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Mitsuma A, Ito Y, Shimokata T, Tanaka C, Uehara K, Nakayama G, Terasaki H, Ando Y. Direct Observation of Retinal Microvessels in Cancer Patients After Systemic Administration of Bevacizumab and Oxaliplatin. Cancer Diagn Progn 2022; 2:330-335. [PMID: 35530649 PMCID: PMC9066537 DOI: 10.21873/cdp.10113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM Antiangiogenic chemotherapy is the backbone of the various anticancer therapies. To date no practical biomarker predicting their antitumor effects and toxicity has been reported. We aimed to determine the feasibility of direct retinal observation as a practical biomarker in antiangiogenic chemotherapy. PATIENTS AND METHODS By direct retinal observation using a nonmydriatic retinal camera, we measured retinal microvessel diameters in 10 patients with colorectal cancer before and after intravenous infusion of bevacizumab and oxaliplatin. All patients also received oral capecitabine during their therapy. RESULTS Retinal microvessel diameters were decreased from baseline temporarily by 14.5±6.5% after infusion of bevacizumab and oxaliplatin in five patients who responded to treatment and 8.8±6.2% in the other five patients (p=0.008). CONCLUSION Measurement of retinal microvessel diameters by direct observation appears to be feasible in patients receiving systemic chemotherapy. The decrease of retinal microvessel diameters might indicate improved tumor response to treatment with bevacizumab-containing systemic chemotherapy.
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Affiliation(s)
- Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Yasuki Ito
- Department of Ophthalmology, Nagoya University Hospital, Nagoya, Japan
- Department of Ophthalmology, Fujita Health University School of Medicine, Aichi, Japan
| | - Tomoya Shimokata
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Chie Tanaka
- Department of Gastroenterological Surgery, Nagoya University Hospital, Nagoya, Japan
| | - Kay Uehara
- Division of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Goro Nakayama
- Department of Gastroenterological Surgery, Nagoya University Hospital, Nagoya, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Hospital, Nagoya, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
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Morita S, Minami H, Mitsuma A, Toyoda M, Kiyota N, Ando Y. A phase I study of LCL161, a novel oral pan-inhibitor of apoptosis protein (IAP) antagonist, in Japanese patients with advanced solid tumors. Asia Pac J Clin Oncol 2022; 18:e427-e434. [PMID: 35098674 DOI: 10.1111/ajco.13744] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION LCL161 is a novel oral pan-inhibitor of apoptosis protein (IAP) antagonist. LCL161 enhances paclitaxel activity in cell lines and xenograft models. A phase I study of LCL161 combined with paclitaxel for the treatment of Japanese patients with advanced solid tumors was conducted. METHODS Each patient received oral LCL161 in a single weekly dose on days 1, 8, and 15 of a 21-day treatment cycle. In the second cycle, patients received a combination treatment with weekly paclitaxel (80 mg/m2 ) whenever possible. A Bayesian logistic regression model by escalation with the overdose control principle was used. RESULTS Nine patients were treated with LCL161 at a dose of 600 mg (five patients) or 1200 mg (four patients). Seven patients were treated with LCL161 plus paclitaxel, and two patients received only LCL161 monotherapy. Because this study was terminated early due to a change in the LCL161 development strategy, the maximum tolerated dose (MTD) was not determined. One patient treated with LCL161 monotherapy at a dose of 1200 mg experienced dose limitind toxicity (grade 3 maculopapular rash). Another patient died on day 86 of bacterial pneumonia, which was suspected to be related to the study treatment. The most common serious adverse events were infections and infestations (n = 3). CONCLUSION The present study suggests that the risk of infection may increase when LCL161 is combined with paclitaxel, but other conclusions about the MTD, pharmacokinetic profile, and preliminary activity of the combination of LCL161 plus paclitaxel were not drawn.
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Affiliation(s)
- Sachi Morita
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Internal Medicine, Kobe University Hospital & Graduate School of Medicine, Kobe, Japan
| | - Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Masanori Toyoda
- Division of Medical Oncology/Hematology, Department of Internal Medicine, Kobe University Hospital & Graduate School of Medicine, Kobe, Japan
| | - Naomi Kiyota
- Division of Medical Oncology/Hematology, Department of Internal Medicine, Kobe University Hospital & Graduate School of Medicine, Kobe, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
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Mitsuma A, Ando Y. [Chemotherapy for Older Patients with Cancer]. Gan To Kagaku Ryoho 2022; 49:13-18. [PMID: 35046353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Older patients with cancer are different physically, psycho-spirituality, and socio-economically, and when considering the indications for chemotherapy and other drug therapies for cancer, it is important to comprehensively assess their condition and risk using geriatric assessment(GA). Multidisciplinary team-based approach is essential to address impaired domains that are found by GA. The G8 screening is useful tool for screening the GA candidates. In recent years, there have been increasing opportunities that older patients with cancer who receive immunotherapy with immune checkpoint inhibitors. There is no consensus on the treatment and management of immune-related adverse events(irAEs)specific to older patients, and therefore it is important to adhere to an evidence-based approach.
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Affiliation(s)
- Ayako Mitsuma
- Dept. of Clinical Oncology and Chemotherapy, Nagoya University Hospital
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Tahara M, Takami H, Ito Y, Okamoto T, Sugitani I, Sugino K, Takahashi S, Takeyama H, Tsutsui H, Hara H, Mitsuma A, Yamashita H, Ohashi Y, Imai T. Planned drug holiday in a cohort study exploring the effect of lenvatinib on differentiated thyroid cancer. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.6070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6070 Background: Lenvatinib is now available for unresectable radioactive iodine (RAI)-refractory differentiated thyroid cancer (DTC). However, toxicities are considerable and require frequent dose interruption and modification. Recently, planned drug holidays, which are dose interruptions in accordance with the timing of severe or intolerable adverse events, have been proposed to avoid severe adverse events due to lenvatinib (Tahara M.ESMO Open 2018). Our retrospective study demonstrated that progression-free survival (PFS) and overall survival (OS) were significantly longer in patients who used planned drug holidays than those who did not (Matsuyama C et.al, 2020 Annual Meeting of the Japan Association of Endocrine Surgeons). Methods: In this prospective observational study, patients with curatively unresectable and progressive RAI-refractory DTC were treated with lenvatinib in a real-world clinical setting. Lenvatinib was administered orally at a dose of 24 mg daily. Dose modification for toxicities were permitted. Primary endpoint was OS, and secondary endpoints were time to treatment failure (TTF), time to failure of strategy (TFS), PFS with clinical progressive disease, response rate, quality of life, safety, and patient reports. This study was registered with UMIN Clinical Trials Registry (UMIN000022243). Results: 262 patients were accrued. Of 255 evaluable, 153 were female; median age was 70 (range 27.0-88.0); histology was papillary thyroid carcinoma/follicular thyroid carcinoma/poorly DTC in 204/45/4; previous therapy was surgery/RAI/molecular targeted drug in 246/164/14; reason for initiation of lenvatinib was disease progression/unsuitable for RAI in 241/4. 1-year OS was 85.6% (95%CI: 80.6-89.4%); 1-year TTF rate was 74.9% (95%CI: 69.1-79.8%); 1-year TFS rate was 80.8% (95%CI: 75.4-85.2%); and 1-year PFS rate was 84.4% (95%CI: 79.3-88.4%). Overall response by RECIST was 3 (1.2%) in CR and 151 (61.9%) in PR. Most common grade 3 or 4 toxicities were hypertension (61.4%), hand foot syndrome (10.2%), fatigue (9.1%), anorexia (8.3%) and diarrhea (4.7%). Grade 5 toxicities occurred in 4 patients (fistula, hypoxia, respiratory failure, trachea stenosis). Of 253 patients evaluable for efficacy, 73 used planned drug holidays. TTF, TFS and PFS were significantly longer in patients who used planned drug holiday than those who did not (Table). Conclusions: Planned drug holiday for lenvatinib demonstrated significantly better clinical outcomes, including TTF, TFS and PFS, than daily oral administration. These data further support use of a planned drug holiday in RAI-refractory DTC patients receiving lenvatinib. Clinical trial information: 000022243. [Table: see text]
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Affiliation(s)
- Makoto Tahara
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | - Takahiro Okamoto
- Department of Breast and Endocrine Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Iwao Sugitani
- Nippon Medical School Graduate School of Medicine, Tokyo, Japan
| | | | - Shunji Takahashi
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | | | - Hisato Hara
- Department of Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | | | | | - Yasuo Ohashi
- Department of Integrated Science and Engineering, Chuo University, Tokyo, Japan
| | - Tsuneo Imai
- National Hospital Organization, Higashinagoya National Hospital, Nagoya, Japan
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Minami H, Doi T, Toyoda M, Imamura Y, Kiyota N, Mitsuma A, Shimokata T, Naito Y, Matsubara N, Tajima T, Tokushige K, Ishihara K, Cameron S, Ando Y. Phase I study of the antiprogrammed cell death-1 Ab spartalizumab (PDR001) in Japanese patients with advanced malignancies. Cancer Sci 2021; 112:725-733. [PMID: 33031626 PMCID: PMC7893979 DOI: 10.1111/cas.14678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 01/01/2023] Open
Abstract
Spartalizumab is a humanized IgG4/κ mAb directed against human programmed cell death-1 (PD-1). In this phase I study, we investigated safety, pharmacokinetics, preliminary antitumor activity, and toxicity of spartalizumab in patients with advanced malignancies. Patients (n = 18) with a range of tumor types received spartalizumab i.v. at doses of 1, 3, and 10 mg/kg every 2 weeks until disease progression, unacceptable toxicity, or discontinuation at the discretion of the investigator or patient. Most patients (61%) had received five or more prior lines of therapy. No dose-limiting toxicities were reported and, hence, the maximum tolerated dose was 10 mg/kg or more. Pharmacokinetics in Japanese patients aligned with those reported in a global dose-escalation study. The safety profile was consistent with other approved anti-PD-1 mAbs; the most common drug-related adverse events were maculopapular rash (22%), followed by malaise and increased blood alkaline phosphatase (11% each). Partial responses were reported in two patients (11%), one with transitional cell carcinoma and the other with hepatocellular carcinoma. In conclusion, this study confirmed the safety of spartalizumab given at a dose of up to 10 mg/kg every 2 weeks in Japanese patients with cancers.
