1
|
Ohmine K, Morinaga Y, Kobayashi S, Matsubara A, Sadanaga K, Tohtani S, Saeki H, Horiuchi H, Fujikawa Y, Sumi K, Natsume M, Inoue H. Cacao Procyanidins-Induced Lifespan Extension in Caenorhabditis elegans in a Nervous System and CaMKII-Dependent Manner. J Gerontol A Biol Sci Med Sci 2024; 79:glae050. [PMID: 38366688 DOI: 10.1093/gerona/glae050] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Indexed: 02/18/2024] Open
Abstract
Procyanidins are gaining attention due to their potential health benefits. We found that cacao liquor procyanidin (CLPr) from Theobroma cacao seeds increased the lifespan of Caenorhabditis elegans, a representative model organism for aging studies. The genetic dependence of the lifespan-extending effect of CLPr was consistent with that of blueberry procyanidin, which is dependent on unc-43, osr-1, sek-1, and mev-1, but not on daf-16, sir-2.1, or skn-1. The lifespan-extending effect of CLPr was inhibited by neuron-specific RNA interference (RNAi) targeting unc-43 and pmk-1, and in worms with loss-of-function mutations in the odr-3, odr-1, or tax-4 genes, which are essential in sensory neurons, including AWC neurons. It was also inhibited in worms in which AWC neurons or AIB interneurons had been eliminated, and in worms with loss-of-function mutations in eat-4 or glr-1, which are responsible for glutamatergic synaptic transmission. These results suggest that the lifespan-extending effect of CLPr is dependent on the nervous system. In addition, it also requires unc-43 and pmk-1 expression in nonneuronal cells, as demonstrated by the experiments with RNAi in wild-type worms, the neuronal cells of which are not affected by systemic RNAi. The osr-1 gene is expressed in hypodermal and intestinal cells and regulates the response to osmotic stress along with unc-43/calcium/calmodulin-dependent protein kinase II and the p38 mitogen-activated protein kinase pathway. Consistent with this, CLPr improved osmotic stress tolerance in an unc-43- and pmk-1-dependent manner, and it was also dependent on AWC neurons. The lifespan-extending and osmotic-tolerance-improving activities were attributed to procyanidins with a tetrameric or higher-order oligomeric structure.
Collapse
Affiliation(s)
- Keiya Ohmine
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan
| | - Yuki Morinaga
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan
| | - Sarina Kobayashi
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan
| | - Aika Matsubara
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan
| | - Kaito Sadanaga
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan
| | - Shuhei Tohtani
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan
| | - Hideaki Saeki
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan
| | - Hiroto Horiuchi
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan
| | - Yuta Fujikawa
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan
| | - Koichiro Sumi
- R&D Division, Meiji Co., Ltd., Hachioji, Tokyo, Japan
| | | | - Hideshi Inoue
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan
| |
Collapse
|
2
|
Suetani Y, Iida Y, Hirose K, Shichijo K, Yamamoto S, Fukui T, Kuramoto M, Arita Y, Saeki H, Miyoshi M, Okada M, Ogasawara N. Urine osmolality predicts worsening renal function and poor prognosis in acute decompensated heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1088] [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: 11/14/2022] Open
Abstract
Abstract
Background/Purpose
Worsening renal function (WRF) can sometimes occur in the patients with acute decompensated heart failure (ADHF) and increase the risk of morbidity and mortality (1). In a previous study, it was reported that fractional excretion of sodium (FENa) reflects net sodium reabsorption from nephron segments and predicts WRF during treating ADHF (2). On the other hand, recently the new drugs which approach urine concentration mechanism and affect urine osmolality (U-OSM), such as tolvaptan and sodium-glucose cotransporter-2 inhibitor, have begun to be widely used as treatment of heart failure. Thus, we focused on U-OSM, which reflects not only sodium handling but also water excretion controlled by the collecting duct, and evaluated the association between WRF and U-OSM. Moreover, previous studies have demonstrated that FENa, fractional excretion of urea nitrogen and transtubular potassium concentration gradient are markers for long-term prognosis in patients with ADHF (3–5). Therefore, we also studied whether U-OSM can predict prognosis in ADHF.
Methods
A total of 157 patients admitted to our hospital because of a primary diagnosis of ADHF from February 2020 through July 2021 were retrospectively reviewed. U-OSM in the spot urinary samples were examined within 72 hours after admission. U-OSM was calculated based on the following validated formula (6): U-OSM = 1.07 × {2 × [urine sodium (mEq/L)] + [urine urea nitrogen (mg/dL)]/2.8 + [urine creatinine (mg/dl)] × 2/3} + 16.2. The primary outcome was the occurrence of WRF during hospitalization. WRF was defined as increased serum creatinine ≥0.3 mg/dL from baseline (7). The secondary outcome was the occurrence of ADHF readmission and all-cause death within 180 days after discharge.
Results
Primary Outcome. WRF developed in 46% of all patients. In the patients that developed WRF during hospitalization, U-OSM was significantly lower than in the patients without WRF (366±106 mOsm/L versus 430±128 mOsm/L; P<0.001). Receiver operating characteristic curve analysis revealed the optimal cutoff values of U-OSM was 403 mOsm/L (AUC 0.64; 95% CI: 0.56–0.72; P<0.001) to predict the WRF (Figure 1). On multivariable logistic regression analysis, U-OSM (OR, 1.99, 95% CI: 1.27–3.12; p=0.003) and serum creatinine (OR, 1.00, 95% CI: 0.99–1.00; P=0.009) were independent predictors of WRF.
Secondary Outcome. There were 34 patients (22%) readmitted and 9 patients (6%) died within 180 days after discharge. ROC curve analysis revealed the optimal cutoff values of U-OSM as 349 mOsm/L (C-statistic 0.74; 95% CI: 0.65–0.83; P<0.001) to predict ADHF readmission and all-cause death within 180 days (Figure 2A). On Kaplan-Meier analysis, the secondary outcome was significantly higher in patients with U-OSM<349 mOsm/L (u-OSM≥349, 57%, U-OSM<349, 43%; HR, 0.99; 95% CI: 0.99–1.00, P<0.001) (Figure 2B).
Conclusion
U-OSM on admission may be a predictor of WRF and a prognostic marker in ADHF patients.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- Y Suetani
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - Y Iida
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - K Hirose
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - K Shichijo
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - S Yamamoto
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - T Fukui
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - M Kuramoto
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - Y Arita
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - H Saeki
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - M Miyoshi
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - M Okada
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - N Ogasawara
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| |
Collapse
|
3
|
Tanaka Y, Takeuchi H, Nakashima Y, Nagano H, Ueno T, Tomizuka K, Morita S, Emi Y, Hamai Y, Hihara J, Saeki H, Oki E, Kunisaki C, Otsuji E, Baba H, Matsubara H, Maehara Y, Kitagawa Y, Yoshida K. Effects of an elemental diet to reduce adverse events in patients with esophageal cancer receiving docetaxel/cisplatin/5-fluorouracil: a phase III randomized controlled trial-EPOC 2 (JFMC49-1601-C5). ESMO Open 2021; 6:100277. [PMID: 34626918 PMCID: PMC8511839 DOI: 10.1016/j.esmoop.2021.100277] [Citation(s) in RCA: 4] [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: 06/25/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 01/11/2023] Open
Abstract
Background Oral mucositis (OM) is an unpleasant adverse event in patients receiving chemotherapy. A prospective feasibility study showed that elemental diet (ED), an oral supplement that does not require digestion, may prevent OM. Based on this, we established a central review system for oral cavity assessment by dental oncology specialists blinded to background data. We used this system to elucidate the preventive effect of an ED against OM in patients with esophageal cancer receiving docetaxel, cisplatin, and 5-fluorouracil (DCF) therapy. Patients and methods In this phase III, multicenter, parallel-group, controlled trial, patients consuming a normal diet orally were randomly assigned (1 : 1) to receive two cycles of DCF with (group A) or without (group B) an ED (Elental® 160 g/day). We assessed the incidence of grade ≥2 OM evaluated by two reviewers, changes in body weight, prealbumin, C-reactive protein, and DCF completion rate based on ED compliance. Results Of the 117 patients randomly assigned to treatment, four failed to start treatment and were excluded from the primary analysis; thus, groups A and B comprised 55 and 58 patients, respectively. There were no significant differences in background characteristics. Grade ≥2 OM was observed in eight (15%) and 20 (34%) patients in groups A and B, respectively (P = 0.0141). Changes in body weight and prealbumin during the two DCF cycles were significantly higher in group A than B (P = 0.0022 and 0.0203, respectively). During the first cycle, changes in C-reactive protein were significantly lower in group A than B (P = 0.0338). In group A (receiving ED), the DCF completion rate was 100% in patients with 100% ED compliance and 70% in patients failing ED completion (P = 0.0046). Conclusions The study findings demonstrate that an ED can prevent OM in patients with esophageal cancer receiving chemotherapy. Patients receiving docetaxel, cisplatin, and 5-fluorouracil (DCF) chemotherapy commonly develop oral mucositis (OM). An elemental diet (ED) was able to prevent OM in patients with esophageal cancer receiving DCF. Grade ≥2 OM was observed in 15% of patients receiving the ED versus 34% of those not receiving the ED (P = 0.0141). Body weight was maintained in the ED group, and hematologic toxicities were lower, compared with the non-ED group. The DCF completion rate significantly correlated with ED compliance (P = 0.0046).
