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Tanaka Y, Takeuchi H, Nakashima Y, Nagano H, Ueno T, Tomizuka K, Morita S, Emi Y, Hamai Y, Hihara J, Saeki H, Oki E, Kunisaki C, Otsuji E, Baba H, Matsubara H, Maehara Y, Kitagawa Y, Yoshida K. Effects of an elemental diet to reduce adverse events in patients with esophageal cancer receiving docetaxel/cisplatin/5-fluorouracil: a phase III randomized controlled trial-EPOC 2 (JFMC49-1601-C5). ESMO Open 2021; 6:100277. [PMID: 34626918 PMCID: PMC8511839 DOI: 10.1016/j.esmoop.2021.100277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 06/25/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 01/11/2023] Open
Abstract
Background Oral mucositis (OM) is an unpleasant adverse event in patients receiving chemotherapy. A prospective feasibility study showed that elemental diet (ED), an oral supplement that does not require digestion, may prevent OM. Based on this, we established a central review system for oral cavity assessment by dental oncology specialists blinded to background data. We used this system to elucidate the preventive effect of an ED against OM in patients with esophageal cancer receiving docetaxel, cisplatin, and 5-fluorouracil (DCF) therapy. Patients and methods In this phase III, multicenter, parallel-group, controlled trial, patients consuming a normal diet orally were randomly assigned (1 : 1) to receive two cycles of DCF with (group A) or without (group B) an ED (Elental® 160 g/day). We assessed the incidence of grade ≥2 OM evaluated by two reviewers, changes in body weight, prealbumin, C-reactive protein, and DCF completion rate based on ED compliance. Results Of the 117 patients randomly assigned to treatment, four failed to start treatment and were excluded from the primary analysis; thus, groups A and B comprised 55 and 58 patients, respectively. There were no significant differences in background characteristics. Grade ≥2 OM was observed in eight (15%) and 20 (34%) patients in groups A and B, respectively (P = 0.0141). Changes in body weight and prealbumin during the two DCF cycles were significantly higher in group A than B (P = 0.0022 and 0.0203, respectively). During the first cycle, changes in C-reactive protein were significantly lower in group A than B (P = 0.0338). In group A (receiving ED), the DCF completion rate was 100% in patients with 100% ED compliance and 70% in patients failing ED completion (P = 0.0046). Conclusions The study findings demonstrate that an ED can prevent OM in patients with esophageal cancer receiving chemotherapy. Patients receiving docetaxel, cisplatin, and 5-fluorouracil (DCF) chemotherapy commonly develop oral mucositis (OM). An elemental diet (ED) was able to prevent OM in patients with esophageal cancer receiving DCF. Grade ≥2 OM was observed in 15% of patients receiving the ED versus 34% of those not receiving the ED (P = 0.0141). Body weight was maintained in the ED group, and hematologic toxicities were lower, compared with the non-ED group. The DCF completion rate significantly correlated with ED compliance (P = 0.0046).
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Affiliation(s)
- Y Tanaka
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - H Takeuchi
- Department of Surgery, School of Medicine, Hamamatsu University, Hamamatsu, Japan
| | - Y Nakashima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Nagano
- Gastroenterological, Breast and Endocrine Surgery, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - T Ueno
- Department of Dentistry, National Cancer Center Hospital, Tokyo, Japan
| | - K Tomizuka
- Department of Dentistry, Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - S Morita
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Emi
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Y Hamai
- Department of Surgical Oncology, Hiroshima University Hospital, Hiroshima, Japan
| | - J Hihara
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - H Saeki
- Department of General Surgical Science, Gunma University, Maebashi, Japan
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - C Kunisaki
- Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan
| | - E Otsuji
- Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - H Baba
- Department of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan
| | - H Matsubara
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Y Maehara
- Director, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - Y Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - K Yoshida
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University, Gifu, Japan.
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Shirasu H, Taniguchi H, Watanabe J, Kotaka M, Yamazaki K, Hirata K, Yokota M, Emi Y, Ikenaga M, Kato K, Akazawa N, Yamaguchi T, Ikeda M, Aleshin A, Kotani D, Mishima S, Yukami H, Oki E, Takemasa I, Kato T, Nakamura Y, Yoshino T. O-11 Monitoring molecular residual disease by circulating tumor DNA in resectable colorectal cancer: Molecular subgroup analyses of a prospective observational study GALAXY in CIRCULATE-Japan. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Takeuchi H, Tanaka Y, Nakashima Y, Otsuji E, Nagano H, Matsubara H, Baba H, Emi Y, Oki E, Ueno T, Tomizuka K, Morita S, Kunisaki C, Hihara J, Saeki H, Hamai Y, Maehara Y, Kitagawa Y, Yoshida K. 1425MO Effects of elemental diet for gastrointestinal adverse events in patients with esophageal cancer receiving docetaxel/cisplatin/5-fluorouracil (EPOC 2 study: JFMC49-1601-C5): A phase III randomized controlled trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Emi Y, Yamanaka T, Muro K, Uetake H, Oki E, Takahashi T, Katayose Y, Yoshida K, Sakamoto M, Aishima S, Ishida K, Imura J, Unno M, Hyodo I, Tomita N, Sugihara K, Maehara Y. Histopathologic evaluation of patients with liver-limited metastatic colorectal cancer receiving mFOLFOX6 plus bevacizumab or mFOLFOX6 plus cetuximab: The ATOM trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Yuki S, Shinozaki K, Kashiwada T, Kusumoto T, Iwatsuki M, Satake H, Tokunaga S, Emi Y, Makiyama A, Kawamoto Y, Komatsu Y, Shimokawa M, Saeki H, Oki E, Baba H, Maehara Y. Updated analysis of a phase II study of SOX plus trastuzumab for the patients with HER2 positive advanced or recurrent gastric cancer: KSCC/HGCSG/CCOG/PerSeUS1501B. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.052] [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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Okamoto T, Yano T, Shimokawa M, Takeo S, Yamazaki K, Sugio K, Takenoyama M, Nagashima A, Tagawa T, Emi Y, Maehara Y. A phase II randomized trial of adjuvant chemotherapy for the patients completely resected pathological stage IB (T > 5cm), II, IIIA non-small cell lung cancer comparing S-1 versus S-1 with cisplatin. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx381.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bando H, Kato T, Yoshino T, Muro K, Yamazaki K, Yamaguchi T, Oki E, Iwamoto S, Tsuji A, Nakayama G, Emi Y, Touyama T, Nakamura M, Kotaka M, Kagawa Y, Taniguchi H, Sakisaka H, Yamanaka T, Kanazawa A. Primary efficacy results and clinical impact of UGT1A1 genotype on safety from a Phase II study of FOLFOXIRI plus bevacizumab in patients with metastatic colorectal cancer: The QUATTRO study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sakamoto Y, Yoshida Y, Ishikawa H, Ohchi T, Takeshita H, Emi Y, Komatsu H, Sawai T, Shimose T, Oki E, Saeki H, Kakeji Y, Yoshida Y, Baba H, Maehara Y. 189P Phase II trial of S-1 plus panitumumab for wild-type KRAS unresectable colorectal cancer patients previously treated with 5-fluorouracil (5-FU), oxaliplatin and irinotecan (KSCC1103). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw581.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sakamoto Y, Yoshida Y, Ishikawa H, Ohchi T, Takeshita H, Emi Y, Komatsu, Sawai T, Shimose T, Oki E, Saeki H, Kakeji Y, Yoshida Y, Baba H, Maehara Y. 189P Phase II trial of S-1 plus panitumumab for wild-type KRAS unresectable colorectal cancer patients previously treated with 5-fluorouracil (5-FU), oxaliplatin and irinotecan (KSCC1103). Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00347-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Yuki S, Komatsu Y, Satake H, Miyamoto Y, Tanioka H, Tsuji A, Asayama M, Shiraishi T, Kotaka M, Makiyama A, Kashiwada T, Takeuchi N, Shimokawa M, Saeki H, Oki E, Emi Y, Baba H, Maehara Y. Updated report: A randomized, double-blind, placebo-controlled phase II study of prophylactic dexamethasone (dex) therapy for fatigue and malaise due to regorafenib in patient (pts) with metastatic colorectal cancer (mCRC): (KSCC1402/HGCSG1402). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.95] [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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Oki E, Murata A, Yoshida K, Maeda K, Ikejiri K, Munemoto Y, Sasaki K, Matsuda C, Kotake M, Suenaga T, Matsuda H, Emi Y, Kakeji Y, Baba H, Hamada C, Saji S, Maehara Y. A randomized phase III trial comparing S-1 versus UFT as adjuvant chemotherapy for stage II/III rectal cancer (JFMC35-C1: ACTS-RC). Ann Oncol 2016; 27:1266-72. [PMID: 27056996 PMCID: PMC4922318 DOI: 10.1093/annonc/mdw162] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [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: 12/30/2015] [Accepted: 03/29/2016] [Indexed: 01/05/2023] Open
