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Yoshida Y, Toriyabe S, Imai H, Sasaki K, Kasahara Y, Ouchi K, Saijo K, Onodera K, Ishioka C. Nivolumab-induced Thrombotic Thrombocytopenic Purpura in Patients with Gastric Tube Cancer. Intern Med 2024:2931-23. [PMID: 38432967 DOI: 10.2169/internalmedicine.2931-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Recently, immune checkpoint inhibitors (ICIs) have been used to treat several cancer types. ICIs have been reported to cause a wide variety of immune-related adverse events, including endocrine, neurologic, gastrointestinal, and cutaneous disorders. Thrombotic thrombocytopenic purpura (TTP) is an autoimmune hematologic disorder characterized by the presence of autoantibodies against a disintegrin and metalloprotease with thrombospondin-1, member 13. Several previous cases of TTP were thought to have been caused by ICI treatment. We herein report a rare case of TTP that developed after long-term treatment with an ICI (nivolumab) for gastric tube cancer.
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Affiliation(s)
- Yuya Yoshida
- Department of Medical Oncology, Tohoku University Hospital, Japan
| | - Sakura Toriyabe
- Department of Medical Oncology, Tohoku University Hospital, Japan
| | - Hiroo Imai
- Department of Medical Oncology, Tohoku University Hospital, Japan
| | - Keiju Sasaki
- Department of Medical Oncology, Tohoku University Hospital, Japan
| | - Yuki Kasahara
- Department of Medical Oncology, Tohoku University Hospital, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Japan
| | - Ken Saijo
- Department of Medical Oncology, Tohoku University Hospital, Japan
| | - Koichi Onodera
- Department of Hematology, Tohoku University Hospital, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Japan
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Tagami K, Chiu SW, Kosugi K, Ishiki H, Hiratsuka Y, Shimizu M, Mori M, Kubo E, Ikari T, Arakawa S, Eto T, Shimoda M, Hirayama H, Nishijima K, Ouchi K, Shimoi T, Shigeno T, Yamaguchi T, Miyashita M, Morita T, Inoue A, Satomi E. Cancer Pain Management in Patients Receiving Inpatient Specialized Palliative Care Services. J Pain Symptom Manage 2024; 67:27-38.e1. [PMID: 37730073 DOI: 10.1016/j.jpainsymman.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023]
Abstract
CONTEXT Cancer pain is a common complication that is frequently undertreated in patients with cancer. OBJECTIVES This study is aimed at assessing the time needed to achieve cancer pain management goals through specialized palliative care (SPC). METHODS This was a multicenter, prospective, longitudinal study of inpatients with cancer pain who received SPC. Patients were continuously followed up until they considered cancer pain management successful, and we estimated this duration using the Kaplan-Meier method. We investigated the effectiveness of pain management using multiple patient-reported outcomes (PROs) and quantitative measures, including pain intensity change in the Brief Pain Inventory. A paired-sample t-test was used to compare the pain intensity at the beginning and end of the observation period. RESULTS Cancer pain management based on the PROs was achieved in 87.9% (385/438) of all cases. In 94.5% (364/385) of these cases, cancer pain management was achieved within 1 week, and the median time to pain management was 3 days (95% confidence interval [CI], 2-3). The mean worst pain intensity in the last 24 h at the start and end of observation were 6.9 ± 2.2 and 4.0 ± 2.3, respectively, with a difference of -2.9 (95% CI, -3.2 to -2.6; p < 0.01). Overall, 81.6% of the patients reported satisfaction with cancer pain management, and 62 adverse events occurred. CONCLUSION SPC achieved cancer pain management over a short period with a high level of patient satisfaction resulting in significant pain reduction and few documented adverse events.
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Affiliation(s)
- Keita Tagami
- Department of Palliative Medicine (K.T., Y.H., T.I., A.I.), Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
| | - Shih-Wei Chiu
- Division of Biostatistics (S-W.C., M.S., T.Y.), Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kazuhiro Kosugi
- Department of Palliative Medicine (K.K., E.K., T.E.), National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine (H.I., S.A., E.S.), National Cancer Center Hospital, Tokyo, Japan
| | - Yusuke Hiratsuka
- Department of Palliative Medicine (K.T., Y.H., T.I., A.I.), Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; Department of Palliative Medicine (Y.H.), Takeda General Hospital, Aizu Wakamatsu, Fukushima, Japan
| | - Masaki Shimizu
- Department of Palliative Care (M.S.), Kyoto-Katsura Hospital, Nishikyo-ku, Kyoto, Japan
| | - Masanori Mori
- Division of Palliative and Supportive Care (M.M., T.M.), Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan
| | - Emi Kubo
- Department of Palliative Medicine (K.K., E.K., T.E.), National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Tomoo Ikari
- Department of Palliative Medicine (K.T., Y.H., T.I., A.I.), Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Sayaka Arakawa
- Department of Palliative Medicine (H.I., S.A., E.S.), National Cancer Center Hospital, Tokyo, Japan
| | - Tetsuya Eto
- Department of Palliative Medicine (K.K., E.K., T.E.), National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Mayu Shimoda
- Division of Biostatistics (S-W.C., M.S., T.Y.), Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hideyuki Hirayama
- Department of Palliative Nursing (H.H., T.S., M.M.), Tohoku University Graduate School of Medicine, Aoba-Ku, Sendai, Japan
| | - Kaoru Nishijima
- Department of Palliative Care (K.N.), Kyowakai Medical Corporation, Daini Kyoritsu Hospital, Kawanishi, Hyogo, Japan
| | - Kota Ouchi
- Department of Medical Oncology (K.O.), Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Tatsunori Shimoi
- Department of Medical Oncology (T.S.), National Cancer Center Hospital, Tokyo, Japan
| | - Tomoko Shigeno
- Department of Palliative Nursing (H.H., T.S., M.M.), Tohoku University Graduate School of Medicine, Aoba-Ku, Sendai, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics (S-W.C., M.S., T.Y.), Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing (H.H., T.S., M.M.), Tohoku University Graduate School of Medicine, Aoba-Ku, Sendai, Japan
| | - Tatsuya Morita
- Division of Palliative and Supportive Care (M.M., T.M.), Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan; Research Association for Community Health (T.M.), Hamamatsu, Shizuoka, Japan
| | - Akira Inoue
- Department of Palliative Medicine (K.T., Y.H., T.I., A.I.), Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Eriko Satomi
- Department of Palliative Medicine (H.I., S.A., E.S.), National Cancer Center Hospital, Tokyo, Japan
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Taniguchi SH, Komine K, Takenaga N, Yoshida Y, Sasaki K, Kawamura Y, Kasahara Y, Ouchi K, Imai H, Saijo K, Shirota H, Takahashi M, Ishioka C. FOLFIRI Chemotherapy for Patients With Metastatic Urachal Carcinoma. Anticancer Res 2023; 43:5699-5704. [PMID: 38030182 DOI: 10.21873/anticanres.16775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND/AIM Urachal carcinoma is a rare cancer, with limited evidence regarding systemic chemotherapy for metastatic urachal carcinoma. This study aimed to evaluate the efficacy and safety of a combination therapy of 5-fluorouracil and irinotecan (FOLFIRI) in patients with metastatic urachal carcinoma. PATIENTS AND METHODS Patients with metastatic urachal carcinoma treated with FOLFIRI between March 2008 and April 2023 at the Department of Medical Oncology, Tohoku University Hospital, were retrospectively analyzed using medical records. RESULTS Six patients with urachal carcinoma received FOLFIRI. The histological type was adenocarcinoma in all patients. The metastatic or recurrent sites were the peritoneum, lungs, lymph nodes, and local relapse sites. Three patients received FOLFIRI as first-line chemotherapy, and the other three received FOLFIRI as second-line chemotherapy. Two patients had only non-measurable lesions as the targets of tumor response. The best response was the stable disease or non-complete response/non-progressive disease in four patients, with a disease control rate of 67%. The median progression-free survival was 7.5 months. In two patients with ascites only as the site of metastasis, the amount of ascites and serum tumor marker levels decreased after FOLFIRI was initiated. Grade 3/4 toxicities included grade 3 neutropenia in one patient and grade 3 diarrhea in one patient. CONCLUSION FOLFIRI has modest efficacy and good tolerability for the treatment of metastatic urachal carcinoma.
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Affiliation(s)
| | - Keigo Komine
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Noriko Takenaga
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Yuya Yoshida
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiju Sasaki
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Yoshifumi Kawamura
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Yuki Kasahara
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Hiroo Imai
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Ken Saijo
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Hidekazu Shirota
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Masanobu Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan;
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Terui Y, Suzuki H, Chikata A, Hanaki Y, Komatsu Y, Ota H, Fujishima F, Umezawa R, Ouchi K, Sato H, Satoh T, Miyamichi-Yamamoto S, Yaoita N, Hayashi H, Nochioka K, Takahama H, Nogami A, Saiki Y, Yasuda S. Intractable Ventricular Tachycardia Prior to an Overt Cardiac Tumor Mass of Metastatic Cardiac Rhabdomyosarcoma (Spindle-cell Type). Intern Med 2023:2568-23. [PMID: 37926544 DOI: 10.2169/internalmedicine.2568-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
We herein report a 37-year-old man who experienced recurrence of metastatic cardiac rhabdomyosarcoma along with intractable ventricular tachycardia (VT) 7 years after resection of rhabdomyosarcoma in his right elbow. At 36 years old, he developed VT unresponsive to radiofrequency catheter ablation (RFCA). Initially, the cardiac tumor was not detected, but it gradually grew in size at the RFCA site. A surgical biopsy confirmed the diagnosis of metastatic cardiac rhabdomyosarcoma. Despite radiation therapy, cardiac tumor progression and VT instability could not be prevented. Ultimately, the patient died 27 months after the initial documentation of VT.
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Affiliation(s)
- Yosuke Terui
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hideaki Suzuki
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Akio Chikata
- Department of Cardiology, Toyama Prefectural Central Hospital, Japan
| | - Yuichi Hanaki
- Department of Cardiology, Institute of Medicine, University of Tsukuba, Japan
| | - Yuki Komatsu
- Department of Cardiology, Institute of Medicine, University of Tsukuba, Japan
| | - Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Japan
| | | | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Kota Ouchi
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Haruka Sato
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Taijyu Satoh
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | | | - Nobuhiro Yaoita
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hideka Hayashi
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Kotaro Nochioka
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hiroyuki Takahama
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Akihiko Nogami
- Department of Cardiology, Institute of Medicine, University of Tsukuba, Japan
| | - Yoshikatsu Saiki
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Japan
| | - Satoshi Yasuda
- Departments of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
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Imai H, Saijo K, Kawamura Y, Kodera S, Komine K, Iwasaki T, Takenaga N, Kasahara Y, Ouchi K, Shirota H, Takahashi M, Ishioka C. Comparison of efficacy and safety between carboplatin-etoposide and cisplatin-etoposide combination therapy in patients with advanced neuroendocrine carcinoma, retrospective study. Oncology 2023:000534747. [PMID: 37903486 DOI: 10.1159/000534747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 10/20/2023] [Indexed: 11/01/2023]
Abstract
INTRODUCTION Neuroendocrine carcinoma (NEC) is characterized by a poor prognosis and is generally treated with platinum and etoposide combination therapy as first-line chemotherapy. However, it remains uncertain whether carboplatin and etoposide combination therapy (CE) and cisplatin and etoposide combination therapy (PE) have comparable treatment efficacy. In this retrospective analysis, we compared the efficacy and safety of CE and PE in patients with NEC. METHODS We retrospectively reviewed the patient's clinical record from 2005 to 2022 at the Department of Medical Oncology, Tohoku University Hospital. Patients who received either CE or PE were included in the study. Statistical analyses were performed using JMP Pro 16.0 (SAS Institute Inc., Cary, N.C., USA). RESULTS A total of 104 patients were enrolled, with 73 patients assigned to the CE group and 31 patients assigned to the PE group. Statistically, the response rate, progression-free survival (PFS) time and overall survival (OS) time were 42.6%, 5.1 months (95%CI: 3.5-6.3) and 13.6 months (95%CI: 8.9-17.4), respectively, in the CE groups and 44.4%, 5.6 months (95%CI: 3.1-7.0) and 12.5 months (95%CI: 11.2-14.6), respectively, in the PE groups. There was no significant difference in treatment efficacy between the CE and the PE groups. However, the number of patients with elevated creatinine (3.35 mg/dl and 3.88 mg/dl in two patients, respectively) was significantly higher in the PE group than in the CE group. CONCLUSION The efficacy of CE and PE in patients with NEC is comparable. However, the incidence of renal dysfunction was found to be significantly higher in the PE group than in the CE group.
