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Kozai H, Ogino H, Mitsuhashi A, Nguyen NT, Tsukazaki Y, Yabuki Y, Ozaki R, Yoneda H, Sato S, Hanibuchi M, Shinohara T, Nokihara H, Nishioka Y. Potential of fluoropyrimidine to be an immunologically optimal partner of immune checkpoint inhibitors through inducing immunogenic cell death for thoracic malignancies. Thorac Cancer 2024; 15:369-378. [PMID: 38146645 PMCID: PMC10864125 DOI: 10.1111/1759-7714.15200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) are a revolutionary paradigm in the treatment of thoracic malignancies and chemoimmunotherapy is a current standard care in this field. Chemotherapeutic agents are known to induce not only direct cytotoxic effects on tumor cells but also immune modulating effects, such as stimulating immunogenic cell death (ICD). Currently, either pemetrexed (PEM) or taxane plus platinum are combined with ICIs for patients with non-small cell lung cancer (NSCLC); however, it is still unknown whether these agents are immunologically optimal partners for ICIs. METHODS To determine the immunologically optimal chemotherapeutic agent, we first evaluated the ability of several chemotherapeutic agents, including platinum, PEM, taxane, and 5-fluorouracil (5-FU) to induce ICD using several thoracic tumor cell lines in vitro. ICD was evaluated by the cell surface expression of calreticulin (CRT) and adenosine-triphosphate (ATP) secretion. We further performed an antitumor vaccination assay in vivo. RESULTS 5-FU induced cell surface expression of CRT and ATP secretion most efficiently among the several chemotherapeutic agents. This effect was enhanced when it was combined with platinum. In the antitumor vaccination assay in vivo, we found that vaccination with dying-AB1-HA (a murine malignant mesothelioma cell line) cells treated with 5-FU, but neither PEM nor PTX, reduced the tumor growth of living-AB1-HA cells inoculated 1 week after vaccination by recruiting CD3+ CD8+ T cells into the tumor microenvironment. CONCLUSION Our findings indicate that fluoropyrimidine can be an immunologically optimal partner of ICIs through the induction of ICD for thoracic malignancies.
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Affiliation(s)
- Hiroyuki Kozai
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Hirokazu Ogino
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Atsushi Mitsuhashi
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Na Thi Nguyen
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Yuki Tsukazaki
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Yohei Yabuki
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Ryohiko Ozaki
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Hiroto Yoneda
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Seidai Sato
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Masaki Hanibuchi
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
- Department of Community Medicine for RespirologyHematology, and Metabolism, Graduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Tsutomu Shinohara
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
- Department of Community Medicine for RespirologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
| | - Hiroshi Nokihara
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
- Respiratory Medicine, Center Hospital of the National Center for Global Health and MedicineTokyoJapan
| | - Yasuhiko Nishioka
- Department of Respiratory Medicine and RheumatologyGraduate School of Biomedical Sciences, Tokushima UniversityTokushimaJapan
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Matuszyk J. MALAT1-miRNAs network regulate thymidylate synthase and affect 5FU-based chemotherapy. Mol Med 2022; 28:89. [PMID: 35922756 PMCID: PMC9351108 DOI: 10.1186/s10020-022-00516-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/22/2022] [Indexed: 12/12/2022] Open
Abstract
Background The active metabolite of 5-Fluorouracil (5FU), used in the treatment of several types of cancer, acts by inhibiting the thymidylate synthase encoded by the TYMS gene, which catalyzes the rate-limiting step in DNA replication. The major failure of 5FU-based cancer therapy is the development of drug resistance. High levels of TYMS-encoded protein in cancerous tissues are predictive of poor response to 5FU treatment. Expression of TYMS is regulated by various mechanisms, including involving non-coding RNAs, both miRNAs and long non-coding RNAs (lncRNAs). Aim To delineate the miRNAs and lncRNAs network regulating the level of TYMS-encoded protein. Main body Several miRNAs targeting TYMS mRNA have been identified in colon cancers, the levels of which can be regulated to varying degrees by lncRNAs. Due to their regulation by the MALAT1 lncRNA, these miRNAs can be divided into three groups: (1) miR-197-3p, miR-203a-3p, miR-375-3p which are downregulated by MALAT1 as confirmed experimentally and the levels of these miRNAs are actually reduced in colon and gastric cancers; (2) miR-140-3p, miR-330-3p that could potentially interact with MALAT1, but not yet supported by experimental results; (3) miR-192-5p, miR-215-5p whose seed sequences do not recognize complementary response elements within MALAT1. Considering the putative MALAT1-miRNAs interaction network, attention is drawn to the potential positive feedback loop causing increased expression of MALAT1 in colon cancer and hepatocellular carcinoma, where YAP1 acts as a transcriptional co-factor which, by binding to the TCF4 transcription factor/ β-catenin complex, may increase the activation of the MALAT1 gene whereas the MALAT1 lncRNA can inhibit miR-375-3p which in turn targets YAP1 mRNA. Conclusion The network of non-coding RNAs may reduce the sensitivity of cancer cells to 5FU treatment by upregulating the level of thymidylate synthase.
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Affiliation(s)
- Janusz Matuszyk
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 12 R. Weigla Street, 53-114, Wroclaw, Poland.
