1
|
Staplin N, Haynes R, Judge PK, Wanner C, Green JB, Emberson J, Preiss D, Mayne KJ, Ng SYA, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Petrini M, Seidi S, Landray MJ, Baigent C, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
Collapse
|
2
|
Judge PK, Staplin N, Mayne KJ, Wanner C, Green JB, Hauske SJ, Emberson JR, Preiss D, Ng SYA, Roddick AJ, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Massey D, Landray MJ, Baigent C, Haynes R, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
Collapse
|
3
|
Nakamura R, Hayama S, Yamamoto N. P122 Clinical impact of fine needle aspiration cytologyon sentinel node biopsy after preoperative chemotherapy for core needle biopsyproven metastatic lymph nodes. Breast 2023. [DOI: 10.1016/s0960-9776(23)00239-4] [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: 03/16/2023] Open
|
4
|
Abe S, Asami S, Eizuka M, Futagi S, Gando A, Gando Y, Gima T, Goto A, Hachiya T, Hata K, Hayashida S, Hosokawa K, Ichimura K, Ieki S, Ikeda H, Inoue K, Ishidoshiro K, Kamei Y, Kawada N, Kishimoto Y, Koga M, Kurasawa M, Maemura N, Mitsui T, Miyake H, Nakahata T, Nakamura K, Nakamura K, Nakamura R, Ozaki H, Sakai T, Sambonsugi H, Shimizu I, Shirai J, Shiraishi K, Suzuki A, Suzuki Y, Takeuchi A, Tamae K, Ueshima K, Watanabe H, Yoshida Y, Obara S, Ichikawa AK, Chernyak D, Kozlov A, Nakamura KZ, Yoshida S, Takemoto Y, Umehara S, Fushimi K, Kotera K, Urano Y, Berger BE, Fujikawa BK, Learned JG, Maricic J, Axani SN, Smolsky J, Fu Z, Winslow LA, Efremenko Y, Karwowski HJ, Markoff DM, Tornow W, Dell'Oro S, O'Donnell T, Detwiler JA, Enomoto S, Decowski MP, Grant C, Li A, Song H. Search for the Majorana Nature of Neutrinos in the Inverted Mass Ordering Region with KamLAND-Zen. Phys Rev Lett 2023; 130:051801. [PMID: 36800472 DOI: 10.1103/physrevlett.130.051801] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/10/2022] [Accepted: 11/29/2022] [Indexed: 06/18/2023]
Abstract
The KamLAND-Zen experiment has provided stringent constraints on the neutrinoless double-beta (0νββ) decay half-life in ^{136}Xe using a xenon-loaded liquid scintillator. We report an improved search using an upgraded detector with almost double the amount of xenon and an ultralow radioactivity container, corresponding to an exposure of 970 kg yr of ^{136}Xe. These new data provide valuable insight into backgrounds, especially from cosmic muon spallation of xenon, and have required the use of novel background rejection techniques. We obtain a lower limit for the 0νββ decay half-life of T_{1/2}^{0ν}>2.3×10^{26} yr at 90% C.L., corresponding to upper limits on the effective Majorana neutrino mass of 36-156 meV using commonly adopted nuclear matrix element calculations.
Collapse
Affiliation(s)
- S Abe
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - S Asami
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - M Eizuka
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - S Futagi
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - A Gando
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - Y Gando
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - T Gima
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - A Goto
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - T Hachiya
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Hata
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - S Hayashida
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Hosokawa
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Ichimura
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - S Ieki
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - H Ikeda
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Inoue
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Ishidoshiro
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - Y Kamei
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - N Kawada
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - Y Kishimoto
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M Koga
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M Kurasawa
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - N Maemura
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - T Mitsui
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - H Miyake
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - T Nakahata
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Nakamura
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Nakamura
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - R Nakamura
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - H Ozaki
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
- Graduate Program on Physics for the Universe, Tohoku University, Sendai 980-8578, Japan
| | - T Sakai
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - H Sambonsugi
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - I Shimizu
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - J Shirai
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Shiraishi
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - A Suzuki
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - Y Suzuki
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - A Takeuchi
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Tamae
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Ueshima
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - H Watanabe
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - Y Yoshida
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - S Obara
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai 980-8578, Japan
| | - A K Ichikawa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - D Chernyak
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - A Kozlov
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Z Nakamura
- Kyoto University, Department of Physics, Kyoto 606-8502, Japan
| | - S Yoshida
- Graduate School of Science, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - Y Takemoto
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - S Umehara
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - K Fushimi
- Department of Physics, Tokushima University, Tokushima 770-8506, Japan
| | - K Kotera
- Graduate School of Integrated Arts and Sciences, Tokushima University, Tokushima 770-8502, Japan
| | - Y Urano
- Graduate School of Integrated Arts and Sciences, Tokushima University, Tokushima 770-8502, Japan
| | - B E Berger
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B K Fujikawa
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J G Learned
- Department of Physics and Astronomy, University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA
| | - J Maricic
- Department of Physics and Astronomy, University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA
| | - S N Axani
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J Smolsky
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Z Fu
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - L A Winslow
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Y Efremenko
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - H J Karwowski
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA; Physics Departments at Duke University, Durham, North Carolina 27708, USA; North Carolina Central University, Durham, North Carolina 27707, USA; and The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - D M Markoff
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA; Physics Departments at Duke University, Durham, North Carolina 27708, USA; North Carolina Central University, Durham, North Carolina 27707, USA; and The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - W Tornow
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA; Physics Departments at Duke University, Durham, North Carolina 27708, USA; North Carolina Central University, Durham, North Carolina 27707, USA; and The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - S Dell'Oro
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - T O'Donnell
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - J A Detwiler
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - S Enomoto
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - M P Decowski
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Nikhef and the University of Amsterdam, Science Park, Amsterdam, Netherlands
| | - C Grant
- Boston University, Boston, Massachusetts 02215, USA
| | - A Li
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA; Physics Departments at Duke University, Durham, North Carolina 27708, USA; North Carolina Central University, Durham, North Carolina 27707, USA; and The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
- Boston University, Boston, Massachusetts 02215, USA
| | - H Song
- Boston University, Boston, Massachusetts 02215, USA
| |
Collapse
|
5
|
Alho M, Battarbee M, Pfau‐Kempf Y, Khotyaintsev YV, Nakamura R, Cozzani G, Ganse U, Turc L, Johlander A, Horaites K, Tarvus V, Zhou H, Grandin M, Dubart M, Papadakis K, Suni J, George H, Bussov M, Palmroth M. Electron Signatures of Reconnection in a Global eVlasiator Simulation. Geophys Res Lett 2022; 49:e2022GL098329. [PMID: 36249284 PMCID: PMC9541212 DOI: 10.1029/2022gl098329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/13/2022] [Accepted: 06/02/2022] [Indexed: 06/16/2023]
Abstract
Geospace plasma simulations have progressed toward more realistic descriptions of the solar wind-magnetosphere interaction from magnetohydrodynamic to hybrid ion-kinetic, such as the state-of-the-art Vlasiator model. Despite computational advances, electron scales have been out of reach in a global setting. eVlasiator, a novel Vlasiator submodule, shows for the first time how electromagnetic fields driven by global hybrid-ion kinetics influence electrons, resulting in kinetic signatures. We analyze simulated electron distributions associated with reconnection sites and compare them with Magnetospheric Multiscale (MMS) spacecraft observations. Comparison with MMS shows that key electron features, such as reconnection inflows, heated outflows, flat-top distributions, and bidirectional streaming, are in remarkable agreement. Thus, we show that many reconnection-related features can be reproduced despite strongly truncated electron physics and an ion-scale spatial resolution. Ion-scale dynamics and ion-driven magnetic fields are shown to be significantly responsible for the environment that produces electron dynamics observed by spacecraft in near-Earth plasmas.
Collapse
Affiliation(s)
- M. Alho
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - M. Battarbee
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - Y. Pfau‐Kempf
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | | | - R. Nakamura
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| | - G. Cozzani
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - U. Ganse
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - L. Turc
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - A. Johlander
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
- Swedish Institute of Space PhysicsUppsalaSweden
| | - K. Horaites
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - V. Tarvus
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - H. Zhou
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - M. Grandin
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - M. Dubart
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - K. Papadakis
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - J. Suni
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - H. George
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - M. Bussov
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - M. Palmroth
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
- Finnish Meteorological InstituteHelsinkiFinland
| |
Collapse
|
6
|
Hasegawa H, Denton RE, Nakamura TKM, Genestreti KJ, Phan TD, Nakamura R, Hwang K, Ahmadi N, Shi QQ, Hesse M, Burch JL, Webster JM, Torbert RB, Giles BL, Gershman DJ, Russell CT, Strangeway RJ, Wei HY, Lindqvist P, Khotyaintsev YV, Ergun RE, Saito Y. Magnetic Field Annihilation in a Magnetotail Electron Diffusion Region With Electron-Scale Magnetic Island. J Geophys Res Space Phys 2022; 127:e2022JA030408. [PMID: 36248013 PMCID: PMC9541864 DOI: 10.1029/2022ja030408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/27/2022] [Accepted: 06/20/2022] [Indexed: 06/16/2023]
Abstract
We present observations in Earth's magnetotail by the Magnetospheric Multiscale spacecraft that are consistent with magnetic field annihilation, rather than magnetic topology change, causing fast magnetic-to-electron energy conversion in an electron-scale current sheet. Multi-spacecraft analysis for the magnetic field reconstruction shows that an electron-scale magnetic island was embedded in the observed electron diffusion region (EDR), suggesting an elongated shape of the EDR. Evidence for the annihilation was revealed in the form of the island growing at a rate much lower than expected for the standard X-type geometry of the EDR, which indicates that magnetic flux injected into the EDR was not ejected from the X-point or accumulated in the island, but was dissipated in the EDR. This energy conversion process is in contrast to that in the standard EDR of a reconnecting current sheet where the energy of antiparallel magnetic fields is mostly converted to electron bulk-flow energy. Fully kinetic simulation also demonstrates that an elongated EDR is subject to the formation of electron-scale magnetic islands in which fast but transient annihilation can occur. Consistent with the observations and simulation, theoretical analysis shows that fast magnetic diffusion can occur in an elongated EDR in the presence of nongyrotropic electron effects. We suggest that the annihilation in elongated EDRs may contribute to the dissipation of magnetic energy in a turbulent collisionless plasma.