Abstract
This phase III study is the first study to demonstrate the superiority of new oral fluoropyrimidine S-1 over tegafur–uracil as adjuvant chemotherapy for stage II/III rectal cancer patients with no preoperative treatment in terms of relapse-free survival. S-1 can be considered an important option, especially for patients who have not received preoperative treatment. Backgrounds Preventing distant recurrence and achieving local control are important challenges in rectal cancer treatment, and use of adjuvant chemotherapy has been studied. However, no phase III study comparing adjuvant chemotherapy regimens for rectal cancer has demonstrated superiority of a specific regimen. We therefore conducted a phase III study to evaluate the superiority of S-1 to tegafur–uracil (UFT), a standard adjuvant chemotherapy regimen for curatively resected stage II/III rectal cancer in Japan, in the adjuvant setting for rectal cancer. Patients and methods The ACTS-RC trial was an open-label, randomized, phase III superiority trial conducted at 222 sites in Japan. Patients aged 20–80 with stage II/III rectal cancer undergoing curative surgery without preoperative therapy were randomly assigned to receive UFT (500–600 mg/day on days 1–5, followed by 2 days rest) or S-1 (80–120 mg/day on days 1–28, followed by 14 days rest) for 1 year. The primary end point was relapse-free survival (RFS), and the secondary end points were overall survival and adverse events. Results In total, 961 patients were enrolled from April 2006 to March 2009. The primary analysis was conducted in 480 assigned to receive UFT and 479 assigned to receive S-1. Five-year RFS was 61.7% [95% confidence interval (CI) 57.1% to 65.9%] for UFT and 66.4% (95% CI 61.9% to 70.5%) for S-1 [P = 0.0165, hazard ratio (HR): 0.77, 95% CI 0.63–0.96]. Five-year survival was 80.2% (95% CI 76.3% to 83.5%) for UFT and 82.0% (95% CI 78.3% to 85.2%) for S-1. The main grade 3 or higher adverse events were increased alanine aminotransferase and diarrhea (each 2.3%) in the UFT arm and anorexia, diarrhea (each 2.6%), and fatigue (2.1%) in the S-1 arm. Conclusion One-year S-1 treatment is superior to UFT with respect to RFS and has therefore become a standard adjuvant chemotherapy regimen for stage II/III rectal cancer following curative resection.
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Affiliation(s)
- E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - A Murata
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Aomori
| | - K Yoshida
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu
| | - K Maeda
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka
| | - K Ikejiri
- Department of Surgery, Gastrointestinal Center, National Hospital Organization Kyushu Medical Center, Fukuoka
| | - Y Munemoto
- Department of Surgery, Fukui-ken Saiseikai Hospital, Fukui
| | - K Sasaki
- Department of Surgery, Otaru Ekisaikai Hospital, Hokkaido
| | - C Matsuda
- Department of Surgery, Osaka General Medical Center, Osaka
| | - M Kotake
- Department of Surgery, Kouseiren Takaoka Hospital, Toyama
| | - T Suenaga
- Gastroenterological Surgery, Nanpuh Hospital, Kagoshima
| | - H Matsuda
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima
| | - Y Emi
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka
| | - Y Kakeji
- Devision of Gastrointestinal Surgery, Kobe University Hospital, Kobe
| | - H Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto
| | - C Hamada
- Faculty of Engineering, Tokyo University of Science, Tokyo
| | - S Saji
- Japanese Foundation for Multidisciplinary Treatment of Cancer, Tokyo, Japan
| | - Y Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
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Oki E, Emi Y, Miyamoto Y, Ogata Y, Tokunaga S, Shirabe K, Beppu T, Uchida S, Takatsuki M, Sakoda M, Eguchi S, Akagi Y, Kakeji Y, Baba H, Natsugoe S, Maehara Y. 2137 Comparison of two Phase II trials of mFOLFOX6 plus bevacizumab (KSCC0802) and SOX (S-1 and oxaliplatin) plus cetuximab (KSCC1002): First line chemotherapy in colorectal cancer patients with initially unresectable or not optimally resectable liver only metastases. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31058-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Satake H, Tsuji A, Emi Y, Shimokawa M, Miyamoto Y, Saeki H, Oki E, Maekawa S, Tanioka H, Akagi Y, Baba H, Ogata Y, Maehara Y. P-244 Prospective study of S-1 + Irinotecan plus bevacizumab as second-line therapy in Japanese patients with metastatic colorectal cancer (KSCC1102). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Yamaguchi K, Hironaka S, Sugimoto N, Moriwaki T, Komatsu Y, Nishina T, Tsuji A, Nakajima T, Gotoh M, Machida N, Fuse N, Esaki T, Emi Y, Takinishi Y, Matsumoto S, Boku N, Baba H, Hyodo I. Randomized Phase Ii Study of S-1 Plus Oral Leucovorin (Sl) Versus Sl Plus Oxaliplatin (Sol) Versus S-1 Plus Cisplatin (Sp) in Patients with Advanced Gastric Cancer (Agc):Updated Overall Survival Data. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Imai K, Emi Y, Iyama KI, Beppu T, Ogata Y, Kakeji Y, Samura H, Oki E, Akagi Y, Maehara Y, Baba H. Splenic volume may be a useful indicator of the protective effect of bevacizumab against oxaliplatin-induced hepatic sinusoidal obstruction syndrome. Eur J Surg Oncol 2013; 40:559-566. [PMID: 24388740 DOI: 10.1016/j.ejso.2013.12.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 11/29/2013] [Accepted: 12/06/2013] [Indexed: 12/13/2022] Open
Abstract
AIMS The aim of this study was to investigate the relationship between the use of bevacizumab (Bmab) in addition to oxaliplatin (OX), the development of sinusoidal obstruction syndrome (SOS) and the changes in splenic volume as an indicator of the protective effect of Bmab against OX-induced SOS. METHODS Seventy-nine patients who received OX-based chemotherapy with (OX + Bmab group: n = 48) or without Bmab (OX group: n = 31) for colorectal liver metastases were included in this study. The changes in splenic volume after chemotherapy were evaluated in the two groups. Furthermore, the relationship between the changes in splenic volume and SOS were analyzed in the 55 patients who underwent hepatectomy. RESULTS A significant increase in the splenic volume was observed in the OX group, but not in the OX + Bmab group. The increase in the splenic volume relative to baseline was significantly higher in the OX group than in the OX + Bmab group (39.1% vs. 2.3%, p < 0.0001). The incidence of moderate or severe SOS was significantly higher in the OX group than in the OX + Bmab group (50.0% vs. 16.0%, p = 0.0068), and the increase in the splenic volume was significantly higher in the patients with SOS than in those without SOS (42.9% vs. 9.9%, p = 0.0001). A multivariate analysis identified the increase in the splenic volume as an independent predictor of the development of SOS. CONCLUSIONS This study demonstrated that the inhibition of splenic volume enlargement might be a useful indicator of the protective effect of Bmab against OX-induced SOS.
