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Inutsuka Y, Iwama E, Shiraishi Y, Yoneshima Y, Shibahara D, Tanaka K, Okamoto I. Osimertinib readministration for central nervous system metastases in non-small cell lung cancer positive for EGFR activating mutations. Respir Investig 2024; 62:334-338. [PMID: 38412569 DOI: 10.1016/j.resinv.2024.02.001] [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: 11/18/2023] [Revised: 01/23/2024] [Accepted: 02/11/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Osimertinib shows pronounced efficacy for EGFR mutation-positive non-small cell lung cancer (NSCLC) including associated central nervous system (CNS) metastases. Tumors inevitably develop resistance to the drug, however. Osimertinib is sometimes readministered after completion of standard chemotherapy. To clarify which patients might receive benefit from osimertinib readministration, we have retrospectively assessed its efficacy with a focus on CNS metastases. METHODS A retrospective analysis of medical records was performed for 21 patients who underwent osimertinib readministration at Kyushu University Hospital between March 2016 and April 2023. CNS metastases were evaluated according to modified Response Evaluation Criteria in Solid Tumors (RECIST). RESULTS Among the 21 enrolled patients, 16 individuals had target lesions on the basis of RECIST. One (6.3%) of these 16 patients achieved a partial response to osimertinib readministration, with the remaining 15 patients showing stable or progressive disease. The median overall progression-free survival (PFS) and median overall survival for all 21 patients were 3.8 and 13.9 months, respectively. The efficacy of osimertinib readministration for CNS metastases was evaluable in eight patients including five individuals with leptomeningeal metastases. The objective response rate for CNS metastases and the improvement rate for leptomeningeal metastases were both 100%. The median PFS with regard to CNS or non-CNS lesions for these eight patients was 24.7 and 10.5 months, respectively. CONCLUSIONS Osimertinib readministration showed limited efficacy for non-CNS lesions but excellent efficacy for CNS metastases, suggesting that such treatment is an option for EGFR-mutated NSCLC patients with CNS metastases.
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Affiliation(s)
- Yu Inutsuka
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Iwama
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuto Yoneshima
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Shibahara
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kentaro Tanaka
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Isamu Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Yamamoto Y, Shibahara D, Mori T, Otsubo K, Shiraishi Y, Yoneshima Y, Iwama E, Tanaka K, Oda Y, Okamoto I. Tracheomediastinal fistula induced by concurrent chemoradiotherapy in small cell lung cancer: A case report and literature review. Thorac Cancer 2024. [PMID: 38528720 DOI: 10.1111/1759-7714.15270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/27/2024] Open
Abstract
Tracheomediastinal fistula is a rare but life-threatening complication of cancer. We report a case of tracheomediastinal fistula induced by concurrent chemoradiotherapy in limited stage small cell lung cancer. Despite the treatment response, the metastatic paratracheal lymph node increased gradually during concurrent chemoradiotherapy, resulting in the occurrence of tracheomediastinal fistula and mediastinitis. Without any surgical intervention, the patient achieved successful recovery from mediastinitis through antibiotic treatment, although the tracheomediastinal fistula remained open. In this report, we also review previous studies of tracheomediastinal and bronchomediastinal fistulas and summarize the clinical features.
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Affiliation(s)
- Yoshihiro Yamamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Shibahara
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Taro Mori
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kohei Otsubo
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuto Yoneshima
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Iwama
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kentaro Tanaka
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Isamu Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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3
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Haratani K, Nakamura A, Mamesaya N, Sawa K, Shiraishi Y, Saito R, Tanizaki J, Tamura Y, Hata A, Tsuruno K, Sakamoto T, Teraoka S, Oki M, Watanabe H, Tokito T, Nagata K, Masuda T, Nakamura Y, Sakai K, Chiba Y, Ito A, Nishio K, Yamamoto N, Nakagawa K, Hayashi H. Association of immune-related adverse events with durvalumab efficacy after chemoradiotherapy in patients with unresectable Stage III non-small cell lung cancer. Br J Cancer 2024:10.1038/s41416-024-02662-2. [PMID: 38519705 DOI: 10.1038/s41416-024-02662-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Immune-related adverse events (irAEs) have been found to predict PD-L1 inhibitor efficacy in metastatic NSCLC. However, the relation of irAEs to clinical outcome for nonmetastatic NSCLC has remained unknown. METHODS In this multicenter prospective study of Stage III NSCLC treated with PACIFIC regimen, the relation of irAEs to PFS was evaluated by 8-week landmark analysis to minimise lead-time bias as well as by multivariable analysis adjusted for baseline factors. irAEs were categorised as mild or nonmild according to whether they were treated with systemic steroid. RESULTS Median PFS was 16.0 months, not reached, and 9.7 months for patients without (85 cases) or with mild (21 cases) or nonmild (21 cases) irAEs, respectively. Multivariable analysis indicated that nonmild irAEs were associated with poor PFS, with HRs of 3.86 (95% CI, 1.31-11.38) compared with no irAEs and 11.58 (95% CI, 2.11-63.63) compared with mild irAEs. This pattern was consistent after irAE grade, the number of durvalumab doses and immune profiles (PD-L1 score, CD8+ tumour-infiltrating lymphocyte density, and tumour mutation burden) were taken into consideration. CONCLUSIONS The development of mild irAEs might predict a better survival outcome, whereas immunosuppressive steroid-treated irAEs were associated with a worse outcome, regardless of baseline clinical and immune profiles.
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Affiliation(s)
- Koji Haratani
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan.
| | - Atsushi Nakamura
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Miyagi, Japan
| | - Nobuaki Mamesaya
- Division of Thoracic Oncology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan
| | - Kenji Sawa
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Osaka, Japan
| | - Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Ryota Saito
- Department of Respiratory Medicine, Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Junko Tanizaki
- Division of Medical Oncology, Kishiwada City Hospital, Kishiwada, Osaka, Japan
| | - Yosuke Tamura
- Respiratory Medicine and Thoracic Oncology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Akito Hata
- Division of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Hyogo, Japan
| | - Kosuke Tsuruno
- Department of Respiratory Medicine, Iizuka Hospital, Iizuka, Fukuoka, Japan
| | - Tomohiro Sakamoto
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Shunsuke Teraoka
- Internal Medicine III, Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Masahide Oki
- Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan
| | - Hiroshi Watanabe
- Department of Respiratory Medicine, Saka General Hospital, Shiogama, Miyagi, Japan
| | - Takaaki Tokito
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kenji Nagata
- Department of Respiratory Medicine, Itami City Hospital, Itami, Hyogo, Japan
| | - Takeshi Masuda
- Department of Respiratory Medicine, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Yasushi Nakamura
- Department of Pathology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Kazuko Sakai
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Yasutaka Chiba
- Clinical Research Center, Kindai University Hospital, Osaka-Sayama, Osaka, Japan
| | - Akihiko Ito
- Department of Pathology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Kazuto Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Nobuyuki Yamamoto
- Internal Medicine III, Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Hidetoshi Hayashi
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
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Nakamichi S, Kubota K, Misumi T, Kondo T, Murakami S, Shiraishi Y, Imai H, Harada D, Isobe K, Itani H, Takata S, Wakui H, Misumi Y, Ikeda S, Asao T, Furuya N, Hosokawa S, Kobayashi Y, Takiguchi Y, Okamoto H. Phase II Study of Durvalumab Immediately after Completion of Chemoradiotherapy in Unresectable Stage III Non-small Cell Lung Cancer: TORG1937 (DATE Study). Clin Cancer Res 2024; 30:1104-1110. [PMID: 38165684 PMCID: PMC10940851 DOI: 10.1158/1078-0432.ccr-23-2568] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/09/2023] [Accepted: 12/21/2023] [Indexed: 01/04/2024]
Abstract
PURPOSE Concurrent chemoradiotherapy (CCRT) followed by durvalumab consolidation for up to 12 months is the standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC). However, exactly when to initiate durvalumab therapy after chemoradiation completion remains unknown. We evaluated the efficacy and safety of durvalumab, administered immediately after CCRT completion, for patients with unresectable stage III NSCLC. PATIENTS AND METHODS This study was a prospective, single-arm, open-label phase II clinical trial. Patients without disease progression after definitive CCRT (two cycles of platinum-based doublet chemotherapy with 60 Gy/30 Fr radiotherapy) received durvalumab (every 2 weeks for up to 12 months) from the next day (up to 5 days) after the final radiation dose. The primary endpoint was the 1-year progression-free survival (PFS) from registration before the start of CCRT. RESULTS From January 2020 to August 2020, 47 of 50 enrolled patients were evaluable for treatment efficacy and safety. The 1-year PFS from registration was 75.0% [60% confidence interval (CI), 69.0-80.0 and 95% CI, 59.4-85.3]. The objective response rate throughout the study treatment and median PFS from registration were 78.7% and 14.2 months (95% CI, 13.4 to not reached), respectively. Grade 3/4 pneumonitis and febrile neutropenia were each 4.3%. CONCLUSIONS Our study met the primary endpoint. The incidence of pneumonitis was similar to that of a Japanese subset in the PACIFIC study. Our data support the efficacy and safety of durvalumab administered immediately after the completion of CCRT for patients with unresectable stage III NSCLC.