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Affiliation(s)
- Hironobu Minami
- Kobe University Graduate School of Medicine and HospitalKobeJapan
| | | | - Masanori Toyoda
- Kobe University Graduate School of Medicine and HospitalKobeJapan
| | | | - Naomi Kiyota
- Kobe University Graduate School of Medicine and HospitalKobeJapan
| | | | | | - Yoichi Naito
- National Cancer Center Hospital EastKashiwaJapan
| | | | | | | | | | - Scott Cameron
- Novartis Institutes for BioMedical ResearchCambridgeMAUSA
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Kobayashi K, Furukawa K, Ishikawa E, Mitsuma A, Funasaka K, Kakushima N, Furune S, Ito N, Wada H, Hirose T, Muroi K, Suzuki T, Suzuki T, Hida E, Hirai K, Shibata H, Koya T, Nakamura M, Kawashima H, Miyahara R, Fujishiro M. Collision Tumors of Gastric Adenocarcinoma and Mucosa-associated Lymphoid Tissue Lymphoma. Intern Med 2021; 60:2419-2424. [PMID: 34334591 PMCID: PMC8381179 DOI: 10.2169/internalmedicine.6124-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
A 65-year-old woman with a history of treatment for splenic marginal zone B-cell lymphoma and gastric mucosa-associated lymphoid tissue (MALT) lymphoma underwent esophagogastroduodenoscopy. A reddish elevated lesion was found in the fundus of the stomach. On image-enhanced endoscopy, several findings, such as glandular structures of varying sizes suggesting well-differentiated adenocarcinoma, pruned blood vessels, and dilated blood vessels in deeper mucosa suggesting MALT lymphoma, were observed. The final pathological diagnosis after surgical resection was collision tumors of well-differentiated adenocarcinoma and MALT lymphoma. The features of both tumors could be observed simultaneously with image-enhanced endoscopy.
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Affiliation(s)
| | - Kazuhiro Furukawa
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | - Eri Ishikawa
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | - Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Japan
| | - Kohei Funasaka
- Department of Gastroenterology, Fujita Health University School of Medicine, Japan
| | - Naomi Kakushima
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | - Satoshi Furune
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Japan
| | - Nobuhito Ito
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | - Hirotaka Wada
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | - Takashi Hirose
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | - Koichi Muroi
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | - Tomohiko Suzuki
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | - Takahiro Suzuki
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | - Emiko Hida
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | - Keiko Hirai
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | - Hiroyuki Shibata
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | - Toshinari Koya
- Department of Gastroenterology, Tokai Central Hospital, Japan
| | - Masanao Nakamura
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
| | | | - Ryoji Miyahara
- Department of Gastroenterology and Gastroenterological Oncology, Fujita Health University School of Medicine, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
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Maeda O, Ebata T, Shimokata T, Matsuoka A, Inada-Inoue M, Morita S, Takano Y, Urakawa H, Miyai Y, Sugishita M, Mitsuma A, Ando M, Mizuno T, Nagino M, Ando Y. Chemotherapy for biliary tract cancer: real-world experience in a single institute. Nagoya J Med Sci 2020; 82:725-733. [PMID: 33311803 PMCID: PMC7719462 DOI: 10.18999/nagjms.82.4.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/19/2020] [Indexed: 11/30/2022]
Abstract
The standard chemotherapy regimen for unresectable or recurrent biliary tract cancer is gemcitabine combined with cisplatin (GC). To evaluate the effectiveness and safety of chemotherapy in patients with unresectable or recurrent biliary tract cancer in the real world, we retrospectively analyzed the clinical courses of patients who underwent chemotherapy with GC from January 2015 to November 2019. Forty-eight patients underwent the GC regimen. One patient (2.1%) achieved a complete response, seven patients (14.6%) achieved a partial response, 26 patients (54.2) achieved stable disease, 11 patients (22.9%) achieved progressive disease, and 3 patients (6.3%) were not evaluable. The overall response rate was 16.7%. The median overall survival was 14.2 months (95% CI: 13.8-14.6), and the median progression-free survival was 7.7 months (95% CI: 4.2-11.2). Thirty-nine patients (81.3%) experienced grade 3 or higher severe adverse events as follows: 54.2% experienced neutropenia, 20.8% experienced anemia, 12.5% experienced thrombocytopenia and 20.8% experienced biliary tract infection. As a second-line chemotherapy, S-1 was used in seventeen patients, and stable disease was achieved in three patients (17.6%). The GC regimen for biliary tract cancer is effective and safe for unresectable or recurrent biliary tract cancer in routine clinical practice.
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Affiliation(s)
- Osamu Maeda
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Tomoki Ebata
- Department of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoya Shimokata
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Ayumu Matsuoka
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Megumi Inada-Inoue
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Sachi Morita
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Yuko Takano
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Hiroshi Urakawa
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Yuki Miyai
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Mihoko Sugishita
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Takashi Mizuno
- Department of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Nagino
- Department of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
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Urakawa H, Ando Y, Hase T, Kikumori T, Arai E, Maeda O, Mitsuma A, Sugishita M, Shimokata T, Ikuta K, Ishiguro N, Nishida Y. Clinical value of serum bone resorption markers for predicting clinical outcomes after use of bone modifying agents in metastatic bone tumors: A prospective cohort study. Int J Cancer 2019; 146:3504-3515. [PMID: 31846063 DOI: 10.1002/ijc.32836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/20/2019] [Accepted: 12/12/2019] [Indexed: 11/09/2022]
Abstract
Bone modifying agents (BMAs) have become a standard treatment to prevent skeletal-related events (SREs) in bone metastases (BMs). The aim of our study is to determine the clinical value of serum bone resorption markers for predicting clinical outcomes after using BMAs in patients with BM. Patients were enrolled between May 2013 and October 2017 at the Nagoya University Hospital, Japan. We prospectively observed changes in pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP) and tartrate-resistant acid phosphatase 5b (TRACP-5b) during treatment with BMAs. The relationship between serum markers before and after treatment and clinical outcomes such as progression of bone disease (BD), SREs and overall survival (OS) were evaluated. Pearson chi-square test and Kaplan-Meier product limit methods were used for analysis. Sixty-seven patients were analyzed. The primary tumor sites were 21 lung, 16 breast and 30 others. Forty and 27 patients were treated with Denosumab and Zoledronic acid, respectively. Progression of BDs, SREs and death were observed in 10, 16 and 31 cases, respectively. The median follow-up period after using BMAs was 12.3 (range 0.3-66.3) months. ICTP at 3-4 weeks was significantly correlated with increasing BD progression, SREs and death after treatment in both the whole and lung cancer cohorts. Base line ICTP and TRACP-5b were also associated with increasing BD progression in the whole cohort. Our study showed that early posttreatment ICTP is useful for predicting BD progression, SREs and OS after use of BMAs in patients with BM and even in patients with lung cancer BM.
