1
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Katayama Y, Yamada T, Morimoto K, Fujii H, Morita S, Tanimura K, Takeda T, Okada A, Shiotsu S, Chihara Y, Hiranuma O, Yamada T, Ota T, Harada T, Hasegawa I, Iwasaku M, Tokuda S, Tanaka N, Miyagawa-Hayashino A, Takayama K. Comparing Three Different Anti-Programmed Death-Ligand 1 Antibodies in Immunohistochemical Evaluation of Combined Chemoimmunotherapy Response in Patients With NSCLC: A Prospective Study. JTO Clin Res Rep 2024; 5:100644. [PMID: 38444594 PMCID: PMC10914581 DOI: 10.1016/j.jtocrr.2024.100644] [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: 05/09/2023] [Revised: 10/23/2023] [Accepted: 01/24/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction Multiple programmed death-ligand 1 (PD-L1) immunohistochemistry assays performed using different antibodies including DAKO 22C3, DAKO 28-8, and Ventana SP142 PD-L1-predictive markers for response to various immune checkpoint inhibitors in NSCLC-have been approved in several countries. The differences in multiple PD-L1 immunohistochemistry assay results in predicting the therapeutic response to combined chemoimmunotherapy in patients with NSCLC remain unclear. Methods In this multicenter prospective observational study, we monitored 70 patients with advanced NSCLC treated with combined chemoimmunotherapy at 10 institutions in Japan. The expression of PD-L1 in pretreatment tumors was evaluated using the 22C3, 28-8, and SP142 assays in all patients. Results The PD-L1 level in tumor cells determined using the 22C3 assay was the highest among the three assays performed with different antibodies. According to the 22C3 assay results, the PD-L1 tumor proportion score greater than or equal to 50% group had a significantly longer progression-free survival period than the PD-L1 tumor proportion score less than 50% group. Nevertheless, the other assays did not reveal remarkable differences in the objective response rate or progression-free survival. Conclusions In our study, PD-L1 expression determined using the 22C3 assay was more correlated with the therapeutic response of patients with NSCLC treated with combined chemoimmunotherapy than that determined using the 28-8 and SP142 assays. Therefore, the 22C3 assay may be useful for clinical decision-making for patients with NSCLC treated with combined chemoimmunotherapy. Trial registration number: UMIN 000043958.
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Affiliation(s)
- Yuki Katayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kenji Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroyuki Fujii
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satomi Morita
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Keiko Tanimura
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Asuka Okada
- Department of Respiratory Medicine, Saiseikai Suita Hospital, Osaka, Japan
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Shiga, Japan
| | - Takahiro Yamada
- Department of Respiratory Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Takahiro Ota
- Department of Respiratory Medicine, Kyoto city Hospital, Kyoto, Japan
| | - Taishi Harada
- Department of Medical Oncology, Fukuchiyama City Hospital, Kyoto, Japan
| | - Isao Hasegawa
- Department of Respiratory Medicine, Saiseikai Shigaken Hospital, Shiga, Japan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinsaku Tokuda
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Noriyuki Tanaka
- Department of Pathology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Aya Miyagawa-Hayashino
- Department of Pathology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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2
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Morita-Tanaka S, Miyagawa-Hayashino A, Yamada T, Matsui Y, Morimoto K, Hiranuma O, Masuzawa N, Yoshimura A, Iwasaku M, Tokuda S, Kaneko Y, Kim YH, Konishi E, Takayama K. Significance of localized expression of full-length growth differentiation factor-15 in cachexia of advanced non-small cell lung cancer. Support Care Cancer 2023; 31:308. [PMID: 37115357 DOI: 10.1007/s00520-023-07771-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE Growth differentiation factor-15 (GDF-15) is one of the key cachexia-inducing factors. Clinical trials on therapies targeting GDF-15 for cancer and cancer cachexia are underway. While the role of circulating GDF-15 in cachexia has been clarified, the effects of GDF-15 expression within cancer cells remain to be fully elucidated. Hence, the objective of this study was to investigate the expression of GDF-15 in advanced lung cancer tissues and to understand its role in cachexia. METHODS We retrospectively examined the expression level of full-length GDF-15 in advanced non-small cell lung cancer tissues and analyzed the relationship between the staining intensity and clinical data in 53 samples. RESULTS We found that 52.8% of the total samples were GDF-15 positive, and GDF-15 expression significantly correlated with improved C-reactive protein/albumin ratio (p = 0.008). It did not correlate with the existence of cancer cachexia and overall survival (p = 0.43). CONCLUSION Our findings show that GDF-15 expression significantly correlated with improved C-reactive protein/albumin ratio, but not the existence of cancer cachexia in advanced NSCLC patients.
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Affiliation(s)
- Satomi Morita-Tanaka
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Aya Miyagawa-Hayashino
- Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tadaaki Yamada
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Yohei Matsui
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kenji Morimoto
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Otsu, Japan
| | - Naoko Masuzawa
- Department of Surgical Pathology, Otsu City Hospital, Otsu, Japan
| | - Akihiro Yoshimura
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masahiro Iwasaku
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinsaku Tokuda
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiko Kaneko
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Young Hak Kim
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Eiichi Konishi
- Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Takayama
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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3
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Tanimura K, Uchino J, Kimura H, Hiranuma O, Chihara Y, Tanzawa S, Takumi C, Kita T, Inoue K, Minato K, Takemoto S, Nakao A, Yoshimura K, Takayama K. Ramucirumab Plus Docetaxel for Patients with Non-small cell Lung Cancer with Brain Metastases: A Multicenter, Open-Label Single-Arm Phase II Trial. Oncologist 2023:7117810. [PMID: 37053467 DOI: 10.1093/oncolo/oyad013] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/03/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Ramucirumab plus docetaxel combination therapy (DOC/RAM) for advanced non-small cell lung cancer (NSCLC) achieves favorable outcomes; however, efficacy and safety for patients with brain metastases are still unclear. METHODS Eligible patients included those with advanced NSCLC with measurable asymptomatic brain metastases that progressed after chemotherapy. Patients were intravenously administered ramucirumab (10 mg/kg) and docetaxel (60 mg/m2) every 21-day cycle. RESULTS Due to difficulties in accumulating the planned 65 participants, enrollment was terminated early when 25 patients were enrolled. Primary endpoint: Median progression-free survival (PFS) was 3.9 months (95% CI, 1.8-5.3). Secondary endpoints: Median intracranial progression-free survival was 4.6 months (95% CI, 2.5-5.9); median overall survival was 20.9 months (95% CI, 6.6-not possible to estimate); objective response rate was 20% (95% CI, 6.8-40.7); disease control rate was 68% (95% CI, 46.5-85.1). The most common grade 3 or higher toxicities were neutropenia in 10 patients (40%). Neither intracranial hemorrhage nor grade 5 adverse events were observed. Patients with higher serum soluble vascular endothelial growth factor receptor 2 concentrations at the start of treatment had slightly longer PFS. CONCLUSION No clinical concerns were identified with DOC/RAM for NSCLC with brain metastases in this study. Further investigation with a larger sample size is needed to determine the tolerability and safety of these populations (Trial Identifiers: University Hospital Medical Information Network in Japan [UMIN000024551] and Japan Registry of Clinical Trials [jRCTs071180048]).
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Affiliation(s)
- Keiko Tanimura
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hideharu Kimura
- Department of Respiratory Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Otsu, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Uji, Japan
| | - Shigeru Tanzawa
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University Hospital, Tokyo, Japan
| | - Chieko Takumi
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Toshiyuki Kita
- Department of Respiratory Medicine, National Hospital Organization, Kanazawa Medical Center, Kanazawa, Japan
| | - Koji Inoue
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Koichi Minato
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
| | - Shinnosuke Takemoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Akira Nakao
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Kenichi Yoshimura
- Future Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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4
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Noguchi R, Yoshimura A, Uchino J, Takeda T, Chihara Y, Ota T, Hiranuma O, Gyotoku H, Takayama K, Kondo T. Comprehensive Kinase Activity Profiling Revealed the Kinase Activity Patterns Associated with the Effects of EGFR Tyrosine Kinase Inhibitor Therapy in Advanced Non-Small-Cell Lung Cancer Patients with Sensitizing EGFR Mutations. Proteomes 2023; 11:proteomes11010006. [PMID: 36810562 PMCID: PMC9944465 DOI: 10.3390/proteomes11010006] [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: 11/08/2022] [Revised: 01/11/2023] [Accepted: 01/26/2023] [Indexed: 02/08/2023] Open
Abstract
EGFR mutations are strong predictive markers for EGFR tyrosine kinase inhibitor (EGFR-TKI) therapy in patients with non-small-cell lung cancer (NSCLC). Although NSCLC patients with sensitizing EGFR mutations have better prognoses, some patients exhibit worse prognoses. We hypothesized that various activities of kinases could be potential predictive biomarkers for EGFR-TKI treatment among NSCLC patients with sensitizing EGFR mutations. In 18 patients with stage IV NSCLC, EGFR mutations were detected and comprehensive kinase activity profiling was performed using the peptide array PamStation12 for 100 tyrosine kinases. Prognoses were observed prospectively after the administration of EGFR-TKIs. Finally, the kinase profiles were analyzed in combination with the prognoses of the patients. Comprehensive kinase activity analysis identified specific kinase features, consisting of 102 peptides and 35 kinases, in NSCLC patients with sensitizing EGFR mutations. Network analysis revealed seven highly phosphorylated kinases: CTNNB1, CRK, EGFR, ERBB2, PIK3R1, PLCG1, and PTPN11. Pathway analysis and Reactome analysis revealed that the PI3K-AKT and RAF/ MAPK pathways were significantly enriched in the poor prognosis group, being consistent with the outcome of the network analysis. Patients with poor prognoses exhibited high activation of EGFR, PIK3R1, and ERBB2. Comprehensive kinase activity profiles may provide predictive biomarker candidates for screening patients with advanced NSCLC harboring sensitizing EGFR mutations.
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Affiliation(s)
- Rei Noguchi
- Division of Rare Cancer Research, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Akihiro Yoshimura
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Bannan Central Hospital, Shizuoka 438-0814, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto 611-0041, Japan
| | - Takayo Ota
- Department of Medical Oncology, Izumi City General Hospital, Osaka 594-0073, Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Shiga 520-0804, Japan
| | - Hiroshi Gyotoku
- Department of Respiratory Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Tadashi Kondo
- Division of Rare Cancer Research, National Cancer Center Research Institute, Tokyo 104-0045, Japan
- Correspondence: ; Tel.: +81-3-3542-2511 (ext. 3419)
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5
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Yoshimura A, Yamada T, Serizawa M, Uehara H, Tanimura K, Okuma Y, Fukuda A, Watanabe S, Nishioka N, Takeda T, Chihara Y, Takemoto S, Harada T, Hiranuma O, Shirai Y, Shukuya T, Nishiyama A, Goto Y, Shiotsu S, Kunimasa K, Morimoto K, Katayama Y, Suda K, Mitsudomi T, Yano S, Kenmotsu H, Takahashi T, Takayama K. High levels of AXL expression in untreated EGFR-mutated non-small cell lung cancer negatively impacts the use of osimertinib. Cancer Sci 2022; 114:606-618. [PMID: 36169649 PMCID: PMC9899603 DOI: 10.1111/cas.15608] [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: 06/16/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 11/29/2022] Open
Abstract
For non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations, the initial therapeutic interventions will have crucial impacts on their clinical outcomes. Drug tolerant factors reportedly have an impact on EGFR-tyrosine kinase inhibitor sensitivity. This prospective study investigated the impacts of drug tolerant-related protein expression in tumors based on the efficacy of osimertinib in the first-setting of EGFR-mutated advanced NSCLC patients. A total of 92 patients with EGFR-mutated advanced or postoperative recurrent NSCLC were analyzed and treated with osimertinib at 14 institutions in Japan. AXL, p53, and programmed death-ligand 1 (PD-L1) expression in patient tumors was determined using immunohistochemistry. The AXL signaling pathway was investigated using a cell line-based assay and AXL-related gene expression in The Cancer Genome Atlas (TCGA) database. High levels of AXL and positive-p53 expression were detected in 26.1% and 53.3% of the pretreatment EGFR-mutated NSCLC tumors, respectively. High AXL expression levels were significantly associated with a shorter progression-free survival compared with low AXL expression levels, irrespective of the EGFR activating mutation status (p = 0.026). Cell line-based assays indicated that the overexpression of AXL protein accelerated PD-L1 expression, which induced insensitivity to osimertinib. In the TCGA database, AXL RNA levels were positively correlated with PD-L1 expression in the lung adenocarcinoma cohort. The results show that high AXL expression levels in tumors impact clinical predictions when using osimertinib to treat EGFR-mutated NSCLC patients. Trial Registration: UMIN000043942.