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Affiliation(s)
- Shinji Nakamichi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Toshihiro Misumi
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - Tetsuro Kondo
- Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Shuji Murakami
- Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hisao Imai
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
- Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Daijiro Harada
- Department of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Kazutoshi Isobe
- Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - Hidetoshi Itani
- Department of Respiratory Medicine, Japanese Red Cross Ise Hospital, Ise, Japan
| | - Saori Takata
- Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Hiroshi Wakui
- Division of Respiratory Diseases, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Yuki Misumi
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Satoshi Ikeda
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Tetsuhiko Asao
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Naoki Furuya
- Department of Internal Medicine, Division of Respiratory Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shinobu Hosokawa
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Yumiko Kobayashi
- Department of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Yuichi Takiguchi
- Department of Medical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
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5
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Shiraishi Y, Kishimoto J, Sugawara S, Mizutani H, Daga H, Azuma K, Matsumoto H, Hataji O, Nishino K, Mori M, Shukuya T, Saito H, Tachihara M, Hayashi H, Tsuya A, Wakuda K, Yanagitani N, Sakamoto T, Miura S, Hata A, Okada M, Kozuki T, Sato Y, Harada T, Takayama K, Yamamoto N, Nakagawa K, Okamoto I. Atezolizumab and Platinum Plus Pemetrexed With or Without Bevacizumab for Metastatic Nonsquamous Non-Small Cell Lung Cancer: A Phase 3 Randomized Clinical Trial. JAMA Oncol 2024; 10:315-324. [PMID: 38127362 PMCID: PMC10739077 DOI: 10.1001/jamaoncol.2023.5258] [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] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 08/22/2023] [Indexed: 12/23/2023]
Abstract
Importance The combination of an antibody to programmed cell death-1 (PD-1) or to its ligand (PD-L1) with chemotherapy is the standard first-line treatment for metastatic non-small cell lung cancer (NSCLC). Bevacizumab is expected to enhance the efficacy not only of chemotherapy but also of PD-1/PD-L1 antibodies through blockade of vascular endothelial growth factor-mediated immunosuppression, but further data are needed to support this. Objective To evaluate the efficacy and safety of bevacizumab administered with platinum combination therapy and atezolizumab in patients with advanced nonsquamous NSCLC. Design, Setting, and Participants An open-label phase 3 randomized clinical trial was conducted at 37 hospitals in Japan. Patients with advanced nonsquamous NSCLC without genetic driver alterations or those with genetic driver alterations who had received treatment with at least 1 approved tyrosine kinase inhibitor were enrolled between January 20, 2019, and August 12, 2020. Interventions Patients were randomly assigned to receive either atezolizumab plus carboplatin with pemetrexed (APP) or atezolizumab, carboplatin plus pemetrexed, and bevacizumab (APPB). After 4 cycles of induction therapy, maintenance therapy with atezolizumab plus pemetrexed or with atezolizumab, pemetrexed, and bevacizumab was administered until evidence of disease progression, development of unacceptable toxic effects, or the elapse of 2 years from the initiation of protocol treatment. Main Outcomes and Measures The primary end point was progression-free survival (PFS) as assessed by blinded independent central review (BICR) in the intention-to-treat (ITT) population. Results A total of 412 patients were enrolled (273 men [66%]; median age, 67.0 [range, 24-89] years) and randomly assigned, with 205 in the APPB group and 206 in the APP group of the ITT population after exclusion of 1 patient for good clinical practice violation. The median BICR-assessed PFS was 9.6 months with APPB vs 7.7 months with APP (stratified hazard ratio [HR], 0.86; 95% CI, 0.70-1.07; 1-sided stratified log-rank test; P = .92). According to prespecified subgroup analysis of BICR-assessed PFS, an improved PFS with APPB vs APP was apparent specifically in driver oncogene-positive patients (median, 9.7 vs 5.8 months; stratified HR, 0.67; 95% CI, 0.46-0.98). Toxic effects related to bevacizumab were increased in the APPB group. Conclusions and Relevance The findings of this trial did not show superiority of APPB over APP for patients with nonsquamous NSCLC; however, this regimen showed a similar tolerability and improved survival relative to APP in patients with driver oncogenes. Trial Registration Japan Registry of Clinical Trials Identifier: jRCT2080224500.
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Affiliation(s)
- Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Junji Kishimoto
- Department of Research and Development of Next Generation Medicine, Kyushu University, Fukuoka, Japan
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Miyagi, Japan
| | - Hideaki Mizutani
- Department of Thoracic Oncology, Saitama Cancer Center, Saitama, Japan
| | - Haruko Daga
- Department of Clinical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Hirotaka Matsumoto
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Hospital, Hyogo, Japan
| | - Osamu Hataji
- Respiratory Center, Matsusaka Municipal Hospital, Mie, Japan
| | - Kazumi Nishino
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Masahide Mori
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Osaka, Japan
| | - Takehito Shukuya
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Haruhiro Saito
- Department of Thoracic Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Motoko Tachihara
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Hidetoshi Hayashi
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Asuka Tsuya
- Department of Medical Oncology, Izumi City General Hospital, Osaka, Japan
| | - Kazushige Wakuda
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Noriko Yanagitani
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomohiro Sakamoto
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Satoru Miura
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - Akito Hata
- Department of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Hyogo, Japan
| | - Morihito Okada
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
| | - Toshiyuki Kozuki
- National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Yuki Sato
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Taishi Harada
- Department of Respiratory Medicine, Japan Community Health Care Organization–Kyushu Hospital, Fukuoka, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nobuyuki Yamamoto
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Isamu Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Shiraishi Y, Tokito T, Toyozawa R, Inagaki C, Nokihara H, Kawashima Y, Ohe Y, Okamoto I. Five Cases of Cytokine Release Syndrome in Patients Receiving Cytotoxic Chemotherapy Together With Nivolumab Plus Ipilimumab: A Case Report. J Thorac Oncol 2024; 19:337-343. [PMID: 37943237 DOI: 10.1016/j.jtho.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 11/10/2023]
Abstract
We conducted a phase 3 clinical trial to compare the efficacy of platinum-based combination chemotherapy together with nivolumab plus ipilimumab relative to that of platinum-based combination chemotherapy together with pembrolizumab in previously untreated patients with advanced NSCLC. The trial was terminated prematurely after treatment of 295 patients because of a high proportion of treatment-related deaths, three of which were due to cytokine release syndrome (CRS), in the nivolumab plus ipilimumab treatment arm. In addition, we encountered two cases of CRS that were effectively managed, for a total of five cases (3.4%) among the 148 patients in the nivolumab plus ipilimumab arm. We here provide details of these five cases. Although patient background and timing of CRS onset differed, fever was observed before the emergence of CRS in all five cases. Oncologists should thus be aware that the development of fever during treatment of patients with nivolumab plus ipilimumab may herald the onset of CRS.
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Affiliation(s)
- Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takaaki Tokito
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Ryo Toyozawa
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Chiaki Inagaki
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hiroshi Nokihara
- Department of Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Yosuke Kawashima
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Miyagi, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Isamu Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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7
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Hazama D, Nakahama K, Kodama H, Miyazaki A, Azuma K, Kawashima Y, Sato Y, Ito K, Shiraishi Y, Miura K, Takahama T, Oizumi S, Namba Y, Ikeda S, Yoshioka H, Tsuya A, Yasuda Y, Negi Y, Hara A, Toda M, Tachihara M. Effectiveness and Safety of Immune Checkpoint Inhibitors Alone or in Combination With Chemotherapy in Pulmonary Sarcomatoid Carcinoma. JTO Clin Res Rep 2024; 5:100613. [PMID: 38229769 PMCID: PMC10788284 DOI: 10.1016/j.jtocrr.2023.100613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 01/18/2024] Open
Abstract
Introduction Pulmonary sarcomatoid carcinoma (PSC) is a rare subtype of lung cancer associated with poor prognosis and resistance to conventional chemotherapy. Immune checkpoint inhibitors (ICIs), alone or in combination with chemotherapy, were found to have clinical benefits in PSC in recent studies. Nevertheless, because these studies included a small number of patients owing to disease rarity, larger studies are needed to evaluate the effectiveness and safety of ICI-based therapy for PSC. Methods This multicenter retrospective study evaluated patients with ICI-naive advanced or metastatic PSC who were treated with ICI-based therapy at 25 hospitals in Japan. Results A total of 124 patients were evaluated. The overall response rate, median progression-free survival (PFS), and median overall survival (OS) were 59.0%, 10.5 months, and 32.8 months, respectively. The PFS and OS rates at 24 months were 35.3% and 51.5%, respectively. Programmed death-ligand 1 expression, concomitant chemotherapy, and the treatment line were not significantly associated with PFS or OS. Immune-related adverse events (irAEs) were observed in 70 patients (56.5%), including 30 (24.2%) with grade 3 to 5 events. Patients with mild irAEs (grades 1-2) had longer PFS and OS than did those with severe (grades 3-5) or no irAEs. In a multivariate analysis, any-grade irAEs and the absence of liver metastases were independently associated with PFS, whereas any-grade irAEs and Eastern Cooperative Oncology Group performance status less than or equal to 1 were independently associated with OS. Conclusions ICI-based therapy was found to have promising effectiveness in patients with advanced or metastatic PSC, regardless of programmed death-ligand 1 expression, concomitant chemotherapy, or treatment line.
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Affiliation(s)
- Daisuke Hazama
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Kenji Nakahama
- Department of Respiratory Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hiroaki Kodama
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Akito Miyazaki
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Osaka, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Yosuke Kawashima
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Miyagi, Japan
| | - Yuki Sato
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Kentaro Ito
- Respiratory Center, Matsusaka Municipal Hospital, Mie, Japan
| | - Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keita Miura
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takayuki Takahama
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Satoshi Oizumi
- Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, Hokkaido, Japan
| | - Yoshinobu Namba
- Department of Respiratory Medicine and Medical Oncology, Takarazuka City Hospital, Hyogo, Japan
| | - Satoshi Ikeda
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
| | - Hiroshige Yoshioka
- Department of Thoracic Oncology, Kansai Medical University, Osaka, Japan
| | - Asuka Tsuya
- Department of Medical Oncology, Izumi City General Hospital, Osaka, Japan
| | - Yuichiro Yasuda
- Department of Thoracic Oncology, Hyogo Cancer Center, Hyogo, Japan
| | - Yoshiki Negi
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, School of Medicine, Hyogo, Japan
| | - Ayako Hara
- Department of Respiratory Medicine, Itami City Hospital, Hyogo, Japan
| | - Michihito Toda
- Department of General Thoracic Surgery, Kansai Rosai Hospital, Hyogo, Japan
| | - Motoko Tachihara
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
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Shiraishi Y, Sekino Y, Horinouchi H, Ohe Y, Okamoto I. High incidence of cytokine release syndrome in patients with advanced NSCLC treated with nivolumab plus ipilimumab. Ann Oncol 2023; 34:1064-1065. [PMID: 37666485 DOI: 10.1016/j.annonc.2023.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023] Open
Affiliation(s)
- Y Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Y Sekino
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - H Horinouchi
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Y Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - I Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
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9
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Tachihara M, Tsujino K, Ishihara T, Hayashi H, Sato Y, Kurata T, Sugawara S, Shiraishi Y, Teraoka S, Azuma K, Daga H, Yamaguchi M, Kodaira T, Satouchi M, Shimokawa M, Yamamoto N, Nakagawa K. Durvalumab Plus Concurrent Radiotherapy for Treatment of Locally Advanced Non-Small Cell Lung Cancer: The DOLPHIN Phase 2 Nonrandomized Controlled Trial. JAMA Oncol 2023; 9:1505-1513. [PMID: 37676681 PMCID: PMC10485744 DOI: 10.1001/jamaoncol.2023.3309] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/14/2023] [Indexed: 09/08/2023]
Abstract
Importance Administration of durvalumab after concurrent chemoradiotherapy is the standard treatment of unresectable, locally advanced non-small cell lung cancer (NSCLC); however, 20% to 30% of patients do not receive durvalumab because of adverse events (AEs) during concurrent chemoradiotherapy. In addition, radiotherapy and immunotherapy have a synergistic effect. Objective To investigate the efficacy and safety of durvalumab immunotherapy plus concurrent radiotherapy followed by maintenance with durvalumab therapy for treatment of locally advanced NSCLC without chemotherapy. Design, Setting, and Participants The multicenter, single-arm DOLPHIN (Phase II Study of Durvalumab [MEDI4736] Plus Concurrent Radiation Therapy in Advanced Localized NSCLC Patients) nonrandomized controlled trial was performed by 12 institutions in Japan from September 13, 2019, to May 31, 2022. Participants in the primary registration phase included 74 patients with programmed cell death ligand 1 (PD-L1)-positive, unresectable, locally advanced NSCLC. The current analyses were conducted from June 1, 2022, to October 31, 2022. Interventions Patients received radiotherapy (60 Gy) in combination with concurrent and maintenance durvalumab immunotherapy, 10 mg/kg every 2 weeks, for up to 1 year. Main Outcomes and Measures The primary end point of the rate of 12-month progression-free survival (PFS), as assessed by an independent central review, was estimated using the Kaplan-Meier method and evaluated with 90% CIs calculated using the Greenwood formula. The key secondary end points were PFS, objective response rate, treatment completion rate, and AEs. Results Data from 35 patients (median [range] age, 72 [44-83] years; 31 [88.6%] men) were included in the full analysis set of the evaluable population. The 12-month PFS rate was 72.1% (90% CI, 59.1%-85.1%), and the median PFS was 25.6 months (95% CI, 13.1 months to not estimable) at a median follow-up of 22.8 months (range, 4.3-31.8 months). Scheduled radiation therapy was completed in 97.1% of patients. The confirmed objective response rate was 90.9% (95% CI, 75.7%-98.1%), and the treatment completion rate was 57.6% (95% CI, 39.2%-74.5%). Among 34 patients evaluated in the safety analysis set, AEs of grade 3 or 4 occurred in 18 patients (52.9%), and of grade 5 in 2 patients (5.9%). Pneumonitis or radiation pneumonitis of any grade occurred in 23 patients (67.6%), and of grades 3 or 4 in 4 patients (11.8%). Conclusions and Relevance Findings from this phase 2 nonrandomized controlled trial indicate that durvalumab immunotherapy combined with curative radiotherapy for patients with PD-L1-positive, unresectable, locally advanced NSCLC is a promising treatment with tolerable AEs and is appropriate as a study treatment for phase 3 clinical trials. Trial Registration Japan Registry of Clinical Trials ID: jRCT2080224763.