Collapse
Affiliation(s)
- Y Tanaka
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - H Takeuchi
- Department of Surgery, School of Medicine, Hamamatsu University, Hamamatsu, Japan
| | - Y Nakashima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Nagano
- Gastroenterological, Breast and Endocrine Surgery, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - T Ueno
- Department of Dentistry, National Cancer Center Hospital, Tokyo, Japan
| | - K Tomizuka
- Department of Dentistry, Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - S Morita
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Emi
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Y Hamai
- Department of Surgical Oncology, Hiroshima University Hospital, Hiroshima, Japan
| | - J Hihara
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - H Saeki
- Department of General Surgical Science, Gunma University, Maebashi, Japan
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - C Kunisaki
- Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan
| | - E Otsuji
- Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - H Baba
- Department of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan
| | - H Matsubara
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Y Maehara
- Director, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - Y Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - K Yoshida
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University, Gifu, Japan.
| |
Collapse
|
4
|
Saeki H, Baba N, Ito K, Yokota D, Tsubouchi H. Difamilast ointment, a selective phosphodiesterase 4 inhibitor, in paediatric patients with atopic dermatitis: A phase 3 randomised double-blind, vehicle-controlled trial. Br J Dermatol 2021; 186:40-49. [PMID: 34289086 PMCID: PMC9298328 DOI: 10.1111/bjd.20655] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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] [Accepted: 07/20/2021] [Indexed: 11/30/2022]
Abstract
Background In atopic dermatitis (AD), phosphodiesterase 4 (PDE4) inhibition reduces proinflammatory mediators and cytokines. Difamilast is a new selective PDE4 inhibitor. Objectives To demonstrate the superiority of topical difamilast to vehicle in Japanese paediatric patients with AD. Methods This was a phase III randomized, double‐blind, vehicle‐controlled trial. Patients aged 2–14 years with an Investigator Global Assessment (IGA) score of 2 or 3 received difamilast 0·3% (n = 83), difamilast 1% (n = 85) or vehicle (n = 83) ointment twice daily for 4 weeks. Results The primary endpoint was the percentage of patients with an IGA score of 0 or 1 with improvement by at least two grades at week 4. The success rates in IGA score at week 4 were 44·6%, 47·1% and 18·1% in the difamilast 0·3%, difamilast 1% and vehicle groups, respectively. Both difamilast groups demonstrated significantly higher success rates in IGA score compared with vehicle at week 4 [difamilast 0·3% (P < 0·001); difamilast 1% (P < 0·001)]. Regarding secondary endpoints, improvements in Eczema Area and Severity Index (EASI; improvement of ≥ 50%, ≥ 75% and ≥ 90% in overall score) at week 4 were significantly higher in patients in the difamilast 0·3% and 1% groups than those in the vehicle group. EASI score in the difamilast 0·3% and 1% groups was significantly reduced compared with that of patients in the vehicle group at week 1. The significant difference between both the difamilast groups and the vehicle groups was maintained from week 1 through to week 4. Most treatment‐emergent adverse events were mild or moderate, and no serious events or deaths were reported. Conclusions Difamilast 0·3% and 1% ointments are superior to vehicle and well tolerated in Japanese paediatric patients with AD.
Collapse
Affiliation(s)
- H Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - N Baba
- Department of Dermatology, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - K Ito
- Headquarters of Clinical Development, Otsuka Pharmaceutical Co., Ltd, Osaka, Japan
| | - D Yokota
- Headquarters of Clinical Development, Otsuka Pharmaceutical Co., Ltd, Osaka, Japan
| | - H Tsubouchi
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd. Osaka, Japan
| |
Collapse
|
5
|
Thomas KS, Apfelbacher CA, Chalmers JR, Simpson E, Spuls PI, Gerbens LAA, Williams HC, Schmitt J, Gabes M, Howells L, Stuart BL, Grinich E, Pawlitschek T, Burton T, Howie L, Gadkari A, Eckert L, Ebata T, Boers M, Saeki H, Nakahara T, Katoh N. Recommended core outcome instruments for health-related quality of life, long-term control and itch intensity in atopic eczema trials: results of the HOME VII consensus meeting. Br J Dermatol 2021; 185:139-146. [PMID: 33393074 PMCID: PMC8359383 DOI: 10.1111/bjd.19751] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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] [Accepted: 11/07/2020] [Indexed: 12/18/2022]
Abstract
Background The Harmonising Outcome Measures for Eczema (HOME) initiative has established a core outcome set of domains for atopic eczema (AE) clinical trials. Previous consensus meetings have agreed on preferred instruments for clinician‐reported signs (Eczema Area and Severity Index, EASI) and patient‐reported symptoms (Patient‐Oriented Eczema Measure, POEM). This paper reports consensus decisions from the HOME VII meeting. Objectives To complete the core outcome set for AE by agreeing on core outcome instruments for the domains of quality of life (QoL), long‐term control and itch intensity. Methods A face‐to‐face consensus meeting was held in Tokyo, Japan (8–10 April 2019) including 75 participants (49 healthcare professionals/methodologists, 14 patients, 12 industry representatives) from 16 countries. Consensus decisions were made by presentations of evidence, followed by whole and small group discussions and anonymous voting using predefined consensus rules. Results It was agreed by consensus that QoL should be measured using the Dermatology Life Quality Index (DLQI) for adults, the Children’s Dermatology Life Quality Index (CDLQI) for children and the Infant’s Dermatology Quality of Life Index (IDQoL) for infants. For long‐term control, the Recap of Atopic Eczema (RECAP) instrument or the Atopic Dermatitis Control Test (ADCT) should be used. Consensus was not reached over the frequency of data collection for long‐term control. The peak itch numerical rating scale (NRS)‐11 past 24 h was recommended as an additional instrument for the symptom domain in trials of older children and adults. Agreement was reached that all core outcome instruments should be captured at baseline and at the time of primary outcome assessment as a minimum. Conclusions For now, the core outcome set for clinical trials in AE is complete. The specified domains and instruments should be used in all new clinical trials and systematic reviews of eczema treatments.
What is already known about this topic?
Core outcomes sets improve the design and reporting of clinical trials, reduce selective outcome reporting bias and facilitate meta‐analysis of results in systematic reviews. The HOME core outcome set for eczema recommends the inclusion of four core domains in all atopic eczema trials: clinician‐reported signs, patient‐reported symptoms, health‐related quality of life (HrQoL) and long‐term control. Clinician‐reported signs should be captured using the Eczema Area and Severity Index (EASI) and patient‐reported symptoms using the Patient‐Oriented Eczema Measure (POEM).
What does this study add?
The HOME core outcome set is now complete and recommended core outcome instruments have been agreed on for all four domains. Core outcome instruments for HrQoL: Dermatology Life Quality Index (DLQI) for adults, Children’s Dermatology Life Quality Index (CDLQI) for children and Infant’s Dermatology Quality of Life Index (IDQoL) for infants. Core outcome instruments for long‐term control: either the Recap of Atopic Eczema (RECAP) or the Atopic Dermatitis Control Test (ADCT). In addition, itch intensity should be measured using the peak NRS‐11 past 24 h for trials including older children and adults.
What are the clinical implications of this work?
If all future trials of eczema treatments include the HOME core outcome instruments, then trial results will be more readily incorporated into meta‐analyses in systematic reviews and clinical care will be informed by the best available evidence.
Linked Comment: D.F. Murrell and C.F. Paul. Br J Dermatol 2021; 185:13–14.
Collapse
Affiliation(s)
- K S Thomas
- Centre of Evidence Based Dermatology, School of Medicine, Nottingham, UK
| | - C A Apfelbacher
- Institute of Social Medicine and Health Systems Research (ISMHSR), Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - J R Chalmers
- Centre of Evidence Based Dermatology, School of Medicine, Nottingham, UK
| | - E Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
| | - P I Spuls
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - L A A Gerbens
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - H C Williams
- Centre of Evidence Based Dermatology, School of Medicine, Nottingham, UK
| | - J Schmitt
- Center for Evidence-based Healthcare, Medical Faculty Carl Gustav Carus, Dresden, Germany
| | - M Gabes
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - L Howells
- Centre of Evidence Based Dermatology, School of Medicine, Nottingham, UK
| | - B L Stuart
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - E Grinich
- School of Medicine (Department of Dermatology), Oregon Health & Science University, Portland, OR, USA
| | - T Pawlitschek
- School of Medicine (Department of Dermatology), Oregon Health & Science University, Portland, OR, USA
| | - T Burton
- Patient representative (independent), Nottingham, UK
| | - L Howie
- Global Parents for Eczema Research, Brisbane, Australia
| | - A Gadkari
- Health Economics and Outcomes Research, Boehringer Ingelheim Inc., Ingelheim, Rheinland-Pfalz, Germany
| | - L Eckert
- Global Dupixent Business Partner, sanofi GHEVA, 1 av. Pierre Brossolette, Chilly-Mazarin, 91380, France
| | - T Ebata
- Chitofuna Dermatology Clinic, Tokyo, Japan
| | - M Boers
- Department of Epidemiology and Data Science, Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - H Saeki
- Department of Dermatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan
| | - T Nakahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Katoh
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
6
|
Wollenberg A, Blauvelt A, Guttman-Yassky E, Worm M, Lynde C, Lacour JP, Spelman L, Katoh N, Saeki H, Poulin Y, Lesiak A, Kircik L, Cho SH, Herranz P, Cork MJ, Peris K, Steffensen LA, Bang B, Kuznetsova A, Jensen TN, Østerdal ML, Simpson EL. Tralokinumab for moderate-to-severe atopic dermatitis: results from two 52-week, randomized, double-blind, multicentre, placebo-controlled phase III trials (ECZTRA 1 and ECZTRA 2). Br J Dermatol 2020; 184:437-449. [PMID: 33000465 PMCID: PMC7986411 DOI: 10.1111/bjd.19574] [Citation(s) in RCA: 239] [Impact Index Per Article: 59.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 12/14/2022]
Abstract
Background Tralokinumab, a fully human monoclonal antibody, specifically neutralizes interleukin‐13, a key cytokine driving peripheral inflammation in atopic dermatitis (AD). In phase II studies, tralokinumab combined with topical corticosteroids provided early and sustained improvements in AD signs and symptoms. Objectives To evaluate the efficacy and safety of tralokinumab monotherapy in adults with moderate‐to‐severe AD who had an inadequate response to topical treatments. Methods In two 52‐week, randomized, double‐blind, placebo‐controlled, phase III trials, ECZTRA 1 and ECZTRA 2, adults with moderate‐to‐severe AD were randomized (3 : 1) to subcutaneous tralokinumab 300 mg every 2 weeks (Q2W) or placebo. Primary endpoints were Investigator’s Global Assessment (IGA) score of 0 or 1 at week 16 and ≥ 75% improvement in Eczema Area and Severity Index (EASI 75) at week 16. Patients achieving an IGA score of 0 or 1 and/or EASI 75 with tralokinumab at week 16 were rerandomized to tralokinumab Q2W or every 4 weeks or placebo, for 36 weeks. The trials were registered with ClinicalTrials.gov: NCT03131648 and NCT03160885. Results At week 16, more patients who received tralokinumab vs. placebo achieved an IGA score of 0 or 1: 15·8% vs. 7·1% in ECZTRA 1 [difference 8·6%, 95% confidence interval (CI) 4·1–13·1; P = 0·002] and 22·2% vs. 10·9% in ECZTRA 2 (11·1%, 95% CI 5·8–16·4; P < 0·001) and EASI 75: 25·0% vs. 12·7% (12·1%, 95% CI 6·5–17·7; P < 0·001) and 33·2% vs. 11·4% (21·6%, 95% CI 15·8–27·3; P < 0·001). Early improvements in pruritus, sleep interference, Dermatology Life Quality Index, SCORing Atopic Dermatitis and Patient‐Oriented Eczema Measure were observed from the first postbaseline measurements. The majority of week 16 tralokinumab responders maintained response at week 52 with continued tralokinumab treatment without any rescue medication (including topical corticosteroids). Adverse events were reported in 76·4% and 61·5% of patients receiving tralokinumab in ECZTRA 1 and ECZTRA 2, respectively, and in 77·0% and 66·0% of patients receiving placebo in ECZTRA 1 and ECZTRA 2, respectively, in the 16‐week initial period. Conclusions Tralokinumab monotherapy was superior to placebo at 16 weeks of treatment and was well tolerated up to 52 weeks of treatment. What is already known about this topic?Atopic dermatitis (AD) is a chronic interleukin (IL)‐13‐mediated disease. There is a need for safe and effective long‐term treatment options for AD. Tralokinumab is a fully human monoclonal antibody that binds specifically to IL‐13 with high affinity, thereby preventing receptor interaction and subsequent downstream signalling. Tralokinumab combined with topical corticosteroids showed early and sustained efficacy and safety in a 12‐week, phase IIb trial in moderate‐to‐severe AD.