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Hiratsuka Y, Tagami K, Inoue A, Sato M, Matsuda Y, Kosugi K, Kubo E, Natsume M, Ishiki H, Arakawa S, Shimizu M, Yokomichi N, Chiu SW, Shimoda M, Hirayama H, Nishijima K, Ouchi K, Shimoi T, Shigeno T, Yamaguchi T, Miyashita M, Morita T, Satomi E. Prevalence of opioid-induced adverse events across opioids commonly used for analgesic treatment in Japan: a multicenter prospective longitudinal study. Support Care Cancer 2023; 31:632. [PMID: 37843639 PMCID: PMC10579154 DOI: 10.1007/s00520-023-08099-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE Although opioids have been shown to be effective for cancer pain, opioid-induced adverse events (AEs) are common. To date, little is known about the differences in risks of AEs by opioid type. This study was performed to compare the prevalence of AEs across opioids commonly used for analgesic treatment in Japan. METHODS This study was conducted as a preplanned secondary analysis of a multicenter prospective longitudinal study of inpatients with cancer pain who received specialized palliative care for cancer pain relief. We assessed daily AEs until termination of follow-up. We rated the severity of AEs based on the Common Terminology Criteria for Adverse Events version 5.0. We computed adjusted odds ratios for each AE (constipation, nausea and vomiting, delirium, and drowsiness) with the following variables: opioid, age, sex, renal dysfunction, and primary cancer site. RESULTS In total, 465 patients were analyzed. Based on the descriptive analysis, the top four most commonly used opioids were included in the analysis: oxycodone, hydromorphone, fentanyl, and tramadol. With respect to the prevalence of AEs among all analyzed patients, delirium (n = 25, 6.3%) was the most frequent, followed by drowsiness (n = 21, 5.3%), nausea and vomiting (n = 19, 4.8%), and constipation (n = 28, 4.6%). The multivariate logistic analysis showed that no single opioid was identified as a statistically significant independent predictor of any AE. CONCLUSION There was no significant difference in the prevalence of AEs among oxycodone, fentanyl, hydromorphone, and tramadol, which are commonly used for analgesic treatment in Japan.
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Affiliation(s)
- Yusuke Hiratsuka
- Department of Palliative Medicine, Takeda General Hospital, Aizu Wakamatsu, Japan.
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Keita Tagami
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mamiko Sato
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasufumi Matsuda
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuhiro Kosugi
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Emi Kubo
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Maika Natsume
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Sayaka Arakawa
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Masaki Shimizu
- Department of Palliative Care, Kyoto-Katsura Hospital, Kyoto, Japan
| | - Naosuke Yokomichi
- Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Shih-Wei Chiu
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mayu Shimoda
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideyuki Hirayama
- Department of Palliative Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kaoru Nishijima
- Department of Palliative Care, Kyowakai Medical Corporation, Daini Kyoritsu Hospital, Kawanishi, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Tatsunori Shimoi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tomoko Shigeno
- Department of Palliative Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tatsuya Morita
- Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
- Research Association for Community Health, Hamamatsu, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
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Ueta R, Imai H, Saijo K, Kawamura Y, Kodera S, Komine K, Ouchi K, Kasahara Y, Taniguchi S, Yoshida Y, Sasaki K, Shirota H, Takahashi M, Ishioka C. Antibiotics May Interfere with Nivolumab Efficacy in Patients with Head and Neck Squamous Cell Carcinoma. Oncology 2023; 102:252-259. [PMID: 37708868 DOI: 10.1159/000533860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/11/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Patients with the head and neck squamous cell carcinoma (SCC) are often treated with immune checkpoint inhibitors (ICIs). Recently, antibiotic intake was reported to lower the efficacy of ICIs in patients with several types of cancers. However, it is unclear if antibiotics affect the efficacy of ICIs in patients with head and neck SCC. We retrospectively assessed the influence of antibiotics on the treatment efficacy of nivolumab, an ICI, in patients with head and neck SCC. METHODS We reviewed the medical records of patients with head and neck SCC treated with nivolumab at the Department of Medical Oncology, Tohoku University Hospital, between 2017 and 2021. Patients who received oral or intravenous antibiotics from a month before the day of nivolumab initiation to the day of the first imaging evaluation of ICI efficacy were assigned to the antibiotic-treated group. The remaining patients were assigned to the antibiotic-untreated group. The response rate (RR), progression-free survival (PFS), and overall survival time (OS) of both groups were compared. RESULTS Forty-five patients were assigned to the antibiotic-treated group and 19 to the antibiotic-untreated group. The RR, median PFS, and median OS of the antibiotic-treated group were 23.7%, 3.2 months (95% confidential interval [CI]: 2.0-4.1), and 8.4 months (95% CI: 5.3-15.1) and those of the antibiotic-untreated group were 42.1%, 5.8 months (95% CI: 2.3-16.7), and 18.4 months (95% CI: 6.2-23.1), respectively. The PFS of the antibiotic-untreated group was significantly longer than that of the antibiotic-treated group. CONCLUSION Our findings indicate that antibiotic treatment significantly shortens the PFS with nivolumab therapy in patients with head and neck SCC.
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Affiliation(s)
- Reio Ueta
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroo Imai
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan,
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan,
| | - Ken Saijo
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshifumi Kawamura
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shuto Kodera
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keigo Komine
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yuki Kasahara
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sakura Taniguchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yuya Yoshida
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiju Sasaki
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hidekazu Shirota
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masanobu Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Wakayama S, Ouchi K, Takahashi S, Yamada Y, Komatsu Y, Shimada K, Yamaguchi T, Shirota H, Takahashi M, Ishioka C. TP53 Gain-of-Function Mutation is a Poor Prognostic Factor in High-Methylated Metastatic Colorectal Cancer. Clin Colorectal Cancer 2023; 22:327-338. [PMID: 37355363 DOI: 10.1016/j.clcc.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/26/2023] [Accepted: 06/02/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Neither TP53 mutation nor DNA methylation status has been established as a biomarker alone of metastatic colorectal cancer. We analyzed the association between TP53 mutation functional subtypes and genome-wide DNA methylation status (GWMS) as combined prognostic markers. METHODS Patient clinical data were obtained from the TRICOLORE study, a randomized phase III trial. The TP53 mutations were classified into wild-type, gain-of-function (GOF) mutations, and non-gain-of-function (non-GOF) mutations. GWMS of the tumor tissues classified them into high-methylated colorectal cancer (HMCC) and low-methylated colorectal cancer (LMCC). Overall survival (OS) was compared based on these subgroups. RESULTS Of the 209 patients, 60 (28.7%) were HMCC and 149 (71.3%) were LMCC, 35 (16.7%) were TP53 wild-type and 174 (83.3%) were TP53 mutants including 79 (45.4%) GOF mutations and 95 (54.6%) non-GOF mutations. The OS of the HMCC group was shorter than that of the LMCC group (median 25.3 vs. 40.3 months, P < .001, hazard ratio 1.87) in the total cohort. The combined subgroup analyses of GWMS and TP53 mutation subtypes showed that the HMCC/GOF group had significantly shorter OS than the HMCC/non-GOF group, the LMCC/GOF group, and the LMCC/non-GOF group (median 17.7; 35.3, 40.3, and 41.2 months, P = .007, P < .001, and P < .001, respectively), regardless of the primary tumor location. By the multivariate analysis, only HMCC (P = .009) was a poor prognostic factor in the GOF mutation group. CONCLUSIONS TP53 GOF with HMCC is a newly identified poorest prognostic molecular subset in metastatic colorectal cancer.
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Affiliation(s)
- Shonosuke Wakayama
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, Japan; Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, Japan; Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Shin Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, Japan; Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Yasuhide Yamada
- Comprehensive Cancer Center, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yoshito Komatsu
- Department of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, Sapporo, Hokkaido, Japan
| | - Ken Shimada
- Department of Internal Medicine, Division of Medical Oncology, Showa University Koto Toyosu Hospital, Koto-ku, Tokyo, Japan
| | - Tatsuro Yamaguchi
- Department of Clinical Genetics, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - Hidekazu Shirota
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, Japan; Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Masanobu Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, Japan; Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, Japan; Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
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Saijo K, Imai H, Ouchi K, Sasaki K, Yoshida Y, Kawamura Y, Taniguchi S, Kasahara Y, Komine K, Shirota H, Takahashi M, Ishioka C. Depth of response may predict clinical outcome in patients with recurrent/metastatic head and neck cancer treated with pembrolizumab-containing regimens. Front Oncol 2023; 13:1230731. [PMID: 37664016 PMCID: PMC10469278 DOI: 10.3389/fonc.2023.1230731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/24/2023] [Indexed: 09/05/2023] Open
Abstract
Background Pembrolizumab-containing regimens are standards of care for recurrent and metastatic head and neck squamous cell carcinoma (R/M HNSCC). The depth of response (DpR) predicts the survival of patients with several types of solid cancers; however, its association with the survival outcomes of patients with R/M HNSCC treated with pembrolizumab-containing regimens remains unclear. Methods This study included 66 patients with R/M HNSCC who received a pemblolizumab-containing regimen as a first-line therapy at Tohoku University Hospital, Sendai, Japan. The patients' characteristics, combined positive score, baseline tumor size, tumor response, DpR, overall survival (OS), progression-free survival (PFS), PFS2, and adverse events were reviewed. The associations between DpR and survival outcomes were analyzed. Results The 1 year-OS and 1 year-PFS rates of pembrolizumab-containing regimens were 69.4% and 24.4%, respectively. The response rate was 28.8%. The mean and median values of tumor change from baseline were 5.1% and -9.0%. In the correlation analysis, a significant negative correlation was observed between tumor change rate from baseline and survival outcomes (OS: r= -0.41, p=0.0017; PFS: r=-0.49, p<0.001). In the multivariate analysis, DpR with tumor change of ≤-45 was associated with better OS and PFS. Conclusion DpR induced by pembrolizumab-containing regimens may be a predictive factor for OS and PFS in patients with R/M HNSCC.
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Affiliation(s)
- Ken Saijo
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate school of Medicine, Sendai, Japan
| | - Hiroo Imai
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate school of Medicine, Sendai, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate school of Medicine, Sendai, Japan
| | - Keiju Sasaki
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate school of Medicine, Sendai, Japan
| | - Yuya Yoshida
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate school of Medicine, Sendai, Japan
| | - Yoshifumi Kawamura
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate school of Medicine, Sendai, Japan
| | - Sakura Taniguchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate school of Medicine, Sendai, Japan
| | - Yuki Kasahara
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate school of Medicine, Sendai, Japan
| | - Keigo Komine
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate school of Medicine, Sendai, Japan
| | - Hidekazu Shirota
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate school of Medicine, Sendai, Japan
| | - Masanobu Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate school of Medicine, Sendai, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Tohoku University Graduate school of Medicine, Sendai, Japan
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10
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Osumi H, Takashima A, Ooki A, Yoshinari Y, Wakatsuki T, Hirano H, Nakayama I, Okita N, Sawada R, Ouchi K, Fukuda K, Fukuoka S, Ogura M, Takahari D, Chin K, Shoji H, Kato K, Ishizuka N, Boku N, Yamaguchi K, Shinozaki E. A multi-institutional observational study evaluating the incidence and the clinicopathological characteristics of NeoRAS wild-type metastatic colorectal cancer. Transl Oncol 2023; 35:101718. [PMID: 37364334 DOI: 10.1016/j.tranon.2023.101718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/30/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
PURPOSE As circulating tumor DNA (ctDNA) measurement becomes more widespread, the "NeoRAS" phenomenon, where tissue rat sarcoma viral oncogene homolog (RAS) status converts from mutant (MT) to wild-type (WT) after treatment in metastatic colorectal cancer (mCRC), is gaining attention because ineffective epidermal growth factor receptor (EGFR) inhibitors may made effective. This study investigated its incidence and clinicopathological characteristics. PATIENTS AND METHODS In total, 107 mCRC patients (refractory or intolerant to previous chemotherapies) with tissue RAS MT were enrolled in four institutions from June 2021 to August 2022. The RAS status in ctDNA was assessed using OncoBEAM™ RAS CRC assay. Clinicopathologic features were compared between patients according to their RAS status in ctDNA, whether WT conversion was noted or not. RESULTS The incidence rate of NeoRAS WT mCRC was 21.5% (23/107). According to tissue RAS mutation sites, NeoRAS WT frequency in patients with KRAS mutation in exon 2 was significantly lower than those in exon 3 and 4 or NRAS (18.2% [18/99] vs 62.5% [5/8], P = 0.011). Regarding clinical background, there were significant differences in NeoRAS WT frequency between male vs female patients (30.6% [19/62] vs 8.9% [4/45], P = 0.008), and absence vs presence of liver metastasis (38.6% [17/44] vs 9.5% [6/63], P < 0.001). Comparing the two groups divided by the median value, NeoRAS WT was associated with smaller tumor diameter (>60.9 mm vs ≤, 3.8% [2/53] vs 38.9% [21/54], P < 0.001), lower carcinoembryonic antigen level (>38.2 ng/ml vs ≤, 11.3% [6/53] vs 31.5% [17/54], P = 0.018), and lower carbohydrate antigen 19-9 level (>158.0 U/ml vs ≤, 9.4% [5/53] vs 33.3% [18/54], P = 0.004). In the logistic regression multivariate analysis, liver metastasis absence (Odds ratio [OR], 4.62; P = 0.019), smaller tumor diameter (OR, 7.92; P = 0.012), and tissue RAS MT in other than KRAS exon 2 (OR, 9.04; P = 0.026) were significantly related to the conversion to NeoRAS WT in ctDNA. CONCLUSIONS Original RAS variants in tissue, tumor diameter, and liver metastasis are related to conversion to NeoRAS WT mCRC in ctDNA.