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Affiliation(s)
- Motoko Tachihara
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kayoko Tsujino
- Department of Radiation Oncology, Hyogo Cancer Center, Akashi, Japan
| | - Takeaki Ishihara
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hidetoshi Hayashi
- Department of Medical Oncology, Kindai University, Osakasayama, Japan
| | - Yuki Sato
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takayasu Kurata
- Department of Thoracic Oncology, Kansai Medical University Hospital, Hirakata, Japan
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shunsuke Teraoka
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Haruko Daga
- Department of Medical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Masafumi Yamaguchi
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Miyako Satouchi
- Department of Thoracic Oncology, Hyogo Cancer Center, Akashi, Japan
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | | | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University, Osakasayama, Japan
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10
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Mizuno R, Sawada M, Tanaka T, Shiraishi Y, Ohashi T, Shigematsu N, Oya M. Comparison of the Efficacy of Low Dose Tadalafil with Tamsulosin against Lower Urinary Tract Symptoms and Sexual Dysfunction after Low Dose Rate Prostate Brachytherapy. Int J Radiat Oncol Biol Phys 2023; 117:e418. [PMID: 37785377 DOI: 10.1016/j.ijrobp.2023.06.1570] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients with clinically localized prostate cancer (PCa) can be curatively treated with different modalities, including low dose rate (LDR) prostate brachytherapy (PB). LDR-PB allows the patient a relatively short recovery time compared with other treatment modalities such as prostatectomy. However, PB might exert distinct impact on quality of life, lower urinary tract symptoms (LUTS) and sexual dysfunction (SD) are two major concerns. The aim of present study was to assess prospectively the efficacy of low dose tadalafil treatment on both SD and LUTS compared with tamsulosin treatment in patients treated PB for localized PCa. MATERIALS/METHODS Patients scheduled for PB with I-125 seeds for low or intermediate-risk localized PCa at our institution were eligible for this study. The prescribed dose was set at 160 gray. Participants were randomized into two groups; those started treating with a daily use of 0.2 mg of tamsulosin hydrochloride or 5 mg of tadalafil just after PB. The duration of the study was 12 months and the patients were assessed for urinary and sexual function status at baseline, and 1, 3, 6, and 12 months after PB. The primary study endpoints were both changes from baseline in urinary and sexual function status. RESULTS Between July 2015 and August 2020, 120 participants were enrolled in this study. The median age was 68 years with the median PSA of 6.5 ng/ml. A total 15 patients were excluded within 6 months after randomization. All subjective LUTS findings, including International Prostate Symptom Score (IPSS), and Over Active Bladder Symptom Score (OABSS), were significantly deteriorated at 1, 3, and 6 months after PB compared with baseline in both groups, respectively (p<0.05). Among objective LUTS findings, a significant decrease in maximum urinary flow rate (Qmax) was found at 1, 3, 6, and 12 months after PB compared with baseline in both groups, respectively (p<0.05). A significant increase in post void residual urine (PVR) was found at 1, 3, and 6 months after PB compared to baseline in tadalafil group, whereas no significant increase was seen in tamsulosin group. There were no statistically significant differences between the 2 groups in scores of the total International Index of Erectile Function (IIEF)-15 and Erection Hardness Score (EHS) before and at 1 month post PB. The EHS was significantly higher in tadalafil group compared with tamsulosin group at 3, 6 and 12 months (p = 0.001, p = 0.004, and p = 0.019, respectively). The EHS after PB in tadalafil group was not significantly decreased from baseline. CONCLUSION After LDR-PB, tamsulosin treatment significantly decreased PVR compared with tadalafil. On the other hand, tadalafil contributed to maintain erection hardness compared with tamsulosin.
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Affiliation(s)
- R Mizuno
- Dept of Urology, Keio university, school of medicine, Tokyo, Japan
| | - M Sawada
- Keio University Graduate School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - T Tanaka
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Y Shiraishi
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - T Ohashi
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - N Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - M Oya
- Dept of Urology, Keio university, school of medicine, Tokyo, Japan
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11
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Nag P, Inubushi T, Sasaki JI, Murotani T, Kusano S, Nakanishi Y, Shiraishi Y, Kurosaka H, Imazato S, Yamaguchi Y, Yamashiro T. Tmem2 Deficiency Leads to Enamel Hypoplasia and Soft Enamel in Mouse. J Dent Res 2023; 102:1162-1171. [PMID: 37449307 DOI: 10.1177/00220345231182355] [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] [Indexed: 07/18/2023] Open
Abstract
Teeth consist of 3 mineralized tissues: enamel, dentin, and cementum. Tooth malformation, the most common craniofacial anomaly, arises from complex genetic and environmental factors affecting enamel structure, size, shape, and tooth eruption. Hyaluronic acid (HA), a primary extracellular matrix component, contributes to structural and physiological functions in periodontal tissue. Transmembrane protein 2 (TMEM2), a novel cell surface hyaluronidase, has been shown to play a critical role during embryogenesis. In this study, we demonstrate Tmem2 messenger RNA expression in inner enamel epithelium and presecretory, secretory, and mature ameloblasts. Tmem2 knock-in reporter mice reveal TMEM2 protein localization at the apical and basal ends of secretory ameloblasts. Micro-computed tomography analysis of epithelial-specific Tmem2 conditional knockout (Tmem2-CKO) mice shows a significant reduction in enamel layer thickness and severe enamel deficiency. Enamel matrix protein expression was remarkably downregulated in Tmem2-CKO mice. Scanning electron microscopy of enamel from Tmem2-CKO mice revealed an irregular enamel prism structure, while the microhardness and density of enamel were significantly reduced, indicating impaired ameloblast differentiation and enamel matrix mineralization. Histological evaluation indicated weak adhesion between cells and the basement membrane in Tmem2-CKO mice. The reduced and irregular expressions of vinculin and integrin β1 suggest that Tmem2 deficiency attenuated focal adhesion formation. In addition, abnormal HA accumulation in the ameloblast layer and weak claudin 1 immunoreactivity in Tmem2-CKO mice indicate impaired tight junction gate function. Irregular actin filament assembly was also observed at the apical and basal ends of secretory ameloblasts. Last, we demonstrated that Tmem2-deficient mHAT9d mouse ameloblasts exhibit defective adhesion to HA-containing substrates in vitro. Collectively, our data highlight the importance of TMEM2 in adhesion to HA-rich extracellular matrix, cell-to-cell adhesion, ameloblast differentiation, and enamel matrix mineralization.
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Affiliation(s)
- P Nag
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - T Inubushi
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - J I Sasaki
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - T Murotani
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - S Kusano
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Y Nakanishi
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Y Shiraishi
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - H Kurosaka
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - S Imazato
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Y Yamaguchi
- Human Genetics Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - T Yamashiro
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
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Nakatsuru K, Tsubouchi K, Hirahata M, Nakashima T, Takahata Y, Okamatsu Y, Shiraishi Y, Okamoto I, Harada T. Acute myeloid leukemia and myelodysplastic syndrome associated with a combination of immune checkpoint inhibitor and platinum-based chemotherapy. Thorac Cancer 2023. [PMID: 37337950 PMCID: PMC10396777 DOI: 10.1111/1759-7714.15005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023] Open
Abstract
Therapy related-acute myeloid leukemia (t-AML) and myelodysplastic syndrome (t-MDS) are complications of chemotherapy and/or radiation therapy for malignant diseases. In this report, we describe a patient with advanced lung adenocarcinoma who developed autoimmune hemolytic anemia and MDS associated with a combination of atezolizumab and platinum-based chemotherapy. The patient showed progression from t-MDS to t-AML 20 months after the treatment was initiated. A combination of immune checkpoint inhibitor (ICI) and chemotherapy may increase the risk of developing therapy-related myeloid neoplasms. As the prognosis of t-AML and t-MDS is poorer than that of de novo AML and MDS, proper surveillance, follow-up, and treatment are needed throughout the course of immunotherapy.
