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Matsumoto N, Mizuno T, Ando Y, Kato K, Nakanishi M, Nakai T, Lee JK, Kameya Y, Nakamura W, Takahara K, Shiroki R, Yamada S. Prediction Model for Severe Thrombocytopenia Induced by Gemcitabine Plus Cisplatin Combination Therapy in Patients with Urothelial Cancer. Clin Drug Investig 2024:10.1007/s40261-024-01361-3. [PMID: 38684605 DOI: 10.1007/s40261-024-01361-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Chemotherapy-induced thrombocytopenia is often a use-limiting adverse reaction to gemcitabine and cisplatin (GC) combination chemotherapy, reducing therapeutic intensity, and, in some cases, requiring platelet transfusion. OBJECTIVE A retrospective cohort study was conducted on patients with urothelial cancer at the initiation of GC combination therapy and the objective was to develop a prediction model for the incidence of severe thrombocytopenia using machine learning. METHODS We performed receiver operating characteristic analysis to determine the cut-off values of the associated factors. Multivariate analyses were conducted to identify risk factors associated with the occurrence of severe thrombocytopenia. The prediction model was constructed from an ensemble model and gradient-boosted decision trees to estimate the risk of an outcome using the risk factors associated with the occurrence of severe thrombocytopenia. RESULTS Of 186 patients included in this study, 46 (25%) experienced severe thrombocytopenia induced by GC therapy. Multivariate analyses revealed that platelet count ≤ 21.4 (×104/µL) [odds ratio 7.19, p < 0.01], hemoglobin ≤ 12.1 (g/dL) [odds ratio 2.41, p = 0.03], lymphocyte count ≤ 1.458 (×103/µL) [odds ratio 2.47, p = 0.02], and dose of gemcitabine ≥ 775.245 (mg/m2) [odds ratio 4.00, p < 0.01] were risk factors of severe thrombocytopenia. The performance of the prediction model using these associated factors was high (area under the curve 0.76, accuracy 0.82, precision 0.68, recall 0.50, and F-measure 0.58). CONCLUSIONS Platelet count, hemoglobin level, lymphocyte count, and gemcitabine dose contributed to the development of a novel prediction model to identify the incidence of GC-induced severe thrombocytopenia.
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Affiliation(s)
- Noriaki Matsumoto
- Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- Sugi Pharmacy Co., Ltd, Obu, Aichi, Japan
| | - Tomohiro Mizuno
- Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
| | - Yosuke Ando
- Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Koki Kato
- Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Masanori Nakanishi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Tsuyoshi Nakai
- Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Jeannie K Lee
- Department of Pharmacy Practice and Science, The University of Arizona R. Ken Coit College of Pharmacy, Tucson, AZ, USA
| | - Yoshitaka Kameya
- Department of Information Engineering, Meijo University, Nagoya, Japan
| | - Wataru Nakamura
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Kiyoshi Takahara
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Ryoichi Shiroki
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Shigeki Yamada
- Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Takase E, Akamatsu H, Teraoka S, Nakaguchi K, Tanaka M, Kaki T, Furuta K, Sato K, Murakami E, Sugimoto T, Shibaki R, Fujimoto D, Hayata A, Tokudome N, Ozawa Y, Koh Y, Nakanishi M, Kanai K, Shimokawa T, Yamamoto N. A Phase II Study of High-Flow Nasal Cannula for Relieving Dyspnea in Advanced Cancer Patients. J Pain Symptom Manage 2024; 67:204-211.e1. [PMID: 37992848 DOI: 10.1016/j.jpainsymman.2023.11.009] [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: 08/10/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 11/24/2023]
Abstract
CONTEXT The efficacy and tolerability of high-flow nasal cannula (HFNC) for relieving dyspnea in advanced cancer patients with limited prognosis requires elucidation. OBJECTIVES The primary aim of this trial was to assess the efficacy and tolerability of HFNC regarding dyspnea including severe as well as moderate for longer durations in patients under palliative care. METHODS In this prospective study, hospitalized patients with advanced cancer who had dyspnea at rest (numeric rating scale, NRS≥3) and hypoxemia were enrolled. They were treated with HFNC for five days in the respiratory unit. Primary endpoint was mean change of modified Borg scale at 24 hours. Key secondary endpoints consisted of mean changes in modified Borg scale during the study period and feasibility (Trial Identifier, UMIN000035738). RESULTS Between February 2019 and February 2022, 25 patients were enrolled and 21 were analyzed. Twenty patients used inspired oxygen and the mean fraction of inspired oxygen (FiO2) was 0.34 (range, 0.21-1.0). At baseline, mean NRS (dyspnea) was 5.9 (range, 3-10). Median survival time was 19 days (range, 3-657). The mean change of modified Borg scale was 1.4 (80% confidence interval [CI]: 0.8-1.9) at 24 hours, 12 patients (57%) showed 1.0 points improvement of modified Borg scale. Within two hours, 15 patients showed 1.0 points improvement of modified Borg scale and such early responders were likely to maintain dyspnea improvement for 24 hours. Nineteen patients could continue HFNC for 24 hours and 11 patients completed five days of HFNC. CONCLUSION To our knowledge, this trial is the first prospective study to assess the five-day efficacy and tolerability of HFNC for dyspnea in patients under palliative care. Although this did not reach the prespecified endpoint, about half of the patients showed 1.0 point improvement, a minimally clinically important difference (MCID) in the chronic lung disease. HFNC can be a palliative treatment option in advanced cancer patients with dyspnea.
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Affiliation(s)
- Eri Takase
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Hiroaki Akamatsu
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan.
| | - Shunsuke Teraoka
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Keita Nakaguchi
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Masanori Tanaka
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Takahiro Kaki
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Katsuyuki Furuta
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Koichi Sato
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Eriko Murakami
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Takeya Sugimoto
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Ryota Shibaki
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Daichi Fujimoto
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Atsushi Hayata
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Nahomi Tokudome
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Yuichi Ozawa
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Yasuhiro Koh
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan; Center for Biomedical Sciences (Y.K.), Wakayama Medical University, Wakayama, Japan
| | - Masanori Nakanishi
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Kuninobu Kanai
- Department of Respiratory Medicine (K.K.), Naga Municipal Hospital, Wakayama, Japan
| | - Toshio Shimokawa
- Clinical Study Support Center (T.S.), Wakayama Medical University, Wakayama, Japan
| | - Nobuyuki Yamamoto
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan; Center for Biomedical Sciences (Y.K.), Wakayama Medical University, Wakayama, Japan
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Miyake MM, Valera FCP, Martins RB, Compagnoni IM, Fantucci MZ, Murashima AAB, da Silva LECM, de Lima TM, de Souza MVO, Melo SR, Dolci RLL, Floriano CG, de Campos CAC, Nakanishi M, Freire GSM, Valente AL, Fornazieri MA, da Silva JLB, Anzolin LK, Issa MJA, Souza TV, Lima BA, SantAnna GD, Abreu CB, Sakano E, Cassettari AJ, Avelino MAG, Goncalves MC, de Camargo LA, Romano FR, Alves RD, Roithmann R, Redeker NK, Filho LLB, Dassi CS, Meurer ATO, Garcia DM, Aragon DC, Tepedino MS, Succar ACS, Vianna PM, Dos Santos MCJ, Filho RHR, Kosugi EM, Villa JF, Gregorio LL, Piltcher OB, Meotti CD, Tamashiro E, Arruda E, Anselmo Lima WT. Smell loss associated with SARS-CoV-2 is not clinically different from other viruses: a multicenter cohort study. Rhinology 2024; 62:55-62. [PMID: 37772802 DOI: 10.4193/rhin23.116] [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: 09/30/2023]
Abstract
BACKGROUND Although the COVID-19 pandemic has increased the prevalence of cases with olfactory loss, other respiratory viruses can also cause this condition. We aimed to compare the prevalence of acute SARS-CoV-2 infection and other respiratory viruses in patients with sudden smell loss, and to assess the impact of SARS-CoV-2 viral load and co-infection on olfactory symptoms. METHODS Patients with sudden smell loss were recruited in a multicenter prospective cohort study in 15 hospitals in Brazil. Clinical questionnaire, Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test and nasopharyngeal swab to perform a PCR-based respiratory viral panel were collected at first visit (day 0) and 30 and 60 days after recruitment. RESULTS 188 of 213 patients presented positive test result for SARS-CoV-2, among which 65 were co-infected with other respiratory viruses (e.g., rhinovirus, enterovirus, and parainfluenza). 25 had negative test results for SARS-CoV-2. Patients in both SARSCoV-2 and non-SARS-CoV-2 groups had objective anosmia (less than 2 points according to the psychophysical olfactory CCCRC) at day 0, with no significant difference between them. Both groups had significant smell scores improvement after 30 and 60 days, with no difference between them. Co-infection with other respiratory viruses, and SARS-CoV-2 viral load did not impact olfactory scores. CONCLUSION Patients with sudden smell loss associated with SARS-CoV-2 and other respiratory viruses had similar presentation, with most participants initiating with anosmia, and total or near total recovery after 60 days. SARS-CoV-2 viral load and co-infections with other respiratory viruses were not associated with poorer olfactory outcomes.
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Affiliation(s)
- M M Miyake
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil and Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil
| | - F C P Valera
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - R B Martins
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - I M Compagnoni
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - M Z Fantucci
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - A A B Murashima
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - L E C M da Silva
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - T M de Lima
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - M V O de Souza
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - S R Melo
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - R L L Dolci
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil
| | - C G Floriano
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil
| | - C A C de Campos
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil
| | - M Nakanishi
- University of Brasilia, Brasilia, DF, Brazil
| | | | - A L Valente
- University of Brasilia, Brasilia, DF, Brazil
| | | | | | - L K Anzolin
- State University of Londrina, Londrina, PR, Brazil
| | - M J A Issa
- Mater Dei Hospital, Belo Horizonte, MG, Brazil
| | - T V Souza
- Mater Dei Hospital, Belo Horizonte, MG, Brazil
| | - B A Lima
- Mater Dei Hospital, Belo Horizonte, MG, Brazil
| | - G D SantAnna
- Santa Casa de Misericordia Hospital de Porto Alegre, Porto Alegre, RS, Brazil
| | - C B Abreu
- Santa Casa de Misericordia Hospital de Porto Alegre, Porto Alegre, RS, Brazil
| | - E Sakano
- State University of Campinas. Campinas, SP, Brazil
| | | | | | | | | | | | - R D Alves
- Hospital Moriah, Sao Paulo, SP, Brazil
| | - R Roithmann
- Lutheran University of Brazil, Canoas, RS, Brazil
| | - N K Redeker
- Lutheran University of Brazil, Canoas, RS, Brazil
| | - L L B Filho
- Hospital Edmundo Vasconcelos, Sao Paulo, SP, Brazil
| | - C S Dassi
- Hospital Edmundo Vasconcelos, Sao Paulo, SP, Brazil
| | - A T O Meurer
- Hospital Edmundo Vasconcelos, Sao Paulo, SP, Brazil
| | - D M Garcia
- Ribeirio Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - D C Aragon
- Ribeirio Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - M S Tepedino
- State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - A C S Succar
- State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - P M Vianna
- State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - E M Kosugi
- Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - J F Villa
- Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - L L Gregorio
- Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | - C D Meotti
- Hospital de Clinicas Porto Alegre, RS, Brazil
| | - E Tamashiro
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - E Arruda
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - W T Anselmo Lima
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
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Murakami E, Akamatsu H, Teraoka S, Takakura T, Takase E, Tanaka M, Kaki T, Harutani Y, Furuta K, Sugimoto T, Shibaki R, Fujimoto D, Hayata A, Ozawa Y, Nakanishi M, Koh Y, Shimokawa T, Yamamoto N. Mannitol versus furosemide in patients with thoracic malignancies who received cisplatin-based chemotherapy using short hydration: A randomized phase II trial. Cancer Med 2024; 13:e6839. [PMID: 38457231 PMCID: PMC10923027 DOI: 10.1002/cam4.6839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/10/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Mannitol is exclusively recommended in the National Comprehensive Cancer Network guidelines for diuresis in cisplatin (CDDP)-based chemotherapy. The utility of furosemide, a widely used and convenient diuretic, thus requires clarification. METHODS This is a prospective, single-centered, open-label, noninferiority phase II study. Patients with thoracic malignancies who planned to receive CDDP-based chemotherapy were randomly assigned to receive either mannitol (arm A) or furosemide (arm B). The primary end point was set as the proportion of patients who experienced any grade of "creatinine (Cr) increased" based on the upper limit of the normal range (ULN) during the first cycle as assessed by Common Terminology Criteria for Adverse Events Version 4.0. Secondary end points were Cr increased based on the baseline value during the first cycle, Cr increased after the completion of CDDP, and the proportion of patients with phlebitis. RESULTS Between April 2018 and March 2022, 115 patients were enrolled and 106 were analyzed. Any grade of Cr increased based on the ULN during the first cycle was 17.3% (arm A) and 24.1% (arm B), respectively (p = 0.34). Therefore, the primary end point was not met. After completion of chemotherapy, any grade of Cr increased was observed in 23.1% (arm A) and 31.5% (arm B), respectively. However, the actual serum Cr level and Cr clearance during the courses were not different between the arms. Phlebitis occurred more frequently in arm A (28.8%) than arm B (16.7%). CONCLUSIONS Mannitol should remain the standard diuresis in CDDP-based chemotherapy assessed by conventional CTCAE grading, but furosemide can be room for consideration when assessed by actual serum Cr level and Cr clearance.
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Affiliation(s)
- Eriko Murakami
- Internal Medicine IIIWakayama Medical UniversityWakayamaJapan
| | | | | | | | - Eri Takase
- Internal Medicine IIIWakayama Medical UniversityWakayamaJapan
| | - Masanori Tanaka
- Internal Medicine IIIWakayama Medical UniversityWakayamaJapan
| | - Takahiro Kaki
- Internal Medicine IIIWakayama Medical UniversityWakayamaJapan
| | - Yuhei Harutani
- Internal Medicine IIIWakayama Medical UniversityWakayamaJapan
| | | | - Takeya Sugimoto
- Internal Medicine IIIWakayama Medical UniversityWakayamaJapan
| | - Ryota Shibaki
- Internal Medicine IIIWakayama Medical UniversityWakayamaJapan
| | - Daichi Fujimoto
- Internal Medicine IIIWakayama Medical UniversityWakayamaJapan
| | - Atsushi Hayata
- Internal Medicine IIIWakayama Medical UniversityWakayamaJapan
| | - Yuichi Ozawa
- Internal Medicine IIIWakayama Medical UniversityWakayamaJapan
| | | | - Yasuhiro Koh
- Internal Medicine IIIWakayama Medical UniversityWakayamaJapan
- Center for Biomedical SciencesWakayama Medical UniversityWakayamaJapan
| | - Toshio Shimokawa
- Clinical Study Support CenterWakayama Medical UniversityWakayamaJapan
| | - Nobuyuki Yamamoto
- Internal Medicine IIIWakayama Medical UniversityWakayamaJapan
- Center for Biomedical SciencesWakayama Medical UniversityWakayamaJapan
- Clinical Study Support CenterWakayama Medical UniversityWakayamaJapan
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5
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Ueda Y, Okamoto T, Sato Y, Hayashi A, Takahashi T, Suzuki R, Aoyagi H, Ueno M, Kobayashi N, Uetake K, Nakanishi M, Ariga T, Manabe A. Changes in bone turnover markers after discontinuing long-term glucocorticoid administration in children with idiopathic nephrotic syndrome: a multicenter retrospective observational study. Pediatr Nephrol 2023; 38:3285-3296. [PMID: 37052692 DOI: 10.1007/s00467-023-05966-2] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/03/2023] [Accepted: 03/27/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Glucocorticoids affect bone turnover. Little is known about how bone turnover changes when glucocorticoids are discontinued following long-term administration. METHODS This retrospective observational study was conducted on the relationship between discontinuation of long-term administration of glucocorticoid and bone turnover markers (BTMs) in patients with childhood-onset idiopathic nephrotic syndrome. Serum bone alkaline phosphatase (BAP), intact procollagen type 1 N-terminal propeptide (P1NP), and tartrate-resistant acid phosphatase-5b (TRACP-5b) were evaluated as BTMs. RESULTS Thirty-eight pairs of BTMs at glucocorticoid administration and after discontinuation were analyzed in 29 patients. The median age at baseline was 12.4 (interquartile range, 9.0-14.5) years, and the median time from the onset of nephrotic syndrome was 5.9 (3.3-9.7) years. The mean period from prednisolone discontinuation to the measurement of BTMs after glucocorticoid discontinuation was 3.5 ± 1.0 months. Changes in BTMs after glucocorticoid discontinuation were modest when the daily prednisolone dose was < 0.25 mg/kg/day (ln BAP standard deviation [SD] score, p = 0.19; log intact P1NP SD score, p = 0.70; TRACP-5b, p = 0.95). When the daily prednisolone dose was ≥ 0.25 mg/kg/day, all BTMs increased significantly after glucocorticoid discontinuation (ln BAP SD score, p < 0.01; log intact P1NP SD score, p < 0.01; TRACP-5b, p < 0.01). CONCLUSIONS Decreased BTMs can rise within a few months of discontinuing long-term glucocorticoid administration. When the administered glucocorticoid dose is low, changes in BTMs may be small. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Yasuhiro Ueda
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, Japan
| | - Takayuki Okamoto
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, Japan.
