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Ishizuka C, Ishikawa T, Yagi H, Yamamoto Y, Koro D, Nishikoshi T, Koshizuka Y, Yanagida N, Shibaki T, Akabane H, Yasuda S, Ishibashi K, Taketomi A. Robot-assisted distal gastrectomy and local resection for gastric cancer and gastrointestinal stromal tumor. Asian J Endosc Surg 2024; 17:e13310. [PMID: 38623612 DOI: 10.1111/ases.13310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024]
Abstract
Gastrointestinal stromal tumors surrounding the esophagogastric junction are often challenging to resect, with no consensus regarding the optimal surgical technique. Here in, we present a case of concurrent gastric cancer in the antrum and gastrointestinal stromal tumors adjacent to the esophagogastric junction. The patient underwent simultaneous distal gastrectomy and local resection assisted by a surgical robot, avoiding the need for total gastrectomy. The utilization of robot-assisted surgery has become an increasingly popular technique, holding promise for simplifying complex surgical procedures across diverse medical settings.
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Affiliation(s)
- Chihiro Ishizuka
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Takahisa Ishikawa
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Hayato Yagi
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Yoichi Yamamoto
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Daisuke Koro
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Takahiro Nishikoshi
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Yasuyuki Koshizuka
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Naoyuki Yanagida
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Taiichiro Shibaki
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Hiromitsu Akabane
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Shunsuke Yasuda
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
- Department of Respiratory Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Kei Ishibashi
- Department of Respiratory Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery 1, Hokkaido University Graduate School, Sapporo, Japan
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Shibaki T, Ikeue S, Akabane H. [A Case of Rheumatoid Arthritis after Administration of an Aromatase Inhibitor in a Menopausal Patient with Breast Cancer]. Gan To Kagaku Ryoho 2024; 51:59-61. [PMID: 38247093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Therapy with an aromatase inhibitor(AI)was initiated in a 91-year-old female patient after she had been diagnosed with breast cancer. One week after taking the medicine, she experienced multiple joint pain in her upper extremities. Finally, she was diagnosed with rheumatoid arthritis(RA). Joint pains are frequently recognized as adverse events associated with the administration of an AI; however, the presentation of RA is rare. It has been shown that AI reinforces the activity of osteoclasts. On the other hand, the association between AI and the pathogenesis of RA remains unclear.
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Horikawa D, Shimazaki R, Manabe K, Ichimura K, Ishibashi K, Fukasaku Y, Ishikawa T, Koshizuka Y, Shibaki T, Yanagida N, Akabane H, Yokoo H, Sumi Y. Hyaline-vascular type unicentric Castleman disease with dysplastic follicular dendritic cell proliferative lesions: a case report. J Surg Case Rep 2023; 2023:rjad536. [PMID: 37781046 PMCID: PMC10539102 DOI: 10.1093/jscr/rjad536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/30/2023] [Indexed: 10/03/2023] Open
Abstract
Castleman disease (CD) is a rare lymphoproliferative disease. Hyaline-vascular type unicentric CD has a good prognosis if completely resected during surgery. However, follicular dendritic cell proliferative lesions have the potential for recurrence and metastasis. A 22-year-old man was referred to our hospital with the chief complaint of nausea and vomiting. These symptoms were caused by a right mesocolonic tumor pushing the duodenum. The patient underwent laparoscopic tumorectomy and complete surgical excision. The postoperative course was uneventful, with no complications. Pathological examination confirmed that the tumor was an enlarged lymph node, typical of hyaline vascular-type CD; however, follicular dendritic cell proliferative lesions were noted. We report a rare case of hyaline-vascular-type CD with follicular dendritic cell proliferative lesions associated with malignancy, as limited case reports exist on this particular disease.
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Affiliation(s)
- Daisuke Horikawa
- Department of Surgery, Furano Kyokai Hospital, Furano, Hokkaido 076-8765, Japan
| | - Ryotaro Shimazaki
- Department of Surgery, Asahikawa Kosei Hospital, Asahikawa, Hokkaido 078-8211, Japan
| | - Kazuya Manabe
- Department of Surgery, Asahikawa Kosei Hospital, Asahikawa, Hokkaido 078-8211, Japan
| | - Kentaro Ichimura
- Department of Surgery, Asahikawa Kosei Hospital, Asahikawa, Hokkaido 078-8211, Japan
| | - Kei Ishibashi
- Department of Surgery, Asahikawa Kosei Hospital, Asahikawa, Hokkaido 078-8211, Japan
| | - Yasutomo Fukasaku
- Department of Surgery, Asahikawa Kosei Hospital, Asahikawa, Hokkaido 078-8211, Japan
| | - Takahisa Ishikawa
- Department of Surgery, Asahikawa Kosei Hospital, Asahikawa, Hokkaido 078-8211, Japan
| | - Yasuyuki Koshizuka
- Department of Surgery, Asahikawa Kosei Hospital, Asahikawa, Hokkaido 078-8211, Japan
| | - Taiichiro Shibaki
- Department of Surgery, Asahikawa Kosei Hospital, Asahikawa, Hokkaido 078-8211, Japan
| | - Naoyuki Yanagida
- Department of Surgery, Asahikawa Kosei Hospital, Asahikawa, Hokkaido 078-8211, Japan
| | - Hiromitsu Akabane
- Department of Surgery, Asahikawa Kosei Hospital, Asahikawa, Hokkaido 078-8211, Japan
| | - Hideki Yokoo
- Department of Hepatobiliary, Pancreatic and Transplant Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan
| | - Yasuo Sumi
- Department of Digestive Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan
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Iwata H, Yamamoto Y, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Ohtani S, Kashiwaba M, Taira N, Toyama T, Fujisawa T, Masuda N, Shibahara Y, Sasano H, Yamaguchi T. Phase III study of long-term prognosis of estrogen receptor-positive early breast cancer treated with neoadjuvant endocrine therapy with/without adjuvant chemotherapy. Breast Cancer Res Treat 2023; 199:231-241. [PMID: 36947277 PMCID: PMC10175450 DOI: 10.1007/s10549-023-06874-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/01/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE Neoadjuvant endocrine therapy (NET) is a treatment option for estrogen receptor-positive (ER+) postmenopausal early breast cancer (EBC). This phase III trial evaluated the prognosis of EBC patients treated with/without chemotherapy (CT) following NET. METHODS ER+/HER2-, T1c-2, and clinically node-negative EBC patients were enrolled in 2008-2013 and treated with endocrine therapy (ET) in weeks 24-28. All patients, excluding those with progressive disease (PD) during NET or ≥ 4 positive lymph nodes after surgery, were randomized to ET for 4.5-5 years with/without CT. The primary endpoint was disease-free survival (DFS). Secondary endpoints included distant DFS (DDFS), overall survival (OS), and DFS/DDFS/OS according to clinical response to NET. RESULTS Of 904 patients, 669 were randomized to CT+ET (n = 333) or ET alone (n = 336). The median follow-up was 7.8 years. DFS (CT+ET, 47 events; ET alone, 70 events) and DDFS did not reach the planned numbers of events. Eight-year DFS/DDFS rates were 86%/93% and 83%/92%, respectively. DFS was significantly better in CT+ET than ET alone in subgroups aged < 60 years (P = 0.016), T2 (P = 0.013), or Ki67 > 20% (P = 0.026). Progesterone receptor and histological grade were predictive markers for clinical responses to NET. CONCLUSION NET may be used as standard treatment for patients with ER+EBC. Although it is difficult to decide whether to administer adjuvant CT based solely on the effect of NET, the response to NET may help to inform this decision. TRIAL REGISTRATION This study was registered at the UMIN Clinical Trials Registry under UMIN000001090 (registered 20 March 2008).
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Affiliation(s)
- Hiroji Iwata
- Breast Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
| | - Yutaka Yamamoto
- Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Takehiko Sakai
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, 38-31 Ariake, Koto, Tokyo, 135-8550, Japan
| | - Yoshie Hasegawa
- Hachinohe City Hospital, 3-1-1 Tamukai, Hachinohe, 031-8555, Japan
| | - Rikiya Nakamura
- Chiba Cancer Center, 666-2 Nitona-cho, Chuo-ku, Chiba, 260-8717, Japan
| | - Hiromitsu Akabane
- Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, 1-24-111, Asahikawa, 078-8211, Japan
| | - Shoichiro Ohtani
- Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Masahiro Kashiwaba
- Adachi Breast Clinic, 98 Kamigamo Matsumoto-cho, Kita-ku, Kyoto, 603-8052, Japan
| | - Naruto Taira
- Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Tatsuya Toyama
- Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Tomomi Fujisawa
- Gunma Prefectural Cancer Center, 617-1 Takahayashinishi-cho, Ota, Gunma, 373-8550, Japan
| | - Norikazu Masuda
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Yukiko Shibahara
- Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
- Kitasato University, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Hironobu Sasano
- Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Takuhiro Yamaguchi
- Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
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Iwata H, Toyama T, Taira N, Masuda N, Yamamoto Y, Fujisawa T, Ohtani S, Kashiwaba M, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T. Abstract PD13-09: Primary analysis from NEOS trial: A randomized phase III study that assessed the long-term prognosis of estrogen receptor positive (ER+) primary breast cancer (PBC) pts who received neoadjuvant endocrine therapy (NET) with/without adjuvant chemotherapy (CT). Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-pd13-09] [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: NET is one of option in postmenopausal PBC with ER+ and molecular signature is useful tool to determine with/without CT after surgery. We presented a relationship between molecular signature and response of NET in this study cohort (BCRT; 2018). Here we report the primary analysis of NEOS trial, a Phase III study that evaluated long-term prognosis with/without CT in ER+ PBC who received NET. Methods: Postmenopausal BC pts with ER +/HER2 negative, T1c-2, clinically node negative, under 76 years old were enrolled at primary registration. Pts were treated by letrozole (LET) in weeks 24-28 after primary enrollment. Pts experienced progression disease (PD) during neoadjuvant phase or with more than 4 positive lymph nodes in pathological findings after surgery were excluded at randomization and received any systemic therapy driven by investigators before or after surgery. Pts who met eligibility criteria were randomized 1:1 to LET for 4.5-5 years after CT or LET alone for 4.5-5 years without CT after surgery. Primary endpoint is disease-free survival (DFS) with/without adjuvant CT. Secondary endpoints include distant DFS (DDFS), overall survival (OS), DFS/DDFS/OS according clinical response of NET and QoL. Statistical analysis plan is as follow. The Hazard ratio (HR) will be compared with the threshold HRs obtained in a pre-study questionnaire survey to reach a conclusion about the choice between LET plus chemotherapy or LET alone. Based on these survey results, the HR thresholds used to choose between the two treatments were set at 0.9 and 0.6. After amendment, the selection probability was finally set as 80-85%. About 170 events were required for both arms. Results: Between May 2008 and June 2013, 904 patients were enrolled at primary registration from 100 institutions in Japan and 21 pts were withdrawn before neoadjuvant phase. 42pts were excluded by PD during NET. 172pts were not randomized because of non-eligible for second enrolled criteria after surgery and patient’s preference. 669pts were randomized (1:1) to adjuvant CT + ET (333pts) or ET alone (336pts). Patients’ characteristics (age, tumor size, progesterone receptor(PgR) status, nuclear grade (NG), clinical and pathological response of NET and a number of Ax LN metastasis) were well balance among two arms. Median follow up is 7.8 years. Primary endpoint (DFS) was not able to evaluated for necessity of chemotherapy because DFS events (CT+ET:46, ET alone:61) was lower compared with planned numbers (HR:0.74 (95%CI; 0.51, 1.09), P=0.13). DDFS was also not able to evaluated similar with DFS (HR:0.79 (95%CI; 0.46, 1.35) P=0.39). DFS/DDFS rate at 8Y were 85.6%/93.1% and 82.7%/91.7% in CT+ ET and ET alone, respectively. OS was not difference between two arms (HR 0.46 (95%CI; 0.20, 1.07) P=0.072). Both DDFS and locoregional events were lower in CT+ET than ET alone arm. A number of any secondary cancers was higher than DDFS events among both arms. DFS was statistically significant better in CT+ET arm than ET alone arm among any subgroups who < 60 years (HR:0.30, p=0.003, clinical T2 (HR:0.56, p=0.012) and ki67 >20% cases (HR:0.49, P=0.026) at baseline characteristics. No statistically significant difference of DFS between two arms according to response of NET (HR:0.76, P=0.35 in CR and PR group, HR:0.70, p=0.19 in SD group). PgR status, NG, a number of Ax LN metastasis were also not predictive factors about the difference of DFS between CT+ET and ET alone. Conclusion: The decision to use adjuvant chemotherapy could not be based solely on clinical response of NET. Adjuvant chemotherapy should be selected by any clinical factors and genomic tool regardless of response by NET for ER+ PBC. UMIN000001090
Citation Format: Hiroji Iwata, Tatsuya Toyama, Naruto Taira, Norikazu Masuda, Yutaka Yamamoto, Tomomi Fujisawa, Shoichiro Ohtani, Masahiro Kashiwaba, Takehiko Sakai, Yoshie Hasegawa, Rikiya Nakamura, Hiromitsu Akabane, Yukiko Shibahara, Hironobu Sasano, Takuhiro Yamaguchi. Primary analysis from NEOS trial: A randomized phase III study that assessed the long-term prognosis of estrogen receptor positive (ER+) primary breast cancer (PBC) pts who received neoadjuvant endocrine therapy (NET) with/without adjuvant chemotherapy (CT) [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr PD13-09.
