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Takeshita T, Iwamoto T, Niikura N, Watanabe K, Kikawa Y, Kobayashi K, Iwakuma N, Okamura T, Tada H, Ozaki S, Okuno T, Toh U, Yamamoto Y, Tsuneizumi M, Ishiguro H, Masuda N, Saji S. Identifying prognostic biomarkers for palbociclib add-on therapy in fulvestrant-resistant breast cancer using cell-free DNA sequencing. ESMO Open 2024; 9:102385. [PMID: 38387111 PMCID: PMC11076976 DOI: 10.1016/j.esmoop.2024.102385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The FUTURE trial (UMIN000029294) demonstrated the safety and efficacy of adding palbociclib after fulvestrant resistance in patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) advanced and metastatic breast cancer (ABC/MBC). In this planned sub-study, cancer panel sequencing of cell-free DNA (cfDNA) was utilized to explore prognostic and predictive biomarkers for further palbociclib treatment following fulvestrant resistance. MATERIALS AND METHODS Herein, 149 cfDNA samples from 65 patients with fulvestrant-resistant disease were analysed at the time of palbociclib addition after fulvestrant resistance (baseline), on day 15 of cycle 1, and at the end of treatment using the assay for identifying diverse mutations in 34 cancer-related genes. RESULTS During the course of treatment, mutations in ESR1, PIK3CA, FOXA1, RUNX1, TBX3, and TP53 were the most common genomic alterations observed. Analysis of genomic mutations revealed that before fulvestrant introduction, baseline PIK3CA mutations were marginally lower in metastatic aromatase inhibitor (AI)-treated patients compared to adjuvant AI-treated patients (P = 0.063). Baseline PIK3CA mutations were associated with poorer progression-free survival [hazard ratio: 1.62, P = 0.04]. Comparative analysis between baseline and early-changing gene mutations identified poor prognostic factors including early-changing MAP3K1 mutations (hazard ratio: 4.66, P = 0.04), baseline AR mutations (hazard ratio: 3.53, P = 0.04), and baseline PIK3CA mutations (hazard ratio: 3.41, P = 0.02). Notably, the relationship between ESR1 mutations and mutations in PIK3CA, MAP3K1, and TP53 weakened as treatment progressed. Instead, PIK3CA mutations became correlated with TP53 and FOXA1 mutations. CONCLUSIONS Cancer panel testing for cfDNA identified prognostic and predictive biomarkers for palbociclib add-on therapy after acquiring fulvestrant resistance in patients with HR+/HER2- ABC/MBC.
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Affiliation(s)
- T Takeshita
- Department of Breast and Endocrine Surgery, Kumamoto City Hospital, Kumamoto.
| | - T Iwamoto
- Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital, Kurashiki
| | - N Niikura
- Department of Breast Oncology, Tokai University School of Medicine, Isehara, Kanagawa
| | - K Watanabe
- Department of Breast Surgery, Hokkaido Cancer Center, Sapporo, Hokkaido
| | - Y Kikawa
- Department of Breast Surgery, Kansai Medical University Hospital, Hirakata, Osaka
| | - K Kobayashi
- Department of Medical Oncology, Saitama Red Cross Hospital, Chuo-ku, Saitama
| | - N Iwakuma
- Breast Center, Department of Breast Surgery, NHO Kyushu Medical Center, Fukuoka
| | - T Okamura
- Department of Breast Oncology, Tokai University School of Medicine, Isehara, Kanagawa
| | - H Tada
- Division of Breast and Endocrine Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi
| | - S Ozaki
- Department of Gastrointestinal and Breast Surgery, Hiroshima Prefectural Hospital, Hiroshima
| | - T Okuno
- Department of Breast Surgery, Kobe City Nishi-Kobe Medical Center, Kobe, Hyogo
| | - U Toh
- Department of Breast Surgery, Kurume University Hospital, Kurume, Fukuoka
| | - Y Yamamoto
- Department of Breast and Endocrine Surgery, Kumamoto University Hospital, Kumamoto
| | - M Tsuneizumi
- Department of Breast Surgery, Shizuoka General Hospital, Shizuoka
| | - H Ishiguro
- Breast Oncology Service, Saitama Medical University International Medical Center, Hidaka, Saitama
| | - N Masuda
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - S Saji
- Department of Medical Oncology, Fukushima Medical University, School of Medicine, Fukushima, Japan
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Manzi F, Ishikawa M, Di Dio C, Itakura S, Kanda T, Ishiguro H, Massaro D, Marchetti A. Infants’ Prediction of Humanoid Robot’s Goal-Directed Action. Int J Soc Robot 2022. [DOI: 10.1007/s12369-022-00941-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractSeveral studies have shown that infants anticipate human goal-directed actions, but not robot’s ones. However, the studies focusing on the robot goal-directed actions have mainly analyzed the effect of mechanical arms on infant’s attention. To date, the prediction of goal-directed actions in infants has not yet been studied when the agent is a humanoid robot. Given this lack of evidence in infancy research, the present study aims at analyzing infants’ action anticipation of both a human’s and a humanoid robot’s goal-directed action. Data were acquired on thirty 17-month-old infants, watching four video clips, where either a human or a humanoid robot performed a goal-directed action, i.e. reaching a target. Infants looking behavior was measured through the eye-tracking technique. The results showed that infants anticipated the goal-directed action of both the human and the robot and there were no differences in the anticipatory gaze behavior between the two agents. Furthermore, the findings indicated different attentional patterns for the human and the robot, showing a greater attention paid to the robot's face than the human’s face. Overall, the results suggest that 17-month-old infants may infer also humanoid robot’ underlying action goals.
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Watanabe K, Niikura N, Kikawa Y, Oba M, Kobayashi K, Tada H, Ozaki S, Toh U, Yamamoto Y, Tsuneizumi M, Okuno T, Iwakuma N, Takeshita T, Iwamoto T, Ishiguro H, Masuda N, Saji S. 228P Fulvestrant with additional palbociclib in advanced or metastatic hormone receptor-positive HER2-negative breast cancer after progression to fulvestrant monotherapy: JBCRG- M07 (FUTURE trial). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.267] [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: 11/01/2022] Open
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Shiono Y, Matsuo H, Fujita H, Tanaka N, Ogasawara Y, Kawamura I, Katayama Y, Matsuo A, Kawase Y, Kakuta T, Takashima H, Yokoi H, Ohira H, Suwa S, Oguri M, Yamamoto F, Kubo T, Akasaka T, Shiono Y, Katayama Y, Hironori K, Kubo T, Akasaka T, Tanaka N, Yamashita J, Fujita H, Matsuo A, Matsuo H, Kawase Y, Kawamura I, Kakuta T, Hoshino M, Sugano T, Takashima H, Amano T, Yokoi H, Yamamoto Y, Nozaki Y, Machida M, Kobori M, Kikuchi T, Ohira H, Yoshino H, Ishiguro H, Wakabayashi Y, Kondo T, Terai H, Suwa T, Kimura T, Kawajiri T, Hirohata A, Uemura S, Neishi Y, Sakamoto T, Yamada M, Okeie K, Hishikari K, Oguri M, Uetani T, Saegusa T, Yamamoto F, Yamada M. Diagnostic Accuracy of Diastolic Fractional Flow Reserve for Functional Evaluation of Coronary Stenosis. JACC: Asia 2021; 1:230-241. [PMID: 36338166 PMCID: PMC9627917 DOI: 10.1016/j.jacasi.2021.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/28/2021] [Accepted: 07/08/2021] [Indexed: 01/10/2023]
Abstract
Background In the resting conditions, narrowing the window of coronary pressure measurements from the whole cardiac cycle to diastole improves diagnostic performance of coronary pressure–derived physiological index. However, whether this also applies to the hyperemic conditions has not yet been thoroughly evaluated. Objectives The purpose of this study was to assess whether diastolic fractional flow reserve (diastolic FFR) has better diagnostic performance in identifying ischemia-causing coronary lesions than conventional FFR in a prospective, multicenter, and independent core laboratory–based environment. Methods In this prospective multicenter registry at 29 Japanese centers, we compared the diagnostic performance of FFR, diastolic FFR, resting distal to aortic coronary pressure (Pd/Pa), and diastolic pressure ratio (dPR) using myocardial perfusion scintigraphy (MPS) as the reference standard in 378 patients with single-vessel coronary disease. Results Inducible myocardial ischemia was found on MPS in the relevant myocardial territory of the target vessel in 85 patients (22%). In the receiver-operating curve analyses, diastolic FFR had comparable area under the curve (AUC) compared with FFR (AUCdiastolic FFR: 0.66; 95% confidence interval [CI]: 0.58-0.73, vs AUCFFR: 0.66; 95% CI: 0.58-0.74, P = 0.624). FFR and diastolic FFR showed significantly larger AUCs than resting Pd/Pa (0.62; 95% CI: 0.54-0.70; P = 0.033 and P = 0.046) but did not show significantly larger AUCs than dPR (0.62; 95% CI: 0.55-0.70; P = 0.102 and P = 0.113). Conclusions Diastolic FFR showed a similar diagnostic performance to FFR as compared with MPS. This result reaffirms the use of FFR as the most accurate invasive physiological lesion assessment. (Diagnostic accuracy of diastolic fractional flow reserve (d-FFR) for functional evaluation of coronary stenosis; UMIN000015906)
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Kang Y, Kikawa Y, Kotake T, Tsuyuki S, Takahara S, Yamashiro H, Yoshibayashi H, Takada M, Yasuoka R, Yamagami K, Suwa H, Okuno T, Nakayama I, Kato T, Moriguchi Y, Ishiguro H, Kagimura T, Taguchi T, Sugie T, Toi M. 52P Chemotherapy selection in routine clinical practice in Japan for HER2-negative advanced or metastatic breast cancer (KBCRN A001: E-SPEC Study). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.072] [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: 11/30/2022] Open
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Bando H, Masuda N, Yamanaka T, Kadoya T, Takahashi M, Nagai S, Ohtani S, Aruga T, Suzuki E, Kikawa Y, Yasojima H, Kasai H, Ishiguro H, Kawabata H, Morita S, Haga H, Kataoka T, Uozumi R, Ohno S, Toi M. 163MO Randomized phase II study of eribulin-based neoadjuvant chemotherapy for triple-negative primary breast cancer patients stratified by homologous recombination deficiency status (JBCRG-22). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Manzi F, Ishikawa M, Di Dio C, Itakura S, Kanda T, Ishiguro H, Massaro D, Marchetti A. The understanding of congruent and incongruent referential gaze in 17-month-old infants: an eye-tracking study comparing human and robot. Sci Rep 2020; 10:11918. [PMID: 32681110 PMCID: PMC7368080 DOI: 10.1038/s41598-020-69140-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/06/2020] [Indexed: 11/09/2022] Open
Abstract
Several studies have shown that the human gaze, but not the robot gaze, has significant effects on infant social cognition and facilitate social engagement. The present study investigates early understanding of the referential nature of gaze by comparing-through the eye-tracking technique-infants' response to human and robot's gaze. Data were acquired on thirty-two 17-month-old infants, watching four video clips, where either a human or a humanoid robot performed an action on a target. The agent's gaze was either turned to the target (congruent) or opposite to it (incongruent). The results generally showed that, independent of the agent, the infants attended longer at the face area compared to the hand and target. Additionally, the effect of referential gaze on infants' attention to the target was greater when infants watched the human compared to the robot's action. These results suggest the presence, in infants, of two distinct levels of gaze-following mechanisms: one recognizing the other as a potential interactive partner, the second recognizing partner's agency. In this study, infants recognized the robot as a potential interactive partner, whereas ascribed agency more readily to the human, thus suggesting that the process of generalizability of gazing behaviour to non-humans is not immediate.
