Shimada T, Hama S, Oshige T, Oshima H, Okano Y. AB0298 THE RISK OF SULPHA ALLERGY IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3448] [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] [Indexed: 11/04/2022]
Abstract
BackgroundSulpha drugs have been used such as sulfasalazine for the treatment of rheumatoid arthritis (RA), and trimethoprim-sulfamethoxazole (TMP-SMX) for the treatment or prevention of pneumocystis pneumonia. However, some patients with RA delay treatment because of allergy to sulpha drugs[1]. We reported that 16.7% of RA patients presented drug allergies[2]. It was not clear what is a risk factor for drug allergies in patients with RA.ObjectivesThe aim of this study was to evaluate the clinical features with sulpha allergy in patients with RA.MethodsWe prospectively examined consecutive patients diagnosed with RA in our hospital from March 2021 to January 2022. The patients with RA met the EULAR/ACR 2010 criteria. We included patients with RA with other rheumatic diseases. A careful allergic history was obtained from patients with RA and physical examination performed.The first analysis was performed on patient baseline laboratory data at diagnosis of patients with RA with or without sulpha allergy. Sulpha allergy (rash, angioedema and anaphylaxis after drug exposure) was allergy to sulfasalazine or TMP-SMX. The second analysis was performed on seven types of allergic reactions: (1) drug allergies other than sulpha drugs (rash, angioedema and anaphylaxis after drug exposure), (2) food allergy (rash, angioedema and anaphylaxis after foods exposure), (3) allergic contact dermatitis such as metals, and other cosmetics, (4) seasonal allergic rhinitis and/or conjunctivitis (AR and/or AC), and AR and/or AC associated with house dust, (5) asthma, and (6) atopic dermatitis.ResultsThere were 513 patients with RA in our study. In the first analysis, 17 patients with sulpha allergy and 496 patients without sulpha drugs were enrolled (Table 1). The median ages (with supha allergy and without sulpha allergy) were 66.0 and 72.0 years old (p=0.40). Females were 82.3% and 77.0%(p=0.4). The median observation period was 97.0 and 69.0 months (p=0.20). Patients with other rheumatic diseases were 11.6 and 6.8% (p=0.34).Table 1.Characteristics of RA patients at diagnosis of RAWith sulpha allergy (n = 17)Without sulpha allergy (n = 496)PFemale83.4%76.9%0.77Age, year, y66.0 (56.0-78.5)72.0 (60.0-80.0)0.40Observation period, m97.0 (45.5-182.0)69.0 (31.0-123.8)0.20Patients with other rheumatic diseases11.8%6.8%0.34ANA-positive patients(>1:80)52.9%28.2%0.052Anti-SSA antibody-positive patients46.2%18.2%0.02RF-positive patients40.0%66.8%0.049The RA patients with sulpha allergy had higher positivity rate of anti-nuclear antibody (ANA) (>1:80) (52.9%, 28.2%: p=0.052), higher positivity rate of anti–Sjögren’s-syndrome-related antigen A autoantibody (anti-SSA antibody) than those without sulpha allergies (46.2%, 18.2%: p = 0.02) and lower positivity rate of rheumatoid factor(RF) than those without sulpha allergies (40.0%, 66.8%: p = 0.049).In the second analysis drug allergies other than sulpha allergy were more frequent in patients with sulpha allergy. Drug allergies other than sulpha allergy were such as antibiotics and nonsteroidal anti-inflammatory drugs. There were no significant differences in other allergies.ConclusionAmong patients with RA, patients with sulpha allergy had higher positivity rate of ANA and anti-SSA antibody, and lower positivity rate of RF than those without sulpha allergy. RA patients with sulpha allergy had a higher prevalence of the other drug allergies than those other than sulpha allergy.References[1]Konishi MH et al. Allergic diseases in adult-onset Still’s disease and rheumatoid arthtitis. Arerugi. 2021; 70: 965-975.[2]Konishi MH et al. Allergic Disorders and Drug Allergies in Primary Sjögren’s Syndrome and Rheumatoid Arthritis. EULAR 2021.Disclosure of InterestsNone declared
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Tamai H, Ikeda K, Miyamoto T, Taguchi H, Kuo CF, Shin K, Hirata S, Okano Y, Sato S, Yasuoka H, Choi IA, Park SH, Weng MY, Kuwana M, Lee YJ, Ishii T, Kim J, Kameda H, Kojima T, Baek HJ, Hsu PN, Huang CM, Cheng TT, Sung WY, Taninaga T, Mori M, Miyagishi H, Sato Y, Takeuchi T, Kaneko Y. OP0062 EFFICACY AND SAFETY OF ADALIMUMAB WITH LOW AND HIGH DOSE-METHOTREXATE IN PATIENTS WITH RHEUMATOID ARTHRITIS WITH INADEQUATE RESPONSE TO METHOTREXATE: THE RANDOMISED CONTROLLED MIRACLE STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4] [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] [Indexed: 11/03/2022]
Abstract
BackgroundRheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that causes not only joint pain but also bone destruction resulting in impairment of quality of life. Tumor necrosis factor inhibitors have improved prognosis of patients with rheumatoid arthritis dramatically, especially in combination with methotrexate, however, the optimal dose of the concomitant methotrexate is unclear.ObjectivesTo evaluate the efficacy and safety of adalimumab in combination with reduced dose of methotrexate in patients with early RA with inadequate response to methotrexate.MethodsThe MIRACLE study was a multinational, randomized, open-label study in patients with RA with inadequate response to methotrexate conducted in Asia. It compared low dose and high dose methotrexate upon starting adalimumab. Methotrexate-naive patients with RA with a disease duration of less than two years started methotrexate at 6 to 8 mg/week and increased it to the maximum tolerable dose by week 12. Patients who have not achieved remission according to simplified disease activity index (SDAI) despite methotrexate ≥ 10 mg/week at week 24 were randomised to the maximum tolerable dose of methotrexate group (10 to 25 mg/week) or the reduced dose group (6 to 8 mg/week) and started to receive subcutaneous adalimumab 40 mg every other week. The primary endpoint was non-inferiority in the achievement of SDAI remission at week 48 in the reduced dose group compared with the maximum tolerable dose group with a non-inferiority margin of -15% based on two-sided 90% confidence interval. (NCT03505008)ResultsA total of 300 patients were enrolled in the study. Among them, 291 started methotrexate and were included in the analysis. The mean age was 57.7±15.2 years, female was 74.6%, and the mean disease duration from the diagnosis of RA was 21.1±56.2 days. Anti-CCP antibody was positive in 211 (73.0%) and the mean SDAI at study enrollment was 26.5±12.4. At week 24, with the mean dose of methotrexate of 12.6±2.9 mg/week, 108 patients (37.1%) achieved remission according to SDAI and continued MTX monotherapy. 134 patients (46.0%) were randomised and started adalimumab with 68 patients in the maximum tolerable dose group and 66 patients in the reduced dose group. At week 48, the remission achievement rates were 38.4 % and 44.8 %, respectively, with the adjusted risk difference of the reduced dose group to the maximum tolerable dose group of 6.4% (-7.0% to 19.8%, 90% CI), which met the criterion for noninferiority. No significant difference was found in health assessment questionnaire disability index ≤0.5 (59.1% vs 62.0%, respectively, p=0.72) and in radiological remission rates (Δmodified total Sharp score ≤0.5, 66.3% vs 62.0 %, respectively, p=0.59). Adverse drug reactions tended to be more frequent in the maximum tolerable dose group than in the reduced dose group (22.1% vs 9.1%, respectively, p=0.06).ConclusionThe MIRACLE randomised study demonstrated that, in patients with inadequate response to methotrexate, the efficacy of adalimumab with reduced dose of concomitant methotrexate was not inferior to that with maximum tolerable dose of methotrexate with better safety profile.Disclosure of InterestsHiroya Tamai Speakers bureau: Eisai, Grant/research support from: Eisai, Kei Ikeda Speakers bureau: AbbVie, Eisai, Eli Lilly, Novartis, Gilead, Asahi-Kasei, Grant/research support from: Mitsubishi-Tanabe, Toshiaki Miyamoto: None declared, Hiroaki Taguchi: None declared, Chang-Fu Kuo: None declared, Kichul Shin: None declared, Shintaro Hirata Speakers bureau: AbbVie, Asahi-Kasei, Astellas, Ayumi, Bristol Myers Squibb, Celgene, Chugai, Eisai, Eli Lilly, Gilead, Glaxo SmithKline, Janssen, Kyorin, Novartis, Pfizer, Sanofi, Tanabe-Mitsubishi, UCB, Paid instructor for: AbbVie, Mitsubishi-Tanabe, Consultant of: AbbVie, Astellas, Bristol Myers Squibb, Eisai, Gilead, Ily Lilly, Grant/research support from: AbbVie, Asahi-Kasei, Eisai, Otsuka, Sanofi, Shionogi, Chugai, Pfizer, Tanabe-Mitsubishi, Eli Lilly, UCB, yutaka okano: None declared, Shinji Sato Speakers bureau: AbbVie, Eisai, Grant/research support from: AbbVie, Eisai, Hidekata Yasuoka Speakers bureau: AbbVie, Asahi Kasei Pharma, Astellas, Daiichi-Sankyo, Eisai, Kissei, Takeda, Mitsubishi-Tanabe, Chugai, Novartis, Eli Lilly, Pfizer, Janssen, Sanofi, Teijin, Boehringer-Ingelheim, Bayer, Glaxo Smith Kline, Paid instructor for: AbbVie, Consultant of: AbbVie, Asahi Kasei, Grant/research support from: Mitsubishi-Tanabe, Takeda, Daiichi-Sankyo, Chugai, Bristol-Myers, MSD, Astellas, In Ah Choi Speakers bureau: Abbvie, Eisai, Sung-Hwan Park: None declared, Meng-Yu Weng Paid instructor for: Novartis, Eli Lilly, ChuGai, Abbvie, Consultant of: Abbvie, Masataka Kuwana Speakers bureau: Astellas, Asahi Kasei Pharma, Boehringer-Ingelheim, Chugai, Eisai, Janssen, Mochida, Nippon Shinyaku, Ono Pharmaceuticals, Pfizer, Mitsubishi-Tanabe, Consultant of: Boehringer-Ingelheim, Kissei, Mochida, Grant/research support from: AbbVie, Asahi Kasei Pharma, Boehringer-Ingelheim, Chugai, Eisai, MBL, Nippon Shinyaku, Ono Pharmaceuticals, Mitsubishi-Tanabe, Yun Jong Lee Grant/research support from: Yuhan, Tomonori Ishii Speakers bureau: Chugai, Mitsubishi-Tanabe, Glaxo Smith Kline, Pfizer, Eli Lilly, Janssen, AbbVie, Eisai, Astellas, Jinhyun Kim: None declared, Hideto Kameda Speakers bureau: AbbVie, Pfizer, Consultant of: AbbVie, Grant/research support from: AbbVie, Eisai, Toshihisa Kojima Speakers bureau: AbbVie, Pfizer, Eisai, Grant/research support from: AbbVie, Han Joo Baek: None declared, Ping-Ning Hsu: None declared, Chun-Ming Huang Paid instructor for: Abbvie, Pfizer, Tien-Tsai Cheng Paid instructor for: Abbvie, Grant/research support from: Abbvie, Wan-Yu Sung: None declared, Takehiro Taninaga Shareholder of: Eisai.co.,Ltd., Employee of: Eisai.co.,Ltd., Masahiko Mori Shareholder of: Eisai.co.,Ltd., Employee of: Eisai.co.,Ltd., Hideaki Miyagishi Shareholder of: Eisai.co.,Ltd., Employee of: Eisai.co.,Ltd., Yasunori Sato Speakers bureau: Eisai Co., Ltd. Kowa Company, Ltd., Consultant of: MOCHIDA PHARMACEUTICAL CO., LTD, Tsutomu Takeuchi Speakers bureau: Astellas, AbbVie, Ayumi, Bristol Myers Squibb, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Glaxo Smith Kline, Janssen, Mitsubishi-Tanabe, Nippon-kayaku, Novartis, Pfizer, Sanofi, UCB, Grant/research support from: Asahi Kasei, AbbVie, Ayumi, Boehringer-Ingelheim, Chugai, Eisai, Eli Lilly, Mitsubishi-Tanabe, Sanofi, UCB, Yuko Kaneko Speakers bureau: Asahi Kasei, Astellas, Ayumi, Bristol Myers Squibb, Chugai, Eisai, Elli Lilly, Mitsubishi-Tanabe, Novartis, UCB, Grant/research support from: AbbVie, Chugai, Eisai, Mitsubishi-Tanabe, UCB.
