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Chiba Y, Kagabu M, Osakabe M, Ito R, Sato S, Takatori E, Kaido Y, Nagasawa T, Shoji T, Yanagawa N, Baba T. A single-institution retrospective exploratory analysis on the effectiveness and safety of lenvatinib plus pembrolizumab for advanced endometrial cancer: insights from ProMisE molecular classification system. Jpn J Clin Oncol 2024; 54:424-433. [PMID: 38251744 DOI: 10.1093/jjco/hyad192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The Proactive Molecular Risk Classifier for Endometrial Cancer has identified four risk groups for the prognosis of endometrial cancer. Lenvatinib plus pembrolizumab was recently approved as a second-line treatment for unresectable endometrial cancer, but reports in clinical practice are lacking. The relationship between the efficacy of lenvatinib/pembrolizumab and Proactive Molecular Risk Classifier for Endometrial Cancer classification is unclear. METHODS This single-centre retrospective study included patients who underwent lenvatinib/pembrolizumab therapy at Iwate Medical University Hospital between January 2022 and March 2023. Formalin-fixed paraffin-embedded specimens obtained from patients before treatment were collected and classified into the mismatch repair-deficient, p53 abnormal and no specific molecular profile subtypes using immunohistochemistry. The response rate, progression-free survival and adverse events were evaluated using electronic medical records. The study was approved by the hospital's ethics committee (approval number: MH2022-093). RESULTS This study enrolled 20 patients, who underwent a median follow-up of 17.8 months (95% confidence interval: 16.6-18.9). The best overall response rate was 60.0% (36.1-80.9), and the median progression-free survival was 11.6 months (2.9-20.3). The median progression-free survival in the p53 abnormal group (n = 9) was 3.4 months (3.0-3.8); however, progression-free survival did not reach the median (P < 0.001) in the mismatch repair-deficient/no specific molecular profile group (n = 11). Symptomatic immune-related adverse events (except hypothyroidism) occurred in 4/20 (25.0%) patients, and partial responses were observed in all cases. No treatment-related deaths occurred. CONCLUSION The p53abn group in the Proactive Molecular Risk Classifier for Endometrial Cancer classification has a poor prognosis even after treatment with lenvatinib/pembrolizumab.
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Affiliation(s)
- Yohei Chiba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Mitsumasa Osakabe
- Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Rikako Ito
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
- Department of Obstetrics and Gynecology, Iwate Prefectural Ofunato Hospital, Iwate, Japan
| | - Sho Sato
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Yoshitaka Kaido
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Naoki Yanagawa
- Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
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Nagasawa T, Shoji T, Takatori E, Kaido Y, Kagabu M, Shimizu D, Shigeto T, Baba T, Sugiyama T, Yokoyama Y. A Phase II Study of S-1 plus Oxaliplatin for Patients with Recurrent Non-Squamous Cell Carcinoma of the Uterine Cervix (Tohoku Gynecologic Cancer Unit: TGCU206 Study). Cancers (Basel) 2023; 15:5201. [PMID: 37958375 PMCID: PMC10650927 DOI: 10.3390/cancers15215201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Recurrent non-squamous cell carcinoma (non-SCC) of the uterine cervix is resistant to treatment and has a poor prognosis. The efficacy and safety of S-1/oxaliplatin (SOX) therapy in patients with recurrent non-SCC was examined in a phase II study. Fifteen patients were enrolled between August 2013 and March 2023. S-1 was administered orally at a daily dose of 80-120 mg for 14 days, and oxaliplatin was administered intravenously at a dose of 100 mg/m2 on day 1. Each treatment cycle lasted 21 days. The anti-tumor effects, adverse events, progression-free survival (PFS), and overall survival (OS) were investigated. The median patient age was 54 (41-74) years. The anti-tumor effect was rated as a partial response in five patients, stable disease in four, and progressive disease in 6. The overall response rate was 33% and the disease control rate was 60%. Regarding hematologic toxicities of grade 3 or more severity, leukopenia, neutropenia, anemia, and thrombocytopenia occurred in 26.6-40.0%. None of the patients discontinued the treatment because of adverse events. The median PFS and OS were 6 months (95% confidence interval [CI]: 2-11 months) and 22 months (95% CI: 11-23 months), respectively. No treatment-related deaths occurred. These results suggest that SOX therapy is useful for the treatment of recurrent non-SCC with promising anti-tumor effects and minimal adverse events.
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Affiliation(s)
- Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Yahaba 028-3695, Japan; (T.N.); (E.T.); (Y.K.); (M.K.); (T.B.)
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Yahaba 028-3695, Japan; (T.N.); (E.T.); (Y.K.); (M.K.); (T.B.)
| | - Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Yahaba 028-3695, Japan; (T.N.); (E.T.); (Y.K.); (M.K.); (T.B.)
| | - Yoshitaka Kaido
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Yahaba 028-3695, Japan; (T.N.); (E.T.); (Y.K.); (M.K.); (T.B.)
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Yahaba 028-3695, Japan; (T.N.); (E.T.); (Y.K.); (M.K.); (T.B.)
| | - Dai Shimizu
- Department of Obstetrics and Gynecology, Akita University School of Medicine, Akita 010-8543, Japan;
| | - Tatsuhiko Shigeto
- Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Aomori 036-8563, Japan; (T.S.); (Y.Y.)
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Yahaba 028-3695, Japan; (T.N.); (E.T.); (Y.K.); (M.K.); (T.B.)
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, St. Mary’s Hospital, Fukuoka 830-8543, Japan;
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Aomori 036-8563, Japan; (T.S.); (Y.Y.)
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3
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Abe M, Shoji T, Chiba Y, Takatori E, Kaido Y, Nagasawa T, Kagabu M, Takahashi F, Aida T, Baba T. Efficacy and Safety of Platinum-based Chemotherapy With Bevacizumab Followed by Bevacizumab Maintenance for Recurrent Ovarian, Fallopian Tube, and Primary Peritoneal Cancer During PARP Inhibitor Therapy: A Multicenter Retrospective Study. Anticancer Res 2023; 43:1265-1272. [PMID: 36854492 DOI: 10.21873/anticanres.16273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/28/2023] [Accepted: 02/03/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND/AIM In recent years, the usefulness of poly ADP-ribose polymerase (PARP) inhibitors as subsequent maintenance therapy with poly ADP-ribose polymerase (PARP) inhibitors has been reported. However, it has been reported shown that platinum-based chemotherapy has a low response rate and short progression-free survival for recurrent platinum-sensitive ovarian cancer during treatment with PARP inhibitor therapy. This retrospective study evaluated platinum-based chemotherapy with bevacizumab (BEV) followed by BEV maintenance in these recurrent patients. PATIENTS AND METHODS Efficacy and safety were evaluated in 23 patients with ovarian, fallopian tube, or primary peritoneal cancer diagnosed with platinum-sensitive recurrence during PARP inhibitor treatment (administered from April 2019 to December 2022). Platinum-based chemotherapy included either paclitaxel with carboplatin, paclitaxel with cisplatin, docetaxel with carboplatin, or doxorubicin with carboplatin. BEV was administered in combination with any of these chemotherapies agents. Chemotherapy was administered for 6 cycles and BEV was administered up to 21 cycles. RESULTS The median numbers of cycles of platinum-based chemotherapy and BEV administration were 6 and 8, respectively. Complete response was observed in four patients (17.4%), partial response in 15 (65.2%), stable disease in two (8.7%), and progressive disease in two (8.7%). Objective response and disease control rates were 82.6% and 91.3%, respectively. Grade 3 or higher hematological toxicity occurred in 8 patients, with leukopenia, neutropenia in 14, anemia in 5, and thrombocytopenia in 4. On the other hand, non-hematological toxicities included hypertension in three patients, proteinuria in two, constipation in one, and carboplatin hypersensitivity in four. Only one patient discontinued chemotherapy due to an adverse event of proteinuria. No treatment-related deaths occurred. CONCLUSION Platinum-based chemotherapy with BEV followed by BEV maintenance for platinum-sensitive recurrence during PARP inhibitor treatment was shown to be efficacious and safe. This combination should be further evaluated in larger randomized clinical trials.
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Affiliation(s)
- Marina Abe
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan;
| | - Yohei Chiba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Yoshitaka Kaido
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Fumiaki Takahashi
- Department of Information Science, Iwate Medical University, Iwate, Japan
| | - Takeshi Aida
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, Aomori, Japan
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
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4
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Shoji T, Takatori E, Nagasawa T, Kagabu M, Baba T, Shigeto T, Matsumura Y, Shimizu D, Terada Y, Seino M, Ohta T, Nagase S, Shigeta S, Tokunaga H, Shimada M, Kaiho-Sakuma M, Furukawa S, Soeda S, Watanabe T, Takahashi F, Yokoyama Y. Comparison of treatment outcomes between first-line chemotherapy with or without bevacizumab for advanced ovarian, fallopian tube, and primary peritoneal cancer (Tohoku gynecologic cancer unit: TGCU-RS001 study). Int J Clin Oncol 2022; 27:1874-1880. [PMID: 36214925 DOI: 10.1007/s10147-022-02246-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/18/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Outcomes with and without bevacizumab as first-line chemotherapy in Japanese-only ovarian cancer patients have not been reported. In this study, we report a retrospective study conducted at the Tohoku Gynecologic Cancer Unit. PATIENTS AND METHODS The study included 453 patients with stage III/IV ovarian, fallopian tube, and primary peritoneal cancer who received first-line platinum-based chemotherapy. The patients were divided into two groups: bevacizumab (168 patients) and without bevacizumab (285 patients). The primary endpoint was the rate of platinum-resistant recurrence and the secondary endpoints were the antitumor response, progression-free survival, overall survival, and adverse events. RESULTS The objective response rates for patients with measurable diseases treated with and without bevacizumab were 84.5% and 73.0%, respectively (P = 0.0066). Platinum-resistant recurrence in the groups treated with and without bevacizumab was noted in 31 (18.4%) and 111 (38.6%) patients, respectively (P < 0.0001). The median progression-free survival for the bevacizumab and without bevacizumab groups was 23 and 15 months, respectively (P = 0.0002), and the median overall survival was not reached and 49 months, respectively (P = 0.0005). Hypertension of grade 3 or higher was observed in 21 patients (12.5%) in the bevacizumab group (P < 0.001), and proteinuria was observed in 18 patients (10.7%) and 1 patient (0.3%) in the bevacizumab and without bevacizumab groups, respectively (P < 0.001). Intestinal perforation was observed in only one patient (0.6%) in the bevacizumab group. CONCLUSION Combination and maintenance with bevacizumab in primary chemotherapy for advanced ovarian, fallopian tube, and primary peritoneal cancer was effective in reducing platinum-resistant recurrence rates and prolonging progression-free and overall survival.
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 2-1-1, Idaidori, Yahaba, Iwate, 028-3695, Japan.
| | - Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 2-1-1, Idaidori, Yahaba, Iwate, 028-3695, Japan
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 2-1-1, Idaidori, Yahaba, Iwate, 028-3695, Japan
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 2-1-1, Idaidori, Yahaba, Iwate, 028-3695, Japan
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 2-1-1, Idaidori, Yahaba, Iwate, 028-3695, Japan
| | - Tatsuhiko Shigeto
- Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Yukiko Matsumura
- Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Dai Shimizu
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Manabu Seino
- Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tsuyoshi Ohta
- Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Satoru Nagase
- Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Shogo Shigeta
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideki Tokunaga
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Muneaki Shimada
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Shigenori Furukawa
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shu Soeda
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takafumi Watanabe
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Fumiaki Takahashi
- Department of Information Science, Iwate Medical University, Yahaba, Japan
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Hirosaki, Japan
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5
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Tanigawa T, Takeshima N, Ishikawa H, Nishio S, Usami T, Yamawaki T, Oishi T, Ihira K, Kato H, Goto M, Saito M, Taira Y, Yokoyama M, Shoji T, Kondo E, Mori A, Yokoi T, Iwasa-Inoue N, Hirashima Y, Nagasawa T, Takenaka M, Mikami M, Sugiyama T, Enomoto T. Paclitaxel-carboplatin and bevacizumab combination with maintenance bevacizumab therapy for metastatic, recurrent, and persistent uterine cervical cancer: An open-label multicenter phase II trial (JGOG1079). Gynecol Oncol 2022; 165:413-419. [PMID: 35487773 DOI: 10.1016/j.ygyno.2022.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This multicenter, open-label, phase II study aimed to evaluate the efficacy and safety of paclitaxel-carboplatin, bevacizumab, and bevacizumab-based maintenance therapy for metastatic, recurrent, and persistent uterine cervical cancer. METHODS Patients with measurable diseases that were not adapted to regional therapies, such as surgery or radiotherapy, and were systematic chemotherapy-naïve were eligible. The participants received paclitaxel (175 mg/m2), carboplatin (AUC 5), and bevacizumab (15 mg/m2) every three weeks until disease progression or unacceptable adverse events occurred. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall response rate (ORR), overall survival (OS), safety, and time to treatment failure. RESULTS Sixty-nine patients were analyzed using our protocol. The median paclitaxel- carboplatin therapy duration was six cycles; 40% of patients received bevacizumab maintenance therapy. The median PFS was 11.3 months. The median OS was not reached; the median time to treatment failure was 5.9 months. The ORR was 79.7% [95% confidence interval (CI) 63.8-88.4]; 16 patients (23.2%) showed complete response (CR) and 39 patients (56.5%) showed partial response (PR). The median PFS was 14.3 months (95% CI 7.3-17 months) for the 25 patients who received maintenance therapy and 7.4 months (95% CI 6.1-11 months) for nonrecipients (p = 0.0449). Gastrointestinal perforation/fistulas occurred in four patients (5.6%), all of whom had a history of radiation therapy. CONCLUSIONS Paclitaxel-carboplatin and bevacizumab therapy is an acceptable and tolerable treatment for advanced or recurrent cervical cancer.