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Affiliation(s)
| | - Tatsuya Toyama
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Norikazu Masuda
- National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | | | | | | | - Takehiko Sakai
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | | | - Hiromitsu Akabane
- Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan
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Tanaka K, Tanabe H, Sato H, Ishikawa C, Goto M, Yanagida N, Akabane H, Yokohama S, Hasegawa K, Kitano Y, Sugiyama Y, Uehara K, Kobayashi Y, Murakami Y, Kunogi T, Sasaki T, Takahashi K, Ando K, Ueno N, Kashima S, Moriichi K, Sato K, Yuzawa S, Tanino M, Taruiishi M, Sumi Y, Mizukami Y, Fujiya M, Okumura T. Prognostic factors to predict the survival in patients with advanced gastric cancer who receive later-line nivolumab monotherapy-The Asahikawa Gastric Cancer Cohort Study (AGCC). Cancer Med 2022; 11:406-416. [PMID: 34845844 PMCID: PMC8729046 DOI: 10.1002/cam4.4461] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 06/26/2021] [Revised: 10/21/2021] [Accepted: 11/08/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Chemotherapy for advanced gastric cancer is recommended in the guidelines; however, later-line treatment remains controversial. Since immune checkpoint inhibitors have been used for the treatment of various malignancies, trials have been performed for gastric cancer. A phase 3 trial indicated the survival benefit of nivolumab monotherapy for gastric cancer patients treated with prior chemotherapy regimens. PATIENTS AND METHODS A regional cohort study was undertaken to determine the real-world data of nivolumab treatment for patients with advanced or recurrent gastric cancer. The patients were enrolled for 2 years from October 2017 to October 2019 and were prospectively followed for 1 year to examine the overall survival (OS). The patient characteristics were analyzed in a multivariate analysis and a nomogram to predict the probability of survival was generated. RESULTS In total, 70 patients who received nivolumab as ≥third-line chemotherapy were included in the Asahikawa Gastric Cancer Cohort. The median OS was 7.5 (95% CI, 4.8-10.2) months and the response rate was 18.6%. Diffuse type classification, bone metastasis, high neutrophil/lymphocyte ratio, and high CRP were associated with poor OS/prognosis in the multivariate analysis. A nomogram was developed based on these clinical parameters and the concordance index was 0.80 (95% CI, 0.68-0.91). The responders were aged and were frequently diagnosed with intestinal type gastric cancer, including patients with a HER2-positive status (27.3%) or microsatellite instability-high (27.3%) status. CONCLUSIONS The regional cohort study of nivolumab monotherapy for gastric cancer patients revealed prognostic factors and a nomogram was developed that could predict the probability of survival.
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Affiliation(s)
- Kazuyuki Tanaka
- Department of GastroenterologyAsahikawa Kosei HospitalAsahikawa HokkaidoJapan
| | - Hiroki Tanabe
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Hiroki Sato
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Chisato Ishikawa
- Department of GastroenterologyJapanese Red Cross Asahikawa HospitalAsahikawa HokkaidoJapan
| | - Mitsuru Goto
- Department of GastroenterologyAsahikawa Kosei HospitalAsahikawa HokkaidoJapan
| | - Naoyuki Yanagida
- Department of SurgeryAsahikawa Kosei HospitalAsahikawa HokkaidoJapan
| | - Hiromitsu Akabane
- Department of SurgeryAsahikawa Kosei HospitalAsahikawa HokkaidoJapan
| | - Shiro Yokohama
- Department of GastroenterologyAsahikawa Medical CenterAsahikawa HokkaidoJapan
| | - Kimiharu Hasegawa
- Division of Gastrointestinal SurgeryAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Yohei Kitano
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Yuya Sugiyama
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Kyoko Uehara
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Yu Kobayashi
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Yuki Murakami
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Takehito Kunogi
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Takahiro Sasaki
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Keitaro Takahashi
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Katsuyoshi Ando
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Nobuhiro Ueno
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Shin Kashima
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Kentaro Moriichi
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Keisuke Sato
- Department of PathologyAsahikawa Kosei HospitalAsahikawa HokkaidoJapan
| | - Sayaka Yuzawa
- Department of Diagnostic PathologyAsahikawa Medical University HospitalAsahikawa Medical UniversityAsahikawaHokkaidoJapan
| | - Mishie Tanino
- Department of Diagnostic PathologyAsahikawa Medical University HospitalAsahikawa Medical UniversityAsahikawaHokkaidoJapan
| | - Masaki Taruiishi
- Department of GastroenterologyAsahikawa City HospitalAsahikawa HokkaidoJapan
| | - Yasuo Sumi
- Division of Gastrointestinal SurgeryAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Yusuke Mizukami
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Mikihiro Fujiya
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
| | - Toshikatsu Okumura
- Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa HokkaidoJapan
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Yamaguchi T, Hozumi Y, Sagara Y, Takahashi M, Yoneyama K, Fujisawa T, Osumi S, Akabane H, Nishimura R, Mieno MN, Mukai H. The impact of neoadjuvant systemic therapy on breast conservation rates in patients with HER2-positive breast cancer: Surgical results from a phase II randomized controlled trial. Surg Oncol 2020; 36:51-55. [PMID: 33310293 DOI: 10.1016/j.suronc.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/04/2020] [Accepted: 11/15/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Neoadjuvant systemic therapy (NST) induces tumor shrinkage and boosts the chance of breast-conserving thearpy (BCT) in patients with breast cancer. However, only a few trials have evaluated the effect of NST in conversion from BCT ineligibility to BCT eligibility in HER2-positive breast cancer. METHODS We conducted the surgical sub-study of a phase II randomized trial, which compared standard neoadjuvant treatment or an experimental treatment modified according to the interim Ki-67 evaluation in women with stage II or III HER2-positive breast cancer. The treating surgeons assessed eligibility for BCT before and after NST. We evaluated the change in BCT eligibility following NST. We also analyzed the type of surgery performed and the success rate of BCT. RESULTS Two hundred six patients were included in this study. Of these, 44.0% were considered BCT candidates at baseline, while 69.8% were deemed eligible for BCT after NST (P < 0.001). Among non-BCT candidates at baseline, 46% successfully converted to BCT candidates. Of 139 patients deemed eligible for BCT following NST, 84.2% attempted BCT, and successful BCT, defined as tumor-free at all surgical margins, was achieved in 96.8% of patients. Different treatment arms did not affect the rate of post-NST BCT eligibility (70.0% vs 69.7%). CONCLUSIONS This study demonstrated that NST resulted in an absolute increase of 25.8% in the rate of BCT eligibility in HER2-positive breast cancer. About a half of non-BCT candidates converted to BCT candidates. BCT was successful in most patients who attempted BCT. There were still patients who chose mastectomy even though they were deemed eligible for BCT. Patients considered BCT-ineligible due to large tumor size most likely converted to BCT-eligible with NST. On the other hand, NST had less impact on the surgical indication of patients with multicentric disease or probable poor cosmetic outcome.
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Affiliation(s)
- Takeshi Yamaguchi
- Medical Oncology, Japanese Red Cross Musashino Hospital. 1-26-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8610, Japan.
| | - Yasuo Hozumi
- Breast and Endocrine Surgery, University of Tsukuba Hospital/ Ibaraki Prefectural Central Hospital. 6528 Koibuchi, Kasama City, Ibaraki, 309-1793, Japan.
| | - Yasuaki Sagara
- Breast Oncology, Sagara Hospital, Hakuaikai Medical Corporation, 3-31 Matsubara-cho, Kagoshima-shi, Kagoshima, 343-0832, Japan.
| | - Masato Takahashi
- Breast Surgery, NHO Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo, Hokkaido, 003-0804, Japan.
| | - Kimiyasu Yoneyama
- Breast Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
| | - Tomomi Fujisawa
- Breast Oncology, Gunma Prefectural Cancer Center, 617-1 Takahayashinishi-cho, Ota-shi, Gunma, 373-8550, Japan.
| | - Shozo Osumi
- Breast Oncology, Shikoku Cancer Center, 160 Kou, Minamiumemoto-cho, Matsuyama, Ehime, 791-0280, Japan.
| | - Hiromitsu Akabane
- Breast Surgery, Asahikawa Kosei Hospital, 24-111, Ichi-jodori, Asahikawa-shi, Hokkaido, 078-8211, Japan
| | - Reiki Nishimura
- Breast Surgery, Kumamoto Shinto General Hospital, 3-2-65 Oe, Chuo-ku, Kumamoto-shi, Kumamoto, 862-8655, Japan.
| | - Makiko Naka Mieno
- Department of Medical Informatics, Center for Information, Jichi Medical University. 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan.
| | - Hirofumi Mukai
- Breast and Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
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Ohsumi S, Mukai H, Takahashi M, Hozumi Y, Akabane H, Park Y, Tokunaga E, Takashima T, Watanabe T, Sagara Y, Kaneko T, Ohashi Y. Factors affecting enrollment in randomized controlled trials conducted for patients with metastatic breast cancer. Jpn J Clin Oncol 2020; 50:873-881. [PMID: 32463090 DOI: 10.1093/jjco/hyaa065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/20/2020] [Accepted: 04/26/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is critical to obtain informed consent from eligible patients to complete clinical trials. We investigated the factors that affect the participation rates of eligible patients. PATIENTS AND METHODS Patients with metastatic breast cancer who were eligible for SELECT BC or SELECT BC-CONFIRM trials, randomized controlled trials conducted for patients with chemotherapy-naive metastatic breast cancer were recruited to prospective studies, SELECT BC-FEEL and SELECT BC-FEEL II, respectively. SELECT BC FEEL and SELECT BC-FEEL II were conducted to identify the factors affecting the rates at which informed consent was obtained, using a self-administered questionnaire we developed. RESULTS In total, 232 patients participated in the studies. The patients who agreed to take part in the randomized trials were more likely than the refusers to answer that they decided to participate because: 'My doctor wanted me to participate in this trial' (P = 0.00000), ' My family or friends wanted me to participate in this trial' (P = 0.00000), 'Both treatment regimens used in the trial are suitable to me' (P = 0.00383), 'I know that the trial is conducted to determine which is a better treatment' (P = 0.01196), and ' I think that my participation in the trial will contribute to the benefit to future patients with the same disease' (P = 0.00756). CONCLUSIONS To enhance the consent rate in randomized trials of metastatic breast cancer patients, concepts of the trials must be considered important and acceptable not only by patients but also by doctors and their families.
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Affiliation(s)
- Shozo Ohsumi
- Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minami-umemoto-machi, Matsuyama 791-0280, Japan
| | - Hirofumi Mukai
- Department of Breast and Medical Oncology, National Cancer Center Hospital East, Kashiwa
| | - Masato Takahashi
- Department of Breast Surgery, National Hospital Organization Hokkaido Cancer Center, Sapporo
| | - Yasuo Hozumi
- Department of Breast Surgery, Ibaraki Prefectural Central Hospital, Kasama
| | | | - Youngjin Park
- Department of Breast and Endocrine Surgery, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai
| | - Eriko Tokunaga
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka
| | - Tsutomu Takashima
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka
| | - Takanori Watanabe
- Department of Breast Surgery, National Hospital Organization Sendai Medical Center, Sendai
| | - Yoshiaki Sagara
- Department of Breast Oncology, Hakuaikai Medical Corp Sagara Hospital, Kagoshima
| | - Tetsuji Kaneko
- Department of Clinical Research, Tokyo Metropolitan Children's Medical Center, Fuchu
| | - Yasuo Ohashi
- Faculty of Science and Engineering, Chuo University, Tokyo
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Mukai H, Yamaguchi T, Takahashi M, Hozumi Y, Fujisawa T, Ohsumi S, Akabane H, Nishimura R, Takashima T, Park Y, Sagara Y, Toyama T, Imoto S, Mizuno T, Yamashita S, Fujii S, Uemura Y. Ki-67 response-guided preoperative chemotherapy for HER2-positive breast cancer: results of a randomised Phase 2 study. Br J Cancer 2020; 122:1747-1753. [PMID: 32238920 PMCID: PMC7283228 DOI: 10.1038/s41416-020-0815-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 05/21/2019] [Revised: 01/15/2020] [Accepted: 03/12/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The effectiveness of a therapeutic strategy that switches chemotherapy, based on Ki-67 tumour expression after initial therapy, relative to that of standard chemotherapy, has not been evaluated. METHODS Patients were randomly assigned to the control arm or the Ki-67 response-guided arm (Ki-67 arm). Primary tumour biopsies were obtained before treatment, and after three once-weekly doses of paclitaxel and trastuzumab to assess the interim Ki-67 index. In the control arm, paclitaxel and trastuzumab were continued for a total of 12 doses, regardless of the interim Ki-67 index. In the Ki-67 arm, subsequent treatment was based on the interim Ki-67 index. Ki-67 early responder is defined as the absolute Ki-67 value that was <10%, and the percentage of Ki-67-positive tumour cells was reduced by >30% compared with before treatment. Early Ki-67 responders continued to receive the same treatment, while early Ki-67 non-responders were switched to epirubicin plus cyclophosphamide. The primary endpoint was the pathological complete response (pCR) rate. RESULTS A total of 237 patients were randomised. There was almost linear correlation between the Ki-67 reduction rate at interim assessment and the pCR rate. The pCR rate in Ki-67 early non-responders in the Ki-67 arm was inferior to that in the control arm (44.1%; 31.4-56.7; P = 0.025). CONCLUSIONS The standard chemotherapy protocol remains as the recommended strategy for patients with HER2-positive breast cancer. CLINICAL TRIAL REGISTRATION Clinical Trial Registration: UMIN-CTR as UMIN000007074.
