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Takahashi K, Uozumi R, Mukohara T, Hayashida T, Iwabe M, Iihara H, Kusuhara-Mamishin K, Kitagawa Y, Tsuchiya M, Kitahora M, Nagayama A, Kosaka S, Asano-Niwa Y, Seki T, Ohnuki K, Suzuki A, Ono F, Futamura M, Kawazoe H, Nakamura T. Proton Pump Inhibitors and Cyclin-Dependent Kinase 4/6 Inhibitors in Patients With Breast Cancer. Oncologist 2024:oyae015. [PMID: 38340010 DOI: 10.1093/oncolo/oyae015] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/16/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Proton pump inhibitors (PPIs) reduce the bioavailability of several anticancer drugs. The impact of PPIs co-administered with cyclin-dependent kinase 4 and 6 inhibitors is controversial. We aimed to clarify whether the concomitant use of PPIs impacts palbociclib and abemaciclib effectiveness in breast cancer treatment. PATIENTS AND METHODS This multicenter, retrospective, observational study, conducted across 4 medical institutions in Japan, consecutively included patients with endocrine-resistant metastatic breast cancer, receiving palbociclib or abemaciclib between December 2017 and August 2022. Propensity score-matched analyses were performed. Treatment efficacy and safety with and without PPIs were compared. Progression-free survival and overall survival were estimated using the Kaplan-Meier method and compared using a log-rank test. A Cox proportional hazards model was used to estimate the hazard ratio. RESULTS The study included 240 patients. After 1:1 matching, 112 patients were treated with and without PPIs. The median progression-free survival period was 1.2 years in the PPI group and 1.3 years in the non-PPI group (hazard ratio, 1.19; 95% CI, 0.70-2.02). The median overall survival period was 3.6 years in the PPI group, whereas it was not reached in the non-PPI group (hazard ratio, 1.23; 95% CI, 0.61-2.47). Consistent results were obtained for subgroups receiving palbociclib (n = 177) and abemaciclib (n = 63) without propensity score matching. Adverse event incidence and severity were similar in both groups. CONCLUSION The effectiveness of cyclin-dependent kinase 4/6 inhibitors is unlikely to be affected by concomitant PPI use. Future prospective pharmacokinetic studies are warranted.
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Affiliation(s)
- Kaori Takahashi
- Division of Pharmaceutical Care Sciences, Center for Social Pharmacy and Pharmaceutical Care Sciences, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Ryuji Uozumi
- Department of Industrial Engineering and Economics, Tokyo Institute of Technology, Tokyo, Japan
| | - Toru Mukohara
- Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Tetsu Hayashida
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Midori Iwabe
- Department of Pharmacy, Miyagi Cancer Center, Miyagi, Japan
| | | | | | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | | | - Mika Kitahora
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Aiko Nagayama
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shinkichi Kosaka
- Department of Surgery, National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | | | - Tomoko Seki
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Koji Ohnuki
- Department of Breast Surgery, Miyagi Cancer Center, Miyagi, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Fumiko Ono
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Manabu Futamura
- Department of Breast Surgery, Gifu University Hospital, Gifu, Japan
| | - Hitoshi Kawazoe
- Division of Pharmaceutical Care Sciences, Center for Social Pharmacy and Pharmaceutical Care Sciences, Keio University Faculty of Pharmacy, Tokyo, Japan
- Division of Pharmaceutical Care Sciences, Keio University Graduate School of Pharmaceutical Sciences, Tokyo, Japan
| | - Tomonori Nakamura
- Division of Pharmaceutical Care Sciences, Center for Social Pharmacy and Pharmaceutical Care Sciences, Keio University Faculty of Pharmacy, Tokyo, Japan
- Division of Pharmaceutical Care Sciences, Keio University Graduate School of Pharmaceutical Sciences, Tokyo, Japan
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2
