1
|
Lu Y, Huang H, Yang H, Hu X, Liu M, Huang C, Feng X, Chen X, Jiang Z. Maintenance therapy improves the survival outcomes of patients with metastatic nasopharyngeal carcinoma responding to first-line chemotherapy: a multicentre, randomized controlled clinical study. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04341-2. [PMID: 36075994 DOI: 10.1007/s00432-022-04341-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To explore the safety and role of tegafur/gimeracil/oteracil (S1) maintenance therapy (MT) in metastatic nasopharyngeal carcinoma (NPC) patients after response to first-line chemotherapy and to assess outcome-associated biomarkers. METHODS This was a multicentre, open-label, randomized controlled study involving metastatic NPC patients recruited (from May 2015 to May 2019) at five hospitals in China. The participants were randomized to S1-MT (receiving S1 MT until disease progression or intolerance) or non-MT (followed up until disease progression) groups. The primary endpoint was the progression-free survival (PFS). The secondary endpoints were the overall survival (OS), the correlation between EBV-DNA, serum amyloid A (SAA) status, and outcomes after the first-line chemotherapy, and safety. RESULTS The median follow-up was 24.3 months; 88 and 95 participants were evaluable in the S1-MT and non-MT groups, respectively. Compared with non-MT, S1-MT prolonged PFS (16.9 vs. 9.3 months, P < 0.001) and OS (33.6 vs. 20.6 months, P < 0.001). Regardless of their EBV-DNA status after first-line chemotherapy, participants were able to benefit from S1 MT, but EBV-DNA-positive participants benefited more significantly (PFS: HR = 0.600, 95% CI = 0.373-0.965, P = 0.035; OS: HR = 0.393, 95% CI = 0.227-0.681, P = 0.001). MT only improved PFS and OS in patients with an SAA decline after first-line chemotherapy (PFS: HR = 0.570, 95% CI = 0.350-0.919, P = 0.021; OS: HR = 0.404, 95% CI = 0.230-0.709, P = 0.002). The median S1 treatment was 23 cycles. Grade 1-2 skin pigmentation, oral mucositis, and hand and foot syndrome were the main adverse reactions. CONCLUSION For metastatic NPC patients with first-line chemotherapy response, S1 MT can improve PFS and OS, with good tolerability. EBV-DNA and SAA can better help us identify patients who can benefit from MT after standard treatment. TRIAL REGISTRATION The study protocol was registered at the Chinese Clinical Trial Registry (ChiCTR-IOR-16007939).
Collapse
Affiliation(s)
- Ying Lu
- Department of Oncology, The Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, 545000, Guangxi, China
| | - Haixin Huang
- Department of Oncology, The Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, 545000, Guangxi, China.
| | - Hui Yang
- Department of Oncology, The Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, 545000, Guangxi, China
| | - Xiaohua Hu
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530000, China
| | - Meilian Liu
- Department of Oncology, Affiliated Hospital of Guilin Medical College, Guilin, 541000, China
| | - Changjie Huang
- Department of Oncology, The Third Affiliated Hospital of Guangxi Medical University, Nanning, 530000, China
| | - Xianbin Feng
- Department of Oncology, Liuzhou Hospital of Traditional Chinese Medicine, Liuzhou, 545000, China
| | - Xishan Chen
- Department of Oncology, The Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, 545000, Guangxi, China
| | - Zhou Jiang
- Department of Oncology, The Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, 545000, Guangxi, China
| |
Collapse
|
2
|
Chen J, Wang J, Zou Y. Long-term response with low-dose of apatinib combined with S-1 in pretreated patient with advanced squamous cell lung cancer: A case report. Medicine (Baltimore) 2021; 100:e24390. [PMID: 33663051 PMCID: PMC7909226 DOI: 10.1097/md.0000000000024390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/29/2020] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Squamous cell lung cancer is one of the major pathological types in patients with non-small cell lung cancer. Since treatment with angiogenic agents and target drugs in patients with advanced squamous cell lung cancer is not promising, there are limited strategies to improve the outcome in such patients. Herein, we report a pretreated patient with advanced squamous cell lung cancer, who received low-dose of apatinib combined with S-1 as salvage treatment, with good long-term response. PATIENT CONCERNS The patient complained of dry cough for one month without any relief by medication. Otherwise, she denied any other medical or family history. DIAGNOSIS According to the chest computed tomography, and pathologic findings from biopsy for lesion in lung, the patient was diagnosed with lung squamous cell lung cancer with enlargement of bilateral supraclavicular lymph nodes suggesting metastasis, staged as IIIb. INTERVENTIONS The patient received gemcitabine plus cisplatin as first line treatment, and gemcitabine as maintenance therapy. After progression, she received vinorelbine as second line treatment. After progression again, she received low-dose apatinib combined with S-1 as third line treatment. OUTCOMES With the follow-up period from October 21, 2014, to April 6, 2019, there were 15 months, 9 months, and 24 months of progression-free survival time for first line (including maintenance therapy), second line, and third line treatment, respectively. The only adverse event was neutropenia at grade 2 (CTC AE) occurring during the maintenance treatment. LESSONS This case indicated that low-dose apatinib combined with S-1 might be effective and safe in selected pretreated patients with advanced squamous cell lung cancer. It might be worthy to conduct further researches to investigate the efficacy and safety of the combination therapy in such patients.
