1
|
Hashino Y, Matushita T, Hatsuyama T, Wakamoto A, Goto K, Hoshi T, Iwayama K, Ohtaki K, Toda T, Sato H. Association of Nutritional Indices With Adverse Effects and Time-to-Treatment-Failure in Triple Therapy for Lung Cancer. In Vivo 2024; 38:864-872. [PMID: 38418111 PMCID: PMC10905434 DOI: 10.21873/invivo.13512] [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: 10/04/2023] [Revised: 11/13/2023] [Accepted: 11/23/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND/AIM Recent lung cancer treatments include an immune checkpoint inhibitor (ICI) pembrolizumab, platinum-based agents, plus an additional cytotoxic anticancer agent. Nutritional indices, such as the geriatric nutritional risk index (GNRI) and the prognostic nutritional index (PNI), are known to correlate with the prognosis of cancer chemotherapy. Several previous studies have investigated the relationship between PNI and treatment response in non-small cell lung cancer patients, reporting significantly increased OS and PFS in the high PNI group before treatment. However, the relationship between the three-drug combination and GNRI/PNI is unclear. The current study aimed to investigate the association of nutritional indices with duration of treatment success and occurrence of side effects in triple therapy. PATIENTS AND METHODS Seventy-two patients with non-small cell lung cancer, treated with combination of carboplatin, pemetrexed, and pembrolizumab from November 2019 to September 30, 2022, were classified into two groups (High and Low) for GNRI and PNI, and a retrospective study was performed. RESULTS In terms of time-to-treatment-failure (TTF), univariate and multivariate Cox proportional hazards regression analysis showed the Low-PNI group to have significantly shorter TTF than the High-PNI group (p=0.006); multivariate analysis results also showed PNI as a factor affecting TTF (HR=2.791, 95%CI=1.362-5.721, p=0.005). On the other hand, GNRI was not shown to be a factor affecting TTF. CONCLUSION PNI at the start of treatment was an independent prognostic factor affecting treatment success time (TTF) in non-small cell lung cancer patients receiving triple therapy. However, PNI was not shown to be a prognostic predictor of irAE development.
Collapse
Affiliation(s)
- Yasuhisa Hashino
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan
| | - Takumu Matushita
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan
| | - Tae Hatsuyama
- Pharmaceutical Division, Sapporo Minami-Sanjo Hospital, Hokkaido, Japan
| | - Azusa Wakamoto
- Pharmaceutical Division, Sapporo Minami-Sanjo Hospital, Hokkaido, Japan
| | - Keisuke Goto
- Pharmaceutical Division, Sapporo Minami-Sanjo Hospital, Hokkaido, Japan
| | - Takanobu Hoshi
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan
| | - Kuninori Iwayama
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan
| | - Koichi Ohtaki
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan
| | - Takaki Toda
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan
| | - Hideki Sato
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Japan;
| |
Collapse
|
2
|
Shigaki R, Yoshida R, Yagita A, Nagasue K, Naraoka T, Nitanai K, Yanada H, Tenma T, Kida R, Umekage Y, Mori C, Minami Y, Sato H, Iwayama K, Hashino Y, Fukudo M, Sasaki T. Case Report: Case series: association between blood concentration and side effects of sotorasib. Front Oncol 2023; 13:1269991. [PMID: 38044989 PMCID: PMC10690615 DOI: 10.3389/fonc.2023.1269991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/30/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Sotorasib is a crucial therapeutic agent for patients with non-small cell lung cancer (NSCLC) harboring the KRAS p.G12C mutation. Despite its efficacy, the relationship between blood sotorasib concentrations and side effects remains largely unexplored. Methods This study enrolled five patients with KRAS p.G12C-positive NSCLC treated with sotorasib (LUMAKRAS® Tablets, Amgen, Japan) between July 2022 and February 2023 at Asahikawa Medical University Hospital. Blood sotorasib levels were monitored, and their association with adverse events was examined, with no adjustments made to drug dosages based on these levels. Results Variable blood sotorasib levels were observed among the participants. Notably, one patient developed interstitial pneumonitis, although a definitive attribution to sotorasib was uncertain due to prior pembrolizumab treatment. The study revealed no consistent association between blood sotorasib levels and adverse events or therapeutic outcomes, with some patients experiencing severe side effects at higher concentrations, while others did not. Conclusion Preliminary findings suggested that monitoring blood sotorasib levels may aid in anticipating adverse events in this small cohort. However, future studies with larger sample sizes and extended follow-up periods are required to validate these initial observations. Such studies could potentially offer insights into personalized dosing strategies, thereby mitigating adverse effects and enhance patient care for individuals with KRAS p.G12C-positive NSCLC.