| | - Yasuyuki Sato
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, Japan
| | - Asako Hayashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, Japan
| | - Toshiyuki Takahashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, Japan
| | - Ryota Suzuki
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, Japan
| | - Hayato Aoyagi
- Department of Pediatrics, Obihiro Kyokai Hospital, Obihiro, Hokkaido, Japan
| | - Michihiko Ueno
- Department of Pediatrics, Nikko Memorial Hospital, Muroran, Hokkaido, Japan
| | - Norio Kobayashi
- Department of Pediatrics, Oji General Hospital, Tomakomai, Hokkaido, Japan
| | - Kimiaki Uetake
- Department of Pediatrics, Obihiro Kosei Hospital, Obihiro, Hokkaido, Japan
| | - Masanori Nakanishi
- Department of Pediatrics, Kushiro Red Cross Hospital, Kushiro, Hokkaido, Japan
| | - Tadashi Ariga
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, Japan
- Department of Pediatrics, Nikko Memorial Hospital, Muroran, Hokkaido, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, Japan
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Tejada MLG, Sano T, Hanyu T, Koppers AAP, Nakanishi M, Miyazaki T, Ishikawa A, Tani K, Shimizu S, Shimizu K, Vaglarov B, Chang Q. New evidence for the Ontong Java Nui hypothesis. Sci Rep 2023; 13:8486. [PMID: 37231104 DOI: 10.1038/s41598-023-33724-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/18/2023] [Indexed: 05/27/2023] Open
Abstract
The formation of the Ontong Java Nui super oceanic plateau (OJN), which is based on the model that the submarine Ontong Java Plateau (OJP), Manihiki Plateau (MP), and Hikurangi Plateau (HP) were once its contiguous fragments, could have been the largest globally consequential volcanic event in Earth's history. This OJN hypothesis has been debated given the paucity of evidence, for example, the differences in crustal thickness, the compositional gap between MP and OJP basalts and the apparent older age of both plateaus relative to HP remain unresolved. Here we investigate the geochemical and 40Ar-39Ar ages of dredged rocks recovered from the OJP's eastern margin. Volcanic rocks having compositions that match the low-Ti MP basalts are reported for the first time on the OJP and new ~ 96-116 Ma and 67-68 Ma 40Ar-39Ar age data bridge the temporal gap between OJP and HP. These results provide new evidence for the Ontong Java Nui hypothesis and a framework for an integrated tectonomagmatic evolution of the OJP, MP, and HP. The isotopic data imply four mantle components in the source of OJN that are also expressed in present-day Pacific hotspots sources, indicating origin from (and longevity of) the Pacific Large Low Shear-wave Velocity Province.
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Affiliation(s)
- M L G Tejada
- Research Institute for Marine Geodynamics, Japan Agency for Marine-Earth Science and Technology, Yokosuka, 237-0061, Japan.
| | - T Sano
- Department of Geology and Paleontology, National Museum of Nature and Science, Tsukuba, 305-005, Japan
| | - T Hanyu
- Research Institute for Marine Geodynamics, Japan Agency for Marine-Earth Science and Technology, Yokosuka, 237-0061, Japan
| | - A A P Koppers
- College of Earth, Ocean and Atmospheric Sciences, Oregon State University, Corvallis, OR, 97331, USA
| | - M Nakanishi
- Graduate School of Science, Chiba University, Chiba, 263-8522, Japan
| | - T Miyazaki
- Research Institute for Marine Geodynamics, Japan Agency for Marine-Earth Science and Technology, Yokosuka, 237-0061, Japan
| | - A Ishikawa
- Department of Earth and Planetary Sciences, Tokyo Institute of Technology, Tokyo, 152-8550, Japan
| | - K Tani
- Department of Geology and Paleontology, National Museum of Nature and Science, Tsukuba, 305-005, Japan
| | - S Shimizu
- Graduate School of Science and Engineering, Chiba University, Chiba, 263-8522, Japan
| | - K Shimizu
- Kochi Institute for Core Sample Research, Japan Agency for Marine-Earth Science and Technology, Kochi, 783-8502, Japan
| | - B Vaglarov
- Research Institute for Marine Geodynamics, Japan Agency for Marine-Earth Science and Technology, Yokosuka, 237-0061, Japan
| | - Q Chang
- Research Institute for Marine Geodynamics, Japan Agency for Marine-Earth Science and Technology, Yokosuka, 237-0061, Japan
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7
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Kato T, Mizuno T, Nakanishi M, Lee JK, Yamada S, Tsuboi N, Takahashi K. Efficacy of Ascorbic Acid, Thiamine, and Hydrocortisone Combination Therapy: Meta-analysis of Randomized Controlled Trials. In Vivo 2023; 37:1236-1245. [PMID: 37103081 DOI: 10.21873/invivo.13200] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND/AIM Sepsis is a life-threatening biological condition that induces systemic tissue and organ dysfunction and confers a high mortality risk. Although the use of hydrocortisone in combination with ascorbic acid and thiamine (HAT therapy) significantly reduced mortality from sepsis or septic shock in a previous study, it did not improve mortality in subsequent randomized controlled trials (RCTs). Therefore, no definitive conclusion has been established on the benefits of HAT therapy for sepsis or septic shock. We performed a meta-analysis to assess the treatment outcomes of HAT therapy in patients with sepsis or septic shock. PATIENTS AND METHODS We searched databases (PubMed/MEDLINE, Embase, Scopus and Cochrane Library) for RCTs using the terms "ascorbic acid", "thiamine", "sepsis", "septic shock", and "RCT". The primary outcome of this meta-analysis was the mortality rate, and the secondary outcomes were the incidence of new-onset acute renal injury (AKI), intensive care unit (ICU) length of stay (ICU-LOS), change in the Sequential Organ Failure Assessment (SOFA) score within 72 hours, and duration of vasopressor use. RESULTS Nine RCTs were identified and included in the outcome evaluation. HAT therapy did not improve the 28-day and ICU mortality, new-onset AKI, ICU-LOS, or SOFA scores. However, HAT therapy significantly shortened the duration of vasopressor use. CONCLUSION HAT therapy did not improve mortality, the SOFA score, renal injury, or ICU-LOS. Further studies are needed to confirm whether it shortens the duration of vasopressor use.
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Affiliation(s)
- Takahiro Kato
- Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tomohiro Mizuno
- Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Japan;
| | - Masanori Nakanishi
- Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Japan
| | - Jeannie K Lee
- Department of Pharmacy Practice & Science, University of Arizona R. Ken Coit College of Pharmacy, Tucson, AZ, U.S.A
| | - Shigeki Yamada
- Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Japan
| | - Naotake Tsuboi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuo Takahashi
- Department of Biomedical Molecular Sciences, Fujita Health University School of Medicine, Toyoake, Japan
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8
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Oyanagi J, Koh Y, Akiyama Y, Morimoto A, Sato K, Teraoka S, Fujimoto D, Tokudome N, Hayata A, Ozawa Y, Akamatsu H, Nakanishi M, Ueda H, Yamamoto N. Abstract 516: N-glycan moiety of IgG-Fc region is a prognostic biomarker for advancednon-small cell lung cancertreated with immune checkpoint inhibitors. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Although it has been known that N-glycan moiety in immunoglobulin G (IgG) fragment crystallizable (Fc) region, which affects antigen dependent cellular cytotoxicity (ADCC) activity is different between healthy individuals and cancer patients, the impact of N-glycan structure on cancer treatment is unknown. Here, we evaluated the putative ADCC activity by the N-glycan moiety of IgG-Fc using serum samples and analyzed its association with clinical benefits from immune checkpoint inhibitors (ICIs) in patients with advanced non-small cell lung cancer (NSCLC).
Patients and Methods: Serum samples from healthy volunteers (HVs) were obtained from Tohoku Medical Megabank and chronic obstructive pulmonary disease (COPD) patients were enrolled as a smoking-related non-cancer disease cohort. Serum samples from advanced NSCLC patients receiving ICIs until disease progression or unacceptable toxicity were collected prior treatment. Three IgG fractions (area 1, 2 and 3) corresponding to three peaks identified by affinity chromatography using TSKgel FcR-IIIA-NPR column (Tosoh, Japan) were quantified and the putative ADCC activity was estimated based on the ratio of area 3, which associates with highest ADCC activity, to the whole area (area 3 (%)). Mann-Whitney U-test, Kaplan-Meier methods and the log-rank test were conducted for statistical analyses using JMP Pro software (ver. 14.0).
Results: Forty-two COPD and ninty-six NSCLC patients were registered in the study between Jan 2016 and May 2021 at Wakayama Medical University. Characteristics of the patients were as follows: median age, 70 (range, 49-91); male. 78%; smoker, 79%; previous treatment ≥1, 77%; performance status 0-1, 82%; stage IV, 69%; squamous/non-squamous/unknown, 29/69/2%; nivolumab/pembrolizumab/atezolizumab, 46/42/12%. The objective response rate was 25.0% (24/96). The median progression free survival (PFS) and median overall survival (OS) was 72 days (95%CI, 49 to 127) and 310 days (95% CI, 216 to 453), respectively. The area 3 (%) was significantly lower in NSCLC patients than both HVs and COPD patients (P=0.0002 and p<0.0001, respectively) and no significant difference was observed between HVs and COPD samples. When time-to-event analysis was conducted by dividing into two groups in NSCLC patients at the median of the area 3 (%), OS was significantly longer in patient with higher ratio than those with lower one in both entire cohort (median OS, 952 vs 482; 95% CI, 453 days-not reached (NR) and 233-744 days; p=0.0236) and 2nd line subset (median OS, 952 vs 292; 95% CI, 453 days-NR and 120-692 days; p=0.001). Evaluation of IgG fraction was not associated with tumor response or PFS in this study cohort.
Conclusion: Our results suggest that evaluation of the N-glycan moiety of IgG-Fc in peripheral blood has a potential as a prognostic biomarker in advanced NSCLC patients treated with ICIs.
Citation Format: Jun Oyanagi, Yasuhiro Koh, Yasuyuki Akiyama, Atsushi Morimoto, Koichi Sato, Shunsuke Teraoka, Daichi Fujimoto, Nahomi Tokudome, Atsushi Hayata, Yuichi Ozawa, Hiroaki Akamatsu, Masanori Nakanishi, Hiroki Ueda, Nobuyuki Yamamoto. N-glycan moiety of IgG-Fc region is a prognostic biomarker for advancednon-small cell lung cancertreated with immune checkpoint inhibitors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 516.
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Affiliation(s)
- Jun Oyanagi
- 1Wakayama Medical University, Wakayama, Japan
| | | | | | | | - Koichi Sato
- 1Wakayama Medical University, Wakayama, Japan
| | | | | | | | | | | | | | | | - Hiroki Ueda
- 1Wakayama Medical University, Wakayama, Japan
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Shibaki R, Ozawa Y, Noguchi S, Murakami Y, Takase E, Azuma Y, Maebeya M, Sugimoto T, Hayata A, Hayakawa T, Tamaki S, Nakanishi M, Teraoka S, Akamatsu H. Impact of pre-existing interstitial lung abnormal shadow on lung injury development and severity in patients of non-small cell lung cancer treated with osimertinib. Cancer Med 2022; 11:3743-3750. [PMID: 35434933 PMCID: PMC9582680 DOI: 10.1002/cam4.4750] [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: 02/11/2022] [Revised: 03/06/2022] [Accepted: 04/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background First‐generation epidermal growth factor receptor‐tyrosine kinase inhibitor (EGFR‐TKI) sometimes causes lung injury, thereby affecting survival. Although pre‐existing interstitial lung abnormal shadow (pre‐ILS) increases the risk of lung injury by EGFR‐TKIs, its impact on osimertinib, a third‐generation EGFR‐TKI, remains unknown. Patients and Methods This retrospective cohort study consecutively enrolled patients of EGFR‐mutated non‐small cell lung cancer treated with osimertinib. Computed tomography images were obtained and evaluated independently by three pulmonologists in a blinded manner. Factors associated with lung injury were assessed using a logistic regression model. Survival curves were calculated by the Kaplan–Meier method and compared using a log‐rank test. Results Of the 195 patients, 40 had pre‐ILS, and 21 (8 with and 13 without pre‐ILS) developed lung injury during the observation period. Multivariate analysis revealed that pre‐ILS was independently associated with lung injury (odds ratio, 3.1; 95% confidence interval [CI], 1.1–8.2; p = 0.025). Severe (≥Grade 3) lung injury was observed in eight (4.1%) patients, of whom, two (5%) and six (3.9%) had and did not have pre‐ILS (p = 0.67), respectively. Grade 5 lung injury was not observed, and survival curves were similar between the patients who developed lung injury and those who did not (median 11 vs. 12 months; hazard ratio, 1.2; 95% CI, 0.56–2.7; p = 0.60). Conclusions Pre‐ILS increased the risk of lung injury in patients of non‐small cell lung cancer treated with osimertinib, while the severity of lung injury was not clearly affected by the presence of pre‐ILS.
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Affiliation(s)
- Ryota Shibaki
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Yuichi Ozawa
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Susumu Noguchi
- Respiratory Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Yusuke Murakami
- Respiratory Medicine, National Hospital Organization Minami Wakayama Medical Center, Wakayama, Japan
| | - Eri Takase
- Department of Respiratory Medicine, Naga Municipal Hospital, Wakayama, Japan
| | - Yuichiro Azuma
- Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, Japan
| | - Masaru Maebeya
- Respiratory Medicine, Wakayama Rosai Hospital, Wakayama, Japan
| | - Takeya Sugimoto
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Hayata
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | | | - Shinya Tamaki
- The Second Department of Internal Medicine, Hidaka General Hospital, Wakayama, Japan
| | | | - Shunsuke Teraoka
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Hiroaki Akamatsu
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
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10
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Harutani Y, Ozawa Y, Murakami E, Sato K, Oyanagi J, Akamatsu H, Yoshikawa T, Shibaki R, Sugimoto T, Furuta K, Teraoka S, Tokudome N, Hayata A, Ueda H, Nakanishi M, Koh Y, Yamamoto N. Pre-treatment serum protein levels predict survival of non-small cell lung cancer patients without durable clinical benefit by PD-1/L1 inhibitors. Cancer Immunol Immunother 2022; 71:2109-2116. [PMID: 35037070 DOI: 10.1007/s00262-022-03141-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 05/04/2021] [Accepted: 12/27/2021] [Indexed: 01/05/2023]
Abstract
While PD-1/L1 inhibitors are characterized by durable tumor control, they also prolong survival without prolongation of progression-free survival (PFS) in part of patients. However, little is known about the factors and mechanisms involved in this. Between December 2015 and September 2018, 106 patients with advanced non-small cell lung cancer treated with ICI monotherapy were enrolled in a prospective-observational study. Sixty-nine of whom progressed or died within 6 months after ICI initiation were defined as patients without durable clinical benefit (NDBs). Clinical factors and 39 serum proteins before ICI initiation and at the time of progressive disease (PD) were explored for an association with overall survival (OS) and OS after PD (OS-PD). As a result, median PFS, OS, and OS-PD were 44 days [95% confidence interval (CI): 39-56), 211 days (95% CI: 158-425), and 193 days (95% CI: 118-349), respectively. By multivariate analysis for OS, CRP (> 1.44 mg/dl) [HR 2.59 (95% CI:1.33-5.04), P = 0.005] and follistatin (> 685 pg/ml) [HR 2.29 (95% CI:1.12-4.69), P = 0.023] before ICI initiation were significantly predictive. Notably, no serum protein at the time of PD was predictive for OS-PD. There were also no serum predictive factors of OS in the 33 patients with durable clinical benefit. In conclusion, serum levels of CRP and follistatin before ICI initiation, not at the time of PD, are predictive for OS in NDBs, suggesting long-term survivor in NDBs are predetermined by the immune status before ICI initiation.