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Affiliation(s)
- F Manzi
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
| | - M Ishikawa
- School of Graduated Letter, Department of Psychology, Kyoto University, Kyoto, Japan
| | - C Di Dio
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - S Itakura
- Centre for Baby Science, Doshisha University, Kyoto, Japan
| | - T Kanda
- Human-Robot Interaction Laboratory, Department of Computer Science, Kyoto University, Kyoto, Japan.,Advanced Telecommunications Research Institute International, IRC/HIL, Keihanna Science City, Kyoto, Japan
| | - H Ishiguro
- Advanced Telecommunications Research Institute International, IRC/HIL, Keihanna Science City, Kyoto, Japan.,Department of Systems Innovation, Osaka University, Toyonaka, Japan
| | - D Massaro
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - A Marchetti
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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Watanabe Y, Mitomo S, Naganuma T, Nakajima A, Tani K, Matsuoka S, Kawamoto H, Tanaka K, Sato T, Ishiguro H, Okutsu M, Tahara S, Kurita N, Nakamura SH, Nakamura S. P6530Clinical outcomes of dialysis patients treated with current generation DES for left main distal bifurcation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objectives
We assessed clinical outcomes after percutaneous coronary intervention (PCI) for unprotected left main (ULM) using current generation drug eluting stents (cDES) in hemodialysis (HD) patients compared to general populations.
Methods
We identified 1269 consecutive patients who underwent PCI for ULM distal bifurcation lesions. Of them, 563 patients were treated with cDES (512 non HD and 51 HD patients). The primary endpoint was target lesion failure (TLF) at 3 years, defined as a composite of cardiac death, target lesion revascularization (TLR) and myocardial infarction (MI).
Results
HD group was more likely to have diabetes mellitus (70.0% vs. 45.8%, p=0.002), peripheral artery disease (56.0% vs. 14.9%, p<0.001), and lower ejection fraction (52.6% vs. 56.3%, p=0.026). The rate of TLF at 3 years was significantly higher in the HD group (adjusted Hazard ratio [HR] 2.59; 95% confidence interval [CI], 1.54–4.37; p<0.001). Cardiac mortality was significantly higher in the HD group (adjusted HR 4.49; 95% CI, 2.07–9.74; p<0.001). The rates of TLR for LM-left anterior descending artery (LAD) and left circumflex ostium (LCXos) were significantly higher in the HD group (LMT-LAD: adjusted HR 3.10; 95% CI, 1.31–7.33; p=0.01, LCXos: adjusted HR 2.56; 95% CI, 1.32–4.94; p=0.005). The rate of MI was similar between the 2 groups.
Conclusions
Hemodialysis was strongly associated with adverse events after PCI for ULM distal bifurcation lesions even with cDES.
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Affiliation(s)
| | - S Mitomo
- New Tokyo Hospital, Matsudo, Japan
| | | | | | - K Tani
- New Tokyo Hospital, Matsudo, Japan
| | | | | | - K Tanaka
- New Tokyo Hospital, Matsudo, Japan
| | - T Sato
- New Tokyo Hospital, Matsudo, Japan
| | | | - M Okutsu
- New Tokyo Hospital, Matsudo, Japan
| | - S Tahara
- New Tokyo Hospital, Matsudo, Japan
| | - N Kurita
- New Tokyo Hospital, Matsudo, Japan
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Omori Y, Enatsu S, Cai Z, Ishiguro H. Abstract P4-12-07: Patients' preferences for postmenopausal hormone receptor-positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) advanced breast cancer treatments in Japan. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-12-07] [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: The objective of this study was to identify factors that affect preferences for treatment of breast cancer (BC) patients in Japan and understand their relative importance. Also this study explored whether patients' sociodemographic and clinical characteristics would affect patient preference in choice of treatment. Methods: A questionnaire for discrete choice experiment (DCE) was developed with five attributes, progression free survival (PFS), incidence of diarrhea (IOD), frequency of diarrhea (FOD) which represents the increase in the number of stools per day than usual, duration of diarrhea (DOD) and route and frequency of administration (RFA) referring MONARCH 2, a global phase III study for abemaciclib plus fulvestrant versus placebo plus fulvestrant in patients with HR+/HER2− advanced BC. Each questionnaire was composed of nine choice sets and each choice set contained those five attributes with different levels. Postmenopausal and HR+ BC patients in Japan who recruited from a patient panel were asked to choose one treatment alternative in each choice set. Conditional logit model was used to identify relative preferences of each attribute. The preference weights were evaluated with βcoefficient and standard error. In addition, conditional logit model including patient-specific covariates, such as patient characteristics (age, employment status, age of children and marital status) and clinical characteristics (experience of relapse or metastasis and with/without hormone sensitivity), was used to identify factors that affect patient preference in choice of treatment. Results: Of 302 respondents recruited, 258 had valid responses and the rest had inappropriate answers for the validity testing choice set. The mean age (SD) was 56.7(6.7), 47.7% had paid employment, median duration since diagnosis was 5.1 years and 98.1% had experienced hormonal therapy. According to the absolute magnitude of coefficients, when the FOD is 6, the order of attributes' relative importance was the following: PFS, DOD, FOD, IOD, RFA. However when the FOD becomes 9, FOD was the most important attribute for patients. All tested attributes were statistically significant (p<.0001) on their preference in choice of treatment. When patient-specific covariates were included in the model, the patients who have had experience of relapse or metastasis showed the strongest preference for the longest PFS of 16 months and the patients who were 45 to 59 years old showed the weakest preference for the highest FOD of 9. Conclusions: Postmenopausal and HR+ BC patients in Japan showed preference for treatments which can extend PFS even with the potentiality of Grade 2 diarrhea by the grading of Common Terminology Criteria for Adverse Events v4.0. Prevention of diarrhea to make it Grade 2 or lower may maintain patients' motivation for the treatment which can extend PFS. This study also showed that patients' sociodemographic and clinical characteristics tend to affect patients' treatment choices. It will be important to choose treatments with considering patients' characteristics such as their life style, age and therapeutic experience.
Citation Format: Omori Y, Enatsu S, Cai Z, Ishiguro H. Patients' preferences for postmenopausal hormone receptor-positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) advanced breast cancer treatments in Japan [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-12-07.
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Affiliation(s)
- Y Omori
- Eli Lilly Japan K.K., Kobe, Japan; International University of Health and Welfare, Narita, Chiba, Japan
| | - S Enatsu
- Eli Lilly Japan K.K., Kobe, Japan; International University of Health and Welfare, Narita, Chiba, Japan
| | - Z Cai
- Eli Lilly Japan K.K., Kobe, Japan; International University of Health and Welfare, Narita, Chiba, Japan
| | - H Ishiguro
- Eli Lilly Japan K.K., Kobe, Japan; International University of Health and Welfare, Narita, Chiba, Japan
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Kodama S, Fujihara K, Horikawa C, Harada M, Ishiguro H, Kaneko M, Furukawa K, Matsubayashi Y, Matsunaga S, Shimano H, Tanaka S, Kato K, Sone H. Network meta-analysis of the relative efficacy of bariatric surgeries for diabetes remission. Obes Rev 2018; 19:1621-1629. [PMID: 30270528 DOI: 10.1111/obr.12751] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/05/2018] [Accepted: 07/11/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Bariatric surgery leads to a higher remission rate for type 2 diabetes mellitus than non-surgical treatment. However, it remains unsolved which surgical procedure is the most efficacious. This network meta-analysis aimed to rank surgical procedures in terms of diabetes remission. METHODS AND FINDINGS We electronically searched for randomized controlled trials in which at least one surgical treatment was included among multiple arms and the diabetes remission rate was included in study outcomes. A random-effects network meta-analysis was performed within a frequentist framework. The hierarchy of treatments was expressed as the surface under the cumulative ranking curve value. Results of the analysis of 25 eligible randomized controlled trials that covered non-surgical treatments and eight surgical procedures (biliopancreatic diversion [BPD], BPD with duodenal switch, Roux-en Y gastric bypass, mini gastric bypass [mini-GBP], laparoscopic adjustable gastric banding, laparoscopic sleeve gastrectomy, greater curvature plication and duodenal-jejunal bypass) showed that BPD and mini-GBP had the highest surface under the cumulative ranking curve values among the eight surgical treatments. CONCLUSION Current network meta-analysis indicated that BPD or mini-GBP achieved higher diabetes remission rates than the other procedures. However, the result needs to be interpreted with caution considering that these procedures were in the minority of bariatric surgeries.
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Affiliation(s)
- S Kodama
- Department of Laboratory Medicine and Clinical Epidemiology for Prevention of Noncommunicable Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - K Fujihara
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - C Horikawa
- Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, Niigata, Japan
| | - M Harada
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - H Ishiguro
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - M Kaneko
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - K Furukawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Y Matsubayashi
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - S Matsunaga
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - H Shimano
- Department of Internal Medicine, University of Tsukuba Institute of Clinical Medicine, Tsukuba, Japan
| | - S Tanaka
- Department of Clinical Trial, Design and Management, Translational Research Center, Kyoto University Hospital, Kyoto, Japan
| | - K Kato
- Department of Laboratory Medicine and Clinical Epidemiology for Prevention of Noncommunicable Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - H Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
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Nakatsukasa K, Kikawa Y, Kotake T, Yamagami K, Tsuyuki S, Yamashiro H, Suwa H, Sugie T, Okuno T, Kato H, Takahara S, Nakayama I, Ogura N, Moriguchi Y, Takata M, Suzuki E, Yoshibayashi H, Ishiguro H, Taguchi T, Toi M. Prospective cohort study of real world chemotherapy sequence for metastatic breast cancer (KBCRN A001: E-SPEC study). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.305] [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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Tada H, Miyashita M, Gonda K, Watanabe M, Suzuki A, Watanabe G, Harada N, Sato A, Hamanaka Y, Masuda N, Toi M, Ohno S, Bando H, Ishiguro H, Inoue K, Yamamoto N, Kuroi K, Ohuchi N, Ishida T. Abstract P2-09-28: New quantitative diagnostic method by fluorescence nanoparticle for HER2 positive breast cancer treated with neoadjuvant lapatinib and trastuzumab: The Neo LaTH study (JBCRG-16TR). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-09-28] [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: HER2 (human epidermal growth factor receptor 2) testing performed by IHC (immunohistochemical) methods and FISH (fluorescence in situ hybridization) is semi-quantitative. Exact quantification of HER2 is needed to predict which patients are more or less likely to response to anti HER2 therapy. To improve the method for cancer patients' HER2 status, we developed a novel fluorescence IHC method using new fluorescence nanoparticle. The fluorescent intensity of this new nanoparticles, termed phosphor-integrated dot (PID), was approximately 100-fold brighter than that of Quantum dots. Because of its increased brightness and analyzing technology, this PID-based fluorescent IHC(IHC-PIC) has an ability of quantifying the biomarker protein in the cancer tissue sample at single particle level. In this study, the primary objective was to investigate if pathological complete response (pCR) rate in HER2- positive breast cancer treated by trastuzumab and lapatinib containing neoadjuvant systemic therapy would depend on the level of HER2, EGFR, HER3, Ki67, ER and PgR protein quantified by this new method.
