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Hirai S, Ida M, Naito Y, Kawaguchi M. Comparison between the effects of epidural and intravenous patient-controlled analgesia on postoperative disability-free survival in patients undergoing thoracic and abdominal surgery: A post hoc analysis. Eur J Pain 2024. [PMID: 38511627 DOI: 10.1002/ejp.2266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Thoracic epidural analgesia (TEA) and intravenous patient-controlled analgesia (IV-PCA) are widely used to mitigate immediate postoperative pain; however, their effects on long-term disability-free survival are poorly documented. This study aimed to compare the effects of postoperative TEA and IV-PCA on disability-free survival in patients who underwent thoracic or abdominal surgery. METHODS This post hoc analysis of a prospective observational study included 845 inpatients aged ≥55 years that underwent elective thoracic and abdominal surgery between 1 April 2016 and 28 December 2018 in a tertiary care hospital. Inverse probability of treatment weighted (IPTW) using stabilized inverse propensity scores was adopted to minimize bias. The primary outcome in this study was disability-free survival, defined as survival with a 12-item World Health Organization Disability Assessment Schedule 2.0 score of <16%, assessed at 3 months and 1 year after surgery. RESULTS The final analysis included 601 patients who received TEA and 244 who received IV-PCA. After IPTW, the weighted incidence of disability-free survival at 3 months and 1 year was 60.5% and 61.4% in the TEA group and 78.3% and 66.2% in the IV-PCA group, respectively. The adjusted OR for disability-free survival at 3 months and 1 year was 0.84 (95% confidence interval [CI]: 0.50-1.39) and 1.21 (95% CI: 0.72-2.05), respectively, for the TEA group. CONCLUSION No significant differences were observed in the disability-free survival at 3 months and 1 year after elective thoracic and abdominal surgery in patients aged ≥55 years who received TEA or IV-PCA. SIGNIFICANCE STATEMENT This study is the first in our setting to document the long-term effects of patient-controlled analgesia. In a post hoc analysis of our prospective cohort study, we show that although differences in chronic postsurgical pain exist at 3 months post-surgery, disability-free survival rates at 1 year do not differ irrespective of the choice of patient-controlled analgesia. The findings of this study highlight the need for shared decision-making between clinicians and patients.
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Affiliation(s)
- S Hirai
- Department of Perioperative Management Center, Nara Medical University Hospital, Nara, Japan
| | - M Ida
- Department of Anaesthesiology, Nara Medical University, Nara, Japan
| | - Y Naito
- Department of Anaesthesiology, Nara Medical University, Nara, Japan
| | - M Kawaguchi
- Department of Anaesthesiology, Nara Medical University, Nara, Japan
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Haraguchi N, Naito Y, Shibasaki M, Sawa T. Tracheal injury diagnosed by a sudden increase in end-tidal carbon dioxide levels during mediastinoscopic subtotal esophagectomy: a case report. JA Clin Rep 2024; 10:11. [PMID: 38349592 PMCID: PMC10864238 DOI: 10.1186/s40981-024-00695-3] [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: 01/21/2024] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Mediastinoscopic surgery for esophageal cancer facilitates early postoperative recovery. However, it can occasionally cause serious complications. Here, we present the case of a patient with a tracheal injury diagnosed by a sudden increase in end-tidal carbon dioxide (EtCO2) during mediastinoscopic subtotal esophagectomy. CASE PRESENTATION A 52-year-old man diagnosed with esophageal cancer was scheduled to undergo mediastinoscopic subtotal esophagectomy. During the mediastinoscopic procedure, the EtCO2 level suddenly increased above 200 mmHg, and the blood pressure dropped below 80 mmHg. We immediately asked the operator to stop insufflation and found a tracheal injury on the right side of the trachea near the carina by bronchoscopy. The endotracheal tube was replaced with a double-lumen tube, and the trachea was repaired via right thoracotomy. There were no further intraoperative complications. After surgery, the patient was extubated and admitted to the intensive care unit. CONCLUSIONS Monitoring EtCO2 levels and close communication with the operator is important for safely managing sudden tracheal injury during mediastinoscopic esophagectomy.
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Affiliation(s)
- Natsuho Haraguchi
- Department of Anesthesiology, Fukuchiyama City Hospital, 231 Atsunaka-Cho, Fukuchiyama, Kyoto, 620-8505, Japan
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Yoshifumi Naito
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, Kyoto, 602-8566, Japan.
| | - Masayuki Shibasaki
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Teiji Sawa
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, Kyoto, 602-8566, Japan
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3
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Yamada T, Obata Y, Sudo K, Kinoshita M, Naito Y, Sawa T. Changes in EEG frequency characteristics during sevoflurane general anesthesia: feature extraction by variational mode decomposition. J Clin Monit Comput 2023; 37:1179-1192. [PMID: 37395808 DOI: 10.1007/s10877-023-01037-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 05/16/2023] [Indexed: 07/04/2023]
Abstract
Mode decomposition is a method for extracting the characteristic intrinsic mode function (IMF) from various multidimensional time-series signals. Variational mode decomposition (VMD) searches for IMFs by optimizing the bandwidth to a narrow band with the [Formula: see text] norm while preserving the online estimated central frequency. In this study, we applied VMD to the analysis of electroencephalogram (EEG) recorded during general anesthesia. Using a bispectral index monitor, EEGs were recorded from 10 adult surgical patients (the median age: 47.0, and the percentile range: 27.0-59.3 years) who were anesthetized with sevoflurane. We created an application named EEG Mode Decompositor, which decomposes the recorded EEG into IMFs and displays the Hilbert spectrogram. Over the 30-min recovery from general anesthesia, the median (25-75 percentile range) bispectral index increased from 47.1 (42.2-50.4) to 97.4 (96.5-97.6), and the central frequencies of IMF-1 showed a significant change from 0.4 (0.2-0.5) Hz to 0.2 (0.1-0.3) Hz. IMF-2, IMF-3, IMF-4, IMF-5, and IMF-6 increased significantly from 1.4 (1.2-1.6) Hz to 7.5 (1.5-9.3) Hz, 6.7 (4.1-7.6) Hz to 19.4 (6.9-20.0) Hz, 10.9 (8.8-11.4) Hz to 26.4 (24.2-27.2) Hz, 13.4 (11.3-16.6) Hz to 35.6 (34.9-36.1) Hz, and 12.4 (9.7-18.1) Hz to 43.2 (42.9-43.4) Hz, respectively. The characteristic frequency component changes in specific IMFs during emergence from general anesthesia were visually captured by IMFs derived using VMD. EEG analysis by VMD is useful for extracting distinct changes during general anesthesia.
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Affiliation(s)
- Tomomi Yamada
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan
| | - Yurie Obata
- Department of Anesthesiology, Yodogawa Christian Hospital, Shibashima 1-7-50, Higashiyodogawa, Osaka, 533-0024, Japan
| | - Kazuki Sudo
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan
| | - Mao Kinoshita
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan
| | - Yoshifumi Naito
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan
| | - Teiji Sawa
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan.
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Inoue K, Kinoshita M, Muranishi K, Ohara J, Sudo K, Kawaguchi K, Shimizu M, Naito Y, Moriyama K, Sawa T. Effect of a Novel Trivalent Vaccine Formulation against Acute Lung Injury Caused by Pseudomonas aeruginosa. Vaccines (Basel) 2023; 11:1088. [PMID: 37376477 DOI: 10.3390/vaccines11061088] [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: 05/03/2023] [Revised: 05/26/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
An effective vaccine against Pseudomonas aeruginosa would benefit people susceptible to severe infection. Vaccination targeting V antigen (PcrV) of the P. aeruginosa type III secretion system is a potential prophylactic strategy for reducing P. aeruginosa-induced acute lung injury and acute mortality. We created a recombinant protein (designated POmT) comprising three antigens: full-length PcrV (PcrV#1-#294), the outer membrane domain (#190-342) of OprF (OprF#190-#342), and a non-catalytic mutant of the carboxyl domain (#406-613) of exotoxin A (mToxA#406-#613(E553Δ)). In the combination of PcrV and OprF, mToxA, the efficacy of POmT was compared with that of single-antigen vaccines, two-antigen mixed vaccines, and a three-antigen mixed vaccine in a murine model of P. aeruginosa pneumonia. As a result, the 24 h-survival rates were 79%, 78%, 21%, 7%, and 36% in the POmT, PcrV, OprF, mTox, and alum-alone groups, respectively. Significant improvement in acute lung injury and reduction in acute mortality within 24 h after infection was observed in the POmT and PcrV groups than in the other groups. Overall, the POmT vaccine exhibited efficacy comparable to that of the PcrV vaccine. The future goal is to prove the efficacy of the POmT vaccine against various P. aeruginosa strains.
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Affiliation(s)
- Keita Inoue
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Mao Kinoshita
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Kentaro Muranishi
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan
| | - Junya Ohara
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Kazuki Sudo
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Ken Kawaguchi
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Masaru Shimizu
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Yoshifumi Naito
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Kiyoshi Moriyama
- Department of Anesthesiology, School of Medicine, Kyorin University, Mitaka 181-8611, Japan
| | - Teiji Sawa
- Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
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Im SA, Gennari A, Park YH, Kim JH, Jiang ZF, Gupta S, Fadjari TH, Tamura K, Mastura MY, Abesamis-Tiambeng MLT, Lim EH, Lin CH, Sookprasert A, Parinyanitikul N, Tseng LM, Lee SC, Caguioa P, Singh M, Naito Y, Hukom RA, Smruti BK, Wang SS, Kim SB, Lee KH, Ahn HK, Peters S, Kim TW, Yoshino T, Pentheroudakis G, Curigliano G, Harbeck N. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, staging and treatment of patients with metastatic breast cancer. ESMO Open 2023; 8:101541. [PMID: 37178669 PMCID: PMC10186487 DOI: 10.1016/j.esmoop.2023.101541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/27/2023] [Accepted: 04/01/2023] [Indexed: 05/15/2023] Open
Abstract
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, staging and treatment of patients with metastatic breast cancer (MBC) was published in 2021. A special, hybrid guidelines meeting was convened by ESMO and the Korean Society of Medical Oncology (KSMO) in collaboration with nine other Asian national oncology societies in May 2022 in order to adapt the ESMO 2021 guidelines to take into account the differences associated with the treatment of MBC in Asia. These guidelines represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with MBC representing the oncological societies of China (CSCO), India (ISMPO), Indonesia (ISHMO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO). The voting was based on the best available scientific evidence and was independent of drug access or practice restrictions in the different Asian countries. The latter were discussed when appropriate. The aim of these guidelines is to provide guidance for the harmonisation of the management of patients with MBC across the different regions of Asia, drawing from data provided by global and Asian trials whilst at the same time integrating the differences in genetics, demographics and scientific evidence, together with restricted access to certain therapeutic strategies.