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Affiliation(s)
- Yuhei Harutani
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Yuichi Ozawa
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan.
| | - Eriko Murakami
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Koichi Sato
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Jun Oyanagi
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Hiroaki Akamatsu
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Takanori Yoshikawa
- Clinical Study Support Center, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Ryota Shibaki
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Takeya Sugimoto
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Katsuyuki Furuta
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Shunsuke Teraoka
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Nahomi Tokudome
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Atsushi Hayata
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Hiroki Ueda
- Oncology Center, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Masanori Nakanishi
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Yasuhiro Koh
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Nobuyuki Yamamoto
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
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Takahashi T, Okamoto T, Yokota I, Sato Y, Hayashi A, Ueda Y, Aoyagi H, Ueno M, Kobayashi N, Uetake K, Nakanishi M, Ariga T. The effect of rituximab on the quality of life of children with refractory nephrotic syndrome. Pediatr Int 2022; 64:e14725. [PMID: 33826766 DOI: 10.1111/ped.14725] [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] [Received: 12/20/2020] [Revised: 03/23/2021] [Accepted: 04/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Rituximab (RTX) is an effective treatment for maintaining remission in patients with nephrotic syndrome (NS), but there are few reports on the effect of RTX treatment on quality of life (QOL). The purpose of this study was to examine the effect of periodically repeated RTX treatment from the perspective of QOL. METHODS We systematically assessed the QOL of pediatric patients with refractory NS and parents' perceptions of their children's QOL through a 2 year RTX treatment protocol. Pediatric patients from Hokkaido University Hospital with refractory NS who met our specific criteria were enrolled between January 2015 and December 2015. The RTX infusion was performed 4 times at 6-month intervals, followed by mizoribine administration with early discontinuation of calcineurin inhibitors. Quality of life scores were measured by the Pediatric Quality of Life Inventory version 4.0 (PedsQL) at each RTX administration and evaluated 2 years later. RESULTS Twenty-two patients were analyzed. The patients' QOL and their parents' perceptions of their QOL improved over our 2 year treatment protocol. Nevertheless, the parents' scores were lower than the patients' scores on all scales, with slower improvement. CONCLUSIONS Our treatment protocol showed a significant improvement of QOL in patients with refractory NS. Although the risk of the RTX treatment should be considered, the treatment is useful for patients with refractory NS.
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Affiliation(s)
- Toshiyuki Takahashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takayuki Okamoto
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Isao Yokota
- Department of Biostatistics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yasuyuki Sato
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Asako Hayashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yasuhiro Ueda
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hayato Aoyagi
- Department of Pediatrics, Obihiro Kyokai Hospital, Obihiro, Japan
| | - Michihiko Ueno
- Department of Pediatrics, Nikko Memorial Hospital, Muroran, Japan
| | - Norio Kobayashi
- Department of Pediatrics, Oji General Hospital, Tomakomai, Japan
| | - Kimiaki Uetake
- Department of Pediatrics, Obihiro Kosei Hospital, Obihiro, Japan
| | | | - Tadashi Ariga
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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12
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Oyanagi J, Koh Y, Akiyama Y, Morimoto A, Sato K, Teraoka S, Fujimoto D, Tokudome N, Hayata A, Ozawa Y, Akamatsu H, Nakanishi M, Ueda H, Yamamoto N. Abstract P014: Clinical impact of evaluating serum IgG fractions in advanced non-small cell lung cancer treated with immune checkpoint inhibitors. Mol Cancer Ther 2021. [DOI: 10.1158/1535-7163.targ-21-p014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Structure of N-linked glycan in immunoglobulin G (IgG) fragment crystallizable (Fc) region is associated with antigen-dependent cellular cytotoxicity (ADCC) activity. Although it has been known that N-glycan moiety is different between healthy individuals and cancer patients, the relationship between the N-glycan structure and treatment response in cancer patients is unknown. Here, we evaluated the putative ADCC activity by the N-glycan moiety of IgG-Fc using peripheral blood and analyzed its association with clinical benefits from immune checkpoint inhibitors (ICIs) in patients with advanced non-small cell lung cancer (NSCLC). Patients and Methods: Advanced NSCLC patients received nivolumab, pembrolizumab or atezolizumab treatment until disease progression or unacceptable toxicity. Serum samples were collected at baseline. Tumor responses were classified into complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) based on RECIST v1.1. Durable clinical benefit (DCB) was defined as patients whose response was lasting over 6 months. Three IgG fractions (area 1, 2 and 3) corresponding to three peaks identified by affinity chromatography using TSKgel FcR-IIIA-NPR column (Tosoh, Japan) were quantified and the putative ADCC activity was estimated based on the ratio of area 3, which associates with highest ADCC activity, to the whole area. All statistical analyses were carried out using JMP Pro software (ver. 14.0). Mann-Whitney U-test was conducted. Time to event analysis was conducted using Kaplan-Meier methods and the log-rank test. Results: Ninety-seven patients were registered in the study between Jan 2016 and Nov 2018 at Wakayama Medical University. Characteristics of the patients were as follows: median age, 70 (range, 49-91); male. 78%; smoker, 79%; previous treatment ≥1, 77%; performance status 0-1, 82%; stage III/IV, 31/69%; squamous/non-squamous/unknown, 29/69/2%; nivolumab/pembrolizumab/atezolizumab, 46/42/12%. The objective response rate was 25.0% (24/96) and the disease control rate was 55.2% (53/96). The DCB rate was 45.4% (44/96). The median progression free survival (PFS) was 72 days (95%CI, 49 to 127) and median overall survival (OS) was 310 days (95% CI, 229 to 475). When time-to-event analysis was conducted by dividing into two groups at the median of the ratio of area 3 to the whole area, OS was significantly longer in patient with higher ratio than those with lower one in both entire cohort (median OS, 952 vs 482; 95% CI, 482 days-not reached and 233-744 days; log rank p=0.0292) and 2nd line cohort (median OS, 952 vs 292; 95% CI, 453 days-not reached and 120-692 days; log rank p=0.0010). Evaluation of IgG fraction was not associated with tumor response or PFS in this study cohort. Conclusion: Our results suggest that evaluation of the N-glycan moiety of IgG-Fc in peripheral blood has a potential as a prognostic biomarker in advanced NSCLC patients treated with ICIs.
Citation Format: Jun Oyanagi, Yasuhiro Koh, Yasuyuki Akiyama, Atsushi Morimoto, Koichi Sato, Shunsuke Teraoka, Daichi Fujimoto, Nahomi Tokudome, Atsushi Hayata, Yuichi Ozawa, Hiroaki Akamatsu, Masanori Nakanishi, Hiroki Ueda, Nobuyuki Yamamoto. Clinical impact of evaluating serum IgG fractions in advanced non-small cell lung cancer treated with immune checkpoint inhibitors [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2021 Oct 7-10. Philadelphia (PA): AACR; Mol Cancer Ther 2021;20(12 Suppl):Abstract nr P014.
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Affiliation(s)
- Jun Oyanagi
- 1Wakayama Medical University, Wakayama, Japan,
| | | | | | | | - Koichi Sato
- 1Wakayama Medical University, Wakayama, Japan,
| | | | | | | | | | | | | | | | - Hiroki Ueda
- 1Wakayama Medical University, Wakayama, Japan,
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13
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Ishiguro N, Sato R, Kikuta H, Nakanishi M, Aoyagi H, Mori T, Nagano N, Tabata Y, Hazama K, Konno M, Yamanaka T, Azuma K, Tanaka H, Narita M, Morita K, Odagawa Y, Ishizaka A, Tsuchida A, Sasaki S, Horino A, Kenri T, Togashi T, Manabe A. P1 gene of Mycoplasma pneumoniae isolated from 2016 to 2019 and relationship between genotyping and macrolide resistance in Hokkaido, Japan. J Med Microbiol 2021; 70. [PMID: 34165424 DOI: 10.1099/jmm.0.001365] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We characterized 515 Mycoplasma pneumoniae specimens in Hokkaido. In 2013 and 2014, the p1 gene type 1 strain, mostly macrolide-resistant, was dominant and the prevalence of macrolide resistance was over 50 %. After 2017, the p1 gene type 2 lineage, mostly macrolide-sensitive, increased and the prevalence of macrolide resistance became 31.0 % in 2017, 5.3 % in 2018 and 16.3 % in 2019.
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Affiliation(s)
- Nobuhisa Ishiguro
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Rikako Sato
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Hideaki Kikuta
- Pediatric Clinic, Touei Hospital, Sapporo, Hokkaido, Japan
| | - Masanori Nakanishi
- Department of Pediatrics, Kushiro Red Cross Hospital, Kushiro, Hokkaido, Japan
| | - Hayato Aoyagi
- Department of Pediatrics, Obihiro Kyokai Hospital, Obihiro, Hokkaido, Japan
| | - Toshihiko Mori
- Department of Pediatrics, NTT East Sapporo Hospital, Sapporo, Hokkaido, Japan
| | - Naoko Nagano
- Nagano Pediatric Clinic, Asahikawa, Hokkaido, Japan
| | - Yuichi Tabata
- Iwamizawa Pediatric and Gynecology Clinic, Iwamizawa, Hokkaido, Japan
| | | | - Mutsuko Konno
- Department of Pediatrics, Sapporo Kosei General Hospital, Sapporo, Hokkaido, Japan
| | | | | | - Hiroshi Tanaka
- Sapporo Cough Asthma Allergy Center, Sapporo, Hokkaido, Japan
| | - Mitsuo Narita
- Department of Pediatrics, Sapporo Tokushukai Hospital, Sapporo, Hokkaido, Japan
| | - Keisuke Morita
- Department of Pediatrics, Red Cross Asahikawa Hospital, Asahikawa, Hokkaido, Japan
| | - Yasuhisa Odagawa
- Department of Pediatircs, Otaru General Hospital, Otaru, Hokkaido, Japan
| | | | | | - Satoshi Sasaki
- Department of Pediatrics, Aiiku Hospital, Sapporo, Hokkaido, Japan
| | - Atsuko Horino
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tsuyoshi Kenri
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takehiro Togashi
- Hokkaido Anti-Tuberculosis Association Sapporo Fukujuji Clinic, Sapporo, Hokkaido, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
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14
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Ozawa Y, Harutani Y, Oyanagi J, Akamatsu H, Murakami E, Shibaki R, Hayata A, Sugimoto T, Sato K, Teraoka S, Fujimoto D, Kitamura Y, Fukuoka J, Tokudome N, Ueda H, Nakanishi M, Koh Y, Yamamoto N. Tumor expression of cGAS, not STING, negatively impacts on the efficacy of PD-1/L1 inhibitors in non-small cell lung cancer with PD-L1 TPS ≥50. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e21048] [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
e21048 Background: The cGAS/STING pathway is an innate immune pathway that promotes cytokine production in response to cytoplasmic DNA, and its activation is important for the induction of anti-tumor immunity. However, predictivity of cGAS/STING tumor expression on the efficacy of PD-1/L1 inhibitors and subsequent immune responses (e.g., changes in serum cytokines) remain to be elucidated. Non-small cell lung cancer with PD-L1 tumor proportion score (TPS) of 50% or higher respond well to immune checkpoint inhibitor (ICI) monotherapy, but there is still a poor response group among them, and the extraction of such patients is an urgent issue. Methods: This is a post hoc analysis of prospective biomarker study, which enrolled 106 patients with advanced non-small cell lung cancer (NSCLC) who were treated with ICI monotherapy between December 2015 and September 2018. We investigated in 68 patients with preserved evaluable tissue samples taken before start of ICI treatment. cGAS, STING, and PD-L1 expression in tumors were stained by immunohistochemistry. cGAS and STING were evaluated by H-score. Using peripheral blood which was collected by the observational study, 41 serum proteins at the time of PD-1/L1 inhibitors initiation and in 4 – 6 weeks later were quantified. Results: The median cGAS and STING H-SCORE were 220 (5 – 300) and 190 (0 – 300), respectively. There were no differences in cGAS or STING H-SCORE between PD-L1 high (TPS ≥50) and low (TPS < 50) groups ( p= 0.990 and 0.283). Cases were divided into two groups according to median of the H-SCORE, respectively, and compared. Unexpectedly, cGAS high (H-SCORE ≥220) patients showed significantly shorter progression free survival of ICI when PD-L1 TPS ≥50 (median progression free survival (PFS); 143 days vs. not reached, p = 0.028) and progression free rate at 18 months was 7 and 53%, while no association was observed when PD-L1 TPS < 50 (median PFS; 47 vs. 61 days, p= 0.798). STING tumor expression was not associated with PFS regardless of PD-L1 TPS. In cytokine analysis, cGAS high was associated with significantly higher serum concentrations of TGF-β1 and β2 before ICI initiation (47.5 vs. 22.3hg/l, p= 0.023; 2118 vs. 882rg/ml, p= 0.037), and H-SCORE of cGAS, not STING, were significantly correlated with TGF-β1 and β2 basal levels (r = 0.447, p= 0.009; r = 0.373, p= 0.033). Analysis about fold change from baseline to 4 – 6 weeks later of 41 cytokines revealed that leptin significantly increased in cGAS high tumor while no difference was seen in all of cytokines between STING high and low tumor. Conclusions: Tumor expression (H-Score) of cGAS, not STING, is a candidate for predictor of poor response to ICI monotherapy in NSCLC with PD-L1 high (TPS ≥50). cGAS tumor expression may be associated with TGF-β producing, immune-suppressive tumor microenvironment in NSCLC. Clinical trial information: UMIN000024414.
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Affiliation(s)
| | | | - Jun Oyanagi
- Wakayama Medical University, Wakayama, Japan
| | | | | | - Ryota Shibaki
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Hayata
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | | | - Koichi Sato
- Wakayama Medical University, Wakayama, Japan
| | - Shunsuke Teraoka
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Daichi Fujimoto
- Department of Respiratory Medicine, Kobe City Medical Center, General Hospital, Kobe, Japan
| | - Yuka Kitamura
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Junya Fukuoka
- Department of Pathology, Nagasaki University Hospital, Sakamoto, Japan
| | | | - Hiroki Ueda
- Pulmonary Medicine and Oncology, Wakayama Medical University, Wakayama, Japan
| | - Masanori Nakanishi
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasuhiro Koh
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Nobuyuki Yamamoto
- Department of Pulmonary Medicine and Medical Oncology, Wakayama Medical University, Wakayama, Japan
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15
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Furuta K, Akamatsu H, Sada R, Miyamoto K, Teraoka S, Hayata A, Ozawa Y, Nakanishi M, Koh Y, Yamamoto N. Comparison of Systemic Inflammatory Response Syndrome and quick Sequential Organ Failure Assessment scores in predicting bacteremia in the emergency department. Acute Med Surg 2021; 8:e654. [PMID: 33968417 PMCID: PMC8088398 DOI: 10.1002/ams2.654] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/08/2021] [Accepted: 03/31/2021] [Indexed: 11/08/2022] Open
Abstract
Aim The emergency department requires simple and useful clinical indicators to identify bacteremia. This retrospective study explored the Systemic Inflammatory Response Syndrome (SIRS) and quick Sequential Organ Failure Assessment (qSOFA) scores for predicting bacteremia. Methods Between April and September 2017, we assessed blood cultures of 307 patients in our emergency department. We calculated the SIRS and qSOFA scores for these patients and evaluated their correlation with bacteremia. Results Of 307 patients, 66 (21.5%) had bacteremia, 237 (77.2%) were SIRS-positive, and 123 (40.0%) were qSOFA-positive. The sensitivity and specificity of the SIRS score for predicting bacteremia were 87.9% and 25.7%, respectively. The sensitivity and specificity of the qSOFA score were 47.0% and 61.8%, respectively. Multivariate analysis revealed that body temperature (odds ratio, 2.16; 95% confidence interval, 1.22-3.84; P = 0.009) and blood pressure (odds ratio, 2.72; 95% confidence interval, 1.39-5.35; P = 0.004) significantly associated with bacteremia. Conclusions The SIRS score was a more sensitive indicator than the qSOFA score for predicting bacteremia.
