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Suhara T, Chaki S, Kimura H, Furusawa M, Matsumoto M, Ogura H, Negishi T, Saijo T, Higuchi M, Omura T, Watanabe R, Miyoshi S, Nakatani N, Yamamoto N, Liou SY, Takado Y, Maeda J, Okamoto Y, Okubo Y, Yamada M, Ito H, Walton NM, Yamawaki S. Strategies for Utilizing Neuroimaging Biomarkers in CNS Drug Discovery and Development: CINP/JSNP Working Group Report. Int J Neuropsychopharmacol 2016; 20:285-294. [PMID: 28031269 PMCID: PMC5604546 DOI: 10.1093/ijnp/pyw111] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 12/15/2016] [Indexed: 01/07/2023] Open
Abstract
Despite large unmet medical needs in the field for several decades, CNS drug discovery and development has been largely unsuccessful. Biomarkers, particularly those utilizing neuroimaging, have played important roles in aiding CNS drug development, including dosing determination of investigational new drugs (INDs). A recent working group was organized jointly by CINP and Japanese Society of Neuropsychopharmacology (JSNP) to discuss the utility of biomarkers as tools to overcome issues of CNS drug development.The consensus statement from the working group aimed at creating more nuanced criteria for employing biomarkers as tools to overcome issues surrounding CNS drug development. To accomplish this, a reverse engineering approach was adopted, in which criteria for the utilization of biomarkers were created in response to current challenges in the processes of drug discovery and development for CNS disorders. Based on this analysis, we propose a new paradigm containing 5 distinct tiers to further clarify the use of biomarkers and establish new strategies for decision-making in the context of CNS drug development. Specifically, we discuss more rational ways to incorporate biomarker data to determine optimal dosing for INDs with novel mechanisms and targets, and propose additional categorization criteria to further the use of biomarkers in patient stratification and clinical efficacy prediction. Finally, we propose validation and development of new neuroimaging biomarkers through public-private partnerships to further facilitate drug discovery and development for CNS disorders.
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Affiliation(s)
- Tetsuya Suhara
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Shigeyuki Chaki
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Haruhide Kimura
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Makoto Furusawa
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Mitsuyuki Matsumoto
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Hiroo Ogura
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Takaaki Negishi
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Takeaki Saijo
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Makoto Higuchi
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Tomohiro Omura
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Rira Watanabe
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Sosuke Miyoshi
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Noriaki Nakatani
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Noboru Yamamoto
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Shyh-Yuh Liou
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Yuhei Takado
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Jun Maeda
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Yasumasa Okamoto
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Yoshiaki Okubo
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Makiko Yamada
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Hiroshi Ito
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Noah M. Walton
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
| | - Shigeto Yamawaki
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Suhara, Higuchi, Takado, Maeda, and Yamada); Taisho Pharmaceutical Co., Ltd., Saitama, Japan (Drs Chaki and Omura); Takeda Pharmaceutical Co., Ltd., Kanagawa, Japan (Drs Kimura and Furusawa); Astellas Pharma Inc., Ibaraki, Japan (Drs Matsumoto and Miyoshi); Eisai Co., Ltd., Tokyo, Japan (Drs Ogura and Yamamoto); Mochida Pharmaceutical Co., Ltd., Tokyo, Japan (Dr Negishi); Mitsubishi Tanabe Pharma Co., Kanagawa, Japan (Dr Saijo); Daiichi Sankyo Co., Ltd., Tokyo, Japan (Dr Watanabe); Chugai Pharmaceutical Co., Ltd, Kanagawa, Japan (Dr Nakatani); Ono Pharmaceutical Co., Ltd., Osaka, Japan (Dr Liou); Hiroshima University, Hiroshima, Japan (Drs Okamoto and Yamawaki); Nippon Medical School, Tokyo, Japan (Dr Okubo); Fukushima Medical University, Fukushima, Japan (Dr Ito); Astellas Research Institute of America LLC, IL, USA (Dr Walton)
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