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Affiliation(s)
- S-A Im
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University, Seoul, Republic of Korea.
| | - A Gennari
- Department of Translational Medicine, University Piemonte Orientale, Novara, Italy
| | - Y H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J H Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Z-F Jiang
- Department of Oncology, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - S Gupta
- Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - T H Fadjari
- Department of Internal Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - K Tamura
- Department of Medical Oncology, Shimane University Hospital, Shimane, Japan
| | - M Y Mastura
- Cancer Centre, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - M L T Abesamis-Tiambeng
- Section of Medical Oncology, Department of Internal Medicine, Cardinal Santos Cancer Center, San Juan, The Philippines
| | - E H Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - C-H Lin
- Department of Medical Oncology, National Taiwan University Hospital, Cancer Center Branch, Taipei, Taiwan
| | - A Sookprasert
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - N Parinyanitikul
- Medical Oncology Unit, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital and Chulalongkorn University, Bangkok, Thailand
| | - L-M Tseng
- Taipei-Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - S-C Lee
- Department of Haematology-Oncology, National University Cancer Institute, Singapore (NCIS), Singapore, Singapore
| | - P Caguioa
- The Cancer Institute of St Luke's Medical Center, National Capital Region, The Philippines; The Cancer Institute of the University of Santo Tomas Hospital, National Capital Region, The Philippines
| | - M Singh
- Department of Radiotherapy, Pantai Cancer Institute, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia; Department of Oncology, Pantai Cancer Institute, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Y Naito
- Department of General Internal Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - R A Hukom
- Department of Hematology and Medical Oncology, Dharmais Hospital (National Cancer Center), Jakarta, Indonesia
| | - B K Smruti
- Medical Oncology, Lilavati Hospital and Research Centre and Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - S-S Wang
- Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - S B Kim
- Department of Oncology, Asan Medical Centre, Seoul, Republic of Korea
| | - K-H Lee
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - H K Ahn
- Division of Medical Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - S Peters
- Oncology Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - T W Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | - G Curigliano
- Istituto Europeo di Oncologia, IRCCS, Milan, Italy; Department of Oncology and Haematology, University of Milano, Milan, Italy
| | - N Harbeck
- Breast Center, Department of Obstetrics and Gynaecology and Comprehensive Cancer Center Munich, LMU University Hospital, Munich, Germany
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Matsukawa Y, Naito Y, Nakane W, Kamizyo S, Miyazi T, Ishida S, Gotoh M. Validation and clinical utility of the Nagoya diagnostic criteria for detrusor underactivity in men. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00081-7] [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: 02/12/2023]
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Matsukawa Y, Ishida S, Naito Y, Matsuo K, Ishikawa T, Gotoh M. Adiponectin predicts urodynamic detrusor underactivity: A prospective study of elderly men with lower urinary tract symptoms. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00106-9] [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: 02/12/2023]
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Rullan A, Giangreco G, Naito Y, Hooper S, Chakravarty P, Hirata E, Harrington K, Sahai E. 1678P The interaction between cancer cells and cancer-associated fibroblasts promotes RAS signalling in squamous cell carcinoma, resulting in an immune-suppressive tumour microenvironment and poorer survival outcomes. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1757] [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] Open
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Sugita S, Naito Y, Zhou L, He H, Hao Q, Sakamoto A, Lee JW. Hyaluronic acid restored protein permeability across injured human lung microvascular endothelial cells. FASEB Bioadv 2022; 4:619-631. [PMID: 36089980 PMCID: PMC9447422 DOI: 10.1096/fba.2022-00006] [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: 01/21/2022] [Revised: 06/02/2022] [Accepted: 06/08/2022] [Indexed: 11/11/2022] Open
Abstract
Lung endothelial permeability is a key pathological feature of acute respiratory distress syndrome. Hyaluronic acid (HA), a major component of the glycocalyx layer on the endothelium, is generated by HA synthase (HAS) during inflammation and injury and is critical for repair. We hypothesized that administration of exogenous high molecular weight (HMW) HA would restore protein permeability across human lung microvascular endothelial cells (HLMVEC) injured by an inflammatory insult via upregulation of HAS by binding to CD44. A transwell coculture system was used to study the effects of HA on protein permeability across HLMVEC injured by cytomix, a mixture of IL‐1β, TNFα, and IFNγ, with or without HMW or low molecular weight (LMW) HA. Coincubation with HMW HA, but not LMW HA, improved protein permeability following injury at 24 h. Fluorescence microscopy demonstrated that exogenous HMW HA partially prevented the increase in “actin stress fiber” formation. HMW HA also increased the synthesis of HAS2 mRNA expression and intracellular HMW HA levels in HLMVEC following injury. Pretreatment with an anti‐CD44 antibody or 4‐methylumbelliferone, a HAS inhibitor, blocked the therapeutic effects. In conclusion, exogenous HMW HA restored protein permeability across HLMVEC injured by an inflammatory insult in part through upregulation of HAS2.
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Affiliation(s)
- Shinji Sugita
- Department of Anesthesiology and Pain Medicine Nippon Medical School Tokyo Japan
- Department of Anesthesiology University of California, San Francisco San Francisco California USA
| | - Yoshifumi Naito
- Department of Anesthesiology University of California, San Francisco San Francisco California USA
| | - Li Zhou
- Department of Anesthesiology University of California, San Francisco San Francisco California USA
| | - Hongli He
- Department of Anesthesiology University of California, San Francisco San Francisco California USA
| | - Qi Hao
- Department of Anesthesiology University of California, San Francisco San Francisco California USA
| | - Atsuhiro Sakamoto
- Department of Anesthesiology and Pain Medicine Nippon Medical School Tokyo Japan
| | - Jae W. Lee
- Department of Anesthesiology University of California, San Francisco San Francisco California USA
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Kurokawa Y, Honma Y, Sawaki A, Naito Y, Iwagami S, Komatsu Y, Takahashi T, Nishida T, Doi T. Pimitespib in patients with advanced gastrointestinal stromal tumor (CHAPTER-GIST-301): a randomized, double-blind, placebo-controlled phase 3 trial. Ann Oncol 2022; 33:959-967. [PMID: 35688358 DOI: 10.1016/j.annonc.2022.05.518] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [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: 01/15/2022] [Revised: 04/06/2022] [Accepted: 05/29/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Prognosis of advanced gastrointestinal stromal tumors (GIST) refractory to tyrosine kinase inhibitors (TKIs) is poor. This randomized, placebo-controlled, phase 3 trial evaluated the efficacy and safety of pimitespib, a novel heat shock protein 90 inhibitor, in advanced GIST refractory to standard TKIs. PATIENTS AND METHODS Patients with histologically confirmed GIST refractory to imatinib, sunitinib, and regorafenib were randomized 2:1 to oral pimitespib 160 mg/day or placebo for five consecutive days per week in 21-day cycles. Following disease progression by blinded central radiological review (BCRR), crossover to open-label pimitespib was permitted. The primary endpoint was progression-free survival (PFS) by BCRR in the full analysis set. Secondary endpoints included overall survival (OS) adjusted using the rank preserving structural failure time method to reduce the expected confounding impact of crossover. RESULTS From Oct 31, 2018 to Apr 30, 2020, 86 patients were randomized to pimitespib (n=58) or placebo (n=28). Median PFS was 2.8 months (95% CI 1.6-2.9) with pimitespib versus 1.4 months (0.9-1.8) with placebo (hazard ratio [HR] 0.51 [95% CI 0.30-0.87]; one-sided p=0.006). Pimitespib showed an improvement in crossover-adjusted OS compared with placebo (HR 0.42 [0.21-0.85], one-sided p=0.007). Seventeen (60.7%) patients receiving placebo crossed-over to pimitespib; median PFS after crossover was 2.7 (95% CI 0.7-4.1) months. The most common (≥30%) treatment-related adverse events (AEs) with pimitespib were diarrhea (74.1%) and decreased appetite (31.0%); the most common (≥10%) grade ≥3 treatment-related AE was diarrhea (13.8%). Treatment-related AEs leading to pimitespib discontinuation occurred in 3 (5.2%) patients. CONCLUSION Pimitespib significantly improved PFS and crossover-adjusted OS compared with placebo and had an acceptable safety profile in patients with advanced GIST refractory to standard TKIs.
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Affiliation(s)
- Y Kurokawa
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan;.
| | - Y Honma
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - A Sawaki
- Department of Medical Oncology, Fujita Health University Hospital, Aichi, Japan
| | - Y Naito
- Department of General Internal Medicine/Medical Oncology/Experimental Therapeutics, National Cancer Center Hospital East, Kashiwa, Japan
| | - S Iwagami
- Department of Gastroenterological Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Y Komatsu
- Department of Cancer Center, Hokkaido University Hospital, Sapporo, Japan
| | - T Takahashi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - T Nishida
- Department of Surgery, National Cancer Center Hospital, Tokyo, Japan;; Department of Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka, Japan
| | - T Doi
- Department of Experimental Therapeutics, National Cancer Center Hospital Kashiwa, Japan
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11
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Naito Y, Kato H, Zhou L, Sugita S, He H, Zheng J, Hao Q, Sawa T, Lee JW. Therapeutic Effects of Hyaluronic Acid Against Cytotoxic Extracellular Vesicles Released During Pseudomonas Aeruginosa Pneumonia. Shock 2022; 57:408-416. [PMID: 34387224 PMCID: PMC8840981 DOI: 10.1097/shk.0000000000001846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Extracellular vesicles (EVs) have now been recognized as important mediators of cellular communication during injury and repair. We previously found that plasma EVs isolated from ex vivo perfused human lungs injured with Escherichia coli bacterial pneumonia were inflammatory, and exogenous administration of high molecular weight (HMW) hyaluronic acid (HA) as therapy bound to these EVs, decreasing inflammation and injury. In the current study, we studied the role of EVs released during severe Pseudomonas aeruginosa (PA) pneumonia in mice and determined whether intravenous administration of exogenous HMW HA would have therapeutic effects against the bacterial pneumonia. EVs were collected from the bronchoalveolar lavage fluid (BALF) of mice infected with PA103 by ultracentrifugation and analyzed by NanoSight and flow cytometry. In a cytotoxicity assay, administration of EVs released from infected mice (I-EVs) decreased the viability of A549 cells compared to EV isolated from sham control mice (C-EVs). Either exogenous HMW HA or an anti-CD44 antibody, when co-incubated with I-EVs, significantly improved the viability of the A549 cells. In mice with PA103 pneumonia, administration of HMW HA improved pulmonary edema and bacterial count in the lungs and decreased TNF-α and caspase-3 levels in the supernatant of lung homogenates. In conclusion, EVs isolated from BALF of mice with P. aeruginosa pneumonia were cytotoxic and inflammatory, and intravenous HMW HA administration was protective against P. aeruginosa pneumonia.