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Affiliation(s)
- Katsuyuki Furuta
- Internal Medicine III Wakayama Medical University Wakayama Japan
| | - Hiroaki Akamatsu
- Internal Medicine III Wakayama Medical University Wakayama Japan
| | - Ryuichi Sada
- Department of General Internal Medicine Tenri Hospital Tenri Japan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
| | - Shunsuke Teraoka
- Internal Medicine III Wakayama Medical University Wakayama Japan
| | - Atsushi Hayata
- Internal Medicine III Wakayama Medical University Wakayama Japan
| | - Yuichi Ozawa
- Internal Medicine III Wakayama Medical University Wakayama Japan
| | | | - Yasuhiro Koh
- Internal Medicine III Wakayama Medical University Wakayama Japan
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16
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Oyanagi J, Koh Y, Sato K, Teraoka S, Tokudome N, Hayata A, Akamatsu H, Ozawa Y, Nakanishi M, Ueda H, Yamamoto N. Bloodborne Cytokines for Predicting Clinical Benefits and Immune-Related Adverse Events in Advanced Non-Small Cell Lung Cancer Treated With Anti-Programmed Cell Death 1 Inhibitors. Clin Lung Cancer 2021; 22:e833-e841. [PMID: 34049821 DOI: 10.1016/j.cllc.2021.04.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/02/2021] [Accepted: 04/17/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Programmed cell death ligand 1 is a biomarker of immune checkpoint inhibitors (ICIs) for treating advanced non-small-cell lung cancer (NSCLC). Here, we evaluated serum proteins from patients with advanced NSCLC treated with ICIs to determine their potential as noninvasive predictive biomarkers for efficacy and immune-related adverse events (irAEs). PATIENTS AND METHODS Patients with advanced NSCLC who received nivolumab or pembrolizumab monotherapy until disease progression or unacceptable toxicity were integrated with previously reported nivolumab-treated patients. Blood samples were collected serially from baseline until the disease progressed. Serum protein levels were quantified using the Luminex assay. Associations of clinical benefit (CB) and onset of irAEs with serum protein levels were evaluated. RESULTS Sixty-three patients with advanced NSCLC were studied, and we used 63 and 47 paired serum samples at baseline and the second sampling point, respectively, for efficacy analysis. Baseline growth-regulated oncogene 1 (GRO-1) levels were significantly lower in durable CB (DCB) patients than in non-DCB patients (P < .05). Changes in monocyte chemoattractant protein 1 (MCP-1) levels significantly decreased between baseline and the second sampling point (P < .05). Patients with the low GRO-1/decreased MCP-1 subtype showed significantly longer progression-free survival (PFS) and overall survival (OS) than the high GRO-1/increased MCP-1 subgroup did (median PFS, not reached vs. 47 days, P < .0001; median OS, 985 days vs. 148 days, P = .0002, respectively). Elevated GRO-1 levels were associated with immune-related adverse event onset. CONCLUSIONS Serum GRO-1 and MCP-1 levels can identify patients with advanced NSCLC who are likely to benefit from ICI treatment. Time-course tracing of these protein levels might be valuable in ICI treatment.
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Affiliation(s)
- Jun Oyanagi
- Internal Medicine III, Wakayama Medical University, Wakayama-city, Wakayama, Japan
| | - Yasuhiro Koh
- Internal Medicine III, Wakayama Medical University, Wakayama-city, Wakayama, Japan.
| | - Koichi Sato
- Internal Medicine III, Wakayama Medical University, Wakayama-city, Wakayama, Japan
| | - Shunsuke Teraoka
- Internal Medicine III, Wakayama Medical University, Wakayama-city, Wakayama, Japan
| | - Nahomi Tokudome
- Internal Medicine III, Wakayama Medical University, Wakayama-city, Wakayama, Japan
| | - Atsushi Hayata
- Internal Medicine III, Wakayama Medical University, Wakayama-city, Wakayama, Japan
| | - Hiroaki Akamatsu
- Internal Medicine III, Wakayama Medical University, Wakayama-city, Wakayama, Japan
| | - Yuichi Ozawa
- Internal Medicine III, Wakayama Medical University, Wakayama-city, Wakayama, Japan
| | - Masanori Nakanishi
- Internal Medicine III, Wakayama Medical University, Wakayama-city, Wakayama, Japan
| | - Hiroki Ueda
- Internal Medicine III, Wakayama Medical University, Wakayama-city, Wakayama, Japan
| | - Nobuyuki Yamamoto
- Internal Medicine III, Wakayama Medical University, Wakayama-city, Wakayama, Japan
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17
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Ozawa Y, Harutani Y, Oyanagi J, Murakami E, Sato K, Akamatsu H, Hayata A, Teraoka S, Ueda H, Kitamura Y, Fukuoka J, Tokudome N, Nakanishi M, Koh Y, Yamamoto N. P60.08 Impact of CD24 and CD47 Tumor Expression on Efficacy and Serum Cytokine Alteration with PD-1/L1 Inhibitors in Non-Small Cell Lung cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.967] [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: 10/21/2022]
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18
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Nakanishi M, Shiroshita A, Nakashima K, Takeshita M, Kiguchi T, Yamada H. Clinical and computed tomographic features of Legionella pneumonia with negative urine antigen test results. Respir Investig 2020; 59:204-211. [PMID: 33339738 DOI: 10.1016/j.resinv.2020.11.005] [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] [Received: 08/19/2020] [Revised: 11/11/2020] [Accepted: 11/16/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Legionella spp. can cause severe pneumonia and most Legionella pneumonia (LP) cases are diagnosed using the urine antigen test (UAT). However, diagnosis of LP with negative UAT results (LPNUAT) is challenging. We investigated the clinical and radiological features of LPNUAT. METHODS We retrospectively collected LP cases with positive UAT (LPPUAT) and cases of suspected LP with negative UAT that were examined by Legionella culture between July 2014 and March 2020. We investigated the clinical and CT findings for LP that showed negative UAT results and was diagnosed by culture and compared these findings with those for other pneumonias suspicious for LP with negative results in UAT and Legionella culture (OPSLP). RESULTS Eight LPNUAT, 20 LPPUAT, and 19 OPSLP cases were included in this study. There were no significant differences in the clinical and CT findings between LPPUAT and LPNUAT when examined by UAT. In LPNUAT, dyspnea, renal dysfunction, liver dysfunction, and bilateral lesions were more commonly observed and inflammatory changes and the number of affected lobes were significantly higher when examined by culture than when examined by UAT. Comparison to OPSLP, LPNUAT did not show such differences, but rather showed disturbances in consciousness, hyponatremia and rhabdomyolysis. Furthermore, lobar consolidation was observed more frequently and bronchial wall thickening and centrilobular nodules were observed less frequently in LPNUAT. CONCLUSIONS LP characteristics such as disturbance of consciousness, hyponatremia, rhabdomyolysis, lobar consolidation, and less bronchial wall thickening and centrilobular nodule contribute to the diagnosis of LP in patients with negative UAT results.
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Affiliation(s)
- Masanori Nakanishi
- Department of Respiratory Medicine, Ichinomiya-nishi Hospital, Ichinomiya, Japan.
| | - Akihiro Shiroshita
- Department of Respiratory Medicine, Ichinomiya-nishi Hospital, Ichinomiya, Japan
| | - Kiyoshi Nakashima
- Department of Respiratory Medicine, Ichinomiya-nishi Hospital, Ichinomiya, Japan
| | - Masafumi Takeshita
- Department of Respiratory Medicine, Ichinomiya-nishi Hospital, Ichinomiya, Japan
| | - Takao Kiguchi
- Department of Radiology, Ichinomiya-nishi Hospital, Ichinomiya, Japan
| | - Hiroki Yamada
- Department of Radiology, Ichinomiya-nishi Hospital, Ichinomiya, Japan
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19
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Ozawa Y, Harutani Y, Oyanagi J, Akamatsu H, Murakami E, Shibaki R, Hayata A, Sugimoto T, Tanaka M, Takakura T, Furuta K, Okuda Y, Sato K, Teraoka S, Ueda H, Tokudome N, Kitamura Y, Fukuoka J, Nakanishi M, Koh Y, Yamamoto N. CD24, not CD47, negatively impacts upon response to PD-1/L1 inhibitors in non-small-cell lung cancer with PD-L1 tumor proportion score < 50. Cancer Sci 2020; 112:72-80. [PMID: 33084148 PMCID: PMC7780034 DOI: 10.1111/cas.14705] [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: 08/20/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 12/05/2022] Open
Abstract
CD24, a heavily glycosylated glycosylphosphatidylinositol–anchored surface protein, inhibits phagocytosis as potently as CD47. The relationship between such anti‐phagocytic factors and the immune response with immune–checkpoint inhibitors (ICI) remains unexplored. We evaluated CD24 and CD47 tumor proportion scores (TPS) in 68 of the 106 patients with advanced non–small‐cell lung cancer who participated in a prospective observational study of ICI treatment. We also explored the impact of CD24 TPS and CD47 TPS on ICI efficacy and serum cytokine changes. CD24 positivity (TPS ≥ 1) was negatively associated with progression–free survival (PFS) of ICI when PD‐L1 TPS was < 50 (median PFS; 37 vs 127 d, P = .033), but there was no association when PD‐L1 TPS was ≥ 50 (median PFS; 494 vs 144 d, P = .168). CD24 positivity was also related to significantly higher increase of CCL2 from baseline to 4‐6 wk later, and such increase was notably observed only when PD‐L1 TPS < 50 (P = .0004). CCL2 increase after ICI initiation was negatively predictive for survival after initiation of ICI (median survival time; not reached vs 233 d; P = .028). CD47 TPS high (≥60) significantly suppressed the increase in vascular endothelial growth factor (VEGF)‐A, D and PDGF‐AB/BB after ICI initiation. There was no association, however, between CD47 tumor expression and the efficacy of ICI. In conclusion, CD24, not CD47, is a candidate negative predictive marker of ICI in advanced, non–small‐cell lung cancer with PD‐L1 TPS < 50. Tumor expression of both CD24 and CD47 was associated with changes in factors related to monocytes and angiogenesis after ICI initiation (UMIN000024414).
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Affiliation(s)
- Yuichi Ozawa
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Yuhei Harutani
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Jun Oyanagi
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Hiroaki Akamatsu
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Eriko Murakami
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Ryota Shibaki
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Hayata
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Takeya Sugimoto
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Masanori Tanaka
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | | | - Katsuyuki Furuta
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Yuka Okuda
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Kouichi Sato
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Shunsuke Teraoka
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Hiroki Ueda
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan.,Oncology Center, Wakayama Medical University, Wakayama, Japan
| | - Nahomi Tokudome
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Yuka Kitamura
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Junya Fukuoka
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Yasuhiro Koh
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
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20
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Lewis A, Beresford A, Chambers MS, Clark G, Hartley DC, Hirst KL, Higashino M, Kawahadara S, Nakanishi M, Saito T, Imagawa A, Habashita H, Maidment S, Macleod AM, Owens AP, Rae A, Rouse C, Wishart G. Discovery of ONO-8590580: A novel, potent and selective GABA A α 5 negative allosteric modulator for the treatment of cognitive disorders. Bioorg Med Chem Lett 2020; 30:127536. [PMID: 32898695 DOI: 10.1016/j.bmcl.2020.127536] [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: 05/11/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 10/23/2022]
Abstract
The identification and SAR development of a series of negative allosteric modulators of the GABAA α5 receptor is described. This novel series of compounds was optimised to provide analogues with high GABAA α5 binding affinity, high α5 negative allosteric modulatory activity, good functional subtype selectivity and low microsomal turnover, culminating in identification of ONO-8590580.
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Affiliation(s)
- A Lewis
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - A Beresford
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - M S Chambers
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - G Clark
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - D C Hartley
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - K L Hirst
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - M Higashino
- Ono Pharmaceutical Co. Ltd., Minase Research Institute, Shimamoto-cho, Mishima-gun, Osaka 618-8585, Japan
| | - S Kawahadara
- Ono Pharmaceutical Co. Ltd., Minase Research Institute, Shimamoto-cho, Mishima-gun, Osaka 618-8585, Japan
| | - M Nakanishi
- Ono Pharmaceutical Co. Ltd., Minase Research Institute, Shimamoto-cho, Mishima-gun, Osaka 618-8585, Japan
| | - T Saito
- Ono Pharmaceutical Co. Ltd., Minase Research Institute, Shimamoto-cho, Mishima-gun, Osaka 618-8585, Japan
| | - A Imagawa
- Ono Pharmaceutical Co. Ltd., Minase Research Institute, Shimamoto-cho, Mishima-gun, Osaka 618-8585, Japan
| | - H Habashita
- Ono Pharmaceutical Co. Ltd., Minase Research Institute, Shimamoto-cho, Mishima-gun, Osaka 618-8585, Japan
| | - S Maidment
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - A M Macleod
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - A P Owens
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - A Rae
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom.
| | - C Rouse
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - G Wishart
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
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21
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Nakanishi M, Mizuno T, Mizokami F, Koseki T, Takahashi K, Tsuboi N, Katz M, Lee JK, Yamada S. Impact of pharmacist intervention for blood pressure control in patients with chronic kidney disease: A meta-analysis of randomized clinical trials. J Clin Pharm Ther 2020; 46:114-120. [PMID: 32949161 DOI: 10.1111/jcpt.13262] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 12/15/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Hypertension (HTN) and chronic kidney disease (CKD) are recognized as silent killers because they are asymptomatic conditions that contribute to the burden of multiple comorbidities. The achievement of a blood pressure (BP) goal can dramatically reduce the risks of CKD. In this study, we aimed to assess the effectiveness of pharmacist intervention on BP control in patients with CKD and evaluate the usefulness of home-based BP telemonitoring. METHODS The terms "chronic kidney disease," "pharmacist," "BP" and "randomized controlled trial (RCT)" were used five databases to search for information regarding pharmacist intervention on BP control in patients with CKD. The inclusion criteria were as follows: (a) studies for adult patients with uncontrolled HTN and (b) studies with adequate data for meta-analysis. The primary outcome was an evaluation of achievement of BP goal in patients with CKD. The secondary outcome was usefulness of home-based BP telemonitoring by pharmacists in patients with CKD. RESULTS AND DISCUSSION Six RCTs were identified and included in the meta-analysis with a total of 2573 patients (mean age 66.0 years and 63.9% male). Pharmacist interventions resulted in significantly better BP control vs usual care (OR = 1.53, 95% CI = 1.15-2.04, P < .01). Pharmacist interventions using home-based BP telemonitoring were significantly superior to control/usual care (OR = 2.03, 95% CI = 1.49-2.77, P < .01), whereas pharmacist interventions without home-based BP telemonitoring did not significantly improve BP control compared to that with control/usual care (OR = 1.30, 95% CI = 0.97-1.75, P = .08). Home-based BP telemonitoring supported team-based care for HTN in these studies. In addition, patient self-monitoring with telemedicine devices might enhance patients' abilities to manage their condition by pharmacist instruction. WHAT IS NEW AND CONCLUSION The findings of this meta-analysis showed that pharmacist interventions with home-based BP telemonitoring improve BP control among adult patients with CKD.
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Affiliation(s)
- Masanori Nakanishi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan.,Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tomohiro Mizuno
- Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Japan
| | - Fumihiro Mizokami
- Department of Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takenao Koseki
- Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuo Takahashi
- Department of Biomedical Molecular Sciences, Fujita Health University School of Medicine, Toyoake, Japan
| | - Naotake Tsuboi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Michael Katz
- Department of Pharmacy Practice & Science, University of Arizona College of Pharmacy, Tucson, AZ, USA
| | - Jeannie K Lee
- Department of Pharmacy Practice & Science, University of Arizona College of Pharmacy, Tucson, AZ, USA
| | - Shigeki Yamada
- Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Japan
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Koh Y, Ikeda M, Teraoka S, Sato K, Tokudome N, Hayata A, Akamatsu H, Ozawa Y, Akamatsu K, Endo K, Higuchi M, Nakanishi M, Ueda H, Yamamoto N. Abstract 775: Longitudinal investigation of PD-L1 expression on circulating tumor cells (CTCs) in non-small cell lung cancer (NSCLC) patients treated with nivolumab. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: We have previously reported that PD-L1-positive rate on CTCs at baseline was correlated with response to nivolumab in NSCLC patients. Here, we conducted a longitudinal follow-up investigation of PD-L1 expression on CTCs and its association with clinical outcome.