Methods: The Neo-LaTH study is a randomized phase II multicenter trial evaluating the efficacy and safety of lapatinib and trastuzumab followed by lapatinib and trastuzumab plus weekly paclitaxel with or without prolongation of anti-HER2 therapy prior to chemotherapy (18 weeks vs. 6 weeks). The primary endpoint was the comprehensive pCR rate. We evaluated the HER2, EGFR, HER3, Ki67, ER and PgR amount by nano-patho method using PID in formalin-fixed paraffin-embedded core biopsy samples taken at diagnosis retrospective analysis. Univariate and multivariate analyses were performed to determine the association between pCR and variables, including HER2, EGFR, HER3, Ki67, ER and PgR nano-patho score and clinicopathological factors including histological grade, tumor status, nodal status and HER2 FISH ratio.
Results: A total of 96 tumor samples from patients were used for the present analysis.The pCR rate was 60.4%. We obtained the images of only PID signal by the image analyses, and calculated the number of PID particles in a cell and defined it as IHC-PID score that reflects the level of HER2, EGFR, HER3, Ki67, ER and PgR protein expression in cancer cells. Univariate analysis showed that HER2 IHC-PID score(p<0.0001), ER IHC-PID score(p=0.009) and PgR IHC-PID score(p=0.019) were associated with pCR and multivariate analysis showed that HER2 IHC-PID score was significantly associated with pCR (adjusted odds ratio, 0.990 [95% CI, 0.984–0.996]; P < .0001).
Conclusion: We successfully performed the quantitative IHC-PID for HER2, EGFR, HER3, Ki67, ER and PgR. And we propose using HER2 IHC-PID score as a predictive factor for trastuzumab and lapatinib containing neoadjuvant systemic therapy. This quantitative diagnostic method would be expected to contribute to the development of a molecular therapeutic strategy.
Citation Format: Tada H, Miyashita M, Gonda K, Watanabe M, Suzuki A, Watanabe G, Harada N, Sato A, Hamanaka Y, Masuda N, Toi M, Ohno S, Bando H, Ishiguro H, Inoue K, Yamamoto N, Kuroi K, Ohuchi N, Ishida T. New quantitative diagnostic method by fluorescence nanoparticle for HER2 positive breast cancer treated with neoadjuvant lapatinib and trastuzumab: The Neo LaTH study (JBCRG-16TR) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-09-28.
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Affiliation(s)
- H Tada
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - M Miyashita
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - K Gonda
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - M Watanabe
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - A Suzuki
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - G Watanabe
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - N Harada
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - A Sato
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - Y Hamanaka
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - N Masuda
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - M Toi
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - S Ohno
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - H Bando
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - H Ishiguro
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - K Inoue
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - N Yamamoto
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - K Kuroi
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - N Ohuchi
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - T Ishida
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
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13
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Matsubayashi Y, Yoshida A, Suganami H, Ishiguro H, Yamamoto M, Fujihara K, Kodama S, Tanaka S, Kaku K, Sone H. Role of fatty liver in the association between obesity and reduced hepatic insulin clearance. Diabetes Metab 2017; 44:135-142. [PMID: 29395810 DOI: 10.1016/j.diabet.2017.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/13/2017] [Accepted: 12/03/2017] [Indexed: 01/29/2023]
Abstract
AIM Hepatic insulin clearance (HIC) is important in regulating plasma insulin levels. Diminished HIC causes inappropriate hyperinsulinaemia, and both obesity and fatty liver (FL), which are known to decrease HIC, can be found either together in the same patient or on their own. The mechanism by which obesity reduces HIC is presumed to be mediated by FL. However, few reports have examined the role of FL in the relationship between obesity and HIC in type 2 diabetes (T2D) patients. Therefore, our study investigated the association of HIC with clinical factors, including insulin sensitivity indices, focusing on the presence or absence of FL and obesity in T2D patients. METHOD Baseline data from 419 patients with T2D (279 men, 140 women; mean age: 57.6 years; body mass index: 25.5kg/m2) controlled by diet and exercise were analyzed. HIC was calculated from the ratio of fasting c-peptide to fasting insulin levels (HICCIR). Correlation analyses between HICCIR and clinical variables were performed using Pearson's product-moment correlation coefficients and single regression analysis in all participants and in those with obesity and FL either alone or in combination. RESULTS HICCIR was significantly correlated with whole-body insulin sensitivity indices and influenced by FL, but only in the FL group was obesity independently influenced HIC level. HICCIR decreased in those with both FL and obesity compared with those with only one such complication. CONCLUSION HICCIR may be used to evaluate whole-body insulin sensitivity in T2D. Also, compared with obesity, the influence of FL strongly contributed to a reduced HIC. TRIAL REGISTRATION NUMBER These trials were registered by the Japan Pharmaceutical Information Centre clinical trials information (JapicCTI) as 101349 and 101351.
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Affiliation(s)
- Y Matsubayashi
- Department of hematology, endocrinology and metabolism, faculty of medicine, Niigata university, Niigata, Japan
| | - A Yoshida
- Department of hematology, endocrinology and metabolism, faculty of medicine, Niigata university, Niigata, Japan; Medical information and product advancement department, Kowa Pharmaceutical Co. Ltd, Tokyo, Japan
| | - H Suganami
- Clinical data science department, Kowa Co. Ltd, 3-4-10 Nihonbashi-Honcho, Chuo-ku, 103-0023 TokyoJapan
| | - H Ishiguro
- Department of hematology, endocrinology and metabolism, faculty of medicine, Niigata university, Niigata, Japan
| | - M Yamamoto
- Department of hematology, endocrinology and metabolism, faculty of medicine, Niigata university, Niigata, Japan
| | - K Fujihara
- Department of hematology, endocrinology and metabolism, faculty of medicine, Niigata university, Niigata, Japan
| | - S Kodama
- Department of hematology, endocrinology and metabolism, faculty of medicine, Niigata university, Niigata, Japan
| | - S Tanaka
- Department of clinical biostatistics, Graduate School of Medicine, Kyoto university
| | - K Kaku
- Kawasaki Medical School, Yoshida-konoe-cho, Sakyo-ku, 606-8501 KyotoOkayama, Japan
| | - H Sone
- Department of hematology, endocrinology and metabolism, faculty of medicine, Niigata university, Niigata, Japan.
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14
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Hamabe Y, Hanai A, Ishiguro H, Kuroda T, Hirota M, Nomura M, Ishikawa H, Muto M. Effects of steroid ointment application on chemotherapy-induced phlebitis: A randomized, double-blind, placebo-controlled clinical trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx676.003] [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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15
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Ohgami M, Bando H, Ishiguro H, Tsuda M, Toriguchi N, Aogi K, Toi M, Masuda N, Mitsuhashi S, Kurosawa A, Homma M. Effect of dose timing on the blood concentration of lapatinib in patients with breast cancer. Ann Oncol 2017; 28:2888-2889. [PMID: 28655197 DOI: 10.1093/annonc/mdx328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Affiliation(s)
- M Ohgami
- Department of Pharmaceutical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki; Department of Pharmacy, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki
| | - H Bando
- Department of Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki
| | | | - M Tsuda
- Department of Breast Surgery, Graduate School of Medicine Kyoto University, Kyoto
| | - N Toriguchi
- Department of Clinical Trial Management, Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto
| | - K Aogi
- Department of Surgery, Shikoku Cancer Center, Ehime
| | - M Toi
- Department of Breast Surgery, Graduate School of Medicine Kyoto University, Kyoto
| | - N Masuda
- Department of Surgery, Breast Oncology, NHO Osaka National Hospital, Osaka
| | - S Mitsuhashi
- Department of Medical Oncology, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki, Japan
| | - A Kurosawa
- Department of Pharmacy, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki
| | - M Homma
- Department of Pharmaceutical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki.
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16
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Hattori M, Tamura K, Mukai H, Miyoshi Y, Masuda N, Suzuki E, Ishiguro H, Ohtani S, Hara F, Shimamoto T, Yamamoto K, Ding Y, Aktan G, Karantza V, Iwata H. Phase 2 study of pembrolizumab for metastatic triple-negative breast cancer (mTNBC): Japanese subgroup results of KEYNOTE 086. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx654.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Takada M, Sugimoto M, Masuda N, Iwata H, Kuroi K, Yamashiro H, Ohno S, Ishiguro H, Inamoto T, Toi M. Abstract P4-21-24: Development of mathematical prediction models to identify disease-free survival events for HER2-positive primary breast cancer patients treated by neoadjuvant chemotherapy and trastuzumab. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-21-24] [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)
The addition of trastuzumab to standard neoadjuvant chemotherapy (NAC) doubles the pathological complete response (pCR) rate in patients with HER2-positive primary breast cancer. Patients who achieved pCR after NAC with trastuzumab showed a better prognosis compared to those without pCR. However, it is still difficult to predict the likelihood of recurrence after surgery at an individual patient-level. The aim of this study was to develop a mathematical model to predict disease-free survival (DFS) events such as recurrence for patients treated with NAC and trastuzumab. Because brain metastasis (BM) often occurs in HER2-positive cancer patients and it is a particular event for those, we planned to develop a specific model for BM as well.
Patients and Methods)
Data of 776 HER2-positive primary breast cancer patients from the multicenter cohort study (JBCRG-C03) were used in the analysis. All patients had received NAC plus trastuzumab between 2001 and 2010. Two prediction models using a machine learning method (alternating decision tree algorithm) were developed using age, body-mass index, menopausal status, clinical stage, histological type, ER/PgR status, histological/nuclear grade, type of surgery, pathological response, adjuvant radiation therapy, and adjuvant hormonal therapy. The model A (DFS) predicted the probability of any disease recurrence, death by any cause, or secondary malignancy within 5 years after starting treatment. The model B (BM) predicted the probability of occurrence of BM within the 5 years. First, bias-controlled virtual datasets were generated for the training of the models using a resampling method. Second, the models were optimized by cross-validation (CV). Finally, the developed models were validated using the original dataset. The area under the receiver operating characteristics curve (AUC) was calculated to assess the discrimination ability of the models.
Results)
The DFS and BM event was observed in 118 and 30 patients, respectively. The AUC values for the model A and model B were 0.833 (95% CI, 0.798–0.868, P < 0.001) and 0.927 (95% CI, 0.905–0.949, P < 0.001), respectively. The sensitivity and specificity at the cut-off value of 50% were 72.0% and 78.4% for the model A, and 100% and 83.7% for the model B, respectively. Patients predicted as “low-risk” by the model A showed a significantly better 5-year DFS rate than “high-risk” patients (91.2% vs 53.8%, P < 0.001). Patients predicted as “low-risk” by the model B showed a significantly better 5-year BM-free survival rate than “high-risk” patients (100% vs 76.1%, P < 0.001). The discrimination ability of these models were maintained for both ER/PgR-positive and ER/PgR-negative subgroups, and also for both pCR and non-pCR subgroups.