Collapse
Affiliation(s)
- H. Hasegawa
- Institute of Space and Astronautical ScienceJapan Aerospace Exploration AgencySagamiharaJapan
| | - R. E. Denton
- Department of Physics and AstronomyDartmouth CollegeHanoverNHUSA
| | - T. K. M. Nakamura
- Space Research InstituteAustrian Academy of SciencesGrazAustria
- Institute of PhysicsUniversity of GrazGrazAustria
| | | | - T. D. Phan
- Space Sciences LaboratoryUniversity of CaliforniaBerkeleyCAUSA
| | - R. Nakamura
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| | - K.‐J. Hwang
- Southwest Research InstituteSan AntonioTXUSA
| | - N. Ahmadi
- Laboratory for Atmospheric and Space PhysicsUniversity of ColoradoBoulderCOUSA
| | - Q. Q. Shi
- Shandong Provincial Key Laboratory of Optical Astronomy and Solar‐Terrestrial EnvironmentInstitute of Space SciencesShandong UniversityWeihaiChina
| | - M. Hesse
- NASA Ames Research CenterMoffett FieldCAUSA
| | - J. L. Burch
- Southwest Research InstituteSan AntonioTXUSA
| | | | - R. B. Torbert
- Institute of PhysicsUniversity of GrazGrazAustria
- Physics DepartmentUniversity of New HampshireDurhamNHUSA
| | - B. L. Giles
- NASA Goddard Space Flight CenterGreenbeltMDUSA
| | | | - C. T. Russell
- Department of Earth, Planetary, and Space SciencesUniversity of CaliforniaLos AngelesCAUSA
| | - R. J. Strangeway
- Department of Earth, Planetary, and Space SciencesUniversity of CaliforniaLos AngelesCAUSA
| | - H. Y. Wei
- Department of Earth, Planetary, and Space SciencesUniversity of CaliforniaLos AngelesCAUSA
| | | | | | - R. E. Ergun
- Department of Astrophysical and Planetary SciencesUniversity of ColoradoBoulderCOUSA
| | - Y. Saito
- Institute of Space and Astronautical ScienceJapan Aerospace Exploration AgencySagamiharaJapan
| |
Collapse
|
7
|
Sekiguchi Y, Kumamoto Y, Nakamura R, Minami K, Fujii M. Basic research to determine normal levels of androgens (testosterone, free testosterone, DHEA-S) in Japanese middle-aged women. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.596] [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]
|
8
|
Cozzani G, Khotyaintsev YV, Graham DB, Egedal J, André M, Vaivads A, Alexandrova A, Le Contel O, Nakamura R, Fuselier SA, Russell CT, Burch JL. Structure of a Perturbed Magnetic Reconnection Electron Diffusion Region in the Earth's Magnetotail. Phys Rev Lett 2021; 127:215101. [PMID: 34860109 DOI: 10.1103/physrevlett.127.215101] [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] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/22/2021] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
We report in situ observations of an electron diffusion region (EDR) and adjacent separatrix region in the Earth's magnetotail. We observe significant magnetic field oscillations near the lower hybrid frequency which propagate perpendicularly to the reconnection plane. We also find that the strong electron-scale gradients close to the EDR exhibit significant oscillations at a similar frequency. Such oscillations are not expected for a crossing of a steady 2D EDR, and can be explained by a complex motion of the reconnection plane induced by current sheet kinking propagating in the out-of-reconnection-plane direction. Thus, all three spatial dimensions have to be taken into account to explain the observed perturbed EDR crossing. These results shed light on the interplay between magnetic reconnection and current sheet drift instabilities in electron-scale current sheets and highlight the need for adopting a 3D description of the EDR, going beyond the two-dimensional and steady-state conception of reconnection.
Collapse
Affiliation(s)
- G Cozzani
- Swedish Institute of Space Physics, Uppsala 75121, Sweden
| | | | - D B Graham
- Swedish Institute of Space Physics, Uppsala 75121, Sweden
| | - J Egedal
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M André
- Swedish Institute of Space Physics, Uppsala 75121, Sweden
| | - A Vaivads
- Space and Plasma Physics, School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, Stockholm 11428, Sweden
| | - A Alexandrova
- Laboratoire de Physique des Plasmas, CNRS, Sorbonne Université, Université Paris-Saclay, Observatoire de Paris, École Polytechnique Institut Polytechnique de Paris, Palaiseau 91128, France
| | - O Le Contel
- Laboratoire de Physique des Plasmas, CNRS, Sorbonne Université, Université Paris-Saclay, Observatoire de Paris, École Polytechnique Institut Polytechnique de Paris, Palaiseau 91128, France
| | - R Nakamura
- Space Research Institute, Austrian Academy of Sciences, Graz 8042, Austria
| | - S A Fuselier
- Southwest Research Institute, San Antonio, Texas 78238, USA
- University of Texas at San Antonio, San Antonio, Texas 78249, USA
| | - C T Russell
- University of California, Los Angeles, California 90095, USA
| | - J L Burch
- Southwest Research Institute, San Antonio, Texas 78238, USA
| |
Collapse
|
9
|
Stein A, Al Malki M, Yang D, Liu A, Han C, Palmer J, Dandapani S, Farol L, Hui S, Marcucci G, Nakamura R, Pullarkat V, Rosenthal J, Salhotra A, Spielberger R, Forman S, Wong J. Total Marrow and Lymphoid Irradiation to 20 Gy Combined With Post-Transplant Cyclophosphamide Graft vs. Host Disease (GvHD) Prophylaxis is Associated With Low Non-Relapse Mortality Rates and Favorable GvHD-Free/Relapse-Free Survival in AML. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
10
|
Inoue H, Sekiguchi Y, Nakamura R. Can the mini-sling become the golden standard for treating stress urinary incontinence? Comment: The TFS retropubic tensioned minisling for SUI-a 14 year experience with high long-term RCT cure. Int Urogynecol J 2021; 32:2877-2878. [PMID: 34287656 PMCID: PMC8455488 DOI: 10.1007/s00192-021-04922-8] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/19/2021] [Indexed: 11/29/2022]
Affiliation(s)
- H Inoue
- Department of Obstetrics and Gynecology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan.
| | - Y Sekiguchi
- LUNA Pelvic Floor Total Support Clinic, Women's Clinic LUNA Group, Yokohama, Japan
| | - R Nakamura
- LUNA Pelvic Floor Total Support Clinic, Women's Clinic LUNA Group, Yokohama, Japan
| |
Collapse
|
11
|
de Almeida CÁ, Guarçoni S, Leverone A, Nakamura R, Canella C. Characterization of nail changes in alopecia areata using 33-MHz ultrasonography. Clin Exp Dermatol 2021; 46:1108-1109. [PMID: 33665814 DOI: 10.1111/ced.14630] [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] [Received: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - S Guarçoni
- Alta Excelência Diagnóstica, Rio de Janeiro, Brazil
| | - A Leverone
- Professor Rubem David Azulay Institute of Dermatology, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - R Nakamura
- Professor Rubem David Azulay Institute of Dermatology, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - C Canella
- Alta Excelência Diagnóstica, Rio de Janeiro, Brazil.,Universidade Federal Fluminense, Niterói, Brazil
| |
Collapse
|
12
|
Yamasaki T, Hattori T, Kakita K, Oota K, Miyai N, Nakamura R, Sawanishi T, Kinoshita N. Quantitative analysis of the isolation area after larger-size laser balloon ablation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0616] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The visually guided laser balloon ablation is a balloon-based catheter ablation technology used for atrial fibrillation (AF) ablation in recent years. This balloon catheter consists of a compliant balloon that has the capability of real-time endoscopic visualization of the targeted pulmonary vein (PV). The sizeable balloon is usually inflated to obtain optimal PV occlusion. The isolation area after laser balloon (LB) ablation was reported to be smaller than that after cryoballoon ablation. However, when LB is inflated with its maximum pressure, it can visualize wide-area PV antrum. Thereby, we suspected that larger-size LB can create wider isolation area.
Purpose
The aim of this study is to quantitatively evaluate the isolation area after LB ablation at the size larger than appropriate size for ablation in the pulmonary vein carina region.
Methods
We assessed 66 patients with AF who underwent LB ablation at the larger inflation size in our hospital during the period from July 2018 to July 2019. After LB ablation, we created voltage maps with a circular mapping catheter and calculated isolation areas with CARTO system.
Results
Figure shows a larger LB with its maximum pressure. PV antrum isolation was extended to the posterior wall in all patients. The left- and right-sided pulmonary vein antrum isolation area were 15.1±3.9 and 19.4±4.3 cm2, respectively.
Conclusion
LB at the larger inflation size with its maximum pressure can isolate wider-area circumferential PV antrum than previously reported. This method may be a new way of pulmonary vein antrum isolation.
Left atrial voltage mapping after PVI.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- T Yamasaki
- Takeda Hospital, Cardiac Arrhythmia, Kyoto, Japan
| | - T Hattori
- Takeda Hospital, Cardiac Arrhythmia, Kyoto, Japan
| | - K Kakita
- Takeda Hospital, Cardiac Arrhythmia, Kyoto, Japan
| | - K Oota
- Takeda Hospital, Cardiology, Kyoto, Japan
| | - N Miyai
- Takeda Hospital, Cardiology, Kyoto, Japan
| | - R Nakamura
- Takeda Hospital, Cardiology, Kyoto, Japan
| | | | | |
Collapse
|
13
|
Wong J, Tsai N, Han C, Palmer J, Liu A, Al Malki M, Dandapani S, Radany E, Salhotra A, Nakamura R, Hui S, Rosenthal J, Forman S, Stein A. Phase II Study of Dose Escalated Total Marrow and Lymphoid Irradiation (TMLI) in Combination with Cyclophosphamide and Etoposide in Patients with Poor-Risk Acute Leukemia. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
14
|
Nakamura TKM, Plaschke F, Hasegawa H, Liu Y, Hwang K, Blasl KA, Nakamura R. Decay of Kelvin-Helmholtz Vortices at the Earth's Magnetopause Under Pure Southward IMF Conditions. Geophys Res Lett 2020; 47:e2020GL087574. [PMID: 32999512 PMCID: PMC7507125 DOI: 10.1029/2020gl087574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/20/2020] [Accepted: 06/05/2020] [Indexed: 06/11/2023]
Abstract
At the Earth's low-latitude magnetopause, clear signatures of the Kelvin-Helmholtz (KH) waves have been frequently observed during periods of the northward interplanetary magnetic field (IMF), whereas these signatures have been much less frequently observed during the southward IMF. Here, we performed the first 3-D fully kinetic simulation of the magnetopause KH instability under the southward IMF condition. The simulation demonstrates that fast magnetic reconnection is induced at multiple locations along the vortex edge in an early nonlinear growth phase of the instability. The reconnection outflow jets significantly disrupt the flow of the nonlinear KH vortex, while the disrupted turbulent flow strongly bends and twists the reconnected field lines. The resulting coupling of the complex field and flow patterns within the magnetopause boundary layer leads to a quick decay of the vortex structure, which may explain the difference in the observation probability of KH waves between northward and southward IMF conditions.