Methods: For CTC detection, 3ml of peripheral blood was collected from advanced NSCLC patients treated with nivolumab at baseline and week 4, 8, 12 and 24 or until progressive disease (PD). CTCs were enriched by microcavity array system based on the difference in size and defined as DAPI-positive, CK-positive, and CD45-negative cells and evaluated for PD-L1 expression by additional immunostaining.
Results: Forty-five patients were enrolled between January 2016 and January 2018 at Wakayama Medical University. The patient characteristics were as follows: median age 68 years (range, 49-86); male 75%; stage III/IV, 25/75%; adenocarcinoma/ squamous cell carcinoma/ other, 68/25/7%; partial response/stable disease/PD/not evaluable, 20/25/45/9%. At baseline, CTCs were evaluated in 44 patients (median, 13; range, 1-104) and PD-L1 positive CTCs were detected in 82% patients (median 29%; range, 0-100%), at week 4, evaluated in 31 patients (median, 4; range, 0-115) and detected in 58% patients (median, 13%; range, 0-100%), at week 8, evaluated in 16 patients (median, 11; range, 1-276) and detected in 56% patients (median, 7%; range, 0-60%), at week 12, evaluated in 13 patients (median, 11; range, 0-449) and detected in 62% patients (median, 15%; range, 0-88%), and at week 24, evaluated in 11 patients (median, 8; range, 0-35) and detected in 55% patients (median, 26%; range, 0-92%). Significant decrease in the ratio of PD-L1 positive CTCs between week 4 to week 8 was determined by Wilcoxon-matched-pairs signed rank test. Cutoff value of PD-L1-positivity rates in CTCs to segregate durable clinical benefit (DCB) from non-DCB was calculated to be 7% at week 8 according to ROC curve. Progression free survival was significantly longer in the patients with 7% or more of PD-L1 positivity rates (n = 8) than in those with less than 7% (n = 8) (p < 0.01) at week 8, suggesting the predictive significance of early evaluation of PD-L1 expression on CTCs after nivolumab treatment. Interestingly, CTC count in 7 out of 9 patients who had a partial response (PR) transiently increased from the one immediately prior to achieving a PR. Progression free survival was significantly longer in patients with 1.5 times or more increase of CTC count (n = 6) than in those with less than 1.5 times (n = 3) (p < 0.05), suggesting the transient tumor cell intravasation due to nivolumab treatment and its potential correlation with the duration of response depending on its magnitude.
Conclusions: Longitudinal evaluation of PD-L1-expressing CTCs may have a predictive potential in NSCLC patients treated with nivolumab.
Citation Format: Yasuhiro Koh, Mio Ikeda, Shunsuke Teraoka, Koichi Sato, Nahomi Tokudome, Atsushi Hayata, Hiroaki Akamatsu, Yuichi Ozawa, Keiichiro Akamatsu, Katsuya Endo, Masayuki Higuchi, Masanori Nakanishi, Hiroki Ueda, Nobuyuki Yamamoto. Longitudinal investigation of PD-L1 expression on circulating tumor cells (CTCs) in non-small cell lung cancer (NSCLC) patients treated with nivolumab [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 775.
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Affiliation(s)
| | - Mio Ikeda
- 1Wakayama Medical University, Wakayama, Japan
| | | | - Koichi Sato
- 1Wakayama Medical University, Wakayama, Japan
| | | | | | | | | | | | | | | | | | - Hiroki Ueda
- 1Wakayama Medical University, Wakayama, Japan
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Ikeda M, Koh Y, Teraoka S, Sato K, Tokudome N, Hayata A, Akamatsu H, Ozawa Y, Akamatsu K, Endo K, Higuchi M, Nakanishi M, Ueda H, Yamamoto N. Abstract B27: Longitudinal evaluation of PD-L1 expression on circulating tumor cells (CTCs) in non-small cell lung cancer (NSCLC) patients treated with nivolumab. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.liqbiop20-b27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: Though programmed death receptor-ligand 1 (PD-L1) expression on tumor tissue is a validated predictive biomarker for PD-1 pathway blockade in NSCLC, its longitudinal change during the treatment remains elusive. We have previously reported that PD-L1-positive rate on CTCs at baseline was correlated with response to nivolumab. Here, we conducted a longitudinal investigation of PD-L1 expression on CTCs in NSCLC patients treated with nivolumab and its association with clinical outcome.
Methods: For CTC detection, 3mL of peripheral blood was collected from advanced NSCLC patients treated with nivolumab at baseline and week 4, 8, 12, and 24 or until progressive disease (PD). The samples were enriched using the microcavity array system based on the difference in size. CTCs were defined as DAPI-positive, CK-positive, and CD45-negative cells and evaluated for PD-L1 expression by additional immunostaining.
Results: Forty-five patients were enrolled between January 2016 and January 2018 at Wakayama Medical University. The patient characteristics were as follows: median age 68 years (range, 49-86); male 75%; stage III/IV, 25/75%; adenocarcinoma/ squamous cell carcinoma/other, 68/25/7%; partial response/stable disease/PD/not evaluable, 20/25/45/9%. At baseline, CTCs were evaluated in 44 patients (median, 13; range, 1-104) and PD-L1 positive CTCs were detected in 82% of patients (median 29%; range, 0-100%); at week 4, evaluated in 31 patients (median, 4; range, 0-115) and detected in 58% of patients (median, 13%; range, 0-100%); at week 8, evaluated in 16 patients (median, 11; range, 1-276) and detected in 56% of patients (median, 7%; range, 0-60%); at week 12, evaluated in 13 patients (median, 11; range, 0-449) and detected in 62% of patients (median, 15%; range, 0-88%); and at week 24, evaluated in 11 patients (median, 8; range, 0-35) and detected in 55% of patients (median, 26%; range, 0-92%). Cutoff value of PD-L1-positivity rates in CTCs to segregate durable clinical benefit (DCB) from non-DCB was calculated to be 7% at week 8 according to receiver operating characteristic curve. Progression-free survival was significantly longer in the patients with less than 7% of PD-L1 positivity rates (n = 8) than in those with 7% or more (n = 8) (p < 0.01) at week 8, suggesting the predictive significance of early evaluation of PD-L1 expression on CTCs after nivolumab treatment. It, however, did not translate into the predictive significance in overall survival. The change in CTC count at PD did not significantly differ between PD and last evaluation point before PD compared to that in non-PD patients at each evaluation point, suggesting the change in CTC count may not be predictive of disease progression upon nivolumab treatment.
Conclusion: Longitudinal evaluation of PD-L1-expressing CTCs may have a predictive potential in NSCLC patients treated with nivolumab. Evaluation in a larger cohort is warranted to confirm the results.
Citation Format: Mio Ikeda, Yasuhiro Koh, Shunsuke Teraoka, Koichi Sato, Nahomi Tokudome, Atsushi Hayata, Hiroaki Akamatsu, Yuichi Ozawa, Keiichiro Akamatsu, Katsuya Endo, Masayuki Higuchi, Masanori Nakanishi, Hiroki Ueda, Nobuyuki Yamamoto. Longitudinal evaluation of PD-L1 expression on circulating tumor cells (CTCs) in non-small cell lung cancer (NSCLC) patients treated with nivolumab [abstract]. In: Proceedings of the AACR Special Conference on Advances in Liquid Biopsies; Jan 13-16, 2020; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(11_Suppl):Abstract nr B27.
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Affiliation(s)
- Mio Ikeda
- 1Wakayama Medical University, Wakayama, Japan,
| | | | | | - Koichi Sato
- 1Wakayama Medical University, Wakayama, Japan,
| | | | | | | | | | | | | | | | | | - Hiroki Ueda
- 1Wakayama Medical University, Wakayama, Japan,
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Nakanishi M, Nakashima K, Takeshita M, Yagi T, Nakayama T, Kiguchi T, Yamada H. Ability of high-resolution computed tomography to distinguish Mycoplasma pneumoniae pneumonia from other bacterial pneumonia: Significance of lateral bronchial lesions, less air bronchogram, and no peripheral predominance. Respir Investig 2020; 58:169-176. [PMID: 32146120 DOI: 10.1016/j.resinv.2020.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 01/17/2020] [Accepted: 01/27/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND No study has investigated the capability of high-resolution computed tomography (HRCT) to detect a lateral bronchus abnormality, degree of air bronchogram, and distribution of affected lesions in the diagnosis of Mycoplasma pneumoniae pneumonia (MPP). METHODS We prospectively enrolled patients with serologically-confirmed MPP or culture-confirmed other bacterial pneumonia (OBP). The distribution of affected areas, abnormalities in lateral bronchial lesions, the degree of air bronchogram, and previously reported findings on HRCT were evaluated for MPP and OBP. Predictive HRCT findings for MPP were determined by logistic regression analysis. We provisionally designed our HRCT criteria (negative, probable, or highly suspected) for diagnosing MPP and investigated the diagnostic yield of the HRCT criteria. RESULTS Sixty-three MPP and 126 OBP patients were included in this study. Logistic regression analysis showed that the absence of peripheral predominance, bronchial wall thickening, lateral bronchial wall thickening, intralobular or lobular ground-glass opacities, intralobular ground-glass opacities connected to a lateral bronchus, and less air bronchogram in infiltrates were significant predictors of MPP. Our HRCT criteria showed that the sensitivity and specificity in negative, probable, and highly suspected MPP were 0.0 and 0.33, 1.0 and 0.69, and 0.5 and 0.98, respectively. CONCLUSIONS HRCT had considerable ability to detect a lateral bronchial abnormality and to diagnose or rule out MPP based on the distribution of affected areas, abnormalities in lateral bronchial lesions, and the degree of air bronchogram in the infiltrates.
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Affiliation(s)
- Masanori Nakanishi
- Department of Respiratory Medicine, Ichinomiya-nishi Hospital, Ichinomiya, Japan.
| | - Kiyoshi Nakashima
- Department of Respiratory Medicine, Ichinomiya-nishi Hospital, Ichinomiya, Japan
| | - Masafumi Takeshita
- Department of Respiratory Medicine, Ichinomiya-nishi Hospital, Ichinomiya, Japan
| | - Takeo Yagi
- Department of Respiratory Medicine, Ichinomiya-nishi Hospital, Ichinomiya, Japan
| | - Tadashi Nakayama
- Department of Radiology, Ichinomiya-nishi Hospital, Ichinomiya, Japan
| | - Takao Kiguchi
- Department of Radiology, Ichinomiya-nishi Hospital, Ichinomiya, Japan
| | - Hiroki Yamada
- Department of Radiology, Ichinomiya-nishi Hospital, Ichinomiya, Japan
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Ikeda M, Koh Y, Teraoka S, Sato K, Kanai K, Hayata A, Tokudome N, Akamatsu H, Ozawa Y, Akamatsu K, Endo K, Higuchi M, Nakanishi M, Ueda H, Yamamoto N. Detection of AXL expression in circulating tumor cells of lung cancer patients using an automated microcavity array system. Cancer Med 2020; 9:2122-2133. [PMID: 31999390 PMCID: PMC7064033 DOI: 10.1002/cam4.2846] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 07/30/2019] [Revised: 12/19/2019] [Accepted: 01/02/2020] [Indexed: 12/13/2022] Open
Abstract
Noninvasive diagnostics using circulating tumor cells (CTCs) are expected to be useful for decision making in precision cancer therapy. AXL, a receptor tyrosine kinase is associated with tumor progression, epithelial‐to‐mesenchymal transition (EMT), and drug resistance, and is a potential therapeutic target. However, the epithelial markers generally used for CTC detection may be not enough to detect AXL‐expressing CTCs due to EMT. Here, we evaluated the detection of AXL‐expressing CTCs using the mesenchymal marker vimentin with a microcavity array system. To evaluate the recovery of cancer cells, spike‐in experiments were performed using cell lines with varying cytokeratin (CK) or vimentin (VM) expression levels. With high CK and low VM‐expressing cell lines, PC‐9 and HCC827, the recovery rate of AXL‐expressing cancer cells was 1%‐17% using either CK or VM as markers. Whereas, with low CK and high VM‐expressing cell lines, MDA‐MB231 and H1299, it was 52%‐75% using CK and 72%‐88% using VM as a marker. For clinical evaluation, peripheral blood was collected from 20 non–small cell lung cancer patients and CTCs were detected using CK or VM as markers in parallel. Significantly more AXL‐expressing single CTCs were detected in VM‐positive than CK‐positive CTCs (P < .001). Furthermore, CTC clusters were identified only among VM‐positive CTCs in 20% of patients. Patients with one or more prior treatments harbored significantly more VM‐positive AXL‐expressing CTCs, suggesting the involvement of these CTCs in drug resistance. These results indicate the necessity of integrating mesenchymal markers with CTC detection and this should be further evaluated clinically.
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Affiliation(s)
- Mio Ikeda
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Yasuhiro Koh
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Shunsuke Teraoka
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Koichi Sato
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Kuninobu Kanai
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Hayata
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Nahomi Tokudome
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Hiroaki Akamatsu
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Yuichi Ozawa
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | | | - Katsuya Endo
- Medical Business Sector, Hitachi Chemical Co., Ltd., Chikusei, Japan
| | - Masayuki Higuchi
- Medical Business Sector, Hitachi Chemical Co., Ltd., Chikusei, Japan
| | | | - Hiroki Ueda
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
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Izumida E, Suzawa T, Miyamoto Y, Yamada A, Otsu M, Saito T, Yamaguchi T, Nishimura K, Ohtaka M, Nakanishi M, Yoshimura K, Sasa K, Takimoto R, Uyama R, Shirota T, Maki K, Kamijo R. Functional Analysis of PTH1R Variants Found in Primary Failure of Eruption. J Dent Res 2020; 99:429-436. [PMID: 31986066 DOI: 10.1177/0022034520901731] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Although many variants of the parathyroid hormone 1 receptor (PTH1R) gene are known to be associated with primary failure of eruption (PFE), the mechanisms underlying the link remains poorly understood. We here performed functional analyses of PTH1R variants reported in PFE patients-namely, 356C>T (P119L), 395C>T (P132L), 439C>T (R147C), and 1148G>A (R383Q)-using HeLa cells with a lentiviral vector-mediated genetic modification. Two particular variants, P119L and P132L, had severe reduction in a level of N-linked glycosylation when compared with wild-type PTH1R, whereas the other 2 showed modest alteration. PTH1R having P119L or P132L showed marked decrease in the affinity to PTH1-34, which likely led to severely impaired cAMP accumulation upon stimulation in cells expressing these mutants, highlighting the importance of these 2 amino acid residues for ligand-mediated proper functioning of PTH1R. To further gain insights into PTH1R functions, we established the induced pluripotent stem cell (iPSC) lines from a patient with PFE and the heterozygous P132L mutation. When differentiated into osteoblastic-lineage cells, PFE-iPSCs showed no abnormality in mineralization. The mRNA expression of RUNX2, SP7, and BGLAP, the osteoblastic differentiation-related genes, and that of PTH1R were augmented in both PFE-iPSC-derived cells and control iPSC-derived cells in the presence of bone morphogenetic protein 2. Also, active vitamin D3 induced the expression of RANKL, a major key factor for osteoclastogenesis, equally in osteoblastic cells derived from control and PFE-iPSCs. In sharp contrast, exposure to PTH1-34 resulted in no induction of RANKL mRNA expression in the cells expressing P132L variant PTH1R, consistent with the idea that a type of heterozygous PTH1R gene mutation would spoil PTH-dependent response in osteoblasts. Collectively, this study demonstrates a link between PFE-associated genetic alteration and causative functional impairment of PTH1R, as well as a utility of iPSC-based disease modeling for future elucidation of pathogenesis in genetic disorders, including PFE.