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Affiliation(s)
- Akihiro Yoshimura
- Department of Pulmonary MedicineGraduate School of Medical Science, Kyoto Prefectural University of MedicineKyotoJapan
| | - Tadaaki Yamada
- Department of Pulmonary MedicineGraduate School of Medical Science, Kyoto Prefectural University of MedicineKyotoJapan
| | - Masakuni Serizawa
- Drug Discovery and Development DivisionShizuoka Cancer Center Research InstituteShizuokaJapan
| | - Hisanori Uehara
- Division of PathologyTokushima University HospitalTokushimaJapan
| | - Keiko Tanimura
- Department of Pulmonary MedicineGraduate School of Medical Science, Kyoto Prefectural University of MedicineKyotoJapan
| | - Yusuke Okuma
- Department of Thoracic Oncology and Respiratory MedicineTokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalTokyoJapan,Department of Thoracic OncologyNational Cancer Center HospitalTokyoJapan
| | - Akito Fukuda
- Department of Thoracic Oncology and Respiratory MedicineTokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalTokyoJapan,Department of Thoracic OncologyNational Cancer Center HospitalTokyoJapan
| | - Satoshi Watanabe
- Department of Respiratory Medicine and Infectious DiseasesNiigata University Graduate School of Medicine and Dental HospitalNiigataJapan
| | - Naoya Nishioka
- Division of Thoracic Oncology, Shizuoka Cancer CenterShizuokaJapan
| | - Takayuki Takeda
- Department of Respiratory MedicineJapanese Red Cross Kyoto Daini HospitalKyotoJapan
| | - Yusuke Chihara
- Department of Respiratory MedicineUji‐Tokushukai Medical CenterUjiJapan
| | - Shinnosuke Takemoto
- Department of Respiratory MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Taishi Harada
- Department of Medical OncologyFukuchiyama City HospitalKyotoJapan
| | - Osamu Hiranuma
- Department of Respiratory MedicineOtsu City HospitalOtsuJapan
| | - Yukina Shirai
- Department of Respiratory MedicineJuntendo UniversityTokyoJapan
| | | | - Akihiro Nishiyama
- Division of Medical Oncology, Cancer Research InstituteKanazawa UniversityKanazawaJapan
| | - Yasuhiro Goto
- Department of Respiratory MedicineFujita Health University School of MedicineToyoakeJapan
| | - Shinsuke Shiotsu
- Department of Respiratory MedicineJapanese Red Cross Kyoto Daiichi HospitalKyotoJapan
| | - Kei Kunimasa
- Department of Thoracic OncologyOsaka International Cancer InstitutionOsakaJapan
| | - Kenji Morimoto
- Department of Pulmonary MedicineGraduate School of Medical Science, Kyoto Prefectural University of MedicineKyotoJapan
| | - Yuki Katayama
- Department of Pulmonary MedicineGraduate School of Medical Science, Kyoto Prefectural University of MedicineKyotoJapan
| | - Kenichi Suda
- Division of Thoracic Surgery, Department of SurgeryKindai University Faculty of MedicineOsakaJapan
| | - Tetsuya Mitsudomi
- Division of Thoracic Surgery, Department of SurgeryKindai University Faculty of MedicineOsakaJapan
| | - Seiji Yano
- Division of Medical Oncology, Cancer Research InstituteKanazawa UniversityKanazawaJapan,Division of Thoracic Surgery, Department of SurgeryKindai University Faculty of MedicineOsakaJapan,Department of Respiratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health SciencesKanazawa UniversityKanazawaJapan,WPI Nano Lifebiomarker Science InstituteKanazawa UniversityKanazawaJapan
| | | | | | - Koichi Takayama
- Department of Pulmonary MedicineGraduate School of Medical Science, Kyoto Prefectural University of MedicineKyotoJapan
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6
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Yoshimura A, Yamada T, Serizawa M, Uehara H, Tanimura K, Okuma Y, Fukuda A, Watanabe S, Nishioka N, Takeda T, Chihara Y, Takemoto S, Harada T, Hiranuma O, Shirai Y, Shukuya T, Nishiyama A, Goto Y, Shiotsu S, Kunimasa K, Morimoto K, Katayama Y, Suda K, Mitsudomi T, Yano S, Kenmotsu H, Takahashi T, Takayama K. High levels of
AXL
expression in untreated
EGFR
‐mutated non‐small cell lung cancer negatively impacts the use of osimertinib. Cancer Sci 2022. [DOI: 10.1111/cas.15608 10.1111/cas.15608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Akihiro Yoshimura
- Department of Pulmonary Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kyoto Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kyoto Japan
| | - Masakuni Serizawa
- Drug Discovery and Development Division Shizuoka Cancer Center Research Institute Shizuoka Japan
| | - Hisanori Uehara
- Division of Pathology Tokushima University Hospital Tokushima Japan
| | - Keiko Tanimura
- Department of Pulmonary Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kyoto Japan
| | - Yusuke Okuma
- Department of Thoracic Oncology and Respiratory Medicine Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Tokyo Japan
- Department of Thoracic Oncology National Cancer Center Hospital Tokyo Japan
| | - Akito Fukuda
- Department of Thoracic Oncology and Respiratory Medicine Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Tokyo Japan
- Department of Thoracic Oncology National Cancer Center Hospital Tokyo Japan
| | - Satoshi Watanabe
- Department of Respiratory Medicine and Infectious Diseases Niigata University Graduate School of Medicine and Dental Hospital Niigata Japan
| | - Naoya Nishioka
- Division of Thoracic Oncology, Shizuoka Cancer Center Shizuoka Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine Japanese Red Cross Kyoto Daini Hospital Kyoto Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine Uji‐Tokushukai Medical Center Uji Japan
| | - Shinnosuke Takemoto
- Department of Respiratory Medicine Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Taishi Harada
- Department of Medical Oncology Fukuchiyama City Hospital Kyoto Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine Otsu City Hospital Otsu Japan
| | - Yukina Shirai
- Department of Respiratory Medicine Juntendo University Tokyo Japan
| | - Takehito Shukuya
- Department of Respiratory Medicine Juntendo University Tokyo Japan
| | - Akihiro Nishiyama
- Division of Medical Oncology, Cancer Research Institute Kanazawa University Kanazawa Japan
| | - Yasuhiro Goto
- Department of Respiratory Medicine Fujita Health University School of Medicine Toyoake Japan
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine Japanese Red Cross Kyoto Daiichi Hospital Kyoto Japan
| | - Kei Kunimasa
- Department of Thoracic Oncology Osaka International Cancer Institution Osaka Japan
| | - Kenji Morimoto
- Department of Pulmonary Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kyoto Japan
| | - Yuki Katayama
- Department of Pulmonary Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kyoto Japan
| | - Kenichi Suda
- Division of Thoracic Surgery, Department of Surgery Kindai University Faculty of Medicine Osaka Japan
| | - Tetsuya Mitsudomi
- Division of Thoracic Surgery, Department of Surgery Kindai University Faculty of Medicine Osaka Japan
| | - Seiji Yano
- Division of Medical Oncology, Cancer Research Institute Kanazawa University Kanazawa Japan
- Division of Thoracic Surgery, Department of Surgery Kindai University Faculty of Medicine Osaka Japan
- Department of Respiratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences Kanazawa University Kanazawa Japan
- WPI Nano Lifebiomarker Science Institute Kanazawa University Kanazawa Japan
| | | | | | - Koichi Takayama
- Department of Pulmonary Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kyoto Japan
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7
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Shiotsu S, Yoshimura A, Yamada T, Morimoto K, Tsuchiya M, Yoshioka H, Hiranuma O, Chihara Y, Yamada T, Hasegawa I, Ohta T, Takeda T, Hiraoka N, Takayama K. Pembrolizumab monotherapy for untreated PD-L1-Positive non-small cell lung cancer in the elderly or those with poor performance status: A prospective observational study. Front Oncol 2022; 12:904644. [PMID: 36158655 PMCID: PMC9504658 DOI: 10.3389/fonc.2022.904644] [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: 03/25/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives We investigated the efficacy and safety of pembrolizumab monotherapy as first-line treatment for poor Eastern Cooperative Oncology Group performance status (PS) and elderly patients with programmed cell death-ligand 1 (PD-L1)-positive advanced non-small cell lung cancer (NSCLC). We also investigated clinical prognostic factors for the efficacy of pembrolizumab monotherapy, based on patient characteristics. Materials and methods In this prospective observational study, PS-2 and elderly NSCLC patients with PD-L1 tumor proportion score (TPS) ≥1% who received first-line pembrolizumab monotherapy, from October 2019 to March 2021, at 10 institutions in Japan were enrolled. Patients judged eligible by their physicians for combined chemotherapy and PD-1/PD-L1 inhibitors as first-line treatment were excluded. Clinicopathological characteristics and adverse events were investigated for correlation with clinical outcomes. Results Forty patients were enrolled in the study. The median progression-free survival (PFS) of patients with PS 2 and those aged ≥ 75 years were 4.4 (95% confidence interval [CI]: 0.9–14.4) months and 5.3 (95% CI 2.9–9.4) months, respectively. The median overall survival (OS) of patients with PS 2 and those aged ≥ 75 years were 11.6 (95% CI: 1.4–not evaluable [NE]) months and 11.6 (95% CI 7.4–18.1) months, respectively. Immune-related adverse events (irAEs) were observed in 19 patients; 6 patients had severe irAEs of Common Terminology Criteria for Adverse Events (CTCAE) Grade 3 or higher. Patients who achieved stable disease or better, had a statistically significant increase in PFS (p < 0.001) and OS (p < 0.001). In the multivariate analysis, the acquisition of disease control with pembrolizumab monotherapy was an independent prognostic factor for PFS and OS. Conclusion Pembrolizumab monotherapy was relatively effective and tolerable as a first-line treatment for patients with PD-L1-positive advanced NSCLC who had poor PS or were elderly. Our results suggest that disease control might be an independent prognostic factor for PFS and OS in this population. (UMIN000044052 https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000050176)
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Affiliation(s)
- Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Akihiro Yoshimura
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- *Correspondence: Tadaaki Yamada,
| | - Kenji Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Michiko Tsuchiya
- Department of Respiratory Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Hiroshige Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, Osaka, Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Shiga, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
| | - Takahiro Yamada
- Department of Respiratory Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Isao Hasegawa
- Department of Respiratory Medicine, Saiseikai Shigaken Hospital, Shiga, Japan
| | - Takahiro Ohta
- Department of Respiratory Medicine, Kyoto City Hospital, Kyoto, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Noriya Hiraoka
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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8
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Morimoto K, Sawada R, Yamada T, Azuma K, Ito K, Goto Y, Kimura H, Harada T, Shiotsu S, Tamiya N, Chihara Y, Takeda T, Hiranuma O, Hasegawa I, Morimoto Y, Iwasaku M, Tokuda S, Takayama K. A Real-World Analysis of Immune Checkpoint Inhibitor-Based Therapy After Osimertinib Treatment in Patients With EGFR-Mutant NSCLC. JTO Clin Res Rep 2022; 3:100388. [PMID: 36082280 PMCID: PMC9445370 DOI: 10.1016/j.jtocrr.2022.100388] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/04/2022] [Accepted: 07/23/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction The use of immune checkpoint inhibitors (ICIs) with chemotherapy has increased the survival of patients with advanced NSCLC. Nevertheless, the efficacy of ICI treatment for NSCLC with EGFR mutations is limited. Previous studies have not evaluated the efficacy of ICI treatment after osimertinib treatment in real-world settings. Methods This study performed a retrospective analysis of the association between clinical characteristics and ICI efficacy in patients with EGFR-mutant NSCLC treated with ICIs after osimertinib treatment at 12 institutions in Japan from March 2016 to March 2021. Results Among 80 patients with EGFR-mutant lung cancer, 42 received ICI monotherapy and 38 received chemoimmunotherapy. In the chemoimmunotherapy group, the progression-free survival (PFS) was significantly longer in the group that exhibited PFS more than 10 months with osimertinib than in the group that exhibited PFS less than or equal to 10 months with osimertinib (8.4 mo versus 3.8 mo, p = 0.026). Nevertheless, there was no significant difference in PFS in the ICI monotherapy group (1.7 mo versus 1.5 mo, p = 0.45). Regardless of the EGFR mutation subtype, PFS of osimertinib treatment was a predictor of the PFS of chemoimmunotherapy (exon 19 deletion mutation: p = 0.03 and exon 21 L858R mutation: p = 0.001). Conclusions The PFS of osimertinib might be a predictor of PFS of chemoimmunotherapy in patients with EGFR-mutant NSCLC. Further clinical investigations on the predictors of efficacy of administering ICIs after osimertinib treatment are required.
