1
|
Hayashi T, Kishimoto N, Abiko K, Konishi I. Treatment With Antitumor Agents Recommended by Cancer Genome Panel for Uterine Leiomyosarcoma. J Clin Med Res 2023; 15:461-468. [PMID: 38189037 PMCID: PMC10769602 DOI: 10.14740/jocmr5052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
To date, cancer genomic medicine, using cancer gene panel covered by health insurance from June 2019, has been performed for advanced malignant tumors under public medical insurance. In gynecology, the first-line treatment for uterine leiomyosarcomas, which is a mesenchymal uterine tumor, is surgery. In uterine leiomyosarcoma cases, recurrence is observed within 2 years postoperatively; however, to date, clinical trials have not shown efficacy with existing antitumor agents. We noted efficacy in two cases with advanced/recurrent uterine leiomyosarcoma using an antitumor agent selected on the basis of cancer gene panel testing results. Following uterine leiomyosarcoma diagnosis, they underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy as standard surgical treatment. After the surgical treatment, the imaging test revealed recurrent tumors; subsequently, they were treated with doxorubicin alone or doxorubicin combined with Gemzar. However, cancer genome gene panel test was performed because the malignant tumor worsened. Based on the cancer genome gene panel test results, the two cases with advanced uterine leiomyosarcoma were associated with increased tumor mutational burden (TMB) or pathogenic variants (PVs) of AKT serine/threonine kinase 1 (AKT1). Therefore, treatment with pembrolizumab, which is a drug covered by insurance for patients with TMB-high, or treatment with kinase inhibitors for patients with PVs in AKT, was considered. Cancer genomic medicine using cancer gene panel provides a new treatment strategy for intractable malignant tumors. This study aimed to discuss the usefulness of cancer genomic medicine by cancer gene panel testing using the cases of advanced and recurrence uterine leiomyosarcoma and the latest findings.
Collapse
Affiliation(s)
- Takuma Hayashi
- Cancer Medicine, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
- First-Track Medical R&D, The Japan Agency for Medical Research and Development (AMED), Tokyo 100-0004, Japan
| | - Naoya Kishimoto
- Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
| | - Kaoru Abiko
- Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
| | - Ikuo Konishi
- First-Track Medical R&D, The Japan Agency for Medical Research and Development (AMED), Tokyo 100-0004, Japan
- Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
| |
Collapse
|
2
|
Morii E, Hatanaka Y, Motoi N, Kawahara A, Hamakawa S, Kuwata T, Nagatomo T, Oda Y, Okamoto A, Tanaka R, Iyoda A, Ichiro M, Matsuo Y, Nakamura N, Nakai T, Fukuhara M, Tokita K, Yamaguchi T, Takenaka M, Kawabata A, Hatanaka KC, Tsubame K, Satoh Y. Guidelines for Handling of Cytological Specimens in Cancer Genomic Medicine. Pathobiology 2023; 90:289-311. [PMID: 36754025 PMCID: PMC10627493 DOI: 10.1159/000528346] [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: 10/03/2022] [Accepted: 11/22/2022] [Indexed: 02/10/2023] Open
Abstract
Rapid advances are being made in cancer drug therapy. Since molecularly targeted therapy has been introduced, personalized medicine is being practiced, pathological tissue from malignant tumors obtained during routine practice is frequently used for genomic testing. Whereas cytological specimens fixed mainly in alcohol are considered to be more advantageous in terms of preservation of the nucleic acid quality and quantity. This article is aimed to share the information for the proper handling of cytological specimens in practice for genomic medicine based on the findings established in "Guidelines for Handling of Cytological Specimens in Cancer Genomic Medicine (in Japanese)" published by the Japanese Society of Clinical Cytology in 2021. The three-part practical guidelines are based on empirical data analyses; Part 1 describes general remarks on the use of cytological specimens in cancer genomic medicine, then Part 2 describes proper handling of cytological specimens, and Part 3 describes the empirical data related to handling of cytological specimens. The guidelines indicated proper handling of specimens in each fixation, preparation, and evaluation.
Collapse
Affiliation(s)
- Eiichi Morii
- Department of Pathology, Osaka University, Suita, Japan
| | - Yutaka Hatanaka
- Research Division of Genome Companion Diagnostics, Hokkaido University Hospital, Sapporo, Japan
| | - Noriko Motoi
- Department of Pathology, Saitama Cancer Center, Saitama, Japan
| | - Akihiko Kawahara
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | | | - Takeshi Kuwata
- Department of Genetic Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryota Tanaka
- Department of Surgery, Kyorin University School of Medicine, Mitaka, Japan
| | - Akira Iyoda
- Division of Chest Surgery, Department of Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Maeda Ichiro
- Department of Diagnostic Pathology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Yukiko Matsuo
- Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Nobuyuki Nakamura
- Department of Clinical Laboratories, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tokiko Nakai
- Department of Diagnostic Pathology, Harima-Himeji General Medical Center, Himeji, Japan
| | - Mei Fukuhara
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuya Tokita
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Tomohiko Yamaguchi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masataka Takenaka
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Ayako Kawabata
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kanako C. Hatanaka
- Center for Development of Advanced Diagnostics, Hokkaido University Hospital, Sapporo, Japan
| | - Kaho Tsubame
- Center for Development of Advanced Diagnostics, Hokkaido University Hospital, Sapporo, Japan
| | - Yukitoshi Satoh
- Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| |
Collapse
|