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Affiliation(s)
- E Izumida
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - T Suzawa
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
| | - Y Miyamoto
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
| | - A Yamada
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
| | - M Otsu
- Stem Cell Bank & Division of Stem Cell Processing, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Present address: Department of Transfusion and Cell Transplantation, School of Medicine, Kitasato University, Sagamihara, Japan
| | - T Saito
- Division of Tissue Engineering, Department of Bone and Cartilage Regenerative Medicine, University of Tokyo Hospital, The University of Tokyo, Tokyo, Japan
| | - T Yamaguchi
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - K Nishimura
- Laboratory for Gene Regulation, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - M Ohtaka
- TOKIWA-Bio, Inc., Tsukuba, Japan
| | - M Nakanishi
- Biotechnology Research Institute for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - K Yoshimura
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
| | - K Sasa
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
| | - R Takimoto
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, Tokyo, Japan
| | - R Uyama
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
| | - T Shirota
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, Tokyo, Japan
| | - K Maki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - R Kamijo
- Department of Biochemistry, School of Dentistry, Showa University, Tokyo, Japan
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Ikeda M, Koh Y, Teraoka S, Sato K, Kanai K, Hayata A, Tokudome N, Akamatsu H, Ozawa Y, Akamatsu K, Endo K, Higuchi M, Nakanishi M, Ueda H, Yamamoto N. Abstract A032: Clinical significance of vimentin-positive AXL-expressing circulating tumor cells in advanced non-small-cell lung cancer patients. Biomarkers 2019. [DOI: 10.1158/1535-7163.targ-19-a032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Yamamoto-Hanada K, Haruna M, Nakanishi M, Saito-Abe M, Ohya Y. P358 DEVELOPMENT OF EDUCATION PROGRAM FOR OFFSPRING ALLERGY DURING PREGNANCY -PILOT STUDY-. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Yokoyama T, Ninomiya K, Oze I, Hata T, Tanaka A, Bessho A, Hosokawa S, Kuyama S, Kudo K, Kozuki T, Harada D, Yasugi M, Murakami T, Nakanishi M, Takigawa N, Katsui K, Maeda Y, Hotta K, Kiura K. A randomized trial of sodium alginate prevention of radiation-induced esophagitis in patients with locally advanced NSCLC receiving concurrent chemoradiotherapy: OLCSG1401. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tsubata Y, Hamai K, Furuya N, Hata T, Saito R, Masuda T, Hotta T, Hamaguchi M, Kuyama S, Honda R, Nakano K, Nakanishi M, Funaishi K, Yamasaki M, Ishikawa N, Fujitaka K, Kubota T, Kobayashi K, Isobe T. MA13.02 Incidence of Venous Thromboembolism at the Time of Lung Cancer Diagnosis: A Multicenter, Prospective Observational Trial (Rising-VTE/NEJ037). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.602] [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: 11/15/2022]
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Nakanishi M, Minakata Y, Tanaka R, Sugiura H, Kuroda H, Yoshida M, Yamamoto N. Simple standard equation for daily step count in Japanese patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2019; 14:1967-1977. [PMID: 31564845 PMCID: PMC6724423 DOI: 10.2147/copd.s218705] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/05/2019] [Indexed: 12/22/2022] Open
Abstract
Purpose The improvement of physical activity in patients with COPD is an important issue. However, no standard for the recommended number of steps for patients with COPD has been determined. We conducted a retrospective observational study to create a simple standard equation for the daily step count, which makes it easier to determine whether each subject is attaining his/her predicted value or not. Patients and methods Stable outpatients diagnosed with COPD whose physical activities had been measured using a triaxial accelerometer for more than 2 weeks were recruited from 5 institutes in Japan. Factors associated with the step count were detected by multivariate regression analysis. After the data were transformed to a normalized distribution, a multivariate linear regression equation was created using stepwise regression. Results One hundred sixty-two patients aged 72.3 (7.2) years and of FEV1 %pred 59.2 (22.8) % were recruited. Among the parameters, age, mMRC dyspnea scale and inspiratory capacity (IC) were detected by the stepwise method. The created standard equation was “Step count = (−0.079×[age]−1.595×[mMRC]+2.078×[IC]+18.149)3”. The correlations between the calculated values and the measured values were observed, and fixed, and proportional biases between them were also observed. When patients with <6500 steps/day were selected, no systematic bias between them could be detected. Conclusion A simple standard equation for Japanese patients with COPD was created using age, mMRC and IC, and could provide an individual-predicted value, especially for patients with <6500 steps/day.
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Affiliation(s)
- Masanori Nakanishi
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yoshiaki Minakata
- Department of Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama, Japan
| | - Rie Tanaka
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hisatoshi Sugiura
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hikaru Kuroda
- Department of Respiratory Medicine, National Hospital Organization Asahikawa Medical Center, Asahikawa, Hokkaido, Japan
| | - Makoto Yoshida
- Department of Respiratory Medicine, National Hospital Organization Fukuoka Hospital, Fukuoka, Japan
| | - Nobuyuki Yamamoto
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
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Ikeda M, Koh Y, Teraoka S, Oyanagi J, Kanai K, Hayata A, Tokudome N, Akamatsu H, Ozawa Y, Akamatsu K, Higuchi M, Nakanishi M, Ueda H, Yamamoto N. Abstract 414: Detection of AXL-expressing circulating tumor cells (CTCs) in non-small-cell lung cancer (NSCLC) patients using an automated microcavity array (MCA) system. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: Noninvasive diagnostics has been developed over the last decade and we have previously reported that CTCs can be utilized for evaluating molecular features of NSCLC. AXL, a receptor tyrosine kinase is linked to epithelial-to-mesenchymal transition (EMT) leading to cancer progression and regarded as a potential therapeutic target. However, many of current technologies rely on epithelial markers to detect CTCs and that makes it difficult to detect AXL-expressing CTCs. Here, we established the detection of AXL expression on CTCs using MCA system.
Methods: Preclinical experiments were performed using NSCLC cell lines H1299, PC9, and HCC827 and a breast cancer cell line MDA-MB231 with varying cytokeratin (CK) and AXL expression levels. The cells were spiked into 3 ml of peripheral blood from healthy donors, then enriched using MCA system, and detected by staining for CD45, DAPI, CK or vimentin (VM) with the addition staining for AXL. For clinical evaluation, 3ml of peripheral blood was collected from advanced NSCLC patients.
Results: DAPI-positive, CK or VM-positive, and CD45-negative cells were defined as CTCs. In spike-in experiments, when CK was used as a marker, AXL expression was detected in 5 and 17% of high CK-expressing HCC827 and PC9 cells, respectively and detected in 52 and 75% of low CK-expressing H1299 and MDA-MB231 cells, respectively. On the other hand, when VM was used as a marker, AXL expression was detected in 72 and 88% of high VM-expressing MDA-MB231 and H1299 cells, respectively whereas detected in 1 and 7% of PC9 and HCC827 cells with low VM expression, respectively. Twenty-four patients were enrolled in the clinical study. The patient characteristics were as follows: median age 69.5 years (range, 49-84); male 88%; stage III/IV, 25/75%; adenocarcinoma/ squamous cell carcinoma/ other, 63/33/4%. Both CK and VM staining in 17 patients, only CK in 6 patients, and only VM in 1 patient were performed. CK-positive single CTCs were detected in all patients (median, 4; range, 1-50) and AXL-expressing CK-positive single CTCs were detected in 26% of patients (median, 0; range, 0-1). On the other hand, VM-positive single CTCs were detected in 94% of patients (median, 6.5; range, 0-128) and AXL-expressing VM-positive single CTCs were detected in 89% of patients (median, 1; range, 0-106). Significantly more AXL-expressing single CTCs were detected in VM-positive than CK-positive (p < 0.001). Notably, all of identified CTC clusters were positive for only VM, not CK and AXL-expressing CTC clusters were detected in 33% of patients (median, 0; range, 0-22).
Conclusion: Our data indicate that incorporating VM staining is necessary to detect AXL-positive CTCs due to EMT. Further clinical evaluation is warranted for validating the method and the clinical significance of AXL-positive CTCs.
Citation Format: Mio Ikeda, Yasuhiro Koh, Shunsuke Teraoka, Jun Oyanagi, Kuninobu Kanai, Atsushi Hayata, Nahomi Tokudome, Hiroaki Akamatsu, Yuichi Ozawa, Keiichiro Akamatsu, Masayuki Higuchi, Masanori Nakanishi, Hiroki Ueda, Nobuyuki Yamamoto. Detection of AXL-expressing circulating tumor cells (CTCs) in non-small-cell lung cancer (NSCLC) patients using an automated microcavity array (MCA) system [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 414.
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Oyanagi J, Koh Y, Teraoka S, Kanai K, Hayata A, Tokudome N, Akamatsu H, Ozawa Y, Akamatsu K, Nakanishi M, Ueda H, Yamamoto N. Abstract 416: Predictive significance of serum protein levels in advanced non-small-cell lung cancer patients treated with pembrolizumab. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: We have previously reported that serum IL-8 and G-CSF were correlated with clinical benefit and immune-related adverse events (irAE), respectively in non-small-cell lung cancer (NSCLC) patients treated with nivolumab. Here, we measured multiple serum proteins serially in NSCLC patients treated with pembrolizumab and explored the potential of predicting clinical response or irAE onset. This study was registered at UMIN (ID: 000024414).
Patients and Methods: Advanced NSCLC patients received pembrolizumab monotherapy (200 mg/body, q3W) until progressive disease (PD) or unacceptable toxicity. Serum samples were collected at baseline and at week 6. Best response was classified into partial response (PR), stable disease (SD), or progressive disease (PD) according to RECIST v1.1. Using LuminexTM xMapTM technology, serum levels of 41 proteins consisting of cytokines, chemokines, growth factors, and angiogenesis factors were measured. All statistical analyses were carried out using JMP Pro software (ver. 13.0) and Mann-Whitney U test were performed accordingly. A p value <0.05 was considered as significant.
Results: Thirty-seven patients were registered in the study between March 2017 and October 2018 at Wakayama Medical University Hospital and 32 were included in the final analysis. Demographics of the patients were as follows: median age 70 (range, 50 to 91); male 75%; smoker 88%; stage III/IV, 22/78%; squamous/non-squamous, 31/69%, previous treatment; 0/1≤, 47/53%. Objective response rate was 28% and disease control rate was 56% in the entire cohort and 40% and 67%, respectively in the first-line subset. Among 41 serum proteins measured, no serum protein at baseline was associated with efficacy or irAE onset in the entire cohort. Levels of serum VEGF-C and sCD40L at baseline, however, in the first-line subset were found significantly lower in the patient who had PR and SD than those who did not. RANTES was also found significantly lower in patients who had PR in the 2nd or later line subset. With regard to irAE prediction, changes of HB-EGF levels between baseline and week 6 were significantly smaller in irAE patients in the entire cohort and changes of MCP-1 levels were significantly smaller in irAE patients in second or later line subset. The serum proteins identified in the current study were not overlapped with those identified in advanced NSCLC patients treated with nivolumab in the previous study.
Conclusions: We identified potential serum protein markers associated with clinical benefit and irAE from pembrolizumab treatment in advanced NSCLC by multi-analyte protein-based assay. Our results suggest that serum proteins associated with efficacy and irAE may vary among different anti-PD-1 antibodies and also between in the first-line setting and later one.
Citation Format: Jun Oyanagi, Yasuhiro Koh, Shunsuke Teraoka, Kuninobu Kanai, Atsuhsi Hayata, Nahomi Tokudome, Hiroaki Akamatsu, Yuichi Ozawa, Keiichiro Akamatsu, Masanori Nakanishi, Hiroki Ueda, Nobuyuki Yamamoto. Predictive significance of serum protein levels in advanced non-small-cell lung cancer patients treated with pembrolizumab [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 416.
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Affiliation(s)
- Jun Oyanagi
- Wakayama Medical University, Wakayama, Japan
| | | | | | | | | | | | | | | | | | | | - Hiroki Ueda
- Wakayama Medical University, Wakayama, Japan
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Maruo Y, Nakanishi M, Suzuki Y, Kaneshi Y, Terashita Y, Narugami M, Takahashi M, Kato S, Suzuki R, Goto A, Miyoshi M, Nagano H, Sugisawa T, Okano M. Outbreak of aseptic meningitis caused by echovirus 30 in Kushiro, Japan in 2017. J Clin Virol 2019; 116:34-38. [PMID: 31082730 DOI: 10.1016/j.jcv.2019.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/23/2019] [Accepted: 05/05/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Echovirus 30 (E30) is one of the most common causative agents for aseptic meningitis. OBJECTIVES In the autumn of 2017, there was an outbreak caused by E30 in Kushiro, Hokkaido, Japan. The aim of this study was to characterize this outbreak. STUDY DESIGN Fifty-nine patients were admitted to the Department of Pediatrics, Kushiro Red Cross Hospital (KRCH) with clinical diagnosis of aseptic meningitis. Among those, 36 patients were finally diagnosed as E30-associated aseptic meningitis by the detection of viral RNA using reverse transcription-polymerase chain reaction (RT-PCR) and/or the evidence of more than four-fold rise in neutralizing antibody (NA) titers in the convalescent phase relative to those in the acute phase. We investigated these 36 confirmed cases. RESULTS The median age was 6 years (range: 6 months-14 years). The positive signs and symptoms were as follows: fever (100%), headache (94%), vomiting (92%), jolt accentuation (77%), neck stiffness (74%), Kernig sign (29%), and abdominal pain (28%). The median cerebrospinal fluid (CSF) white cell count, neutrophil count, and lymphocyte count were 222/μL (range: 3-1434/μL), 144/μL (range: 1-1269/μL), and 85/μL (range: 2-354/μL), respectively. Although the detected viral genes demonstrated same cluster, they were different from E30 strains observed in Japan between 2010 and 2014. CONCLUSION We mainly showed clinical and virological features of the E30-associated aseptic meningitis outbreak that occurred in Kushiro. To prevent further spread of E30 infection, continuous surveillance of enterovirus (EV) circulation and standard precautions are considered essential.
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Affiliation(s)
- Yuji Maruo
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan.
| | - Masanori Nakanishi
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Yasuto Suzuki
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Yosuke Kaneshi
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Yukayo Terashita
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Masashi Narugami
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Michi Takahashi
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Sho Kato
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Ryota Suzuki
- Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan
| | - Akiko Goto
- Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan
| | - Masahiro Miyoshi
- Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan
| | - Hideki Nagano
- Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan
| | - Takahisa Sugisawa
- Kushiro Center of Public Health, 4-22, Shiroyama 2, Kushiro 085-0826, Japan
| | - Motohiko Okano
- Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan
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Koseki K, Kawakami E, Kawasaki H, Atsugi T, Nakanishi M, Mizuno M, Naru E, Ebihara T, Amagai M. 360 Assessment of skin barrier function from skin images with topological data analysis. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.436] [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: 10/27/2022]
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Nagano H, Yokoyama H, Kato M, Hashimoto H, Shimo T, Watanabe M, Nakanishi M, Kaneko Y, Suzuki H, Noguchi A, Kobayashi K. EP-1514 Binary exponential model for the PSA fall after IMRT, dependency on initial PSA and Prostate volume. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31934-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Koh Y, Yagi S, Akamatsu H, Kanai K, Hayata A, Tokudome N, Akamatsu K, Higuchi M, Kanbara H, Nakanishi M, Ueda H, Yamamoto N. Heterogeneous Expression of Programmed Death Receptor-ligand 1 on Circulating Tumor Cells in Patients With Lung Cancer. Clin Lung Cancer 2019; 20:270-277.e1. [PMID: 31005568 DOI: 10.1016/j.cllc.2019.03.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/20/2019] [Accepted: 03/17/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Blockade of the programmed death receptor-1 (PD-1) pathway is effective against solid tumors including lung cancer. PD-ligand 1 (PD-L1) expression on tumor tissue serves as a predictive biomarker for the efficacy of PD-1 pathway blockade. Here, we evaluated the expression of PD-L1 on circulating tumor cells (CTCs) in patients with lung cancer. MATERIALS AND METHODS Peripheral whole blood (3 mL) was collected from patients, and CTCs and PD-L1 expression were detected using a microcavity array (MCA) system. Immunohistochemistry for PD-L1 detection was also performed using matched tumor tissues. RESULTS Sixty-seven patients with lung cancer were enrolled in the study between July 2015 and April 2016 at Wakayama Medical University Hospital. The characteristics of the patients were as follows: median age, 71 years (range, 39-86 years); male, 72%; stage II to III/IV, 14%/85%; non-small-cell lung cancer/small-cell lung cancer/other, 73%/21%/6%. CTCs were detected in 66 of 67 patients (median, 19; range, 0-115), and more than 5 CTCs were detected in 78% of patients. PD-L1-expressing CTCs were detected in 73% of patients, and the proportion score of PD-L1-expressing CTCs ranged from 3% to 100%, suggesting intra-patient heterogeneity of PD-L1 expression on CTCs. Tumor tissues were available from 27 patients and were immunostained for PD-L1, and no correlation was observed between tumor tissues and CTCs based on the proportion score (R2 = 0.0103). CONCLUSION PD-L1 expression was detectable on CTCs in patients with lung cancer, and intra-patient heterogeneity was observed. No correlation was observed between PD-L1 expression in tumor tissues and CTCs.
