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Nakahama K, Izumi M, Yoshimoto N, Fukui M, Sugimoto A, Nagamine H, Ogawa K, Sawa K, Tani Y, Kaneda H, Mitsuoka S, Watanabe T, Asai K, Kawaguchi T. Clinical significance of KL-6 in immune-checkpoint inhibitor treatment for non-small cell lung cancer. Cancer Chemother Pharmacol 2023; 92:381-390. [PMID: 37606723 DOI: 10.1007/s00280-023-04573-0] [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: 05/31/2023] [Accepted: 07/29/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE Krebs von den Lungen-6 (KL-6) functions as a tumor marker, as well as a diagnostic tool for interstitial pneumonia (IP). However, the significance of KL-6 in the immune-checkpoint inhibitor (ICI) treatment of non-small cell lung cancer (NSCLC), especially in patients without IP, is unknown. METHODS This multicenter, retrospective study, which included patients with advanced NSCLC who received ICI therapy, analyzed the association between serum KL-6 values and ICI efficacy and the association between serum KL-6 values and ICI-induced interstitial lung disease (ILD) occurrence, focusing primarily on patients without IP. RESULTS In total, 322 patients had available KL-6 values before ICI therapy. Among 202 patients without IP who received ICI monotherapy, the high-KL-6 group (≥ 500 U/mL) showed significantly shorter progression-free survival (PFS) and overall survival (OS) than the low-KL-6 group (< 500 U/mL) (median: 2.1 vs. 3.6 months, p = 0.048; median: 9.2 vs. 14.5 months, p = 0.035). There was no significant difference in response rate between the KL-6 high and low groups (19% vs. 29%, p = 0.14). In the multivariate analysis, high KL-6 was a significant predictor of poor PFS (hazard ratio [HR], 1.52; 95% confidence interval [CI] 1.10-2.11, p = 0.012) and OS (HR, 1.51; 95% CI 1.07 - 2.13, p = 0.019) for patients treated with ICI monotherapy. There was no significant difference in the occurrence rate of ILD between the high KL-6 and low KL-6 groups in patients with (20% vs. 15%, p = 1.00) or without IP (12% vs. 12%, p = 1.00). CONCLUSION In ICI monotherapy for NSCLC without IP, elevated serum KL-6 levels were associated with poorer outcomes.
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Affiliation(s)
- Kenji Nakahama
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Asahimachi 1-4-3, Abeno-ku, Osaka City, Osaka, 545-8585, Japan.
| | - Motohiro Izumi
- Department of Pulmonary Medicine, Bell Land General Hospital, Sakai, Japan
| | - Naoki Yoshimoto
- Department of Pulmonary Medicine, Ishikiriseiki Hospital, Higashiosaka, Japan
| | - Mitsuru Fukui
- Department of Laboratory of Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Akira Sugimoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Asahimachi 1-4-3, Abeno-ku, Osaka City, Osaka, 545-8585, Japan
| | - Hiroaki Nagamine
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Asahimachi 1-4-3, Abeno-ku, Osaka City, Osaka, 545-8585, Japan
| | - Koichi Ogawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Asahimachi 1-4-3, Abeno-ku, Osaka City, Osaka, 545-8585, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Asahimachi 1-4-3, Abeno-ku, Osaka City, Osaka, 545-8585, Japan
| | - Yoko Tani
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Hiroyasu Kaneda
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Shigeki Mitsuoka
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Asahimachi 1-4-3, Abeno-ku, Osaka City, Osaka, 545-8585, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Asahimachi 1-4-3, Abeno-ku, Osaka City, Osaka, 545-8585, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Asahimachi 1-4-3, Abeno-ku, Osaka City, Osaka, 545-8585, Japan
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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Nagamine H, Yashiro M, Yoshimoto N, Izumi M, Sugimoto A, Nakahama K, Ogawa K, Matsumoto Y, Sawa K, Tani Y, Kaneda H, Mitsuoka S, Yamada K, Watanabe T, Aasai K, Fukumura K, Mayeda A, Kawaguchi T. RBM17 Expression Is Associated With the Efficacy of ICI Monotherapy in NSCLC With Low PD-L1 Expression. Anticancer Res 2023; 43:4663-4672. [PMID: 37772582 DOI: 10.21873/anticanres.16662] [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: 07/21/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND/AIM Immune checkpoint inhibitors (ICIs) are currently a standard treatment tool for non-small cell lung cancer (NSCLC). RNA-binding motif protein 17 (RBM17), a splicing factor, is frequently over-expressed in NSCLC, but little is known about the role of RBM17 in the efficacy of ICIs for NSCLC. Thus, we investigated the correlation between RBM17 expression and ICI efficacy in NSCLC. PATIENTS AND METHODS Biopsy or surgical specimens were collected from patients with advanced or recurrent NSCLC who received ICI monotherapy or chemo-immunotherapy in a first-line setting. RBM17 expression was examined using immunohistochemistry. The correlation between the efficacy of ICI monotherapy or chemo-immunotherapy and RBM17 expression was evaluated. RESULTS Among the 218 cases, 115 (52.8%) cases were positive for RBM17 expression. RBM17 expression was not associated with the objective response rate (ORR) or progression-free survival (PFS) in either of the ICI monotherapy or chemo-immunotherapy groups. However, among those with a low PD-L1 expression level (PD-L1 <50%; n=86), RBM17 expression was significantly associated with a better ORR (p=0.045) and a better PFS (p<0.001) in the ICI monotherapy group, and was significantly associated with a poor ORR in the chemo-immunotherapy group (p=0.041). CONCLUSION RBM17 might be a useful predictive marker for a higher efficacy of ICI monotherapy in NSCLC patients with a low PD-L1 expression level.
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Affiliation(s)
- Hiroaki Nagamine
- Department of Respiratory Medicine, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | - Masakazu Yashiro
- Molecular Oncology and Therapeutics, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan;
| | - Naoki Yoshimoto
- Department of Pulmonary Medicine, Ishikiriseiki Hospital, Higashiosaka, Japan
| | - Motohiro Izumi
- Department of Pulmonary Medicine, Bell land General Hospital, Sakai, Japan
| | - Akira Sugimoto
- Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Kenji Nakahama
- Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Koichi Ogawa
- Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Yoshiya Matsumoto
- Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Yoko Tani
- Department of Clinical Oncology, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Hiroyasu Kaneda
- Department of Clinical Oncology, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Shigeki Mitsuoka
- Department of Clinical Oncology, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Kazuhiro Yamada
- Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Kazuhisa Aasai
- Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Kazuhiro Fukumura
- Division of Gene Expression Mechanism, Center for Medical Science, Fujita Health University, Toyoake, Japan
| | - Akila Mayeda
- Division of Gene Expression Mechanism, Center for Medical Science, Fujita Health University, Toyoake, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
- Department of Clinical Oncology, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
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Nakahama K, Izumi M, Yoshimoto N, Fukui M, Sugimoto A, Nagamine H, Ogawa K, Sawa K, Tani Y, Kaneda H, Mitsuoka S, Watanabe T, Asai K, Kawaguchi T. Influence of Smoking History on the Effectiveness of Immune-checkpoint Inhibitor Therapy for Non-small Cell Lung Cancer: Analysis of Real-world Data. Anticancer Res 2023; 43:2185-2197. [PMID: 37097681 DOI: 10.21873/anticanres.16381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/05/2023] [Accepted: 03/20/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND/AIM There is no real-world data in an Asian population to investigate the difference between the outcome of immune-checkpoint inhibitor (ICI) monotherapy and combination therapy for non-small cell lung cancer (NSCLC) based on smoking status. In this study, we investigated the correlation between smoking status and the efficacy of ICI therapy for NSCLC patients. PATIENTS AND METHODS This multicentre retrospective study enrolled patients with recurrent or metastatic NSCLC who were treated using ICI therapy between December 2015 and July 2020. We analysed the objective response rate (ORR) of patients who received ICI monotherapy or combination therapy, based on smoking status using Fisher's exact test, and progression-free survival (PFS) and overall survival (OS) based on smoking status using the Kaplan-Meier method, the log-rank test, and Cox proportional hazards model. RESULTS A total of 487 patients were included in the study. In the ICI monotherapy group, non-smokers showed significantly lower ORR and shorter PFS and OS than smokers (10% vs. 26%, p=0.002; median: 1.8 vs. 3.8 months, p<0.001; median: 8.0 vs. 15.4 months, p=0.026). In the ICI combination therapy group, non-smokers showed significantly longer OS than smokers (median: not reached vs. 26.3 months, p=0.045), and there was no significant difference in ORR and PFS between non-smokers and smokers (63% vs. 51%, p=0.43; median: 10.2 vs. 9.2 months, p=0.81). In the multivariate analysis of patients who received ICI combination therapy, the "non-smoker" status was not significantly associated with PFS [hazard ratio (HR)=1.31; 95% confidence interval (CI)=0.70-2.45, p=0.40] and OS (HR=0.40; 95% CI=0.14-1.13, p=0.083). CONCLUSION Non-smokers showed worse outcomes than smokers with ICI monotherapy, but not with ICI combination therapy.
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Affiliation(s)
- Kenji Nakahama
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan;
| | - Motohiro Izumi
- Department of Pulmonary Medicine, Bell Land General Hospital, Sakai, Japan
| | - Naoki Yoshimoto
- Department of Pulmonary Medicine, Ishikiriseiki Hospital, Higashiosaka, Japan
| | - Mitsuru Fukui
- Department of Laboratory of Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Akira Sugimoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Hiroaki Nagamine
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Koichi Ogawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yoko Tani
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Hiroyasu Kaneda
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Shigeki Mitsuoka
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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Nakahama K, Izumi M, Yoshimoto N, Fukui M, Sugimoto A, Nagamine H, Ogawa K, Sawa K, Tani Y, Kaneda H, Mitsuoka S, Watanabe T, Asai K, Kawaguchi T. Vimentin expression correlates with immune-checkpoint inhibitor efficacy in non-small cell lung cancer. Cancer 2023. [PMID: 37021822 DOI: 10.1002/cncr.34782] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 02/20/2023] [Accepted: 03/09/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Although vimentin is often expressed in non-small cell lung cancer (NSCLC), the association between vimentin expression and immune-checkpoint inhibitor (ICI) efficacy remains unclear. METHODS This retrospective multicenter study enrolled patients with NSCLC who received ICI treatment between December 2015 and July 2020. The authors constructed tissue microarrays and performed immunohistochemical staining with vimentin. They analyzed the relationship between vimentin expression rate and objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). RESULTS Immunohistochemically evaluable specimens on microarray blocks were available for 397 patients, of whom 343 (86%) were negative (<10%), 30 (8%) were positive (10%-49%), and 24 (6%) were highly positive (≥50%) for vimentin expression. Both rates of programmed death-ligand 1 (PD-L1) tumor proportion score ≥1% and ≥50% were significantly higher in the vimentin-positive group (≥10%) than the vimentin-negative group (<10%) (96% vs. 78%, p = .004; 64% vs. 42%, p = .006, respectively). In patients treated with ICI monotherapy, ORR, PFS, and OS were significantly better in the vimentin-positive group (10%-49%) than in the vimentin-negative group (<10%) (54% vs. 25%, p = .003, median = 7.9 vs. 3.2 months, p = .011; median = 27.0 vs. 13.6 months, p = .015, respectively), whereas there was no significant difference in PFS and OS between the vimentin highly positive group (≥50%) and the vimentin-negative group (<10%) (median = 3.4 vs. 3.2 months, p = .57; median = 7.2 vs. 13.6 months, p = .086, respectively). CONCLUSIONS Vimentin expression correlated with PD-L1 expression and ICI efficacy. PLAIN LANGUAGE SUMMARY We constructed tissue microarrays and performed immunohistochemical staining with vimentin on 397 patients with advanced non-small cell lung cancer who were treated with immune-checkpoint inhibitor (ICI). The vimentin-positive group who were treated with ICI monotherapy showed significantly better objective response rate, progression-free survival, and overall survival than the vimentin negative group. The measurement of vimentin expression will aid in determining appropriate immunotherapy strategies.
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Affiliation(s)
- Kenji Nakahama
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Motohiro Izumi
- Department of Pulmonary Medicine, Bell Land General Hospital, Sakai, Japan
| | - Naoki Yoshimoto
- Department of Pulmonary Medicine, Ishikiriseiki Hospital, Higashiosaka, Japan
| | - Mitsuru Fukui
- Department of Laboratory of Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Akira Sugimoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Hiroaki Nagamine
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Koichi Ogawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yoko Tani
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Hiroyasu Kaneda
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Shigeki Mitsuoka
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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Tani Y, Kaneda H, Koh Y, Tamiya A, Isa S, Kubo A, Ogawa K, Matsumoto Y, Sawa K, Yoshimoto N, Mitsuoka S, Kawaguchi T. The Impact of Estrogen Receptor Expression on Mutational Status in the Evolution of Non-Small Cell Lung Cancer. Clin Lung Cancer 2023; 24:165-174. [PMID: 36646585 DOI: 10.1016/j.cllc.2022.12.010] [Citation(s) in RCA: 2] [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] [Received: 08/24/2022] [Revised: 11/15/2022] [Accepted: 12/14/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND The role of estrogen receptor (ER) status in the carcinogenesis of lung cancer and its impact on prognosis remain unclear. MATERIALS AND METHODS We previously reported a prospective, multicenter, molecular epidemiology study (Japan Molecular Epidemiology for Lung Cancer Study [JME]). We examined the relationship of ER status with reproductive and hormonal factors, mutational profile, and survival using JME study data. Patients were enrolled between July 2012 and December 2013, with follow-up until November, 2017. RESULTS Among 441 ever- and 435 never-smokers, ER expression was observed in 46.4% and 53.5%, respectively (P = .022). Hormone use and reproductive history of female patients were not associated with ER status. Mutations in EGFR (P = .003), TP53 (P = .007), and CTNNB1 (P = .027) were significantly associated with ER expression. Multivariate analysis showed that mutations in EGFR (P = .032) and CTNNB1 (P = .026) were significantly associated with ER expression, whereas TP53 mutations exhibited a trend toward significance (P = .059). Relapse-free survival (RFS) was longer in all the patients with ER-positive tumors than those with ER-negative tumors (P = .021). RFS and overall survival were longer (P = .024, P = .011, respectively) in the stage I patients with ER-positive tumors than those with ER-negative tumors. CONCLUSION ERβ expression is positively associated with EGFR mutations and negatively with TP53 and CTNNB1 mutations. ER-positive tumors can be associated with better prognosis of the patients, suggesting that ER expression with coexisting EGFR mutations and wild-type TP53 contribute to the biology of non-small cell lung cancer.