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Affiliation(s)
- Yoshifumi Naito
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Japan
| | - Hideya Kato
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Japan
| | - Li Zhou
- Department of Anesthesiology, University of California San Francisco, San Francisco, California
| | - Shinji Sugita
- Department of Anesthesiology, University of California San Francisco, San Francisco, California
| | - Hongli He
- Department of Anesthesiology, University of California San Francisco, San Francisco, California
| | - Justin Zheng
- Department of Anesthesiology, University of California San Francisco, San Francisco, California
| | - Qi Hao
- Department of Anesthesiology, University of California San Francisco, San Francisco, California
| | - Teiji Sawa
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Japan
| | - Jae-Woo Lee
- Department of Anesthesiology, University of California San Francisco, San Francisco, California
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12
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Kainuma A, Itatani K, Akiyama K, Naito Y, Ishii M, Shimizu M, Ohara J, Nakamura N, Nakajima Y, Numata S, Yaku H, Sawa T. Preoperative Left Ventricular Energy Loss in the Operating Theater Reflects Subjective Symptoms in Chronic Aortic Regurgitation. Front Surg 2022; 9:739743. [PMID: 35252323 PMCID: PMC8889468 DOI: 10.3389/fsurg.2022.739743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 01/04/2022] [Indexed: 11/26/2022] Open
Abstract
Background There is currently no subjective, definitive evaluation method for therapeutic indication other than symptoms in aortic regurgitation. Energy loss, a novel parameter of cardiac workload, can be visualized and quantified using echocardiography vector flow mapping. The purpose of the present study was to evaluate whether energy loss in patients with chronic aortic regurgitation can quantify their subjective symptoms more clearly than other conventional metrics. Methods We studied 15 patients undergoing elective aortic valve surgery for aortic regurgitation. We divided the patients into symptomatic and asymptomatic groups using their admission records. We analyzed the mean energy loss in one cardiac cycle using transesophageal echocardiography during the preoperative period. The relationships between symptoms, energy loss, and other conventional metrics were statistically analyzed. Results There were seven and eight patients in the symptomatic and asymptomatic groups, respectively. The mean energy loss of one cardiac cycle was higher in the symptomatic group (121 mW/m [96–184]) than in the asymptomatic group (87 mW/m [80–103]) (p = 0.040), whereas the diastolic diameter was higher in the asymptomatic group (65 mm [59–78]) than in the symptomatic group (57 mm [51–57]) (p = 0.040). There was no significant difference between the symptomatic and asymptomatic groups in terms of other conventional metrics. Conclusions An energy loss can quantify patients' subjective symptoms more clearly than other conventional metrics. The small sample size is the primary limitation of our study, further studies assessing larger cohort of patients are warranted to validate our findings.
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Affiliation(s)
- Atsushi Kainuma
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Keiichi Itatani
- Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
- *Correspondence: Keiichi Itatani
| | - Koichi Akiyama
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshifumi Naito
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Maki Ishii
- North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masaru Shimizu
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Junya Ohara
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naotoshi Nakamura
- Center for Mathematical Modeling and Data Science, Osaka University, Osaka, Japan
| | - Yasufumi Nakajima
- Department of Anesthesiology and Critical Care, Kansai Medical University, Osaka, Japan
| | - Satoshi Numata
- Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hitoshi Yaku
- Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Teiji Sawa
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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13
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Zhang X, Sugita S, Liu A, Naito Y, Hwang W, Qiu H, Sakamoto A, Sawa T, Matthay MA, Lee JW. Therapeutic effects of high molecular weight hyaluronic acid in severe Pseudomonas aeruginosa pneumonia in ex vivo perfused human lungs. Am J Physiol Lung Cell Mol Physiol 2021; 321:L827-L836. [PMID: 34524905 DOI: 10.1152/ajplung.00626.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We previously reported that extracellular vesicles (EVs) released during Escherichia coli (E. coli) bacterial pneumonia were inflammatory, and administration of high molecular weight hyaluronic acid (HMW HA) suppressed several indices of acute lung injury (ALI) from E. coli pneumonia by binding to these inflammatory EVs. The current study was undertaken to study the therapeutic effects of HMW HA in ex vivo perfused human lungs injured with Pseudomonas aeruginosa (PA)103 bacterial pneumonia. For lungs with baseline alveolar fluid clearance (AFC) <10%/h, HMW HA 1 or 2 mg was injected intravenously after 1 h (n = 4-9), and EVs released during PA pneumonia were collected from the perfusate over 6 h. For lungs with baseline AFC > 10%/h, HMW HA 2 mg was injected intravenously after 1 h (n = 6). In vitro experiments were conducted to evaluate the effects of HA on inflammation and bacterial phagocytosis. For lungs with AFC < 10%/h, administration of HMW HA intravenously significantly restored AFC and numerically decreased protein permeability and alveolar inflammation from PA103 pneumonia but had no effect on bacterial counts at 6 h. However, HMW HA improved bacterial phagocytosis by human monocytes and neutrophils and suppressed the inflammatory properties of EVs released during pneumonia on monocytes. For lungs with AFC > 10%/h, administration of HMW HA intravenously improved AFC from PA103 pneumonia but had no significant effects on protein permeability, inflammation, or bacterial counts. In the presence of impaired alveolar epithelial transport capacity, administration of HMW HA improved the resolution of pulmonary edema from Pseudomonas PA103 bacterial pneumonia.
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Affiliation(s)
- Xiwen Zhang
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,Departments of Anesthesiology, Medicine, and Cardiovascular Research Institute, University of California, San Francisco, California
| | - Shinji Sugita
- Department of Anesthesiology, Nippon Medical School, Tokyo, Japan.,Departments of Anesthesiology, Medicine, and Cardiovascular Research Institute, University of California, San Francisco, California
| | - Airan Liu
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yoshifumi Naito
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Wonjung Hwang
- Departments of Anesthesiology, Medicine, and Cardiovascular Research Institute, University of California, San Francisco, California
| | - Haibo Qiu
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | | | - Teiji Sawa
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Michael A Matthay
- Departments of Anesthesiology, Medicine, and Cardiovascular Research Institute, University of California, San Francisco, California
| | - Jae-Woo Lee
- Departments of Anesthesiology, Medicine, and Cardiovascular Research Institute, University of California, San Francisco, California
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14
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Kawamura K, Ejiri K, Toda H, Miyoshi T, Yamanaka T, Taniguchi M, Kawamoto K, Tokioka K, Naito Y, Yoshioka R, Karashima E, Fujio H, Fuke S, Nakamura K, Ito H. Association between adherence to home-based walking exercise with a pedometer and one-year adverse outcomes among lower extremity peripheral artery disease patients with endovascular treatment. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Home-based exercise after endovascular treatment (EVT) for lower extremity peripheral artery disease (LE-PAD) patients with intermittent claudication is suggested as an alternative therapy for supervised exercise; however, an association of adherence to home-based exercise with clinical adverse events has not been fully investigated.
Purpose
We aimed to investigate the association of adherence to home-based exercise with 1-year major adverse events (MAE), patency, and leg symptoms after EVT in a contemporary Japanese registry.
Methods
A total of 500 patients with LE-PAD within the Long Term Outcome of Endovascular Therapy for PAD with Intermittent Claudication Observational Prospective Multicenter (ASHIMORI-IC) registry (UMINCTR, UMINehab724.203718753) who underwent EVT between January 2016 and March 2019 were included in the analysis. After EVT, all patients were instructed to do home-based walking exercise with a pedometer. The study population was divided and compared between 2 groups according to adherence to home-based exercise: well-adherence and poor-adherence. The adherence of home-based exercise was as defined by step count derived from a pedometer on sites. The primary outcome was MAE defined as composite of all-cause death, myocardial infarction, stroke, target vessel revascularization, and major amputation of target lower limb for one year. The main secondary outcome was 1-year primary patency of the treated lesion, and the improvement of leg symptom (6-minute walk distance [6MWD] and claudication distance). The study followed the Consensus definitions from peripheral academic research consortium criteria.
Results
Overall, the mean age was 72.8 years, and 78% were men. At 1 year, MAE occurred in 45 patients (9.0%), and the primary patency rate was 85.3% (94.2% of EVT for aortoiliac and 71.9% of EVT for femoropopliteal). A significant difference in the incidence of MAE was observed between the well-adherence group and the poor-adherence group (10 of 233 patients [4.3%] vs. 35 of 267 patients [13.1%]; P<0.001). After multivariate Cox regression analysis, patients in the well-adherence group showed the lower hazard ratio for 1-year MAE (0.30; 95% confidence interval, 0.15–0.58; P<0.001) compared to those in the poor-adherence group. In the well-adherence group, compared with the poor-adherence group, higher primary patency rate (88.9% vs 81.5%; p=0.015), longer claudication onset distance (370 m [IQR 240–453 m] vs 240m [IQR 126–324 m]; P<0.001), and longer 6MWD (422 m [IQR 359–483 m] vs 325 m [IQR 213–400 m]; P<0.001) were observed even after adjusting for each baseline value.
Conclusion
Our study demonstrates the importance of adherence to home-based walking exercise after EVT in LE-PAD patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - K Ejiri
- Okayama University Hospital, Okayama, Japan
| | - H Toda
- Okayama University Hospital, Okayama, Japan
| | - T Miyoshi
- Okayama University Hospital, Okayama, Japan
| | - T Yamanaka
- Tsuyama Central Hospital, Tsuyama, Japan
| | - M Taniguchi
- Fukuyama Cardiovascular Hospital, Fukuyama, Japan
| | | | - K Tokioka
- Okayama City Hospital, Okayama, Japan
| | - Y Naito
- Fukuyama City Hospital, Fukuyama, Japan
| | - R Yoshioka
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - E Karashima
- Shimonoseki City Hospital, Shimonoseki, Japan
| | - H Fujio
- Himeji Red Cross Hospital, Himeji, Japan
| | - S Fuke
- Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - K Nakamura
- Okayama University Hospital, Okayama, Japan
| | - H Ito
- Okayama University Hospital, Okayama, Japan
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15
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Kage H, Sunami K, Naito Y, Amano T, Ennishi D, Imai M, Kanai M, Kenmotsu H, Komine K, Koyama T, T. M, Morita S, Saigusa Y, Sakai D, Yamanaka T, Kohsaka S, Tsuchihara K, Yoshino T. 519MO Concordance analysis of treatment recommendations between central consensus and multidisciplinary tumor boards. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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16
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Komine K, Sunami K, Naito Y, Amano T, Ennishi D, Imai M, Kage H, Kanai M, Kenmotsu H, Koyama T, T. M, Morita S, Sakai D, Kohsaka S, Tsuchihara K, Saigusa Y, Yamanaka T, Yoshino T. 551P Chronological improvement in precision oncology implementation in Japan. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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17
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Zhou L, Hao Q, Sugita S, Naito Y, He H, Yeh CC, Lee JW. Role of CD44 in increasing the potency of mesenchymal stem cell extracellular vesicles by hyaluronic acid in severe pneumonia. Stem Cell Res Ther 2021; 12:293. [PMID: 34016170 PMCID: PMC8136222 DOI: 10.1186/s13287-021-02329-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/07/2021] [Indexed: 12/17/2022] Open
Abstract
Background Although promising, clinical translation of human mesenchymal stem or stromal cell-derived extracellular vesicles (MSC EV) for acute lung injury is potentially limited by significant production costs. The current study was performed to determine whether pretreatment of MSC EV with high molecular weight hyaluronic acid (HMW HA) would increase the therapeutic potency of MSC EV in severe bacterial pneumonia. Methods In vitro experiments were performed to determine the binding affinity of HMW HA to MSC EV and its uptake by human monocytes, and whether HMW HA primed MSC EV would increase bacterial phagocytosis by the monocytes. In addition, the role of CD44 receptor on MSC EV in the therapeutic effects of HMW HA primed MSC EV were investigated. In Pseudomonas aeruginosa (PA) pneumonia in mice, MSC EV primed with or without HMW HA were instilled intravenously 4 h after injury. After 24 h, the bronchoalveolar lavage fluid, blood, and lungs were analyzed for levels of bacteria, inflammation, MSC EV trafficking, and lung pathology. Results MSC EV bound preferentially to HMW HA at a molecular weight of 1.0 MDa compared with HA with a molecular weight of 40 KDa or 1.5 MDa. HMW HA primed MSC EV further increased MSC EV uptake and bacterial phagocytosis by monocytes compared to treatment with MSC EV alone. In PA pneumonia in mice, instillation of HMW HA primed MSC EV further reduced inflammation and decreased the bacterial load by enhancing the trafficking of MSC EV to the injured alveolus. CD44 siRNA pretreatment of MSC EV prior to incubation with HMW HA eliminated its trafficking to the alveolus and therapeutic effects. Conclusions HMW HA primed MSC EV significantly increased the potency of MSC EV in PA pneumonia in part by enhancing the trafficking of MSC EV to the sites of inflammation via the CD44 receptor on MSC EV which was associated with increased antimicrobial activity. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-021-02329-2.