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Muroyama Y, Tamiya H, Tanaka G, Tanaka W, Huang AC, Oldridge DA, Matsusaka K, Takazawa Y, Jo T, Ushiku T, Nagase T. Alpha-Fetoprotein-Producing Lung Hepatoid Adenocarcinoma with Brain Metastasis Treated with S-1. Case Rep Oncol 2020; 13:1552-1559. [PMID: 33564297 PMCID: PMC7841735 DOI: 10.1159/000511763] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 11/19/2022] Open
Abstract
Lung hepatoid adenocarcinoma (HAC) is a rare primary lung carcinoma pathologically characterized by hepatocellular carcinoma-like tumor cells, the majority of which produce alpha-fetoprotein (AFP). The clinical prognosis of lung HAC is generally poor, and effective therapeutic regimens for inoperable or recurrent cases have not been established. Here, we report a case of AFP-producing lung HAC with brain metastasis with long-term disease control, treated with the 5-fluorouracil-derived regimen S-1. The patient was a 66-year-old male admitted to the hospital with alexia. Chest X-ray revealed a massive tumor in the left upper lobe, and a head CT scan revealed a metastasis in the left parietal lobe. The laboratory data showed a remarkably elevated AFP level (97,561 ng/mL). Pathological assessment of the resected brain tumor revealed HAC, which was compatible with the lung biopsies. Together with the absence of other metastatic lesions, a final diagnosis of primary lung HAC, stage IV T4N3M1b, was given. The patient first underwent non-small cell lung cancer chemotherapy regimens (carboplatin and paclitaxel as the first line, and pemetrexed as the second line), but had clinical progression. After third-line oral S-1 (tegafur/gimeracil/oteracil) administration, the serum AFP level significantly dropped and the patient achieved long-term disease control without relapse, surviving more than 19 months after disease presentation. The autopsy result was consistent with the diagnosis of primary lung HAC, and immunohistochemical staining was AFP+, glypican 3+, and spalt-like transcription factor 4+. Here, we report the case of a rare primary lung HAC with apparent disease control on S-1 therapy, together with a literature review.
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Affiliation(s)
- Yuki Muroyama
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of System Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hiroyuki Tamiya
- Department of Respiratory Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Goh Tanaka
- Department of Respiratory Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Wakae Tanaka
- Department of Respiratory Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Alexander C Huang
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Derek A Oldridge
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Keisuke Matsusaka
- Department of Molecular Oncology, School of Medicine, Chiba University, Chiba, Japan.,Department of Pathology, Chiba University Hospital, Chiba, Japan
| | | | - Taisuke Jo
- Department of Respiratory Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takahide Nagase
- Department of Respiratory Medicine, The University of Tokyo Hospital, Tokyo, Japan
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García-Fernández C, Fornaguera C, Borrós S. Nanomedicine in Non-Small Cell Lung Cancer: From Conventional Treatments to Immunotherapy. Cancers (Basel) 2020; 12:E1609. [PMID: 32570729 PMCID: PMC7352459 DOI: 10.3390/cancers12061609] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/15/2020] [Accepted: 06/15/2020] [Indexed: 02/06/2023] Open
Abstract
Non-small cell lung cancer (NSCLC) remains the most common cause of cancer-related mortality. The heterogeneous nature of this disease hinders its diagnosis and treatment, requiring continuous advances in research aiming to understand its intricate nature. Consequently, the retrospective analysis of conventional therapies has allowed the introduction of novel tools provided by nanotechnology, leading to considerable improvements in clinical outcomes. Furthermore, the development of novel immunotherapies based on the recently understood interaction of the immune system with the tumor highlights the real possibility of definitively treating NSCLC from its early stages. Novel engineering approaches in nanomedicine will enable to overcome the intrinsic limits of conventional and emerging therapies regarding off-site cytotoxicity, specificity, resistance mechanisms, and administration issues. The convergence point of these therapies with nanotechnology lays the foundation for achieving currently unmet needs.
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Affiliation(s)
| | - Cristina Fornaguera
- Grup d’Enginyeria de Materials (GEMAT), Institut Químic de Sarrià (IQS), Universitat Ramon Llull (URL), 08022 Barcelona, Spain; (C.G.-F.); (S.B.)
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Lai CL, Wei YF, Hsia TC, Chang GC, Wu JT, Chen JY, Chen YM. S-1 plus cisplatin as first-line treatment of patients with advanced non-small cell lung cancer in Taiwan. Asia Pac J Clin Oncol 2019; 16:e68-e73. [PMID: 31773897 DOI: 10.1111/ajco.13294] [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: 03/04/2019] [Accepted: 10/26/2019] [Indexed: 11/30/2022]
Abstract
AIM S-1 combined with cisplatin is known to be noninferior to taxanes plus platinum as the first-line treatment for patients with advanced nonsmall cell lung cancer (NSCLC) in the Japanese population. This study aimed to evaluate the efficacy and safety profiles of oral S-1 plus cisplatin (SP) in Taiwanese patients. METHODS Patients with previously untreated stage IIIB or IV NSCLC were prospectively recruited to receive 40-60 mg of S-1 twice daily on days 1-21 plus 60 mg/m2 of cisplatin on day 8 in a 5-week cycle for up to six cycles. RESULTS A total of 55 patients from five cancer centers in Taiwan were enrolled. Among the 46 evaluable patients, those administered with SP achieved disease control rate of 69.6% (partial response, 19.6%; stable disease, 50.0%), with median overall survival and progression-free survival (PFS) of 15.1 and 5.7 months, respectively. Moreover, a better survival trend was observed in epidermal growth factor receptor mutation-positive patients versus mutation-negative patients treated with SP (PFS, 8.6 vs 5.6 months). The most commonly observed treatment-related adverse events (AEs) were nausea (41.8%), followed by decreased appetite, anemia, and diarrhea. Grade of ≥3 AEs related to the study treatment occurred in 11 patients (20.0%). No febrile neutropenia or treatment-related death was found in this study. CONCLUSIONS This study demonstrated that SP is an effective and safe first-line regimen for Taiwanese patients with advanced NSCLC.
