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Multimodal modeling with low-dose CT and clinical information for diagnostic artificial intelligence on mediastinal tumors: a preliminary study. BMJ Open Respir Res 2024; 11:e002249. [PMID: 38589197 PMCID: PMC11015206 DOI: 10.1136/bmjresp-2023-002249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/22/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Diagnosing mediastinal tumours, including incidental lesions, using low-dose CT (LDCT) performed for lung cancer screening, is challenging. It often requires additional invasive and costly tests for proper characterisation and surgical planning. This indicates the need for a more efficient and patient-centred approach, suggesting a gap in the existing diagnostic methods and the potential for artificial intelligence technologies to address this gap. This study aimed to create a multimodal hybrid transformer model using the Vision Transformer that leverages LDCT features and clinical data to improve surgical decision-making for patients with incidentally detected mediastinal tumours. METHODS This retrospective study analysed patients with mediastinal tumours between 2010 and 2021. Patients eligible for surgery (n=30) were considered 'positive,' whereas those without tumour enlargement (n=32) were considered 'negative.' We developed a hybrid model combining a convolutional neural network with a transformer to integrate imaging and clinical data. The dataset was split in a 5:3:2 ratio for training, validation and testing. The model's efficacy was evaluated using a receiver operating characteristic (ROC) analysis across 25 iterations of random assignments and compared against conventional radiomics models and models excluding clinical data. RESULTS The multimodal hybrid model demonstrated a mean area under the curve (AUC) of 0.90, significantly outperforming the non-clinical data model (AUC=0.86, p=0.04) and radiomics models (random forest AUC=0.81, p=0.008; logistic regression AUC=0.77, p=0.004). CONCLUSION Integrating clinical and LDCT data using a hybrid transformer model can improve surgical decision-making for mediastinal tumours, showing superiority over models lacking clinical data integration.
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Deep learning model to predict Ki-67 expression of breast cancer using digital breast tomosynthesis. Breast Cancer 2024:10.1007/s12282-024-01549-7. [PMID: 38448777 DOI: 10.1007/s12282-024-01549-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/24/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Developing a deep learning (DL) model for digital breast tomosynthesis (DBT) images to predict Ki-67 expression. METHODS The institutional review board approved this retrospective study and waived the requirement for informed consent from the patients. Initially, 499 patients (mean age: 50.5 years, range: 29-90 years) referred to our hospital for breast cancer were participated, 126 patients with pathologically confirmed breast cancer were selected and their Ki-67 expression measured. The Xception architecture was used in the DL model to predict Ki-67 expression levels. The high Ki-67 vs low Ki-67 expression diagnostic performance of our DL model was assessed by accuracy, sensitivity, specificity, areas under the receiver operating characteristic curve (AUC), and by using sub-datasets divided by the radiological characteristics of breast cancer. RESULTS The average accuracy, sensitivity, specificity, and AUC were 0.912, 0.629, 0.985, and 0.883, respectively. The AUC of the four subgroups separated by radiological findings for the mass, calcification, distortion, and focal asymmetric density sub-datasets were 0.890, 0.750, 0.870, and 0.660, respectively. CONCLUSIONS Our results suggest the potential application of our DL model to predict the expression of Ki-67 using DBT, which may be useful for preoperatively determining the treatment strategy for breast cancer.
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Neuropil Variation in the Prefrontal, Motor, and Visual Cortex of Six Felids. BRAIN, BEHAVIOR AND EVOLUTION 2024; 99:25-44. [PMID: 38354714 DOI: 10.1159/000537843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 02/04/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Felids have evolved a specialized suite of morphological adaptations for obligate carnivory. Although the musculoskeletal anatomy of the Felidae has been studied extensively, the comparative neuroanatomy of felids is relatively unexplored. Little is known about how variation in the cerebral anatomy of felids relates to species-specific differences in sociality, hunting strategy, or activity patterns. METHODS We quantitatively analyzed neuropil variation in the prefrontal, primary motor, and primary visual cortices of six species of Felidae (Panthera leo, Panthera uncia, Panthera tigris, Panthera leopardus, Acinonyx jubatus, Felis sylvestris domesticus) to investigate relationships with brain size, neuronal cell parameters, and select behavioral and ecological factors. Neuropil is the dense, intricate network of axons, dendrites, and synapses in the brain, playing a critical role in information processing and communication between neurons. RESULTS There were significant species and regional differences in neuropil proportions, with African lion, cheetah, and tiger having more neuropil in all three cortical regions in comparison to the other species. Based on regression analyses, we find that the increased neuropil fraction in the prefrontal cortex supports social and behavioral flexibility, while in the primary motor cortex, this facilitates the neural activity needed for hunting movements. Greater neuropil fraction in the primary visual cortex may contribute to visual requirements associated with diel activity patterns. CONCLUSION These results provide a cross-species comparison of neuropil fraction variation in the Felidae, particularly the understudied Panthera, and provide evidence for convergence of the neuroanatomy of Panthera and cheetahs.