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Shimokawa M, Kanazu M, Saito R, Mori M, Tamura A, Okano Y, Fujita Y, Endo T, Motegi M, Takata S, Kita T, Sukoh N, Takenoyama M, Atagi S. 64P Clinical benefit of platinum doublet therapy for elderly patients with advanced non-small cell lung cancer: A prospective multicenter study of the national hospital organization in Japan. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Nounaka Y, Tenjin H, Okano Y, Morita A. Training Model for Brain Tumor Removal (Model TOM Meningioma). Neurosurgery Open 2022. [DOI: 10.1227/neuopn.0000000000000003] [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: 11/19/2022] Open
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Okano Y, Kunishige M, Kondo Y, Kadota N, Morishita A, Naruse K, Machida H, Hatakeyama N, Hino H, Shinohara T, Sakiyama S, Takeuchi E. Dramatic response to immunochemotherapy followed by salvage surgery in an elderly lung cancer patient. Thorac Cancer 2022; 13:510-513. [PMID: 34931476 PMCID: PMC8807244 DOI: 10.1111/1759-7714.14293] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) have caused a paradigm shift in the treatment of lung cancer. Here, we encountered a case of inoperable locally advanced squamous cell carcinoma of the lung that became operable with pembrolizumab-based immunochemotherapy and achieved a pathological complete response. An 82-year-old man suspected of having lung cancer was referred to our hospital. The patient was clinically diagnosed with left upper lobe squamous cell carcinoma cT2aN3M0 c-stage IIIC. Immunostaining revealed the expression of programmed death-ligand 1 in 60% of tumor cells. The cancer cells disappeared after two cycles of chemotherapy with carboplatin and nanoparticle albumin-bound paclitaxel plus pembrolizumab. As the abnormal accumulation of 18 F-fluorodeoxyglucose (FDG) on FDG-positron emission tomography/computed tomography before chemotherapy almost disappeared after pembrolizumab-based immunochemotherapy, left upper lobectomy and lymph node dissection were performed. No cancer cells were pathologically detected from the resected tissue. Therefore, ICIs combined with chemotherapy may enable inoperable advanced lung cancer patients to undergo surgery and achieve a complete response.
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Affiliation(s)
- Yoshio Okano
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochi CityJapan
| | - Michihiro Kunishige
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochi CityJapan
| | - Yoshihiro Kondo
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochi CityJapan
| | - Naoki Kadota
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochi CityJapan
| | - Atsushi Morishita
- Department of Thoracic SurgeryNational Hospital Organization Kochi HospitalKochi CityJapan
| | - Keishi Naruse
- Department of PathologyNational Hospital Organization Kochi HospitalKochi CityJapan
| | - Hisanori Machida
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochi CityJapan
| | - Nobuo Hatakeyama
- Department of Respiratory MedicineNational Hospital Organization Kochi HospitalKochi CityJapan
| | - Hiroyuki Hino
- Department of Thoracic SurgeryNational Hospital Organization Kochi HospitalKochi CityJapan
| | - Tsutomu Shinohara
- Department of Community Medicine for RespirologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Shoji Sakiyama
- Department of Thoracic SurgeryNational Hospital Organization Kochi HospitalKochi CityJapan
| | - Eiji Takeuchi
- Department of Clinical InvestigationNational Hospital Organization Kochi HospitalKochi CityJapan
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Kondo Y, Kunishige M, Kadota N, Okano Y, Machida H, Hatakeyama N, Naruse K, Shinohara T, Takeuchi E. A single dose of pembrolizumab treatment causing a profound and durable response in lung cancer. Thorac Cancer 2022; 13:648-652. [PMID: 35023292 PMCID: PMC8841699 DOI: 10.1111/1759-7714.14314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 11/30/2022] Open
Abstract
Profound and durable responses to a single dose of pembrolizumab in lung cancer are rare. We encountered a non‐small cell lung cancer patient showing a deep and durable response with a single dose of pembrolizumab. A 79‐year‐old man reported bloody sputum for several weeks and visited a general physician. A chest x‐ray revealed a tumor shadow in the right middle lung field at that time, and the patient was referred to our hospital. He was diagnosed with adenocarcinoma of the lung by transbronchial biopsy. The expression of programmed death ligand 1 in tumor cells was 100% by immunostaining. Based on the above, immunotherapy with pembrolizumab was performed as first‐line therapy. Cancer cells had significantly shrunk at the end of the first cycle. The patient had grade‐3 immune‐related hepatitis at the end of the first cycle. Pembrolizumab treatment was stopped and prednisolone (80 mg/body) was initiated. Subsequently, liver function normalized, and prednisolone was tapered and discontinued. Since then, no tumor recurrence has been detected for 1.5 years without treatment. There have been few reports of profound and durable responses to a single dose of pembrolizumab in lung cancer. The results indicate that a single dose of pembrolizumab alone may be sufficient to cause durable response and serious immune‐related adverse events in some cases.
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Affiliation(s)
- Yoshihiro Kondo
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi city, Kochi, Japan
| | - Michihiro Kunishige
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi city, Kochi, Japan
| | - Naoki Kadota
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi city, Kochi, Japan
| | - Yoshio Okano
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi city, Kochi, Japan
| | - Hisanori Machida
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi city, Kochi, Japan
| | - Nobuo Hatakeyama
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi city, Kochi, Japan
| | - Keishi Naruse
- Department of Pathology, National Hospital Organization Kochi Hospital, Kochi city, Kochi, Japan
| | - Tsutomu Shinohara
- Department of Community Medicine for Respirology, Graduate School of Biomedical Sciences, Tokushima University, Kuramoto-cho, Tokushima, Japan
| | - Eiji Takeuchi
- Department of Clinical Investigation, National Hospital Organization Kochi Hospital, Kochi city, Kochi, Japan
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Okano Y, Yamasaki T, Imai R, Okazaki H, Higuchi Y, Shinohara T. Cardiopulmonary arrest due to bronchoscopy-induced Takotsubo syndrome in a patient with antineutrophil cytoplasmic autoantibody-associated lung disease: a case report. J Rural Med 2022; 17:181-183. [PMID: 35847748 PMCID: PMC9263952 DOI: 10.2185/jrm.2022-008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 03/25/2022] [Indexed: 11/27/2022] Open
Abstract
Objective: Cardiac arrest (CA) has been observed in some patients with
Takotsubo syndrome (TTS), most of whom had CA at the initial presentation of TTS. The
objective of this report was to discuss the factors underlying the onset of this
syndrome. Case presentation: A 72-year-old woman with refractory antineutrophil
cytoplasmic autoantibody-associated lung disease was referred to our hospital. Twenty
minutes after bronchoscopic examination, cardiopulmonary arrest suddenly occurred.
Resuscitation immediately resumed her heartbeat and spontaneous breathing. Subsequent
12-lead electrocardiography, echocardiography, and left ventricular angiography revealed
TTS. Conclusion: This case indicates that bronchoscopy can cause severe TTS,
especially in patients with systemic inflammation.
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Affiliation(s)
- Yoshio Okano
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Japan
| | - Takashi Yamasaki
- Division of Cardiovascular Disease, National Hospital Organization Kochi Hospital, Japan
| | - Ryuichiro Imai
- Department of Medicine & Cardiology, Chikamori Hospital, Japan
| | | | - Yuji Higuchi
- Division of Internal Medicine, Shimanto City Hospital, Japan
| | - Tsutomu Shinohara
- Division of Internal Medicine, Japan Agricultural Cooperatives Kochi Hospital, Japan
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Kadota N, Hatakeyama N, Hino H, Kunishige M, Kondo Y, Okano Y, Machida H, Naruse K, Shinohara T, Sakiyama S, Ogushi F, Takeuchi E. Complete and durable response of pulmonary large-cell neuroendocrine carcinoma to pembrolizumab. Cancer Rep (Hoboken) 2021; 5:e1589. [PMID: 34817132 PMCID: PMC9351647 DOI: 10.1002/cnr2.1589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/21/2021] [Accepted: 10/25/2021] [Indexed: 12/26/2022] Open
Abstract
Background Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive tumor with a poor prognosis and standard therapy has not yet been established. Case A 65‐year‐old male with a cough for 2 months presented to our hospital. He was clinically diagnosed with non small cell lung cancer cT3N1M0 stage IIIA and underwent right pneumonectomy. The final diagnosis was pulmonary LCNEC pT3N1M0 stage IIIA. Multiple subcutaneous masses were detected 4 months after surgery, and biopsy revealed postoperative recurrence and metastasis. Chemotherapy with carboplatin plus etoposide was initiated. Subcutaneous masses increased and multiple new brain metastases developed after two cycles. Additional tests revealed that epidermal growth factor receptor and anaplastic lymphoma kinase were negative, and the programmed death ligand 1 (PD‐L1) expression rate in tumor cells was 40% (22C3 clones). The primary cells infiltrating the tumor were CD3‐positive T cells and CD138‐positive plasma cells. Second‐line treatment with pembrolizumab was started. The shrinkage of subcutaneous masses was observed after one cycle, and the tumor had completely disappeared after six cycles. Treatment was continued for approximately 2 years. This response has been maintained for 4 years and is still ongoing. Conclusion Pembrolizumab may be used as a treatment option for pulmonary LCNEC.
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Affiliation(s)
- Naoki Kadota
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Nobuo Hatakeyama
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Hiroyuki Hino
- Department of Thoracic Surgery, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Michihiro Kunishige
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Yoshihiro Kondo
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Yoshio Okano
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Hisanori Machida
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Keishi Naruse
- Department of Pathology, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Tsutomu Shinohara
- Department of Community Medicine for Respirology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Shoji Sakiyama
- Department of Thoracic Surgery, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Fumitaka Ogushi
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Eiji Takeuchi
- Department of Clinical Investigation, National Hospital Organization Kochi Hospital, Kochi, Japan
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Takeuchi E, Okano Y, Machida H, Atagi K, Kondou Y, Kadota N, Hatakeyama N, Naruse K, Shinohara T. Eosinophilic pleural effusion due to lung cancer has a better prognosis than non-eosinophilic malignant pleural effusion. Cancer Immunol Immunother 2021; 71:365-372. [PMID: 34170380 PMCID: PMC8783892 DOI: 10.1007/s00262-021-02994-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/19/2021] [Indexed: 11/26/2022]
Abstract
Objective Tumor-related eosinophilia may have extended survival benefits for some cancer patients. However, there has been no report on the prognosis difference between eosinophilic pleural effusion (EPE) and non-EPE in lung cancer patients. Our study aimed to investigate the prognosis difference between EPE and non-EPE due to lung cancer. Patients and methods We retrospectively reviewed patients diagnosed with lung cancer who presented with malignant pleural effusion (MPE) between May 2007 and September 2020 at the National Hospital Organization Kochi Hospital. EPE is defined as pleural fluid with a nucleated cell count containing 10% or more eosinophils. Results A total of 152 patients were included: 89 were male (59%). The median age was 74.4 years (range 37–101), and all patients were pathologically shown to have MPE. Most patients (140; 92%) had an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0/1. Twenty patients had EPE. The median overall survival (OS) of all 152 lung cancer patients with MPE was 298 days. The median OS of the patients with EPE was 766 days, and the median OS of the patients with non-EPE was 252 days. Kaplan–Meier univariate analysis showed that lung cancer patients with EPE had a significantly better prognosis than patients with non-EPE (P < 0.05). Cox proportional regression analysis showed that EPE, ECOG PS, sex, and the neutrophil-to-lymphocyte ratio in the serum (sNLR) may be independent prognostic factors affecting survival in patients with MPE. Conclusion Lung cancer patients with EPE have a better prognosis than those with non-EPE.