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Affiliation(s)
- Kousei Nakatsuru
- Department of Respiratory Medicine, Japan Community Health Care Organization Kyushu Hospital, Fukuoka, Japan
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuya Tsubouchi
- Department of Respiratory Medicine, Japan Community Health Care Organization Kyushu Hospital, Fukuoka, Japan
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Minori Hirahata
- Department of Hematology, Japan Community Health Care Organization Kyushu Hospital, Fukuoka, Japan
| | - Tadayuki Nakashima
- Department of Respiratory Medicine, Japan Community Health Care Organization Kyushu Hospital, Fukuoka, Japan
| | - Yuriko Takahata
- Department of Respiratory Medicine, Japan Community Health Care Organization Kyushu Hospital, Fukuoka, Japan
| | - Yuki Okamatsu
- Department of Respiratory Medicine, Japan Community Health Care Organization Kyushu Hospital, Fukuoka, Japan
| | - Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Isamu Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Taishi Harada
- Department of Respiratory Medicine, Japan Community Health Care Organization Kyushu Hospital, Fukuoka, Japan
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13
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Tsutsumi H, Inoue H, Shiraishi Y, Hirayama A, Nakanishi T, Ando H, Nakajima M, Shinozaki S, Ogata H, Okamura K, Kimura S, Ogawa T, Ota K, Yoneshima Y, Tanaka K, Hamada N, Okamoto I, Iwama E. Impact of increased plasma levels of calreticulin on prognosis of patients with advanced lung cancer undergoing combination treatment of chemotherapy and immune checkpoint inhibitors. Lung Cancer 2023; 181:107264. [PMID: 37276707 DOI: 10.1016/j.lungcan.2023.107264] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/20/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Damage-associated molecular pattern (DAMP)-related immunogenic cell death triggers secondary adaptive immune responses. The relationship between DAMP levels and prognosis in patients with non-small cell lung cancer (NSCLC) who undergo a combination therapy of immune checkpoint inhibitors (ICI) and chemotherapy remains unclear. METHODS Serial plasma samples were prospectively collected from 45 patients treated with ICI combination therapy for advanced NSCLC. Plasma concentrations of high-mobility group box 1 (HMGB1), calreticulin (CRT), annexin A1, and heat shock protein 70 were measured. Associations between increases in plasma DAMP levels and the efficacy of the ICI combination therapy were evaluated. RESULTS The maximum fold changes in plasma levels differed across individuals but demonstrated a marked increase, especially for CRT (mean ± SEM, 11.61 ± 46.15). Increased plasma DAMP levels were not clearly associated with clinical responses. There was a significant correlation between the maximum fold change in CRT levels and progression-free survival (PFS; r = 0.49, P < 0.001). Median PFS and overall survival (OS) rates were higher in patients with a ≥ 2-fold increase in plasma CRT levels than in those with a < 2-fold increase (PFS, 14.9 versus 6.0 months, hazard ratio (HR), 0.58; P = 0.17; OS, not reached versus 21.6 months, HR, 0.31, P = 0.02). CONCLUSIONS Plasma CRT level monitoring has the potential to predict the efficacy of ICI combination therapy and shed light on the mechanisms underlying DAMP-related immunogenic cell death.
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Affiliation(s)
- Hirono Tsutsumi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Inoue
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Respiratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Aiko Hirayama
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takayuki Nakanishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Ando
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Maako Nakajima
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Seiji Shinozaki
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroaki Ogata
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Okamura
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shinichi Kimura
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Ogawa
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keiichi Ota
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuto Yoneshima
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kentaro Tanaka
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hamada
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Respiratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Isamu Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Iwama
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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14
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Nakashima T, Shiraishi Y, Shiota A, Yoneshima Y, Iwama E, Tanaka K, Okamoto I. Afatinib-induced bronchiolitis obliterans. Current Problems in Cancer: Case Reports 2023. [DOI: 10.1016/j.cpccr.2023.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023] Open
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15
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Oku Y, Toyokawa G, Wakasu S, Kinoshita F, Takamori S, Watanabe K, Haratake N, Nagano T, Kosai K, Takada K, Fujimoto A, Higashijima K, Shiraishi Y, Tanaka K, Takeoka H, Okamoto M, Yamashita T, Shimokawa M, Shoji F, Yamazaki K, Okamoto T, Seto T, Ueda H, Takeo S, Nakashima N, Okamoto I, Takenaka T, Yoshizumi T. Impact of the pretreatment prognostic nutritional index on the survival after first-line immunotherapy in non-small-cell lung cancer patients. Cancer Med 2023. [PMID: 37211905 DOI: 10.1002/cam4.6110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 05/02/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Immunotherapy has become a standard-of-care for patients with non-small-cell lung cancer (NSCLC). Although several biomarkers, such as programmed cell death-1, have been shown to be useful in selecting patients likely to benefit from immune checkpoint inhibitors (ICIs), more useful and reliable ones should be investigated. The prognostic nutritional index (PNI) is a marker of the immune and nutritional status of the host, and is derived from serum albumin level and peripheral lymphocyte count. Although several groups reported its prognostic role in patients with NSCLC receiving a single ICI, there exist no reports which have demonstrated its role in the first-line ICI combined with or without chemotherapy. MATERIALS AND METHODS Two-hundred and eighteen patients with NSCLC were included in the current study and received pembrolizumab alone or chemoimmunotherapy as the first-line therapy. Cutoff value of the pretreatment PNI was set as 42.17. RESULTS Among 218 patients, 123 (56.4%) had a high PNI (≥42.17), while 95 (43.6%) had a low PNI (<42.17). A significant association was observed between the PNI and both the progression-free survival (PFS; hazard ratio [HR] = 0.67, 95% confidence interval [CI]: 0.51-0.88, p = 0.0021) and overall survival (OS; HR = 0.46, 95% CI: 0.32-0.67, p < 0.0001) in the entire population, respectively. The multivariate analysis identified the pretreatment PNI as an independent prognosticator for the PFS (p = 0.0011) and OS (p < 0.0001), and in patients receiving either pembrolizumab alone or chemoimmunotherapy, the pretreatment PNI remained an independent prognostic factor for the OS (p = 0.0270 and 0.0006, respectively). CONCLUSION The PNI might help clinicians appropriately identifying patients with better treatment outcomes when receiving first-line ICI therapy.
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Affiliation(s)
- Yuka Oku
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Gouji Toyokawa
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
- Department of Surgery, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan
| | - Sho Wakasu
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Fumihiko Kinoshita
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Shinkichi Takamori
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Kenji Watanabe
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Haratake
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Taichi Nagano
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keisuke Kosai
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Airi Fujimoto
- Department of Pharmacy, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Kodo Higashijima
- Department of Pharmacy, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan
| | - Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kentaro Tanaka
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroaki Takeoka
- Department of Respiratory Medicine, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Masaki Okamoto
- Department of Respiratory Medicine, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | | | - Mototsugu Shimokawa
- Department of Biostatistics, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Fumihiro Shoji
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Koji Yamazaki
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Tatsuro Okamoto
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Takashi Seto
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Hitoshi Ueda
- Department of Surgery, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan
| | - Sadanori Takeo
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Isamu Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyoshi Takenaka
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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16
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Fujimoto D, Miura S, Tomii K, Sumikawa H, Yoshimura K, Wakuda K, Oya Y, Yokoyama T, Kijima T, Asao T, Tamiya M, Nakamura A, Yoshioka H, Tokito T, Murakami S, Tamiya A, Yokouchi H, Watanabe S, Yamaguchi O, Morinaga R, Jodai T, Ito K, Shiraishi Y, Kogure Y, Shibaki R, Yamamoto N. Pneumonitis associated with pembrolizumab plus chemotherapy for non-squamous non-small cell lung cancer. Sci Rep 2023; 13:3698. [PMID: 36878936 PMCID: PMC9988982 DOI: 10.1038/s41598-023-30676-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
Studies elucidating detailed characteristics of pneumonitis in association with chemo-immunotherapy are limited. We aimed to investigate the characteristics of images, prognostic factors, and clinical course of combination therapy associated with pneumonitis. A multicenter, retrospective cohort study of patients with non-squamous non-small cell lung cancer who received a combination of platinum, pemetrexed, and pembrolizumab was conducted. Patients with confirmed pneumonitis established by an independent multidisciplinary team were enrolled. For 53 patients with pneumonitis, radiographic features at diagnosis predominantly comprised an organizing pneumonia pattern (62%, 33/53). Twelve (23%) patients experienced a worsening respiratory status during pneumonitis management, which was associated with a high mortality rate (58%, 7/12) during treatment. Severe grade at pneumonitis diagnosis (p < 0.001), diffuse alveolar damage (DAD) pattern (p = 0.002), and disease extent ≥ 25% in the lungs (p = 0.009) were significantly associated with worsening respiratory status. Furthermore, post-diagnosis survival was significantly worse in severe pneumonitis (p = 0.02) than in mild and in patients with the DAD pattern than in those without (p < 0.0001). We showed detailed clinical course of patients with pneumonitis and reported several important influencing factors. Given the small number of trials on pneumonitis, our findings provide valuable information to guide the development of appropriate management guidelines and improve pneumonitis treatment.
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Affiliation(s)
- Daichi Fujimoto
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Satoru Miura
- Department of Internal Medicine, Niigata Cancer Center Hospital, 2-15-3, Kawagishi-Cho, Chuo-Ku, Niigata, 951-8566, Japan.