Collapse
Affiliation(s)
| | - Junhui Wang
- Department of Radiation Oncology, Quzhou People′s Hospital, Quzhou, Zhejiang, China
| | - Yan Zou
- Department of Medical Oncology
| |
Collapse
|
3
|
Nie K, Guo X, You Y, Zhuang X, Zhang C, Ji Y. S-1 Maintenance Therapy in Extensive Stage Small-Cell Lung Cancer-A Randomized Clinical Study. Cancer Control 2021; 27:1073274820932004. [PMID: 32551853 PMCID: PMC7307401 DOI: 10.1177/1073274820932004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Small-cell lung cancer (SCLC) is a recalcitrant cancer for its dismal prognosis
although extensive research had been done. Four to 6 cycles platinum-based
chemotherapy is the mainstay treatment for the extensive-stage disease; but the
role of maintenance treatment is not fully understood. This is a phase 2,
open-label study. Patients with extensive-stage SCLC reaching an objective
response or stable disease (SD) after induction chemotherapy were randomly
assigned (1:1) with a minimization procedure. One group received oral S-1 and
the other group received placebo as maintenance treatment until disease
progression or unacceptable toxicities. The primary end point of this study was
progression-free survival (PFS), and the secondary end points were overall
survival (OS), response rates, and toxicities. This study was based on earlier
work, the preliminary results was reported on 2019 ASCO annual meeting. A total
of 89 patients were enrolled, of whom 45 received S-1 maintenance therapy and 44
received placebo. The median PFS and OS were 6.35 months and 10.82 months in the
S-1 group, as compared to 5.98 months and 10.09 months in the placebo group. The
PFS was 7.2 months and 5.3 months, and OS was 12.9 months and 10.9 months in
patients with an objective response compared to in patients with SD after
induction chemotherapy, respectively. S-1 maintenance therapy did not prolong
PFS or OS in patients with extensive-stage SCLC; tumor regression rate was the
prognostic factor of PFS or OS. Further research with novel agents in the
maintenance setting is warranted.
Collapse
Affiliation(s)
- Keke Nie
- Department of Oncology, Qingdao Central Hospital, Qingdao University, China
| | - Xiuhui Guo
- Pingdu People's Hospital, Qingdao, China
| | - Yunhong You
- Department of Oncology, Qingdao Central Hospital, Qingdao University, China
| | - Xingjun Zhuang
- Department of Oncology, PLA 971 Hospital, Qingdao City, China
| | - Chunling Zhang
- Department of Oncology, Qingdao Central Hospital, Qingdao University, China
| | - Youxin Ji
- Department of Oncology, Qingdao Central Hospital, Qingdao University, China
| |
Collapse
|
4
|
Guo Q, Chen M, Xu H, Lu T, Zhou H, Chen Y, Zong J, Xu Y, Chen B, Wang B, Zhu L, Pan J, Lin S. Oral Maintenance Chemotherapy Using S-1/Capecitabine in Metastatic Nasopharyngeal Carcinoma Patients After Systemic Chemotherapy: A Single-Institution Experience. Cancer Manag Res 2020; 12:1387-1396. [PMID: 32158270 PMCID: PMC7049279 DOI: 10.2147/cmar.s234271] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/25/2020] [Indexed: 12/22/2022] Open
Abstract
Background In this study, we retrospectively evaluated a series of metastatic nasopharyngeal carcinoma (mNPC) patients who received oral maintenance chemotherapy using S-1/capecitabine after systemic chemotherapy and local radiation therapy, and aimed to explore potential efficient treatment strategies for this subset of patients. Patients and Methods Thirty-seven patients with mNPC (19 newly diagnosed metastatic patients and 18 metastatic cases after definitive chemoradiotherapy) who received the treatment strategies mentioned above were analyzed. Results After a median follow-up time of 37 months, the 3-year progression-free survival and overall survival (OS) rates were 47.6% and 87.7%, respectively. The median time to progression was 27.6 months, while the median OS was not reached at time of last follow-up. The most common acute adverse events were hematological and gastrointestinal toxicity, and all were tolerable and curable. Conclusion Oral maintenance chemotherapy using S-1/capecitabine in mNPC patients after systemic chemotherapy could yield a superb outcome. Further multicenter prospective clinical trials are warranted.