Conclusions)
Our models showed high accuracy for predicting DFS events and BM in HER2-positive primary breast cancer patients treated with NAC and trastuzumab. These two models would help to realize accurate prediction of DFS events and to optimize the postoperative surveillance plan. The identification of high-risk patients for recurrence including BM may be useful for selecting a patient-subpopulation who requires new therapeutic approach.
Citation Format: Takada M, Sugimoto M, Masuda N, Iwata H, Kuroi K, Yamashiro H, Ohno S, Ishiguro H, Inamoto T, Toi M. Development of mathematical prediction models to identify disease-free survival events for HER2-positive primary breast cancer patients treated by neoadjuvant chemotherapy and trastuzumab [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-21-24.
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Affiliation(s)
- M Takada
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - M Sugimoto
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - N Masuda
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - H Iwata
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - K Kuroi
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - H Yamashiro
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - S Ohno
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - H Ishiguro
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - T Inamoto
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - M Toi
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
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Tsuda M, Ishiguro H, Toriguchi N, Masuda N, Bando H, Ohgami M, Homma M, Morita S, Yamamoto N, Kuroi K, Takano T, Shimizu S, Toi M. Abstract P2-11-07: Duration of fasting before taking lapatinib is associated with skin toxicity in neoadjuvant treatment of HER2 positive breast cancer: A cohort study from JBCRG-16/Neo-LaTH. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-11-07] [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: In neoadjuvant dual HER2 blockade, over 30% of patients fail to complete treatment as planned because of lapatinib-induced diarrhea, rash, and hepatotoxicity. Lapatinib bioavailability, which affects both efficacy and toxicity, is influenced by prandial conditions.
Methods: To investigate the association between lapatinib dosage timing and toxicity, we reviewed the medical records of patients who were enrolled in the JBCRG-16/Neo-LaTH randomized phase II multicenter trial evaluating the efficacy and safety of neoadjuvant 1000 mg/day lapatinib (La) and trastuzumab (T) therapy for 6 or 12 weeks followed by 750 mg/day La, T and weekly paclitaxel for 12 weeks in Japanese patients with primary HER2 positive breast cancer. Lapatinib dosage timing was divided into three groups: after overnight fasting, between meals, and at bedtime. We also measured serum lapatinib concentrations at steady state and dosage timing on the day prior to pharmacokinetic blood sampling. The primary endpoint was to investigate the association between lapatinib dosage timing and frequency of ≥grade 2 diarrhea. The secondary endpoint was to assess the association between dosage timing and other toxicities, pharmacokinetics, efficacy, and treatment discontinuation. Statistical analyses performed included one-way ANOVA, Welch's test and logistic regression.
Results: Out of 213 patients enrolled in JBCRG-16/Neo LaTH, we obtained dosage timing data from 143 (67%) patients: 16 (11%) after overnight fasting, 53 (37%) between meals, and 74 (52%) at bedtime. Serum lapatinib concentrations were obtained in 34/143 (24%) of patients. Dosage timing was not associated with ≥grade 2 diarrhea (8/16 (50%) after overnight fasting, 18/53 (34%) between meals, and 26/74 (35%) at bedtime; p = 0.48). However, multivariate analysis revealed that the after overnight fasting group is less likely to develop acne-like rash during La + T treatment regardless of age, BMI, or treatment.
Multivariate logistic regression analysis of factors predicting rash during La + T treatmentFactor Adjusted odds ratio95% confidence intervalp valueAge (years)≥55Reference <552.671.18-6.310.018*BMI (kg/m2)≥23Reference <231.040.45-2.390.933La + T duration6 weeksReference 12 weeks3.621.49-9.770.004*Concurrent endocrine treatmentYesReference No2.170.94-5.150.068Dosage timingAfter overnight fastingReference Others3.681.16-11.90.027*BMI cut off is based on Asian criteria for overweight status. La: Lapatinib, T: Trastuzumab, *statistically significant
In addition, serum lapatinib trough concentration and it's variability were significantly reduced in the after overnight fasting group (mean ± standard deviation (SD) = 0.35 ± 0.15 µg/ml, coefficient of variation (CV) = 42.7%) as compared to the others (mean ± SD = 0.77 ± 0.44 µg/ml, CV = 57.8%) (p<0.01) . The chance of pCR was not associated with dosage timing (8/16 (50%) after overnight fasting, 24/53, (45%) between meals, and 38/74 (51%) at bedtime; p = 0.79).
Conclusions: These data suggest that overnight fasting stabilizes the bioavailability of lapatinib, which may aid in managing lapatinib-induced rash without diminishing its therapeutic efficacy.
Citation Format: Tsuda M, Ishiguro H, Toriguchi N, Masuda N, Bando H, Ohgami M, Homma M, Morita S, Yamamoto N, Kuroi K, Takano T, Shimizu S, Toi M. Duration of fasting before taking lapatinib is associated with skin toxicity in neoadjuvant treatment of HER2 positive breast cancer: A cohort study from JBCRG-16/Neo-LaTH [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-11-07.
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Affiliation(s)
- M Tsuda
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - H Ishiguro
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - N Toriguchi
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - N Masuda
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - H Bando
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - M Ohgami
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - M Homma
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - S Morita
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - N Yamamoto
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - K Kuroi
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - T Takano
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - S Shimizu
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - M Toi
- Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Syogoin, Sakyo-ku, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan; Toranomon Hospital, Minato, Tokyo, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
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Yamaguchi A, Ishiguro H, Torii M, Takada M, Suzuki E, Takeuchi M, Sato F, Toi M. 69P Cisplatin based preoperative chemotherapy regimens for basal-like breast cancer potentially improve prognosis even in patients without pCR: A retrospective analysis from a single-institution. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00229-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Yamaguchi A, Ishiguro H, Torii M, Takada M, Suzuki E, Takeuchi M, Sato F, Toi M. 69P Cisplatin based preoperative chemotherapy regimens for basal-like breast cancer potentially improve prognosis even in patients without pCR: A retrospective analysis from a single-institution. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw575.008] [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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Saji S, Ishiguro H, Nomura S, Iwata H, Tanaka S, Ueno T, Onoue M, Yamanaka T, Sasaki Y, Toi M. Phase I/II pharmacokinetics/pharmacodynamics study of irinotecan and S-1 for recurrent/metastatic breast cancer in patients with select UGT1A1 genotypes (the JBCRG-M01 study). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.58] [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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Tanaka S, Ueno T, Ishiguro H, Toi M. Alteration of circulating endothelial progenitor cell counts could be an independent predictive factor for response to neoadjuvant chemotherapy in patients with breast cancer. Eur J Cancer 2016. [DOI: 10.1016/j.ejca.2016.03.035] [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: 11/30/2022]
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Bando H, Masuda N, Nakamura R, Kondo N, Kuroi K, Akiyoshi S, Ohtani S, Toshimi T, Inoue K, Yanagida Y, Ishiguro H, Shimizu S, Aogi K, Amano S, Ozaki S, Iguchi-Manaka A, Kasai H, Morita S, Kataoka T, Toi M. 1951 Impact of lapatinib (La) treatment duration and endocrine therapy (ET) addition on the efficacy of primary dual HER2 blockage with La and trastuzumab (T) for HER2+ breast cancer (BC) patients. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30899-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Yamashita T, Masuda N, Yamamoto N, Kondo N, Bando H, Akiyoshi S, Ohtani S, Takano T, Inoue K, Fujisawa T, Ishiguro H, Nakayama H, Aogi K, Amano S, Ozaki H, Yasojima H, Kasai H, Kataoka T, Morita S, Toi M. 1955 Primary systemic therapy by dual HER2 blockage with lapatinib (La) + trastuzumab (T) for Japanese patients (pts) with HER2+ breast cancer (BC): Association of La toxicity and dose with treatment efficacy. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30903-0] [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: 10/22/2022]
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Ishiguro H, Abe H, Seki N, Sugita T, Aida Y, Itagaki M, Sutoh S, Shimada N, Furihata T, Tsubota A, Aizawa Y. Interferon-λ3 polymorphisms in pegylated-interferon-α plus ribavirin therapy for genotype-2 chronic hepatitis C. World J Gastroenterol 2015; 21:3904-11. [PMID: 25852275 PMCID: PMC4385537 DOI: 10.3748/wjg.v21.i13.3904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 11/29/2014] [Accepted: 01/16/2015] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate interferon-λ3 (IFNL3) polymorphisms in response-guided pegylated interferon-α plus ribavirin (Peg-IFNα/RBV) therapy for genotype 2 (G2) chronic hepatitis C. METHODS Between January 2006 and June 2012, a total of 180 patients with chronic infections of G2 hepatitis C virus (HCV) were treated with response-guided Peg-IFNα/RBV therapy. The treatment duration was 24 wk for patients who achieved rapid virologic response (RVR), and 36 or 48 wk for patients who did not. Then, the impact of the IFNL3 single nucleotide polymorphism genotype (TT/non-TT at rs8099917) on treatment outcomes was evaluated in the 180 patients, and between patients infected with either HCV sub-genotype 2a or 2b. RESULTS Of the 180 patients evaluated, 111 achieved RVR, while the remaining 69 patients did not. In RVR patients, the sustained virologic response (SVR) rate was 96.4%, and the IFNL3 genotype did not influence the SVR rate (96.6% vs 95.8% in IFNL3 genotype TT vs non-TT). However, in non-RVR patients, the SVR rate decreased to 72.5% (P < 0.0001), and this rate was significantly different between the IFNL3 genotype TT and non-TT groups (80.0% vs 42.9%, P = 0.0146). Multivariate regression analysis in non-RVR patients identified the IFNL3 genotype TT as the only baseline-significant factor associated with SVR (OR = 5.39, 95%CI: 1.29-22.62; P = 0.0189). In analysis according to HCV sub-genotype, no significant difference in the SVR rate was found between HCV sub-genotypes 2a and 2b. CONCLUSION In response-guided Peg-IFNα/RBV combination therapy for chronically HCV G2-infected patients, the impact of the IFNL3 genotype on SVR was limited to non-RVR patients.