What does this study add?These are the first pivotal phase III trials demonstrating that by specifically targeting IL‐13 alone, patients can achieve significant improvements in AD signs and symptoms and quality of life, and maintain these improvements over time without the requirement for topical corticosteroids. These trials provide evidence that tralokinumab offers a long‐term, well‐tolerated treatment option for patients with moderate‐to‐severe AD.
Linked Comment: Morra and Drucker. Br J Dermatol 2021; 184:386–387. Plain language summary available online
Collapse
Affiliation(s)
- A Wollenberg
- Department of Dermatology and Allergy, Ludwig Maximilian University of Munich, Munich, Germany
| | - A Blauvelt
- Oregon Medical Research Center, Portland, OR, USA
| | - E Guttman-Yassky
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Worm
- Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - C Lynde
- Lynde Dermatology, Probity Medical Research, Markham, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - J-P Lacour
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - L Spelman
- Veracity Clinical Research, Brisbane, QLD, Australia.,Probity Medical Research, Woolloongabba, QLD, Australia
| | - N Katoh
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - H Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Y Poulin
- Laval University and Centre Dermatologique du Québec Métropolitain and Centre de Recherche Dermatologique du Québec Métropolitain, Québec, QC, Canada
| | - A Lesiak
- Department of Dermatology and Pediatric and Oncologic Dermatology, Medical University of Łódź, Łódź, Poland
| | - L Kircik
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Indiana University Medical Center, Indianapolis, IN, USA
| | - S H Cho
- Department of Dermatology, The Catholic University of Korea, Seoul, South Korea
| | - P Herranz
- Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain
| | - M J Cork
- Sheffield Dermatology Research, Department of Infection, Immunity, and Cardiovascular Disease, The University of Sheffield and Sheffield Teaching Hospitals NIHR Clinical Research Facility, Sheffield, UK
| | - K Peris
- Dermatology, Catholic University and Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | | | - B Bang
- LEO Pharma A/S, Ballerup, Denmark
| | | | | | | | - E L Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
| | | |
Collapse
|
7
|
Thomas KS, Apfelbacher CA, Chalmers JR, Simpson E, Spuls PI, Gerbens LAA, Williams HC, Schmitt J, Gabes M, Howells L, Stuart BL, Grinich E, Pawlitschek T, Burton T, Howie L, Gadkari A, Eckert L, Ebata T, Boers M, Saeki H, Nakahara T, Katoh N. Recommended core outcome instruments for health-related quality of life, long-term control and itch intensity in atopic eczema trials: results of the HOME VII consensus meeting. Br J Dermatol 2020:bjd.19673. [PMID: 33179283 DOI: 10.1111/bjd.19673] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Harmonising Outcome Measures for Eczema (HOME) initiative has established a core outcome set of domains for atopic eczema clinical trials. Previous consensus meetings have agreed upon preferred instruments for clinician-reported signs (Eczema Area and Severity Index - EASI) and patient-reported symptoms (Patient-Oriented Eczema Measure - POEM). This paper reports consensus decisions from the HOME VII meeting. OBJECTIVE To complete the core outcome set for atopic eczema by agreeing upon core outcome instruments for the domains of quality of life, long-term control and itch intensity. METHODS Face-to-face consensus meeting held in Tokyo, Japan (8th to 10th April, 2019) including 74 participants (47 healthcare professionals/methodologists, 14 patients, 13 industry representatives), from 16 countries. Consensus decisions were made by presentations of evidence, followed by whole and small group discussions and anonymous voting using pre-defined consensus rules. RESULTS It was agreed by consensus that quality of life should be measured using the Dermatology Life Quality Index (DLQI) for adults, the Children's Dermatology Life Quality Index (CDLQI) for children, and the Infant's Dermatology Quality of Life Index (IDQoL) for infants. For long-term control, the Recap of Atopic Eczema (RECAP) instrument or the Atopic Dermatitis Control Test (ADCT) should be used. Consensus was not reached over the frequency of data collection for long-term control. The peak itch numerical rating scale(NRS)-11 past 24 hours was recommended as an additional instrument for the symptom domain in trials of older children and adults. Agreement was reached that all core outcome instruments should be captured at baseline and at the time of primary outcome assessment as a minimum. CONCLUSIONS For now, the core outcome set for clinical trials in atopic eczema is complete. The specified domains and instruments should be used in all new clinical trials and systematic reviews of eczema treatments.
Collapse
Affiliation(s)
- K S Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - C A Apfelbacher
- Institute of Social Medicine and Health Systems Research (ISMHSR), Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - J R Chalmers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - E Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - P I Spuls
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - L A A Gerbens
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - J Schmitt
- Center for Evidence-based Healthcare, Medical Faculty Carl Gustav Carus, Dresden, Germany
| | - M Gabes
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - L Howells
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - B L Stuart
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - E Grinich
- School of Medicine, Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - T Pawlitschek
- School of Medicine, Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - T Burton
- Patient Representative (independent), Nottingham, United Kingdom
| | - L Howie
- Global Parents for Eczema Research, Brisbane, Australia
| | - A Gadkari
- Health Economics and Outcomes Research, Boehringer Ingelheim Inc, Germany
| | - L Eckert
- Global Dupixent Business Partner, sanofi GHEVA, 1 av. Pierre Brossolette, 91 380, Chilly Mazatin, France
| | - T Ebata
- Chitofuna Dermatology Clinic, Tokyo, Japan
| | - M Boers
- Department of Epidemiology and data Science; Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - H Saeki
- Department of Dermatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan
| | - T Nakahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Katoh
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
8
|
Takeuchi H, Tanaka Y, Nakashima Y, Otsuji E, Nagano H, Matsubara H, Baba H, Emi Y, Oki E, Ueno T, Tomizuka K, Morita S, Kunisaki C, Hihara J, Saeki H, Hamai Y, Maehara Y, Kitagawa Y, Yoshida K. 1425MO Effects of elemental diet for gastrointestinal adverse events in patients with esophageal cancer receiving docetaxel/cisplatin/5-fluorouracil (EPOC 2 study: JFMC49-1601-C5): A phase III randomized controlled trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1931] [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] Open
|
9
|
Katoh N, Kataoka Y, Saeki H, Hide M, Kabashima K, Etoh T, Igarashi A, Imafuku S, Kawashima M, Ohtsuki M, Fujita H, Arima K, Takagi H, Chen Z, Shumel B, Ardeleanu M. Efficacy and safety of dupilumab in Japanese adults with moderate-to-severe atopic dermatitis: a subanalysis of three clinical trials. Br J Dermatol 2019; 183:39-51. [PMID: 31564057 PMCID: PMC7384164 DOI: 10.1111/bjd.18565] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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] [Accepted: 09/25/2019] [Indexed: 12/15/2022]
Abstract
Background Dupilumab, a human monoclonal antibody, blocks the shared receptor unit for interleukin‐4 and interleukin‐13. International phase II and III studies have evaluated the efficacy and safety of dupilumab in adults with moderate‐to‐severe atopic dermatitis (AD), but the effects of dupilumab in Japanese patients have not been reported. Objectives To evaluate the efficacy and safety of dupilumab in Japanese patients with moderate‐to‐severe AD. Methods We analysed the efficacy and safety of dupilumab in the Japanese cohorts of a 16‐week, phase IIb dose‐finding trial (AD‐1021; NCT01859988); a 16‐week, phase III, placebo‐controlled monotherapy trial (LIBERTY AD SOLO 1; NCT02277743) and a 52‐week, phase III, placebo‐controlled study of dupilumab with topical corticosteroids (LIBERTY AD CHRONOS; NCT02260986). Results Twenty‐seven, 106 and 117 Japanese patients were enrolled in AD‐1021, SOLO 1 and CHRONOS, respectively. Baseline disease severity was numerically higher in the Japanese cohort than in the overall study population. Generally, dupilumab significantly improved signs and symptoms of AD, including pruritus and patient quality of life, compared with placebo in the Japanese cohort, consistent with the overall study population. The combined safety profile of dupilumab in the Japanese cohort was similar to that in the total study populations; dupilumab was associated with an increased incidence of injection‐site reactions and conjunctivitis compared with placebo. Dupilumab was associated with rapid reduction in thymus and activation‐regulated chemokine and gradual IgE reductions. Conclusions Dupilumab alone or with topical corticosteroids improved signs and symptoms of AD, had an acceptable safety profile, and suppressed biomarkers of type 2 inflammation compared with placebo in Japanese adult patients with moderate‐to‐severe AD. What's already known about this topic? Differences in atopic dermatitis (AD) pathology have been reported between Asian and Western populations, in which distinct helper T‐cell activation profiles have been observed. International clinical studies in adults with moderate‐to‐severe AD have evaluated the efficacy and safety of dupilumab, which blocks interleukin‐4 and interleukin‐13, key molecules in type 2 inflammation. The effects of dupilumab in Japanese patients specifically have not yet been reported.
What does this study add? Dupilumab alone or with topical corticosteroids improved signs and symptoms of AD and had an acceptable safety profile compared with placebo in Japanese patients with moderate‐to‐severe AD. The effects were comparable with those observed in the overall study population. Reported immunological differences in AD pathology in Asian patients may be secondary to type 2 immune activation.