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Affiliation(s)
- Hiroki Osumi
- Department of Gastroenterological Chemotherapy, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Atsuo Takashima
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Akira Ooki
- Department of Gastroenterological Chemotherapy, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yuri Yoshinari
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Takeru Wakatsuki
- Department of Gastroenterological Chemotherapy, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hidekazu Hirano
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Izuma Nakayama
- Department of Gastroenterological Chemotherapy, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Natsuko Okita
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Ryoichi Sawada
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
| | - Koshiro Fukuda
- Department of Gastroenterological Chemotherapy, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shota Fukuoka
- Department of Gastroenterological Chemotherapy, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mariko Ogura
- Department of Gastroenterological Chemotherapy, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Daisuke Takahari
- Department of Gastroenterological Chemotherapy, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Keisho Chin
- Department of Gastroenterological Chemotherapy, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hirokazu Shoji
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Ken Kato
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Naoki Ishizuka
- Department of Clinical Trial Planning and Management, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Narikazu Boku
- Department of Oncology and General Medicine, IMSUT Hospital, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Kensei Yamaguchi
- Department of Gastroenterological Chemotherapy, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Eiji Shinozaki
- Department of Gastroenterological Chemotherapy, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
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11
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Sasaki K, Takahashi S, Ouchi K, Otsuki Y, Wakayama S, Ishioka C. Different impacts of TP53 mutations on cell cycle-related gene expression among cancer types. Sci Rep 2023; 13:4868. [PMID: 36964217 PMCID: PMC10039000 DOI: 10.1038/s41598-023-32092-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/22/2023] [Indexed: 03/26/2023] Open
Abstract
Functional properties caused by TP53 mutations are involved in cancer development and progression. Although most of the mutations lose normal p53 functions, some of them, gain-of-function (GOF) mutations, exhibiting novel oncogenic functions. No reports have analyzed the impact of TP53 mutations on the gene expression profile of the p53 signaling pathway across cancer types. This study is a cross-cancer type analysis of the effects of TP53 mutations on gene expression. A hierarchical cluster analysis of the expression profile of the p53 signaling pathway classified 21 cancer types into two clusters (A1 and A2). Changes in the expression of cell cycle-related genes and MKI67 by TP53 mutations were greater in cluster A1 than in cluster A2. There was no distinct difference in the effects between GOF and non-GOF mutations on the gene expression profile of the p53 signaling pathway.
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Affiliation(s)
- Keiju Sasaki
- Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Shin Takahashi
- Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Kota Ouchi
- Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Yasufumi Otsuki
- Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Shonosuke Wakayama
- Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Chikashi Ishioka
- Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, Japan.
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
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12
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Furukawa M, Ueno M, Sakai D, Ouchi K, Hamamoto Y, Aikata H, Ozaka M, Tsumura H, Tsuji K, Kubo S, Nishina T, Katanuma A, Morizane C, Ikeda M, Mizuno N, Inagaki T, Shioji K, Furuse J. A multicenter, single-arm, phase II study of nivolumab in patients with biliary tract cancer with a PD-L1 combined positive score ≥ 1. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.533] [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: 01/25/2023] Open
Abstract
533 Background: Patients with advanced biliary tract cancer (BTC) have a poor prognosis, and high unmet medical needs still exist for the treatment of this disease. Nivolumab has shown its effectiveness against multiple cancer types, especially those with PD-L1 expression. This study assessed the efficacy and safety of nivolumab in BTC patients with a combined positive score (CPS) ≥ 1 who were refractory or intolerant to the standard of care (SOC): gemcitabine, cisplatin and tegafur/gimeracil/oteracil (S-1). Methods: This was a single-arm, multicenter, open-label, prospective phase II study. Key eligibility criteria were as follows: having unresectable or recurrent BTC (intrahepatic bile duct cancer, extrahepatic bile duct cancer, gallbladder cancer, or ampullary cancer); being refractory or intolerant to SOC; having adequate hepatic, renal and hematological function; and having a CPS ≥ 1 in central assessment. Patients received nivolumab (480 mg, every 4 weeks) until disease progression, clinical deterioration, or unacceptable toxicity. The primary endpoint was objective response rate (ORR) assessed by the central review according to RECIST 1.1. The secondary endpoints included overall survival (OS), progression-free survival (PFS), and safety. Results: A total of 84 patients were enrolled between Mar 11, 2020 and Mar 15, 2021, of them 12 received one regimen and 72 received two or more regimens. The median follow-up period was 6.90 months. ORR per central assessment was 10.7% (CR: 3.6%, PR: 7.1%), and ORR per investigator assessment was 15.5% (CR: 2.4%, PR: 13.1%). The median PFS per central and investigator assessment was 1.02 (95% CI 0.95–1.77) months and 2.48 (95% CI 1.87–2.83) months, respectively. The median OS was 6.90 (95% CI 5.26–9.20) months. The median duration of response per central and investigator assessment was not reached (range 2.8–13.0+) and 10.15 (range 2.0–12.8+) months, respectively. The 1-year survival rate was 25.3% (95% CI 15.4–36.4). The most frequent treatment-related adverse events were pyrexia (19.0%), pruritus (16.7%), and decreased appetite (13.1%). Conclusions: Nivolumab may have some activity with a durable response and a manageable safety profile in heavily treated BTC patients with CPS ≥ 1. Clinical trial information: JapicCTI-205097 .
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Affiliation(s)
| | | | | | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Yasuo Hamamoto
- Division of outpatient chemotherapy, Cancer center, Keio University School of Medicine, Tokyo, Japan
| | | | - Masato Ozaka
- Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Tokyo, Japan
| | | | - Kunihiro Tsuji
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Shoji Kubo
- Osaka Metropolitan University, Osaka, Japan
| | - Tomohiro Nishina
- National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Akio Katanuma
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | | | | | - Nobumasa Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | | | | | - Junji Furuse
- Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan
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13
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Yoshinami Y, Osumi H, Takashima A, Sawada R, Ouchi K, Wakatsuki T, Ooki A, Nakayama I, Fukuoka S, Ogura M, Takahari D, Chin K, Hirano H, Shoji H, Okita NO, Boku N, Kato K, Ishizuka N, Yamaguchi K, Shinozaki E. A multi-institutional observational study evaluating the incidence and the clinicopathological characteristics of Neo RAS wild-type metastatic colorectal cancer. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.206] [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: 01/25/2023] Open
Abstract
206 Background: The ’’Neo RAS’’ phenomenon, in which tissue rat sarcoma viral oncogene homolog ( RAS) status converts from mutant (MT) to wild-type (WT) after treatment in metastatic colorectal cancer (mCRC), is gaining attention because epidermal growth factor receptor (EGFR) inhibitors, which were originally considered to be ineffective, may converted to be effective. This multi-center study investigated its incidence and clinicopathological characteristics that are still unclear. Methods: 107 mCRC patients with tissue RAS MT, confirmed using MEBGEN RASKET-B, who were refractory or intolerant to previous chemotherapies, including fluoropyrimidines, oxaliplatin, or irinotecan were enrolled in 4 institutions from June 2021 to August 2022. The RAS status in ctDNA was investigated after prior chemotherapy using ONCOBEAMTM RAC CRC. Clinicopathological characteristics were compared between patients with RAS MT and RAS WT (Neo RAS) in ctDNA. Results: The incidence of Neo RAS WT mCRC was 21.5% (23/107). The frequency of Neo RAS in KRAS exon 2 was significantly lower than that in other alleles such as exon 3 and 4 or NRAS (18.2% [18/99] vs 62.5% [5/8], P = 0.011). There were significant differences in frequency of Neo RAS between male vs female (30.6% [19/62] vs 8.9% [4/45], P = 0.008), absence vs presence of liver metastasis (38.6% [17/44] vs 9.5% [6/63], P < 0.001), and between two groups divided at the median: tumor diameter (> 60.9 mm vs ≤, 3.8% [2/53] vs 38.9% [21/54], P < 0.001), carcinoembryonic antigen level (> 38.2 ng/ml vs ≤, 11.3% [6/53] vs 31.5% [17/54], P = 0.018), carbohydrate antigen 19-9 level (> 158.0 U/ml vs ≤, 9.4% [5/53] vs 33.3% [18/54], P = 0.004). Logistic regression multivariate analysis, absence of liver metastasis (Odds ratio [OR], 4.62; P = 0.019), smaller tumor diameter (OR, 7.92; P = 0.012) and tissue RAS MT in other than KRAS exon 2 (OR, 9.04; P = 0.026) were significantly related to the appearance of Neo RAS WT mCRC. Conclusions: Original RAS status in tissue, tumor diameter and liver metastasis are related to conversion to Neo RAS WT mCRC.
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Affiliation(s)
- Yuri Yoshinami
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroki Osumi
- Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Atsuo Takashima
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Ryoichi Sawada
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
| | - Takeru Wakatsuki
- Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Akira Ooki
- The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Izuma Nakayama
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shota Fukuoka
- The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mariko Ogura
- The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Daisuke Takahari
- Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Keisho Chin
- Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hidekazu Hirano
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hirokazu Shoji
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Natsuko Okita Okita
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Narikazu Boku
- Department of Oncology and General Medicine, IMSUT Hospital, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Ken Kato
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Naoki Ishizuka
- Department of Clinical Trial Planning and Management, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kensei Yamaguchi
- Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Eiji Shinozaki
- Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
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14
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Ouchi K, Wakayama S, Takahashi S, Yamada Y, Komatsu Y, Shimada K, Yamaguchi T, Shirota H, Takahashi M, Ishioka C. TP53 gain of function mutation as a prognostic factor in high-methylated metastatic colorectal cancer: Translational research of TRICOLORE study. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.179] [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: 01/25/2023] Open
Abstract
179 Background: TP53 tumor suppressor gene is frequently inactivated by loss-of-function mutations. Some of the mutations gain additional oncogenic functions and are known as gain-of-function (GOF) mutations. This study analyzed the association among primary tumor site (PS), genome-wide DNA methylation status (GWMS), and TP53 mutation subtypes about prognosis in metastatic colorectal cancer (mCRC). Methods: Tumor tissues of mCRC patients registered in the TRICOLORE Study (clinical trial number) were analyzed for GWMS and TP53 mutation as translational research and were classified into high-methylated colorectal cancer (HMCC) and low-methylated colorectal cancer (LMCC) for GWMS, and wild-type , GOF mutation and non-GOF mutation for TP53 mutation. Overall survival (OS) was compared between single or combined subgroups, and Cox regression analysis was performed to identify factors contributing to OS. Results: A total of 209 patients were analyzed, HMCC and LMCC were 60 (28.7%) and 149 (71.3%), respectively. TP53 wild-type , GOF mutation and non-GOF mutation were 35 (16.7%), 79 (37.8%) and 95 (45.5%), respectively. HMCC showed a significantly worse prognosis than LMCC (median OS 25.3 vs. 40.3 months, P < 0.01, hazard ratio 1.87). Combining GWMS and TP53 mutation subtypes about prognosis, the HMCC/GOF (n = 26) group had a significantly poorer prognosis than the other three groups including HMCC/non-GOF (n = 22), LMCC/GOF (n = 53), and LMCC/non-GOF groups (n = 73) (median OS 17.7, 35.3, 40.3, 41.2 months, p = 0.007, p < 0.001, p < 0.001, respectively). The HMCC/GOF group had a poorer prognosis than the other 3 groups regardless of the PS. In the multivariate analysis in the GOF mutation subgroup, HMCC (p < 0.01) was the only poor prognostic factor, while right-sided colon cancer (p = 0.03) and RAS mutations (p = 0.01) were significant poor prognostic factors in the multivariate analysis in the non-GOF mutation subgroup. Conclusions: TP53 gain of function mutations are independent poor prognostic factors in high-methylated metastatic colorectal cancer.