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Affiliation(s)
- Hirofumi Mukai
- National Cancer Center Hospital East, Kashiwa, Chiba, 277-8577, Japan.
| | | | - Masato Takahashi
- National Hospital Organization Hokkaido Cancer Center, Sapporo, Hokkaido, 003-0804, Japan
| | - Yasuo Hozumi
- University of Tsukuba Hospital, Tsukuba, Ibaraki, 305-8576, Japan
| | - Tomomi Fujisawa
- Gunma Prefectural Cancer Center, Ota, Gunma, 373-0828, Japan
| | - Shozo Ohsumi
- National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, 791-0245, Japan
| | | | - Reiki Nishimura
- Kumamoto Shinto General Hospital, Chuo Ward, Kumamoto, 862-8655, Japan
| | - Tsutomu Takashima
- Osaka City University Graduate School of Medicine, Sumiyoshi Ward, Osaka, 558-0022, Japan
| | - Youngjin Park
- Tohoku Medical and Pharmaceutical University Hospital, Sendai, Miyagi, 981-8558, Japan
| | - Yasuaki Sagara
- Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan
| | - Tatsuya Toyama
- Nagoya City University Graduate School of Medical Sciences, Aichi, Nagoya, 467-8601, Japan
| | - Shigeru Imoto
- Kyorin University Hospital, Mitaka, Tokyo, 181-8611, Japan
| | | | - Satoshi Yamashita
- National Cancer Center Research Institute, Chuo-ku, Tokyo, 104-0045, Japan
| | - Satoshi Fujii
- Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, 277-8577, Japan
| | - Yukari Uemura
- National Center for Global Health and Medicine, Tokyo, Japan
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Hozumi Y, Ohsumi S, Mukai H, Takahashi M, Akabane H, Park Y, Tokunaga E, Takashima T, Watanabe T, Sagara Y, Kaneko T, Ohashi Y. Abstract P1-21-01: Factors affecting enrolment in randomised controlled trials of Japanese patients with metastatic breast cancer. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p1-21-01] [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: It is critical that a large proportion of eligible patients should participate in clinical trials. However, recruitment into clinical trials requires informed consent and involves some difficult and complex problems. Therefore, it is important to know what factors affect the participation of eligible patients in clinical trials.
Patients and Methods: Patients with metastatic breast cancer (MBC) who were eligible to participate in the SELECT BC or SELECT BC-CONFIRM trials were recruited to a prospective study accompanying them named SELECT BCFEEL. The SELECT BC and SELECT BC-CONFIRM trials were randomised controlled trials (RCTs) that compared taxanes or anthracyclines, respectively, with the oral regimen of S-1 in the first line setting for Japanese patients with MBC. The SELECT BC FEEL was conducted to identify factors affecting the rates at which informed consent was obtained, using a self-administered questionnaire we developed. The questionnaire included the following items: Physician recommendation, family or friend recommendation, satisfaction with the explanation about the trial, both from the doctor or clinical research coordinator and from printed matter, regimens used, understanding of the concept of the trial, benefit to future patients, relationship with the doctor, attitude toward random assignment, concerns about privacy, burden on the patient, and potential adverse effects. We also asked the patients their age, whether they received prior chemotherapy, and about the time needed to decide whether or not to participate, communication with their doctor or other patients, potential adverse effects they were concerned about, and other people's opinions that affected their decision. The patients were asked to answer most of the questions in 5-point Likert scales. To investigate the associations between patients’ decision regarding whether or not to participate in the RCTs and their responses to each question, the Chi-square test, the Mann-Whitney U test, and the t-test were used. P values of < 0.05 were considered statistically significant.
Results: Two hundred and thirty-two patients participated in the present study. Data were missing for 3 patients, and they were excluded from the analyses. One hundred and eighty five participated in the RCT, but 44 did not. The patients who chose to participate in these RCTs were more likely to answer that they decided to participate because "My doctor wanted me to participate in this trial" (69.2% vs. 25.6%; P <0.001), "My family or friends wanted me to participate in this trial" (46.7% vs. 9.3%; P< 0.001), "Both treatment regimens used in the trial are suitable for me" (48.4% vs. 23.8%; P = 0.004), "I know that the trial is conducted to determine which is a better treatment" (91.9% vs. 76.8%; P = 0.012), and "I think that my participation in the trial will contribute to the benefit of future patients with the same disease" (96.2% vs. 84.1%; P = 0.008), and spent fewer days making a decision (P =0.017) in comparison with those who declined to participate. The answering direction was reversed in only one question: those who answered "I am worried about the fact that I cannot choose which treatment to receive if I participate in the trial" were less likely to participate (46.4% vs. 67.4%; P = 0.010). The persons who had the greatest influence on the decision also differed significantly between the two groups (P = 0.005). Those who chose to participate were more likely to answer that "their doctors" were most influential (66.1% vs. 39.5%), but those who declined answered "their family" (22.8% vs. 46.5%) more frequently than the participants.
Conclusions: To enhance the consent rate in randomised trials of Japanese breast cancer patients, the concepts of the trials must be considered important and acceptable by the doctors and families of the patients.
Citation Format: Yasuo Hozumi, Shozo Ohsumi, Hirofumi Mukai, Masato Takahashi, Hiromitsu Akabane, Youngjin Park, Eriko Tokunaga, Tsutomu Takashima, Takanori Watanabe, Yoshiaki Sagara, Tetsuji Kaneko, Yasuo Ohashi. Factors affecting enrolment in randomised controlled trials of Japanese patients with metastatic breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-21-01.
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Affiliation(s)
- Yasuo Hozumi
- 1University of Tsukuba Hospital/Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Shozo Ohsumi
- 2National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | | | - Masato Takahashi
- 4National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | | | - Youngjin Park
- 6Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Eriko Tokunaga
- 7National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | | | - Takanori Watanabe
- 9National Hospital Organization Sendai Medical Center, Sendai, Japan
| | | | - Tetsuji Kaneko
- 11Tokyo Metropolitan Children's Medical Center, Fuchu, Japan
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Nishimura R, Mukai H, Uemura Y, Akabane H, Park Y, Takahashi M, Sagara Y, Takashima T, Fujisawa T, Hozumi Y, Kawahara T, Watanabe T. Evaluation of oral S-1 as a first-line chemotherapy for metastatic HER2-negative breast cancer: An analysis of two randomized phase III studies (SELECT BC-CONFIRM and SELECT BC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.1083] [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: 11/20/2022] Open
Abstract
1083 Background: Anthracycline regimens and taxane have been first line chemotherapeutic options for HER2 negative metastatic breast cancer. In a previous phase III trial (SELECT BC), non-inferiority of S-1 was demonstrated in terms of overall survival (OS). The SELECT BC-CONFIRM study was designed to confirm the results of the SELECT BC study and to combine the two randomized studies. Methods: Patients (n = 618) in the first trial were randomly assigned (1:1) to the S-1 group or the taxane group. Patients (n = 230) in the second trial (SELECT BC-CONFIRM) were randomly assigned to the anthracycline group or the S-1 group. Treatment continued until tumor progression, unacceptable toxic effects, or completion of six courses in the standard regimen group and four courses in the S-1 group. The primary endpoint was OS and secondary endpoints were progression-free survival (PFS), time to treatment failure, adverse events, HRQOL and cost-effectiveness. A pooled analysis of the two studies was predefined to confirm the results of the SELECT BC study. Results: 1. The HR for the anthracycline group was 1.09 [95%CI 0.80-1.48] in SELECT BC-CONFIRM, and the estimated predictive posterior probability that the HR does not exceed the threshold 1.333 was 90.27%. 2. Median OS was 32.7 months (S-1 group) and 36.3 months (standard treatment group). S-1 was not inferior to standard treatment in terms of OS (p non-inferiority = 0.0062). Median PFS was 11.2 months (S-1 group) and 11.2 months (standard treatment group). 3. Treatment was discontinued due to adverse events (i.e., neutropenia, febrile neutropenia, fatigue and edema) in 5.7% in the S-1 group and 6.6% in the standard treatment group 4. The EORTC QLQ-C30 questionnaire (global health status) revealed that there was no difference between the S-1 and anthracycline groups (p = 0.257), but there was a significant difference between the S-1 and taxane groups (p = 0.0039). Conclusions: S-1 is not inferior to taxane or anthracycline with respect to OS as a first-line treatment for MBC. S-1 should be considered a new option as a first-line chemotherapy for HER2-negative metastatic breast cancer patients. Clinical trial information: UMIN000005449.
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Affiliation(s)
- Reiki Nishimura
- Breast Center, Kumamoto Shinto General Hospital, Kumamoto, Japan
| | | | | | - Hiromitsu Akabane
- Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Youngjin Park
- Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | | | | | | | - Tomomi Fujisawa
- Department of Breast Oncology, Gunma Prefectural Cancer Center, Gunma, Japan
| | - Yasuo Hozumi
- Department of Breast and Endocrine Surgery, University of Tsukuba Hospital/ Department of Breast Surgery, Ibaraki Prefectural Central Hospital, Tsukuba, Japan
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Park Y, Akabane H, Watanabe T, Takahashi M, Sagara Y, Nishimura R, Tsurutani J, Takashima T, Fujisawa T, Hozumi Y, Uemura Y, Mukai H. Abstract P1-14-07: Randomized phase 3 study of anthracycline-containing regimens versus S-1 as first-line treatment for metastatic breast cancer (SELECT BC-CONFIRM)–A combined analysis of two randomized phase 3 studies (SELECT BC-CONFIRM and SELECT BC)–. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-14-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Anthracycline-containing regimens and taxane have been standard as the first-line chemotherapy for metastatic breast cancer (MBC). We conducted SELECT BC (randomized phase 3 study of taxane versus S-1 as first-line treatment for MBC) for evaluating the efficacy of S-1 for patients with HER2-negative MBC from 2006 to 2010 in Japan. This study demonstrated non-inferiority of S-1 in overall survival (OS) (median OS was 37.2 months in taxes group and 35.0 months in S-1 group (HR 1.05, 95% CI 0.86–1.27, p=0.015)), and superiority in health-related quality of life (HRQOL) to taxanes. S-1 was also shown as less toxic than taxane (Lancet Oncol 2016; 17: 90-98). S-1 might provide clinical benefit as first-line treatment for patients with HER2-negative MBC. To confirm this suggestion, we have conducted further study (randomized phase 3 study of anthracycline-containing regimens versus S-1 as first-line treatment for HER2-negative MBC: SELECT BC-CONFIRM) from 2011 to present, and a combined analysis of two randomized studies (SELECT-BC CONFIRM and SELECT-BC).
Methods: In SELECT BC-CONFIRM, 230 patients receiving first-line treatment for MBC were randomly assigned to either anthracycline group (n=115) or S-1 group (n=115). Anthracycline group patients received anthracycline-containing regimens (AC, EC, FAC, FEC, q3w) at the discretion of the treating physician. S-1 group patients received S-1 40–60 mg twice daily based on the patient's body surface area for 28 days on, 14-day off. The primary endpoint was OS, and secondary endpoints were progression-free survival (PFS), time to treatment failure (TTF), adverse events, HRQOL, and cost-effectiveness. The results were combined with SELECT-BC, to confirm the hypothesis that S-1 treatment is not inferior to the standard therapy (taxanes / anthracycline) for HER2-negative MBC.
Results: A combined analysis of the two studies showed that HR was 1.06, 95%CI 0.90-1.253, and p=0.0071 between the standard therapy group and S-1 group. In addition, the Bayesian posterior probability for which HR would be less than 1.333 was about 99.6%.
Conclusions: A combined analysis of SELECT BC-CONFIRM and SELECT BC clearly demonstrated that OS with S-1 was not inferior to that with the standard therapy in patients receiving first-line treatment for HER2-negative MBC. S-1 could become a standard therapy for this patient population.
Citation Format: Park Y, Akabane H, Watanabe T, Takahashi M, Sagara Y, Nishimura R, Tsurutani J, Takashima T, Fujisawa T, Hozumi Y, Uemura Y, Mukai H. Randomized phase 3 study of anthracycline-containing regimens versus S-1 as first-line treatment for metastatic breast cancer (SELECT BC-CONFIRM)–A combined analysis of two randomized phase 3 studies (SELECT BC-CONFIRM and SELECT BC)– [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 P1-14-07.