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Aida Y, Abe H, Tomita Y, Nagano T, Seki N, Sugita T, Itagaki M, Ishiguro H, Sutoh S, Aizawa Y. Serum Immunoreactive Collagen IV detected by Monoclonal Antibodies as a Marker of Severe Fibrosis in Patients with Non- Alcoholic Fatty Liver Disease. JGLD 2015; 24:61-8. [DOI: 10.15403/jgld.2014.1121.yad] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Background & Aims: The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing worldwide. We evaluated serum collagen IV as a direct non-invasive marker of severe liver fibrosis in NAFLD.Methods: The study included 148 NAFLD and 187 chronic hepatitis C patients in whom histological severity of liver fibrosis was evaluated. The utility of serum collagen IV measured by immune-mediated agglutination using two types of monoclonal antibodies for distinguishing severe fibrosis (≥ stage 3 and ≥ F3) from non-to-moderate fibrosis in NAFLD or chronic hepatitis C was assessed in comparison to serum hyaluronic acid or other indirect fibrosis markers.Results: Multiple logistic regression analysis showed that serum collagen IV was significantly associated with severe fibrosis in NAFLD (odds ratio: 1.21, p<0.001) but not in chronic hepatitis C. For distinguishing severe fibrosis in NAFLD, collagen IV showed the largest area under the receiver-operating characteristic curve (0.827, 95%CI: 0.746-0.908) followed by FIB-4 (0.805, 95%CI: 0.728-0.890); in chronic hepatitis C, those for FIB-4 (0.813, 95%CI: 0.748-0.878) and collagen IV (0.770, 95%CI: 0.683-0.857) were the largest and smallest, respectively. To detect severe fibrosis in NAFLD, a cutoff of collagen IV > 177 exhibited 77.1% sensitivity, 84.0% specificity, 76.5% positive predictive value, and 84.0% negative predictive value. Combined with a cutoff of FIB-4 > 2.09, the negative and positive predictive values, and specificity for detecting severe fibrosis in NAFLD increased further.Conclusion: Collagen IV is a reliable marker for distinguishing severe liver fibrosis from non-to-moderate fibrosis in NAFLD but not chronic hepatitis C.
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Aida Y, Abe H, Tomita Y, Nagano T, Seki N, Sugita T, Itagaki M, Ishiguro H, Sutoh S, Aizawa Y. Serum cytokeratin 18 fragment level as a noninvasive biomarker for non-alcoholic fatty liver disease. Int J Clin Exp Med 2014; 7:4191-4198. [PMID: 25550930 PMCID: PMC4276188] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 10/23/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND AND AIM We evaluated the usefulness of serum cytokeratin 18 fragment (CK18-F) as a noninvasive biomarker in differentiating nonalcoholic steatohepatitis (NASH) from nonalcoholic fatty liver (NAFL) since the prognosis of the 2 diseases differ. METHODS 116 Japanese patients with nonalcoholic fatty liver disease (NAFLD) proven by liver biopsy were studied. Histological findings were classified according to the NAFLD activity score (NAS) proposed by the Nonalcoholic Steatohepatitis Clinical Research Network. The correlation between histological findings and serum CK18-F levels was investigated. RESULTS Serum CK18-F levels showed a positive correlation with histologic steatosis (ρ = 0.271, P = 0.0033), inflammation (ρ = 0.353, P = 0.0005), ballooning (ρ = 0.372, P = 0.0001), and the total NAS (ρ = 0.474, P = 2.68 × 10-7). The serum CK18-F level was significantly lower for NAFL (NAS ≤ 2) than for borderline NASH (NAS of 3-4) or definite NASH (NAS ≥ 5) (P = 0.0294, P = 1.163 × 10-5, respectively). The serum CK18-F level was significantly higher for definite NASH than for borderline NASH (P = 0.0002). The area under the receiver operating characteristic curve of serum CK18-F to predict the presence of NAFL and definite NASH was 0.762 and 0.757, respectively. The optimal cut-off point of serum CK18-F for NAFL and definite NASH was 230 and 270 U/L, respectively. The sensitivity, specificity, positive predict value, and negative predict value of serum CK18-F for NAFL were 0.89, 0.65, 0.34, and 0.97, and those for definite NASH were 0.64, 0.76, 0.72, and 0.67, respectively. Accuracies of diagnosis for both NAFL and definite NASH were 0.70. CONCLUSIONS Serum CK18-F could be a clinically useful biomarker to discriminate between NAFL and NASH.
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Affiliation(s)
- Yuta Aida
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Jikei University School of Medicine, Katsushika Medical Center 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Hiroshi Abe
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Jikei University School of Medicine, Katsushika Medical Center 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Yoichi Tomita
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Jikei University School of Medicine, Katsushika Medical Center 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Tomohisa Nagano
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Jikei University School of Medicine, Katsushika Medical Center 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Nobuyoshi Seki
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Jikei University School of Medicine, Katsushika Medical Center 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Tomonori Sugita
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Jikei University School of Medicine, Katsushika Medical Center 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Munenori Itagaki
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Jikei University School of Medicine, Katsushika Medical Center 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Haruya Ishiguro
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Jikei University School of Medicine, Katsushika Medical Center 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Satoshi Sutoh
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Jikei University School of Medicine, Katsushika Medical Center 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Yoshio Aizawa
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Jikei University School of Medicine, Katsushika Medical Center 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan
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Affiliation(s)
- H. Ishiguro
- Human Nutrition; Nagoya University Graduate School of Medicine; Research Center of Health, Physical Fitness, and Sports; Nagoya University; Nagoya Japan
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Takada M, Ishiguro H, Nagai S, Ohtani S, Kawabata H, Yanagita Y, Hozumi Y, Shimizu C, Takao S, Sato N, Kosaka Y, Sagara Y, Iwata H, Ohno S, Kuroi K, Masuda N, Yamashiro H, Sugimoto M, Kondo M, Naito Y, Sasano H, Inamoto T, Morita S, Toi M. Survival of HER2-positive primary breast cancer patients treated by neoadjuvant chemotherapy plus trastuzumab: a multicenter retrospective observational study (JBCRG-C03 study). Breast Cancer Res Treat 2014; 145:143-53. [PMID: 24682674 DOI: 10.1007/s10549-014-2907-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 03/04/2014] [Indexed: 10/25/2022]
Abstract
We investigated the disease-free survival (DFS) of HER2-positive primary breast cancer patients treated with neoadjuvant chemotherapy plus trastuzumab, as well as predictive factors for DFS and pathologic response. Data from 829 female patients treated between 2001 and 2010 were collected from 38 institutions in Japan. Predictive factors were evaluated using multivariate analyses. The 3-year DFS rate was 87 % [95 % confidence interval (CI) 85-90]. The pathologic complete response (pCR: ypT0/is + ypN0) rate was 51 %. The pCR rate was higher in the ER/PgR-negative patients than in the ER/PgR-positive patients (64 vs. 36 %, P < 0.001). Patients with pCR showed a higher DFS rate than patients without pCR (93 vs. 82 %, P < 0.001). Multivariate analysis revealed three independent predictors for poorer DFS: advanced nodal stage [hazard ratio (HR) 2.63, 95 % CI 1.36-5.21, P = 0.004 for cN2-3 vs. cN0], histological/nuclear grade 3 (HR 1.81, 95 % CI 1.15-2.91, P = 0.011), and non-pCR (HR 1.98, 95 % CI 1.22-3.24, P = 0.005). In the ER/PgR-negative dataset, non-pCR (HR 2.63, 95 % CI 1.43-4.90, P = 0.002) and clinical tumor stage (HR 2.20, 95 % CI 1.16-4.20, P = 0.017 for cT3-4 vs. cT1-2) were independent predictors for DFS, and in the ER/PgR-positive dataset, histological grade of 3 (HR 3.09, 95 % CI 1.48-6.62, P = 0.003), clinical nodal stage (HR 4.26, 95 % CI 1.53-13.14, P = 0.005 for cN2-3 vs. cN0), and young age (HR 2.40, 95 % CI 1.12-4.94, P = 0.026 for ≤40 vs. >40) were negative predictors for DFS. Strict pCR (ypT0 + ypN0) was an independent predictor for DFS in both the ER/PgR-negative and -positive datasets (HR 2.66, 95 % CI 1.31-5.97, P = 0.006 and HR 3.86, 95 % CI 1.13-24.21, P = 0.029, respectively). These results may help assure a more accurate prognosis and personalized treatment for HER2-positive breast cancer patients.
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Affiliation(s)
- M Takada
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, 54 Kawaracho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Yoshizawa K, Abe H, Aida Y, Ishiguro H, Ika M, Shimada N, Tsubota A, Aizawa Y. Serum apolipoprotein B-100 concentration predicts the virological response to pegylated interferon plus ribavirin combination therapy in patients infected with chronic hepatitis C virus genotype 1b. J Med Virol 2014; 85:1180-90. [PMID: 23918536 DOI: 10.1002/jmv.23597] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2013] [Indexed: 12/23/2022]
Abstract
Host lipoprotein metabolism is associated closely with the life cycle of hepatitis C virus (HCV), and serum lipid profiles have been linked to the response to pegylated interferon (Peg-IFN) plus ribavirin (RBV) therapy. Polymorphisms in the human IL28B gene and amino acid substitutions in the core and interferon sensitivity-determining region (ISDR) in NS5A of HCV genotype 1b (G1b) were also shown to strongly affect the outcome of Peg-IFN plus RBV therapy. In this study, an observational cohort study was performed in 247 HCV G1b-infected patients to investigate whether the response to Peg-IFN and RBV combination therapy in these patients is independently associated with the level of lipid factors, especially apolipoprotein B-100 (apoB-100), an obligatory structural component of very low density lipoprotein and low density lipoprotein. The multivariate logistic analysis subsequently identified apoB-100 (odds ratio (OR), 1.602; 95% confidence interval (CI), 1.046-2.456), alpha-fetoprotein (OR, 0.764; 95% CI, 0.610-0.958), non-wild-type ISDR (OR, 5.617; 95% CI, 1.274-24.754), and the rs8099917 major genotype (OR, 34.188; 95% CI, 10.225-114.308) as independent factors affecting rapid initial virological response (decline in HCV RNA levels by ≥3-log10 at week 4). While lipid factors were not independent predictors of complete early or sustained virological response, the serum apoB-100 level was an independent factor for sustained virological response in patients carrying the rs8099917 hetero/minor genotype. Together, we conclude that serum apoB-100 concentrations could predict virological response to Peg-IFN plus RBV combination therapy in patients infected with HCV G1b, especially in those with the rs8099917 hetero/minor genotype.
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Affiliation(s)
- Kai Yoshizawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine Katsushika Medical Center, Tokyo, Japan.
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Yoshida Y, Matsuda K, Tamai N, Yoshizawa K, Nikami T, Ishiguro H, Tajiri H. A pilot study using an infrared imaging system in prevention of post-endoscopic submucosal dissection ulcer bleeding. Gastric Cancer 2014; 17:116-21. [PMID: 23392913 DOI: 10.1007/s10120-013-0231-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 01/03/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Endoscopic submucosal dissection (ESD) for superficial gastric neoplasm is a curative method. The aim of this study was to detect potential nonbleeding visible vessels (NBVVs) by using an infrared imaging (IRI) system. METHODS A total of 24 patients (25 lesions) were consecutively enrolled between March 2010 and December 2010. The day after ESD, endoscopist A (K.M.), who was blinded to the actual procedure of ESD, performed esophagogastroduodenoscopy (EGD) of the post-ESD ulcer base using the IRI system. Endoscopist A marked gray/blue points in the hard-copy images with the IRI system. After the first procedure, endoscopist B (Y.Y.), who was blinded to the results recorded by endoscopist A, performed a second EGD with white light endoscopy and administered water-jet pressure with the maximum level of an Olympus flushing pump onto the post-ESD ulcer base. This test can cause iatrogenic bleeding via application of pressure to NBVV in the post-ESD ulcer. RESULTS The IRI system detected 58 gray points and 71 blue points. The post-ESD ulcer was divided into the central area and the peripheral area. There were 14 gray points (24 %) in the central area and 44 gray points (76 %) in the peripheral area. There were 19 blue points (27 %) in the central area and 52 blue points (73 %) in the peripheral area. There was no significant difference when comparing the distribution of gray points and blue points. Bleeding occurred with a water-jet pressure in 11 of 58 gray points and in none of the blue points (P = 0.000478). Among the gray points, bleeding in response to a water-jet pressure occurred in 2 points in the central area and in 9 points in the peripheral area. CONCLUSION The IRI system detects visible vessels (VVs) that are in no need of coagulation as blue points, and VVs have a potential risk of bleeding as gray points.