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Iihara H, Shimokawa M, Bando H, Niwa Y, Mizuno Y, Kawaguchi Y, Kitahora M, Murakami A, Kawai M, Ishida K, Takeuchi M, Ishihara K, Iyoda T, Nakada T, Ogiso A, Kojima Y, Kumagai F, Sawa A, Mori R, Higuchi K, Furuta T, Kamei Y, Tsuchiya M, Terasaki A, Yamamoto S, Kitazawa M, Okazaki M, Suzuki A, Futamura M. Doublet or Triplet Antiemetic Prophylaxis for Nausea and Vomiting Induced by Trastuzumab Deruxtecan: an Open-Label, Randomized, and Multicenter Exploratory Phase 2 Study. J Cancer 2023; 14:2644-2654. [PMID: 37779870 PMCID: PMC10539399 DOI: 10.7150/jca.87169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/17/2023] [Indexed: 10/03/2023] Open
Abstract
Background: Trastuzumab deruxtecan is classified as an anticancer agent that poses a moderate emetic risk in the international guidelines for antiemetic therapy. The guidelines recommend emesis prophylaxis using a two-drug combination therapy comprising a 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA) and dexamethasone (DEX). However, the high incidence of nausea and vomiting associated with trastuzumab deruxtecan is problematic. The National Comprehensive Cancer Network guideline version 1.2023 classified trastuzumab deruxtecan as having a high risk of emesis and changed its recommendation to a triplet regimen including a neurokinin-1 receptor antagonist (NK1RA). However, the emetogenic potential of trastuzumab-deruxtecan and the optimal antiemetic prophylaxis are controversial. Hence, this exploratory phase 2 study aimed to assess the efficacy and safety of treatment comprising 5-HT3RA and DEX with or without a NK1RA in preventing trastuzumab deruxtecan-induced nausea and vomiting. Methods: We conducted an open-label and randomized exploratory phase 2 study at 14 centers in Japan. Patients with breast cancer who were scheduled to receive trastuzumab deruxtecan were enrolled in this study. The patients were randomly assigned to receive granisetron and DEX (arm GD) or granisetron, DEX, and aprepitant (fosaprepitant; arm GDA). The primary endpoint was complete response (CR; no emesis or no rescue therapy) during the overall phase (120 h after the start of trastuzumab deruxtecan). Results: Between September 2020 and March 2023, 40 patients were randomly assigned to the GD (n = 19) or GDA (n = 21) arm. In the GDA arm, one patient who did not complete the use of the rescue medication listed in the diary was excluded from the efficacy analysis, which included the use of rescue medication. The CR rates during the overall phase were 36.8% and 70.0% in the GD and GDA arms, respectively (odds ratio 0.1334; 95% confidence interval [CI]: 0.0232-0.7672; P = 0.0190), with a difference of 33.2%. No grade 3 or 4 toxicity related to antiemetic therapy was observed. Conclusions: Patients receiving trastuzumab deruxtecan require triple therapy, including mandatory NK1RA administration.
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Affiliation(s)
- Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
- Patient Safety Division, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
- Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, 1-25-4 Daigakunishi, Gifu, Gifu 501-1196, Japan
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan
- Cancer Biostatistics Laboratory, Clinical Research Institute, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan
| | - Hiroko Bando
- Institute of Medicine, Breast and Endocrine Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Yoshimi Niwa
- Department of Breast Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
| | - Yutaka Mizuno
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi, Mie 510-8567, Japan
| | - Yoshihiro Kawaguchi
- Department of Breast Surgery, Asahi University Hospital, 3-23 Hashimoto-cho, Gifu, Gifu 500-8523, Japan
| | - Mika Kitahora
- Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
| | - Akari Murakami
- Department of Breast Center, Ehime University Hospital, 454 Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Masaaki Kawai
- Department of Breast Surgery, Miyagi Cancer Center, 47-1 Aza-nodayama, Medeshima-shiote, Natori, Miyagi 981-1239, Japan
- Department of First Surgery, Yamagata University Graduate School of Medicine, 2-2-2 Iida-Nishi, Yamagata, Yamagata, 990-9585, Japan (present address)
| | - Kazushige Ishida
- Department of Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Shiwa, Iwate 028-3695, Japan
| | - Makoto Takeuchi
- Department of Breast Surgery, Central Japan International Medical Hospital, 1-1 Kenkonomachi, Minokamo, Gifu 505-8510, Japan
| | - Kazuhiro Ishihara
- Department of Surgery, Gihoku Kosei Hospital, 1187-3 Takatomi, Yamagata, Gifu 501-2105, Japan
| | - Tomokazu Iyoda
- Department of Pharmacy, Fukushima Medical University Hospital, 1 Hikariga-oka, Fukushima 960-1247, Japan