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Affiliation(s)
- Hiroshi Urakawa
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Japan.,Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Tetsunari Hase
- Department of Respiratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Toyone Kikumori
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan
| | - Eisuke Arai
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Japan
| | - Osamu Maeda
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Mihoko Sugishita
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Tomoya Shimokata
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Kunihiro Ikuta
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Japan
| | - Naoki Ishiguro
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Japan
| | - Yoshihiro Nishida
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Japan.,Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
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Matsuoka A, Mitsuma A, Maeda O, Tsunoda N, Kikumori T, Ando Y. A longitudinal tracking and quantitative assessment of paclitaxel-induced peripheral neurotoxicity. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ota A, Morita S, Matsuoka A, Shimokata T, Maeda O, Mitsuma A, Yagi T, Asahara T, Ando Y. Detection of bacteria in blood circulation in patients receiving cancer chemotherapy. Int J Clin Oncol 2019; 25:210-215. [PMID: 31407169 DOI: 10.1007/s10147-019-01521-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/01/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Bacterial translocation, in which intestinal bacteria pass through the intestinal wall, enter the blood circulation, and spread to other sites of the body, is thought to cause bacteremia and sometimes febrile neutropenia (FN) in patients who receive cancer chemotherapy. MATERIALS AND METHODS We collected blood samples from 39 patients with various cancers at baseline and after chemotherapy began (during chemotherapy) and explored how frequently bacteria could be detected in the blood using a highly-sensitive, bacterial rRNA-targeted reverse transcription quantitative polymerase chain reaction (PCR) assay. RESULTS Bacterial traces, typically Escherichia coli and Enterobacter spp., were detected in 10 patients (25.6%) at baseline and 11 patients (28.2%) during chemotherapy. The bacterial traces were positive either at baseline or during chemotherapy in 3 (60%) of 5 patients who had FN, and 6 (46%) of 13 patients aged 65 years or older. CONCLUSION These findings support the notion that bacterial translocation occurs in patients with cancer regardless of whether they receive chemotherapy and can lead to the development of FN and other treatment-related infections.
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Affiliation(s)
- Akiko Ota
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Aichi, Japan.
| | - Sachi Morita
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Aichi, Japan
| | - Ayumu Matsuoka
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Aichi, Japan
| | - Tomoya Shimokata
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Aichi, Japan
| | - Osamu Maeda
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Aichi, Japan
| | - Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Aichi, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Takashi Asahara
- Yakult Central Institute, Yakult Honsha Co. Ltd., 5-11 Izumi, Kunitachi, Tokyo, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Aichi, Japan
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Tahara M, Takami H, Ito Y, Sugino K, Takahashi S, Takeyama H, Tsutsui H, Hara H, Mitsuma A, Yamashita H, Okamoto T, Sugitani I, Ohashi Y, Imai T. Cohort study exploring the effect of lenvatinib on differentiated thyroid cancer. Endocr J 2018; 65:1071-1074. [PMID: 30369531 DOI: 10.1507/endocrj.ej18-0261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Lenvatinib is a molecular-targeting agent that was recently approved in Japan for treatment of curatively unresectable, radioactive iodine-refractory, progressive differentiated thyroid cancer (DTC). Because only a few Japanese patients have received lenvatinib in clinical trials, there are limited domestic data on its safety and efficacy or prognostic factors. Therefore, a prospective observational study has been designed to collect safety and efficacy data in at least 300 patients with curatively unresectable DTC receiving lenvatinib therapy (24 mg/day), in order to find predictors of antitumor activity and survival. Patients with progressive curatively unresectable DTC refractory to radioiodine therapy will be enrolled and the primary endpoint will be overall survival. This study is designed to estimate the 95% confidence intervals of the 1-year and 2-year survival rates with a two-sided width of less than 10%. Secondary endpoints will be the time to treatment failure, time to strategy failure, progression-free survival time with clinical progressive disease, response rate, quality of life, safety, and patient reports. The ultimate goal is to obtain information for developing evidence-based guidelines for treatment of DTC, including recommendations on patient selection, dosages, and duration of treatment. This study has been registered with the UMIN Clinical Trials Registry (UMIN000022243).
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Affiliation(s)
- Makoto Tahara
- Department of Head and Neck Cancer Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Hiroshi Takami
- Department of Surgery, Ito Hospital, Shibuya-ku, Tokyo 150-8308, Japan
| | - Yasuhiro Ito
- Department of Clinical Trial, Department of Surgery, Kuma Hospital, Kobe, Hyogo 650-0011, Japan
| | - Kiminori Sugino
- Department of Surgery, Ito Hospital, Shibuya-ku, Tokyo 150-8308, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Hiroshi Takeyama
- Department of Breast and Endocrine Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo 105-8461, Japan
| | - Hidemitsu Tsutsui
- Department of Thoracic and Thyroid Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Hisato Hara
- Department of Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8576, Japan
| | - Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi 466-8560, Japan
| | - Hiroyuki Yamashita
- Department of Surgery, Yamashita Thyroid Hospital, Fukuoka 812-0034, Japan
| | - Takahiro Okamoto
- Department of Breast and Endocrine Surgery, Tokyo Women's Medical University Hospital, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Iwao Sugitani
- Department of Endocrine Surgery, Nippon Medical School Graduate School of Medicine, Bunkyo-ku, Tokyo 113-8603, Japan
| | - Yasuo Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Bunkyo-ku, Tokyo 112-8551, Japan
| | - Tsuneo Imai
- National Hospital Organization, Higashinagoya National Hospital, Nagoya, Aichi 465-8620, Japan
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12
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Ando Y, Doi T, Mitsuma A, Mizutani T, Toyoda M, Imamura Y, Kiyota N, Naito Y, Matsubara N, Ishihara K, Tajima T, Tokushige K, Cameron S, Minami H. Phase I study of spartalizumab (PDR001), an anti-PD1 mAb, in Japanese patients with advanced malignancies. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy374.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Matsuoka A, Maeda O, Mitsuma A, Uehara K, Nakayama G, Nagino M, Kodera Y, Ando Y. A longitudinal study of a new point-of-care nerve conduction device for quantitative assessment of chemotherapy-induced peripheral neurotoxicity. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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14
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Urakawa H, Nishida Y, Mitsuma A, Maeda O, Sugishita M, Shimokata T, Mizutani T, Arai E, Ikuta K, Hamada S, Ota T, Ishiguro N, Ando Y. Outpatient chemotherapy for patients with unresectable or metastatic bone sarcomas. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy374.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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15
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Nakayama G, Mitsuma A, Sunagawa Y, Ishigure K, Yokoyama H, Matsui T, Nakayama H, Nakata K, Ishiyama A, Asada T, Umeda S, Ezaka K, Hattori N, Takami H, Kobayashi D, Tanaka C, Kanda M, Yamada S, Koike M, Fujiwara M, Fujii T, Murotani K, Ando Y, Kodera Y. Randomized Phase II Trial of CapOX plus Bevacizumab and CapIRI plus Bevacizumab as First-Line Treatment for Japanese Patients with Metastatic Colorectal Cancer (CCOG-1201 Study). Oncologist 2018; 23:919-927. [PMID: 30049885 DOI: 10.1634/theoncologist.2017-0640] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 01/23/2018] [Indexed: 01/11/2023] Open
Abstract
PURPOSE The aim of this randomized, multicenter, noncomparative, phase II trial was to investigate the efficacy and safety of two potential first-line treatments, capecitabine and oxaliplatin (CapOX) plus bevacizumab (BEV) and capecitabine and irinotecan (CapIRI) plus bevacizumab, in Japanese patients with metastatic colorectal cancer (mCRC). PATIENTS AND METHODS Patients with untreated mCRC were randomly assigned to receive either CapOX plus bevacizumab (CapOX/BEV arm: bevacizumab 7.5 mg/kg and oxaliplatin 130 mg/m2 on day 1 and oral capecitabine 2,000 mg/m2 on days 1-14, every 3 weeks) or CapIRI plus bevacizumab (CapIRI/BEV arm: bevacizumab 7.5 mg/kg and irinotecan 200 mg/m2 on day 1 and capecitabine 1,600 mg/m2 on days 1-14, every 3 weeks). The primary endpoint was overall response rate (ORR), and the secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety. RESULTS A total of 107 patients were enrolled. The intent-to-treat population comprised 54 patients in the CapOX/BEV arm and 53 patients in the CapIRI/BEV arm. The median follow-up period was 35.5 months. ORR was 56% in the CapOX/BEV arm and 55% in the CapIRI/BEV arm. Median PFS and OS were 12.4 and 26.7 months in the CapOX/BEV arm and 11.5 and 28.7 months in the CapIRI/BEV arm, respectively. The frequencies of hematological and nonhematological adverse events above grade 3 were 13% and 30% in the CapOX/BEV arm and 25% and 23% in the CapIRI/BEV arm, respectively. CONCLUSION CapOX plus bevacizumab and CapIRI plus bevacizumab are equally effective and feasible as the first-line treatments in Japanese patients with mCRC. IMPLICATIONS FOR PRACTICE The CCOG-1201 study was designed to evaluate the efficacy and safety of capecitabine and oxaliplatin plus bevacizumab and capecitabine and irinotecan plus bevacizumab as a first-line treatment in Japanese patients with metastatic colorectal cancer. This article reports on the trial and efforts to define the role of these regimens, including the effect of KRAS status and UGT1A1 polymorphisms in metastatic colorectal cancer.