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Affiliation(s)
- Terumi Tanigawa
- Department of Gynecology, The Cancer Institute Hospital of JFCR, Tokyo, Japan.
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Hideki Ishikawa
- JGOG1079 Data Center, Medical Research Support, Osaka, Japan
| | - Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Fukuoka, Japan
| | - Tomoka Usami
- Department of Obstetrics and Gynecology, Ehime University School of Medicine, Ehime, Japan
| | - Takaharu Yamawaki
- Department of Obstetrics and Gynecology, Ise Red Cross Hospital, Mie, Japan
| | - Tetsuro Oishi
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Tottori, Japan
| | - Kei Ihira
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido, Japan
| | - Hisamori Kato
- Department of Gynecology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Mayako Goto
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Hyogo, Japan
| | - Motoaki Saito
- Department of Obstetrics and Gynecology, Tokyo Jikei kai Medical University School of Medicine, Tokyo, Japan
| | - Yusuke Taira
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan
| | - Masatoshi Yokoyama
- Department of Obstetrics and Gynecology, Saga University School of Medicine, Saga, Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, Aomori, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Atsushi Mori
- Department of Obstetrics and Gynecology, Nagano Municipal Hospital, Nagano, Japan
| | - Takeshi Yokoi
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Naomi Iwasa-Inoue
- Department of Obstetrics and Gynecology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | | | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University school of Medicine, Iwate, Japan
| | - Motoki Takenaka
- Department of Obstetrics and Gynecology, Gihu University School of Medicine, Gihu, Japan
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, St. Mary's Hospital, Fukuoka, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan
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6
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Egawa-Takata T, Ueda Y, Ito K, Hori K, Shoji T, Nagasawa T, Nishio S, Ushijima K, Nishino K, Enomoto T, Kikuchi A, Honma S, Oishi T, Shimada M, Takei Y, Fujiwara H, Tanabe H, Okamoto A, Nishio Y, Yamada T, Kimura T. The ACE trial: A randomized phase II study for advanced endometrial carcinoma. Cancer Sci 2022; 113:1693-1701. [PMID: 35218673 PMCID: PMC9128191 DOI: 10.1111/cas.15310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 11/26/2022] Open
Abstract
This study evaluated the feasibility and efficacy of three postoperative adjuvant chemotherapy regimens for endometrial cancer. Endometrioid cancer patients with intermediate-risk stage I and II or high-risk stage III and IV disease were randomly assigned to receive six cycles of either Paclitaxel-Epirubicin-Carboplatin (TEC), Paclitaxel-Anthracycline (Doxorubicin)-Carboplatin (TAC), or dose-dense paclitaxel-carboplatin (ddTC). The primary endpoint was the completion rate (CRate) of six cycles of treatment. The secondary endpoints were progression-free survival (PFS) and overall survival (OS). One hundred and one patients were treated as follows: 33 received TEC, 33 TAC, and 35 ddTC. The CRates for TEC, TAC and ddTC were 94%, 64% and 69%, respectively (p=0.005). The TEC CRate was significantly higher than for the other two groups. However, the PFS and OS outcomes were not statistically different between the three groups. The two-year survival rates were 94%, 97%, and 97% for TEC, TAC, and ddTC, respectively. When compared to the current standard treatments for endometrial cancer, TEC is a promising candidate for a phase III trial based on its significantly superior CRate and equivalent PFS and OS. This study is registered with UMIN Clinical Trials Registry (UMIN000008911).
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Affiliation(s)
- Tomomi Egawa-Takata
- Dept. Obstetrics and Gynecology, Kansai Rosai Hospital, 3-1-69 Inabasou, Amagasaki, Hyogo, 660-8511, Japan.,Dept. Obstetrics and Gynecology, Osaka Police Hospital, 10-31 Kitayama-cho Tennoji-ku, Osaka, 543-0035, Japan
| | - Yutaka Ueda
- Dept. Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kimihiko Ito
- Dept. Obstetrics and Gynecology, Kansai Rosai Hospital, 3-1-69 Inabasou, Amagasaki, Hyogo, 660-8511, Japan
| | - Kensuke Hori
- Dept. Obstetrics and Gynecology, Kansai Rosai Hospital, 3-1-69 Inabasou, Amagasaki, Hyogo, 660-8511, Japan
| | - Tadahiro Shoji
- Dept. Obstetrics and Gynecology, Iwate Medical University, 2-1-1 Nishitokuta, Yanaba-cho, Shiwa, Iwate, 028-3694, Japan
| | - Takayuki Nagasawa
- Dept. Obstetrics and Gynecology, Iwate Medical University, 2-1-1 Nishitokuta, Yanaba-cho, Shiwa, Iwate, 028-3694, Japan
| | - Shin Nishio
- Dept. Obstetrics and Gynecology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Kimio Ushijima
- Dept. Obstetrics and Gynecology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Koji Nishino
- Dept. Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Takayuki Enomoto
- Dept. Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Akira Kikuchi
- Dept. Obstetrics and Gynecology, Niigata Cancer Center 2-15-3 Kawagishi-chou, Chuou-ku, Niigata, 951-8566, Japan
| | - Shigeru Honma
- Dept. Obstetrics and Gynecology, Niigata Cancer Center 2-15-3 Kawagishi-chou, Chuou-ku, Niigata, 951-8566, Japan.,Niigata Association of Occupational Health, Nishi-ku, Japan
| | - Tetsuro Oishi
- Dept. Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago, Tottori, 683-8504, Japan
| | - Muneaki Shimada
- Dept. Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago, Tottori, 683-8504, Japan.,Dept. Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Yuji Takei
- Dept. Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Hiroyuki Fujiwara
- Dept. Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Hiroshi Tanabe
- Dept. Obstetrics and Gynecology, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan.,Dept. Obstetrics and Gynecology, The Jikei University Kashiwa Hospital, 163-1, Kashiwashita, Kashiwa, Chiba, Japan.,Dept. Gynecology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan
| | - Aikou Okamoto
- Dept. Obstetrics and Gynecology, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Yukihiro Nishio
- Dept. Obstetrics and Gynecology, Osaka Police Hospital, 10-31 Kitayama-cho Tennoji-ku, Osaka, 543-0035, Japan
| | - Tomomi Yamada
- Dept. Medical Innovation Data Coordinating Center, Osaka University Hospital, Yamadaoka, Suita, Osaka, 543-0035, Japan
| | - Tadashi Kimura
- Dept. Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
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Shoji T, Tatsuki S, Abe M, Tomabechi H, Takatori E, Kaido Y, Nagasawa T, Kagabu M, Baba T, Itamochi H. Novel Therapeutic Strategies for Refractory Ovarian Cancers: Clear Cell and Mucinous Carcinomas. Cancers (Basel) 2021; 13:6120. [PMID: 34885229 PMCID: PMC8656608 DOI: 10.3390/cancers13236120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 12/13/2022] Open
Abstract
Ovarian cancer has the worst prognosis among gynecological cancers. In particular, clear cell and mucinous carcinomas are less sensitive to chemotherapy. The establishment of new therapies is necessary to improve the treatment outcomes for these carcinomas. In previous clinical studies, chemotherapy with cytotoxic anticancer drugs has failed to demonstrate better treatment outcomes than paclitaxel + carboplatin therapy. In recent years, attention has been focused on treatment with molecular target drugs and immune checkpoint inhibitors that target newly identified biomarkers. The issues that need to be addressed include the most appropriate combination of therapies, identifying patients who may benefit from each therapy, and how results should be incorporated into the standard of care for ovarian clear cell and mucinous carcinomas. In this article, we have reviewed the most promising therapies for ovarian clear cell and mucinous carcinomas, which are regarded as intractable, with an emphasis on therapies currently being investigated in clinical studies.
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Shunsuke Tatsuki
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Marina Abe
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Hidetoshi Tomabechi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Yoshitaka Kaido
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Hiroaki Itamochi
- Department of Clinical Oncology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan;
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8
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Shoji T, Enomoto T, Abe M, Okamoto A, Nagasawa T, Oishi T, Nagase S, Mori M, Inokuchi Y, Kamiura S, Komiyama S, Takeshima N, Sugiyama T. Efficacy and safety of standard of care with/without bevacizumab for platinum-resistant ovarian/fallopian tube/peritoneal cancer previously treated with bevacizumab: The Japanese Gynecologic Oncology Group study JGOG3023. Cancer Sci 2021; 113:240-250. [PMID: 34716979 PMCID: PMC8748228 DOI: 10.1111/cas.15185] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/04/2021] [Accepted: 10/20/2021] [Indexed: 11/28/2022] Open
Abstract
We investigated the efficacy and safety of further bevacizumab therapy in patients with platinum-resistant ovarian cancer whose disease had progressed after bevacizumab plus chemotherapy. In this multicenter, open-label, phase II trial (JGOG3023), patients were randomized 1:1 to a single-agent chemotherapy alone (either pegylated liposomal doxorubicin [40 or 50 mg/m2 administered intravenously], topotecan [1.25 mg/m2 intravenously], paclitaxel [80 mg/m2 intravenously], or gemcitabine [1000 mg/m2 intravenously]) or single-agent chemotherapy + bevacizumab (15 mg/m2 intravenously). The primary endpoint was investigator-assessed progression-free survival (PFS) according to RECIST version 1.1. Secondary endpoints were overall survival (OS), objective response rate (ORR), and response rate according to Gynecological Cancer Intergroup cancer antigen 125 criteria. In total, 103 patients were allocated to chemotherapy (n = 51) or chemotherapy + bevacizumab (n = 52). Median investigator-assessed PFS was 3.1 and 4.0 mo in each group, respectively (hazard ratio [HR] = 0.54, 95% confidence interval [CI]: 0.32-0.90, P = .0082). Median OS was 11.3 and 15.3 mo in each group, respectively (HR = 0.67, 95% CI: 0.38-1.17, P = .1556). Respective ORRs were 13.7% and 25.0% (P = .0599) and response rates were 16.7% and 21.4% (P = .8273). The incidence of grade ≥3 treatment-related AEs was 42.0% in the chemotherapy group and 54.9% in the chemotherapy + bevacizumab group; AEs were well tolerated, with only 2 and 12 events leading to discontinuation of therapy, respectively. Bevacizumab was effective beyond progressive disease and AEs were manageable. The observed improvement in PFS requires further verification.