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Affiliation(s)
- Y Park
- Tohoku Medical and Pharmaceutical University, Faculty of Medicine, Sendai, Japan; Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; National Hospital Organization, Sendai Medical Center, Sendai, Japan; National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan; Kumamoto Shinto General Hospital, Kumamoto, Japan; Kindai University, Faculty of Medicine, Osakasayama, Japan; Osaka City University, Graduate School of Medicine, Osaka, Japan; Gunma Prefectural Cancer Center, Ota, Japan; University of Tsukuba Hospital /Ibaraki Prefectural Central Hospital, Kasama, Japan; The University of Tokyo Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - H Akabane
- Tohoku Medical and Pharmaceutical University, Faculty of Medicine, Sendai, Japan; Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; National Hospital Organization, Sendai Medical Center, Sendai, Japan; National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan; Kumamoto Shinto General Hospital, Kumamoto, Japan; Kindai University, Faculty of Medicine, Osakasayama, Japan; Osaka City University, Graduate School of Medicine, Osaka, Japan; Gunma Prefectural Cancer Center, Ota, Japan; University of Tsukuba Hospital /Ibaraki Prefectural Central Hospital, Kasama, Japan; The University of Tokyo Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - T Watanabe
- Tohoku Medical and Pharmaceutical University, Faculty of Medicine, Sendai, Japan; Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; National Hospital Organization, Sendai Medical Center, Sendai, Japan; National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan; Kumamoto Shinto General Hospital, Kumamoto, Japan; Kindai University, Faculty of Medicine, Osakasayama, Japan; Osaka City University, Graduate School of Medicine, Osaka, Japan; Gunma Prefectural Cancer Center, Ota, Japan; University of Tsukuba Hospital /Ibaraki Prefectural Central Hospital, Kasama, Japan; The University of Tokyo Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - M Takahashi
- Tohoku Medical and Pharmaceutical University, Faculty of Medicine, Sendai, Japan; Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; National Hospital Organization, Sendai Medical Center, Sendai, Japan; National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan; Kumamoto Shinto General Hospital, Kumamoto, Japan; Kindai University, Faculty of Medicine, Osakasayama, Japan; Osaka City University, Graduate School of Medicine, Osaka, Japan; Gunma Prefectural Cancer Center, Ota, Japan; University of Tsukuba Hospital /Ibaraki Prefectural Central Hospital, Kasama, Japan; The University of Tokyo Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - Y Sagara
- Tohoku Medical and Pharmaceutical University, Faculty of Medicine, Sendai, Japan; Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; National Hospital Organization, Sendai Medical Center, Sendai, Japan; National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan; Kumamoto Shinto General Hospital, Kumamoto, Japan; Kindai University, Faculty of Medicine, Osakasayama, Japan; Osaka City University, Graduate School of Medicine, Osaka, Japan; Gunma Prefectural Cancer Center, Ota, Japan; University of Tsukuba Hospital /Ibaraki Prefectural Central Hospital, Kasama, Japan; The University of Tokyo Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - R Nishimura
- Tohoku Medical and Pharmaceutical University, Faculty of Medicine, Sendai, Japan; Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; National Hospital Organization, Sendai Medical Center, Sendai, Japan; National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan; Kumamoto Shinto General Hospital, Kumamoto, Japan; Kindai University, Faculty of Medicine, Osakasayama, Japan; Osaka City University, Graduate School of Medicine, Osaka, Japan; Gunma Prefectural Cancer Center, Ota, Japan; University of Tsukuba Hospital /Ibaraki Prefectural Central Hospital, Kasama, Japan; The University of Tokyo Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - J Tsurutani
- Tohoku Medical and Pharmaceutical University, Faculty of Medicine, Sendai, Japan; Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; National Hospital Organization, Sendai Medical Center, Sendai, Japan; National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan; Kumamoto Shinto General Hospital, Kumamoto, Japan; Kindai University, Faculty of Medicine, Osakasayama, Japan; Osaka City University, Graduate School of Medicine, Osaka, Japan; Gunma Prefectural Cancer Center, Ota, Japan; University of Tsukuba Hospital /Ibaraki Prefectural Central Hospital, Kasama, Japan; The University of Tokyo Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - T Takashima
- Tohoku Medical and Pharmaceutical University, Faculty of Medicine, Sendai, Japan; Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; National Hospital Organization, Sendai Medical Center, Sendai, Japan; National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan; Kumamoto Shinto General Hospital, Kumamoto, Japan; Kindai University, Faculty of Medicine, Osakasayama, Japan; Osaka City University, Graduate School of Medicine, Osaka, Japan; Gunma Prefectural Cancer Center, Ota, Japan; University of Tsukuba Hospital /Ibaraki Prefectural Central Hospital, Kasama, Japan; The University of Tokyo Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - T Fujisawa
- Tohoku Medical and Pharmaceutical University, Faculty of Medicine, Sendai, Japan; Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; National Hospital Organization, Sendai Medical Center, Sendai, Japan; National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan; Kumamoto Shinto General Hospital, Kumamoto, Japan; Kindai University, Faculty of Medicine, Osakasayama, Japan; Osaka City University, Graduate School of Medicine, Osaka, Japan; Gunma Prefectural Cancer Center, Ota, Japan; University of Tsukuba Hospital /Ibaraki Prefectural Central Hospital, Kasama, Japan; The University of Tokyo Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - Y Hozumi
- Tohoku Medical and Pharmaceutical University, Faculty of Medicine, Sendai, Japan; Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; National Hospital Organization, Sendai Medical Center, Sendai, Japan; National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan; Kumamoto Shinto General Hospital, Kumamoto, Japan; Kindai University, Faculty of Medicine, Osakasayama, Japan; Osaka City University, Graduate School of Medicine, Osaka, Japan; Gunma Prefectural Cancer Center, Ota, Japan; University of Tsukuba Hospital /Ibaraki Prefectural Central Hospital, Kasama, Japan; The University of Tokyo Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - Y Uemura
- Tohoku Medical and Pharmaceutical University, Faculty of Medicine, Sendai, Japan; Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; National Hospital Organization, Sendai Medical Center, Sendai, Japan; National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan; Kumamoto Shinto General Hospital, Kumamoto, Japan; Kindai University, Faculty of Medicine, Osakasayama, Japan; Osaka City University, Graduate School of Medicine, Osaka, Japan; Gunma Prefectural Cancer Center, Ota, Japan; University of Tsukuba Hospital /Ibaraki Prefectural Central Hospital, Kasama, Japan; The University of Tokyo Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
| | - H Mukai
- Tohoku Medical and Pharmaceutical University, Faculty of Medicine, Sendai, Japan; Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; National Hospital Organization, Sendai Medical Center, Sendai, Japan; National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; Hakuaikai Medical Corp Sagara Hospital, Kagoshima, Japan; Kumamoto Shinto General Hospital, Kumamoto, Japan; Kindai University, Faculty of Medicine, Osakasayama, Japan; Osaka City University, Graduate School of Medicine, Osaka, Japan; Gunma Prefectural Cancer Center, Ota, Japan; University of Tsukuba Hospital /Ibaraki Prefectural Central Hospital, Kasama, Japan; The University of Tokyo Hospital, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan
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Iwata H, Masuda N, Yamamoto Y, Fujisawa T, Toyama T, Taira N, Kashiwaba M, Ohtani S, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Ohashi Y. Distant disease-free survival (DDFS) according to response category in neoadjuvant endocrine therapy (NET): 6-year analysis in phase III NEOS trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kenno S, Inagaki M, Funakoshi T, Yanagida N, Akabane H, Nakano S, Sato K. [A Case of Rectal Gastrointestinal Stromal Tumor(GIST)Treated with Imatinib Mesylate Neoadjuvant Therapy to Preserve the Anus]. Gan To Kagaku Ryoho 2018; 45:981-984. [PMID: 30026427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A woman in her 40's who initially presented with anal pain was diagnosed with rectal GIST. A 9 cm tumor extended to near the anus, and curative abdominoperineal tumor resection was required. The patient initially received neoadjuvant therapy with imatinib mesylate. Neoadjuvant chemotherapy for 6 months reduced the tumor to approximately 47% of its original size and permitted anus-preserving surgery. The present case suggests that neoadjuvant therapy with imatinib mesylate is useful for large rectal GISTs, from the standpoint of anal function preservation.
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Iwata H, Masuda N, Fujisawa T, Toyama T, Ohtani S, Yamamoto Y, Kashiwaba M, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Ohashi Y. Abstract P3-13-03: NEOS: A randomized, open label, phase 3 trial of adjuvant chemotherapy for postmenopausal breast cancer patients who responded to neoadjuvant letrozole: First report of long-term outcome and prognostic value of response to neoadjuvant endocrine therapy. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-13-03] [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: Whether adjuvant chemotherapy is required for patients (pts) with intermediate-risk endocrine-responsive postmenopausal breast cancer (BC) remains unknown. Sufficient data have not been available about the long-term prognosis of patients with neoadjuvant endocrine therapy (ET). NEOS is a randomized phase III study that assessed the long-term prognosis of estrogen receptor positive (ER+) primary breast cancer (PBC) pts who received neoadjuvant ET with/without adjuvant chemotherapy.
Methods: Postmenopausal BC pts with ER +/HER2 negative, T1c-2, clinically node negative, under 76 years old were enrolled at primary registration. Pts were treated by leterozole (LET) in weeks 24-28 after primary enrollment. Pts experienced progression (PD) during neoadjuvant phase were excluded at randomization and received any systemic therapy driven by investigators before or after surgery. The long-term prognosis was followed in all registered pts including PD pts. Response to neoadjuvant ET was evaluated as complete response (CR), partial response (PR) or stable disease (SD) using calipers, ultrasound and MRI (or CT) at the baseline and end of treatment before surgery. Pts who met eligibility criteria were randomized 1:1 to LET for 4.5-5 years after chemotherapy or LET alone for 4.5-5 years without chemotherapy after surgery. Pts excluded at second registration were treated any systemic therapies driven by investigators. The primary endpoint was disease-free survival (DFS) and secondary endpoints included overall survival (OS), clinical response rate in neoadjuvant phase, pathological response, and breast-conserving surgery rate. The randomization code have been blinded to the investigators.
Results: Between May 2008 and June 2013, 904 patients were enrolled at primary registration from 100 institutions in Japan (median follow-up: 4.0 years) and 24 pts were withdrawn during neoadjuvant phase. The median age was 63 years, T1c:37%, T2:63%, and PgR+:78%. Clinical response rates (CR, PR, SD and PD) were2% (16pts), 48% (421pts), 45% (400pts) and 5% (43pts), respectively and, in each response category, 0% (0/16), 5.5% (23/421), 7.8% (31/400), and 20.9% (9/43) experienced DFS events. DFS in PD pts to neoadjuvant ET were statistically significantly worse than CR, PR, SD pts (p<0.0001, hazard ratio 4.7 (95% CI:2.3-9.5). The prognosis after surgery in 669 randomized pts was good regardless with/without chemotherapy, forty four pts (6.6%) experienced DFS events after surgery. The predictive markers of PD for neoadjuvant ET were yet unclear among evaluated clinical factors.
Conclusion: This is the first report of DFS in the largest neoadjuvant ET trial (NEOS). The DFS of postmenopausal, ER+/HER2-, PBC pts excluding PD pts to neoadjuvant ET is highly good regardless with/without chemotherapy. Neoadjuvant ET with utilization of PD response as a prognostic marker can be considered as a standard treatment option for these patients. Clinical trial information: UMIN000001090.
Citation Format: Iwata H, Masuda N, Fujisawa T, Toyama T, Ohtani S, Yamamoto Y, Kashiwaba M, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Ohashi Y. NEOS: A randomized, open label, phase 3 trial of adjuvant chemotherapy for postmenopausal breast cancer patients who responded to neoadjuvant letrozole: First report of long-term outcome and prognostic value of response to neoadjuvant endocrine therapy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-13-03.
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Affiliation(s)
- H Iwata
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - N Masuda
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Fujisawa
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Toyama
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - S Ohtani
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Yamamoto
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - M Kashiwaba
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - N Taira
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Sakai
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Hasegawa
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - R Nakamura
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - H Akabane
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Shibahara
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - H Sasano
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Yamaguchi
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Ohashi
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
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Yamamoto Y, Iwata H, Masuda N, Fujisawa T, Toyama T, Kashiwaba M, Ohtani S, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Sakamaki K, Chao C, McCullough D, Sugiyama N, Ohashi Y. Abstract PD5-03: TransNEOS: Validation of the oncotype DX recurrence score (RS) testing core needle biopsy samples from NEOS as predictor of clinical response to neoadjuvant endocrine therapy for postmenopausal estrogen receptor positive (ER+), HER2 negative (HER2-) breast cancer patients. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd5-03] [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: Neoadjuvant therapy for locally advanced breast cancer has the potential to improve surgical therapeutic outcomes without sacrificing the survival advantages of adjuvant therapy. However, determining whether ER+ patients (pts) will respond to neoadjuvant (NA) chemotherapy (CT) or hormone therapy (HT) can be difficult. Not all ER+ pts respond to NACT, while response to NAHT can vary across ER+ pts. Thus, the ability to select pts more likely to benefit from NAHT would represent progress in clinical management of breast cancer. NEOS is a randomized phase III study assessinglong-term prognosis of ER+ primary breast cancer with/without adjuvant CT following NAHT (UMIN 000001090, http://www.umin.ac.jp/). We used archived core biopsy tumor samples from the NEOS study to validate the RS result as a predictor of clinical response and its association with successful breast conserving surgery (BCS) in pts treated with 6 months of NAHT.
Methods: NEOS enrolled 904 postmenopausal pts with ER+, HER2-, clinically node negative (cN0) breast cancer to evaluate whether adjuvant CT was necessary for pts who responded to NAHT. In this current study, we enrolled pts with tumors ≥2cm from the NEOS study. Biopsy samples of 333 pts were assessed for the Oncotype DX assay. Response to NAHT was recorded as complete/partial response (CR/PR), or stable/progressive disease (SD/PD).
Primary endpoint of this study was to evaluate clinical response (CR/PR) to NA letrozole between pts with low (<18) and high (≥31) RS result. Secondary endpoints include evaluating the relationships between clinical response and continuous RS results, and other covariates including age, tumor size, grade, Ki67 by IHC, ER and PR single gene scores, and ER and proliferation gene group scores by RT-PCR.
Results: The analysis included 294 pts with median age of 63 yrs, median tumor size of 25mm, and 66% were nuclear grade 1. 156 (53.0%), 83 (28.6%) and 54(18.4%) cases were low, intermediate, and high RS groups by Oncotype DX, respectively. Six (2%), 126 (42.8%), 149 (50.3%), 13 (4.4%) cases experienced CR, PR, SD, PD as clinical response, respectively, similar to that of all NEOS pts. Clinical response rate was 54%, 42% and 22% in low, intermediate, and high RS groups, respectively. The proportion of pts with clinical response was significantly higher in the low RS group vs the high RS group (p<0.001). In univariate analyses, continuous RS was significantly associated with clinical response (p<0.001), along with ER (p=.02), PR (p<0.001), and ER gene group score (p<0.001). Other covariates were not associated with clinical response.
Conclusion: The Oncotype DX RS test in core biopsy samples is validated as a predictive assay for clinical response of NAHT in postmenopausal, ER+/HER2-, cN0, primary early breast cancer pts. Further results on the association of RS results with BCS outcomes following NAHT will be presented. These results when combined with previously published data on RS in NACT studies help guide pts with ER+, HER2- breast cancer with NAHT vs NACT treatment options to maximize clinical response.