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Affiliation(s)
- K Imai
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Y Emi
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - K-I Iyama
- Department of Surgical Pathology, Kumamoto University Hospital, Kumamoto, Japan
| | - T Beppu
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Y Ogata
- Department of Surgery, Kurume University Medical Center, Kurume, Japan
| | - Y Kakeji
- Department of Surgery, Division of Gastrointestinal Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - H Samura
- Division of Digestive and General Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Y Akagi
- Department of Surgery, Kurume University Hospital, Kurume, Japan
| | - Y Maehara
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - H Baba
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
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Matsuyama S, Emi Y, Kohmura Y, Tamasaku K, Yabashi M, Ishikawa T, Yamauchi K. Development of achromatic full-field hard X-ray microscopy using four total-reflection mirrors. ACTA ACUST UNITED AC 2013. [DOI: 10.1088/1742-6596/463/1/012017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Akagi Y, Beppu T, Emi Y, Kakechi Y, Saeki H, Oki E, Fujita F, Inomata M, Sawai T, Samura H, Baba H, Natsugoe S, Ogata Y, Tokunaga S, Maehara Y. Liver Resectability Following MFOLFOX6 with Bevacizumab as the First-Line Treatment of Unresectable Liver Limited Metastases from Colorectal Cancer in Japanese Patients (KSCC 0802). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32187-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Emi Y, Ogata Y, Akagi Y, Kakeji Y, Oki E, Saeki H, Shimokawa M, Touyama T, Samura H, Baba H, Natsugoe S, Shirouzu K, Tokunaga S, Maehara Y. Phase II Study Alternating Mfolfox 6 and Folfiri (FIREFOX) Plus Bevacizumab (BEV) Regimen in First-Line Treatment of Advanced Colorectal Cancer in Japanese Patients (KSCC 0801). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32375-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Kitazono M, Kobayashi K, Emi Y, Kakechi Y, Takahashi T, Akagi Y, Tuji A, Yoshida K, Baba H, Ogata H, Shimokawa M, Natsugoe S, Maehara Y. Phase II Study of Combination Therapy with S-1 and Cetuximab in Patients with Kras Wild-Type Unresectable Colorectal Cancer, who Had Previously Received Irinotecan, Oxaliplatin, and Fluoropyrimidines (KSCC0901). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32341-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Suqivama M, Yonemitsu Y, Kakeji Y, Saeki H, Oki E, Emi Y, Morita M, Morodomi Y, Hasegawa M, Maehara Y. 1112 POSTER Imbalance in VEGF-A/sFLT-1 Enables Malignant Ascites to Resist Dendritic Cell-based Immunotherapy. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70755-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Kohnoe S, Saeki H, Emi Y, Ando K, Ohga T, Oki E, Ikeda T, Tsujitani S, Kakeji Y, Maehara Y. 6122 POSTER Impact of Cetuximab-based Therapy and KRas Genotypes in Japanese Patients With Chemotherapy-refractory Metastatic Colorectal Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71767-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Saeki H, Kitao H, Ando K, Egashira A, Oki E, Ohga T, Morita M, Emi Y, Kakeji Y, Maehara Y. 1050 POSTER Copy-neutral Loss of Heterozygosity at the P53 Locus in Esophageal Squamous Cell Carcinomas Associated With p53 Mutations. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70693-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kusumoto T, Oki E, Hiroshige S, Endo Y, Uchida H, Matsumoto T, Takeuchi H, Matsushima T, Emi Y, Matsuura H, Muto Y, Maehara Y. Efficacy and safety of consecutive chemotherapy treatments for elderly patients with advanced or recurrent gastric cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14586] [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: 11/20/2022] Open
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Watanabe M, Emi Y, Kakeji Y, Oki E, Sakaguchi Y, Yoshida K, Hirabayashi N, Yamanaka T, Baba H, Maehara Y. Phase II study of docetaxel (DTX) and S-1 as neoadjuvant chemotherapy for potentially R0 advanced gastric cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
106 Background: This trial sought to evaluate the efficacy and safety of preoperative chemotherapy with DTX plus S-1 for advanced gastric cancer with poor prognosis even after R0 curative resection. Methods: Preoperative staging was confirmed by laparoscopy. Eligibility criteria included 1) negative peritoneal cytology, H0, P0 and M0, 2) possible curative resection, and 3) ECOG PS 0-1. Patients received DTX (35 mg/m2) on days 1 and 15, and daily oral administration of S-1 (80 mg/m2/day) for days 1–14 every 4 weeks of 2 courses, followed by gastrectomy with D2 lymphadenectomy. The primary endpoint was pathological response rate (pRR), which was defined as degeneration occupying more than one-third of the cross-sectional surface area of the tumor. A sample size of 45 was planned for the expected pRR of 40% and threshold value of 20%, with one-sided alpha of 0.05 and beta of approximately 0.1. This study was registered in the UMIN clinical trial registry (UMIN000000875). Results: A total of 47 patients were centrally registered between November 2007 and November 2009 from 14 centers. All patients were eligible for analysis. The median age was 63 (range 37–79); male/female: 36/11; PS0/1:41/6; and clinical stage IIIA/IIIB: 31/16. The target pRR was 47% (90% CI, 34–60%; p < 0.0001). Forty six patients (98%) underwent surgery, in whom curative resection was performed in 44 patients, and 37 patients completed the protocol treatment. The response to preoperative chemotherapy was PR/SD/PD/NE in 16/24/2/5 with a response rate of 34%. The most common toxicities of neoadjuvant chemotherapy were grade 3/4 neutropenia (42%), febrile neutropenia (4%), grade 2 anorexia (21%), and fatigue (15%). Seven did not complete the neoadjuvant therapy due to 2 allergic reaction, 1 grade 3 anorexia, 2 grade 2 nausea and anorexia, 2 PD (all 7 had gastrectomy). Major operative morbidity included pancreatic fistula (9%), abdominal abscess (11%), pneumonia (2%), and anastomotic leakage (0%). No patients died due to surgical complications. Conclusions: The combination of DTX and S-1 was well tolerated and promising as a preoperative chemotherapy regimen for patients with potentially resectable advanced gastric cancer. [Table: see text]
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Affiliation(s)
- M. Watanabe
- Kumamoto University, Kumamoto, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan; Department of Surgery Hiroshima City Asa Hospital, Hiroshima, Japan; National Kyushu Cancer Center, Fukuoka, Japan
| | - Y. Emi
- Kumamoto University, Kumamoto, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan; Department of Surgery Hiroshima City Asa Hospital, Hiroshima, Japan; National Kyushu Cancer Center, Fukuoka, Japan
| | - Y. Kakeji
- Kumamoto University, Kumamoto, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan; Department of Surgery Hiroshima City Asa Hospital, Hiroshima, Japan; National Kyushu Cancer Center, Fukuoka, Japan
| | - E. Oki
- Kumamoto University, Kumamoto, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan; Department of Surgery Hiroshima City Asa Hospital, Hiroshima, Japan; National Kyushu Cancer Center, Fukuoka, Japan
| | - Y. Sakaguchi
- Kumamoto University, Kumamoto, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan; Department of Surgery Hiroshima City Asa Hospital, Hiroshima, Japan; National Kyushu Cancer Center, Fukuoka, Japan
| | - K. Yoshida
- Kumamoto University, Kumamoto, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan; Department of Surgery Hiroshima City Asa Hospital, Hiroshima, Japan; National Kyushu Cancer Center, Fukuoka, Japan
| | - N. Hirabayashi
- Kumamoto University, Kumamoto, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan; Department of Surgery Hiroshima City Asa Hospital, Hiroshima, Japan; National Kyushu Cancer Center, Fukuoka, Japan
| | - T. Yamanaka
- Kumamoto University, Kumamoto, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan; Department of Surgery Hiroshima City Asa Hospital, Hiroshima, Japan; National Kyushu Cancer Center, Fukuoka, Japan
| | - H. Baba
- Kumamoto University, Kumamoto, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan; Department of Surgery Hiroshima City Asa Hospital, Hiroshima, Japan; National Kyushu Cancer Center, Fukuoka, Japan
| | - Y. Maehara
- Kumamoto University, Kumamoto, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan; Department of Surgery Hiroshima City Asa Hospital, Hiroshima, Japan; National Kyushu Cancer Center, Fukuoka, Japan
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Kitazono M, Emi Y, Kakeji Y, Sakaguchi Y, Samura H, Ogata Y, Natsugoe S, Shirouzu K, Tokunaga S, Maehara Y. Adjuvant capecitabine treatment for stage III colon cancer in Japanese patients (KSCC0803). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