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Affiliation(s)
- Eiji Takeuchi
- Department of Clinical Investigation, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi-city, Kochi 780-8507 Japan
| | - Yoshio Okano
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi-city, Kochi 780-8507 Japan
| | - Hisanori Machida
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi-city, Kochi 780-8507 Japan
| | - Katsuhiro Atagi
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi-city, Kochi 780-8507 Japan
| | - Yoshihiro Kondou
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi-city, Kochi 780-8507 Japan
| | - Naoki Kadota
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi-city, Kochi 780-8507 Japan
| | - Nobuo Hatakeyama
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi-city, Kochi 780-8507 Japan
| | - Keishi Naruse
- Department of Pathology, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi-city, Kochi 780-8507 Japan
| | - Tsutomu Shinohara
- Department of Community Medicine for Respirology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503 Japan
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Izumi K, Moriwaki D, Toda T, Higashida-Konishi M, Koyama M, Oshima H, Okano Y, Kaneko Y, Ko S, Takeuchi T. AB0145 SMARTPHONE- AND SMARTWATCH-ACQUIRED DAILY STEPS, ACTIVITY, AND BAROMETRIC PRESSURES ASSOCIATED WITH SUBJECTIVE MEASURES OF RHEUMATOID ARTHRITIS: A PROSPECTIVE STUDY FOR RA DIGITAL PHENOTYPING. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3730] [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] [Indexed: 11/04/2022]
Abstract
Background:Symptoms in patients with rheumatoid arthritis (RA) are potentially influenced by exercise load and meteorological change, and often vary from day to day, especially in unstable condition of RA. Patients with RA not infrequently experience worsening of joint symptoms when the load on the joint, such as walking and doing housework, exceeds a moderate range. However, the worsening of joint symptoms is often not observed in the midst of the loading of the joint, but often becomes apparent after a few hours or days.Objectives:To elucidate the relationship between smartphone- and smartwatch-acquired daily objective data (barometric pressures, steps, and activity) and daily subjective patient reported outcomes of RA.Methods:A smartphone (iPhone 8) and a wristband-type smartwatch (Fitbit Versa 2) were lent to each patient for free. A mobile app was developed and installed into the smartphones to collect patients’ daily subjective RA symptoms including Pt-P-VAS (patient-pain-visual analogue scale), Pt-G-VAS (pt-general-VAS), PtTJCount(68)(patient self-determined tender joint count among 68 joints), PtTJCount(28), PtSJCount(66)(patient self-determined swollen joint count among 66 joints), PtSJCount(28). Also, the smartwatch data and physicians’ assessment were collected from the same subject. Physicians’ and patients’ assessment of TJC, SJC, and G-VAS was independently performed without seeing each other’s assessment.We conducted a simple linear regression analysis with outcome variables of Pt-P-VAS, Pt-G-VAS, PtTJCount(68), PtTJCount(28), PtSJCount(66), and PtSJCount(28). The independent variables included smartphone-acquired daily steps and barometric pressure of the reported day and the previous day, and smartwatch-acquired minutes of “lightly active (1-3 METs equivalent)”, “fairly active(3-6 METs equivalent)”, and “very active(>6 METs equivalent)” of the reported day and previous day. We defined low barometric pressure as below 1000 hPa. The level of activity was measured by the smartwatch. Patients were blinded to daily barometric pressure data and their daily active time when the patients answered daily symptom questions on the smartphones.Results:A total of five patients were enrolled. At baseline, mean (± standard deviation (SD)) age was 50.8±14.8 years; all patients were females; mean disease duration was 6.6±4.9 years; mean SDAI was 18.6±25.5; mean DAS28-CRP was 3.23±1.85; mean morning stiffness was 134±116 min; mean HAQ-DI was 0.7±0.9. Mean observation period was 77.8 days. Because of the missing data, the sample size (N) for the regression analysis varies with the outcomes: Pt-P-VAS and Pt-G-VAS are 250 while PtTJCount and PtSJCount are 260.The table 1 showed that the patients’ assessment of TJC, SCJ, and G-VAS was correlated well with the physicians’ assessment.Table 1.Evaluation itemCorrelation between physicians and patients (ρ)Tender Joint Count (68)0.909Tender Joint Count(28)0.913Swollen Joint Count(66)0.896Swollen Joint Count(28)0.890General VAS0.688The figure 1 showed the change associated with one SD increment in each independent variable with 90% confidence intervals. Low barometric pressure was associated with bad health conditions (high Pt-G-VAS, Pt-P-VAS, and SJCount). Moreover, longer very active time in the previous day (“veryactive_1” in the Figure 1) was associated with bad health condition (high SJCount). Many steps were associated with good health conditions (low Pt-G-VAS, Pt-P-VAS, and SJCount).Figure 1.Conclusion:High barometric pressure was associated with good health conditions, and longer very active time in the previous day was associated with bad health condition. Barometric pressure data and physical activity data acquired by mobile digital devices may predict the change in RA symptoms. Further investigation in larger patient numbers is warranted.Acknowledgements:The authors would like to thank Harumi Kondo for her assistance.Disclosure of Interests:Keisuke Izumi Speakers bureau: Abbvie, Asahi Kasei Pharma, Bristol Myers Squibb, Chugai Pharmaceutical, Eli-Lily, Mochida Pharmaceutical, Ono Pharmaceutical, Grant/research support from: Abbvie, Asahi Kasei Pharma, Daisuke Moriwaki Employee of: CyberAgent, Inc., Takamichi Toda Employee of: AI Shift, Inc., Misako Higashida-Konishi: None declared, Manami Koyama: None declared, Hisaji Oshima: None declared, yutaka okano Speakers bureau: Asahi Kasei Pharma, Yuko Kaneko Speakers bureau: AbbVie, Astellas, Ayumi, Bristol–Myers Squibb, Chugai, Eisai, Eli Lilly, Hisamitsu, Jansen, Kissei, Kirin, Novartis, Pfizer, Sanofi, Takeda, Taisho, Tanabe-Mitsubishi, and UCB, Shigeru Ko: None declared, Tsutomu Takeuchi Speakers bureau: Abbott Japan Co, Ltd, Bristol–Myers KK, Chugai Pharmaceutical Co, Ltd, Eisai Co, Ltd, Janssen Pharmaceutical KK, Mitsubishi Tanabe Pharma Co, Pfizer Japan Inc, Takeda Pharmaceutical Co, Ltd, Astellas Pharma and Daiichi Sankyo Co, Ltd., Consultant of: Astra Zeneca KK, Eli Lilly Japan KK, Novartis Pharma KK, Mitsubishi Tanabe Pharma Co, Asahi Kasei Medical KK, Abbvie GK and Daiichi Sankyo Co, Ltd., Grant/research support from: Abbott Japan Co, Ltd, Astellas Pharma, Bristol-Myers KK, Chugai Pharmaceutical Co, Ltd, Daiichi Sankyo Co, Ltd, Eisai Co, Ltd, Janssen Pharmaceutical KK, Mitsubishi Tanabe Pharma Co, Pfizer Japan Inc, Sanofi–Aventis KK, Santen Pharmaceutical Co, Ltd, Takeda Pharmaceutical Co, Ltd, Teijin Pharma Ltd, Abbvie GK, Asahikasei Pharma Corp and Taisho Toyama Pharmaceutical Co, Ltd.
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Tamai H, Kaneko Y, Kameda H, Kuwana M, Okano Y, Ishii T, Ikeda K, Taguchi H, Sato S, Miyamoto T, Hirata S, Yasuoka H, Kojima T, Park SH, Shin K, Baek HJ, Lee YJ, Choi IA, Kim J, Hsu PN, Kuo CF, Huang CM, Weng MY, Sung WY, Tsai WC, Cheng TT, Taninaga T, Mori M, Miyagishi H, Sato Y, Takeuchi T. AB0253 COMPARISON OF PHARMACODYNAMICS OF METHOTREXATE AS METHOTREXATE-POLYGLUTAMATES CONCENTRATIONS IN RHEUMATOID ARTHRITIS; INTERIM DATA EVALUATION OF MIRACLE STUDY CONDUCTED IN JAPAN, KOREA AND TAIWAN. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.762] [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] [Indexed: 11/04/2022]
Abstract
Background:Methotrexate (MTX) is the first-line therapy for rheumatoid arthritis (RA). The concentrations of MTX-polyglutamates (PG) in erythrocytes, an active form of MTX, are useful markers for the optimal usage of MTX in patients with RA. The concentrations of MTX-PG have been reported to be different between Japanese and Caucasians. However, the difference among Asian ethnicity remains unclear.Objectives:To examine MTX-PG concentrations in association with MTX dose during the first 24 weeks after the initiation of MTX for newly diagnosed RA patients in Japan, Korea and Taiwan.Methods:MIRACLE study is a multicenter, open-label, randomized, 48 weeks interventional study conducted in Japan, Korea and Taiwan to evaluate non-inferiority of low dose to high dose of MTX as an add-on therapy to adalimumab in 300 patients with RA who do not achieve remission after 24 weeks MTX monotherapy in stipulated dosage. In the first 24 weeks, MTX was started at 6 to 8 mg/week for newly diagnosed RA patients, and promptly escalated to the maximum tolerable dose in 12 weeks in principle. This interim data evaluation was intended to investigate the differences among countries in the relationship between MTX dose, safety and MTX-PG concentrations in erythrocytes during the first 24 weeks. The efficacy of the treatment is not included at this point.Results:A total of 166 patients (106 in Japan, 35 in Korea, 25 in Taiwan) were included in this interim data. The age at treatment initiation was 57.2 years old on average and female was 79.5%. The time course changes in total and individual MTX-PG levels differed in the three countries. At 24 weeks, whereas the mean total MTX-PG concentrations were comparable (112.9 nmol/L in Japan, 104.4 nmol/L in Korea, and 115.7 nmol/L in Taiwan) with a dose of MTX of 12.3 mg/week, 14.1 mg/week, and 12.2 mg/week, respectively, the individual MTX-PG concentrations were different. The MTX-PG1 and MTX-PG2 concentrations were lower in Korea than Japan and Taiwan whereas MTX-PG3, MTX-PG4 and MTX-PG5 concentrations were the highest in Korea.Conclusion:The distribution of short-chain and long-chain MTX-PG concentrations were various among Asian countries despite similar dose of MTX administration: NCT03505008.Disclosure of Interests:Hiroya Tamai: None declared, Yuko Kaneko Speakers bureau: AbbVie, Astellas, Ayumi, Bristol–Myers Squibb, Chugai, Eisai, Eli Lilly, Hisamitsu, Jansen, Kissei, Kirin, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi, and UCB., Grant/research support from: Sanofi, Hideto Kameda Speakers bureau: AbbVie, Pfizer, Consultant of: AbbVie, Grant/research support from: AbbVie, Eisai, Masataka Kuwana Speakers bureau: Astellas, Asahi Kasei Pharma, Boehringer- Ingelheim, Chugai, Eisai, Janssen, Mochida, Nippon Shinyaku, Ono Pharmaceuticals, Pfizer, Mitsubishi-Tanabe, Consultant of: Corbus, Grant/research support from: AbbVie, Asahi Kasei Pharma, Boehringer- Ingelheim, Chugai, Eisai, MBL, Nippon Shinyaku, Ono Pharmaceuticals, Mitsubishi-Tanabe, Yutaka Okano: None declared, Tomonori Ishii Speakers bureau: Chugai, Mitsubishi- Tanabe, Glaxo Smith Kline, Pfizer, Eli Lilly, Janssen, AbbVie, Eisai, Astellas, Kei Ikeda Speakers bureau: AbbVie, Eli Lilly, Novartis, Mitsubishi-Tanabe, Eisai, BMS, Grant/research support from: Mitsubishi-Tanabe, Hiroaki Taguchi: None declared, Shinji Sato: None declared, Toshiaki Miyamoto: None declared, Shintaro Hirata Speakers bureau: AbbVie, Asahi Kasei Pharma, Astellas, Ayumi, Bristol Myers Squibb, Chugai, Eisai, Eli Lilly, Janssen, Glaxo Smith Kline, Kissei, Pfizer, Sanofi, Mitsubishi- Tanabe, UCB, Paid instructor for: AbbVie, Mitsubishi- Tanabe, Consultant of: AbbVie, Eisai, Gilead, Grant/research support from: AbbVie, Chugai, Mitsubishi-Tanabe, UCB, Hidekata Yasuoka Speakers bureau: AbbVie, Asahi Kasei Pharma, Astellas, Daiichi- Sankyo, Eisai, Kissei, Takeda, Mitsubishi- Tanabe, Chugai, Novartis, Eli Lilly, Pfizer, Janssen, Sanofi, Teijin, Boehringer- Ingelheim, Bayer, Glaxo Smith Kline, Paid instructor for: AbbVie, Consultant of: AbbVie, Asahi Kasei, Grant/research support from: Mitsubishi-Tanabe, Takeda, Daiichi-Sankyo, Chugai, Bristol-Myers, MSD, Astellas, Toshihisa Kojima Speakers bureau: AbbVie, Pfizer, Eisai, Grant/research support from: AbbVie, Sung-Hwan Park: None declared, Kichul Shin: None declared, Han Joo Baek: None declared, Yun Jong Lee Grant/research support from: research fund, In Ah Choi Speakers bureau: Abbvie, Eizai, Grant/research support from: Abbvie, Eizai, Jinhyun Kim: None declared, Ping-Ning Hsu: None declared, Chang-Fu Kuo: None declared, Chun-Ming Huang Paid instructor for: AbbVie, Pfizer, Meng-Yu Weng Consultant of: AbbVie, Wan-Yu Sung: None declared, Wen-Chan Tsai: None declared, Tien-Tsai Cheng Paid instructor for: AbbVie, Grant/research support from: AbbVie, Takehiro Taninaga Shareholder of: Eisai Co., Ltd., Employee of: Eisai Co., Ltd., Masahiko Mori Shareholder of: Eisai Co., Ltd., Employee of: Eisai Co., Ltd., Hideaki Miyagishi Employee of: Eisai Co., Ltd., Yasunori Sato: None declared, Tsutomu Takeuchi Speakers bureau: Astellas, Abbvie, Daiichi Sankyo, Ayumi, Eisai, GlaxoSmithKline, Mitsubishi Tanabe, Chugai, Novartis, Eli Lilly, Pfizer, Bristol Myers Squibb, Janssen, UCB, TaishoToyama, Sanofi–Aventis, Nipponkayaku, Taiho, Gilead, Boehringer Ingelheim, Grant/research support from: Asahikasei, Astellas, Abbvie, Daiichi Sankyo, Ayumi, Eisai, Takeda, Mitsubishi Tanabe, Chugai, Eli Lilly, UCB, Sanofi–Aventis, Nipponkayaku, Boehringer Ingelheim
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Hayashi Y, Izumi K, Hama S, Higashida-Konishi M, Ushikubo M, Oshima H, Okano Y. AB0442 CLINICAL FEATURES OF POLYMYOSITIS AND DERMATOMYOSITIS PATIENTS WITH SEVERE DYSPHAGIA. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Polymyositis (PM) and dermatomyositis (DM) are autoimmune inflammatory diseases characterized by proximal myositis. Dysphagia has been reported to develop in 35 to 62% of PM/DM patients and known as poor prognosis factor.Objectives:The purpose of this study is to determine the clinical characteristics of PM/DM patients who present with deglutition disorder.Methods:Consecutive patients with PM/DM who visited National Hospital Organization Tokyo Medical Center between April 2010 and January 2021 are included in this study. We compared clinical features between the patients with and without dysphagia. The diagnosis of dysphagia was based on videofluorography swallow study, and dysphagia requiring gastrostomy was defined as severe dysphagia. The clinical characteristics compared in this study were following: age of onset, levels of serum creatine kinase (CK) and lactate dehydrogenase(LDH), sense of dysphagia, manual muscle test (MMT) score, and complication of malignancy or interstitial pneumonia.Results:A total of 73 patients with PM/DM were identified. Among them, 12 patients were diagnosed with dysphagia, and 5 patients developed severe dysphagia. Patients with dysphagia had the following characteristics compared to patients without dysphagia: higher levels of serum LDH (833.7 ± 500.1 U/L vs 471.9 ± 321.0 U/L, p = 0.0088), higher levels of serum CK at initial examination (6070.3 ± 7184.8 IU/L vs 1534.7 ± 2978.8 IU/L, p = 0.0086) and more frequent sense of dysphagia (90.9% vs 10.6%, p< 0.0001), lower MMT score(3.18 ± 1.07 vs 4.31 ± 0.75, p = 0.0017). In addition to those, patients with severe dysphagia presented older age of onset (mean age 69.4 ± 12.0 vs 51.7 ± 14.8, p = 0.014), more frequent complication of malignancy (80.0% vs 14.8%, p= 0.0048) and less frequent complication of interstitial pneumonia (0.0% vs 55.5%, p= 0.023).Conclusion:These results indicate that dysphagia develops frequently in PM/DM patients with higher levels of serum LDH or CK, sense of dysphagia and low MMT score. Among them, patients with elderly onset or malignancy are at risk for sever dysphagia, and should be treated carefully.Disclosure of Interests:None declared.