Collapse
Affiliation(s)
- Ryota Shigaki
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Ryohei Yoshida
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
- Department of Respiratory Medicine, Yoshida Hospital, Hokkaido, Japan
| | - Akari Yagita
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Kazunori Nagasue
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Taeka Naraoka
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Kiichi Nitanai
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Hiraku Yanada
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Toshiyuki Tenma
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Ryotaro Kida
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Yasuhiro Umekage
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Chie Mori
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Yoshinori Minami
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| | - Hideki Sato
- Department of Pharmacotherapy, Hokkaido University of Science, Hokkaido, Japan
| | - Kuninori Iwayama
- Department of Pharmacotherapy, Hokkaido University of Science, Hokkaido, Japan
| | - Yasuhisa Hashino
- Department of Pharmacotherapy, Hokkaido University of Science, Hokkaido, Japan
| | - Masahide Fukudo
- Department of Pharmacy, Sapporo Medical University Hospital, Hokkaido, Japan
| | - Takaaki Sasaki
- Respiratory Center, Asahikawa Medical University, Hokkaido, Japan
| |
Collapse
|
3
|
Hashino Y, Hatsuyama T, Iwayama K, Hoshi T, Wakamoto A, Ohtaki K, Toda T, Sato H. The Relationship Between Efficacy and Safety of Osimertinib Blood Concentration in Patients With EGFR Mutation-positive Lung Cancer: A Prospective Observational Study. In Vivo 2023; 37:2669-2677. [PMID: 37905656 PMCID: PMC10621464 DOI: 10.21873/invivo.13376] [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: 06/26/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND/AIM Osimertinib blood levels and their impact on treatment continuation in patients with EGFR mutation-positive lung cancer is not known. This study investigated the drug blood levels and risk factors affecting treatment continuation. PATIENTS AND METHODS Fifty-six patients with recurrent and inoperable epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer who received Osimertinib (80 mg once daily, daily dose) between October 1, 2016, and August 31, 2021, were included. Patients were classified into two groups using a cutoff blood level of 155 ng/ml. The primary endpoint was the relationship between Osimertinib exposure and efficacy, and secondary endpoints were the relationship between Osimertinib exposure and side effects, and the effect of covariates on efficacy and blood levels. RESULTS The median progression-free survival (PFS) for evaluable patients in the steady-state trough concentration (Cmin ss) ≥155 ng/ml and Cmin ss <155 ng/ml groups was 18.7 months and 31.2 months. Serum albumin (Alb) levels were 3.73±0.40 g/dl and 3.93±0.28 g/dl (p=0.030), respectively, and in multivariate analysis, Alb <3.7 g/dl was associated with a hazard ratio of 5.304 (95%CI=1.431-19.66; p=0.013), indicating that Alb <3.7 g/dl significantly shortened PFS. CONCLUSION Free blood concentration of Osimertinib may have been increased by a combination of factors, including decreased hepatic metabolic function and decreased albumin production caused by systemic inflammation in patients with cancer. However, there was no effect of Osimertinib Cmin ss on PFS.
Collapse
Affiliation(s)
- Yasuhisa Hashino
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Tae Hatsuyama
- Pharmaceutical Division, Sapporo Minami-sanjo Hospital, Sapporo, Japan
| | - Kuninori Iwayama
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Takanobu Hoshi
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Azusa Wakamoto
- Pharmaceutical Division, Sapporo Minami-sanjo Hospital, Sapporo, Japan
| | - Koichi Ohtaki
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Takaki Toda
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Hideki Sato
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan;
| |
Collapse
|
4
|
Nakagawa Y, Matsumura F, Hashino Y. Effect of diflubenzuron on incorporation of [3H]-N-acetylglucosamine ([3H]NAGA) into chitin in the intact integument from the newly molted American cockroach Periplaneta americana. Comp Biochem Physiol C Comp Pharmacol Toxicol 1993; 106:711-5. [PMID: 7905808 DOI: 10.1016/0742-8413(93)90231-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
1. Diflubenzuron and polyoxin D clearly inhibited the incorporation of [3H]-N-acetylglucosamine ([3H]NAGA) into chitin in the isolated integument from newly molted American cockroaches under the experimental condition. 2. Upon homogenization, or tissue slicing, such an inhibitory effect of diflubenzuron on chitin synthesis totally disappeared, while that of polyoxin D did not. 3. Mitochondrial poisons (oligomycin and FCCP), protein phosphorylation modulations (8-Br-cAMP, Na3VO4 and MnCl2), potassium ionophores (valinomycin), and calmodulin inhibitor (trifluoperazine) clearly inhibited [3H]NAGA incorporation. 4. Phospholipase A2 and calcium ion significantly enhanced the [3H]NAGA incorporation.
Collapse
Affiliation(s)
- Y Nakagawa
- Department of Environmental Toxicology, University of California, Davis 95616
| | | | | |
Collapse
|