Collapse
Affiliation(s)
| | - F. Plaschke
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| | - H. Hasegawa
- Institute of Space and Astronautical ScienceJapan Aerospace Exploration AgencySagamiharaJapan
| | - Y.‐H. Liu
- Department of Physics and AstronomyDartmouth CollegeHanoverNHUSA
| | - K.‐J. Hwang
- Southwest Research InstituteSan AntonioTXUSA
| | - K. A. Blasl
- Space Research InstituteAustrian Academy of SciencesGrazAustria
- Institute of PhysicsUniversity of GrazGrazAustria
| | - R. Nakamura
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| |
Collapse
|
15
|
Chen LJ, Wang S, Le Contel O, Rager A, Hesse M, Drake J, Dorelli J, Ng J, Bessho N, Graham D, Wilson LB, Moore T, Giles B, Paterson W, Lavraud B, Genestreti K, Nakamura R, Khotyaintsev YV, Ergun RE, Torbert RB, Burch J, Pollock C, Russell CT, Lindqvist PA, Avanov L. Lower-Hybrid Drift Waves Driving Electron Nongyrotropic Heating and Vortical Flows in a Magnetic Reconnection Layer. Phys Rev Lett 2020; 125:025103. [PMID: 32701350 DOI: 10.1103/physrevlett.125.025103] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
We report measurements of lower-hybrid drift waves driving electron heating and vortical flows in an electron-scale reconnection layer under a guide field. Electrons accelerated by the electrostatic potential of the waves exhibit perpendicular and nongyrotropic heating. The vortical flows generate magnetic field perturbations comparable to the guide field magnitude. The measurements reveal a new regime of electron-wave interaction and how this interaction modifies the electron dynamics in the reconnection layer.
Collapse
Affiliation(s)
- L-J Chen
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - S Wang
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
- University of Maryland, College Park, Maryland 20747, USA
| | - O Le Contel
- CNRS/Ecole Polytechnique/Sorbonne Université/Univ. Paris Sud/Observatoire de Paris, Paris F91128, France
| | - A Rager
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - M Hesse
- University of Bergen, Bergen 5020, Norway
| | - J Drake
- University of Maryland, College Park, Maryland 20747, USA
| | - J Dorelli
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - J Ng
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
- University of Maryland, College Park, Maryland 20747, USA
| | - N Bessho
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
- University of Maryland, College Park, Maryland 20747, USA
| | - D Graham
- Swedish Institute of Space Physics, Uppsala SE-75121, Sweden
| | - Lynn B Wilson
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - T Moore
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - B Giles
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - W Paterson
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - B Lavraud
- Institut de Recherche en Astrophysique et Planétologie, Université de Toulouse (UPS), CNRS, CNES, Toulouse 31027 Cedex 4, France
| | - K Genestreti
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - R Nakamura
- Space Research Institute, Austrian Academy of Sciences, Graz A-8042, Austria
| | | | - R E Ergun
- University of Colorado, Boulder, Colorado 80305, USA
| | - R B Torbert
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - J Burch
- Southwest Research Institute, San Antonio, Texas 78238, USA
| | - C Pollock
- Denali Scientific, Healy, Alaska 99743, USA
| | - C T Russell
- University of California, Los Angeles, Los Angeles, California 90095, USA
| | - P-A Lindqvist
- KTH Royal Institute of Technology, Stockholm SE-11428, Sweden
| | - L Avanov
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
- University of Maryland, College Park, Maryland 20747, USA
| |
Collapse
|
16
|
Ninomiya N, Nakamura R, Sekiguchi Y, Nakatani T. 065 Vulvar Findings in GSM Patients Correlate with Severity of Overactive Bladder. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.301] [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: 11/29/2022]
|
17
|
Sekiguchi Y, Nakamura R, Ninomiya N. 071 Estradiol does not Increase with Low-dose Testosterone Replacement in Women after Menopause. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.307] [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: 10/23/2022]
|
18
|
Matsuda S, Kawakubo H, Takeuchi H, Hayashi M, Mayanagi S, Takemura R, Irino T, Fukuda K, Nakamura R, Wada N, Kitagawa Y. Minimally invasive oesophagectomy with extended lymph node dissection and thoracic duct resection for early-stage oesophageal squamous cell carcinoma. Br J Surg 2020; 107:705-711. [PMID: 32077101 DOI: 10.1002/bjs.11487] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/05/2019] [Accepted: 12/02/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Oesophageal squamous cell carcinoma is an aggressive disease owing to early and widespread lymph node metastases. Multimodal therapy and radical surgery may improve prognosis. Few studies have investigated the efficacy of radical lymph node and thoracic duct resection. METHODS Patients with oesophageal squamous cell carcinoma who underwent transthoracic minimally invasive oesophagectomy (TMIE) for cancer at Keio University Hospital between January 2004 and December 2016 were selected. Between 2004 and 2008, TMIE was performed in the lateral decubitus position without thoracic duct resection (standard TMIE). From 2009 onwards, TMIE with extended lymph node and thoracic duct resection was introduced (extended TMIE). Demographics, co-morbidity, number of retrieved lymph nodes, pathology, postoperative complications and recurrence-free survival (RFS) were compared between groups. RESULTS Forty-four patients underwent standard TMIE and 191 extended TMIE. There were no significant differences in clinical and pathological tumour stage or postoperative complications. The extended-TMIE group had more lymph nodes removed at nodal stations 106recL and 112. Among patients with cT1 N0 disease, RFS was better in the extended-TMIE group (P < 0·001), whereas there was no difference in RFS between groups in patients with advanced disease. CONCLUSION Extended TMIE including thoracic duct resection increased the number of lymph nodes retrieved and was associated with improved survival in patients with cT1 N0 oesophageal squamous cell carcinoma.
Collapse
Affiliation(s)
- S Matsuda
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - H Kawakubo
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - H Takeuchi
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - M Hayashi
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - S Mayanagi
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - R Takemura
- Biostatistics Unit, Clinical and Translational Research Centre, Keio University Hospital, Tokyo, Japan
| | - T Irino
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - K Fukuda
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - R Nakamura
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - N Wada
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| | - Y Kitagawa
- Department of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan
| |
Collapse
|
19
|
Nakamura TKM, Umeda T, Nakamura R, Fu HS, Oka M. Disturbance of the Front Region of Magnetic Reconnection Outflow Jets due to the Lower-Hybrid Drift Instability. Phys Rev Lett 2019; 123:235101. [PMID: 31868466 DOI: 10.1103/physrevlett.123.235101] [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] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 09/02/2019] [Indexed: 06/10/2023]
Abstract
A 3D fully kinetic simulation shows that the lower-hybrid drift instability disturbs the front of magnetic reconnection outflow jets and additionally causes energy dissipation. The result is very consistent with a disturbance observed at the dipolarization front (DF) in Earth's magnetotail by the Magnetospheric Multiscale (MMS) mission. A fully kinetic dispersion relation solver, validated by the MMS observations, further predicts that the disturbance of the reconnection jet front could occur over different parameter regimes in space plasmas including Earth's DF and solar flares.
Collapse
Affiliation(s)
- T K M Nakamura
- Space Research Institute, Austrian Academy of Sciences, Graz 8042, Austria
| | - T Umeda
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya 464-8601, Japan
| | - R Nakamura
- Space Research Institute, Austrian Academy of Sciences, Graz 8042, Austria
| | - H S Fu
- School of Space and Environment, Beihang University, Beijing 100083, China
| | - M Oka
- Space Sciences Laboratory, University of California, Berkeley, California 94720, USA
| |
Collapse
|
20
|
Ohara Y, Yabuki A, Nakamura R, Ichii O, Mizukawa H, Yokoyama N, Yamato O. Renal Infiltration of Macrophages in Canine and Feline Chronic Kidney Disease. J Comp Pathol 2019; 170:53-59. [PMID: 31375159 DOI: 10.1016/j.jcpa.2019.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/09/2019] [Accepted: 05/13/2019] [Indexed: 12/21/2022]
Abstract
During the progression of chronic kidney disease (CKD), macrophage infiltration is a crucial event leading to tubulointerstitial fibrosis. In the present study, macrophages infiltrating renal tissue in dogs and cats with CKD were analysed immunohistochemically. Iba-1 was used as a pan-macrophage marker, CD204 was used as a marker of M2 macrophages and tumour necrosis factor (TNF)-α was used as a marker of M1 macrophages. Signals for Iba1 and CD204 were observed in the interstitium of all tested kidney samples. In dogs, the signals were diffusely scattered. In cats, both diffuse and focal signals were observed. Cells that were positive for Iba1 and CD204 were also observed in the tubular lumina in cats. Co-expression of Iba1 and CD204 was also observed in the infiltrating cells by immunofluorescence labelling, and these cells were negative for TNF-α. By quantitative analysis, the indices for Iba1- and CD204-positive cells were significantly correlated with the concentrations of plasma creatinine and/or urea and the extent of interstitial fibrosis in both dogs and cats. These results demonstrated that renal infiltration of M2 macrophages plays an important role in the progression of CKD in dogs and cats. The distribution pattern of the kidney-infiltrating macrophages was unique in cats and may be associated with a cat-specific renal fibrotic process.
Collapse
Affiliation(s)
- Y Ohara
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima
| | - A Yabuki
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima.
| | - R Nakamura
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima
| | - O Ichii
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo
| | - H Mizukawa
- Laboratory of Environmental Analytical Chemistry, Department of Science and Technology for Biological Resources and Environment, Graduate School of Agriculture, Ehime University, Matsuyama
| | - N Yokoyama
- Laboratory of Veterinary Internal Medicine, Department of Clinical Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - O Yamato
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima
| |
Collapse
|
21
|
Ninomiya N, Obayashi M, Nakamura R, Sekiguchi Y. 096 Effect of CO2 Fractional Laser on Female Lower Urinary Tract Symptoms by Genitourinary Syndrome of Menopause. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.535] [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: 12/01/2022]
|
22
|
Cozzani G, Retinò A, Califano F, Alexandrova A, Le Contel O, Khotyaintsev Y, Vaivads A, Fu HS, Catapano F, Breuillard H, Ahmadi N, Lindqvist PA, Ergun RE, Torbert RB, Giles BL, Russell CT, Nakamura R, Fuselier S, Mauk BH, Moore T, Burch JL. In situ spacecraft observations of a structured electron diffusion region during magnetopause reconnection. Phys Rev E 2019; 99:043204. [PMID: 31108651 DOI: 10.1103/physreve.99.043204] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Indexed: 11/07/2022]
Abstract
The electron diffusion region (EDR) is the region where magnetic reconnection is initiated and electrons are energized. Because of experimental difficulties, the structure of the EDR is still poorly understood. A key question is whether the EDR has a homogeneous or patchy structure. Here we report Magnetospheric Multiscale (MMS) spacecraft observations providing evidence of inhomogeneous current densities and energy conversion over a few electron inertial lengths within an EDR at the terrestrial magnetopause, suggesting that the EDR can be rather structured. These inhomogenenities are revealed through multipoint measurements because the spacecraft separation is comparable to a few electron inertial lengths, allowing the entire MMS tetrahedron to be within the EDR most of the time. These observations are consistent with recent high-resolution and low-noise kinetic simulations.