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Uda S, Yamada T, Yoshimura A, Goto Y, Yoshimine K, Nakamura Y, Shiotsu S, Yokoi T, Tamiya N, Kimura H, Chihara Y, Umeda Y, Izumi M, Takeda T, Yamada T, Hibino M, Hiranuma O, Ito K, Okada A, Osugi S, Takemura Y, Ishii H, Chibana K, Hasegawa I, Morimoto Y, Iwasaku M, Tokuda S, Takayama K. Clinical impact of amrubicin monotherapy in patients with relapsed small cell lung cancer: a multicenter retrospective study. Transl Lung Cancer Res 2022; 11:1847-1857. [PMID: 36248326 PMCID: PMC9554692 DOI: 10.21037/tlcr-22-160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/11/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Sayaka Uda
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Akihiro Yoshimura
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yasuhiro Goto
- Department of Respiratory Medicine, Fujita Health University School of Medicine, Aichi, Japan
| | - Kohei Yoshimine
- Department of Respiratory Medicine, Izuka Hospital, Fukuoka, Japan
| | - Yoichi Nakamura
- Division of Thoracic Oncology, Tochigi Cancer Center, Tochigi, Japan
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Takashi Yokoi
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Nobuyo Tamiya
- Department of Pulmonary Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Hideharu Kimura
- Department of Respiratory Medicine, Kanazawa University, Ishikawa, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
| | - Yukihiro Umeda
- Third Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Miiru Izumi
- Department of Respiratory Medicine, National Hospital Organization Omuta National Hospital, Fukuoka, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Takahiro Yamada
- Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan
| | - Osamu Hiranuma
- Department of Pulmonary Medicine, Otsu City Hospital, Shiga, Japan
| | - Kazuhiro Ito
- Department of Thoracic Surgery, Kyoto Yamashiro Medical Center, Kyoto, Japan
| | - Asuka Okada
- Department of Respiratory Medicine, Saiseikai Suita Hospital, Osaka, Japan
| | - Shuji Osugi
- Department of Respiratory Medicine, Japan Community Health Care Organization Kobe Central Hospital, Hyogo, Japan
| | - Yoshizumi Takemura
- Department of Respiratory Medicine, Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center, Kyoto, Japan
| | - Hiroshi Ishii
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Kenji Chibana
- Department of Respiratory Medicine, National Hospital Organization Okinawa National Hospital, Okinawa, Japan
| | - Isao Hasegawa
- Department of Respiratory Medicine, Saiseikai Shiga Hospital, Shiga, Japan
| | - Yoshie Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinsaku Tokuda
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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10
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Hibino M, Uryu K, Takeda T, Kunimatsu Y, Shiotsu S, Uchino J, Hirai S, Yamada T, Okada A, Hasegawa Y, Hiranuma O, Chihara Y, Kamada R, Tobe S, Maeda K, Horiuchi S, Kondo T, Takayama K. Safety and Immunogenicity of mRNA Vaccines Against Severe Acute Respiratory Syndrome Coronavirus 2 in Patients With Lung Cancer Receiving Immune Checkpoint Inhibitors: A Multicenter Observational Study in Japan. J Thorac Oncol 2022; 17:1002-1013. [PMID: 35752437 PMCID: PMC9220466 DOI: 10.1016/j.jtho.2022.05.015] [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: 02/15/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Patients with cancer have been prioritized for vaccination against severe acute respiratory syndrome coronavirus 2. Nevertheless, there are limited data regarding the safety, efficacy, and risk of developing immune-related adverse events (irAEs) associated with mRNA vaccines in patients with lung cancer, especially those being actively treated with immune checkpoint inhibitors. METHODS This multicenter observational study was conducted at nine hospitals in Japan. Patients with lung cancer (≥20 y) actively treated with immune checkpoint inhibitors between 4 weeks prefirst vaccination and 4 weeks postsecond vaccination were enrolled. The primary end point was the incidence of irAEs of any grade on the basis of an assumed incidence without vaccination rate of 35%. Immunogenicity was assessed by measuring anti-spike (S)-IgG antibody levels against severe acute respiratory syndrome coronavirus 2. RESULTS A total of 126 patients with lung cancer (median age, 71 y; interquartile range, 65-74) were enrolled from May to November 2021 and followed up until December 2021. There were 26 patients (20.6%, 95% confidence interval: 13.9%-28.8%) and seven patients (5.6%, 95% confidence interval: 2.3%-11.1%) who developed irAEs of any grade pre- and postvaccination, respectively, which was lower than the predicted incidence without vaccination. None of the patients experienced exacerbation of preexisting irAE postvaccination. S-IgG antibodies were seroconverted in 96.7% and 100% of the patients with lung cancer and controls, respectively, but antibody levels were significantly lower in patients with lung cancer (p < 0.001). CONCLUSIONS Patients with lung cancer who were actively treated with ICIs were safely vaccinated without an increased incidence of irAEs; however, their vaccine immunogenicity was lower. This requires further evaluation.
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Affiliation(s)
- Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan.
| | - Kiyoaki Uryu
- Department of Respiratory Medicine, Yao Tokushukai General Hospital, Osaka, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Yusuke Kunimatsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Soichi Hirai
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Asuka Okada
- Department of Respiratory Medicine, Saiseikai Suita Hospital, Osaka, Japan
| | - Yoshikazu Hasegawa
- Department of Medical Oncology, Izumi City General Hospital, Osaka, Japan
| | - Osamu Hiranuma
- Department of Pulmonary Medicine, Otsu City Hospital, Shiga, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji Tokushukai Medical Center, Kyoto, Japan
| | - Riko Kamada
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan
| | - Shunichi Tobe
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan
| | - Kazunari Maeda
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan
| | - Shigeto Horiuchi
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan
| | - Tetsuri Kondo
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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11
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Morimoto K, Yamada T, Takeda T, Shiotsu S, Date K, Harada T, Tamiya N, Chihara Y, Hiranuma O, Yamada T, Kanda H, Nakano T, Morimoto Y, Iwasaku M, Tokuda S, Takayama K. Efficacy and Safety of Programmed Death-Ligand 1 Inhibitor Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC: A Prospective Observational Study. JTO Clin Res Rep 2022; 3:100353. [PMID: 35789793 PMCID: PMC9250020 DOI: 10.1016/j.jtocrr.2022.100353] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/17/2022] [Accepted: 05/30/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction To date, the efficacy and safety of programmed death-ligand 1 (PD-L1) inhibitor plus platinum-etoposide chemotherapy for patients with extensive-stage SCLC (ES-SCLC), with real-world evidence, stratified on the basis of age and performance status (PS), have not been fully investigated. The aim of this study was to evaluate the efficacy and safety of PD-L1 inhibitor plus platinum-etoposide chemotherapy in patients with ES-SCLC. Methods This multicenter prospective study evaluated patients with ES-SCLC who received PD-L1 inhibitor plus platinum-etoposide chemotherapy between September 2019 and October 2021. Results A total of 45 patients with ES-SCLC received the aforementioned treatment, including 18 elderly (≥75 y old) patients and six patients with a PS of 2. Multivariate analysis indicated that a PS of 2 was a significant independent prognostic factor for progression-free survival and overall survival (p = 0.008 and p = 0.001, respectively). Of patients with PS of 2 at the initial phase, those that achieved PS improvement during treatment had significantly longer progression-free survival and overall survival than those who did not (p = 0.02 and p = 0.02, respectively). The incidence of adverse events accompanied with treatment discontinuation was significantly higher in the elderly patients than in the non-elderly patients (p = 0.03). Conclusions This real-world prospective study found that PD-L1 inhibitor plus platinum-etoposide chemotherapy had limited efficacy in patients with ES-SCLC with a PS of 2, except for cases with improvement of PS during treatment. Owing to the emergence of adverse events and treatment discontinuation, this treatment should be administered with caution in elderly patients with ES-SCLC.
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12
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Tanaka S, Uchino J, Yokoi T, Kijima T, Goto Y, Suga Y, Katayama Y, Nakamura R, Morimoto K, Nakao A, Hibino M, Tani N, Takeda T, Yamaguchi H, Tachibana Y, Takumi C, Hiraoka N, Takeshita M, Onoi K, Chihara Y, Taniguchi R, Yamada T, Matsui Y, Hiranuma O, Morimoto Y, Iwasaku M, Tokuda S, Kaneko Y, Yamada T, Takayama K. Prognostic Nutritional Index and Lung Immune Prognostic Index as Prognostic Predictors for Combination Therapies of Immune Checkpoint Inhibitors and Cytotoxic Anticancer Chemotherapy for Patients with Advanced Non-Small Cell Lung Cancer. Diagnostics (Basel) 2022; 12:diagnostics12020423. [PMID: 35204513 PMCID: PMC8870759 DOI: 10.3390/diagnostics12020423] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 01/04/2022] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 12/04/2022] Open
Abstract
Combination therapy with immune checkpoint inhibitors and cytotoxic chemotherapies (chemoimmunotherapy) is associated with significantly better survival outcomes than cytotoxic chemotherapies alone in patients with advanced non-small cell lung cancer (NSCLC). However, there are no prognostic markers for chemoimmunotherapy. The prognostic nutritional index (PNI) and lung immune prognostic index (LIPI) are prognostic biomarkers for immune checkpoint inhibitor (ICI) monotherapy or cytotoxic chemotherapies. Thus, we aimed to examine whether these factors could also be prognostic markers for chemoimmunotherapy. We retrospectively examined 237 patients with advanced NSCLC treated with chemoimmunotherapy. In the total group, the median overall survival (OS) was not reached, and the median progression-free survival (PFS) was 8.6 months. Multivariate analysis of OS and PFS revealed significant differences based on PNI and LIPI. Programmed cell death ligand 1 (PD-L1) was also significantly associated with OS and PFS. PNI and a PD-L1 tumor proportion score (TPS) of <50% and poor LIPI (regardless of PD-L1 TPS) were associated with poor prognosis. PNI and LIPI predicted survival outcomes in patients with advanced NSCLC treated with chemoimmunotherapy, especially in patients with PD-L1 TPS <50%. For patients in this poor category, chemoimmunotherapy may result in a worse prognosis than expected.
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Affiliation(s)
- Satomi Tanaka
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (S.T.); (Y.S.); (Y.K.); (R.N.); (K.M.); (Y.M.); (M.I.); (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (S.T.); (Y.S.); (Y.K.); (R.N.); (K.M.); (Y.M.); (M.I.); (S.T.); (Y.K.); (T.Y.); (K.T.)
- Correspondence: ; Tel.: +81-75-251-5111
| | - Takashi Yokoi
- Department of Respiratory Medicine and Hematology and Department of Thoracic Oncology, Hyogo College of Medicine, 1-1 Mukogawachō, Nishinomiya 663-8501, Japan; (T.Y.); (T.K.)
| | - Takashi Kijima
- Department of Respiratory Medicine and Hematology and Department of Thoracic Oncology, Hyogo College of Medicine, 1-1 Mukogawachō, Nishinomiya 663-8501, Japan; (T.Y.); (T.K.)
| | - Yasuhiro Goto
- Department of Respiratory Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan;
| | - Yoshifumi Suga
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (S.T.); (Y.S.); (Y.K.); (R.N.); (K.M.); (Y.M.); (M.I.); (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Yuki Katayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (S.T.); (Y.S.); (Y.K.); (R.N.); (K.M.); (Y.M.); (M.I.); (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Ryota Nakamura
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (S.T.); (Y.S.); (Y.K.); (R.N.); (K.M.); (Y.M.); (M.I.); (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Kenji Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (S.T.); (Y.S.); (Y.K.); (R.N.); (K.M.); (Y.M.); (M.I.); (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Akira Nakao
- Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, 8 Chome-19-1 Nanakuma, Jonan Ward, Fukuoka 814-0180, Japan;
| | - Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, 1 Chome-5-1 Tsujidokandai, Fujisawa 251-0041, Japan;
| | - Nozomi Tani
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, 355-5, Haruobicho, Kamaza Dori Marutamachi Agaru, Kamigyo Ward, Kyoto 602-8026, Japan; (N.T.); (T.T.)