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Higashida-Konishi M, Izumi K, Hama S, Takei H, Oshima H, Okano Y. AB0324 ALLERGIC DISORDERS AND DRUG ALLERGIES IN PRIMARY SJÖGREN’S SYNDROME AND RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2704] [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] [Indexed: 11/03/2022]
Abstract
Background:Allergic disorders have been reported in a variety of rheumatic diseases. A high prevalence of allergic disorders was found in patients with Sjoegren’s syndrome [1]. Nevertheless, it was not clear what is a risk factor for allergic disorders and drug allergies in patients with primary Sjögren’s syndrome (pSS). Drug allergies may lead to delayed treatment and unnecessary clinical tests.Objectives:The primary aim of this study was to compare the prevalence of allergic disorders and drug allergies in patients with pSS and rheumatoid arthritis (RA). The secondary aim was to compare the clinical features with and without drug allergies in patients with pSS.Methods:We retrospectively examined consecutive patients diagnosed with pSS or RA in our hospital from 2010 to 2020. The patients with SS met the criteria of the 1999 revised Japanese Ministry of Health criteria[2]. We included patients with pSS without RA or other rheumatic diseases. The patients with RA met the EULAR/ACR 2010 criteria. We included patients with RA without other rheumatic diseases.The first analysis was performed on six types of allergic reactions: (1) food allergy (exanthema, angioedema and anaphylaxis after foods exposure), (2) drug allergy (exanthema, angioedema and anaphylaxis after drug exposure), (3) allergic contact dermatitis such as metals, alcohol swab, and other cosmetics, (4) seasonal allergic rhinitis and/or allergic conjunctivitis, and allergic rhinitis and/or allergic conjunctivitis associated with house dust, (5) asthma, and (6) atopic dermatitis.The secondary analysis was performed on patient baseline laboratory data at diagnosis of pSS and RA patients with or without drug allergies.Results:In the first analysis, 292 patients with pSS and 413 patients with RA were enrolled (Table 1). The mean ages (pSS, RA) were 57.3±15.8, 66.0±14.6 years old. Females were 94.2%, 78.2%. The mean observation period was 82.7±70.8, 65.6±37.0 months. 54.8% of pSS patients and 34.9% of RA patients presented at least one type of allergic disorders or drug allergies. These included food allergy, drug allergy, allergic rhinitis/conjunctivitis, asthma, and atopic dermatitis. Allergic disorders and drug allergies were more frequent in patients with pSS.In the second analysis, 77 patients with drug allergies and 215 patients without drug allergies were enrolled. The mean ages with drug allergies and without drug allergies were 56.0±15.8 and 57.8±15.8 years old, respectively; females were 96.1% and 93.5%; the mean observation period was 90.9±72.4 and 79.8±70.2 months. The pSS patients with drug allergies had higher levels of Immunoglobulin G (IgG) (2028±1409 mg/dL, 1726±587 mg/dL: p = 0.01), higher levels of eosinophils (220±247/μL, 126±112/μL: p<0.019), and higher positivity rate of anti–Sjögren’s-syndrome-related antigen A autoantibody (anti-SSA antibody) than those without drug allergies (89.6%, 79.7%: p = 0.06).Conclusion:Patients with pSS had a higher prevalence of allergic disorders and drug allergies than patients with RA. Among patients with pSS, patients with drug allergies had higher levels of IgG, higher levels of eosinophils, and higher positivity rate of anti-SSA antibody than those without drug allergies.Table 1.Allergic Disorders and Drug Allergies in pSS and RApSS (n = 292)RA (n = 413)Pat least one type of allergy, n (%)160 (54.8)144 (34.9)<0.01food allergy, n (%)35 (12.0)27 (6.7)0.02drug allergy, n (%)76 (26.1)69 (16.7)<0.01allergic contact dermatitis, n (%)10 (3.4)19 (4.6)0.6allergic rhinitis and/or conjunctivitis, n (%)99 (33.9)35 (8.5)<0.01asthma, n (%)29 (9.9)25 (6.1)0.06atopic dermatitis, n (%)15 (5.1)0 (0)<0.01References:[1]Hama et al. Clinical features of patients with Sjoegren syndrome associated with adult onset Still’s disease. Japan College of Rheumatology Annual Congress 2020.[2]Fujibayashi et al. Revised Japanese criteria for Sjögren’s syndrome (1999): availability and validity. Mod Rheumatol. 2004; 14: 425-34.Disclosure of Interests:None declared
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Shimokawa M, Kanazu M, Saito R, Mori M, Tamura A, Okano Y, Fujita Y, Endo T, Motegi M, Takata S, Kita T, Sukoh N, Takenoyama M, Atagi S. 1375P Predicting chemotherapy toxicity in elderly patients with advanced non-small cell lung cancer: A prospective multicenter study of the national hospital organization in Japan. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1689] [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: 11/30/2022] Open
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Hama S, Hayashi Y, Izumi K, Higashida-Konishi M, Ushikubo M, Akiya K, Okano Y, Oshima H. FRI0205 CLINICAL FEATURES OF MONONEURITIS MULTIPLEX ASSOCIATED WITH ANCA-ASSOCIATED VASCULITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5392] [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] [Indexed: 11/04/2022]
Abstract
Background:ANCA-associated vasculitis sometimes presents mononeuritis multiplex which worsens the prognosis and activity of daily living in patients.Objectives:This study aimed to determine the clinical feature of mononeuritis multiplex associated with AAV.Methods:Consecutive patients with AAV who visited Tokyo Medical Center between April 2006 and December 2019 were included in this study. We examined the following clinical features: prevalence of neuropathy, age of onset, sex, the worst blood test values before the initial therapy (white blood cell count (WBC), eosinophil count (Eo), MPO-ANCA, PR3-ANCA, and C-reactive protein(CRP) levels), manual muscle testing (MMT)score of 20 muscles (Max 100 points), and time (days) from the initial symptoms to the initial induction therapies.Results:A total of 89 patients with AAV were identified. Among them, 19 patients had eosinophilic granulomatosis with polyangiitis (EGPA) (8 males and 11 females, mean age 63.3 ± 2.7), 9 patients had granulomatosis with polyangiitis (GPA) (0 males, 9 females, mean age 75.6 ± 3.9), and 61 patients had microscopic polyangiitis (MPA) (17 males, 44 females, mean age 78.2 ± 1.5). Of the 89 AAV patients, 26 had sensory neuropathy (15/19 EGPA (78.9%), 11/61 MPA (18.0%), and 0/9 GPA (0%)). Motor neuropathy was observed in 19 patients (EGPA 14/19 (73.7%), MPA 5/61 (8.2%), GPA 0/9 (0%)). 15 patients had both sensory and motor neuropathies (EGPA 12/19 (63.2%), MPA 3/61 (4.9%), GPA 0 (0%)). In patients with both sensory and motor neuropathy, sensory impairment preceded in all cases. Among patients with neuropathy, the time from initial symptoms to initial induction therapy in patients with and without motor neuropathy was 34 ± 10.1 days and 30 ± 10.8 days (p = 0.776), respectively. Also, when comparing those who were treated within 7 days from the onset of movement disorders with those who were treated later, MMT score two weeks after the start of treatment were 92.15 ± 1.47 vs. 91.25 ± 2.65 (p = 0.77).Between the patients with EGPA with and without sensory neuropathy, there were no significant differences in the following: highest WBC(19620.0 ± 2082.6 vs. 19350.0 ± 4033.5 cells/uL (p = 0.953)), highest Eo(10790.6 ± 1774.8 vs 12440.8 ± 3436.9 cells/uL (p = 0.6750)), and highest CRP levels (4.467 ± 0.96 vs 2.70 ± 1.85 mg/dL (p = 0.41)) before the initial therapy. On the other hand, comparing the EGPA patients with and without motor neuron disorder, CRP levels were significantly higher in those with motor impairment than those without(WBC 20978.6 ± 2049.8 vs. 15600.0 ± 3429.9 cells/uL (p = 0.20); Eo 12213.4 ± 1775.5 vs. 8127.0 ± 2971.0 cells/uL (p = 0.25); CRP 5.13 ± 0.89 vs. 1.20 ± 1.48 mg/dL (p = 0.04)). And in patients with motor neuropathy, the decrease in MMT score was significantly correlated with the worst levels of CRP(p = 0.001)while the decrease was not correlated with the other blood tests. ANCA levels were not associated with sensory or motor neuropathy. In similar analyses of patients with MPA and GPA, there were no significant findings.Conclusion:Worst CRP levels before the initial therapy can be a poor prognosis factor for motor neuropathy in patients with EGPA. Therefore, EGPA patients with high CRP levels need to be paid more attention to because of possible development of motor neuropathy.Disclosure of Interests:satoshi hama: None declared, Yutaro Hayashi: None declared, Keisuke Izumi Grant/research support from: Asahi Kasei Pharma, Takeda Pharmaceutical Co., Ltd., Speakers bureau: Asahi Kasei Pharma Corp, Astellas Pharma Inc., Bristol Myers Squibb, Chugai Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Mitsubishi Tanabe Pharma Co., Misako Higashida-Konishi: None declared, mari ushikubo: None declared, kumiko akiya: None declared, yutaka okano: None declared, Hisaji Oshima: None declared
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Higashida-Konishi M, Izumi K, Hama S, Hayashi Y, Okano Y, Oshima H. FRI0488 CLINICAL AND LABORATORY FEATURES OF PATIENTS WITH REMITTING SERONEGATIVE SYMMETRICAL SYNOVITIS WITH PITTING EDEMA COMPARED TO PATIENTS WITH SERONEGATIVE RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5871] [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] [Indexed: 11/03/2022]
Abstract
Background:In the case of seronegative arthritis, it was difficult to make a differential diagnosis between remitting seronegative symmetrical synovitis with pitting edema syndrome (RS3PE) and seronegative rheumatoid arthritis (seronegative RA) because the distribution of affected joints was similar and the patients with RS3PE or seronegative RA may have edema.Objectives:To compare the clinical characteristics of RS3PE and seronegative RAMethods:We retrospectively examine consecutive patients diagnosed with RS3PE or seronegative RA in our hospital from 2007 to 2019. Patients in whom both ACPA and RF were negative were included. The patients with RS3PE met the criteria of McCarty et al.: (1) pitting edema of the dorsum of both hands and both feet, (2) sudden onset of polyarthritis, (3) seronegative for ACPA and RF. (4)no radiologically evident erosions developed. The patients with seronegative RA met the EULAR/ACR 2010 criteria. The patients who were diagnosed with RS3PE at first and then diagnosed with seronegative RA afterward were included in seronegative RA group. The first analysis was performed on the affected joints, CRP, ESR, Hb, LDH, edema, the history of malignancy 2 years before and after the diagnosis, treatment, and the history of infection requiring hospitalization after the start of treatment. The affected joints were shoulders, elbows, wrists, finger joints (the MCP, and PIP joints), hips, knees, ankles, and toe joints (the MTP and PIP joints). The secondary analysis was performed on the above evaluations with a propensity score (PS) matching for age.Results:In the first analysis, 20 patients with RS3PE and 122 patients with seronegative RA were enrolled. The mean ages (RS3PE, seronegative RA) were 81.1, 67.4 years old. Females were 60.0%, 63.1%. The mean observation period was 25.4, 63.6 months. The proportion of affected joints were shoulders (25.0%, 42.6%), elbows (10.0%, 29.5%: p=0.06), wrists (85.0%, 73.8%), finger joints (80.0%, 