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hiromitsu Sumikawa
- Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Kenichi Yoshimura
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima University, Hiroshima, Japan
| | - Kazushige Wakuda
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yuko Oya
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Toshihide Yokoyama
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Takashi Kijima
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, School of Medicine, Hyogo, Japan
| | - Tetsuhiko Asao
- Department of Respiratory Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Motohiro Tamiya
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Atsushi Nakamura
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Hiroshige Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, Hirakata, Japan
| | - Takaaki Tokito
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Shuji Murakami
- Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Akihiro Tamiya
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hiroshi Yokouchi
- Department of Respiratory Medicine, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Satoshi Watanabe
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ou Yamaguchi
- Department of Respiratory Medicine, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Ryotaro Morinaga
- Department of Thoracic Medical Oncology, Oita Prefectural Hospital, Oita, Japan
| | - Takayuki Jodai
- Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Kentaro Ito
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihito Kogure
- Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - Ryota Shibaki
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
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Isa K, Tanaka K, Shiraishi Y, Yoneshima Y, Iwama E, Okamoto I. Osimertinib failure followed by successful treatment of afatinib in a patient with compound uncommon, G719S and V834L mutations. Current Problems in Cancer: Case Reports 2023. [DOI: 10.1016/j.cpccr.2023.100236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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18
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Goto K, Shiraishi Y, Murakami H, Horinouchi H, Toyozawa R, Takeda M, Uno M, Crawford N, McGill J, Jimbo T, Ishigami M, Takayama G, Nakayama S, Ohwada S, Nishio M. Phase 1 study of DS-1205c combined with gefitinib for EGFR mutation-positive non-small cell lung cancer. Cancer Med 2023; 12:7090-7104. [PMID: 36621830 PMCID: PMC10067098 DOI: 10.1002/cam4.5508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/24/2022] [Accepted: 11/22/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Tyrosine kinase inhibitors (TKIs) are effective for the treatment of non-small cell lung cancer (NSCLC) patients with activating mutations of the epidermal growth factor receptor (EGFR), but responses are not durable as tumors develop resistance. DS-1205c is a novel, specific, orally bioavailable, small-molecule AXL receptor TKI. In preclinical studies, DS-1205c restored TKI antitumor activity in a TKI acquired-resistance EGFR-mutant NSCLC tumor xenograft model. METHODS This first-in-human, multicenter, open-label Phase 1 study (registered at ClinicalTrials.gov: NCT03599518) primarily evaluated the safety and tolerability of combination therapy with DS-1205c and gefitinib in Japanese patients with metastatic or unresectable EGFR-mutant NSCLC and tumor progression during treatment with EGFR-TKIs. Patients (n = 20) received DS-1205c monotherapy (200-1200 mg twice daily [BID]) in a 7-day safety monitoring period before combination DS-1205c/gefitinib (250 mg once daily) in 21-day cycles. RESULTS The observed common treatment-emergent adverse events (TEAEs) were increased aspartate aminotransferase (35%), increased alanine aminotransferase (30%), rash maculo-papular (30%), and diarrhea (25%). No serious TEAEs were reported. Plasma concentrations and pharmacokinetic parameters of DS-1205a (free form of DS-1205c) were unaffected by concomitant administration of gefitinib. No patient achieved a complete or partial response and 5 patients (25%) had stable disease. CONCLUSION DS-1205c was generally safe and well tolerated at all dose levels, but the safety profile of ≤800 mg BID was more favorable than 1200 mg BID. The recommended dose for dose-expansion cohorts of DS-1205c in combination therapy with gefitinib was 800 mg BID.
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Affiliation(s)
- Koichi Goto
- National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | | | - Ryo Toyozawa
- National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | | | | | | | | | | | | | | | | | | | - Makoto Nishio
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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Shiraishi Y, Shimose T, Tsuchiya-Kawano Y, Ishii H, Daga H, Ito K, Saruwatari K, Okamoto I. Forthcoming Phase II Study of Durvalumab (MEDI4736) Plus Chemotherapy for Small Cell Lung Cancer with Brain Metastases. Cancer Manag Res 2022; 14:3449-3453. [PMID: 36540201 PMCID: PMC9760036 DOI: 10.2147/cmar.s391220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/19/2022] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND The standard of care for extensive-stage small cell lung cancer (ES-SCLC) is an immune checkpoint inhibitor (ICI) combined with platinum-etoposide (PE) chemotherapy. At initial diagnosis, about 25% of ES-SCLC patients have brain metastases, which are associated with a poor prognosis. The decision as to whether to treat brain metastases with local therapies such as surgery or radiotherapy before initiation of systemic chemoimmunotherapy is based on symptoms due to the brain lesions and the general condition of the patient. Subset analysis of the CASPIAN study showed that combination therapy with PE plus durvalumab (MEDI4736) is promising for ES-SCLC with brain metastases. However, data required in daily clinical practice, such as intracranial response rate and duration of intracranial response, are insufficient for such patients. PATIENTS AND METHODS We have designed a single-arm phase II trial of durvalumab plus PE for patients aged ≥20 years with chemotherapy-naïve ES-SCLC and at least one brain metastasis ≥5 mm in size that has not been previously treated. Patients receive durvalumab intravenously combined with four cycles of PE. Enrollment of 50 patients over 2 years at 25 oncology facilities in Japan is planned. The primary endpoint is intracranial response rate. CONCLUSION This is the first prospective study to evaluate the effects of an ICI with PE specifically in ES-SCLC patients with brain metastases. If it demonstrates intracranial efficacy, this regimen will be a potential treatment option for such individuals, and radiation therapy or surgery for brain metastases can be avoided or postponed.
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Affiliation(s)
- Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takayuki Shimose
- Department of Statistics and Data Center, Clinical Research Support Center Kyushu, Fukuoka, Japan
| | - Yuko Tsuchiya-Kawano
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Hidenobu Ishii
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Haruko Daga
- Department of Medical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Kentaro Ito
- Respiratory Center, Matsusaka Municipal Hospital, Mie, Japan
| | - Koichi Saruwatari
- Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Isamu Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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20
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Kaneda H, Hazama D, Kodama H, Miyazaki A, Azuma K, Kawashima Y, Sato Y, Ito K, Shiraishi Y, Miura K, Takahama T, Oizumi S, Namba Y, Ikeda S, Miura S, Tachihara M. 333P Efficacy and safety of immune checkpoint inhibitors alone or combined with chemotherapy in pulmonary sarcomatoid carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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21
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Dal Fabbro C, Rompré P, Kato T, Maluly M, Haraki S, Toyota R, Shiraishi Y, Andersen ML, Tufik S, Montplaisir J, Herrero Babiloni A, Lavigne G. The Influence of Age on the Frequency of Rhythmic Masticatory Muscle Activity During Sleep in General Population differs from that in Clinical Research Samples. J Oral Rehabil 2022; 50:54-61. [DOI: 10.1111/joor.13388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/18/2022] [Accepted: 09/19/2022] [Indexed: 11/29/2022]
Affiliation(s)
- C. Dal Fabbro
- CIUSSS Nord Ile Montreal, CEAMS and research centre Montreal Canada
- Instituto do Sono São Paulo Brazil
- Faculty of Dental Medicine Université de Montréal Montreal Canada
| | - P. Rompré
- Faculty of Dental Medicine Université de Montréal Montreal Canada
| | - T. Kato
- Graduate School of Dentistry Osaka University Suita Japan
| | | | - S. Haraki
- Graduate School of Dentistry Osaka University Suita Japan
| | - R. Toyota
- Graduate School of Dentistry Osaka University Suita Japan
| | - Y. Shiraishi
- Graduate School of Dentistry Osaka University Suita Japan
| | - M. L. Andersen
- Instituto do Sono São Paulo Brazil
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo Brazil
| | - S. Tufik
- Instituto do Sono São Paulo Brazil
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo Brazil
| | - J. Montplaisir
- CIUSSS Nord Ile Montreal, CEAMS and research centre Montreal Canada
- Psychiatry Department, Faculty of Medicine Université de Montréal Montreal Canada
| | - A. Herrero Babiloni
- CIUSSS Nord Ile Montreal, CEAMS and research centre Montreal Canada
- Division of Experimental Medicine McGill University Montreal Canada
| | - G. Lavigne
- CIUSSS Nord Ile Montreal, CEAMS and research centre Montreal Canada
- Instituto do Sono São Paulo Brazil
- Faculty of Dental Medicine Université de Montréal Montreal Canada
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22
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Taniguchi Y, Shimokawa T, Takiguchi Y, Misumi T, Nakamura Y, Kawashima Y, Furuya N, Shiraishi Y, Harada T, Tanaka H, Miura S, Uchiyama A, Nakahara Y, Tokito T, Naoki K, Bessho A, Goto Y, Seike M, Okamoto H. A Randomized Comparison of Nivolumab versus Nivolumab + Docetaxel for Previously Treated Advanced or Recurrent ICI-Naïve Non-Small Cell Lung Cancer: TORG1630. Clin Cancer Res 2022; 28:4402-4409. [PMID: 35980349 PMCID: PMC9561604 DOI: 10.1158/1078-0432.ccr-22-1687] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/07/2022] [Accepted: 08/15/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE The addition of cytotoxic chemotherapy to immune-checkpoint inhibitor (ICI) may enhance antitumor effects. We conducted an open-label randomized phase II/III study to evaluate nivolumab + docetaxel combination therapy in comparison with nivolumab monotherapy for previously treated ICI-naïve non-small cell lung cancer (NSCLC). PATIENTS AND METHODS The primary endpoint of the phase III study was overall survival (OS), and the secondary endpoints included progression-free survival (PFS), overall response rate (ORR), and toxicity. As ICI and platinum-doublet combination chemotherapy was approved in the first-line setting during this study, patient accrual was discontinued. RESULTS One hundred twenty-eight patients (each arm, n = 64) were included in the full analysis set. The median OS in nivolumab (arm A) and nivolumab + docetaxel (arm B) was 14.7 months (95% CI, 11.4-18.7) and 23.1 months (95% CI, 16.7-NR), respectively. The HR for OS was 0.63 (90% CI, 0.42-0.95; P = 0.0310). The median PFS in arms A and arm B was 3.1 months (95% CI, 2.0-3.9) and 6.7 months (95% CI, 3.8-9.4), respectively. The HR for progression was 0.58 (95% CI, 0.39-0.88; P = 0.0095). The ORR was 14.0% (95% CI, 6.3-25.8) in arm A and 41.8% (95% CI, 28.7-55.9) in arm B. Hematotoxicity and gastrointestinal adverse events were more common in arm B than in arm A. Two treatment-related deaths were observed, including one patient in arm A who died of pneumonitis and one in arm B who died of myocarditis. CONCLUSIONS Despite a slightly elevated toxicity, the addition of docetaxel to nivolumab has significantly prolonged the OS and PFS of patients with previously treated ICI-naïve NSCLC.
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Affiliation(s)
- Yuri Taniguchi
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
- Corresponding Author: Yuri Taniguchi, Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa-nishimachi, Kanagawa-ku, Yokohama-shi, Kanagawa 221-0855, Japan. Phone: 814-5331-1961; Fax: 814-5332-5599; E-mail:
| | - Tsuneo Shimokawa
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Yuichi Takiguchi
- Department of Medical Oncology, Chiba University Hospital, Chiba, Japan
| | - Toshihiro Misumi
- Department of Data Science, National Cancer Center Hospital East, Chiba, Japan
| | - Yukiko Nakamura
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Yosuke Kawashima
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Miyagi, Japan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yoshimasa Shiraishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiyuki Harada
- Department of Respiratory Medicine, Japan Community Health Care Organization Hokkaido Hospital, Hokkaido, Japan
| | - Hisashi Tanaka
- Department of Respiratory Medicine, Hirosaki University Hospital, Aomori, Japan
| | - Satoru Miura
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - Ayumi Uchiyama
- Department of Respiratory Medicine, Jichi Medical University Hospital, Tochigi, Japan
| | - Yoshiro Nakahara
- Department of Thoracic Oncology, Kanagawa Cancer Center, Kanagawa, Japan
- Department of Respiratory Medicine, Kitasato University Hospital, Kanagawa, Japan
| | - Takaaki Tokito
- Division of Respirology Neurology and Rheumatology Department of Internal Medicine, Kurume University Hospital, Fukuoka, Japan
| | - Katsuhiko Naoki
- Department of Respiratory Medicine, Kitasato University Hospital, Kanagawa, Japan
| | - Akihiro Bessho
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Yasuhiro Goto
- Department of Respiratory Medicine and Allergies, Fujita Health University, Aichi, Japan
| | - Masahiro Seike
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
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Ito M, Maeda D, Matsue Y, Shiraishi Y, Dotare T, Sunayama T, Nogi K, Kohsaka S, Yoshikawa T, Saito Y, Minamino T. Increasing the class of foundational medication for heart failure is associated with improved prognosis in hospitalized patients with heart failure with reduced or mildly reduced ejection fraction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aim
To clarify the association between changes in the number of foundational medications for heart failure (FMHF) during hospitalization for worsening heart failure and post-discharge prognosis.