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, 355-5, Haruobicho, Kamaza Dori Marutamachi Agaru, Kamigyo Ward, Kyoto 602-8026, Japan; (N.T.); (T.T.)
| | - Hiroyuki Yamaguchi
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan;
| | - Yusuke Tachibana
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Higashiyama Ward, Honmachi, Kyoto 605-0981, Japan; (Y.T.); (C.T.); (N.H.)
| | - Chieko Takumi
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Higashiyama Ward, Honmachi, Kyoto 605-0981, Japan; (Y.T.); (C.T.); (N.H.)
| | - Noriya Hiraoka
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Higashiyama Ward, Honmachi, Kyoto 605-0981, Japan; (Y.T.); (C.T.); (N.H.)
| | - Masafumi Takeshita
- Department of Respiratory Medicine, Ichinomiya Nishi Hospital, Hira-1 Kaimei, Ichinomiya City 494-0001, Japan;
| | - Keisuke Onoi
- Uji-Tokushukai Medical Center, Department of Respiratory Medicine, 145 Ishibashi Makishimacho, Uji-shi 611-0041, Japan; (K.O.); (Y.C.)
| | - Yusuke Chihara
- Uji-Tokushukai Medical Center, Department of Respiratory Medicine, 145 Ishibashi Makishimacho, Uji-shi 611-0041, Japan; (K.O.); (Y.C.)
| | - Ryusuke Taniguchi
- Department of Pulmonary Medicine, Matsushita Memorial Hospital, 5-55 Sotojima-cho, Moriguchi 570-8540, Japan; (R.T.); (T.Y.)
| | - Takahiro Yamada
- Department of Pulmonary Medicine, Matsushita Memorial Hospital, 5-55 Sotojima-cho, Moriguchi 570-8540, Japan; (R.T.); (T.Y.)
| | - Yohei Matsui
- Department of Pulmonary Medicine, Otsu City Hospital, 2-9-9 Motomiya, Otsu-City 520-0804, Japan; (Y.M.); (O.H.)
| | - Osamu Hiranuma
- Department of Pulmonary Medicine, Otsu City Hospital, 2-9-9 Motomiya, Otsu-City 520-0804, Japan; (Y.M.); (O.H.)
| | - Yoshie Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (S.T.); (Y.S.); (Y.K.); (R.N.); (K.M.); (Y.M.); (M.I.); (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (S.T.); (Y.S.); (Y.K.); (R.N.); (K.M.); (Y.M.); (M.I.); (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Shinsaku Tokuda
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (S.T.); (Y.S.); (Y.K.); (R.N.); (K.M.); (Y.M.); (M.I.); (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (S.T.); (Y.S.); (Y.K.); (R.N.); (K.M.); (Y.M.); (M.I.); (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (S.T.); (Y.S.); (Y.K.); (R.N.); (K.M.); (Y.M.); (M.I.); (S.T.); (Y.K.); (T.Y.); (K.T.)
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (S.T.); (Y.S.); (Y.K.); (R.N.); (K.M.); (Y.M.); (M.I.); (S.T.); (Y.K.); (T.Y.); (K.T.)
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13
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Ishida M, Morimoto K, Yamada T, Shiotsu S, Chihara Y, Yamada T, Hiranuma O, Morimoto Y, Iwasaku M, Tokuda S, Takeda T, Takayama K. Impact of docetaxel plus ramucirumab in a second-line setting after chemoimmunotherapy in patients with non-small-cell lung cancer: A retrospective study. Thorac Cancer 2022; 13:173-181. [PMID: 34791812 PMCID: PMC8758423 DOI: 10.1111/1759-7714.14236] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/30/2021] [Accepted: 11/01/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Chemoimmunotherapy has become a standard treatment option for patients with untreated advanced non-small-cell lung cancer (NSCLC). However, numerous patients with advanced NSCLC develop disease progression. Therefore, the selection of second-line treatment after chemoimmunotherapy is crucial for improving clinical outcomes. METHODS Of 88 enrolled patients with advanced NSCLC who received chemoimmunotherapy, we retrospectively evaluated 33 who received second-line chemotherapy after progression of chemoimmunotherapy at six centers in Japan. Among them, 18 patients received docetaxel plus ramucirumab and 15 patients received single-agent chemotherapy. RESULTS The objective response rate in patients treated with docetaxel plus ramucirumab was significantly higher than that in patients treated with a single-agent chemotherapy regimen (55.6% vs. 0%, p < 0.001). The median progression-free survival (PFS) of patients who received docetaxel plus ramucirumab and single-agent chemotherapy was 5.8 months and 5.0 months, respectively (log-rank test p = 0.17). In the docetaxel plus ramucirumab regimen group, patients who responded to chemoimmunotherapy for ≥8.8 months had a significantly longer response to docetaxel plus ramucirumab than those who responded for <8.8 months (not reached vs. 4.1 months, log-rank test p = 0.003). In contrast, in the single-agent chemotherapy group, there was no significant difference in PFS between the ≥8.8- and <8.8-month PFS groups with chemoimmunotherapy (5.0 vs. 1.6 months, log-rank test p = 0.66). CONCLUSION Our retrospective observations suggest that the group with longer PFS with chemoimmunotherapy might be expected to benefit from docetaxel plus ramucirumab treatment in second-line settings for patients with advanced NSCLC.
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Affiliation(s)
- Masaki Ishida
- Department of Pulmonary Medicine, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Kenji Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Shinsuke Shiotsu
- Department of Respiratory MedicineJapanese Red Cross Kyoto Daiichi HospitalKyotoJapan
| | - Yusuke Chihara
- Department of Respiratory MedicineUji‐Tokushukai Medical CenterKyotoJapan
| | - Takahiro Yamada
- Department of Pulmonary MedicineMatsushita Memorial HospitalOsakaJapan
| | - Osamu Hiranuma
- Department of Pulmonary MedicineOtsu City HospitalOtsuJapan
| | - Yoshie Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Shinsaku Tokuda
- Department of Pulmonary Medicine, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Takayuki Takeda
- Department of Respiratory MedicineJapanese Red Cross Kyoto Daini HospitalKyotoJapan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
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14
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Nakamura R, Yamada T, Morimoto K, Nakao A, Goto Y, Ogura Y, Takeda T, Takumi C, Onoi K, Chihara Y, Taniguchi R, Yamada T, Hiranuma O, Tanaka S, Morimoto Y, Iwasaku M, Tokuda S, Kaneko Y, Uchino J, Takayama K. Impact of maintenance therapy following induction immunochemotherapy for untreated advanced non-small cell lung cancer patients. J Cancer Res Clin Oncol 2021; 148:2985-2994. [PMID: 34825950 DOI: 10.1007/s00432-021-03866-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/18/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE The primary objective of this study was to identify the potential predictors to assess the impact of maintenance therapy after induction immunochemotherapy in the real-world setting of patients with advanced non-small cell lung cancer (NSCLC). METHODS We retrospectively identified 152 patients with advanced NSCLC who received immunochemotherapy at 8 hospitals in Japan between January 2019 and December 2019. Patients who received at least four cycles of induction immunochemotherapy and one cycle of maintenance therapy with immune checkpoint inhibitors were included. We investigated the biomarkers for progression-free survival (PFS) for maintenance therapy after induction immunochemotherapy. RESULTS Out of the 92 patients with advanced NSCLC included in the study, 42 received maintenance therapy with cytotoxic agents, whereas 50 received maintenance therapy without cytotoxic agents. Among those who received maintenance therapy without cytotoxic agents, responders to prior immunochemotherapy had significantly longer PFS than non-responders (p = 0.004), except those with maintenance therapy with cytotoxic agents. In non-responders to prior immunochemotherapy, patients with maintenance therapy with cytotoxic agents had significantly longer PFS than those with maintenance therapy without cytotoxic agents (log-rank p = 0.007), whereas, among responders to prior immunochemotherapy, there was no significant difference in PFS for different maintenance regimens (log-rank p = 0.31). CONCLUSIONS This retrospective study showed that response to prior immunochemotherapy was associated with clinical outcomes among patients with advanced NSCLC who received maintenance therapy.
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Affiliation(s)
- Ryota Nakamura
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Kenji Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Akira Nakao
- Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yasuhiro Goto
- Department of Respiratory Medicine, Fujita Health University School of Medicine, Aichi, Japan
| | - Yuri Ogura
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Chieko Takumi
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Keisuke Onoi
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
| | - Ryusuke Taniguchi
- Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Takahiro Yamada
- Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Osamu Hiranuma
- Department of Pulmonary Medicine, Otsu City Hospital, Shiga, Japan
| | - Satomi Tanaka
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshie Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Shinsaku Tokuda
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
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15
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Yoshimura A, Yamada T, Okuma Y, Fukuda A, Watanabe S, Nishioka N, Takeda T, Chihara Y, Takemoto S, Harada T, Hiranuma O, Shirai Y, Nishiyama A, Yano S, Goto Y, Shiotsu S, Kunimasa K, Morimoto Y, Iwasaku M, Kaneko Y, Uchino J, Kenmotsu H, Takahashi T, Takayama K. Impact of tumor programmed death ligand-1 expression on osimertinib efficacy in untreated EGFR-mutated advanced non-small cell lung cancer: a prospective observational study. Transl Lung Cancer Res 2021; 10:3582-3593. [PMID: 34584858 PMCID: PMC8435385 DOI: 10.21037/tlcr-21-461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/11/2021] [Indexed: 12/26/2022]
Abstract
Background Osimertinib monotherapy is currently the standard of care as a first-line treatment for patients harboring epidermal growth factor receptor (EGFR) mutations; however, some EGFR-mutated non-small cell lung cancer (NSCLC) patients exhibit primary resistance and an insufficient response to EGFR-tyrosine kinase inhibitors (EGFR-TKIs). Elevated programmed death-ligand 1 (PD-L1) expression in tumors was reported as a negative predictive factor for outcomes of first- or second-generation EGFR-TKIs. Methods We prospectively assessed advanced NSCLC patients with EGFR mutations who were treated with osimertinib at 14 institutions in Japan between September 2019 and December 2020. Relationships between outcomes of osimertinib monotherapy and patients’ characteristics were reviewed. Results Seventy-one patients who underwent the tumor PD-L1 test were enrolled. Multivariate analysis identified tumor PD-L1 expression as an independent predictor for progression-free survival (PFS) with osimertinib treatment (P=0.029). The objective-response and disease-control rates for osimertinib treatment were significantly lower in patients demonstrating elevated PD-L1 levels relative to those with low or negative PD-L1 level (P=0.043 and P=0.007, respectively). Furthermore, among patients treated with osimertinib, those with high PD-L1 levels exhibited shorter PFS relative to those with low plus negative PD-L1 level (median PFS: 5.0 vs. 17.4 months; P<0.001). Conclusions Elevated tumor PD-L1 expression is associated with poor outcomes of osimertinib monotherapy in previously untreated advanced NSCLC patients with EGFR mutation. Further clinical trials are warranted to accumulate evidence demonstrating the effectiveness of combination therapy with osimertinib for EGFR-mutated advanced NSCLC patients with elevated tumor PD-L1 expression. Trial Registration UMIN000043942.
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Affiliation(s)
- Akihiro Yoshimura
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yusuke Okuma
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.,Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akito Fukuda
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.,Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Watanabe
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medicine and Dental Hospital, Niigata, Japan
| | - Naoya Nishioka
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
| | - Shinnosuke Takemoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Taishi Harada
- Department of Medical Oncology, Fukuchiyama City Hospital, Kyoto, Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Shiga, Japan
| | - Yukina Shirai
- Department of Respiratory Medicine, Juntendo University, Tokyo, Japan
| | - Akihiro Nishiyama
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Seiji Yano
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Yasuhiro Goto
- Department of Respiratory Medicine, Fujita Health University School of Medicine, Aichi, Japan
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Kei Kunimasa
- Department of Thoracic Oncology, Osaka International Cancer Institution, Osaka, Japan
| | - Yoshie Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | | | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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16
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Morimoto K, Uchino J, Yokoi T, Kijima T, Goto Y, Nakao A, Hibino M, Takeda T, Yamaguchi H, Takumi C, Takeshita M, Chihara Y, Yamada T, Hiranuma O, Morimoto Y, Iwasaku M, Kaneko Y, Yamada T, Takayama K. Early discontinuation of induction therapy in chemoimmunotherapy as an effective alternative to the standard regimen in patients with non-small cell lung cancer: a retrospective study. J Cancer Res Clin Oncol 2021; 148:2437-2446. [PMID: 34510271 DOI: 10.1007/s00432-021-03782-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 08/15/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE We aimed to investigate whether induction chemotherapy with less than four courses is as effective as induction chemotherapy with more than four courses in non-small cell lung cancer (NSCLC) patients receiving chemoimmunotherapy. METHODS We retrospectively enrolled 249 patients with NSCLC who received chemoimmunotherapy at 12 centers in Japan between January and December 2019. The patient group that completed less than four courses owing to adverse events (AEs), and received subsequent maintenance therapy was compared to the group that received at least four courses of induction chemotherapy followed by maintenance therapy. RESULTS On univariate and multivariate analyses, the patient group that transitioned to maintenance therapy after completing less than four courses of induction chemotherapy had significantly shorter progression-free survival (PFS) than those who completed at least four courses (hazard ratio [HR] 2.15, 95% confidence interval: 1.38-3.37, p < 0.001 and HR 2.32, 95% confidence interval: 1.40-3.84, p = 0.001, respectively). There was no obvious difference in PFS between the group in which induction chemotherapy ended in two or three courses leading to partial or complete response, and the group that continued at least four courses of induction chemotherapy (log-rank test p = 0.53). CONCLUSION Treatment efficacy may be maintained if induction chemotherapy is completed in less than four courses owing to development of AEs, and is administered for more than two courses with partial or complete response; efficacy is maintained even on transitioning to maintenance therapy.