Collapse
Affiliation(s)
- Giulia Cozzani
- Laboratoire de Physique des Plasmas, CNRS/Ecole Polytechnique/Sorbonne Université, Université Paris Sud, Observatoire de Paris, 91128 Palaiseau, France.,Dipartimento di Fisica "E. Fermi", Università di Pisa, I-56127 Pisa, Italy
| | - A Retinò
- Laboratoire de Physique des Plasmas, CNRS/Ecole Polytechnique/Sorbonne Université, Université Paris Sud, Observatoire de Paris, 91128 Palaiseau, France
| | - F Califano
- Dipartimento di Fisica "E. Fermi", Università di Pisa, I-56127 Pisa, Italy
| | - A Alexandrova
- Laboratoire de Physique des Plasmas, CNRS/Ecole Polytechnique/Sorbonne Université, Université Paris Sud, Observatoire de Paris, 91128 Palaiseau, France
| | - O Le Contel
- Laboratoire de Physique des Plasmas, CNRS/Ecole Polytechnique/Sorbonne Université, Université Paris Sud, Observatoire de Paris, 91128 Palaiseau, France
| | - Y Khotyaintsev
- Swedish Institute of Space Physics, SE-75121 Uppsala, Sweden
| | - A Vaivads
- Swedish Institute of Space Physics, SE-75121 Uppsala, Sweden
| | - H S Fu
- School of Space and Environment, Beihang University, Beijing, 100083, P.R. China
| | - F Catapano
- Laboratoire de Physique des Plasmas, CNRS/Ecole Polytechnique/Sorbonne Université, Université Paris Sud, Observatoire de Paris, 91128 Palaiseau, France.,Dipartimento di Fisica, Università della Calabria, I-87036, Arcavacata di Rende (CS), Italy
| | - H Breuillard
- Laboratoire de Physique des Plasmas, CNRS/Ecole Polytechnique/Sorbonne Université, Université Paris Sud, Observatoire de Paris, 91128 Palaiseau, France.,Laboratoire de Physique et Chimie de l'Environnement et de l'Espace, CNRS-Université d'Orléans, UMR 7328, 45071 Orléans, France
| | - N Ahmadi
- Laboratory of Atmospheric and Space Physics, University of Colorado Boulder, Boulder, Colorado 80309, USA
| | - P-A Lindqvist
- KTH Royal Institute of Technology, SE-10044, Stockholm, Sweden
| | - R E Ergun
- Laboratory of Atmospheric and Space Physics, University of Colorado Boulder, Boulder, Colorado 80309, USA
| | - R B Torbert
- Space Science Center, University of New Hampshire, Durham, New Hampshire 03824, USA
| | - B L Giles
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - C T Russell
- Department of Earth and Space Sciences, University of California, Los Angeles, California 90095, USA
| | - R Nakamura
- Space Research Institute, Austrian Academy of Sciences, 8042 Graz, Austria
| | - S Fuselier
- Southwest Research Institute, San Antonio, Texas 78238, USA.,University of Texas at San Antonio, San Antonio, Texas 78238, USA
| | - B H Mauk
- The Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland 20723, USA
| | - T Moore
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - J L Burch
- Southwest Research Institute, San Antonio, Texas 78238, USA
| |
Collapse
|
23
|
Sasaki T, Konno M, Hasegawa Y, Imaji A, Terabaru M, Nakamura R, Ohira N, Matsukura K, Seiwa K. Role of mycorrhizal associations in tree spatial distribution patterns based on size class in an old-growth forest. Oecologia 2019; 189:971-980. [DOI: 10.1007/s00442-019-04376-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 03/04/2019] [Indexed: 11/29/2022]
|
24
|
Nakamura R, Yamamoto N, Miyaki T, Itami M. Abstract P3-03-22: Prognostic impact of axillary lymph node status after neoadjuvant chemotherapy for patients with breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-03-22] [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:
Patients were stratified by final pathological axillary status: ypN0, ypN1, pN0 or pN1.
The prognostic impact of lymph node involvement after neoadjuvant chemotherapy (NAC) for breast cancer is not straightforward. The aim of this study was to compare overall survival (OS) between pathologically
node-positive T1,T2 T3 breast cancer patients treated with NAC, with ypN0 or ypN1 and those treated without NAC with pN0 or pN1.
METHODS:
A total of 3903 consecutive patients with operable breast cancer were prospectively identified at our institution between April 2006 and December 2017. Patients with suspicious axillary LN of breast cancer were assessed using preoperative imaging, underwent fine-needle aspiration cytology or core needle biopsy.
The patients in this study were divided into four groups as follows: the ER(+), the ER(+)/HER2(+) , the HER2(+) and the Triple negative (TN) group.
We evaluate the prognostic impact of the ypN0, ypN1 (with one to three positive lymph nodes after NAC), pN0 and pN1 with no NAC.
The main outcome measures DFS and OS were analyzed using Kaplan–Meier survival analysis.
Result
A number of 270 and 3633 patients were included for NAC and non NAC, respectively. Pathologic nodal status was ypN0 in 58%, ypN1 in 42% for NAC and pN0 in 76%, pN1 in 24% of patients for non NAC.
Overall, 10-year DFS and OS was 81%, 93% in ypN0, 67%, 80% in ypN1, in 90%, 97%, in pN0 and 83%, 94% in pN1 (p <0.001).
In subgroup analysis, 10-year DFS of ypN0, ypN1, pN0 and pN1 was 86%,77%,95% and 80% in the ER group, 91%,56%,93%,and 76% in the ER/HER2 group,89%,55%,91% and 80% in the HER2 group, 85%,59%,92% and 80% in the TN group.
10 years DFS for the ER group were significantly different between ypN0 and pN0 (HR, 2.42 (1.03–4.86, p = 0.04) but were not significantly different between ypN0 and pN0 for the ER/HER2 group (HR 3.58 (0.2–6.88, p = 0.66), for the HER2 group (HR 2.6 (0.78–7.65, p = 0.10) and for the TN group (HR 1.22(0.56–2.38, p = 0.58), respectively).
In all group, DFS for ypN1 was inferior to ypN0.
Conclusions
In the ER group treated with NAC, DFS for ypN0 be inferior to pN0 with adjuvant treatment. In the HER2, the ERHER2 and the TN group treated with NAC, ypN0 is similar to pN0 with adjuvant chemotherapy.
Axillary nodal status ypN1 in each subgroup is associated with a less favorable prognosis compared to ypN0. In conclusion, the HER2 or TN group is highest for predicting ypN0, shown to be most prognostic of long-term survival similar to the patients with pN0. They could be omitted the axillary dissection.
Citation Format: Nakamura R, Yamamoto N, Miyaki T, Itami M. Prognostic impact of axillary lymph node status after neoadjuvant chemotherapy for patients with breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-22.
Collapse
Affiliation(s)
| | | | - T Miyaki
- Chiba Cancer Center, Chiba, Japan
| | - M Itami
- Chiba Cancer Center, Chiba, Japan
| |
Collapse
|
25
|
Torbert RB, Burch JL, Phan TD, Hesse M, Argall MR, Shuster J, Ergun RE, Alm L, Nakamura R, Genestreti KJ, Gershman DJ, Paterson WR, Turner DL, Cohen I, Giles BL, Pollock CJ, Wang S, Chen LJ, Stawarz JE, Eastwood JP, Hwang KJ, Farrugia C, Dors I, Vaith H, Mouikis C, Ardakani A, Mauk BH, Fuselier SA, Russell CT, Strangeway RJ, Moore TE, Drake JF, Shay MA, Khotyaintsev YV, Lindqvist PA, Baumjohann W, Wilder FD, Ahmadi N, Dorelli JC, Avanov LA, Oka M, Baker DN, Fennell JF, Blake JB, Jaynes AN, Le Contel O, Petrinec SM, Lavraud B, Saito Y. Electron-scale dynamics of the diffusion region during symmetric magnetic reconnection in space. Science 2018; 362:1391-1395. [PMID: 30442767 DOI: 10.1126/science.aat2998] [Citation(s) in RCA: 158] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 11/06/2018] [Indexed: 11/02/2022]
Abstract
Magnetic reconnection is an energy conversion process that occurs in many astrophysical contexts including Earth's magnetosphere, where the process can be investigated in situ by spacecraft. On 11 July 2017, the four Magnetospheric Multiscale spacecraft encountered a reconnection site in Earth's magnetotail, where reconnection involves symmetric inflow conditions. The electron-scale plasma measurements revealed (i) super-Alfvénic electron jets reaching 15,000 kilometers per second; (ii) electron meandering motion and acceleration by the electric field, producing multiple crescent-shaped structures in the velocity distributions; and (iii) the spatial dimensions of the electron diffusion region with an aspect ratio of 0.1 to 0.2, consistent with fast reconnection. The well-structured multiple layers of electron populations indicate that the dominant electron dynamics are mostly laminar, despite the presence of turbulence near the reconnection site.
