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Sato K, Takigawa N, Kubo T, Katayama H, Kishino D, Okada T, Hisamoto A, Mimoto J, Ochi N, Yoshino T, Ueoka H, Tanimoto M, Maeda Y, Kiura K. Effect of a Cyclooxygenase-2 Inhibitor in Combination with (-)-Epigallocatechin Gallate or Polyphenon E on Cisplatin-Induced Lung Tumorigenesis in A/J Mice. Acta Med Okayama 2023; 77:65-70. [PMID: 36849147 DOI: 10.18926/amo/64363] [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] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
We investigated the effects of celecoxib combined with (-)-epigallocatechin-3-gallate (EGCG) or polyphenon E in a cisplatin-induced lung tumorigenesis model. Four-week-old female A/J mice were divided into seven groups: (i) Control, (ii) 150 mg/kg celecoxib (150Cel), (iii) 1,500 mg/kg celecoxib (1500Cel), (iv) EGCG+150 mg/kg celecoxib (EGCG+150Cel), (v) EGCG+1,500 mg/kg celecoxib (EGCG+1500Cel), (vi) polyphenon E+150 mg/kg celecoxib (PolyE+150Cel), and (vii) polyphenon E+1,500 mg/kg celecoxib (PolyE+1500Cel). All mice were administered cisplatin (1.62 mg/kg of body weight, i.p.) 1×/week for 10 weeks and sacrificed at week 30; the numbers of tumors on the lung surface were then determined. The tumor incidence and multiplicity (no. of tumors/mouse, mean±SD) were respectively 95% and 2.15±1.50 in Control, 95% and 2.10±1.29 in 150Cel, 86% and 1.67±1.20 in 1500Cel, 71% and 1.38±1.24 in EGCG+150Cel, 67% and 1.29±1.38 in EGCG+1500Cel, 80% and 1.95±1.36 in PolyE+150Cel, and 65% and 1.05±0.10 in PolyE+1500Cel. The combination of high-dose celecoxib with EGCG or polyphenon E significantly reduced multiplicity in cisplatin-induced lung tumors.
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Affiliation(s)
- Ken Sato
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Nagio Takigawa
- Department of General Internal Medicine 4, Kawasaki Medical School
| | - Toshio Kubo
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | | | - Daizo Kishino
- Department of Medicine, Yamaguchi-Ube Medical Center
| | - Toshiaki Okada
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Akiko Hisamoto
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Junko Mimoto
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Nobuaki Ochi
- Department of General Internal Medicine 4, Kawasaki Medical School
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Hiroshi Ueoka
- Department of Medicine, Yamaguchi-Ube Medical Center
| | - Mitsune Tanimoto
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Yoshionobu Maeda
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Katsuyuki Kiura
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Murata Y, Aoe K, Mimura-Kimura Y, Murakami T, Oishi K, Matsumoto T, Ueoka H, Matsunaga K, Yano M, Mimura Y. Association of immunoglobulin G4 and free light chain with idiopathic pleural effusion. Clin Exp Immunol 2017; 190:133-142. [PMID: 28617941 DOI: 10.1111/cei.12999] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2017] [Indexed: 12/24/2022] Open
Abstract
The cause of pleural effusion remains uncertain in approximately 15% of patients despite exhaustive evaluation. As recently described immunoglobulin (Ig)G4-related disease is a fibroinflammatory disorder that can affect various organs, including the lungs, we investigate whether idiopathic pleural effusion includes IgG4-associated etiology. Between 2000 and 2012, we collected 830 pleural fluid samples and reviewed 35 patients with pleural effusions undiagnosed after pleural biopsy at Yamaguchi-Ube Medical Center. Importantly, IgG4 immunostaining revealed infiltration of IgG4-positive plasma cells in the pleura of 12 patients (34%, IgG4+ group). The median effusion IgG4 level was 41 mg/dl in the IgG4+ group and 27 mg/dl in the IgG4- group (P < 0·01). The light and heavy chains of effusion IgG4 antibodies of patients in the IgG4+ group were heterogeneous by two-dimensional electrophoresis, indicating the absence of clonality of the IgG4 antibodies. Interestingly, the κ light chains were more heterogeneous than the λ light chains. The measurement of the κ and λ free light chain (FLC) levels in the pleural fluids showed significantly different κ FLC levels (median: 28·0 versus 9·1 mg/dl, P < 0·01) and κ/λ ratios (median: 2·0 versus 1·2, P < 0·001) between the IgG4+ and IgG4- groups. Furthermore, the κ/λ ratios were correlated with the IgG4+ /IgG+ plasma cell ratios in the pleura of the IgG4+ group. Taken together, these results demonstrate the involvement of IgG4 in certain idiopathic pleural effusions and provide insights into the diagnosis, pathogenesis and therapeutic opportunities of IgG4-associated pleural effusion.
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Affiliation(s)
- Y Murata
- The Department of Clinical Research, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan.,The Department of Respiratory Medicine, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan.,Division of Cardiology, The Department of Medicine and Clinical Science, Ube, Japan
| | - K Aoe
- The Department of Clinical Research, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - Y Mimura-Kimura
- The Department of Clinical Research, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - T Murakami
- The Department of Clinical Research, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - K Oishi
- The Department of Clinical Research, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan.,The Department of Respiratory Medicine, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan.,Division of Cardiology, The Department of Medicine and Clinical Science, Ube, Japan
| | - T Matsumoto
- The Department of Clinical Research, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - H Ueoka
- The Department of Clinical Research, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - K Matsunaga
- The Department of Respiratory Medicine and Infectious Disease, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - M Yano
- Division of Cardiology, The Department of Medicine and Clinical Science, Ube, Japan
| | - Y Mimura
- The Department of Clinical Research, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
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Bessho A, Ochi N, Kuyama S, Fujimoto N, Umeno T, Ninomiya K, Ikeda G, Harada D, Kishino D, Hosokawa S, Chikamori K, Nogami N, Harita S, Ueoka H, Hotta K, Takigawa N, Tanimoto M, Kiura K. A phase II trial of carboplatin plus S-1 for elderly patients with advanced non-small cell lung cancer with wild type EGFR (OLCSG1202). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e20614] [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
e20614 Background: S-1 is an oral fluoropyrimidine anticancer agent that combines tegafur, gimeracil, and oteracil potassium. Two phase III trials in advanced non-small cell lung cancer (NSCLC) showed the non-inferiority of combination of S-1 with carboplatin or cisplatin compared with standard platinum doublet chemotherapy. Although the S-1/platinum is one of the first line combinations for advanced NSCLC, efficacy and safety of the regimen in the elderly remain unknown. Methods: Patients were required to be previously untreated advanced NSCLC with wild-type EGFR, aged 70 or more, PS of 0-2. They received oral S-1 (40 mg/m2, twice daily) for 2 weeks and carboplatin (AUC 5 on day 1) every 4 weeks as an induction treatment. After 4 cycles of the induction, S-1 alone (40 mg/m2, twice daily for 2 weeks) was administrated every 4 weeks as a maintenance therapy until PD. Primary endpoint was overall response rate (ORR), which was expected more than 20%, and secondary endpoints included disease control rate (DCR), PFS, OS, and toxicity profile. The association between clinical outcomes and gene expressions including thymidylate synthase, thymidine phosphorylase, dihydropyrimidine dehydrogenase, orotate phosphoribosyl transferase, VEGF and ERCC1 in tumors was evaluated. Results: Thirty-three patients were enrolled between March 2013 and June 2015. Median age was 78 years old (range: 70 – 89), and 51.5% had a PS of 0. ORR was 30.3% (95% CI: 14.6 – 46.0%) and DCR was 57.6% (95% CI: 40.7 – 74.4%). Grade 3/4 toxicities included thrombocytopenia (42.4%), neutropenia (33.3%) and anemia (27.3%). There was one treatment-related death due to aspiration pneumonia following febrile neutropenia. Median PFS and OS times were 134 days (95% CI: 79 – 173) and 479 days (95% CI: 250 – 571), respectively. Low thymidine phosphorylase expression was associated with DCR (P < 0.01). Conclusions: Carboplatin plus S-1 showed preferable efficacy and tolerable toxicity for elderly with NSCLC. (Clinical trial number: UMIN000009345) Clinical trial information: 9345.
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Affiliation(s)
| | - Nobuaki Ochi
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | | | | | - Takahiro Umeno
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Kiichiro Ninomiya
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Genyo Ikeda
- Department of Respiratory Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Daijiro Harada
- Department of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Daizo Kishino
- Department of Respiratory Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
| | - Shinobu Hosokawa
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Kenichi Chikamori
- Department of Medical Oncology, NHO Yamaguchi-Ube Medical Center, Ube, Japan
| | - Naoyuki Nogami
- Department of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Shingo Harita
- Department of Respiratory Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Hiroshi Ueoka
- Department of Respiratory Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Katsuyuki Hotta
- Center for Innovative Clinical Medicine, Okayama Unversity Hospital, Okayama, Japan
| | - Nagio Takigawa
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Mitsune Tanimoto
- Department of Hematology, Iwakuni Clinical Center, Iwakuni, Japan
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Oishi K, Aoe K, Mimura Y, Murata Y, Sakamoto K, Koutoku W, Matsumoto T, Ueoka H, Yano M. Survival from an Acute Exacerbation of Idiopathic Pulmonary Fibrosis with or without Direct Hemoperfusion with a Polymyxin B-immobilized Fiber Column: A Retrospective Analysis. Intern Med 2016; 55:3551-3559. [PMID: 27980253 PMCID: PMC5283953 DOI: 10.2169/internalmedicine.55.6056] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) are fatal episodes of acute respiratory worsening of unknown etiology. Previous studies on acute respiratory distress syndrome have shown that direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) can have a beneficial effect on the respiratory status. This retrospective study investigated the prognosis and survival outcome of patients with AE-IPF who underwent PMX-DHP. Methods We examined the records of 50 patients with AE-IPF treated in our hospital. All patients received corticosteroid pulse therapy. We compared the disease outcome between 27 patients who underwent PMX-DHP (PMX group) and 23 patients who did not (non-PMX group). The independent predictors of survival were determined using Cox proportional hazards analyses. Results A multivariate analysis of all patients revealed that PMX-DHP therapy was a significant predictor of survival (HR=0.442, 95% CI 0.223-0.873; p=0.019). The 12-month survival rate was significantly higher in the PMX group than in the non-PMX group (41.7% vs. 9.8%; p=0.040). According to a subanalysis of the PMX group, the time from AE-IPF onset to PMX-DHP was a significant predictor of survival (HR=1.080, 95% CI 1.001-1.166; p=0.049). Conclusion PMX-DHP improved the prognosis of AE-IPF. The time from AE-IPF onset to PMX-DHP may therefore be informative for predicting the patient outcome.