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Affiliation(s)
- Yoko Tani
- Department of Clinical Oncology, Osaka Metropolitan University Graduate School of Medicine, Osaka City, Osaka Prefecture, Japan
| | - Hiroyasu Kaneda
- Department of Clinical Oncology, Osaka Metropolitan University Graduate School of Medicine, Osaka City, Osaka Prefecture, Japan.
| | - Yasuhiro Koh
- Center for Biomedical Sciences, Wakayama Medical University, Wakayama City, Wakayama Prefecture, Japan; Department of Internal Medicine III, Wakayama Medical University, Wakayama City, Wakayama Prefecture, Japan
| | - Akihiro Tamiya
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City, Osaka Prefecture, Japan
| | - Shunichi Isa
- Department of Thoracic Oncology, Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City, Osaka Prefecture, Japan
| | - Akihito Kubo
- Department of Medical Oncology, Oncology Center, Aichi Medical University Hospital, Nagakute City, Aichi Prefecture, Japan
| | - Koichi Ogawa
- Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka City, Osaka Prefecture, Japan
| | - Yoshiya Matsumoto
- Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka City, Osaka Prefecture, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka City, Osaka Prefecture, Japan
| | - Naoki Yoshimoto
- Department of Clinical Oncology, Osaka Metropolitan University Graduate School of Medicine, Osaka City, Osaka Prefecture, Japan; Department of Respiratory Medicine, Ishikiri Seiki Hospital, Osaka City, Osaka Prefecture, Japan
| | - Shigeki Mitsuoka
- Department of Clinical Oncology, Osaka Metropolitan University Graduate School of Medicine, Osaka City, Osaka Prefecture, Japan
| | - Tomoya Kawaguchi
- Department of Clinical Oncology, Osaka Metropolitan University Graduate School of Medicine, Osaka City, Osaka Prefecture, Japan; Department of Respiratory Medicine, Osaka Metropolitan University, Graduate School of Medicine, Osaka City, Osaka Prefecture, Japan
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Nakahama K, Osawa M, Izumi M, Yoshimoto N, Sugimoto A, Nagamine H, Ogawa K, Matsumoto Y, Sawa K, Tani Y, Kaneda H, Mitsuoka S, Watanabe T, Asai K, Kawaguchi T. SP142 evaluation contributes to the prediction of immune checkpoint inhibitor efficacy in non-small cell lung cancer with high PD-L1 expression assessed by 22C3. Transl Lung Cancer Res 2022; 11:2438-2451. [PMID: 36636414 PMCID: PMC9830255 DOI: 10.21037/tlcr-22-496] [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: 07/01/2022] [Accepted: 10/23/2022] [Indexed: 12/03/2022]
Abstract
Background It remains unclear whether assessing programmed death-ligand 1 (PD-L1) expression by SP142 plus 22C3 adds value for predicting the response to immunotherapy in non-small cell lung cancer (NSCLC). Methods This retrospective multicenter study included patients with advanced NSCLC treated with immune-checkpoint inhibitors. We constructed tissue microarrays (TMAs) and performed immunohistochemical staining with 22C3 and SP142 assays. We denoted the PD-L1 tumor proportion score (TPS) obtained from clinical medical records based on 22C3 staining as "22C3 (C)" and that obtained with 22C3 staining using our TMA as "22C3 (TMA)". SP142 staining was evaluated in both tumor cells and immune cells. We assessed the concordance between each PD-L1 assessment method and analyzed the objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) based on the PD-L1 expression level determined using the 22C3 and SP142 assays. Results In total, 288 patients were included. Among those with 22C3 (TMA) ≥50%, 60% of patients showed SP142 TC3 or IC3; among patients with 22C3 (C) <1%, 9% and 18% exhibited 22C3 (TMA) ≥1% and SP142 TC1/2/3 or IC1/2/3, respectively. Among patients with 22C3 (C) ≥50% treated with immune-checkpoint inhibitor monotherapy, the SP142 TC1/2/3 or IC1/2/3 group showed significantly better ORR, PFS and OS than the SP142 TC0 and IC0 group (54% vs. 29%, P=0.040, median =11.0 vs. 3.2 months, P=0.002, median =27.9 vs. 12.6 months, P=0.030, respectively). Multivariate analysis revealed that SP142 TC0 and IC0 was an independent unfavorable prognostic factor for PFS and OS in patients with 22C3 (C) ≥50% treated with immune-checkpoint inhibitor monotherapy. For those with 22C3 (C) ≥50% and SP142 TC0 and IC0, immune-checkpoint inhibitor concurrent with chemotherapy tended to result in a longer PFS and OS than immune-checkpoint inhibitor monotherapy (median =13.7 vs. 2.3 months, P=0.054, median = not estimable vs. 12.0 months, P=0.064, respectively). Conclusions SP142 evaluation contributes to the prediction of immune-checkpoint inhibitor efficacy in NSCLC with high PD-L1 expression assessed by 22C3.
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Affiliation(s)
- Kenji Nakahama
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Masahiko Osawa
- Department of Diagnostic Pathology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Motohiro Izumi
- Department of Pulmonary Medicine, Bell land General Hospital, Sakai, Japan
| | - Naoki Yoshimoto
- Department of Pulmonary Medicine, Ishikiriseiki Hospital, Higashiosaka, Japan
| | - Akira Sugimoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Hiroaki Nagamine
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Koichi Ogawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yoshiya Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yoko Tani
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Hiroyasu Kaneda
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Shigeki Mitsuoka
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan;,Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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Matsumoto Y, Kawaguchi T, Watanabe M, Isa SI, Ando M, Tamiya A, Kubo A, Kitagawa C, Yoshimoto N, Koh Y. Prognostic impact of pretreatment T790M mutation on outcomes for patients with resected, EGFR-mutated, non-small cell lung cancer. BMC Cancer 2022; 22:775. [PMID: 35840951 PMCID: PMC9288048 DOI: 10.1186/s12885-022-09869-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background Many previous studies have demonstrated that minor-frequency pretreatment T790M mutation (preT790M) could be detected by ultrasensitive methods in a considerable number of treatment-naïve, epidermal growth factor receptor (EGFR)-mutated, non-small cell lung cancer (NSCLC) cases. However, the impact of preT790M in resected cases on prognosis remains unclear. Methods We previously reported that preT790M could be detected in 298 (79.9%) of 373 surgically resected, EGFR-mutated NSCLC patients. Therefore, we investigated the impact of preT790M on recurrence-free survival (RFS) and overall survival (OS) in this cohort by multivariate analysis. All patients were enrolled from July 2012 to December 2013, with follow-up until November 30, 2017. Results The median follow-up time was 48.6 months. Using a cutoff value of the median preT790M allele frequency, the high-preT790M group (n = 151) had significantly shorter RFS (hazard ratio [HR] = 1.51, 95% confidence interval [CI]: 1.01–2.25, P = 0.045) and a tendency for a shorter OS (HR = 1.87, 95% CI: 0.99–3.55, P = 0.055) than the low-preT790M group (n = 222). On multivariate analysis, higher preT790M was independently associated with shorter RFS (high vs low, HR = 1.56, 95% CI: 1.03–2.36, P = 0.035), irrespective of advanced stage, older age, and male sex, and was also associated with shorter OS (high vs low, HR = 2.16, 95% CI: 1.11–4.20, P = 0.024) irrespective of advanced stage, older age, EGFR mutation subtype, and history of adjuvant chemotherapy. Conclusions Minor-frequency, especially high-abundance of, preT790M was an independent factor associated with a poor prognosis in patients with surgically resected, EGFR-mutated NSCLC. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09869-7.
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Affiliation(s)
- Yoshiya Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Masaru Watanabe
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Shun-Ichi Isa
- Clinical Research Center, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Japan
| | - Masahiko Ando
- Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Akihiro Tamiya
- Internal Medicine, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Japan
| | - Akihito Kubo
- Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Chiyoe Kitagawa
- Medical Oncology and Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan
| | - Naoki Yoshimoto
- Respiratory Medicine, Ishikiriseiki Hospital, Higashiosaka, Japan
| | - Yasuhiro Koh
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan. .,Center for Biomedical Sciences, CIMS, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama, 641-8509, Japan.
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8
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Nakahama K, Kaneda H, Osawa M, Izumi M, Yoshimoto N, Sugimoto A, Nagamine H, Ogawa K, Matsumoto Y, Sawa K, Tani Y, Mitsuoka S, Watanabe T, Asai K, Kawaguchi T. Association of thyroid transcription factor-1 with the efficacy of immune-checkpoint inhibitors in patients with advanced lung adenocarcinoma. Thorac Cancer 2022; 13:2309-2317. [PMID: 35808895 PMCID: PMC9376174 DOI: 10.1111/1759-7714.14560] [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: 05/09/2022] [Revised: 06/09/2022] [Accepted: 06/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background We aimed to identify the relationship between thyroid transcription factor‐1 (TTF‐1) expression of lung adenocarcinoma and the efficacy of immune‐checkpoint inhibitor (ICI) therapy. Methods This retrospective multicenter study comprised patients with advanced lung adenocarcinoma treated with ICI monotherapy. We collected clinical medical records including data on TTF‐1 expression and analyzed the relationship between TTF‐1 expression and programmed death‐ligand 1 tumor proportion score (PD‐L1 TPS), objective response rate (ORR), progression‐free survival (PFS), and overall survival (OS). Results In total, 108 patients with lung adenocarcinoma were analyzed. The rate of TPS ≥1% and ≥50% in patients with positive TTF‐1 expression was significantly higher than that in patients with negative TTF‐1 expression (88% vs. 60%, p < 0.001; 65% vs. 24%, p < 0.001). The ORR was significantly higher in TTF‐1 positive patients than in TTF‐1‐negative patients (38% vs. 8%, p = 0.003). Among patients with TPS ≥50% and 1%–49%, the ORR in TTF‐1 positive and negative patients was 48% (26/54) versus 17% (1/6) (p = 0.21), and 32% (6/19) versus 11% (1/9) (p = 0.37), respectively. The ORR for patients with TPS <1% was 0% in both the TTF‐1 negative and positive cases. The median PFS and OS was significantly longer in TTF‐1‐positive patients than in TTF‐1‐negative patients (5.4 vs. 1.6 months, p < 0.001; 18.2 vs. 8.0 months, p = 0.041). Multivariate analysis revealed that TTF‐1‐negative status was an independent unfavorable prognostic factor for PFS. Conclusion Patients with TTF‐1‐positive status receiving ICI monotherapy showed better outcomes than those with TTF‐1‐negative lung adenocarcinoma.
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Affiliation(s)
- Kenji Nakahama
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hiroyasu Kaneda
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Masahiko Osawa
- Department of Diagnostic Pathology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Motohiro Izumi
- Department of Pulmonary Medicine, Bell land General Hospital, Sakai, Japan
| | - Naoki Yoshimoto
- Department of Pulmonary Medicine, Ishikiriseiki Hospital, Higashiosaka, Japan
| | - Akira Sugimoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Hiroaki Nagamine
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Koichi Ogawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yoshiya Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yoko Tani
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Shigeki Mitsuoka
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tomoya Kawaguchi
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.,Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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Nakahama K, Kaneda H, Osawa M, Fukui M, Izumi M, Yoshimoto N, Sugimoto A, Nagamine H, Ogawa K, Matsumoto Y, Sawa K, Tani Y, Mitsuoka S, Watanabe T, Asai K, Kawaguchi T. Vascular endothelial growth factor receptor 2 expression and immunotherapy efficacy in non-small cell lung cancer. Cancer Sci 2022; 113:3148-3160. [PMID: 35722982 PMCID: PMC9459341 DOI: 10.1111/cas.15464] [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: 05/12/2022] [Revised: 06/11/2022] [Accepted: 06/14/2022] [Indexed: 12/24/2022] Open
Abstract
It is unclear whether tumor vascular endothelial growth factor receptor 2 expression affects the therapeutic efficacy of immune‐checkpoint inhibitors and antiangiogenic agents. This retrospective, multicenter study included patients with advanced non–small cell lung cancer who were treated with immune‐checkpoint inhibitors. We constructed tissue microarrays and performed immunohistochemistry with an anti‐vascular endothelial growth factor receptor 2 antibody. We analyzed immune and tumor cell staining separately in order to determine their correlation with the objective response rate, progression‐free survival, and overall survival in patients receiving immune‐checkpoint inhibitors. Of 364 patients, 37 (10%) expressed vascular endothelial growth factor receptor 2 in immune cells and 165 (45%) in tumor cells. The objective response rate, progression‐free survival, and overall survival were significantly worse in patients treated with immune checkpoint inhibitor monotherapy who expressed vascular endothelial growth factor receptor 2 in immune cells than those who did not (10% vs 30%, p = 0.028; median = 2.2 vs 3.6 months, p = 0.012; median = 7.9 vs 17.0 months, p = 0.049, respectively), while there was no significant difference based on tumor cell expression (24% vs 30%, p = 0.33; median = 3.1 vs 3.5 months, p = 0.55; median = 13.6 vs 16.8 months, p = 0.31). There was no significant difference in overall survival between patients treated with and without antiangiogenic agents in any treatment period based on vascular endothelial growth factor receptor 2 expression. Immune checkpoint inhibitor efficacy was limited in patients expressing vascular endothelial growth factor receptor 2 in immune cells.