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Affiliation(s)
- Chun-Liang Lai
- Division of Pulmonology and Critical Care, Department of Internal Medicine, Buddhish Dalin Tzu Chi Hospital, Chiayi, Taiwan.,School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan.,Institute of Molecular Biology, Department of Life Science, National Chung Cheng University, Chiayi, Taiwan
| | - Yu-Fen Wei
- Division of Respiratory and Chest Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.,Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Te-Chun Hsia
- Department of Respiratory Therapy, China Medical University Hospital, Taichung, Taiwan
| | - Gee-Chen Chang
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan and Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jiun-Ting Wu
- Division of Respiratory and Chest Medicine, E-Da Cancer Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Jung-Yueh Chen
- Division of Respiratory and Chest Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Yuh-Min Chen
- Department of Chest Medicine, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan
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ABCC11 gene polymorphism as a potential predictive biomarker for an oral 5-fluorouracil derivative drug S-1 treatment in non-small cell lung cancer. Cancer Chemother Pharmacol 2019; 84:1229-1239. [DOI: 10.1007/s00280-019-03959-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 09/05/2019] [Indexed: 01/09/2023]
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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.
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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
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Sun X, Sun L, Zhang SL, Xiong ZC, Ma JT, Han CB. Meta-analysis Exploring the Effectiveness of S-1-Based Chemotherapy for Advanced Non-Small Cell Lung Cancer. TOHOKU J EXP MED 2017; 241:1-11. [PMID: 27980246 DOI: 10.1620/tjem.241.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Xin Sun
- Department of Oncology, Shengjing Hospital of China Medical University
| | - Li Sun
- Department of Oncology, Shengjing Hospital of China Medical University
| | - Shu-Ling Zhang
- Department of Oncology, Shengjing Hospital of China Medical University
| | - Zhi-Cheng Xiong
- Department of Oncology, Shengjing Hospital of China Medical University
| | - Jie-Tao Ma
- Department of Oncology, Shengjing Hospital of China Medical University
| | - Cheng-Bo Han
- Department of Oncology, Shengjing Hospital of China Medical University
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9
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Safety and efficacy of S-1 in combination with carboplatin in non-small cell lung cancer patients with interstitial lung disease: a pilot study. Cancer Chemother Pharmacol 2016; 77:1245-52. [DOI: 10.1007/s00280-016-3040-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 04/19/2016] [Indexed: 12/14/2022]
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Hamamoto Y, Takeoka S, Mouri A, Fukusumi M, Wakuda K, Ibe T, Honma C, Arimoto Y, Yamada K, Wagatsuma M, Tashiro A, Kamoshida S, Kamimura M. Orotate phosphoribosyltransferase is overexpressed in malignant pleural mesothelioma: Dramatically responds one case in high OPRT expression. Rare Dis 2016; 4:e1165909. [PMID: 27274438 PMCID: PMC4878580 DOI: 10.1080/21675511.2016.1165909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/16/2016] [Accepted: 03/07/2016] [Indexed: 12/29/2022] Open
Abstract
Objective: Malignant pleural mesothelioma (MPM) is a rare and aggressive, treatment-resistant cancer. Pemetrexed, an inhibitor of thymidylate synthase (TS), is used worldwide for MPM as a first-line chemotherapy regimen. However, there is little consensus for a second-line chemotherapy. S-1, a highly effective dihydropyrimidine dehydrogenase (DPD)-inhibitory fluoropyrimidine, mainly acts via a TS inhibitory mechanism similar to pemetrexed. Orotate phosphoribosyltransferase (OPRT) is a key enzyme related to the first step activation of 5-fluorouracil (5-FU) for inhibiting RNA synthesis. We investigated 5-FU related-metabolism proteins, especially focusing on OPRT expression, in MPM Methods and Patients: Fifteen MPM patients who were diagnosed between July 2004 and December 2013 were enrolled. We examined the protein levels of 5-FU metabolism-related enzymes (TS, DPD, OPRT, and thymidine phosphorylase [TP]) in 14 cases Results: High TS, DPD, OPRT, and TP expressions were seen in 28.6%, 71.4%, 85.7%, and 35.7% of patients, respectively. We found that OPRT expression was extremely high in MPM tissue. We experienced one remarkable case of highly effective S-1 combined therapy for pemetrexed refractory MPM. This case also showed high OPRT protein expression Conclusion: The present study suggests that OPRT expression is high in MPM tumors. Although pemetrexed is mainly used for MPM chemotherapy as a TS inhibitor, S-1 has potential as an anticancer drug not only as a TS inhibitor but also inhibiting RNA synthesis through the OPRT pathway. This is the first report investigating OPRT protein expressions in MPM.