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Affiliation(s)
- Keiji Oishi
- Department of Respiratory Medicine, National Hospital Organization Yamaguchi-Ube Medical Center, Japan
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Mimura Y, Kelly RM, Unwin L, Albrecht S, Jefferis R, Goodall M, Mizukami Y, Mimura-Kimura Y, Matsumoto T, Ueoka H, Rudd PM. Enhanced sialylation of a human chimeric IgG1 variant produced in human and rodent cell lines. J Immunol Methods 2015; 428:30-6. [PMID: 26627984 DOI: 10.1016/j.jim.2015.11.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/11/2015] [Accepted: 11/23/2015] [Indexed: 12/11/2022]
Abstract
Glycosylation of the IgG-Fc is essential for optimal binding and activation of Fcγ receptors and the C1q component of complement. However, it has been reported that the effector functions are down-regulated when the Fc glycans terminate in sialic acid residues and that sialylated IgG mediates anti-inflammatory effects of intravenous immunoglobulin (IVIG). Although recombinant IgG is hypo-sialylated, Fc sialylation is shown to be markedly increased when a mouse/human chimeric IgG3 Phe243Ala (F243A) variant is expressed in Chinese hamster ovary (CHO)-K1 cells. Here we investigate whether sialylation is increased in IgG1 F243A when expressed in CHO-K1, mouse myeloma J558L and human embryonic kidney (HEK) 293. Although the sialylation level was 2-5% for IgG1 wild type (WT), it was increased to 31%, 10% and 33% for the variant from CHO-K1, J558L and HEK293 cells, respectively. Interestingly, an increased addition of bisecting GlcNAc and α(1-3)-galactose residues to the Fc glycan was observed for HEK293-derived and J558L-derived IgG1 F243A, respectively. Fucosylation of HEK293-derived IgG1 F243A was maintained despite increased bisecting GlcNAc content. Although sialic acid and bisecting GlcNAc residues are reported to have an opposing effect on antibody-dependent cellular cytotoxicity (ADCC), IgG1 F243A showed 7 times lower ADCC activities than IgG1 WT, irrespective of bisecting GlcNAc residue. Thus, highly sialylated, human cell-derived IgG1 F243A with lowered ADCC activity may be of interest for the development of therapeutic antibodies with anti-inflammatory properties as an alternative to IVIG.
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Affiliation(s)
- Yusuke Mimura
- Department of Clinical Research, NHO Yamaguchi-Ube Medical Center, 685 Higashi-Kiwa, Ube 755-0241, Japan; NIBRT GlycoScience Group, National Institute for Bioprocessing Research and Training, Mount Merrion, Blackrock, Dublin 4, Ireland.
| | - Ronan M Kelly
- NIBRT GlycoScience Group, National Institute for Bioprocessing Research and Training, Mount Merrion, Blackrock, Dublin 4, Ireland; Eli Lilly and Company, Indianapolis, USA
| | - Louise Unwin
- NIBRT GlycoScience Group, National Institute for Bioprocessing Research and Training, Mount Merrion, Blackrock, Dublin 4, Ireland
| | - Simone Albrecht
- NIBRT GlycoScience Group, National Institute for Bioprocessing Research and Training, Mount Merrion, Blackrock, Dublin 4, Ireland
| | - Roy Jefferis
- School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Margaret Goodall
- School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Yoichi Mizukami
- Center for Gene Research, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube 755-8505, Japan
| | - Yuka Mimura-Kimura
- Department of Clinical Research, NHO Yamaguchi-Ube Medical Center, 685 Higashi-Kiwa, Ube 755-0241, Japan; NIBRT GlycoScience Group, National Institute for Bioprocessing Research and Training, Mount Merrion, Blackrock, Dublin 4, Ireland
| | - Tsuneo Matsumoto
- Department of Clinical Research, NHO Yamaguchi-Ube Medical Center, 685 Higashi-Kiwa, Ube 755-0241, Japan
| | - Hiroshi Ueoka
- Department of Clinical Research, NHO Yamaguchi-Ube Medical Center, 685 Higashi-Kiwa, Ube 755-0241, Japan
| | - Pauline M Rudd
- NIBRT GlycoScience Group, National Institute for Bioprocessing Research and Training, Mount Merrion, Blackrock, Dublin 4, Ireland
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Nogami N, Takigawa N, Hotta K, Segawa Y, Kato Y, Kozuki T, Oze I, Kishino D, Aoe K, Ueoka H, Kuyama S, Harita S, Okada T, Hosokawa S, Inoue K, Gemba K, Shibayama T, Tabata M, Takemoto M, Kanazawa S, Tanimoto M, Kiura K. A phase II study of cisplatin plus S-1 with concurrent thoracic radiotherapy for locally advanced non-small-cell lung cancer: The Okayama Lung Cancer Study Group Trial 0501. Lung Cancer 2015; 87:141-7. [DOI: 10.1016/j.lungcan.2014.11.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 11/01/2014] [Accepted: 11/02/2014] [Indexed: 10/24/2022]
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Hotta K, Kiura K, Tabata M, Takigawa N, Tanimoto M, Ueoka H. A survey of Japanese thoracic oncologists' perception of diagnostic and treatment strategies for EGFR mutant or EML4-ALK fusion non-small cell lung cancer. Chest 2014; 146:e222-e225. [PMID: 25451370 DOI: 10.1378/chest.14-2055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Katsuyuki Hotta
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Katsuyuki Kiura
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Masahiro Tabata
- Center for Oncology, Okayama University Hospital, Okayama, Japan
| | - Nagio Takigawa
- Department of General Internal Medicine 4, Kawasaki Hospital, Kawasaki Medical School, Okayama, Japan
| | - Mitsune Tanimoto
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Hiroshi Ueoka
- Department of Medical Oncology, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
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Nogami N, Ichihara E, Kozuki T, Kubo T, Kishino D, Kuyama S, Bessho A, Fujii M, Takigawa N, Chikamori K, Aoe K, Nagata T, Fujimoto N, Hosokawa S, Harita S, Kamei H, Ueoka H, Hotta K, Tanimoto M, Kiura K. A Phase Ii Trial of Gefitinib in Combination with Bevacizumab As First-Line Therapy for Advanced Non-Small-Cell Lung Cancer with Activating Egfr Gene Mutations: Olcsg 1001. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.64] [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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Chikamori K, Aoe K, Maeda T, Kishino D, Oishi K, Hotta K, Matsumoto T, Ueoka H. Impact of concomitant use of anti-acid agents on efficacy of gefitinib in EGFR-mutant non-small-cell lung cancer (NSCLC). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e19008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19008 Background: Gefitinib, an EGFR-tyrosine kinase inhibitor, is an essential agent for EGFR-mutant NSCLC. The preclinical studies revealed its reduced area under the curve (AUC) by elevation of pH in GI tract, potentially leading to alteration in the absorption of gefitinib. It, however, has been controversial as to whether and how simultaneous use of anti-acid agents, commonly used in clinical practices, could alter the sensitivity of gefitinib, especially in EGFR-mutant NSCLC. Thus, we conducted a retrospective cohort study to clarify this issue. Methods: We evaluated progression-free survival (PFS) and overall survival (OS) from the medical charts of chemotherapy-naïve patients with EGFR-mutant NSCLC treated with gefitinib monotherapy in our institution. We also identified history of concomitant use of anti-acid agents (proton pomp inhibitors and histamine type 2 receptor blockers) at the time of initiation of gefitinib therapy and assessed its impact on the efficacy of gefitinib using Cox’s proportional hazard model. Results: Between 2006 and 2012, consecutive 83 patients received gefitinib therapy, of whom 29 (34.9%) used anti-acid agents simultaneously. Baseline clinical characteristics between the two groups (use and non-use of anti-acid agents) were well balanced except performance status (PS) of 0: 17.2% vs. 37.0% respectively. Neither PFS nor OS were influenced by concomitant use of anti-acid agents in univariate analysis (hazard ratio: 1.12; 95% confidence interval: 0.66-1.92 and 1.67; 0.86-3.44, respectively). Multivariate analysis also showed no significant effect of anti-acid agent use on PFS and OS (1.18; 0.67-2.06 and 1.66; 0.81-3.38, respectively), whilst poor PS affected OS (2.03; 1.27-3.26). Additionally, no difference in the impact of use of anti-acid agents on the gefitinib sensitivity was observed when stratified by the type of EGFR mutations. Conclusions: Concomitant use of anti-acid agents does not seem to affect efficacy of gefitinib in EGFR-mutant NSCLC. It is unlikely that physicians need to keep in mind the drug interaction of gefitinib and anti-acid agents in daily clinical practices, although further extensive cohort studies are warranted.