Collapse
Affiliation(s)
- R B Torbert
- University of New Hampshire, Durham, NH, USA. .,Southwest Research Institute (SwRI), San Antonio, TX, USA
| | - J L Burch
- Southwest Research Institute (SwRI), San Antonio, TX, USA
| | - T D Phan
- University of California, Berkeley, CA, USA
| | - M Hesse
- Southwest Research Institute (SwRI), San Antonio, TX, USA.,University of Bergen, Bergen, Norway
| | - M R Argall
- University of New Hampshire, Durham, NH, USA
| | - J Shuster
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - R E Ergun
- University of Colorado Laboratory for Atmospheric and Space Physics, Boulder, CO, USA
| | - L Alm
- Swedish Institute of Space Physics, Uppsala, Sweden
| | - R Nakamura
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - K J Genestreti
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - D J Gershman
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - W R Paterson
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - D L Turner
- Aerospace Corporation, El Segundo, CA, USA
| | - I Cohen
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - B L Giles
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - C J Pollock
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - S Wang
- University of Maryland, College Park, MD, USA
| | - L-J Chen
- NASA Goddard Space Flight Center, Greenbelt, MD, USA.,University of Maryland, College Park, MD, USA
| | - J E Stawarz
- Blackett Laboratory, Imperial College London, London, UK
| | - J P Eastwood
- Blackett Laboratory, Imperial College London, London, UK
| | - K J Hwang
- Southwest Research Institute (SwRI), San Antonio, TX, USA
| | - C Farrugia
- University of New Hampshire, Durham, NH, USA
| | - I Dors
- University of New Hampshire, Durham, NH, USA
| | - H Vaith
- University of New Hampshire, Durham, NH, USA
| | - C Mouikis
- University of New Hampshire, Durham, NH, USA
| | - A Ardakani
- University of New Hampshire, Durham, NH, USA
| | - B H Mauk
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - S A Fuselier
- Southwest Research Institute (SwRI), San Antonio, TX, USA.,University of Texas, San Antonio, TX, USA
| | - C T Russell
- University of California, Los Angeles, CA, USA
| | | | - T E Moore
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J F Drake
- University of Maryland, College Park, MD, USA
| | - M A Shay
- University of Delaware, Newark, DE, USA
| | | | | | - W Baumjohann
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - F D Wilder
- University of Colorado Laboratory for Atmospheric and Space Physics, Boulder, CO, USA
| | - N Ahmadi
- University of Colorado Laboratory for Atmospheric and Space Physics, Boulder, CO, USA
| | - J C Dorelli
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - L A Avanov
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - M Oka
- University of California, Berkeley, CA, USA
| | - D N Baker
- University of Colorado Laboratory for Atmospheric and Space Physics, Boulder, CO, USA
| | | | - J B Blake
- Aerospace Corporation, El Segundo, CA, USA
| | | | - O Le Contel
- Laboratoire de Physique des Plasmas, CNRS/Ecole Polytechnique/Sorbonne Université/Univ. Paris Sud/Observatoire de Paris, Paris, France
| | - S M Petrinec
- Lockheed Martin Advanced Technology Center, Palo Alto, CA, USA
| | - B Lavraud
- Institut de Recherche en Astrophysique et Planétologie, CNRS, Centre National d'Etudes Spatiales, Université de Toulouse, Toulouse, France
| | - Y Saito
- Institute for Space and Astronautical Sciences, Sagamihara, Japan
| |
Collapse
|
26
|
Genestreti KJ, Nakamura TKM, Nakamura R, Denton RE, Torbert RB, Burch JL, Plaschke F, Fuselier SA, Ergun RE, Giles BL, Russell CT. How Accurately Can We Measure the Reconnection Rate E M for the MMS Diffusion Region Event of 11 July 2017? J Geophys Res Space Phys 2018; 123:9130-9149. [PMID: 30775197 PMCID: PMC6360497 DOI: 10.1029/2018ja025711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/10/2018] [Accepted: 09/11/2018] [Indexed: 06/09/2023]
Abstract
We investigate the accuracy with which the reconnection electric field E M can be determined from in situ plasma data. We study the magnetotail electron diffusion region observed by National Aeronautics and Space Administration's Magnetospheric Multiscale (MMS) on 11 July 2017 at 22:34 UT and focus on the very large errors in E M that result from errors in an L M N boundary normal coordinate system. We determine several L M N coordinates for this MMS event using several different methods. We use these M axes to estimate E M. We find some consensus that the reconnection rate was roughly E M = 3.2 ± 0.6 mV/m, which corresponds to a normalized reconnection rate of 0.18 ± 0.035. Minimum variance analysis of the electron velocity (MVA-v e), MVA of E, minimization of Faraday residue, and an adjusted version of the maximum directional derivative of the magnetic field (MDD-B) technique all produce reasonably similar coordinate axes. We use virtual MMS data from a particle-in-cell simulation of this event to estimate the errors in the coordinate axes and reconnection rate associated with MVA-v e and MDD-B. The L and M directions are most reliably determined by MVA-v e when the spacecraft observes a clear electron jet reversal. When the magnetic field data have errors as small as 0.5% of the background field strength, the M direction obtained by MDD-B technique may be off by as much as 35°. The normal direction is most accurately obtained by MDD-B. Overall, we find that these techniques were able to identify E M from the virtual data within error bars ≥20%.
Collapse
Affiliation(s)
- K. J. Genestreti
- Space Research InstituteAustrian Academy of SciencesGrazAustria
- Now at Space Science CenterUniversity of New HampshireDurhamNHUSA
| | | | - R. Nakamura
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| | - R. E. Denton
- Department of Physics and AstronomyDartmouth CollegeHanoverNHUSA
| | - R. B. Torbert
- Space Science CenterUniversity of New HampshireDurhamNHUSA
- Space Science and Engineering DivisionSouthwest Research InstituteSan AntonioTXUSA
| | - J. L. Burch
- Space Science and Engineering DivisionSouthwest Research InstituteSan AntonioTXUSA
| | - F. Plaschke
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| | - S. A. Fuselier
- Space Science and Engineering DivisionSouthwest Research InstituteSan AntonioTXUSA
- Department of Physics and AstronomyUniversity of Texas at San AntonioSan AntonioTXUSA
| | - R. E. Ergun
- Laboratory of Atmospheric and Space SciencesUniversity of Colorado BoulderBoulderCOUSA
| | - B. L. Giles
- Heliophysics Science DivisionNASA Goddard Space Flight CenterGreenbeltMDUSA
| | - C. T. Russell
- Institute of Geophysics and Planetary PhysicsUniversity of CaliforniaLos AngelesCAUSA
| |
Collapse
|
27
|
Iwata H, Masuda N, Yamamoto Y, Fujisawa T, Toyama T, Taira N, Kashiwaba M, Ohtani S, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Ohashi Y. Distant disease-free survival (DDFS) according to response category in neoadjuvant endocrine therapy (NET): 6-year analysis in phase III NEOS trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
28
|
Nakamura R, Yamamoto N, Miyaki T. Impact on disease-free survival (DFS) of the surgical waiting time (SWT) for patients (Pts) with early breast cancer (BC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.249] [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: 11/12/2022] Open
|
29
|
Yamauchi Y, Okishige K, Shigeta T, Nishimura T, Nakamura R, Aoyagi H, Hirao K. P5753How to create linear conduction block at left atrial roof by cyroballoon catheter. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Y Yamauchi
- Yokohama Minato Red Cross Hospital, Cardiology, Yokohama, Japan
| | - K Okishige
- Yokohama Minato Red Cross Hospital, Cardiology, Yokohama, Japan
| | - T Shigeta
- Yokohama Minato Red Cross Hospital, Cardiology, Yokohama, Japan
| | - T Nishimura
- Yokohama Minato Red Cross Hospital, Cardiology, Yokohama, Japan
| | - R Nakamura
- Yokohama Minato Red Cross Hospital, Cardiology, Yokohama, Japan
| | - H Aoyagi
- Yokohama Minato Red Cross Hospital, Cardiology, Yokohama, Japan
| | - K Hirao
- Tokyo Medical and Dental University, Cardiology, Tokyo, Japan
| |
Collapse
|
30
|
Yamauchi Y, Yamauchi Y, Okishige K, Shigeta T, Nishimura T, Aoyagi H, Nakamura R, Hiao K. P1915An underrecognized complication of coronary artery spasm during cryoballoon-guided atrial fibrillation ablation under deep sedation with dexmedetomidine. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y Yamauchi
- Musashino Red Cross Hospital, cardiology, Musashino, Japan
| | - Y Yamauchi
- Yokohama Minato Red Cross Hospital, Cardiology, Yokohama, Japan
| | - K Okishige
- Yokohama Minato Red Cross Hospital, Cardiology, Yokohama, Japan
| | - T Shigeta
- Yokohama Minato Red Cross Hospital, Cardiology, Yokohama, Japan
| | - T Nishimura
- Yokohama Minato Red Cross Hospital, Cardiology, Yokohama, Japan
| | - H Aoyagi
- Yokohama Minato Red Cross Hospital, Cardiology, Yokohama, Japan
| | - R Nakamura
- Yokohama Minato Red Cross Hospital, Cardiology, Yokohama, Japan
| | - K Hiao
- Tokyo Medical and Dental University, Cardiology, Tokyo, Japan
| |
Collapse
|
31
|
Sekiguchi Y, Nakamura R, Ninomiya N, Yao M. 250 Safety and efficacy of high intensity focused ultrasound treatment for vagina-3 months results-. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.215] [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: 11/24/2022]
|
32
|
Saito Y, Takeuchi H, Fukuda K, Suda K, Nakamura R, Wada N, Kawakubo H, Kitagawa Y. Size of recurrent laryngeal nerve as a new risk factor for postoperative vocal cord paralysis. Dis Esophagus 2018; 31:4986869. [PMID: 29701761 DOI: 10.1093/dote/dox162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Recurrent laryngeal nerve paralysis (RLNP) is a frequent and serious complication following esophageal cancer surgery. Therefore, this study aims to evaluate the correlation between recurrent laryngeal nerve (RLN) size and RLNP. This was a retrospective study of esophageal cancer patients who underwent thoracoscopic esophagectomy from January 2012 to December 2014. Eighty-four patients were included in the primary analysis. Diameter of the RLN was measured using the digital video recording of surgical procedures by the ratio between scissor and RLN. For evaluation of vocal cord paralysis or paresis, indirect laryngoscopy was performed. Because RLNP more frequently occurs on the left side than the right, we evaluated the correlation between size of the left RLN and left RLNP. The median size of the left RLN was 1.51 mm. We found that the incidence of postoperative left RLNP (Clavien-Dindo classification ≥1) was significantly higher (71% vs. 24%; P < 0.001) in thin RLNs (≤1.5 mm) than in thick RLNs (>1.5 mm). Thin RLN (P < 0.001), female sex (P = 0.025), and being overweight (P = 0.034) were identified as significant independent risk factors for postoperative RLNP. RLNP more easily occurred when the RLN was thin. It is difficult to confirm occurrence of postoperative RLNP before and at extubation. Therefore, it is helpful to know its risk factors including size of RLN.