95.1%: p=0.01), hips (0%, 9.8%), knees (40.0%, 37.7%), ankles (65.0%, 39.3%: p=0.03) and toe joints (40.0%, 32.8%). Edema at diganosis was observed in 100%, 17.21% (p <0.0001). The mean levels of the following blood tests at diagnosis were noted: CRP, 9.0 and 4.8 mg/dL (p=0.02); ESR, 87.6 and 60.7 mm/1h (p=0.003); Hb, 10.4 and 11.8 mg/dl (p=0.001); LDH, 198.3 and 177.9 U/L (p = 0.12); MMP-3, 742.5 and 633.8 ng/mL (p = 0.14). The proportion of patients with high LDH levels (>222 U/L) was 13.6% and 9.0% (p=0.0269). The proportion of patients having the history of malignancy was 20.0%, 8.2% (p=0.10). The patient treated with prednisolone as the initial treatment was 100% and 41.0%; the mean dose was 14.3 and 9.9 mg/d. After the start of treatment, the proportion of infection requiring hospitalization was 20.0 and 3.28% (p=0.002).In the secondary analysis with PS, 17 patients with RS3PE and 17 patients with seronegative RA were enrolled. The mean ages were 80.4, 78.9 years old. Females were 52.9, 76.4%. The affected joints with difference were elbows (11.8, 35.3%: p=0.10), wrists (82.4, 100%: p=0.06), and finger joints (82.4, 100%: p=0.06). The mean levels of Hb at diagnosis was 10.4, 11.4 mg/dL (p=0.01). The proportion of patients having the history of malignancy was 23.5% and 0% (p=0.03). After the start of treatment, the proportion of infection requiring hospitalization was 23.5% and 0% (p=0.03).Conclusion:When the ankles are affected and edema is observed, RS3PE is more likely than seronegative RA. RS3PE had higher levels of CRP, ESR, and LDH. The proportion of anemia was higher in RS3PE. The proportions of infection requiring hospitalization and the history of malignancy were higher in RS3PE.References:[1]McCarty DJ, O’Duffy JD et al. Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE Syndrome). JAMA 1985; 254: 2763–2767. DOI:10.1001/jama.1985.03360190069027Disclosure of Interests:Misako Higashida-Konishi: None declared, Keisuke Izumi Grant/research support from: Asahi Kasei Pharma, Takeda Pharmaceutical Co., Ltd., Speakers bureau: Asahi Kasei Pharma Corp, Astellas Pharma Inc., Bristol Myers Squibb, Chugai Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Mitsubishi Tanabe Pharma Co., Satoshi Hama: None declared, Yutaro Hayashi: None declared, Yutaka Okano: None declared, Hisaji Oshima: None declared
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Shimada M, Kanazu M, Shimokawa M, Saito R, Mori M, Tamura A, Okano Y, Fujita Y, Endo T, Motegi M, Takata S, Kita T, Sukoh N, Takenoyama M, Atagi S. Clinical outcomes in elderly patients with advanced non-small cell lung cancer: A prospective multicenter study of the National Hospital Organization in Japan. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz437.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Okano Y, Ishikawa T, Hiro S, Hirano Y, Tajima K, Kasahara K. PF-06439535 (a bevacizumab biosimilar) for non-small cell lung cancer: subgroup analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz343.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kanazu M, Shimokawa M, Saito R, Mori M, Tamura A, Okano Y, Fujita Y, Endo T, Motegi M, Takata S, Kita T, Sukoh N, Takenoyama M, Atagi S. Predicting chemotherapy toxicity in elderly patients with advanced non-small cell lung cancer: A prospective multicenter study of the National Hospital Organization in Japan. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Imai Y, Yamamoto T, Sekimoto A, Okano Y, Sato R, Shigeta Y. Numerical investigation of the nano-scale solutal Marangoni convections. J Taiwan Inst Chem Eng 2019. [DOI: 10.1016/j.jtice.2018.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Masaki H, Kikuchi N, Mizutani T, Okano Y. 322 The Role of carbonylated proteins in corneocytes on skin barrier function. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.398] [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]
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Ohji H, Shinohara T, Kadota N, Okano Y, Naruse K, Iwahara Y, Ogushi F. Pneumocystis jirovecii pneumonia in an HIV-infected patient mimicking acute eosinophilic pneumonia: a case report with a review of the literature. J Thorac Dis 2019; 10:E774-E778. [PMID: 30622810 DOI: 10.21037/jtd.2018.10.49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Hiroshi Ohji
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Tsutomu Shinohara
- Department of Clinical Investigation National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Naoki Kadota
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Yoshio Okano
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Keishi Naruse
- Division of Pathology, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Yoshihito Iwahara
- Division of Hematology, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Fumitaka Ogushi
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
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Shinohara T, Tsuji S, Okano Y, Machida H, Hatakeyama N, Ogushi F. Elevated Levels of Intelectin-1, a Pathogen-binding Lectin, in the BAL Fluid of Patients with Chronic Eosinophilic Pneumonia and Hypersensitivity Pneumonitis. Intern Med 2018; 57:3507-3514. [PMID: 30101907 PMCID: PMC6355400 DOI: 10.2169/internalmedicine.0841-18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective Human intelectin-1 (hITLN-1) binds to galactofuranosyl residues, which are present in the microbial cell wall, but which are absent in mammalian tissues, and has been suggested to play an immunological role against microorganisms. However, the involvement of hITLN-1 in the pathogenesis of diffuse pulmonary diseases remains unknown. The aim of this study was to compare the hITLN-1 concentrations in the bronchoalveolar lavage (BAL) fluid of patients with diffuse pulmonary diseases. Methods The cell components and concentrations of hITLN-1 were analyzed in the BAL fluid of 8 patients with idiopathic chronic eosinophilic pneumonia (ICEP), 3 patients with drug-induced eosinophilic pneumonia, 4 patients with hypersensitivity pneumonitis (HP), 11 patients with sarcoidosis, 9 patients with cryptogenic organizing pneumonia, and 5 patients with idiopathic fibrosing interstitial pneumonia (fibrosing nonspecific interstitial pneumonia or usual interstitial pneumonia). Results The hITLN-1 concentrations in the BAL fluid of patients with ICEP and HP were higher than in those with other diseases. In the ICEP group, no significant difference was observed in the hITLN-1 concentrations of patients with or without a history of bronchial asthma. Conclusion The results of the present study suggest that hITLN-1 may be involved in the pathogenesis of ICEP and HP, and that an increase in the hITLN-1 concentration in the BAL fluid may represent a new biomarker for these diseases.
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Affiliation(s)
- Tsutomu Shinohara
- Department of Clinical Investigation, National Hospital Organization Kochi Hospital, Japan
| | - Shoutaro Tsuji
- Molecular Diagnostic Project, Kanagawa Cancer Center Research Institute, Japan
| | - Yoshio Okano
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Japan
| | - Hisanori Machida
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Japan
| | - Nobuo Hatakeyama
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Japan
| | - Fumitaka Ogushi
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, Japan
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Suganuma A, Nakashima S, Okano Y, Nozawa Y. Mass Contents of Inositol 1,4,5-Trisphosphate and 1,2-Diacylglycerol in Human Platelets Stimulated with a Thromboxane Analogue and Thrombin. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1656377] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryMass contents of inositol 1,4,5-trisphosphate (IP3) and 1,2-diacylglycerol (DG) were measured in U46619-stimulated human platelets. 1 µM of U46619 induced maximum responses in aggregation, 5-hydroxytryptamine (5HT) secretion and increase in intracellular free Ca2+ concentration ([Ca2+]i). Aggregation was almost comparable to that induced by maximal dose (1 U/ml) of thrombin, while 5HT release was almost half. The initial [Ca2+]i peak in response to U46619 was about half of thrombin stimulation. Production of IP3 and DG was, however, less than one tenth of that seen in thrombin stimulation. The profile (time course and concentration-dependency) of IP3 formation did not correlate with that of [Ca2+]i, suggesting that U46619 stimulates IPs-dependent and -independent Ca2+ mobilization. DG production was small but sustained for more than 5 min. These findings support the recent hypothesis that aggregation is regulated by a delayed accumulation of DG. The low level of 5HT secretion could be explained by the low production of second messengers, IP3 and DG.
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Affiliation(s)
- A Suganuma
- The Department of Drug Safety Research, Eisai Co., Ltd., Gifu, Japan
| | - S Nakashima
- The Department of Biochemistry, Gifu University School of Medicine, Gifu, Japan
| | - Y Okano
- The Department of Biochemistry, Gifu University School of Medicine, Gifu, Japan
| | - Y Nozawa
- The Department of Biochemistry, Gifu University School of Medicine, Gifu, Japan
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Goto H, Okano Y, Machida H, Hatakeyama N, Ogushi F, Haku T, Kanematsu T, Urata T, Kakiuchi S, Hanibuchi M, Sone S, Nishioka Y. Phase II study of tailored S-1 monotherapy with a 1-week interval after a 2-week dosing period in elderly patients with advanced non-small cell lung cancer. Respir Investig 2017; 56:80-86. [PMID: 29325686 DOI: 10.1016/j.resinv.2017.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/16/2017] [Accepted: 09/18/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND S-1 is an oral fluoropyrimidine that is active in the treatment of non-small cell lung cancer (NSCLC); however, an optimal treatment schedule and appropriate dose adjustments of S-1 in elderly patients have not yet been established. METHODS We conducted a phase II trial to evaluate the efficacy and safety of a 2-week S-1 monotherapy treatment followed by a 1-week interval as a first-line treatment of elderly NSCLC patients, by adjusting the dose based on the individual creatinine clearance (Ccr) and body surface area (BSA). The primary endpoint was the disease control rate. RESULTS Forty patients were enrolled. The disease control and response rates were 89.5% (95% confidence interval [CI] = 79.8-99.2) and 7.9% (95% CI = 0.0-16.4), respectively. The median progression-free survival and overall survival times were 4.4 months (95% CI = 4.2-8.5) and 17.0 months (95% CI = 11.2-18.7), respectively. Neutropenia, anorexia, hyponatremia, hypokalemia, and pneumonia of grade ≥ 3 occurred in 5.0%, 7.5%, 5.0%, 2.5%, and 2.5% of patients, respectively. Among the patient-reported outcomes, most of the individual factors in the patients' quality of life, including upper intestine-related symptoms improved with the treatment, except for dyspnea, which slightly albeit continuously worsened throughout the study. CONCLUSIONS In elderly patients with previously untreated advanced NSCLC, a 2-week S-1 monotherapy treatment, tailored to both the Ccr and BSA, with a 1-week interval was well tolerated and demonstrated promising efficacy. This study was registered at the University Hospital Medical Information Network (UMIN) Center (ID: UMIN000002035), Japan.