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Affiliation(s)
- Goro Nakayama
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Yuki Sunagawa
- Department of Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | | | | | - Takanori Matsui
- Department of Gastroenterological Surgery, Aichi Cancer Center, Aichi Hospital, Okazaki, Japan
| | | | | | | | | | - Shinichi Umeda
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuhiro Ezaka
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norifumi Hattori
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideki Takami
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Daisuke Kobayashi
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chie Tanaka
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mitsuro Kanda
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Suguru Yamada
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masahiko Koike
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michitaka Fujiwara
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tsutomu Fujii
- Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Kenta Murotani
- Division of Biostatistics, Clinical Research Center, Aichi Medical University Hospital, Nagakute, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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16
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Maeda O, Yokoyama Y, Yamaguchi J, Ota A, Matsuoka A, Morita S, Inoue M, Mizutani T, Shimokata T, Urakawa H, Mitsuma A, Nagino M, Ando Y. Real-world experience with FOLFIRINOX and gemcitabine plus nab-paclitaxel in the treatment of pancreatic cancer in Japan. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx660.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Yamamoto E, Niimi K, Fujikake K, Nishida T, Murata M, Mitsuma A, Ando Y, Kikkawa F. Erratum: High-dose chemotherapy with autologous peripheral blood stem cell transplantation for choriocarcinoma: A case report and literature review. Mol Clin Oncol 2017; 7:510. [PMID: 28781822 PMCID: PMC5530323 DOI: 10.3892/mco.2017.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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18
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Kanda K, Hirai K, Iino K, Nomura H, Yasui H, Kano T, Ichikawa C, Hiura S, Morita T, Mitsuma A, Komatsu H. Salient Features and Outline of the Joint Japanese Guidelines for Safe Handling of Cancer Chemotherapy Drugs. Asia Pac J Oncol Nurs 2017; 4:304-312. [PMID: 28966958 PMCID: PMC5559940 DOI: 10.4103/apjon.apjon_30_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The purpose of this paper is to introduce the outline and describe the salient features of the “Joint Guidelines for Safe Handling of Cancer Chemotherapy Drugs” (hereinafter, “Guideline”), which were published in July 2015. The purpose of this Guideline is to provide guidance to protect against occupational exposure to hazardous drugs (HDs) to all medical personnel involved in cancer chemotherapy, including physicians, pharmacists, and nurses and home health-care providers. The Guideline was developed according to the Medical Information Network Distribution Service guidance for developing clinical practice guidelines, with reference to five authoritative guidelines used worldwide. PubMed, Cumulative Index to Nursing and Allied Health Literature, Ichushi-Web, and Cochrane Central Register of Controlled Trials were used for a systematic search of the literature. Eight clinical questions (CQs) were eventually established, and the strength of recommendation for each CQ is presented based on 867 references. The salient features of the Guideline are that it was jointly developed by three societies (Japanese Society of Cancer Nursing, Japanese Society of Medical Oncology, and Japanese Society of Pharmaceutical Oncology), contains descriptions including the definition of HDs and the concept of hierarchy of controls, and addresses exposure control measures during handling of chemotherapy drugs. Our future task is to collect additional evidence for the recommended exposure control measures and to assess whether publication of the Guideline has led to adherence of measures to prevent occupational exposure.
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Affiliation(s)
- Kiyoko Kanda
- Department of Nursing, Graduate School of Health Sciences, Gunma University, Gunma, Japan
| | - Kazue Hirai
- School of Nursing, Faculty of Medicine, Tokyo Medical University, Tokyo, Japan
| | - Keiko Iino
- Department of Nursing, National College of Nursing, Tokyo, Japan
| | - Hisanaga Nomura
- Department of Pharmacy, National Cancer Center Hospital East, Chiba, Japan
| | - Hisateru Yasui
- Department of Medical Oncology, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Taro Kano
- Department of Nursing, Gunma Prefectural College of Health Sciences, Gunma, Japan
| | - Chisato Ichikawa
- Department of Nursing, National Cancer Center Hospital East, Chiba, Japan
| | - Sumiko Hiura
- Department of Pharmacy, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Tomoko Morita
- Department of Pharmacy, National Cancer Center Hospital East, Chiba, Japan
| | - Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroko Komatsu
- Department of Nursing, Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan
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19
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Morita S, Inaishi T, Ota A, Matsuoka A, Mizutani T, Shimokata T, Maeda O, Mitsuma A, Tsunoda N, Kikumori T, Ando Y. Feasibility study of dose dense epirubicin and cyclophosphamide in the primaly breast cancer treatment. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw521.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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20
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Yamamoto E, Niimi K, Fujikake K, Nishida T, Murata M, Mitsuma A, Ando Y, Kikkawa F. High-dose chemotherapy with autologous peripheral blood stem cell transplantation for choriocarcinoma: A case report and literature review. Mol Clin Oncol 2016; 5:660-664. [PMID: 27900108 DOI: 10.3892/mco.2016.1011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 05/30/2016] [Indexed: 11/06/2022] Open
Abstract
Choriocarcinoma is a malignant gestational trophoblastic neoplasia (GTN) and one of the curable types of gynecological cancer. However, 10% of choriocarcinoma patients have a poor prognosis, particularly when they have metastasis, apart from pulmonary metastasis, or do not go into remission by the second chemotherapeutic regimen. We herein present the case of a 36-year-old patient who had choriocarcinoma with metastases to the lungs, liver and kidneys. The 5th and 6th regimens with cisplatin for choriocarcinoma failed and the patient developed brain metastases. She was then treated with four cycles of high-dose ifosfamide, carboplatin and etoposide (ICE) with blood progenitor cell support after confirming the effectiveness of ICE at normal doses. The serum human chorionic gonadotropin (hCG) level was 140,009 mIU/ml at the start of high-dose ICE and the patient tolerated this regimen well. However, the beneficial effect was decreasing with each successive course of treatment, with the lowest level of hCG at 103 mIU/ml after the fourth course. The patient did not achieve complete remission and succumbed to the disease 4 months after the last chemotherapy. The findings of the present case and a review of the related literature suggest that high-dose ICE with stem cell rescue may be considered as a viable treatment option for a multi-drug resistant choriocarcinoma or GTN.
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Affiliation(s)
- Eiko Yamamoto
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan; Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Kaoru Niimi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Kayo Fujikake
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Tetsuya Nishida
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Makoto Murata
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi 466-8550, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi 466-8550, Japan
| | - Fumitaka Kikkawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
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21
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Matsuoka A, Mitsuma A, Maeda O, Kajiyama H, Kiyoi H, Kodera Y, Nagino M, Goto H, Ando Y. Quantitative assessment of chemotherapy-induced peripheral neurotoxicity using a point-of-care nerve conduction device. Cancer Sci 2016; 107:1453-1457. [PMID: 27412083 PMCID: PMC5084655 DOI: 10.1111/cas.13010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/14/2016] [Accepted: 07/11/2016] [Indexed: 11/29/2022] Open
Abstract
Chemotherapy-induced peripheral neurotoxicity (CIPN) seriously impairs patients' quality of life cumulatively and dose-dependently. Because assessment of CIPN usually depends on patients' subjective evaluation of symptoms, objective and quantitative measures are needed. We evaluated a point-of-care nerve conduction device (POCD), previously validated for the assessment of diabetic peripheral neuropathy. Sensory nerve action potential (SNAP) amplitude and sensory nerve conduction velocity (SNCV) of the sural nerve were measured using a portable, automated POCD (DPNCheck; NeuroMetrix Inc., Waltham, MA, USA) in patients with a clinical diagnosis of CIPN of grade 1 or higher. We compared SNAP and SNCV among patients with different grades of CIPN according to the Common Terminology Criteria for Adverse Events. A total of 50 patients (22 men, 28 women; median age, 64 years; grade 1/2/3, 21/18/11) were evaluated. Anticancer drugs responsible for CIPN were cisplatin in five patients, oxaliplatin in 15, carboplatin in 5, paclitaxel in 16, docetaxel in 14, nab-paclitaxel in 7, vincristine in 6, and bortezomib in 3. Unadjusted SNAP was 8.45 ± 3.67 μV (mean ± SD) in patients with grade 1 CIPN, 5.42 ± 2.68 μV with grade 2, and 2.45 ± 1.52 μV with grade 3. Unadjusted SNCV was 49.71 ± 4.77 m/s in patients with grade 1 CIPN, 48.78 ± 6.33 m/s with grade 2, and 44.14 ± 7.31 m/s with grade 3. The adjusted SNAP after controlling for age significantly differed between each CTCAE grade (P < 0.001, ancova). The adjusted SNCV after controlling for age and height also differed significantly (P = 0.027). Differences in the severity of CIPN could be detected objectively and quantitatively using this POCD.