571 Background: Capecitabine was approved in Japan in 2007 for the adjuvant treatment of stage III colon cancer based on Japanese clinical trial data in advanced and recurrent colorectal and breast cancers as well as data from the Phase III X-ACT trial. For the current study, we aimed to clarify compliance and tolerability of adjuvant treatment with capecitabine in Japanese patients. The study was entered in the UMIN clinical trial registry (UMIN000001444) by the Kyushu Study Group of Clinical Cancer (KSCC). Ethical approval was granted by the institutional review board of each hospital involved. Methods: Based on completion rates from the X-ACT trial we enrolled 97 patients with R0 stage III colon cancer who had histologically confirmed disease and had undergone curative resection (3D2 lymph node dissection). Patients were given oral capecitabine therapy (2,500 mg/m2/day; days 1–14 q3w; eight cycles) within 8 weeks of surgery. The proportion of patients completing eight cycles of treatment per protocol was the primary endpoint, and adverse event (AE) rate was analyzed as a secondary endpoint. Results: Treatment completion in the total patient population was 66.0% (64/97 patients; 95% CI: 55.7–75.3%) and in the per protocol population (PPP) was 70.3% (64/91; 95% CI: 59.8–79.5%). AEs leading to treatment discontinuation included hand-foot syndrome (HFS; n=7), hematotoxicity (n=5) and increased hepatic activity (n=4). Grade 3/4 AEs of note included HFS (22.7%), neutropenia (7.2%), diarrhea (2.1%), and increased bilirubin (0.0%). Of note, any treatment delay >3 weeks in the current trial was considered a withdrawal. In the X-ACT trial, delays of any duration were permitted. Using the X-ACT criteria the completion rate for the PPP in this study was 80.2%, comparable to the figure reported in X-ACT. Conclusions: Our results confirm those of previous global phase III studies and show that capecitabine is well tolerated in both global and Japanese-only populations, with similar high completion rates in both. [Table: see text]
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Affiliation(s)
- M. Kitazono
- Department of Gastrointestinal Surgery, Graduate School of Medical Science, Kagoshima University, Kagoshima, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Department of Surgery, Kurume Medical Center, Kurume University School of Medicine, Kurume, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of
| | - Y. Emi
- Department of Gastrointestinal Surgery, Graduate School of Medical Science, Kagoshima University, Kagoshima, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Department of Surgery, Kurume Medical Center, Kurume University School of Medicine, Kurume, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of
| | - Y. Kakeji
- Department of Gastrointestinal Surgery, Graduate School of Medical Science, Kagoshima University, Kagoshima, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Department of Surgery, Kurume Medical Center, Kurume University School of Medicine, Kurume, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of
| | - Y. Sakaguchi
- Department of Gastrointestinal Surgery, Graduate School of Medical Science, Kagoshima University, Kagoshima, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Department of Surgery, Kurume Medical Center, Kurume University School of Medicine, Kurume, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of
| | - H. Samura
- Department of Gastrointestinal Surgery, Graduate School of Medical Science, Kagoshima University, Kagoshima, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Department of Surgery, Kurume Medical Center, Kurume University School of Medicine, Kurume, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of
| | - Y. Ogata
- Department of Gastrointestinal Surgery, Graduate School of Medical Science, Kagoshima University, Kagoshima, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Department of Surgery, Kurume Medical Center, Kurume University School of Medicine, Kurume, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of
| | - S. Natsugoe
- Department of Gastrointestinal Surgery, Graduate School of Medical Science, Kagoshima University, Kagoshima, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Department of Surgery, Kurume Medical Center, Kurume University School of Medicine, Kurume, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of
| | - K. Shirouzu
- Department of Gastrointestinal Surgery, Graduate School of Medical Science, Kagoshima University, Kagoshima, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Department of Surgery, Kurume Medical Center, Kurume University School of Medicine, Kurume, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of
| | - S. Tokunaga
- Department of Gastrointestinal Surgery, Graduate School of Medical Science, Kagoshima University, Kagoshima, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Department of Surgery, Kurume Medical Center, Kurume University School of Medicine, Kurume, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of
| | - Y. Maehara
- Department of Gastrointestinal Surgery, Graduate School of Medical Science, Kagoshima University, Kagoshima, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Department of Surgery, Kurume Medical Center, Kurume University School of Medicine, Kurume, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of
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Kusumoto T, Emi Y, Kakeji Y, Akagi Y, Samura H, Baba H, Natsugoe S, Tokunaga S, Maehara Y. Analysis of oxaliplatin-induced sensory neurotoxicity (sNT) in patients receiving FIREFOX, alternating regimen of mFOLFOX-6 and FOLFIRI, with metastatic colorectal cancer (MCRC): Results from combined analysis of KSCC0501 and KSCC0701. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
492 Background: The Kyushu Study Group of Clinical Cancer (KSCC) conducted two phase II trials (KSCC0501 and KSCC0701, Akagi et al. J Clin Oncol. 28:15s, 2010, UMIN ID: 000001342) to evaluate the efficacy and safety of first-line oxaliplatin-based chemotherapy for MCRC. This combined analysis was performed to compare the incidence of oxaliplatin-induced sNT between the two trials. Methods: Patients (pts) were accrued from 2005 to 2007 in KSCC0501 and from 2007 to 2008 in KSCC0701. Sixty pts received FOLFOX-4 in KSCC0501 and 47 pts received FIREFOX(4 cycles of mFOLFOX-6 alternating with 4 cycles of FOLFIRI) in KSCC0701. All pts were reviewed for efficacy and toxicity (NCI-CTCAEv3.0). Kaplan-Meier analysis was performed to assess the incidence of sNT. Results: The incidence of sNT was 71.4% with FOLFOX-4 and 36.2% with FIREFOX (Table). The ORR was 34.5% (95% CI F22.5-48.1%) for FOLFOX4 and 58.7% (43.9-73.5%) for FIREFOX. Median PFS was 7.0 M (5.1-9.8 M) with FOLFOX-4 and 10.3 M (7.5-11.9 M) with FIREFOX. MST and 2-year survival were respectively 31.5 M (18.1-40.1 M) and 58.0% for FOLFOX4, versus not determined and 57.1% for FIREFOX. The median no. of treatment cycles was 9 for FOLFOX-4 and 12 for FIREFOX. After 4, 8, and 12 cumulative treatment cycles, the incidence of grade 2+sNT was respectively 24.0%, 30.7%, and 60.5% with FOLFOX-4 versus 6.5%, 6.5%, and 16.0% with FIREFOX. Conclusions: As first-line oxaliplatin-based chemotherapy for MCRC, FIREFOX caused less oxaliplatin-induced sNT and prolonged the duration of treatment. We have now finished enrollment for study KSCC 0801 (KSCC 0701+bevacizumab) and are following the pts. [Table: see text] [Table: see text]
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Affiliation(s)
- T. Kusumoto
- Institute of Clinical Research, National Beppu Medical Center, Beppu, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Surgery, Kurume University School of Medicine, Kurume, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Kumamoto University, Kumamoto, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan
| | - Y. Emi
- Institute of Clinical Research, National Beppu Medical Center, Beppu, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Surgery, Kurume University School of Medicine, Kurume, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Kumamoto University, Kumamoto, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan
| | - Y. Kakeji
- Institute of Clinical Research, National Beppu Medical Center, Beppu, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Surgery, Kurume University School of Medicine, Kurume, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Kumamoto University, Kumamoto, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan
| | - Y. Akagi
- Institute of Clinical Research, National Beppu Medical Center, Beppu, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Surgery, Kurume University School of Medicine, Kurume, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Kumamoto University, Kumamoto, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan
| | - H. Samura
- Institute of Clinical Research, National Beppu Medical Center, Beppu, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Surgery, Kurume University School of Medicine, Kurume, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Kumamoto University, Kumamoto, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan
| | - H. Baba
- Institute of Clinical Research, National Beppu Medical Center, Beppu, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Surgery, Kurume University School of Medicine, Kurume, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Kumamoto University, Kumamoto, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan