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Affiliation(s)
- Kenichi Chikamori
- National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - Keisuke Aoe
- National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - Tadashi Maeda
- National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - Daizo Kishino
- Department of Medical Oncology, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - Keiji Oishi
- National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - Katsuyuki Hotta
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Tsuneo Matsumoto
- National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - Hiroshi Ueoka
- National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
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Hotta K, Kiura K, Tabata M, Takigawa N, Tanimoto M, Ueoka H. A survey on Japanese thoracic oncologists’ preference on treatment strategy for EGFR-mutant or EML4-ALK-mutant non-small cell lung cancer (NSCLC). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e19124] [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
e19124 Background: NSCLC pts have become categorized based on two genetic alterations in their tumors, EGFR and EML4-ALK, to provide personalized therapy. In EGFR-mutant NSCLC, EGFR-TKI yields a comparable survival with platinum-based chemotherapy, suggesting either of them can be initiated first, and its choice seems to depend partly on oncologists’ preference. As for the other, EML4-ALK, NCCN guideline recommends first-line crizotinib use despite no relevant survival data. The decision whether to choose crizotinib might be also influenced by oncologists’ preference. We here assessed their preference. Methods: The Japanese thoracic oncologists were asked to complete a self-administered questionnaire at the Japanese meeting specific for thoracic oncology. Results: Of 3,046 subjects, 871 (29%) responded voluntarily to a survey, mainly consisting of medical and surgical oncologists (93%). Majority considered EGFR mutation status should be checked at the time of diagnosis (89%), whereas only 60% and 33% reported EML4-ALK gene status would be assessed at the time of diagnosis and until the initiation of second-line setting, respectively. The subjects also considered pts with EGFR-wild-typed tumor and pts with clinical characteristics possibly related to EML4-ALK rearrangement should selectively receive EML4-ALK gene status check rather than all NSCLC pts (57%, 22% and 16%, respectively). Among the subjects, 52% preferred to choose gefitinib rather than platinum in the first-line setting in EGFR-mutant NSCLC, whilst 44% preferred crizotinib to platinum in the first-line setting in EML4-ALK-positive NSCLC. The major reasons why they chose gefitinib in EGFR-mutant NSCLC were ‘PFS is better’ (36%) and ‘it is easy to improve QOL’ (25%), whereas ‘PFS is better’ (43%), and ‘I want to prescribe when patients are still in good condition’ (19%) were the predominant reasons for choosing crizotinib in EML4-ALK-positive NSCLC. Conclusions: About half of the subjects preferred each molecular-targeted agent to the conventional cytotoxic chemotherapy in first-line setting. They considered better PFS was important in the treatment of EGFR-mutant or EML4-ALK-mutant NSCLC.
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Affiliation(s)
- Katsuyuki Hotta
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Katsuyuki Kiura
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Masarhiro Tabata
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Nagio Takigawa
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Mitsune Tanimoto
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Hiroshi Ueoka
- National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
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Okada T, Takigawa N, Kishino D, Katayama H, Kuyama S, Sato K, Mimoto J, Ueoka H, Tanimoto M, Kiura K. Selective cyclooxygenase-2 inhibitor prevents cisplatin-induced tumorigenesis in A/J mice. Acta Med Okayama 2012; 66:245-51. [PMID: 22729105 DOI: 10.18926/amo/48564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Cisplatin is used to treat lung cancer; however, it is also a known carcinogen. Cyclooxygenase-2 (COX-2) inhibitors have been shown to prevent carcinogen-induced experimental tumors. We investigated the effect of a COX-2 inhibitor, celecoxib, on cisplatin-induced lung tumors. One hundred twenty 4-week-old A/J mice were divided into 6 groups: group 1, no treatment; group 2, low-dose celecoxib (150 mg/kg); group 3, high-dose celecoxib (1,500 mg/kg); group 4, cisplatin alone; group 5, cisplatin plus low-dose celecoxib;and group 6, cisplatin plus high-dose celecoxib. Mice in groups 4-6 were administered cisplatin (1.62 mg/kg, i.p.) once a week for 10 weeks between 7 and 16 weeks of age. All mice were sacrificed at week 30. Tumor incidence was 15.8% in group 1, 25% in group 2, 26.3% in group 3, 60% in group 4, 50% in group 5, and 50% in group 6. Tumor multiplicity was 0.2, 0.3, 0.3, 1.3, 1.0, and 0.6 in groups 1-6, respectively. Tumor multiplicity in the cisplatin-treated mice was reduced by celecoxib treatment in a dose-dependent manner (p < 0.05, group 4 vs. group 6). Celecoxib significantly reduced COX-2 expression in cisplatin-induced tumors (p < 0.01, group 4 vs. group 6).
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Affiliation(s)
- Toshiaki Okada
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
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Nogami N, Kozuki T, Segawa Y, Shinkai T, Maeda T, Ueoka H, Harita S, Kuyama S, Hosokawa S, Gemba K, Takemoto M, Takigawa N, Tabata M, Tanimoto M, Kiura K. A Phase II Study of Cisplatin (P), S-1 (S) and Concurrent Thoracic Radiotherapy (TRT) for Locally Advanced Non-Small-Cell Lung Cancer (LA-NSCLC): Okayama Lung Cancer Study Group Trial 0501. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32313-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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13
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Chikamori K, Aoe K, Kishino D, Katayama H, Oishi K, Seki C, Murata Y, Sakamoto K, Okumura M, Maeda T, Ueoka H. Long-Term Administration of Pemetrexed Raised Toxicity of Peripheral Edema Treated with Oral Anti-Diuretics. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32497-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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14
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Oishi K, Mimura-Kimura Y, Miyasho T, Aoe K, Ogata Y, Katayama H, Murata Y, Ueoka H, Matsumoto T, Mimura Y. Association between cytokine removal by polymyxin B hemoperfusion and improved pulmonary oxygenation in patients with acute exacerbation of idiopathic pulmonary fibrosis. Cytokine 2012; 61:84-9. [PMID: 23021430 DOI: 10.1016/j.cyto.2012.08.032] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 08/03/2012] [Accepted: 08/29/2012] [Indexed: 02/08/2023]
Abstract
Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is characterized by severe worsening dyspnea of unknown etiology and high mortality without effective treatment. Recently, direct hemoperfusion with polymyxin B (PMX)-immobilized fiber cartridge (PMX-DHP) has been reported to improve pulmonary oxygenation and survival in patients with AE-IPF although its mechanism of action remains unknown. To gain insights into the pathobiology of AE-IPF through the beneficial effects of PMX-DHP, we analyzed the profile of cytokines adsorbed onto PMX-fibers used in 9 AE-IPF patients. In addition, the sera of these AE-IPF patients collected immediately before and after PMX-DHP, 9 stable IPF patients and 8 healthy individuals were also analyzed. The serum levels of cytokines including IL-9, IL-12, IL-17, PDGF and VEGF were significantly decreased immediately after PMX-DHP (P<0.02), and VEGF and IL-12 were most prominently reduced. In addition to PDGF and VEGF, IL-1β, IL-1ra, IL-8, IL-23, FGF basic, GM-CSF, IP-10, RANTES and TGF-β were eluted from used PMX-fibers. Interestingly, improved pulmonary oxygenation after PMX-DHP was correlated well with the quantities of eluted VEGF. These results suggest that adsorption of proinflammatory, profibrotic and proangiogenic cytokines onto PMX-fibers is one of the mechanisms of action of PMX-DHP in AE-IPF. Notably, removal of VEGF by PMX-DHP may contribute to the rapid improvement in oxygenation by suppressing vascular permeability in the lung.
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Affiliation(s)
- Keiji Oishi
- The Department of Respiratory Medicine, NHO Yamaguchi-Ube Medical Center, Ube 755-0241, Japan.
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Kishino D, Nogami N, Segawa Y, Aoe K, Ueoka H, Takigawa N, Harita S, Tabata M, Tanimoto M, Kiura K. A phase II study of cisplatin (P), S-1 (S), and concurrent thoracic radiotherapy (TRT) for locally advanced non-small cell lung cancer (LA-NSCLC): Okayama Lung Cancer Study Group trial 0501. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.7042] [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
7042 Background: We previously reported an efficacy and safety of fractionated schedule ofP and docetaxel (D) (days 1, 8, 29, and 36, each) and concurrent TRT (DP-TRT) for LA-NSCLC (JCO 2010). Although the median survival time (MST: 26.3 months) was excellent, grade 3 or greater pneumonitis (10%) and esophagitis (14%) were observed and treatment-related death was 3%.Thus, further improvement in the safety as well as efficacy is strongly warranted. S, an oral fluoropyrimidine, is a new active agent possessing a radio-sensitizing effect. Additionally, combining S and P offered an active and safe regimen for metastatic NSCLC. The objective of this study was to assess the efficacy and safety of S + P with concurrent TRT for LA-NSCLC. Methods: Patients with stage IIIA/IIIB, aged ≤75 years and PS 0-1, and without any prior chemotherapy were eligible for this study. Patients were treated with P (40 mg/m² on day 1, 8, 29 and 36) and S (40 mg/m²/dose b.i.d. on days 1-14 and 29-42) and TRT (60 Gy/30 fr over 6 weeks starting on day 1). Primary endpoint was response rate (RR), and required sample size was 48 patients. Results: Between 2006 and 2009, 48 patients were enrolled (37 men; median age, 66 years; PS 0/1, 36/14; IIIA/IIIB, 23/25; sq/non-sq, 22/26). Partial response was observed in 37 patients (77%; 95% confidence interval: 63-88%). The response rate was higher in older patients (≥65 yrs) than younger (<65 yrs) (89% vs. 64%, p=0.041). At a median follow-up of 40 months, median progression-free survival and MST were 9.3 months and 31.3 months, respectively. No difference in efficacy (response and survivals) was observed stratified by histology (sq vs. non-sq). Toxicities were generally mild, including G3/4 neutropenia (44%), G3/4 thrombocytopenia (13%), G3 febrile neutropenia (8%) and G3 pneumonitis (4%). No one developed Gr3/4 esophagitis. No toxic deaths occurred. Conclusions: This chemoradiotherapy regimen yielded a favorable overall survival data. Also, it was well-tolerated in patients with LA-NSCLC as compared with concurrent DP-TRT therapy especially in term of TRT-related toxicities. A phase III trial of this regimen vs. DP-TRT is now planned.
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Affiliation(s)
- Daizo Kishino
- National Hospital Organization Yamaguchi-Ube Medical Center, Ube-shi, Yamaguchi, Japan
| | - Naoyuki Nogami
- National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | | | - Keisuke Aoe
- National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | | | - Nagio Takigawa
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | | | - Masahiro Tabata
- Center for Clinical Oncology, Okayama University Hospital, Okayama, Japan
| | - Mitsune Tanimoto
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Katsuyuki Kiura
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
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Ogata Y, Aoe K, Hiraki A, Murakami K, Kishino D, Chikamori K, Maeda T, Ueoka H, Kiura K, Tanimoto M. Is adenosine deaminase in pleural fluid a useful marker for differentiating tuberculosis from lung cancer or mesothelioma in Japan, a country with intermediate incidence of tuberculosis? Acta Med Okayama 2012; 65:259-63. [PMID: 21860532 DOI: 10.18926/amo/46851] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The objective of this study was to evaluate the utility of the determination of adenosine deaminase (ADA) level in pleural fluid for the differential diagnosis between tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) in Japan, a country with intermediate incidence of tuberculosis (TB). We retrospectively reviewed the clinical records of 435 patients with pleural effusion and investigated their pleural ADA levels as determined by an auto analyzer. ROC analysis was also performed. The study included patients with MPE (n=188), TPE (n=124), benign nontuberculous pleural effusion (n=94), and pleural effusion of unknown etiology (n=29). The median ADA level in the TPE group was 70.8U/L, which was significantly higher than that in any other groups (p<0.05). The area under the curve (AUC) in ROC analysis was 0.895. With a cut-off level for ADA of 36U/L, the sensitivity, specificity, positive predictive value, and negative predictive value were 85.5%, 86.5%, 69.7%, and 93.6%, respectively. As many as 9% of patients with lung cancer and 15% of those with mesothelioma were false-positive with this ADA cutoff setting. Although the ADA activity in pleural fluid can help in the diagnosis of TPE, it should be noted that some cases of lung cancer or mesothelioma show high ADA activity in geographical regions with intermediate incidence of TB, in contrast to high prevalence areas.