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Affiliation(s)
- Ayumu Matsuoka
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan. .,Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Osamu Maeda
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Hiroaki Kajiyama
- Obstetrics and Gynecology/Reproductive Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hitoshi Kiyoi
- Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiro Kodera
- Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Nagino
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidemi Goto
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
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22
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Honda K, Takeshita K, Murotani K, Mitsuma A, Hayashi H, Tsunoda N, Kikumori T, Murohara T, Ando Y. Assessment of left ventricular diastolic function during trastuzumab treatment in patients with HER2-positive breast cancer. Breast Cancer 2016; 24:312-318. [DOI: 10.1007/s12282-016-0705-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 05/16/2016] [Indexed: 10/21/2022]
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23
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Shibata T, Ebata T, Fujita KI, Shimokata T, Maeda O, Mitsuma A, Sasaki Y, Nagino M, Ando Y. Optimal dose of gemcitabine for the treatment of biliary tract or pancreatic cancer in patients with liver dysfunction. Cancer Sci 2016; 107:168-72. [PMID: 26595259 PMCID: PMC4768397 DOI: 10.1111/cas.12851] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 11/09/2015] [Accepted: 11/15/2015] [Indexed: 11/26/2022] Open
Abstract
A clear consensus does not exist about whether the initial dose of gemcitabine, an essential anticancer antimetabolite, should be reduced in patients with liver dysfunction. Adult patients with biliary tract or pancreatic cancer were divided into three groups according to whether they had mild, moderate, or severe liver dysfunction, evaluated on the basis of serum bilirubin and liver transaminase levels at baseline. As anticancer treatment, gemcitabine at a dose of 800 or 1000 mg/m(2) was given as an i.v. infusion once weekly for 3 weeks of a 4-week cycle. The patients were prospectively evaluated for adverse events during the first cycle, and the pharmacokinetics of gemcitabine and its inactive metabolite, difluorodeoxyuridine, were studied to determine the optimal initial dose of gemcitabine as monotherapy according to the severity of liver dysfunction. A total of 15 patients were studied. Liver dysfunction was mild in one patient, moderate in six, and severe in eight. All 15 patients had been undergoing biliary drainage for obstructive jaundice when they received gemcitabine. Grade 3 cholangitis developed in one patient with moderate liver dysfunction who received gemcitabine at the dose level of 1000 mg/m(2). No other patients had severe treatment-related adverse events resulting in the omission or discontinuation of gemcitabine treatment. The plasma concentrations of gemcitabine and difluorodeoxyuridine were similar among the groups. An initial dose reduction of gemcitabine as monotherapy for the treatment of biliary tract or pancreatic cancers is not necessary for patients with hyperbilirubinemia, provided that obstructive jaundice is well managed. (Clinical trial registration no. UMIN000005363.)
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Affiliation(s)
- Takashi Shibata
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Tomoki Ebata
- Department of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ken-ichi Fujita
- Institute of Molecular Oncology, Showa University, Tokyo, Japan
| | - Tomoya Shimokata
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Osamu Maeda
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Yasutsuna Sasaki
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Masato Nagino
- Department of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
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24
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Morita S, Hiramatsu M, Sugishita M, Gyawali B, Shibata T, Shimokata T, Urakawa H, Mitsuma A, Moritani S, Kubota T, Ichihara S, Ando Y. Pazopanib monotherapy in a patient with a malignant granular cell tumor originating from the right orbit: A case report. Oncol Lett 2015; 10:972-974. [PMID: 26622607 DOI: 10.3892/ol.2015.3263] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 04/14/2015] [Indexed: 12/27/2022] Open
Abstract
Granular cell tumors are uncommon, usually benign tumors of Schwann cell origin. The malignant variant is extremely rare, representing <2% of all granular cell tumors. Therefore, standard systemic chemotherapy for this disease does not exist. The present study reports the case of a 40-year-old female with a malignant granular cell tumor that originally arose in the right orbit and subsequently relapsed. The patient was started on pazopanib monotherapy following treatment with two investigational drugs, a smoothened inhibitor and then a phosphatidylinositol 3-kinase inhibitor, as part of a clinical trial. Although additional radiotherapy for local control was necessary, the lung metastases remained stable during the pazopanib monotherapy, which lasted for 7 months, following which a clinically stable disease state was determined. This case suggests that pazopanib can be a treatment option for the stabilization of disease progression in metastatic malignant granular cell tumor.
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Affiliation(s)
- Sachi Morita
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi 466-8560, Japan
| | - Mariko Hiramatsu
- Department of Otorhinolaryngology, Nagoya Graduate School of Medicine, Nagoya, Aichi 466-0027, Japan
| | - Mihoko Sugishita
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi 466-8560, Japan
| | - Bishal Gyawali
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi 466-8560, Japan
| | - Takashi Shibata
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi 466-8560, Japan
| | - Tomoya Shimokata
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi 466-8560, Japan
| | - Hiroshi Urakawa
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi 466-8560, Japan
| | - Ayako Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi 466-8560, Japan
| | - Suzuko Moritani
- Department of Pathology, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi 460-0008, Japan
| | - Toshinobu Kubota
- Department of Ophthalmology, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi 460-0008, Japan
| | - Shu Ichihara
- Department of Pathology, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi 460-0008, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi 466-8560, Japan
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Matsuoka A, Mitsuma A, Maeda O, Uehara K, Kikumori T, Kajiyama H, Kiyoi H, Kodera Y, Ando Y. 375PD A validation study of a new point-of-care nerve conduction device for the quantitative assesment of chemotherapy-induced peripheral neurotoxicity. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv531.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mukai H, Masuda N, Ishiguro H, Mitsuma A, Shibata T, Yamamura J, Toi M, Watabe A, Sarashina A, Uttenreuther-Fischer M, Ando Y. Phase I trial of afatinib plus vinorelbine in Japanese patients with advanced solid tumors, including breast cancer. Cancer Chemother Pharmacol 2015; 76:739-50. [DOI: 10.1007/s00280-015-2826-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 07/09/2015] [Indexed: 01/26/2023]
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Tanaka S, Shimokata T, Tsukuura H, Maeda O, Mitsuma A, Ohno E, Kawashima H, Hirooka Y, Goto H, Ando Y. Interstitial Lung Disease Associated with Erlotinib/Gemcitabine Therapy in Patients with Pancreatic Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu436.136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sugishita M, Imai T, Kikumori T, Mitsuma A, Shimokata T, Shibata T, Morita S, Inada-Inoue M, Sawaki M, Hasegawa Y, Ando Y. Pharmacogenetic association between GSTP1 genetic polymorphism and febrile neutropenia in Japanese patients with early breast cancer. Breast Cancer 2014; 23:195-201. [DOI: 10.1007/s12282-014-0547-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 06/16/2014] [Indexed: 11/28/2022]
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Ando Y, Inada-Inoue M, Mitsuma A, Yoshino T, Ohtsu A, Suenaga N, Sato M, Kakizume T, Robson M, Quadt C, Doi T. Phase I dose-escalation study of buparlisib (BKM120), an oral pan-class I PI3K inhibitor, in Japanese patients with advanced solid tumors. Cancer Sci 2014; 105:347-53. [PMID: 24405565 PMCID: PMC4317947 DOI: 10.1111/cas.12350] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 12/19/2013] [Accepted: 12/28/2013] [Indexed: 12/27/2022] Open
Abstract
Buparlisib (BKM120) is an oral pan-phosphatidylinositol 3-kinase inhibitor, targeting all four isoforms of class I PI3K (α, β, γ and δ). This open-label Phase I dose-escalation study was conducted to determine the maximum tolerated dose of continuous daily buparlisib in Japanese patients with advanced solid tumors. Secondary objectives included safety and tolerability, pharmacokinetics, antitumor activity and pharmacodynamic marker changes. Fifteen patients were treated at 25 mg/day (n = 3), 50 mg/day (n = 3) and 100 mg/day (n = 9) dose levels. One dose-limiting toxicity of Grade 4 abnormal liver function occurred at 100 mg/day. Considering the safety profile and the maximum tolerated dose in the first-in-man study of buparlisib in non-Japanese patients, further dose escalation was stopped and 100 mg/day was declared the recommended dose. The most common treatment-related adverse events were rash, abnormal hepatic function (including increased transaminase levels), increased blood insulin levels and increased eosinophil count. Hyperglycemia was experienced by two patients, one Grade 1 and one Grade 4, and mood alterations were experienced by three patients, two Grade 1 and one Grade 2. Pharmacokinetic results showed that buparlisib was rapidly absorbed in a dose-proportional manner. Best overall response was stable disease for six patients, including one unconfirmed partial response. In these Japanese patients with advanced solid tumors, buparlisib had a manageable safety profile, with similar pharmacokinetics to non-Japanese patients. The recommended dose of 100 mg/day will be used in future studies of buparlisib in Japanese patients.
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Masuda N, Mukai H, Ishiguro H, Mitsuma A, Shibata T, Yamamura J, Toi M, Watabe A, Sarashina A, Ebisawa R, Uttenreuther-Fischer M, Ando Y. Abstract P4-16-11: Phase I trial of afatinib plus vinorelbine in Japanese patients with advanced solid tumors including breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-16-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Afatinib, a potent irreversible ErbB Family Blocker, inhibits signaling from HER1, HER2 and HER4 dimers, and transphosphorylation of HER3. A Phase I trial was conducted to assess if afatinib 40 mg/day in combination with vinorelbine (VNR) 25 mg/m2 i.v. weekly could be safely administered to Japanese patients (pts).