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Affiliation(s)
- Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Shonosuke Wakayama
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Shin Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Yasuhide Yamada
- Comprehensive Cancer Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshito Komatsu
- Department of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, Sapporo, Japan
| | - Ken Shimada
- Department of Internal Medicine, Division of Medical Oncology, Showa University Koto Toyosu Hospital, Koto-Ku, Japan
| | - Tatsuro Yamaguchi
- Department of Clinical Genetics, Tokyo Metroplitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-Ku, Japan
| | - Hidekazu Shirota
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Masanobu Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
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15
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Takahashi S, Ouchi K, Sakamoto Y, Mori T, Shimodaira H, Takahashi M, Ohori H, Kudo C, Takahashi Y, Imai H, Akiyama S, Takahashi M, Suto T, Murakawa Y, Oishi T, Isobe H, Okada Y, Kawai S, Yoshioka T, Sato T, Shindo Y, Sugiyama S, Komine K, Chiba N, Okita A, Yamaguchi T, Ishioka C. Phase II study of biweekly cetuximab plus mFOLFOX6 or mFOLFIRI as second-line treatment for metastatic colorectal cancer and exploratory analysis of associations between DNA methylation status and the efficacy of the anti-EGFR antibody: T-CORE1201. J Gastrointest Oncol 2023; 14:676-691. [DOI: 10.21037/jgo-22-862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 02/10/2023] [Indexed: 03/29/2023] Open
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16
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Stephens K, Ball E, Kamdar N, Unruh M, Ouchi K, Crandall C, George N. 68 Extracorporeal Membrane Oxygenation for Cardiac Arrest: Does Age Matter? Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.091] [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: 11/27/2022]
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17
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Ouchi K, Takahashi S, Osumi H, Otsuki Y, K. Sasaki, Shinozaki E, Ishioka C. 348P Prediction of sensitivity to anti-EGFR inhibitors in salvage-line treatment for metastatic colorectal cancer using a modified MethyLight assay. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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18
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Osumi H, Ishizuka N, Takashima A, Kumekawa Y, Nakano D, Shiozawa M, Denda T, Sawada R, Ouchi K, Wakatsuki T, Narikazu B, Kato K, Yamaguchi K, Shinozaki E. Multicentre single-arm phase II trial evaluating the safety and effiCacy of Panitumumab and iRinOtecan in NeoRAS Wild-type mEtaStatic colorectal cancer patientS (C-PROWESS trial): study protocol. BMJ Open 2022; 12:e063071. [PMID: 36581973 PMCID: PMC9438189 DOI: 10.1136/bmjopen-2022-063071] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 01/05/2023] Open
Abstract
INTRODUCTION A new concept of 'NeoRAS wild-type (WT)', which means conversion of RAS status from RAS mutant to RAS WT after treatment, has been reported. Previous observational and proof-of-concept studies have demonstrated the efficacy of epidermal growth factor receptor inhibitors in patients with NeoRAS WT metastatic colorectal cancer (mCRC). Moreover, posthoc biomarker analyses of these studies have suggested that not only the RAS status in the circulating tumour DNA (ctDNA) but also other gene mutational status may be useful as biomarkers of epidermal growth factor receptor inhibitors for NeoRAS WT mCRC. METHODS AND ANALYSIS This trial is a multicentre, single-arm, phase II trial to assess the efficacy and safety of panitumumab plus irinotecan therapy for patients with NeoRAS mCRC. The key eligibility criteria include RAS mutant mCRC initially proven in tumour tissue refractory or intolerant to fluoropyrimidine, oxaliplatin and irinotecan; RAS WT in ctDNA (defined as plasma mutant allele frequencies of all RAS ≤0.1%) within 28 days before enrolment and Eastern Cooperative Oncology Group performance status ≤2. The primary endpoint is the response rate. The target sample size is 30 patients. Biomarker analyses are planned to be performed using next-generation sequencing-based ctDNA analysis. ETHICS AND DISSEMINATION This study was approved by the certified review board of National Cancer Center Hospital. The main results of the trial will be presented in international meetings and in medical journals. TRIAL REGISTRATION NUMBER s031210565.
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Affiliation(s)
- Hiroki Osumi
- Department of Gastroenterology, Cancer Institute Hospital Gastroenterology Center, Koto-ku, Tokyo, Japan
| | - Naoki Ishizuka
- Department of Clinical Trial Planning and Management, Cancer Institute Hospital Gastroenterology Center, Koto-ku, Tokyo, Japan
| | - Atsuo Takashima
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yosuke Kumekawa
- Divison of Gastrointestinal Oncology, Saitama Cancer Center, Saitama, Japan
| | - Daisuke Nakano
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Manabu Shiozawa
- Department of Surgery, Kanagawa Cancer Center, Kanagawa, Japan
| | - Tadamichi Denda
- Division of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - Ryoichi Sawada
- Division of Gastroenterology and Hepatology, Jikei University Hospital, Tokyo, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
| | - Takeru Wakatsuki
- Department of Gastroenterology, Cancer Institute Hospital Gastroenterology Center, Koto-ku, Tokyo, Japan
| | - Boku Narikazu
- Department of Medical Oncology and General Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ken Kato
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Kensei Yamaguchi
- Department of Gastroenterology, Cancer Institute Hospital Gastroenterology Center, Koto-ku, Tokyo, Japan
| | - Eiji Shinozaki
- Department of Gastroenterology, Cancer Institute Hospital Gastroenterology Center, Koto-ku, Tokyo, Japan
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19
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Saijo K, Imai H, Katayama H, Fujishima F, Nakamura K, Kasahara Y, Ouchi K, Komine K, Shirota H, Takahashi M, Ishioka C. BRAF and MEK Inhibitor Treatment for Metastatic Undifferentiated Sarcoma of the Spermatic Cord with BRAF V600E Mutation. Case Rep Oncol 2022; 15:762-769. [PMID: 36157689 PMCID: PMC9459523 DOI: 10.1159/000526018] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/05/2022] [Indexed: 11/25/2022] Open
Abstract
An 18-year-old Japanese man was diagnosed with an undifferentiated sarcoma of the spermatic cord, with multiple distant metastases to the lungs and bones. The patient received doxorubicin-based standard chemotherapy. Although the chemotherapy was effective, it induced severe adverse events, which led to treatment discontinuation. A comprehensive genomic profiling test using resected tumor tissue revealed the BRAF V600E mutation. Based on the result, the patient received combination therapy with dabrafenib and trametinib. The combination therapy achieved a good response with few adverse events. However, 6.5 months later, pleural metastases and meningeal dissemination had emerged. A liquid comprehensive genomic profiling test was performed after the progression to identify the resistance mechanism, which resulted in the detection of no actionable gene alterations other than BRAF V600E. This report shows that the BRAF V600E mutation may be a promising therapeutic target and that resistance to the targeted therapy could also occur in soft tissue sarcoma. The significance of BRAF mutations across different types of cancer should be validated, and it is necessary to apply targeted therapies and develop methods to overcome resistance based on the optimal use of comprehensive genomic profiling tests.
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Affiliation(s)
- Ken Saijo
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Hiroo Imai
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | | | | | - Kenichi Nakamura
- Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Kasahara
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Keigo Komine
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Hidekazu Shirota
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Masanobu Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- *Chikashi Ishioka,
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20
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Ouchi K, Ishioka C. [Biomarkers of Anti-EGFR Antibodies in the Treatment of Metastatic Colorectal Cancer]. Gan To Kagaku Ryoho 2022; 49:801-808. [PMID: 36046960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Anti-EGFR antibodies(cetuximab and panitumumab)are molecular targeted agents that exert their antitumor effects by binding directly to the epidermal growth factor receptor(EGFR)and inhibiting its downstream signaling. Anti-EGFR antibodies have become one of the most important agents in the treatment of metastatic colorectal cancer(CRC), showing efficacy in combination with cytotoxic chemotherapeutic agents and as single agents in first-line and second-line treatment or later. Molecular targeted agents show more potent therapeutic effects than conventional chemotherapeutic agents, but their cost-effectiveness is often an issue due to their high drug costs. Predictive biomarkers of therapeutic efficacy that enable appropriate patient selection have an important role not only in improving the cost-effectiveness of molecular targeted agents, but also from the perspective of avoiding side effects in invalid patients. In addition to RAS and BRAF genotypes as molecular biological factors, anatomical factors such as the site of primary tumor(sidedness)are described in guidelines as important biomarkers for anti-EGFR treatment in the treatment of metastatic CRC. Recently, an association between HER2 gene amplification and anti-EGFR antibody resistance in RAS/BRAF wild-type metastatic CRC was reported. Furthermore, an epigenetic factor, DNA methylation status, was reported to be associated with the therapeutic effect of anti-EGFR treatments, and our subsequent studies have suggested that DNA methylation status is predictive of therapeutic efficacy of anti- EGFR antibodies regardless of the site of the primary tumor. Novel biomarkers will continue to be developed from a variety of approaches to provide more optimal cancer treatment for each individual patient.
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Affiliation(s)
- Kota Ouchi
- Dept. of Medical Oncology, Tohoku University Hospital
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21
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Katoh Y, Yaguchi T, Kubo A, Iwata T, Morii K, Kato D, Ohta S, Satomi R, Yamamoto Y, Oyamada Y, Ouchi K, Takahashi S, Ishioka C, Matoba R, Suematsu M, Kawakami Y. Inhibition of stearoyl-CoA desaturase 1 (SCD1) enhances the antitumor T cell response through regulating β-catenin signaling in cancer cells and ER stress in T cells and synergizes with anti-PD-1 antibody. J Immunother Cancer 2022; 10:jitc-2022-004616. [PMID: 35793868 PMCID: PMC9260842 DOI: 10.1136/jitc-2022-004616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 11/26/2022] Open
Abstract
Background Understanding the mechanisms of non-T cell inflamed tumor microenvironment (TME) and their modulation are important to improve cancer immunotherapies such as immune checkpoint inhibitors. The involvement of various immunometabolisms has recently been indicated in the formation of immunosuppressive TME. In this study, we investigated the immunological roles of stearoyl-CoA desaturase 1 (SCD1), which is essential for fatty acid metabolism, in the cancer immune response. Methods We investigated the roles of SCD1 by inhibition with the chemical inhibitor or genetic manipulation in antitumor T cell responses and the therapeutic effect of anti-programmed cell death protein 1 (anti-PD-1) antibody using various mouse tumor models, and their cellular and molecular mechanisms. The roles of SCD1 in human cancers were also investigated by gene expression analyses of colon cancer tissues and by evaluating the related free fatty acids in sera obtained from patients with non-small cell lung cancer who were treated with anti-PD-1 antibody. Results Systemic administration of a SCD1 inhibitor in mouse tumor models enhanced production of CCL4 by cancer cells through reduction of Wnt/β-catenin signaling and by CD8+ effector T cells through reduction of endoplasmic reticulum stress. It in turn promoted recruitment of dendritic cells (DCs) into the tumors and enhanced the subsequent induction and tumor accumulation of antitumor CD8+ T cells. SCD1 inhibitor was also found to directly stimulate DCs and CD8+ T cells. Administration of SCD1 inhibitor or SCD1 knockout in mice synergized with an anti-PD-1 antibody for its antitumor effects in mouse tumor models. High SCD1 expression was observed in one of the non-T cell-inflamed subtypes in human colon cancer, and serum SCD1 related fatty acids were correlated with response rates and prognosis of patients with non-small lung cancer following anti-PD-1 antibody treatment. Conclusions SCD1 expressed in cancer cells and immune cells causes immunoresistant conditions, and its inhibition augments antitumor T cells and therapeutic effects of anti-PD-1 antibody. Therefore, SCD1 is an attractive target for the development of new diagnostic and therapeutic strategies to improve current cancer immunotherapies including immune checkpoint inhibitors.
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Affiliation(s)
- Yuki Katoh
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Tokyo, Japan.,Division of Anatomical Science, Department of Functional Morphology, Nihon University School of Medicine, Tokyo, Japan
| | - Tomonori Yaguchi
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Kubo
- Department of Biochemistry, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Iwata
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Tokyo, Japan.,Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Kenji Morii
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Daiki Kato
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Tokyo, Japan.,Laboratory of Veterinary Surgery, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Shigeki Ohta
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Ryosuke Satomi
- National Hospital Organisation Tokyo Medical Center, Tokyo, Japan
| | - Yasuhiro Yamamoto
- Department of Respiratory Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan.,Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shin Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan.,Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan.,Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Makoto Suematsu
- Department of Biochemistry, Keio University School of Medicine, Tokyo, Japan
| | - Yutaka Kawakami
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Tokyo, Japan .,Department of Immunology, International University of Health and Welfare, Chiba, Japan
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22
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Osumi H, Ouchi K, Shinozaki E, Takahashi S, Ooki A, Shimozaki K, Nakayama I, Wakatsuki T, Ogura M, Takahari D, Chin K, Yamaguchi K, Ishioka C. Clinical impact of DNA methylation status on first-line antiepidermal growth factor receptor treatment in patients with metastatic colorectal cancer. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.3528] [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
3528 Background: The CpG island methylator phenotype (CIMP), important for carcinogenesis, is a predictor of prognosis and chemotherapy sensitivity in colorectal cancer. However, there is a lack of consensus of CIMP markers, and thus, more comprehensive methylation markers are required to reliably predict the clinical outcomes. Previously, we reported that genome-wide DNAmethylation statuscould predict the effect of epidermal growth factor receptor (EGFR) inhibitors more accurately than previously reported methylation classifications (Ouchi et al. Cancer Sci 2015). Moreover, we had developed a DNA methylation assay based on MethyLight to reflect genome-wide DNA methylation status and reported its usefulness in predicting prognosis in patients with metastatic colorectal cancer (mCRC) treated with EGFR inhibitors as a third-line chemotherapy (Ouchi et al. Cancer Sci 2022). This study aimed to clarify the effects of genome-wide DNA methylation status on clinical outcomes in patients with mCRC treated with first-line EGFR inhibitors. Methods: We enrolled 241 patients with mCRC, who received chemotherapy plus EGFR inhibitors as a first-line treatment, and analyzed the associations between genome-wide DNA methylation status using a novel comprehensive methylation marker panel and clinical outcomes and evaluated the predictive power and value of the methylation status. Results: Total 169 patients were included in the final analyses. The frequency of highly methylated CRC (HMCC) was 8.9% (15/169). The characteristics of patients with HMCC included right-sided primary tumor location (P = 0.042), undifferentiated histology (P = 0.047), and BRAFV600E mutation (P < 0.001). Patients with HMCC showed worse clinical outcomes than those with low methylated CRC in terms of response rate (P = 0.017), progression-free survival (PFS; P = 0.004), and overall survival (P = 0.019). In the multivariate analysis, peritoneal metastasis (Hazard ratio (HR): 2.24, P = 0.017), methylation status (HR: 3.04, P = 0.037), and BRAFV600E mutations (HR: 5.83, P = 0.0001) were independent factors for shorter PFS. Conclusions: Genome-wide DNA methylation status may be an independent predictor of first-line EGFR inhibitors in patients with mCRC.