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Affiliation(s)
- Kenji Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Takashi Yokoi
- Department of Thoracic Oncology, Hyogo College of Medicine, Hyogo, Japan
| | - Takashi Kijima
- Department of Thoracic Oncology, Hyogo College of Medicine, Hyogo, Japan
| | - Yasuhiro Goto
- Department of Respiratory Medicine, Fujita Health University, Aichi, Japan
| | - Akira Nakao
- Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Hiroyuki Yamaguchi
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Chieko Takumi
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Masafumi Takeshita
- Department of Respiratory Medicine, Ichinomiyanishi Hospital, Aichi, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
| | - Takahiro Yamada
- Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Osamu Hiranuma
- Department of Pulmonary Medicine, Otsu City Hospital, Shiga, Japan
| | - Yoshie Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
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17
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Morimoto K, Yamada T, Yokoi T, Kijima T, Goto Y, Nakao A, Hibino M, Takeda T, Yamaguchi H, Takumi C, Takeshita M, Chihara Y, Yamada T, Hiranuma O, Morimoto Y, Iwasaku M, Kaneko Y, Uchino J, Takayama K. Clinical impact of pembrolizumab combined with chemotherapy in elderly patients with advanced non-small-cell lung cancer. Lung Cancer 2021; 161:26-33. [PMID: 34500218 DOI: 10.1016/j.lungcan.2021.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/01/2021] [Revised: 08/09/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Combination therapy of immune checkpoint inhibitors and chemotherapy is considered to be one of the standard treatment options for patients with advanced non-small-cell lung cancer (NSCLC). However, the clinical significance of immune checkpoint inhibitors combined with chemotherapy in elderly patients with NSCLC has not yet been fully understood. Therefore, this study aimed to evaluate how aging affects the therapeutic impact of chemotherapy combine with immune checkpoint inhibitors in elderly patients. MATERIALS AND METHODS We retrospectively analyzed 203 patients with advanced NSCLC who were treated with the combination therapy of pembrolizumab and chemotherapy between January 2019 and December 2019 at 12 institutions in Japan. We analyzed the clinical impacts of age on the following two groups: those who received pembrolizumab with platinum and pemetrexed (pemetrexed regimen) and those who received pembrolizumab with carboplatin and nab-paclitaxel/paclitaxel (paclitaxel regimen). Progression-free and overall survival were assessed via the Kaplan-Meier method. RESULTS Multivariate analysis demonstrated that progression-free and overall survival were significantly shorter in elderly patients (aged ≥75 years) with NSCLC than in non-elderly patients (aged <75 years) with NSCLC in the pemetrexed regimen group. In contrast, there were no significant differences in progression-free and overall survival between elderly patients and non-elderly patients with NSCLC in the paclitaxel regimen group. In elderly patients with NSCLC, a programmed death-ligand 1 tumor proportion score of ≥50% was significantly associated with progression-free survival, and performance status of ≥2 was significantly associated with overall survival. Low albumin level (<3.5 g/dL) was significantly associated with both progression-free and overall survival. CONCLUSION The results of this retrospective study show that the pemetrexed regimen, but not the paclitaxel regimen, was related to poor clinical outcomes in elderly patients with NSCLC.
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Affiliation(s)
- Kenji Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Takashi Yokoi
- Department of Thoracic Oncology, Hyogo College of Medicine, Hyogo, Japan
| | - Takashi Kijima
- Department of Thoracic Oncology, Hyogo College of Medicine, Hyogo, Japan
| | - Yasuhiro Goto
- Department of Respiratory Medicine, Fujita Health University, Aichi, Japan
| | - Akira Nakao
- Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Hiroyuki Yamaguchi
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Chieko Takumi
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Masafumi Takeshita
- Department of Respiratory Medicine, Ichinomiyanishi Hospital, Aichi, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
| | - Takahiro Yamada
- Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Osamu Hiranuma
- Department of Pulmonary Medicine, Otsu City Hospital, Shiga, Japan
| | - Yoshie Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho, Kamigyo-ku, Kyoto, Japan
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18
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Morimoto K, Uchino J, Yokoi T, Kijima T, Goto Y, Nakao A, Hibino M, Takeda T, Yamaguchi H, Takumi C, Takeshita M, Chihara Y, Yamada T, Hiranuma O, Morimoto Y, Iwasaku M, Kaneko Y, Yamada T, Takayama K. Impact of cancer cachexia on the therapeutic outcome of combined chemoimmunotherapy in patients with non-small cell lung cancer: a retrospective study. Oncoimmunology 2021; 10:1950411. [PMID: 34290909 PMCID: PMC8274442 DOI: 10.1080/2162402x.2021.1950411] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 04/07/2021] [Accepted: 06/26/2021] [Indexed: 01/06/2023] Open
Abstract
Although previous studies suggest that cancer cachexia is a poor prognostic factor for immune checkpoint inhibitor monotherapy, the impact of cancer cachexia on chemoimmunotherapy is unclear. We investigated the impact of cancer cachexia on the therapeutic outcomes of chemoimmunotherapy for non-small cell lung cancer (NSCLC). We retrospectively analyzed patients' medical records with NSCLC who received chemoimmunotherapy in 12 institutions in Japan between January and November 2019. We defined cancer cachexia as weight loss exceeding 5% of the total body weight or a body mass index of < 20 kg/m2 and weight loss of more than 2% of the total body weight within 6 months before chemoimmunotherapy initiation, with laboratory results exceeding reference values. This study enrolled 235 patients with NSCLC, among whom 196 were eligible for analysis, and 50 (25.5%) met the criteria for cachexia diagnosis. Patients with cancer cachexia had a significantly higher frequency of a programmed death-ligand 1 (PD-L1) expression of ≥ 50% (48%, p = .01) and shorter progression-free survival (PFS; log-rank test: p = .04) than patients without cachexia. There was no significant difference in overall survival (OS) between the cachexia and no-cachexia groups (log-rank test: p = .14). In the PD-L1 ≥ 50% population, there was no significant difference in PFS and OS (log-rank test: p = .19 and p = .79, respectively) between patients with NSCLC in the cachexia or no-cachexia groups. Cancer cachexia might be a poor prognostic factor in patients with NSCLC receiving chemoimmunotherapy.
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Affiliation(s)
- Kenji Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takashi Yokoi
- Department of Thoracic Oncology, Hyogo College of Medicine, Hyogo, Japan
| | - Takashi Kijima
- Department of Thoracic Oncology, Hyogo College of Medicine, Hyogo, Japan
| | - Yasuhiro Goto
- Department of Respiratory Medicine, Fujita Health University, Aichi, Japan
| | - Akira Nakao
- Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Hiroyuki Yamaguchi
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Chieko Takumi
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Masafumi Takeshita
- Department of Respiratory Medicine, Ichinomiyanishi Hospital, Aichi, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
| | - Takahiro Yamada
- Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Osamu Hiranuma
- Department of Pulmonary Medicine, Otsu City Hospital, Shiga, Japan
| | - Yoshie Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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19
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Morimoto K, Yamada T, Takumi C, Ogura Y, Takeda T, Onoi K, Chihara Y, Taniguchi R, Yamada T, Hiranuma O, Morimoto Y, Iwasaku M, Kaneko Y, Uchino J, Takayama K. Immune-Related Adverse Events Are Associated With Clinical Benefit in Patients With Non-Small-Cell Lung Cancer Treated With Immunotherapy Plus Chemotherapy: A Retrospective Study. Front Oncol 2021; 11:630136. [PMID: 33833990 PMCID: PMC8021904 DOI: 10.3389/fonc.2021.630136] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/03/2021] [Indexed: 12/24/2022] Open
Abstract
Background The immunotherapy plus chemotherapy combination is one of the most promising treatments in advanced non-small-cell lung cancer (NSCLC). Immunotherapy often causes immune-related adverse events (irAEs), which have been reported to be associated with the good clinical outcomes. However, the effects of immunotherapy plus chemotherapy remain unknown. In this study, we investigated the association between irAEs caused by immunotherapy plus chemotherapy and clinical efficacy in patients with advanced NSCLC. Materials and Methods We retrospectively analyzed the data of patients with advanced NSCLC, who received a combination of immunotherapy plus chemotherapy at six institutions in Japan between January 2019 and September 2019. We examined the effect of irAEs on various clinical outcomes. Results We included 70 patients with advanced NSCLC. Patients were divided into two groups: patients with irAEs and patients without irAEs. Patients with irAEs had significantly longer progression-free survival than those without irAEs on univariate (hazard ratio 0.53, 95% confidence interval 0.30–0.93, p = 0.026) and multivariate (hazard ratio 0.53, 95% confidence interval 0.29–0.97, p = 0.041) analyses. In addition, patients with grade 1–2 irAEs (mild irAEs) had significantly longer progression-free and overall survival than those with grade 3-5 irAEs (severe irAEs) or without irAEs on univariate (398 days versus 189 days, respectively; p = 0.0061) and multivariate (not reached versus 412 days, respectively; p = 0.021) analyses. Conclusion Patients with NSCLC who experienced mild irAEs showed better response to treatment with immunotherapy plus chemotherapy than those with severe irAEs or without irAEs. Further large-scale research is warranted to confirm these findings.
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Affiliation(s)
- Kenji Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chieko Takumi
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Yuri Ogura
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Keisuke Onoi
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
| | - Ryusuke Taniguchi
- Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Takahiro Yamada
- Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Osamu Hiranuma
- Department of Pulmonary Medicine, Otsu City Hospital, Shiga, Japan
| | - Yoshie Morimoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Seto Y, Kaneko Y, Mouri T, Fujii H, Tanaka S, Shiotsu S, Hiranuma O, Morimoto Y, Iwasaku M, Yamada T, Uchino J, Takayama K. Prognostic factors in older patients with wild-type epidermal growth factor receptor advanced non-small cell lung cancer: a multicenter retrospective study. Transl Lung Cancer Res 2021; 10:193-201. [PMID: 33569304 PMCID: PMC7867752 DOI: 10.21037/tlcr-20-894] [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] [Indexed: 11/06/2022]
Abstract
Background Over 40% Japanese patients with lung cancer are above 75 years of age. A specific strategy to treat such older patients is necessary because most trials exclude older patients with poor physical health. Herein, we aimed to identify predictive factors associated with overall survival (OS) in older patients by evaluating patient backgrounds and laboratory data before the start of treatment. Methods This multicenter retrospective medical chart review study was conducted at three Japanese institutions and involved patients aged 75 years and above with epidermal growth factor receptor (EGFR) mutation-negative advanced non-small cell lung cancer (NSCLC). Of the patients, 75 had received best supportive care (BSC) and 49 mono-chemotherapy or platinum-doublet chemotherapy, including immune checkpoint inhibitors (ICIs). OS after diagnosis was analyzed using the Kaplan-Meier survival analysis. Cox proportional hazard models, which included age, Eastern Cooperative Oncology Group performance status (ECOG PS), staging, serum albumin levels, and receipt of chemotherapy were analyzed. Results Age at diagnosis was not shown to be related to OS in patients receiving BSC. In patients aged 81 years and above, the chemotherapy group tended to have longer survival than did the BSC group, but there was no statistically significant difference in the median OS between the two groups due to the very small number of subjects (n: 30 vs. 12, median: 52 vs. 30 weeks, hazard ratio: 0.512, 95% confidence interval: 0.232–1.130, P=0.088). The patients’ performance status and albumin levels at lung cancer diagnosis had the highest impact on OS in the BSC group. Conclusions Careful consideration should be given to the indications of chemotherapy for patients aged 81 years and above with wild-type EGFR advanced non-small lung cancer.