Collapse
Affiliation(s)
- Y Saito
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - H Takeuchi
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo.,Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - K Fukuda
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - K Suda
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - R Nakamura
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - N Wada
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - H Kawakubo
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - Y Kitagawa
- Department of Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| |
Collapse
|
33
|
Ninomiya N, Obayashi M, Nakamura R, Sekiguchi Y. 077 On the Initial Treatment Experience of CO2 Fractional Laser for Vulvovaginal Atrophy Symptom in a Single Institute. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.03.068] [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: 11/24/2022]
|
34
|
Sekiguchi Y, Nakamura R, Ninomiya N. 004 Safety and Efficacy of High Intensity Focused Ultrasound Treatment for Vagina-3 Months Results. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
35
|
Oka T, Miyagaki T, Nakamura R, Funamizu K, Sugaya M, Ebisawa K, Koya J, Kurokawa M, Sato S. Methotrexate-associated lymphoproliferative disorder presenting as giant ulcers on the leg. Clin Exp Dermatol 2018; 43:930-933. [DOI: 10.1111/ced.13660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2017] [Indexed: 11/27/2022]
Affiliation(s)
- T. Oka
- Department of Dermatology; Faculty of Medicine; University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8655 Japan
| | - T. Miyagaki
- Department of Dermatology; Faculty of Medicine; University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8655 Japan
| | - R. Nakamura
- Department of Dermatology; Faculty of Medicine; University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8655 Japan
| | - K. Funamizu
- Department of Dermatology; Faculty of Medicine; University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8655 Japan
| | - M. Sugaya
- Department of Dermatology; Faculty of Medicine; University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8655 Japan
- Department of Dermatology; International University of Health and Welfare; Chiba Japan
| | - K. Ebisawa
- Department of Hematology and Oncology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - J. Koya
- Department of Hematology and Oncology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - M. Kurokawa
- Department of Hematology and Oncology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
- Department of Cell Therapy and Transplantation; University of Tokyo Hospital; Tokyo Japan
| | - S. Sato
- Department of Dermatology; Faculty of Medicine; University of Tokyo; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8655 Japan
| |
Collapse
|
36
|
Izaki S, Toyoshima S, Nunomura S, Kanegae K, Kashiwakura J, Nakamura R, Nishimori N, Endo T, Akiyama H, Hayama K, Fujita H, Okayama Y, Terui T. 018 Statistically higher ability of aggregation of FcɛRI by autoantibody against FcɛRI α-chain and IgE of patients with chronic spontaneous urticaria compared with normal subjects. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.022] [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: 10/17/2022]
|
37
|
Yamaguchi T, Nakamura R. Laparoscopic training using a quantitative assessment and instructional system. Int J Comput Assist Radiol Surg 2018; 13:1453-1461. [DOI: 10.1007/s11548-018-1771-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 04/16/2018] [Indexed: 01/13/2023]
|
38
|
Booka E, Takeuchi H, Suda K, Fukuda K, Nakamura R, Wada N, Kawakubo H, Kitagawa Y. Meta-analysis of the impact of postoperative complications on survival after oesophagectomy for cancer. BJS Open 2018; 2:276-284. [PMID: 30263978 PMCID: PMC6156161 DOI: 10.1002/bjs5.64] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [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: 07/13/2017] [Accepted: 02/28/2018] [Indexed: 12/16/2022] Open
Abstract
Background Oesophagectomy has a high risk of postoperative morbidity. The impact of postoperative complications on overall survival of oesophageal cancer remains unclear. This meta‐analysis addressed the impact of complications on long‐term survival following oesophagectomy. Methods A search of PubMed and Cochrane Library databases was undertaken for systematic review of papers published between January 1995 and August 2016 that analysed the relation between postoperative complications and long‐term survival. In the meta‐analysis, data were pooled. The main outcome was overall survival (OS). Secondary endpoints included disease‐free (DFS) and cancer‐specific (CSS) survival. Results A total of 357 citations was reviewed; 21 studies comprising 11 368 patients were included in the analyses. Overall, postoperative complications were associated with significantly decreased 5‐year OS (hazard ratio (HR) 1·16, 95 per cent c.i. 1·06 to 1·26; P = 0·001) and 5‐year CSS (HR 1·27, 1·09 to 1·47; P = 0·002). Pulmonary complications were associated with decreased 5‐year OS (HR 1·37, 1·16 to 1·62; P < 0·001), CSS (HR 1·60, 1·35 to 1·89; P < 0·001) and 5‐year DFS (HR 1·16, 1·00 to 1·33; P = 0·05). Patients with anastomotic leakage had significantly decreased 5‐year OS (HR 1·20, 1·10 to 1·30; P < 0·001), 5‐year CSS (HR 1·81, 1·11 to 2·95; P = 0·02) and 5‐year DFS (HR 1·13, 1·02 to 1·25; P = 0·01). Conclusion Postoperative complications after oesophagectomy, including pulmonary complications and anastomotic leakage, decreased long‐term survival.
Collapse
Affiliation(s)
- E Booka
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| | - H Takeuchi
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan.,Department of Surgery Hamamatsu University School of Medicine Hamamatsu Shizuoka Japan
| | - K Suda
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| | - K Fukuda
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| | - R Nakamura
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| | - N Wada
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| | - H Kawakubo
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| | - Y Kitagawa
- Department of Surgery Keio University School of Medicine Tokyo Shizuoka Japan
| |
Collapse
|
39
|
Ariga H, Kikuchi K, Iwaya T, Oikawa H, Kakuhara H, Segawa T, Yamaguchi S, Nakamura R. PO-0776: Induction chemotherapy with TPF followed by chemoradiotherapy for esophageal squamous cell carcinoma. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31086-7] [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: 11/25/2022]
|
40
|
Nakamura R. PO-1025: Effects of antecedent androgen deprivation therapy in prostate seed implant brachytherapy dosimetry. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31335-5] [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: 10/14/2022]
|
41
|
Kikuchi K, Nakamura R, Segawa T, Kakuhara H, Oikawa H, Ariga H. PO-0831: Modified Glasgow prognostic score can predict survival in elderly patients with bladder cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31141-1] [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: 10/14/2022]
|
42
|
Iwata H, Masuda N, Fujisawa T, Toyama T, Ohtani S, Yamamoto Y, Kashiwaba M, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Ohashi Y. Abstract P3-13-03: NEOS: A randomized, open label, phase 3 trial of adjuvant chemotherapy for postmenopausal breast cancer patients who responded to neoadjuvant letrozole: First report of long-term outcome and prognostic value of response to neoadjuvant endocrine therapy. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-13-03] [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: Whether adjuvant chemotherapy is required for patients (pts) with intermediate-risk endocrine-responsive postmenopausal breast cancer (BC) remains unknown. Sufficient data have not been available about the long-term prognosis of patients with neoadjuvant endocrine therapy (ET). NEOS is a randomized phase III study that assessed the long-term prognosis of estrogen receptor positive (ER+) primary breast cancer (PBC) pts who received neoadjuvant ET with/without adjuvant chemotherapy.
Methods: Postmenopausal BC pts with ER +/HER2 negative, T1c-2, clinically node negative, under 76 years old were enrolled at primary registration. Pts were treated by leterozole (LET) in weeks 24-28 after primary enrollment. Pts experienced progression (PD) during neoadjuvant phase were excluded at randomization and received any systemic therapy driven by investigators before or after surgery. The long-term prognosis was followed in all registered pts including PD pts. Response to neoadjuvant ET was evaluated as complete response (CR), partial response (PR) or stable disease (SD) using calipers, ultrasound and MRI (or CT) at the baseline and end of treatment before surgery. Pts who met eligibility criteria were randomized 1:1 to LET for 4.5-5 years after chemotherapy or LET alone for 4.5-5 years without chemotherapy after surgery. Pts excluded at second registration were treated any systemic therapies driven by investigators. The primary endpoint was disease-free survival (DFS) and secondary endpoints included overall survival (OS), clinical response rate in neoadjuvant phase, pathological response, and breast-conserving surgery rate. The randomization code have been blinded to the investigators.
Results: Between May 2008 and June 2013, 904 patients were enrolled at primary registration from 100 institutions in Japan (median follow-up: 4.0 years) and 24 pts were withdrawn during neoadjuvant phase. The median age was 63 years, T1c:37%, T2:63%, and PgR+:78%. Clinical response rates (CR, PR, SD and PD) were2% (16pts), 48% (421pts), 45% (400pts) and 5% (43pts), respectively and, in each response category, 0% (0/16), 5.5% (23/421), 7.8% (31/400), and 20.9% (9/43) experienced DFS events. DFS in PD pts to neoadjuvant ET were statistically significantly worse than CR, PR, SD pts (p<0.0001, hazard ratio 4.7 (95% CI:2.3-9.5). The prognosis after surgery in 669 randomized pts was good regardless with/without chemotherapy, forty four pts (6.6%) experienced DFS events after surgery. The predictive markers of PD for neoadjuvant ET were yet unclear among evaluated clinical factors.
Conclusion: This is the first report of DFS in the largest neoadjuvant ET trial (NEOS). The DFS of postmenopausal, ER+/HER2-, PBC pts excluding PD pts to neoadjuvant ET is highly good regardless with/without chemotherapy. Neoadjuvant ET with utilization of PD response as a prognostic marker can be considered as a standard treatment option for these patients. Clinical trial information: UMIN000001090.
Citation Format: Iwata H, Masuda N, Fujisawa T, Toyama T, Ohtani S, Yamamoto Y, Kashiwaba M, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Ohashi Y. NEOS: A randomized, open label, phase 3 trial of adjuvant chemotherapy for postmenopausal breast cancer patients who responded to neoadjuvant letrozole: First report of long-term outcome and prognostic value of response to neoadjuvant endocrine therapy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-13-03.
Collapse
Affiliation(s)
- H Iwata
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - N Masuda
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Fujisawa
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Toyama
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - S Ohtani
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Yamamoto
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - M Kashiwaba
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - N Taira
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Sakai
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Hasegawa
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - R Nakamura
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - H Akabane
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Shibahara
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - H Sasano
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Yamaguchi
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Ohashi
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| |
Collapse
|
43
|
Nakamura R, Yamamoto N, Miyaki T, Teranaka R, Itami M. Abstract P3-02-01: Impact of prognoses on the discrepancies in histological grade of breast cancer between core needle biopsy and surgical excision specimen. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-02-01] [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
Purpose: The high reliability and utility of core needle biopsy (CNB) have been previously described. Histological grade in CNB is one of the main determinants of the need for neoadjuvant systemic therapy. Our aim in this study was to clarify the host and histopathological factors influencing the discrepancies in histological grade (HG) between CNB and surgically excision specimen (SES).
Methods: A total of 1342 operable invasive breast carcinoma biopsies were assessed and compared with surgical specimens in our hospital. Patients who required neoadjuvat chemotherapy were excluded. Histological grade (tubule formation, nuclear pleomorphism and mitotic index) was assessed between paired CNB and SET samples.
ER and PgR status were determined using immunohistochemistry(IHC). HER2 status was determined using IHC and scored from 0 to 3+. Fluorescence in-situ hybridization analysis was carried out in HER2 2+ cases. The cut off point for ER and PgR positivity was set at 1%.