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Affiliation(s)
- Hiroki Osumi
- Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research., Tokyo, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Eiji Shinozaki
- Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research., Tokyo, Japan
| | - Shin Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Akira Ooki
- Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research., Tokyo, Japan
| | - Keitaro Shimozaki
- Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Izuma Nakayama
- Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research., Tokyo, Japan
| | - Takeru Wakatsuki
- Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research., Tokyo, Japan
| | - Mariko Ogura
- Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research., Tokyo, Japan
| | - Daisuke Takahari
- Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Keisho Chin
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research., Tokyo, Japan
| | - Kensei Yamaguchi
- Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research., Tokyo, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
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23
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Otsuki Y, Ouchi K, Takahashi S, Sasaki K, Sakamoto Y, Okita A, Ishioka C. Altered gene expression due to aberrant DNA methylation correlates with responsiveness to anti-EGFR antibody treatment. Cancer Sci 2022; 113:3221-3233. [PMID: 35403373 PMCID: PMC9459254 DOI: 10.1111/cas.15367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/26/2022] [Accepted: 04/03/2022] [Indexed: 11/29/2022] Open
Abstract
The cetuximab gene expression signature and DNA methylation status of colorectal cancer (CRC) are predictive of the therapeutic effects of anti‐epidermal growth factor receptor (EGFR) antibody therapy. As DNA methylation is a means of regulating gene expression, it may play an important role in the expression of cetuximab signature genes. This study aims to determine the effects of aberrant DNA methylation on the regulation of cetuximab signature gene expression. Comprehensive DNA methylation and gene expression data were retrieved from CRC patients in three tumor tissue (TT) cohorts and three normal colorectal mucosa/tumor tissue paired (NCM‐TT) cohorts. Of the 231 cetuximab signature genes, 57 exhibited an inverse correlation between the methylation of promoter CpG sites and gene expression level in multiple cohorts. About two‐thirds of the promoter CpG sites associated with the 57 genes exhibited this correlation. In all 57 gene promoter regions, the methylation levels in NCMs did not differ according to comparisons based on cetuximab signature or DNA methylation status classification of matched TTs. Thus, the altered expression of 57 genes was caused by aberrant DNA methylation during carcinogenesis. Analysis of the association between cetuximab signature or DNA methylation status and progression‐free survival (PFS) of anti‐EGFR antibody agents in the same cohort showed that DNA methylation status was most associated with PFS. In conclusion, we found that aberrant DNA methylation regulates specific gene expression in cetuximab signature during carcinogenesis, suggesting that it is one of the important determinants of sensitivity to anti‐EGFR antibody agents.
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Affiliation(s)
- Yasufumi Otsuki
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Miyagi, Japan.,Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
| | - Kota Ouchi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Miyagi, Japan.,Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
| | - Shin Takahashi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Miyagi, Japan.,Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
| | - Keiju Sasaki
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Miyagi, Japan.,Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
| | - Yasuhiro Sakamoto
- Department of Medical Oncology, Osaki Citizen Hospital, Miyagi, Japan
| | - Akira Okita
- Department of Medical Oncology, Osaki Citizen Hospital, Miyagi, Japan
| | - Chikashi Ishioka
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Miyagi, Japan.,Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan.,Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Miyagi, Japan
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24
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Ouchi K, Takahashi S, Okita A, Sakamoto Y, Muto O, Amagai K, Okada T, Ohori H, Shinozaki E, Ishioka C. A modified MethyLight assay predicts the clinical outcomes of anti-EGFR treatment in metastatic colorectal cancer. Cancer Sci 2021; 113:1057-1068. [PMID: 34962023 PMCID: PMC8898715 DOI: 10.1111/cas.15252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 12/24/2022] Open
Abstract
DNA methylation status correlates with clinical outcomes of anti‐epidermal growth factor receptor (EGFR) treatment. There is a strong need to develop a simple assay for measuring DNA methylation status for the clinical application of drug selection based on it. In this study, we collected data from 186 patients with metastatic colorectal cancer (mCRC) who had previously received anti‐EGFR treatment. We modified MethyLite to develop a novel assay to classify patients as having highly methylated colorectal cancer (HMCC) or low‐methylated colorectal cancer (LMCC) based on the methylation status of 16 CpG sites of tumor‐derived genomic DNA in the development cohort (n = 30). Clinical outcomes were then compared between the HMCC and LMCC groups in the validation cohort (n = 156). The results showed that HMCC had a significantly worse response rate (4.2% vs 33.3%; P = .004), progression‐free survival (median: 2.5 vs 6.6 mo, P < .001, hazard ratio [HR] = 0.22), and overall survival (median: 5.6 vs 15.5 mo, P < .001, HR = 0.23) than did LMCC in patients with RAS wild‐type mCRC who were refractory or intolerable to oxaliplatin‐ and irinotecan‐based chemotherapy (n = 101). The DNA methylation status was an independent predictive factor and a more accurate biomarker than was the primary site of anti‐EGFR treatment. In conclusion, our novel DNA methylation measurement assay based on MethyLight was simple and useful, suggesting its implementation as a complementary diagnostic tool in a clinical setting.
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Affiliation(s)
- Kota Ouchi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Miyagi, Japan.,Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
| | - Shin Takahashi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Miyagi, Japan.,Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
| | - Akira Okita
- Department of Clinical Oncology, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Miyagi, Japan.,Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
| | - Yasuhiro Sakamoto
- Department of Medical Oncology, Osaki Citizen Hospital, Miyagi, Japan
| | - Osamu Muto
- Department of Medical Oncology, Akita Red Cross Hospital, Akita, Japan
| | - Kenji Amagai
- Department of Gastroenterology, Ibaraki Prefectural Central Hospital, Ibaraki Cancer Center, Ibaraki, Japan
| | - Takaho Okada
- Department of Digestive Surgery, Sendai Open Hospital, Miyagi, Japan
| | - Hisatsugu Ohori
- Department of Medical Oncology, Ishinomaki Red Cross Hospital, Miyagi, Japan
| | - Eiji Shinozaki
- Gastrointestinal Oncology Department, The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - Chikashi Ishioka
- Department of Clinical Oncology, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Miyagi, Japan.,Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan.,Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Miyagi, Japan
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25
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Ichikawa S, Inokura K, Kawamura Y, Fukuhara N, Yokoyama H, Ouchi K, Fujishima F, Harigae H. Massive bone marrow infiltration of neuroendocrine carcinoma mimicking aggressive hematological malignancy. J Hematop 2021. [DOI: 10.1007/s12308-021-00475-3] [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: 10/20/2022] Open
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26
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Takahashi S, Sakamoto Y, Denda T, Takashima A, Komatsu Y, Nakamura M, Ohori H, Yamaguchi T, Kobayashi Y, Baba H, Kotake M, Amagai K, Kondo H, Shimada K, Sato A, Yuki S, Okita A, Ouchi K, Komine K, Watanabe M, Morita S, Ishioka C. Advanced colorectal cancer subtypes (aCRCS) help select oxaliplatin-based or irinotecan-based therapy for colorectal cancer. Cancer Sci 2021; 112:1567-1578. [PMID: 33548159 PMCID: PMC8019218 DOI: 10.1111/cas.14841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 12/12/2022] Open
Abstract
Oxaliplatin (OX) and irinotecan (IRI) are used as key drugs for the first‐line treatment of metastatic colorectal cancer (mCRC). However, no biomarkers have been identified to decide which of the drugs is initially used. In this translational research (TR) of the TRICOLORE trial, the advanced colorectal cancer subtype (aCRCS) was analyzed as a potential biomarker for the selection of OX or IRI. We collected 335 (68.8%) formalin‐fixed, paraffin‐embedded (FFPE) primary tumor specimens from 487 patients registered in the TRICOLORE trial and performed direct sequencing and immunohistochemical staining of CRC‐related genes, comprehensive gene‐expression analysis, and genome‐wide methylation analysis. The progression‐free survival (PFS) of the IRI group was significantly better compared with the OX group in BRAF wild‐type (WT), PTEN‐positive, and aCRCS A1 patients. Among the molecular factors, aCRCS were only associated with the PFS of OX and IRI groups. The PFS of the IRI group was significantly better compared with the OX group in aCRCS A1 + B1 (hazard ratio [HR] = 0.58; 95% confidence interval [CI] = 0.41‐0.82; P = .0023). In contrast, the OX group had better PFS compared with the IRI group in aCRCS B2, although this was not statistically significant (HR = 1.66; 95% CI = 0.94‐2.96; P = .083). Nearly half of patients with mCRC (46.8%, aCRCS A1 + B1) respond well to IRI, while only about 18.5% (aCRCS B2) of patients with mCRC responded well to OX. In conclusion, the aCRCS might be a predictive factor for the clinical outcomes of OX‐based and IRI‐based therapies.
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Affiliation(s)
- Shin Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan.,Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Yasuhiro Sakamoto
- Department of Medical Oncology, Osaki Citizen Hospital, Miyagi, Japan
| | - Tadamichi Denda
- Division of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - Atsuo Takashima
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshito Komatsu
- Department of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, Hokkaido, Japan
| | - Masato Nakamura
- Aizawa Comprehensive Cancer Center, Aizawa Hospital, Nagano, Japan
| | - Hisatsugu Ohori
- Department of Medical Oncology, Japanese Red Cross Ishinomaki Hospital, Miyagi, Japan
| | - Tatsuro Yamaguchi
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yoshimitsu Kobayashi
- Gastroenterology and Medical Oncology, KKR Sapporo Medical Center, Hokkaido, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masanori Kotake
- Department of Surgery, Kouseiren Takaoka Hospital, Toyama, Japan
| | - Kenji Amagai
- Division of Gastroenterology, Ibaraki Prefectural Central Hospital, Ibaraki, Japan
| | - Hitoshi Kondo
- Division of Gastroenterology, Tonan Hospital, Hokkaido, Japan
| | - Ken Shimada
- Department of Internal Medicine, Division of Medical Oncology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Atsushi Sato
- Department of Medical Oncology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Satoshi Yuki
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Hokkaido, Japan
| | - Akira Okita
- Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan.,Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan.,Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Keigo Komine
- Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan.,Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Mika Watanabe
- Department of Pathology, Tohoku University Hospital, Miyagi, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan.,Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
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Takahashi M, Sakamoto Y, Otsuka K, Kanbe M, Ohori H, Shindo Y, Honda H, Saijo K, Ouchi K, Murakawa Y, Takahashi H, Kawai S, Tanaka Y, Yamaguchi T, Shimodaira H, Yoshioka T, Ishioka C. Phase II Study of the Reuse of Trastuzumab with Docetaxel beyond Progression after First-Line Treatment in Second-Line Treatment for Unresectable, Metastatic Gastric Cancer (T-CORE1203). TOHOKU J EXP MED 2021; 254:49-55. [PMID: 34053967 DOI: 10.1620/tjem.254.49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Whether trastuzumab use beyond disease progression is beneficial in second-line treatment for patients with unresectable human epidermal growth factor receptor 2 (HER2)-positive gastric cancer remains to be elucidated. We conducted this phase II study to assess whether trastuzumab plus docetaxel was effective for patients with previously treated advanced HER2-positive gastric cancer. This trial was a single-arm, open-label, multicenter, phase II study, conducted by Tohoku Clinical Oncology Research and Education Society (T-CORE). Patients aged 20 years or older who had advanced HER2-positive gastric cancer and were refractory to trastuzumab, fluoropyrimidine, and cisplatin were enrolled. Patients were treated with 6 mg/kg trastuzumab and 60 mg/m2 docetaxel every 3 weeks. The primary endpoint was the overall response rate. The threshold overall response rate was estimated to be at 15%. Secondary endpoints were progression-free survival, 6-month survival rate, overall survival, and toxicities. A total of 27 patients were enrolled from 7 hospitals. The median age was 67 years. Partial response was seen in 3 patients among the 26 evaluated patients. The overall response rate was at 11.5% (90% confidence interval 1.2%-21.8%). The median progression-free survival was 3.2 months, the 6-month survival rate was 85%, and the median overall survival was 11.6 months. Febrile neutropenia was observed in 14.8%. The most frequently observed grade 3 non-hematologic toxicity was anorexia (14.8%). The primary endpoint was not achieved. The results support a current consensus that the continuation of trastuzumab in second-line therapy for gastric cancer is not a recommended option.