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Affiliation(s)
- Yurie Seto
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takako Mouri
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroyuki Fujii
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Satomi Tanaka
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Shiga, Japan
| | - Yoshie Morimoto
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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21
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Katayama Y, Yamada T, Chihara Y, Tanaka S, Tanimura K, Okura N, Hirose K, Uda S, Shiotsu S, Hirai S, Hiranuma O, Harada T, Shimamoto T, Iwasaku M, Kaneko Y, Uchino J, Takeda T, Takayama K. Significance of inflammatory indexes in atezolizumab monotherapy outcomes in previously treated non-small-cell lung cancer patients. Sci Rep 2020; 10:17495. [PMID: 33060826 PMCID: PMC7566597 DOI: 10.1038/s41598-020-74573-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 10/05/2020] [Indexed: 12/20/2022] Open
Abstract
Cancer immunotherapy, including atezolizumab monotherapy, is a promising alternative strategy for patients with advanced non-small-cell lung cancer (NSCLC). Several inflammatory indices have been reported as potential biomarkers regarding the effectiveness of various treatments. This study aimed to analyze the efficacy of atezolizumab monotherapy using baseline inflammatory markers in NSCLC patients. We retrospectively enrolled 81 NSCLC patients who received atezolizumab monotherapy at six different medical institutions in Japan. The Cox proportional hazards model was used to assess the impact of the clinical variables, including inflammatory indexes, on clinical outcomes. Median progression-free survival (PFS) and overall survival (OS) were 60 days and 252 days, respectively. The objective response rate was 7.4%, and the disease control rate was 54.3%. Patients with high neutrophil to lymphocyte ratio (NLR), low lymphocyte to monocyte ratio (LMR), and/or high platelet to lymphocyte ratio (PLR), at baseline, demonstrated substantially shorter PFS and OS compared to those with a low NLR, high LMR, and/or low PLR. The multivariate analysis demonstrated that a high baseline NLR was substantially associated with short PFS and short OS. Our retrospective observations suggest that inflammatory indices may be a potential negative prognostic factor of atezolizumab monotherapy outcomes in NSCLC patients.
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Affiliation(s)
- Yuki Katayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Uji, Japan
| | - Satomi Tanaka
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Keiko Tanimura
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Naoko Okura
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Kazuki Hirose
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Sayaka Uda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Soichi Hirai
- Department of Respiratory Medicine, Otsu City Hospital, Otsu, Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Otsu, Japan
| | - Taishi Harada
- Department of Medical Oncology, Fukuchiyama City Hospital, Fukuchiyama, Japan
| | - Takayuki Shimamoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
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22
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Matsui Y, Yamada T, Masuzawa N, Hamada S, Takayama K, Hiranuma O. Advanced G-CSF-producing non-small cell lung cancer-not otherwise specified, with favourable response to pembrolizumab monotherapy. Respirol Case Rep 2020; 8:e00625. [PMID: 32695401 PMCID: PMC7364764 DOI: 10.1002/rcr2.625] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 11/26/2022] Open
Abstract
Advanced granulocyte colony-stimulating factor (G-CSF)-producing lung tumours are generally refractory to platinum-based chemotherapy and are associated with poor prognosis. However, therapeutic strategies for these tumours remain unknown. A 74-year-old man was diagnosed with non-small cell lung cancer-not otherwise specified (NSCLC-NOS); the clinical stage was T4N0M1c stage IVb. Blood testing showed leucocytosis and aberrant G-CSF expression. We chose single-agent pembrolizumab as the initial treatment because PD-L1 was highly expressed in the tumours. A clinically favourable response was achieved from seven courses of pembrolizumab with a total disease-free survival of 10 months. During this period, the blood leucocyte count was concordant with the disease condition. These observations showed that pembrolizumab monotherapy may be an effective treatment for patients with advanced G-CSF-producing NSCLC-NOS and that the monitoring of leucocyte count may be a useful biomarker for predicting the efficacy of pembrolizumab monotherapy.
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Affiliation(s)
- Yohei Matsui
- Department of Pulmonary MedicineOtsu City HospitalOtsuJapan
- Department of Pulmonary Medicine, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | | | | | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Osamu Hiranuma
- Department of Pulmonary MedicineOtsu City HospitalOtsuJapan
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23
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Nakao A, Hiranuma O, Uchino J, Sakaguchi C, Araya T, Hiraoka N, Ishizuka T, Takeda T, Kawasaki M, Goto Y, Imai H, Hattori N, Nakatomi K, Uramoto H, Uryu K, Fukuda M, Uchida Y, Yokoyama T, Akai M, Mio T, Nagashima S, Chihara Y, Tamiya N, Kaneko Y, Mouri T, Yamada T, Yoshimura K, Fujita M, Takayama K. Final Results from a Phase II Trial of Osimertinib for Elderly Patients with Epidermal Growth Factor Receptor t790m-Positive Non-Small Cell Lung Cancer That Progressed during Previous Treatment. J Clin Med 2020; 9:E1762. [PMID: 32517152 PMCID: PMC7356339 DOI: 10.3390/jcm9061762] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 11/29/2022] Open
Abstract
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are used for treating EGFR-mutated lung cancer, and osimertinib is effective in cases that acquired T790M mutations after treatment with the first- and second-generation EGFR-TKIs. However, no study has evaluated its safety and efficacy in older patients. This phase II trial (jRCTs071180002) evaluated osimertinib in T790M mutation-positive Japanese patients who were ≥75 years old and had experienced relapse or progression after previous EGFR-TKI treatment. Our previous report that enrolled 36 patients showed the overall response rate (58.3%) and disease control rate (97.2%), while this report describes the results for the progression-free survival (PFS), overall survival (OS), and safety analyses. The median PFS was 11.9 months (95% confidence interval (CI): 7.9-17.5), and the median OS was 22.0 months (95% CI: 16.0 months-not reached). The most frequent adverse events were anemia/hypoalbuminemia (27 patients, 75.0%), thrombocytopenia (21 patients, 58.3%), and paronychia/anorexia/diarrhea/neutropenia (15 patients, 41.7%). Pneumonitis was observed in four patients (11.1%), including two patients (5.6%) with Grade 3-4 pneumonitis. These results suggest that osimertinib was relatively safe and effective for non-small cell lung cancer that acquired T790M mutations after previous EGFR-TKI treatment, even among patients who were ≥75 years old.
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Affiliation(s)
- Akira Nakao
- Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (A.N.); (M.F.)
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Shiga 520-0804, Japan;
| | - Junji Uchino
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
| | - Chikara Sakaguchi
- Department of Pulmonary Medicine, Rakuwakai Otowa Hospital, Kyoto 607-8062, Japan;
| | - Tomoyuki Araya
- Department of Respiratory Medicine, National Hospital Organization, Kanazawa Medical Center, Ishikawa 920-8650, Japan;
| | - Noriya Hiraoka
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan;
| | - Tamotsu Ishizuka
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan;
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Society Kyoto Daini Hospital, Kyoto 602-8026, Japan;
| | - Masayuki Kawasaki
- Department of Respiratory Medicine, National Hospital Organization, Omuta National Hospital, Fukuoka 837-0911, Japan;
| | - Yasuhiro Goto
- Department of Respiratory Medicine, Fujita Health University, Aichi 470-1192, Japan;
| | - Hisao Imai
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Gunma 373-8550, Japan;
| | - Noboru Hattori
- Department of Molecular and Internal Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Keita Nakatomi
- Department of Respiratory Medicine, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka 815-8588, Japan;
| | - Hidetaka Uramoto
- Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa 920-0293, Japan;
| | - Kiyoaki Uryu
- Department of Respiratory Medicine, Yao Tokushukai General Hospital, Osaka 581-0011, Japan;
| | - Minoru Fukuda
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki 852-8523, Japan;
| | - Yasuki Uchida
- Department of Respiratory Medicine, Shiga University of Medical Science Hospital, Shiga 520-2192, Japan;
| | - Toshihide Yokoyama
- Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama 710-8602, Japan;
| | - Masaya Akai
- Department of Respiratory Medicine, Japanese Red Cross Fukui Hospital, Fukui 918-8501, Japan;
| | - Tadashi Mio
- Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan;
| | - Seiji Nagashima
- Department of Respiratory Medicine, National Hospital Organization Nagasaki Medical Center, Nagasaki 856-0835, Japan;
| | - Yusuke Chihara
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
| | - Nobuyo Tamiya
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
| | - Takako Mouri
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
| | - Kenichi Yoshimura
- Center for Integrated Medical Research, Hiroshima University Hospital, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Masaki Fujita
- Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (A.N.); (M.F.)
| | - Koichi Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
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Fukano H, Hiranuma O, Matsui Y, Tanaka S, Hoshino Y. The first case of chronic pulmonary Mycobacterium shigaense infection in an immunocompetent patient. New Microbes New Infect 2020; 33:100630. [PMID: 31908785 PMCID: PMC6940610 DOI: 10.1016/j.nmni.2019.100630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/20/2019] [Accepted: 11/25/2019] [Indexed: 11/26/2022] Open
Abstract
Mycobacterium shigaense has recently been recognized as an emerging human pathogen, and is well known as a skin pathogen in immunocompromised individuals. In this report we describe the first case of chronic pulmonary infectious disease caused by M. shigaense in an immunocompetent individual.
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Affiliation(s)
- H Fukano
- Leprosy Research Centre, Department of Mycobacteriology, National Institute of Infectious Diseases, Tokyo, Japan
| | | | - Y Matsui
- Otsu City Hospital, Shiga, Japan
| | - S Tanaka
- Otsu City Hospital, Shiga, Japan
| | - Y Hoshino
- Leprosy Research Centre, Department of Mycobacteriology, National Institute of Infectious Diseases, Tokyo, Japan
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25
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Katayama Y, Shimamoto T, Yamada T, Takeda T, Yamada T, Shiotsu S, Chihara Y, Hiranuma O, Iwasaku M, Kaneko Y, Uchino J, Takayama K. Retrospective Efficacy Analysis of Immune Checkpoint Inhibitor Rechallenge in Patients with Non-Small Cell Lung Cancer. J Clin Med 2019; 9:jcm9010102. [PMID: 31906082 PMCID: PMC7019787 DOI: 10.3390/jcm9010102] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 12/19/2019] [Accepted: 12/29/2019] [Indexed: 12/26/2022] Open
Abstract
Little is known regarding the effectiveness and tolerability of immune checkpoint inhibitor (ICI) rechallenge after disease progression following initial ICI treatments. To identify eligible patients for ICI rechallenge, we retrospectively analyzed the relationship between clinical profiles and the effect of ICI rechallenge in patients with non-small cell lung cancer (NSCLC). We enrolled 35 NSCLC patients at six different institutions who were retreated with ICIs after discontinued initial ICI treatments due to disease progression. Cox proportional hazards models were used to assess the impact of clinical profiles on overall survival (OS) and progression-free survival (PFS). Median PFS and OS were 81 d (95% confidence interval, CI, 41-112 d) and 225 d (95% CI 106-361 d), respectively. The objective response rate was 2.9%, and the disease control rate was 42.9%. Multivariate analysis demonstrated that Eastern Cooperative Oncology Group Performance Score (ECOG-PS) ≥ 2 (hazard ratio, HR, 2.38; 95% CI 1.03-5.52; p = 0.043) and body mass index (BMI) > 20 (HR 0.43, 95% CI 0.19-0.95, p = 0.036) were significantly associated with PFS of ICI rechallenge. Our observations suggest that poor ECOG-PS and low BMI at intervention with ICI rechallenge may be negative predictors for ICI rechallenge treatment in patients with NSCLC.
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Affiliation(s)
- Yuki Katayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.K.); (T.S.); (M.I.); (Y.K.); (J.U.); (K.T.)
| | - Takayuki Shimamoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.K.); (T.S.); (M.I.); (Y.K.); (J.U.); (K.T.)
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.K.); (T.S.); (M.I.); (Y.K.); (J.U.); (K.T.)
- Correspondence: ; Tel.: +81-75-251-5513
| | - Takayuki Takeda
- Department of Pulmonary Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan;
| | - Takahiro Yamada
- Department of Pulmonary Medicine, Matsushita Memorial Hospital, Moriguchi 570-8540, Japan;
| | - Shinsuke Shiotsu
- Department of Pulmonary Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan;
| | - Yusuke Chihara
- Department of Pulmonary Medicine, Uji-Tokushukai Medical Center, Uji 611-0041, Japan;
| | - Osamu Hiranuma
- Department of Pulmonary Medicine, Otsu City Hospital, Otsu 520-0804, Japan;
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.K.); (T.S.); (M.I.); (Y.K.); (J.U.); (K.T.)