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Affiliation(s)
- Yasuhiro Koh
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan.
| | - Satomi Yagi
- Medical Business Unit, Hitachi Chemical Co, Ltd, Ibaraki, Japan
| | - Hiroaki Akamatsu
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Kuninobu Kanai
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Hayata
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Nahomi Tokudome
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | | | | | | | | | - Hiroki Ueda
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
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Oyanagi J, Koh Y, Sato K, Mori K, Teraoka S, Akamatsu H, Kanai K, Hayata A, Tokudome N, Akamatsu K, Nakanishi M, Ueda H, Yamamoto N. Predictive value of serum protein levels in patients with advanced non-small cell lung cancer treated with nivolumab. Lung Cancer 2019; 132:107-113. [PMID: 31097082 DOI: 10.1016/j.lungcan.2019.03.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 01/25/2019] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although programmed cell death-ligand-1 (PD-L1) expression in tumor tissue has been established as predictive biomarker for the anti-programmed cell death-1 (PD-1) antibody treatment of non-small-cell lung cancer (NSCLC), additional biomarkers are critically needed. We evaluated serum proteins relevant to immune checkpoint blockade in patients with NSCLC treated with nivolumab to identify novel non-invasive predictive biomarkers. PATIENTS AND METHODS Patients with advanced NSCLC, who had failed at least one prior chemotherapy regimen, received nivolumab monotherapy (3 mg/kg, Q2W) until progressive disease (PD) or unacceptable toxicity was observed. Blood samples were collected at baseline and week 4. Fifty-seven serum protein levels were quantified with a Milliplex MAP assay. The associations of both clinical benefit (CB) and the onset of immune related adverse events (irAEs) with serum proteins levels were evaluated. RESULTS Thirty-eight patients with advanced NSCLC were enrolled in the study, with 38 and 32 paired serum samples at baseline and week 4 being available for efficacy analysis and irAE analysis, respectively. In durable CB (DCB) patients compared with non-DCB patients, the baseline serum levels of BMP-9 were significantly higher, whereas the follistatin, IL-8, IP-10, and TNF-α levels were significantly lower. In irAE patients compared with non-irAE patients the serum levels of G-CSF and RANTES at week 4 were significantly higher, whereas the levels of leptin were significantly lower. A multivariate analysis revealed that follistatin and IP-10 were statistically associated with DCB (p < 0.05) and RANTES was associated with irAE onset (p < 0.05). In a subset of irAE-developed patients, RANTES levels decreased after steroid administration, supporting its involvement in irAE. CONCLUSION Serum proteins have the potential to be predictive markers for DCB and irAEs onset in patients with NSCLC treated with nivolumab. In addition, antitumor activity and irAEs may not be regulated by the same mechanisms.
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Affiliation(s)
- Jun Oyanagi
- Internal Medicine III, Wakayama Medical University, 811-1, Kimiidera, Wakayama-city, Wakayama, 641-8501, Japan
| | - Yasuhiro Koh
- Internal Medicine III, Wakayama Medical University, 811-1, Kimiidera, Wakayama-city, Wakayama, 641-8501, Japan.
| | - Koichi Sato
- Internal Medicine III, Wakayama Medical University, 811-1, Kimiidera, Wakayama-city, Wakayama, 641-8501, Japan
| | - Keita Mori
- Clinical Research Support Center, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Shunsuke Teraoka
- Internal Medicine III, Wakayama Medical University, 811-1, Kimiidera, Wakayama-city, Wakayama, 641-8501, Japan
| | - Hiroaki Akamatsu
- Internal Medicine III, Wakayama Medical University, 811-1, Kimiidera, Wakayama-city, Wakayama, 641-8501, Japan
| | - Kuninobu Kanai
- Internal Medicine III, Wakayama Medical University, 811-1, Kimiidera, Wakayama-city, Wakayama, 641-8501, Japan
| | - Atsushi Hayata
- Internal Medicine III, Wakayama Medical University, 811-1, Kimiidera, Wakayama-city, Wakayama, 641-8501, Japan
| | - Nahomi Tokudome
- Internal Medicine III, Wakayama Medical University, 811-1, Kimiidera, Wakayama-city, Wakayama, 641-8501, Japan
| | - Keiichiro Akamatsu
- Internal Medicine III, Wakayama Medical University, 811-1, Kimiidera, Wakayama-city, Wakayama, 641-8501, Japan
| | - Masanori Nakanishi
- Internal Medicine III, Wakayama Medical University, 811-1, Kimiidera, Wakayama-city, Wakayama, 641-8501, Japan
| | - Hiroki Ueda
- Internal Medicine III, Wakayama Medical University, 811-1, Kimiidera, Wakayama-city, Wakayama, 641-8501, Japan
| | - Nobuyuki Yamamoto
- Internal Medicine III, Wakayama Medical University, 811-1, Kimiidera, Wakayama-city, Wakayama, 641-8501, Japan
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Takahashi T, Okamoto T, Sato Y, Yamazaki T, Hayashi A, Aoyagi H, Ueno M, Kobayashi N, Uetake K, Nakanishi M, Ariga T. Periodically repeated rituximab administrations in children with refractory nephrotic syndrome: 2-year multicenter observational study. Pediatr Nephrol 2019; 34:87-96. [PMID: 30141179 DOI: 10.1007/s00467-018-4063-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 08/09/2018] [Accepted: 08/16/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Rituximab (RTX) is effective in maintaining remission in patients with nephrotic syndrome (NS), but a standard protocol of RTX administration has not been established. METHODS This study was a 2-year multicenter observational study, in which consistent treatments and evaluations were performed. We enrolled pediatric patients with refractory NS between January 2015 and December 2015. RTX infusion was performed four times at 6-month intervals, followed by mizoribine pulse therapy with early discontinuation of calcineurin inhibitor (CNI). Primary endpoints were the relapse-free survival rate and the number of relapses after RTX administration. Secondary endpoints were changes in side effects associated with long-term steroid administration. RESULTS Twenty-two patients were analyzed. The relapse-free survival rate at 1 year and 2 years was 50 and 46%, respectively. Twenty-one patients accomplished our protocol and the frequency of relapse was reduced under the discontinuation of CNI. Although two patients were diagnosed with frequent relapse and/or steroid dependency during the observation period, the frequency of relapse decreased with each rituximab dose. Statistically significant improvements in all steroid complications were observed in the final examination, but no significant improvements were observed from 1 to 2 years after RTX administration. One patient had agranulocytosis, and three patients showed electrocardiographic abnormalities. CONCLUSIONS Our protocol was useful and safe for refractory NS. However, RTX administration four times might have been excessive in patients who had no relapse by 1 year after the initial RTX administration. Further investigation of the most appropriate method of RTX administration is required.
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Affiliation(s)
- Toshiyuki Takahashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, 060-8638, Japan
| | - Takayuki Okamoto
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, 060-8638, Japan.
| | - Yasuyuki Sato
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, 060-8638, Japan
| | - Takeshi Yamazaki
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, 060-8638, Japan
| | - Asako Hayashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, 060-8638, Japan
| | - Hayato Aoyagi
- Department of Pediatrics, Obihiro Kyokai Hospital, Obihiro, Japan
| | - Michihiko Ueno
- Department of Pediatrics, Nikko Memorial Hospital, Muroran, Japan
| | - Norio Kobayashi
- Department of Pediatrics, Oji General Hospital, Tomakomai, Japan
| | - Kimiaki Uetake
- Department of Pediatrics, Obihiro Kosei Hospital, Obihiro, Japan
| | | | - Tadashi Ariga
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo, Hokkaido, 060-8638, Japan
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Sato K, Akamatsu H, Murakami E, Sasaki S, Kanai K, Hayata A, Tokudome N, Akamatsu K, Koh Y, Ueda H, Nakanishi M, Yamamoto N. Corrigendum to "Correlation between immune-related adverse events and efficacy in non-small cell lung cancer treated with nivolumab" [Lung Cancer 115 (2018) 71-74]. Lung Cancer 2018; 126:230-231. [PMID: 30459086 DOI: 10.1016/j.lungcan.2018.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Koichi Sato
- Third Department of Internal Medicine, Wakayama Medical University, Japan
| | - Hiroaki Akamatsu
- Third Department of Internal Medicine, Wakayama Medical University, Japan.
| | - Eriko Murakami
- Third Department of Internal Medicine, Wakayama Medical University, Japan
| | - Seigo Sasaki
- Third Department of Internal Medicine, Wakayama Medical University, Japan
| | - Kuninobu Kanai
- Third Department of Internal Medicine, Wakayama Medical University, Japan
| | - Atsushi Hayata
- Third Department of Internal Medicine, Wakayama Medical University, Japan
| | - Nahomi Tokudome
- Third Department of Internal Medicine, Wakayama Medical University, Japan
| | - Keiichiro Akamatsu
- Third Department of Internal Medicine, Wakayama Medical University, Japan
| | - Yasuhiro Koh
- Third Department of Internal Medicine, Wakayama Medical University, Japan
| | - Hiroki Ueda
- Third Department of Internal Medicine, Wakayama Medical University, Japan
| | - Masanori Nakanishi
- Third Department of Internal Medicine, Wakayama Medical University, Japan
| | - Nobuyuki Yamamoto
- Third Department of Internal Medicine, Wakayama Medical University, Japan
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Yoshioka Y, Yamachika E, Nakanishi M, Ninomiya T, Nakatsuji K, Kobayashi Y, Fujii T, Iida S. Cathepsin K inhibitor causes changes in crystallinity and crystal structure of newly-formed mandibular bone in rats. Br J Oral Maxillofac Surg 2018; 56:732-738. [PMID: 30131193 DOI: 10.1016/j.bjoms.2018.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 08/03/2018] [Indexed: 11/16/2022]
Abstract
Cathepsin K inhibitors are new drugs with the potential for the treatment of osteoporosis because they sustain bony remodelling better than bone resorption inhibitors such as bisphosphonates. The treatment of osteoporosis with inhibitors of bony resorption is associated with osteonecrosis of the jaw, as the deterioration in bony quality that they induce is thought to be one of its causes. The quality of bone is delineated by structural and material characteristics (which include the degree and quality of mineralisation, and depends on the content of proteoglycan and the structural integrity of the bony collagen).1,2 Animal and clinical studies have shown that cathepsin K inhibitors improve the mineral density and structural characteristics of bone, but their effect on the rest remains unknown. We therefore hypothesised that these inhibitors will affect the material characteristics of newly-formed mandibular bone. To verify our hypothesis, we used Raman microspectroscopy to examine such bone in rats that were given a cathepsin K inhibitor, and found unusual crystallinity and an increased substitution of carbonate (CO32-) in its crystal structure.
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Affiliation(s)
- Y Yoshioka
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City 700-8558, Japan
| | - E Yamachika
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama City 700-8558, Japan.
| | - M Nakanishi
- Department of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama University, 1-1-1 Tsushima-Naka, Kita-ku, Okayama City 700-8530, Japan
| | - T Ninomiya
- Division of Hard Tissue Research, Institute for Oral Science, Matsumoto Dental University, 1780 Gobara Hirooka, Shiojiri, Nagano 399-0781, Japan
| | - K Nakatsuji
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City 700-8558, Japan
| | - Y Kobayashi
- Division of Hard Tissue Research, Institute for Oral Science, Matsumoto Dental University, 1780 Gobara Hirooka, Shiojiri, Nagano 399-0781, Japan
| | - T Fujii
- Department of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama University, 1-1-1 Tsushima-Naka, Kita-ku, Okayama City 700-8530, Japan
| | - S Iida
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City 700-8558, Japan
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Miura H, Morita Y, Hosoda H, Yoneda S, Nakao K, Fujino M, Otsuka F, Arakawa T, Asaumi Y, Kataoka Y, Tahara Y, Nakanishi M, Fukuda T, Noguchi T, Yasuda S. P4676Prediction of adverse left ventricular remodeling after acute myocardial infarction using feature-tracking imaging. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4676] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H Miura
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - Y Morita
- National Cerebral and Cardiovascular Center, Radiology, Suita, Japan
| | - H Hosoda
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - S Yoneda
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - K Nakao
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - M Fujino
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - F Otsuka
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - T Arakawa
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - Y Asaumi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - Y Tahara
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - M Nakanishi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - T Fukuda
- National Cerebral and Cardiovascular Center, Radiology, Suita, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
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Oyanagi J, Koh Y, Akamatsu H, Kanai K, Hayata A, Tokudome N, Akamatsu K, Akamatsu K, Nakanishi M, Ueda H, Yamamoto N. Abstract 2608: Predictive values of serum protein levels in advanced non-small cell lung cancer patients treated with nivolumab. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-2608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Though PD-ligand 1 (PD-L1) expression on tumor tissue has been established as companion diagnostics in non-small-cell lung cancer (NSCLC) for anti-PD-L1 treatment, additional biomarkers to enrich the patients likely to benefit from the therapy are critically needed. Here, we conducted a serial evaluation of multiple serum proteins relevant to the modulation of immune system in NSCLC patients treated with nivolumab.
Patients and Methods: Advanced NSCLC patients after failure of at least one prior chemotherapy regimen received nivolumab monotherapy (3mg/kg, q2W) until progressive disease (PD) or unacceptable toxicity. Serum samples were collected at baseline and at week 4. Best response was classified into partial response (PR), stable disease (SD), or progressive disease (PD) according to RECIST v1.1. Using LuminexTM xMapTM technology, serum levels of 54 proteins consisting of cytokines, chemokines, growth factors, and angiogenesis factors were measured. All statistical analyses were carried out using JMP Pro software (ver. 13.0) and Mann-Whitney U test and Spearman's test were performed accordingly. A p value <0.05 was considered as significant.
Results: Thirty-eight patients were registered in the study between January 2016 and March 2017 at Wakayama Medical University Hospital and 34 were included in the final analysis. Demographics of the patients were as follows: median age 68 (range, 49 to 86); male 73 %; stage IV, 100 %; squamous/non-squamous, 30/70 %. Overall response rate was 22% (7/34), and disease control rate was 53% (18/34). Among 54 serum proteins measured serially, the level of serum TNF-α was significantly lower at baseline in non-PD patients than PD patients (p < 0.05). The level of TNF-α was also correlated with longer progression free survival (PFS) (r= -0.5693). Serum IL-8 level at week 4 in PR patients were significantly lower than those in non-PR patients (p <0.01) though no difference was observed at baseline between the two, supporting the relevance of serum IL-8 level to the efficacy of nivolumab. Correlation between IL-8 levels at week 4 and longer PFS turned out to be more significant (r=-0.6864). In addition, serum levels of VEGF-A, TGF-β1 and PDGF-AB/BB were significantly lower in PR patients than those in non-PR patients at week 4 (p <0.05). However, these protein levels were not correlated with PFS.
Conclusions: We identified that the serum levels of IL-8, TNF-α, VEGF-A, TGF-β1 and PDGF-AB/BB as potential biomarkers to predict clinical benefit from nivolumab treatment in advanced NSCLC by multi-analyte protein-based assay. Incorporating additional serum protein levels may have potential to improve the patient enrichment besides previously reported potential biomarkers such as IL-8 and VEGF levels. Further evaluation is warranted in a larger cohort to validate the findings.