Plain language summary available online Respond to this article
Collapse
Affiliation(s)
- N Katoh
- Department of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Y Kataoka
- Department of Dermatology, Osaka Habikino Medical Center, Osaka, Japan
| | - H Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - M Hide
- Department of Dermatology, Hiroshima University, Hiroshima, Japan
| | - K Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Etoh
- Department of Dermatology, Tokyo Teishin Postal Services Agency Hospital, Tokyo, Japan
| | - A Igarashi
- Department of Dermatology, NTT Medical Center Tokyo, Tokyo, Japan
| | - S Imafuku
- Department of Dermatology, Fukuoka University, Fukuoka, Japan
| | - M Kawashima
- Department of Dermatology, Tokyo Women's Medical University, School of Medicine, Tokyo, Japan
| | - M Ohtsuki
- Department of Dermatology, Jichi Medical University, Tochigi, Japan
| | | | | | | | - Z Chen
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, U.S.A
| | - B Shumel
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, U.S.A
| | - M Ardeleanu
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, U.S.A
| |
Collapse
|
10
|
Makiyama A, Oki E, Miyamoto Y, Kotaka M, Kawanaka H, Miwa K, Kabashima A, Noguchi T, Yuge K, Kashiwada T, Shimokawa M, Saeki H, Akagi Y, Baba H, Mori M. Bevacizumab plus trifluridine/tipiracil in elderly patients with previously untreated metastatic colorectal cancer (KSCC 1602): A single-arm, phase II study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
11
|
Yamashita N, Hisamatsu Y, Shigechi T, Tokunaga E, Saeki H, Oki E, Maehara Y. Abstract P5-07-07: The immune microenvironment of ductal carcinoma in situ of the breast. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-07-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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 importance of tumor-infiltrating lymphocytes (TIL) in invasive breast carcinoma for tumor development and therapeutic response is widely accepted. However, the immune microenvironment of breast ductal carcinoma in situ (DCIS) has not been fully elucidated. Evasion of immune surveillance is a necessary step in tumor evolution. In DCIS, the tumor cells are relatively protected from the immune system due to an myoepithelial cell layer and basement membrane, and intraductal immune cells are rarely detected. In contrast, in invasive disease, cancer cells and immune cells are often intermingled. Thus, understanding the immune microenviroment of in situ to invasive carcinoma transition might be particularly important to identify novel targets for early stage of tumor invasion.
Aims: The aim of this study is to evaluate the clinical importance of TILs in DCIS.
Methods: TILs were assessed in 133 DCIS samples with or without microinvasive disease according to the proposed method from the International Immuno-Oncology Working Group on Breast Cancer. In addition, the relationship between TILs in DCIS and clinicopathological features was evaluated.
Results: TILs are present in most DCIS in varying levels. The median proportion of TILs in DCIS was 14%. Only a minority of DCIS showed >50% TILs, which represented only 12.8% of all cases. High TILs in DCIS was significantly associated with comedo necrosis (p<0.0001), high nuclear grade (p=0.0030), ER negativity (p<0.0001), PR negativity (p<0.0001), HER2 positivity (p=0.0030). Triple negative DCIS and HER2 positive DCIS had significantly higher level of TILs (p=0.0008). No correlation was demonstrated between TILs and recurrence risk.
Conclusions: High TILs in DCIS was significantly associated with adverse histopathologic features. Further characterization of immune environment of DCIS may be essential for immunotherapy and breast cancer prevention.
Citation Format: Yamashita N, Hisamatsu Y, Shigechi T, Tokunaga E, Saeki H, Oki E, Maehara Y. The immune microenvironment of ductal carcinoma in situ of the breast [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 P5-07-07.
Collapse
Affiliation(s)
- N Yamashita
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan; Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - Y Hisamatsu
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan; Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - T Shigechi
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan; Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - E Tokunaga
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan; Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - H Saeki
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan; Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - E Oki
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan; Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - Y Maehara
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan; Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| |
Collapse
|
12
|
Umezawa Y, Torisu-Itakura H, Morisaki Y, ElMaraghy H, Nakajo K, Akashi N, Saeki H. Long-term efficacy and safety results from an open-label phase III study (UNCOVER-J) in Japanese plaque psoriasis patients: impact of treatment withdrawal and retreatment of ixekizumab. J Eur Acad Dermatol Venereol 2018; 33:568-576. [PMID: 30325534 PMCID: PMC6587494 DOI: 10.1111/jdv.15292] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 06/28/2018] [Accepted: 08/07/2018] [Indexed: 12/29/2022]
Abstract
Background Long‐term management of moderate‐to‐severe psoriasis is usually discussed in terms of continuous administration; however, there are many situations in clinical practice where treatment may be withdrawn with subsequent retreatment. Objective To assess the clinical course after ixekizumab treatment withdrawal and retreatment, as well as the effectiveness of ixekizumab retreatment, in Japanese patients with plaque psoriasis. Methods This single‐arm, open‐label study (UNCOVER‐J; NCT01624233) comprised 78 patients with plaque psoriasis. After ixekizumab treatment (160‐mg loading dose, 80 mg every 2 weeks for the first 12 weeks, and then 80 mg every 4 weeks (IXE Q4W) until Week 52), 70 patients achieved a Psoriasis Area Severity Index (PASI)75 response at Week 52. These 70 patients withdrew from ixekizumab treatment from Weeks 52 to 100. Patients who relapsed (PASI ≤50) during the Treatment Withdrawal Period were retreated with IXE Q4W for 192 weeks. Results At Weeks 52, 76 and 100, PASI75 response rates were 100%, 26% and 7%; PASI90 response rates were 87%, 11% and 3%; and PASI100 response rates were 53%, 0% and 0%. After treatment withdrawal, 87% of patients relapsed; median time to relapse was 143 days. After 12 weeks of retreatment with IXE Q4W, 83% of relapsed patients achieved PASI75, 68% achieved PASI90 and 25% achieved PASI100; improvements were maintained up to 120 weeks of retreatment. Treatment‐emergent adverse events and serious adverse events were reported in 56% and 4% of patients during the Treatment Withdrawal Period, and in 88% and 14% of patients during the Retreatment Period. Conclusion In patients withdrawn from ixekizumab after achieving PASI75, approximately half relapsed within 5 months of withdrawal; however, most patients recaptured response within 12 weeks, and response was maintained for up to 120 weeks of retreatment.
Collapse
Affiliation(s)
- Y Umezawa
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | | | | | - H ElMaraghy
- Eli Lilly and Company, Indianapolis, IN, USA
| | - K Nakajo
- Eli Lilly Japan K.K., Kobe, Japan
| | - N Akashi
- Eli Lilly Japan K.K., Kobe, Japan
| | - H Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | | |
Collapse
|
13
|
Kato K, Kojima T, Saeki H, Hara H, Kajiwara T, Hironaka S, Nakatsumi H, Kadowaki S, Kagawa Y, Esaki T, Moriwaki T, Kobayashi T, Izawa N, Nomura S, Kuwata T, Fujii S, Okamoto W, Shitara K, Ohtsu A, Yoshino T. The nationwide cancer genome screening project in Japan, SCRUM-Japan GI-SCREEN: Efficient identification of cancer genome alterations in advanced esophageal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
14
|
Oki E, Samura H, Okumura H, Ohchi T, Orita H, Kobayashi K, Kinjo T, Mori S, Touyama T, Ohgaki K, Kawanaka H, Makiyama A, Ureshino N, Kotaka M, Shimose T, Saeki H, Nishimaki T, Baba H, Maehara Y. Initial report of a phase I/II study of S-1 and irinotecan (IRIS) in combination with cetuximab in patients with wild-type RAS metastatic colorectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.040] [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
|
15
|
Kobayashi K, Iwatsuki M, Orita H, Hidaka S, Arigami T, Kusumoto T, Satake H, Oki E, Satoshi K, Tobimatsu K, Shimokawa M, Saeki H, Makiyama A, Kakeji Y, Natsugoe S, Baba H, Eguchi S, Maehara Y. Phase II study of S-1 and oxaliplatin as neo-adjuvant chemotherapy for locally advanced gastric and esophago-gastric cancer (KSCC1601). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
16
|
Yuki S, Shinozaki K, Kashiwada T, Kusumoto T, Iwatsuki M, Satake H, Tokunaga S, Emi Y, Makiyama A, Kawamoto Y, Komatsu Y, Shimokawa M, Saeki H, Oki E, Baba H, Maehara Y. Updated analysis of a phase II study of SOX plus trastuzumab for the patients with HER2 positive advanced or recurrent gastric cancer: KSCC/HGCSG/CCOG/PerSeUS1501B. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.052] [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
|
17
|
Inoue Y, Yamashita N, Tokunaga E, Saeki H, Oki E, Kitao H, Maehara Y. Clinical significance of the wild-type p53-induced phosphatase 1(Wip1) expression in invasive breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx653.006] [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
|
18
|
Oki E, Shimokawa M, Murata A, Takahashi T, Maeda K, Kusumoto T, Munemoto Y, Ando K, Nakanishi R, Sugiyama M, Nakashima Y, Saeki H, Saji S, Maehara Y. Effect of lateral lymph node dissection for lower rectal cancer: An ad hoc analysis of the ACTS-RC randomized clinical trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.027] [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
|
19
|
Saeki H, Kabashima K, Tokura Y, Murata Y, Shiraishi A, Tamamura R, Randazzo B, Imanaka K. Efficacy and safety of ustekinumab in Japanese patients with severe atopic dermatitis: a randomized, double-blind, placebo-controlled, phase II study. Br J Dermatol 2017; 177:419-427. [DOI: 10.1111/bjd.15493] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2017] [Indexed: 01/05/2023]
Affiliation(s)
- H. Saeki
- Department of Dermatology; Nippon Medical School; Tokyo Japan
| | - K. Kabashima
- Department of Dermatology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Y. Tokura
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
| | - Y. Murata
- Janssen Pharmaceutical K.K.; Tokyo Japan
| | | | | | - B. Randazzo
- Immunology; Janssen Research & Development, LLC; Spring House PA U.S.A
| | - K. Imanaka
- Janssen Pharmaceutical K.K.; Tokyo Japan
| |
Collapse
|
20
|
Yamashita N, Tokunaga E, Inoue Y, Tanaka K, Saeki H, Oki E, Maehara Y. Abstract P6-01-17: Epithelial paradox; clinical significance of co-expression of E-cadherin and vimentin in the invasion and the metastasis of breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-01-17] [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: E-cadherin and vimentin are now regarded as major and conventional canonical markers of epithelial-mesenchymal transition (EMT). It is commonly assumed E-cadherin is uniformly lost during the process of EMT. We previously reported that the elevated expression of vimentin contributes to the aggressive phenotype in invasive breast cancer. On the other hand, the role of E-cadherin in breast cancer biology might be unclear and more complex. Although, cell cohesion during breast cancer invasion is often overlooked, accumulating evidences indicate breast tumor cells are typically cohesive and often display membrane-localized E-cadherin in both the primary tumor and distant metastases, termed collective invasion. Multiple mechanisms have emerged to address how epithelial breast tumors invade.