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Affiliation(s)
- Li Zhou
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Department of Anesthesiology, University of California, San Francisco, 505 Parnassus Ave., Box 0648, San Francisco, CA, USA
| | - Qi Hao
- Department of Anesthesiology, University of California, San Francisco, 505 Parnassus Ave., Box 0648, San Francisco, CA, USA
| | - Shinji Sugita
- Department of Anesthesiology, University of California, San Francisco, 505 Parnassus Ave., Box 0648, San Francisco, CA, USA
| | - Yoshifumi Naito
- Department of Anesthesiology, University of California, San Francisco, 505 Parnassus Ave., Box 0648, San Francisco, CA, USA
| | - Hongli He
- Department of Anesthesiology, University of California, San Francisco, 505 Parnassus Ave., Box 0648, San Francisco, CA, USA
| | - Che-Chung Yeh
- Department of Anesthesiology, University of California, San Francisco, 505 Parnassus Ave., Box 0648, San Francisco, CA, USA
| | - Jae-Woo Lee
- Department of Anesthesiology, University of California, San Francisco, 505 Parnassus Ave., Box 0648, San Francisco, CA, USA.
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18
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Demetri GD, Antonescu CR, Bjerkehagen B, Bovée JVMG, Boye K, Chacón M, Dei Tos AP, Desai J, Fletcher JA, Gelderblom H, George S, Gronchi A, Haas RL, Hindi N, Hohenberger P, Joensuu H, Jones RL, Judson I, Kang YK, Kawai A, Lazar AJ, Le Cesne A, Maestro R, Maki RG, Martín J, Patel S, Penault-Llorca F, Premanand Raut C, Rutkowski P, Safwat A, Sbaraglia M, Schaefer IM, Shen L, Serrano C, Schöffski P, Stacchiotti S, Sundby Hall K, Tap WD, Thomas DM, Trent J, Valverde C, van der Graaf WTA, von Mehren M, Wagner A, Wardelmann E, Naito Y, Zalcberg J, Blay JY. Diagnosis and management of tropomyosin receptor kinase (TRK) fusion sarcomas: expert recommendations from the World Sarcoma Network. Ann Oncol 2020; 31:1506-1517. [PMID: 32891793 PMCID: PMC7985805 DOI: 10.1016/j.annonc.2020.08.2232] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 12/22/2022] Open
Abstract
Sarcomas are a heterogeneous group of malignancies with mesenchymal lineage differentiation. The discovery of neurotrophic tyrosine receptor kinase (NTRK) gene fusions as tissue-agnostic oncogenic drivers has led to new personalized therapies for a subset of patients with sarcoma in the form of tropomyosin receptor kinase (TRK) inhibitors. NTRK gene rearrangements and fusion transcripts can be detected with different molecular pathology techniques, while TRK protein expression can be demonstrated with immunohistochemistry. The rarity and diagnostic complexity of NTRK gene fusions raise a number of questions and challenges for clinicians. To address these challenges, the World Sarcoma Network convened two meetings of expert adult oncologists and pathologists and subsequently developed this article to provide practical guidance on the management of patients with sarcoma harboring NTRK gene fusions. We propose a diagnostic strategy that considers disease stage and histologic and molecular subtypes to facilitate routine testing for TRK expression and subsequent testing for NTRK gene fusions.
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Affiliation(s)
- G D Demetri
- Dana-Farber Cancer Institute and Ludwig Center at Harvard Medical School, Boston, USA
| | - C R Antonescu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - B Bjerkehagen
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - J V M G Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - K Boye
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - M Chacón
- Oncology Service Chair, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - A P Dei Tos
- Department of Pathology, University of Padua, Padova, Italy
| | - J Desai
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - J A Fletcher
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - H Gelderblom
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - S George
- Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - A Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - R L Haas
- Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - N Hindi
- Institute of Biomedicine of Sevilla (IBIS, HUVR, CSIC, Universidad de Sevilla), Sevilla, Spain; Medical Oncology Department, University Hospital Virgen del Rocio, Sevilla, Spain
| | - P Hohenberger
- Division of Surgical Oncology and Thoracic Surgery, Mannheim University Medical Center, Mannheim, Germany
| | - H Joensuu
- Department of Oncology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - R L Jones
- Sarcoma Unit, Royal Marsden NHS Foundation Trust, London, UK; Division of Clinical Studies, Institute of Cancer Research, London, UK
| | - I Judson
- Division of Clinical Studies, Institute of Cancer Research, London, UK
| | - Y-K Kang
- Department of Oncology, University of Ulsan College of Medicine, Seoul, Korea
| | - A Kawai
- Department of Musculoskeletal Oncology, National Cancer Center, Tokyo, Japan
| | - A J Lazar
- Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Le Cesne
- Medical Oncology, Insitut Gustave Roussy, Villejuif, Ile-de-France, France
| | - R Maestro
- Unit of Oncogenetics and Functional Oncogenomics, Centro di Riferimento Oncologico di Aviano (CRO Aviano) IRCCS, National Cancer Institute, Aviano, Italy
| | - R G Maki
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - J Martín
- Institute of Biomedicine of Sevilla (IBIS, HUVR, CSIC, Universidad de Sevilla), Sevilla, Spain; Medical Oncology Department, University Hospital Virgen del Rocio, Sevilla, Spain
| | - S Patel
- Department of Sarcoma Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | | | - C Premanand Raut
- Division of Surgical Oncology, Brigham and Women's Hospital, Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - A Safwat
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - M Sbaraglia
- Department of Pathology, University of Padua, Padova, Italy
| | - I-M Schaefer
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - L Shen
- Department of GI Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - C Serrano
- Sarcoma Translational Research Program, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Medical Oncology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - P Schöffski
- Department of General Medical Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - S Stacchiotti
- Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - K Sundby Hall
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - W D Tap
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - D M Thomas
- The Kinghorn Cancer Centre and Cancer Theme, Garvan Institute of Medical Research, Darlinghurst, Australia
| | - J Trent
- Sylvester Comprehensive Cancer Center at University of Miami Miller School of Medicine, Miami, USA
| | - C Valverde
- Medical Oncology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - W T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M von Mehren
- Department of Hematology and Medical Oncology, Fox Chase Cancer Center, Philadelphia, USA
| | - A Wagner
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA
| | - E Wardelmann
- Gerhard Domagk Institute of Pathology, University of Münster, Münster, Germany
| | - Y Naito
- National Cancer Center Hospital East, Kashiwa, Japan
| | - J Zalcberg
- Department of Epidemiology and Preventative Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Medical Oncology, Alfred Health, Melbourne, Australia
| | - J-Y Blay
- Centre Léon Bérard, Unicancer, LYRICAN and Université Claude Bernard Lyon 1, Lyon, France.
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Tamura K, Takahashi S, Mukohara T, Tanioka M, Yasojima H, Ono M, Naito Y, Shimoi T, Otani Y, Kobayashi K, Kogawa T, Suzuki T, Takase T, Matsunaga R, Masuda N. 346P Phase I study of the liposomal formulation of eribulin (E7389-LF): Results from the HER2-negative breast cancer expansion. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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20
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Matsukawa Y, Majima T, Funahashi Y, Ishida S, Naito Y, Kato M, Yamamoto T, Gotoh M. What are useful signs to differentiate detrusor underactivity from bladder outlet obstruction in men with non-neurogenic lower urinary tract symptoms? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33563-1] [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: 11/26/2022] Open
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21
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Yoshino T, Pentheroudakis G, Mishima S, Overman MJ, Yeh KH, Baba E, Naito Y, Calvo F, Saxena A, Chen LT, Takeda M, Cervantes A, Taniguchi H, Yoshida K, Kodera Y, Kitagawa Y, Tabernero J, Burris H, Douillard JY. JSCO-ESMO-ASCO-JSMO-TOS: international expert consensus recommendations for tumour-agnostic treatments in patients with solid tumours with microsatellite instability or NTRK fusions. Ann Oncol 2020; 31:861-872. [PMID: 32272210 DOI: 10.1016/j.annonc.2020.03.299] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/15/2020] [Indexed: 01/05/2023] Open
Abstract
A Japan Society of Clinical Oncology (JSCO)-hosted expert meeting was held in Japan on 27 October 2019, which comprised experts from the JSCO, the Japanese Society of Medical Oncology (JSMO), the European Society for Medical Oncology (ESMO), the American Society of Clinical Oncology (ASCO), and the Taiwan Oncology Society (TOS). The purpose of the meeting was to focus on what we have learnt from both microsatellite instability (MSI)/deficient mismatch repair (dMMR) biomarkers in predicting the efficacy of anti-programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) immunotherapy, and the neurotrophic tyrosine receptor kinase (NTRK) gene fusions in predicting the efficacy of inhibitors of the tropomyosin receptor kinase (TRK) proteins across a range of solid tumour types. The recent regulatory approvals of the anti-PD-1 antibody pembrolizumab and the TRK inhibitors larotrectinib and entrectinib, based on specific tumour biomarkers rather than specific tumour type, have heralded a paradigm shift in cancer treatment approaches. The purpose of the meeting was to develop international expert consensus recommendations on the use of such tumour-agnostic treatments in patients with solid tumours. The aim was to generate a reference document for clinical practice, for pharmaceutical companies in the design of clinical trials, for ethics committees in the approval of clinical trial protocols and for regulatory authorities in relation to drug approvals, with a particular emphasis on diagnostic testing and patient selection.