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Computer-aided diagnosis of chest X-ray for COVID-19 diagnosis in external validation study by radiologists with and without deep learning system. Sci Rep 2023; 13:17533. [PMID: 37845348 PMCID: PMC10579343 DOI: 10.1038/s41598-023-44818-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 10/12/2023] [Indexed: 10/18/2023] Open
Abstract
To evaluate the diagnostic performance of our deep learning (DL) model of COVID-19 and investigate whether the diagnostic performance of radiologists was improved by referring to our model. Our datasets contained chest X-rays (CXRs) for the following three categories: normal (NORMAL), non-COVID-19 pneumonia (PNEUMONIA), and COVID-19 pneumonia (COVID). We used two public datasets and private dataset collected from eight hospitals for the development and external validation of our DL model (26,393 CXRs). Eight radiologists performed two reading sessions: one session was performed with reference to CXRs only, and the other was performed with reference to both CXRs and the results of the DL model. The evaluation metrics for the reading session were accuracy, sensitivity, specificity, and area under the curve (AUC). The accuracy of our DL model was 0.733, and that of the eight radiologists without DL was 0.696 ± 0.031. There was a significant difference in AUC between the radiologists with and without DL for COVID versus NORMAL or PNEUMONIA (p = 0.0038). Our DL model alone showed better diagnostic performance than that of most radiologists. In addition, our model significantly improved the diagnostic performance of radiologists for COVID versus NORMAL or PNEUMONIA.
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Deep learning model for predicting the presence of stromal invasion of breast cancer on digital breast tomosynthesis. Radiol Phys Technol 2023; 16:406-413. [PMID: 37466807 DOI: 10.1007/s12194-023-00731-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 07/03/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023]
Abstract
To develop a deep learning (DL)-based algorithm to predict the presence of stromal invasion in breast cancer using digital breast tomosynthesis (DBT). Our institutional review board approved this retrospective study and waived the requirement for informed consent from the patients. Initially, 499 patients (mean age 50.5 years, age range, 29-90 years) who were referred to our hospital under the suspicion of breast cancer and who underwent DBT between March 1 and August 31, 2019, were enrolled in this study. Among the 499 patients, 140 who underwent surgery after being diagnosed with breast cancer were selected for the analysis. Based on the pathological reports, the 140 patients were classified into two groups: those with non-invasive cancer (n = 20) and those with invasive cancer (n = 120). VGG16, Resnet50, DenseNet121, and Xception architectures were used as DL models to differentiate non-invasive from invasive cancer. The diagnostic performance of the DL models was assessed based on the area under the receiver operating characteristic curve (AUC). The AUC for the four models were 0.56 [95% confidence intervals (95% CI) 0.49-0.62], 0.67 (95% CI 0.62-0.74), 0.71 (95% CI 0.65-0.75), and 0.75 (95% CI 0.69-0.81), respectively. Our proposed DL model trained on DBT images is useful for predicting the presence of stromal invasion in breast cancer.
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Deep learning model for breast cancer diagnosis based on bilateral asymmetrical detection (BilAD) in digital breast tomosynthesis images. Radiol Phys Technol 2023; 16:20-27. [PMID: 36342640 DOI: 10.1007/s12194-022-00686-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
The purpose of this study was to develop a deep learning model to diagnose breast cancer by embedding a diagnostic algorithm that examines the asymmetry of bilateral breast tissue. This retrospective study was approved by the institutional review board. A total of 115 patients who underwent breast surgery and had pathologically confirmed breast cancer were enrolled in this study. Two image pairs [230 pairs of bilateral breast digital breast tomosynthesis (DBT) images with 115 malignant tumors and contralateral tissue (M/N), and 115 bilateral normal areas (N/N)] were generated from each patient enrolled in this study. The proposed deep learning model is called bilateral asymmetrical detection (BilAD), which is a modified convolutional neural network (CNN) model of Xception with two-dimensional tensors for bilateral breast images. BilAD was trained to classify the differences between pairs of M/N and N/N datasets. The results of the BilAD model were compared to those of the unilateral control CNN model (uCNN). The results of BilAD and the uCNN were as follows: accuracy, 0.84 and 0.75; sensitivity, 0.73 and 0.58; and specificity, 0.93 and 0.92, respectively. The mean area under the receiver operating characteristic curve of BilAD was significantly higher than that of the uCNN (p = 0.02): 0.90 and 0.84, respectively. The proposed deep learning model trained by embedding a diagnostic algorithm to examine the asymmetry of bilateral breast tissue improves the diagnostic accuracy for breast cancer.