Aims: The aim of this study is to reveal the clinical importance of the expression pattern of E-cadherin and vimentin in breast cancer.
Methods: The E-cadherin and vimentin protein expression were evaluated by immunohistochemistry (IHC) in 177 invasive breast cancer samples. Among these, E-cadherin and vimentin expression were evaluated in the set of primary breast cancer and metastatic lymph nodes in 65 cases. In addition, E-cadherin and vimentin expression were analyzed by immunofluorescent staining and evaluated using confocal laser scanning microscopy to see E-cadherin and vimentin localization in the breast cancer cells.
Results: The positive vimentin expression was highly correlated with poor disease-free survival (DFS) and overall survival (OS) (p=0.019 and p=0.0044), however, the E-cadherin expression alone did not correlate with prognosis. Interestingly, both E-cadherin and vimentin positive tumors had the worst DFS and OS among all breast cancer (p=0.03 and p=0.0089). Vimentin expression was highly correlated between primary tumors and metastatic lymph nodes. However, E-cadherin expression levels were significantly elevated in metastatic lymph nodes (p=0.0017). Co-expression of E-cadherin and vimentin in the metastatic lymph nodes also showed worst DFS and OS (p=0.12 and p=0.027).Immunofluorescent analysis revealed that E-cadherin and vimentin were co-localized within the same tumor cells in many of the E-cadherin high/vimentin positive tumors.
Conclusions: Co-expression of E-cadherin and vimentin seems to be associated with the most aggressive phenotype and poorest prognosis in breast cancer. Moreover, co-localization of E-cadherin and vimentin within the same breast cancer cells suggests the significance of the expressions of both proteins in breast cancer invasion and metastasis.
Citation Format: Yamashita N, Tokunaga E, Inoue Y, Tanaka K, Saeki H, Oki E, Maehara Y. Epithelial paradox; clinical significance of co-expression of E-cadherin and vimentin in the invasion and the metastasis of breast cancer [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 P6-01-17.
Collapse
Affiliation(s)
- N Yamashita
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - E Tokunaga
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Y Inoue
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - K Tanaka
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - H Saeki
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - E Oki
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Y Maehara
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| |
Collapse
|
21
|
Inoue Y, Yamashita N, Tokunaga E, Kitao H, Tanaka K, Saeki H, Oki E, Maehara Y. Abstract P1-08-13: The clinical importance of nuclear wild-type p53-induced phosphatase 1(Wip1) expression in breast cancer patients. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-08-13] [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
Backgrounds; The wild-type p53-induced phosphatase 1(Wip1) is a member of the serine/threonine protein phosphatases, and plays an important role in the nucleus as one of the key components in the DNA damage response network. Wip1 is encoded by the protein phosphatase magnesium dependent 1 delta (PPM1D), sited on locus 17q23. PPM1D gene amplification and/or Wip1 expression have been observed in numerous tumors, including breast cancer. PPM1D is referred to as oncogene, as Wip1 inhibits phosphorylation of p53 and work as a negative regulator in cell death. Inhibition of Wip1 may have an important therapeutic role in suppressing tumor growth and evolution.
Aims; We evaluated the expression of Wip1 mRNA, Wip1 protein and PPM1D DNA copy number to clarify the relationship between Wip1 expression and the clinicopathological features and prognosis to determine the biological significance of Wip1.
Materials and Methods; Breast cancer cell lines (MCF7, T47D, MDA-MB231, HCC1937, HS578T, BT20 and SKBr3) were used for Wip1 expression analysis and copy number analysis. The specimens were obtained from Japanese breast cancer patients who underwent surgery without neoadjuvant chemotherapy or endocrine therapy in our department. Wip1 mRNA expression was evaluated in 140 cases by quantitative RT-PCR and Wip1 protein expression was evaluated in 192 cases by immunohistochemistry (IHC). The PPM1D DNA copy number was analyzed by genomic PCR in 33 breast cancer cases and by SNP-CGH array (Illumina, Human Omni 2.5-8) in 12 cases. The effects on the cell growth of the Wip1 inhibitor (GSK2830371) were analyzed by the viability assay in MCF7.
Results; Wip1 mRNA expression was significantly higher in MCF7, luminal type cell line. There was no significant correlation between Wip1 mRNA expression and prognosis. In IHC, positive nuclear Wip1 protein expression was detected in 21 cases (10.9%). There was no significant correlation between Wip1 mRNA expression and Wip1 protein expression. There was no significant association between the Wip1 protein expression levels and the clinicopathological factors and the prognosis. PPM1D DNA copy number significantly correlated with Wip1 protein expression (p=0.0035). Copy number gain at 17q23 was detected in 6 cases by SNP-CGH array, and all of these six cases showed positive nuclear Wip1 expression. PPM1D copy number gain was not observed in Wip1 negative cases. In the cell viability assay, the MCF7 cell growth was suppressed by Wip1 inhibitor administration.
Conclusions;Wip1 protein expression in nucleus is important as oncogene, and its expression may be regulated by PPM1D copy number gain. Wip1 is considered to be the new therapeutic target for breast cancer patients.
Citation Format: Inoue Y, Yamashita N, Tokunaga E, Kitao H, Tanaka K, Saeki H, Oki E, Maehara Y. The clinical importance of nuclear wild-type p53-induced phosphatase 1(Wip1) expression in breast cancer patients [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 P1-08-13.
Collapse
Affiliation(s)
- Y Inoue
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2)National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - N Yamashita
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2)National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - E Tokunaga
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2)National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - H Kitao
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2)National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - K Tanaka
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2)National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - H Saeki
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2)National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - E Oki
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2)National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Y Maehara
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2)National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| |
Collapse
|
22
|
Baba Y, Saeki H, Nakashima Y, Oki E, Shigaki H, Yoshida N, Watanabe M, Maehara Y, Baba H. Review of chemotherapeutic approaches for operable and inoperable esophageal squamous cell carcinoma. Dis Esophagus 2017; 30:1-7. [PMID: 27868285 DOI: 10.1111/dote.12521] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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] [Indexed: 12/11/2022]
Abstract
The predominant histological types of esophageal cancer are adenocarcinoma and squamous cell carcinoma. Since these two histological types present as different diseases in terms of their epidemiology, pathologenesis, and tumor biology, separate therapeutic approaches should be developed against each type. While surgical resection remains the dominant therapeutic intervention for patients with operable esophageal squamous cell carcinoma (ESCC), their high rates of tumor recurrence have prompted investigation of multimodality therapies that combine surgery with chemotherapy, radiotherapy, and chemoradiotherapy. In Japan, preoperative chemotherapy with cisplatin (CDDP) plus 5-fluorouracil (5-FU) followed by radical esophagectomy has been accepted as the standard therapeutic approach for resactable clinical Stage II/III ESCC. Similarly, the CDDP and 5-FU regimen has been accepted as the first-line treatment for metastatic and unresectable ESCCs in Japan. Thus, in Japan chemotherapy is an indispensable component of therapy for both resectable and unresectable ESCCs. This review discusses the current knowledge, rationale, and available data regarding chemotherapy for resectable and unresectable ESCCs.
Collapse
Affiliation(s)
- Y Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.,Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
| | - H Saeki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
| | - Y Nakashima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
| | - H Shigaki
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
| | - N Yoshida
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
| | - M Watanabe
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Y Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
| | - H Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
| |
Collapse
|
23
|
Nako T, Hoashi T, Kanzaki A, Serizawa N, Funasaka Y, Saeki H. A case of blue naevus of the mucocutaneous junction of the lower eyelid margin associated with acquired bilateral naevus of Ota-like macule. Clin Exp Dermatol 2017; 42:339-341. [DOI: 10.1111/ced.13037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2016] [Indexed: 11/28/2022]
Affiliation(s)
- T. Nako
- Department of Dermatology; Nippon Medical School; 1-1-5, Sendagi, Bunkyo-ku Tokyo 113-8603 Japan
| | - T. Hoashi
- Department of Dermatology; Nippon Medical School; 1-1-5, Sendagi, Bunkyo-ku Tokyo 113-8603 Japan
| | - A. Kanzaki
- Department of Dermatology; Nippon Medical School; 1-1-5, Sendagi, Bunkyo-ku Tokyo 113-8603 Japan
| | - N. Serizawa
- Department of Dermatology; Nippon Medical School; 1-1-5, Sendagi, Bunkyo-ku Tokyo 113-8603 Japan
| | - Y. Funasaka
- Department of Dermatology; Nippon Medical School; 1-1-5, Sendagi, Bunkyo-ku Tokyo 113-8603 Japan
| | - H. Saeki
- Department of Dermatology; Nippon Medical School; 1-1-5, Sendagi, Bunkyo-ku Tokyo 113-8603 Japan
| |
Collapse
|
24
|
Sakamoto Y, Yoshida Y, Ishikawa H, Ohchi T, Takeshita H, Emi Y, Komatsu H, Sawai T, Shimose T, Oki E, Saeki H, Kakeji Y, Yoshida Y, Baba H, Maehara Y. 189P Phase II trial of S-1 plus panitumumab for wild-type KRAS unresectable colorectal cancer patients previously treated with 5-fluorouracil (5-FU), oxaliplatin and irinotecan (KSCC1103). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw581.022] [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
|
25
|
Sakamoto Y, Yoshida Y, Ishikawa H, Ohchi T, Takeshita H, Emi Y, Komatsu, Sawai T, Shimose T, Oki E, Saeki H, Kakeji Y, Yoshida Y, Baba H, Maehara Y. 189P Phase II trial of S-1 plus panitumumab for wild-type KRAS unresectable colorectal cancer patients previously treated with 5-fluorouracil (5-FU), oxaliplatin and irinotecan (KSCC1103). Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00347-1] [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: 11/28/2022] Open
|
26
|
Okumura H, Mori N, Tanaka T, Morita M, Toh Y, Saeki H, Maehara Y, Nakamura K, Honda H, Yoshida N, Baba H, Natsugoe S. Clinical features and treatment of patients with esophageal cancer and a history of gastrectomy: a multicenter, questionnaire survey in Kyushu, Japan. Dis Esophagus 2016; 29:1135-1143. [PMID: 26542524 PMCID: PMC5132208 DOI: 10.1111/dote.12439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
It is still controversial whether patients with a history of gastrectomy have high risk of esophageal carcinogenesis. On the other hand, the treatment strategy for esophageal cancer patients after gastrectomy is complicated. The association between histories of gastrectomy and esophageal carcinogenesis was retrospectively analyzed, and the treatment of esophageal cancer patients after gastrectomy was evaluated based on questionnaire data collected from multiple centers in Kyushu, Japan. The initial subject population comprised 205 esophageal cancer patients after gastrectomy. Among them, 108 patients underwent curative surgical treatment, and 70 patients underwent chemoradiation therapy (CRT). The time between gastrectomy and esophageal cancer development was longer in peptic ulcer patients (28.3 years) than in gastric cancer patients (9.6 years). There were no differences in the location of esophageal cancer according to the gastrectomy reconstruction method. There were no significant differences in the clinical background characteristics between patients with and without a history of gastrectomy. Among the 108 patients in the surgery group, the 5-year overall survival rates for stages I (n = 30), II (n = 18), and III (n = 60) were 68.2%, 62.9%, and 32.1%, respectively. In the CRT group, the 5-year overall survival rate of stage I (n = 29) was 82.6%, but there were no 5-year survivors in other stages. The 5-year overall survival rate of patients with CR (n = 33) or salvage surgery (n = 10) was 61.2% or 36%, respectively. For the treatment of gastrectomized esophageal cancer patients, surgery or CRT is recommended for stage I, and surgery with or without adjuvant therapy is the main central treatment in advanced stages, with surgery for stage II, neoadjuvant therapy + surgery for stage III, and CRT + salvage surgery for any stage, if the patient's condition permits.