Citation Format: Yamamoto Y, Iwata H, Masuda N, Fujisawa T, Toyama T, Kashiwaba M, Ohtani S, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Sakamaki K, Chao C, McCullough D, Sugiyama N, Ohashi Y. TransNEOS: Validation of the oncotype DX recurrence score (RS) testing core needle biopsy samples from NEOS as predictor of clinical response to neoadjuvant endocrine therapy for postmenopausal estrogen receptor positive (ER+), HER2 negative (HER2-) breast cancer patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD5-03.
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Affiliation(s)
- Y Yamamoto
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - H Iwata
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - N Masuda
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Fujisawa
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Toyama
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - M Kashiwaba
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - S Ohtani
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - N Taira
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Sakai
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - Y Hasegawa
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - R Nakamura
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - H Akabane
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - Y Shibahara
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - H Sasano
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Yamaguchi
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - K Sakamaki
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - C Chao
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - D McCullough
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - N Sugiyama
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - Y Ohashi
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
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17
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Yoo C, Ryu MH, Kurokawa Y, Yang HK, Nishida T, Kong SH, Tsujinaka T, Lee KH, Yabusaki H, Song HS, Akabane H, Im SA, Tanabe K, Kang HJ, Nomura T, Kang BW, Nakamura T, Okubo M, Taniguchi H, Kang YK. Serial monitoring of imatinib pharmacokinetics (PK) in perioperative imatinib treatment in patients (pts) with gastrointestinal stromal tumors (GISTs): Results from the multinational phase II trial. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.118] [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: 11/20/2022] Open
Abstract
118 Background: Imatinib plasma levels may be affected by the duration of exposure to imatinib and resection of the stomach. Therefore, we performed PK study to monitor imatinib plasma levels serially in the multinational phase II trial of perioperative imatinib for pts with large ( ≥ 10 cm) gastric GISTs without distant metastasis. Methods: In this trial conducted in Japan and Korea, 53 pts received neoadjuvant imatinib 400 mg daily and 40 pts received adjuvant imatinib after surgery. Blood samples for imatinib trough levels (Cmin) were collected after 1, 3, 6 months of each neoadjuvant and adjuvant imatinib and measured by using liquid chromatography-tandem mass spectrometry. For the comparison of imatinib Cmin between different time points, values were dose-adjusted and log-transformed. Results: During the neoadjuvant treatment, imatinib Cmin (mean ± standard deviation) was 2253.0 ± 1148.0 ng/mL (n = 49), 1623.3 ± 832.4 ng/mL (n = 47), and 1852.0 ± 1572.4 ng/mL (n = 45) after 1, 3, and 6 months of imatinib, respectively. During the postoperative treatment, imatinib Cmin was 1436.1 ± 852.8 ng/mL (n = 31), 1357.8 ± 646.4 ng/mL (n = 33), and 1084.2 ± 360.8 ng/mL (n = 31) after 1, 3, and 6 months of imatinib, respectively. In the neoadjuvant setting, imatinib Cmin was significantly reduced after 3 months (p = 0.0001) and 6 months (p = 0.004) compared to the value at 1 month. In 36 patients that imatinib Cmin was measured at both preoperative and postoperative setting, imatinib Cmin was significantly reduced after surgery (1732.4 ± 997.9 ng/mL vs 1282.8 ± 557.3 ng/mL; p = 0.04). The magnitude of changes in imatinib Cmin after surgery was greatest in patients who underwent total gastrectomy (10.6%, n = 2) followed by proximal gastrectomy (8.4%, n = 3), and wedge resection (3.3%, n = 30). There were no significant relationships between imatinib Cmin and toxicity or objective response. Conclusions: Imatinib exposure was reduced until approximately 3 months after imatinib treatment. It was also significantly reduced after surgery and the magnitude of changes might be affected by the extent of surgical resection of stomach.
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Affiliation(s)
- Changhoon Yoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Min-Hee Ryu
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yukinori Kurokawa
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Han-Kwang Yang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | | | - Seong-Ho Kong
- Department of Surgery, Seoul National University Hospital, Seoul, South Korea
| | | | - Kyung Hee Lee
- Yeungnam University Medical Center, Gyeonsan, North Gyeongsang, Republic of Korea
| | | | - Hong-Suk Song
- Department of Internal Medicine, Dongsan Medical Center, Keimyung University, Daegu, South Korea
| | - Hiromitsu Akabane
- Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Seock-Ah Im
- Department of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | | | - Hye Jin Kang
- Korea Cancer Center Hospital, Seoul, Korea South
| | - Takashi Nomura
- Department of Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Byung Wook Kang
- Department of Oncology/Hematology, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Tetsu Nakamura
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masaaki Okubo
- Department of Gastroenterology, Fujita Health University, Aichi, Japan
| | | | - Yoon-Koo Kang
- Departments of Oncology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
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18
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Shiroiwa T, Fukuda T, Shimozuma K, Mouri M, Hagiwara Y, Doihara H, Akabane H, Kashiwaba M, Watanabe T, Ohashi Y, Mukai H. Long-term health status as measured by EQ-5D among patients with metastatic breast cancer: comparison of first-line oral S-1 and taxane therapies in the randomized phase III SELECT BC trial. Qual Life Res 2016; 26:445-453. [PMID: 27517267 PMCID: PMC5288429 DOI: 10.1007/s11136-016-1388-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2016] [Indexed: 12/29/2022]
Abstract
Purpose The goal of chemotherapy for metastatic breast cancer (MBC) is to prolong survival and maintain health-related quality of life. This study aimed to evaluate long-term health status of patients with MBC who participated in the phase III randomized SELECT BC trial. Methods In the SELECT BC trial, patients were randomly allocated to the S-1 or taxane (paclitaxel or docetaxel) arm. Health status was assessed by EQ-5D at pre-treatment, 3 and 6 months after randomization, and every 6 months thereafter to the extent possible. Least square mean scores were assessed to compare EQ-5D index values between groups. Time to deterioration analysis was also performed by defining the minimally important difference of EQ-5D as 0.05 or 0.1. Results The number of patients for EQ-5D analysis was 175 and 208 in the taxane and S-1 arms, respectively. Least square mean EQ-5D index values up to 60 months were 0.741 (95 % CI [0.713–0.769]) in the taxane arm and 0.748 [0.722–0.775] in the S-1 arm. The EQ-5D index value during PFS up to 12 months in the S-1 was superior to the corresponding index value in the taxane (0.812 [0.789–0.834] vs. 0.772 [0.751–0.792], P = 0.009). Time to deterioration analysis also revealed that S-1 significantly delayed the deterioration of EQ-5D index value during the period before progression (P = 0.002 and 0.003). Conclusions Our findings suggest that the EQ-5D index value was higher in patients treated with S-1 during first-line chemotherapy. Considering non-inferiority of S-1 in terms of OS, obtained quality-adjusted life years may be greater in the S-1 arm.
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Affiliation(s)
- T Shiroiwa
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - T Fukuda
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - K Shimozuma
- Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - M Mouri
- Kanagawa Academy of Science and Technology (KAST), 3-2-1 Sakado, Takatsu-ku, Kawasaki, Kanagawa, 213-0012, Japan
| | - Y Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - H Doihara
- Breast and Endocrine Surgery Department, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - H Akabane
- Department of Surgery, Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, 24-111 Ichijo dori, Asahikawa, Hokkaido, 078 8211, Japan
| | - M Kashiwaba
- Department of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - T Watanabe
- Department of Breast Surgery, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, Tokyo, 112-8551, Japan
| | - H Mukai
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
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19
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Hara F, Mukai H, Ohsumi S, Yotsumoto D, Takashima T, Hozumi Y, Watanabe T, Saito T, Watanabe KI, Tsurutani J, Toyama T, Akabane H, Nishimura R, Taira N, Uemura Y, Ohashi Y. Biomarker analysis of S-1 in SELECT-BC: A randomized phase III study of taxane versus S-1 as the first-line chemotherapy for metastatic breast cancer (SELECT-BC EURECA). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e23274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - Daisuke Yotsumoto
- Sagara Hospital, Social Medical Corporation Hakuaikai, Kagoshima, Japan
| | | | - Yasuo Hozumi
- Department of Breast and Endocrine Surgery, University of Tsukuba Hospital/ Department of Breast Surgery, Ibaraki Prefectural Central Hospital, Tsukuba, Japan
| | | | - Tsuyoshi Saito
- Department of Breast Surgery, Saitama Red Cross Hospital, Saitama, Japan
| | | | | | | | - Hiromitsu Akabane
- Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | | | | | - Yukari Uemura
- Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Yasuo Ohashi
- Department of Integrated Science and Engineering, Chuo University, Tokyo, Japan
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20
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Funakoshi T, Kato T, Kuratani Y, Yamada K, Kenno S, Shibaki T, Yanagida N, Inagaki M, Ikeue S, Akabane H, Nakano S. [A Case of Advanced Colon Cancer with Long-Term and Re-Administration of Regorafenib]. Gan To Kagaku Ryoho 2016; 43:633-635. [PMID: 27210098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 54-year-old woman diagnosed with sigmoid colon cancer and multiple liver metastases underwent sigmoidectomy, partial hepatectomy, and RFA in September 2009. Because of postoperative liver and lung recurrence, 5 regimens with combinations of L-OHP/CPT-11 plus anti-VEGF antibody/anti-EGFR antibody was performed. Following these treatments, she underwent hepatic arterial infusion therapy with UFT/Krestin for progressive liver metastases. Starting in November 2014, regorafenib was administered, with an immediate decrease in tumor marker levels; tumor reduction demonstrated enhanced effect against liver metastases. After 8 months of administration, we stopped regorafenib and changed to TAS-102 due to diarrhea and eating disorders. However, TAS-102 was not effective; there were significant increases in tumor markers, liver function tests, and tumor size on computed tomography, and worsening of abdominal pain. After re-administration of regorafenib, a rapid decrease in tumor marker levels and improvement of liver dysfunction and abdominal pain were observed. Re-administration continued for 8 months until best supportive care was instituted. In cases with observed therapeutic effect of regorafenib, long-term or re-administration is possible, with extension of the prognosis depending on the adjustment, and without size reduction of metastatic tumors.
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Affiliation(s)
- Tohru Funakoshi
- Dept. of Surgery, Hokkaido P. W. F. A. C. Asahikawa-Kosei General Hospital
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21
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Aihara T, Toyama T, Takahashi M, Yamamoto Y, Hara F, Akabane H, Fujisawa T, Ishikawa T, Nagai S, Nakamura R, Tsurutani J, Ito Y, Mukai H. The Japanese Breast Cancer Society Clinical Practice Guideline for systemic treatment of breast cancer, 2015 edition. Breast Cancer 2016; 23:329-42. [DOI: 10.1007/s12282-016-0670-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 12/18/2015] [Indexed: 02/07/2023]
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Matsumoto S, Takahashi M, Takahashi S, Nakano S, Akabane H, Yanagida N. [A Case of Pseudomyxoma Peritonei Derived from Cecum Colon Cancer with Long-Term Recurrence-Free Survival]. Gan To Kagaku Ryoho 2015; 42:2122-2124. [PMID: 26805284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 29-year-old woman was diagnosed with advanced cecum colon cancer, and right hemicolectomy was performed. The pathological findings showed stage Ⅲa disease, including moderately differentiated tubular adenocarcinoma>mucinous adenocarcinoma, pT3, pN1, cM0, and Cur A resection. The patient was treated with 5-FU plus l-LV adjuvant chemotherapy. Fourteen months after surgery, bilateral ovarian metastasis and ascites were found, and another surgery was performed, revealing that the abdominal cavity was filled with a gelatinous ascites. Under the diagnosis of pseudomyxoma peritonei, resection of both ovaries, abdominal lavage, and intraperitoneal administration of CDDP were performed, followed by S-1 plus CDDP treatment. Two years after the recurrence, peritoneal re-recurrence on the vaginal fornix was detected. A total hysterectomy, partial vaginectomy, and resection of disseminated peritoneal nodules were performed. The patient received mFOLFOX6 treatment postoperatively. To date, 8 years and 9 months after her re-recurrence, the patient is alive and without signs of a third recurrence.
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Affiliation(s)
- Satoru Matsumoto
- Dept. of Surgery, Hokkaido P. W. F. A. C. Sapporo-Kosei General Hospital
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23
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Sakai T, Iwata H, Hasegawa Y, Nakamura R, Akabane H, Ohtani S, Kashiwaba M, Taira N, Toyama T, Yamamoto Y, Fujisawa T, Masuda N, Yamaguchi T, Mukai H, Ohashi Y. Abstract P1-14-01: First report of clinicopathological analysis in neoadjuvant treatment phase in NEOS: A randomized study of adjuvant endocrine therapy with or without chemotherapy for postmenopausal breast cancer patients who responded to neoadjuvant letrozole. Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-p1-14-01] [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: Whether adjuvant chemotherapy is required for patients with intermediate-risk endocrine-responsive postmenopausal breast cancer remains unknown. The New primary Endocrine-therapy Origination Study (NEOS: N-SAS BC06 study: UMIN 000001090 (http://www.umin.ac.jp/) was a randomized controlled trial to verify the necessity of adjuvant chemotherapy in node-, ER+, and HER2- postmenopausal breast cancer patients who responded to neoadjuvant endocrine therapy. The primary registration and primary treatment have finished. This report evaluated clinical responses and radiological findings in the neoadjuvant LET treatment phase of 6 months.