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The location of unilateral axillary lymphadenopathy after COVID-19 vaccination compared with that of metastasis from breast cancer without vaccination. Jpn J Radiol 2023; 41:617-624. [PMID: 36626076 PMCID: PMC9830608 DOI: 10.1007/s11604-023-01387-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023]
Abstract
PURPOSE Unilateral axillary lymphadenopathy is known to occur after coronavirus disease (COVID-19) vaccination. Post-vaccination lymphadenopathy may mimic the metastatic lymph nodes in breast cancer, and it is challenging to distinguish between them. This study investigated whether the localization of axillary lymphadenopathy on magnetic resonance imaging (MRI) could be used to distinguish reactive lymphadenopathy after COVID-19 vaccines from metastatic nodes. MATERIALS AND METHODS We retrospectively examined preoperative MRI images of 684 axillae in 342 patients who underwent breast cancer surgery from June to October 2021. Lymphadenopathy was defined as cortical thickening or short axis ≥ 5 mm. The axilla was divided into ventral and dorsal parts on the axial plane using a perpendicular line extending from the most anterior margin of the muscle group, including the deltoid, latissimus dorsi, or teres major muscles, relative to a line along the lateral chest wall. We recorded the presence or absence of axillary lymphadenopathy in each area and the number of visible lymph nodes. RESULTS Of 80 axillae, 41 and 39 were included in the vaccine and metastasis groups, respectively. The median time from the last vaccination to MRI was 19 days in the vaccine group. The number of visible axillary lymph nodes was significantly higher in the vaccine group (median, 15 nodes) than in the metastasis group (7 nodes) (P < 0.001). Dorsal lymphadenopathy was observed in 16 (39.0%) and two (5.1%) axillae in the vaccine and metastasis groups, respectively (P < 0.001). If the presence of both ventral and dorsal lymphadenopathy is considered indicative of vaccine-induced reaction, this finding has a sensitivity of 34.1%, specificity of 97.4%, and positive and negative predictive values of 93.3% and 58.5%, respectively. CONCLUSION The presence of deep axillary lymphadenopathy may be an important factor for distinguishing post-vaccination lymphadenopathy from metastasis. The number of axillary lymph nodes may also help.
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Why is the depth/width ratio of a typical fibroadenoma small in breast ultrasonography? J Med Ultrason (2001) 2023; 50:97-101. [PMID: 36258100 DOI: 10.1007/s10396-022-01267-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/24/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE Typical myxomatous fibroadenomas have a small depth/width (D/W) ratio on ultrasonography. The small D/W ratio of fibroadenomas is speculated to be caused by the softness of the mass and its orientation along the longitudinal aspect of the ductal elements without adhesion to the surrounding tissue; however, this has not been clearly proven. This study aimed to confirm the reason why fibroadenomas present with a small D/W ratio on ultrasonography. METHODS We retrospectively analyzed imaging data from 17 patients who were diagnosed with typical fibroadenomas on ultrasonography and who underwent magnetic resonance imaging (MRI) at our hospital. RESULTS The median D/W ratio obtained from ultrasonography images was 0.48 (0.32-0.67), while that obtained from MRI was 1.38 (0.62-1.68). The D/W ratios calculated from MRI were significantly greater than those calculated from ultrasonography images (p < 0.001). The D/W ratio obtained using ultrasonography was not greater than the D/W ratio obtained using MRI in any of the cases. CONCLUSION This study revealed that the small D/W ratio of fibroadenomas on ultrasonography may be attributable to the horizontal force acting on the breast against the chest wall in the supine position, the elasticity of the fibroadenoma, and the lack of adhesion between the mass and surrounding tissue.