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan
| | - Masakazu Abe
- Department of Gynecology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Tetsuro Oishi
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Tottori, Japan
| | - Satoru Nagase
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Masahiko Mori
- Department of Gynecology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Yuki Inokuchi
- Department of Biostatistics, Kitasato Academic Research Organization, Kitasato University, Tokyo, Japan
| | - Shoji Kamiura
- Department of Gynecologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Shinichi Komiyama
- Department of Obstetrics and Gynecology, Faculty of Medicine, Toho University, Tokyo, Japan
| | | | - Toru Sugiyama
- Department of Obstetrics and Gynecology, St. Mary's Hospital, Fukuoka, Japan
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Koyama Y, Sato Y, Shoji T, Fuke S, Umayahara T, Sakamoto M. POS0881 DETECTION OF THE GENE EXPRESSIONS IN PERIPHERAL BLOOD INVOLVED IN THE PROGRESSION OF PULMONARY VESSEL DISEASE AT THE SUBCLINICAL STAGE OF PULMONARY HYPERTENSION ASSOCIATED WITH SYSTEMIC SCLEROSIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Pulmonary hypertension (PH) is prominent as a vascular involvement of systemic sclerosis (SSc), which remains a leading cause of death in spite of current best treatments. Recently, hemodynamic definition of PH was updated from mPAP≥25mmHg to mPAP>20mmHg and PVR≥3WU. Although new definition may improve the prognosis of PH associated with SSc by giving a chance to start management early, it may be insufficient as more than 2/3 of the pulmonary circulation is already impaired by the time of meeting the definition. Therefore, the ideal therapeutic intervention should be started at the subclinical stage of PH in SSc patients, but little is known about underlying pathological mechanisms at the stage. In this study, we investigate progression to exercise-induced PH (exPH)1), which is considered subclinical PH, in the prospective registry of high-risk population for developing PH associated with SSc.Objectives:To detect the gene expressions in peripheral blood involved in the progression of pulmonary vessel disease (PVD) at the subclinical stage of PH associated with SSc.Methods:Total of 180 patients who had not met PH criteria with Raynaud phenomenon, skin sclerosis or SSc-related autoantibody was registered. To detect the early PVD, exercise Doppler echocardiography (exDE) was carried out every 6 or 12 months for up to 6 years. The definition of exPH was maximum sPAP>40mmHg or increase in sPAP>20mmHg estimated by exDE during exercise. For gene expression analysis, total RNAs from whole peripheral blood cells were extracted by PAXgene system, and then multiplex sequencing was done. To identify candidate genes involved in the progression to exPH, random forest machine learning method was employed. Volcano plots, a scatter plots to visualize fold-changes and p-values of differentially expressed genes (DEGs) between exPH and others (exN), were also used for seeking the important genes for disease progression.Results:At the time of registration, 34.4% of patients met exPH criteria, and 15.6% of patients developed exPH during follow-up period (35.0±18.1 months). Expression of TNF gene was selected as the most useful genes to predict progression to exPH by random forest, and the accuracy of the model was about 87%. Volcano plots indicated that expressions of TMEM176A and TMEM176B were prominent (fold-change >2.4 and -log10 p-value >3.5) in exPH patients. The accuracy was improved to 90% if the expression of TNF and TMEMA/B were used for the prediction of progression to exPH. We found that statistically significant increase in the expression of TNF was eliminated at the time of fulfilling the exPH criteria, while increase in expressions of TMEM A/B were still kept.Conclusion:It was reported that TNFα drives pulmonary arterial hypertension by suppressing the BMP type-II receptor and altering NOTCH signalling2). Our findings suggest that TNFα plays important role only in the period of pre-exPH. On the other hand, increase in expressions of TMEM A/B were observed through the period of pre-exPH to post-exPH. It suggests that there are multiple phases before developing PH associated with SSc. It is very important to understand the phases for the precise treatment to arrest the progression of PVD.References:[1]R. Naeije et al., Am J resp and critical care med 187, 576-583 (2013). 2) LA. Hurst et al., Nat Commun. 13;8:14079 (2017).Disclosure of Interests:Yoshinobu Koyama Speakers bureau: Asahikasei, Ayumi, BMS, Mitsubishi Tanabe, Shin-nihon, Paid instructor for: Asahikasei, Asteras, BMS, Grant/research support from: Eli-Lilly, Yoshiharu Sato: None declared, Tatsuma Shoji: None declared, Soichiro Fuke: None declared, Takatsune Umayahara: None declared, Moe Sakamoto: None declared
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Shimada M, Sato S, Shoji T, Nagao S, Tokunaga H, Sueoka K, Takehara K, Nakamura K, Yamaguchi S, Kigawa J. Docetaxel and carboplatin chemotherapy for treating patients with stage IVB or recurrent non-squamous cell carcinoma of the uterine cervix: a phase II study. Int J Clin Oncol 2021; 26:1314-1321. [PMID: 33826028 DOI: 10.1007/s10147-021-01903-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 03/20/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND This phase II study evaluated the efficacy and safety of docetaxel/carboplatin chemotherapy for treating patients with stage IVB or recurrent non-squamous cell carcinoma of the uterine cervix. METHODS A total of 50 patients with International Federation of Gynecology and Obstetrics stage IVB or recurrent non-squamous cell carcinoma of the uterine cervix were enrolled and administered docetaxel at a dose of 60 mg/m2, followed by carboplatin at a dose based on the area under the receiver operating characteristic curve of 6. The treatments were repeated every 21 days until disease progression or unacceptable adverse events. Except for two patients, 48 were eligible for evaluation. Another patient withdrew consent before treatment; adverse events were evaluated in 47. RESULTS The response rate was 47.9% with 5 patients achieving complete response, 18 partial response, 14 stable disease, and 6 progressive disease. The disease control rate was 77.1%. With a median follow-up duration of 368 days, the median progression-free survival and overall survival were 6.1 months (95% CI 5.5-8.6) and 15.8 months (95% CI 18.2-28.3), respectively. The most frequent grade 3 and grade 4 hematological toxicity was neutropenia, with 38 patients (81%) having grade 4 and 4 (9%) having grade 3 neutropenia. The non-hematological toxicities were mainly grade 1 or 2 in severity. CONCLUSION Docetaxel/carboplatin chemotherapy was effective, with a higher disease control rate and well-tolerated chemotherapeutic regimen for patients with stage IVB or recurrent non-squamous cell carcinoma of the uterine cervix.
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Affiliation(s)
- Muneaki Shimada
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Shinya Sato
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1, Nishi-cho, Yonago, Tottori, 683-8504, Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University, 2-1-1, Idaidori, Yahaba-cho, Shiwa-gun, Morioka, Iwate, 020-8505, Japan
| | - Shoji Nagao
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
- Department of Gynecology, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
| | - Hideki Tokunaga
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Kotaro Sueoka
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Kazuhiro Takehara
- Department of Obstetrics and Gynecology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1, Aoyama-cho, Kure, Hiroshima, 737-0023, Japan
- Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center, 160, Minami-Umenomoto, Matsuyama, Ehime, 791-0280, Japan
| | - Keiichiro Nakamura
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Sikada-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Satoshi Yamaguchi
- Department of Gynecology, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
| | - Junzo Kigawa
- Matsue City Hospital, 32-1, Noshira-cho, Matsue, Shimane, 690-8509, Japan
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Komiyama K, Kobayashi S, Shoji T, Kikushima K, Dohi T, Kita Y. Practical synthesis of diaryliodonium(iii) triflates using ArI(OAc)2/TfOH/MeCN reaction system. Russ Chem Bull 2020. [DOI: 10.1007/s11172-020-3035-9] [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: 11/24/2022]
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Takeuchi S, Kagabu M, Shoji T, Nitta Y, Sugiyama T, Sato J, Nakamura Y. Anti-cancer immunotherapy using cancer-derived multiple epitope-peptides cocktail vaccination clinical studies in patients with refractory/persistent disease of uterine cervical cancer and ovarian cancer [phase 2]. Oncoimmunology 2020; 9:1838189. [PMID: 33235818 PMCID: PMC7671072 DOI: 10.1080/2162402x.2020.1838189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 01/04/2023] Open
Abstract
We had conducted phase 1/2 studies of cancer vaccination therapy using neo-tumor antigens in patients with refractory/persistent cervical cancer (CC) and ovarian cancer (OC) to assess the feasibility and efficacy. Enrollees must be refractory/persistent disease for usual treatments with Human Leukocyte Antigen-A*0201 or A*2402. The targets were epitope peptides obtained from driver genes in surviving pathways as follows: for CC A*0201, peptides from Up Regulating Lung Cancer 10 gene (URLC10) and Hypoxia-inducible gene 2 (HIG-2) and for OC A*0201, HIG2, VEGFR (vascular epithelial growth factor receptor) 1 and 2 were used. For CC A*2402, Forkhead Box M1 (FOXM1), Maternal Embryonic Leucine zipper Kinase (MELK), and Holliday Junction Recognition Protein (HJURP) were used. For OC A*2402, cocktails of peptides from FOXM1, MELK, HJURP, VEGFR1, and VEGFR2 were used. Subcutaneous administration was performed with adjuvant weekly. The toxicity profiles and tumor-response were analyzed in eight-week interval. Sixty-six patients were accrued, and 64 were evaluable for adverse events (AEs), and 35 for response. AEs of G2/3 dermatologic reaction (DR) of injection site had been identified in 15.6% and no other severe AEs were detected. Response rate in OC and CC were 22.9% and 20%, respectively. Median overall survival showed longer in performance status (PS) 0 (versus PS1/2), in CRP negative (versus positive) and in DR positive (versus negative) such as 8.7 m versus 1.2 m (p < .001), 8.8 m versus 3.0 m (p < .05) and 10.2 m versus 1.2 m (p < .001), respectively. In conclusion, our vaccination therapy was feasible and effective in this cohort of patients.
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Affiliation(s)
- Satoshi Takeuchi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Yahaba town, Japan
- Division of Gynecologic Oncology, Department of Gynecology, Women Health Care, Kobe Tokushukai Hospital Women’s Cancer Center, Gynecologic Oncology, Kobe, Japan
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Yahaba town, Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Yahaba town, Japan
| | - Yukari Nitta
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Yahaba town, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Yahaba town, Japan
- Gynecology, St. Mary’s Hospital, Kurume, Japan
| | - Junya Sato
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Yahaba town, Japan
- Department of Pharmacy, Shizuoka Cancer Center, Tokyo, Japan
| | - Yusuke Nakamura
- Department of Cancer, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Cancer precision Medicine, Cancer Institute Hospital of JFCR (Japanese Foundation for Cancer Research), Tokyo, Japan
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Hu Y, Zhao L, Lu Y, Shoji T. The effect of different turbulent flow on failure behavior in secondary loop of the pressurized water reactor. Nuclear Engineering and Design 2020. [DOI: 10.1016/j.nucengdes.2020.110812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kagabu M, Nagasawa T, Sato C, Fukagawa Y, Kawamura H, Tomabechi H, Takemoto S, Shoji T, Baba T. Immunotherapy for Uterine Cervical Cancer Using Checkpoint Inhibitors: Future Directions. Int J Mol Sci 2020; 21:E2335. [PMID: 32230938 PMCID: PMC7177858 DOI: 10.3390/ijms21072335] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 12/12/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) have demonstrated marked clinical effects worldwide, and "cancer immunotherapy" has been recognized as a feasible option for cancer treatment. Significant treatment responses have already been attained for malignant melanoma and lung cancer, ahead of gynecologic cancer. In cervical cancer, however, results are only available from phase II trials, not from phase III trials. Cervical cancer is a malignant tumor and is the fourth most common cancer among women worldwide. Since the introduction of angiogenesis inhibitors, treatment for recurrent and advanced cervical cancers has improved in the past five years, but median overall survival is 16.8 months for advanced cervical cancer, and all-stage five-year overall survival rate is 68%, indicating that treatment effects remain inadequate. For this reason, the development of new therapeutic approaches is imperative. We describe herein the KEYNOTE-158 and CheckMate 358 clinical trials, which were conducted for cervical cancer, and discuss future directions, including potential combinations with concurrent chemoradiation therapy (CCRT), as noted for other types of cancer.
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Affiliation(s)
- Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 028-3695, Japan; (T.N.); (C.S.); (H.K.); (Y.F.); (H.T.); (S.T.); (T.S.); (T.B.)
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Shoji T, Takeshita R, Saito T, Aida T, Sasou S, Baba T. A case of primary ovarian signet-ring cell carcinoma treated with S-1/CDDP therapy. J Ovarian Res 2020; 13:33. [PMID: 32199455 PMCID: PMC7085154 DOI: 10.1186/s13048-020-00636-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 03/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary ovarian signet-ring cell carcinoma is extremely rare, with only five recent case reports. Almost all reported cases of ovarian signet-ring cell carcinoma have been treated with TC therapy and none have reported regarding the use of S-1/CDDP therapy. We report a case of primary ovarian signet-ring cell carcinoma treated postoperatively with S-1/CDDP therapy. CASE PRESENTATION We describe a 55-year-old woman diagnosed with stage IB primary ovarian signet-ring cell carcinoma that was treated with S-1/CDDP therapy. Preoperative transvaginal ultrasonography and contrast-enhanced computed tomography (CT) revealed a solid tumor measuring 10 cm in diameter in the pelvis. The tumor marker levels were as follows: CA125, 41.6 U/mL; CA19-9, < 2.0 U/mL; and CEA, 2.2 ng/mL. Ovarian cancer was suspected, and total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy were performed. The left ovary was enlarged to greater than fist-sized, and there was a small amount of clear yellow ascites. Histological examination of the left ovary led to the diagnosis of signet-ring cell carcinoma. Histological examination of the right ovary also showed the presence of a signet-ring cell carcinoma. After surgery, upper and lower gastrointestinal endoscopy and positron-emission tomography-CT were performed to search for a possible primary lesion, but none was found. The patient was diagnosed with primary ovarian signet-ring cell carcinoma with FIGO Stage IB (PT1b, NX, M0). As postoperative adjuvant chemotherapy, S-1/CDDP therapy (S-1120 mg/day/body × 14 days, CDDP 50 mg/m2 day 8, q 21 days) was administered for six cycles. There was no recurrence 27 months after the initial treatment. CONCLUSIONS We considered S-1/CDDP therapy was effective for primary ovarian signet-ring cell carcinoma. This is the first case report of primary ovarian signet-ring cell carcinoma treated with S-1/CDDP therapy in the world.