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Affiliation(s)
- Yukinaga Yoshida
- Department of Endoscopy, Katsushika Medical Center, The Jikei University School of Medicine, 6-41-2 Katsushika-ku, Tokyo, 125-8506, Japan,
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Toi M, Masuda N, Andre F, Ishiguro H, Fasolo A, Xu B, Jerusalem G, Shen K, Wilks S, O'Regan R, Isaacs C, Zhang Y, Taran T, Yap YS. Abstract P4-12-19: BOLERO-3: Everolimus plus trastuzumab and vinorelbine in Asian patients with HER2-positive metastatic breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-12-19] [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: Resistance to trastuzumab may occur through activation of the PI3K/Akt/mTOR signaling pathway, the inhibition of which may restore trastuzumab sensitivity. BOLERO-3, a phase 3, double-blind, international trial involving 569 patients with trastuzumab-resistant, HER2-positive (HER2+), advanced breast cancer pretreated with a taxane, recently reported that adding everolimus (EVE; an mTOR inhibitor) to vinorelbine and trastuzumab significantly improved progression-free survival (PFS) vs placebo (PBO) plus vinorelbine and trastuzumab (hazard ratio [HR] = 0.78; log-rank P = .0067). As EVE pharmacokinetics and, therefore, clinical effects may be different in Asian patients, we analyzed the efficacy and safety data from BOLERO-3 for the Asian population.
Methods: Eligible women with trastuzumab-resistant, HER2+, advanced breast cancer who received prior taxane therapy were randomized (1:1) to EVE (5 mg/day) or matching PBO in combination with weekly vinorelbine (25 mg/m2) and trastuzumab (2 mg/kg after 4-mg/kg loading dose). The primary endpoint was PFS by investigator. Secondary endpoints included safety.
Results: Among 569 patients enrolled in this study, 166 (29%) patients were Asian; 88 and 78 were assigned to EVE or PBO arms, respectively. In this subpopulation, adding EVE to vinorelbine and trastuzumab prolonged median PFS compared with the PBO arm (8.3 vs 6.8 months, respectively; HR = 0.83; 95% confidence interval, 0.59 - 1.18). In general, the incidence of all grade adverse events was similar for Asian versus non-Asian patients in the EVE arm (stomatitis, 71% vs 59%; pneumonitis, 7% vs 5%; and infections, 58% vs 70%) and the PBO arm (stomatitis, 31% vs 26%; pneumonitis, 1% vs 4%; and infections, 48% vs 49%). Serious adverse events had a low incidence and included febrile neutropenia (9.1%), neutropenia (2.3%), stomatitis (2.3%), anemia (2.3%), and cataract (2.3%) as the most common among Asian patients in the EVE arm. The incidence of serious pneumonitis was low: Asian (1.1%) versus non-Asian patients (0%) in the EVE arm and 0% versus 1.5%, respectively, in the PBO arm.
Conclusions: Asian patients in the BOLERO-3 trial treated with EVE plus vinorelbine and trastuzumab showed PFS benefits similar to the overall population and had a comparable manageable safety profile. Thus, EVE in combination with vinorelbine and trastuzumab may be considered as a new therapeutic option for Asian women with trastuzumab-resistant, HER2+, advanced breast cancer progressing after taxane-based therapies.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-12-19.
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Affiliation(s)
- M Toi
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - N Masuda
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - F Andre
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - H Ishiguro
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - A Fasolo
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - B Xu
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - G Jerusalem
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - K Shen
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - S Wilks
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - R O'Regan
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - C Isaacs
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - Y Zhang
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - T Taran
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
| | - Y-S Yap
- Kyoto University, Kyoto, Japan; NHO Osaka National Hospital, Osaka, Japan; Institut Gustave Roussy, Villejuif, France; Kyoto University Hospital, Kyoto University Cancer Center, Kyoto, Japan; San Raffaele Cancer Center, Milan, Italy; Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; CHU Sart Tilman Liege, Liege, Belgium; Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai City, China; Cancer Care Center of South Texas, TX; Winship Cancer Institute of Emory University, Atlanta, GA; Georgetown University, Washington, DC; Novartis Pharmaceuticals, East Hanover, NJ; National Cancer Centre Singapore, Singapore, Singapore
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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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Takada M, Ishiguro H, Nagai S, Ohtani S, Kawabata H, Yanagita Y, Hozumi Y, Shimizu C, Takao S, Sato N, Kosaka Y, Sagara Y, Iwata H, Ohno S, Kuroi K, Masuda N, Yamashiro H, Sugimoto M, Kondo M, Naito Y, Sasano H, Inamoto T, Morita S, Toi M. Abstract P6-06-20: Predictive factors for pathologic complete response and disease-free survival after neoadjuvant chemotherapy with trastuzumab: A multicenter retrospective observational study in patients with HER2-positive primary breast cancer (JBCRG-C03 study). Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p6-06-20] [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:
Addition of trastuzumab to neoadjuvant chemotherapy (NAC) improved pathologic complete response (pCR) rate in HER2-positive breast cancer. Although recent trials have shown favorable prognosis with NAC plus trastuzumab, clinicopathological factors to predict the outcome have not been fully understood. The aim of this study was to investigate the survival after NAC with trastuzumab and to explore the predictive factors.
PATIENTS AND METHODS:
This is a multicenter retrospective observational study. Patients with HER2-positive primary breast cancer treated with NAC plus trastuzumab from 2001 to 2010 were identified from the institutional database. Primary end point was disease-free survival (DFS). pCR was defined as ypT0/is+ypN0. Kaplan-Meier method was used to estimate DFS. Logistic regression and proportional hazard analysis were used to identify clinicopathological factors to predict pCR and DFS, respectively.
RESULTS:
733 patients were included in the analysis (whole dataset). 425 were ER/PgR-negative (HR- dataset) and 306 were ER/PgR-positive (HR+ dataset). Radiation therapy was performed in 90% of lumpectomy and 31% of mastectomy. Hormonal therapy was performed in 84% of HR+ dataset. pCR rate was 45% in whole dataset, 60% in HR- dataset, and 34% in HR+ dataset. Table 1 showed the result of multivariate analysis for pCR in whole dataset. When HR+ and HR- dataset were analyzed separately, no definitive predictors for pCR were identified in multivariate analysis. Although the patients with pCR showed a significantly favorable prognosis than those without pCR at 3 years DFS, in whole dataset (93% vs 83%, p<0.0001) and HR- dataset (94% vs 80%, p<0.0001), there was no significant difference in HR+ dataset (89% vs 86%, p = 0.10). Different predictors were selected for DFS when multivariate analysis was conducted separately between HR- and HR+ dataset (Table 2).
CONCLUSIONS:
In this observational study, we clarified predictors for pCR and DFS in HER2-positive patients treated with neoadjuvant trastuzumab containing therapy based on tumor subtype. Our results may help us to predict the prognosis more precisely and to simulate the disease course.
Table 1) Multivariate logistic regression analysis for pCR in whole datasetFactorsOR95%CIp-valuePost- vs Pre-menopause1.50(1.05-2.15)0.026*cT1-2 vs cT3-41.72(1.16-2.59)0.008*ER/PgR-negative vs ER/PgR-positive3.32(2.30-4.82)<0.0001*Grade 3 vs 1-21.28(0.89-1.84)0.183
Table 2) Multivariate proportional hazard analysis for DFSFactors†HR95%CIp-valueWhole dataset Pre- vs Post-menopause1.61(1.04-2.52)0.033*cN2-3 vs cN03.06(1.58-6.24)0.001*cN1 vs cN02.26(1.23-4.41)0.007*Grade 3 vs 1-21.87(1.20-2.97)0.006*non-pCR vs pCR1.90(1.18-3.13)0.008*HR- dataset Pre- vs Post-menopause1.70(1.01-2.85)0.046*cT3-4 vs cT1-21.86(1.09-3.17)0.024*non-pCR vs pCR3.28(1.90-5.87)<0.0001*HR+ dataset cN2-3 vs cN05.01(1.79-16.19)0.002*cN1 vs cN03.50(1.40-10.61)0.006*Grade 3 vs 1-22.95(1.52-5.87)0.001*†Only factors with statistical significance
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-06-20.
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Affiliation(s)
- M Takada
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - H Ishiguro
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - S Nagai
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - S Ohtani
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - H Kawabata
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - Y Yanagita
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - Y Hozumi
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - C Shimizu
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - S Takao
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - N Sato
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - Y Kosaka
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - Y Sagara
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - H Iwata
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - S Ohno
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - K Kuroi
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - N Masuda
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - H Yamashiro
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - M Sugimoto
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - M Kondo
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - Y Naito
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - H Sasano
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - T Inamoto
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - S Morita
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - M Toi
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
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Ogawa R, Ishiguro H, Kimura M, Funahashi H, Wakasugi T, Ando T, Shiozaki M, Takeyama H. NOTCH1 expression predicts patient prognosis in esophageal squamous cell cancer. Eur Surg Res 2013; 51:101-7. [PMID: 24217574 DOI: 10.1159/000355674] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 09/17/2013] [Indexed: 11/19/2022]
Abstract
PURPOSE The prognosis of patients with esophageal cancer remains poor, and the classification of tumor node metastasis has proven insufficient to predict patient prognosis. Therefore, novel predictive markers of esophageal cancer prognosis are needed. Notch receptors and their ligands have been reported to be upregulated in cervical, lung, colon, renal, and pancreatic cancers, but NOTCH1 expression has not been studied in esophageal cancer. METHODS Expression of NOTCH1 was quantified by real-time reverse transcription-polymerase chain reaction in 55 primary esophageal squamous cell carcinomas (ESCCs) and their paired normal esophageal mucosa. We then examined the correlations between NOTCH1 expression, clinicopathological factors, and prognosis in patients with ESCC. RESULTS The probability of overall survival was significantly lower for patients with high NOTCH1 expression (p = 0.0028; log-rank test). Overexpression of NOTCH1 was identified as a significant and independent prognostic factor (p = 0.0061) in patients who had undergone surgical treatment for ESCCs. The hazard ratio for predicting early death was 4.298 (95% confidence interval 1.515-12.195) for high versus low NOTCH1 expression. CONCLUSIONS Our data indicate that NOTCH1 may be a candidate molecular prognostic marker and a molecular target for the development of an effective therapeutic intervention for patients with ESCC.