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Affiliation(s)
- T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
| | - G Pentheroudakis
- Department of Medical Oncology, University of Ioannina, Ioannina, Greece
| | - S Mishima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - M J Overman
- Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - K-H Yeh
- Department of Medical Oncology, National Taiwan University Cancer Center and Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan
| | - E Baba
- Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Naito
- Department of Experimental Therapeutics/Breast and Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - F Calvo
- Department of Clinical Pharmacology, University of Paris and Institute Gustave Roussy, Villejuif, France
| | - A Saxena
- Department of Medicine, Division of Hematology & Medical Oncology, Thoracic Oncology Service, Weill Cornell Medicine, New York, USA
| | - L-T Chen
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - M Takeda
- Department of Medical Oncology, Kindai University, Osaka, Japan
| | - A Cervantes
- CIBERONC, Department of Medical Oncology, Institute of Health Research, INCLIVIA, University of Valencia, Valencia, Spain
| | - H Taniguchi
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - K Yoshida
- Department of Surgical Oncology, Gifu University, Graduate School of Medicine, Gifu, Japan
| | - Y Kodera
- Department of Gastrointestinal Surgery, Nagoya University, Nagoya, Japan
| | - Y Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - J Tabernero
- Medical Oncology Department, Vall d' Hebron University Hospital, Vall d'Hebron Institute of Oncology (V.H.I.O.), Barcelona, Spain
| | - H Burris
- The Sarah Cannon Research Institute, Nashville, USA
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Kainuma A, Akiyama K, Naito Y, Hayase K, Hongu H, Itatani K, Yamagishi M, Sawa T. Energetic performance index improvement after Glenn and Damus-Kaye-Stansel procedure using vector flow mapping analysis: a case report. JA Clin Rep 2020; 6:5. [PMID: 32026035 PMCID: PMC6973790 DOI: 10.1186/s40981-020-0312-4] [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: 08/26/2019] [Accepted: 01/14/2020] [Indexed: 11/30/2022] Open
Abstract
Background Echocardiography vector flow mapping can assess dynamic flow to treat congenital heart diseases. We evaluated intracardiac flow, energy loss, left ventricular output kinetic energy, and energetic performance index using vector flow mapping during Glenn and Damus-Kaye-Stansel procedures in order to assess the efficacy of the surgery. Case presentation A 9-month-old boy underwent Glenn and Damus-Kaye-Stansel procedures. The energy loss depends on the left ventricular preload; therefore, energy loss decreased after the Glenn procedure. After the Damus-Kaye-Stansel procedure, the kinetic energy would increase owing to the integrated systemic outflow; however, in our case, kinetic energy decreased, which was potentially explained by the fact that kinetic energy also depends on the left ventricular preload. After the Glenn and Damus-Kaye-Stansel procedures, we detected an improvement in energetic performance index, indicating that the cardiac workload improved as well. Conclusion We revealed the efficiency of the Glenn and Damus-Kaye-Stansel procedures using vector flow mapping.
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Affiliation(s)
- Atsushi Kainuma
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyoku, Kyoto, 602-8566, Japan.
| | - Koichi Akiyama
- Department of Anesthesiology, Yodogawa Christian Hospital, 1 Chome-7-50, Kunijima, Higashiyodogawa Ward, Osaka, 533-0024, Japan
| | - Yoshifumi Naito
- Department of Anesthesia and Perioperative care, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Kazuma Hayase
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyoku, Kyoto, 602-8566, Japan
| | - Hisayuki Hongu
- Department of Pediatric Cardiovascular Surgery, Children's Medical Center, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyoku, Kyoto, 602-8566, Japan
| | - Keiichi Itatani
- Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyoku, Kyoto, 602-8566, Japan
| | - Masaaki Yamagishi
- Department of Pediatric Cardiovascular Surgery, Children's Medical Center, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyoku, Kyoto, 602-8566, Japan
| | - Teiji Sawa
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyoku, Kyoto, 602-8566, Japan
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Liu A, Zhang X, He H, Zhou L, Naito Y, Sugita S, Lee JW. Therapeutic potential of mesenchymal stem/stromal cell-derived secretome and vesicles for lung injury and disease. Expert Opin Biol Ther 2019; 20:125-140. [PMID: 31701782 DOI: 10.1080/14712598.2020.1689954] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: The acute respiratory distress syndrome (ARDS) is a devastating clinical condition common in patients with respiratory failure. Based largely on numerous preclinical studies and recent Phase I/II clinical trials, administration of stem cells, specifically mesenchymal stem or stromal cells (MSC), as a therapeutic for acute lung injury (ALI) holds great promise. However, concern for the use of stem cells, specifically the risk of iatrogenic tumor formation, remains unresolved. Accumulating evidence now suggest that stem cell-derived conditioned medium (CM) and/or extracellular vesicles (EV) might constitute compelling alternatives.Areas covered: The current review focuses on the preclinical studies testing MSC CM and/or EV as treatment for ALI and other inflammatory lung diseases.Expert opinion: Clinical application of MSC or their secreted CM may be limited by the cost of growing enough cells, the logistic of MSC storage, and the lack of standardization of what constitutes MSC CM. However, the clinical application of MSC EV remains promising, primarily due to the ability of EV to maintain the functional phenotype of the parent cell as a therapeutic. However, utilization of MSC EV will also require large-scale production, the cost of which may be prohibitive unless the potency of the EV can be increased.
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Affiliation(s)
- Airan Liu
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Xiwen Zhang
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Hongli He
- Departments of Anesthesiology and Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Li Zhou
- Departments of Anesthesiology and Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Yoshifumi Naito
- Departments of Anesthesiology and Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Shinji Sugita
- Departments of Anesthesiology and Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Jae-Woo Lee
- Departments of Anesthesiology and Cardiovascular Research Institute, University of California, San Francisco, CA, USA
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Liu A, Park JH, Zhang X, Sugita S, Naito Y, Lee JH, Kato H, Hao Q, Matthay MA, Lee JW. Therapeutic Effects of Hyaluronic Acid in Bacterial Pneumonia in Ex Vivo Perfused Human Lungs. Am J Respir Crit Care Med 2019; 200:1234-1245. [PMID: 31390880 PMCID: PMC6857490 DOI: 10.1164/rccm.201812-2296oc] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 08/07/2019] [Indexed: 12/18/2022] Open
Abstract
Rationale: Recent studies have demonstrated that extracellular vesicles (EVs) released during acute lung injury (ALI) were inflammatory.Objectives: The current study was undertaken to test the role of EVs induced and released from severe Escherichia coli pneumonia (E. coli EVs) in the pathogenesis of ALI and to determine whether high-molecular-weight (HMW) hyaluronic acid (HA) administration would suppress lung injury from E. coli EVs or bacterial pneumonia.Methods:E. coli EVs were collected from the perfusate of an ex vivo perfused human lung injured with intrabronchial E. coli bacteria for 6 hours by ultracentrifugation and then given intrabronchially or intravenously to naive human lungs. One hour later, HMW HA was instilled into the perfusate (n = 5-6). In separate experiments, HMW HA was given after E. coli bacterial pneumonia (n = 6-10). In vitro experiments were conducted to evaluate binding of EVs to HMW HA and uptake of EVs by human monocytes.Measurements and Main Results: Administration of HMW HA ameliorated the impairment of alveolar fluid clearance, protein permeability, and acute inflammation from E. coli EVs or pneumonia and reduced total bacteria counts after E. coli pneumonia. HMW HA bound to E. coli EVs, inhibiting the uptake of EVs by human monocytes, an effect associated with reduced TNFα (tumor necrosis factor α) secretion. Surprisingly, HMW HA increased E. coli bacteria phagocytosis by monocytes.Conclusions: EVs induced and released during severe bacterial pneumonia were inflammatory and induced ALI, and HMW HA administration was effective in inhibiting the uptake of EVs by target cells and decreasing lung injury from E. coli EVs or bacterial pneumonia.
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Affiliation(s)
- Airan Liu
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China; and
- Department of Anesthesiology and
- Department of Medicine, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Jeong-Hyun Park
- Department of Anesthesiology and
- Department of Medicine, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Xiwen Zhang
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China; and
- Department of Anesthesiology and
- Department of Medicine, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Shinji Sugita
- Department of Anesthesiology and
- Department of Medicine, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Yoshifumi Naito
- Department of Anesthesiology and
- Department of Medicine, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Jae-Hoon Lee
- Department of Anesthesiology and
- Department of Medicine, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Hideya Kato
- Department of Anesthesiology and
- Department of Medicine, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Qi Hao
- Department of Anesthesiology and
- Department of Medicine, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Michael A. Matthay
- Department of Anesthesiology and
- Department of Medicine, Cardiovascular Research Institute, University of California, San Francisco, California
| | - Jae-Woo Lee
- Department of Anesthesiology and
- Department of Medicine, Cardiovascular Research Institute, University of California, San Francisco, California
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Shimada J, Okada S, Tsunezuka H, Shimomura M, Ishihara S, Inoue M, Naito Y. EP1.16-36 A Good Intestinal Bacterial Environment Can Reduce the Side Effects of Tyrosine Kinase Inhibitors and Enhance Their Anti-Cancer Effects. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Ishikawa T, Yasuda T, Okayama T, Konishi H, Naito Y, Taguchi T, Itoh Y. Efficacy and safety of early administration of pegfilgrastim in patients with esophageal cancer treated by docetaxel, cisplatin, and 5-fluorouracil (DCF): a phase 2 prospective study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Oue N, Naito Y, Hayashi T, Takigahira M, Kawano-Nagatsuma A, Sentani K, Sakamoto N, Oo HZ, Uraoka N, Yanagihara K, Ochiai A, Sasaki H, Yasui W. Correction: Signal peptidase complex 18, encoded by SEC11A, contributes to progression via TGF-α secretion in gastric cancer. Oncogene 2019; 38:5748. [DOI: 10.1038/s41388-019-0837-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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28
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Naito Y, Hamaoka S, Kinoshita M, Kainuma A, Shimizu M, Katoh H, Moriyama K, Ishii KJ, Sawa T. The protective effects of nasal PcrV-CpG oligonucleotide vaccination against Pseudomonas aeruginosa pneumonia. Microbiol Immunol 2019; 62:774-785. [PMID: 30378708 DOI: 10.1111/1348-0421.12658] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/13/2018] [Accepted: 10/27/2018] [Indexed: 01/15/2023]
Abstract
An effective vaccine against Pseudomonas aeruginosa would be hugely beneficial to people who are susceptible to the serious infections it can cause. Vaccination against PcrV of the P. aeruginosa type III secretion system is a potential prophylactic strategy for improving the incidence and prognosis of P. aeruginosa pneumonia. Here, the effect of nasal PcrV adjuvanted with CpG oligodeoxynucleotide (CpG) was compared with a nasal PcrV/aluminum hydroxide gel (alum) vaccine. Seven groups of mice were vaccinated intranasally with one of the following: 1, PcrV-CpG; 2, PcrV-alum; 3, PcrV alone; 4, CpG alone; 5, alum alone; 6 and 7, saline control. Fifty days after the first immunization, anti-PcrV IgG, IgA and IgG isotype titers were measured; significant increases in these titers were detected only in the PcrV-CpG vaccinated mice. The vaccinated mice were then intratracheally infected with a lethal dose of P. aeruginosa and their body temperatures and survival monitored for 24 hr, edema, bacteria, myeloperoxidase activity and lung histology also being evaluated at 24 hr post-infection. It was found that 73% of the PcrV-CpG-vaccinated mice survived, whereas fewer than 30% of the mice vaccinated with PcrV-alum or adjuvant alone survived. Lung edema and other inflammation-related variables were less severe in the PcrV-CpG group. The significant increase in PcrV-specific IgA titers detected following PcrV-CpG vaccination is probably a component of the disease protection mechanism. Overall, our data show that intranasal PcrV-CpG vaccination has potential efficacy for clinical application against P. aeruginosa pneumonia.