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
| | - Ryosuke Takeshita
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, 2 Nakaaketo, Tamonoki, Hachinohe, Aomori, 039-1104, Japan
| | - Tatsunori Saito
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, 2 Nakaaketo, Tamonoki, Hachinohe, Aomori, 039-1104, Japan
| | - Takeshi Aida
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, 2 Nakaaketo, Tamonoki, Hachinohe, Aomori, 039-1104, Japan
| | - Shunichi Sasou
- Department of Pathology and Laboratory, Hachinohe Red Cross Hospital, 2 Nakaaketo, Tamonoki, Hachinohe, Aomori, 039-1104, Japan
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
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Watanabe T, Soeda S, Nishiyama H, Kiko Y, Tokunaga H, Shigeta S, Yaegashi N, Yamada H, Ohta T, Nagase S, Shoji T, Kagabu M, Baba T, Shimizu D, Sato N, Terada Y, Futagami M, Yokoyama Y, Fujimori K. Clinical and reproductive outcomes of fertility-sparing surgery in stage I epithelial ovarian cancer. Mol Clin Oncol 2019; 12:44-50. [PMID: 31832189 PMCID: PMC6904870 DOI: 10.3892/mco.2019.1954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/23/2019] [Indexed: 12/12/2022] Open
Abstract
The aim of the present study was to evaluate the oncologic safety and reproductive outcome in patients with stage I epithelial ovarian cancer (EOC) treated with fertility-sparing surgery (FSS). Women aged ≤40 years with stage I EOC who had undergone FSS between 2000 and 2010 were retrospectively reviewed. Survival was examined using the Kaplan-Meier method and statistical significance was analyzed using the log-rank test. A total of 29 EOC patients (stage IA, n=14; stage IC1 n=6; stage IC3, n=9) from seven participating institutions belonging to the Tohoku Gynecologic Cancer Unit were enrolled. After a median follow-up duration of 60.6 months (range, 6–135 months), five patients (17.2%) experienced tumor recurrence. The respective five-year relapse-free survival (RFS) and overall survival (OS) rates were 90.9 and 100% for stage IA/IC1, and 43.8 and 87.5% for stage IC3. Significant differences in RFS were observed between stage IA/IC1 and IC3 patients (P=0.026). However, there was no significant difference in OS between patients with 1A/1C1 and those with 1C3 (P=0.712). After FSS, seven pregnancies occurred in five patients, which resulted in the birth of six healthy children. The results of the present study confirmed that FSS may be an acceptable treatment method for stage IA and IC1 EOC, exhibiting a favorable reproductive outcome. However, the safety of FSS for treating stage IC3 EOC is uncertain and warrants further investigation.
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Affiliation(s)
- Takafumi Watanabe
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Shu Soeda
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hiroshi Nishiyama
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Yuichiroh Kiko
- Department of Diagnostic Pathology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hideki Tokunaga
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Shogo Shigeta
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - Hidekazu Yamada
- Miyagi Cancer Center, Medeshima-shiote, Natori, Miyagi 981-1293, Japan
| | - Tsuyoshi Ohta
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
| | - Satoru Nagase
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Dai Shimizu
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Naoki Sato
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Masayuki Futagami
- Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Hirosaki, Aomori 036-8563, Japan
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Hirosaki, Aomori 036-8563, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
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Yoshizane T, Tanaka R, Kawasaki M, Otsuka M, Shoji T, Nagaya M, Hattori K, Yagasaki H, Minatoguchi S, Ono K, Murata I, Deguchi T, Arai M, Noda T, Okura H. P4384Noninvasive and novel method to evaluate left ventricular contractility using pressure-volume loop area obtained by 3-dimensional speckle tracking echocardiography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0789] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Left ventricular (LV) pressure-volume (P-V) loop area reflects stroke work (SW), but clinical use of this index is limited by the need of invasive pressure measurement. A noninvasive method to obtain LV pressure-strain loop was recently introduced to assess myocardial work (MW). The minimum LV diastolic pressure (mLVP) was reported to have a strong correlation with Tau and we reported that Tau was noninvasively evaluated by speckle tracking echocardiography (STE).
Purpose
We sought to evaluate the impact of preload change by leg lifts on LV SW noninvasively obtained by the novel method and to examine the utility to assess LV contractility by SW and end-diastolic (ED) volume relation (SW-VED).
Methods
Thirty six controls (age 71±10) and 30 patients with heart failure with reduced ejection fraction (EF) <50% (HF) (age 73±6) were enrolled. LV pressure in a cardiac cycle was estimated using systolic blood pressure (SBP), minimum diastolic pressure (mDP) and ED pressure (EDP) by utilizing the profile of an empiric, normalized reference curve. The mDP and EDP were estimated as (Tau − 33.7)/2.06 and as 12.3 − 10.1 x Log (left atrial active emptying function/minimum volume) as we reported. LVSW was obtained by P-V loop by the combination of these pressures and LV volume using 3-D STE.
Results
LVEF and longitudinal strain in HF before leg up by 3D-STE were lower compared to normal (LVEF; normal: 58±5 vs HF: 39±10*% and strain; −12±3 vs −8±3%*, *p<0.05 vs normal). LVEF was increased after leg up by 7±6% in normal and by 8±8% in HF associated with increased LVED volume (normal: 84±24 to 90±24 and HF: 124±36* to 136±42*ml). LV MW and SW in HF before leg up were lower compared to normal (MW: 1790±412 vs 1002±432*mmHg% and SW: 3946±1682 vs 3352±1026mmHgml). LV SW increased after leg up by 26±19% in normal and by 25±20% in HF. LV SW-VED in normal was greater than HF (241±151 vs 90±54*).
Conclusion
LV SW noninvasively obtained by P-V loop area was increased after leg up in both normal and HF but SW-VED in HF was smaller than normal, indicating reduced contractility in HF. This noninvasive method may be a new echocardiographic approach for quantification of LV SW and contractility.
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Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Asahi University Hospital, Cardiology, Gifu, Japan
| | | | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Shoji
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - K Hattori
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Yagasaki
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - I Murata
- Gifu Prefectural General Medical Center, Nephrology, Gifu, Japan
| | - T Deguchi
- Asahi University Hospital, Cardiology, Gifu, Japan
| | - M Arai
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Okura
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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Shoji T, Kikuchi E, Kikuchi J, Maeda M, Takashima Y, Furuta M, Takahashi H, Kinoshita I, Dosaka-Akita H, Sakakibara-Konishi J, Konno S. P2.03-53 Immunoproteasome as a Potential Therapeutic Target in Cisplatin-Resistant Small and Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1500] [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]
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19
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Yoshizane T, Tanaka R, Kawasaki M, Otsuka M, Shoji T, Nagaya M, Hattori K, Murayama M, Yagasaki H, Minatoguchi S, Ono K, Tanihata S, Arai M, Noda T, Okura H. P2474Noninvasive estimation of pulmonary capillary wedge pressure by novel 3D speckle tracking echocardiography and validation study by cardiac catheterization. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0806] [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: 11/13/2022] Open
Abstract
Abstract
Background
We previously reported that pulmonary capillary wedge pressure (PCWP) was noninvasively evaluated by 2D speckle tracking echocardiography (STE). Recently, novel software was introduced to examine volume and function of left ventricular and left atrium (LA) by 3D-STE automatically.
Purpose
We sought to compare the PCWP estimated by conventional 2D-STE (2D-ePCWP) and by novel 3D-STE (3D-ePCWP), and validate those values by cardiac catheterization.
Methods
Echocardiography and catheterization were performed in 29 patients (age 72±2) (7 ischemic heart disease, 2 hypertensive heart disease, 5 dilated cardiomyopathy, 12 valvular heart disease and 3 primary pulmonary hypertension).The ePCWP (mmHg) is noninvasively obtained as 10.8 − 12.4 x Log (left atrial active emptying function/minimum volume) as we previously reported. Echocardiography was performed just before the catheterization and we analyzed the 2D and 3D data by novel off-line software. 3D data was automatically analyzed and the border settings were fixed at default (ES60, ED30) (Figure).
Results
2D-ePCWP and 3D-ePCWP had a good correlation with PCWP invasively obtained by catheterization (r=0.87 and 0.83, respectively, both p<0.001). There was an excellent correlation between 2D-ePCWP and 3D-ePCWP (r=0.94, p<0.001) and there was a good correlation between 2D-LA volume index and 3D- LA volume index (r=0.80, p<0.001). Bland-Altman analysis revealed a good agreement between 2D-ePCWP and 3D-ePCWP, and between 2D-ePCWP and 3D-ePCWP without fixed and proportional bias.
Conclusion
This study demonstrated that PCWP might be noninvasively assessed by not only 2D-STE but also 3D-STE with reasonable accuracy and 3D-STE might have utility and value in the routine clinical practice.
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Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Asahi University Hospital, Cardiology, Gifu, Japan
| | | | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Shoji
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - K Hattori
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Murayama
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Yagasaki
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Tanihata
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Arai
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Okura
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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Yoshizane T, Tanaka R, Kawasaki M, Otsuka M, Shoji T, Nagaya M, Hattori K, Yagasaki H, Minatoguchi S, Ono K, Deguchi T, Tanihata S, Arai M, Noda T, Okura H. P4351Validation by cardiac catheterization of noninvasive evaluation of left ventricular chamber and myocardial stiffness as a diastolic function using speckle tracking echocardiography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0758] [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: 11/12/2022] Open
Abstract
Abstract
Background
Left ventricular (LV) diastolic function is mainly composed of LV relaxation and LV stiffness. We reported that pulmonary capillary wedge pressure (ePCWP) and LV relaxation assessed by Tau (eTau) are noninvasively evaluated by speckle tracking echocardiography (STE). The minimum LV diastolic pressure (mLVP) was reported to have a strong correlation with Tau. Therefore, LV chamber stiffness (c-stiffness) may be assessed with the use of two LV diastolic pressure-volume coordinates: the mLVP and volume and the end-diastolic pressure (EDP) and volume.
Purpose
We sought to noninvasively assess LV stiffness using STE and validate the value by cardiac catheterization.
Methods
Echocardiography and catheterization were performed in 124 patients (age 72±8) (70 angina pectoris, 20 prior myocardial infarction, 19 hypertensive heart disease, 11 congestive heart failure and 4 paroxysmal atrial fibrillation). The ePCWP (mmHg) is noninvasively obtained as 10.8 − 12.4 × Log (left atrial active emptying function/minimum volume) and the eTau (ms) is obtained as isovolumic relaxation time/(ln 0.9 × systolic blood pressure − ln ePCWP) as previously reported. The mLVP (e-mLVP) was estimate using Tau. The estimated EDP (e-EDP) was calculated as 12.3 − 10.1 × Log (left atrial active emptying function / minimum volume). LV c-stiffness (mmHg/ml) was calculated as LV pressure change (from mLVP to EDP) obtained by catheterization divided by LV volume change during diastole which equals to stroke volume by echocardiography. Estimated c-stiffness (e-c-stiffness) was noninvasively obtained using e-mLVP and e-EDP. Furthermore, LV myocardial stiffness (m-stiffness) was calculated by LVED stress / LV longitudinal strain by STE, where LV stress (kdynes/cm2) was calculated as 0.334 × pressure × dimension / [thickness (1 + thickness/dimension)]. The estimated m-stiffness (e-m-stiffness) was calculated using e-EDP.
Results
The eTau and e-EDP estimated by STE had a good correlation with Tau and EDP invasively obtained by catheterization (r=0.75 and 0.63, respectively, both p<0.001). There was a good correlation between Tau and mLVP (Tau = 2.06 mLVP + 33.7, r=0.70). The estimated LVED stress had good correlation with ED stress obtained by catheterization (r=0.77, p<0.001). The e-c-stiffness and e-m-stiffness had a good correlation with those obtained by catheterization (e-c-stiffness; 0.116±0.07 and c-stiffness; 0.115±0.06, r=0.603, e-m-stiffness; 0.81±0.41 and m-stiffness; 0.85±0.45, r=0.89, respectively). Bland-Altman analysis revealed a good agreement between e-c-stiffness and c-stiffness, and between e-m-stiffness and m-stiffness without fixed and proportional bias.
Conclusion
This study demonstrated that LV stiffness may be noninvasively assessed by STE with reasonable accuracy and may have utility and value in the routine clinical practice for the diagnosis and treatment in patients with diastolic dysfunction.
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Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Asahi University Hospital, Cardiology, Gifu, Japan
| | | | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Shoji
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - K Hattori
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Yagasaki
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Deguchi
- Asahi University Hospital, Cardiology, Gifu, Japan
| | - S Tanihata
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Arai
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Okura
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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21
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Abe Y, Yuki I, Otani K, Shoji T, Ishibashi T, Murayama Y. Agreement of intracranial vessel diameters measured on 2D and 3D digital subtraction angiography using an automatic windowing algorithm. J Neuroradiol 2019; 48:311-315. [PMID: 31563590 DOI: 10.1016/j.neurad.2019.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Precise vessel measurement plays a major role in size selection of stents used for the treatment of intracranial aneurysms and became even more critical after the introduction of flow diverter stents. We assessed agreement between intracranial vessel diameters of aneurysm patients measured on 2D digital subtraction (2D DSA) and 3D volume rendering digital subtraction angiography (3D DSA) images using an automatic windowing algorithm. MATERIALS AND METHODS Ten patients with intracranial aneurysms were enrolled and 120 measurement points were selected on both 2D and 3D DSA images acquired by a biplane angiographic system. Automatic windowing was applied to the 3D DSA images. Inter-method agreement of vessel measurements on 2D and 3D DSA images was assessed by Bland Altman plots and intraclass correlation coefficients (ICC). Inter- and intra-rater agreement of measurements on 3D DSA images were assessed by ICCs. RESULTS The mean differences between measurements on 2D and 3D DSA images were 0.14mm for the ICA, and 0.18mm for the ACA and MCA, which is about the size of one 3D DSA image voxel. For ICA measurements, inter-method, inter-rater and intra-rater agreements were good or excellent (consistency and absolute ICC≥0.95). For ACA and MCA measurements, the inter-method, inter-rater and intra-rater agreements were also good or excellent (consistency ICC=0.94, 0.89 and 0.93, absolute ICC=0.83, 0.84 and 0.85 respectively). CONCLUSIONS Vessel diameters may be measured on 3D DSA images with sufficient reliability for clinical use when applying an automatic windowing algorithm.