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Affiliation(s)
- Kenji Nakahama
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Japan
| | - Hiroyasu Kaneda
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Japan
| | - Masahiko Osawa
- Department of Diagnostic Pathology, Graduate School of Medicine, Osaka Metropolitan University, Japan
| | - Mitsuru Fukui
- Department of Laboratory of Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Motohiro Izumi
- Department of Pulmonary Medicine, Bell land General Hospital, Sakai, Japan
| | - Naoki Yoshimoto
- Department of Pulmonary Medicine, Ishikiriseiki Hospital, Higashiosaka, Japan
| | - Akira Sugimoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Hiroaki Nagamine
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Koichi Ogawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yoshiya Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yoko Tani
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Japan
| | - Shigeki Mitsuoka
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tomoya Kawaguchi
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Japan.,Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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Sakurai Y, Matsuura H, Oshima Y, Hirai K, Tani E, Yoshimoto N, Minami K, Wakasa K, Hirashima T. A case of renal cell carcinoma with late recurrence in the bilateral hilar lymph nodes twenty years after surgery. Respir Med Case Rep 2022; 36:101617. [PMID: 35300291 PMCID: PMC8920930 DOI: 10.1016/j.rmcr.2022.101617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022] Open
Abstract
Renal cell carcinoma (RCC) is a common malignancy with a high recurrence rate. However, brain and bilateral hilar lymph node (BHL) relapse is rare. A 65-year-old man with a chief complaint of hemosputum visited the primary care clinic. Computed tomography revealed BHL enlargement. Histopathological examination of biopsy specimens from the left lingular bronchus revealed RCC. This finding was similar to that of a left nephrectomy specimen of RCC observed 20 years ago. If patients have a medical history of RCC, physicians should consider the possibility of RCC recurrence, regardless of the number of years relapsed postoperatively.
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11
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Tani E, Hirashima T, Hasegawa T, Aohara D, Oshima Y, Sakurai Y, Hirai K, Yoshimoto N, Nishida M, Tateishi Y, Minami K. Acromegaly Initially Presenting with Severe Infectious Diseases: A Case Report. JMA J 2022; 5:161-166. [PMID: 35224284 PMCID: PMC8827133 DOI: 10.31662/jmaj.2021-0150] [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: 08/19/2021] [Accepted: 11/15/2021] [Indexed: 11/09/2022] Open
Abstract
A 39-year-old man presented with worsening fever, cough, and fatigue. He was immediately admitted to the intensive care unit (ICU) and was found to have sepsis, septic pulmonary embolism, right empyema, liver abscess, pyelonephritis, and a prostate abscess, with background diabetes mellitus. While receiving treatment, an ICU nurse noticed that the patient’s toe tips were too large to fit the clamp device of pulse oximeters. Thus, we re-examined the patient and confirmed that he had clinical features indicative of acromegaly including bulging eyebrows, enlarged nose and lips, large feet, and prognathism. He and his family had not noticed these features except for his enlarged feet. We evaluated the patient further for acromegaly, and a pituitary mass was detected via contrast-enhanced head magnetic resonance imaging. Whole-body computed tomography also revealed thickened heel pads, cauliflower deformity, frontal sinus enlargement, sella turcica enlargement, and mandibular malocclusion. A 75 g oral glucose tolerance test was performed to investigate abnormal secretion of growth hormone (GH), and the results revealed a paradoxical increase in GH levels. The patient was then diagnosed with acromegaly according to the clinical guidance of the Japan Endocrine Society. Acromegaly develops slowly; thus, to improve patients’ prognoses, physicians including internists, family physicians, and endocrinologists should include acromegaly in their differential when signs are apparent.
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Affiliation(s)
- Eriko Tani
- Department of Respiratory Medicine, Ishikiri-Seiki Hospital, Higashi-Osaka, Japan
| | - Tomonori Hirashima
- Department of Thoracic Oncology, Ishikiri-Seiki Hospital, Higashi-Osaka, Japan
| | - Takamasa Hasegawa
- Department of Endocrinology, Ishikiri-Seiki Hospital, Higashi-Osaka, Japan
| | - Daisuke Aohara
- Department of Respiratory Medicine, Ishikiri-Seiki Hospital, Higashi-Osaka, Japan
| | - Yuri Oshima
- Department of Respiratory Medicine, Ishikiri-Seiki Hospital, Higashi-Osaka, Japan
| | - Yusuke Sakurai
- Department of Respiratory Medicine, Ishikiri-Seiki Hospital, Higashi-Osaka, Japan
| | - Kaho Hirai
- Department of Respiratory Medicine, Ishikiri-Seiki Hospital, Higashi-Osaka, Japan
| | - Naoki Yoshimoto
- Department of Respiratory Medicine, Ishikiri-Seiki Hospital, Higashi-Osaka, Japan
| | - Mana Nishida
- Department of Endocrinology, Ishikiri-Seiki Hospital, Higashi-Osaka, Japan
| | - Yu Tateishi
- Department of Nephrology, Ishikiri-Seiki Hospital, Higashi-Osaka, Japan
| | - Kenichi Minami
- Department of Respiratory Medicine, Ishikiri-Seiki Hospital, Higashi-Osaka, Japan
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12
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Oshima Y, Matsuura H, Sakurai Y, Hirai K, Tani E, Yoshimoto N, Minami K, Yamasaki F, Nishime M, Hirashima T. A case of squamous cell lung cancer treated with anamorelin in combination with a multidisciplinary collaborative approach for treating cancer cachexia. Respir Med Case Rep 2022; 36:101609. [PMID: 35242522 PMCID: PMC8866093 DOI: 10.1016/j.rmcr.2022.101609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/25/2022] [Accepted: 02/15/2022] [Indexed: 11/26/2022] Open
Abstract
Anamorelin (ANA) is approved for treating cancer cachexia (CCX) in Japan. We report the case of a 69-year-old man with stage IVB squamous cell lung cancer complicated by CCX, having a 13.6% weight loss in 6 months. After chemotherapy was initiated, his weight was further reduced. Therefore, we started ANA combined with a treatment approach by a multidisciplinary collaboration, including nutritionists and physical therapists. After initiation of ANA, the body weight, appetite, psoas muscle index, and physical functions rapidly improved during chemotherapy. ANA administration combined with a multidisciplinary collaboration approach can be an effective supportive therapy against CCX during chemotherapy.
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Hayama Y, Imanishi H, Yoshimoto N, Sugawara K, Tsuruta D. A Case of Dapsone-induced Mild Methemoglobinemia with Dyspnea and Cyanosis. Acta Dermatovenerol Croat 2020; 28:249-250. [PMID: 33835002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Dear Editor, Dapsone is a dual-function drug with antimicrobial and antiprotozoal effects and anti-inflammatory features (1). In dermatology, it is a first choice for conditions such as leprosy, IgA pemphigus, dermatitis herpetiformis, and linear IgA bullous dermatosis, or an adjunctive treatment for, e.g. bullous pemphigoid (BP) and pemphigus vulgaris (1). However, dapsone is associated with some adverse effects, including methemoglobinemia (1). Methemoglobin (MetHb) concentrations of less than 15% usually cause no symptoms in patients with normal hemoglobin concentrations (2). Herein, we report the case of a patient with BP who developed dyspnea because of dapsone-induced methemoglobinemia that was as mild as 4.7%. A 93-year-old man was diagnosed with BP based on skin manifestations (Figure 1, a and b), histopathological findings (Figure 1, c and d), and anti-BP180 NC16A antibody titer determined by chemiluminescence enzyme immunoassay (279 U/mL) 3 years earlier. His comorbidities included diabetes mellitus, chronic heart failure, right pleural effusion, and brain infarction. The patient had been successfully treated with oral prednisolone, so the steroid was tapered to 4 mg/day. The blisters recurred, however, and new ones kept developing even though the prednisolone was increased to 25 mg/day. Dapsone (75 mg/day) was begun as adjunctive treatment, and new blister formation ceased. At one week from dapsone initiation, the patient developed dyspnea, and his oxygen saturation as measured by pulse oximetry decreased to 88% on room air. At presentation, his blood pressure was 118/78 mmHg, the heart rate was 95 beats/minute, and axillary temperature was 36.3 °C. Neurological examination and consciousness findings remained unchanged compared with findings before dyspnea onset. Chest examination showed normal breath and heart sounds, but lip and peripheral cyanosis was present. Blood tests revealed a white blood cell count of 12,920/μl; red blood cells, 370×104/μl; hemoglobin, 11.7 g/dl; and CMV antigenemia (or C7-HRP), negative. Chest CT and echocardiography indicated no remarkable change compared with imaging from one year earlier. Arterial blood gas analysis showed a pH of 7.454, PaO2 63.1 mmHg, PaCO2 35.4 mmHg, HCO3- 24.3 mmol/L, SaO2 92.4%, and MetHb of 4.7%. These findings indicated a saturation gap (difference between SpO2 and SaO2) induced by MetHb. Upon cessation of dapsone, MetHb levels and SpO2 returned to normal and the dyspnea resolved, implicating dapsone in the methemoglobinemia (Figure 1, e). Differential diagnoses were pulmonary disease, heart disease, neuromuscular disease, sepsis, and drug intoxication. These possibilities were ruled out by the physical examination, drug history, vital signs, blood tests, and chest CT and echocardiography. In normal individuals, MetHb levels are less than 1% (2). Healthy patients with normal hemoglobin concentrations develop cyanosis at MetHb level of 15-20%, dyspnea at 20-50%, and coma at 50-70%, and die at more than 70% (2). However, patients with hematologic disease, acidosis, or cardiopulmonary diseases, for example, present with symptoms even with MetHb levels less than 15% (2,3). We inferred that our patient presented with dyspnea even under mild methemoglobinemia because he had anemia, chronic heart failure, and right pleural effusion. The occurrence of dapsone-induced methemoglobinemia with obvious symptoms is rare (1,4). Clinicians should be aware that methemoglobinemia symptoms are influenced not only by MetHb concentrations but also by comorbidities.
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Affiliation(s)
| | - Hisayoshi Imanishi
- Hisayoshi Imanishi, MD, PhD, Division of Dermatology, Daito Central Hospital, 2-1-11 Ono, Daito, Osaka 574-0042, Japan;
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Yoshimoto N, Takashima S, Kawamura T, Inamura E, Sugai T, Ujiie I, Izumi K, Natsuga K, Nishie W, Shimizu H, Ujiie H. A case of non-bullous pemphigoid induced by IgG4 autoantibodies targeting BP230. J Eur Acad Dermatol Venereol 2020; 35:e282-e285. [PMID: 33219610 DOI: 10.1111/jdv.17044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/12/2020] [Accepted: 11/12/2020] [Indexed: 11/27/2022]
Affiliation(s)
- N Yoshimoto
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - S Takashima
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - T Kawamura
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - E Inamura
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - T Sugai
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - I Ujiie
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - K Izumi
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - K Natsuga
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - W Nishie
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - H Shimizu
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - H Ujiie
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Ogawa K, Koh Y, Kaneda H, Izumi M, Matsumoto Y, Sawa K, Fukui M, Taniguchi Y, Yoshimoto N, Tamiya A, Ando M, Kubo A, Isa SI, Saka H, Matsumura A, Kawaguchi T. Can smoking duration alone replace pack-years to predict the risk of smoking-related oncogenic mutations in non-small cell lung cancer? A cross-sectional study in Japan. BMJ Open 2020; 10:e035615. [PMID: 32907893 PMCID: PMC7482473 DOI: 10.1136/bmjopen-2019-035615] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To investigate whether smoking duration alone can replace pack-years to predict the risk of oncogenic mutations in non-small cell lung cancer (NSCLC). DESIGN A cross-sectional study using the baseline dataset from the Japan Molecular Epidemiology for Lung Cancer Study. SETTING Forty-three medical institutions nationwide in Japan. PARTICIPANTS From July 2012 to December 2013, 957 patients with newly diagnosed stage I-IIIB NSCLC who underwent surgery were enrolled, and molecular analyses were performed on 876 samples (from 441 ever-smokers and 435 never-smokers). MAIN OUTCOMES MEASURED We calculated the area under the receiver operating characteristic curve (AUC) values using logistic regression to compare between the predictive values of smoking duration and pack-years for mutational frequencies in the v-Ki-ras2 Kirsten rat sarcoma (KRAS), tumour suppressor p53 (TP53), and epidermal growth factor receptor (EGFR) genes and for cytosine-to-adenine base substitution (C>A). RESULTS For predicting KRAS mutations, the AUC values for smoking duration and pack-years were 0.746 (95% CI 0.682 to 0.800) and 0.759 (95% CI 0.700 to 0.810), respectively (p=0.058). For predicting KRAS mutations in smokers, the AUC values for smoking duration and pack-years were 0.772 (95% CI 0.697 to 0.833) and 0.787 (95% CI 0.714 to 0.845), respectively (p=0.036). There were no significant differences between the AUC values for smoking duration and pack-years in terms of predicting TP53 and EGFR mutations and C>A. Pack-years was a significantly better predictor of KRAS mutations than smoking duration. CONCLUSION Smoking duration was not significantly different from pack-years in predicting the likelihood of smoking-related gene mutations. Given the recall bias in obtaining smoking information, smoking duration alone should be considered for further investigation as a simpler alternative to pack-years.