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Affiliation(s)
- Yoshifumi Naito
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyo, Kyoto, 602-8566, Japan
| | - Saeko Hamaoka
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyo, Kyoto, 602-8566, Japan
| | - Mao Kinoshita
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyo, Kyoto, 602-8566, Japan
| | - Atsushi Kainuma
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyo, Kyoto, 602-8566, Japan
| | - Masaru Shimizu
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyo, Kyoto, 602-8566, Japan
| | - Hideya Katoh
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyo, Kyoto, 602-8566, Japan
| | - Kiyoshi Moriyama
- Department of Anesthesiology, School of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Ken J Ishii
- Laboratory of Adjuvant Innovation, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Asagi, Saito, Ibaraki, Osaka, 567-0085, Japan.,Laboratory of Vaccine Science, Immunology Frontier Research Center, World Premier International Research Center, Osaka University, 1-1 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Teiji Sawa
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyo, Kyoto, 602-8566, Japan
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Nishida T, Naito Y, Takahashi T, Honma Y, Saito T, Ichikawa H, Hirota S. Clinicopathological features of wild-type GISTs based on multiple-gene panel analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy443.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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Ishii H, Azuma K, Sakai K, Naito Y, Matsuo N, Tokito T, Yamada K, Hoshino T, Nishio K. P3.01-45 Multifactorial Gene Alterations in EGFR Bypass Pathway are Induced by Afatinib in T790M-Mutant NSCLC Resistant to Osmertinib. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Okuno K, Naito Y, Asakura M, Sugahara M, Ando T, Nagai T, Saito Y, Yoshikawa T, Masuyama T, Anzai T. P5648Appropriate hemoglobin levels in HFpEF patients: results of Japanese heart failure syndrome with preserved ejection fraction (JASPER) registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Okuno
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - Y Naito
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - M Asakura
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - M Sugahara
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - T Ando
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - T Nagai
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - Y Saito
- Nara Medical University, First Department of Internal Medicine, Nara, Japan
| | - T Yoshikawa
- Sakakibara Memorial Hospital, Department of Cardiology, Tokyo, Japan
| | - T Masuyama
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - T Anzai
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
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Okuno K, Naito Y, Yasumura S, Nishimura K, Asakura M, Ishihara M, Masuyama T. P2623Transferrin receptor 1 hetero deletion attenuates angiogenesis in mouse hind limb ischemia model. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Okuno
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - Y Naito
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - S Yasumura
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - K Nishimura
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - M Asakura
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - M Ishihara
- Hyogo College of Medicine, Cardiovascular Division, Department of Internal Medicine, Nishinomiya, Japan
| | - T Masuyama
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
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Okuno K, Naito Y, Asakura M, Sugahara M, Ando T, Nagai T, Saito Y, Yoshikawa T, Masuyama T, Anzai T. P3756Impact of anemia in patients with HFpEF with chronic kidney disease: results of Japanese heart failure syndrome with preserved ejection fraction (JASPER) registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Okuno
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - Y Naito
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - M Asakura
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - M Sugahara
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - T Ando
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - T Nagai
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - Y Saito
- Nara Medical University, First Department of Internal Medicine, Nara, Japan
| | - T Yoshikawa
- Sakakibara Memorial Hospital, Department of Cardiology, Tokyo, Japan
| | - T Masuyama
- Hyogo College of Medicine, Cardiology, Nishinomiya, Japan
| | - T Anzai
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
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Yamanaka K, Inoue S, Naito Y, Kawaguchi M. Amiodarone does not affect brain injury in a rat model of transient forebrain ischemia. Med Intensiva 2018; 43:457-463. [PMID: 30029951 DOI: 10.1016/j.medin.2018.05.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/26/2018] [Accepted: 05/18/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Although amiodarone may cause neurotoxicity that can affect patient outcomes when used during cardiopulmonary resuscitation (CPR), it has been commonly prescribed during CPR. This study investigated the possible neurotoxic effects of amiodarone in a rat model of transient forebrain ischemia. DESIGN A prospective laboratory animal study was carried out. SETTING Animal laboratory. MATERIALS Male Sprague-Dawley rats. INTERVENTION Eight minutes of forebrain ischemia was induced in rats by bilateral carotid occlusion and hypotension (mean arterial pressure=35mmHg) under isoflurane (1.5%) anesthesia. Amiodarone (0, 50, 100 and 150mg/kg) with saline was injected intraperitoneally 10min after ischemia. Rats given 0mg/kg of amiodarone were used as saline-treated controls. Sham operated rats received no treatment. VARIABLES OF INTEREST Animals were evaluated neurologically on postoperative days 4-7, and histologically after a one-week recovery period. RESULTS The greatest improvement in water maze test performance corresponded to the sham operated group (p=0.015 vs. saline-treated controls). No differences in performance were seen in amiodarone-treated rats compared with saline-treated controls. In the control group, 45% of the CA1 hippocampal neurons survived, compared with 78% in the sham operated group (p=0.009). Neuron survival after ischemia in the amiodarone treatment groups (50, 100 and 150mg/kg) (58%, 40% and 36%, respectively) and in the control rats did not differ significantly. CONCLUSIONS The administration of amiodarone immediately after transient forebrain ischemia did not worsen spatial cognitive function or neuronal survival in the hippocampal CA1 region in rats. The current results must be applied with caution in humans. However, they indicate that the potential neurotoxicity induced by amiodarone during resuscitation after cardiac arrest may be negligible.
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Affiliation(s)
- K Yamanaka
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan
| | - S Inoue
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan.
| | - Y Naito
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan
| | - M Kawaguchi
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan
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Gnatiuc L, Herrington WG, Halsey J, Tuomilehto J, Fang X, Kim HC, De Bacquer D, Dobson AJ, Criqui MH, Jacobs DR, Leon DA, Peters SAE, Ueshima H, Sherliker P, Peto R, Collins R, Huxley RR, Emberson JR, Woodward M, Lewington S, Aoki N, Arima H, Arnesen E, Aromaa A, Assmann G, Bachman DL, Baigent C, Bartholomew H, Benetos A, Bengtsson C, Bennett D, Björkelund C, Blackburn H, Bonaa K, Boyle E, Broadhurst R, Carstensen J, Chambless L, Chen Z, Chew SK, Clarke R, Cox C, Curb JD, D'Agostino R, Date C, Davey Smith G, De Backer G, Dhaliwal SS, Duan XF, Ducimetiere P, Duffy S, Eliassen H, Elwood P, Empana J, Garcia-Palmieri MH, Gazes P, Giles GG, Gillis C, Goldbourt U, Gu DF, Guasch-Ferre M, Guize L, Haheim L, Hart C, Hashimoto S, Hashimoto T, Heng D, Hjermann I, Ho SC, Hobbs M, Hole D, Holme I, Horibe H, Hozawa A, Hu F, Hughes K, Iida M, Imai K, Imai Y, Iso H, Jackson R, Jamrozik K, Jee SH, Jensen G, Jiang CQ, Johansen NB, Jorgensen T, Jousilahti P, Kagaya M, Keil J, Keller J, Kim IS, Kita Y, Kitamura A, Kiyohara Y, Knekt P, Knuiman M, Kornitzer M, Kromhout D, Kronmal R, Lam TH, Law M, Lee J, Leren P, Levy D, Li YH, Lissner L, Luepker R, Luszcz M, MacMahon S, Maegawa H, Marmot M, Matsutani Y, Meade T, Morris J, Morris R, Murayama T, Naito Y, Nakachi K, Nakamura M, Nakayama T, Neaton J, Nietert PJ, Nishimoto Y, Norton R, Nozaki A, Ohkubo T, Okayama A, Pan WH, Puska P, Qizilbash N, Reunanen A, Rimm E, Rodgers A, Saitoh S, Sakata K, Sato S, Schnohr P, Schulte H, Selmer R, Sharp D, Shifu X, Shimamoto K, Shipley M, Silbershatz H, Sorlie P, Sritara P, Suh I, Sutherland SE, Sweetnam P, Tamakoshi A, Tanaka H, Thomsen T, Tominaga S, Tomita M, Törnberg S, Tunstall-Pedoe H, Tverdal A, Ueshima H, Vartiainen E, Wald N, Wannamethee SG, Welborn TA, Whincup P, Whitlock G, Willett W, Woo J, Wu ZL, Yao SX, Yarnell J, Yokoyama T, Yoshiike N, Zhang XH. Sex-specific relevance of diabetes to occlusive vascular and other mortality: a collaborative meta-analysis of individual data from 980 793 adults from 68 prospective studies. Lancet Diabetes Endocrinol 2018; 6:538-546. [PMID: 29752194 PMCID: PMC6008496 DOI: 10.1016/s2213-8587(18)30079-2] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men. METHODS In our meta-analysis, we obtained individual participant-level data from studies included in the Prospective Studies Collaboration and the Asia Pacific Cohort Studies Collaboration that had obtained baseline information on age, sex, diabetes, total cholesterol, blood pressure, tobacco use, height, and weight. Data on causes of death were obtained from medical death certificates. We used Cox regression models to assess the relevance of diabetes (any type) to occlusive vascular mortality (ischaemic heart disease, ischaemic stroke, or other atherosclerotic deaths) by age, sex, and other major vascular risk factors, and to assess whether the associations of blood pressure, total cholesterol, and body-mass index (BMI) to occlusive vascular mortality are modified by diabetes. RESULTS Individual participant-level data were analysed from 980 793 adults. During 9·8 million person-years of follow-up, among participants aged between 35 and 89 years, 19 686 (25·6%) of 76 965 deaths were attributed to occlusive vascular disease. After controlling for major vascular risk factors, diabetes roughly doubled occlusive vascular mortality risk among men (death rate ratio [RR] 2·10, 95% CI 1·97-2·24) and tripled risk among women (3·00, 2·71-3·33; χ2 test for heterogeneity p<0·0001). For both sexes combined, the occlusive vascular death RRs were higher in younger individuals (aged 35-59 years: 2·60, 2·30-2·94) than in older individuals (aged 70-89 years: 2·01, 1·85-2·19; p=0·0001 for trend across age groups), and, across age groups, the death RRs were higher among women than among men. Therefore, women aged 35-59 years had the highest death RR across all age and sex groups (5·55, 4·15-7·44). However, since underlying confounder-adjusted occlusive vascular mortality rates at any age were higher in men than in women, the adjusted absolute excess occlusive vascular mortality associated with diabetes was similar for men and women. At ages 35-59 years, the excess absolute risk was 0·05% (95% CI 0·03-0·07) per year in women compared with 0·08% (0·05-0·10) per year in men; the corresponding excess at ages 70-89 years was 1·08% (0·84-1·32) per year in women and 0·91% (0·77-1·05) per year in men. Total cholesterol, blood pressure, and BMI each showed continuous log-linear associations with occlusive vascular mortality that were similar among individuals with and without diabetes across both sexes. INTERPRETATION Independent of other major vascular risk factors, diabetes substantially increased vascular risk in both men and women. Lifestyle changes to reduce smoking and obesity and use of cost-effective drugs that target major vascular risks (eg, statins and antihypertensive drugs) are important in both men and women with diabetes, but might not reduce the relative excess risk of occlusive vascular disease in women with diabetes, which remains unexplained. FUNDING UK Medical Research Council, British Heart Foundation, Cancer Research UK, European Union BIOMED programme, and National Institute on Aging (US National Institutes of Health).