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.K.); (T.S.); (M.I.); (Y.K.); (J.U.); (K.T.)
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.K.); (T.S.); (M.I.); (Y.K.); (J.U.); (K.T.)
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.K.); (T.S.); (M.I.); (Y.K.); (J.U.); (K.T.)
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26
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Yamada T, Yoshimura A, Takeda T, Shiotsu S, Hiranuma O, Chihara Y, Uchino J, Takayama K. EP1.14-05 Clinical Characteristics of Osimertinib Responder in Non-Small Cell Lung Cancer Patients with EGFR-T790M Mutation. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2290] [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: 11/28/2022]
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27
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Tanaka S, Hoshino Y, Sakagami T, Fukano H, Matsui Y, Hiranuma O. Pathogenicity of Mycolicibacterium phlei, a non-pathogenic nontuberculous mycobacterium in an immunocompetent host carrying anti-interferon gamma autoantibodies: a case report. BMC Infect Dis 2019; 19:454. [PMID: 31117976 PMCID: PMC6530062 DOI: 10.1186/s12879-019-4050-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/09/2019] [Accepted: 04/30/2019] [Indexed: 01/20/2023] Open
Abstract
Background Mycolicibacterium phlei (M. phlei) is known to be a non-pathogenic nontuberculous mycobacterium (NTM) which rarely causes diseases in humans. A disseminated NTM infection is mostly caused by the Mycobacterium avium complex (MAC) and is known to develop in immunocompromised hosts, like those with acquired immune deficiency syndrome (AIDS). Here, we report a case of disseminated M. phlei infection in an immunocompetent host carrying anti-interferon gamma (IFN-γ) autoantibodies. Case presentation We detected M. phlei in multiple organs of an elderly woman with no significant medical history except positivity for anti-IFN-γ autoantibodies. She tested negative for human immunodeficiency virus (HIV)-1, 2/ Human T-cell leukemia virus type 1 (HTLV-1) antibody. High-resolution computed tomography (HRCT) of the chest demonstrated a nodule in the left S1 + 2 segment, interlobular septal thickening, multi lymphadenopathy, and osteolysis. A maximum intensity projection image following fluorodeoxyglucose-positron emission tomography (FDG-PET) revealed multifocal hypermetabolic lesions in the nodule and all the swollen lymph nodes seen in HRCT. FDG also accumulated in multiple bones. Advanced primary lung cancer was suspected, and biopsies of each lesion were performed. The pathology revealed caseating granuloma, positive for acid-fast bacteria, and DNA sequencing of the acid-fast bacteria confirmed the organism to be M. phlei. The patient also tested positive for anti-IFN-γ autoantibodies. Based on these findings, she was diagnosed with disseminated M. phlei infection, with anti-IFN-γ autoantibodies. Conclusions Though known to be non-pathogenic, we show that M. phlei can be pathogenic like the MAC in immunocompetent individuals carrying anti-IFN-γ autoantibodies.
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Affiliation(s)
- Satomi Tanaka
- Otsu City Hospital, 2-9-9, Motomiya, Otsu-city, Shiga Prefecture, Japan.
| | - Yoshihiko Hoshino
- Leprosy Research Centre, National Institute of Infectious Diseases, 4 Chome-2-1 Aobacho, Higashimurayama, Tokyo, Japan
| | - Takuro Sakagami
- Department of Respiratory Medicine, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Japan
| | - Hanako Fukano
- Leprosy Research Centre, National Institute of Infectious Diseases, 4 Chome-2-1 Aobacho, Higashimurayama, Tokyo, Japan
| | - Yohei Matsui
- Otsu City Hospital, 2-9-9, Motomiya, Otsu-city, Shiga Prefecture, Japan
| | - Osamu Hiranuma
- Otsu City Hospital, 2-9-9, Motomiya, Otsu-city, Shiga Prefecture, Japan
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Hiranuma O, Uchino J, Yamada T, Chihara Y, Tamiya N, Kaneko Y, Yoshimura K, Takayama K. Rationale and Design of a Phase II Trial of Osimertinib Combined With Bevacizumab in Patients With Untreated Epidermal Growth Factor Receptor-mutated Non-small-cell Lung Cancer and Malignant Pleural and/or Pericardial Effusion (SPIRAL II Study). Clin Lung Cancer 2019; 20:e402-e406. [PMID: 30905617 DOI: 10.1016/j.cllc.2019.02.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 12/07/2018] [Accepted: 02/18/2019] [Indexed: 01/20/2023]
Abstract
Progression-free survival (PFS) of patients with non-small-cell lung cancer with pleural or pericardial effusion is expected to be prolonged with combination use of an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor plus bevacizumab compared with that with an EGFR-tyrosine kinase inhibitor alone. Phase I clinical trial data have been reported for combined treatment with osimertinib plus bevacizumab and demonstrated their safety, but the efficacy remains unclear, particularly in patients with pleural or pericardial effusion. This is an ongoing single arm, prospective, open-label, multicenter, phase II trial to evaluate the efficacy and safety of osimertinib plus bevacizumab combination therapy in EGFR mutation-positive patients with untreated or recurrent non-small-cell lung cancer and pleural and/or pericardial effusion. Osimertinib will be administered orally once daily at a dose of 80 mg. One cycle consists of 21 days. Bevacizumab 15 mg/kg will be administered by drip infusion on Day 1 of each cycle. Treatment will be continued until progressive disease or any of the discontinuation criteria are met. The primary endpoint will be the 1-year PFS rate. Secondary endpoints are response rate, PFS, overall survival, survival not requiring pleural/pericardial drainage, and safety. Osimertinib plus bevacizumab combination therapy is expected to prolong PFS and reduce adverse events. TRIAL REGISTRATION NUMBER: UMIN000028071.
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Affiliation(s)
- Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Shiga, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yusuke Chihara
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nobuyo Tamiya
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kenichi Yoshimura
- Department of Biostatistics, Innovative Clinical Research Center, Kanazawa University, Kanazawa, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Tanimura K, Yamada T, Chihara Y, Kubota Y, Shiotsu S, Takeda T, Yamada T, Hiranuma O, Uchino J, Takayama K. The Impact of Immune-related Adverse Events on the Effect of Immune Checkpoint Inhibitors in Non-small Cell Lung Cancer. ACTA ACUST UNITED AC 2019. [DOI: 10.2482/haigan.59.128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Keiko Tanimura
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
| | - Yusuke Chihara
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
| | - Yutaka Kubota
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital
| | - Takayuki Takeda
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center
| | - Takahiro Yamada
- Department of Respiratory Medicine, Matsushita Memorial Hospital
| | | | - Junji Uchino
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
| | - Koichi Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
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Nakao A, Hiranuma O, Uchino J, Sakaguchi C, Kita T, Hiraoka N, Ishizuka T, Kubota Y, Kawasaki M, Goto Y, Imai H, Hattori N, Nakatomi K, Uramoto H, Uryu K, Fukuda M, Uchida Y, Yokoyama T, Akai M, Mio T, Nagashima S, Chihara Y, Tamiya N, Kaneko Y, Mouri T, Yamada T, Yoshimura K, Fujita M, Takayama K. Osimertinib in Elderly Patients with Epidermal Growth Factor Receptor T790M-Positive Non-Small-Cell Lung Cancer Who Progressed During Prior Treatment: A Phase II Trial. Oncologist 2019; 24:593-e170. [PMID: 30651400 PMCID: PMC6516134 DOI: 10.1634/theoncologist.2019-0003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 12/29/2018] [Indexed: 01/08/2023] Open
Abstract
LESSONS LEARNED Non-small-cell lung cancer (NSCLC) represents 85% of lung cancer in elderly patients.In the present study performed in the 36 elderly subjects with epidermal growth factor receptor (EGFR) T790M mutation-positive NSCLC, osimertinib 80 mg demonstrated statistically significant improvement in the objective response rate, which was comparable to those in the nonelderly population.Osimertinib appears to be an effective and safe treatment option in elderly patients with advanced NSCLC with EGFR mutation; further research in larger scale is warranted. BACKGROUND Previous findings suggest the possibility of relatively safe use of osimertinib for patients with T790M-positive non-small-cell lung cancer (NSCLC), with few serious adverse events for the elderly in comparison with conventional endothelial growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), and with an antitumor effect. METHODS This phase II study was performed to prospectively investigate the efficacy and safety of osimertinib for elderly patients aged ≥75 years with ineffective prior EGFR TKI treatment or with recurrence in T790M EGFR TKI resistance mutation-positive NSCLC. RESULTS A total of 36 patients were included in the analyses. Among the 36 subjects, 63.9% were female, with mean age of 79.9 years. The objective response rate (ORR) was 58.3% (95% confidence interval [CI], 42.2%-72.9%), demonstrating statistically significant efficacy of osimertinib (p = .0017). The median duration of response (DOR) was 27.9 weeks (95% CI, 21.1-82.0). Complete response (CR) and partial response (PR) were 2.8% and 55.6%, respectively. Disease control rate (DCR) was 97.2%. A waterfall plot revealed that 33 (91.6%) subjects exhibited tumor shrinkage during treatment, including 12 of 14 subjects who had stable disease (SD). All adverse events were not reason for discontinuation of the study drug. CONCLUSION Osimertinib may be an effective and safe treatment option in elderly patients with advanced NSCLC with EGFR mutation.
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Affiliation(s)
- Akira Nakao
- Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Shiga, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chikara Sakaguchi
- Department of Pulmonary Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Toshiyuki Kita
- Department of Respiratory Medicine, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Noriya Hiraoka
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Tamotsu Ishizuka
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yutaka Kubota
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Masayuki Kawasaki
- Department of Respiratory Medicine, National Hospital Organization, Omuta Hospital, Fukuoka, Japan
| | - Yasuhiro Goto
- Department of Respiratory Medicine, Fujita Health University, Aichi, Japan
| | - Hisao Imai
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Gunma, Japan
| | - Noboru Hattori
- Department of Molecular and Internal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keita Nakatomi
- Department of Respiratory Medicine, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - Hidetaka Uramoto
- Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa, Japan
| | - Kiyoaki Uryu
- Department of Respiratory Medicine, Yao Tokushukai General Hospital, Osaka, Japan
| | - Minoru Fukuda
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Yasuki Uchida
- Department of Respiratory Medicine, Shiga University of Medical Science Hospital, Shiga, Japan
| | - Toshihide Yokoyama
- Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama, Japan
| | - Masaya Akai
- Department of Respiratory Medicine, Japanese Red Cross Fukui Hospital, Fukui, Japan
| | - Tadashi Mio
- Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Seiji Nagashima
- Department of Respiratory Medicine, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Yusuke Chihara
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nobuyo Tamiya
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takako Mouri
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kenichi Yoshimura
- Department of Biostatistics, Innovative Clinical Research Center, Kanazawa University, Ishikawa, Japan
| | - Masaki Fujita
- Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Yoshimura A, Yamada T, Okura N, Takeda T, Furutani W, Kubota Y, Shiotsu S, Hiranuma O, Nishioka N, Chihara Y, Tamiya N, Kaneko Y, Uchino J, Takayama K. The impact of the tumor shrinkage by initial EGFR inhibitors according to the detection of EGFR-T790M mutation in patients with non-small cell lung cancer harboring EGFR mutations. BMC Cancer 2018; 18:1241. [PMID: 30537950 PMCID: PMC6288862 DOI: 10.1186/s12885-018-5153-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The EGFR-T790M mutation is clinically detected using re-biopsy in approximately 50% of patients with acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in advanced non-small cell lung cancer (NSCLC) who harbor EGFR mutations. However, little is known about the population of NSCLC patients who develop acquired resistance due to the T790M mutation. In this study, we focused on the emergence of the T790M mutation and analyzed patients refractory to initial EGFR-TKIs with successful re-biopsy samples. METHODS Seventy-eight advanced NSCLC patients with EGFR mutations who had successful re-biopsy samples after resistance to initial EGFR-TKI treatment were enrolled at 5 institutions in Japan. We validated the association between the emergence of the T790M mutation and their clinical profiles. RESULTS Thirty-nine patients tested positive for T790M and 39 tested negative in the re-biopsy samples. The objective response rate to initial EGFR-TKIs was higher in patients with the T790M mutation than in those without the mutation (89.7% versus 51.2%, p < 0.001). Moreover, there was a significant difference in the maximal tumor shrinkage rate relative to baseline in T790M-positive tumors compared with T790M-negative tumors (42.7% versus 24.0%, p = 0.001). Multivariate analysis demonstrated that the maximum tumor shrinkage rate was a significant predictive factor for the detection of the T790M mutation (p = 0.023, odds ratio 1.03, 95% confidence interval 1.00-1.05). CONCLUSIONS Our retrospective observations suggested that the maximum tumor shrinkage rate with initial EGFR-TKI treatment might be one of the promising predictive biomarkers for emerging refractory tumors with the EGFR-T790M mutation.