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Affiliation(s)
- Koichi Ogawa
- Respiratory Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yasuhiro Koh
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiroyasu Kaneda
- Clinical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Motohiro Izumi
- Respiratory Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yoshiya Matsumoto
- Respiratory Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kenji Sawa
- Respiratory Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mitsuru Fukui
- Laboratory of Statistics, Osaka City University Faculty of Medicine, Osaka, Japan
| | - Yoshihiko Taniguchi
- Internal Medicine, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Japan
| | - Naoki Yoshimoto
- Clinical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Akihiro Tamiya
- Internal Medicine, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Japan
| | - Masahiko Ando
- Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Akihito Kubo
- Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Aichi Medical University Graduate School of Medicine, Nagakute, Japan
| | - Shun-Ichi Isa
- Clinical Research Center, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Japan
| | - Hideo Saka
- Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan
| | - Akihide Matsumura
- Surgery, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Japan
| | - Tomoya Kawaguchi
- Respiratory Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
- Clinical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
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Izumi M, Suzumura T, Ogawa K, Matsumoto Y, Sawa K, Yoshimoto N, Tani Y, Watanabe T, Kaneda H, Mitsuoka S, Asai K, Kawaguchi T. Differences in molecular epidemiology of lung cancer among ethnicities (Asian vs. Caucasian). J Thorac Dis 2020; 12:3776-3784. [PMID: 32802457 PMCID: PMC7399397 DOI: 10.21037/jtd.2019.08.61] [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] [Indexed: 01/05/2023]
Abstract
Background Differences in carcinogenesis and therapeutic efficacy according to ethnicity have been reported for lung cancer, and understanding differences in genetic mutation profiles among ethnicities is important for interpreting the results of clinical trials, preventing carcinogenesis, and individualizing treatment. However, no studies have focused on differences in mutation profiles among different ethnicities using large-scale genomic analysis data with detailed information on smoking history, the main cause of lung cancer. Methods To clarify the differences in genetic mutation profiles between Caucasian and Japanese subjects, we compared data from The Cancer Genome Atlas, which mainly included Caucasians, with results from the Japan Molecular Epidemiology for lung cancer study, which is an epidemiological study only involving Japanese subjects. We divided the participants into four groups according to smoking status and performed comparative analysis by tissue type (lung adenocarcinoma and squamous cell lung cancer). Results In patients with lung adenocarcinoma, the frequency of EGFR mutations was lower in Caucasian subjects than in Japanese subjects (14.6% vs. 51.1%), whereas the frequencies of mutations in other genes, namely KRAS (32.9% vs. 9.3%), TP53 (45.2% vs. 20.7%), BRAF (9.6% vs. 1.3%), PIK3CA (5.9% vs. 2.6%), KEAP1 (17.8% vs. 0.5%), NF1 (10.9% vs. 0.5%), STK11 (17.8% vs. 0.7%), RBM10 (8.7% vs. 0.1%), and MET (7.8% vs. 0.1%), were higher in Caucasian subjects. Among patients with squamous cell carcinoma, TP53 (81.2% vs. 49.1%), PIK3CA (14.5% vs. 6.8%), KEAP1 (12.7% vs. 0.9%), and NFE2L2 mutations (15.8% vs. 13.6%) were more common in Caucasian subjects. Conclusions Ethnicity is an important and complex characteristic that must be recognized and considered, even in the era of precision medicine. We should collaborate to share data for different ethnicities and incorporate them into clinical practice and the design of global clinical studies. Carefully designed molecular epidemiological studies focusing on ethnic differences are warranted.
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Affiliation(s)
- Motohiro Izumi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Tomohiro Suzumura
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Koichi Ogawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yoshiya Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Naoki Yoshimoto
- Department of Respiratory Medicine, Ishikiriseiki Hosipital, Higashiosaka, Japan
| | - Yoko Tani
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hiroyasu Kaneda
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Shigeki Mitsuoka
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.,Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Osaka, Japan
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Tani Y, Koh Y, Tamiya A, Isa SI, Kubo A, Ando M, Saka H, Izumi M, Ogawa K, Matsumoto Y, Sawa K, Yoshimoto N, Suzumura T, Watanabe T, Kaneda H, Mitsuoka S, Asai K, Kawaguchi T. The impact of estrogen receptor status on EGFR/TP53/ CTNNB1 axis in the evolution of non-small cell lung cancer. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e21035] [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
e21035 Background: The role of estrogen receptor status in the carcinogenesis of lung cancer remains elusive. A census of clonal and sub-clonal mutations has been defined through the analyses of evolutionary histories of cancers. We previously reported a prospective multicenter molecular epidemiology study (JME study; Kawaguchi T, J Clin Oncol 2016), which included the expression levels of estrogen receptors β (ER) using immunohistochemistry(IHC) and the mutational profile using next generation sequencing as well as solid smoking information and reproductive/ hormonal risk factors from the detailed questionnaire. Methods: Utilizing the data of the JME study, the impact of ER in lung cancer development was explored. All the patients underwent surgery. In 441 ever- and 435 never-smokers, ER were observed in 46.4% and 53.5%, respectively. The cancer-associated 72 gene mutations and 5 gene amplifications examined in this study included EGFR, SMAD4, APC, FBXW7, BRAF, STK11, PIK3CA, TP53, PTEN, KRAS, CTNNB1, NFE2L2, NF1, and MET. ALK fusion was detected by IHC. Patients were enrolled between July 2012 and December 2013, with follow up until November 30th, 2017.Cox proportional hazards models were used to assess the ER expression on relapse free survival (RFS) and overall survival (OS). A logistic regression model was applied to assess the impact of ER (positive vs. negative) on gene alterations, using sex, smoking history, age and stage as independent variables. Results: ER expression was significantly higher in never smokers (vs. ever smokers; p = 0.022) and earlier stage (stage I vs. II-IV; p = 0.002). Patients with ER positive tumors had a longer RFS than those with negative tumors (RFS rate at 4 years: 33.7 vs. 26.5%; p = 0.021), however, there was no significant difference in OS between the two groups (p = 0.108). In the impact of ER status on the gene alterations, mutations in EGFR (p = 0.003), TP53 (p = 0.007) and CTNNB1 (p = 0.027) were significantly associated with ER expression. Multivariate analysis showed that EGFR mutations (OR = 1.394, 95%CI: 1.029-1.890, p = 0.032) and CTNNB1 mutations (OR = 0.272, 95%CI: 0.087-0.853, p = 0.026) were significantly associated with ER expression, while there was a trend for significance with TP53 mutations (OR = 0.737, 95%CI: 0.537-1.011, p = 0.059). Conclusions: ER positive status triggered the clonal EGFR mutations and suppressed the sub-clonal mutations of TP53 and CTNNB1. It is suggested that ER plays a critical role in the alterations of EGFR/TP53/ CTNNB1 axis in lung cancer evolution.
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Affiliation(s)
- Yoko Tani
- Department of Clinical Oncology, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | - Yasuhiro Koh
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Akihiro Tamiya
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Shun-ichi Isa
- Department of Thoracic Oncology, Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Akihito Kubo
- Division of Respiratory Medicine and Allergology, Aichi Medical University School of Medicine, Nagakute, Japan
| | | | - Hideo Saka
- Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan
| | - Motohiro Izumi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Koichi Ogawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yoshiya Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Naoki Yoshimoto
- Department of Clinical Oncology, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | - Tomohiro Suzumura
- Department of Clinical Oncology, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hiroyasu Kaneda
- Department of Clinical Oncology, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | - Shigeki Mitsuoka
- Department of Clinical Oncology, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
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Tamiya A, Koh Y, Isa SI, Kubo A, Ando M, Saka H, Yoshimoto N, Takeo S, Adachi H, Tagawa T, Kawashima O, Yamashita M, Kataoka K, Takenoyama M, Takeuchi Y, Watanabe K, Matsumura A, Kawaguchi T. Impact of somatic mutations on prognosis in resected non-small-cell lung cancer: The Japan Molecular Epidemiology for lung cancer study. Cancer Med 2020; 9:2343-2351. [PMID: 32022477 PMCID: PMC7131842 DOI: 10.1002/cam4.2897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 10/29/2019] [Accepted: 01/17/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND To report the follow up data and clinical outcomes of the JME study (UMIN 000008177), a prospective, multicenter, molecular epidemiology examination of 876 surgically resected non-small-cell lung cancer (NSCLC) cases, and the impact of somatic mutations (72 cancer-associated genes) on recurrence-free survival (RFS) and overall survival (OS). METHODS Patients were enrolled between July 2012 and December 2013, with follow up to 30th November 2017. A Cox proportional hazards model was used to assess the impact of gene mutations on RFS and OS, considering sex, smoking history, age, stage, histology, EGFR, KRAS, TP53, and number of coexisting mutations. RESULTS Of 876 patients, 172 had ≥2 somatic mutations. Median follow-up was 48.4 months. On multivariate analysis, number of coexisting mutations (≥2 vs 0 or 1, HR = 2.012, 95% CI: 1.488-2.695), age (≥70 vs <70 years, HR = 1.583, 95% CI: 1.229-2.049), gender (male vs female, HR = 1.503, 95% CI: 1.045-2.170) and pathological stage (II vs I, HR = 3.386, 95% CI: 2.447-4.646; ≥III vs I, HR = 6.307, 95% CI: 4.680-8.476) were significantly associated with RFS, while EGFR mutation (yes vs no, HR = 0.482, 95% CI: 0.309-0.736), number of coexisting mutations (≥2 vs 0 or 1, HR = 1.695, 95% CI: 1.143-2.467), age (≥70 vs <70 years, HR = 1.932, 95% CI: 1.385-2.726), and pathological stage (II vs I, HR = 2.209, 95% CI: 1.431-3.347; ≥III vs I, HR = 5.286, 95% CI: 3.682-7.566) were also significant for OS. CONCLUSION A smaller number of coexisting mutations, earlier stage, and younger age were associated with longer RFS and OS, while EGFR mutations were significantly associated with improved OS.
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Affiliation(s)
- Akihiro Tamiya
- National Hospital Organization (NHO) Kinki-Chuo Chest Medical Center, Sakai, Japan
| | | | - Shun-Ichi Isa
- National Hospital Organization (NHO) Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Akihito Kubo
- Aichi Medical University School of Medicine, Nagakute, Japan
| | | | - Hideo Saka
- NHO Nagoya Medical Center, Nagoya, Japan
| | | | | | | | | | | | | | | | | | | | | | - Akihide Matsumura
- National Hospital Organization (NHO) Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Tomoya Kawaguchi
- Graduate School of Medicine, Osaka City University, Osaka, Japan
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19
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Ogawa K, Kawaguchi T, Koh Y, Isa SI, Kubo A, Ando M, Saka H, Yoshimoto N, Matsumura A, Kaneda H, Tamiya A, Taniguchi Y, Sawa K, Matsumoto Y, Izumi M. Can smoking duration alone replace pack-years to predict the risk of smoking-related oncogenic mutations in non-small cell lung cancer (NSCLC)? J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e20017] [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
e20017 Background: P has widely been used for the risk assessment of lung cancer and chronic obstructive pulmonary disease (COPD). We previously reported that mutations in KRAS, TP53, and EGFR were also associated with P from a prospective multicenter molecular epidemiology study (JME study; Kawaguchi T, J Clin Oncol 2016). Recently, D alone has been reported to provide stronger risk estimates of COPD than P. Here, we show the comparison of these two indices in predicting the risk of smoking-related oncogenic mutations in NSCLC, utilizing the database from the JME study including detailed smoking information and the mutational profile by next generation sequencing. Methods: In 439 ever- and 437 never-smokers, the frequency of mutations in KRAS, TP53 and EGFR were 9.4, 26.8 and 42.5%, respectively, and smoking-related cytosine to adenine base substitution (C > A) was observed in 12.7 % of cases. AUC values (area under the ROC curves) for logistic regression determined from P and D to predict the mutations or C > A change were compared, considering gender, age, stage and histology as covariates. Results: The median of P and D were 43 (1-189) and 41 (years, 1-65) in smokers, respectively. The AUC values in EGFR and KRAS were numerically higher than others, suggesting stronger association with smoking. There was no significant difference in AUC values between P and D in TP53, EGFR and C > A, and P was a significantly better estimate of KRAS mutations (table). Conclusions: P remains the standard method to evaluate the risk of oncogenic mutations in NSCLC. D, however, warrants further investigation as a simpler alternative to P.[Table: see text]
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Affiliation(s)
- Koichi Ogawa
- Department of Respiratory Medicine, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | | | - Shun-Ichi Isa
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Akihito Kubo
- Division of Respiratory Medicine and Allergology, Aichi Medical University School of Medicine, Nagakute, Japan
| | | | - Hideo Saka
- Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan
| | - Naoki Yoshimoto
- Department of Clinical Oncology, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | - Akihide Matsumura
- National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Hiroyasu Kaneda
- Department of Medical Oncology, Kishiwada City Hospital, Kishiwada, Japan
| | - Akihiro Tamiya
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Yoshihiko Taniguchi
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | | | - Motohiro Izumi
- Osaka City University, Graduate School of Medicine, Osaka, Japan
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Takashima S, Shinkuma S, Fujita Y, Natsuga K, Yoshimoto N, Shichinohe R, Hatanaka K, Shimizu H. 368 Novel mevalonate kinase mutation in a patient with porokeratosis ptychotropica. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Zheng M, Ujiie H, Iwata H, Muramatsu K, Yoshimoto N, Ito T, Ujiie I, Shimizu S, Sato-Matsumura KC, Shimizu H. Characteristics of IgG subclasses and complement deposition in BP230-type bullous pemphigoid. J Eur Acad Dermatol Venereol 2019; 33:595-600. [PMID: 30394605 DOI: 10.1111/jdv.15325] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/04/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bullous pemphigoid (BP) is the most common autoimmune blistering disease. BP180 is the primary autoantigen of BP, and in a portion of BP cases, BP230 is the only target of autoantibodies. Such BP is called BP230-type BP. BP230-type BP tends to show milder clinical phenotypes than conventional BP, but the reason is unclear. The pathogenic roles of autoantibodies and complement activation have been shown in conventional BP, but the distribution of IgG subclasses and the degree of complement deposition in BP230-type BP remain unclear. OBJECTIVE To compare the distribution of IgG subclasses and the degree of complement deposition in BP230-type BP with those in conventional BP with autoantibodies to BP180 and BP230 (BP180-BP230-type BP). METHODS The diagnosis of BP was confirmed by the histopathology of the lesions, the deposition of IgG and complement in the perilesional skin and the presence of circulating autoantibodies to BP180 and BP230. The disease severity was determined by bullous pemphigoid disease area index. The deposition of IgG subclasses and complement deposition were examined by direct immunofluorescence of the perilesional skin in 6 BP230-type BP cases and 11 BP180-BP230-type BP cases. RESULTS Sixty seven percent of BP230-type BP cases show a mild clinical phenotype. All BP230-type BP cases and 82% of BP180-BP230-type BP cases were found to demonstrate the clear deposition of IgG4 at the basement membrane zone of skin specimens. Notably, the deposition of IgG1 and IgG3 was faint or negative in all of the BP230-type BP cases, whereas they were clearly detected in 91% and 64% of the BP180-BP230-type BP cases, respectively. The deposition of complement C3 tended to be weaker in BP230-type BP than in BP180-BP230-type BP. CONCLUSION The mild clinical phenotype of BP230-type BP may correlate with the weaker deposition of IgG1, IgG3 and complement in the skin lesions.