Collapse
Affiliation(s)
- H. Okumura
- Department of Digestive Surgery, Breast and Thyroid SurgeryKagoshima UniversityKagoshima
| | - N. Mori
- Department of SurgeryKurume University School of MedicineFukuokaJapan
| | - T. Tanaka
- Department of SurgeryKurume University School of MedicineFukuokaJapan
| | - M. Morita
- Department of Gastroenterological SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Y. Toh
- Department of Gastroenterological SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - H. Saeki
- Department of Surgery and ScienceKyushu UniversityFukuokaJapan
| | - Y. Maehara
- Department of Surgery and ScienceKyushu UniversityFukuokaJapan
| | - K. Nakamura
- Department of Clinical RadiologyKyushu UniversityFukuokaJapan
| | - H. Honda
- Department of Clinical RadiologyKyushu UniversityFukuokaJapan
| | - N. Yoshida
- Department of Gastroenterological SurgeryKumamoto UniversityKumamotoJapan
| | - H. Baba
- Department of Gastroenterological SurgeryKumamoto UniversityKumamotoJapan
| | - S. Natsugoe
- Department of Digestive Surgery, Breast and Thyroid SurgeryKagoshima UniversityKagoshima
| |
Collapse
|
27
|
Yuki S, Komatsu Y, Satake H, Miyamoto Y, Tanioka H, Tsuji A, Asayama M, Shiraishi T, Kotaka M, Makiyama A, Kashiwada T, Takeuchi N, Shimokawa M, Saeki H, Oki E, Emi Y, Baba H, Maehara Y. Updated report: A randomized, double-blind, placebo-controlled phase II study of prophylactic dexamethasone (dex) therapy for fatigue and malaise due to regorafenib in patient (pts) with metastatic colorectal cancer (mCRC): (KSCC1402/HGCSG1402). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.95] [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
|
28
|
Yamase A, Kono T, Ishii N, Hashimoto T, Saeki H. An autoimmune bullous dermatosis with clinical, histopathological and immunological features of bullous pemphigoid and epidermolysis bullosa acquisita in an adult. Br J Dermatol 2016; 175:790-3. [PMID: 26989994 DOI: 10.1111/bjd.14553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Yamase
- Department of Dermatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
| | - T Kono
- Department of Dermatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - N Ishii
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
| | - T Hashimoto
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
| | - H Saeki
- Department of Dermatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| |
Collapse
|
29
|
Ichiyama S, Funasaka Y, Otsuka Y, Takayama R, Kawana S, Saeki H, Kubo A. Effective treatment by glycolic acid peeling for cutaneous manifestation of familial generalized acanthosis nigricans caused by FGFR3 mutation. J Eur Acad Dermatol Venereol 2016; 30:442-5. [PMID: 26818779 DOI: 10.1111/jdv.13580] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 11/27/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Acanthosis nigricans (AN) can occur as a cutaneous manifestation of genetic diseases, one of which is associated with activating mutations of the fibroblast growth factor receptor 3 gene (FGFR3). OBJECTIVE We explored familial AN patients with FGFR3 mutations and examined the effectiveness of glycolic acid (GA) peeling in improving their skin manifestations. METHODS Sanger sequencing was performed for the genomic DNA extracted from leucocytes of the family members involving familial AN. GA peeling was carried out for the two patients of familial AN once every 2 weeks. RESULTS Heterozygous c.1949A>C (p.K650T) mutation in FGFR3 was identified for the affected family members examined, whereas the wild-type sequence was found for two unaffected individuals. Hyperpigmentation and coarseness of the skin were improved by GA peeling at regular intervals with few adverse effects. CONCLUSION We diagnosed our cases as familial generalized AN caused by heterozygous c.1949A>C (p.K650T) mutation of FGFR3. We propose that GA peeling is a useful and safe therapeutic option to treat familial AN.
Collapse
Affiliation(s)
- S Ichiyama
- Department of Dermatology, Nippon Medical School Hospital, Tokyo, Japan
| | - Y Funasaka
- Department of Dermatology, Nippon Medical School Hospital, Tokyo, Japan
| | - Y Otsuka
- Department of Dermatology, Nippon Medical School Hospital, Tokyo, Japan
| | - R Takayama
- Department of Dermatology, Nippon Medical School Hospital, Tokyo, Japan
| | - S Kawana
- Department of Dermatology, Nippon Medical School Hospital, Tokyo, Japan
| | - H Saeki
- Department of Dermatology, Nippon Medical School Hospital, Tokyo, Japan
| | - A Kubo
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
30
|
Ikegami T, Yoshizumi T, Soejima Y, Harimoto N, Itoh S, Takeishi K, Uchiyama H, Kawanaka H, Yamashita YI, Tsujita E, Harada N, Oki E, Saeki H, Kimura Y, Shirabe K, Maehara Y. Triple therapy using direct-acting agents for recurrent hepatitis C after liver transplantation: a single-center experience. Transplant Proc 2015; 47:730-2. [PMID: 25891720 DOI: 10.1016/j.transproceed.2014.10.058] [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] [Received: 08/22/2014] [Revised: 10/05/2014] [Accepted: 10/28/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hepatitis C viral graft reinfection is almost a universal event after liver transplantation with consequent disease progression. METHODS We applied triple therapy (n = 21) with the use of telaprevir (TVR; n = 12) or simeprevir (SVR; n = 9). RESULTS TVR was given at the dose 1,500 mg daily (n = 11) with reduced dose of cyclosporine at 25% to 50%, and SVR was given at the dose 100 mg daily with unadjusted cyclosporine, followed by 12 weeks of dual therapy. The early viral response was achieved in 91.7% (n = 11), end of treatment response rate was 91.7% (n = 11), and sustained viral response rate was 83.3% (n = 10) in the TVR group, and respective rates were 88.9% (n = 8), 77.8% (n = 7), and 77.8% (n = 7) in the SVR group. Although granulocyte colony-stimulating factor was not given in the patients with triple therapy, blood transfusion was performed in 7 cases (58.3%) in the TVR group and 1 case (11.1%) in the SVR group. Interferon-mediated graft dysfunction was observed in 4 cases (33.3%) in the TVR group and 3 cases (33.3%) in the SVR group, respectively. The cumulative viral clearance rates in triple (n = 21) and dual (n = 105) therapy were 95.0% and 18.1% at 12 weeks, and 95.0% and 40.0%, respectively, at 24 weeks (P < .01). CONCLUSIONS Although careful monitoring for possible adverse events is required during treatment, triple therapy with the use of direct-acting agents are very effective in treating hepatitis C after liver transplantation.