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Affiliation(s)
- Y Abe
- Department of Radiology, The Jikei University Hospital, Tokyo, Japan.
| | - I Yuki
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan
| | - K Otani
- Siemens Healthcare, Tokyo, Japan
| | - T Shoji
- Department of Radiology, The Jikei University Hospital, Tokyo, Japan
| | - T Ishibashi
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Y Murayama
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan
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22
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Kagabu M, Nagasawa T, Fukagawa D, Tomabechi H, Sato S, Shoji T, Baba T. Immunotherapy for Uterine Cervical Cancer. Healthcare (Basel) 2019; 7:E108. [PMID: 31533297 PMCID: PMC6787701 DOI: 10.3390/healthcare7030108] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 09/02/2019] [Accepted: 09/10/2019] [Indexed: 11/21/2022] Open
Abstract
Cervical cancer is a malignant neoplastic disease that is the fourth most commonly occurring cancer in women worldwide. Since the introduction of angiogenesis inhibitors, treatments for recurrent and advanced cervical cancers have improved significantly in the past five years. However, the median overall survival in advanced cervical cancer is 16.8 months, with a 5-year overall survival rate of 68% for all stages, indicating that the effects of the treatment are still unsatisfactory. The development of a new treatment method is therefore imperative. Recently, in the clinical oncology field, remarkable progress has been made in immunotherapy. Immunotherapy is already established as standard therapy in some fields and in some types of cancers, and its clinical role in all areas, including the gynecology field, will change further based on the outcomes of currently ongoing clinical trials. This manuscript summarizes the results from previous clinical trials in cervical cancer and describes the ongoing clinical trials, as well as future directions.
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Affiliation(s)
- Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan.
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan.
| | - Daisuke Fukagawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan.
| | - Hidetoshi Tomabechi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan.
| | - Saiya Sato
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan.
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan.
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan.
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Shoji T, Okute Y, Tsujimoto Y, Nakatani S, Mori K, Fukumoto S, Emoto M, Inaba M. SUN-054 ALTERED BIOMARKER PROFILE OF CHOLESTEROL ABSORPTION IN ASSOCIATION WITH RISK OF FUTURE CARDIOVASCULAR EVENTS AND MORTALOTY IN A HEMODIALYSIS COHORT. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.450] [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] Open
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24
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Yasunaga Y, Tanaka R, Mifuji K, Shoji T, Yamasaki T, Adachi N, Ochi M. Rotational acetabular osteotomy for symptomatic hip dysplasia in patients younger than 21 years of age: seven- to 30-year survival outcomes. Bone Joint J 2019; 101-B:390-395. [PMID: 30929485 DOI: 10.1302/0301-620x.101b4.bjj-2018-1200.r1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS The aim of this study was to report the long-term results of rotational acetabular osteotomy (RAO) for symptomatic hip dysplasia in patients aged younger than 21 years at the time of surgery. PATIENTS AND METHODS We evaluated 31 patients (37 hips) aged younger than 21 years at the time of surgery retrospectively. There were 29 female and two male patients. Their mean age at the time of surgery was 17.4 years (12 to 21). The mean follow-up was 17.9 years (7 to 30). The RAO was combined with a varus or valgus femoral osteotomy or a greater trochanteric displacement in eight hips, as instability or congruence of the hip could not be corrected adequately using RAO alone. RESULTS The mean Merle d'Aubigné clinical score improved significantly from 15.4 to 17.2 (p < 0.0001). The mean centre-edge (CE) angle improved from -2.6° to 26°, the mean acetabular roof angle improved from 3.0° to 5.2°, and the mean head lateralization index improved from 0.68 to 0.62. Progression of radiological osteoarthritis (OA) was seen in seven hips, but no patient underwent total hip arthroplasty. CONCLUSION RAO is an effective form of correction for a severely dysplastic hip in adolescent and young adult patients. Cite this article: Bone Joint J 2019;101-B:390-395.
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Affiliation(s)
- Y Yasunaga
- Hiroshima Prefectural Rehabilitation Center, Higashi-Hiroshima, Japan
| | - R Tanaka
- Hiroshima Prefectural Rehabilitation Center, Higashi-Hiroshima, Japan
| | - K Mifuji
- Department of Orthopaedic Surgery, Hiroshima University, Higashi-Hiroshima, Japan
| | - T Shoji
- Department of Orthopaedic Surgery, Hiroshima University, Higashi-Hiroshima, Japan
| | - T Yamasaki
- Department of Orthopaedic Surgery, Hiroshima University, Higashi-Hiroshima, Japan
| | - N Adachi
- Department of Orthopaedic Surgery, Hiroshima University, Higashi-Hiroshima, Japan
| | - M Ochi
- Hiroshima University, Higashi-Hiroshima, Japan
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25
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Shoji T, Takeshita R, Mukaida R, Takatori E, Nagasawa T, Omi H, Sugiyama T. Safe administration of bevacizumab combination chemotherapy for the patients with recurrent cervical cancer after pelvic radiotherapy: Two case reports. Mol Clin Oncol 2018; 9:173-177. [PMID: 30101016 PMCID: PMC6083409 DOI: 10.3892/mco.2018.1642] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 05/24/2018] [Indexed: 11/27/2022] Open
Abstract
In Japan, bevacizumab has not been proven either effective or safe for the treatment of recurrent cervical cancer. The present study reported two cases in which bevacizumab combination chemotherapy was safely administered for recurrent cervical cancer following pelvic radiotherapy. Case 1 was a 62-year-old woman with stage IIIB squamous cell carcinoma of the cervix who had received whole pelvic external beam radiotherapy (WPEBRT) at a dose of 50.4 Gy and high dose rate intra-cavitary brachytherapy at a dose of 24 Gy to the pelvis one year earlier. For recurrent cervical cancer, chemotherapy with paclitaxel, carboplatin and bevacizumab was administered for six cycles. Case 2 was a 52-year-old woman with stage IIB squamous cell carcinoma of the cervix who had received WPEBRT at a dose of 50.4 Gy to the pelvis 11 years earlier. For lymph node and liver metastases, chemotherapy with paclitaxel, cisplatin, and bevacizumab was administered for six cycles. Although grade 2 proteinuria was observed in one of these patients, there were no intestinal perforation, fistula, hypertension, proteinuria or thrombosis events, which are the characteristic adverse reactions associated with bevacizumab. Hematotoxicity was also manageable. Regarding the antitumor effect, case 1 demonstrated a complete response, whereas case 2 resulted in stable disease.
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, Hachinohe, Aomori 039-1104, Japan
| | - Ryosuke Takeshita
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, Hachinohe, Aomori 039-1104, Japan
| | - Rika Mukaida
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, Hachinohe, Aomori 039-1104, Japan
| | - Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Hideo Omi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
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Shoji T, Komiyama S, Kigawa J, Tanabe H, Kato K, Itamochi H, Fujiwara H, Kamiura S, Hamano T, Sugiyama T. An open-label, randomized, phase II trial evaluating the efficacy and safety of standard of care with or without bevacizumab in platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer patients previously treated with bevacizumab for front-line or platinum-sensitive ovarian cancer: rationale, design, and methods of the Japanese Gynecologic Oncology Group study JGOG3023. BMC Cancer 2018; 18:771. [PMID: 30064406 PMCID: PMC6069952 DOI: 10.1186/s12885-018-4505-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/15/2018] [Indexed: 11/30/2022] Open
Abstract
Background We present the study rationale and design of the JGOG3023 study, an open-label, parallel-arm, randomized, phase II trial that aimed to assess the efficacy and safety of chemotherapy with or without bevacizumab in patients with platinum-resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who were previously treated with bevacizumab for front-line or platinum-sensitive ovarian cancer. We hypothesize that patients treated with a combination of single-agent chemotherapy and bevacizumab will show improved progression-free survival (PFS) compared with those treated with single-agent chemotherapy alone, in the setting beyond disease progression following prior bevacizumab treatment. Methods/design A total of 106 patients who have recurrence or progression of ovarian cancer, while receiving chemotherapy or within 6 months after the final dose of platinum, after completing at least three cycles of bevacizumab plus platinum chemotherapy will be randomized in a 1:1 ratio to treatment with single-agent chemotherapy or single-agent chemotherapy combined with bevacizumab. For chemotherapy, one of the following four drugs will be chosen by an investigator: pegylated liposomal doxorubicin, topotecan, paclitaxel, or gemcitabine. The primary endpoint is investigator-assessed PFS. The secondary endpoints are overall survival, objective response rate, number of paracentesis, and response rate by CA125. Safety will be evaluated by the incidence of adverse events. Discussion This study will assess the efficacy and safety of bevacizumab in combination with single-agent chemotherapy, which could be used continuously after disease progression following standard platinum-based chemotherapy with bevacizumab. Trial registration UMIN000017247 (registered April 22, 2015).
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
| | - Shinichi Komiyama
- Department of Gynecology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Junzo Kigawa
- Department of Obstetrics and Gynecology, Matsue City Hospital, Shimane, Japan
| | - Hiroshi Tanabe
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
| | - Kazuyoshi Kato
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Hiroaki Itamochi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Hiroyuki Fujiwara
- Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan
| | - Shoji Kamiura
- Department of Gynecology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Tetsutaro Hamano
- Clinical Trial Coordinating Center, Kitasato Academic Research Organization, Kitasato University, Tokyo, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
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Nishio S, Takekuma M, Takeuchi S, Kawano K, Tsuda N, Tasaki K, Takahashi N, Abe M, Tanaka A, Nagasawa T, Shoji T, Xiong H, Nuthalapati S, Leahy T, Hashiba H, Kiriyama T, Komarnitsky P, Hirashima Y, Ushijima K. Phase 1 study of veliparib with carboplatin and weekly paclitaxel in Japanese patients with newly diagnosed ovarian cancer. Cancer Sci 2017; 108:2213-2220. [PMID: 28837250 PMCID: PMC5665762 DOI: 10.1111/cas.13381] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 07/31/2017] [Accepted: 08/09/2017] [Indexed: 01/06/2023] Open
Abstract
This phase 1, open-label, dose-escalation study was conducted to determine the safety, tolerability, pharmacokinetics and preliminary efficacy of veliparib with carboplatin and weekly paclitaxel in Japanese women with newly diagnosed, advanced ovarian cancer. Patients received veliparib at 100 or 150 mg b.i.d. on days 1-21 with carboplatin (area under the concentration-time curve 6 mg/mL•min) on day 1 and paclitaxel 80 mg/m2 on days 1, 8 and 15 every 3 weeks for up to 6 21-day cycles. Dose escalation followed a 3 + 3 design to determine dose-limiting toxicities, maximum tolerated dose and the recommended phase 2 dose. Nine patients (median age 62 [range 27-72] years) received a median of 5 (range 3-6) cycles of treatment (3 at 100 mg, 6 at 150 mg). There were no dose-limiting toxicities. The most common adverse events of any grade were neutropenia (100%), alopecia (89%), peripheral sensory neuropathy (78%), and anemia, nausea and malaise (67% each). Grade 3 or 4 adverse events were associated with myelosuppression. Pharmacokinetics of carboplatin/paclitaxel were similar at both veliparib doses. Response, assessed in five patients, was partial in four and complete in one (objective response rate 100%). The response could not be assessed in four patients who had no measurable disease at baseline. The recommended phase 2 dose of veliparib, when combined with carboplatin/paclitaxel, is 150 mg b.i.d. Findings from this phase 1 trial demonstrate the tolerability and safety of veliparib with carboplatin/paclitaxel, a regimen with potential clinical benefit in Japanese women with ovarian cancer.