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Affiliation(s)
- M Zheng
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - H Ujiie
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - H Iwata
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - K Muramatsu
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - N Yoshimoto
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - T Ito
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - I Ujiie
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - S Shimizu
- Department of Dermatology, Sapporo City General Hospital, Sapporo, Japan
| | | | - H Shimizu
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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22
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Yamamoto N, Watanabe T, Yamada K, Nakai T, Suzumura T, Sakagami K, Yoshimoto N, Sato K, Tanaka H, Mitsuoka S, Asai K, Kimura T, Kanazawa H, Hirata K, Kawaguchi T. Efficacy and safety of ultrasound (US) guided percutaneous needle biopsy for peripheral lung or pleural lesion: comparison with computed tomography (CT) guided needle biopsy. J Thorac Dis 2019; 11:936-943. [PMID: 31019783 DOI: 10.21037/jtd.2019.01.88] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Ultrasound (US)-guided percutaneous needle biopsy is a useful diagnostic technique with short examination time and real-time monitoring at the bedside. However, there are only a few studies that report on thoracic lesions, whereas the computed tomography (CT)-guided biopsy is well established. There is also limited data comparing US- and CT-guided biopsy. We aimed to clarify the efficacy and safety of US-guided biopsy for thoracic lesions adjacent to the chest wall. Methods We retrospectively enrolled consecutive patients who underwent US- or CT-guided percutaneous biopsies for thoracic lesions adjacent to the chest wall between April 2012 and December 2017. Clinical characteristics, lesion size, lesion-pleura contact arc length (LPCAL), diagnostic rate, and complications were compared between the 2 groups. Results This study enrolled 61 US-guided and 70 CT-guided biopsies. No significant difference was found in age or sex. The lesion size and LPCAL in the US-guided group were significantly larger than those in the CT-guided group (P<0.0001). The diagnostic rate was marginally higher in the US-guided group (93.4%) than in the CT-guided group (84.3%) (P=0.101). When the median cut-off of the LPCAL was defined as 40 mm in all cases, the diagnostic rate for lesion size >40 mm was significantly higher in the US-guided group than in the CT-guided group (P=0.009). Complication rates were significantly lower in the US-guided group (3.3%) than in the CT-guided group (24.3%) (P<0.001). Conclusions US-guided percutaneous needle biopsy for thoracic lesions adjacent to the chest wall is a feasible technique compared with CT-guided biopsy because of its higher diagnostic rate with a longer LPCAL and reduced complications.
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Affiliation(s)
- Norio Yamamoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kazuhiro Yamada
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Toshiyuki Nakai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Tomohiro Suzumura
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kazuki Sakagami
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Naoki Yoshimoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kanako Sato
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hidenori Tanaka
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Shigeki Mitsuoka
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Tatsuo Kimura
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hiroshi Kanazawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kazuto Hirata
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
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Yoshimoto N, Ujiie H, Zheng M, Iwata H, Kosumi H, Hata H, Shimizu H. Bullous pemphigoid with the deposition of IgG2 but not IgG1, IgG3 nor IgG4 autoantibodies at the basement membrane zone. J Eur Acad Dermatol Venereol 2018; 32:e344-e346. [DOI: 10.1111/jdv.14920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- N. Yoshimoto
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - H. Ujiie
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - M. Zheng
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - H. Iwata
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - H. Kosumi
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - H. Hata
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - H. Shimizu
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
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24
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Mai Y, Nishie W, Izumi K, Yoshimoto N, Morita Y, Watanabe M, Toyonaga E, Ujiie H, Iwata H, Fujita Y, Nomura T, Sato-Matsumura KC, Shimizu S, Shimizu H. Detection of anti-BP180 NC16A autoantibodies after the onset of dipeptidyl peptidase-IV inhibitor-associated bullous pemphigoid: a report of three patients. Br J Dermatol 2018; 179:790-791. [PMID: 29624639 DOI: 10.1111/bjd.16656] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Y Mai
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - W Nishie
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - K Izumi
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - N Yoshimoto
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Y Morita
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
- Department of Dermatology, JR Sapporo Hospital, Sapporo, Japan
| | - M Watanabe
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - E Toyonaga
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - H Ujiie
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - H Iwata
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Y Fujita
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - T Nomura
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - K C Sato-Matsumura
- Department of Dermatology, Japan Community Health Care Organization, Sapporo Hokushin Hospital, Sapporo, Japan
| | - S Shimizu
- Department of Dermatology, Sapporo City General Hospital, Sapporo, Japan
| | - H Shimizu
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
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Matsumoto Y, Sawa K, Oyanagi J, Fukui M, Yoshimoto N, Suzumura T, Mitsuoka S, Asai K, Kimura T, Yamamoto N, Kawaguchi T, Hirata K, Koh Y. Abstract 2613: Predictive impact of low-frequency pretreatment T790M mutation in patients with EGFR-mutated non-small cell lung cancer treated with EGFR tyrosine kinase inhibitors. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-2613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: T790M mutation in EGFR accounts for nearly 50% of the acquired mechanism of resistance to EGFR-tyrosine kinase inhibitors (TKIs). Previous studies suggested that EGFR T790M mutation was also detected in a considerable number of EGFR-TKI-naïve non-small-cell lung cancer (NSCLC) patients utilizing ultrasensitive detection methods such as droplet digital PCR (ddPCR). Here we investigated the significance of low-frequency pretreatment EGFR T790M mutation (preT790M) and its association with cancer molecular heterogeneity in the efficacy of EGFR-TKIs.
Materials and methods: Fifty-two advanced NSCLC patients harboring activating EGFR mutations treated with first-line EGFR-TKIs at Osaka City University Hospital between August 2013 and July 2016 were enrolled in the study. DNAs from tumor biopsies at diagnosis were available from 44 patients for detecting preT790M by the cobas® EGFR Mutation Test v2 (cobas) and ddPCR (RainDance Technologies) and those from 33 were available for assessing the actionable mutations in 50 genes by next-generation sequencing (NGS). NGS was performed on the Ion PGM using Ion AmpliSeq Cancer Hotspot Panel v2 (Life Technologies). Paired biopsies before EGFR-TKIs treatment and at disease progression (PD) were obtained from 15 patients to assess the T790M mutation by cobas.
Results: The overall detection rate of preT790M by ddPCR was 40.9% (18/44), while not detected in any case by cobas. The median progression free survival (mPFS) was 10.0 months for the patients with preT790M and 13.5 months for those without preT790M (p=0.288), respectively. When divided into 3 categories based on the frequency of preT790M such as high with T790M allele frequency (AF) >0.3%, low with AF ≤0.3% and undetected, 12 patients with high AF had a relatively shorter mPFS than 6 with low AF (p=0.090) and 26 without detectable preT790M (p=0.046) (7.7 vs 17.1 vs 13.5 months, respectively). NGS revealed 18 additional coexisting actionable mutations in 15 out of 33 patients: TP53 (n=7), PIK3CA (n=5), CTNNB1 (n=3) and uncommon EGFR (n=3). There was a trend for patients with higher preT790M AF to harbor less additional coexisting mutations (27% with high AF, 60% with low AF and 53% without preT790M, p=0.320). In 15 paired biopsies, T790M mutation was detected in 60% (9/15) at PD by cobas in the clinical setting; 67% (2/3) with high AF, 50% (1/2) with low AF and 60% (6/10) without detectable preT790M, suggesting T790M mutation after first-line EGFR-TKIs developed from both clonal selection and secondary acquisition models.
Conclusion: Results of our study indicated that EGFR-mutated NSCLCs with higher AF preT790M >0.3% had significantly shorter duration of response to EGFR-TKIs. In addition, the AF of preT790M in EGFR-mutated NSCLC may be associated with coexisting actionable mutation load potentially affecting the efficacy of EGFR-TKIs.
Citation Format: Yoshiya Matsumoto, Kenji Sawa, Jun Oyanagi, Mitsuru Fukui, Naoki Yoshimoto, Tomohiro Suzumura, Shigeki Mitsuoka, Kazuhisa Asai, Tatsuo Kimura, Nobuyuki Yamamoto, Tomoya Kawaguchi, Kazuto Hirata, Yasuhiro Koh. Predictive impact of low-frequency pretreatment T790M mutation in patients with EGFR-mutated non-small cell lung cancer treated with EGFR tyrosine kinase inhibitors [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 2613.
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Affiliation(s)
| | | | - Jun Oyanagi
- 2Wakayama Medical University, Wakayama, Japan
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Tamiya A, Koh Y, Kubo A, Ando M, Isa SI, Saka H, Yoshimoto N, Serizawa M, Takeo S, Adachi H, Tagawa T, Kawashima O, Yamashita M, Kataoka K, Ichinose Y, Takeuchi Y, Watanabe K, Matsumura A, Kawaguchi T. Impact of somatic mutations on recurrence free survival (RFS) and overall survival (OS) for resected non-small cell lung cancer (NSCLC): results from the Japan Molecular Epidemiology for lung cancer study (JME). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.8549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Akihiro Tamiya
- National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | | | - Akihito Kubo
- Division of Respiratory Medicine and Allergology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Shun-ichi Isa
- National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hideo Saka
- Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan
| | - Naoki Yoshimoto
- Department of Clinical Oncology, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | - Masakuni Serizawa
- Division of Drug Discovery and Development, Shizuoka Cancer Center Research Institute, Nagaizumi-Cho, Shizuoka, Japan
| | - Sadanori Takeo
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hirofumi Adachi
- Department of Thoracic Surgery, National Hospital Organization, Hokkaido Cancer Center, Hokkaido, Japan
| | - Tsutomu Tagawa
- National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Osamu Kawashima
- National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | | | - Kazuhiko Kataoka
- National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan
| | - Yukito Ichinose
- National Hospital Organization Kyushu Cancer Center, Fukuoka-Shi, Japan
| | - Yukiyasu Takeuchi
- National Hospital Organization Toneyama National Hospital, Toyonaka, Japan
| | - Katsuya Watanabe
- National Hospital Organization Yokohama Medical Center, Yokohama City, Japan
| | - Akihide Matsumura
- National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Osaka City University, Graduate School of Medicine, Osaka, Japan
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Sawa K, Kawaguchi T, Koh Y, Kubo A, Tamiya A, Yoshimoto N, Isa SI, Saka H, Matsumura A. Co-mutations in surgically resected and EGFR mutated lung adenocarcinoma: A subset analysis of the large prospective cohort study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e20520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Kenji Sawa
- Department of Respiratory Medicine, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | | | - Akihito Kubo
- Division of Respiratory Medicine and Allergology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akihiro Tamiya
- National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Naoki Yoshimoto
- Department of Clinical Oncology, Osaka City University, Graduate School of Medicine, Osaka, Japan
| | - Shun-ichi Isa
- National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hideo Saka
- Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan
| | - Akihide Matsumura
- National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
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Isshiki A, Ito H, Nakato T, Nakata T, Inokuchi T, Inoue Y, Sasaki O, Nishioka T, Yoshimoto N. 57Prognosis of Patients with Vasospastic Angina Resuscitated from Cardiac Arrest. Europace 2018. [DOI: 10.1093/europace/euy015.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Isshiki
- Saitama Medical center, Saitama Medical University, Department of Cardiology, Kawagoe, Saitama, Japan
| | - H Ito
- Saitama Medical center, Saitama Medical University, Department of Cardiology, Kawagoe, Saitama, Japan
| | - T Nakato
- Saitama Medical center, Saitama Medical University, Department of Cardiology, Kawagoe, Saitama, Japan
| | - T Nakata
- Saitama Medical center, Saitama Medical University, Department of Cardiology, Kawagoe, Saitama, Japan
| | - T Inokuchi
- Saitama Medical center, Saitama Medical University, Department of Cardiology, Kawagoe, Saitama, Japan
| | - Y Inoue
- Saitama Medical center, Saitama Medical University, Department of Cardiology, Kawagoe, Saitama, Japan
| | - O Sasaki
- Saitama Medical center, Saitama Medical University, Department of Cardiology, Kawagoe, Saitama, Japan
| | - T Nishioka
- Saitama Medical center, Saitama Medical University, Department of Cardiology, Kawagoe, Saitama, Japan
| | - N Yoshimoto
- Saitama Medical center, Saitama Medical University, Department of Cardiology, Kawagoe, Saitama, Japan
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Kawaguchi T, Sawa K, Yoshimoto N, Hirata K, Mack P. MS 02.02 Molecular Epidemiology. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.201] [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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Matsumoto Y, Kawaguchi T, Yamamoto N, Sawa K, Yoshimoto N, Suzumura T, Watanabe T, Mitsuoka S, Asai K, Kimura T, Yoshimura N, Kuwae Y, Hirata K. Interstitial Lung Disease Induced by Osimertinib for Epidermal Growth Factor Receptor (EGFR) T790M-positive Non-small Cell Lung Cancer. Intern Med 2017; 56:2325-2328. [PMID: 28794368 PMCID: PMC5635308 DOI: 10.2169/internalmedicine.8467-16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 01/15/2017] [Indexed: 01/23/2023] Open
Abstract
A 75-year-old man with stage IV lung adenocarcinoma was treated with osimertinib due to disease progression despite having been administered erlotinib. Both an epidermal growth factor receptor (EGFR) L858R mutation on exon 21 and a T790M mutation on exon 20 were detected in a specimen from a recurrent primary tumor. Five weeks after osimertinib initiation, he developed general fatigue and dyspnea. Chest computed tomography scan revealed diffuse ground glass opacities and consolidation on both lungs. An analysis of the bronchoalveolar lavage fluid revealed marked lymphocytosis, and a transbronchial lung biopsy specimen showed a thickened interstitium with fibrosis and prominent lymphocytic infiltration. We diagnosed the patient to have interstitial lung disease induced by osimertinib.