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Affiliation(s)
- R Ogawa
- Department of Gastroenterological Surgery, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
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Kawaguchi K, Ishiguro H, Yano I, Yamashiro H, Toi M. Therapeutic Drug Monitoring of Docetaxel for a Living Donor Liver Transplantation Recipient. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.139] [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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Inami T, Kataoka M, Shimura N, Yanagisawa R, Ishiguro H, Tamura Y, Kawakami T, Fukuda K, Yoshino H, Satoh T. Influence of balloon pulmonary angioplasty on prognosis in patients with chronic thrombo-embolic pulmonary hypertension. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.765] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Yanagisawa R, Kataoka M, Inami T, Shimura N, Taguchi H, Ishiguro H, Fukuda K, Yoshino H, Satoh T. Impact of percutaneous transluminal pulmonary angioplasty for the treatment of chronic thromboembolic pulmonary hypertension. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2196] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nagaoka M, Goda A, Shimura N, Yanagisawa R, Taguchi H, Inami T, Ishiguro H, Satoh T, Yoshino H. Sleep apnea syndrome is not associated with a poor prognosis in patients with pulmonary arterial hypertension. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1531] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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40
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Abe H, Aida Y, Ishiguro H, Yoshizawa K, Seki N, Miyazaki T, Itagaki M, Sutoh S, Ika M, Kato K, Shimada N, Tsubota A, Aizawa Y. New proposal for response-guided peg-interferon-plus-ribavirin combination therapy for chronic hepatitis C virus genotype 2 infection. J Med Virol 2013; 85:1523-33. [PMID: 23775277 DOI: 10.1002/jmv.23626] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2013] [Indexed: 11/06/2022]
Abstract
This study aimed to determine the most suitable duration of pegylated-interferon (Peg-IFN)-plus-ribavirin combination therapy in patients infected with hepatitis C virus (HCV) genotype 2 who had not achieved rapid virological response (serum HCV RNA disappearance after 4 weeks of therapy). HCV genotype 2 patients (n = 182) with a high viral load received >80% of the standard Peg-IFN-plus-ribavirin dose for at least 24 weeks, and their final virological responses were studied. Patients were classified into "rapid virological response" and "non-rapid virological response" groups. The non-rapid virological response group was further divided into a "virological response at 8 weeks" (serum HCV RNA disappearance after 8 weeks of therapy) and a "non-virological response at 8 weeks" group. Factors related to rapid virological response and optimal therapy duration in the non-rapid virological response group were evaluated. Multivariate logistic regression analysis showed that subtype HCV genotype 2a (P = 0.0015) and low concentration of pretreatment serum HCV RNA (P = 0.0058) were independent factors in a rapid virological response. In the virological response at 8 weeks group, the sustained virological response rate after 24 weeks of therapy was significantly lower than after 36 weeks (P = 0.044) or after 48 weeks (P = 0.006), and was similar for 36- and 48-weeks. The cost for achieving (CAS) one sustained virological response was lowest with 36-week therapy. Prolongation of Peg-IFN-plus-ribavirin combination therapy to 36 weeks is suitable for achieving virological response at 8 weeks, given the high, sustained virological response rate and cost benefit.
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Affiliation(s)
- Hiroshi Abe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine Katsushika Medical Center, Katsushika-Ku, Tokyo, Japan.
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Aizawa Y, Shimada N, Abe H, Seki N, Aida Y, Ishiguro H, Ika M, Kato K, Tsubota A. Serum lipoprotein profiles and response to pegylated interferon plus ribavirin combination therapy in patients with chronic HCV genotype 1b infection. Hepat Mon 2013; 13:e8988. [PMID: 23967025 PMCID: PMC3743300 DOI: 10.5812/hepatmon.8988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 03/07/2013] [Accepted: 04/07/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Abnormal serum lipid profiles have been noted in patients with chronic hepatitis C virus (HCV) infection. Moreover, many reports suggest that serum lipoprotein profiles are more profoundly distorted in patients with HCV G1b infection who have an unfavorable response to pegylated interferon (peg-IFN) plus ribavirin (RBV) combination therapy. However, after the discovery of single nucleotide polymorphisms near the IL28B gene (rs8099917 and rs12979860) as potent predictive factors affecting the response to peg-IFN plus RBV, lipid factors are thought to be confounding factors. OBJECTIVES To re-examine the significance of lipoprotein profiles on virological response to peg-IFN plus RBV combination therapy in patients with chronic HCV G1b infection, we examined cholesterol and triglyceride concentrations in each lipoprotein fraction separated by high performance liquid chromatography. PATIENTS AND METHODS Lipoprotein profiles were examined using fasting sera from 108 patients infected with HCV G1b who had chronic hepatitis, as determined by liver biopsy. Results of lipoprotein profiles and clinical data, including IL28B genotype and amino acid substitution at aa70 of HCV G1b, were compared between patients with a sustained virological response (SVR) and non-SVR or a non-virological response (NVR) and virological responses other than NVR (non-NVR). In addition, significant predictive factors independently associated with virological response to peg-IFNα-2b plus RBV were determined by logistic regression analysis. RESULTS An increased ratio of cholesterol/triglyceride in very low-density lipoprotein (odds ratio (OR) 3.03; 95% confidence interval (CI) 1.01-9.44) along with a major genotype of rs8099917 (OR 9.09; 95% CI 2.94-33.33), were independent predictive factors for SVR. In contrast, lipid factors were not elucidated as independent predictive factors for NVR. CONCLUSIONS Examination of the fasting lipid profile has clinical importance in predicting the efficacy of peg-IFN-α-2b plus RBV combination therapy for patients with HCV G1b even after the discovery of the IL28 genotype as a potent predictive factor.
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Affiliation(s)
- Yoshio Aizawa
- Department of Gastroenterology and Hepatology, Jikei University School of Medicine, Tokyo, Japan
- Corresponding author: Yoshio Aizawa, Department of Gastroenterology and Hepatology, Jikei University School of Medicine, Tokyo, Japan, Tel.: +81-336032111, Fax: +81-338389944, E-mail:
| | - Noritomo Shimada
- Department of Gastroenterology and Hepatology, Shinmatsudo Chuo General Hospital, Chiba, Japan
| | - Hiroshi Abe
- Department of Gastroenterology and Hepatology, Jikei University School of Medicine, Tokyo, Japan
| | - Nobuyoshi Seki
- Department of Gastroenterology and Hepatology, Jikei University School of Medicine, Tokyo, Japan
| | - Yuta Aida
- Department of Gastroenterology and Hepatology, Jikei University School of Medicine, Tokyo, Japan
| | - Haruya Ishiguro
- Department of Gastroenterology and Hepatology, Jikei University School of Medicine, Tokyo, Japan
| | - Makiko Ika
- Department of Gastroenterology and Hepatology, Shinmatsudo Chuo General Hospital, Chiba, Japan
| | - Keizo Kato
- Department of Gastroenterology and Hepatology, Shinmatsudo Chuo General Hospital, Chiba, Japan
| | - Akihito Tsubota
- Institute of Clinical Medicine and Research, Jikei University Kashiwa Hospital, Chiba, Japan
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Abe H, Aida Y, Ishiguro H, Yoshizawa K, Miyazaki T, Itagaki M, Sutoh S, Aizawa Y. Alcohol, postprandial plasma glucose, and prognosis of hepatocellular carcinoma. World J Gastroenterol 2013; 19:78-85. [PMID: 23326166 PMCID: PMC3542757 DOI: 10.3748/wjg.v19.i1.78] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 09/17/2012] [Accepted: 09/29/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To identify factors associated with prognosis of hepatocellular carcinoma (HCC) after initial therapy.
METHODS: A total of 377 HCC patients who were newly treated at Katsushika Medical Center, Japan from January 2000 to December 2009 and followed up for > 2 years, or died during follow-up, were enrolled. The factors related to survival were first analyzed in 377 patients with HCC tumor stage T1-T4 using multivariate Cox proportional hazards regression analysis. A similar analysis was performed in 282 patients with tumor stage T1-T3. Additionally, factors associated with the period between initial and subsequent therapy were examined in 144 patients who did not show local recurrence. Finally, 214 HCC stage T1-T3 patients who died during the observation period were classified into four groups according to their alcohol consumption and postprandial glucose levels, and differences in their causes of death were examined.
RESULTS: On multivariate Cox proportional hazards regression analysis, the following were significantly associated with survival: underlying liver disease stage [non-cirrhosis/Child-Pugh A vs B/C, hazard ratio (HR): 0.603, 95% CI: 0.417-0.874, P = 0.0079], HCC stage (T1/T2 vs T3/T4, HR: 0.447, 95% CI: 0.347-0.576, P < 0.0001), and mean postprandial plasma glucose after initial therapy (< 200 vs≥ 200 mg/dL, HR: 0.181, 95% CI: 0.067-0.488, P = 0.0008). In T1-T3 patients, uninterrupted alcohol consumption after initial therapy (no vs yes, HR: 0.641, 95% CI: 0.469-0.877, P = 0.0055) was significant in addition to underlying liver disease stage (non-cirrhosis/Child-Pugh A vs B/C, HR: 0649, 95% CI: 0.476-0.885, P = 0.0068), HCC stage (T1 vs T2/T3, HR: 0.788, 95% CI: 0.653-0.945, P = 0.0108), and mean postprandial plasma glucose after initial therapy (< 200 mg/dL vs≥ 200 mg/dL, HR: 0.502, 95% CI: 0.337-0.747, P = 0.0005). In patients without local recurrence, time from initial to subsequent therapy for newly emerging HCC was significantly longer in the “postprandial glucose within 200 mg/dL group” than the “postprandial glucose > 200 mg/dL group” (log-rank test, P < 0.05), whereas there was no difference in the period between the “non-alcohol group” (patients who did not drink regularly or those who could reduce their daily consumption to < 20 g) and the “continuation group” (drinkers who continued to drink > 20 g daily). Of 214 T1-T3 patients who died during the observation period, death caused by other than HCC progression was significantly more frequent in “group AL” (patients in the continuation and postprandial glucose within 200 mg/dL groups) than “group N” (patients in the non-alcohol and postprandial glucose within 200 mg/dL groups) (P = 0.0016).
CONCLUSION: This study found that abstinence from habitual alcohol consumption and intensive care for diabetes mellitus were related to improved prognosis in HCC patients.