Methods and results
We retrospectively analyzed a combined dataset of three large-scale registries of hospitalized patients with heart failure in Japan (NARA-HF, WET-HF, and REALITY-AHF) and included patients already diagnosed with heart failure with reduced or mildly reduced left ventricular ejection fraction (HFr/mrEF) before admission. Patients were stratified by changes in the number of prescribed FMHF classes, namely angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta blockers, and mineralocorticoid receptor blockers, from admission to discharge. The primary endpoint was defined as the combined endpoint of heart failure rehospitalization and all-cause death within 1-year of discharge. The cohort consisted of 1,113 patients, and 482 combined endpoints were observed. In total, 413 (37.1%) patients were on increased FMHF (increased group), 607 (54.5%) remained unchanged (unchanged group), and 93 (8.4%) had a decreased number of FMHF (decreased group) at discharge compared to the time of admission. In multivariable analysis, the increased group was associated with a significantly lower incidence of the primary endpoint compared with the unchanged group (hazard ratio 0.56, 95% confidence interval 0.45–0.60; P<0.001) and decreased group (hazard ratio 0.58, 95% confidence interval 0.40–0.84; P=0.004).
Conclusion
Increasing the number of FMHF cases during heart failure hospitalization is associated with a better prognosis in patients with HFr/mrEF.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): REALITY registry was funded by the Cardiovascular Research Fund of Japan.WET-HF registry was supported by a Grant-in-Aid for Young Scientists (Y.S. JSPS KAKENHI, 18K15860).
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Affiliation(s)
- M Ito
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - D Maeda
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - Y Matsue
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - Y Shiraishi
- Keio University School of Medicine, Division of Cardiology, Department of Medicine , Tokyo , Japan
| | - T Dotare
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - T Sunayama
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - K Nogi
- Nara Medical University, Department of Cardiovascular Medicine , Nara , Japan
| | - S Kohsaka
- Keio University School of Medicine, Division of Cardiology, Department of Medicine , Tokyo , Japan
| | - T Yoshikawa
- Sakakibara Heart Institute, Department of Cardiology , Tokyo , Japan
| | - Y Saito
- Nara Medical University, Department of Cardiovascular Medicine , Nara , Japan
| | - T Minamino
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
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Shiraishi Y, Kishimoto J, Shimose T, Toi Y, Sugawara S, Okamoto I. Phase II study of carboplatin/nab-paclitaxel/atezolizumab combination therapy for advanced nonsquamous non-small cell lung cancer patients with impaired renal function: RESTART trial. BMC Cancer 2022; 22:964. [PMID: 36076179 PMCID: PMC9461146 DOI: 10.1186/s12885-022-10056-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 09/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background First-line treatment of nonsquamous non–small cell lung cancer (NSCLC) has undergone a paradigm shift to platinum combination therapy together with immune checkpoint inhibitors (ICIs). However, phase III studies of combinations of cytotoxic chemotherapy and ICIs have included only patients with maintained organ function, not those with renal impairment. Methods Cytotoxic chemotherapy–naïve advanced nonsquamous NSCLC patients aged 20 years or older with impaired renal function (creatinine clearance of 15 to 45 mL/min) are prospectively registered in this single-arm phase II study and receive combination therapy with carboplatin, nanoparticle albumin-bound (nab-) paclitaxel, and atezolizumab. Individuals with known genetic driver alterations including those affecting EGFR, ALK, ROS1, BRAF, MET, RET, and NTRK are excluded. We plan to enroll 40 patients over 2 years at 32 oncology facilities in Japan. The primary end point is confirmed objective response rate. Discussion If the study demonstrates efficacy and safety of carboplatin/nab-paclitaxel/atezolizumab, then this combination regimen may become a treatment option even for nonsquamous NSCLC patients with impaired renal function. Trial registration Registered with Japan Registry for Clinical Trials on 25 February 2021 (jRCTs071200102).
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Affiliation(s)
- Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Junji Kishimoto
- Department of Research and Development of Next Generation Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Takayuki Shimose
- Department of Statistics and Data Center, Clinical Research Support Center Kyushu, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yukihiro Toi
- Department of Pulmonary Medicine, Sendai Kousei Hospital, 4-15 Hirose-machi, Sendai, Miyagi, 980-0873, Japan
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, 4-15 Hirose-machi, Sendai, Miyagi, 980-0873, Japan
| | - Isamu Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
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25
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Tachihara M, Tsujino K, Shimokawa M, Ishihara T, Hayashi H, Sato Y, Kurata T, Sugawara S, Shiraishi Y, Teraoka S, Azuma K, Daga H, Yamaguchi M, Kodaira T, satouchi M, Yamamoto N, Nakagawa K. MA06.04 Phase II Study of Durvalumab Plus Concurrent Radiotherapy in Unresectable Locally Advanced NSCLC: DOLPHIN Study (WJOG11619L). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Matsuda M, Fukuyama N, Matsuda T, Kikuchi S, Shiraishi Y, Takimoto Y, Kamei Y, Kurata M, Kitazawa R, Kido T. Utility of synthetic MRI in predicting pathological complete response of various breast cancer subtypes prior to neoadjuvant chemotherapy. Clin Radiol 2022; 77:855-863. [DOI: 10.1016/j.crad.2022.06.019] [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] [Received: 02/23/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022]
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Miura S, Akamatsu H, Teraoka S, Takamori S, Hayashi H, Hata A, Toi Y, Shiraishi Y, Mamesaya N, Sato Y, Furuya N, Koh Y, Misumi T, Yamamoto N, Nakagawa K. MO44-4 Phase II study of nivolumab rechallenge in advanced NSCLC pts who responded to prior anti-PD-1/L1 inhibitors; WJOG 9616L. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.05.212] [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: 11/01/2022] Open
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Akamatsu H, Teraoka S, Takamori S, Miura S, Hayashi H, Hata A, Toi Y, Shiraishi Y, Mamesaya N, Sato Y, Furuya N, Oyanagi J, Koh Y, Misumi T, Yamamoto N, Nakagawa K. Nivolumab Retreatment in Non-Small Cell Lung Cancer Patients Who Responded to Prior Immune Checkpoint Inhibitors and Had ICI-Free Intervals (WJOG9616L). Clin Cancer Res 2022; 28:OF1-OF7. [PMID: 35762926 PMCID: PMC9662947 DOI: 10.1158/1078-0432.ccr-22-0602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/23/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE To explore the efficacy of retreatment with immune checkpoint inhibitors (ICI) in patients with advanced non-small cell lung cancer (NSCLC) who responded to prior ICI and had adequate ICI-free interval. PATIENTS AND METHODS Patients with advanced NSCLC who had achieved complete response (CR), partial response (PR), or stable disease for ≥6 months with prior ICI therapy preceding progression were prospectively enrolled. All patients should have had ICI-free interval ≥60 days before registration. Patients were treated with nivolumab (240 mg) every 2 weeks until progression. The primary endpoint was overall response rate (ORR). Secondary endpoints included progression-free survival (PFS), overall survival, and safety (Trial Identifier, UMIN000028561). RESULTS Sixty-one patients were enrolled during October 2017 to February 2020, with 59 analyzed for efficacy. Regarding prior ICI, 41 patients had CR or PR. Median treatment on ICI and median ICI-free intervals were 8.1 months and 9.2 months, respectively. Twenty patients experienced immune-related adverse events (irAE) that required discontinuation of prior ICI. Nivolumab retreatment demonstrated ORR of 8.5% [95% confidence interval (CI), 2.8-18.7%] and median PFS of 2.6 months (95% CI, 1.6-2.8 months) while 5 responders had 11.1 months of median PFS. In the multivariate analysis, ICI-free interval was the only predictive factor of PFS (HR, 2.02; P = 0.02), while prior efficacy or history of irAE was not. Common adverse events were skin disorders (23%), malaise (20%), and hypoalbuminemia (15%). CONCLUSIONS Even in patients who initially responded to prior ICI and had ICI-free interval, once resistance occurred, retreatment with nivolumab had limited efficacy.