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Affiliation(s)
- Yoichiro Hamamoto
- Respiratory Department, National Hospital Organization Disaster Medical Center, Tachikawa , Tokyo, Japan
| | - Shinjiro Takeoka
- Respiratory Department, National Hospital Organization Disaster Medical Center, Tachikawa , Tokyo, Japan
| | - Atsuto Mouri
- Respiratory Department, National Hospital Organization Disaster Medical Center, Tachikawa , Tokyo, Japan
| | - Munehisa Fukusumi
- Respiratory Department, National Hospital Organization Disaster Medical Center, Tachikawa , Tokyo, Japan
| | - Kazushige Wakuda
- Respiratory Department, National Hospital Organization Disaster Medical Center, Tachikawa , Tokyo, Japan
| | - Tatsuya Ibe
- Respiratory Department, National Hospital Organization Disaster Medical Center, Tachikawa , Tokyo, Japan
| | - Chie Honma
- Respiratory Department, National Hospital Organization Disaster Medical Center, Tachikawa , Tokyo, Japan
| | - Yoshihito Arimoto
- Respiratory Department, National Hospital Organization Disaster Medical Center, Tachikawa , Tokyo, Japan
| | - Kazuaki Yamada
- Department of Pathology, National Hospital Organization Disaster Medical Center, Tachikawa , Tokyo, Japan
| | - Miyuki Wagatsuma
- Department of Pathology, National Hospital Organization Disaster Medical Center, Tachikawa , Tokyo, Japan
| | - Akito Tashiro
- Department of Medical Biophysics, Laboratory of Pathology, Kobe University Graduate School of Health Sciences , Kobe, Hyogo, Japan
| | - Shingo Kamoshida
- Department of Medical Biophysics, Laboratory of Pathology, Kobe University Graduate School of Health Sciences , Kobe, Hyogo, Japan
| | - Mitsuhiro Kamimura
- Respiratory Department, National Hospital Organization Disaster Medical Center, Tachikawa , Tokyo, Japan
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Sakiyama T, Tsurutani J, Iwasa T, Kawakami H, Nonagase Y, Yoshida T, Tanaka K, Fujisaka Y, Kurata T, Komoike Y, Nishio K, Nakagawa K. A phase I dose-escalation study of eribulin and S-1 for metastatic breast cancer. Br J Cancer 2015; 112:819-24. [PMID: 25654665 PMCID: PMC4453950 DOI: 10.1038/bjc.2015.10] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 12/12/2014] [Accepted: 12/21/2014] [Indexed: 02/07/2023] Open
Abstract
Background: We evaluated the safety, maximum-tolerated dose (MTD), pharmacokinetics, recommended dose for phase II (P2RD), and preliminary anticancer activity of a combination eribulin and S-1 therapeutic in metastatic breast cancer patients pretreated with anthracycline and taxane. Method: Patients aged 20–74 years were recruited. In level 1, patients received S-1 (65 mg m−2) from day 1 to 14, and eribulin (1.1 mg m−2) on day 1 and 8 in a 21-day cycle. In level 2, eribulin was increased to 1.4 mg m−2. In level 3, S-1 was increased to 80 mg m−2. Results: Twelve patients were enrolled into three cohorts. Planned dose escalation was completed, with one case exhibiting dose-limiting toxicity (grade 3 hypokalaemia) at level 3, without reaching the MTD. The P2RD was determined to be level 2 (eribulin 1.4 mg m−2 and S-1 65 mg m−2). The most common grade 3 or 4 toxicity was neutropenia (83.3%), followed by febrile neutropenia (25.0%). Five of eleven patients (41.7%) with measurable disease had a partial response. Pharmacokinetics were characterised by dose-dependent elimination and nonlinear exposure. Conclusion: Dose level 3 was not tolerated owing to febrile neutropenia development. Thus, intermediate dose level 2 was recommended for further evaluation. Preliminary antitumour activity warrants further investigation in this setting.