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Affiliation(s)
- Yoshiko Ogata
- Department of Respiratory Medicine, NHO Yamaguchi-Ube Medical Center, Ube, Japan
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Tao H, Mimura Y, Aoe K, Kobayashi S, Yamamoto H, Matsuda E, Okabe K, Matsumoto T, Sugi K, Ueoka H. Prognostic potential of FOXP3 expression in non-small cell lung cancer cells combined with tumor-infiltrating regulatory T cells. Lung Cancer 2011; 75:95-101. [PMID: 21719142 DOI: 10.1016/j.lungcan.2011.06.002] [Citation(s) in RCA: 174] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 05/10/2011] [Accepted: 06/03/2011] [Indexed: 12/23/2022]
Abstract
Expression of the transcription factor FOXP3 characterizes regulatory T cells (Tregs) that engage in the maintenance of immunological self-tolerance and immune homeostasis. Intra-tumoral accumulation of Tregs is associated with unfavorable prognosis in several kinds of cancers. Recently, expression of FOXP3 and its association with prognosis have also been shown in some cancer cells in clinical studies. For non-small cell lung cancer (NSCLC), however, prognostic significance of tumor FOXP3 expression and its relationship with Tregs remain unknown. FOXP3 expression in cancer cells and tumor-infiltrating lymphocytes was examined by immunohistochemical staining of surgical specimens from 87 patients with NSCLC. Prognostic values of the tumor-infiltrating Treg count and tumor FOXP3 expression status were evaluated retrospectively. FOXP3-positive cancer cells were observed in 27 of 87 (31.0%) patients. There was no significant relationship between Treg count and tumor FOXP3 status. Increased Treg counts were associated with worse overall and relapse-free survival whereas the influence of tumor FOXP3 status on survival was not significant. However, when FOXP3-positive cancer cells were present, the relationship between Treg accumulation and worse prognosis was attenuated. In contrast, patients without tumor FOXP3 expression and high Treg count had significantly worse overall and relapse-free survival (hazard ratio: 3.118 and 3.325, p=0.028 and 0.024, respectively) than other groups. These results suggest that tumor FOXP3 expression has a better prognostic potential in NSCLC and that in combination with tumor-infiltrating Treg count the absence of tumor FOXP3 allows the selection of high-risk patients.
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Affiliation(s)
- Hiroyuki Tao
- Department of Thoracic Surgery, NHO Yamaguchi-Ube Medical Center, 685 Higashi-kiwa, Ube, 755-0241, Japan.
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18
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Kiura K, Takigawa N, Matsuo K, Kuyama S, Hosokawa S, Fujiwara K, Hisamoto A, Kozuki T, Ueoka H, Tanimoto M. Long-term follow-up of phase III trial of docetaxel and cisplatin (DP) versus mitomycin, vindesine, and cisplatin (MVP) with concurrent thoracic radiation therapy (TRT) for locally advanced non-small cell lung cancer (OLCSG 0007). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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19
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Nogami N, Hotta K, Kuyama S, Kiura K, Takigawa N, Chikamori K, Shibayama T, Kishino D, Hosokawa S, Tamaoki A, Harita S, Tabata M, Ueoka H, Shinkai T, Tanimoto M. A phase II study of amrubicin and topotecan combination therapy in patients with relapsed or extensive-disease small-cell lung cancer: Okayama Lung Cancer Study Group Trial 0401. Lung Cancer 2011; 74:80-4. [DOI: 10.1016/j.lungcan.2011.01.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 01/23/2011] [Indexed: 10/18/2022]
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20
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Hotta K, Kiura K, Takigawa N, Suzuki E, Yoshioka H, Okada T, Kishino D, Ueoka H, Inoue K, Tabata M, Tanimoto M. Association between poor performance status and risk for toxicity during erlotinib monotherapy in Japanese patients with non-small cell lung cancer: Okayama Lung Cancer Study Group experience. Lung Cancer 2010; 70:308-12. [PMID: 20416970 DOI: 10.1016/j.lungcan.2010.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Revised: 03/01/2010] [Accepted: 03/16/2010] [Indexed: 11/19/2022]
Affiliation(s)
- Katsuyuki Hotta
- Department of Respiratory Medicine, Okayama University Hospital, 2-5-1, Shikata-cho, Kitaku, Okayama 700-8558, Japan.
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Segawa Y, Kiura K, Takigawa N, Kamei H, Harita S, Hiraki S, Watanabe Y, Sugimoto K, Shibayama T, Yonei T, Ueoka H, Takemoto M, Kanazawa S, Takata I, Nogami N, Hotta K, Hiraki A, Tabata M, Matsuo K, Tanimoto M. Phase III trial comparing docetaxel and cisplatin combination chemotherapy with mitomycin, vindesine, and cisplatin combination chemotherapy with concurrent thoracic radiotherapy in locally advanced non-small-cell lung cancer: OLCSG 0007. J Clin Oncol 2010; 28:3299-306. [PMID: 20530281 DOI: 10.1200/jco.2009.24.7577] [Citation(s) in RCA: 191] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To demonstrate the efficacy of docetaxel and cisplatin (DP) chemotherapy with concurrent thoracic radiotherapy (TRT) for patients with locally advanced non-small-cell lung cancer (LA-NSCLC). PATIENTS AND METHODS Patients age 75 years or younger with LA-NSCLC, stratified by performance status, stage, and institution, were randomly assigned to two arms consisting of DP (docetaxel 40 mg/m(2) and cisplatin 40 mg/m(2) on days 1, 8, 29, and 36) or mitomycin, vindesine, and cisplatin (MVP) chemotherapy with concurrent TRT. RESULTS Between July 2000 and July 2005, 200 patients were allocated into either the DP or MVP arm. The survival time at 2 years, a primary end point, was favorable to the DP arm (P = .059 by a stratified log-rank test as a planned analysis and P = .044 by an early-period, weighted log-rank as an unplanned analysis). There was a trend toward improved response rate, 2-year survival rate, median progression-free time, and median survival in the DP arm (78.8%, 60.3%,13.4 months, and 26.8 months, respectively) compared with the MVP arm (70.3%, 48.1%, 10.5 months, and 23.7 months, respectively), which was not statistically significant (P > .05). Grade 3 febrile neutropenia occurred more often in the MVP arm than in the DP arm (39% v 22%, respectively; P = .012), and grade 3 to 4 radiation esophagitis was likely to be more common in the DP arm than in the MVP arm (14% v 6%, P = .056). CONCLUSION DP chemotherapy combined with concurrent TRT is an alternative to MVP chemotherapy for patients with LA-NSCLC.
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Affiliation(s)
- Yoshihiko Segawa
- Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Hospital, Kitaku, Okayama, Japan
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Fujimoto N, Kiura K, Takigawa N, Fujiwara Y, Toyooka S, Umemura S, Tabata M, Ueoka H, Tanimoto M. Triplet chemotherapy with cisplatin, docetaxel, and irinotecan for patients with recurrent or refractory non-small cell lung cancer. Acta Med Okayama 2010; 64:33-7. [PMID: 20200582 DOI: 10.18926/amo/32866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We examined the feasibility of triplet chemotherapy using cisplatin, docetaxel, and irinotecan for patients with recurrent or refractory non-small cell lung cancer (NSCLC), retrospectively. Twenty-five patients (21 men and 4 women) with NSCLC and good performance status who were < or = 70 years old were analyzed. The median age was 58 years. Most patients had performance status 1 (16/25), stage IV disease (18/25) and adenocarcinoma-histology (16/25). Cisplatin and docetaxel were given on day 1 and irinotecan on day 2; the cycle was repeated every 3 weeks. The objective response rate was 39.1% (95% confidence interval: 18.7-59.5%). The median survival time and actual 2-, 3-, and 5-year survival rates were 14.3 months, 32%, 20%, and 8%, respectively. Of note, only 6 patients were treated with gefitinib at the recurrence after triplet chemotherapy; of these, 4 (67%) achieved a partial response, which might result in favorable survival. Grade 3/4 toxicities consisted of neutropenia (100%), neutropenic fever (56%), nausea/vomiting (40%), and diarrhea (16%); no cases of treatment-related death occurred. Triplet chemotherapy showed impressive survival data in our clinical trial, but proved too toxic for use in treating patients with NSCLC in the clinical practice.
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Affiliation(s)
- Nobukazu Fujimoto
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hospital, Okayama 700-8558, Japan
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Tobise K, Miyairi M, Yamazaki Y, Waga S, Fukai S, Yamagishi F, Tsuchiya T, Yotsumoto H, Tano M, Nishimura O, Kurasawa T, Sagami K, Ueoka H, Nishimura K, Ueno M, Mori T, Ishikawa S, Sakatani M. [A DRG/PPS simulation in the medical care of tuberculosis]. Kekkaku 2010; 85:145-150. [PMID: 20384207] [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: 05/29/2023]
Abstract
PURPOSE To study the expected usefulness of the introduction of the DRG-PPS (Diagnosis-Related Group/Prospective Payment System, in which an insurer pays a fixed medical fee per hospitalization) into the current medical care of tuberculosis (TB) in Japan. METHOD The medical fees were reviewed for all TB inpatients at 19 hospitals under the National Hospital Organization who were discharged in either June 2007 or February 2008. The sum of the fixed fee by the DRG was assumed based on the bivariate regression analysis of each patient's hospital days and his or her total actual fees during the hospital stay under the current (fee for care) system, since it was difficult to directly calculate the daily fees for every patient that would be the basis of DRG-PPS. RESULTS Linear regression analysis estimated that the medical fees (including fees for the medical examinations and the treatments) for a hospital stay of 60 days, which is the standard for TB treatment, was 1,192,470 yen (19,870 yen per person per day) in June 2007, and 1,167,600 yen (19,460 yen per person per day) in February 2008. DISCUSSION If we assume an average medical fee of about Y1.1-1.2 million yen for the standard hospital care of TB, the economic balance of the hospitals is negative, with a deficit of 0.6-0.7 million yen, given the estimated expenses of 1.8 million yen (i.e., 30,000 yen per person per day x 60 days). CONCLUSION If the DRG-PPS is to be implemented based on the current medical fee rating system, the hospital administrators could not accept its introduction to the TB medical care service as it is, because it may undermine the economic management of hospitals.