Collapse
Affiliation(s)
- Qiaojuan Guo
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, People's Republic of China.,Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, People's Republic of China.,Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Mengwei Chen
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital & Fujian Cancer Hospital, Fuzhou, China
| | - Hanchuan Xu
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, People's Republic of China
| | - Tianzhu Lu
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, People's Republic of China
| | - Han Zhou
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, People's Republic of China
| | - Yanyan Chen
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, People's Republic of China
| | - Jingfeng Zong
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, People's Republic of China
| | - Yun Xu
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, People's Republic of China
| | - Bijuan Chen
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, People's Republic of China
| | - Bingyi Wang
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, People's Republic of China
| | - Lili Zhu
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, People's Republic of China
| | - Jianji Pan
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, People's Republic of China.,Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, People's Republic of China
| | - Shaojun Lin
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, People's Republic of China.,Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, People's Republic of China
| |
Collapse
|
5
|
Yokoi T, Minami S, Shiroyama T, Koba T, Torii Y, Sugimoto H, Niki M, Mori M, Morimura O, Hirashima T, Komuta K, Kijima T. A Phase II Study of Tailored-dose S-1 Plus Carboplatin Followed by Maintenance S-1 for Advanced Squamous Cell Lung Cancer: OSAKA-LCSG 1102. Intern Med 2019; 58:1405-1410. [PMID: 30713297 PMCID: PMC6548931 DOI: 10.2169/internalmedicine.1172-18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective A subset analysis of the LETS study suggested that S-1 plus carboplatin was more beneficial than paclitaxel plus carboplatin in terms of the overall survival (OS) in squamous cell lung cancer. However, the benefit of maintenance therapy for squamous cell non-small cell lung cancer (NSCLC) patients is still unknown. We herein report a phase II study to evaluate the efficacy and safety of a tailored dose of S-1 plus carboplatin followed by maintenance S-1 in chemotherapy-naive advanced squamous cell NSCLC. Methods Patients received carboplatin on day 1 plus S-1 on days 1 to 14 every 21 days. The dose of S-1 was determined by the body surface area and creatinine clearance. After four cycles of induction, non-progressive patients continued to receive S-1 until disease progression or unacceptable toxicity occurred. The primary endpoint was an objective response rate (RR) with a threshold value of 15%. The secondary endpoints were the progression-free survival (PFS) and OS from enrollment, the PFS in the maintenance phase, and safety. Results In the 33 patients analyzed, the rate of patients who met the primary endpoint was 30.3% (95% confidence interval: 15.6-48.7%), and the disease control rate was 75.8%. The median PFS and OS were 3.5 and 11.3 months, respectively. Ten patients received maintenance S-1, and the median PFS from the beginning of induction treatment was 5.3 months. Grade 3/4 toxicities with a frequency of more than 5% were all controllable. Conclusion Tailored-dose S-1 plus carboplatin followed by maintenance S-1 is an effective and feasible treatment for advanced squamous cell NSCLC.