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Affiliation(s)
- Masanobu Takahashi
- Department of Medical Oncology, Tohoku University Hospital.,Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | | | | | - Mariko Kanbe
- Department of Internal Medicine, Senseki Hospital
| | - Hisatsugu Ohori
- Department of Clinical Oncology, Japanese Red Cross Ishinomaki Hospital
| | - Yoshiaki Shindo
- Department of Gastroenterological Surgery, Nakadori General Hospital
| | | | - Ken Saijo
- Department of Medical Oncology, Tohoku University Hospital.,Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Kota Ouchi
- Department of Medical Oncology, Osaki Citizen Hospital
| | | | | | | | - Yuichi Tanaka
- Department of Gastroenterological Surgery, Nakadori General Hospital
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine
| | - Hideki Shimodaira
- Department of Medical Oncology, Tohoku University Hospital.,Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Takashi Yoshioka
- Department of Clinical Oncology, Yamagata University School of Medicine
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital.,Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University.,Department of Clinical Oncology, Tohoku University Graduate School of Medicine
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Yuki S, Gamoh M, Denda T, Takashima A, Takahashi S, Nakamura M, Ohori H, Yamaguchi T, Kobayashi Y, Baba H, Kotake M, Amagai K, Kondo H, Shimada K, Sato A, Ishioka C, Komine K, Ouchi K, Morita S, Komatsu Y. Analysis of consensus molecular subtypes (CMS) classification in the TRICOLORE trial: A randomized phase III trial of S-1 and irinotecan (IRI) plus bevacizumab (Bmab) versus mFOLFOX6 or CapeOX plus Bmab as first-line treatment for metastatic colorectal cancer (mCRC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.4_suppl.169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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
169 Background: The TRICOLORE trial previously demonstrated that S-1+IRI+Bmab (Arm B) was non-inferior to mFOLFOX6/CapeOX+Bmab (Arm A) in terms of progression-free survival (PFS) as first-line treatment for mCRC, irrespective of RAS status. CMS was reported to be a prognostic factor for mCRC. Previously, it was reported that the CMS could be a predictive factor for the efficacy of oxaliplatin (OX) and IRI (Okita A, et al. Oncotarget. 2018). In this exploratory study of TRICOLORE trial, we examined if the CMS could be a predictive factor of OX and IRI regimen. Methods: We collected formalin-fixed paraffin-embedded (FFPE) primary tumor tissues and performed gene expression analysis by microarray. The subtype of CMS was determined by the CMS classifier (Guinney et al. Nature Med. 2015). PFS and overall survival (OS) were compared between arm A and B in each subtypes of CMS. Results: Total of 308 FFPE samples from 487 cases who were enrolled in the TRICOLORE study were collected. Number of patients classified into CMS1 to CMS4 were 47, 72, 99 and 90, respectively. Similar to the previous reports, the proportion of RAS mutant cases was highest in CMS3 and the most of BRAF mutant cases were classified into CMS1. The median PFS (mPFS) of arm A and B were almost same in CMS2 (16.1m vs. 17.6m, HR = 1.10, p = 0.79) and CMS3 (10.6 vs. 11.4, HR = 0.95, p = 0.81). In CMS1, mPFS of arm A was worse than that of arm B, although not statistically significant (7.4m vs. 13.2m, HR = 0.73, p = 0.35). In CMS4, mPFS of arm B was better than that of arm A, although not statistically significant again (9.7m vs. 14.1m, HR = 0.72, p = 0.15). The median OS (mOS) of both arm in CMS2-CMS4 and arm B in CMS1 were good and were 29.0m or more. On the other hand, mOS of arm A in CMS1 (18.1m) was worse than the others. Conclusions: From these results, it was not concluded that CMS was a predictor of mFOLFOX6/CapeOX+Bmab and S-1+IRI+Bmab. However, mPFS and mOS of mFOLFOX6/CapeOX+Bmab in CMS1 were poor unlike other CMS subtypes, and these were consistent with a previous report. Whereas S-1+IRI+Bmab was effective in all subtypes of CMS. Clinical trial information: UMIN000007834.
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Affiliation(s)
- Satoshi Yuki
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Japan
| | - Makio Gamoh
- Department of Medical Oncology, Osaki Citizen Hospital, Osaki, Japan
| | | | - Atsuo Takashima
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Shin Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Masato Nakamura
- Aizawa Comprehensive Cancer Center, Aizawa Hospital, Matsumoto, Japan
| | - Hisatsugu Ohori
- Department of Medical Oncology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Tatsuro Yamaguchi
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yoshimitsu Kobayashi
- Department of Gastroenterology and Medical Oncology, KKR Sapporo Medical Hospital, Sapporo, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masanori Kotake
- Department of Surgery, Kouseiren Takaoka Hospital, Takaoka, Japan
| | - Kenji Amagai
- Division of Gastroenterology, Ibaraki Prefectural Central Hospital, Ibaraki, Japan
| | - Hitoshi Kondo
- Division of Gastroenterology, Tonan Hospital, Sapporo, Japan
| | - Ken Shimada
- Department of Internal Medicine, Division of Medical Oncology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Atsushi Sato
- Department of Medical Oncology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Keigo Komine
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshito Komatsu
- Department of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, Sapporo, Japan
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29
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Hiraide S, Komine K, Sato Y, Ouchi K, Imai H, Saijo K, Takahashi M, Takahashi S, Shirota H, Takahashi M, Ishioka C. Efficacy of modified FOLFOX6 chemotherapy for patients with unresectable pseudomyxoma peritonei. Int J Clin Oncol 2019; 25:774-781. [PMID: 31823151 PMCID: PMC7118031 DOI: 10.1007/s10147-019-01592-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 11/29/2019] [Indexed: 01/02/2023]
Abstract
Background Pseudomyxoma peritonei (PMP) is a rare malignancy, and there is insufficient evidence about systemic chemotherapy for this disease. Methods We retrospectively evaluated the efficacy and safety of a chemotherapeutic regimen with 5-fluorouracil and oxaliplatin (modified FOLFOX6, mFOLFOX6) for patients with unresectable pseudomyxoma peritonei. Patients who received the therapy between April 2000 and February 2019 at the Department of Medical Oncology, Tohoku University Hospital, were enrolled in this study. Results Eight patients were treated with mFOLFOX6. The sites of primary tumor were appendix in six patients, ovary in a patient, and urachus in a patient. Six patients received surgery. Seven patients had histologically high-grade PMP, and one patient had low-grade PMP. The median follow-up duration was 27.2 months. All the patients had non-measurable regions as the targets of tumor response. Non-complete response or non-progressive disease was observed in seven patients, with a disease control rate of 87.5%. The median progression-free survival and overall survival were 13.0 months and 27.9 months, respectively. An obvious reduction in the symptoms was observed in two patients. Five patients experienced decline in the serum tumor markers, CEA or CA19-9. The grade 3/4 toxicity that was observed was grade 4 neutropenia in one patient and grade 3 neutropenia in two patients. Conclusions mFOLFOX6 might be an effective and tolerable treatment option for patients with unresectable PMP. To our knowledge, this is the first case series of mFOLFOX6 in patients with unresectable PMP and the first case series of systemic chemotherapy for Asian patients with unresectable PMP. Electronic supplementary material The online version of this article (10.1007/s10147-019-01592-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sakura Hiraide
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
| | - Keigo Komine
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
| | - Yuko Sato
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
| | - Hiroo Imai
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
| | - Ken Saijo
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
| | - Masahiro Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Shin Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
| | - Hidekazu Shirota
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
| | - Masanobu Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan.
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
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30
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Saijo K, Imai H, Ouchi K, Okada Y, Sato Y, Komine K, Takahashi M, Takahashi S, Shirota H, Takahashi M, Ishioka C. Therapeutic Benefits of Ipilimumab among Japanese Patients with Nivolumab-Refractory Mucosal Melanoma: A Case Series Study. TOHOKU J EXP MED 2019; 248:37-43. [PMID: 31105123 DOI: 10.1620/tjem.248.37] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The antibodies targeting programmed death 1 (PD-1) and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) have provided survival benefits in patients with advanced malignant melanoma. The anti-PD-1 antibodies nivolumab and pembrolizumab are considered superior to the anti-CTLA-4 antibody ipilimumab as first-line therapy, suggesting that ipilimumab should be administered to patients with anti-PD-1 antibody-refractory melanoma in the second-line setting. However, there is limited evidence regarding the efficacy and safety of ipilimumab after disease progression on anti-PD-1 antibody therapy. Moreover, in patients with mucosal melanoma, a rare and aggressive subtype, evidence is extremely poor. This study aimed to clarify the efficacy and safety of ipilimumab among Japanese patients with nivolumab-refractory advanced mucosal melanoma. We retrospectively analyzed the seven patients with advanced mucosal melanoma who were treated with ipilimumab after disease progression on nivolumab at our hospital between September 2015 and December 2017. No patient achieved complete response or partial response to ipilimumab therapy. However, six patients achieved stable disease, and of these patients, three achieved a decline in the tumor size. All the three patients with a decline in tumor size developed grade 3 toxicity: two patients developed colitis and one patient experienced alanine aminotransferase elevation. The median progression-free survival (PFS) for prior nivolumab therapy was 148 days. The median PFS for ipilimumab therapy after disease progression with nivolumab was 193 days. The median overall survival was 661 days. In conclusion, although even partial response was undetectable with ipilimumab therapy, ipilimumab could produce additional PFS among nivolumab-refractory advanced mucosal melanoma patients.
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Affiliation(s)
- Ken Saijo
- Department of Medical Oncology, Tohoku University Hospital
| | - Hiroo Imai
- Department of Medical Oncology, Tohoku University Hospital
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital
| | | | - Yuko Sato
- Department of Medical Oncology, Tohoku University Hospital
| | - Keigo Komine
- Department of Medical Oncology, Tohoku University Hospital
| | | | - Shin Takahashi
- Department of Medical Oncology, Tohoku University Hospital
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31
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Ouchi K, Takahashi S, Okita A, Sakamoto Y, Muto O, Amagai K, Okada T, Ohori H, Shinozaki E, Gamou M, Ishioka C. Development of novel in vitro diagnostics to predict the efficacy of anti-EGFR treatment based on DNA methylation status. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz339.015] [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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32
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Tsuchie H, Miyakoshi N, Iba K, Kasukawa Y, Nozaka K, Dohke T, Kosukegawa I, Aizawa T, Maekawa S, Abe H, Takeshima M, Tomite T, Segawa T, Ouchi K, Kinoshita H, Suzuki M, Yamashita T, Shimada Y. The effects of teriparatide on acceleration of bone healing following atypical femoral fracture: comparison between daily and weekly administration. Osteoporos Int 2018; 29:2659-2665. [PMID: 30105400 DOI: 10.1007/s00198-018-4658-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 08/06/2018] [Indexed: 12/17/2022]
Abstract
UNLABELLED We compared the effectiveness of promoting bone healing between two teriparatide preparations for atypical femoral fracture (AFF). A total of 45 AFFs were included in this study, and we compared the duration of bone union. Teriparatide administered by daily injection enhanced bone union more than weekly administration in complete AFFs. INTRODUCTION The efficacy of teriparatide for atypical femoral fracture (AFF) has been recently reported. Although two different teriparatide preparations can be used to treat osteoporosis in Japan, daily or weekly injection, all previous reports on the effectiveness of teriparatide for AFF only examined daily injection formulations. Therefore, we compared the promotion of bone healing between the two teriparatide preparations for AFF. METHODS A total of 45 consecutive AFFs in 43 Japanese patients were included in this study. They received either a daily 20-μg teriparatide injection (daily group; n = 32) or a once-a-week 56.5-μg teriparatide injection (weekly group; n = 13). We compared the clinical background and duration of bone union between these two groups. RESULTS When all patents were included, the fracture healing time was not significantly different between the two groups. Only patients with complete AFFs had significantly fewer daily bisphosphonate or denosumab injections than the weekly group (P < 0.05). The fracture healing time in the daily group (6.1 ± 4.1 months) was significantly shorter than that in the weekly group (10.1 ± 4.2 months) (P < 0.05). Even if the influence of bisphosphonate or denosumab usage was excluded, a similar significant difference was observed in the fracture healing time (P < 0.05). There was no significant difference between the two groups among patients with incomplete AFFs. CONCLUSIONS Daily teriparatide injections enhance bone union more than weekly injections in complete AFF patients.