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Affiliation(s)
- Katsuyuki Tobise
- Katsuyuki Tobise, National Hospital Organization Sapporo Minami National Hospital, 1814 Shirakawa, Minami-ku, Sapporo-shi, Hokkaido 061-2276 Japan.
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Chikamori K, Kishino D, Takigawa N, Hotta K, Nogami N, Kamei H, Kuyama S, Gemba K, Takemoto M, Kanazawa S, Ueoka H, Segawa Y, Takata S, Tabata M, Kiura K, Tanimoto M. A phase I study of combination S-1 plus cisplatin chemotherapy with concurrent thoracic radiation for locally advanced non-small cell lung cancer. Lung Cancer 2009; 65:74-9. [PMID: 19056143 DOI: 10.1016/j.lungcan.2008.10.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Revised: 10/16/2008] [Accepted: 10/21/2008] [Indexed: 11/24/2022]
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Hotta K, Kiura K, Takigawa N, Fujiwara Y, Tabata M, Ueoka H, Tanimoto M. Association of the benefit from gefitinib monotherapy with smoking status in Japanese patients with non-small-cell lung cancer. Lung Cancer 2008; 62:236-41. [DOI: 10.1016/j.lungcan.2008.03.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Revised: 03/11/2008] [Accepted: 03/12/2008] [Indexed: 11/15/2022]
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Umemura S, Fujimoto N, Hiraki A, Gemba K, Takigawa N, Fujiwara K, Fujii M, Umemura H, Satoh M, Tabata M, Ueoka H, Kiura K, Kishimoto T, Tanimoto M. Aberrant promoter hypermethylation in serum DNA from patients with silicosis. Carcinogenesis 2008; 29:1845-9. [PMID: 18632757 DOI: 10.1093/carcin/bgn169] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
It is well established that patients with silicosis are at high risk for lung cancer; however, it is difficult to detect lung cancer by chest radiography during follow-up treatment of patients with silicosis because of preexisting diffuse pulmonary shadows. The purpose of this study is to evaluate the usefulness of detection of serum DNA methylation for early detection of lung cancer in silicosis. Serum samples from healthy controls (n = 20) and silicosis patients with (n = 11) and without (n = 67) lung cancer were tested for aberrant hypermethylation at the promoters of the DNA repair gene O(6)-methylguanine-DNA methyltransferase (MGMT), p16(INK4a), ras association domain family 1A (RASSF1A), the apoptosis-related gene death-associated protein kinase (DAPK) and retinoic acid receptor beta (RARbeta) by methylation-specific polymerase chain reaction. Aberrant promoter methylation in at least one of five tumor suppressor genes was detected more frequently in the serum DNA of silicosis patients with lung cancer than in that of patients without it (P = 0.006). Furthermore, the odds ratio of having lung cancer was 9.77 (P = 0.009) for those silicosis patients with methylation of at least one gene. Extended exposure to silica (>30 years) was correlated with an increased methylation frequency (P = 0.017); however, methylation status did not correlate with age, smoking history or radiographic findings of silicosis. These results suggest that testing for aberrant promoter methylation of tumor suppressor genes using serum DNA may facilitate early detection of lung cancer in patients with silicosis.
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Affiliation(s)
- Shigeki Umemura
- Department of Hematology, Oncology and Respiratory Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 7008558, Japan
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Hotta K, Kiura K, Takigawa N, Kuyama S, Segawa Y, Yonei T, Gemba K, Aoe K, Shibayama T, Matsuo K, Kamei H, Fujiwara Y, Bessho A, Moritaka T, Sugimoto K, Tabata M, Ueoka H, Tanimoto M. Sex difference in the influence of smoking status on the responsiveness to gefitinib monotherapy in adenocarcinoma of the lung: Okayama Lung Cancer Study Group experience. J Cancer Res Clin Oncol 2008; 135:117-23. [DOI: 10.1007/s00432-008-0431-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Accepted: 05/23/2008] [Indexed: 10/21/2022]
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Hotta K, Kiura K, Fujiwara Y, Takigawa N, Tabata M, Ueoka H, Tanimoto M. Role of time to progression as a surrogate marker for overall survival in patients with advanced non-small-cell lung cancer (NSCLC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8022] [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: 11/20/2022] Open
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29
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Kiura K, Takigawa N, Segawa Y, Kamei H, Takemoto M, Tabata M, Ueoka H, Hiraki S, Matsuo K, Tanimoto M. Randomized phase III trial of docetaxel and cisplatin combination chemotherapy versus mitomycin, vindesine, and cisplatin combination chemotherapy with concurrent thoracic radiation therapy for locally advanced non-small-cell lung cancer: OLCSG 0007. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.7515] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kozuki T, Hisamoto A, Tabata M, Takigawa N, Kiura K, Segawa Y, Nakata M, Mandai K, Eguchi K, Ueoka H, Tanimoto M. Mutation of the epidermal growth factor receptor gene in the development of adenocarcinoma of the lung. Lung Cancer 2007; 58:30-5. [PMID: 17561305 DOI: 10.1016/j.lungcan.2007.04.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Revised: 04/08/2007] [Accepted: 04/14/2007] [Indexed: 10/23/2022]
Abstract
Recently, a mutation of the epidermal growth factor receptor (EGFR) gene has been reported to be implicated in the development of pulmonary adenocarcinoma. However, the involvement of the mutation in atypical adenomatous hyperplasia (AAH) and multiple adenocarcinomas still remains unclear. We herein examined the EGFR mutations in 9 AAH and 31 adenocarcinoma lesions obtained from 30 Japanese patients. Nine patients had synchronous or metachronous multiple adenocarcinomas and/or AAH. Mutations in exons 18-21 of EGFR gene were analysed using polymerase chain reaction and direct sequence methods. EGFR mutations were detected in 4 (44%) of 9 AAH and in 7 (23%) of 31 adenocarcinomas. A gefitinib-resistant point mutation (T790M) in exon 20 without gefitinib treatment was detected in 1 AAH and 1 adenocarcinoma. The patient with T790M mutated AAH, which also had an exon 19 mutation of D761Y, had synchronous adenocarcinoma, which had only an exon 19 mutation of D761Y. The other exon 19 mutations were all in-frame deletions. In the two patients with synchronous AAH and adenocarcinoma, AAH had mutations at exon 19 although adenocarcinoma did not have any mutations. In the patient with synchronous 2 adenocarcinomas, each had different mutations (exons 19 and 21). In two patients with double adenocarcinomas, 1 adenocarcinoma harbored exon 21 mutations, while the other demonstrated no mutations. Although EGFR mutations appeared to be partially associated with the early steps of adenocarcinoma development, such mutations may possibly occur randomly even in multiple lesions in a single patient.
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Affiliation(s)
- Toshiyuki Kozuki
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
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Suzaki N, Hiraki A, Takigawa N, Ueoka H, Tanimoto Y, Kozuki T, Tabata M, Kanehiro A, Kiura K, Tanimoto M. Severe interstitial pneumonia induced by paclitaxel in a patient with adenocarcinoma of the lung. Acta Med Okayama 2007; 60:295-8. [PMID: 17072376 DOI: 10.18926/amo/30737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A 71-year-old Japanese man with adenocarcinoma of the lung developed interstitial pneumonia after treatment with paclitaxel. The patient had acute chills and fever on the fourth day after the second exposure to paclitaxel, rapidly got worse despite empiric therapies, and developed prolonged respiratory failure requiring mechanical ventilation. Four months later, he died of respiratory failure due to progression of both interstitial pneumonia and lung cancer. This is the first case developing fatal paclitaxel-induced pulmonary toxicity to date. Interstitial pneumonia should be considered one of the possible life-threatening complications during treatment with paclitaxel.
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Affiliation(s)
- Noriyuki Suzaki
- Department of Respiratory Medicine, Okayama University Hospital, Okayama 700-8558, Japan
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Segawa Y, Nogami N, Shinkai T, Kiura K, Tabata M, Takigawa N, Hotta K, Shibayama T, Ueoka H, Tanimoto M. A phase II trial of combination chemotherapy with irinotecan and amrubicin in pretreated patients with non-small cell lung cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.18111] [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
18111 Background: Amrubicin, a totally synthetic anthracycline, is a topoisomerase II inhibitor and highly effective for non-small cell lung cancer (NSCLC) as a single agent with response rates of 25% to 28%. We previously conducted a phase I trial of combination chemotherapy with irinotecan and amrubicin for NSCLC and found acceptable toxicity profiles with a favorable efficacy in patients with pretreated NSCLC. The aim of this phase II trial was to further evaluate its efficacy and toxicity in this population. Methods: Primary endpoint was objective response. Patients with NSCLC previously treated with one or two chemotherapy regimens were enrolled in this trial. Irinotecan and amrubicin were both administered on days 1 and 8, every 3 weeks at doses of 100 and 40 mg/m2, respectively. Response and toxicity were assessed according to the RECIST guideline and NCI Common Terminology Criteria for Adverse Events v3.0. Results: Thirty-one pretreated NSCLC patients were enrolled between 2004 and 2006. A median number of courses administered was 3 (range: 1 to 6). All patients and courses were assessable for efficacy and safety. Demographics of the patients were as follows: M/F: 21/10, Ad/others: 21/10, ECOG-PS 0/1: 12/19, and smoker/non-smoker: 21/10. Platinum-based regimens were commonly used as the prior chemotherapy. Objective response was obtained in 9 of the 31 patients with a response rate of 29.0% (95%CI: 12.1–46.0%). Grade 4 leukopenia and neutropenia were observed in 6 (19%) and 14 (45%) patients, respectively, whereas thrombocytopenia were generally mild. Grade 3 febrile neutropenia was observed in 7 patients (23%), of whom two patients further developed Grade 4 and 5 septic shock each. Other grade 3 or greater non-hematological toxicities included diarrhea, vomiting, pneumonitis, liver dysfunction in 4, 1, 1 and 2 patients, respectively. At the time of this analysis with a median follow-up time in the surviving patients of 7.5 months, median survival time and median progression-free survival time were 11.9 and 4.0 months, respectively. Conclusion: This combination seemed highly effective for pretreated NSCLC despite the moderate toxicity profiles. Development of efficient patient selection is needed to avoid the serious toxicities. No significant financial relationships to disclose.