| | - Takumi Nakada
- Department of Breast Surgery, Gifu Municipal hospital, 7-1 Kashimacho, Gifu, Gifu 500-8513, Japan
| | - Atsuko Ogiso
- Department of Breast Surgery, Gifu Prefectural General Medical Center, 4-6-1 Noishiki, Gifu, Gifu 500-8717, Japan
| | - Yasuyuki Kojima
- Department of Breast and Endocrine Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa 216-8511, Japan
| | - Fumiyoshi Kumagai
- Department of Pharmacy, Tohoku Rosai Hospital, 4-3-21 Dainohara, Miyagino, Sendai, Miyagi 981-8563, Japan
| | - Aya Sawa
- Department of breast, thyroid, endocrine surgery, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
| | - Ryutaro Mori
- Department of Breast Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
| | - Kosuke Higuchi
- Department of Pharmacy, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi, Mie 510-8567, Japan
| | - Tomoko Furuta
- Department of Pharmacy, Asahi University Hospital, 3-23 Hashimoto-cho, Gifu, Gifu 500-8523, Japan
| | - Yoshiaki Kamei
- Department of Breast Center, Ehime University Hospital, 454 Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Masami Tsuchiya
- Department of Pharmacy, Miyagi Cancer Center, 47-1 Nodayama, Medeshimashiote, Natori, Miyagi 981-1293, Japan
| | - Azusa Terasaki
- Department of breast, thyroid, endocrine surgery, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
| | - Senri Yamamoto
- Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
| | - Mai Kitazawa
- Department of Breast Surgery, Asahi University Hospital, 3-23 Hashimoto-cho, Gifu, Gifu 500-8523, Japan
| | - Mai Okazaki
- Department of breast, thyroid, endocrine surgery, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
- Laboratory of Advanced Medical Pharmacy, Gifu Pharmaceutical University, 1-25-4 Daigakunishi, Gifu, Gifu, 501-1196, Japan
| | - Manabu Futamura
- Department of Breast Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
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3
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Fujii H, Ueda Y, Hirose C, Ohata K, Sekiya K, Kitahora M, Sadaka S, Yamamoto S, Watanabe D, Kato-Hayashi H, Iihara H, Kobayashi R, Kaburaki M, Matsuhashi N, Takahashi T, Makiyama A, Yoshida K, Hayashi H, Suzuki A. Pharmaceutical intervention for adverse events improves quality of life in patients with cancer undergoing outpatient chemotherapy. J Pharm Health Care Sci 2022; 8:8. [PMID: 35236407 PMCID: PMC8889741 DOI: 10.1186/s40780-022-00239-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background The effect of pharmaceutical intervention to treat adverse events on quality of life (QOL) in outpatients receiving cancer chemotherapy is unclear. We investigated whether pharmaceutical intervention provided by pharmacists in collaboration with physicians improves QOL with outpatient cancer chemotherapy. Methods We conducted a single-center retrospective descriptive study of pharmaceutical intervention for patients receiving outpatient cancer chemotherapy at Gifu University Hospital between September 2017 and July 2020. We assessed patient QOL using the Japanese version of the EuroQol 5 Dimension5 Level (EQ-5D-5L). Adverse events were graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. We compared the EQ-5D-5L utility value and incidence of grade 2 or higher adverse events before and after pharmaceutical intervention. Results Our analysis included 151 patients who underwent 210 chemotherapy cycles. Pharmaceutical intervention significantly improved patients’ EQ-5D-5L utility values from 0.8197 to 0.8603 (P < 0.01). EQ-5D-5L utility values were significantly improved after pharmaceutical intervention for nausea and vomiting (pre-intervention 0.8145, post-intervention 0.8603, P = 0.016), peripheral neuropathy (pre-intervention 0.7798, post-intervention 0.7988, P = 0.032) and pain (pre-intervention 0.7625, post-intervention 0.8197, P = 0.035). Although not statistically significant, the incidence of grade 2 or higher adverse events, including nausea and vomiting, dermopathy, pain, oral mucositis, diarrhea and dysgeusia, tended to be lower post-intervention than pre-intervention. Conclusions Pharmaceutical intervention by pharmacists in collaboration with physicians may improve QOL in patients undergoing outpatient cancer chemotherapy.
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Affiliation(s)
- Hironori Fujii
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan. .,Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan.