Methods: Patients meeting eligibility criteria received LET preoperatively in weeks 24-28 after primary enrollment. Patients evaluated as complete response (CR), partial response (PR) or stable disease (SD) by each investigators underwent secondary enrollment and will be divided at random into two arms, an arm given LET for 4.5-5 years after chemotherapy and another arm given only LET for 4.5-5 years. Patients evaluated as progressive disease during LET treatment will receive discretionary treatment. The primary endpoint was disease-free survival and secondary endpoints were overall survival, clinical response rate in neoadjuvant treatment phase, pathological response, breast-conserving surgery rate, DFS/OS in subgroups according to clinical response, safety, HRQOL, and cost-effectiveness.
Results: Between May 2008 and June 2013, 905 patients entered primary registration. We excluded 42 patients without confirmed data. The 863 included patients’ characteristics at baseline are: median age: 63 years old, median Body Mass Index (BMI):23.90, T1c:37%, T2:63%, and PgR+:79%, and 74% of patients had planned breast-conserving surgery (BCS). The clinical responses were evaluated with calipers, ultrasound and MRI (or CT) at the baseline and end of treatment before surgery. Clinical response rates were 2, 48, 46 and 4% in CR, PR, SD and PD, respectively. Excluding those who could not enter secondary registration according to the protocol, 83 (56.1%) of 148 patients with planned total mastectomy were converted to BCS according to final radiological evaluations before surgery. The correlation between the tumor size on MRI (r=0.87) after neoadjuvant LET and the pathological invasive tumor size was stronger than with other modalities (r=0.68, 0.57, 0.33 by CT, US and calipers, respectively). On univariate analysis, a small tumor size (T1c rather than T2), PgR+, HER2:2+ and a high BMI at the baseline were significantly correlated with the clinical response. On multivariate analysis, PgR + (HR: 1.13, 95%CI: 1.01-1.27, p=0.032) and a small tumor size (HR: 1.11, 95%CI: 1.03-1.17, p=0.003) were significant independent predictors of the clinical response.
Conclusion: This is the first clinical report of neoadjuvant hormone therapy for early breast cancer. Neoadjuvant LET therapy improved BCS rates. MRI was useful for predicting the residual pathological invasive tumor size. PgR + and a small tumor size at the baseline were significant independent predictors of the clinical response.
Citation Format: Takehiko Sakai, Hiroji Iwata, Yoshie Hasegawa, Rikiya Nakamura, Hiromitsu Akabane, Shoichiro Ohtani, Masahiro Kashiwaba, Naruto Taira, Tatsuya Toyama, Yutaka Yamamoto, Tomomi Fujisawa, Norikazu Masuda, Takuhiro Yamaguchi, Hirofumi Mukai, Yasuo Ohashi. First report of clinicopathological analysis in neoadjuvant treatment phase in NEOS: A randomized study of adjuvant endocrine therapy with or without chemotherapy for postmenopausal breast cancer patients who responded to neoadjuvant letrozole [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-14-01.
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Affiliation(s)
- Takehiko Sakai
- 1Cancer Institute Hospital, Japanese Foundation for Cancer Research
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Watanabe T, Shimozuma K, Imi K, Doihara H, Akabane H, Ueo H, Ohno S, Kashiwaba M, Fukuuchi A, Watanabe K, Tsuneizumi M, Isaka H, Uemura Y, Ohashi Y, Mukai H. Abstract P3-10-01: Randomized phase III trial of taxanes versus S-1 as first-line chemotherapy for metastatic breast cancer (SELECT BC: CSPOR- MBC01). Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-p3-10-01] [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: Treatment goals of metastatic breast cancer (MBC) are to prolong survival and improve health-related quality of life (HRQOL). Current standard first-line chemotherapy for MBC are the taxanes or anthracyclines; however treatment-related adverse events greatly reduce HRQOL. S-1 is an oral 5-fluorouracil derivative, and phase II trials showed good clinical efficacy and tolerability. We conducted a phase III randomized controlled trial to establish non-inferiority of S-1 in overall survival (OS) and superiority in HRQOL to taxanes, when given as first-line chemotherapy for MBC.
Methods: Patients with HER2-negative non-life-threatening MBC, naïve to chemotherapy for metastatic disease, were randomly assigned to the taxane or S-1 groups. In the taxane group, patients received docetaxel 60-75mg/m2 q3w, paclitaxel 80-100mg/m2 q1w, or paclitaxel 175 mg/m2 q3w according to institutional policy. In the S-1 group, patients received S-1 40–60 mg twice daily based on body surface area using a 28 days on;14 days off regimen. Treatment was repeated until tumor progression or for at least 6 cycles (taxane) or 4 cycles (S-1). After failure of the first-line protocol therapy, another cytotoxic agent was administered, based on the investigator’s discretion. HRQOL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, the Patient Neurotoxicity Questionnaire (PNQ) and the EQ-5D at baseline and 3, 6, 12 months after the start of the treatment. The primary endpoint was OS. Secondary endpoints were time to treatment failure (TTF), adverse events, and HRQOL.
Results: A total of 618 women were enrolled. After a median follow-up of 34.6 months, median OS was 37.2 months in the taxane group (n=309) and 35.0 months in the S-1 group (n=309) (hazard ratio [HR] 1.05, 95% confidence interval [CI] 0.86–1.27, non-inferiority test p=0.015). Median TTF was 8.9 months in the taxane group and 8.0 months in the S-1 group (HR 1.10, 95% CI 0.93–1.30, p=0.022). The incidence of the following grade 3-4 adverse events, allergic reaction, edema and sensory neuropathy, were statistically significantly more frequent in the taxane group (p=0.038, 0.0013 and 0.0077, respectively). Hematologic and non hematologic toxicities except above did not differ significantly between the two groups. The results of the EORTC QLQ-C30 under study treatment indicated that the S-1 was better than the taxanes in global health status/QOL (p=0.044), physical functioning (p=0.002), role functioning (p=0.002), emotional functioning (p=0.004), cognitive functioning (p=0.026), social functioning (p<0.0001), pain (p=0.042) and financial difficulties (p=0.003). EQ-5D utility scores were significantly higher in the S-1 group (p=0.033) during the first year. PNQ sensory and motor scores were significantly better in the S-1 group (p<0.0001 and p=0.0002, respectively).
Conclusions: This study clearly demonstrated that S-1 was superior to taxanes in terms of HRQOL and toxicity, without compromising the prolonged OS. S-1 should be considered as a new standard for first-line chemotherapy for MBC. We are conducting another similar trial (UMIN000005449) that compares first-line anthracycline with S-1 in terms of OS and HRQOL.
Citation Format: Takanori Watanabe, Kojiro Shimozuma, Kentaro Imi, Hiroyoshi Doihara, Hiromitsu Akabane, Hiroaki Ueo, Shinji Ohno, Masahiro Kashiwaba, Atsushi Fukuuchi, Kenichi Watanabe, Michiko Tsuneizumi, Hirotsugu Isaka, Yukari Uemura, Yasuo Ohashi, Hirofumi Mukai. Randomized phase III trial of taxanes versus S-1 as first-line chemotherapy for metastatic breast cancer (SELECT BC: CSPOR- MBC01) [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-10-01.
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Affiliation(s)
| | | | | | | | | | | | - Shinji Ohno
- 7National Hospital Organization Kyushu Cancer Center
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25
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Mukai H, Aihara T, Yamamoto Y, Takahashi M, Toyama T, Sagara Y, Yamaguchi H, Akabane H, Tsurutani J, Hara F, Fujisawa T, Yamamoto N, Ohsumi S. The Japanese Breast Cancer Society Clinical Practice Guideline for systemic treatment of breast cancer. Breast Cancer 2014; 22:5-15. [PMID: 25200171 DOI: 10.1007/s12282-014-0563-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 08/20/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Hirofumi Mukai
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan,
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26
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Shonaka T, Inagaki M, Akabane H, Yanagida N, Shomura H, Yanagawa N, Oikawa K, Nakano S. Total pancreatectomy for metachronous mixed acinar-ductal carcinoma in a remnant pancreas. World J Gastroenterol 2014; 20:11904-11909. [PMID: 25206298 PMCID: PMC4155384 DOI: 10.3748/wjg.v20.i33.11904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/28/2014] [Accepted: 04/23/2014] [Indexed: 02/06/2023] Open
Abstract
In October 2009, a 71-year-old female was diagnosed with a cystic tumor in the tail of the pancreas with an irregular dilatation of the main pancreatic duct in the body and tail of the pancreas. A distal pancreatectomy with splenectomy, and partial resection of the duodenum, jejunum and transverse colon was performed. In March 2011, a follow-up computed tomography scan showed a low density mass at the head of the remnant pancreas. We diagnosed it as a recurrence of the tumor and performed a total pancreatectomy for the remnant pancreas. In the histological evaluation of the resected specimen of the distal pancreas, the neoplastic cells formed an acinar and papillary structure that extended into the main pancreatic duct. Mucin5AC, α1-antitrypsin (α-AT) and carcinoembryonic antigen (CEA) were detected in the tumor cells by immunohistochemistry. In the resected head of the pancreas, the tumor was composed of both acinar and ductal elements with a mottled pattern. The proportions of each element were approximately 40% and 60%, respectively. Strongly positive α-AT cells were detected in the acinar element. Some tumor cells were also CEA positive. However, the staining for synaptophysin and chromogranin A was negative in the tumor cells. Ultimately, we diagnosed the tumor as a recurrence of mixed acinar-ductal carcinoma in the remnant pancreas. In conclusion, we report here a rare case of repeated pancreatic resection for multicentric lesions of mixed acinar-ductal carcinoma of the pancreas.
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MESH Headings
- Aged
- Biomarkers, Tumor/analysis
- Biopsy
- Carcinoma, Pancreatic Ductal/chemistry
- Carcinoma, Pancreatic Ductal/pathology
- Carcinoma, Pancreatic Ductal/surgery
- Cholangiopancreatography, Endoscopic Retrograde
- Endosonography
- Female
- Humans
- Immunohistochemistry
- Multimodal Imaging
- Neoplasm Recurrence, Local
- Neoplasms, Complex and Mixed/chemistry
- Neoplasms, Complex and Mixed/pathology
- Neoplasms, Complex and Mixed/surgery
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/surgery
- Pancreatectomy/adverse effects
- Pancreatic Neoplasms/chemistry
- Pancreatic Neoplasms/pathology
- Pancreatic Neoplasms/surgery
- Positron-Emission Tomography
- Predictive Value of Tests
- Reoperation
- Tomography, X-Ray Computed
- Treatment Outcome
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27
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Takahashi M, Watanabe K, Akabane H, Ichinokawa K, Ogasawara K, Kato H, Konishi K, Suzuki Y, Tanaka K, Narita Y, Hata T, Hosoda M, Yamamoto M. Clinical Study Evaluating the Safety, Tolerability and Efficacy of Weekly Nab-Paclitaxel Dosed at 100 Mg/M2 for Metastatic Breast Cancer : Hbcc1101 Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu329.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Ishii D, Inagaki M, Shonaka T, Akabane H, Yanagida N, Shomura H, Orimo T, Aiyama T, Sato K, Nakano S. Clear cell sarcoma of the esophagus: report of a case. Clin J Gastroenterol 2014; 7:228-32. [PMID: 26183741 DOI: 10.1007/s12328-014-0479-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 03/12/2014] [Indexed: 01/19/2023]
Abstract
We report a rare case of clear cell sarcoma of the esophagus and review the literature regarding clear cell sarcomas of the gastrointestinal tract. A 57-year-old male was admitted with dysphagia during swallowing. Preoperative imaging studies, including upper gastrointestinal endoscopy and endoscopic ultrasonography, showed that the tumor was located between the mucosa and the muscularis propria of the lower esophagus. We performed subtotal esophagectomy with gastric tube reconstruction. Pathological findings of the tumor showed mixed spindle cells and oval cells. Immunohistochemical staining showed that the tumor cells were positive for S-100, vimentin and neuron-specific enolase and negative for α-smooth muscle actin, myoglobin and c-kit. Fluorescence in situ hybridization using a Ewing sarcoma breakpoint region 1 probe showed split signals in a small percentage of cells. We finally diagnosed the patient with clear cell sarcoma of the esophagus.
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Affiliation(s)
- Daisuke Ishii
- Division of Surgery, Hokkaido P.W.F.A.C Asahikawa-Kosei General Hospital, 1 Jo 24 Chome 111, 1 Jodori, Asahikawa, 078-8211, Japan,
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29
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Itoh M, Sako Y, Itoh S, Ishikawa Y, Akabane H, Nakaya K, Nagaoka F, Ito A. Immunodiagnosis of alveolar echinococcosis using urine samples. Parasitol Int 2013; 62:514-6. [DOI: 10.1016/j.parint.2013.07.007] [Citation(s) in RCA: 2] [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] [Received: 07/30/2012] [Revised: 03/26/2013] [Accepted: 07/11/2013] [Indexed: 10/26/2022]
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30
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Otani Y, Shomura H, Aiyama T, Funai T, Tsuji T, Orimo T, Shonaka T, Shibaki T, Yanagida N, Inagaki M, Akabane H, Nakano S. [Prognostic factors affecting the surgical treatment of metastatic lung tumor from colorectal cancer]. Kyobu Geka 2013; 66:279-283. [PMID: 23575178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
For aging, people having malignant disease are increasing. And surgical resection is an important part in the treatment of pulmonary metastasis from colorectal cancer. We analyzed the treatment outcome and prognostic factors affecting survival in our subset of patients. We have experienced 64 operations of metastatic lung tumors from colorectal cancer for 23 years since January 1988. Various factors affecting prognosis are studied based on 5-year survival in this report. Overall 5-year survival rate was 38.7%. The disease-free intervals more than 2 years, a solitary metastatic pulmonary lesion and the serum level of prethoracotomy carcinoembryonic antigen (CEA) were significantly affecting factors on the prognosis. Furthermore, sequential study for 23 years couldn't demonstrate the prognostic improvement by the advance of the thoracoscopic technology or the development of the new anti-cancer drugs, though the treatment of patients with pulmonary metastases from colorectal cancer continues to evolve. The role of pulmonary metastasectomy is very important to reduce the volume of metastatic lesions for the better prognosis.