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Affiliation(s)
- Y. Segawa
- Shikoku Cancer Center, Matsuyama, Japan; Okayama University, Okayama, Japan; NHO Minami-Okayama Medical Center, Okayama, Japan; NHO Sanyo National Hospital, Ube, Japan
| | - N. Nogami
- Shikoku Cancer Center, Matsuyama, Japan; Okayama University, Okayama, Japan; NHO Minami-Okayama Medical Center, Okayama, Japan; NHO Sanyo National Hospital, Ube, Japan
| | - T. Shinkai
- Shikoku Cancer Center, Matsuyama, Japan; Okayama University, Okayama, Japan; NHO Minami-Okayama Medical Center, Okayama, Japan; NHO Sanyo National Hospital, Ube, Japan
| | - K. Kiura
- Shikoku Cancer Center, Matsuyama, Japan; Okayama University, Okayama, Japan; NHO Minami-Okayama Medical Center, Okayama, Japan; NHO Sanyo National Hospital, Ube, Japan
| | - M. Tabata
- Shikoku Cancer Center, Matsuyama, Japan; Okayama University, Okayama, Japan; NHO Minami-Okayama Medical Center, Okayama, Japan; NHO Sanyo National Hospital, Ube, Japan
| | - N. Takigawa
- Shikoku Cancer Center, Matsuyama, Japan; Okayama University, Okayama, Japan; NHO Minami-Okayama Medical Center, Okayama, Japan; NHO Sanyo National Hospital, Ube, Japan
| | - K. Hotta
- Shikoku Cancer Center, Matsuyama, Japan; Okayama University, Okayama, Japan; NHO Minami-Okayama Medical Center, Okayama, Japan; NHO Sanyo National Hospital, Ube, Japan
| | - T. Shibayama
- Shikoku Cancer Center, Matsuyama, Japan; Okayama University, Okayama, Japan; NHO Minami-Okayama Medical Center, Okayama, Japan; NHO Sanyo National Hospital, Ube, Japan
| | - H. Ueoka
- Shikoku Cancer Center, Matsuyama, Japan; Okayama University, Okayama, Japan; NHO Minami-Okayama Medical Center, Okayama, Japan; NHO Sanyo National Hospital, Ube, Japan
| | - M. Tanimoto
- Shikoku Cancer Center, Matsuyama, Japan; Okayama University, Okayama, Japan; NHO Minami-Okayama Medical Center, Okayama, Japan; NHO Sanyo National Hospital, Ube, Japan
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Hotta K, Fujiwara Y, Matsuo K, Suzuki T, Kiura K, Tabata M, Takigawa N, Ueoka H, Tanimoto M. Recent improvement in the survival of patients with advanced nonsmall cell lung cancer enrolled in phase III trials of first-line, systemic chemotherapy. Cancer 2007; 109:939-48. [PMID: 17285602 DOI: 10.1002/cncr.22478] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [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: 11/09/2022]
Abstract
BACKGROUND Few studies have assessed formally whether treatment outcomes have improved substantially over the years for patients with advanced nonsmall cell lung cancer (NSCLC) enrolled in Phase III trials. The objective of the current investigation was to determine the time trends in outcomes for the patients in those trials. METHODS The literature was searched to identify trials that addressed the role of chemotherapy regimens in the first-line setting for the treatment of advanced NSCLC. Trends were tested by using multiple regression analysis. RESULTS In total, 121 Phase III trials were identified that involved 42,768 patients with 263 chemotherapy arms and 11 best supportive care (BSC) arms, all of which were initiated between 1982 and 2002. Although the number of randomized patients and the proportion of patients with metastatic disease had increased over the years, the number of patients with a poor performance status who were accrued into the trials had decreased. Cisplatin-based chemotherapy was been investigated most frequently during the period. The multiple regression analysis revealed a significant improvement in median survival and in the median time to disease progression over the years, with annual prolongations of 0.1203 months (3.609 days) and 0.0617 months (1.851 days), respectively (P< .0001 and P < .0130, respectively). In addition, the use of cisplatin and carboplatin was associated significantly with survival prolongation. The median survival for patients who received BSC also increased progressively over the years (P = .0487). CONCLUSIONS The survival of patients with NSCLC in Phase III trials improved slowly but steadily over time, although the main factors responsible for this improvement remain unknown. Nonetheless, the current results also suggested that novel targets and new agents will be required in the future fight against advanced NSCLC.
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Affiliation(s)
- Katsuyuki Hotta
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan.
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Hotta K, Fujiwara Y, Kiura K, Takigawa N, Tabata M, Ueoka H, Tanimoto M. Relationship between Response and Survival in More Than 50,000 Patients with Advanced Non-small Cell Lung Cancer Treated with Systemic Chemotherapy in 143 Phase III Trials. J Thorac Oncol 2007; 2:402-7. [PMID: 17473655 DOI: 10.1097/01.jto.0000268673.95119.c7] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The association between the objective response to chemotherapy and survival has not yet been fully evaluated using large cohorts in advanced non-small cell lung cancer. METHODS We searched for phase III trials conducted between 1991 and 2006 to investigate the role of systemic chemotherapy for advanced non-small cell lung cancer. Associations were tested by multiple regression analysis. RESULTS Of the 1255 trials screened, 143 met our criteria, involving 50,569 patients with 309 chemotherapy regimens. In the first-line setting, the median intention-to-treat objective response rate (ORR) and disease control rate (DCR) were 26.4% and 62.5%, respectively (43,551 randomized patients; 290 trials). The median of the median survival time (MST) was 8.5 months in the first-line setting, and both the ORR and DCR were significantly associated with the MST in the multivariate analysis (regression coefficient = 0.0788 [p < 0.0001] and 0.0794 [p < 0.0001], respectively). Subgroup analysis showed no correlation between the ORR and MST in patients receiving chemotherapy containing molecular-targeted agents (p = 0.3817). In the second-line or later setting, the median ORR was only 6.8%, whereas the median DCR was 42.4% (4318 randomized patients; 19 trials). The median MST (6.6 months) was not associated with the ORR (p = 0.6992), but was associated with the DCR (p = 0.0129), despite the small sample size. CONCLUSIONS We found that survival was associated with both the ORR and DCR in the first-line setting, although it should be interpreted cautiously because of the abstracted data-based analysis. Regarding chemotherapy regimens containing molecular-targeted agents and salvage chemotherapy regimens, further assessments are warranted to clarify the association between the parameters.
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Affiliation(s)
- Katsuyuki Hotta
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan.
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Katayama H, Hiraki A, Fujiwara K, Matsuo K, Maeda T, Chikamori K, Kishino D, Tajima K, Ueoka H, Aoe K. Aberrant promoter methylation profile in pleural fluid DNA and clinicopathological factors in patients with non-small cell lung cancer. Asian Pac J Cancer Prev 2007; 8:221-4. [PMID: 17696735] [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: 05/16/2023] Open
Abstract
The aim of this study was to investigate the prognostic value of hypermethylation of tumor suppressor genes in patients with non-small cell lung cancer (NSCLC). In samples from 34 lung patients with malignant pleural effusions, we used a methylation-specific polymerase chain reaction to detect aberrant hypermethylation of the promoters of the DNA repair gene O6-methylguanine-DNA methyltransferase (MGMT), p16INK4a, ras association domain family 1A (RASSF1A), apoptosis-related genes, death-associated protein kinase (DAPK), and retinoic acid receptor beta(RARbeta). There is no association between methylation status of five tumor suppressor genes including MGMT, p16INK4a, RASSF1A, DAPK and RARbeta in pleural fluid DNA and clinicopathological parameters including clinical outcome. Aberrant promoter methylation of tumor suppressor genes in pleural fluid DNA could not be a valuable prognostic marker of NSCLC patients with malignant pleural effusion.
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Affiliation(s)
- Hideki Katayama
- Department of Medical Oncology, NHO Sanyo National Hospital, Yamaguchi, Japan
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Tabata M, Kiura K, Okimoto N, Segawa Y, Shinkai T, Yonei T, Kuyama S, Harita S, Hotta K, Ueoka H, Tanimoto M. A phase II trial of cisplatin and irinotecan alternating with doxorubicin, cyclophosphamide and etoposide in previously untreated patients with extensive-disease small-cell lung cancer. Cancer Chemother Pharmacol 2007; 60:1-6. [PMID: 17393168 DOI: 10.1007/s00280-006-0336-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2006] [Accepted: 08/20/2006] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this trial was to investigate the efficacy and safety of cisplatin (P) and irinotecan (I) (PI) alternating with doxorubicin (A), cyclophosphamide (C) and etoposide (E) (ACE) in patients with extensive-disease small-cell lung cancer (ED-SCLC). PATIENTS AND METHODS Patients with previously untreated ED-SCLC were enrolled in this trial. In the first, third and fifth cycles, PI (P: 60 mg/m(2) on day 1; I: 60 mg/m(2)/day on days 1, 8 and 15) was administered, whereas ACE (A: 50 mg/m(2) on day 1; C: 750 mg/m(2) on day 1; E 80 mg/m(2)/day on days 1-3) was given in the second, fourth and sixth cycles. Each cycle was repeated every 4 weeks. At the end of six cycles, patients who had obtained a complete response were given prophylactic cranial irradiation. RESULTS In total, 28 patients were enrolled, of whom 27 were assessable for efficacy and safety. Objective responses, including 4 (15%) complete responses, were observed in 25 patients (93%). Median survival time was 12.9 months. The principal toxicity was myelosuppression; grade 4 neutropenia and thrombocytopenia were observed in 89 and 4%, respectively. Febrile neutropenia occurred in 30% of patients. Diarrhea was mild (grade 3-4; 4%). All toxicities were reversible and there were no treatment-related deaths. The mean percentage of the delivered doses, relative to the projected doses, of PI and ACE were 84.6 and 91.1%, respectively. CONCLUSIONS These results indicate the PI-ACE regimen to have promising activity against ED-SCLC with moderate toxicities.