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Serum heat shock protein 27 levels in patients with systemic sclerosis: a possible biomarker of skin sclerosis. J Eur Acad Dermatol Venereol 2020; 35:e157-e159. [PMID: 32805744 DOI: 10.1111/jdv.16885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/28/2020] [Accepted: 08/06/2020] [Indexed: 12/14/2022]
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460P Update analysis of phase II study of oxaliplatin based regimen in relapsed colorectal cancer patients treated with oxaliplatin based adjuvant chemotherapy: INSPIRE study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Left omental artery bleeding in two patients with segmental arterial mediolysis successfully isolated with coil embolization. CVIR Endovasc 2020; 3:36. [PMID: 32686023 PMCID: PMC7370341 DOI: 10.1186/s42155-020-00127-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/20/2020] [Indexed: 11/17/2022] Open
Abstract
Background Segmental arterial mediolysis (SAM) is a rare, nonatherosclerotic, noninflammatory arteriopathy of unknown etiology, rarely involving omental artery (OA). No case reports have described left OA bleeding successfully treated with transarterial embolization (TAE) with coils. This report describes two cases of SAM-affected left OA bleeding successfully embolized using isolation technique with coils, recognizing the potential for the greater omentum to have arterial collateral network between OAs. Case presentation Case 1. A 55-year-old male with no significant past medical history presented with an acute abdomen. Contrast-enhanced computed tomography (CT) revealed possible hemorrhagic ascites involving the left portion of the greater omentum and dilated, stenotic change of the left OA with a possible hematoma. SAM-associated left OA bleeding was suspected. Given its acute-angled branching from a splenic artery or branch and long, tortuous catheter-trajectory, we used a triaxial catheter system. Left OA angiography revealed the proximal dilated, stenotic change and a distal pseudoaneurysm. Isolation was successfully performed with coils. Because he had no abdominal pain or progressive anemia, he was discharged on hospital day 5. Neither recurrence nor new SAM-associated findings were observed during two-years of follow-up. Case 2. A 60-year-old-man with no significant past medical history presented with an acute abdomen. CT revealed similar finding as Case 1. SAM-associated left OA bleeding was suspected. Left OA angiography revealed proximal dilated, stenotic change with distal occlusion. Despite having no signs of active bleeding, review of the CT and angiography findings suggested the left OA as the bleeding site. Given proximal embolization at this point could lead to incomplete hemostasis or rebleeding via the arterial collateral network between OAs, an attempt was made to navigate the microcatheter into the distal side beyond the occlusion. Distal left OA angiography confirmed that the distal OA over the occlusion was intact and directly communicated with a right OA arising from right gastroepiploic artery. The SAM-associated lesion was successfully isolated with coils. Because he had no abdominal pain or progressive anemia, he was transported to another hospital on hospital day 3. Neither recurrence nor new SAM-associated findings were observed during two-years follow-up. Conclusion SAM can involve left OA and be controlled using an isolation technique with coils.
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P-37 phase II study of oxaliplatin-based regimen in relapsed colon cancer patients treated with oxaliplatin-based adjuvant chemotherapy: INSPIRE study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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JFMC51-1702-C7: Phase II study investigating efficacy and safety of trifluridine/tipiracil (FTD/TPI) plus bevacizumab (BEV) in patients (pts) with metastatic colorectal cancer (mCRC) refractory or intolerant to standard chemotherapies. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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The relationship between the survival and fixed dosing of S-1 in advanced gastric cancer patients by pooled analysis using individual data from four Japanese randomized phase III trials. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Prognostic impact of residual lateral lymph node metastasis after neoadjuvant (chemo)radiotherapy in patients with advanced low rectal cancer. BJS Open 2019; 3:822-829. [PMID: 31832589 PMCID: PMC6887909 DOI: 10.1002/bjs5.50194] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 05/13/2019] [Indexed: 12/17/2022] Open
Abstract
Background There is a lack of large studies focusing on the prognostic significance of lateral lymph node (LLN) metastasis following LLN dissection (LLND) in rectal cancer. The aim of this study was to evaluate the prognostic impact of LLN metastases on survival of patients with advanced low rectal cancer. Methods Consecutive patients with locally advanced, but not metastatic, extraperitoneal rectal cancer treated with neoadjuvant (chemo)radiotherapy plus total mesorectal excision between 2004 and 2015 were included in the study. LLND was performed when pretreatment imaging documented enlarged LLNs (7 mm or greater in size). Localization of nodal metastases and long‐term outcomes were analysed. Kaplan–Meier analysis was used to compare the survival of patients with ypN0 disease with that of patients with mesorectal ypN+/LLN− status and patients with positive LLNs. The Cox proportional hazards model was used to evaluate predictors of disease‐free survival (DFS) and local recurrence. Results A total of 613 patients were included in the study; LLND was performed in 212 patients (34·6 per cent) and 57 (9·3 per cent) had LLN metastasis. Patients with LLN metastasis had improved DFS and local recurrence cumulative incidence rates compared with patients with mesorectal ypN2+/LLN− disease (DFS: P = 0·014; local recurrence: P = 0·006). Although the DFS rate of patients with LLN metastasis was worse than that of patients with ypN0 disease (P < 0·001), the cumulative incidence of local recurrence was similar (P = 0·491). In multivariable analysis, residual LLN metastasis was not an independent predictor of worse DFS or local recurrence. Conclusion LLN metastasis is not an independent predictor of local recurrence or survival. Survival of patients presenting with LLN metastasis after (chemo)radiotherapy was intermediate between that of patients with ypN0 status and those with mesorectal ypN2 positivity.