| | - S. Natsugoe
- Institute of Clinical Research, National Beppu Medical Center, Beppu, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Surgery, Kurume University School of Medicine, Kurume, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Kumamoto University, Kumamoto, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan
| | - S. Tokunaga
- Institute of Clinical Research, National Beppu Medical Center, Beppu, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Surgery, Kurume University School of Medicine, Kurume, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Kumamoto University, Kumamoto, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan
| | - Y. Maehara
- Institute of Clinical Research, National Beppu Medical Center, Beppu, Japan; Department of Surgery and Science, Kyushu University, Fukuoka, Japan; Department of Surgery, Kurume University School of Medicine, Kurume, Japan; Department of Surgery, Ryukyu University, Nakagami-Gun, Japan; Kumamoto University, Kumamoto, Japan; Kagoshima University Graduate School, Kagoshima, Japan; Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan
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Morita M, Yoshinaga K, Saeki H, Egashira A, Ohga T, Emi Y, Kakeji Y, Shioyama Y, Maehara Y. Significance of definitive chemoradiotherapy and salvage surgery for squamous cell carcinoma of the esophagus. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14521] [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: 11/20/2022] Open
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Tokunaga E, Hisamatsu Y, Okada S, Yamashita N, Nakashima Y, Saeki H, Emi Y, Morita M, Kakeji Y, Maehara Y. Expression of forkhead-box protein A1 (FOXA1) as a significant prognostic and predictive marker for ER-positive breast cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.608] [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: 11/20/2022] Open
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Akagi Y, Tokunaga S, Emi Y, Kakeji Y, Kusumoto T, Baba H, Ogata Y, Tanaka T, Shirouzu K, Maehara Y. Phase II trial alternating mFOLFOX 6 and FOLFIRI (FIREFOX) regimens in first-line treatment of advanced colorectal cancer in Japanese patients (KSCC 0701). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3553] [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: 11/20/2022] Open
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Oki E, Kakeji Y, Morita M, Emi Y, Taketomi A, Kusumoto T, Maehara Y. Transient elastography for the assessment of oxaliplatin-associated liver damage in colon cancer patients with liver metastasis. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14088] [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: 11/20/2022] Open
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Kakeji Y, Oki E, Yoshinaga K, Saeki H, Tokunaga E, Morita M, Kitao H, Emi Y, Sakaguchi Y, Maehara Y. Staging laparoscopy and neoadjuvant chemotherapy of biweekly docetaxel and S-1 for gastric cancer with peritoneal dissemination. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14570] [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: 11/20/2022] Open
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Iwashita S, Tsuchida M, Tsukuda M, Yamashita Y, Emi Y, Kida Y, Komori M, Kashiwayama Y, Imanaka T, Sakaguchi M. Multiple organelle-targeting signals in the N-terminal portion of peroxisomal membrane protein PMP70. J Biochem 2009; 147:581-90. [DOI: 10.1093/jb/mvp205] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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Emi Y, Orita H, Yamamoto M, Sadanaga T, Kusumoto T, Takahashi I, Kakeji Y, Maehara Y. 6536 Feasibility of adjuvant S-1 plus docetaxel against stage II-III gastric cancer following R0 resection in gastrectomy. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71258-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Kakeji Y, Mizokami K, Sumiyoshi Y, Yoshinaga K, Saeki H, Tokunaga E, Endo K, Morita M, Kitao H, Emi Y, Maehara Y. The prognostic impact of hypoxia-inducible factor-1α and VEGF, IGF-2, p21, p53 expression in gastric adenocarcinoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4571] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4571 Background: Hypoxia caused by either radiation or chemotherapy induces various intracellular adaptive responses, which contribute to tumor progression. The clinicopathological characteristics of human gastric cancer and the clinical outcomes were analyzed to investigate the effects of the expression of hypoxia-inducible factor1α (HIF-1α) and some related proteins, such as, vascular endothelial growth factor (VEGF), insulin-like growth factor-2 (IGF-2), p21, and p53 on the prognosis of human gastric cancer. Methods: The expressions of HIF-1α, VEGF, IGF-2, p21, and p53 proteins were determined by immunohistochemistry in 216 specimens of primary gastric cancer. Results: Of all 216 patients, 85 (39.4%) showed a positive expression of HIF-1α. In addition, the HIF-1α expression positively correlated with the tumor size and depth of invasion, while it was also more frequent in tumors with lymphatic invasion and undifferentiated adenocarcinomas. Though the VEGF expression significantly correlated with the HIF-1α expression, the expressions of IGF-2, p21 and p53 did not show any correlation. HIF-1α-positive/p21-negative tumors had a lower apoptotic index, and the patients with such tumors also had a significantly poorer prognosis. Similarly, HIF-1α-positive/p53-positive tumors had a significantly poorer prognosis. A multivariate Cox regression analysis showed the depth of invasion, lymph node metastasis, and HIF-1α positivity to all be independent prognostic factors in patients with gastric cancer. Conclusions: Based on the above findings, HIF-1α is therefore considered to be a useful independent prognostic factor in gastric cancer, and the combination of a HIF-1α protein overexpression with the loss of p21 expression or nonfunctional p53 thus tends to indicate a dismal prognosis. Controlling hypoxia, especially in the HIF-1α pathways, may therefore hold the key to a greater individualization of therapy and also lead to the development of new treatments for patients with gastric cancer. No significant financial relationships to disclose.
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Affiliation(s)
| | | | | | | | - H. Saeki
- Kyushu University, Fukuoka, Japan
| | | | - K. Endo
- Kyushu University, Fukuoka, Japan
| | | | - H. Kitao
- Kyushu University, Fukuoka, Japan
| | - Y. Emi
- Kyushu University, Fukuoka, Japan
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Kakeji Y, Oki E, Nishida K, Koga T, Tokunaga E, Morita M, Emi Y, Maehara Y. Phase II study of S-1 and biweekly docetaxel combination in advanced or recurrent gastric cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.14031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
14031 Background: Docetaxel (TXT) and S-1 are active agents against gastric cancer. A synergistic antitumor effect has been shown in a preclinical study (Takahashi et al., Oncology 2005), and our previous phase I trial demonstrated the safety and tolerability of the combination, and its potent activity. To prospectively evaluate toxicity and efficacy of S-1/ biweekly TXT, we conducted the current phase II study in patients with advanced and recurrent gastric cancer. Methods: Patients (pts) with advanced or recurrent gastric cancer, who have not received any chemotherapy except postoperative chemotherapy (not including S-1 or TXT), were eligible for the trial, and were treated with docetaxel 35 mg/m2 one hour iv infusion on day 1 and 15, and S-1 at a full dose of 80 mg/m2/day for two weeks every four weeks. Results: Thirty-five pts with measurable lesions (RECIST) (10 females, 25 males; performance status [PS] 0/1/2: 23/8/4, age 27–74, differentiated/undifferentiated adenocarcinoma: 19/16) have been enrolled. A total of 113 cycles were administered (median 3, range 1–6), and all pts were assessable for toxicity and efficacy. Grade 3–4 toxicities were: neutropenia in 20.0% (grade 4: 11.4%) of patients, leukocytopenia in 11.4% (grade 4: 0%), anemia in 5.7%, appetite loss in 8.6%, stomatitis in 8.6%, fever in 2.9%, and fatigue in 2.9%. All treatment related toxicities resolved, and no toxic death was reported. Thirteen partial responses (PR) were obtained, resulting in an overall response (OR) rate of 37.1% (95% CI: 0.22–0.55). Thirteen pts (37.5%) had stable disease, and 4 pts (12.5%) progressed. The tumor control rate was 74.3% (95% CI: 0.57–0.88). The median survival time (MST) and time to treatment failure (TTF) were 326 and 75 days, respectively. Conclusions: The combination of S-1/ biweekly TXT is active in advanced or recurrent gastric cancer, and can be given safely with proper management of adverse events even in outpatient clinic. S-1/ biweekly TXT is one of the most effective regimen to control metastatic gastric cancer with less toxicity. No significant financial relationships to disclose.