| | - Yukino Ueda
- Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Koichi Ohata
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Kumiko Sekiya
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Mika Kitahora
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Shiori Sadaka
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Senri Yamamoto
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Daichi Watanabe
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Hiroko Kato-Hayashi
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan.,Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Ryo Kobayashi
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Miho Kaburaki
- Laboratory of Community Healthcare Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Nobuhisa Matsuhashi
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takao Takahashi
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Akitaka Makiyama
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuhiro Yoshida
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hideki Hayashi
- Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan.,Laboratory of Community Healthcare Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan.,Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan
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4
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Hirose C, Fujii H, Iihara H, Ishihara M, Nawa-Nishigaki M, Kato-Hayashi H, Ohata K, Sekiya K, Kitahora M, Matsuhashi N, Takahashi T, Okuda K, Naruse M, Ishihara T, Sugiyama T, Yoshida K, Suzuki A. Real-world data of the association between quality of life using the EuroQol 5 Dimension 5 Level utility value and adverse events for outpatient cancer chemotherapy. Support Care Cancer 2020; 28:5943-5952. [PMID: 32281034 PMCID: PMC7686000 DOI: 10.1007/s00520-020-05443-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/27/2020] [Indexed: 01/17/2023]
Abstract
Background Outpatient cancer chemotherapy may lead to improved quality of life (QOL) by allowing treatment to continue without impairing the social lives of patients compared with hospitalization. However, the occurrence of serious adverse events may cause a decline in QOL. We investigated the relationship between outpatient chemotherapy–induced adverse events and QOL. Methods A single-center retrospective descriptive study was conducted in patients who received outpatient chemotherapy at Gifu University Hospital (Gifu, Japan) between September 2017 and December 2018. The utility values of QOL, type and severity of adverse events, type of cancer, chemotherapy regimen, and other patient demographics were analyzed. Adverse events were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. QOL was evaluated using the Japanese version of the EuroQol 5 Dimension 5 Level (EQ-5D-5L). Associations between the EQ-5D-5L utility value and serious adverse events were assessed using adjusted (age and sex) odds ratios obtained with a proportional odds logistic regression model. Results Data from 1008 patients who received 4695 chemotherapy cycles were analyzed. According to proportional odds logistic regression, the adverse events that significantly correlated with a decreased EQ-5D-5L utility value were malaise, edema of the limbs, peripheral neuropathy, pruritus, and dry skin. Based on the proportional odds logistic analysis, neither cancer type nor anticancer drugs were significantly correlated with the EQ-5D-5L utility value in patients who received chemotherapy. Pharmaceutical care for peripheral neuropathy significantly improved patients’ EQ-5D-5L utility value from 0.747 to 0.776 (P < 0.01). Conclusions Adverse events (i.e., peripheral neuropathy, malaise, and edema of the limbs) are significantly correlated with a decrease in QOL, regardless of the type of cancer or anticancer drugs used. Pharmaceutical care provided by pharmacists in collaboration with physicians may improve QOL. Electronic supplementary material The online version of this article (10.1007/s00520-020-05443-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Hironori Fujii
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
| | | | | | | | | | - Koichi Ohata
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Kumiko Sekiya
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Mika Kitahora
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Nobuhisa Matsuhashi
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takao Takahashi
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kumiko Okuda
- Division of Nursing, Gifu University Hospital, Gifu, Japan
| | - Masayo Naruse
- Division of Nursing, Gifu University Hospital, Gifu, Japan
| | - Takuma Ishihara
- Gifu University Hospital Innovative and Clinical Research Promotion Center, Gifu University, Gifu, Japan
| | - Tadashi Sugiyama
- Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Kazuhiro Yoshida
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
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5
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Fujii H, Matsuhashi N, Kitahora M, Takahashi T, Hirose C, Iihara H, Yamada Y, Watanabe D, Ishihara T, Suzuki A, Yoshida K. Bevacizumab in Combination with TAS-102 Improves Clinical Outcomes in Patients with Refractory Metastatic Colorectal Cancer: A Retrospective Study. Oncologist 2019; 25:e469-e476. [PMID: 32162797 PMCID: PMC7066722 DOI: 10.1634/theoncologist.2019-0541] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/16/2019] [Indexed: 12/14/2022] Open
Abstract
Objective TAS‐102 is effective for treating patients with metastatic colorectal cancer (mCRC). This study determined whether combining bevacizumab (Bmab) with TAS‐102 improves clinical outcomes in refractory mCRC. Patients and Methods We retrospectively analyzed data from Japanese patients with refractory mCRC who received TAS‐102 (35 mg/m2, twice a day) with (T‐B group) or without Bmab (TAS‐102 monotherapy; T group) between July 2014 and December 2018. The primary endpoint was median overall survival (OS), and secondary endpoints were median time to treatment failure, overall response rate, and the incidence of adverse events. Clinical outcomes were compared using propensity score matched analysis. Results Data from 57 patients were analyzed (T‐B group: 21 patients, T group: 36 patients). Median OS was significantly longer in the T‐B group than the T group (14.4 months vs. 4.5 months, p < .001). Cox proportional hazard analysis showed that combination therapy with Bmab was significantly correlated with OS. Propensity score matched analysis confirmed that the median OS was significantly longer in the T‐B group than the T group (14.4 months vs. 6.1 months, p = .006) and that there was a significant correlation between Bmab and OS. The incidence of hypertension (grade ≥2) as an adverse event was significantly higher in the T‐B group than the T group (23.8% vs. 0.0%, p = .005), whereas other adverse events were comparable between the two groups. Conclusion Treatment with Bmab in combination with TAS‐102 is significantly associated with improved clinical outcomes in patients with mCRC refractory to standard therapies. Implications for Practice Combining bevacizumab (Bmab) with TAS‐102 significantly improved overall survival and several prognostic indicators in patients with metastatic colorectal cancer (mCRC) refractory to standard therapies, with manageable toxicities. Treatment with Bmab in combination with TAS‐102 is significantly associated with improved clinical outcomes in patients with mCRC. To determine whether combined treatment with bevacizumab improves clinical outcomes, this retrospective study compared the efficacy and safety of treatment with or without bevacizumab in patients receiving TAS‐102 for metastatic colorectal cancer.