Results: The clinicopathological characteristics of tumors showed in
Clinico-pathological characteristics of 1342 patients and tumors by discordance group between CNB and SES for histological grade LL groupHH groupHL groupLLHgroupp valupTT1a31 (94%)0(0%)2(6%)0(0%)0.001 T1b162(92%)4(2%)1(1%)10(6%) T1c421(79%)43(8%)14(3%)52(10%) T2335(68%)63(13%)10(2%)82(17%) T352(68%)8(10%)2(3%)15(19%) T425(71%)4(11%)0(0%)6(17%) pNnegtive668(78%)73(9%)13(2%)101(12%)0.08 positive358(74%)49(10%)16(3%)64(13%) lynegative600(79%)6(4(8%)14(2%)85(11%)0.18 positive426(74%)58(10%)15(3%)80(14%) vnegative799(80%)81(5%)23(2%)98(10%)0.001 positive227(67%)41(12%)6(2%)67(20%) ER/PgRmegative82(33%)83(33%)13(5%)72(29%)0.001 positive944(86%)39(4%)16(1%)93(9%) HER2negative932(80%)86(7%)22(2%)121(10%)0.001 positive94(52%)36(20%)7(4%)44(24%) CNB;core needle biopsy, SES;surgical excision specimen, HH group (high grade in CNB/high grade in SES), LL group (low grade in CNB/low grade in SES), HL group (high grade in CNB/low grade in SES) and LH group (low grade in CNB/high grade in SES)
. The concordance rates of HG of luminal type, HER2 type luminal HER2 type and Triple negative type in CNB and SES were 91%, 64%, 73% and 66%, respectively (p>0.001). Factors of discrepancy were T size, vessel invasion and ER/HER2 status for HG. The discrepancy factors were assessed with univariate and multivariate analysis. The underestimate and overestimate rates of HG in CNB compared to SES were7.5% and 1.3% in ER(+)HER2(-) type, 32%, and 3.1% in HER2 type, 22% and 4.3% in ER(+) HER2(+) type and 29% and 5.5% in Triple negative type(TN), respectively. The concordance rates of tubule formation, nuclear pleomorphism and mitotic index in CNB and SES were 81%, 97% and 93% in luminal type, 85%, 66% and 33% in HER2 type, 77%, 87% and 83% in luminal HER2 type and 82%, 67% and 73% in TN type respectively.
Conclusions: Using the largest known dataset to date of paired samples from a single institution, we evaluated the accuracy of CNB and the discrepancy factors between CNB and SES in breast cancer patients.
We conclude that CNB for histological grade assessment in patients with HER2 positive or TN breast cancer before neoadjuvant treatment should be used with caution.
Citation Format: Nakamura R, Yamamoto N, Miyaki T, Teranaka R, Itami M. Impact of prognoses on the discrepancies in histological grade of breast cancer between core needle biopsy and surgical excision specimen [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-02-01.
Collapse
Affiliation(s)
- R Nakamura
- Chiba Cancer Center, Chiba, Japan; Chiba Cancer Center, Japan
| | - N Yamamoto
- Chiba Cancer Center, Chiba, Japan; Chiba Cancer Center, Japan
| | - T Miyaki
- Chiba Cancer Center, Chiba, Japan; Chiba Cancer Center, Japan
| | - R Teranaka
- Chiba Cancer Center, Chiba, Japan; Chiba Cancer Center, Japan
| | - M Itami
- Chiba Cancer Center, Chiba, Japan; Chiba Cancer Center, Japan
| |
Collapse
|
44
|
Yamamoto Y, Iwata H, Masuda N, Fujisawa T, Toyama T, Kashiwaba M, Ohtani S, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Sakamaki K, Chao C, McCullough D, Sugiyama N, Ohashi Y. Abstract PD5-03: TransNEOS: Validation of the oncotype DX recurrence score (RS) testing core needle biopsy samples from NEOS as predictor of clinical response to neoadjuvant endocrine therapy for postmenopausal estrogen receptor positive (ER+), HER2 negative (HER2-) breast cancer patients. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd5-03] [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: Neoadjuvant therapy for locally advanced breast cancer has the potential to improve surgical therapeutic outcomes without sacrificing the survival advantages of adjuvant therapy. However, determining whether ER+ patients (pts) will respond to neoadjuvant (NA) chemotherapy (CT) or hormone therapy (HT) can be difficult. Not all ER+ pts respond to NACT, while response to NAHT can vary across ER+ pts. Thus, the ability to select pts more likely to benefit from NAHT would represent progress in clinical management of breast cancer. NEOS is a randomized phase III study assessinglong-term prognosis of ER+ primary breast cancer with/without adjuvant CT following NAHT (UMIN 000001090, http://www.umin.ac.jp/). We used archived core biopsy tumor samples from the NEOS study to validate the RS result as a predictor of clinical response and its association with successful breast conserving surgery (BCS) in pts treated with 6 months of NAHT.
Methods: NEOS enrolled 904 postmenopausal pts with ER+, HER2-, clinically node negative (cN0) breast cancer to evaluate whether adjuvant CT was necessary for pts who responded to NAHT. In this current study, we enrolled pts with tumors ≥2cm from the NEOS study. Biopsy samples of 333 pts were assessed for the Oncotype DX assay. Response to NAHT was recorded as complete/partial response (CR/PR), or stable/progressive disease (SD/PD).
Primary endpoint of this study was to evaluate clinical response (CR/PR) to NA letrozole between pts with low (<18) and high (≥31) RS result. Secondary endpoints include evaluating the relationships between clinical response and continuous RS results, and other covariates including age, tumor size, grade, Ki67 by IHC, ER and PR single gene scores, and ER and proliferation gene group scores by RT-PCR.
Results: The analysis included 294 pts with median age of 63 yrs, median tumor size of 25mm, and 66% were nuclear grade 1. 156 (53.0%), 83 (28.6%) and 54(18.4%) cases were low, intermediate, and high RS groups by Oncotype DX, respectively. Six (2%), 126 (42.8%), 149 (50.3%), 13 (4.4%) cases experienced CR, PR, SD, PD as clinical response, respectively, similar to that of all NEOS pts. Clinical response rate was 54%, 42% and 22% in low, intermediate, and high RS groups, respectively. The proportion of pts with clinical response was significantly higher in the low RS group vs the high RS group (p<0.001). In univariate analyses, continuous RS was significantly associated with clinical response (p<0.001), along with ER (p=.02), PR (p<0.001), and ER gene group score (p<0.001). Other covariates were not associated with clinical response.
Conclusion: The Oncotype DX RS test in core biopsy samples is validated as a predictive assay for clinical response of NAHT in postmenopausal, ER+/HER2-, cN0, primary early breast cancer pts. Further results on the association of RS results with BCS outcomes following NAHT will be presented. These results when combined with previously published data on RS in NACT studies help guide pts with ER+, HER2- breast cancer with NAHT vs NACT treatment options to maximize clinical response.
Citation Format: Yamamoto Y, Iwata H, Masuda N, Fujisawa T, Toyama T, Kashiwaba M, Ohtani S, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Sakamaki K, Chao C, McCullough D, Sugiyama N, Ohashi Y. TransNEOS: Validation of the oncotype DX recurrence score (RS) testing core needle biopsy samples from NEOS as predictor of clinical response to neoadjuvant endocrine therapy for postmenopausal estrogen receptor positive (ER+), HER2 negative (HER2-) breast cancer patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD5-03.
Collapse
Affiliation(s)
- Y Yamamoto
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - H Iwata
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - N Masuda
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Fujisawa
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Toyama
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - M Kashiwaba
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - S Ohtani
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - N Taira
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Sakai
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - Y Hasegawa
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - R Nakamura
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - H Akabane
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - Y Shibahara
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - H Sasano
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Yamaguchi
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - K Sakamaki
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - C Chao
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - D McCullough
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - N Sugiyama
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - Y Ohashi
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| |
Collapse
|
45
|
Kawaguchi H, Yamashita T, Masuda N, Kitada M, Narui K, Hattori M, Yoshinami T, Matsunami N, Yanagihara K, Kawasoe T, Nagashima T, Bando H, Yano H, Hasegawa Y, Nakamura R, Kashiwaba M, Morita S, Ohno S, Toi M. Abstract P5-21-07: Phase II study of eribulin in combination with pertuzumab plus trastuzumab for human epidermal growth factor receptor 2 (HER2)-positive advanced or metastatic breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-21-07] [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: Pertuzumab provided overall and progression-free survival (PFS) benefits in HER2-positive metastatic breast cancer patients (pts) in the CLEOPATRA (Clinical evaluation of docetaxel, pertuzumab and trastuzumab) study. However, few studies have described the efficacy of other drugs in combination with pertuzumab plus trastuzumab. Here, we present a pre-specified analysis of eribulin in combination with pertuzumab plus trastuzumab as first- and second-line therapy for advanced or metastatic breast cancer (AMBC) in a multicenter, open-label phase II study (UMIN000012232, JBCRG-M03).
Methods: HER2-positive AMBC with no or single prior chemotherapy for AMBC were enrolled. All pts were administered trastuzumab and taxane as adjuvant or first-line chemotherapy. Treatment consisted of eribulin 1.4 mg/m2 on days 1 and 8 of a 21-day cycle and trastuzumab (8 mg/kg loading dose, then 6 mg/kg) plus pertuzumab (840 mg/body loading dose, then 420 mg/ body) once every 3 weeks, all administered intravenously. The primary endpoint was PFS, and secondary endpoints included overall response rate (ORR) and safety. PFS was determined using Kaplan–Meier analysis. Tumor response was assessed according to RECIST ver. 1.1.
Results: Fifty pts were enrolled from November 2013 to April 2016. Forty-nine pts were eligible for safety analysis and the full analysis set (FAS) included 46 pts. The median age was 56 years (23–70), and 8 (16%) and 41 (84%) pts were treated in first- and second-line settings, respectively. Eleven pts (23.9%) were de-novo Stage 4, and 35 pts (76.1%) had progressed in metastatic disease after completion of local therapy. Median PFS was 9.3 months (M) (95% confidence interval [CI]: 6.4–12.3). Table 1 shows the efficacy data for each treatment line and includes ORR, complete response rate (CR), partial response rate (PR), stable disease rate (SD), progressive disease rate (PD), not evaluable rate (NE) and PFS in the FAS. The median relative dose intensities of eribulin, trastuzumab, and pertuzumab were 93.3% (77.0%–100%), 100% (96.0%–100%), and 100% (89.7%–100%), respectively, in the FAS. The grade 3/4 adverse events (AE) were neutropenia in 5 pts (10.2%), including 2 pts (4.1%) with febrile neutropenia; hypertension in 3 pts (6.1%), and other AEs in only one patient. The average of the ejection fraction did not decrease significantly. Symptomatic left ventricular systolic dysfunction was not observed.
Conclusion: In pts with HER2-positive AMBC, first- and second-line therapy of eribulin in combination with pertuzumab plus trastuzumab demonstrated substantial antitumor activity with an acceptable safety profile. We are planning a phase III study comparing eribulin with taxanes in combination with pertuzumab plus trastuzumab for the treatment of HER2-positive AMBC.
Efficacy data for each treatment lineTreatment LineTotal (n=46)First line (n=8)Second line (n=38)PFS (95% CI), months9.3 (6.4-12.3)20.8 (2.8-38.7)8.7 (7.2-10.2)ORR (%)28 (60.9)7 (87.5)21 (55.3)CR (%)8 (17.4)3 (37.5)5 (13.2)PR (%)20 (43.5)4 (50.0)16 (42.1)SD (%)11 (23.9)1 (12.5)10 (26.3)PD (%)5 (10.9)05 (13.2)NE (%)2 (4.3)02 (5.3)
Citation Format: Kawaguchi H, Yamashita T, Masuda N, Kitada M, Narui K, Hattori M, Yoshinami T, Matsunami N, Yanagihara K, Kawasoe T, Nagashima T, Bando H, Yano H, Hasegawa Y, Nakamura R, Kashiwaba M, Morita S, Ohno S, Toi M. Phase II study of eribulin in combination with pertuzumab plus trastuzumab for human epidermal growth factor receptor 2 (HER2)-positive advanced or metastatic breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-21-07.