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Affiliation(s)
- T Sakiyama
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - J Tsurutani
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - T Iwasa
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - H Kawakami
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - Y Nonagase
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - T Yoshida
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - K Tanaka
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - Y Fujisaka
- Clinical Research Center, Osaka Medical Collage Hospital, 2-7 Daigaku-cho, Takatsuki 569-8686, Japan
| | - T Kurata
- Department of Thoracic Oncology, Kansai Medical University Hirakata Hospital, 2-3-1 Shinmachi, Hirakata 573-1191, Japan
| | - Y Komoike
- Department of Surgery, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - K Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
| | - K Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-sayama 589-8511, Japan
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Phase II trial of carboplatin, S-1, and gefitinib as first-line triplet chemotherapy for advanced non-small cell lung cancer patients with activating epidermal growth factor receptor mutations. Med Oncol 2015; 32:40. [PMID: 25616723 DOI: 10.1007/s12032-014-0474-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 12/18/2014] [Indexed: 10/24/2022]
Abstract
Gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), is an effective treatment for advanced non-small cell lung cancer (NSCLC) in patients with activating EGFR mutations. However, there have been little evidence-based studies of gefitinib in combination with platinum-doublet therapy in these patients. We performed a phase II trial to determine the efficacy and safety of triplet chemotherapy with gefitinib, carboplatin, and S-1 as a first-line treatment. This was a multicentre, single-arm, phase II trial of carboplatin, S-1, and gefitinib in advanced NSCLC patients with activating EGFR mutations. Patients received four courses of these drugs in 3-4 week cycles. In each cycle, carboplatin (area under curve = 5) was administered on day 1, S-1 (80 mg/m(2)) on days 1-14, and gefitinib (250 mg) every day. Subsequently, the same regimen without carboplatin was administered until disease progression or unacceptable toxicity occurred. The 1-year progression-free survival (PFS) was the primary endpoint, while response rate (RR), PFS, overall survival (OS), and safety were secondary endpoints. Thirty-five patients were enrolled into this study. The 1-year PFS was 74.3% and the overall RR was 85.7%. The median PFS for all patients was 17.6 months (95% confidence interval 15.5-∞), but the median OS was not reached, because 28 patients were still alive after a median follow-up time of 21.4 months. Haematological adverse events (grade 3 or higher) included neutropaenia (17.1%), thrombocytopenia (14.3%), and anaemia (5.7%), while non-haematological adverse events (grade 3 or higher) included elevated aminotransferase (20.0%), diarrhoea (14.3%), and febrile neutropaenia (2.9%). No interstitial lung disease or treatment-related deaths occurred. Combination chemotherapy with carboplatin, S-1, and gefitinib is efficacious and well tolerated as a first-line treatment in advanced NSCLC patients with activating EGFR mutations.
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Yajima T, Onozato R, Shitara Y, Mogi A, Tanaka S, Kuwano H. Relapsed cervicomediastinal lymph node carcinoma with an unknown primary site treated with TS-1 alone: a case report. BMC Res Notes 2013; 6:558. [PMID: 24370171 PMCID: PMC3877879 DOI: 10.1186/1756-0500-6-558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 12/20/2013] [Indexed: 11/12/2022] Open
Abstract
Background Cervicomediastinal lymph node carcinoma with an unknown primary site is quite rare, and useful treatment of these diseases has not been established. We report here the case of a patient successfully treated with TS-1 alone after the relapse of cervicomediastinal lymph node carcinoma with an unknown primary site. Case presentation A 62-year-old man was referred to our hospital because of cervicomediastinal lymph node swelling and high serum levels of carbohydrate antigen 19-9 and carcinoembryonic antigen. Fluorodeoxyglucose-positron emission tomography/computed tomography revealed an accumulation of fluorodeoxyglucose in the left supraclavicular lymph nodes, mediastinal lymph nodes, and the pelvic cavity. Colonoscopy revealed rectal cancer, which was diagnosed by biopsy as a tubular adenocarcinoma. Because metastases from rectal cancer to the cervicomediastinal lymph nodes are rare, the patient underwent thoracoscopic mediastinal lymphadenectomy. A biopsy specimen from the paraaortic lymph nodes demonstrated papillary adenocarcinoma that was pathologically different from the rectal cancer; therefore, a diagnosis of mediastinal carcinoma with an unknown primary site was established. The patient underwent low anterior resection of the rectum for the rectal cancer, and no abdominal lymph node metastasis (pMP, N0/stage I) was found. Although radiotherapy was performed for the cervicomediastinal lymph nodes, the mediastinal carcinoma relapsed after 6 months. Because the patient desired oral chemotherapy on an outpatient basis, TS-1 was administered at a dosage of 80 mg/day for 2 weeks, followed by a 1-week rest. TS-1 treatment resulted in a decrease in the size of the cervicomediastinal lymph nodes, and the serum tumor marker levels decreased to normal after the fourth course. The patient continued TS-1 treatment without adverse events and is currently alive without recurrence or identification of the primary site at the 32nd month after TS-1 treatment. Conclusion This is the first reported case of relapsed cervicomediastinal lymph node carcinoma with an unknown primary site treated by TS-1 alone. TS-1 treatment for the carcinoma with an unknown primary site may be useful in patients who are not candidates for systemic platinum-based chemotherapy.
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Affiliation(s)
- Toshiki Yajima
- Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, 371-8511, Maebashi-shi, Gunma, Japan.
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14
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Igawa S, Yanagisawa N, Ishihara M, Kimura M, Maki S, Otani S, Sasaki J, Masuda N. Successful chemotherapy with Carboplatin and s-1 for thymic carcinoma: a case report. Case Rep Oncol 2013; 6:526-30. [PMID: 24348388 PMCID: PMC3843928 DOI: 10.1159/000356143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Thymic carcinoma is a rare but aggressive neoplasm. Although there is no clearly optimal first- or second-line chemotherapy regimen for thymic carcinoma, platinum-based chemotherapy has repeatedly been shown to be of benefit to patients with advanced thymic carcinoma. Some case reports have described S-1 as a novel agent with good activity against advanced thymic carcinoma. A 74-year-old female was diagnosed with thymic carcinoma complicated by pleural dissemination and pericardial effusion of carcinomatosa. She was treated with carboplatin on day 1 plus S-1 on days 1-14 in cycles repeated every 3 or 4 weeks. Four cycles of this regimen were administered, and a partial response was confirmed. There were no severe hematological or nonhematological toxicities, and no dose reduction was necessary. To our knowledge, this is the first report to demonstrate the efficacy of combination chemotherapy consisting of carboplatin and S-1 against thymic carcinoma.