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Immunogenomic profiles associated with response to neoadjuvant chemoradiotherapy in patients with rectal cancer. Br J Surg 2019; 106:1381-1392. [PMID: 31197828 DOI: 10.1002/bjs.11179] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 02/17/2019] [Accepted: 02/18/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Accumulating evidence suggests that radiotherapy success has an immune-associated component. The immunogenomic profiles associated with responses to chemoradiotherapy (CRT) were assessed in patients with locally advanced rectal cancer in this study. METHODS CD8+ tumour-infiltrating lymphocyte (TIL) and stromal lymphocyte densities were assessed by immunohistochemistry using pretreatment biopsies from patients with advanced rectal cancer who had preoperative CRT. Whole-exome sequencing and gene expression microarray analysis were conducted to investigate the genomic properties associated with the response to CRT and CD8+ TIL density. Response to CRT was determined based on Dworak tumour regression grade (TRG); tumours with complete (TRG 4) or near-complete (TRG 3) regression were grouped as good responders, and those with TRG 1 as non-responders. RESULTS Immunohistochemical examinations (275 patients) showed that pre-CRT CD8+ TIL density was associated with better response to CRT and improved recurrence-free survival, whereas pre-CRT stromal CD8+ cell density was not associated with either response to CRT or recurrence-free survival. Whole-exome sequencing (74 patients) showed that the numbers of single-nucleotide variations (SNVs) and neoantigens predicted from SNVs were higher in good responders than in non-responders, and these correlated positively with CD8+ TIL density (rS = 0·315 and rS = 0·334 respectively). Gene expression microarray (90 patients) showed that CD8A expression correlated positively with the expression of programmed cell death 1 (PDCD1) (rS = 0·264) and lymphocyte-activation gene 3 (LAG3) (rS = 0·507). CONCLUSION Pre-CRT neoantigen-specific CD8+ T cell priming may be a key event in CRT responses where immune checkpoint molecules could be useful targets to enhance tumour regression.
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Phase Ib/II study of biweekly TAS-102 with bevacizumab combination for patients with metastatic colorectal cancer refractory to standard therapies (BiTS study): Phase Ib results. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy431.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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A phase II study of bevacizumab and irinotecan plus alternate-day S-1 as a second-line therapy for colorectal cancer: The AIRS study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Relation of overall survival, progression free survival, post progression survival and response rate in four randomized Japanese phase III trials comparing various combinations of S-1 therapy for first-line treatment of advanced gastric cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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An exploratory study of intraperitoneal paclitaxel combined with mFOLFOX6 for peritoneal disseminated gastric cancer patients with inadequate oral intake. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Epithelioid cell granuloma in the bone marrow secondary to Epstein-Barr virus infection. THE LANCET. INFECTIOUS DISEASES 2018; 17:460. [PMID: 28346186 DOI: 10.1016/s1473-3099(16)30520-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 09/29/2016] [Accepted: 11/17/2016] [Indexed: 11/26/2022]
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P4566Predictors for angiographic edge restenosis of 2nd generation drug-eluting stents: Integrated angiographic analyses from the post-marketing surveillance studies of everolimus-eluting stents in Japan. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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SAPPHIRE: A randomized phase II study of oxaliplatin discontinuation after 6 cycles of mFOLFOX6 + panitumumab therapy in patients with colorectal cancer: Final analysis of efficacy and safety results. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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A phase I/II study of panitumumab combined with TAS-102 in patients (pts) with RAS wild-type (wt) metastatic colorectal cancer (mCRC) refractory to standard chemotherapy: APOLLON study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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Multicenter phase Ib/II study of biweekly TAS-102 with bevacizumab combination for patients with metastatic colorectal cancer refractory to standard therapies (BiTS study) - Trial in progress. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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HGCSG 1201: Phase II study of trastuzumab with irinotecan in HER2-positive metastatic or advanced gastric cancer patients previously treated with trastuzumab. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx660.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Clinical impact of postoperative surgical complications on the colorectal cancer survival and recurrence: Analyses of pooled individual patients’ data from three large phase III randomized trials. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx659.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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APOLLON study: a phase I/II study for the safety and efficacy of panitumumab in combination with TAS-102 for patients with RAS wild-type metastatic colorectal cancer refractory to standard chemotherapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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P-276 Safety and Efficacy of mFOLFOX6 + Panitumumab Combination Therapy and 5-FU/LV + Panitumumab Combination Therapy in Patients with Chemotherapy-Naïve Metastatic Colorectal Cancer (SAPPHIRE). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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P-157 A phase II study of XELOX and Cetuximab (Erbitux) as first-line therapy in patients with KRAS wild-type metastatic colorectal cancer (FLEET2). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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228TiP Safety and efficacy of mFOLFOX6 + panitumumab combination therapy and 5-FU/LV + panitumumab combination therapy in patients with chemotherapy-naïve metastatic colorectal cancer (SAPPHIRE). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv523.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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157P Randomized controlled trial on the skin toxicity of panitumumab in third line treatment of KRAS Exon2 wild-type mCRC: Japanese Skin Toxicity Evaluation Protocol with Panitumumab: J-STEPP/HGCSG1001: updated analysis of anti-tumor efficacy. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv523.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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AB0293 High Serum Levels of Anti-Cyclic Citrullinated Peptide Antibody and Matrix Metalloproteinase-3 at the Time of Diagnosis of Rheumatoid Arthritis Are Possible Predictors of Future Initiation of Biological Agents. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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FOLFIRI plus bevacizumab as second-line therapy in patients with metastatic colorectal cancer after first-line bevacizumab plus oxaliplatin-based therapy: the randomized phase III EAGLE study. Ann Oncol 2015; 26:1427-33. [PMID: 25908603 PMCID: PMC4478977 DOI: 10.1093/annonc/mdv197] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 04/15/2015] [Indexed: 11/13/2022] Open
Abstract
EAGLE was a randomized, multicenter phase III study which evaluated the superiority of bevacizumab 10 mg/kg plus FOLFIRI compared with bevacizumab 5 mg/kg plus FOLFIRI in patients with mCRC previously treated with first-line bevacizumab plus an oxaliplatin-based regimen. The results suggest that the higher 10 mg/kg dose offers no clear clinical benefit compared with bevacizumab 5 mg/kg in this setting. Background A targeted agent combined with chemotherapy is the standard treatment in patients with metastatic colorectal cancer (mCRC). The present phase III study was conducted to compare two doses of bevacizumab combined with irinotecan, 5-fluorouracil/leucovorin (FOLFIRI) in the second-line setting after first-line therapy with bevacizumab plus oxaliplatin-based therapy. Patients and methods Patients were randomly assigned to receive FOLFIRI plus bevacizumab 5 or 10 mg/kg in 2-week cycles until disease progression. The primary end point was progression-free survival (PFS), and secondary end points included overall survival (OS), time to treatment failure (TTF), and safety. Results Three hundred and eighty-seven patients were randomized between September 2009 and January 2012 from 100 institutions in Japan. Baseline patient characteristics were well balanced between the two groups. Efficacy was evaluated in 369 patients (5 mg/kg, n = 181 and 10 mg/kg, n = 188). Safety was evaluated in 365 patients (5 mg/kg, n = 180 and 10 mg/kg, n = 185). The median PFS was 6.1 versus 6.4 months (hazard ratio, 0.95; 95% confidence interval [CI] 0.75–1.21; P = 0.676), and median TTF was 5.2 versus 5.2 months (hazard ratio, 1.01; 95% CI 0.81–1.25; P = 0.967), respectively, for the bevacizumab 5 and 10 mg/kg groups. Follow-up of OS is currently ongoing. Adverse events, including hypertension and hemorrhage, occurred at similar rates in both groups. Conclusion Bevacizumab 10 mg/kg plus FOLFIRI as the second-line treatment did not prolong PFS compared with bevacizumab 5 mg/kg plus FOLFIRI in patients with mCRC. If bevacizumab is continued after first-line therapy in mCRC, a dose of 5 mg/kg is appropriate for use as second-line treatment. Clinical trial identifier UMIN000002557.
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Percutaneous absorption of a drug into hair follicles. CURRENT PROBLEMS IN DERMATOLOGY 2015; 22:195-200. [PMID: 7587325 DOI: 10.1159/000424253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Randomized Controlled Trial on the Skin Toxicity of Panitumumab in Third Line Treatment of Kras Wild-Type Metastatic Colorectal Cancer: Hgcsg1001 (Japanese Skin Toxicity Evaluation Protocol with Panitumumab: J-Stepp): Additional Analysis of Qol and Skin Toxicity. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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A Phase III Study of Eagle Comparing Two Doses of Bevacizumab Combined with Folfiri in the Second-Line Setting After First-Line Treatment with Bevacizumab Plus Oxaliplatin-Based Therapy : Kras Subgroup Findings. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
The objective of this study was to clarify the long-term outcome in patients with lupus nephritis (LN) according to the International Society of Nephrology and Renal Pathology Society classification. This retrospective analysis comprised 186 Japanese patients given a diagnosis of LN by renal specimen with a mean observation period of 12 years. Primary end point was defined as death or end-stage renal disease, and standardized mortality ratios were calculated. Five patients presented with histopathological class I, 62 with II, 21 with III or III+V, 73 with IV or IV+V and 25 with V. Fourteen deaths occurred, corresponding to an overall standardized mortality ratio of 3.59 (95% confidence interval 2.02-5.81, p < 0.0001). Kaplan-Meier analysis revealed a 10-year overall survival of 95.7%. Nephrotic proteinuria (≥3.5 g/day) at baseline was identified as an independent poor prognostic factor for overall survival in Cox regression analysis. Kaplan-Meier analysis revealed a 10-year renal survival as 94.3%. Male gender and nephrotic proteinuria at baseline were identified as independent poor prognostic factors for renal survival in Cox regression analysis. In conclusion, LN was associated with a 3.59-fold increase in mortality compared with the general population. Male gender and nephrotic proteinuria were predictive for poor renal outcome.