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Naito Y, Kawahara A, Okabe Y, Ishida Y, Sadashima E, Murata K, Takase Y, Abe H, Yamaguchi T, Tanigawa M, Mihara Y, Kondo R, Kusano H, Nakayama M, Shimamatsu K, Yano H, Akiba J. SurePath ® LBC improves the diagnostic accuracy of intrahepatic and hilar cholangiocarcinoma. Cytopathology 2018; 29:349-354. [PMID: 29723910 DOI: 10.1111/cyt.12565] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2018] [Indexed: 01/22/2023]
Abstract
INTRODUCTION The current study aimed to compare cytology using SurePath® (SP)-LBC and biliary tissue histology (BTH) for the diagnosis of biliary disease. METHODS Between January 2014 and December 2016, 57 patients underwent endoscopic retrograde cholangiopancreatography for the diagnosis of biliary disease. Biliary cytological samples were processed using SP-LBC and subsequently BTH was performed. A final diagnosis was confirmed by surgery (23 malignant cases) and clinical follow-up (34 benign and malignant cases): 18 extrahepatic cholangiocarcinoma; 17 intrahepatic/hilar cholangiocarcinoma (intra/H-CC); eight other malignant disease; and 14 benign biliary disease. The diagnoses made using SP-LBC and BTH were classified into four categories: (1) benign; (2) indeterminate; (3) suspicious for malignancy/malignant; and (4) inadequate. In addition, diagnostic accuracy was compared between SP-LBC and BTH. RESULTS Although 23% (13/57) of BTH samples were classified as inadequate, all SP-LBC cases were classified as adequate. Among 43 malignant cases, 11 normal, four indeterminate and 28 suspicious for malignancy/malignant were found using SP-LBC (26%, 9% and 65%, respectively), in contrast to 10 inadequate, nine normal, 10 indeterminate and 14 suspicious for malignancy/malignant observed using BTH (23%, 21%, 23%, and 33%, respectively). The identification of malignant cells was strikingly different between SP-LBC and BTH. Furthermore, limited to intra/H-CC, accuracy was significantly higher using SP-LBC than using BTH (P < .001). CONCLUSIONS SP-LBC of the biliary tract is a useful and reliable method for diagnosing biliary malignant disease and has an advantage over BTH for detecting malignant cells and accurately diagnosing intra/H-CC.
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Affiliation(s)
- Y Naito
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.,Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - A Kawahara
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Y Okabe
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Y Ishida
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - E Sadashima
- Shin-Koga Hospital, Medical Corporation Tenjinkai, Kurume, Japan
| | - K Murata
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Y Takase
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - H Abe
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - T Yamaguchi
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - M Tanigawa
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Y Mihara
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - R Kondo
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - H Kusano
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - M Nakayama
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - K Shimamatsu
- Department of Pathology, Omuta City Hospital, Omuta, Japan
| | - H Yano
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - J Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
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Affiliation(s)
- K. Nagahara
- ENT Department, Kyoto National Hospital, Kyoto University, Kyoto, Japan
| | - Y. Miyake
- Department of Image Science and Technology, Chiba University, Kyoto, Japan
| | - Y. Naito
- ENT Department, Kyoto National Hospital, Kyoto University, Kyoto, Japan
| | - T. Yoza
- ENT Department, Kyoto National Hospital, Kyoto University, Kyoto, Japan
| | - H. Fukushima
- ENT Department, Municipal Hospitalof Shizuoka, and Kyoto University, Kyoto, Japan
| | - T. Aoyama
- Department of Molecular Biology, Kyoto University, Kyoto, Japan
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Kainuma A, Momiyama K, Kimura T, Akiyama K, Inoue K, Naito Y, Kinoshita M, Shimizu M, Kato H, Shime N, Fujita N, Sawa T. An outbreak of fluoroquinolone-resistant Pseudomonas aeruginosa ST357 harboring the exoU gene. J Infect Chemother 2018; 24:615-622. [PMID: 29628388 DOI: 10.1016/j.jiac.2018.03.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 01/27/2018] [Revised: 03/11/2018] [Accepted: 03/14/2018] [Indexed: 12/15/2022]
Abstract
Antimicrobial-resistant isolates of Pseudomonas aeruginosa collected from 2005 to 2014 in a university hospital in Kyoto, Japan, were retrospectively analyzed by multilocus sequence typing (MLST), exoenzyme genotype determination, integron characterization, and clinical associations. During the study, 1573 P. aeruginosa isolates were detected, and 41 of these were resistant to more than two classes of antimicrobial agents. Twenty-five (61.0%) isolates were collected from urine. All isolates were resistant to ciprofloxacin, 8 (19.5%) isolates showed resistance to imipenem/cilastatin, and 8 (19.5%) isolates showed resistance to meropenem. None of the isolates fulfilled the clinical criteria for multidrug-resistant P. aeruginosa. All isolates were negative in the metallo-β lactamase test. Thirty-six (87.8%) isolates were of the exoS-exoU+ genotype and 5 (12.2%) isolates were of the exoS+exoU- genotype. Among 36 exoS-exoU+ isolates, 33 (80.5%) were ST357, and 3 (7.3%) were ST235. Five isolates of exoS+exoU- were ST186, ST244, ST314, ST508, and ST512. Thirty-three isolates were positive for class 1 integrons and four different class 1 integrons were detected: aminoglycoside (2') adenyltransferase and chloramphenicol transporter (AadB+CmlA6), OXA-4 β-lactamase and aminoglycoside 3'-adenyltransferase (OXA4+AadA2), AadB alone, and aminoglycoside acetyltransferase alone (AacA31). Among the 41 patients from which the isolates originated, the most common underlying disease was cancer in 16 patients (39%), and 9 patients (22.0%) died during the hospitalization period. There was no statistical correlation between MLST, exoenzyme genotype, and patient mortality. The results indicated outbreaks of fluoroquinolone-resistant P. aeruginosa in immunocompromised patients mainly due to the propagation of potentially virulent ST357 isolates possessing the exoU+ genotype.
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Affiliation(s)
| | - Kyoko Momiyama
- School of Pharmacy, Kyoto Pharmaceutical University, Kyoto, Japan.
| | - Takeshi Kimura
- Division of Infection Control & Laboratory Medicine at University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Koichi Akiyama
- Department of Anesthesiology, School of Medicine, Japan.
| | - Keita Inoue
- Department of Anesthesiology, School of Medicine, Japan.
| | | | - Mao Kinoshita
- Department of Anesthesiology, School of Medicine, Japan.
| | - Masaru Shimizu
- Department of Anesthesiology, School of Medicine, Japan.
| | - Hideya Kato
- Department of Anesthesiology, School of Medicine, Japan.
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Institute of Biochemical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Naohisa Fujita
- Division of Infection Control & Laboratory Medicine at University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Teiji Sawa
- Department of Anesthesiology, School of Medicine, Japan.
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Kawahara A, Fukumitsu C, Azuma K, Taira T, Abe H, Takase Y, Murata K, Sadashima E, Hattori S, Naito Y, Akiba J. Cover Image. Cytopathology 2018. [DOI: 10.1111/cyt.12543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Yoshimasu T, Maebeya S, Suzuma T, Bessho T, Tanino H, Arimoto J, Sakurai T, Naito Y. Disappearance Curves for Tumor Markers after Resection of Intrathoracic Malignancies. Int J Biol Markers 2018; 14:99-105. [PMID: 10399629 DOI: 10.1177/172460089901400207] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Determination of the standard elimination kinetics of tumor markers will be helpful in the diagnosis of malignancies. We analyzed the disappearance curves for serum tumor marker levels after resection of intrathoracic malignancies. Serum levels of CEA, SLX, AFP, CA 19-9, SCC, TPA and CYFRA were measured several times after surgery in a total of 40 patients. To obtain precise biological half-lives, we applied non-linear least square analysis, taking into consideration the possibility of residual tumor cells. Disappearance curves were monophasic for CEA, SCC, TPA, CYFRA and SLX and biphasic for CA 19-9 and AFP. Temporary elevation of serum levels after surgery was observed for SCC, TPA and CYFRA. The average half-lives of CEA, SLX, SCC, TPA and CYFRA were 1.5 days, 2.7 days, 2.2 hours, 2.5 hours and 1.5 hours, respectively. The average half-life of CA 19-9 was 0.5 days in the first compartment and 4.3 days in the second compartment, while that of AFP was 1.0 days and 6.3 days, respectively. These values will be helpful in the interpretation of serum tumor marker levels after surgery.
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Affiliation(s)
- T Yoshimasu
- Department of Thoracic and Cardiovascular Surgery, Wakayama Medical College, Japan
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Ueta M, Hamuro J, Nishigaki H, Nakamura N, Shinomiya K, Mizushima K, Hitomi Y, Tamagawa-Mineoka R, Yokoi N, Naito Y, Tokunaga K, Katoh N, Sotozono C, Kinoshita S. Mucocutaneous inflammation in the Ikaros Family Zinc Finger 1-keratin 5-specific transgenic mice. Allergy 2018; 73:395-404. [PMID: 28914974 DOI: 10.1111/all.13308] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Our genomewide association study documented an association between cold medicine-related Stevens-Johnson syndrome/toxic epidermal necrolysis (CM-SJS/TEN) and Ikaros Family Zinc Finger 1 (IKZF1). Few studies examined biological and pathological functions of IKZF1 in mucosal immunity. We hypothesized that IKZF1 contributes to the mucocutaneous inflammation. METHODS Human skin and conjunctival tissues were obtained for immunohistological studies. Primary human conjunctival epithelial cells (PHCjECs) and adult human epidermal keratinocytes (HEKa) also used for gene expression analysis. We also generated K5-Ikzf1-EGFP transgenic mice (Ikzf1 Tg) by introducing the Ik1 isoform into cells expressing keratin 5, which is expressed in epithelial tissues such as the epidermis and conjunctiva, and then examined them histologically and investigated gene expression of the epidermis. Moreover, Ikzf1 Tg were induced allergic contact dermatitis. RESULTS We found that human epidermis and conjunctival epithelium expressed IKZF1, and in PHCjECs and HEKa, the expression of IKZF1 mRNA was upregulated by stimulation with polyI:C, a TLR3 ligand. In Ikzf1 Tg, we observed dermatitis and mucosal inflammation including the ocular surface. In contact dermatitis model, inflammatory infiltrates in the skin of Ikzf1 Tg were significantly increased compared with wild type. Microarray analysis showed that Lcn2, Adh7, Epgn, Ifi202b, Cdo1, Gpr37, Duoxa1, Tnfrsf4, and Enpp5 genes were significantly upregulated in the epidermis of Ikzf1 Tg compared with wild type. CONCLUSION Our findings support the hypothesis that Ikaros might participate in mucocutaneous inflammation.