Citation Format: Jun Oyanagi, Yasuhiro Koh, Hiroaki Akamatsu, Kuninobu Kanai, Atsushi Hayata, Nahomi Tokudome, Keiichiro Akamatsu, Keiichiro Akamatsu, Masanori Nakanishi, Hiroki Ueda, Nobuyuki Yamamoto. Predictive values of serum protein levels in advanced non-small cell lung cancer patients treated with nivolumab [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2608.
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Affiliation(s)
- Jun Oyanagi
- Wakayama Medical University, Wakayama, Japan
| | | | | | | | | | | | | | | | | | - Hiroki Ueda
- Wakayama Medical University, Wakayama, Japan
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Koh Y, Akamatsu H, Mori K, Kanai K, Hayata A, Tokudome N, Higuchi M, Akamatsu K, Nakanishi M, Ueda H, Yamamoto N. Abstract 5595: Predictive impact of sequential evaluation of PD-L1-expressing circulating tumor cells in NSCLC patients treated with nivolumab. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-5595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Anti-PD-1 antibody nivolumab has become a new standard treatment for pretreated, advanced non-small cell lung cancer (NSCLC). Although PD-L1 expression on tumor tissue has a predictive value, significance of its expression on circulating tumor cells (CTCs) is unknown. Here, we conducted a sequential evaluation of PD-1-expressing CTCs in NSCLC patients treated with nivolumab.
Methods: Advanced NSCLC patients who received nivolumab at Wakayama Medical University Hospital were enrolled in the study (UMIN000024414). Nivolumab was administered 3 mg/kg bi-weekly until progressive disease (PD) or unacceptable toxicity. Peripheral whole blood (3 mL) was collected in an EDTA collection tube (BD vacutainer) and processed within 3 hours for CTC evaluation at baseline, week 4 and week 8. CTCs were detected using automated microcavity array system (Hitachi Chemical Co.). PD-L1 expression was immunohistochemically examined on both tumor tissues and CTCs using anti-PD-L1 antibody, clone 28-8 (Abcam).
Results: Thirty-eight patients were registered in the study between January 2016 and September 2016. Clinical characteristics of the patients were as follows: median age 68 (range, 49 to 86); male 73 %; stage IV 100 %; squamous/non-squamous, 30/65 %. Regarding nivolumab treatment, overall response rate (ORR) was 22% (95% confidence interval [CI]: 10-38%), and median progression-free survival (PFS) was 62 days (95%CI: 40-235 days). At baseline, CTCs were detected in all patients (median, 15; range, 1-90) and PD-L1-expressing CTCs were detected in 87% of patients. Tumor proportion score (TPS) of PD-L1 expression on CTCs varied from 6% to 100%. Matched tumor tissues were available from 14 patients and 7 showed the PD-L1 TPS ≥50%. PD-L1 status on CTCs was not correlated with that on tumor tissues both using proportional score and H score (Spearman's correlation: r = 0.0007 and 0.08, respectively). On CTCs, patients with PD-L1 ≥50 % have significantly higher disease control rate than those with below 50% (83.3% versus 36.4%, p<0.01). Similarly, patients with PD-L1 ≥50 % on CTC had significantly longer PFS compared with those with below 50% (293 days versus 49 days, hazard ratio 2.41 (95% CI: 1.05-5.54), p = 0.03). During nivolumab treatment, number of CTCs was decreased (median number was 10 at 4 weeks, and 5 at 8 weeks). Among those with PD-L1 ≥50 % on CTC at baseline, changes in number and PD-L1 status on CTCs at 4 weeks did not correlate with PFS.
Conclusions: Sequential monitoring of PD-L1 expression on CTCs during nivolumab treatment was successfully conducted. PD-L1 expression on CTCs at baseline was a strong predictor in efficacy. Predictive significance of PD-L1-positive CTCs should be evaluated in a larger validation cohort.
Citation Format: Yasuhiro Koh, Hiroaki Akamatsu, Keita Mori, Kuninobu Kanai, Atsushi Hayata, Nahomi Tokudome, Masayuki Higuchi, Keiichiro Akamatsu, Masanori Nakanishi, Hiroki Ueda, Nobuyuki Yamamoto. Predictive impact of sequential evaluation of PD-L1-expressing circulating tumor cells in NSCLC patients treated with nivolumab [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5595.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Hiroki Ueda
- 1Wakayama Medical University, Wakayama, Japan
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Yoshioka Y, Yamachika E, Nakanishi M, Ninomiya T, Nakatsuji K, Matsubara M, Moritani N, Kobayashi Y, Fujii T, Iida S. Molecular alterations of newly formed mandibular bone caused by zoledronate. Int J Oral Maxillofac Surg 2018; 47:1206-1213. [PMID: 29550280 DOI: 10.1016/j.ijom.2018.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 07/13/2017] [Revised: 12/07/2017] [Accepted: 02/06/2018] [Indexed: 12/21/2022]
Abstract
Bone quality is defined by structural and material characteristics. Most studies on the mandible have focused on the analysis of structural characteristics, with insufficient investigation of material characteristics. This study tested whether zoledronate affects the material characteristics of newly formed mandibular bone. Thirty-six female Wistar rats were assigned to three groups: sham-ovariectomized rats (SHAM, n=12), ovariectomized rats (OVX, n=12), and ovariectomized rats treated with zoledronate (ZOL, n=12). The left side of the mandibular ramus of all rats was drilled bicortically. Twenty-eight days after surgery, all surviving rats were euthanized and all mandibles were removed. Raman microspectroscopy was performed, and five spectra per specimen of newly formed mandibular bone were analysed. Compared with OVX rats, the mineral/matrix ratio in ZOL rats was significantly increased (5.43±1.88 vs. 7.86±2.05), while crystallinity (0.055±0.002 vs. 0.050±0.002), relative proteoglycan content (0.43±0.10 vs. 0.31±0.05), and collagen structural integrity (1.16±0.21 vs. 0.72±0.06) were significantly decreased. These changes in material characteristics may explain why rats that received zoledronate exhibited peculiar biological phenomena such as bisphosphonate-related osteonecrosis of the jaw.
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Affiliation(s)
- Y Yoshioka
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan
| | - E Yamachika
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Hospital, Okayama City, Japan.
| | - M Nakanishi
- Department of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama University, Okayama City, Japan
| | - T Ninomiya
- Division of Hard Tissue Research, Institute for Oral Science, Matsumoto Dental University, Shiojiri, Nagano, Japan
| | - K Nakatsuji
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan
| | - M Matsubara
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan
| | - N Moritani
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan
| | - Y Kobayashi
- Division of Hard Tissue Research, Institute for Oral Science, Matsumoto Dental University, Shiojiri, Nagano, Japan
| | - T Fujii
- Department of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama University, Okayama City, Japan
| | - S Iida
- Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan
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Hatooka S, Shigematsu Y, Nakanishi M, Yamaki K. Subxiphoid approach for extracting a giant solitary fibrous tumour of the pleura. Interact Cardiovasc Thorac Surg 2018; 25:834-835. [PMID: 28520889 DOI: 10.1093/icvts/ivx134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 04/03/2017] [Indexed: 11/14/2022] Open
Abstract
We describe a case of resection of a solitary fibrous tumour of the pleura using video-assisted thoracic surgery and removal of the giant tumour using a subxiphoid incision without the need for minithoracotomy. Use of the subxiphoid approach as a retrieval port is simple and feasible.
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Affiliation(s)
- Shunzo Hatooka
- Department of Respiratory Surgery, Ichinomiya-Nishi Hospital, Ichinomiya, Japan
| | - Yoshiki Shigematsu
- Department of Respiratory Surgery, Ichinomiya-Nishi Hospital, Ichinomiya, Japan
| | - Masanori Nakanishi
- Department of Respiratory Medicine, Ichinomiya-Nishi Hospital, Ichinomiya, Japan
| | - Kenichi Yamaki
- Department of Respiratory Medicine, Ichinomiya-Nishi Hospital, Ichinomiya, Japan
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Akamatsu H, Koh Y, Mori K, Kanai K, Hayata A, Tokudome N, Higuchi M, Kanbara HI, Akamatsu K, Nakanishi M, Ueda H, Yamamoto N. Abstract A056: Sequential tracking of PD-L1 expression on circulating tumor cells in NSCLC patients treated with nivolumab. Mol Cancer Ther 2018. [DOI: 10.1158/1535-7163.targ-17-a056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Nivolumab (anti-PD-1 antibody) has become a new standard treatment in pretreated, advanced non-small cell lung cancer (NSCLC). Although strong expression of PD-L1 on tumor tissue has predictive value, significance of its expression on circulating tumor cell (CTC) is unknown and its status can be changed during the treatment. Here, we conducted a serial evaluation of PD-1-expressing CTCs in NSCLC patients treated with nivolumab. Methods: Advanced NSCLC patients who receive nivolumab at Wakayama Medical University Hospital were enrolled in this prospective observational study (registered at UMIN (000024414)). Nivolumab was administered 3 mg/kg biweekly until progressive disease (PD) or unacceptable toxicity. Peripheral whole blood (3 mL) was collected in a EDTA collection tube (BD vacutainer) and processed within 3 hours for CTC evaluation at baseline, week 4, and week 8. CTCs were detected using microcavity array system (Hitachi Chemical Co.). PD-L1 expression was immunohistochemically examined on both tumor tissues and CTCs using anti-PD-L1 antibody, clone 28-8 (Abcam). Results: Thirty-eight patients were registered in this study between January 2016 and September 2016. Clinical characteristics of the patients were as follows: median age 68 (range, 49 to 86); male 73%; stage IV 100%; squamous/non-squamous, 30/65%. Regarding nivolumab treatment, overall response rate (ORR) was 22% (95% confidence interval (CI): 10-38%), and median progression-free survival (PFS) was 62 days (95%CI: 40-235 days). At baseline, CTCs were detected in all patients (median, 15; range, 1-90) and PD-L1-expressing CTCs were detected in 87% of patients. Tumor proportion score (TPS) of PD-L1 expression on CTCs varied from 6% to 100%. Matched tumor tissues were available from 14 patients and 7 showed the PD-L1 TPS ≥ 50%. PD-L1 status on CTCs was not correlated with that on tumor tissues both using proportional score and H score (Spearman’s correlation: r = 0.0007 and 0.08, respectively). On CTCs, patients with PD-L1 ≥ 50 have significantly higher disease control rate than those with below 50% (83.3% versus 36.4%, p<0.01). Similarly, patients with PD-L1 ≥ 50% on CTC was significantly longer PFS compared with those with below 50% (293 days versus 49 days, hazard ratio 2.41 (95% CI: 1.05-5.54), p = 0.03). During nivolumab treatment, number of CTCs was decreased (median number was 10 at 4 weeks and 5 at 8 weeks). Among those with PD-L1 ≥ 50% on CTC at baseline, changes in number and PD-L1 status on CTCs at 4 weeks did not correlate with PFS. Conclusions: Serial monitoring of PD-L1 expression on CTCs during nivolumab treatment was successfully conducted. PD-L1 expression on CTCs at baseline was a strong predictor in efficacy. Predictive significance of PD-L1-positive CTCs should be also evaluated in validation cohort using pembrolizumab.
Citation Format: Hiroaki Akamatsu, Yasuhiro Koh, Keita Mori, Kuninobu Kanai, Atsushi Hayata, Nahomi Tokudome, Masayuki Higuchi, HIsashige Kanbara, Keiichiro Akamatsu, Masanori Nakanishi, Hiroki Ueda, Nobuyuki Yamamoto. Sequential tracking of PD-L1 expression on circulating tumor cells in NSCLC patients treated with nivolumab [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2017 Oct 26-30; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2018;17(1 Suppl):Abstract nr A056.
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Affiliation(s)
| | | | - Keita Mori
- 2Shizuoka Cancer Center, Shizuoka, Japan
| | | | | | | | | | | | | | | | - Hiroki Ueda
- 1Wakayama Medical University, Wakayama, Japan
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Oyanagi J, Koh Y, Akamatsu H, Kanai K, Hayata A, Tokudome N, Akamatsu K, Nakanishi M, Ueda H, Yamamoto N. Abstract A057: Serial evaluation of multiple serum protein levels in non-small lung cancer patients treated with nivolumab. Mol Cancer Ther 2018. [DOI: 10.1158/1535-7163.targ-17-a057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Blockade of programmed death receptor-1 (PD-1) pathway is effective against various malignancies. Although PD-ligand 1 (PD-L1) expression on tumor tissue has been established as companion diagnostics in non-small cell lung cancer (NSCLC), additional biomarkers to enrich the patients likely to benefit from the therapy are critically needed. Here, we conducted a serial evaluation of multiple serum cytokines, growth factors, and angiogenesis factors relevant to immune checkpoint blockade in NSCLC patients treated with nivolumab. Patients and Methods: Advanced NSCLC patients after failure of at least one prior chemotherapy regimen received nivolumab monotherapy (3mg/kg, q2W) until progressive disease (PD) or unacceptable toxicity. Serum samples were collected in a serum separation tube (Venoject II autosep, TERUMO) at baseline and at week 4. Best response was classified into partial response (PR), stable disease (SD), or progressive disease (PD) according to RECIST v1.1. Using LuminexTM xMapTM technology, serum levels of 54 proteins consisting of cytokines, chemokines, growth factors, and angiogenesis factors were analyzed. All statistical analyses were carried out using JMP Pro software (ver. 13.0) and Mann-Whitney U test and Spearman's test were performed accordingly. A p value <0.05 was considered as significant. Results: Thirty-eight patients were registered in the study between January 2016 and March 2017 at Wakayama Medical University Hospital and 34 were included in the analysis. Demographics of the patients were as follows: median age 68 (range, 49 to 86); male 73 %; stage IV, 100%; squamous/non-squamous, 30/70 %. Overall response rate was 22% (7/34), and disease control rate was 53% (18/34). Among 54 serum proteins measured serially, the levels of serum IL-8 and TNF-α were significantly lower at baseline in non-PD patients than in PD patients (p < 0.01 in both cases). In addition, the levels of both serum IL-8 and TNF-α were correlated with longer progression-free survival (PFS) (r=-0.4695 and -0.5912, respectively). It is noteworthy that serum IL-8 levels at week 4 in PR patients were significantly lower than those in non-PR patients (p <0.01). Correlation between IL-8 levels at week 4 and longer PFS was shown to be more significant (r=-0.6864). Serum VEGF-A levels were significantly lower in PR patients than those in non-PR patients at week 4 (p <0.05). Conclusions: We identified the serum levels of IL-8, TNF-α, and VEGF-A as potential biomarkers to predict clinical benefit from nivolumab treatment in advanced NSCLC by multi-analyte protein-based assay. Incorporating serum TNF-α levels may have potential to improve the patient enrichment in addition to previously reported potential biomarkers such as IL-8 and VEGF levels. Further evaluation is warranted in a larger cohort to validate the findings.
Citation Format: Jun Oyanagi, Yasuhiro Koh, Hiroaki Akamatsu, Kuninobu Kanai, Atsushi Hayata, Nahomi Tokudome, keiichiro Akamatsu, Masanori Nakanishi, Hiroki Ueda, Nobuyuki Yamamoto. Serial evaluation of multiple serum protein levels in non-small lung cancer patients treated with nivolumab [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2017 Oct 26-30; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2018;17(1 Suppl):Abstract nr A057.
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Affiliation(s)
- Jun Oyanagi
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasuhiro Koh
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiroaki Akamatsu
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kuninobu Kanai
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Hayata
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Nahomi Tokudome
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - keiichiro Akamatsu
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masanori Nakanishi
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiroki Ueda
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Nobuyuki Yamamoto
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
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Shibaki R, Akamatsu H, Mori K, Teraoka S, Kanai K, Hayata A, Tokudome N, Akamatsu K, Koh Y, Ueda H, Nakanishi M, Yamamoto N. PUB058 Is Efficacy Result in Phase 2 Trial Replicated in Phase 3 Trial in Advanced NSCLC: A Meta-Analysis. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1921] [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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Hashimoto S, Ogino H, Iwata H, Hattori Y, Nakajima K, Nakanishi M, Baba F, Sasaki S, Shimamura Y, Kuwabara Y, Senoo K, Shibamoto Y, Mizoe J. Efficacy of Proton Beam Therapy for Hepatocellular Carcinoma With Portal Vein or Inferior Vena Cava Tumor Thrombosis. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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