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Effects of KIR ligand incompatibility on clinical outcomes of umbilical cord blood transplantation without ATG for acute leukemia in complete remission. Blood Cancer J 2013; 3:e164. [PMID: 24292416 PMCID: PMC3880445 DOI: 10.1038/bcj.2013.62] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 10/29/2013] [Indexed: 01/08/2023] Open
Abstract
To clarify the effect of killer cell immunoglobulin-like receptor (KIR) ligand incompatibility on outcomes of acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) patients in complete remission after single cord blood transplantation (CBT), we assessed the outcomes of CBT registered in the Japan Society for Hematopoietic Cell Transplantation (JSHCT) database. A total of 643 acute leukemia (357 AML and 286 ALL) patient and donor pairs were categorized according to their KIR ligand incompatibility by determining whether or not they expressed HLA-C, Bw4 or A3/A11 by DNA typing. A total of 128 patient–donor pairs were KIR ligand-incompatible in the graft-versus-host (GVH) direction and 139 patient–donor pairs were incompatible in the host-versus-graft (HVG) direction. Univariate and multivariate analyses showed no significant differences between the KIR ligand-incompatible and compatible groups in the GVH direction for both AML and ALL patients of overall survival, disease-free survival, relapse incidence, non-relapse mortality and acute GVH disease. However, KIR incompatibility in the HVG direction ameliorated engraftment in ALL patients (hazard ratio 0.66, 95% confidence interval 0.47–0.91, P=0.013). Therefore, there were no effects of KIR ligand incompatibility in the GVH direction on single CBT outcomes for acute leukemia patients without anti-thymocyte globulin use. However, it is necessary to pay attention to KIR incompatibility in the HVG direction for engraftment.
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P227 Effect on infectious diseases practice and antimicrobial stewardship of one infectious diseases doctor at a community hospital. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70468-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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THU0231 The efficacy of tacrolimus in patients with interstitial lung diseases complicated with polymyositis or dermatomyositis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Reduced-intensity vs myeloablative conditioning allogeneic hematopoietic SCT for patients aged over 45 years with ALL in remission: a study from the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation (JSHCT). Bone Marrow Transplant 2013; 48:1389-94. [PMID: 23665820 DOI: 10.1038/bmt.2013.68] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 03/05/2013] [Accepted: 04/08/2013] [Indexed: 11/09/2022]
Abstract
In this study, outcomes for 575 adult ALL patients aged ≥45 years who underwent first allo-SCT in CR were analyzed according to the type of conditioning regimen (myeloablative conditioning (MAC) for 369 patients vs reduced-intensity conditioning (RIC) for 206 patients). Patients in the RIC group were older (median age, 58 vs 51 years, P<0.0001). There were no statistically significant differences in 3-year OS, disease-free survival (DFS) and non-relapse mortality (NRM): 51% vs 53%, 47% vs 39% and 38% vs 36%, respectively. Multivariate analysis showed that CR2 and HLA mismatching were associated with poor OS (P=0.002 and P=0.019, respectively). HLA mismatching was associated with lower rate of relapse (P=0.016), but was associated with higher rate of NRM (P=0.001). RIC was associated with good OS and DFS in patients who received HLA-mismatch transplantation and were aged ≥55 years compared with MAC by multivariate analysis for each event with interaction (hazard ratio (HR) and 95% confidence interval 0.35 and 0.15-0.81, P=0.014 for OS and 0.36 and 0.16-0.81, P=0.013 for DFS). Therefore, patients ≥55 years of age with HLA-mismatch transplantation should be candidates for RIC rather than MAC.
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Abstract
The aim of this study was to demonstrate the effects of sex and age on serum levels of 1,5-AG in nondiabetic subjects.A total of 1 134 nondiabetic subjects aged 16-96 years with HbA1c less than 6.8% were recruited and divided into 4 HbA1c groups (Q1: HbA1c≤5.3; Q2: 5.4-5.8; Q3: 5.9-6.3; and Q4: 6.4-6.8 [%]). 38 elderly subjects (65 years or older) in the Q3 and Q4 groups (13 men and 25 women) underwent a 75-g oral glucose tolerance test (OGTT).The Q4 group had significantly lower 1,5-AG levels than did the Q1 group among nonelderly males, nonelderly females, and elderly men. In elderly women, 1,5-AG levels did not differ among the 4 HbA1c groups. In both nonelderly and elderly subjects, the 1,5-AG level of the Q1 group was significantly higher in males than in females. Stepwise multivariate regression analysis showed that age was significantly associated with 1,5-AG level in both sexes. HbA1c was significantly associated with the 1,5-AG level in males, while there was no significant association between HbA1c and the 1,5-AG level in females. In the elderly OGTT group, although the glucose levels of both sexes during OGTT were identical, the mean urinary glucose levels and the percentages of subjects with glucosuria were significantly higher in elderly men than in elderly women.Serum 1,5-AG levels were significantly associated with age and sex. The sensitivity of the 1,5-AG level for identifying postprandial hyperglycemia in elderly women with near-normoglycemia is less reliable because they have a higher renal threshold for glucose.