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Affiliation(s)
- Hironori Fujii
- Department of Pharmacy, Gifu University HospitalGifuJapan
| | - Nobuhisa Matsuhashi
- Department of Surgical Oncology, Gifu University Graduate School of MedicineGifuJapan
| | - Mika Kitahora
- Department of Pharmacy, Gifu University HospitalGifuJapan
| | - Takao Takahashi
- Department of Surgical Oncology, Gifu University Graduate School of MedicineGifuJapan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University HospitalGifuJapan
| | | | - Yunami Yamada
- Department of Pharmacy, Gifu University HospitalGifuJapan
| | | | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University HospitalGifuJapan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University HospitalGifuJapan
| | - Kazuhiro Yoshida
- Department of Surgical Oncology, Gifu University Graduate School of MedicineGifuJapan
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6
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Kaito D, Iihara H, Funaguchi N, Endo J, Ito F, Yanase K, Toyoshi S, Sasaki Y, Hirose C, Arai N, Kitahora M, Ohno Y, Itoh Y, Minatoguchi S. Efficacy of Single-dose First-generation 5-HT 3 Receptor Antagonist and Dexamethasone for Preventing Nausea and Vomiting Induced by Low-dose Carboplatin-based Chemotherapy. Anticancer Res 2017; 37:1965-1970. [PMID: 28373467 DOI: 10.21873/anticanres.11537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/07/2017] [Accepted: 03/08/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Carboplatin (CBDCA) is known to exhibit a high emetic risk among moderate-emetic risk anticancer drugs, and the dose of CBDCA varies in different therapies. In concurrent chemoradiotherapy (CCRT) for non-small cell lung cancer (NSCLC), the weekly administration of CBDCA (area under the curve (AUC) 2 mg/ml/min) and paclitaxel (PTX: 40 mg/m2) is frequently applied as standard therapy. However, the optimal antiemetic measures in the use of such low-dose CBDCA remain unclear. In this study, we retrospectively assessed the antiemetic effect of a single-dose of a first-generation 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA) and dexamethasone in the weekly CBDCA+PTX therapy in CCRT. PATIENTS AND METHODS The subjects were patients with NSCLC who were administered weekly CBDCA+PTX therapy in CCRT between January 2011 and December 2016 at our Department. As an antiemetic measure, a first-generation 5-HT3RA, azasetron (10 mg, orally) or granisetron (3 mg, intravenously), and dexamethasone (9.9 mg, intravenously) were administered on day 1. The patients were evaluated for the following efficacy end-points for the first cycle: Complete response (CR; defined as no vomiting or retching episodes with no rescue medication) in the acute phase (0-24 hours), delayed phase (>24-120 hours), and overall phase (0-120 hours). Other efficacy endpoints evaluated were no vomiting or retching, and no nausea in all phases. RESULTS The subjects we assessed in this study were 46 patients who were administered weekly CBDCA+PTX therapy in CCRT. For the overall, acute, and delayed phases, the complete response rates were 89.1%, 100%, and 89.1%, respectively. The rate of no nausea in the overall, acute, and delayed phases was 78.3%, 100%, and 78.3%, respectively. The rate of no vomiting in the overall, acute, and delayed phases was 95.7%, 100%, and 95.7%, respectively. CONCLUSION A single dose of a first-generation 5-HT3RA and dexamethasone had a favorable suppressive effect on nausea and vomiting in weekly CBDCA+PTX therapy for NSCLC.
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Affiliation(s)
- Daizo Kaito
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | | | - Norihiko Funaguchi
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan.,Department of Respiratory Medicine, Murakami Memorial Hospital, Asahi University, Gifu, Japan
| | - Junki Endo
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Fumitaka Ito
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Komei Yanase
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Sayaka Toyoshi
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuka Sasaki
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Natsumi Arai
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Mika Kitahora
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Yasushi Ohno
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yoshinori Itoh
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Shinya Minatoguchi
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
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