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Affiliation(s)
| | - E. Oki
- Kyushu University, Fukuoka, Japan
| | | | - T. Koga
- Kyushu University, Fukuoka, Japan
| | | | | | - Y. Emi
- Kyushu University, Fukuoka, Japan
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Nagata N, Tsuburaya A, Kimura M, Emi Y, Hirabayashi N, Kobayashi M, Itoh H, Sakamoto J. A multicenter phase II study of sequential paclitaxel and S-1 (TXL/S-1) as postoperative adjuvant chemotherapy for gastric cancer (GC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4067] [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)
- N. Nagata
- Univ of Occupational & Environmental Health, Kitakyushu, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; St. Marianna Univ, Kawasaki, Japan; Hiroshima Red Cross Hosp, Hiroshima, Japan; Hiroshima City Asa Hosp, Hiroshima, Japan; Kochi Univ, Kochi, Japan; Kyoto Univ, Kyoto, Japan
| | - A. Tsuburaya
- Univ of Occupational & Environmental Health, Kitakyushu, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; St. Marianna Univ, Kawasaki, Japan; Hiroshima Red Cross Hosp, Hiroshima, Japan; Hiroshima City Asa Hosp, Hiroshima, Japan; Kochi Univ, Kochi, Japan; Kyoto Univ, Kyoto, Japan
| | - M. Kimura
- Univ of Occupational & Environmental Health, Kitakyushu, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; St. Marianna Univ, Kawasaki, Japan; Hiroshima Red Cross Hosp, Hiroshima, Japan; Hiroshima City Asa Hosp, Hiroshima, Japan; Kochi Univ, Kochi, Japan; Kyoto Univ, Kyoto, Japan
| | - Y. Emi
- Univ of Occupational & Environmental Health, Kitakyushu, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; St. Marianna Univ, Kawasaki, Japan; Hiroshima Red Cross Hosp, Hiroshima, Japan; Hiroshima City Asa Hosp, Hiroshima, Japan; Kochi Univ, Kochi, Japan; Kyoto Univ, Kyoto, Japan
| | - N. Hirabayashi
- Univ of Occupational & Environmental Health, Kitakyushu, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; St. Marianna Univ, Kawasaki, Japan; Hiroshima Red Cross Hosp, Hiroshima, Japan; Hiroshima City Asa Hosp, Hiroshima, Japan; Kochi Univ, Kochi, Japan; Kyoto Univ, Kyoto, Japan
| | - M. Kobayashi
- Univ of Occupational & Environmental Health, Kitakyushu, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; St. Marianna Univ, Kawasaki, Japan; Hiroshima Red Cross Hosp, Hiroshima, Japan; Hiroshima City Asa Hosp, Hiroshima, Japan; Kochi Univ, Kochi, Japan; Kyoto Univ, Kyoto, Japan
| | - H. Itoh
- Univ of Occupational & Environmental Health, Kitakyushu, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; St. Marianna Univ, Kawasaki, Japan; Hiroshima Red Cross Hosp, Hiroshima, Japan; Hiroshima City Asa Hosp, Hiroshima, Japan; Kochi Univ, Kochi, Japan; Kyoto Univ, Kyoto, Japan
| | - J. Sakamoto
- Univ of Occupational & Environmental Health, Kitakyushu, Japan; Kanagawa Cancer Ctr, Yokohama, Japan; St. Marianna Univ, Kawasaki, Japan; Hiroshima Red Cross Hosp, Hiroshima, Japan; Hiroshima City Asa Hosp, Hiroshima, Japan; Kochi Univ, Kochi, Japan; Kyoto Univ, Kyoto, Japan
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37
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Baba H, Emi Y, Kakeji Y, Tokunaga E, Ushiro S, Watanabe M, Maehara Y. Phase II study of weekly paclitaxel in patients with advanced gastric cancer in Japan. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- H. Baba
- Kyushu University, Fukuoka, Japan; Hiroshima Red Cross Hospital, Hiroshima, Japan
| | - Y. Emi
- Kyushu University, Fukuoka, Japan; Hiroshima Red Cross Hospital, Hiroshima, Japan
| | - Y. Kakeji
- Kyushu University, Fukuoka, Japan; Hiroshima Red Cross Hospital, Hiroshima, Japan
| | - E. Tokunaga
- Kyushu University, Fukuoka, Japan; Hiroshima Red Cross Hospital, Hiroshima, Japan
| | - S. Ushiro
- Kyushu University, Fukuoka, Japan; Hiroshima Red Cross Hospital, Hiroshima, Japan
| | - M. Watanabe
- Kyushu University, Fukuoka, Japan; Hiroshima Red Cross Hospital, Hiroshima, Japan
| | - Y. Maehara
- Kyushu University, Fukuoka, Japan; Hiroshima Red Cross Hospital, Hiroshima, Japan
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38
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Koga J, Kakeji Y, Sumiyoshi Y, Kimura Y, Shibahara K, Emi Y, Maehara Y, Sugimachi K. [Angiogenesis and macrophage infiltration in Borrmann type IV gastric cancer]. Fukuoka Igaku Zasshi 2001; 92:334-9. [PMID: 11680976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
The clinical significance of angiogenesis was investigated in Borrmann type IV gastric cancer. Tumors with high microvessel density (MVD) often metastasized to the liver and lymph nodes. A significant correlation was recognized between macrophage infiltration and MVD. However, MVD was not a prognostic factor. Peritoneal dissemination was a prognostic factor in Borrmann type IV gastric cancer. Thus, angiogenesis plays an important role in the metastasis, but not prognosis in Borrmann type IV gastric cancer.
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Affiliation(s)
- J Koga
- Department of Surgery and Science (Surgery II), Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582
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39
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Luquita MG, Catania VA, Pozzi EJ, Veggi LM, Hoffman T, Pellegrino JM, Emi Y, Iyanagi T, Vore M, Mottino AD. Molecular basis of perinatal changes in UDP-glucuronosyltransferase activity in maternal rat liver. J Pharmacol Exp Ther 2001; 298:49-56. [PMID: 11408524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
The molecular basis of perinatal changes occurring in major UDP-glucuronosyltransferase (UGT) family 1 isoforms and in UGT2B1, a relevant isoform belonging to family 2, was analyzed in rat liver. Nonpregnant, pregnant (19-20 days of pregnancy), and two groups of postpartum animals corresponding to early and middle stages of lactation (2-4 and 10-12 days after delivery, respectively) were studied. UGT activity determined in UDP-N-acetylglucosamine-activated microsomes revealed that bilirubin, p-nitrophenol, and ethynylestradiol (17beta-OH and 3-OH) but not androsterone and estrone glucuronidation rates, were decreased in pregnant rats. Decreased enzyme activities returned to control values after delivery. p-Nitrophenol, androsterone, and estrone conjugation rate increased in postpartum rats. Western blot analysis performed with anti-peptide-specific (anti-1A1, 1A5, 1A6, and 2B1) antibodies revealed decreased levels of all family 1 isoforms and UGT2B1 during pregnancy. In postpartum animals, protein level recovered (1A5 and 2B1) or even increased (1A1 and 1A6) with respect to control rats. Northern blot analysis suggested that expression of UGT proteins is down-regulated at a post-translational level during pregnancy and that increased levels of 1A1 and 1A6 observed in postpartum rats were associated to increased mRNA. To establish whether prolactin is involved in up-regulation of UGT1A1 and 1A6 postpartum, ovariectomized rats were treated with 300 microg of ovine prolactin per day for 7 days. The data indicated that prolactin was able to increase expression of UGT1A6 (protein and mRNA) but not 1A1. Thus, prolactin is the likely mediator of the increased expression of UGT1A6 observed in maternal liver postpartum.