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Affiliation(s)
- Yoshiya Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Japan
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Japan
| | - Norio Yamamoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Japan
| | - Naoki Yoshimoto
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Japan
| | - Tomohiro Suzumura
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Japan
| | - Shigeki Mitsuoka
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Japan
| | - Tatsuo Kimura
- Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka City University, Japan
| | - Naruo Yoshimura
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Japan
| | - Yuko Kuwae
- Department of Pathology, Graduate School of Medicine, Osaka City University, Japan
| | - Kazuto Hirata
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Japan
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Sawa K, Koh Y, Kawaguchi T, Kambayashi S, Asai K, Mitsuoka S, Kimura T, Yoshimura N, Yoshimoto N, Kubo A, Saka H, Matsumura A, Wanibuchi H, Yamamoto N, Nishiyama N, Hirata K. PIK3CA mutation as a distinctive genetic feature of non-small cell lung cancer with chronic obstructive pulmonary disease: A comprehensive mutational analysis from a multi-institutional cohort. Lung Cancer 2017; 112:96-101. [PMID: 29191607 DOI: 10.1016/j.lungcan.2017.07.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 05/30/2017] [Revised: 07/28/2017] [Accepted: 07/31/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Non-small cell lung cancer (NSCLC) and chronic obstructive pulmonary disease (COPD) have been proposed to have a mutual developmental mechanism, but their association has not been fully understood. We aimed to examine the association of the mutational landscape of NSCLC with co-morbid COPD. MATERIALS AND METHODS A total of 197 surgical specimens of early stage NSCLC were retrospectively collected from two independent sources, namely, the Japan Molecular Epidemiology for Lung Cancer Study and the Osaka City University Hospital cohort from 2010 to 2013. COPD and its severity were defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines and grading system. For molecular profiling of NSCLC patients with COPD, the extracted DNAs were deep-sequenced using next generation sequence technologies for somatic mutations in a maximum 72 cancer-associated genes. Logistic regression analysis was performed to evaluate the impact of COPD on the somatic mutations. RESULTS The COPD group (n=77), including 56 GOLD 1 and 21 GOLD 2 or 3 patients, had 58 squamous cell lung carcinoma (SCC) cases and 19 adenocarcinoma cases. The non-COPD group (n=120) had 53 SCC cases, 64 adenocarcinoma cases, and three cases with other histology. The frequency of PIK3CA mutation was significantly higher in the COPD group than in the non-COPD group (10.4% vs. 1.7%, p=0.015). Meanwhile, NFE2L2 mutation was observed only in SCC cases, with no difference in the frequency between the two groups (17.2% vs. 17.0%). In the multivariate logistic regression model with consideration for COPD status, age, smoking dose, pathological stage, and histology, significantly more PIK3CA mutation was observed in the presence of COPD (odds ratio=5.31, 95% CI: 1.03-27.29, p=0.046). CONCLUSIONS PIK3CA mutation is a distinctive genetic feature of NSCLC with COPD, regardless of age, smoking dose, pathological stage, and histology.
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Affiliation(s)
- Kenji Sawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yasuhiro Koh
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
| | - Satoshi Kambayashi
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Shigeki Mitsuoka
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Tatsuo Kimura
- Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Naruo Yoshimura
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Naoki Yoshimoto
- Department of Clinical Oncology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Akihito Kubo
- Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan
| | - Hideo Saka
- Department of Respiratory Medicine and Medical Oncology, Japanese National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
| | - Akihide Matsumura
- Department of Surgery, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Japan
| | - Hideki Wanibuchi
- Department of Molecular Pathology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Nobuyuki Yamamoto
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kazuto Hirata
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
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Yoshimoto N, Ujiie H, Hirata Y, Izumi K, Nishie W, Shimizu H. Bullous pemphigoid developed in a patient with prurigo nodularis. J Eur Acad Dermatol Venereol 2016; 31:e187-e189. [DOI: 10.1111/jdv.13911] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- N. Yoshimoto
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - H. Ujiie
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - Y. Hirata
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - K. Izumi
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - W. Nishie
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - H. Shimizu
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
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Kawaguchi T, Koh Y, Ando M, Isa SI, Tamiya A, Kubo A, Yoshimoto N, Kitagawa C, Saka H, Hirata K, Matsumura A. Mutational landscape of non-small cell lung cancer (NSCLC) associated with chronic obstructive pulmonary disease (COPD). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.8526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Yasuhiro Koh
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Shun-ichi Isa
- National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Akihiro Tamiya
- National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Akihito Kubo
- Division of Respiratory Medicine and Allergology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Naoki Yoshimoto
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Chiyoe Kitagawa
- National Hospital Organization Nagoya Medical Center, Nagoya-shi, Japan
| | | | - Kazuto Hirata
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Akihide Matsumura
- National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
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Kawaguchi T, Koh Y, Ando M, Ito N, Takeo S, Adachi H, Tagawa T, Kakegawa S, Yamashita M, Kataoka K, Ichinose Y, Takeuchi Y, Serizawa M, Tamiya A, Shimizu S, Yoshimoto N, Kubo A, Isa SI, Saka H, Matsumura A. Prospective Analysis of Oncogenic Driver Mutations and Environmental Factors: Japan Molecular Epidemiology for Lung Cancer Study. J Clin Oncol 2016; 34:2247-57. [PMID: 27161973 DOI: 10.1200/jco.2015.64.2322] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Oncogenic driver mutations are critical for lung cancer development and serve as therapeutic targets. However, their associations with environmental factors are not fully understood. We aimed to elucidate the relationship between tumor developmental biology and exposure to environmental factors. PATIENTS AND METHODS This was a prospective, multicenter, molecular epidemiology study. Eligible patients were those with newly diagnosed stages I to IIIB non-small-cell lung cancer (NSCLC) who underwent surgery. The tumors were examined for somatic mutations in 72 cancer-associated genes by targeted deep sequencing, estrogen receptor β (ERβ) expression using immunohistochemical staining, and infection with any of 37 types of human papillomavirus (HPV) using a polymerase chain reaction-based microarray system. Detailed information on patient demographics and environmental factors was obtained from a comprehensive questionnaire. RESULTS From July 2012 to December 2013, 957 patients were enrolled, and molecular analyses were performed on 876 samples (from 441 ever- and 435 never-smokers). Oncogenic driver mutations in P53 and KRAS increased proportionally with smoking status, whereas mutations in EGFR and SMAD4 decreased. KRAS mutations in smokers and SMAD4 mutations were observed more frequently in proportion to body mass index. TP53 and NFE2L2 mutations were observed more frequently in advanced NSCLC stages. As for never-smokers, no environmental factors were significantly associated with mutational changes. EGFR mutations and TP53 mutations were observed more frequently in women and in men, respectively. Mutations in these two genes were also potentially associated with ERβ expression. Only three patients (0.3%) were HPV positive. CONCLUSION The mutational spectrum is associated with smoking, body mass index, and other environmental factors, as well as with ERβ expression. Little association was observed between HPV and NSCLC.
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Affiliation(s)
- Tomoya Kawaguchi
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan.
| | - Yasuhiro Koh
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Masahiko Ando
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Norimasa Ito
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Sadanori Takeo
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Hirofumi Adachi
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Tsutomu Tagawa
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Seiichi Kakegawa
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Motohiro Yamashita
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Kazuhiko Kataoka
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Yukito Ichinose
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Yukiyasu Takeuchi
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Masakuni Serizawa
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Akihiro Tamiya
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Shigeki Shimizu
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Naoki Yoshimoto
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Akihito Kubo
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Shun-Ichi Isa
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Hideo Saka
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
| | - Akihide Matsumura
- Tomoya Kawaguchi, Akihiro Tamiya, Shigeki Shimizu, Shun-ichi Isa, and Akihide Matsumura, National Hospital Organization Kinki-chuo Chest Medical Center; Tomoya Kawaguchi and Naoki Yoshimoto, Osaka City University, Osaka; Yasuhiro Koh, Seiichi Kakegawa, Masakuni Serizawa, Akihito Kubo, and Hideo Saka, National Hospital Organization Nagoya Medical Center; Masahiko Ando, Nagoya University, Nagoya; Yasuhiro Koh, Wakayama Medical University, Wakayama; Yasuhiro Koh and Masakuni Serizawa, Shizuoka Cancer Center Research Institute, Shizuoka; Norimasa Ito, National Hospital Organization Matsue Medical Center, Matsue; Sadanori Takeo, National Hospital Organization Kyushu Medical Center; Yukito Ichinose, National Kyushu Cancer Center, Fukuoka; Hirofumi Adachi, National Hospital Organization Hokkaido Cancer Center, Hokkaido; Tsutomu Tagawa, National Hospital Organization Nagasaki Medical Center, Omura; Seiichi Kakegawa, National Hospital Organization Nishigunma National Hospital, Shibukawa; Motohiro Yamashita, National Hospital Organization Shikoku Cancer Center, Matsuyama; Kazuhiko Kataoka, National Hospital Organization Iwakuni Clinical Center, Iwakuni; Yukiyasu Takeuchi, National Hospital Organization Toneyama National Hospital, Toyonaka; Shigeki Shimizu, Hyogo Medical Collage, Hyogo; and Akihito Kubo, Aichi Medical University School of Medicine, Aichi, Japan
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Mitsuoka S, Kawaguchi T, Kubo A, Isa SI, Asai K, Uji M, Watanabe T, Sawa K, Yoshimoto N, Oka T, Nakai T, Suzumura T, Tanaka H, Matsuura K, Kimura T, Yoshimura N, Kudoh S, Hirata K. Epidermal growth factor receptor tyrosine kinase inhibitors in previously treated advanced non-small-cell lung cancer with wild-type EGFR. Expert Opin Pharmacother 2016; 17:193-203. [PMID: 26781399 DOI: 10.1517/14656566.2016.1109635] [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] [Indexed: 11/05/2022]
Abstract
INTRODUCTION While epidermal growth factor receptor (EGFR) - tyrosine kinase inhibitors (TKIs) lead to longer progression-free survival (PFS) when compared with conventional chemotherapy in non-small-cell lung cancer (NSCLC) harboring activating EGFR mutations, the role of EGFR-TKI remains unclear in EGFR-wild-type (WT) NSCLC. AREAS COVERED This article reviews selected data from randomized trials regarding the use of TKIs in EGFR-WT NSCLC. Nine randomized phase III trials have compared EGFR-TKI with chemotherapy in NSCLC patients in a second or later line setting. Two of these trials, TAILOR and DELTA, which were designed to investigate treatment benefits according to EGFR genotype, demonstrated that docetaxel chemotherapy displayed significantly better in progression-free survival (PFS) when compared with the EGFR-TKI erlotinib. Biomarkers to predict clinical benefits of the drug against EGFR WT tumor, and the efficacy of combination regimens using erlotinib or single-use afatinib against tumors are also covered in this article. EXPERT OPINION Considering the modest benefits of erlotinib for EGFR-WT tumors, future studies are warranted, including the exploration of useful biomarkers and new treatment strategies for EGFT-TKI use, as well as the development of more sensitive EGFR mutation tests.