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Affiliation(s)
- Akihiro Yoshimura
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Naoko Okura
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Uji, Japan
| | - Wataru Furutani
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Yutaka Kubota
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu city hospital, Otsu, Japan
| | - Naoya Nishioka
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yusuke Chihara
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Nobuyo Tamiya
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
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Yoshimura A, Uchino J, Tanimura K, Chihara Y, Tamiya N, Kaneko Y, Takeda T, Hiranuma O, Hasegawa I, Kubota Y, Shiotsu S, Takumi C, Hiraoka N, Yamada T, Takayama K. An observational study of the epidermal growth factor receptor-tyrosine kinase inhibitor resistance mechanism in epidermal growth factor receptor gene mutation-positive non-small cell lung cancer. Medicine (Baltimore) 2018; 97:e12660. [PMID: 30290647 PMCID: PMC6200532 DOI: 10.1097/md.0000000000012660] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation show a high response to EGFR-tyrosine kinase inhibitor (EGFR-TKI). Clinically, EGFR-positive NSCLC acquires several resistance mechanisms during EGFR-TKI treatment, such as the emergence of a secondary mutation (T790M), MET gene amplification, and transformation to small cell lung cancer. However, the mechanism of resistance to afatinib, a second-generation EGFR-TKI, remains unclear. In this study, we prospectively investigate the mechanism of resistance to afatinib using proteomic analyses.In total, 35 EGFR-positive NSCLC patients of both sexes and ≥20 years old will be included. NSCLC patients with major obstacles in major organs, such as bone marrow, heart, lung, liver, and kidney, will be excluded. Eligible patients will be administered afatinib or gefitinib until disease progression and proteomic analysis will be performed with biopsy samples before treatment and at disease progression.The primary outcome is to detect the potential predictive anomalies in proteins that can be candidates for the resistance factor of afatinib. The secondary outcome is to detect gene and protein abnormalities affecting progression-free survival, response rate, and rate of disease control in afatinib therapy.The protocol was approved by the institutional review boards of Kyoto Prefectural University of Medicine and all the participating hospitals. Written informed consent was obtained from all patients before registration, in accordance with the Declaration of Helsinki. The results of the study will be disseminated via publications in peer-reviewed journals.Trial registration number is UMIN000031013.
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Affiliation(s)
- Akihiro Yoshimura
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
| | - Junji Uchino
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
| | - Keiko Tanimura
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
| | - Yusuke Chihara
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
| | - Nobuyo Tamiya
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
| | - Takayuki Takeda
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center
| | | | - Isao Hasegawa
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital
| | - Yutaka Kubota
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Japan
| | - Chieko Takumi
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Japan
| | - Noriya Hiraoka
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
| | - Koichi Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
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Okura N, Yamada T, Yoshimura A, Takeda T, Kubota Y, Shiotsu S, Hiranuma O, Uchino J, Takayama K. P3.01-80 Retrospective Analysis of the Impact of EGFR T790M Mutation Detection by Re-Biopsy in Patients with NSCLC Harboring EGFR Mutations. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1640] [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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Fukano H, Yoshida M, Kazumi Y, Fujiwara N, Katayama K, Ogura Y, Hayashi T, Miyamoto Y, Fujimoto N, Hongsheng W, Mizumoto C, Koizumi Y, Maeda H, Hiranuma O, Mitarai S, Ishii N, Hoshino Y. Mycobacterium shigaense sp. nov., a slow-growing, scotochromogenic species, is a member of the Mycobacterium simiae complex. Int J Syst Evol Microbiol 2018; 68:2437-2442. [PMID: 29939124 DOI: 10.1099/ijsem.0.002845] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 11/18/2022] Open
Abstract
Among non-tuberculous mycobacteria (NTM), the Mycobacterium simiae complex is one of the largest groups, consisting of 18 species of slow-growing mycobacteria. In 2009, a case of NTM-associated infectious skin disease was reported in Shiga Prefecture, Japan. The patient presented with scattered nodules on the chest, back and extremities, and an M. simiae-like organism was isolated from skin biopsy specimens obtained from one of these lesions. Based on several assessments, including multiple-gene analyses, biochemical characterization and drug susceptibility testing, we concluded that this isolate represented a novel species of NTM, and proposed the name 'Mycobacterium shigaense'. Since 2009, five more cases of NTM-associated infectious disease in which there was a suspected involvement of 'M. shigaense' have been reported. Interestingly, four of these six cases occurred in Shiga Prefecture. Here we performed multiple-gene phylogenetic analyses, physiological and biochemical characterization tests, drug susceptibility tests, and profiling of proteins, fatty acids and mycolic acids of eight clinical isolates from the six suspected 'M. shigaense' cases. The results confirmed that all of the clinical isolates were 'M. shigaense', a slow-growing, scotochromogenic species. Here M. shigaense is validly proposed as a new member of the M. simiae complex, with the type strain being UN-152T (=JCM 32072T=DSM 46748T).
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Affiliation(s)
- Hanako Fukano
- 1Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba, Higashi-Murayama, Tokyo, Japan
| | - Mitsunori Yoshida
- 1Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba, Higashi-Murayama, Tokyo, Japan
| | - Yuko Kazumi
- 2Research Institute of Tuberculosis, Japan Anti-tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, Japan
| | - Nagatoshi Fujiwara
- 3Department of Food and Nutrition, Faculty of Contemporary Human Life Science, Tezukayama University, 3-1-3 Gakuen-Minami, Nara, Japan
| | - Kinya Katayama
- 4Laboratory of Biomolecular Chemistry, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino, Tokyo, Japan
| | - Yoshitoshi Ogura
- 5Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi, Fukuoka, Japan
| | - Tetsuya Hayashi
- 5Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi, Fukuoka, Japan
| | - Yuji Miyamoto
- 1Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba, Higashi-Murayama, Tokyo, Japan
| | - Noriki Fujimoto
- 6Department of Dermatology, Shiga University of Medical Science, Shiga, Japan
| | - Wang Hongsheng
- 7Institute of Dermatology, Chinese Academy of Medical Sciences, St 12 Jiangwangmiao, Nanjing 210042, PR China
| | - Chisaki Mizumoto
- 8Department of Hematology and Immunology, Otsu Red Cross Hospital, Shiga, Japan
| | - Yusuke Koizumi
- 9Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan
| | - Hiroyoshi Maeda
- 10Department of Pulmonary Medicine, Nagoya City East Medical Center, Aichi, Japan
| | - Osamu Hiranuma
- 11Department of Respiratory Medicine, Otsu City Hospital, Shiga, Japan
| | - Satoshi Mitarai
- 2Research Institute of Tuberculosis, Japan Anti-tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, Japan
| | - Norihisa Ishii
- 1Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba, Higashi-Murayama, Tokyo, Japan
| | - Yoshihiko Hoshino
- 1Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba, Higashi-Murayama, Tokyo, Japan
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Affiliation(s)
- Takahiro Sawada
- Department of Dermatology, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, Japan. E-mail: ; Department of Dermatology, Otsu Municipal Hospital, 2-9-9, Motomiya, Otsu, Shiga 520-0804, Japan
| | - Mitsuhiro Suehiro
- Department of Dermatology, Otsu Municipal Hospital, 2-9-9, Motomiya, Otsu, Shiga 520-0804, Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu Municipal Hospital, 2-9-9, Motomiya, Otsu, Shiga 520-0804, Japan
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Abstract
A 52-year-old woman was admitted to our hospital with thrombophlebitis of the internal jugular vein. Abdominal ultrasonography demonstrated a high echogenic mass measuring 4.5 cm in diameter in the liver, and abdominal CT revealed another liver tumor and an isodensity mass in the spleen. Abdominal MRI and angiography were performed and we presumed the tumors to be two hepatic angiomyolipoma and a splenic hamartoma. As an abdominal CT 21 months later revealed that all tumors were growing, these tomors were surgically resected. The histological diagnoses were hepatic angiomyolipoma and splenic hamartoma.
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Affiliation(s)
- Hidekazu Irie
- Department of Internal Medicine, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc, Ritto
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Kono Y, Sawada S, Kawahara T, Tsuda Y, Higaki T, Yamasaki S, Imamura H, Tada Y, Sato T, Hiranuma O, Akamatsu N, Komatsu S, Tamagaki T, Nakagawa K, Tsuji H, Nakagawa M. Bradykinin inhibits serum-depletion-induced apoptosis of human vascular endothelial cells by inducing nitric oxide via calcium ion kinetics. J Cardiovasc Pharmacol 2002; 39:251-61. [PMID: 11791011 DOI: 10.1097/00005344-200202000-00012] [Citation(s) in RCA: 8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Vascular endothelial cells play important roles in atherogenesis, and bradykinin is associated with atherosclerosis. The effect of bradykinin on apoptosis in human umbilical vein endothelial cells (HUVECs) was investigated, with a focus on Ca2+ kinetics and nitric oxide production. In serum-free conditions, the number of apoptotic cells increased in a time-dependent manner, but this increase was inhibited by bradykinin in a dose-dependent manner. The apoptosis inhibited by bradykinin was reduced by nitric oxide inhibitor N(G)-monomethyl-L-arginine (L-NMMA) and consequently restored by combined treatment with L-NMMA and L-arginine. Bradykinin increased influx of extracellular Ca2+, generation of inositol 1,4,5-trisphosphate, and release of Ca2+ from intracellular storage sites, thus increasing the total intracellular Ca2+ concentration ([Ca2+]i). Bradykinin increased nitric oxide production, which was inhibited by L-NMMA and restored by combined treatment with L-NMMA and L-arginine. Sodium nitroprusside (SNP) dose-dependently increased nitric oxide production and inhibited apoptosis; however, 10(-5) M SNP did not inhibit apoptosis. Caspase-3 inhibitor, acetyl-Asp-Met-Gln-Asp-aldehyde, enhanced bradykinin-induced inhibition of apoptosis but did not effect bradykinin-induced nitric oxide production. These findings suggest that bradykinin inhibits serum-depletion-induced apoptosis in HUVECs by enhancing nitric oxide production via an increase in [Ca2+]i.
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Affiliation(s)
- Yoshihito Kono
- Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
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Akamatsu N, Sawada S, Komatsu S, Tamagaki T, Hiranuma O, Kawahara T, Tsuda Y, Kono Y, Higaki T, Tada Y, Yamasaki S, Imamura H, Sato T, Tsuji H, Nakagawa M. Effect of cicletanine on the nitric oxide pathway in human umbilical vein endothelial cells. J Cardiovasc Pharmacol 2001; 38:174-82. [PMID: 11483866 DOI: 10.1097/00005344-200108000-00002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 11/25/2022]
Abstract
The purpose of this study was to evaluate the effects of cicletanine, a slightly diuretic antihypertensive drug, on human vascular endothelial cells with regard to nitric oxide, intracellular calcium concentration ([Ca2+]i), cyclic nucleotide, inositol 1,4,5-trisphosphate (IP3), and prostacyclin generation. Primary cultured human umbilical vein endothelial cells were used in this study. [Ca2+]i was measured by fura-2/AM. Cyclic adenosine monophosphate (AMP), cyclic guanosine monophosphate (GMP), IP3, and prostacyclin were measured by radioimmunoassay. Nitric oxide was measured by the Griess method. Cicletanine had no effect on [Ca2+]i. Cicletanine (10(-6)-10(-4) M) increased cyclic GMP but decreased prostacyclin generation. Cicletanine had no stimulating effect on cyclic AMP or IP3 generation. IP3 increased 45Ca release from storage sites. Cicletanine decreased prostacyclin generation via increase in cyclic GMP. Cicletanine had no stimulating effect on nitrogen oxides for 2 h after incubation but increased it after 3-24 h. Pretreatment with L-N(G)-monomethyl-arginine (L-NMMA) prevented this increase. The inhibitory effect of L-NMMA was prevented by pretreatment with L-arginine. These results indicate that nitric oxide and cyclic GMP may contribute to the antihypertensive action of cicletanine.
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Affiliation(s)
- N Akamatsu
- Second Department of Medicine, Kyoto Prefectural University of Medicine, Japan
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