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Onaivi ES, Ishiguro H, Sgro S, Leonard CM. Cannabinoid Receptor Gene Variations in Drug Addiction and Neuropsychiatric Disorders. ACTA ACUST UNITED AC 2013. [DOI: 10.4303/jdar/235714] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ishiguro H, Takashima S, Yoshimura K, Yano I, Yamamoto T, Niimi M, Yamashiro H, Ueno T, Takeuchi M, Sugie T, Yanagihara K, Toi M, Fukushima M. Degree of freezing does not affect efficacy of frozen gloves for prevention of docetaxel-induced nail toxicity in breast cancer patients. Support Care Cancer 2012; 20:2017-24. [PMID: 22086405 PMCID: PMC3411307 DOI: 10.1007/s00520-011-1308-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [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] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 10/25/2011] [Indexed: 11/29/2022]
Abstract
PURPOSE Frozen gloves (FG) are effective in preventing docetaxel-induced nail toxicity (DNT), but uncomfortable. The preventive effect of FG for DNT was compared using a standard (-25 to -30°C) or more comfortable (-10 to -20°C) preparation. METHODS Breast cancer patients receiving docetaxel were eligible. Each patient wore an FG (prepared at -10 to -20°C for 90 min) for 60 min without replacement on the right hand. The left hand was protected by standard methods (FG prepared at -25 to -30°C overnight and worn for 90 min with replacement at 45 min). The primary endpoint was DNT occurrence at 5 months. Secondary endpoints included docetaxel exposure [cumulative dose and area under the blood concentration time curve (AUC)] until DNT occurrence and discomfort from FG. The pharmacokinetics of docetaxel was assessed. RESULTS From 23 patients enrolled between December 2006 and June 2010, seven who received docetaxel for less than 5 months were excluded from evaluation. The median accumulated docetaxel dose was 700 mg/m(2) (340-1430 mg/m(2)). Within 5 months of FG use, none developed protocol-defined DNT in either hand. Two patients (13%) developed DNT at 7.2 and 7.3 months, respectively, both at -10 to -20°C. In the control hand (-25 to -30°C), discomfort occurred in 92% of the cycles, compared to 15% in the experimental hand (-10 to -20°C). Five patients (22%) experienced pain at -25 to -30°C, but none did at -10 to -20°C. The degree of docetaxel exposure was not related to DNT occurrence in our study. CONCLUSION A convenient preparation of FG at -10 to -20°C is almost as effective as a standard preparation at -25 to -30°C, with significantly less discomfort.
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Affiliation(s)
- H Ishiguro
- Outpatient Oncology Unit, Kyoto University Hospital, Kyoto, Japan.
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Aizawa Y, Yohizawa K, Aida Y, Ishiguro H, Abe H, Tsubota A. Genotype rs8099917 near the IL28B gene and amino acid substitution at position 70 in the core region of the hepatitis C virus are determinants of serum apolipoprotein B-100 concentration in chronic hepatitis C. Mol Cell Biochem 2012; 360:9-14. [PMID: 21879313 DOI: 10.1007/s11010-011-1037-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 08/13/2011] [Indexed: 02/06/2023]
Abstract
The life cycle of the hepatitis C virus (HCV) is closely related to host lipoprotein metabolism. Serum levels of lipid are associated with the response to pegylated interferon plus ribavirin (PEG-IFN/RBV) therapy, while single nucleotide polymorphisms (SNPs) around the human interleukin 28B (IL28B) gene locus and amino acid substitutions in the core region of the HCV have been reported to affect the efficacy of PEG-IFN/RBV therapy in chronic hepatitis with HCV genotype 1b infection. The aim of this study was to elucidate the relationship between serum lipid and factors that are able to predict the efficacy of PEG-IFN/RB therapy, with specific focus on apolipoprotein B-100 (apoB-100) in 148 subjects with chronic HCV G1b infection. Our results demonstrated that both the aa 70 substitution in the core region of the HCV and the rs8099917 SNP located proximal to the IL28B were independent factors in determining serum apoB-100 and low-density lipoprotein (LDL) cholesterol levels. A significant association was noted between higher levels of apoB-100 (P = 1.1 × 10(-3)) and LDL cholesterol (P = 0.02) and the subjects having Arg70. A significant association was also observed between subjects carrying the rs8099917 TT responder genotype and higher levels of apoB-100 (P = 6.4 × 10(-3)) and LDL cholesterol (P = 4.2 × 10(-3)). Our results suggest that apoB-100 and LDL cholesterol are markers of impaired cellular lipoprotein pathways and/or host endogenous interferon response to HCV in chronic HCV infection. In particular, serum apoB-100 concentration might be an informative marker for judging changes in HCV-associated intracellular lipoprotein metabolism in patients carrying the rs8099917 responder genotype.
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Affiliation(s)
- Yoshio Aizawa
- Division of Gastroenterology and Hepatology, Jikei University Aoto Hospital, Tokyo, Japan.
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Kanai M, Ishiguro H, Mori Y, Kitano T, Nishimura T, Matsumoto S, Yanagihara K, Chiba T, Toi M. Temporary blood pressure drop after bevacizumab administration is associated with clinical course of advanced colorectal cancer. Br J Cancer 2011; 105:1693-6. [PMID: 22033274 PMCID: PMC3242590 DOI: 10.1038/bjc.2011.398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: A blood pressure drop after bevacizumab administration and its clinical significance have not been previously reported. Methods: Blood pressure data at 0, 90, and 180 min after a total of 162 bevacizumab administrations in 81 advanced colorectal cancer patients were retrospectively investigated. Results: Twenty-five patients (30%) demonstrated an average temporary drop of 20 mm Hg or more in systolic blood pressure. We classified these 25 patients as group A and the others as group B. Median time-to-treatment failure (TTF) was significantly longer in group A than in group B (291 vs 162 days; P=0.02). Furthermore, the proportion of patients who required intervention with antihypertensive drugs during bevacizumab treatment was significantly higher in group A than in group B (36% vs 4% P<0.01). Conclusion: This study suggests that a temporary blood pressure drop after bevacizumab administration could be a predictive marker for bevacizumab treatment.
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Affiliation(s)
- M Kanai
- Outpatient Oncology Unit, Kyoto University Hospital, 54 Shogin-Kawahara-cho, Sakyo-ku, Kyoto, Japan.
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Tanaka S, Syu A, Ishiguro H, Inada T, Horiuchi Y, Ishikawa M, Koga M, Noguchi E, Ozaki N, Someya T, Kakita A, Takahashi H, Nawa H, Arinami T. DPP6 as a candidate gene for neuroleptic-induced tardive dyskinesia. Pharmacogenomics J 2011; 13:27-34. [PMID: 21826085 DOI: 10.1038/tpj.2011.36] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We implemented a two-step approach to detect potential predictor gene variants for neuroleptic-induced tardive dyskinesia (TD) in schizophrenic subjects. First, we screened associations by using a genome-wide (Illumina HumanHapCNV370) SNP array in 61 Japanese schizophrenia patients with treatment-resistant TD and 61 Japanese schizophrenia patients without TD. Next, we performed a replication analysis in 36 treatment-resistant TD and 138 non-TD subjects. An association of an SNP in the DPP6 (dipeptidyl peptidase-like protein-6) gene, rs6977820, the most promising association identified by the screen, was significant in the replication sample (allelic P=0.008 in the replication sample, allelic P=4.6 × 10(-6), odds ratio 2.32 in the combined sample). The SNP is located in intron-1 of the DPP6 gene and the risk allele was associated with decreased DPP6 gene expression in the human postmortem prefrontal cortex. Chronic administration of haloperidol increased Dpp6 expression in mouse brains. DPP6 is an auxiliary subunit of Kv4 and regulates the properties of Kv4, which regulates the activity of dopaminergic neurons. The findings of this study indicate that an altered response of Kv4/DPP6 to long-term neuroleptic administration is involved in neuroleptic-induced TD.
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Affiliation(s)
- S Tanaka
- Department of Medical Genetics, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
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Kawaguchi K, Ishiguro H, Morita S, Nakamura S, Ohno S, Masuda N, Iwata H, Aogi K, Kuroi K, Toi M. Correlation between docetaxel-induced skin toxicity and the use of steroids and H₂ blockers: a multi-institution survey. Breast Cancer Res Treat 2011; 130:627-34. [PMID: 21698408 DOI: 10.1007/s10549-011-1641-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 06/13/2011] [Indexed: 11/25/2022]
Abstract
Steroids and H(2) blockers are commonly used as supportive care for taxane-containing chemotherapy, but they also affect docetaxel's primary metabolizer, cytochrome P(450) 3A4. This retrospective observational study was performed to better understand the effects of these compounds on docetaxel-induced skin toxicities, specifically hand-foot syndrome (HFS) and facial erythema (FE), a relationship that is currently poorly understood. Member institutions of the Japan Breast Cancer Research Group were invited to complete a questionnaire on the occurrence of grade 2 or higher HFS and FE among patients treated between April 2007 and March 2008 with docetaxel as an adjuvant or neoadjuvant chemotherapeutic treatment for breast cancer. We obtained data for 993 patients from 20 institutions. Twenty percent received H(2) blockers, and all patients received dexamethasone. Univariate and multivariate analyses revealed that H(2) blockers are associated with a significantly higher incidence of both HFS and FE. The incidence of FE was significantly higher for the docetaxel + cyclophosphamide (TC) regimen than for non-TC regimens combined. Dexamethasone usage did not affect the incidence of either HFS or FE. In conclusion, use of H(2) blockers as premedication in breast cancer patients receiving docetaxel significantly increases the risk of both HFS and FE.
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Affiliation(s)
- K Kawaguchi
- Department of Breast Surgery, Kyoto University Hospital, Kyoto, Japan
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Nagai H, Yasuda H, Kanai M, Nishimura T, Kitano T, Matsumoto S, Mori Y, Ishiguro H, Kakudo Y, Sato H, Yamaguchi T, Takashima S, Nakata K, Kobayashi M, Terada T, Sasaki T, Mio T, Mishima M, Yanagihara K, Fukushima M. A double-blind, randomized, multicenter study regarding the effects of solution for gemcitabine on frequency and degree of vascular pain in patients with cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19642] [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: 11/20/2022] Open
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Onaivi ES, Benno R, Halpern T, Mehanovic M, Schanz N, Sanders C, Yan X, Ishiguro H, Liu QR, Berzal AL, Viveros MP, Ali SF. Consequences of cannabinoid and monoaminergic system disruption in a mouse model of autism spectrum disorders. Curr Neuropharmacol 2011; 9:209-14. [PMID: 21886592 PMCID: PMC3137184 DOI: 10.2174/157015911795017047] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [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: 10/01/2009] [Revised: 04/17/2010] [Accepted: 05/26/2010] [Indexed: 01/06/2023] Open
Abstract
Autism spectrum disorders (ASDs) are heterogenous neurodevelopmental disorders characterized by impairment in social, communication skills and stereotype behaviors. While autism may be uniquely human, there are behavioral characteristics in ASDs that can be mimicked using animal models. We used the BTBR T+tf/J mice that have been shown to exhibit autism-like behavioral phenotypes to 1). Evaluate cannabinoid-induced behavioral changes using forced swim test (FST) and spontaneous wheel running (SWR) activity and 2). Determine the behavioral and neurochemical changes after the administration of MDMA (20 mg/kg), methamphetamine (10 mg/kg) or MPTP (20 mg/kg). We found that the BTBR mice exhibited an enhanced basal spontaneous locomotor behavior in the SWR test and a reduced depressogenic profile. These responses appeared to be enhanced by the prototypic cannabinoid, Δ(9)-THC. MDMA and MPTP at the doses used did not modify SWR behavior in the BTBR mice whereas MPTP reduced SWR activity in the control CB57BL/6J mice. In the hippocampus, striatum and frontal cortex, the levels of DA and 5-HT and their metabolites were differentially altered in the BTBR and C57BL/6J mice. Our data provides a basis for further studies in evaluating the role of the cannabinoid and monoaminergic systems in the etiology of ASDs.
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