Patients and methods: The safety, tolerability and pharmacokinetics (PK) of daily oral afatinib plus weekly i.v. VNR in a 28-day cycle in Japanese pts was assessed using a 3+3 design. The primary endpoint was to determine the maximum tolerated dose (MTD), based on dose-limiting toxicities (DLTs) in Cycle 1 (see Table; dose Levels 1 and 2). When the MTD was exceeded, dose Levels 2a and 3 allowed modifications of VNR dosing as used in clinical practice. Eligible pts were ≥20 years old with histologically confirmed refractory advanced/metastatic solid tumours, and an ECOG performance status (PS) 0-1. Adverse events (AEs) were documented as per NCI CTCAE v3.0. Response was assessed using RECIST 1.1, and PK parameters for both drugs were analyzed by intra-individual comparison, based on frequent blood sampling.
Results: Seventeen pts were recruited. Median age was 60 (range 40-68) years, all pts had received previous chemotherapy, and 7/9 pts with BC had received HER2-targeted therapy. No DLTs were observed at dose Level 1. When 3/5 pts developed DLTs in Cycle 1 at an afatinib dose of 40 mg in Level 2 (see Table), an intermediate cohort 2a was introduced at 20 mg/m2 VNR i.v. weekly. Tolerability at Level 2a was confirmed. With afatinib dose modification permitted, and VNR dose skipping allowed for ANC <1500/mm3, dose re-escalation to VNR 25mg/m2 i.v. weekly at Level 3 was performed to establish a recommended phase II dose. At Level 3, 7/24 planned doses of VNR were skipped due to Grade 2 and 3 neutropenia, not qualifying as DLTs. One DLT occurred in a pt with Grade 2 epigastralgia in Course 1, who required afatinib dose reduction. Overall, the most frequent drug-related AEs were leukopenia, neutropenia (100% each), diarrhea (94%), anemia (70%), stomatitis (64%) and rash (41%). Nine BC pts were treated in cohorts 2a and 3, and all experienced diarrhea, leukopenia and neutropenia. No PK drug-drug interactions between afatinib and VNR were observed. Safety and PK profiles did not appear to differ between Japanese pts and Caucasian pts in a previous Phase I study. Two pts with BC and prior trastuzumab treatment had partial responses. Tumor shrinkage was observed in four of six evaluable BC pts, but not in other tumor types.
Conclusions: Afatinib 40 mg/day plus vinorelbine 25 mg/m2/week was tolerable and showed early signs of clinical activity in Japanese pts. AEs were as expected and were managed by dose modifications of both compounds. Final data will be presented at this congress.
Dose LevelsAfatinibVinorelbineN treatedDLTs (n)120 mg/day25 mg/m2/week3None240 mg/day25 mg/m2/week5Grade 4 neutropenia for 7 days (1); Grade 3 febrile neutropenia (1); Grade 3 pharyngeal infection with Grade 4 lipase and amylase elevations (1)2a40 mg/day20 mg/m2/week3 (all BC)None340 mg/day25 mg/m2/week6 (all BC)Grade 2 epigastralgia (1)
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-16-11.
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Affiliation(s)
- N Masuda
- Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kyoto University Hospital, Kyoto, Japan; Nagoya University Hospital, Nagoya, Japan; Sakai City Hospital, Osaka, Japan; Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan; Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
| | - H Mukai
- Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kyoto University Hospital, Kyoto, Japan; Nagoya University Hospital, Nagoya, Japan; Sakai City Hospital, Osaka, Japan; Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan; Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
| | - H Ishiguro
- Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kyoto University Hospital, Kyoto, Japan; Nagoya University Hospital, Nagoya, Japan; Sakai City Hospital, Osaka, Japan; Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan; Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
| | - A Mitsuma
- Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kyoto University Hospital, Kyoto, Japan; Nagoya University Hospital, Nagoya, Japan; Sakai City Hospital, Osaka, Japan; Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan; Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
| | - T Shibata
- Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kyoto University Hospital, Kyoto, Japan; Nagoya University Hospital, Nagoya, Japan; Sakai City Hospital, Osaka, Japan; Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan; Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
| | - J Yamamura
- Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kyoto University Hospital, Kyoto, Japan; Nagoya University Hospital, Nagoya, Japan; Sakai City Hospital, Osaka, Japan; Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan; Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
| | - M Toi
- Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kyoto University Hospital, Kyoto, Japan; Nagoya University Hospital, Nagoya, Japan; Sakai City Hospital, Osaka, Japan; Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan; Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
| | - A Watabe
- Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kyoto University Hospital, Kyoto, Japan; Nagoya University Hospital, Nagoya, Japan; Sakai City Hospital, Osaka, Japan; Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan; Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
| | - A Sarashina
- Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kyoto University Hospital, Kyoto, Japan; Nagoya University Hospital, Nagoya, Japan; Sakai City Hospital, Osaka, Japan; Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan; Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
| | - R Ebisawa
- Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kyoto University Hospital, Kyoto, Japan; Nagoya University Hospital, Nagoya, Japan; Sakai City Hospital, Osaka, Japan; Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan; Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
| | - M Uttenreuther-Fischer
- Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kyoto University Hospital, Kyoto, Japan; Nagoya University Hospital, Nagoya, Japan; Sakai City Hospital, Osaka, Japan; Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan; Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
| | - Y Ando
- Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kyoto University Hospital, Kyoto, Japan; Nagoya University Hospital, Nagoya, Japan; Sakai City Hospital, Osaka, Japan; Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan; Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
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Kogure Y, Yamada Y, Saka H, Kitagawa C, Iwasa S, Yamamoto N, Aoki T, Kakizume T, Robson M, Quadt C, Mitsuma A, Shibata T, Ando Y. Abstract B188: A Phase l study of BYL719, an α-isoform selective PI3K inhibitor, in Japanese patients with advanced solid malignancies. Mol Cancer Ther 2013. [DOI: 10.1158/1535-7163.targ-13-b188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: BYL719 is an oral inhibitor that selectively targets the α-isoform of class l PI3K, which is encoded by PIK3CA, a frequently altered gene in human cancers. In a first-in-man Phase I study in mostly Western patients (including one Asian patient) with advanced solid malignancies harboring a PIK3CA alteration (mutation and/or amplification), the maximum tolerated dose (MTD) for once-daily (QD) BYL719 was declared as 400 mg, and preliminary antitumor activity was observed (Gonzalez-Angulo et al. ASCO 2013). Here, we report preliminary findings of an ongoing multicenter, open-label Phase l dose-escalation study in Japanese patients with advanced solid malignancies irrespective of PIK3CA alterations (NCT01387321).
Methods: Patients were aged ≥18 years with histologically confirmed, advanced unresectable solid tumors, who had progressed despite standard therapy or for whom no standard therapy existed. Patients received continuous oral BYL719 QD in 28-day cycles until disease progression, unacceptable toxicity, or investigator/patient decision. Dose escalation was guided by an adaptive Bayesian logistic regression model with overdose control. The primary objective was to determine the MTD and/or recommended phase 2 dose (RP2D) of BYL719 QD. MTD was defined as the highest drug dosage not causing medically unacceptable does limiting toxicities (DLTs) in >33% of treated patients during Cycle 1. Secondary objectives included assessments of preliminary antitumor activity (RECIST v1.1), safety (CTCAE v4), and PK profiles.
Results: As of May 20, 2013, 24 patients (median age 56 years) were enrolled, receiving BYL719 QD at 90 mg (n=3), 180 mg (n=4), 270 mg (n=5), 350 mg (n=5), or 400 mg (n=7). DLTs occurred in 2 out of 4 evaluable patients at 400 mg QD (both had Grade [G] 3 maculopapular rash). Nineteen (79%) patients discontinued treatment [5 due to adverse event (AE); 11 disease progression; 2 patient/guardian decision; 1 death (due to disease progression)]. Median duration of exposure was 7.6 (range: 2.4-55.9) weeks. The most common suspected BYL719-related all-grade AEs (>25%) were maculopapular rash (50%), diarrhea (42%), hyperglycemia (38%), decreased appetite (29%), and pruritus (29%), and G3/4 AEs (≥10%) were maculopapular rash (29%) and hyperglycemia (13%). After May 20, 2013, one additional patient was enrolled at 350 mg QD, and no DLTs were observed out of 6 evaluable patients. Based on the Bayesian logistic regression model, 380 mg QD was the next recommended dose; however, considering the DLTs observed at 400 mg QD, 350 mg QD was declared as the RP2D. One patient with uterine clear cell carcinoma receiving 350 mg QD had an unconfirmed partial response. A dose-dependent increase of plasma exposure was observed and accumulation ratios were generally <1.5.
Conclusions: In this Phase l, first-in-Japanese patients study of BYL719, 350 mg QD was declared as the RP2D and preliminary antitumor activity was observed. An expansion cohort is open at the RP2D in patients whose tumors harbor PIK3CA alterations.
Citation Information: Mol Cancer Ther 2013;12(11 Suppl):B188.