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Affiliation(s)
- Masahiro Tabata
- Department of Medicine II, Okayama University Medical School, 2-5-1, Shikata-cho, Okayama, 700-8558, Japan.
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Umemura S, Segawa Y, Ueoka H, Hotta K, Kiura K, Takigawa N, Tabata M, Bessho A, Shinkai T, Tanimoto M. Serum level of arginine-vasopressin influences the prognosis of extensive-disease small-cell lung cancer. J Cancer Res Clin Oncol 2007; 133:519-24. [PMID: 17370088 DOI: 10.1007/s00432-007-0196-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 08/28/2006] [Accepted: 02/12/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study is to elucidate the influence of serum arginine-vasopressin (AVP) level on prognosis of extensive-disease small-cell lung cancer (ED-SCLC). METHODS We retrospectively investigated the clinical records of 163 patients with ED-SCLC, who were admitted to Okayama University Hospital or National Shikoku Cancer Center Hospital. The influence of 14 pretreatment variables on survival was analyzed. RESULTS In a multivariate analysis of 163 patients, elevation of serum LDH level (P = 0.028) and poor performance status (PS > or = 2, P = 0.002) were independent poor prognostic factors. In 34 patients whose serum AVP levels were available, high serum AVP level was related to the poor prognosis (P < 0.001). The serum-sodium level did not affect the survival. Median serum level of osmotic pressure in 34 patients was normal (284.9 mOsm/kg), although, serum osmotic pressure was low in four of six patients with high serum AVP level. In all patients with high serum AVP level, serum LDH level was elevated. CONCLUSIONS The data from the current study suggested that serum LDH level and PS were the poor prognostic factors for ED-SCLC. But we additionally identified the prognostic significance of serum AVP level, which may be a more useful factor than serum-sodium level.
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Affiliation(s)
- Shigeki Umemura
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
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Hirano A, Ueoka H. Successful treatment of idiopathic thrombocytopenic purpura by Chinese herbal medicine EK-49 and ascorbic acid in an elderly patient developing chronic subdural hematoma. Geriatr Gerontol Int 2007. [DOI: 10.1111/j.1447-0594.2007.00376.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Katayama H, Hiraki A, Aoe K, Fujiwara K, Matsuo K, Maeda T, Murakami T, Toyooka S, Sugi K, Ueoka H, Tanimoto M. Aberrant promoter methylation in pleural fluid DNA for diagnosis of malignant pleural effusion. Int J Cancer 2007; 120:2191-5. [PMID: 17285579 DOI: 10.1002/ijc.22576] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [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: 11/09/2022]
Abstract
Accumulating evidence implicates epigenetic changes such as hypermethylation in carcinogenesis. We investigated whether DNA methylation of 5 tumor suppressor genes in pleural fluid samples could aid in diagnosis of malignant effusion. In samples from 47 patients with malignant pleural effusions and 34 with nonmalignant effusions, we used a methylation-specific polymerase chain reaction to detect aberrant hypermethylation of the promoters of the DNA repair gene O(6)-methylguanine-DNA methyltransferase (MGMT), p16(INK4a), ras association domain family 1A (RASSF1A), apoptosis-related genes, death-associated protein kinase (DAPK), and retinoic acid receptor beta (RARbeta). Promoter hypermethylation was associated with malignant effusion for MGMT (Odds ratio (OR) = infinity), p16(INK4a) (OR = infinity), RASSF1A (OR = 13.8; CI, 1.71-112), and RARbeta (OR = 3.17; CI, 1.10-9.11), but not for DAPK. Instead, DAPK methylation was associated with the length of smoking (p < 0.05). Patients with hypermethylation of MGMT, p16(INK4a), RASSF1A or RARbeta were 5.68 times more likely to have malignant effusions than patients without methylation (p = 0.008). Methylations per patient were more numerous for lung cancer than nonmalignant pulmonary disease (0.915 vs. 0.206, p < 0.001). Sensitivity, specificity, and positive predictive value of methylation in one or more genes for diagnosis of malignant effusion were 59.6%, 79.4%, and 80.0% respectively. In conclusion, aberrant promoter methylation of tumor suppressor genes in pleural fluid DNA could be a valuable diagnostic marker for malignant pleural effusion.
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Affiliation(s)
- Hideki Katayama
- Department of Respiratory Medicine and Clinical Research, NHO Sanyo National Hospital, Respiratory Disease Center, 685 Higashi-Kiwa, Ube, Yamaguchi 755-0241, Japan
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Hotta K, Tabata M, Kiura K, Kozuki T, Hisamoto A, Katayama H, Takigawa N, Fujimoto N, Fujiwara K, Ueoka H, Tanimoto M. Gefitinib induces premature senescence in non-small cell lung cancer cells with or without EGFR gene mutation. Oncol Rep 2007; 17:313-7. [PMID: 17203166] [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: 05/13/2023] Open
Abstract
Despite its tremendous antitumor effect in a subset of patients with non-small cell lung cancer (NSCLC), the exact mechanism of gefitinib-induced cell death has not been fully determined. In this study, forms of cell death in various NSCLC cell lines after gefitinib exposure was analyzed to elucidate the cell death mechanism of gefitinib. Though higher concentration of gefitinib (10 microM) induced extensive apoptosis in two cell lines (EGFR-mutated PC-9 cells and EGFR wild- type EBC-2/R cells), clinically relevant concentrations of gefitinib (1 microM) induced prominent premature senescence instead of apoptosis in these cells. This induction of senescence was preceded by immediate increase of p16INK4A, p21WAF1/Cip1 and p27Kip1 levels and subsequent G1 cell cycle arrest. These phenomena were not observed in gefitinib-resistant (RERF-LC-MS) cells. Additionally, ex vivo exposure to gefitinib induced senescence in short-term cultured tumor cells that were obtained from malignant pleural effusion of a patient with NSCLC, whose tumor was later revealed to be clinically sensitive to gefitinib. Our results indicate that senescence might be a major anti-tumor mechanism of gefitinib in these NSCLC cells regardless of the EGFR gene mutation status.
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Affiliation(s)
- Katsuyuki Hotta
- Department of Medicine II, Okayama University Medical School, Okayama 700-8558, Japan.
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Hotta K, Tabata M, Kiura K, Kozuki T, Hisamoto A, Katayama H, Takigawa N, Fujimoto N, Fujiwara K, Ueoka H, Tanimoto M. Gefitinib induces premature senescence in non-small cell lung cancer cells with or without EGFR gene mutation. Oncol Rep 2007. [DOI: 10.3892/or.17.2.313] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Kiura K, Takigawa N, Segawa Y, Tabata M, Shibayama T, Gemba K, Bessho A, Fujimoto N, Takata I, Hotta K, Fujiwara K, Tokuda Y, Kuyama S, Shinkai T, Ueoka H, Tanimoto M. Triple Combination Chemotherapy with Cisplatin, Docetaxel, and Irinotecan for Advanced Non-small Cell Lung Cancer: A Phase I/II Trial. J Thorac Oncol 2007; 2:44-50. [PMID: 17410009 DOI: 10.1097/jto.0b013e31802bafe2] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND To determine the recommended dose and evaluate the response rate and toxicity of triplet chemotherapy using cisplatin, docetaxel, and irinotecan for non-small cell lung cancer (NSCLC) patients with stage IIIB or IV. METHODS A total of 65 patients (33 men and 32 women) with advanced NSCLC, a good performance status, and 65 years of age or younger were included in these phase I/II studies. The median age was 52 years. Most patients had performance status 1 (49/65) and stage IV disease (49/65). Adenocarcinoma was the most common tumor histology (55 patients). Cisplatin and docetaxel were given on day 1 and irinotecan on day 2; the cycles were repeated every 3 weeks. RESULTS In the phase I study, the maximum tolerated doses of combination cisplatin/docetaxel/irinotecan were, respectively, 80/60/60 (mg/m) and the recommended doses for the phase II study were determined to be 60/60/60 (mg/m), respectively. The dose-limiting toxicities were neutropenia, neutropenic fever, and diarrhea. In the phase II study, 157 cycles of chemotherapy were delivered to 49 patients (median three cycles per patient). The objective response rate was 57.1% (95% confidence interval: 43.1%-71.1%). The median survival time and the actual 2-, 3- and estimated 5-year survival rates were 17 months, 33%, 25%, and 18%, respectively. Grade 3/4 toxicities consisted of neutropenia (92%), neutropenic fever (45%), nausea/vomiting (27%), diarrhea (35%), and hepatic toxicity (2%); there were no cases of treatment-related death. CONCLUSION This triplet chemotherapy has shown a promising activity against advanced NSCLC according to admission-based treatment with adequate supportive care. The principal toxicity was neutropenic fever, but supportive care should be explored to reduce this incidence.
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Affiliation(s)
- Katsuyuki Kiura
- Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences & Okayama University Hospital, Okayama, Japan.
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Ohashi K, Kiura K, Takigawa N, Mizushima T, Ino H, Tabata M, Ueoka H, Tanimoto M. Successful treatment of a patient with gastric and duodenal metastases from large cell carcinoma of the lung with carboplatin and gemcitabine. Anticancer Res 2006; 26:4695-6. [PMID: 17214328] [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: 05/13/2023]
Abstract
A 62-year-old man with large cell carcinoma of the lung underwent a right upper lobectomy and four months later demonstrated a relapse in the stomach and duodenum. He received systemic chemotherapy consisting of carboplatin and gemcitabine. After the first cycle of chemotherapy, the duodenal lesion disappeared, however, the gastric lesion demonstrated no response. Considering the risk of bleeding or perforation, a partial gastroduodenal resection was therefore performed. Subsequently, he received adjuvant chemotherapy with the same regimen. He has since been doing well for 24 months after the recurrence. Although the prognosis for patients with gastrointestinal metastases from lung cancer tends to be extremely poor, treatment with chemotherapy and a metastasectomy have resulted in this patient, achieving a long survival.