Collapse
Affiliation(s)
- H Kawaguchi
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - T Yamashita
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - N Masuda
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - M Kitada
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - K Narui
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - M Hattori
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - T Yoshinami
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - N Matsunami
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - K Yanagihara
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - T Kawasoe
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - T Nagashima
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - H Bando
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - H Yano
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - Y Hasegawa
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - R Nakamura
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - M Kashiwaba
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - S Morita
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - S Ohno
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - M Toi
- Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan; Kanagawa Cancer Center, Yokohama, Kanagawa, Japan; NHO Osaka National Hospital, Osaka, Japan; Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan; Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Aichi Cancer Center, Nagoya, Aichi, Japan; Osaka International Cancer Institute, Osaka, Osaka, Japan; Osaka Rosai Hospital, Osaka, Japan; Kansai Electric Power Hospital, Osaka, Japan; Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan; Chiba University Hospital, Chiba, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Hirosaki Municipal Hospital, Horosaki, Aomori, Japan; Chiba Cancer Center, Chiba, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Tokyo, Japan
| |
Collapse
|
46
|
Nakamura TKM, Hasegawa H, Daughton W, Eriksson S, Li WY, Nakamura R. Turbulent mass transfer caused by vortex induced reconnection in collisionless magnetospheric plasmas. Nat Commun 2017; 8:1582. [PMID: 29150662 PMCID: PMC5693928 DOI: 10.1038/s41467-017-01579-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [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: 04/04/2017] [Accepted: 10/01/2017] [Indexed: 11/09/2022] Open
Abstract
Magnetic reconnection is believed to be the main driver to transport solar wind into the Earth's magnetosphere when the magnetopause features a large magnetic shear. However, even when the magnetic shear is too small for spontaneous reconnection, the Kelvin-Helmholtz instability driven by a super-Alfvénic velocity shear is expected to facilitate the transport. Although previous kinetic simulations have demonstrated that the non-linear vortex flows from the Kelvin-Helmholtz instability gives rise to vortex-induced reconnection and resulting plasma transport, the system sizes of these simulations were too small to allow the reconnection to evolve much beyond the electron scale as recently observed by the Magnetospheric Multiscale (MMS) spacecraft. Here, based on a large-scale kinetic simulation and its comparison with MMS observations, we show for the first time that ion-scale jets from vortex-induced reconnection rapidly decay through self-generated turbulence, leading to a mass transfer rate nearly one order higher than previous expectations for the Kelvin-Helmholtz instability.
Collapse
Affiliation(s)
- T K M Nakamura
- Space Research Institute, Austrian Academy of Sciences, 8010, Graz, Austria.
| | - H Hasegawa
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara, 252-5210, Japan
| | - W Daughton
- Los Alamos National Laboratory, Los Alamos, NM, 87545, USA
| | - S Eriksson
- Laboratory for Atmospheric and Space Physics, University of Colorado Boulder, Boulder, CO, 80303, USA
| | - W Y Li
- Swedish Institute of Space Physics, SE751-21, Uppsala, Sweden.,State Key Laboratory of Space Weather, National Space Science Center, Chinese Academy of Sciences, Beijing, 100190, China
| | - R Nakamura
- Space Research Institute, Austrian Academy of Sciences, 8010, Graz, Austria
| |
Collapse
|
47
|
Varsani A, Nakamura R, Sergeev VA, Baumjohann W, Owen CJ, Petrukovich AA, Yao Z, Nakamura TKM, Kubyshkina MV, Sotirelis T, Burch JL, Genestreti KJ, Vörös Z, Andriopoulou M, Gershman DJ, Avanov LA, Magnes W, Russell CT, Plaschke F, Khotyaintsev YV, Giles BL, Coffey VN, Dorelli JC, Strangeway RJ, Torbert RB, Lindqvist P, Ergun R. Simultaneous Remote Observations of Intense Reconnection Effects by DMSP and MMS Spacecraft During a Storm Time Substorm. J Geophys Res Space Phys 2017; 122:10891-10909. [PMID: 29399431 PMCID: PMC5784414 DOI: 10.1002/2017ja024547] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/27/2017] [Accepted: 10/05/2017] [Indexed: 06/07/2023]
Abstract
During a magnetic storm on 23 June 2015, several very intense substorms took place, with signatures observed by multiple spacecraft including DMSP and Magnetospheric Multiscale (MMS). At the time of interest, DMSP F18 crossed inbound through a poleward expanding auroral bulge boundary at 23.5 h magnetic local time (MLT), while MMS was located duskward of 22 h MLT during an inward crossing of the expanding plasma sheet boundary. The two spacecraft observed a consistent set of signatures as they simultaneously crossed the reconnection separatrix layer during this very intense reconnection event. These include (1) energy dispersion of the energetic ions and electrons traveling earthward, accompanied with high electron energies in the vicinity of the separatrix; (2) energy dispersion of polar rain electrons, with a high-energy cutoff; and (3) intense inward convection of the magnetic field lines at the MMS location. The high temporal resolution measurements by MMS provide unprecedented observations of the outermost electron boundary layer. We discuss the relevance of the energy dispersion of the electrons, and their pitch angle distribution, to the spatial and temporal evolution of the boundary layer. The results indicate that the underlying magnetotail magnetic reconnection process was an intrinsically impulsive and the active X-line was located relatively close to the Earth, approximately at 16-18 RE.
Collapse
Affiliation(s)
- A. Varsani
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| | - R. Nakamura
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| | - V. A. Sergeev
- Earth's Physics DepartmentSt. Petersburg State UniversitySt. PetersburgRussia
| | - W. Baumjohann
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| | - C. J. Owen
- Mullard Space Science Laboratory/UCLDorkingUK
| | | | - Z. Yao
- Space Science Technologies and Astrophysics Research InstituteLiegeBelgium
| | | | - M. V. Kubyshkina
- Earth's Physics DepartmentSt. Petersburg State UniversitySt. PetersburgRussia
| | - T. Sotirelis
- Applied Physics LaboratoryThe Johns Hopkins UniversityBaltimoreMAUSA
| | - J. L. Burch
- Southwest Research InstituteSan AntonioTXUSA
| | | | - Z. Vörös
- Space Research InstituteAustrian Academy of SciencesGrazAustria
- Institute of PhysicsUniversity of GrazGrazAustria
| | - M. Andriopoulou
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| | - D. J. Gershman
- Heliophysics Science DivisionNASA Goddard Space Flight CenterGreenbeltMDUSA
| | - L. A. Avanov
- Heliophysics Science DivisionNASA Goddard Space Flight CenterGreenbeltMDUSA
| | - W. Magnes
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| | - C. T. Russell
- University of California Los Angeles, IGPP/EPSSLos AngelesCAUSA
| | - F. Plaschke
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| | | | - B. L. Giles
- Heliophysics Science DivisionNASA Goddard Space Flight CenterGreenbeltMDUSA
| | - V. N. Coffey
- NASA Marshall Space Flight CenterHuntsvilleALUSA
| | - J. C. Dorelli
- Heliophysics Science DivisionNASA Goddard Space Flight CenterGreenbeltMDUSA
| | | | - R. B. Torbert
- Southwest Research InstituteSan AntonioTXUSA
- University of New HampshireDurhamNHUSA
| | | | - R. Ergun
- Laboratory for Atmospheric and Space PhysicsUniversity of Colorado BoulderBoulderCOUSA
| |
Collapse
|
48
|
Masuda C, Monnai M, Ishimaru C, Nakamura R, Kinoshita M, Yorozu K, Kurasawa M, Sugimoto M, Yamamoto K. P2.02-051 Bevacizumab Prevents Growth of Established Non-Small Cell Lung Cancer Brain Metastases in Hematogenous Brain Metastasis Model. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
49
|
Nakamura R, Komatsu N, Fujita K, Kuroda K, Takahashi M, Omi R, Katsuki Y, Tsuchiya H. Appropriate hinge position for prevention of unstable lateral hinge fracture in open wedge high tibial osteotomy. Bone Joint J 2017; 99-B:1313-1318. [PMID: 28963152 DOI: 10.1302/0301-620x.99b10.bjj-2017-0103.r1] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 05/17/2017] [Indexed: 11/05/2022]
Abstract
AIMS Open wedge high tibial osteotomy (OWHTO) for medial-compartment osteoarthritis of the knee can be complicated by intra-operative lateral hinge fracture (LHF). We aimed to establish the relationship between hinge position and fracture types, and suggest an appropriate hinge position to reduce the risk of this complication. PATIENTS AND METHODS Consecutive patients undergoing OWHTO were evaluated on coronal multiplanar reconstruction CT images. Hinge positions were divided into five zones in our new classification, by their relationship to the proximal tibiofibular joint (PTFJ). Fractures were classified into types I, II, and III according to the Takeuchi classification. RESULTS Among 111 patients undergoing OWHTOs, 22 sustained lateral hinge fractures. Of the 89 patients without fractures, 70 had hinges in the zone within the PTFJ and lateral to the medial margin of the PTFJ (zone WL), just above the PTFJ. Among the five zones, the relative risk of unstable fracture was significantly lower in zone WL (relative risk 0.24, confidence interval 0.17 to 0.34). CONCLUSION Zone WL appears to offer the safest position for the placement of the osteotomy hinge when trying to avoid a fracture at the osteotomy site. Cite this article: Bone Joint J 2017;99B10:1313-18.
Collapse
Affiliation(s)
- R Nakamura
- Harue Hospital, 65-7 Harue-cho Haribara, Sakai, Japan
| | - N Komatsu
- Yawata Medical Center, Komatsu, Japan
| | - K Fujita
- Kanazawa University, Kanazawa, Japan
| | - K Kuroda
- Yawata Medical Center, Komatsu, Japan
| | | | - R Omi
- Yawata Medical Center, Komatsu, Japan
| | - Y Katsuki
- Yawata Medical Center, Komatsu, Japan
| | | |
Collapse
|
50
|
Atsuta N, Yokoi D, Nakamura R, Watanabe H, Hayashi N, Ito M, Watanabe H, Katsuno M, Izumi Y, Morita M, Taniguchi A, Oda M, Abe K, Mizoguchi K, Kano O, Kuwabara S, Aoki M, Hattori N, Kaji R, Sobue G. Prognosis of japanese patients with amyotrophic lateral sclerosis according to motor phenotype. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|