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Affiliation(s)
- M G Luquita
- Institute of Experimental Physiology, School of Biochemical and Pharmaceutical Sciences, Rosario, Argentina
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40
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Utsunomiya T, Emi Y, Ikejiri K, Suzuki M, Saitsu H, Yakabe S, Nonaka M, Saku M, Yoshida K, Shimada M, Sugimachi K. Retrospective study on the effects of lipiodolization before a potentially curative hepatectomy for colorectal liver metastases: long-term results of a pilot study. Hepatogastroenterology 2001; 48:790-3. [PMID: 11462925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND/AIMS Lipiodolization, a selective regional cancer chemotherapeutic modality using lipiodol plus anticancer drugs, can prolong the survival time of patients with unresectable liver cancer. A preliminary study was conducted with adjuvant lipiodolization before a potentially curative hepatectomy for patients with metachronous colorectal liver metastases. The ultimate aim of this study was to improve the long-term survival after hepatectomy. METHODOLOGY Twenty-one consecutive patients with colorectal hepatic metastases were included in this study. Seven patients underwent preoperative lipiodolization, while the remaining 14 patients did not receive any preoperative adjuvant therapy. The clinicopathological features and prognoses of these patients were investigated. The median follow-up period after a curative hepatectomy was 56 months. RESULTS The clinicopathological factors did not differ markedly between the 2 groups. However, the cumulative survival rate of the 7 patients receiving preoperative lipiodolization was significantly (P < 0.05) better than that in those not receiving any preoperative treatment. CONCLUSIONS Based on the above encouraging findings, we therefore propose that a prospective randomized trial should be carried out to confirm the beneficial effects of our adjuvant chemotherapeutic modality on patient survival following a curative hepatectomy for the patients with colorectal liver metastases.
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Affiliation(s)
- T Utsunomiya
- Department of Surgery of National Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan
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41
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Emi Y, Ohnishi A, Kajimoto T, Ikushiro SI, Iyanagi T. A 66-base-pair enhancer module activates the expression of a distinct isoform of UDP-glucuronosyltransferase family 1 (UGT1A2) in primary hepatocytes. Arch Biochem Biophys 2000; 378:384-92. [PMID: 10860556 DOI: 10.1006/abbi.2000.1837] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
UGT1A2, an isoform of the UDP-glucuronosyltransferase family 1 (UGT1), is not expressed in the rat liver, but its expression was highly induced in primary cultures of rat hepatocytes. In primary hepatocytes that had been cultured for 70 h, the amount of UGT1A2 mRNA was 100 times higher than that in the rat liver. Deletion analysis of a 4.8-kb promoter region of the UGT1A2 gene revealed that a 66-nucleotide region between -307 and -242 upstream of the transcription start site was required for induction of UGT1A2 expression. The 66-nucleotide region acted on a heterologous promoter in a manner independent of its position and orientation in reporter constructs. Gel mobility shift assay showed that a specific binding protein to this region appeared in the nuclei of cultured hepatocytes, but was not present in the rat liver. DNase I protection analysis revealed the existence of a CTGGCAC core sequence between -274 and -268 of the UGT1A2 promoter. Methylation interference assay showed that the guanine residues at -294 and -287 on the upper strand and the guanine residue at -267 on the lower strand as well as the core sequence were required for the DNA-protein interaction. These results suggest that the 66-nucleotide region, which was designated culture-associated expression responsive enhancer module (CEREM), interacts with a specific nuclear protein and enhances the expression of UGT1A2 in cultured hepatocytes.
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Affiliation(s)
- Y Emi
- Department of Life Science, Faculty of Science, Himeji Institute of Technology, Harima Science Park City, Hyogo, 678-1297, Japan.
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42
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Utsunomiya T, Saku M, Emi Y, Ikejiri K, Suzuki M, Saitsu H, Yakabe S, Nonaka M, Muranaka T, Yoshida K. Intraoperative localization of right-sided small colonic lesions: a novel use of the cholangioscope. Dig Surg 2000; 17:15-6. [PMID: 10720826 DOI: 10.1159/000018794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND/AIM We describe a novel use of the cholangioscope to help in the intraoperative localization of small colonic malignancies on the right side of the colon. METHODS A small incision was made at the base of the appendix and a cholangioscope was inserted into the ascending colon through the incised hole of the appendix. RESULTS The site of the lesion was precisely determined by palpating the distal end of the cholangioscope while observing the area right under it. CONCLUSION Our procedure therefore appears to be worthy of consideration in patients with small colonic lesions on the right side of the colon in whom preoperative endoscopic marking techniques might otherwise be required.
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Affiliation(s)
- T Utsunomiya
- Department of Surgery, National Kyushu Medical Center, Fukuoka, Japan
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43
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Nagasue N, Dhar DK, Yamanoi A, Emi Y, Udagawa J, Yamamoto A, Tachibana M, Kubota H, Kohno H, Harada T. Production and release of endothelin-1 from the gut and spleen in portal hypertension due to cirrhosis. Hepatology 2000; 31:1107-14. [PMID: 10796886 DOI: 10.1053/he.2000.6596] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study was aimed to evaluate the source of endothelin-1 (ET-1) in cirrhotic patients. ET-1 is implicated in the pathogenesis of portal hypertension. However, the mechanism and source for increased plasma ET-1 in cirrhotic patients are still obscure. Plasma ET-1 levels in systemic (SV), superior mesenteric (SMV), and splenic venous (SPV) blood were measured in 23 patients with cirrhosis and 8 controls with normal liver. Fourteen removed spleens were immunohistochemically studied for ET-1, CD34, CD68, and CD20. In situ hybridization was done to localize ET-1 messenger RNA (mRNA). In cirrhosis, ET-1 levels in both SMV and SPV were higher than in SV. ET-1 in SV and SPV were significantly higher in cirrhotic patients than in control patients. Three groups of cells in the spleen expressed both protein and mRNA of ET-1: endothelial cells in the sinus, which were also stained for CD34; cells in the germinal center; and cells in the marginal zone of lymphoid sheaths and follicles, which were also stained for CD20 but not for CD34 and CD68. The ET-1 concentration released from the spleen was in parallel with the grade of ET-1 expression in the spleen. The spleen is one of the major sites of ET-1 release in cirrhotic patients. Endothelial cells of the splenic sinus and possibly B lymphocytes in the germinal center and marginal zone of lymphoid sheaths and follicles seem to be the sites of ET-1 production in the spleen.
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Affiliation(s)
- N Nagasue
- Second Department of Surgery, Shimane Medical University, Izumo,
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44
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Rai Y, Emi Y, Nishijima N, Kai S, Kano T. [A patient with hepatic metastasis of breast cancer successfully treated with combined chemoendocrine therapy using epirubicin, tegafur and tamoxifen]. Gan To Kagaku Ryoho 1999; 26:1475-8. [PMID: 10500537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
A solitary 1 cm sized metastatic lesion was found in the S5 region of the liver on a postoperative ultrasound screening of a 52-year-old breast cancer patient. It was confirmed by CT, MRI and hepatic angiography. At first, she was successfully treated with trans-arterial pirarubicin and lipiodol infusion but a metastatic lesion of similar size was found 6 months later in the same region. We then administered a triple 20 mg dose of epirubicin intravenously, and 450 mg of UFT and 30 mg of tamoxifen daily. Six months later the lesion had disappeared on US and CT scans and a complete remission has persisted for 18 months.