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Affiliation(s)
- Satoshi Igawa
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Nobuyuki Yanagisawa
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Mikiko Ishihara
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Michiko Kimura
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Sachiyo Maki
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Sakiko Otani
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Jiichiro Sasaki
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Noriyuki Masuda
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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Kosaka T, Mogi A, Yamaki E, Miyazaki T, Kuwano H. Surgical resection of a solitary pulmonary metastasis from basaloid squamous cell carcinoma of the esophagus: a case report. Ann Thorac Cardiovasc Surg 2013; 20 Suppl:646-9. [PMID: 24088918 DOI: 10.5761/atcs.cr.13-00100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Basaloid squamous cell carcinoma (BSCC) of the esophagus is a relatively rare variant of esophageal malignancies. It is regarded as a disease with a poor prognosis because of the high frequency of distant metastases. We managed a case of resected solitary pulmonary metastasis of BSCC of the esophagus in a 78-year-old female. We performed curative thoracic esophagectomy with three-field lymph node dissection for her disease. After two years and nine months, a thoracoscopic partial resection of the left lung was performed for the solitary pulmonary metastasis. At present, one year after the surgery, the patient is doing well without any recurrence. There have been few reports of case of resected pulmonary metastases. In addition, no treatment strategy for pulmonary metastases from BSCC of the esophagus has been established because of the limited number of cases. Additional cases are required to determine the treatment method.
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Affiliation(s)
- Takayuki Kosaka
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, Japan
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A DPYD variant (Y186C) in individuals of african ancestry is associated with reduced DPD enzyme activity. Clin Pharmacol Ther 2013; 94:158-66. [PMID: 23588312 PMCID: PMC3821392 DOI: 10.1038/clpt.2013.69] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
5-fluorouracil (5-FU) is used to treat many aggressive cancers, such as those of the colon, breast, and head & neck. The responses to 5-FU, both toxicity and efficacy, vary between racial groups, potentially due to variability in enzyme activity of dihydropyrimidine dehydrogenase (DPD, encoded by DPYD). In the present study, the genetic associations between DPYD variations and circulating mononuclear cell DPD enzyme activity were evaluated in 94 African American and 81 European American volunteers. The DPYD-Y186C variant was unique to individuals of African ancestry, and DPD activity was 46% reduced in carriers compared to non-carriers (279±35 compared to 514±168 pmol 5-FU min−1 mg−1; P=0.00029). 26% of the African Americans with reduced DPD activity in this study carried Y186C. In the African American cohort, following exclusion of Y186C carriers, homozygous carriers of C29R showed 27% higher DPD activity compared to non-carriers (609±152 and 480±152 pmol 5-FU min−1 mg−1, respectively; P=0.013).
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Phase I and pharmacokinetic study of gefitinib and S-1 combination therapy for advanced adenocarcinoma of the lung. Cancer Chemother Pharmacol 2013; 71:859-65. [DOI: 10.1007/s00280-013-2077-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 01/01/2013] [Indexed: 11/26/2022]
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Yoshioka H, Okamoto I, Morita S, Ando M, Takeda K, Seto T, Yamamoto N, Saka H, Atagi S, Hirashima T, Kudoh S, Satouchi M, Ikeda N, Iwamoto Y, Sawa T, Nakanishi Y, Nakagawa K. Efficacy and safety analysis according to histology for S-1 in combination with carboplatin as first-line chemotherapy in patients with advanced non-small-cell lung cancer: updated results of the West Japan Oncology Group LETS study. Ann Oncol 2012; 24:1326-31. [PMID: 23277482 DOI: 10.1093/annonc/mds629] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND A phase III study (Lung Cancer Evaluation of TS-1) previously demonstrated noninferiority in terms of overall survival (OS) at interim analysis for carboplatin-S-1 compared with carboplatin-paclitaxel for first-line treatment of advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS A total of 564 patients were randomly assigned to receive either carboplatin on day 1 plus oral S-1 on days 1-14 or carboplatin-paclitaxel on day 1 every 21 days. Updated results and post hoc subgroup analysis according to tumor histology are presented. RESULTS The updated analysis revealed a median OS of 15.2 months in the carboplatin-S-1 arm and 13.1 months in the carboplatin-paclitaxel arm, with a hazard ratio (HR) of 0.956 [95% confidence interval (CI) 0.793-1.151], consistent with the previous primary analysis. Median OS was 14.0 months in the carboplatin-S-1 arm and 10.6 months in the carboplatin-paclitaxel arm (HR 0.713; 95% CI 0.476-1.068) for patients with squamous cell carcinoma (SCC), with corresponding values of 15.5 and 13.9 months (HR 1.060; 95% CI 0.859-1.308) for those with non-SCC. CONCLUSIONS These results establish the efficacy and safety of carboplatin-S-1 in patients with advanced NSCLC regardless of tumor histology.