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Affiliation(s)
- Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Munetaka Takekuma
- Division of Gynecology, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
| | - Satoshi Takeuchi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate, Japan
| | - Kouichirou Kawano
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Naotake Tsuda
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kazuto Tasaki
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Nobutaka Takahashi
- Division of Gynecology, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
| | - Masakazu Abe
- Division of Gynecology, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
| | - Aki Tanaka
- Division of Gynecology, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate, Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate, Japan
| | - Hao Xiong
- AbbVie, North Chicago, Illinois, USA
| | | | | | | | | | | | - Yasuyuki Hirashima
- Division of Gynecology, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Shoji T, Yamasaki T, Izumi S, Murakami H, Mifuji K, Sawa M, Yasunaga Y, Adachi N, Ochi M. Factors affecting the potential for posterior bony impingement after total hip arthroplasty. Bone Joint J 2017; 99-B:1140-1146. [DOI: 10.1302/0301-620x.99b9.bjj-2016-1078.r2] [Citation(s) in RCA: 21] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 05/09/2017] [Indexed: 11/05/2022]
Abstract
Aims Our aim was to evaluate the radiographic characteristics of patients undergoing total hip arthroplasty (THA) for the potential of posterior bony impingement using CT simulations. Patients and Methods Virtual CT data from 112 patients who underwent THA were analysed. There were 40 men and 72 women. Their mean age was 59.1 years (41 to 76). Associations between radiographic characteristics and posterior bony impingement and the range of external rotation of the hip were evaluated. In addition, we investigated the effects of pelvic tilt and the neck/shaft angle and femoral offset on posterior bony impingement. Results The range of external rotation and the ischiofemoral length were significantly lower, while femoral anteversion, the ischial ratio, and ischial angle were significantly higher in patients with posterior bony impingement compared with those who had implant impingement (p < 0.05). The range of external rotation positively correlated with ischiofemoral length (r = 0.49, p < 0.05), and negatively correlated with ischial length (r = -0.49, p < 0.05), ischial ratio (r =- 0.49, p < 0.05) and ischial angle (r = -0.55, p < 0.05). The range of external rotation was lower in patients with posterior pelvic tilt (p < 0.05) and in those with a high offset femoral component (p < 0.05) due to posterior bony impingement. Conclusion Posterior bony impingement after THA is more likely in patients with a wider ischium and a narrow ischiofemoral space. A high femoral offset and posterior pelvic tilt are also risk factors for this type of impingement. Cite this article: Bone Joint J 2017;99-B:1140–6.
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Affiliation(s)
- T. Shoji
- Graduate School of Biomedical Sciences,
Hiroshima University,
1-2-3 Kasumi, Minami-ku, Hiroshima
734-8551, Japan
| | - T. Yamasaki
- Graduate School of Biomedical Sciences,
Hiroshima University,
1-2-3 Kasumi, Minami-ku, Hiroshima
734-8551, Japan
| | - S. Izumi
- Graduate School of Biomedical Sciences,
Hiroshima University,
1-2-3 Kasumi, Minami-ku, Hiroshima
734-8551, Japan
| | - H. Murakami
- Graduate School of Biomedical Sciences,
Hiroshima University,
1-2-3 Kasumi, Minami-ku, Hiroshima
734-8551, Japan
| | - K. Mifuji
- Graduate School of Biomedical Sciences,
Hiroshima University,
1-2-3 Kasumi, Minami-ku, Hiroshima
734-8551, Japan
| | - M. Sawa
- Graduate School of Biomedical Sciences,
Hiroshima University,
1-2-3 Kasumi, Minami-ku, Hiroshima
734-8551, Japan
| | - Y. Yasunaga
- Hiroshima Prefectural Rehabilitation Center, 295-3
Taguchi, Saijo-town, Higashi-hiroshima, 739-0036, Japan
| | - N. Adachi
- Graduate School of Biomedical Sciences,
Hiroshima University,
1-2-3 Kasumi, Minami-ku, Hiroshima
734-8551, Japan
| | - M. Ochi
- Graduate School of Biomedical Sciences,
Hiroshima University,
1-2-3 Kasumi, Minami-ku, Hiroshima
734-8551, Japan
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Saito Y, Kitahara H, Shoji T, Tokimasa S, Nakayama T, Sugimoto K, Fujimoto Y, Kobayashi Y. P859Relation between severity of myocardial bridge and vasospasm. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nakagomi A, Sunami Y, Okada S, Ohno Y, Shoji T, Fujisawa T, Kobayashi Y. P5460Association between arterial stiffness and metabolic risk factors in apparent healthy and prediabetic subjects. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shoji T, Takeshita R, Mukaida R, Sato T, Taguchi M, Sasou S. Angiomyofibroblastoma of the vulva diagnosed preoperatively: A case report. Mol Clin Oncol 2017; 7:407-411. [PMID: 28811899 DOI: 10.3892/mco.2017.1347] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 06/13/2017] [Indexed: 12/29/2022] Open
Abstract
A 50-year-old woman (gravida 2, para 2) first noticed a small nodule in the right labium majus 2 years prior to the initial visit to the Hachinohe Red Cross Hospital (Hachinohe, Japan), which had gradually increased in size. On physical examination, a well-circumscribed, elastic, firm, goose egg-sized, subcutaneous mass protruding from the right labium majus was identified. On magnetic resonance imaging (MRI), the lesion was hypointense on T1-weighted images and was well-circumscribed, strongly enhanced and homogeneous on gadolinium-enhanced images, measuring 7.5×4 cm. The same tumor had measured 2.6 cm on an MRI performed 6 years earlier. Based on the clinical course and imaging findings, angiomyofibroblastoma was diagnosed and surgical resection of the tumor was performed. The tumor was well-circumscribed and highly vascular. The intraoperative blood loss was 70 ml. Histopathologically, the tumor cells were concentrated around blood vessels, were spindle-shaped to oval with mild atypia, and were positive for vimentin, desmin, neural cell adhesion molecule (N-CAM), CD-34, estrogen receptor and progesterone receptor, and negative for S-100. Based on these findings, the diagnosis of angiomyofibroblastoma was confirmed. Angiomyofibroblastoma is a benign mesenchymal tumor that occurs in the female external genitalia. Differentiation of this tumor from aggressive angiomyxoma, a fast-growing infiltrative malignancy that occurs in the same region, may be challenging. The diagnosis of angiomyofibroblastoma is usually based on the histopathological findings of the resected specimen. The present case is of value, as the angiomyofibroblastoma was successfully diagnosed preoperatively based on the clinical course and imaging findings.
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, Hachinohe, Aomori 039-1104, Japan
| | - Ryosuke Takeshita
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, Hachinohe, Aomori 039-1104, Japan
| | - Rika Mukaida
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, Hachinohe, Aomori 039-1104, Japan
| | - Tamotsu Sato
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, Hachinohe, Aomori 039-1104, Japan
| | - Masami Taguchi
- Department of Radiology, Hachinohe Red Cross Hospital, Hachinohe, Aomori 039-1104, Japan
| | - Shunichi Sasou
- Department of Pathology and Laboratory Medicine, Hachinohe Red Cross Hospital, Hachinohe, Aomori 039-1104, Japan
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Yokota A, Hirai H, Shoji T, Maekawa T, Okuda K. Constitutively active ABL family kinases, TEL/ABL and TEL/ARG, harbor distinct leukemogenic activities in vivo. Leukemia 2017; 31:2742-2751. [PMID: 28386107 DOI: 10.1038/leu.2017.114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 03/27/2017] [Indexed: 01/10/2023]
Abstract
ABL (ABL1) and ARG (ABL2) are highly homologous to each other in overall domain structure and amino-acid sequence, with the exception of their C termini. As with ABL, translocations that fuse ARG to ETV6/TEL have been identified in patients with leukemia. To assess the in vivo leukemogenic activity of constitutively active ABL and ARG, we generated a bone marrow (BM) transplantation model using the chimeric forms TEL/ABL and TEL/ARG, which have comparable kinase activities. TEL/ABL rapidly induced fatal myeloid leukemia in recipient mice, whereas recipients of TEL/ARG-transduced cells did not develop myeloid leukemia, instead, they succumbed to a long-latency infiltrative mastocytosis that could be adoptively transferred to secondary recipients. Swapping of the C termini of ABL and ARG altered disease latency and phenotypes. In a detailed in vitro study, TEL/ARG strongly promoted mast cell differentiation in response to stem cell factor or interleukin-3, whereas TEL/ABL preferentially induced myeloid differentiation of hematopoietic stem/progenitor cells. These results indicate that ABL and ARG kinase activate distinct differentiation pathways to induce specific diseases in vivo, that is, myeloid leukemia and mastocytosis, respectively. Further elucidation of the differences in their properties should provide important insight into the pathogenic mechanisms of oncogenes of the ABL kinase family.
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Affiliation(s)
- A Yokota
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan
| | - H Hirai
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan
| | - T Shoji
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan
| | - T Maekawa
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan
| | - K Okuda
- Department of Molecular Diagnostics and Therapeutics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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Miura Y, Mori M, Shoji T, Matsumoto H, Kamiya K, Ida K, Kasai S. Studies of Improved Confinement in JFT-2M. Fusion Science and Technology 2017. [DOI: 10.13182/fst06-a1090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Y. Miura
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken, 311-0193 Japan
| | - M. Mori
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken, 311-0193 Japan
| | - T. Shoji
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken, 311-0193 Japan
| | - H. Matsumoto
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken, 311-0193 Japan
| | - K. Kamiya
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken, 311-0193 Japan
| | - K. Ida
- National Institute for Fusion Science Science, 322-6 Oroshi-cho, Toki 509-5292, Japan
| | - S. Kasai
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken, 311-0193 Japan
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Finken KH, Reiter D, Denner T, Dippel KH, Hobirk J, Mank G, Kever H, Wolf GH, Noda N, Miyahara A, Shoji T, Sato KN, Akaishi K, Boedo JA, Brooks JN, Conn RW, Corbett WJ, Doerner RP, Goebel D, Gray DS, Hillis DL, Hogan J, Mcgrath RT, Matsunaga M, Moyer R, Nygren RE, Watkins J. The Toroidal Pump Limiter ALT-II in TEXTOR. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a694] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- K. H. Finken
- Institut für Plasmaphysik, Forschungszentrum Jülich GmbH, EURATOM Association, Trilateral Euregio Cluster, D-52425 Jülich, Germany
| | - D. Reiter
- Institut für Plasmaphysik, Forschungszentrum Jülich GmbH, EURATOM Association, Trilateral Euregio Cluster, D-52425 Jülich, Germany
| | - T. Denner
- Institut für Plasmaphysik, Forschungszentrum Jülich GmbH, EURATOM Association, Trilateral Euregio Cluster, D-52425 Jülich, Germany
| | - K. H. Dippel
- Institut für Plasmaphysik, Forschungszentrum Jülich GmbH, EURATOM Association, Trilateral Euregio Cluster, D-52425 Jülich, Germany
| | - J. Hobirk
- Institut für Plasmaphysik, Forschungszentrum Jülich GmbH, EURATOM Association, Trilateral Euregio Cluster, D-52425 Jülich, Germany
| | - G. Mank
- Institut für Plasmaphysik, Forschungszentrum Jülich GmbH, EURATOM Association, Trilateral Euregio Cluster, D-52425 Jülich, Germany
| | - H. Kever
- Institut für Plasmaphysik, Forschungszentrum Jülich GmbH, EURATOM Association, Trilateral Euregio Cluster, D-52425 Jülich, Germany
| | - G. H. Wolf
- Institut für Plasmaphysik, Forschungszentrum Jülich GmbH, EURATOM Association, Trilateral Euregio Cluster, D-52425 Jülich, Germany
| | - N. Noda
- Institut für Plasmaphysik, Forschungszentrum Jülich GmbH, EURATOM Association, Trilateral Euregio Cluster, D-52425 Jülich, Germany
| | - A. Miyahara
- National Institute for Fusion Science, Orochi-Cho, Toki, Gifu, Japan
| | - T. Shoji
- Nagoya University, Department of Energy Engineering and Science, 464-8603 Nagoya, Japan
| | - K. N. Sato
- National Institute for Fusion Science, Orochi-Cho, Toki, Gifu, Japan
| | - K. Akaishi
- National Institute for Fusion Science, Orochi-Cho, Toki, Gifu, Japan
| | - J. A. Boedo
- University of California, San Diego, Department of Applied Mechanics and Engineering Sciences San Diego, California
| | | | - R. W. Conn
- University of California, San Diego, Department of Applied Mechanics and Engineering Sciences San Diego, California
| | - W. J. Corbett
- University of California, San Diego, Department of Applied Mechanics and Engineering Sciences San Diego, California
| | - R. P. Doerner
- University of California, San Diego, Department of Applied Mechanics and Engineering Sciences San Diego, California
| | - D. Goebel
- University of California, San Diego, Department of Applied Mechanics and Engineering Sciences San Diego, California
| | - D. S. Gray
- University of California, San Diego, Department of Applied Mechanics and Engineering Sciences San Diego, California
| | - D. L. Hillis
- Oak Ridge National Laboratory, Building 9201-2, MS-8072, Oak Ridge, Tennessee
| | - J. Hogan
- Oak Ridge National Laboratory, Building 9201-2, MS-8072, Oak Ridge, Tennessee
| | - R. T. Mcgrath
- Sandia National Laboratories, Albuquerque, New Mexico
| | - M. Matsunaga
- Toyama University, Hydrogen Isotope Research Center, Gofuku 3190, Toyama 930-8555, Japan
| | - R. Moyer
- University of California, San Diego, Department of Applied Mechanics and Engineering Sciences San Diego, California
| | - R. E. Nygren
- Sandia National Laboratories, Albuquerque, New Mexico
| | - J. Watkins
- Sandia National Laboratories, Albuquerque, New Mexico
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Mori K, Emoto M, Numaguchi R, Yamazaki Y, Urata H, Motoyama K, Morioka T, Shoji T, Inaba M. POTENTIAL ADVANTAGE OF REPAGLINIDE MONOTHERAPY IN GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES AND SEVERE RENAL IMPAIRMENT. Acta Endocrinol (Buchar) 2017; 13:133-137. [PMID: 31149163 DOI: 10.4183/aeb.2017.133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Context Oral anti-diabetic drugs (OADs) are leading option for treatment of type 2 diabetes (T2D). However, availability of OADs are limited in the presence of renal impairment (RI). Objective In this study, we examined the efficacy of repaglinide, which is mainly metabolized and excreted via non-renal route, in patients with T2D and severe RI that consists mainly of chronic kidney disease (CKD) stage 4. Design Subjects and Methods This was an open label, single arm, interventional study by repaglinide monotherapy. The primary efficacy end point was HbA1c change from baseline to week 12. Results Repaglinide treatment significantly reduced HbA1c levels from 7.7 ± 0.7% to 6.1 ± 0.3% (p<0.001) in 9 patients with severe RI (mean estimated glomerular filtration rate was 26.4 ± 7.5 mL/min/1.73m2). Focusing on 4 patients who received DPP-4 inhibitor monotherapy at enrolment, switching to repaglinide also significantly improved HbA1c levels. No hypoglycemic symptoms or severe hypoglycemia was reported in patients who completed the period of 12 weeks. Conclusions We demonstrated the efficacy of repaglinide in patients with T2D and severe RI. In case that DPP-4 inhibitors are not enough to achieve targeted range of glycemic control, repaglinide is another good candidate.