Collapse
Affiliation(s)
- Takashi Yokoi
- Department of Thoracic Oncology, Kansai Medical University Hospital, Japan
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Japan
| | - Seigo Minami
- Department of Respiratory Medicine, Osaka Police Hospital, Japan
| | - Takayuki Shiroyama
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan
| | - Taro Koba
- Department of Respiratory Medicine, Osaka Police Hospital, Japan
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Japan
| | - Yoshitaro Torii
- Department of Thoracic Oncology, Kansai Medical University Hospital, Japan
| | - Hiroyuki Sugimoto
- Department of Thoracic Oncology, Kansai Medical University Hospital, Japan
| | - Maiko Niki
- Department of Thoracic Oncology, Kansai Medical University Hospital, Japan
| | - Masahide Mori
- Department of Thoracic Oncology, National Hospital Organization Toneyama National Hospital, Japan
| | - Osamu Morimura
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Japan
| | - Tomonori Hirashima
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan
| | - Kiyoshi Komuta
- Department of Respiratory Medicine, Osaka Police Hospital, Japan
| | - Takashi Kijima
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Japan
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Japan
| |
Collapse
|
6
|
Switch maintenance therapy with S-1 after induction therapy with carboplatin and nanoparticle albumin-bound paclitaxel in advanced lung squamous cell carcinoma. Invest New Drugs 2019; 37:531-537. [PMID: 30790149 DOI: 10.1007/s10637-019-00747-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 02/12/2019] [Indexed: 10/27/2022]
Abstract
Background Optimal maintenance therapy for lung squamous cell carcinoma (SCC) has not been established. The aim of this study was to evaluate the efficacy and safety of switch maintenance therapy with S-1, an oral fluoropyrimidine, after induction therapy with carboplatin and nanoparticle albumin-bound paclitaxel (nab-paclitaxel) in chemotherapy-naïve patients with advanced SCC. Methods Chemotherapy-naïve patients with advanced SCC received induction therapy with four cycles of carboplatin (at an area under the curve of 6, day 1 of a 28-day cycle) and nab-paclitaxel (100 mg/kg, days 1, 8, and 15). Patients who achieved disease control after induction therapy received maintenance therapy with S-1 (80 mg/m2, days 1-14 of a 21-day cycle) until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS) from the start of maintenance therapy. Results Seventy-two patients with SCC were enrolled to the study. After four cycles of induction therapy, 35 (48.6%) patients achieved disease control, and 31 (43.1%) of these patients received maintenance therapy. Median PFS from the start of maintenance therapy was 3.0 months (95% confidence interval: 2.1-3.8 months). The most common toxicities of grade 3 or higher during maintenance therapy were nausea (13.3%), neutropenia (10.0%), and diarrhea (6.7%). Conclusions Switch maintenance therapy with S-1 after induction therapy with carboplatin and nab-paclitaxel was associated with moderate efficacy and acceptable safety and may represent a feasible treatment option for patients with advanced SCC.
Collapse
|
7
|
A phase II trial of carboplatin plus S-1 for elderly patients with advanced non-small-cell lung cancer with wild-type epidermal growth factor receptor: The Okayama Lung Cancer Study Group Trial 1202. Lung Cancer 2017; 112:188-194. [DOI: 10.1016/j.lungcan.2017.08.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/30/2017] [Accepted: 08/09/2017] [Indexed: 02/01/2023]
|
8
|
Igawa S, Otani S, Nakahara Y, Ryuge S, Hiyoshi Y, Fukui T, Mitsufuji H, Kubota M, Katagiri M, Sato Y, Sasaki J, Masuda N. Phase I study of Nedaplatin, a platinum based antineoplastic drug, combined with nab-paclitaxel in patients with advanced squamous non-small cell lung cancer. Invest New Drugs 2017; 36:45-52. [PMID: 28466376 DOI: 10.1007/s10637-017-0472-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 04/25/2017] [Indexed: 10/19/2022]
Abstract
Background This study was designed to determine the recommended dose of a combination of nedaplatin (NED) and nab-paclitaxel (nab-PTX) in chemotherapy-naive patients with advanced squamous non-small-cell lung cancer (NSCLC). Methods Patients received escalating doses of NED on day 1 and nab-PTX on days 1, 8, and 15 every 4 weeks by an intravenous infusion for up to six cycles. Results A dose of 100 mg/m2 NED and 100 mg/m2 nab-PTX was determined to be the recommended dose for patients with advanced squamous NSCLC. The study had an overall response rate of 66.7% (95% confidence interval [CI]: 38.4-88.2) and disease control rate of 93.3% (95% CI: 68.1-99.8). The median progression-free survival time and survival time was 7.0 months (95% CI: 5.9-8.1) and 13.1 months (95% CI: 6.2-20.1), respectively. The most common adverse events were neutropenia (grade 3/4, 33%) and leukopenia (grade 3/4, 27%). Although peripheral neuropathy was observed in 5 patients (grade 1/2), non-hematological toxic effects were relatively mild. Febrile neutropenia, pneumonitis, and treatment-related death were not observed. Conclusions The combination of NED and nab-PTX was a tolerable and effective regimen and its recommended dose was 100 mg/m2 and 100 mg/m2, respectively, in chemotherapy-naive patients with advanced squamous NSCLC (UMIN000010963).
Collapse
Affiliation(s)
- Satoshi Igawa
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Sakiko Otani
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Yoshiro Nakahara
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Shinichiro Ryuge
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Yasuhiro Hiyoshi
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Tomoya Fukui
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Hisashi Mitsufuji
- Kitasato University School of Nursing, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0329, Japan
| | - Masaru Kubota
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Masato Katagiri
- School of Allied Health Sciences, Kitasato University, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Yuichi Sato
- School of Allied Health Sciences, Kitasato University, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Jiichiro Sasaki
- Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Noriyuki Masuda
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| |
Collapse
|