Citation Format: Yoshihito Kogure, Yasuhide Yamada, Hideo Saka, Chiyoe Kitagawa, Satoru Iwasa, Noboru Yamamoto, Takuji Aoki, Tomoyuki Kakizume, Matthew Robson, Cornelia Quadt, Ayako Mitsuma, Takashi Shibata, Yuichi Ando. A Phase l study of BYL719, an α-isoform selective PI3K inhibitor, in Japanese patients with advanced solid malignancies. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr B188.
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Yoshioka Y, Uehara K, Ebata T, Yokoyama Y, Mitsuma A, Ando Y, Nagino M. Postoperative complications following neoadjuvant bevacizumab treatment for advanced colorectal cancer. Surg Today 2013; 44:1300-6. [PMID: 23942819 DOI: 10.1007/s00595-013-0686-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 07/16/2013] [Indexed: 12/22/2022]
Abstract
PURPOSES Attempts have been made to use bevacizumab (BEV) in an adjuvant or neoadjuvant setting. However, BEV is known to cause various adverse events, and the safety of neoadjuvant BEV has not yet been fully evaluated. This study assessed the postoperative complications in patients receiving neoadjuvant BEV for colorectal cancer. METHODS The data for 78 patients with resectable advanced or metastatic colorectal cancer who received neoadjuvant BEV followed by surgical resection were retrospectively analyzed. RESULTS The median interval between the last BEV dose and surgery was 9 weeks. The most common postoperative complication was pelvic sepsis, which occurred in 11 patients (14 %). A biliary fistula developed in four of 23 patients who underwent liver resection. Anastomotic leakage occurred in six of 24 patients with a colorectal anastomosis, four of whom required re-laparotomy. In a univariate analysis, male gender and a greater intraoperative blood loss were associated with postoperative complications of any grade. Colorectal anastomosis was a risk factor for major complications. In a multivariate analysis, intraoperative blood loss was an independent risk factor for postoperative complications of any grade (HR 6.338; P = 0.003). With regard to major postoperative complications, colorectal primary anastomosis was the only independent predictive risk factor (HR 8.285; P = 0.013). CONCLUSIONS In patients with colorectal cancer who underwent elective surgery after BEV treatment, the interval between BEV and surgery was not a risk factor for postoperative complications (based on a median interval of 9 weeks). Colorectal primary anastomosis was the only independent risk factor for major postoperative complications.
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Affiliation(s)
- Yuichiro Yoshioka
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Fujiwara Y, Ando Y, Mukohara T, Kiyota N, Chayahara N, Mitsuma A, Inada-Inoue M, Sawaki M, Ilaria R, Kellie Turner P, Funai J, Maeda K, Minami H. A phase I study of tasisulam sodium using an albumin-tailored dose in Japanese patients with advanced solid tumors. Cancer Chemother Pharmacol 2013; 71:991-8. [DOI: 10.1007/s00280-013-2092-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 01/12/2013] [Indexed: 11/24/2022]
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Morita S, Uehara K, Nakayama G, Shibata T, Oguri T, Inada-Inoue M, Shimokata T, Sugishita M, Mitsuma A, Ando Y. Association between bevacizumab-related hypertension and vascular endothelial growth factor (VEGF) gene polymorphisms in Japanese patients with metastatic colorectal cancer. Cancer Chemother Pharmacol 2012; 71:405-11. [DOI: 10.1007/s00280-012-2028-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 11/05/2012] [Indexed: 10/27/2022]
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Morita S, Inada M, Shibata T, Oguri T, Shimokata T, Sugishita M, Mitsuma A, Uehara K, Nakayama G, Ando Y. Association between Bevacizumab-Related Hypertension and VEGF Gene Polymorphisms in Japanese Colorectal Cancer Patients. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32378-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Morita S, Inada M, Shibata T, Oguri T, Shimokata T, Sugishita M, Mitsuma A, Uehara K, Nakayama G, Ando Y. Association between Bevacizumab-Related Hypertension and VEGF Gene Polymorphisms in Japanese Colorectal Cancer Patients. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32379-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Ando Y, Kawada K, Inada M, Morita S, Mitsuma A, Yasuda Y, Hiramatsu M, Fujimoto Y, Fujita KI. Pharmacokinetic study of S-1 in patients in whom inulin clearance was measured. Oncology 2012; 83:38-44. [PMID: 22722580 DOI: 10.1159/000337232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 02/07/2012] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This pharmacokinetic study of S-1 was conducted in patients in whom glomerular filtration rate (GFR) was directly measured to explore the possibility of adjusting the S-1 dose on the basis of GFR in patients with normal or nearly normal renal function. METHODS S-1 was given to 12 patients twice daily for 28 consecutive days followed by 14 days of rest, repeated every 6 weeks. GFR was measured on the basis of inulin clearance (CLin) before the first day of treatment. RESULTS The area under the time-concentration curve (AUC) of 5-fluorouracil (5-FU) correlated with that of 5-chloro-2,4-dihydroxypyridine (CDHP, r = 0.750, p = 0.005). The AUC of CDHP correlated with the measured 24-hour creatinine clearance (CLcr) per subject (r = -0.620, p = 0.032), but not with the CLin (r = -0.356, p = 0.257). The AUC of 5-FU did not correlate with either the 24-hour CLcr per subject (r = -0.401, p = 0.187) or with the CLin (r = -0.300, p = 0.351). CONCLUSION Dosage adjustment based on the GFR does not reduce individual variations in 5-FU concentrations among patients with normal or nearly normal renal function who receive S-1.
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Affiliation(s)
- Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Aichi, Japan
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Kitagawa K, Kawada K, Morita S, Inada M, Mitsuma A, Sawaki M, Iino S, Inden Y, Murohara T, Imai T, Ando Y. Prospective evaluation of corrected QT intervals and arrhythmias after exposure to epirubicin, cyclophosphamide, and 5-fluorouracil in women with breast cancer. Ann Oncol 2012; 23:743-747. [PMID: 21690231 DOI: 10.1093/annonc/mdr296] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Corrected QT (QTc) interval prolongation can induce fatal arrhythmias such as torsade de pointes. PATIENTS AND METHODS To assess the characteristics of QTc intervals and arrhythmias in women with early breast cancer who received FEC100 adjuvant chemotherapy, electrocardiograms (ECGs) were recorded before and after each chemotherapy. Associations between QTc interval prolongation and single nucleotide polymorphisms (SNPs) of potassium channel genes were also investigated. RESULTS A total of 131 ECG records were obtained in 34 patients who received 153 cycles of FEC100. QTc intervals could be measured in 127 records. There was a significant trend toward QTc interval prolongation after each treatment, persisting through four cycles of chemotherapy (P < 0.001). Median QTc interval prolongations were 13, 11, 18, and 14 ms in the first through fourth cycles of chemotherapy, respectively. QTc intervals differed significantly between cycles 1 and 4 before treatment as well as after treatment (P < 0.05). A single supraventricular premature contraction was noted in 3 (2.3%) of the 131 cycles in 2 (5.9%) of the 34 patients. There was no significant association between QTc interval prolongation and SNPs of potassium channel genes. CONCLUSION This prospective study confirmed that FEC100 is associated with significant QTc interval prolongation in women with early breast cancer.
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Affiliation(s)
- K Kitagawa
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital
| | - K Kawada
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital
| | - S Morita
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital
| | - M Inada
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital
| | - A Mitsuma
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital
| | - M Sawaki
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital
| | - S Iino
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Y Inden
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - T Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - T Imai
- Department of Breast and Endocrine Surgery, Nagoya University School of Medicine, Nagoya, Japan
| | - Y Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital.
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Doi T, Ando Y, Bando H, Yoshino T, Inada M, Mitsuma A, Quadt C, Robson M, Ohtsu A. Abstract B159: Phase I dose-escalation study of BKM120, an oral pan-class I PI3K inhibitor, in Japanese patients with advanced solid tumors. Mol Cancer Ther 2011. [DOI: 10.1158/1535-7163.targ-11-b159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Signaling via the phosphatidylinositol 3-kinase (PI3K) pathway is critical to cancer cell growth, survival, and metabolism. BKM120 is a potent and highly specific oral pan-class I (α, β, γ, δ) PI3K inhibitor that has demonstrated clinical anti-tumor effects in a broad range of cancer types.
Patients and methods: This was a phase I, open-label, dose-escalation study of single-agent BKM120 in Japanese patients with advanced solid tumors. Patients received 28-day cycles of continuous BKM120 once daily until disease progression, unacceptable toxicity, investigator's decision or patient's refusal. Eligible patients had histologically-confirmed, advanced unresectable solid tumors and had progressed on standard therapy, were unable to tolerate standard therapy, or had disease for which no standard therapy exists. Dose escalation, determined by agreement of investigators and the sponsor, was guided by an adaptive Bayesian logistic regression model with overdose control.