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Affiliation(s)
- K Mori
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Emoto
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - R Numaguchi
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Yamazaki
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - H Urata
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Motoyama
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Morioka
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Shoji
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Inaba
- Osaka City University Graduate School of Medicine, Osaka, Japan
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Takatori E, Shoji T, Takada A, Nagasawa T, Omi H, Kagabu M, Honda T, Miura F, Takeuchi S, Sugiyama T. A retrospective study of neoadjuvant chemotherapy plus radical hysterectomy versus radical hysterectomy alone in patients with stage II cervical squamous cell carcinoma presenting as a bulky mass. Onco Targets Ther 2016; 9:5651-5657. [PMID: 27695343 PMCID: PMC5028091 DOI: 10.2147/ott.s101146] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective In order to evaluate the usefulness of neoadjuvant chemotherapy (NAC) for stage II cervical squamous cell carcinoma with a bulky mass, we retrospectively compared patients receiving NAC followed by radical hysterectomy (RH; NAC group) with patients who underwent RH without NAC (Ope group). Patients and methods The study period was from June 2002 to March 2014. The subjects were 28 patients with a stage II bulky mass in the NAC group and 17 such patients in the Ope group. The chi-square test was used to compare operative time, volume of intraoperative blood loss, use of blood transfusion, and time from surgery to discharge between the two groups. Moreover, the log-rank test using the Kaplan–Meier method was performed to compare disease-free survival (DFS) and overall survival (OS) between the groups. Results There were no statistically significant differences between the two groups in operative time, volume of intraoperative blood loss, or use of blood transfusion. However, the time from surgery to discharge was 18 days (14–25 days) in the NAC group and 25 days (21–34 days) in the Ope group; the patients in the NAC group were discharged earlier (P=0.032). The hazard ratio for DFS in the NAC group as compared with that in the Ope group was 0.36 (95% CI 0.08–0.91), and the 3-year DFS rates were 81.2% and 41.0%, respectively (P=0.028). Moreover, the hazard ratio for OS was 0.39 (95% CI 0.11–1.24), and the 3-year OS rates were 82.3% and 66.4%, respectively (P=0.101). Conclusion NAC with cisplatin and irinotecan was confirmed to prolong DFS as compared with RH alone. The results of this study suggest that NAC might be a useful adjunct to surgery in the treatment of stage II squamous cell carcinoma presenting as a bulky mass.
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Affiliation(s)
- Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Anna Takada
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Hideo Omi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Tatsuya Honda
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Fumiharu Miura
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Satoshi Takeuchi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
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Sato S, Itamochi H, Oumi N, Oishi T, Shoji T, Fujiwara H, Suzuki M, Kigawa J, Harada T, Sugiyama T. Loss of ARID1A expression is associated with poor prognosis in patients with stage I/II clear cell carcinoma of the ovary. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw374.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shoji T, Takatori E, Murakami K, Kaido Y, Takeuchi S, Kikuchi A, Sugiyama T. A case of ovarian adenosquamous carcinoma arising from endometrioid adenocarcinoma: a case report and systematic review. J Ovarian Res 2016; 9:48. [PMID: 27514842 PMCID: PMC4981951 DOI: 10.1186/s13048-016-0255-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 07/19/2016] [Indexed: 12/04/2022] Open
Abstract
Background The aims of this report were to describe a case of ovarian adenosquamous carcinoma and to systematically review the pertinent literature. Methods We describe a case in which a 57-year-old woman had stage IC ovarian cancer histologically diagnosed as adenosquamous carcinoma. We also systematically reviewed the literature using the PubMed database. Case Presentation Preoperative computed tomography and magnetic resonance imaging showed a tumor measuring 14 cm in diameter and containing solid areas. Tumor marker levels were as follows: CA125, 42.6 U/mL; CA 19–9, 134.1 U/mL; CEA, 0.9 ng/mL; and SCC, 1.6 ng/mL. The patient underwent multiple surgeries including total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymph node dissection, para-aortic lymph node biopsy, and total omentectomy. Based on the cytological features of the ascitic fluid, the tumor was diagnosed as a squamous cell carcinoma. Histological examination of an excised specimen showed the transition of an endometrioid adenocarcinoma to a squamous cell carcinoma. There was no evidence of any teratomas or endometriosis-related features. We considered the tumor to be an adenosquamous carcinoma, with the squamous cell carcinoma component arising from the endometrioid adenocarcinoma component. After surgery, the patient underwent 6 cycles of paclitaxel and carboplatin chemotherapy. There has been no recurrence to date, 66 months after the initial treatment. Results Histologically, the 8 adenosquamous carcinomas reported in the literature either arose from the mature cystic teratoma (4 cases) or endometriosis (3 cases) or were pure adenosquamous carcinomas (1 case). Our literature search uncovered no cases of ovarian adenosquamous carcinomas originating from endometrioid adenocarcinomas. Conclusions This is the first reported case of an adenosquamous carcinoma arising from an endometrioid adenocarcinoma. Because such tumors are rare, their standard management is unclear.
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
| | - Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Kazuyuki Murakami
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Yoshitaka Kaido
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Satoshi Takeuchi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Akihiko Kikuchi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
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Nakashima H, Inazawa K, Ichiyama K, Ito M, Ikushima N, Shoji T, Katsuraya K, Uryu T, Yamamoto N, Juodawlkis AS, Schinazi RF. Sulfated Alkyl Oligosaccharides Inhibit Human Immunodeficiency virus in vitro and Provide Sustained Drug Levels in Mammals. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/095632029500600410] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study provides an estimate of the relative anti-human immunodeficiency virus (HIV) activities of synthetic sulfated alkyl oligosaccharides in vitro and of their mechanism of action, and an assessment of the levels of alkyl oligosaccharides in small mammals. The antiviral activities of the compounds against several human immunodeficiency virus type-1 and type-2 strains were determined in human CD4+ cells, including primary lymphocytes and macrophages. Laser flow cytometry and a cell-based syncytium assay were used to elucidate the anti-binding/fusion properties of the oligosaccharides. The sulfated alkyl laminarioligosaccharide DL-110 was shown to be the most potent and selective anti-HIV agent in culture with a median inhibitory concentration of 0.2 μM in primary human lymphocytes. This compound did not markedly interact with the CD4+ receptor on lymphocytes at 50 μM, but demonstrated potent anti-syncytium properties in vitro at submicromolar concentrations. DL-110 had no anti-coagulation activity at 38 μM. Mice, rabbits and beagle dogs were given an intravenous injection of test compounds and the drug levels in serum were quantified. When 32 mg kg−1 of DL-110 was administered to mice, significant antiviral concentrations in serum were achieved even 12 h after treatment. Similarly, prolonged antiviral effects were noted in rabbits and dogs 24 h after injection of DL-110. The half-life of DL-110 in mice, rabbits and dogs was estimated to be 5 h. DL-110 and some of its derivatives are promising candidates for further evaluation of the prophylaxis and therapy of HIV infections.
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Affiliation(s)
- H. Nakashima
- Department of Microbiology, Yamanashi Medical University, 1110 Shimokato Tamaho-cho, Nakakomagun, Yamanashi, Japan
| | - K. Inazawa
- Department of Microbiology, Yamanashi Medical University, 1110 Shimokato Tamaho-cho, Nakakomagun, Yamanashi, Japan
| | - K. Ichiyama
- Department of Microbiology, Yamanashi Medical University, 1110 Shimokato Tamaho-cho, Nakakomagun, Yamanashi, Japan
| | - M. Ito
- Department of Microbiology, Yamanashi Medical University, 1110 Shimokato Tamaho-cho, Nakakomagun, Yamanashi, Japan
| | - N. Ikushima
- Central Research Laboratories, Dainippon Ink and Chemicals, Inc., Chiba, Japan
| | - T. Shoji
- Central Research Laboratories, Dainippon Ink and Chemicals, Inc., Chiba, Japan
| | - K. Katsuraya
- Institute of Industrial Science, University of Tokyo, Tokyo, Japan
| | - T. Uryu
- Institute of Industrial Science, University of Tokyo, Tokyo, Japan
| | - N. Yamamoto
- Department of Microbiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - A. S. Juodawlkis
- Veterans Affairs Medical Center and Department of Pediatrics, Laboratory of Biochemical Pharmacology, Emory University School of Medicine, 1670 Clairmont Road, Decatur, Georgia 30033, USA
| | - R. F. Schinazi
- Veterans Affairs Medical Center and Department of Pediatrics, Laboratory of Biochemical Pharmacology, Emory University School of Medicine, 1670 Clairmont Road, Decatur, Georgia 30033, USA
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Shoji T, Takatori E, Furutake Y, Takada A, Nagasawa T, Omi H, Kagabu M, Honda T, Miura F, Takeuchi S, Kumagai S, Yoshizaki A, Sato A, Sugiyama T. Phase II clinical study of neoadjuvant chemotherapy with CDDP/CPT-11 regimen in combination with radical hysterectomy for cervical cancer with a bulky mass. Int J Clin Oncol 2016; 21:1120-1127. [PMID: 27342833 PMCID: PMC5124439 DOI: 10.1007/s10147-016-1008-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 06/14/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND We examined the efficacy and safety of neoadjuvant chemotherapy (NAC) with the CPT-11 + CDDP regimen in combination with radical hysterectomy. SUBJECTS AND METHODS The subjects were 42 patients with stages IB2 to IIIB squamous cell carcinoma of the uterine cervix with a bulky mass. CDDP at 70 mg/m2 was intravenously administered on day 1 and CPT-11 at 70 mg/m2 was intravenously administered on days 1 and 8 of a 21-day cycle. In principle, two cycles were administered followed by radical hysterectomy. We examined antitumor efficacy, adverse events, completion rate of radical hysterectomy, operative time, surgical blood loss, progression-free survival (PFS), and overall survival (OS). RESULTS The antitumor effect was complete response in 7 patients, partial response in 28, stable disease in 6, and progressive disease in 1; the response rate was 83.3 % (95 % confidence interval, 68.6-93.0). Grade 3 or more severe neutropenia, anemia, and platelet count decreases were noted in 23 (54.8 %), 4 (9.5 %), and 1 (2.4 %) patient, respectively. Grade 3 nausea occurred in 3 patients (7.1 %), vomiting in 1 (2.4 %), and grade 3 febrile neutropenia in 2 (7.1 %). The completion rate of radical hysterectomy was 88.1 %. The median operative time and surgical blood loss were 260 min (range, 210-334) and 500 ml (range, 393-898), respectively. The 5-year PFS rate was 67.2 %, and the 5-year OS rate was 68.0 %. In multivariate analysis, lymph node metastasis before NAC [hazard ratio (HR), 34.88] and non-response to NAC (HR 30.58) were significant prognostic factors. CONCLUSION NAC with the CDDP/CPT-11 regimen achieves a high antitumor efficacy with moderate adverse reactions, allowing safe radical hysterectomy, and is thus considered to be a useful therapeutic method that can improve prognosis.