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Affiliation(s)
- Yoshimi Otani
- Department of Thoracic Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
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31
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Shomura H, Nakano S, Akabane H, Inagaki M, Yanagida N, Shibaki T, Kudo T, Shonaka T, Orimo T, Oikawa F, Aiyama T. [Two cases of neuroendocrine carcinoma of the rectum]. Gan To Kagaku Ryoho 2011; 38:2265-2267. [PMID: 22202350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We report two cases of neuroendocrine carcinoma of the rectum. CASE 1: A 50s woman was diagnosed as rectal cancer and underwent anterior resection of the rectum and lymphnode dissection. The histological diagnosis was neuroendocrine carcinoma with peritoneal dissemination. She was treated with chemotherapy as an outpatient. One year later from the operation, multiple liver metastases were revealed and she died eight months later. CASE 2: A 50s man underwent endoscopic mucosal resection (EMR) of the rectum as rectal tumor and histological diagnosis was an early well-moderate deferenciated carcinoma and its cut-tend was unclear. He received a careful follow-up. One year later, a follow-up colonoscopy revealed a submucosal tumor in the lower rectum. He was diagnosised with local reccurence of rectal cancer, and then underwent an abdominoperineal resection of the rectum and lymphnode dissection. The histological diagnosis was poorly differenciated neuroendocrine carcinoma with lymphnode metastasis. Two months later from the operation, a local reccurence was revealed and he was treated with octreotide and irradiation.
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32
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Orimo T, Nakano S, Inagaki M, Akabane H, Yanagida N, Shibaki T, Shomura H, Kudo T, Shonaka T, Oikawa F, Aiyama T. [A case of AFP-producing gastric cancer patient with liver relapse occurred three months after endoscopic mucosal resection (EMR) and gastrectomy]. Gan To Kagaku Ryoho 2011; 38:2328-2330. [PMID: 22202371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 60s male was admitted to our hospital for a diagnosis of gastric tumor sized 20 mm in diameter at the fornix of the stomach. Endoscopic mucosal resection (EMR) was performed, and the resected tumor was pap, m, ly0, v0, HMX, VM0, pathologically. One month after the EMR, the local recurrence was confirmed and a partial gastrectomy was performed. Pathological findings were tub1, sm2, ly1, v1, HM0, VM0. Total gastrectomy was added because of the possibility of the lymph node metastasis. Pathological findings revealed no residual cancers. The final pathological diagnosis was T1b(sm2) N0H0P0M0, Stage IA, based on the Japanese classification of gastric cancer. Three months thereafter, CT showed multiple liver metastases. Immunohistochemical study of the operated tumor revealed AFP-producing gastric cancer. Chemotherapy was performed, but he died of the gastric cancer. Endoscopic treatment is a minimally invasive therapeutic strategy, but it requires a considerable care in application.
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33
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Nakano S, Shomura H, Akabane H, Inagaki M, Yanagida N. [Two cases of gastric endocrine cell carcinoma]. Gan To Kagaku Ryoho 2010; 37:2505-2507. [PMID: 21224621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Gastric endocrine cell carcinoma is rare and associated with a poor prognosis. The first case was a man in his sixties with gastric endocrine cell carcinoma, of which a clinical finding was T2N1M0H1 (Stage IV). S-1 + CDDP therapy was selected and failed. CDDP+CPT-11 therapy was started and CT showed a partial response in ten months. But the tumor was re-grown and the patient died twenty months after diagnosis. The second case was a man in his seventies with gastric endocrine cell carcinoma, of which a clinical finding was T3N1M0H0P0, Stage IIIa, underwent total gastrectomy. Abdominal contrast-enhanced CT scan performed a month after the operation disclosed hepatic metastasis. After two months of S-1 regimen, CDDP + CPT-11 therapy was started.
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Affiliation(s)
- Shiro Nakano
- Dept. of Surgery, Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital
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34
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Shomura H, Nakano S, Funai T, Akabane H, Inagaki M, Yanagida N, Kudo T, Orimo T, Oikawa F, Emoto S, Yoneya R. [A case of metastasis to the stomach from primary adenocarcinoma of the lung cancer]. Gan To Kagaku Ryoho 2010; 37:2481-2483. [PMID: 21224613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We report a case of gastric metastasis of lung cancer performed gastrectomy for the primary foci. A 70s woman was diagnosed as having right lung cancer and underwent right lower lobectomy and lymph node dissection. The histological diagnosis was adenocarcinoma (pT4, N2, M0). Four years later, positron emission tomography (PET)-CT revealed a tumor in the stomach and para-aortic lymph nodes swelling. The submucosal tumor was showed in the cardia by endoscopic examination. Biopsy showed a papillary adenocarcinoma. With the diagnosis of gastric metastasis from lung cancer, she was operated on. A proximal gastrectomy was carried out. The histopathological examination demonstrated papillary adenocarcinoma similar to that of the lung cancer with lymph node metastasis. No postoperative complications occurred and she was discharged from the hospital. Since then, she was treated with adjuvant chemotherapy as an outpatient.
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Affiliation(s)
- Hiroki Shomura
- Dept of Surgery, Hokkaido PWFAC Asahikawa-Kosei Hospital
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35
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Kita K, Takahashi M, Nakano S, Akabane H, Yanagida N, Shomura H, Hanamoto T, Kuji M, Oikawa F, Miyagi H. [A case of long-term survival of unresectable-advanced gastric cancer due to chemotherapy]. Gan To Kagaku Ryoho 2009; 36:2281-2283. [PMID: 20037396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The case was a 50s male with chief complaints of body weight loss and nausea. A clinical finding was Stage IV gastric cancer of poorly differentiated adenocarcinoma. We diagnosed it unresectable and started 5-FU+CDDP as the first-line chemotherapy. Partial response (PR) was observed and progression free time was 7 months. After 9 courses of 5-FU+ CDDP, the tumor grew and an oral intake was getting impossible. Gastro-jejunostomy was performed and then started a weekly PTX as the second-line chemotherapy after operation. The response was progressive disease (PD) after 4 courses of weekly PTX. Then we started S-1+CPT-11 as the third-line chemotherapy. We could continue S-1+CPT-11 for 9 courses without a severe adverse effect. Overall survival was 26.2 months.
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Affiliation(s)
- Kengo Kita
- Department of Surgery, Hokkaido P.W.F.A.C Asahikawa-Kousei General Hospital
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36
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Shomura H, Takahashi M, Nakano S, Akabane H, Yanagida N, Takaoka M, Hanamoto T, Kuji M, Kita K, Oikawa F, Miyagi H, Yoneya R. [A case report of metastatic liver tumor from rectosigmoid colon cancer demonstrating a pathological complete response with FOLFOX and FOLFIRI treatment]. Gan To Kagaku Ryoho 2009; 36:2158-2159. [PMID: 20037355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We report a case of multiple liver metastases of rectsigmoid colon cancer treated with systemic chemotherapy and hepatectomy. A 40s woman had undergone anterior resection of rectum for rectsigmoid colon cancer with multiple liver metastases. Then FOLFOX4 regimen was performed fifteen times, and FOLFIRI regimen was performed eleven times. After chemotherapy was enforced, an abdominal CT revealed that liver metastases were reduced in size (effect judgment of partial response). Hepatic resection of the right lobe and partial of S2 segment were performed. Pathological findings of the resected liver revealed no residual cancer cells, indicating that the histological effect of chemotherapy was complete response (CR).
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Affiliation(s)
- Hiroki Shomura
- Department of Surgery, Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital
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37
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Shomura H, Takahashi M, Saitoh H, Nakano S, Akabane H, Yanagida N, Hanamoto T, Kuji M, Kita K, Oikawa F, Takeuchi S, Hokodate H, Orii Y, Gotoh M. [Expandable metallic stent treatment for obstructive colorectal cancer patients]. Gan To Kagaku Ryoho 2008; 35:2195-2197. [PMID: 19106568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
UNLABELLED The expandable metallic stent (EMS) have been used to treat obstructive colorectal cancer. We used EMS in 13 out of 14 cases of obstructive colorectal carcinoma patients (insertion rate 93%). Of these 13 cases, 6 cases were male patients, and 7 cases were female patients. The average age was 69.1-years-old (44-87). The placement of insertion part in rectum and sigmoid colon was 8 cases and 5 cases, respectively. We detained Ultraflex non-covered type for all patients. Seven patients were able to have an operation after stenting. After the stent treatment, 11 patients were able to eat, and 7 patients were discharged from hospital. COMPLICATIONS perforation and stent migration were occurred in one case. These results suggested that EMS might be an effective treatment for obstructive colorectal carcinoma.
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38
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Gotoh J, Akabane H, Kita K, Fujiyoshi M, Hirokata G, Imai K, Kawai T, Yanagida N, Nakano S, Takahashi M. [A case of local recurrence of rectal cancer in long-term responding to combined therapy of low-dose CPT-11 and 5'-DFUR]. Gan To Kagaku Ryoho 2006; 33:1349-51. [PMID: 16969040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
A 68-year-old man underwent Miles'operation for advanced rectal cancer. Local recurrence occurred 9 months following the operation. We started the combined therapy of low-dose CPT-11 and doxifluridine (5'-DFUR). CPT-11 was administered at 80 mg/body biweekly and 5'-DFUR was orally administered at 800 mg/day/body on day 3-7. We then reduced the CPT-11 dose to 60 mg/body because of neutropenia. Four months later,we obtained a decrease in the tumor marker (carcinoembryonic antigen: CEA) to the normal serum level, and stopped the medication. However, 3 months later the serum CEA level was increased, and we restarted the same therapy. Six months after restarting this therapy, the serum CEA level decreased to the normal level,and the local recurrence was decreased in size. We finished this combined therapy and changed to 5'-DFUR only. No tumor progression or recurrences in this patient are seen 2 years after completing this combined therapy.
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39
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Tsuchiya K, Ikeda K, Mimura M, Takahashi M, Miyazaki H, Anno M, Shiotsu H, Akabane H, Niizato K, Uchihara T, Tominaga I, Nakano I. Constant involvement of the Betz cells and pyramidal tract in amyotrophic lateral sclerosis with dementia: a clinicopathological study of eight autopsy cases. Acta Neuropathol 2002; 104:249-59. [PMID: 12172910 DOI: 10.1007/s00401-002-0543-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2001] [Revised: 12/17/2001] [Accepted: 02/28/2002] [Indexed: 10/25/2022]
Abstract
We investigated clinicopathologically pyramidal signs, including hyperreflexia, Babinski sign, and spasticity, and the involvement of the primary motor cortex and pyramidal tract, in eight Japanese autopsy cases of amyotrophic lateral sclerosis (ALS) with dementia. Pyramidal signs were observed in seven (88%) of the eight autopsy cases. Hyperreflexia and Babinski sign were evident in seven (88%) and three (38%) patients, respectively, but spasticity was not observed in any of the eight patients. Loss of Betz cells in the primary motor cortex was evident in the seven cases in which this structure was examined. Astrocytosis in the fifth layer of the primary motor cortex was noticed in three cases. In all eight cases, involvement of the pyramidal tract was obvious in the medulla oblongata, but no involvement of the pyramidal tract was found in the midbrain. Involvement of the pyramidal tract in the spinal cord, particularly of large myelinated fibers, was observed in all six cases in which the spinal cord was examined. In ALS with dementia, pyramidal signs were shown to be present more frequently than previously believed, and the clinicopathological correlation between pyramidal signs and involvement of the pyramidal tract was obvious. Constant involvement of Betz cells and the pyramidal tract in ALS with dementia has not been reported. Our clinicopathological findings may make a contribution to the understanding of the clinicopathological hallmarks of this disorder. Furthermore, we believe that this study will also contribute to the elucidation of the nosological status of ALS with dementia.
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Affiliation(s)
- K Tsuchiya
- Department of Laboratory Medicine and Pathology, Tokyo Metropolitan Matsuzawa Hospital, 2-1-1 Kamikitazawa, Setagaya-ku, Tokyo 156-0057, Japan.
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40
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Iwamoto KS, Fujii S, Kurata A, Suzuki M, Hayashi T, Ohtsuki Y, Okada Y, Narita M, Takahashi M, Hosobe S, Doishita K, Manabe T, Hata S, Murakami I, Hata S, Itoyama S, Akatsuka S, Ohara N, Iwasaki K, Akabane H, Fujihara M, Seyama T, Mori T. p53 mutations in tumor and non-tumor tissues of thorotrast recipients: a model for cellular selection during radiation carcinogenesis in the liver. Carcinogenesis 1999; 20:1283-91. [PMID: 10383902 DOI: 10.1093/carcin/20.7.1283] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Concerns over cancer development from exposure to environmental sources of densely ionizing, high linear energy transfer (LET) radiation, such as alpha-particles from radon, is a current public health issue. The study of tumors attributable to high LET irradiation would greatly augment our insights into the biological mechanisms of carcinogenesis. Chronic low-dose-rate internal exposure to alpha-radiation from thorium dioxide deposits following intravascular administration of the radiographic contrast agent Thorotrast is known to markedly increase the risk of cancer development, especially that of hepatic angiosarcomas and cholangiocarcinomas. Although the mechanism is hypothesized to be via cellular damage, DNA being a major target, wrought by the high LET alpha-particles, the specific genes and the actual sequence of events involved in the process of transforming a normal cell into a malignant one are largely unknown. To shed some light on the molecular mechanisms of cancer development during a lifetime exposure to alpha-radiation, we analyzed the most commonly affected tumor suppressor gene in humans, p53, in 20 Thorotrast recipients who developed cancer, mostly of hepatic bile duct and blood vessel origin. Of the 20 cases, 19 were found to harbor p53 point mutations. Moreover, the accompanying non-tumor tissues from these patients also had p53 mutations, albeit at lower frequency. The distribution pattern of the point mutations was significantly different between the non-tumor and tumor tissues, with most mutations in malignant tissues located in the highly conserved domains of the p53 gene. Our results support the idea that p53 mutations are important in the genesis of Thorotrast-induced tumors but that these point mutations are a secondary outcome of genomic instability induced by the irradiation. Additionally, non-tumor cells harboring p53 mutations may gain some survival advantage in situ but mutations in the domains responsible for the formation of structural elements critical in binding DNA may be necessary for a cell to reach full malignancy.