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Affiliation(s)
- Hisatsugu Goto
- Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, Tokushima 770-8503, Japan.
| | - Yoshio Okano
- Department of Respiratory Medicine, Kochi National Hospital, National Hospital Organization, 25-2-1 Asakura-Nishi Machi, Kochi, Kochi 780-8077, Japan.
| | - Hisanori Machida
- Department of Respiratory Medicine, Kochi National Hospital, National Hospital Organization, 25-2-1 Asakura-Nishi Machi, Kochi, Kochi 780-8077, Japan.
| | - Nobuo Hatakeyama
- Department of Respiratory Medicine, Kochi National Hospital, National Hospital Organization, 25-2-1 Asakura-Nishi Machi, Kochi, Kochi 780-8077, Japan.
| | - Fumitaka Ogushi
- Department of Respiratory Medicine, Kochi National Hospital, National Hospital Organization, 25-2-1 Asakura-Nishi Machi, Kochi, Kochi 780-8077, Japan.
| | - Takashi Haku
- Department of Respiratory Medicine, Tokushima Prefectural Central Hospital, 1-10-3 Kuramoto-cho, Tokushima, Tokushima 770-8539, Japan.
| | - Takanori Kanematsu
- Center of Respiratory Medicine, Matsuyama Red Cross Hospital, 1 Bunkyo-cho, Matsuyama, Ehime 790-8524, Japan.
| | - Tomoyuki Urata
- Department of Respiratory Medicine, Kochi Health Science Center, 2125-1 Ike, Kochi, Kochi 781-8555, Japan.
| | - Soji Kakiuchi
- Department of Oncology, Tokushima Municipal Hospital, 2-34 Kitajosanjima-cho, Tokushima, Tokushima 770-0812, Japan.
| | - Masaki Hanibuchi
- Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, Tokushima 770-8503, Japan.
| | - Saburo Sone
- Department of Oncology, Tokushima Municipal Hospital, 2-34 Kitajosanjima-cho, Tokushima, Tokushima 770-0812, Japan.
| | - Yasuhiko Nishioka
- Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, Tokushima 770-8503, Japan.
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Otaka S, Kato Y, Okano Y, Yamaga J, Kuwahara K, Okumoto K. 34 Does an In-Hospital START Protocol Predict Admission at the Time of Earthquakes? Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ogino H, Goto H, Okano Y, Machida H, Hatakeyama N, Ogushi F, Haku T, Kanematsu T, Urata T, Kakiuchi S, Hanibuchi M, Sone S, Nishioka Y. Phase II study of S-1 with patient-reported outcome evaluation in elderly patients with previously untreated advanced non-small cell lung cancer. Lung Cancer 2017. [DOI: 10.1183/1393003.congress-2017.oa1475] [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: 11/05/2022]
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Zhang W, Nakashima T, Sakai N, Yamada H, Okano Y, Nozawa Y. Activation of phosphoipase D by platelet-derived growth factor (PDGF) in rat C6 glioma cells: Possible role in mitogenic signal transduction. Neurol Res 2016; 14:397-401. [PMID: 1362254 DOI: 10.1080/01616412.1992.11740092] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The effects of platelet-derived growth factor (PDGF) on phospholipase D (PLD) activity and deoxyribonucleic acid (DNA) synthesis in rat C6 glioma cells have been investigated. Pretreatment of serum-starved C6 cells with PDGF results in enhanced choline production and the phosphatidylethanol (PEt) formation in the presence of ethanol, indicating the activation of PLD acting on phosphatidylcholine (PC). The dose-response curve for choline generation and DNA synthesis were comparable. In addition, the effects of PDGF on both PEt formation and [3H]thymidine incorporation into acid-precipitable material was blocked by the potent protein kinase C (PKC) inhibitor 1-(5-isoquinolinesulphonyl)-2-methylpiperazine (H-7) but not by N-(2-guanidinoethyl)-5-isoquinolinesulphonamide (HA1004), a relatively weak inhibitor of PKC, suggesting that PDGF plays an important role as a positive regulator of glioma cell growth via a PLD-mediated mitogenic signal transduction cascades, which depends largely on the activation of PKC.
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Affiliation(s)
- W Zhang
- Department of Neurosurgery, Gifu University School of Medicine, Japan
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Takenaka K, Kishino J, Yamada H, Sakai N, Arita H, Okano Y, Nozawa Y. DNA synthesis and intracellular calcium elevation in porcine cerebral arterial smooth muscle cells by cerebrospinal fluid from patients with subarachnoid haemorrhage. Neurol Res 2016; 14:330-4. [PMID: 1360629 DOI: 10.1080/01616412.1992.11740079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To understand the molecular mechanism of the pathogenesis of cerebral vasospasm following subarachnoid haemorrhage, we analysed the effect of cerebrospinal fluid from patients with subarachnoid haemorrhage on DNA synthesis and cytosolic-free calcium elevation in cultured porcine cerebral smooth muscle cells. Cerebrospinal fluid from patients on day 2 after subarachnoid haemorrhage induced transient elevation in cytosolic-free calcium levels. In contrast, the maximal elevation of cytosolic-free calcium levels induced by cerebrospinal fluid from control patients (without subarachnoid haemorrhage) was significantly lower than that induced by cerebrospinal fluid from patients with subarachnoid haemorrhage. In cultured porcine cerebral arterial smooth muscle cells, cerebrospinal fluid from patients with subarachnoid haemorrhage promoted levels of [3H]-thymidine incorporation (DNA synthesis) more than 2.5-fold higher than that promoted by cerebrospinal fluid from control patients without subarachnoid haemorrhage. However, in cultured aortic smooth muscle cells, there was no significant difference in [3H]-thymidine incorporation between cerebrospinal fluid from patients with subarachnoid haemorrhage and that by control cerebrospinal fluid. From these results in cerebral arterial smooth muscle cells, cerebrospinal fluid from patients following subarachnoid haemorrhage may play not only constrictive functions, evidenced by cytosolic-free calcium elevations, but also proliferative functions, demonstrated by promotion of [3H]-thymidine incorporation. The relevance of these factors to vasospasm will be discussed.
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Affiliation(s)
- K Takenaka
- Department of Neurosurgery, Gifu University School of Medicine, Japan
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Shinohara T, Kagawa K, Okano Y, Sawada T, Kobayashi T, Takikawa M, Iwahara Y, Ogushi F. Disseminated tuberculosis after pregnancy progressed to paradoxical response to the treatment: report of two cases. BMC Infect Dis 2016; 16:284. [PMID: 27297079 PMCID: PMC4906776 DOI: 10.1186/s12879-016-1624-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 06/07/2016] [Indexed: 11/17/2022] Open
Abstract
Background Early postpartum women are more likely to develop tuberculosis than nonpregnant women mainly due to immune reconstitution after delivery. Paradoxical response (PR) during antituberculosis treatment also arises via recovery from immunosuppression. However, no study focused on PR during antituberculosis treatment in a postpartum patient has been reported. Case presentation We present two sequential cases (Patient 1: 26-year-old; Patient 2: 29-year-old) of postpartum tuberculosis with pulmonary and extrapulmonary lesions (Patient 1: peritonitis; Patient 2: psoas abscess secondary to spondylitis). Both cases progressed to PR (worsening of pre-existing lung infiltrations (Patients 1, 2) and new contralateral effusion (Patient 2)) in a relatively short time after initiation of treatment (Patient 1: 1 week; Patient 2: 3 weeks), suggesting that immune modulations during pregnancy and delivery may contribute to the pathogenesis of both disseminated tuberculosis and its PR. The pulmonary lesions and effusion of both cases gradually improved without change of chemotherapy regimen. Conclusion Physicians should recognize PR in tuberculosis patients with postpartum and then evaluate treatment efficacy.
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Affiliation(s)
- Tsutomu Shinohara
- Department of Clinical Investigation, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
| | - Kozo Kagawa
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
| | - Yoshio Okano
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
| | - Toru Sawada
- Division of Thoracic Surgery, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
| | - Tooru Kobayashi
- Division of Orthopaedic Surgery, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
| | - Masaya Takikawa
- Division of Obstetrics and Gynecology, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
| | - Yoshihito Iwahara
- Division of Hematology, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
| | - Fumitaka Ogushi
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
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Okano Y, Shinohara T, Imanishi S, Takahashi N, Naito N, Taoka T, Kadota N, Ogushi F. Miliary pulmonary nodules due to Mycobacterium xenopi in a steroid-induced immunocompromised patient successfully treated with chemotherapy: a case report. BMC Pulm Med 2016; 16:92. [PMID: 27287608 PMCID: PMC4902965 DOI: 10.1186/s12890-016-0252-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 06/01/2016] [Indexed: 11/13/2022] Open
Abstract
Background Mycobacterium xenopi-infected patients have a high prevalence of pulmonary cavities and nodules. However, the clinical course for patients with miliary nodules due to M. xenopi has not yet been reported. Case presentation We encountered a case of miliary nodules with gradually worsening coughing and sputum production in a 44-year-old male who had renal dysfunction due to glomerulosclerosis with a decade-long history of steroid therapy. Although we started anti-tuberculosis treatment on clinical suspicion of miliary tuberculosis, cultures of sputum and bronchial lavage were both positive for M. xenopi. The patient was successfully treated with rifampin, ethambutol and clarithromycin, without fibrosis. It was unclear whether the miliary pattern was induced by hematogenous or endobronchial spread of the M. xenopi infection. Conclusion Even when clinical and radiological disease manifestations are similar to those of miliary tuberculosis, M. xenopi infection should be considered in the differential diagnosis of miliary nodules.
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Affiliation(s)
- Yoshio Okano
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
| | - Tsutomu Shinohara
- Department of Clinical Investigation, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan.
| | - Shino Imanishi
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
| | - Naoki Takahashi
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
| | - Nobuhito Naito
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
| | - Takanari Taoka
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
| | - Naoki Kadota
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
| | - Fumitaka Ogushi
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan
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Affiliation(s)
- Y Maeda
- From the Department of Internal Medicine and
| | - H Taguchi
- Center for Arthritis and Rheumatic Disease, Kawasaki Municipal Kawasaki Hospital, Japan
| | - T Kudo
- Center for Arthritis and Rheumatic Disease, Kawasaki Municipal Kawasaki Hospital, Japan
| | - Y Okano
- Center for Arthritis and Rheumatic Disease, Kawasaki Municipal Kawasaki Hospital, Japan
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Kubota T, Okano Y, Sakai M, Takaoka M, Tsukuda T, Anabuki K, Kawase S, Miyamoto S, Ohnishi H, Hatakeyama N, Machida H, Urata T, Yamamoto A, Ogushi F, Yokoyama A. Carboplatin plus Weekly Paclitaxel with Bevacizumab for First-line Treatment of Non-small Cell Lung Cancer. Anticancer Res 2016; 36:307-312. [PMID: 26722058] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM The present study aimed to evaluate the effectiveness and safety of weekly paclitaxel (PTX) combined with carboplatin (CBDCA) plus bevacizumab (BEV), followed by maintenance BEV in patients with advanced NSCLC. PATIENTS AND METHODS Patients with unresectable stage IIIB and IV NSCLC (n=43) were treated with CBDCA (AUC 6, day 1), BEV (15 mg/kg, day 1), and PTX (70 mg/m(2), days 1, 8, 15) intravenously every 4 weeks, for 3 to 6 cycles, followed by maintenance BEV (15 mg/kg) every 3 weeks. RESULTS The objective response rate and disease control rate were 67.4% and 90.7%, respectively. The median progression-free survival was 7.6 months. The median overall survival was 17.7 months. Common adverse events were tolerable bone marrow suppression, fatigue, hypertension, and nasal bleeding. CONCLUSION Weekly administration of PTX combined with CBDCA plus BEV therapy was effective, and well-tolerated by advanced NSCLC patients.
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Affiliation(s)
- Tetsuya Kubota
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Yoshio Okano
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Mizu Sakai
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Masato Takaoka
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Tsukie Tsukuda
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kazuki Anabuki
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Shigeo Kawase
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Shintaro Miyamoto
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Hiroshi Ohnishi
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Nobuo Hatakeyama
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Hisanori Machida
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Tomoyuki Urata
- Division of Respiratory Medicine, Kochi Health Sciences Center, Kochi, Japan
| | - Akira Yamamoto
- Division of Respiratory Surgery, Chikamori Hospital, Kochi, Japan
| | - Fumitaka Ogushi
- Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Akihito Yokoyama
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
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Okano Y, Yoshida S, Shinohara T, Takahashi N, Naito N, Kagawa K, Machida H, Hatakeyama N, Ohno A, Wada T, Ogushi F. Primary Gingival Tuberculosis Diagnosed Based on Genetic Identification. Intern Med 2015; 54:2765-8. [PMID: 26521908 DOI: 10.2169/internalmedicine.54.4353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A case of primary gingival tuberculosis in a 71-year-old Japanese woman is herein presented. A serous saliva culture was positive for tuberculosis, and we recognized that the origin of the tuberculosis infection was the gingiva based on the genetic identification in gingival biopsy tissue. The definitive diagnosis was facilitated by the genetic identification, a useful modern tool for diagnosing infectious diseases. The location and clinical presentation of this lesion were unusual, which underlines the importance of considering tuberculosis in the differential diagnosis of oral lesions that affect the gingiva.