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan.
| | - Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Yoko Furutake
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Anna Takada
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hideo Omi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Tatsuya Honda
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Fumiharu Miura
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Satoshi Takeuchi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Seisuke Kumagai
- Department of Obstetrics and Gynecology, National Hospital Organization Kokura Medical Center, Kokura, Japan
| | | | - Akira Sato
- Department of Gynecology, Medical Coat Hachinohe West Hospital, Hachinohe, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan
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Atsumi T, Yamamoto K, Takeuchi T, Yamanaka H, Ishiguro N, Tanaka Y, Eguchi K, Watanabe A, Origasa H, Shoji T, Togo O, Okada T, van der Heijde D, Miyasaka N, Koike T. THU0157 Clinical Outcomes at Week 104 and Analysis of Associated Baseline Factors after An Initial 1 Year of Certolizumab Pegol and MTX Treatment in MTX-Naïve Patients with Early RA: Results from The Second Year of The C-Opera Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1249] [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: 11/04/2022]
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Sato K, Shidahara M, Watabe H, Watanuki S, Ishikawa Y, Arakawa Y, Nai YH, Furumoto S, Tashiro M, Shoji T, Yanai K, Gonda K. Performance evaluation of the small-animal PET scanner ClairvivoPET using NEMA NU 4-2008 Standards. Phys Med Biol 2015; 61:696-711. [PMID: 26716872 DOI: 10.1088/0031-9155/61/2/696] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of this study was to evaluate the performance of ClairvivoPET using NEMA NU4 standards. The ClairvivoPET incorporates a LYSO dual depth-of-interaction detector system with 151 mm axial field of view (FOV). Spatial resolution, sensitivity, counting rate capabilities, and image quality were evaluated using NEMA NU4-2008 standards. Normal mouse imaging was also performed for 10 min after intravenous injection of (18)F(-)-NaF. Data were compared with 19 other preclinical PET scanners. Spatial resolution measured using full width at half maximum on FBP-ramp reconstructed images was 2.16 mm at radial offset 5 mm of the axial centre FOV. The maximum absolute sensitivity for a point source at the FOV centre was 8.72%. Peak noise equivalent counting rate (NECR) was 415 kcps at 14.6 MBq ml(-1). The uniformity with the image-quality phantom was 4.62%. Spillover ratios in the images of air and water filled chambers were 0.19 and 0.06, respectively. Our results were comparable with the 19 other preclinical PET scanners based on NEMA NU4 standards, with excellent sensitivity because of the large FOV. The ClairvivoPET with iterative reconstruction algorithm also provided sufficient visualization of the mouse spine. The high sensitivity and resolution of the ClairvivoPET scanner provided high quality images for preclinical studies.
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Affiliation(s)
- K Sato
- Department of Medical Physics, Tohoku University Graduate School of Medicine, Sendai, Japan. Department of Radiology, Hachinohe National Hospital, Hachinohe, Japan
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Takatori E, Shoji T, Nagasawa T, Takeuchi S, Hosoyachi A, Sugiyama T. A recurrent ovarian cancer patient with a history of nine prior chemotherapy regimens who was safely treated with weekly paclitaxel plus bevacizumab and achieved a complete response: a case report. Onco Targets Ther 2015; 8:2097-100. [PMID: 26316778 PMCID: PMC4540113 DOI: 10.2147/ott.s80143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Herein, we describe our experience with a recurrent ovarian cancer patient who was treated safely with bevacizumab and who achieved a complete response despite receiving nine prior chemotherapy regimens. The patient was a 54-year-old woman with stage IIIC recurrent ovarian serous adenocarcinoma (grade 3). Computed tomography (CT) revealed that no evidence of ascites, multiple intraperitoneal dissemination, or intrapelvic lymph node metastases was present. The absence of bowel obstruction and disseminated lesions involving the intestinal tract was confirmed by CT. Performance status was 0, and a blood test also indicated preservation of major organ function. In our hospital, weekly paclitaxel plus bevacizumab therapy (paclitaxel at 80 mg/m2 on days 1, 8, and 15; bevacizumab at 15/mg/kg on day 1 and every 21 days thereafter) was started. Eight cycles were administered, with no signs of gastrointestinal perforation, and the antitumor effect was evaluated as a complete response. The observed adverse events included grade 1 hyponatremia and grade 1 hypochloremia, and there was one grade 1 sensory peripheral neuropathy. These adverse events neither delayed treatment nor necessitated any dosage reductions. This case suggests that bevacizumab can be safely administered even to patients with recurrent ovarian cancer who have received three or more prior chemotherapy regimens if there are neither symptoms of bowel obstruction nor lesions suggestive of intestinal invasion on diagnostic imaging.
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Affiliation(s)
- Eriko Takatori
- Department of Obstetrics and Gynecology, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Satoshi Takeuchi
- Department of Obstetrics and Gynecology, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Akira Hosoyachi
- Department of Obstetrics and Gynecology, Iwate Prefectural Miyako Hospital, Miyako, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, School of Medicine, Iwate Medical University, Morioka, Japan
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Itamochi H, Oumi N, Oishi T, Taniguchi F, Shoji T, Fujiwara H, Sugiyama T, Suzuki M, Kigawa J, Harada T. Abstract 3556: Fibroblast growth factor receptor 2 is associated with poor overall survival in clear cell carcinoma of the ovary and may be a novel therapeutic approach. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-3556] [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
Objective: Clear cell carcinoma of the ovary (CCC) has a poor prognosis because of its resistance to conventional platinum- or taxane-based chemotherapy. We previously found that both gene and protein expression of fibroblast growth factor receptor (FGFR) 2 are increased in CCC. FGFR activate intracellular signaling pathways that are known to regulate key biological processes. Overexpression of FGFR2 has been reported in several cancers such as lung, pancreatic, breast and colorectal cancers, and has been associated with a poor prognosis. We therefore investigated whether FGFR2 could be a biomarker and a therapeutic target for CCC.
Methods: We analyzed the protein expression of FGFR2 by immunohistochemical staining in paraffin-embedded tumors from 112 CCC patients, and evaluated the association of this molecular parameter with clinical outcome. Next, we examined the expression of proteins of the FGFR2 signaling pathway in 12 ovarian cancer cell lines (11 CCC and one serous adenocarcinoma) by western blotting. The sensitivity of the cells to a FGFR inhibitor was determined by WST-8 assay, and cell cycle distribution was assessed by flow cytometry.
Results: One hundred and eight of 112 (96%) CCC tumors showed positive expression of FGFR2. No significant associations between the levels of FGFR2 expression and patient age or disease stage were found. The 5-year survival rate of patients with moderate or strong tumor expression of FGFR2 was significantly lower than those with an absent or low tumor expression of FGFR2 (54% vs. 79%). Multivariable analysis revealed that FGFR2 expression and disease stage were independent prognostic factors. All 11 CCC cell lines expressed substantial amounts of FGFR2 protein compared with the serous adenocarcinoma cell line. The protein expression level of 8 of 11 CCC cell lines was more than five times that of the serous adenocarcinoma cell line, and thus we defined these CCC cell lines as high FGFR2-expressing cells. The FGFR inhibitor effectively suppressed the growth of high FGFR2-expressing CCC cells compared with low FGFR2-expressing cells, with induction of G1 cell cycle arrest and downregulation of phosphorylated (p-) Akt and p-ERK expression.
Conclusions: The FGFR2 protein may be a promising biomarker that is predictive of patient outcome, and FGFR2 is a potential therapeutic target for CCC. Further study of FGFR inhibitor in the treatment of CCC is warranted.
Citation Format: Hiroaki Itamochi, Nao Oumi, Tetsuro Oishi, Fuminori Taniguchi, Tadahiro Shoji, Hiroyuki Fujiwara, Toru Sugiyama, Mitsuaki Suzuki, Junzo Kigawa, Tasuku Harada. Fibroblast growth factor receptor 2 is associated with poor overall survival in clear cell carcinoma of the ovary and may be a novel therapeutic approach. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3556. doi:10.1158/1538-7445.AM2015-3556
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Affiliation(s)
| | - Nao Oumi
- 1Tottori Univ. School of Medicine, Yonago, Japan
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Nakagomi A, Okada S, Shoji T, Kobayashi Y. 2D.08. J Hypertens 2015. [DOI: 10.1097/01.hjh.0000467429.87677.d1] [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]
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Atsumi T, Yamamoto K, Takeuchi T, Yamanaka H, Ishiguro N, Tanaka Y, Eguchi K, Watanabe A, Origasa H, Shoji T, Togo O, Okada T, van der Heijde D, Miyasaka N, Koike T. SAT0173 Baseline Parameters Identified in Early, Methotrexate-Naïve Rheumatoid Arthritis Patients with Better Outcomes with Certolizumab Pegol+Methotrexate Compared to Placebo+Methotrexate: Post-Hoc Analyses of C-OPERA, A Randomized, Controlled, Phase 3 Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Takeuchi S, Shoji T, Kagabu M, Honda T, Kojima A, Nitta Y, Sugiyama T, Nakamura Y. Phase 2 studies of multiple peptides cocktail vaccine for treatment-resistant cervical and ovarian cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Tadahiro Shoji
- Iwate Medical University School of Medicine, Morioka, Japan
| | | | - Tatsuya Honda
- Iwate Medical University School of Medicine, Morioka, Japan
| | - Atsumi Kojima
- Gynecologic Oncology, Shikoku Cancer Center, Matsuyama, Japan
| | - Yukari Nitta
- Iwate Medical University School of Medicine Gynecology, Morioka, Japan
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Koyama H, Tahara H, Shoji T, Nishizawa Y, Inaba M, Otani S, Yanagisawa M, Ishiguro Y, Takanashi N, Morii H. Uremic serum contains humoral factor(s) larger than fifty kilodaltons which suppresses endothelin production in cultured endothelial cells. Contrib Nephrol 2015; 90:111-5. [PMID: 1959336 DOI: 10.1159/000420132] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Direct effects of human uremic serum on the production of endothelin-1 in cultured porcine endothelial cells were examined in this study. Uremic serum decreased the level of monomeric endothelin-1 secreted into the culture medium by endothelial cells. This effect occurred at a transcriptional step because uremic serum decreased the endothelin-1 mRNA level in those cells. For the partial characterization of this inhibitory activity, uremic serum was fractionated with a centricut column. Uremic serum contains humoral factor(s) larger than 50 kD which suppress the endothelin-1 mRNA level in cultured endothelial cells.
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Affiliation(s)
- H Koyama
- Second Department of Internal Medicine, Osaka City University Medical School, Japan
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Itotani R, Marumo S, Kumagai S, Yamanashi K, Tokuno J, Sumitomo R, Shoji T, Huang C, Fukui M. Post-Operative Outcomes in Non-Small Cell Lung Cancer Patients with Mild to Moderate Stage Chronic Obstructive Pulmonary Disease. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv048.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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50
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Takatori E, Shoji T, Miura Y, Nagao M, Takada A, Nagasawa T, Omi H, Kagabu M, Honda T, Sugiyama T. A phase II clinical trial of palonosetron for the management of delayed vomiting in gynecological cancer patients receiving paclitaxel/carboplatin therapy. Mol Clin Oncol 2015; 3:281-286. [PMID: 25798254 DOI: 10.3892/mco.2015.484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 09/10/2014] [Accepted: 11/01/2014] [Indexed: 11/05/2022] Open
Abstract
There are currently no studies demonstrating the effects of palonosetron on delayed chemotherapy-induced nausea and vomiting (CINV) in gynecological cancer patients receiving chemotherapy with moderately emetogenic chemotherapeutic agents. We conducted a phase II clinical trial to assess the efficacy and safety of palonosetron in patients receiving paclitaxel/carboplatin (TC) therapy. The study population consisted of 42 patients who had been diagnosed with gynecological malignancies and treated with TC. On day 1, 0.75 mg/body palonosetron and 19.8 mg/body dexamethasone were administered intravenously immediately prior to TC therapy. Dexamethasone in daily doses of 6.6 mg/body was also administered intravenously on days 2 and 3. The efficacy and safety of palonosetron + dexamethasone were evaluated by the self-completion method using the Multinational Association of Supportive Care in Cancer Antiemesis Tool during an observation period lasting from day 1 through day 8 of the initial cycle of TC therapy. The severity of the nausea was assessed using a visual analog scale. During the acute (0-24 h), delayed (24-96 h) and overall (0-96 h) periods, the complete response rates were 95.2, 90.5 and 85.7%, respectively, whereas the complete control rates were 90.5, 85.7 and 78.6%, respectively. Grade ≥ 2 constipation and diarrhea developed in 1 patient (2.4%) each. The palonosetron + dexamethasone regimen proved to be effective for delayed CINV in gynecological cancer patients receiving TC therapy. This combined antiemetic regimen was associated with only mild adverse reactions and may serve as supportive therapy, allowing cancer chemotherapy to be continued while maintaining an adequate quality of life.
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Affiliation(s)
- Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Yuki Miura
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Miyuki Nagao
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Anna Takada
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Hideo Omi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Tatsuya Honda
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate 020-8505, Japan
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