Collapse
Affiliation(s)
- T Ikegami
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
| | - T Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Y Soejima
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - N Harimoto
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - S Itoh
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - K Takeishi
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - H Uchiyama
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - H Kawanaka
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Y-I Yamashita
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - E Tsujita
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - N Harada
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - H Saeki
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Y Kimura
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - K Shirabe
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Y Maehara
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| |
Collapse
|
31
|
Satake H, Tsuji A, Emi Y, Shimokawa M, Miyamoto Y, Saeki H, Oki E, Maekawa S, Tanioka H, Akagi Y, Baba H, Ogata Y, Maehara Y. P-244 Prospective study of S-1 + Irinotecan plus bevacizumab as second-line therapy in Japanese patients with metastatic colorectal cancer (KSCC1102). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.241] [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
|
32
|
Furue M, Onozuka D, Takeuchi S, Murota H, Sugaya M, Masuda K, Hiragun T, Kaneko S, Saeki H, Shintani Y, Tsunemi Y, Abe S, Kobayashi M, Kitami Y, Tanioka M, Imafuku S, Abe M, Inomata N, Morisky DE, Katoh N. Poor adherence to oral and topical medication in 3096 dermatological patients as assessed by the Morisky Medication Adherence Scale-8. Br J Dermatol 2014; 172:272-5. [PMID: 25154923 PMCID: PMC4303916 DOI: 10.1111/bjd.13377] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- M Furue
- Department of Dermatology, Kyushu University, Maidashi 3-1-1, Higashiku, Fukuoka, 812-8582, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Saeki H, Nakagawa H, Ishii T, Morisaki Y, Aoki T, Berclaz PY, Heffernan M. Efficacy and safety of open-label ixekizumab treatment in Japanese patients with moderate-to-severe plaque psoriasis, erythrodermic psoriasis and generalized pustular psoriasis. J Eur Acad Dermatol Venereol 2014; 29:1148-55. [DOI: 10.1111/jdv.12773] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 09/12/2014] [Indexed: 11/29/2022]
Affiliation(s)
- H. Saeki
- Department of Dermatology; Nippon Medical School; Tokyo Japan
| | - H. Nakagawa
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - T. Ishii
- Lilly Research Laboratories; Eli Lilly Japan K.K.; Kobe Japan
| | - Y. Morisaki
- Lilly Research Laboratories; Eli Lilly Japan K.K.; Kobe Japan
| | - T. Aoki
- Lilly Research Laboratories; Eli Lilly Japan K.K.; Kobe Japan
| | - P.-Y. Berclaz
- Lilly Research Laboratories; Eli Lilly and Company; Indianapolis IN USA
| | - M. Heffernan
- Lilly Research Laboratories; Eli Lilly and Company; Indianapolis IN USA
| |
Collapse
|
34
|
Saeki H, Ito K, Nobeyama Y, Ishiji T, Fukunaga M, Nakagawa H. Hybrid peripheral nerve sheath tumour with intermingled perineuriomatous and schwannomatous areas reflected in skin ultrasonography image. Clin Exp Dermatol 2014; 39:747-9. [PMID: 24985502 DOI: 10.1111/ced.12370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2014] [Indexed: 11/27/2022]
Affiliation(s)
- H Saeki
- Department of Dermatology, The Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | | | | | | | | | | |
Collapse
|
35
|
Saeki H, Ito T, Hayashi M, Fukuchi O, Umezawa Y, Nobeyama Y, Teruya K, Nakagawa H. Successful treatment of ustekinumab in a severe psoriasis patient with human immunodeficiency virus infection. J Eur Acad Dermatol Venereol 2014; 29:1653-5. [DOI: 10.1111/jdv.12531] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 03/28/2014] [Indexed: 12/01/2022]
Affiliation(s)
- H. Saeki
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - T. Ito
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - M. Hayashi
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - O. Fukuchi
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - Y. Umezawa
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - Y. Nobeyama
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - K. Teruya
- AIDS Clinical Center; National Center for Global Health and Medicine; Tokyo Japan
| | - H. Nakagawa
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| |
Collapse
|
36
|
Omori Y, Saeki H, Ito K, Matsuzaki H, Tokita M, Itoh M, Tanito K, Ishiji T, Fukunaga M, Nakagawa H. Solitary fibrous tumour of the scalp. Clin Exp Dermatol 2014; 39:539-41. [PMID: 24712870 DOI: 10.1111/ced.12309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Y Omori
- Department of Dermatology, The Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Kubo N, Morita M, Nakashima Y, Kitao H, Egashira A, Saeki H, Oki E, Kakeji Y, Oda Y, Maehara Y. Oxidative DNA damage in human esophageal cancer: clinicopathological analysis of 8-hydroxydeoxyguanosine and its repair enzyme. Dis Esophagus 2014; 27:285-93. [PMID: 23902537 DOI: 10.1111/dote.12107] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [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] [Indexed: 12/11/2022]
Abstract
Both internal and external oxidative stresses act on DNA and can induce carcinogenesis. 8-hydroxydeoxyguanosine (8-OHdG) is an indicator of oxidative stress and it leads to transversion mutations and carcinogenesis. 8-OHdG is excision-repaired by 8-OHdG DNA glycosylase (OGG1). The purpose of this study is to clarify the effect of oxidative DNA damage and repair enzymes on esophageal carcinogenesis. The levels of 8-OHdG and OGG1 were immunohistochemically evaluated in resected specimens, including squamous cell carcinoma (SCC) in 97 patients with esophageal cancer. Higher levels of 8-OHdG in normal esophageal epithelium were associated with a higher smoking index (P = 0.0464). The 8-OHdG level was higher in cancerous areas than in normal epithelia (P = 0.0061), whereas OGG1 expression was weaker in cancerous areas than in normal epithelia (P < 0.0001). An increase of OGG1 expression in normal epithelium was observed as 8-OHdG levels increased (P = 0.0011). However, this correlation was not observed in cancerous areas. High OGG1 expression in the cytoplasm was related to deeper tumors (P = 0.0023), node metastasis (P = 0.0065) and stage (P = 0.0019). Oxidative DNA damage, which is attributable to smoking as well as disturbances in DNA repair systems, appears to be closely related to esophageal carcinogenesis and its progression.
Collapse
Affiliation(s)
- N Kubo
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Tokunaga E, Yamashita N, Tanaka K, Saeki H, Oki E, Kitao H, Morita M, Maehara Y. Abstract P2-08-04: Subtype specific chromosomal aberrations in breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-08-04] [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: Breast cancer is a heterogeneous disease and divided into five distinct groups (Luminal A, Luminal B, HER2-enriched, Basal-like, and Claudin-low subtypes). DNA copy number studies have suggested that chromosomal aberrations are different among subtypes. Basal-like, and Claudin-low subtypes are mainly ER-, PR- and HER2- (triple negative: TN). Recent study reported that the basal-like subtype was the most distinct with common losses of the regions containing tumor suppressor genes such as RB1, BRCA1, INPP4B, and the greatest overall genomic instability. On the other hand, Claudin-low tumors showed few copy number changes. Luminal A tumors show fewer chromosomal copy number changes than Luminal B and HER2-enriched subtypes.
Aims: To investigate the extent of the chromosomal aberrations and to evaluate the relationships between chromosomal aberrations and breast cancer subtypes and other clinicopathological characteristics and prognosis.
Methods: Specimens were obtained from 363 invasive breast cancer patients who underwent surgery in our department between 1994 and 2011. Four breast cancer subtypes were determined by the immunohistochemical analysis of ER, PR and HER2; hormone receptor (HR; ER and/or PR)+/HER2-, HR+/HER2+, HR-/HER2+(HER2) and TN. Loss of heterozygosity (LOH) at the tumor suppressor gene (TSGs), BRCA1, BRCA2, TP53, RB1, PTEN and INPP4B, was investigated with microsatellite markers using our microsatellite analysis system. Copy number aberrations (CNAs) were analyzed by SNP-CGH array (Illumina, HumanOmni2.5-8).% Defects, which represents the percent of genome region containing chromosomal aberration, was determined by Karyostudio Software v1.4 (Illumina).
Results: The incidence of LOH at BRCA, BRCA2, TP53, RB1, PTEN and INPP4B locus was 37.4, 34.0, 57.1, 41.9, 25.8 and 18.0%, respectively. The incidence of LOH was lowest in hormone receptor (HR)+/HER2- subtype, and higher in HER2 and triple negative (TN) subtypes. LOH at INPP4B locus was significantly associated with TN subtype. The LOH at BRCA1 and TP53 loci was highest in HER2 subtype. The LOH at BRCA1, TP53 and INPP4B loci was significantly associated with poor prognosis in all cases; however, the impact of LOH at these TSGs on the prognosis was different among subtypes. Coexistence of LOH at both BRCA1 and TP53 loci was significantly associated with aggressive phenotype and chromosomal aberrations.%Defect was highest in the tumors with LOH at both BRCA1 and TP53 loci. Coexistence of LOH at both BRCA1 and TP53 loci was significantly associated with poor prognosis, especially in HR+/HER2- subtype. Many cases with TN subtype reveal gross chromosomal aberrations, and these tumors were considered to be basal-like. However, there are some cases with few chromosomal alterations in TN, whose prognosis was very poor. These tumors were considered to be Claudin-low subtype.
Conclusions: The incidence and biological significance of LOH at TSGs are different among breast cancer subtypes. Coexistence of LOH at both BRCA1 and TP53 loci was associated with gross chromosomal aberrations and poor prognosis.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-08-04.
Collapse
Affiliation(s)
| | | | - K Tanaka
- Kyushu University, Fukuoka, Japan
| | - H Saeki
- Kyushu University, Fukuoka, Japan
| | - E Oki
- Kyushu University, Fukuoka, Japan
| | - H Kitao
- Kyushu University, Fukuoka, Japan
| | - M Morita
- Kyushu University, Fukuoka, Japan
| | | |
Collapse
|
39
|
Yamashita N, Tokunaga E, Tanaka K, Saeki H, Oki E, Kitao H, Morita M, Maehara Y. Abstract P2-06-03: The BRCA1 promoter methylation is one of the mechanisms of th BRCA1 dysfunction of triple-negative breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-06-03] [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: Triple negative breast cancer (TNBC) is typically associated with aggressive tumor phenotype and poor prognosis. TNBC is also considered highly heterogeneous disease. A better understanding of molecular and histopathological features of TNBC is of great importance, in order to develop a new therapeutic strategy and to improve the prognosis of TNBC. TNBC has many similarities with basal-like breast cancer, and is also associated with BRCAness. The major role of BRCA1 is to respond to DNA damage by participating in cellular pathways for DNA repair, mRNA transcription, cell cycle regulation, and protein ubiquitination. BRCA1 function loss leads to impaired homologous recombination mediated DNA repair. A loss of BRCA1 may thus be a biomarker of responsiveness to DNA damaging agents such as PARP inhibitor and cis/carboplatin. Germline mutations in BRCA1, however, account for approximately 5% of breast cancer cases, somatic mutations in BRCA1 rarely occur. Instead, lower than normal expression of BRCA1 is reported to be an important contributing factor in sporadic tumors. The BRCA1 promoter methylation may thus play an important role in the BRCA1 function loss in sporadic breast cancer.
Aim: To evaluate the clinical importance of BRCA1 promoter methylation in breast cancer.
Materials and Methods: Specimens were obtained from 71 TNBC and 163 non-TNBC patients who underwent surgery without neoadjuvant therapy in our department between 1990 and 2011. BRCA1 promoter methylation was investigated by using combined bisulfate and restriction analysis (COBRA). The BRCA1 mRNA expression was evaluated by quantitive RT-PCR. The BRCA1 protein level was assessed by immnohistochemistry. Loss of heterozygosity(LOH) at the BRCA1 locus was analyzed with microsatellite markers (D17S855 and D17S579) using our microsatellite analysis system. Copy number variations(CNVs) were analysed by SNP-CGH array (Illumina, HumanOmni2.5-8).
Results: We found 12 patients with BRCA1 promoter methylation and all of them were TNBC (p<0.0001). BRCA1 promoter methylation was associated with lymphovessel invasion (p = 0.009), high nuclear grade (p = 0.03), low BRCA1 mRNA expression (p = 0.002) and low BRCA1 protein expression (p<0.0001). CNVs were observed more frequently in TNBC(p = 0.012). High CNVs significantly correlated with BRCA1 LOH (p = 0.0025), but not with BRCA1 promoter methylation among TNBC patients.
Conclusions: The BRCA1 promoter methylation is considered to be a specific feature of aggressive phenotype of TNBC and to be one of the mechanisms of BRCA1 dysfunction in breast cancer.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-06-03.