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Affiliation(s)
- M. Ueta
- Department of Frontier Medical Science and Technology for Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - J. Hamuro
- Department of Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - H. Nishigaki
- Department of Frontier Medical Science and Technology for Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - N. Nakamura
- Department of Dermatology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - K. Shinomiya
- Department of Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - K. Mizushima
- Department of Molecular Gastroenterology and Hepatology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Y. Hitomi
- Department of Human Genetics; Graduate School of Medicine; University of Tokyo; Tokyo Japan
| | - R. Tamagawa-Mineoka
- Department of Dermatology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - N. Yokoi
- Department of Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Y. Naito
- Department of Molecular Gastroenterology and Hepatology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - K. Tokunaga
- Department of Human Genetics; Graduate School of Medicine; University of Tokyo; Tokyo Japan
| | - N. Katoh
- Department of Dermatology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - C. Sotozono
- Department of Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - S. Kinoshita
- Department of Frontier Medical Science and Technology for Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
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Kawahara A, Fukumitsu C, Azuma K, Taira T, Abe H, Takase Y, Murata K, Sadashima E, Hattori S, Naito Y, Akiba J. A Combined test using both cell sediment and supernatant cell-free DNA in pleural effusion shows increased sensitivity in detecting activating EGFR mutation in lung cancer patients. Cytopathology 2018; 29:150-155. [PMID: 29363841 DOI: 10.1111/cyt.12517] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2017] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The aim of this study was to examine whether a combined test using both cell sediment and supernatant cytology cell-free DNA (ccfDNA) is more useful in detecting EGFR mutation than using cell sediment DNA or supernatant ccfDNA alone in pleural effusion of lung cancer patients. METHODS A total of 74 lung adenocarcinoma patients with paired samples between primary tumour and corresponding metastatic tumour with both cell sediment and supernatant ccfDNA of pleural effusion cytology were enrolled in this study. Cell sediment and supernatant ccfDNA were analysed separately for EGFR mutations by polymerase chain reaction. RESULTS Out of 45 patients with mutant EGFR in primary tumours, EGFR mutations were detected in 23 cell sediments of corresponding metastases (sensitivity; 51.1%) and 20 supernatant ccfDNA corresponding metastases (sensitivity; 44.4%). By contrast, the combined test detected EGFR mutations in 27 corresponding metastases (sensitivity; 60.0%), and had a higher sensitivity than the cell sediment or the supernatant ccfDNA alone (P < .05). Out of 45 patients with mutant EGFR, 24, three and 18 were cytologically diagnosed as positive, atypical or negative, respectively. The detection rate in the combined test was highest (95.8%) in the positive group, and mutant EGFR was also detected in four of 18 samples (22.2%) in the negative group. CONCLUSIONS A combined test using both cell sediment DNA and supernatant ccfDNA samples increases the concordance rate of EGFR mutations between primary tumour and corresponding metastases. Our findings indicate that supernatant ccfDNA is useful even in cases where the cytological diagnosis is negative.
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Affiliation(s)
- A Kawahara
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - C Fukumitsu
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - K Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - T Taira
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - H Abe
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Y Takase
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - K Murata
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - E Sadashima
- Department of Clinical Laboratory, Tenjinkai Shin-Koga Hospital, Kurume, Japan
| | - S Hattori
- Department of Integrated Medicine, Biomedical Statistics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Naito
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - J Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
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Tani S, Watanabe H, Naito Y, Sakusabe T, Watanabe H, Nakaya J, Sasaki F, Numano T, Furuta T, Furuta T, Kimura M. High Speed Clinical Data Retrieval System with Event Time Sequence Feature. Methods Inf Med 2018; 47:560-8. [DOI: 10.3414/me9125] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Summary
Objectives:
This paper illustrates a high speed clinical data retrieving system, from 10 years of data of operating hospital information system for the purposes of research, evidence creation, patient safety, etc., even incorporating time sequence of causal relations.
Methods:
Total of 73,709,298 records of 10 years at Hamamatsu University Hospital (as of June 2008) are sent from HIS to retrieval system in HL7 v2.5 format. Hierarchical variable length database is used to install them.
Results:
A search for “listing patients who were prescribed Pravastatin (Mevalotin and generic drugs, any titer)” took 1.92 seconds. “Pravastatin (any) prescribed and recorded AST >150 within two weeks” took 112.22 seconds. Searching conditions can be set to be more complex, connected by Boolean operator and/or. This system called D*D is in operation at Hamamatsu University Hospital since August 2002. It is used for 48,518 times (monthly average of 703 searches). Neither searching, nor background export of data from HIS caused delay of routine operating CPOE.
Conclusions:
Search database outside of routine operating CPOE, with daily export of order data in HL7 v2.5 format, is proved to provide excellent search environment without causing trouble. Hierarchical representation gives high-speed search response, especially with time sequence of events.
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Kimura M, Nakayasu K, Ohshima Y, Fujita N, Nakashima N, Jozaki H, Numano T, Shimizu T, Shimomura M, Sasaki F, Fujiki T, Nakashima T, Toyoda K, Hoshi H, Sakusabe T, Naito Y, Kawaguchi K, Watanabe H, Tani S. SS-MIX: A Ministry Project to Promote Standardized Healthcare Information Exchange. Methods Inf Med 2018; 50:131-9. [PMID: 21206962 DOI: 10.3414/me10-01-0015] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Accepted: 08/29/2010] [Indexed: 11/09/2022]
Abstract
Summary
Objectives: To promote healthcare information exchange between providers and to allow hospital information systems (HIS) export information in standardized format (HL7 and DICOM) in an environment of widespread legacy systems, which only can export data in proprietary format.
Methods: Through the Shizuoka prefecture EMR project in 2004–2005, followed by the ministry’s SS-MIX project, many software products have been provided, which consist of 1) a standardized storage to receive HL7 v2.5 mes sages of patient demographics, prescription orders, laboratory results, and diagnostic disease in ICD-10, 2) a referral letter creation system, 3) a formatted document creation system, 4) a progress note/nursing record system, and 5) an archive/viewer to incorporate incoming healthcare data CD and allow users to view on HIS terminal. Meanwhile, other useful applications have been produced, such as adverse event reporting and clinical information retrieval. To achieve the above-mentioned objectives, these software products were created and propagated, because users can use these software products, provided that their HIS can export the above information to the standardized storage in HL7 v2.5 format.
Results: In 20 hospitals of Japan, the standardized storage has been installed and some applications have been used. As major HIS vendors are shipping HIS with HL7 export function since 2007, HIS of 594 hospitals in Japan became capable of exporting data in HL7 v2.5 format (as of March 2010).
Conclusions: In high CPOE installation rate (85% in 400+ bed hospitals), though most of them only capable of exporting data in proprietary format, prefecture and ministry projects were effective to promote healthcare information exchange between providers. The standardized storage became an infrastructure for many useful applications, and many hospitals started using them. Ministry designation of proposed healthcare standards was effective so as to allow vendors to conform their products, and users to install them.
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Affiliation(s)
- M Kimura
- Hamamatsu University, Hamamatsu, Japan
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Akiyama K, Naito Y, Kinoshita M, Ishii M, Nakajima Y, Itatani K, Miyazaki T, Yamagishi M, Yaku H, Sawa T. Flow Energy Loss Evaluation in a Systolic Anterior Motion Case After the Ross Procedure. J Cardiothorac Vasc Anesth 2017; 31:2118-2122. [DOI: 10.1053/j.jvca.2017.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Indexed: 11/11/2022]
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Nakase H, Motoya S, Matsumoto T, Watanabe K, Hisamatsu T, Yoshimura N, Ishida T, Kato S, Nakagawa T, Esaki M, Nagahori M, Matsui T, Naito Y, Kanai T, Suzuki Y, Nojima M, Watanabe M, Hibi T. Significance of measurement of serum trough level and anti-drug antibody of adalimumab as personalised pharmacokinetics in patients with Crohn's disease: a subanalysis of the DIAMOND trial. Aliment Pharmacol Ther 2017; 46:873-882. [PMID: 28884856 PMCID: PMC5656923 DOI: 10.1111/apt.14318] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 07/18/2017] [Accepted: 08/18/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Significance of monitoring adalimumab trough levels and anti-adalimumab antibodies (AAA) for disease outcome in Crohn's disease (CD) patients remained unclear. AIM To evaluate the association of adalimumab trough levels and AAA at week 26 with clinical remission at week 52, the effect of azathiopurine on AAA and factors influencing trough levels in CD patients in the DIAMOND trial. METHODS We performed this study using adalimumab trough levels, AAA at week 26 and 6-thioguanine nucleotide (TGN) in red blood cells at week 12. A multiple regression model and receiver operating analysis was performed to identify factors influencing adalimumab trough levels and AAA, and adalimumab thresholds for predicting disease activity. RESULTS There was a significant difference of adalimumab trough level at week 26 between patients with disease remission and without at week 52 (7.7 ± 3.3 μg/mL vs 5.4 ± 4.3 μg/mL: P <.001). Adalimumab trough level of 5.0 μg/mL yielded optimal sensitivity and specificity for remission prediction (80.2% and 55.6%, respectively). AAA development at week 26 significantly affected remission at week 52 (P = .021), which was strongly associated with adalimumab trough levels. Female gender and increasing body weight were independently associated with low adalimumab trough levels, and female gender was associated with AAA development. A cut-off 6TGN level of >222.5 p mol/8 ×108 RBCs yielded sensitivity (100%) and specificity (60.6%) for AAA negativity. CONCLUSION Adalimumab trough levels and AAA occurrence were significantly associated with clinical remission. Higher 6TGN affected AAA negativity. The combination therapy is beneficial in some relevant aspects for CD patients. (UMIN Registration No. 000005146).
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Osa A, Koyama S, Uenami T, Fujimoto K, Naito Y, Hirata H, Takimoto T, Nagatomo I, Takeda Y, Kida H, Mori M, Kijima T, Kumanogoh A. P2.07-009 Monitoring Nivolumab Binding as a Method to Clarify the Residual Therapeutic Effects in Previously Treated Lung Cancer Patients. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.11.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Matsubara N, Naito Y, Sasaki M, Yamamoto N, Takahashi S, Uemura H, Doi T. Phase I expansion cohort of TAS-115, a novel oral MET/VEGFR/FMS inhibitor, for castration-resistant prostate cancer patients (CRPC pts) with bone metastases. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kurokawa Y, Doi T, Sawaki A, Komatsu Y, Ozaka M, Takahashi T, Naito Y, Okubo S, Nishida T. Phase II study of TAS-116, an oral inhibitor of heat shock protein 90 (HSP90), in metastatic or unresectable gastrointestinal stromal tumor refractory to imatinib, sunitinib and regorafenib. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx387.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Aogi K, Yonemori K, Takahashi M, Masuda N, Naito Y, Shimizu S, Nakamura R, Yamamoto H, Hamada A, Michimae H, Tamura K, Sukigara T, Nagasaka R, Fujiwara Y. Efficacy and safety of olaparib combined with eribulin in patients with advanced or metastatic triple negative breast cancer (TNBC) previously treated with anthracyclines and taxanes: The final analysis of a Japanese phase I/II trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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