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Affiliation(s)
- H Yoshioka
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Japan
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Kaneda H, Okamoto I, Sakai K, Tanizaki J, Takeda M, Nishio K, Nakagawa K. Marked response to both S-1 and pemetrexed in a patient with echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase-positive lung adenocarcinoma. Acta Oncol 2012; 51:942-4. [PMID: 22283471 DOI: 10.3109/0284186x.2011.653827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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A phase I study of S-1 with concurrent radiotherapy in elderly patients with locally advanced non-small cell lung cancer. Invest New Drugs 2012; 31:599-604. [PMID: 22623066 DOI: 10.1007/s10637-012-9833-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 05/08/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND A phase I study was performed to evaluate dose-limiting toxicity and the recommended dose for the oral fluoropyrimidine S-1 administered concurrently with thoracic radiotherapy (TRT) in elderly (≥ 70 years of age) patients with locally advanced non-small cell lung cancer. METHODS S-1 was administered on days 1 to 14 and 22 to 35 at oral doses of 65 or 80 mg m(-2) day(-1). TRT was administered in 2-Gy fractions five times weekly for a total dose of 60 Gy. Twelve previously untreated patients were treated with S-1 at 65 (n=6) or 80 (n=6) mg m(-2) day(-1). RESULTS All patients completed the planned 60 Gy of TRT. Dose-limiting toxicity included pneumonitis (n=2), infection (n=1), and stomatitis (n=1), each of grade 3, but each event was reversible. The recommended dose for S-1 was determined to be 80 mg m(-2) day(-1). No patient experienced toxicity of grade 4. The dose intensity of S-1 was well maintained and the combination of S-1 plus TRT was well tolerated overall. The overall response rate was 83.3 %, with a median survival time of 34.0 months. CONCLUSIONS Administration of S-1 at 80 mg m(-2) day(-1) on days 1 to 14 and 22 to 35 can be safely combined with concurrent TRT in elderly patients with locally advanced non-small cell lung cancer.
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Retrospective analysis of third-line and fourth-line chemotherapy for advanced non-small-cell lung cancer. Clin Lung Cancer 2011; 13:39-43. [PMID: 21890422 DOI: 10.1016/j.cllc.2011.06.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 06/01/2011] [Accepted: 06/08/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND The efficacy of third-line and further-line chemotherapy for advanced non-small-cell lung cancer (NSCLC) remains unknown. PATIENTS AND METHODS We evaluated the clinical outcome of third- and fourth-line chemotherapy for the treatment of advanced NSCLC in consecutive patients who received first-line chemotherapy at our institute between July 2002 and June 2006. From a hospital-based registry, the following data were extracted: (a) patient characteristics, (b) type of chemotherapeutic agents, and (c) objective response and survival data. RESULTS A total of 599 patients were included in this analysis. Overall, 69.3%, 38.4%, 17.7%, and 6.0% of the patients received second-, third-, fourth-, and fifth-line chemotherapy, respectively. Significant differences in age (P < .0001), performance status at the start of first-line chemotherapy (P < .0001), and histology (P = .0175) were observed between patients who received third-line chemotherapy and those who did not. Docetaxel, gefitinib, and S-1 were the most frequently used regimens for third- or fourth-line chemotherapy. Five percent of the patients had participated in phase I trials of investigational new drugs. The objective response rates and disease control rates of third- and fourth-line chemotherapy were 17.0% and 34.4% and 11.3% and 24.5%, respectively. The median survival times (95% confidence interval [CI]) from the start of first-, second-, third-, and fourth-line chemotherapy until death were 15.3 months (95% CI, 13.8-16.5 months), 12.8 months (95% CI, 10.7-14.5 months), 12.0 months (95% CI, 9.3-14.2 months), and 9.9 months (95% CI, 8.6-12.0 months), respectively. CONCLUSION As many as 38% of patients with advanced NSCLC who received first-line chemotherapy could receive third-line chemotherapy. This result emphasizes the need for randomized controlled trials of third-line treatment in patients with advanced NSCLC.