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Affiliation(s)
- Yoshio Okano
- Respiratory Medicine, National Hospital Organization, National Kochi Hospital, Japan
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Kawaguchi T, Ando M, Asami K, Okano Y, Fukuda M, Nakagawa H, Ibata H, Kozuki T, Endo T, Tamura A, Kamimura M, Sakamoto K, Yoshimi M, Soejima Y, Tomizawa Y, Isa SI, Takada M, Saka H, Kubo A. Randomized Phase III Trial of Erlotinib Versus Docetaxel As Second- or Third-Line Therapy in Patients With Advanced Non–Small-Cell Lung Cancer: Docetaxel and Erlotinib Lung Cancer Trial (DELTA). J Clin Oncol 2014; 32:1902-8. [DOI: 10.1200/jco.2013.52.4694] [Citation(s) in RCA: 208] [Impact Index Per Article: 20.8] [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
Purpose To investigate the efficacy of erlotinib versus docetaxel in previously treated patients with advanced non–small-cell lung cancer (NSCLC) in an epidermal growth factor receptor (EGFR) –unselected patient population. Patients and Methods The primary end point was progression-free survival (PFS). Secondary end points included overall survival (OS), response rate, safety, and analyses on EGFR wild-type tumors. Patients with stage IIIB or IV NSCLC, previous treatment with one or two chemotherapy regimens, evaluable or measurable disease, and performance status of 0 to 2 were eligible. Results From August 2009 to July 2012, 150 and 151 patients were randomly assigned to erlotinib (150 mg daily) and docetaxel (60 mg/m2 every 3 weeks), respectively. EGFR wild-type NSCLC was present in 109 and 90 patients in the erlotinib and docetaxel groups, respectively. Median PFS for erlotinib versus docetaxel was 2.0 v 3.2 months (hazard ratio [HR], 1.22; 95% CI, 0.97 to 1.55; P = .09), and median OS was 14.8 v 12.2 months (HR, 0.91; 95% CI, 0.68 to 1.22; P = .53), respectively. In a subset analysis of EGFR wild-type tumors, PFS for erlotinib versus docetaxel was 1.3 v 2.9 months (HR, 1.45; 95% CI, 1.09 to 1.94; P = .01), and OS was 9.0 v 10.1 months (HR, 0.98; 95% CI, 0.69 to 1.39; P = .91), respectively. Conclusion Erlotinib failed to show an improvement in PFS or OS compared with docetaxel in an EGFR-unselected patient population.
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Affiliation(s)
- Tomoya Kawaguchi
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Masahiko Ando
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Kazuhiro Asami
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Yoshio Okano
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Masaaki Fukuda
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Hideyuki Nakagawa
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Hidenori Ibata
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Toshiyuki Kozuki
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Takeo Endo
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Atsuhisa Tamura
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Mitsuhiro Kamimura
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Kazuhiro Sakamoto
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Michihiro Yoshimi
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Yoshifumi Soejima
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Yoshio Tomizawa
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Shun-ichi Isa
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Minoru Takada
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Hideo Saka
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
| | - Akihito Kubo
- Tomoya Kawaguchi, Kazuhiro Asami, and Shun-ichi Isa, National Hospital Organization Kinki-Chuo Chest Medical Center; Minoru Takada, Koyo Hospital, Osaka; Masahiko Ando, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital; Akihito Kubo, Aichi Medical University School of Medicine, Aichi; Yoshio Okano, National Hospital Organization Kochi Hospital, Kochi; Masaaki Fukuda, National Hospital Organization Nagasaki Medical Center, Nagasaki; Hideyuki Nakagawa, National Hospital
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Takahashi C, Kaneko Y, Okano Y, Ooshima H, Takeuchi T. THU0118 Methotrexate Polyglutamates in Erythrocytes Correlates with Clinical Response in Japanese Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3527] [Citation(s) in RCA: 3] [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: 11/04/2022]
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Ibata H, Ando M, Asami K, Okano Y, Fukuda M, Nakagawa H, Kozuki T, Endo T, Tamura A, Kamimura M, Sakamoto K, Yoshimi M, Soejima Y, Tomizawa Y, Isa SI, Takada M, Saka H, Kubo A, Kawaguchi T. Updated overall survival (OS) results of randomized phase III trial of erlotinib (E) versus (v) docetaxel (D) as second- or third-line therapy in patients with advanced non-small cell lung cancer (NSCLC): Docetaxel and Erlotinib Lung Cancer Trial (DELTA). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e19003] [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)
- Hidenori Ibata
- National Hospital Organization Mie Central Medical Center, Mie, Japan
| | | | - Kazuhiro Asami
- National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Yoshio Okano
- National Hospital Organization Kochi Hospital, Kochi, Japan
| | - Masaaki Fukuda
- National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | | | - Toshiyuki Kozuki
- Department of Thoracic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Tateo Endo
- National Hospital Organization Mito Medical Center, Mito, Japan
| | - Atsuhisa Tamura
- National Hospital Organization Tokyo Hospital, Kiyose, Japan
| | | | - Kazuhiro Sakamoto
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - Michihiro Yoshimi
- National Hospital Organization Fukuoka East Medical Center, Fukuoka, Japan
| | - Yoshifumi Soejima
- National Hospital Organization Ureshino Medical Center, Ureshino, Japan
| | | | - Shun-ichi Isa
- Department of Lung Cancer Research, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | | | - Hideo Saka
- Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Akihito Kubo
- Aichi Medical University School of Medicine, Nagoya, Japan
| | - Tomoya Kawaguchi
- National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
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50
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He BJ, Nolte G, Nagata K, Takano D, Yamazaki T, Fujimaki Y, Maeda T, Satoh Y, Heckers S, George MS, Lopes da Silva F, de Munck JC, Van Houdt PJ, Verdaasdonk RM, Ossenblok P, Mullinger K, Bowtell R, Bagshaw AP, Keeser D, Karch S, Segmiller F, Hantschk I, Berman A, Padberg F, Pogarell O, Scharnowski F, Karch S, Hümmer S, Keeser D, Paolini M, Kirsch V, Koller G, Rauchmann B, Kupka M, Blautzik J, Pogarell O, Razavi N, Jann K, Koenig T, Kottlow M, Hauf M, Strik W, Dierks T, Gotman J, Vulliemoz S, Lu Y, Zhang H, Yang L, Worrell G, He B, Gruber O, Piguet C, Hubl D, Homan P, Kindler J, Dierks T, Kim K, Steinhoff U, Wakai R, Koenig T, Kottlow M, Melie-García L, Mucci A, Volpe U, Prinster A, Salvatore M, Galderisi S, Linden DEJ, Brandeis D, Schroeder CE, Kayser C, Panzeri S, Kleinschmidt A, Ritter P, Walther S, Haueisen J, Lau S, Flemming L, Sonntag H, Maess B, Knösche TR, Lanfer B, Dannhauer M, Wolters CH, Stenroos M, Haueisen J, Wolters C, Aydin U, Lanfer B, Lew S, Lucka F, Ruthotto L, Vorwerk J, Wagner S, Ramon C, Guan C, Ang KK, Chua SG, Kuah WK, Phua KS, Chew E, Zhou H, Chuang KH, Ang BT, Wang C, Zhang H, Yang H, Chin ZY, Yu H, Pan Y, Collins L, Mainsah B, Colwell K, Morton K, Ryan D, Sellers E, Caves K, Throckmorton S, Kübler A, Holz EM, Zickler C, Sellers E, Ryan D, Brown K, Colwell K, Mainsah B, Caves K, Throckmorton S, Collins L, Wennberg R, Ahlfors SP, Grova C, Chowdhury R, Hedrich T, Heers M, Zelmann R, Hall JA, Lina JM, Kobayashi E, Oostendorp T, van Dam P, Oosterhof P, Linnenbank A, Coronel R, van Dessel P, de Bakker J, Rossion B, Jacques C, Witthoft N, Weiner KS, Foster BL, Miller KJ, Hermes D, Parvizi J, Grill-Spector K, Recanzone GH, Murray MM, Haynes JD, Richiardi J, Greicius M, De Lucia M, Müller KR, Formisano E, Smieskova R, Schmidt A, Bendfeldt K, Walter A, Riecher-Rössler A, Borgwardt S, Fusar-Poli P, Eliez S, Schmidt A, Sekihara K, Nagarajan SS, Schoffelen JM, Guggisberg AG, Nolte G, Balazs S, Kermanshahi K, Kiesenhofer W, Binder H, Rattay F, Antal A, Chaieb L, Paulus W, Bodis-Wollner I, Maurer K, Fein G, Camchong J, Johnstone J, Cardenas-Nicolson V, Fiederer LDJ, Lucka F, Yang S, Vorwerk J, Dümpelmann M, Cosandier-Rimélé D, Schulze-Bonhage A, Aertsen A, Speck O, Wolters CH, Ball T, Fuchs M, Wagner M, Kastner J, Tech R, Dinh C, Haueisen J, Baumgarten D, Hämäläinen MS, Lau S, Vogrin SJ, D'Souza W, Haueisen J, Cook MJ, Custo A, Van De Ville D, Vulliemoz S, Grouiller F, Michel CM, Malmivuo J, Aydin U, Vorwerk J, Küpper P, Heers M, Kugel H, Wellmer J, Kellinghaus C, Scherg M, Rampp S, Wolters C, Storti SF, Boscolo Galazzo I, Del Felice A, Pizzini FB, Arcaro C, Formaggio E, Mai R, Manganotti P, Koessler L, Vignal J, Cecchin T, Colnat-Coulbois S, Vespignani H, Ramantani G, Maillard L, Rektor I, Kuba R, Brázdil M, Chrastina J, Rektorova I, van Mierlo P, Carrette E, Strobbe G, Montes-Restrepo V, Vonck K, Vandenberghe S, Ahmed B, Brodely C, Carlson C, Kuzniecky R, Devinsky O, French J, Thesen T, Bénis D, David O, Lachaux JP, Seigneuret E, Krack P, Fraix V, Chabardès S, Bastin J, Jann K, Gee D, Kilroy E, Cannon T, Wang DJ, Hale JR, Mayhew SD, Przezdzik I, Arvanitis TN, Bagshaw AP, Plomp G, Quairiaux C, Astolfi L, Michel CM, Mayhew SD, Mullinger KJ, Bagshaw AP, Bowtell R, Francis ST, Schouten AC, Campfens SF, van der Kooij H, Koles Z, Lind J, Flor-Henry P, Wirth M, Haase CM, Villeneuve S, Vogel J, Jagust WJ, Kambeitz-Ilankovic L, Simon-Vermot L, Gesierich B, Duering M, Ewers M, Rektorova I, Krajcovicova L, Marecek R, Mikl M, Bracht T, Horn H, Strik W, Federspiel A, Schnell S, Höfle O, Stegmayer K, Wiest R, Dierks T, Müller TJ, Walther S, Surmeli T, Ertem A, Eralp E, Kos IH, Skrandies W, Flüggen S, Klein A, Britz