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Affiliation(s)
- Kadoaki Ohashi
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
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44
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Aoe K, Hiraki A, Tanaka T, Gemba KI, Taguchi K, Murakami T, Sueoka N, Kamei T, Ueoka H, Sugi K, Yoshino T, Kishimoto T. Expression of vascular endothelial growth factor in malignant mesothelioma. Anticancer Res 2006; 26:4833-6. [PMID: 17214348] [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: 05/13/2023]
Abstract
Malignant mesothelioma is the most common primary pleural neoplasm. Angiogenesis is an important component of a variety of pathological processes, including carcinogenesis and tumor metastases. Vascular endothelial growth factor (VEGF) is the most potent known endothelial, cell specific mitogen. The authors assessed the relation between VEGF expression and clinicopathological variables or overall survival, in malignant mesothelioma. We studied 37 patients with malignant pleural mesothelioma and found that 36 out of 37 (97.3%) malignant mesothelioma samples were stained positively for VEGF. An increased expression of VEGF was observed in the epithelioid type compared with the other histological types of malignant mesothelioma, including the biphasic and sarcomatoid types. No statistically significant association was observed between VEGF expression and gender, age, or clinical stage. Furthermore, the expression of VEGF did not impact on the survival of patients with malignant mesothelioma. Although VEGF expression might be important for tumor development and maintenance, it was not identified as a prognostic factor in malignant mesothelioma.
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Affiliation(s)
- Keisuke Aoe
- Department of Medical Oncology, NHO Sanyo National Hospital, Yamaguchi, Japan.
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45
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Takigawa N, Kiura K, Segawa Y, Watanabe Y, Kamei H, Moritaka T, Shibayama T, Ueoka H, Gemba K, Yonei T, Tabata M, Shinkai T, Hiraki S, Takemoto M, Kanazawa S, Matsuo K, Tanimoto M. Second primary cancer in survivors following concurrent chemoradiation for locally advanced non-small-cell lung cancer. Br J Cancer 2006; 95:1142-4. [PMID: 17031394 PMCID: PMC2360581 DOI: 10.1038/sj.bjc.6603422] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Long-term cancer survivors risk development of second primary cancers (SPC). Vigilant follow-up may be required. We report outcomes of 92 patients who underwent chemoradiation for unresectable stage III non-small-cell lung cancer, with a median follow-up of 8.9 years. The incidence of SPC was 2.4 per 100 patient-years (95% confidence interval: 1.0–4.9).
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Affiliation(s)
- N Takigawa
- Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan.
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46
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Tabata M, Kozuki T, Ueoka H, Kiura K, Harita S, Tada A, Shibayama T, Takigawa N, Yonei T, Gemba K, Segawa Y, Kishino D, Tada S, Hiraki S, Tanimoto M. A triplet chemotherapy with cisplatin, docetaxel and gemcitabine in patients with advanced non-small-cell lung cancer: a phase I/II study. Cancer Chemother Pharmacol 2006; 60:53-9. [PMID: 17009034 DOI: 10.1007/s00280-006-0346-y] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Accepted: 09/04/2006] [Indexed: 11/28/2022]
Abstract
PURPOSE We conducted a phase I/II study of triplet chemotherapy consisting of cisplatin (CDDP), docetaxel (DCT) and gemcitabine (GEM) in patients with advanced non-small-cell lung cancer (NSCLC). METHODS Fifty-three untreated patients with stage IIIB or IV NSCLC were enrolled. All drugs were given on days 1 and 8. The doses of CDDP and DCT were fixed at 40 mg/m(2) and 30 mg/m(2), respectively. In the phase I portion, a dose escalation study of GEM with starting dose of 400 mg/m(2) was conducted and primary objective in the phase II portion was response rate. RESULTS The maximally tolerated dose (MTD) and recommended dose (RD) of GEM were determined as 800 mg/m(2) because grade 3 non-hematological toxicity (liver damage, diarrhea, and fatigue) developed in three of nine patients evaluated at that dose level. In pharmacokinetic analysis, C (max) and AUC of dFdC and dFdU were increased along with the dose escalation of GEM. However, no relationship between pharmacokinetic parameters and toxicity or response was observed. Objective response rate was 34% and median survival time was 11.7 months. Though major toxicity was myelosuppression, there were no life-threatening toxicities. CONCLUSION These results indicate that this triplet chemotherapy is feasible and effective in patients with advanced NSCLC.
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Affiliation(s)
- Masahiro Tabata
- Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan
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47
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Hiraki A, Murakami T, Aoe K, Matsuda E, Maeda T, Uemori Y, Ueoka H. Recurrent superior mediastinal primary hemangiopericytoma 23 years after the complete initial excision: a case report. Acta Med Okayama 2006; 60:197-200. [PMID: 16838049 DOI: 10.18926/amo/30750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We describe here a patient with a recurrent hemangiopericytoma of the superior mediastinum 23 years after an initial complete resection. In the current biopsy specimen, the tumor cells were much more anaplastic than those seen 23 years ago. Although the patient was treated with chemotherapy, which consisted of ifosfamide and epirubicin, the tumor was unresponsive and he died 6 months later from disease progression. Careful long-term follow-up is mandatory for patients with hemangiopericytomas because recurrence with greater malignancy can develop following an extended disease-free interval.
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Affiliation(s)
- Akio Hiraki
- Department of Respiratory Medicine, NHO Sanyo National Hospital, Respiratory Disease Center, Ube, Yamaguchi 755-0241, Japan
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48
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Kitajima T, Nishii K, Ueoka H, Shibayama T, Gemba K, Kodani T, Kiura K, Tabata M, Hotta K, Tanimoto M, Sobue T. Recent improvement in lung cancer screening: a comparison of the results carried out in two different time periods. Acta Med Okayama 2006; 60:173-9. [PMID: 16838046 DOI: 10.18926/amo/30751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
To evaluate recent improvements in lung cancer screening, we compared the results of recently conducted lung cancer screening with those of a previous screening. This study compared the survival of lung cancer patients detected by lung cancer screening conducted between 1976 and 1984 (early period) with that conducted between 1989 and 1997 (late period). Two hundred seventy-six patients with lung cancer were detected in the early period and 541 patients with lung cancer were detected in the late period. The median survival time (late : 49.8 vs. early : 27.8 months) and the 5-year survival rate (late : 47.8 vs. early : 34.8%) of the patients with lung cancer detected in the late period were significantly better than those in the early period (p = 0.0054). Among patients undergoing resection, the proportion of pathological stage I patients in the late period was significantly higher than that in the early period (late : 60.8 vs. early : 54.9%, p = 0.005). Multivariate analysis showed that the screening time period was a significant prognostic factor (hazard ratio = 0.685, 95% confidence interval : 0.563-0.832, p = 0.0002). These results were consistent with the findings of case-control studies of lung cancer screening programs in the late period recently conducted in Japan, which also showed a greater efficacy for screening than for previous case-control studies in the early period.
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Affiliation(s)
- Takuji Kitajima
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
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Hiraki A, Murakami T, Aoe K, Sueoka E, Sueoka N, Taguchi K, Kamei T, Sugi K, Ueoka H, Kishimoto T. Heterogeneous nuclear ribonucleoprotein B1 expression in malignant mesothelioma. Cancer Sci 2006; 97:1175-81. [PMID: 16939492 DOI: 10.1111/j.1349-7006.2006.00311.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Heterogeneous nuclear ribonucleoprotein B1, an RNA-binding protein required for mRNA maturation, reportedly is overexpressed in early lung cancer and in several other tumors, including precancerous lesions. Expression of the protein was assessed immunohistochemically in 39 specimens of malignant mesothelioma and five of non-neoplastic pleura, and by flow cytometry in a human epithelioid mesothelioma cell line. No tumor showed overexpression, but 29 of 39 cases showed modest expression. Patients whose tumors showed expression had significantly better survival rates than others. Epithelioid tumors and reactive mesothelial cells were more likely to express the protein than sarcomatoid tumors and resting mesothelial cells. Flow cytometric analysis of an epithelioid mesothelioma cell line demonstrated stronger expression in exponentially growing than growth-restricted cells. Heterogeneous nuclear ribonucleoprotein B1 is expressed widely in malignant mesotheliomas and in reactive mesothelial cells, but is not overexpressed. This protein may regulate proliferation linked with differentiation toward epithelioid morphology in mesothelial cells. Expression of the protein may be a prognostic indicator for patents with malignant mesothelioma.
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Affiliation(s)
- Akio Hiraki
- Department of Respiratory Medicine, NHO Sanjo National Hospital, Respiratory Disease center, Ube, Yamaguchi, Japan.
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50
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Aoe K, Hiraki A, Yamazaki K, Nakamura Y, Murakami T, Maeda T, Nishimura M, Sugi K, Ueoka H. Elevated pleural fluid RCAS1 is a diagnostic marker and outcome predictor in lung cancer patients. Int J Oncol 2006; 29:65-72. [PMID: 16773186] [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: 05/10/2023] Open
Abstract
RCAS1, a type II membrane protein also secreted in soluble form, may be important in tumor cell evasion of immune surveillance and contribute to the aggressiveness of human tumors. We examined the implications of elevated pleural fluid RCAS1 at the onset of effusion in lung cancer patients. Of 102 patients presenting with pleural effusion, 59 proved to have a malignant effusion and 43, nonmalignant. Malignant effusions exhibited higher RCAS1 concentrations than nonmalignant effusions (mean +/- SD; 36.3 +/- 114 vs. 2.7 +/- 1.8 U/ml; p=0.014). Lung cancer patients with pleural fluid RCAS1 concentrations below 15 U/ml had a longer mean survival than those with higher concentrations (4.7 vs. 1.7 months; p<0.05). By multivariate analysis, pleural fluid RCAS1 was an independent prognostic factor in lung cancer patients with effusion. In conclusion, RCAS1 determination at onset of pleural effusion is informative for both diagnosis and outcome prediction in lung cancer patients.
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Affiliation(s)
- Keisuke Aoe
- Department of Respiratory Medicine and Clinical Research, NHO Sanyo National Hospital, Respiratory Disease Center, Ube, Yamaguchi 755-0241, Japan.
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