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Affiliation(s)
- K S Iwamoto
- Department of Radiobiology, Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan.
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41
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Tsuchiya K, Miyazaki H, Akabane H, Yamamoto M, Kondo H, Mizusawa H, Ikeda K. MELAS with prominent white matter gliosis and atrophy of the cerebellar granular layer: a clinical, genetic, and pathological study. Acta Neuropathol 1999; 97:520-4. [PMID: 10334491 DOI: 10.1007/s004010051023] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This report concerns an autopsy case of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) with unusual neuropathological findings. The patient was a Japanese woman who was 21 years old at the time of death. Her mother is a patient with genetically confirmed MELAS. Her clinical manifestations included convulsions and lactic acidosis in the latter half of the first decade of life, followed by deafness, dementia, muscle weakness in the lower extremities, slight ataxia in the upper and lower extremities, and diabetes mellitus. Muscle biopsy revealed ragged-red fibers, and genetic study showed a point mutation at nucleotide pair 3243 in mitochondrial DNA. She died of lactic acidosis. In the clinical course, she did not develop stroke-like episodes. The neuropathological examination revealed not only minute to small necrotic foci in the cerebral cortex, amygdala, hippocampus, and cerebellum, but also prominent white matter gliosis in the central nervous system and cerebellar cortical degeneration of granular cell type. Our neuropathological findings, including prominent white matter gliosis of the central nervous system and cerebellar cortical degeneration of granular cell type, may indicate morphologically widespread cellular dysfunction, not restricted to either neuronal or vascular derangement, in the brain pathology of MELAS.
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Affiliation(s)
- K Tsuchiya
- Department of Laboratory Medicine and Pathology, Tokyo Metropolitan Matsuzawa Hospital, Japan
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42
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Kitamura F, Araki S, Tanigawa T, Miura H, Akabane H, Iwasaki R. Assessment of mutations of Ha- and Ki-ras oncogenes and the p53 suppressor gene in seven malignant mesothelioma patients exposed to asbestos--PCR-SSCP and sequencing analyses of paraffin-embedded primary tumors. Ind Health 1998; 36:52-56. [PMID: 9473858 DOI: 10.2486/indhealth.36.52] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
To examine whether malignant mesothelioma due to asbestos has genetic alterations in the Ha- and Ki-ras oncogenes or in the p53 suppressor gene, we analyzed the point mutations of these genes in paraffin-embedded autopsy samples of the primary tumors of malignant mesothelioma in seven asbestos patients who died from malignant mesothelioma. The genetic analysis was conducted by the polymerase chain reaction-single strand comformation polymorphysms (PCR-SSCP) method in all patients, and through the sequencing of deoxyribonucleic acid (DNA) bases in one patient. No genetic alterations were found in exons 1 or 2 of Ha- and Ki-ras oncogenes, or in exons 5 to 9 of the p53 gene, in any of the patients. Further studies on a larger number of patients are required to reach a definite conclusion concerning the genetic effects of asbestos on malignant mesothelioma.
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Affiliation(s)
- F Kitamura
- Department of Public Health, Faculty of Medicine, University of Tokyo, Japan
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43
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Takabe K, Tsukada Y, Shimizu T, Takagiwa J, Hirayama M, Nakayama M, Miura H, Akabane H, Takayama S, Aida S. [The clinical utility of asbestos body counts in bronchoalveolar lavage fluid]. Nihon Kyobu Shikkan Gakkai Zasshi 1997; 35:1196-204. [PMID: 9493446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
To assess the clinical utility of measuring the number of asbestos bodies (AB) present in bronchoalveolar lavage fluid (BALF), we counted the number of AB in BALF from 119 subjects using light microscopy. The results were analyzed according to occupational histories, radiological findings of asbestos-induced lung and pleural changes, and asbestos-related diseases. The 94 subjects in group 1 had a history of dust exposure, whereas group 2 subjects (n = 25) had no dust exposure. Group 1 was subdivided into subjects with obvious exposure to asbestos (group 1A, n = 61), and subjects with no known exposure to asbestos (group 1B, n = 33). The distribution of AB counts per ml of BALF (means +/- SEM) differed significantly between groups 1 and 2 (38.8 +/- 17.4 vs 0.06 +/- 0.04, p < 0.0001). The AB counts were significantly different between groups 1A and 1B (57.9 +/- 26.6 vs 3.4 +/- 1.2, p = 0.01). Subject, exposed to dust who had radiological evidence of pleural thickening had significantly higher AB counts than subjects in whom pleural thickening was absent (66.0 +/- 31.1 vs 5.1 +/- 4.2, p = 0.03). In group 1, the BALF was positive for AB in 7 of 14 patients with pulmonary fibrosis, 4 of 5 patients with lung cancer, all 6 patients with malignant mesothelioma, and all 4 patients with benign asbestos pleural effusion. We conclude that AB counts in BALF are useful for evaluating both the history of asbestos exposure in a population exposed to dust, as well as patients having asbestos-related diseases.
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Affiliation(s)
- K Takabe
- Department of Internal Medicine, Yokosuka Kyosai Hospital, Kanagawa, Japan
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Takabe K, Tsukada Y, Shimizu T, Takagiwa J, Hirayama M, Nakayama M, Miura H, Akabane H, Takayama S, Aida S, Kimura Y. Malignant lymphoma involving the penis following malignant pleural mesothelioma. Intern Med 1997; 36:712-5. [PMID: 9372333 DOI: 10.2169/internalmedicine.36.712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
A 74-year-old man who had been diagnosed with malignant mesothelioma developed malignant lymphoma of B-cell origin involving the penis. He had a history of occupational exposure to asbestos as a construction worker. The association of malignant mesothelioma with lymphoma is rare, and the possibility of asbestos exposure as a common etiology is discussed. The intense stimulation of B lymphocytes and decreased T lymphocyte activity in asbestos-exposed populations may result in development of B-cell malignancies. Though the relationship between asbestos exposure and malignant mesothelioma is firmly established, the relationship between asbestos exposure and lymphoma remains to be investigated.
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Affiliation(s)
- K Takabe
- Department of Internal Medicine, Yokosuka Kyosai Hospital, Kanagawa
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Miyazaki H, Saito Y, Kijima Y, Akabane H, Tsuchiya K. [An autopsy case of corticobasal degeneration mimicking frontal Pick's disease]. No To Shinkei 1997; 49:277-82. [PMID: 9125734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A pathologically proven case of corticobasal degeneration (CBD) with marked psychiatric symptoms was reported. A 59-year-old female was admitted to our hospital in October 1989 because of her "forgetfulness". Her abnormal behavior began in August 1989, and she had no psychiatric signs before that time. On this admission she was diagnosed to have panhypopituitarism due to Sheehan syndrome. Cortisone and levothyroxine were administered, but her mental symptoms deteriorated. Strange behaviors such as buying same materials every day and wandering around all day long fully dressed with all of her jewels were observed. She could not perform her housework after March 1991. She was in a bed ridden state after 1992 and died in March 1993, at the age of 62. The total duration of her illness was 3 years and 7 months. Her clinical course resembled frontal Pick's disease. At autopsy advanced gastric cancer without metastasis and infarct of the pituitary gland were found. The weight of the brain was 987g and atrophy of the bilateral frontal lobes was evident on macroscopical examination. Neuronal loss, proliferation of the glia, and spongy state were observed in the superficial layer of the frontal cerebral cortex. Widespread appearance of ballooned neurones was also observed in the deep layers of the frontal cerebral cortex. Neuronal loss and gliosis were found in the striatum, pallidum, thalamus, and substantia nigra. There was neither senile plaques nor Pick bodies. Numerous argyrophilic threads were found by Gallyas-Braak method and all these pathological findings were compatible with the previously reported cases of CBD. Although CBD is considered as predominantly a motor disorder, there are a few reports of pathologically proven cases of CBD mimicking Pick's disease. These cases suggest clinical diversity of CBD and further investigations are essential to establish the disease entity of CBD and Pick's disease.
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Affiliation(s)
- H Miyazaki
- Department of Neurology, Yokosuka Kyosai Hospital, Kanagawa, Japan
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46
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Miyoshi Y, Asakura T, Matsuzaki J, Fukuda M, Satomi Y, Akabane H. [A case of CEA and CA19-9 producing recurrent transitional cell carcinoma in an Indiana pouch after total cystectomy]. Hinyokika Kiyo 1996; 42:961-4. [PMID: 9013232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 73-year-old female with transitional cell carcinoma (TCC) of the bladder underwent total cystectomy and Indiana pouch replacement in April, 1992. Histological examination revealed grade 3 TCC. In February 1995, she complained of gross hematuria. Intravenous pyelography (IVP) revealed a right non-functional kidney and filling defect in the Indiana pouch. We suspected colon cancer in the Indiana pouch because the levels of serum carcino-embryonic antigen (CEA) and CA19-9 were elevated. Endoscopic biopsy of intrapouch tumor was done. Pathological examination revealed grade 2 TCC. In July 1995, right nephroureterectomy with resection of Indiana pouch was performed and the surgical specimen revealed renal pelvic and ureteral cancer, grade 2 TCC. The levels of serum CEA and CA19-9 returned to the normal range 21 days after the operation. CEA and CA19-9 histochemical stain of renal pelvic and ureteral cancer were positive. Also CEA-, CA19-9-positive cells were detected in the specimens of the bladder tumor from the total cystectomy performed in 1992. This rare case is discussed and the literature is reviewed.
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Affiliation(s)
- Y Miyoshi
- Department of Urology, Yokosuka Kyosai Hospital
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Shimamura T, Une Y, Nakajima Y, Sato N, Matsushita M, Kamiyama T, Haneda T, Nakanishi K, Akabane H, Tomioka N. [Advantages and disadvantages of the intraarterial chemotherapy using a reservoir as postoperative adjuvant therapy for hepatocellular carcinoma]. Gan To Kagaku Ryoho 1995; 22:1511-4. [PMID: 7574746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We conducted a retrospective study on the efficacy and disadvantages of intraarterial chemotherapy using a reservoir (ICUR), as postoperative adjuvant therapy for hepatocellular carcinoma (HCC). One hundred and seventy HCC patients who underwent hepatectomy since 1987 to 1992 in our institute were enrolled in this study. Ninety-two patients were postoperatively treated with ICUR (group R), and seventy-eight patients without it (group N). There were no significant differences between the two groups in the preoperative evaluations of the characteristics of patients, tumors, and operative procedures. Although statistical significances were not found, disease-free rates within 1 year and cumulative survival rates appeared to be higher in group R than in group N. Patency of the catheter of reservoirs at one and two years were maintained in 80.3 and 44.1% of the patients, respectively. HCC recurred after an occlusion of the reservoir in 18 patients. In four out of these 18 patients, transcatheter arterial embolization (TAE) for recurrent tumors was not feasible, because of occlusion of the hepatic artery. TAEs for recurrent lesions would have been impossible in about 10% of all patients treated with ICUR. Thus, both the advantages and disadvantages should be taken into consideration on the indication of ICUR, and the maintainance of the catheter is important for successful ICUR.
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Affiliation(s)
- T Shimamura
- First Dept. of Surgery, Hokkaido University School of Medicine
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Tazawa J, Sakai Y, Koizumi K, Asahina Y, Tajiri K, Yamaoka K, Maeda M, Akabane H, Marumo F, Sato C. Endoscopic ligation for ruptured duodenal varices. Am J Gastroenterol 1995; 90:677-8. [PMID: 7717347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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49
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Affiliation(s)
- K Sato
- Department of Neurology, Tsuchiura Kyodo Hospital, Ibaragi, Japan
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50
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Yamaoka K, Tazawa J, Koizumi K, Asahina Y, Tajiri K, Tsubaki M, Hiranuma S, Maeda M, Akabane H, Nouchi T. Choledochocele with obstructive jaundice: a case report and a review of the Japanese literature. J Gastroenterol 1994; 29:661-4. [PMID: 8000518 DOI: 10.1007/bf02365453] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A case of a 57-year-old farmer with a rare type of choledochal cyst (choledochocele; Alonso-Lej's type III) is described. The patient was admitted because of obstructive jaundice and acute biliary infection. Abdominal computed tomography scan showed a cystic lesion in the head of the pancreas, and endoscopic retrograde cholangiopancreatography disclosed cystic dilatation of the terminal portion of the common bile duct. It was suspected that the choledochocele could swell and compress the common bile duct, causing obstructive jaundice and acute cholangitis; therefore, it was surgically resected. We also reviewed 61 cases of choledochocele reported in Japan; the findings were similar to those reported in the English literature.
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Affiliation(s)
- K Yamaoka
- Department of Medicine, Tsuchiura Kyodo Hospital, Ibaraki, Japan
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