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Affiliation(s)
- H Tsuchie
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - N Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - K Iba
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, S-1 W-16, Cyuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Y Kasukawa
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - K Nozaka
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - T Dohke
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, S-1 W-16, Cyuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - I Kosukegawa
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, S-1 W-16, Cyuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - T Aizawa
- Department of Orthopedic Surgery, Northern Akita Municipal Hospital, 16-29 Shimosugi aza Kamishimizusawa, Kitaakita, 018-4221, Japan
| | - S Maekawa
- Department of Orthopedic Surgery, Ogachi Central Hospital, 25 Yamada aza Isamigaoka, Yuzawa, 012-0055, Japan
| | - H Abe
- Department of Orthopedic Surgery, Ugo Municipal Hospital, 44-5 Otomichi, Nishomonai, Ugo, 012-1131, Japan
| | - M Takeshima
- Department of Orthopedic Surgery, Honjyo Daiichi Hospital, 111 Iwabuchishita, Yurihonjyo, 015-8567, Japan
| | - T Tomite
- Department of Orthopedic Surgery, Japanese Red Cross Akita Hospital, 222-1 Saruta aza Inawashirosawa, Kamikitate, Akita, 010-1495, Japan
| | - T Segawa
- Department of Orthopedic Surgery, Akita City Hospital, 4-30 Matsuokamachi, Kawamoto, Akita, 010-0933, Japan
| | - K Ouchi
- Department of Orthopedic Surgery, Yokote Municipal Hospital, 5-31 Negishimachi, Yokote, 013-8602, Japan
| | - H Kinoshita
- Department of Orthopedic Surgery, Akita Kousei Medical Center, 1-1-1 Iijima, Nishifukuro, Akita, 011-0948, Japan
| | - M Suzuki
- Department of Orthopedic Surgery, Yuri Kumiai General Hospital, Kawaguchi aza Yaushiro, Yurihonjyo, 015-8511, Japan
| | - T Yamashita
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, S-1 W-16, Cyuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Y Shimada
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
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33
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Okita A, Takahashi S, Ouchi K, Inoue M, Watanabe M, Endo M, Honda H, Yamada Y, Ishioka C. Consensus molecular subtypes classification of colorectal cancer as a predictive factor for chemotherapeutic efficacy against metastatic colorectal cancer. Oncotarget 2018; 9:18698-18711. [PMID: 29721154 PMCID: PMC5922348 DOI: 10.18632/oncotarget.24617] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 02/24/2018] [Indexed: 12/16/2022] Open
Abstract
The consensus molecular subtypes (CMS) classification is one of the most robust colorectal cancer (CRC) classifications based on comprehensive gene expression profiles. This study aimed to clarify whether the CMS is a predictive factor for therapeutic effects of standard chemotherapies for metastatic CRC (mCRC). We retrospectively enrolled 193 patients with mCRCs, and using comprehensive gene expression data, classified them into 4 subtypes: CMS1-CMS4. The associations between the subtypes and treatment outcomes were analyzed. Regarding first-line chemotherapy, irinotecan (IRI)-based chemotherapy was significantly superior to oxaliplatin (OX)-based chemotherapy for progression-free survival (PFS; hazard ratio [HR] = 0.31, 95% confidence interval [CI] 0.13-0.64) and overall survival (OS; HR = 0.45, 95% CI 0.19-0.99) in CMS4. Regarding the anti-epidermal growth factor receptor (anti-EGFR) therapy, CMS1 showed particularly worse PFS (HR = 2.50, 95% CI 1.31-4.39) and OS (HR = 4.23, 95% CI 1.83-9.04), and CMS2 showed particularly good PFS (HR = 0.67, 95% CI 0.44-1.01) and OS (HR = 0.49, 95% CI 0.27-0.87) compared with the other subtypes. The biological characteristics of CMS may influence the efficacy of chemotherapy. CMS might be a new predictive factor for the efficacy of chemotherapy against mCRCs.
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Affiliation(s)
- Akira Okita
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Japan
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Japan
| | - Shin Takahashi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Japan
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Japan
| | - Kota Ouchi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Japan
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Japan
| | - Masahiro Inoue
- Department of Clinical Oncology, Akita University Graduate School of Medicine, Akita, Japan
| | - Mika Watanabe
- Department of Pathology, Tohoku University Graduate School of Medicine, Aobaku, Sendai, Japan
| | - Mareyuki Endo
- Department of Pathology, Sendai Kousei Hospital, Aobaku, Sendai, Japan
| | - Hiroshi Honda
- Department of Surgery, Tohoku Rosai Hospital, Aobaku, Sendai, Japan
| | - Yasuhide Yamada
- Department of Clinical Oncology, Hamamatsu University School of Medicine, Higashiku, Hamamatsu, Japan
- Department of Oncology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Chikashi Ishioka
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Japan
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Japan
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Ouchi K, Takahashi S, Chikamatsu S, Ito S, Takahashi Y, Kawai S, Okita A, Kasahara Y, Okada Y, Imai H, Komine K, Saijo K, Takahashi M, Shirota H, Takahashi M, Gamoh M, Ishioka C. Retrospective analysis on the clinical outcomes of recombinant human soluble thrombomodulin for disseminated intravascular coagulation syndrome associated with solid tumors. Int J Clin Oncol 2018; 23:790-798. [PMID: 29511940 PMCID: PMC6097084 DOI: 10.1007/s10147-018-1261-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 02/27/2018] [Indexed: 01/15/2023]
Abstract
Background Recombinant human soluble thrombomodulin (rTM) has been established and introduced in the clinic as a standard treatment for disseminated intravascular coagulation (DIC). However, the efficacy and safety of rTM for DIC associated with solid tumors (DIC-STs) have not been fully established. Here, we performed a retrospective analysis of the clinical outcomes of rTM for DIC-STs and considered a treatment strategy with rTM for DIC-STs. Methods Patients with DIC-STs between November 2009 and March 2016 in 2 cancer core hospitals were retrospectively analyzed. Data, including patient background, treatment course, and clinical outcomes of rTM for DIC-STs, were extracted. The clinical outcomes were evaluated by comparing the DIC score, resolution rate, and overall survival (OS) duration. Results The study included 123 patients with DIC-STs. The median OS in all patients was 41 days. The DIC resolution rate was 35.2%. DIC scores and DIC-related blood test data (fibrin degradation product and prothrombin time-international normalized ratio) significantly improved at the end of rTM administration (P < 0.001). The OS duration was longer in patients who were treated with chemotherapy after DIC onset than in those who were not treated with chemotherapy (median, 178 days vs. 17 days, P < 0.001). In both univariate and multivariate analyses, chemotherapy after DIC onset showed the strongest association with OS. Conclusions rTM can at least temporarily improve or maintain the state of DIC-STs. It is suggested that prolongation of survival can be expected when control of DIC and treatment of the underlying disease are compatible. Electronic supplementary material The online version of this article (10.1007/s10147-018-1261-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Shin Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Sonoko Chikamatsu
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Shukuei Ito
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | | | - Sadayuki Kawai
- Department of Medical Oncology, Osaki Citizen Hospital, Osaki, Japan
| | - Akira Okita
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Yuki Kasahara
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Yoshinari Okada
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Hiroo Imai
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Keigo Komine
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Ken Saijo
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Masahiro Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Hidekazu Shirota
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Masanobu Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Makio Gamoh
- Department of Medical Oncology, Osaki Citizen Hospital, Osaki, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan.
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan.
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Okita A, Takahashi S, Ouchi K, Inoue M, Yamada Y, Ishioka C. The consensus molecular subtypes of colorectal cancer as a predictive factor for chemotherapies against metastatic colorectal cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
736 Background: Since treatment options of chemotherapy for metastatic colorectal cancer (mCRC) have been diversified, biomarkers which could predict efficacy of chemotherapies are needed for optimal treatment. In this study, we analyzed the association of the treatment outcomes by several chemotherapies and the consensus molecular subtypes (CMS), which was developed from large-scale comprehensive gene expression analysis of colorectal cancer (Guinney J et al. Nat Med 21:1350-6, 2015). Methods: A total of 193 patients with previously treated mCRC were classified in 4 subtypes, CMS1 to CMS4 by using the microarrays data of primary tumors and the “CMS classifier” package for the R software. Then the association between the subtypes and the treatment outcomes was analyzed retrospectively. Results: The193 cases were classified into 21 CMS1, 53 CMS2, 69 CMS3 and 50 CMS4. The molecular characteristics of each subtype such as mutation status of KRAS and BRAF genes, and DNA methylation status were consistent with those of the previous study. First-line chemotherapies of the 193 patients were oxaliplatin (OX)-based treatment (121 patients), irinotecan (IRI)-based treatment (59 patients) and others (13 patients). In CMS4, the median progression-free survival (PFS) of the IRI-based group was significantly longer than that of the OX-based group (21.8 months vs. 10.5 months, p < 0.01). The median overall survival (OS) and objective response rate of the IRI-based group were also better than that of the OX-based group in CMS4. Among 193 patients, 103 were RAS wild-type and treated with anti-EGFR antibody. The effect of the anti-EGFR treatment was low in CMS1 (median PFS: 2.4 months, p < 0.01, median OS: 5.7 months, p < 0.01) and whereas was high in CMS2 (median PFS: 8.0 months, p = 0.05, median OS: 26.6 months, p = 0.02). CMS significantly correlated with PFS and OS after anti-EGFR treatment by univariate analysis. However the most useful predictive biomarker was a DNA methylation status by multivariable analysis. Conclusions: The biological characteristics of CMS may affect the therapeutic effect of anti-cancer agents in mCRC and, therefore, might be a new predictive factor of anti-cancer treatment.
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Okita A, Imai H, Takahashi M, Takahashi H, Umegaki S, Kawamura Y, Hiraide S, Ouchi K, Sato Y, Okada Y, Komine K, Saijo K, Takahashi S, Takahashi M, Shirota H, Ohori H, Gamoh M, Ishioka C. Efficacy and Safety of Trastuzumab in Combination with S-1 and Cisplatin Therapy for Japanese Patients with HER2-Positive Advanced Gastric Cancer: Retrospective Analysis. TOHOKU J EXP MED 2018; 245:123-129. [DOI: 10.1620/tjem.245.123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Akira Okita
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Hiroo Imai
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Masahiro Takahashi
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | | | - Sho Umegaki
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Yoshifumi Kawamura
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Sakura Hiraide
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Yuko Sato
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Yoshinari Okada
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Keigo Komine
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Ken Saijo
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Shin Takahashi
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Masanobu Takahashi
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Hidekazu Shirota
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
| | - Hisatsugu Ohori
- Department of Medical Oncology, Ishinomaki Red Cross Hospital
| | - Makio Gamoh
- Department of Medical Oncology, Osaki Citizen Hospital
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University
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Takahashi H, Takahashi M, Ohnuma S, Unno M, Yoshino Y, Ouchi K, Takahashi S, Yamada Y, Shimodaira H, Ishioka C. microRNA-193a-3p is specifically down-regulated and acts as a tumor suppressor in BRAF-mutated colorectal cancer. BMC Cancer 2017; 17:723. [PMID: 29115941 PMCID: PMC5678600 DOI: 10.1186/s12885-017-3739-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 10/31/2017] [Indexed: 02/06/2023] Open
Abstract
Background The aim of this study was to identify miRNAs specifically dysregulated in BRAF-mutated colorectal cancer, which could lead to a better understanding of the molecular mechanisms underlying oncogenesis of this malignant subtype of colorectal cancer. Methods Candidate dysregulated miRNAs were selected in genome-wide miRNA expression array analysis using a screening set composed of 15 BRAF-mutated and 15 non-KRAS/BRAF-mutated colorectal cancers. The miRNA expressions were validated in another set of patients. The functional roles of the miRNAs were analyzed by cell growth and invasion assays. The association between miRNA expression status and the clinical outcome of patients treated with various chemotherapies was analyzed. Results Within the top five of the miRNAs screened, we validated miRNA-31 (miR-31) and miR-135b as up-regulated, while miR-193a-3p was down-regulated in BRAF-mutated cancer. Moreover, miR-193a-3p inhibited cell growth, and invasion of colorectal cancer cells. Low miR-193a-3p expression was associated with shorter progression-free survival in patients who received anti-EGFR therapy. Conclusions Our results disclose a novel tumor suppressive role of miR-193a-3p in colorectal cancer. These results could lead to novel therapeutic strategies for colorectal cancer, particularly in BRAF-mutated colorectal cancer. Electronic supplementary material The online version of this article (10.1186/s12885-017-3739-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hidekazu Takahashi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Masanobu Takahashi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. .,Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, 980-8574, Japan.
| | - Shinobu Ohnuma
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan
| | - Michiaki Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan
| | - Yuki Yoshino
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Kota Ouchi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Shin Takahashi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, 980-8574, Japan
| | - Yasuhide Yamada
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, 104-0045, Japan
| | - Hideki Shimodaira
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.,Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, 980-8574, Japan
| | - Chikashi Ishioka
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. .,Department of Medical Oncology, Tohoku University Hospital, Sendai, Miyagi, 980-8574, Japan.