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Affiliation(s)
- Hiroaki Akamatsu
- Internal Medicine III, Wakayama Medical University, Kimiidera, Wakayama, Japan
| | - Shunsuke Teraoka
- Internal Medicine III, Wakayama Medical University, Kimiidera, Wakayama, Japan
| | - Shinkichi Takamori
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Notame, Minami-Ku, Fukuoka, Japan
| | - Satoru Miura
- Department of Internal Medicine, Niigata Cancer Center Hospital, Kawagishi-cho, Chuo-Ku, Niigata, Japan
| | - Hidetoshi Hayashi
- Department of Medical Oncology, Kindai University Faculty of Medicine, Onohigashi, Osakasayama, Japan
| | - Akito Hata
- Division of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Minatojima-Nakamachi, Chuo-Ku, Kobe, Japan
| | - Yukihiro Toi
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Hirosemachi, Aoba-Ku, Sendai, Japan
| | - Yoshimasa Shiraishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Maidashi, Higashi-Ku, Fukuoka, Japan
| | - Nobuaki Mamesaya
- Department of Thoracic Oncology, Shizuoka Cancer Center, Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, Japan
| | - Yuki Sato
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Minatojimaminami-Machi, Chuo-Ku, Kobe, Japan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Sugao, Miyamae-ku, Kawasaki, Japan
| | - Jun Oyanagi
- Internal Medicine III, Wakayama Medical University, Kimiidera, Wakayama, Japan
| | - Yasuhiro Koh
- Internal Medicine III, Wakayama Medical University, Kimiidera, Wakayama, Japan
| | - Toshihiro Misumi
- Department of Biostatistics, Yokohama City University Graduate School of Medicine, Fukuura, Kanazawa-Ku, Yokohama, Japan
| | - Nobuyuki Yamamoto
- Internal Medicine III, Wakayama Medical University, Kimiidera, Wakayama, Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Onohigashi, Osakasayama, Japan
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Oku Y, Toyokawa G, Yamashita T, Wakasu S, Kinoshita F, Takamori S, Haratake N, Shiraishi Y, Shimokawa M, Yamazaki K, Okamoto T, Nakashima N, Okamoto I, Takenaka T. Predictive model of the prognosis in non-small cell lung cancer treated with first-line immunotherapy based on machine learning. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e21125] [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
e21125 Background: In recent years, there have been expectations for the application of artificial intelligence (AI) in the clinical practice of lung cancer. In the first-line setting, immune checkpoint inhibitors (ICIs) in combination with cytotoxic agents (CTx) have become a standard-of-care for patients with non-small cell lung cancer (NSCLC); however, no absolute biomarkers have been established for the prediction of the response to such therapy. In this study, we aimed to construct a new prognostic model by using AI in NSCLC patients treated with first-line ICI plus CTx. Methods: We retrospectively identified 218 NSCLC patients with advanced or postoperatively recurrent disease. They received first-line treatment with ICI alone or in combination with cytotoxic agents between January 2016 and October 2020. AI model using Gradient Boosting Decision Tree (GBDT) was used to identify predictors (explanatory variables) of the survivals (objective variables). A total of 53 factors were selected for the explanatory variables including clinical, hematological and pathological information. The objective variables were overall survival (OS) and progression-free survival (PFS). GBDT constructed the optimal predicting model, and calculated the contribution of each explanatory variable to the objective variables. Additionally, the importance of each feature was interpreted by SHapley Additive exPlanation (SHAP). Results: The median follow-up period was 14.4 months (range: 0.5-52.0) after the initiation of the therapy. The characteristics were shown below; the median age was 69 years old (range: 36-85); males and females were 165 (75.7%) and 53 (24.3%); patients with ICI alone or combination with cytotoxic anticancer agents were 91 (41.7%) or 127 (58.3%); the distributions of performance status (PS) were 107 (49.1%), 94 (43.1%), 13 (6.0%) with PS 0, 1 and 2; the Sq, non-Sq and others were found in 51 (23.4%), 165 (75.7%) and 2 (0.9%); 170 patients (78.0%) showed a PD-L1 expression of > 1% and 36 (16.5%) patients had no PD-L1 expression. The median PFS and OS were 10.2 and 21.8 months, respectively. The predicting optimal model for OS and PFS were constructed by GBDT, and the respective area under the curves (AUC) were 0.724 and 0.656. The explanatory variables indicating high contribution to OS were serum C-reactive protein (CRP), cytokeratin subunit 19 fragment (CYFRA), alkaline phosphatase (ALP), peripheral lymphocyte count and chloride ion level. As for PFS, the highest five contributions were CYFRA, CRP, immune-related adverse events, ALP and peripheral platelet count. Furthermore, all of these factors were explained their importance by SHAP. Neither PD-L1 expression nor PS were predictors of the survivals. Conclusions: Machine learning identified several novel factors possibly contributing to the prognoses in NSCLCs patients treated with the first-line immunotherapy.
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Affiliation(s)
- Yuka Oku
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Gouji Toyokawa
- Department of Surgery, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan
| | | | - Sho Wakasu
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Fukuoka, Japan
| | - Fumihiko Kinoshita
- Department of Thoracic Oncology, National Hospital Organization, Fukuoka, Japan
| | | | - Naoki Haratake
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshimasa Shiraishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Koji Yamazaki
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Tatsuro Okamoto
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Isamu Okamoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyoshi Takenaka
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Sawada M, Shiraishi Y, Nemoto T, Tanaka T, Kota R, Koike N, Shigematsu N. PO-1796 Dosimetric comparison of rectal dose reduction methods in brachytherapy for cervical cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03759-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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31
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Hayakawa N, Mizuno R, Shiraishi Y, Tanaka T, Matsumoto K, Kosaka T, Ohashi T, Kikuchi E, Shigematsu N, Oya M. PO-1818 Prospective study of tadalafil treatment in patients treated with prostate brachytherapy in Japan. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03781-1] [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: 11/12/2022]
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32
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Takamori S, Oku Y, Toyokawa G, Wakasu S, Kinoshita F, Watanabe K, Haratake N, Nagano T, Kosai K, Shiraishi Y, Yamashita T, Shimokawa M, Shoji F, Yamazaki K, Okamoto T, Seto T, Takeo S, Nakashima N, Okamoto I, Takenaka T. 62P Impact of the pretreatment prognostic nutritional index on the survival after first-line immunotherapy in non-small cell lung cancer patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.071] [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: 11/01/2022] Open
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33
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Tsuchiya-Kawano Y, Shiraishi Y, Kiyomi F, Okamoto I. Phase II Study of Nivolumab Plus Ipilimumab with Platinum-Based Chemotherapy for Treatment-Naïve Advanced Non-Small Cell Lung Cancer with Untreated Brain Metastases: NIke Trial (LOGiK2004). Cancer Manag Res 2021; 13:8489-8493. [PMID: 34795528 PMCID: PMC8593342 DOI: 10.2147/cmar.s341287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/28/2021] [Indexed: 11/23/2022] Open
Abstract
The standard of care for advanced non-small cell lung cancer (NSCLC) without known driver oncogenes is immune checkpoint inhibitor (ICI) therapy combined with platinum-based chemotherapy. About 20% of patients with advanced NSCLC have brain metastases, which are related to poor prognosis. However, the effect of ICI therapy combined with platinum-based chemotherapy on untreated brain metastases derived from NSCLC remains unclear. The primary endpoint of this study is intracranial response rate as determined by modified Response Evaluation Criteria in Solid Tumors (RECIST) for brain metastases of ≥5 mm as target lesions. Eligible patients are 20 years of age or older with chemotherapy-naïve advanced NSCLC and at least one brain metastasis ≥5 mm in size that has not been previously treated. Patients receive nivolumab plus ipilimumab intravenously combined with histology-based platinum doublet chemotherapy (two cycles). Individuals with known genetic driver alterations such as those affecting EGFR or ALK are excluded. Planned enrollment is 30 patients over 2.5 years at 27 oncology facilities in Japan. This is the first prospective study to focus on the intracranial response to ICI therapy combined with platinum-based chemotherapy in patients with untreated brain metastases derived from NSCLC. If the study demonstrates intracranial efficacy for this patient population, then this regimen has the potential to become a new treatment option for such individuals.
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Affiliation(s)
- Yuko Tsuchiya-Kawano
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Yoshimasa Shiraishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Fumiaki Kiyomi
- Statistics and Data Center, Clinical Research Support Center Kyushu, Fukuoka, Japan
| | - Isamu Okamoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Sakata S, Otsubo K, Yoshida H, Ito K, Nakamura A, Teraoka S, Matsumoto N, Shiraishi Y, Haratani K, Tamiya M, Ikeda S, Miura S, Tanizaki J, Omori S, Yoshioka H, Hata A, Yamamoto N, Nakagawa K. Real-world data on NGS using the Oncomine DxTT for detecting genetic alterations in non-small-cell lung cancer: WJOG13019L. Cancer Sci 2021; 113:221-228. [PMID: 34704312 PMCID: PMC8748216 DOI: 10.1111/cas.15176] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 12/01/2022] Open
Abstract
Considering the increasing number of identified driver oncogene alterations, additional genetic tests are required to determine the treatment for advanced non-small-cell lung cancer (NSCLC). Next-generation sequencing can detect multiple driver oncogenes simultaneously, enabling the analysis of limited amounts of biopsied tissue samples. In this retrospective, multicenter study (UMIN ID000039523), we evaluated real-world clinical data using the Oncomine Dx Target Test Multi-CDx System (Oncomine DxTT) as a companion diagnostic system. Patients with NSCLC who were tested for a panel of 46 genes using the Oncomine DxTT between June 2019 and January 2020 were eligible for enrollment. Patients from 19 institutions affiliated to the West Japan Oncology Group were recruited. The primary endpoint of the study was the success rate of genetic alteration testing in four driver genes (EGFR, ALK, ROS1, and BRAF) using the Oncomine DxTT. In total, 533 patients were enrolled in the study. The success rate of genetic alteration testing for all four genes was 80.1% (95% CI 76.5%-83.4%). Surgical resection was associated with the highest success rate (88.0%), which was significantly higher than that for bronchoscopic biopsy (76.8%, P = .005). Multivariate analysis revealed a significant difference for surgical resection alone (P = .006, 95% CI 1.36-6.18, odds ratio 2.90). Although the success rate of genetic alteration testing immediately after Oncomine DxTT induction was not sufficient in this study, optimizing specimen quantity and quality may improve the use of driver gene testing in clinical settings.
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Affiliation(s)
- Shinya Sakata
- Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Kohei Otsubo
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Fukuoka, Japan
| | - Hisako Yoshida
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kentaro Ito
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Mie, Japan
| | - Atsushi Nakamura
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Miyagi, Japan
| | - Shunsuke Teraoka
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Naohisa Matsumoto
- Department of Respiratory Medicine, Juntendo University, Tokyo, Japan
| | - Yoshimasa Shiraishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Haratani
- Department of Medical Oncology, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
| | - Motohiro Tamiya
- Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Satoshi Ikeda
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan
| | - Satoru Miura
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - Junko Tanizaki
- Department of Medical Oncology, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
| | - Shota Omori
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hiroshige Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, Hirakata, Osaka, Japan
| | - Akito Hata
- Department of Medical Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Hyogo, Japan
| | | | - Kazuhiko Nakagawa
- Department of Medical Oncology, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
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Yumita Y, Nagatomo Y, Takei M, Saji M, Goda A, Kohno T, Nakano S, Nishihata Y, Ikegami Y, Shiraishi Y, Kohsaka S, Yoshikawa T. “Target Heart Rate” calculated aiming at zero overlap of mitral E and A waves is useful for prediction of long-term outcome for patients with heart failure and reduced ejection fraction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Lower heart rate (HR) is associated with more favourable long-term outcome in patients with heart failure with reduced ejection fraction (HFrEF). However, an optimal threshold of HR remains unclear. Targeted HR (THR), defined by echocardiographic deceleration time (DCT) to eliminated overlap of E and A waves, may aid in risk stratification of HFrEF patients.
Purpose
In this study, we aimed to clarify the impact of on long-term clinical outcome in patients with HFrEF.