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An Open-Label, Multicenter, Three-Stage, Phase II Study of S-1 in Combination with Cisplatin as First-Line Therapy for Patients with Advanced Non-small Cell Lung Cancer. J Thorac Oncol 2011; 6:1400-6. [PMID: 21673602 DOI: 10.1097/jto.0b013e31820d7805] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Thymidylate synthase and dihydropyrimidine dehydrogenase expression levels are associated with response to S-1 plus carboplatin in advanced non-small cell lung cancer. Lung Cancer 2011; 73:103-9. [DOI: 10.1016/j.lungcan.2010.10.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 09/08/2010] [Accepted: 10/28/2010] [Indexed: 11/19/2022]
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Hirao A, Oiso N, Tsurutani J, Kimura M, Watatani M, Nakagawa K, Kawada A. Transient effectiveness of an oral 5-Fluorouracil derivative, s-1, for epirubicin, cyclophosphamide and Paclitaxel refractory skin metastases from possible occult breast cancer in a male. Case Rep Dermatol 2011; 3:42-8. [PMID: 21487460 PMCID: PMC3073752 DOI: 10.1159/000325069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Recent chemotherapies for skin metastases from breast cancer have shown to be effective for regression, disappearance, and favorable quality of life. We describe the case of a 76-year-old male showing transient effectiveness with an oral 5-fluorouracil derivative, S-1 (tegafur, 5-chloro-2,4-dihydroxypyridine and potassium oxonate), for epirubicin, cyclophosphamide and paclitaxel refractory skin metastases from possible occult breast cancer. The male patient was initially diagnosed as having lymph node metastases in the left axilla as possible occult breast cancer. The skin metastases developed after chemotherapy with a combination of epirubicin and cyclophosphamide, subsequent chemotherapy with paclitaxel, and radiotherapy. Chemotherapy with paclitaxel was resumed for skin metastases, but it was not effective. Alternative chemotherapy with the oral agent S-1 was administered. The skin metastases completely disappeared after the second course, but recurred at the end of the third course. This case suggests that S-1 may be a candidate for chemotherapy for skin metastases from occult breast cancer in males.
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Affiliation(s)
- Ayaka Hirao
- Department of Dermatology, Kinki University Faculty of Medicine, Osakasayama, Japan
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25
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Okamoto I, Yoshioka H, Morita S, Ando M, Takeda K, Seto T, Yamamoto N, Saka H, Asami K, Hirashima T, Kudoh S, Satouchi M, Ikeda N, Iwamoto Y, Sawa T, Miyazaki M, Tamura K, Kurata T, Fukuoka M, Nakagawa K. Phase III Trial Comparing Oral S-1 Plus Carboplatin With Paclitaxel Plus Carboplatin in Chemotherapy-Naïve Patients With Advanced Non–Small-Cell Lung Cancer: Results of a West Japan Oncology Group Study. J Clin Oncol 2010; 28:5240-6. [PMID: 21079147 DOI: 10.1200/jco.2010.31.0326] [Citation(s) in RCA: 136] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose The primary goal of this open-label, multicenter, randomized phase III trial was to determine whether treatment with carboplatin plus the oral fluoropyrimidine derivative S-1 was noninferior versus that with carboplatin plus paclitaxel with regard to overall survival (OS) in chemotherapy-naive patients with advanced non–small-cell lung cancer (NSCLC). Patients and Methods A total of 564 patients were randomly assigned to receive either carboplatin (area under the curve, 5) on day 1 plus oral S-1 (40 mg/m2 twice per day) on days 1 to 14 or carboplatin (area under the curve, 6) plus paclitaxel (200 mg/m2) on day 1 every 21 days. Results At the planned interim analysis, with a total of 268 death events available, the study passed the O'Brien-Fleming boundary of 0.0080 for a positive result and noninferiority of carboplatin and S-1 compared with carboplatin and paclitaxel was confirmed for OS (hazard ratio, 0.928; 99.2% CI, 0.671 to 1.283). Median OS was 15.2 months in the carboplatin and S-1 arm and 13.3 months in the carboplatin and paclitaxel arm, with 1-year survival rates of 57.3% and 55.5%, respectively. Rates of leukopenia or neutropenia of grade 3/4, febrile neutropenia, alopecia, and neuropathy were more frequent in the carboplatin and paclitaxel arm, whereas thrombocytopenia, nausea, vomiting, and diarrhea were more common in the carboplatin and S-1 arm. The carboplatin and S-1 arm had significantly more dose delays than the carboplatin and paclitaxel arm. Conclusion Oral S-1 with carboplatin was noninferior in terms of OS compared with carboplatin and paclitaxel in patients with advanced NSCLC, and is thus a valid treatment option.
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Affiliation(s)
- Isamu Okamoto
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Hiroshige Yoshioka
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Satoshi Morita
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Masahiko Ando
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Koji Takeda
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Takashi Seto
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Nobuyuki Yamamoto
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Hideo Saka
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Kazuhiro Asami
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Tomonori Hirashima
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Shinzoh Kudoh
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Miyako Satouchi
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Norihiko Ikeda
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Yasuo Iwamoto
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Toshiyuki Sawa
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Masaki Miyazaki
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Kenji Tamura
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Takayasu Kurata
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Masahiro Fukuoka
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
| | - Kazuhiko Nakagawa
- From the Kinki University Faculty of Medicine; Osaka City General Hospital; National Hospital Organization, Kinki-chuo Chest Medical Center; Osaka Prefectural Medical Center for Respiratory and Allergic Diseases; Osaka City University Medical School; Cancer Center, Izumi Municipal Hospital, Osaka; Kurashiki Central Hospital, Kurashiki; Yokohama City University Medical Center, Yokohama; Kyoto University School of Public Health, Kyoto; National Kyushu Cancer Center, Fukuoka; Shizuoka Cancer Center,
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Ramnath N, Govindan R. Progress in the treatment of metastatic non-small-cell lung cancer: slow but steady! Clin Lung Cancer 2009; 10:260-1. [PMID: 19632945 DOI: 10.3816/clc.2009.n.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Nithya Ramnath
- Division of Oncology, Department of Medicine, University of Michigan, Ann Arbor, MI, USA
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