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Affiliation(s)
- Shigeki Mitsuoka
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Tomoya Kawaguchi
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Akihito Kubo
- b Department of Respiratory Medicine , Aichi Medical University School of Medicine , Aichi , Japan
| | - Shun-ichi Isa
- c Clinical Research Center , National Hospital Organization Kinki-chuo Chest Medical Center , Osaka , Japan
| | - Kazuhisa Asai
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Masato Uji
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Tetsuya Watanabe
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Kenji Sawa
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Naoki Yoshimoto
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Takako Oka
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Toshiyuki Nakai
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Tomohiro Suzumura
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Hidenori Tanaka
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Kuniomi Matsuura
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Tatsuo Kimura
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Naruo Yoshimura
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Shinzoh Kudoh
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
| | - Kazuto Hirata
- a Department of Respiratory Medicine, Graduate School of Medicine , Osaka City University , Osaka , Japan
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Toshiyuki N, Kimura T, Suzumura T, Yoshimoto N, Oka T, Yamamoto N, Matsuura K, Mitsuoka S, Asai K, Tochino Y, Yoshimura N, Kawaguchi T, Kudoh S, Matsuoka T, Ohsawa M, Hirata K. The Macroscopic Appearance of Computed Tomography-guided Needle Biopsy Specimens Correlates with Tumor Metastasis in Non-small Cell Lung Cancer. Osaka City Med J 2015; 61:105-112. [PMID: 26995854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Computed tomography (CT)-guided needle biopsy is a well-established and dependable procedure for the diagnosis of pulmonary lesions. Some tissue biopsy samples have loose cohesion and disintegrate into tiny pieces before formalin fixation. The purpose of this study was to assess the association between the fresh macroscopic appearance of samples obtained using CT-guided needle biopsy and the clinicopathological features of non-small cell lung cancer (NSCLC). METHODS A total of 111 patients who underwent CT-guided lung needle biopsy at Osaka City University Hospital between May 2009 and May 2013 were enrolled. Macroscopic appearance was categorized as either loose or tight cohesion. Samples were evaluated using Azan staining to detect collagen fibers. The staining intensity was multiplied by the percentage of positive cells, and the specimen was categorized as having either low (<100) or high expression ( ≥100). Univariate and multivariate logistic regression models were used to evaluate significant covariates for tumor metastasis. RESULTS In the cohort of 111 patients, the diagnostic rates in loose and tight cohesions were 82.6% and 87.5%, respectively (p=0.509). In 60 patients diagnosed with NSCLC, Azan staining of collagen fibers was positive in 93.5% of the samples with tight cohesion and 28.6% of the samples with loose cohesion (p<0.001). In the multivariate logistic regression models, distant metastasis was significantly associated with loose cohesion (p=0.026). CONCLUSIONS These results suggest that the macroscopic appearance of CT-guided biopsy samples correlates with tumor metastasis in NSCLC.
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Yoshimura N, Kudoh S, Mitsuoka S, Yoshimoto N, Oka T, Nakai T, Suzumira T, Matusura K, Tochino Y, Asai K, Kimura T, Kawaguchi T, Hirata K. Phase II study of a combination regimen of gefitinib and pemetrexed as first-line treatment in patients with advanced non-small cell lung cancer harboring a sensitive EGFR mutation. Lung Cancer 2015; 90:65-70. [DOI: 10.1016/j.lungcan.2015.06.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 06/04/2015] [Accepted: 06/05/2015] [Indexed: 10/23/2022]
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Yoshimoto N, Kawaguchi T, Tamiya A, Isa SI, Shimizu S, Asai K, Kudoh S, Hirata K. Integrative analysis on expression of estrogen, environmental tobacco smoke and EGFR mutations from a prospective cohort study for never-smokers with non-small cell lung cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e18517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Naoki Yoshimoto
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | - Akihiro Tamiya
- National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Shun-ichi Isa
- National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Shigeki Shimizu
- National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Kazuhisa Asai
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shinzoh Kudoh
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kazuto Hirata
- Osaka City University Graduate School of Medicine, Osaka, Japan
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Shirato T, Iwata H, Yoshimoto N, Nomura Y, Yamane N, Shimizu H. Dermoscopy is useful for bed bug (Cimex lectularius
) bites. J Eur Acad Dermatol Venereol 2015; 30:539-40. [PMID: 25600584 DOI: 10.1111/jdv.12938] [Citation(s) in RCA: 6] [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: 11/28/2022]
Affiliation(s)
- T. Shirato
- Department of Dermatology; Hokkaido University Graduate School of Medicine; North 15 West 7 Kita-ku Sapporo 060-8638 Japan
| | - H. Iwata
- Department of Dermatology; Hokkaido University Graduate School of Medicine; North 15 West 7 Kita-ku Sapporo 060-8638 Japan
| | - N. Yoshimoto
- Department of Dermatology; Hokkaido University Graduate School of Medicine; North 15 West 7 Kita-ku Sapporo 060-8638 Japan
| | - Y. Nomura
- Department of Dermatology; Hokkaido University Graduate School of Medicine; North 15 West 7 Kita-ku Sapporo 060-8638 Japan
| | - N. Yamane
- Department of Dermatology; Hokkaido University Graduate School of Medicine; North 15 West 7 Kita-ku Sapporo 060-8638 Japan
| | - H. Shimizu
- Department of Dermatology; Hokkaido University Graduate School of Medicine; North 15 West 7 Kita-ku Sapporo 060-8638 Japan
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Oka T, Kimura T, Suzumura T, Yoshimoto N, Nakai T, Yamamoto N, Matsuura K, Mitsuoka S, Yoshimura N, Kudoh S, Hirata K. Magnesium supplementation and high volume hydration reduce the renal toxicity caused by cisplatin-based chemotherapy in patients with lung cancer: a toxicity study. BMC Pharmacol Toxicol 2014; 15:70. [PMID: 25472655 PMCID: PMC4272804 DOI: 10.1186/2050-6511-15-70] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 11/19/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Renal toxicity is a clinical problem that affects 28-42% of patients undergoing treatment with cisplatin. Renal toxicity can be minimized by high volume hydration with mannitol diuresis. Recent reports have shown that cisplatin induces depletion of Mg and that Mg supplementation can reduce renal toxicity. We hypothesized that Mg infusion combined with low volume hydration may not be sufficient to overcome cisplatin-induced renal toxicity. METHODS In total, 85 patients with lung cancer receiving their first cycle of cisplatin-based chemotherapy at the Osaka City University Hospital were classified into three groups: those administered high volume hydration without Mg infusion (high-volume Mg-), high volume hydration with Mg infusion (high-volume Mg+), and with low volume hydration with Mg infusion (low-volume Mg+). Serum creatinine (sCr) and creatinine clearance (CrCl) were examined before and after treatment with cisplatin. Multivariable analysis was carried out to identify the most important contributing factors. RESULTS There were no significant differences in pre-treatment sCr levels or CrCl between groups. In the high-volume Mg- group, post-treatment sCr significantly increased compared with pre-treatment levels, while post-CrCl significantly decreased compared with pre-treatment CrCl (p < 0.001 and p < 0.001, respectively). In the high-volume Mg+ group, there was no significant difference between pre- and post-treatment levels of sCr, or between pre- and post-treatment CrCl (p = 0.118 and p = 0.254, respectively). In the low-volume Mg+ group, there was a trend towards increased sCr levels and decreased CrCl after treatment (p = 0.068 and p = 0.055, respectively). Multivariate analysis revealed that the absence of Mg infusion and low-volume hydration were both independent factors for decreased CrCl (p < 0.001 and p = 0.001, respectively). CONCLUSIONS High-volume hydration and Mg infusion reduces the renal toxicity induced by cisplatin. A low-volume Mg+ regimen may be considered for patients with adequate renal function. TRIAL REGISTRATION Observational Study UMIN000013950; Registered 13 May 2014.
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Affiliation(s)
| | - Tatsuo Kimura
- Department of Respiratory Medicine, Graduate school of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
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Yoshimura N, Mitsuoka S, Yoshimoto N, Nakai T, Oka T, Matsuura K, Kimura T, Kudoh S, Kawaguchi T, Hirata K. Gefitinib and Pemetrexed As a First Line Treatment in Patients with Egfr Mutant Advanced Nsclc: a Phase Ii Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yoshimoto N, Nishiyama T, Yamashita H, Takahashi S, Shiraki N, Sugiura H, Endo Y, Iwasa M, Asano T, Hato Y, Fujii Y, Toyama T. Abstract P5-13-07: Genetic polymorphism of estrogen metabolizing enzyme CYP17A1 rs743572 impacts on serum testosterone level in Japanese premenopausal women. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p5-13-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The incidence of breast cancer in Japanese women has doubled in all age groups over the past two decades. We recently demonstrated that this marked increase is mostly due to an increase in the estrogen receptor (ER)-positive subtype, and we created risk prediction models for ER-positive breast cancer in both pre- and post- menopausal women using genetic factors (single nucleotide polymorphism (SNP)), environmental risk factors, serum hormones and growth factors by logistic regression analysis. Serum level of testosterone, which is the precursor of estradiol in estradiol synthesis, was found to be a risk predictor in both pre- and post- menopausal women. On the other hand, it has been reported that some SNPs, including those of estrogen-related genes such as ESR1 and CYP17A1, are correlated with breast cancer risk by genome-wide association studies. To acquire some insights into this mechanism, we analyzed genetic factors (14 SNPs), serum hormones and growth factors (estradiol, testosterone, prolactin, insulin-like growth factor 1 (IGF1) and IGF binding protein 3 (IGFBP3)) in 913 women with breast cancer and 278 disease-free controls for correlation between them.
Serum testosterone and prolactin levels were significantly higher in ER-positive breast cancer patients than in disease-free controls in both pre- (p<0.0001, p<0.0001) and post- (p<0.0001, p = 0.007) menopausal women, and serum estradiol level was significantly higher in ER-positive breast cancer patients than in disease-free controls only in premenopausal women (p = 0.0005). There were significant differences in serum hormone levels among the women with each SNP genotype (homozygotes of major allele, heterozygotes and homozygotes of minor allele), including testosterone among rs743572 genotype (p = 0.014), estradiol among rs827421 genotype (p = 0.016), IGF-1 among rs6905370 genotype (p = 0.032), and prolactin among rs1042522 genotype (p = 0.035) in premenopausal women, as well as estradiol among rs3803662 genotype (p = 0.027) and IGFBP3 among rs6905370 genotype (p = 0.036) in postmenopausal women. In particular, serum testosterone level was significantly different among the rs743572, which is one of the enzymes that convert testosterone to estradiol, of genotypes (AA: 0.308 +/- 0.180 ng/ml, AG: 0.319 +/- 0.193 ng/ml and GG: 0.380 +/- 0.187 ng/ml, p = 0.014). On the other hand, the rs743572 heterozygotes of CYP17A1 have been reported to have increased breast cancer risk than homozygotes of both the major allele and minor allele in premenopausal women. Further studies are required to clarify this mechanism.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-13-07.
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Affiliation(s)
- N Yoshimoto
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Nagoya City West Medical Center, Nagoya, Aichi, Japan
| | - T Nishiyama
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Nagoya City West Medical Center, Nagoya, Aichi, Japan
| | - H Yamashita
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Nagoya City West Medical Center, Nagoya, Aichi, Japan
| | - S Takahashi
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Nagoya City West Medical Center, Nagoya, Aichi, Japan
| | - N Shiraki
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Nagoya City West Medical Center, Nagoya, Aichi, Japan
| | - H Sugiura
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Nagoya City West Medical Center, Nagoya, Aichi, Japan
| | - Y Endo
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Nagoya City West Medical Center, Nagoya, Aichi, Japan
| | - M Iwasa
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Nagoya City West Medical Center, Nagoya, Aichi, Japan
| | - T Asano
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Nagoya City West Medical Center, Nagoya, Aichi, Japan
| | - Y Hato
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Nagoya City West Medical Center, Nagoya, Aichi, Japan
| | - Y Fujii
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Nagoya City West Medical Center, Nagoya, Aichi, Japan
| | - T Toyama
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Nagoya City West Medical Center, Nagoya, Aichi, Japan
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Toyama T, Asano T, Sato S, Yoshimoto N, Endo Y, Hato Y, Takahashi S, Yamashita H. Abstract P5-05-04: Relationship between plasma estradiol levels and estrogen-regulated gene expressions in premenopausal estrogen receptor-positive breast cancers. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p5-05-04] [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: Estrogen receptor (ER) and progesterone receptor (PgR) expression status in breast cancer are important factors in determining the use of adjuvant therapy. Plasma estradiol (E2) and progesterone vary markedly through the menstrual cycle. Recently, the levels of PgR expression were reported to be correlated with E2 at the time of surgery in Caucasian premenopausal breast cancer patients. Materials and methods: In this study, plasma E2 levels at surgery were examined for correlations with expressions of estrogen-regulated genes (ERGs), including PgR, and proliferation genes in 147 Japanese premenopausal ER-positive breast cancers. Plasma E2 and progesterone, FSH, and LH were measured on the day of surgery by ECLIA and mRNA expressions were analyzed for 4 ERGs (PgR, GREB1, TFF1, PDZK1), 2 progesterone-regulated (RANKL, cyclin D1) and 2 proliferation genes (MKI67, BIRC5) by RT-PCR using the TaqMan system. ER and PgR protein expression levels were estimated by immunohistochemistry. Results: Our results revealed that expressions of PgR mRNA and protein in breast cancer tissues were significantly correlated with plasma E2 levels at surgery (p = 0.005, p = 0.0165, respectively). Other ERGs were also significantly correlated with plasma E2 levels. However, there were no correlations between mRNA expressions of proliferation genes, MKI67 and BIRC5, and plasma E2 levels. Furthermore, mRNA expressions of the progesterone-regulated genes, RANKL and cyclin D1, were significantly correlated with PgR mRNA expression (p<0.0001, p<0.0001, respectively). Discussion: Significant correlations were seen in the expression of ERGs in Japanese ER-positive breast cancers according to the plasma E2 levels, which vary markedly through the menstrual cycle. Our results supported the previous report in Caucasian patients by other group. This variability may affect the interpretation of gene expression profiles incorporating ERGs such as the 21-gene recurrence score.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-05-04.