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Bowman J, George N, Aaronson E, Ouchi K. 290 Usability and Acceptability of a Brief Tool to Guide Code Status Conversations in the Emergency Department. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.268] [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: 10/18/2022]
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39
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Takahashi M, Takahashi M, Komine K, Yamada H, Kasahara Y, Chikamatsu S, Okita A, Ito S, Ouchi K, Okada Y, Imai H, Saijo K, Shirota H, Takahashi S, Mori T, Shimodaira H, Ishioka C. The G8 screening tool enhances prognostic value to ECOG performance status in elderly cancer patients: A retrospective, single institutional study. PLoS One 2017. [PMID: 28640844 PMCID: PMC5480957 DOI: 10.1371/journal.pone.0179694] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background Some elderly cancer patients, even with good Eastern Cooperative Oncology Group performance status (ECOG-PS), have poor survival outcomes and cannot tolerate standard therapy. Few studies have detailed the associations between the G8 screening tool, ECOG-PS, and overall survival (OS) in such patients. Methods Cancer patients, aged 70 years or older, were assessed for G8 and classified into three groups according to their G8 score: <11 as the low score group, 11–14 as the intermediate score group, and >14 as the high score group. We retrospectively analyzed the association between G8 score and OS in all patients and for each ECOG-PS-categorized group. Results Out of 264 enrolled patients, most patients (87%) with solid tumor were categorized as TNM stage IV. ECOG-PS was 0 or 1 in 215 patients and ≥2 in 48; there was missing data for one patient. Among all patients, the low score group with a median OS of 7.7 months survived significantly less than both the high score group with a median OS of 25.6 months [Hazard ratio (HR) 3.48; 95% confidence interval (CI), 1.96–6.63; p < 0.0001] and the intermediate score group with a median of 15.6 months (HR 1.83; 95% CI, 1.28–2.65; p < 0.001). In the multivariate analysis, TNM stage and G8 score were independent prognostic factors for OS. When patients with an ECOG-PS of 0 or 1 were analyzed, patients with a lower G8 score showed significantly shorter OS than patients with a higher score when any two groups were compared. Conclusion This novel classification of the G8 score contributes to prompt identification of patients with poor prognosis and improved the prognostic value of ECOG-PS. Using G8 with ECOG-PS may be helpful in deciding treatment for elderly patients with advanced cancer.
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Affiliation(s)
- Masahiro Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Masanobu Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Keigo Komine
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Hideharu Yamada
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Yuki Kasahara
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Sonoko Chikamatsu
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Akira Okita
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Shukuei Ito
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Kota Ouchi
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Yoshinari Okada
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Hiroo Imai
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Ken Saijo
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Hidekazu Shirota
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
| | - Shin Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Takahiro Mori
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
| | - Hideki Shimodaira
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Chikashi Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Aoba-ku, Sendai, Miyagi, Japan
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- * E-mail:
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Zhang X, Shimodaira H, Soeda H, Komine K, Takahashi H, Ouchi K, Inoue M, Takahashi M, Takahashi S, Ishioka C. CpG island methylator phenotype is associated with the efficacy of sequential oxaliplatin- and irinotecan-based chemotherapy and EGFR-related gene mutation in Japanese patients with metastatic colorectal cancer. Int J Clin Oncol 2016; 21:1091-1101. [PMID: 27435270 DOI: 10.1007/s10147-016-1017-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 06/24/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND The CpG island methylator phenotype (CIMP) with multiple promoter methylated loci has been observed in a subset of human colorectal cancer (CRC) cases. CIMP status, which is closely associated with specific clinicopathological and molecular characteristics, is considered a potential predictive biomarker for efficacy of cancer treatment. However, the relationship between the effect of standard chemotherapy, including cytotoxic drugs and anti-epidermal growth factor receptor (EGFR) antibodies, and CIMP status has not been elucidated. METHODS In 125 metastatic colorectal cancer (mCRC) patients, we investigated how clinical outcome of chemotherapy was related to CIMP status as detected by methylation-specific PCR (MSP) and to genetic status in five EGFR-related genes (KRAS, BRAF, PIK3CA, NRAS, and AKT1) as detected by direct sequencing. RESULTS CIMP-positive status was significantly associated with proximal tumor location and peritoneum metastasis (all P values <0.05). The progression-free survival of patients with CIMP-positive tumors receiving sequential therapy with FOLFOX as the first-line treatment followed by irinotecan-based therapy as the second-line treatment (median = 6.6 months) was inferior to that of such patients receiving the reverse sequence (median = 15.2 months; P = 0.043). Furthermore, CIMP-positive tumors showed higher mutation frequencies for the five EGFR-related genes (74.1 %) than the CIMP-negative tumors did (50.0 %). Among the KRAS wild-type tumors, CIMP-positive tumors were associated with a worse clinical outcome than CIMP-negative tumors following anti-EGFR antibody therapy. CONCLUSION Sequential FOLFOX followed by an irinotecan-based regimen is unfavorable in patients with CIMP-positive tumors. High frequencies of mutation in EGFR-related genes in CIMP-positive tumors may cause the lower response to anti-EGFR antibody therapy seen in patients with wild-type KRAS and CIMP-positive tumors.
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Affiliation(s)
- Xiaofei Zhang
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Hideki Shimodaira
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan.,Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Hiroshi Soeda
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan.,Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Keigo Komine
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan.,Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Hidekazu Takahashi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Kota Ouchi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan
| | - Masahiro Inoue
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan.,Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Masanobu Takahashi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan.,Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Shin Takahashi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan.,Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Chikashi Ishioka
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1, Seiryo-machi, Aobaku, Sendai, 980-8575, Japan. .,Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan.
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Ouchi K, Takahashi S, Yamada Y, Tsuji S, Tatsuno K, Takahashi H, Takahashi N, Takahashi M, Shimodaira H, Aburatani H, Ishioka C. DNA methylation status as a biomarker of anti-epidermal growth factor receptor treatment for metastatic colorectal cancer. Cancer Sci 2015; 106:1722-9. [PMID: 26426205 PMCID: PMC4714671 DOI: 10.1111/cas.12827] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/17/2015] [Accepted: 09/18/2015] [Indexed: 12/22/2022] Open
Abstract
Anti‐epidermal growth factor receptor (EGFR) treatment is an effective option for metastatic colorectal cancer (CRC) treatment. However, there are few reliable biomarkers to predict the clinical response to anti‐EGFR treatment. We investigated the genome‐wide DNA methylation status in metastatic colorectal cancer to identify associations between the methylation status and clinical response to anti‐EGFR antibody. We retrospectively reviewed the medical records of 97 patients (45 patients for the first cohort and 52 patients for the second cohort) who received anti‐EGFR treatment for KRAS wild‐type metastatic CRC. Then we analyzed the associations between genome‐wide DNA methylation status and clinical response to anti‐EGFR treatment, and evaluated the predictive power and value of the methylation status statistically. As a result, each cohort was classified into highly methylated CRC and low methylated CRC subgroups by unsupervised clustering analyses. In the first cohort, clinical outcomes were significantly better in the low methylated CRC subgroup than in the highly methylated CRC subgroup (response rate, 35.7% vs 6.3%, P = 0.03; disease control rate, 75% vs 31.3%, P = 0.005; hazard ratio for progression‐free survival, 0.27; 95% confidence interval, 0.13–0.57, P < 0.001; overall survival, 0.19; 95% confidence interval, 0.06–0.54, P < 0.001). These results were reproducible in the second cohort. The genome‐wide methylation status was a predictive factor of progression‐free survival and overall survival independently of RAS mutation status. In conclusion, we found that the genome‐wide DNA methylation status is a powerful epigenetic predictor of anti‐EGFR treatment in patients with KRAS wild‐type metastatic colorectal cancer (UMIN000005490).
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Affiliation(s)
- Kota Ouchi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Shin Takahashi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Yasuhide Yamada
- Gastrointestinal Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Shingo Tsuji
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Kenji Tatsuno
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Hidekazu Takahashi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Naoki Takahashi
- Gastrointestinal Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Masanobu Takahashi
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Hideki Shimodaira
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Hiroyuki Aburatani
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Chikashi Ishioka
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
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Ouchi K, Takahashi SHIN, Yamada Y, Tsuji S, Tatsuno K, Takahashi H, Takahashi N, Takahashi M, Shimodaira H, Aburatani H, Ishioka C. DNA methylation profile to predict clinical outcome of anti-EGFR treatment in metastatic colorectal cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e14574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Yasuhide Yamada
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | | | | | | | - Naoki Takahashi
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | | | - Hideki Shimodaira
- Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Hiroyuki Aburatani
- Genome Science Division, Research Center for Advanced Science and Technology, University of Tokyo, Tokyo, Japan
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Yoshida H, Miyachi M, Sakamoto K, Ouchi K, Yagyu S, Kikuchi K, Kuwahara Y, Tsuchiya K, Imamura T, Iehara T, Kakazu N, Hojo H, Hosoi H. PAX3-NCOA2 fusion gene has a dual role in promoting the proliferation and inhibiting the myogenic differentiation of rhabdomyosarcoma cells. Oncogene 2013; 33:5601-8. [DOI: 10.1038/onc.2013.491] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 09/20/2013] [Indexed: 11/10/2022]
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45
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Takahashi H, Takahashi M, Inoue M, Soeda H, Ouchi K, Zhang X, Takahashi S, Shimodaira H, Kato S, Ishioka C. Clinical Phenotype of Microsatellite Instable Metastatic or Recurrent Colorectal Cancer in a Japanese Population. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.134] [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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46
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Ouchi K, Takahashi S, Tatsuno K, Hayashi A, Yamamoto S, Ueda H, Inoue M, Nakano H, Aburatani H, Ishioka C. Whole-Exome Sequencing (WES) Using Formalin-Fixed Paraffin Embedded (FFPE) Tissue. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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47
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Kushida T, Nohara S, Yoshino K, Fujiwara D, Ouchi K, Amano T, Isayama F, Tomita N, Iwanuma Y, Sasai K, Tsurumaru M, Kajiyama Y. Utility of weekly docetaxel combined with preoperative radiotherapy for locally advanced esophageal cancer from pathological analysis. Dis Esophagus 2013; 27:368-73. [PMID: 23865505 DOI: 10.1111/dote.12105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Esophageal squamous cell cancer (ESCC) is a high-grade carcinoma that is treated with multidisciplinary approaches, including chemoradiotherapy (CRT) followed by surgery. Despite some success with these therapies, overall survival remains poor. In order to investigate a newer CRT regimen, we designed a comparative study to evaluate preoperative CRT using docetaxel (DOC) or 5-Fluorouracil and cisplatin (FU+CDDP [FP] therapy) for treatment of resectable ESCC. In a retrospective review of patients with resectable, locally advanced ESCC, 95 patients received preoperative CRT between 2001 and 2007. CRT was administered using either FP (n = 40) or DOC (n = 55). Pathological response and clinical outcomes were compared between the two groups. Hazard ratios and time-to-event analyses were used to assess outcomes; the ratios were controlled by multivariate logistic regression analysis of potential prognostic factors, and survival was presented with Kaplan-Meier curves. In the FP group, a significant curative effect was observed on the basis of pathological examination of postoperative lesions. However, the DOC group presented a significantly better prognosis on the basis of cumulative survival rates. Logistic regression analysis revealed that the presence of five or more lymph node metastases was an independent predictor of reduced survival. Patients with lymph node metastasis exhibited a better prognosis in the DOC group than those in the FP group. Preoperative CRT for locally advanced esophageal cancer using DOC results in similar or better long-term outcomes compared with FP-based CRT. Therefore, CRT using DOC is a promising therapy option for esophageal cancer.
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Affiliation(s)
- T Kushida
- Department of Esophageal and Gastroenterological Surgery, Juntendo University Hospital, Tokyo, Japan
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Kawai Y, Kato A, Nishizawa Y, Kondo E, Saito A, Wakabayashi T, Akaike H, Tanaka T, Nakano T, Ouchi K, Miyashita N. P343 Prevalence of macrolide-resistant Mycoplasma pneumoniae infection in pediatric patients: a multicenter epidemiological study. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70584-3] [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: 10/26/2022]
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Taniguchi A, Takakura Y, Sugimoto K, Hayashi K, Ouchi K, Kumai T, Tanaka Y. The use of a ceramic talar body prosthesis in patients with aseptic necrosis of the talus. ACTA ACUST UNITED AC 2013; 94:1529-33. [PMID: 23109634 DOI: 10.1302/0301-620x.94b11.29543] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The purpose of this study was to evaluate the clinical results of a newly designed prosthesis to replace the body of the talus in patients with aseptic necrosis. Between 1999 and 2006, 22 tali in 22 patients were replaced with a ceramic prosthesis. A total of eight patients were treated with the first-generation prosthesis, incorporating a peg to fix into the retained neck and head of the talus, and the remaining 14 were treated with the second-generation prosthesis, which does not have the peg. The clinical results were assessed by the American Orthopaedic Foot and Ankle Society ankle/hindfoot scale. The mean follow-up was 98 months (18 to 174). The clinical results of the first-generation prostheses were excellent in three patients, good in one, fair in three and poor in one. There were, however, radiological signs of loosening, prompting a change in design. The clinical results of the second-generation prostheses were excellent in three patients, good in five, fair in four and poor in two, with more favourable radiological appearances. Revision was required using a total talar implant in four patients, two in each group. Although the second-generation prosthesis produced better results, we cannot recommend the use of a talar body prosthesis. We now recommend the use of a total talar implant in these patients.
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Affiliation(s)
- A Taniguchi
- Nara Medical University, Department of Orthopaedic Surgery, 840 Shijyo-cho, Kashihara Chity, Nara 634-8522, Japan.
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Miyashita N, Kawai Y, Yamaguchi T, Ouchi K, Oka M. Clinical potential of diagnostic methods for the rapid diagnosis of Mycoplasma pneumoniae pneumonia in adults. Eur J Clin Microbiol Infect Dis 2010; 30:439-46. [DOI: 10.1007/s10096-010-1107-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Accepted: 10/19/2010] [Indexed: 11/30/2022]
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