Collapse
Affiliation(s)
- N Yamashita
- Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - E Tokunaga
- Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - K Tanaka
- Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - H Saeki
- Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - E Oki
- Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - H Kitao
- Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - M Morita
- Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Y Maehara
- Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| |
Collapse
|
40
|
Omori Y, Saeki H, Ito K, Umezawa Y, Ishiji T, Ota A, Fukunaga M, Nakagawa H. Extragenital subcutaneous cellular angiofibroma of the elbow. J Eur Acad Dermatol Venereol 2013; 28:828-30. [DOI: 10.1111/jdv.12312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Y. Omori
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - H. Saeki
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - K. Ito
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - Y. Umezawa
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - T. Ishiji
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - A. Ota
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - M. Fukunaga
- Department of Pathology; The Jikei University School of Medicine; Tokyo Japan
| | - H. Nakagawa
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| |
Collapse
|
41
|
Shimizu Y, Kishimura H, Kanno G, Nakamura A, Adachi R, Akiyama H, Watanabe K, Hara A, Ebisawa M, Saeki H. Molecular and immunological characterization of '-component (Onc k 5), a major IgE-binding protein in chum salmon roe. Int Immunol 2013; 26:139-47. [DOI: 10.1093/intimm/dxt051] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
42
|
Sakaida E, Sekine I, Kurimoto R, Uehara T, Iwasawa S, Imai C, Saeki H, Tada Y, Oda S, Takiguchi Y. Feasibility of Cancer Chemotherapy in Patients Who Undergo Dialysis Treatment. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.104] [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
|
43
|
Shibanuma K, Arai T, Hasegawa K, Hoshi R, Kamiya K, Kawashima H, Kubo H, Masaki K, Saeki H, Sakurai S, Sakata S, Sakasai A, Sawai H, Shibama Y, Tsuchiya K, Tsukao N, Yagyu J, Yoshida K, Kamada Y, Mizumaki S, Hayakawa A, Takigami H, Barabaschi P, Davis S, Peyrot M, Phillips G. Assembly study for JT-60SA tokamak. Fusion Engineering and Design 2013. [DOI: 10.1016/j.fusengdes.2012.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
44
|
Saeki H, Morita M, Harada N, Egashira A, Oki E, Uchiyama H, Ohga T, Kakeji Y, Sakaguchi Y, Maehara Y. Esophageal replacement by colon interposition with microvascular surgery for patients with thoracic esophageal cancer: the utility of superdrainage. Dis Esophagus 2013; 26:50-6. [PMID: 22394201 DOI: 10.1111/j.1442-2050.2012.01327.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [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: 12/11/2022]
Abstract
Replacing the thoracic esophagus with the colon is one mode of reconstruction after esophagectomy for esophageal cancer. There is, however, a high incidence of postoperative necrosis of the transposed colon. This study evaluated the outcomes of colon interposition with the routine use of superdrainage by microvascular surgery. Twenty-one patients underwent colon interposition from 2004 to 2009. The strategy for colon interposition was to: (i) use the right hemicolon; (ii) reconstruct via the subcutaneous route; (iii) perform a microvascular venous anastomosis for all patients; and (iv) perform a microvascular arterial anastomosis when the arterial blood flow was insufficient. The clinicopathologic features, surgical findings, and outcomes were investigated. The colon was used because of a previous gastrectomy in 18 patients (85.7%) and synchronous gastric cancer in three patients (14.3%). Eight patients (38.1%) underwent preoperative chemoradiotherapy including three (14.3%) treated with definitive chemoradiotherapy. Seven patients (33.3%) underwent microvascular arterial anastomosis to supplement the right colon blood supply. Pneumonia occurred in four patients (19.0%). Anastomotic leakage was observed in five patients (23.8%); however, no colon necrosis was observed. The 3-year and 5-year overall survival rates were both 50.6%. Colon interposition with superdrainage results in successful treatment outcomes. This technique is one option for colon interposition employing the right hemicolon.
Collapse
Affiliation(s)
- H Saeki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Toh Y, Kuwano H, Sonoda K, Saeki H, Kawaguchi H, Kitamura K, Nakashima H, Sugimachi K. Correlation between reduced p21(WAF1/CIP1) expression and abnormal p53 expression in esophageal carcinomas. Int J Oncol 2012; 11:703-8. [PMID: 21528264 DOI: 10.3892/ijo.11.4.703] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
p21(WAF1/CIP1) is a potent inhibitor of various cyclin-dependent kinases, the expression of which is transcriptionally regulated by tumor suppressor gene product p53. We immunohistochemically examined the expression of p53 and p21(WAF1/CIP1) in 61 esophageal squamous cell carcinomas. p53 protein was expressed in 37 (61%) of 61 carcinomas. p21(WAF1/CIP1) was consistently expressed in the normal stratified esophageal mucosa. In the carcinomas, the expression of p21(WAF1/CIP1) protein was markedly reduced or not expressed in 33 (54%) cases. Clinicopathologic analyses revealed that no significant correlation exists either between p53-positive and -negative cases or between p21(WAF1)/(CIP1)-positive and -negative cases. Twenty-four cases were p53-positive/p21(WAF1/CIP1) negative, 15 were p53-negative/p21(WAF1/CIP1)-positive, 13 were positive for both and 9 were negative for both, and these findings thus showed an inverse correlation of the positivity between p53 and p21(WAF1/CIP1) (p<0.05). Furthermore, of the 13 cases with positive staining for both, the distribution of the expression was mutually exclusive in 6 cases and coincidental in the remaining 7 cases. These findings showed the p53-dependent expression of p21(WAF1/CIP1) was observed in esophageal squamous cell carcinomas, while the lack of an absolute correlation between abnormal p53 expression and p21(WAF1/CIP1) expression suggested that the p53-independent expression of p21(WAF1/CIP1) might also occur in some portions of the esophageal squamous carcinomas, suggesting that the molecular mechanisms of esophageal carcinogenesis appear to be complicated.
Collapse
Affiliation(s)
- Y Toh
- KYUSHU UNIV HOSP,CTR CANC,FUKUOKA,JAPAN. KYUSHU UNIV,FAC MED,DEPT SURG 2,FUKUOKA 812,JAPAN
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Akagi Y, Beppu T, Emi Y, Kakechi Y, Saeki H, Oki E, Fujita F, Inomata M, Sawai T, Samura H, Baba H, Natsugoe S, Ogata Y, Tokunaga S, Maehara Y. Liver Resectability Following MFOLFOX6 with Bevacizumab as the First-Line Treatment of Unresectable Liver Limited Metastases from Colorectal Cancer in Japanese Patients (KSCC 0802). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32187-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
47
|
Emi Y, Ogata Y, Akagi Y, Kakeji Y, Oki E, Saeki H, Shimokawa M, Touyama T, Samura H, Baba H, Natsugoe S, Shirouzu K, Tokunaga S, Maehara Y. Phase II Study Alternating Mfolfox 6 and Folfiri (FIREFOX) Plus Bevacizumab (BEV) Regimen in First-Line Treatment of Advanced Colorectal Cancer in Japanese Patients (KSCC 0801). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32375-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
48
|
Sakaida E, Ashinuma H, Kitazono S, Kitazono M, Kitamura A, Ohoka Y, Uehara T, Oku T, Imai C, Saeki H, Nakasa H, Kitada M, Sekine I, Takiguchi Y. Feasibility on Short Hydration Regimen of Intermediate- to High-Dose Cisplatin-Based Chemotherapy for Outpatient Treatment. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32214-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
49
|
Yamashita N, Tokunaga E, Kitao H, Hisamatsu Y, Akiyoshi S, Saeki H, Oki E, Ohga T, Kakeji Y, Maehara Y. P1-02-10: Vimentin Expression; as a Prognostic Factor and a Possible Molecular Target of Triple Negative Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p1-02-10] [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: Triple negative breast cancer (TNBC), characterized by absence of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2), is typically associated with aggressive tumor phenotype and poor prognosis. TNBC is also considered highly heterogeneous disease. Since TNBC lacks efficient therapeutic target, it is generally treated with nonspecific cytotoxic agents. A better understanding of molecular and histopathological features of TNBC is of great importance, in order to develop a new therapeutic strategy and to improve the prognosis of TNBC. TNBC has many similarities with basal-like breast cancer (BLBC), and is also associated with stemness and BRCAness. In addition, recent studies suggest links between TNBC and epithelial-mesenchymal transition (EMT). To identify prognostic biomarkers and novel therapeutic targets, we investigated the expression of the factors associated with EMT in TNBC.
MATERIALS and METHODS: Sporadic invasive breast cancer specimens were obtained from 659 Japanese patients who underwent surgery in our department between 1994 and 2010, and 90(14%) cases were diagnosed as TNBC. The E-cadherin and vimentin mRNA expression was evaluated by quantitative RT-PCR. The E-cadherin, vimentin, CK5/6 and epidermal growth factor receptor(EGFR) protein expression was assessed by immunohistochemistry. In this study, we defined TNBC with positive expression of CK5/6 and/or EGFR as BLBC, and TNBC with low expression of E-cadherin and positive expression of vimentin as EMT-type.
RESULTS: Compared with non-TNBC cases, E-cadherin mRNA expression was significantly lower in TNBC cases (p=0.0012). Immunohistochemically, E-cadherin expression was significantly lower (p=0.0001) and vimentin expression was significantly higher (p=0.0049) in TNBC cases. Vimentin expression was associated with younger age (<50 years old, p=0.021), high nuclear grade (p=0.017) and high Ki67 expression (p<.001) in TNBC. Among the patients with TNBC, vimentin expression was significantly associated with poor prognosis, in terms of disease free survival (p=0.0059) and overall survival (p=0.013). Multivariate analysis showed that vimentin expression was an independent prognostic factor for both disease free survival (p=0.017) and overall survival (p=0.012). Among TNBC cases, 52(63%) cases were BLBCs and 15(18%) cases were EMT-type. Among BLBC patients, vimentin expression was also associated with significantly shorter disease free survival (p=0.0085) and overall survival (p=0.0057). The patients with both BLBC and EMT-type features showed especially poor prognosis(P=0.05). CONCLUSION: These findings suggest that elevated expression of vimentin attributes to the aggressive phenotype in TNBC patients. Vimentin expression might be useful as a molecular marker for prognosis of TNBC, and vimentin may represent a novel therapeutic target of TNBC.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-02-10.
Collapse
Affiliation(s)
| | | | - H Kitao
- 1Kyushu University, Fukuoka, Japan
| | | | | | - H Saeki
- 1Kyushu University, Fukuoka, Japan
| | - E Oki
- 1Kyushu University, Fukuoka, Japan
| | - T Ohga
- 1Kyushu University, Fukuoka, Japan
| | - Y Kakeji
- 1Kyushu University, Fukuoka, Japan
| | | |
Collapse
|
50
|
Oki E, Sakaguchi Y, Ohgaki K, Saeki H, Chinen Y, Minami K, Sakamoto Y, Toh Y, Kusumoto T, Maehara Y. Feasibility of Delta-Shaped Anastomoses in Totally Laparoscopic Distal Gastrectomy. Eur Surg Res 2011; 47:205-10. [DOI: 10.1159/000332850] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 08/15/2011] [Indexed: 12/13/2022]
|