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Affiliation(s)
- T Toyama
- Immunology & Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - T Asano
- Immunology & Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - S Sato
- Immunology & Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - N Yoshimoto
- Immunology & Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Y Endo
- Immunology & Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Y Hato
- Immunology & Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - S Takahashi
- Immunology & Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - H Yamashita
- Immunology & Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Hokkaido University Hospital, Sapporo, Hokkaido, Japan
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Sasaki O, Nishioka T, Inoue Y, Toyama K, Isshiki A, Ando T, Inokuchi T, Yamaguchi R, Ito H, Yoshimoto N. Renal function is one of the determinant factors of subclinical coronary calcification. An intravascular ultrasound virtual histology study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hagisawa K, Nishioka T, Suzuki R, Maruyama K, Takase B, Ishihara M, Kurita A, Yoshimoto N, Nishida Y, Iida K, Luo H, Siegel RJ. Thrombus-targeted perfluorocarbon-containing liposomal bubbles for enhancement of ultrasonic thrombolysis: in vitro and in vivo study. J Thromb Haemost 2013; 11:1565-73. [PMID: 23773778 DOI: 10.1111/jth.12321] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [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: 12/05/2012] [Accepted: 06/09/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND External low-frequency ultrasound (USD) in combination with microbubbles has been reported to recanalize thrombotically occluded arteries in animal models. OBJECTIVE The purpose of this study was to examine the enhancing effect of thrombus-targeted bubble liposomes (BLs) developed for fresh thrombus imaging during ultrasonic thrombolysis. METHODS In vitro: after the administration of thrombus-targeted BLs or non-targeted BLs, the clot was exposed to low-frequency (27 kHz) USD for 5 min. In vivo: Rabbit iliofemoral arteries were thrombotically occluded, and an intravenous injection of either targeted BLs (n = 22) or non-targeted BLs (n = 22) was delivered. External low-frequency USD (low intensity, 1.4 W cm(-2) , to 12 arteries, and high intensity, 4.0 W cm(-2) , to 10 arteries, for both the targeted BL group and the non-targeted BL group) was applied to the thrombotically occluded arteries for 60 min. In another 10 rabbits, recombinant tissue-type plasminogen activator (rt-PA) was intravenously administered. RESULTS In vitro: the weight reduction rate of the clot with targeted BLs was significantly higher than that of the clot with non-targeted BLs. In vivo: TIMI grade 3 flow was present in a significantly higher number of rabbits with USD and targeted BLs than rabbits with USD and non-targeted BLs, or with rt-PA monotherapy. High-intensity USD exposure with targeted BLs achieved arterial recanalization in 90% of arteries, and the time to reperfusion was shorter than with rt-PA treatment (targeted BLs, 16.7 ± 5.0 min; rt-PA, 41.3 ± 14.4 min). CONCLUSIONS Thrombus-targeted BLs developed for USD thrombus imaging enhance ultrasonic disruption of thrombus both in vitro and in vivo.
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Affiliation(s)
- K Hagisawa
- Department of Physiology, National Defense Medical College, Tokorozawa, Japan
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Yoshimoto N, Nishiyama T, Toyama T, Takahashi S, Shiraki N, Sugiura H, Endo Y, Iwasa M, Asano T, Fujii Y, Yamashita H. Abstract P4-12-06: A mammographic density prediction model using environmental factors, endogenous hormones and growth factors in Japanese women. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p4-12-06] [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
The incidence of breast cancer in Japanese women has doubled in all age groups over the past two decades, making it important to evaluate breast cancer risk factors in Japanese women. It is well known that mammographic density is positively associated with breast cancer risk in Western countries, and mammographic density is known to be affected by some environmental factors, serum hormones, and growth factors. We performed stepwise variable selection in a multiple regression model with fifteen independent variables as described below, based on the Akaike information criteria (AIC) to build a mammographic density prediction model using a dataset of 1191 women (913 women with breast cancer and 278 disease-free controls). The variables included were: environmental risk factors (body-mass index (BMI), age at menarche, pregnancy, age at first birth, breastfeeding, family history of breast cancer, age at menopause, use of hormone replacement therapy, alcohol intake and smoking), serum hormones and growth factors (estradiol, testosterone, prolactin, insulin-like growth factor 1 (IGF1) and IGF binding protein 3 (IGFBP3)) and mammographic density. The resulting prediction model is:
Mammographic density = + 0.000476 (IGF1) −0.0605 (testosterone) − 0.0508 (IGFBP3) − 0.00683 (age) − 0.0175 (BMI) + 0.00883 (age at menarche) − 0.0153 (breast feeding), (R2 = 0.336).
In this model, IGF1, testosterone, IGFBP3, age, BMI, age at menarche, and breastfeeding were considered to be important factors. IGF1 and age at menarche were positively associated with mammographic density, while on the other hand testosterone, IGFBP3, age, BMI, and breast feeding were negatively associated with mammographic density. Further studies are required to build a modified model incorporating serial measurements of serum hormones and growth factors to take into account time-dependent changes of serum hormones and growth factors, and to assess its accuracy.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-12-06.
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Affiliation(s)
- N Yoshimoto
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - T Nishiyama
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - T Toyama
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - S Takahashi
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - N Shiraki
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - H Sugiura
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Y Endo
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - M Iwasa
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - T Asano
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Y Fujii
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - H Yamashita
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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Yoshimoto N, Nishiyama T, Toyama T, Takahashi S, Shiraki N, Sugiura H, Endo Y, Iwasa M, Fujii Y, Yamashita H. P4-10-11: Genetic and Environmental Predictors, Endogenous Hormones and Growth Factors and Risk of Estrogen Receptor-Positive Breast Cancer in Japanese Women. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p4-10-11] [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
The incidence of breast cancer in Japanese women has doubled in all age groups over the past two decades. We have recently demonstrated that this marked increase is mostly due to an increase in the estrogen receptor (ER)-positive subtype. It is necessary to establish risk factors capable of predicting the risk of ER-positive breast cancer which will enable the efficient selection of candidates for preventive chemotherapy. We analyzed genetic factors, including 14 single nucleotide polymorphisms (SNPs), environmental risk factors (body-mass index (BMI), age at menarche, pregnancy, age at first birth, breastfeeding, family history of breast cancer, age at menopause, use of hormone replacement therapy, alcohol intake and smoking), serum hormones and growth factors (estradiol, testosterone, prolactin, insulin-like growth factor 1 (IGF1) and IGF binding protein 3 (IGFBP3)) and mammographic density in 913 women with breast cancer and 278 disease-free controls. To identify important risk factors, risk prediction models for ER-positive breast cancer in both pre- and postmenopausal women were created by logistic regression analysis. In premenopausal women, 1 SNP (CYP19A1-rs10046), age, pregnancy, breastfeeding, alcohol intake, serum levels of prolactin, testosterone and IGFBP3 were considered to be risk predictors. In postmenopausal women, 1 SNP (TP53-rs1042522), age, BMI, age at menopause, serum levels of testosterone and IGF1 were identified as risk predictors. Risk factors may differ between women of different menopausal status, and inclusion of common genetic variants and serum hormone measurements as well as environmental factors might improve risk assessment models. Further validation studies will clarify appropriate risk groups for preventive chemotherapy.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-10-11.
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Affiliation(s)
- N Yoshimoto
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - T Nishiyama
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - T Toyama
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - S Takahashi
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - N Shiraki
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - H Sugiura
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Y Endo
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - M Iwasa
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Y Fujii
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - H Yamashita
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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Toyama T, Kondo N, Endo Y, Sugiura H, Yoshimoto N, Iwasa M, Takahashi S, Iwase H, Fujii Y, Yamashita H. P3-03-01: Low Expression of microRNA-210 Is an Independent Good Prognostic Factor in Japanese Triple-Negative Breast Cancer Patients. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p3-03-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: microRNAs (miRNAs) have emerged as a new class of non-coding genes involved in regulating cell proliferation, differentiation, and viability. Recent studies have identified miR-210 among a set of hypoxia-regulated miRNAs and demonstrated a direct regulatory role of hypoxia-inducible factor-1 alpha (HIF-1 a) in its transcription. High expression of miR-210 has been reported to be a poor prognostic factor in several types of cancers including breast.
Materials and Methods: TaqMan MicroRNA assays for miR-210 expression were performed in 219 breast cancers (58 triple-negative (TNBCs), and 161 ER-positive and HER2−negative). Correlations between miR-210 expression and clinicopathological factors were analyzed. The effects of several variables on survival were tested by Cox proportional hazards regression analysis.
Results: miR-210 expression in TNBCs was significantly higher than in ER-positive and HER2−negative breast cancers (p<0.001). Patients whose TNBCs had low miR-210 expression experienced significantly better disease-free and overall survival compared with high miR-210 expressors (p=0.02 and p=0.05, respectively). Notably, among 40 node-negative TNBCs, 5-year disease-free survival was approximately 60% in patients whose tumors had high or intermediate miR-210 expression (n=26), while no patients with low miR-210 expression (n=14) suffered recurrent disease. Cox univariate and multivariate analyses demonstrated that low expression of miR-210 was an independent good prognostic factor in TNBCs.
Discussion: Although prognosis of patients with TNBCs is poor, those whose tumors expressed low levels of miR-210 had a more favorable prognosis. Thus, the degree of miR-210 expression might be a clinically useful prognostic factor for decision-making regarding treatment in the adjuvant setting, especially in node-negative TNBC patients.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-03-01.
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Affiliation(s)
- T Toyama
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - N Kondo
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Y Endo
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - H Sugiura
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - N Yoshimoto
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - M Iwasa
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - S Takahashi
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - H Iwase
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Y Fujii
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - H Yamashita
- 1Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
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Hosono M, Maeda R, Yoshimoto N, Yamamoto S. Rational Method for Designing Efficient Chromatography Processes based on the Iso-Resolution Curve. Chem Eng Technol 2011. [DOI: 10.1002/ceat.201100356] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Yamashita H, Iwase H, Toyama T, Takahashi S, Sugiura H, Yoshimoto N, Endo Y, Kobayashi S. Abstract P3-13-05: Estrogen Receptor-Positive Breast Cancer in Japanese Women: Trends in Incidence, Characteristics and Prognosis. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p3-13-05] [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: The incidence of breast cancer in Japanese women has doubled in all age groups over the past two decades. Patients and Methods: We examined the characteristics of patients and tumors treated in three time periods between 1982 and 2010. Estrogen receptor (ER), progesterone receptor (PgR), and HER2 status were assessed by immunohistochemistry. Correlation of hormone receptor levels with clinicopathological factors and prognosis was analyzed in ER-positive, HER2-negative breast cancer in two age groups (≥50 years vs. >50 years).
Results: A total of 1903 women with breast cancer, who were treated at Nagoya City University Hospital, were included in this study. The frequency of ER-positive breast cancer in women aged 50 years or younger increased greatly over the interval studied (1982-1991: 52.5%, 1992-2001: 72.6%, 2002-2010: 87.1%, P < 0.0001). The frequency of ER-positive tumors was also significantly increased in women over 50 years of age (1982-1991: 69.4%, 1992-2001: 73.3%, 2002-2010: 78.6%, P = 0.029). In ER-positive, HER2-negative breast cancer, tumor grade was negatively correlated with expression levels of ER (P = 0.0029) and PgR (P < 0.0001). Interestingly, PgR levels were significantly higher in women aged 50 years or younger than in women over 50 years old (P < 0.0001). In both age groups, the prognosis for patients with ER-positive, HER2- negative breast cancer significantly improved over time, due to advances in adjuvant therapies. ER and PgR expression levels were not associated with disease-free survival. Lymph node status and tumor size were strong prognostic factors regardless of the biological characteristics of the tumors in ER-positive, HER2-negative breast cancer in both age groups. Conclusions: It is necessary to establish risk factors, both genetic and environmental, capable of predicting the risk of ER-positive breast cancer and thus enable the efficient selection of candidates for hormone receptor-targeted chemoprevention. Furthermore, new approach should be considered to improve survival for node-positive, ER-positive breast cancer.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-13-05.
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Affiliation(s)
- H Yamashita
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Kumamoto University, Kumamoto, Japan
| | - H Iwase
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Kumamoto University, Kumamoto, Japan
| | - T Toyama
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Kumamoto University, Kumamoto, Japan
| | - S Takahashi
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Kumamoto University, Kumamoto, Japan
| | - H Sugiura
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Kumamoto University, Kumamoto, Japan
| | - N Yoshimoto
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Kumamoto University, Kumamoto, Japan
| | - Y Endo
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Kumamoto University, Kumamoto, Japan
| | - S. Kobayashi
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Kumamoto University, Kumamoto, Japan
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