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Affiliation(s)
- Y Rai
- Dept. of Breast Surgery, Beppu National Hospital
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Ikushiro S, Emi Y, Kimura S, Iyanagi T. Chemical modification of rat hepatic microsomes with N-ethylmaleimide results in inactivation of both UDP-N-acetylglucosamine-dependent stimulation of glucuronidation and UDP-glucuronic acid uptake. Biochim Biophys Acta 1999; 1428:388-96. [PMID: 10434058 DOI: 10.1016/s0304-4165(99)00066-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Chemical modification of rat hepatic microsomes with N-ethylmaleimide (NEM) resulted in inactivation of UDP-N-acetylglucosamine (UDP-GlcNAc)-dependent stimulation of glucuronidation of p-nitrophenol. Inactivation kinetics and pH dependence were in agreement with the modification of a single sulfhydryl group. NEM also inactivated the uptake of UDP-glucuronic acid (UDP-GlcUA) but not UDP-glucose. With various sulfhydryl-modifying reagents, the inactivation of UDP-GlcUA uptake was linked to that of glucuronidation. UDP-GlcUA protected against NEM-sensitive inactivation of both UDP-GlcNAc-dependent stimulation of glucuronidation and UDP-GlcUA uptake, suggesting that the sulfhydryl group is located within or near the UDP-GlcUA binding site of the microsomal protein involved in the stimulation. Using microsomes labeled with biotin-conjugated maleimide and immunopurification with anti-peptide antibody against UDP-glucuronosyltransferase family 1 (UGT1) isozymes, immunopurified UGT1s were found to be labeled with the maleimide and UDP-GlcUA protected against the labeling as it did with the NEM-sensitive inactivation. These data suggest the involvement of a sulfhydryl residue of microsomal protein in the UDP-GlcNAc-dependent stimulation mechanism via the stimulation of UDP-GlcUA uptake into microsomal vesicles.
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Affiliation(s)
- S Ikushiro
- Department of Life Science, Faculty of Science, Himeji Institute of Technology, Harima Science Garden City, Hyogo 678-1297, Japan.
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Kimura S, Emi Y, Ikushiro S, Iyanagi T. Systematic mutations of highly conserved His49 and carboxyl-terminal of recombinant porcine liver NADH-cytochrome b5 reductase solubilized domain. Biochim Biophys Acta 1999; 1430:290-301. [PMID: 10082957 DOI: 10.1016/s0167-4838(99)00008-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The cDNA encoding solubilized porcine liver NADH-cytochrome b5 reductase catalytic domain (Pb5R) was cloned and overexpressed in Escherichia coli. A highly conserved His49 and a C-terminal Phe272 of Pb5R, which are located near the isoalloxazine moiety of the FAD, were systematically modulated by site-directed mutagenesis. Large structural change was not detected on the absorption and circular dichroism spectra of mutant proteins. Drastic changes in enzymatic properties were not observed, but the apparent Km value for soluble form of porcine liver cytochrome b5 (Pb5) was affected by the substitutions of His49 with glutamic acid and with lysine, deletion of C-terminal Phe272, and addition of Gly273. The values of the catalytic constant (kcat) were obviously decreased by the substitution of His49 with glutamic acid or the addition of Gly273. In these two mutants, the rate for reduction of FAD was decreased, and the rate for autoxidation of reduced FAD was increased. These results showed that His49 and C-terminal carboxyl group in Pb5R are not critical for the electron transfer to Pb5, but the electrostatic environmental changes at these positions could affect the recognition of Pb5 and modulate the catalytic function of the enzyme by changing the stability of reduced FAD.
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Affiliation(s)
- S Kimura
- Department of Life Science, Faculty of Science, Himeji Institute of Technology, Harima Science Garden City, Hyogo 678-1297, Japan.
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Maehara Y, Kakeji Y, Kabashima A, Emi Y, Watanabe A, Akazawa K, Baba H, Kohnoe S, Sugimachi K. Role of transforming growth factor-beta 1 in invasion and metastasis in gastric carcinoma. J Clin Oncol 1999; 17:607-14. [PMID: 10080606 DOI: 10.1200/jco.1999.17.2.607] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Transforming growth factor-beta1 (TGF-beta1) is a major modulator of cellular proliferation and extracellular matrix formation. We determined the role of TGF-beta1 in invasion and metastasis in gastric cancer. MATERIALS AND METHODS We detected TGF-beta1 expression in primary and lymph node metastatic lesions of gastric cancer, using an antibody and in situ hybridization. The plasma TGF-beta1 levels in the peripheral vein and in the tumor drainage vein were assayed. RESULTS In the cytoplasm of cancer cells, TGF- beta1 was immunostained in 35.9% (78 of 217) of primary gastric carcinomas, and this expression was confirmed by in situ hybridization. Of 59 gastric carcinomas with a TGF-beta1-negative primary tumor, metastatic lymph nodes were positive for TGF-beta1 staining in 32 cases (54.2%). Positive staining of TGF-beta1 in gastric cancer tissues was closely related to serosal invasion, infiltrative growth, and lymph node metastasis. Multivariate analysis showed that the expression of TGF-beta1 was an independent risk factor for serosal invasion and infiltrative growth of the tumor. The plasma level of TGF-beta1 did not differ between TGF-beta1-negative and -positive groups. There were also no differences in plasma TGF-beta1 levels among each tumor stage, between the peripheral and the tumor drainage veins, and between preoperative and postoperative testings. CONCLUSION Transforming growth factor-beta1 is closely related to the invasion and metastasis of gastric cancer, and production of TGF-beta1 in the tumor does not contribute to the total amount of TGF-beta1 in the blood circulation. We interpret our observations to mean that in a tumor microenvironment, TGF-beta1 alters the biologic behavior of the tumor.
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Affiliation(s)
- Y Maehara
- Cancer Center, Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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Kohnoe S, Maehara Y, Takahashi I, Emi Y, Baba H, Sugimachi K. Treatment of advanced gastric cancer with 5-fluorouracil and cisplatin in combination with dipyridamole. Int J Oncol 1998; 13:1203-6. [PMID: 9824632 DOI: 10.3892/ijo.13.6.1203] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We investigated the efficacy of combination chemo-therapy using 5-fluorouracil (5-FU), cisplatin (CDDP), and dipyridamole (DP), which is based on the concept of double biochemical modulation. Twenty-eight patients with advanced gastric cancer were treated with the simultaneous continuous intravenous (i.v.) infusion of 5-FU (800 mg/m2/day) and DP (4 mg/kg/day), and i.v. infusion of CDDP (20 mg/m2/day) for 5 days. The cycles were repeated every 4 weeks. Twelve patients (43%) had a partial response (PR), while stable disease (NC) occurred in 13 patients (46%), and progression (PD) in 3 patients (11%). An improved performance status was observed in 20 patients (71%). The carcinoembryonic antigen (CEA) level was markedly decreased in 75% of the CEA-positive patients. Toxicity was acceptable. The mean steady state plasma concentration of total DP was 6.40.5 microM, which thus seemed adequate to potentiate the cytotoxicity of 5-FU. The treatment regimen described herein thus appears to be effective, safe and well tolerated by patients with advanced gastric cancer.
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Affiliation(s)
- S Kohnoe
- Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka 811-1395, Japan
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49
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Abstract
Bilirubin, the oxidative product of heme in mammals, is excreted into the bile after its esterification with glucuronic acid to polar mono- and diconjugated derivatives. The accumulation of unconjugated and conjugated bilirubin in the serum is caused by several types of hereditary disorder. The Crigler-Najjar syndrome is caused by a defect in the gene which encodes bilirubin UDP-glucuronosyltransferase (UGT), whereas the Dubin-Johnson syndrome is characterized by a defect in the gene which encodes the canalicular bilirubin conjugate export pump of hepatocytes. Animal models such as the unconjugated hyperbilirubinemic Gunn rat, the conjugated hyperbilirubinemic GY/TR-, and the Eisai hyperbilirubinemic rat, have contributed to the understanding of the molecular basis of hyperbilirubinemia in humans. Elucidation of both the structure of the UGT1 gene complex, and the Mrp2 (cMoat) gene which encodes the canalicular conjugate export pump, has led to a greater understanding of the genetic basis of hyperbilirubinemia.
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Affiliation(s)
- T Iyanagi
- Department of Life Science, Himeji Institute of Technology, Hyogo, Japan.
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50
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Abstract
We report a very rare case of ileo-abdominal fistula caused by penetration of the ileal diverticulum. Small bowel diverticulosis is generally considered to be an innocuous condition. In this report, we describe a case of ileal diverticulitis associated with an abdominal wall abscess.
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Affiliation(s)
- N Eriguchi
- Department of Surgery, Kurume University School of Medicine, Japan
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