Results: A total of 15 patients (median age 58 [range 22 to 71] yrs) received BKM120 once daily: 25 mg (n = 3), 50 mg (n = 3), and 100 mg (n = 9). The most common primary tumor sites were the salivary gland, rectum (n = 3 each), colon, and head & neck (n = 2 each). Patients were heavily pretreated (median 3 prior regimens [range 0–9]). One patient experienced a DLT (CTCAE grade 4 abnormal hepatic function at 100 mg BKM120 during cycle 1). Across all doses, the most common (≥ 4 patients) all-cause adverse events (AEs) were increased eosinophil count/eosinophilia, rash, increased blood insulin, constipation, decreased appetite, fatigue, increased alanine aminotransferase, anemia, increased insulin C-peptide, mood altered/psychiatric symptom, and pruritus. The most common (≥ 2 patients) non-dose limiting grade 3/4 AEs (all cause) were abnormal hepatic function (n = 5, including increased transaminase in 2 patients), and anemia (n = 2). Five patients experienced serious AEs (all cause): abnormal hepatic function (n = 3), pneumonitis, dyspnea, hyperglycemia, pneumonia, and delirium (n = 1 each). A patient with pneumonitis died 11 days after study drug discontinuation (100 mg cohort). There were 4 AE-associated discontinuations: 2 for increased transaminases (discontinuation on days 47 and 78 of treatment; 25 mg BKM120), 1 abnormal hepatic function (on day 30) and 1 increased lipase (on day 56; both 100 mg BKM120). Preliminary pharmacokinetic (PK) data showed rapid absorption, with Cmax occurring 1–3 hours post-dose. BKM120 accumulated ∼3-fold in achieving steady state. Doses ≥ 50 mg led to steady-state drug exposure (AUC0–24,ss) ≥ 10,000 ng*h/mL, a target preclinically estimated to be efficacious. Both Cmax and AUC increased dose proportionally between 25 and 100 mg. Five patients had stable disease (RECIST criteria) as the best response (8–24 weeks' duration). Based on the overall safety profile of BKM120, dose escalation over 100 mg was not pursued, and the recommended dose was declared as 100 mg once daily.
Conclusions: BKM120 administered orally once daily up to 100 mg was well tolerated. PK parameters were comparable with those of Western patients. Continuous BKM120 100 mg once daily was recommended in Japanese patients and will be taken forward in the clinical development program.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2011 Nov 12-16; San Francisco, CA. Philadelphia (PA): AACR; Mol Cancer Ther 2011;10(11 Suppl):Abstract nr B159.
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Affiliation(s)
- Toshihiko Doi
- 1National Cancer Centre Hospital East, Kashiwa, Japan
| | | | - Hideaki Bando
- 1National Cancer Centre Hospital East, Kashiwa, Japan
| | | | | | | | | | | | - Atsushi Ohtsu
- 1National Cancer Centre Hospital East, Kashiwa, Japan
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Kawada K, Kitagawa K, Kamei S, Inada M, Mitsuma A, Sawaki M, Kikumori T, Fujimoto Y, Arima H, Imai T, Ando Y. The feasibility study of docetaxel in patients with anaplastic thyroid cancer. Jpn J Clin Oncol 2010; 40:596-9. [PMID: 20200039 DOI: 10.1093/jjco/hyq025] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
There is no established chemotherapy for anaplastic thyroid cancer. We conducted a prospective feasibility study at a single center to explore the antitumor activity of docetaxel against anaplastic thyroid cancer. Docetaxel was administered intravenously at a dose of 60 mg/m(2) over the course of 1 h every 3 weeks in patients with anaplastic thyroid cancer who had received no prior chemotherapy. A total of seven patients with anaplastic thyroid cancer were enrolled over the course of 30 months and received docetaxel. The treatment response was complete response in one patient, stable disease in two and progressive disease in four. The response rate was 14%, and the disease control rate (complete response plus stable disease) was 43%. The median time to progression was 6 weeks (range, 1-50). Toxicity was tolerable. Docetaxel could be an effective drug for the treatment of anaplastic thyroid cancer, with tolerable toxicity.
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Affiliation(s)
- Kenji Kawada
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan.
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Mitsuma A, Naoe T. [Standard chemotherapy of hematological cancers]. Nihon Naika Gakkai Zasshi 2009; 98:1880-1886. [PMID: 19894349 DOI: 10.2169/naika.98.1880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Mitsuma A, Asano H, Kinoshita T, Murate T, Saito H, Stamatoyannopoulos G, Naoe T. Transcriptional regulation of FKLF-2 (KLF13) gene in erythroid cells. ACTA ACUST UNITED AC 2005; 1727:125-33. [PMID: 15716005 PMCID: PMC2808416 DOI: 10.1016/j.bbaexp.2004.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2004] [Revised: 12/15/2004] [Accepted: 12/20/2004] [Indexed: 11/25/2022]
Abstract
FKLF-2 (KLF13) was cloned from fetal globin-expressing tissues and has been shown to be abundantly expressed in erythroid cells. In this study we examined the transcriptional regulation of the KLF13 gene. A 5.5 kb 5' flanking region cloned from mouse erythroleukemia (MEL) cell genomic DNA showed that major cis regulatory activities exist in the 550 bp sequence to the unique transcription start site, and that the promoter is more active in K562 cells than in COS-7 cells. The promoter was trans-activated by co-expressed GATA-1 through the sequence containing two CCAAT motifs, suggesting that GATA-1 is involved in the abundant expression of KLF13 mRNA in the erythroid tissue. Dual action, i.e. activating effect in COS-7 and repressive effect in K562 cell, was observed on its own promoter, suggesting a feedback mechanism for the transcriptional control of the KLF13 gene in the erythroid environment. These findings provide an insight on the mechanism of inducible mRNA expression of the KLF13 gene in erythroid cells.
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Affiliation(s)
- Ayako Mitsuma
- Department of Hematology, Nagoya University Graduate School of Medicine, Tsurumai-cho 65, Showa-ku, Nagoya, 466-8550, Japan
| | - Haruhiko Asano
- Department of Hematology, Nagoya University Graduate School of Medicine, Tsurumai-cho 65, Showa-ku, Nagoya, 466-8550, Japan
- Corresponding author. Tel.: +81 52 744 2158; fax: +81 52 744 2141., (H. Asano)
| | - Tomohiro Kinoshita
- Department of Hematology, Nagoya University Graduate School of Medicine, Tsurumai-cho 65, Showa-ku, Nagoya, 466-8550, Japan
| | - Takashi Murate
- Nagoya University School of Health Sciences, Daiko-minami, 1-1-20, Higashi-ku, Nagoya, 461-8673, Japan
| | - Hidehiko Saito
- Department of Hematology, Nagoya University Graduate School of Medicine, Tsurumai-cho 65, Showa-ku, Nagoya, 466-8550, Japan
| | | | - Tomoki Naoe
- Department of Hematology, Nagoya University Graduate School of Medicine, Tsurumai-cho 65, Showa-ku, Nagoya, 466-8550, Japan
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Mitsuma A. [Functional importance of FKLF-2 in erythroid cell development]. Rinsho Ketsueki 2003; 44:70-5. [PMID: 12692978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
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Hirabayashi N, Goto S, Ishii M, Yuge M, Mitsuma A, Noda N. Busulfan, cyclophosphamide and total body irradiation as conditioning for allogeneic bone marrow transplantation for acute and chronic myeloid leukemia. Bone Marrow Transplant 1998; 21:1079-83. [PMID: 9645568 DOI: 10.1038/sj.bmt.1701244] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Fifty patients with acute myeloid leukemia (AML) or chronic myeloid leukemia (CML) underwent allogeneic bone marrow transplantation between October 1988 and January 1997. Patients received 8 mg/kg of busulfan (BU) with 120 mg/kg of cyclophosphamide (CY) followed by 10 Gy of total body irradiation (TBI). Twenty consecutive patients with AML in first remission (n = 9) or CML, in chronic phase (n = 11) entered the study (group I). Thirty consecutive patients with advanced myeloid malignancies including AML (n = 19) and CML (n = 11) also entered the study (group II). The probability of leukemia-free survival at 5 years was 85% for group I patients and 50% for group II patients. Severe regimen-related toxicities occurred in 16% of patients (two in group I, six in group II). The most common sites affected by severe toxicities were lung (n = 6), liver (n = 2) and heart (n = 2). The relapse rate was higher for patients allografted in advanced stages of disease (O% at 5 years for group I and 28% for group II). These results suggest that BU + CY + TBI is a very effective conditioning regimen in patients with myeloid malignancies.
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MESH Headings
- Adolescent
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bone Marrow Transplantation/adverse effects
- Busulfan/administration & dosage
- Child
- Child, Preschool
- Cyclophosphamide/administration & dosage
- Female
- Graft vs Host Disease/etiology
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/therapy
- Leukemia, Myeloid, Chronic-Phase/mortality
- Leukemia, Myeloid, Chronic-Phase/therapy
- Male
- Middle Aged
- Recurrence
- Survival Rate
- Transplantation Conditioning/adverse effects
- Transplantation Conditioning/methods
- Transplantation, Homologous
- Whole-Body Irradiation
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