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SAMIT: Preliminary safety data from a 2x2 factorial randomized phase III trial to investigate weekly paclitaxel (PTX) followed by oral fluoropyrimidines (FPs) versus FPs alone as adjuvant chemotherapy in patients (pts) with gastric cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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A novel prognostic classification for overall survival in Japanese patients with untreated metastatic renal cell carcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Multicenter phase II study of FOLFOX for metastatic colorectal cancer (mCRC) in Japan; SWIFT-1 and 2 study. HEPATO-GASTROENTEROLOGY 2009; 56:1346-1353. [PMID: 19950789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND/AIMS This study assessed the efficacy and toxicity of the FOLFOX4 (SWIFT1) and mFOLFOX6 (SWIFT2) regimens in Japanese patients with metastatic colorectal cancer (mCRC). METHODOLOGY Patients with mCRC were required to have ECOG performance status of 0 to 1, and to have adequate organ function. Two multicenter Phase II studies (SWIFT1/SWIFT2) were conducted in chemotherapy naive patients with mCRC. RESULTS 112 patients were enrolled in these studies (SWIFT1: 54 patients / SWIFT2: 58 patients). The disease sites for each study were the colon in 27 patients and 28 patients, and the rectum in 27 patients and 30 patients, respectively. All patients received a median of 8 courses. After a median follow-up period of 35 months, 54 patients and 58 patients were evaluable in the respective studies, and the overall response rate was 50.0% (CR:31 PR:53). The response rate according to the sites of metastasis were as follows: liver, 54.1% (46/85); lung, 17.4% (4/23); and lymph node, 23.3% (7/30). Grade 3/4 neutropenia occurred in 14 patients (12.5%), while Grade 3/4 non-hematological toxicities were observed in 16 patients (31.0%) and Grade 3 neurotoxicity was observed in 6patients (5.4%) and 5 patients (4.5%), respectively. CONCLUSIONS FOLFOX4 (SWIFT1) and mFOLFOX6 (SWIFT2) regimens complying with the international standard dosage and schedule can also be administered safely and effectively in Japan.
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Abstract: P910 VASCULAR ENDOTHELIAL FUNCTION IS CLOSELY RELATED TO GLUCOSE METABOLISM IN HEALTHY JAPANESE SUBJECTS. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71031-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Efficacy of adjuvant chemotherapy using oral fluorinated pyrimidines for curatively resected gastric cancer: a meta-analysis of centrally randomized controlled clinical trials in Japan. J Chemother 2008; 18:311-7. [PMID: 17129844 DOI: 10.1179/joc.2006.18.3.311] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Adjuvant chemotherapy for gastric cancer has been extensively explored in Japan since the 1950s, and a combination of oral fluorinated pyrimidines (o-FP) and mitomycin C (MMC) has been mainly utilized for adjuvant chemotherapy. However, there is no sufficient evidence for the efficacy of adjuvant therapy. Therefore, we assessed the efficacy of o-FPs over surgery alone (control) by means of a meta-analysis of Japanese centrally randomized controlled clinical trials conducted between 1980 and 2005. For inclusion in this study, studies had to compare adjuvant chemotherapy for curatively resected gastric cancer with surgery alone, mainly targeting o-FP, and central randomization designed to comply with contemporary standards for clinical trials in Japan. For the 4 trials that met the eligibility criteria, the estimated hazard ratio was 0.73 (95%CI=0.60-0.89). Our findings show that in Japan adjuvant chemotherapy using o-FP for long-term maintenance therapy appears to be effective for gastric cancer patients after curative resection.
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Meta-analyses of randomized trials assessing the interest chemotherapy in advanced gastric cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4563] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Multicenter phase II trial of combination chemotherapy with weekly paclitaxel and 5-fluorouracil for the treatment of advanced or recurrent gastric carcinoma. J Chemother 2007; 19:444-50. [PMID: 17855190 DOI: 10.1179/joc.2007.19.4.444] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The aim of this study was to investigate the efficacy and safety of combination chemotherapy with weekly paclitaxel and 5-fluorouracil (5-FU) as first-line treatment in patients with advanced or recurrent gastric carcinoma. A total of 65 patients were treated with the following regimen, administered every 28 days; 5-FU 600 mg/m2 by 24-hour continuous infusion from days 1 through 5, and weekly paclitaxel 80 mg/m2 by 3-hour intravenous infusion on days 8, 14, and 21. A total of 272 cycles were conducted with a median of 4 (2-13) cycles per case. Out of 57 patients with measurable disease by RECIST criteria, there were 2 complete responses (3.5%), 20 partial responses (35.1%) and 25 cases with stable disease (43.9%). The overall response rate was 38.6% (95%CI: 26.0-51.2%). The median survival time and 1-year survival rates were 329 days and 47.4%, respectively. Both hematologic and non-hematologic toxicities were well tolerated.
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