J, Díaz Hernàndez L, Ro T, Michel CM, Lenartowicz A, Lau E, Rodriguez C, Cohen MS, Loo SK, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Giannoudas I, La Porta P, Verardo AR, Niolu C, Fernandez I, Siracusano A, Flor-Henry P, Lind J, Koles Z, Bollmann S, Ghisleni C, O'Gorman R, Poil SS, Klaver P, Michels L, Martin E, Ball J, Eich-Höchli D, Brandeis D, Salisbury DF, Murphy TK, Butera CD, Mathalon DH, Fryer SL, Kiehl KA, Calhoun VC, Pearlson GD, Roach BJ, Ford JM, McGlashan TH, Woods SW, Volpe U, Merlotti E, Vignapiano A, Montefusco V, Plescia GM, Gallo O, Romano P, Mucci A, Galderisi S, Mingoia G, Langbein K, Dietzek M, Wagner G, Smesny, Scherpiet S, Maitra R, Gaser C, Sauer H, Nenadic I, Gonzalez Andino S, Grave de Peralta Menendez R, Grave de Peralta Menendez R, Sanchez Vives M, Rebollo B, Gonzalez Andino S, Frølich L, Andersen TS, Mørup M, Belfiore P, Gargiulo P, Ramon C, Vanhatalo S, Cho JH, Vorwerk J, Wolters CH, Knösche TR, Watanabe T, Kawabata Y, Ukegawa D, Kawabata S, Adachi Y, Sekihara K, Sekihara K, Nagarajan SS, Wagner S, Aydin U, Vorwerk J, Herrmann C, Burger M, Wolters C, Lucka F, Aydin U, Vorwerk J, Burger M, Wolters C, Bauer M, Trahms L, Sander T, Faber PL, Lehmann D, Gianotti LRR, Pascual-Marqui RD, Milz P, Kochi K, Kaneko S, Yamashita S, Yana K, Kalogianni K, Vardy AN, Schouten AC, van der Helm FCT, Sorrentino A, Luria G, Aramini R, Hunold A, Funke M, Eichardt R, Haueisen J, Gómez-Aguilar F, Vázquez-Olvera S, Cordova-Fraga T, Castro-López J, Hernández-Gonzalez MA, Solorio-Meza S, Sosa-Aquino M, Bernal-Alvarado JJ, Vargas-Luna M, Vorwerk J, Magyari L, Ludewig J, Oostenveld R, Wolters CH, Vorwerk J, Engwer C, Ludewig J, Wolters C, Sato K, Nishibe T, Furuya M, Yamashiro K, Yana K, Ono T, Puthanmadam Subramaniyam N, Hyttinen J, Lau S, Güllmar D, Flemming L, Haueisen J, Sonntag H, Vorwerk J, Wolters CH, Grasedyck L, Haueisen J, Maeß B, Freitag S, Graichen U, Fiedler P, Strohmeier D, Haueisen J, Stenroos M, Hauk O, Grigutsch M, Felber M, Maess B, Herrmann B, Strobbe G, van Mierlo P, Vandenberghe S, Strobbe G, Cárdenas-Peña D, Montes-Restrepo V, van Mierlo P, Castellanos-Dominguez G, Vandenberghe S, Lanfer B, Paul-Jordanov I, Scherg M, Wolters CH, Ito Y, Sato D, Kamada K, Kobayashi T, Dalal SS, Rampp S, Willomitzer F, Arold O, Fouladi-Movahed S, Häusler G, Stefan H, Ettl S, Zhang S, Zhang Y, Li H, Kong X, Montes-Restrepo V, Strobbe G, van Mierlo P, Vandenberghe S, Wong DDE, Bidet-Caulet A, Knight RT, Crone NE, Dalal SS, Birot G, Spinelli L, Vulliémoz S, Seeck M, Michel CM, Emory H, Wells C, Mizrahi N, Vogrin SJ, Lau S, Cook MJ, Karahanoglu FI, Grouiller F, Caballero-Gaudes C, Seeck M, Vulliemoz S, Van De Ville D, Spinelli L, Megevand P, Genetti M, Schaller K, Michel C, Vulliemoz S, Seeck M, Genetti M, Tyrand R, Grouiller F, Vulliemoz S, Spinelli L, Seeck M, Schaller K, Michel CM, Grouiller F, Heinzer S, Delattre B, Lazeyras F, Spinelli L, Pittau F, Seeck M, Ratib O, Vargas M, Garibotto V, Vulliemoz S, Vogrin SJ, Bailey CA, Kean M, Warren AE, Davidson A, Seal M, Harvey AS, Archer JS, Papadopoulou M, Leite M, van Mierlo P, Vonck K, Boon P, Friston K, Marinazzo D, Ramon C, Holmes M, Koessler L, Rikir E, Gavaret M, Bartolomei F, Vignal JP, Vespignani H, Maillard L, Centeno M, Perani S, Pier K, Lemieux L, Clayden J, Clark C, Pressler R, Cross H, Carmichael DW, Spring A, Bessemer R, Pittman D, Aghakhani Y, Federico P, Pittau F, Grouiller F, Vulliémoz S, Gotman J, Badier JM, Bénar CG, Bartolomei F, Cruto C, Chauvel P, Gavaret M, Brodbeck V, van Leeuwen T, Tagliazzuchi E, Melloni L, Laufs H, Griskova-Bulanova I, Dapsys K, Klein C, Hänggi J, Jäncke L, Ehinger BV, Fischer P, Gert AL, Kaufhold L, Weber F, Marchante Fernandez M, Pipa G, König P, Sekihara K, Hiyama E, Koga R, Iannilli E, Michel CM, Bartmuss AL, Gupta N, Hummel T, Boecker R, Holz N, Buchmann AF, Blomeyer D, Plichta MM, Wolf I, Baumeister S, Meyer-Lindenberg A, Banaschewski T, Brandeis D, Laucht M, Natahara S, Ueno M, Kobayashi T, Kottlow M, Bänninger A, Koenig T, Schwab S, Koenig T, Federspiel A, Dierks T, Jann K, Natsukawa H, Kobayashi T, Tüshaus L, Koenig T, Kottlow M, Achermann P, Wilson RS, Mayhew SD, Assecondi S, Arvanitis TN, Bagshaw AP, Darque A, Rihs TA, Grouiller F, Lazeyras F, Ha-Vinh Leuchter R, Caballero C, Michel CM, Hüppi PS, Hauser TU, Hunt LT, Iannaccone R, Stämpfli P, Brandeis D, Dolan RJ, Walitza S, Brem S, Graichen U, Eichardt R, Fiedler P, Strohmeier D, Freitag S, Zanow F, Haueisen J, Lordier L, Grouiller F, Van de Ville D, Sancho Rossignol A, Cordero I, Lazeyras F, Ansermet F, Hüppi P, Schläpfer A, Rubia K, Brandeis D, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Giannoudas I, Verardo AR, La Porta P, Niolu C, Fernandez I, Siracusano A, Tamura K, Karube C, Mizuba T, Matsufuji M, Takashima S, Iramina K, Assecondi S, Ostwald D, Bagshaw AP, Marecek R, Brazdil M, Lamos M, Slavícek T, Marecek R, Jan J, Meier NM, Perrig W, Koenig T, Minami T, Noritake Y, Nakauchi S, Azuma K, Minami T, Nakauchi S, Rodriguez C, Lenartowicz A, Cohen MS, Rodriguez C, Lenartowicz A, Cohen MS, Iramina K, Kinoshita H, Tamura K, Karube C, Kaneko M, Ide J, Noguchi Y, Cohen MS, Douglas PK, Rodriguez CM, Xia HJ, Zimmerman EM, Konopka CJ, Epstein PS, Konopka LM, Giezendanner S, Fisler M, Soravia L, Andreotti J, Wiest R, Dierks T, Federspiel A, Razavi N, Federspiel A, Dierks T, Hauf M, Jann K, Kamada K, Sato D, Ito Y, Okano K, Mizutani N, Kobayashi T, Thelen A, Murray M, Pastena L, Formaggio E, Storti SF, Faralli F, Melucci M, Gagliardi R, Ricciardi L, Ruffino G, Coito A, Macku P, Tyrand R, Astolfi L, He B, Wiest R, Seeck M, Michel C, Plomp G, Vulliemoz S, Fischmeister FPS, Glaser J, Schöpf V, Bauer H, Beisteiner R, Deligianni F, Centeno M, Carmichael DW, Clayden J, Mingoia G, Langbein K, Dietzek M, Wagner G, Smesny S, Scherpiet S, Maitra R, Gaser C, Sauer H, Nenadic I, Dürschmid S, Zaehle T, Pannek H, Chang HF, Voges J, Rieger J, Knight RT, Heinze HJ, Hinrichs H, Tsatsishvili V, Cong F, Puoliväli T, Alluri V, Toiviainen P, Nandi AK, Brattico E, Ristaniemi T, Grieder M, Crinelli RM, Jann K, Federspiel A, Wirth M, Koenig T, Stein M, Wahlund LO, Dierks T, Atsumori H, Yamaguchi R, Okano Y, Sato H, Funane T, Sakamoto K, Kiguchi M, Tränkner A, Schindler S, Schmidt F, Strauß M, Trampel R, Hegerl U, Turner R, Geyer S, Schönknecht P, Kebets V, van Assche M, Goldstein R, van der Meulen M, Vuilleumier P, Richiardi J, Van De Ville D, Assal F, Wozniak-Kwasniewska A, Szekely D, Harquel S, Bougerol T, David O, Bracht T, Jones DK, Horn H, Müller TJ, Walther S, Sos P, Klirova M, Novak T, Brunovsky M, Horacek J, Bares M, Hoschl C C, Fellhauer I, Zöllner FG, Schröder J, Kong L, Essig M, Schad LR, Arrubla J, Neuner I, Hahn D, Boers F, Shah NJ, Neuner I, Arrubla J, Hahn D, Boers F, Jon Shah N, Suriya Prakash M, Sharma R, Kawaguchi H, Kobayashi T, Fiedler P, Griebel S, Biller S, Fonseca C, Vaz F, Zentner L, Zanow F, Haueisen J, Rochas V, Rihs T, Thut G, Rosenberg N, Landis T, Michel C, Moliadze V, Schmanke T, Lyzhko E, Bassüner S, Freitag C, Siniatchkin M, Thézé R, Guggisberg AG, Nahum L, Schnider A, Meier L, Friedrich H, Jann K, Landis B, Wiest R, Federspiel A, Strik W, Dierks T, Witte M, Kober SE, Neuper C, Wood G, König R, Matysiak A, Kordecki W, Sieluzycki C, Zacharias N, Heil P, Wyss C, Boers F, Arrubla J, Dammers J, Kawohl W, Neuner I, Shah NJ, Braboszcz C, Cahn RB, Levy J, Fernandez M, Delorme A, Rosas-Martinez L, Milne E, Zheng Y, Urakami Y, Kawamura K, Washizawa Y, Hiyoshi K, Cichocki A, Giroud N, Dellwo V, Meyer M, Rufener KS, Liem F, Dellwo V, Meyer M, Jones-Rounds JD, Raizada R, Staljanssens W, Strobbe G, van Mierlo P, Van Holen R, Vandenberghe S, Pefkou M, Becker R, Michel C, Hervais-Adelman A, He W, Brock J, Johnson B, Ohla K, Hitz K, Heekeren K, Obermann C, Huber T, Juckel G, Kawohl W, Gabriel D, Comte A, Henriques J, Magnin E, Grigoryeva L, Ortega JP, Haffen E, Moulin T, Pazart L, Aubry R, Kukleta M, Baris Turak B, Louvel J, Crespo-Garcia M, Cantero JL, Atienza M, Connell S, Kilborn K, Damborská A, Brázdil M, Rektor I, Kukleta M, Koberda JL, Bienkiewicz A, Koberda I, Koberda P, Moses A, Tomescu M, Rihs T, Britz J, Custo A, Grouiller F, Schneider M, Debbané M, Eliez S, Michel C, Wang GY, Kydd R, Wouldes TA, Jensen M, Russell BR, Dissanayaka N, Au T, Angwin A, O'Sullivan J, Byrne G, Silburn P, Marsh R, Mellic G, Copland D, Bänninger A, Kottlow M, Díaz Hernàndez L, Koenig T, Díaz Hernàndez L, Bänninger A, Koenig T, Hauser TU, Iannaccone R, Mathys C, Ball J, Drechsler R, Brandeis D, Walitza S, Brem S, Boeijinga PH, Pang EW, Valica T, Macdonald MJ, Oh A, Lerch JP, Anagnostou E, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Verardo AR, Giannoudas I, La Porta P, Niolu C, Fernandez I, Siracusano A, Shimada T, Matsuda Y, Monkawa A, Monkawa T, Hashimoto R, Watanabe K, Kawasaki Y, Matsuda Y, Shimada T, Monkawa T, Monkawa A, Watanabe K, Kawasaki Y, Stegmayer K, Horn H, Federspiel A, Razavi N, Bracht T, Laimböck K, Strik W, Dierks T, Wiest R, Müller TJ, Walther S, Koorenhof LJ, Swithenby SJ, Martins-Mourao A, Rihs TA, Tomescu M, Song KW, Custo A, Knebel JF, Murray M, Eliez S, Michel CM, Volpe U, Merlotti E, Vignapiano A, Montefusco V, Plescia GM, Gallo O, Romano P, Mucci A, Galderisi S, Laimboeck K, Jann K, Walther S, Federspiel A, Wiest R, Strik W, Horn H. Abstracts of Presentations at the International Conference on Basic and Clinical Multimodal Imaging (BaCI), a Joint Conference of the International Society for Neuroimaging in Psychiatry (ISNIP), the International Society for Functional Source Imaging (ISFSI), the International Society for Bioelectromagnetism (ISBEM), the International Society for Brain Electromagnetic Topography (ISBET), and the EEG and Clinical Neuroscience Society (ECNS), in Geneva, Switzerland, September 5-8, 2013. Clin EEG Neurosci 2013; 44:1550059413507209. [PMID: 24368763 DOI: 10.1177/1550059413507209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- B J He
- National Institutes of Health, Bethesda, MD, USA
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