Methods
In the multicenter WET-HF registry, 4000 consecutive patients hospitalized for acute decompensated HF (ADHF) were registered between 2006 and 2017. Among them, the patients with EF ≥40% or a history of atrial fibrillation were excluded. THR was calculated based on their DCT value measured in compensated HF phase during the index admission. The following formula was applied; THR (bpm)=93 - 0.13 × deceleration time (DCT, msec). A total of 876 patients with HFrEF were included in the present analysis (age: 72 [60–81], male: 69%) and the patients were divided into the 2 groups of HR at discharge ≤ THR (L group) and > THR (H group). The primary endpoint (PE) was defined as the composite of all-cause death and ADHF re-admission.
Results
Compared to the H group, the L group showed higher prevalence of males (74% vs. 66%, P=0.025) with higher body mass index (BMI, 23.2 vs. 22.2, P=0.016), hemoglobin (Hb, 12.9 vs. 12.4, P=0.031), albumin (Alb, 3.7 vs. 3.6, P=0.039) and larger left atrial diameter (LAD, 44 mm vs. 41 mm, P=0.002) and tricuspid regurgitation pressure gradient (TRPG, 29 mmHg vs. 27 mmHg, P=0.012). Age, estimated glomerular filtration rate (eGFR), LVEF (29% vs. 30%, P=NS) and E/e' (17.7 vs. 16.8, P=NS) were similar for both groups. At discharge, HR was lower in L group (66 [60–71] bpm vs. 80 [74–86] bpm, P<0.001), albeit there were no significant differences in b-blocker prescription (90% vs. 85%, P=0.069) or its dose (3.75 [1.25–7.25] mg vs. 2.5 [1.25–5] mg, P=0.11).
In the survival analysis, the L group showed a significantly lower rate of PE (P=0.03), whereas there was no significant difference in the incidence of PE between the patients with HR at discharge ≥70 bpm and <70 bpm (P=NS).
Multivariate Cox hazard analysis showed that HR at discharge ≤ THR was an independent predictor of PE (hazard ratio 0.67 [0.46–0.97], P=0.037), even after adjusting for confounding factors including age, sex, BMI, Hb, Alb, and b-blocker prescription, whereas HR at discharge <70 bpm was not (hazard ratio 0.94 [0.65–1.33], P=0.71).
Conclusion
THR was associated with long-term outcomes in patients with HFrEF after acute decompensation, suggesting that it may aid in tailored treatment for HR reduction in these patients.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- Y Yumita
- National Defense Medical College, Department of Cardiology, Saitama, Japan
| | - Y Nagatomo
- National Defense Medical College, Department of Cardiology, Saitama, Japan
| | - M Takei
- Saiseikai Central Hospital, Department of Cardiology, Tokyo, Japan
| | - M Saji
- Sakakibara Heart Institute, Department of Cardiology, Tokyo, Japan
| | - A Goda
- Kyorin University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - T Kohno
- Kyorin University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - S Nakano
- Saitama Medical University, Department of Cardiology, Saitama, Japan
| | - Y Nishihata
- St. Luke's International Hospital, Department of Cardiology, Tokyo, Japan
| | - Y Ikegami
- National Hospital Organization Tokyo Medical Center, Department of Cardiology, Tokyo, Japan
| | - Y Shiraishi
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - S Kohsaka
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - T Yoshikawa
- Sakakibara Heart Institute, Department of Cardiology, Tokyo, Japan
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Inoue H, Tsutsumi H, Tanaka K, Iwama E, Yoneshima Y, Shiraishi Y, Ota K, Nakanishi Y, Okamoto I. P12.02 Systemic Anticancer Therapy Upregulate Plasma Levels of Damage-Associated Molecular Patterns in Patients With Advanced Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.324] [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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Makishima H, Nannya Y, Momozawa Y, Gurnari C, Kulasekararaj A, Yoshizato T, Takeda J, Atsuta Y, Shiozawa Y, Iijima-Yamashita Y, Saiki R, Yoshida K, Shiraishi Y, Nagata Y, Onizuka M, Nakagawa M, Itonaga H, Kanda Y, Miyazaki Y, Sanada M, Tsurumi H, Kasahara S, Kondo-Takaori A, Ohyashiki K, Kiguchi T, Matsuda F, Jansen J, Papaemmanuil E, Creignou M, Tobiasson M, Hellström-Lindberg E, Polprasert C, Malcovati L, Cazzola M, Haferlach T, Maciejewski J, Kamatani Y, Miyano S, Ogawa S. Topic: AS04-MDS Biology and Pathogenesis/AS04b-Clonal diversity & evolution. Leuk Res 2021. [DOI: 10.1016/j.leukres.2021.106679.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Saiki R, Momozawa Y, Nannya Y, Nakagawa M, Ochi Y, Yoshizato T, Terao C, Kuroda Y, Shiraishi Y, Chiba K, Tanaka H, Niida A, Imoto S, Matsuda K, Morisaki T, Murakami Y, Kamatani Y, Matsuda S, Kubo M, Miyano S, Makishima H, Ogawa S. Topic: AS04-MDS Biology and Pathogenesis/AS04a-Normal, MDS, and leukemic stem cells. Leuk Res 2021. [DOI: 10.1016/j.leukres.2021.106679.3] [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]
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Toyozawa R, Itahashi K, Goto Y, Fujiwara Y, Okuma Y, Kurata T, Yokoyama T, Nokihara H, Yokoi T, Yamaguchi T, Shiraishi Y, Takeda M, Tokito T, Nakamura A, Hosomi Y, Ohe Y. 1292P Two single-arm, multicenter phase-II trials of PD-1 inhibitors in patients with pulmonary sarcomatoid carcinoma (NCCH1603/NCCH1703). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1894] [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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Takeuchi H, Matsumoto T, Morimoto K, Atsumi J, Yamamoto S, Nakagawa T, Yamada S, Kurosaki A, Shiraishi Y, Hasebe T. Pre-operative endovascular coil embolisation for chronic pulmonary aspergillosis. Int J Tuberc Lung Dis 2021; 25:725-731. [PMID: 34802494 DOI: 10.5588/ijtld.21.0028] [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: 11/10/2022] Open
Abstract
OBJECTIVE: To retrospectively evaluate the clinical outcomes of pre-operative endovascular coil embolisation (ECE) for chronic pulmonary aspergillosis (CPA).METHODS: We evaluated surgical patients with CPA between November 2016 and April 2020. Pre-operative ECE for CPA with severe adhesions was selectively performed to reduce intra-operative blood loss. ECE procedures, operative procedures, intra-operative blood loss and complications were evaluated.RESULTS: Twenty-eight patients (21 males and 7 females; median age: 55 years) were included in the study. Of the 28 patients, 8 (28.6%) underwent pre-operative ECE. Technical success rate in pre-operative ECE was 100%. The median time required for ECE procedures was 123 min. The median number of vessels embolised per procedure was 2.5. The median period between embolisation and surgery was 5 days. Major complications were observed in three patients (10.7%). There were no significant differences between patients with and without pre-operative ECE in operative time (284 vs. 365 min, respectively, P = 0.7602) and intra-operative blood loss (294 vs. 228 mL, respectively, P = 0.8987).CONCLUSIONS: Pre-operative ECE for CPA appears to be feasible and safe; however, its role in reducing intra-operative blood loss needs further investigation.
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Affiliation(s)
- H Takeuchi
- Department of Diagnostic Radiology, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - T Matsumoto
- Kochi Medical School, Kochi University, Kochi, Japan, Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - K Morimoto
- Respiratory Disease Center, Fukujuji Hospital, JATA, Tokyo, Japan
| | - J Atsumi
- Respiratory Disease Center, Fukujuji Hospital, JATA, Tokyo, Japan
| | - S Yamamoto
- Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - T Nakagawa
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - S Yamada
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - A Kurosaki
- Department of Diagnostic Radiology, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Y Shiraishi
- Respiratory Disease Center, Fukujuji Hospital, JATA, Tokyo, Japan
| | - T Hasebe
- Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
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Ito K, Sakata S, Otsubo K, Nakamura A, Teraoka S, Matsumoto N, Shiraishi Y, Haratani K, Tamiya M, Ikeda S, Miura S, Tanizaki J, Omori S, Yoshioka H, Hata A, Yoshida H, Yamamoto N, Nakagawa K. MO4-5 A multicenter retrospective study of Oncomine Dx Target Test multi-CDx system for genetic profiling of NSCLC: WJOG13019L. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.569] [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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Inoue H, Tsutsumi H, Tanaka K, Iwama E, Shiraishi Y, Hirayama A, Nakanishi T, Ando H, Nakajima M, Shinozaki S, Ogata H, Uryu K, Okamura K, Kimura S, Ogawa T, Ota K, Yoneshima Y, Hamada N, Nakanishi Y, Okamoto I. Increased plasma levels of damage-associated molecular patterns during systemic anticancer therapy in patients with advanced lung cancer. Transl Lung Cancer Res 2021; 10:2475-2486. [PMID: 34295655 PMCID: PMC8264341 DOI: 10.21037/tlcr-21-92] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/30/2021] [Indexed: 12/28/2022]
Abstract
Background Immunogenic cell death (ICD) characterized by the release of damage-associated molecular patterns (DAMPs) from dying cancer cells may contribute to the synergistic antitumor effect of cytotoxic chemotherapy combined with an immune checkpoint inhibitor. The kinetics of circulating DAMP levels in cancer patients have remained largely uncharacterized, however. Methods We evaluated the possible effects of various systemic anticancer therapy modalities on the kinetics of plasma DAMP concentrations in a prospective observational study of patients with advanced lung cancer. The plasma concentrations of high-mobility group box 1 (HMGB1), calreticulin (CRT), heat shock protein 70 (HSP70), annexin A1, and histone H3 were thus determined in 121 such patients at four time points during the first cycle of treatment. Results The mean of the maximum fold change in HMGB1, HSP70, or annexin A1 concentration observed during treatment was significantly greater than the corresponding baseline value (P<0.005). The maximum fold changes in HMGB1 and CRT concentrations tended to be associated with clinical response as evaluated by RECIST criteria, although the changes in the levels of these two DAMPs were not correlated, suggestive of differential induction mechanisms. Among the various treatment modalities administered, platinum-based combination or single-agent chemotherapy tended to elicit robust increases in the concentrations of HMGB1 and CRT. Conclusions Serial monitoring of plasma revealed that systemic anticancer therapy increased the circulating levels of HMGB1 and CRT and that these changes tended to be associated with clinical response, suggesting that agents capable of releasing these DAMPs into plasma might induce ICD in advanced lung cancer patients.
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Affiliation(s)
- Hiroyuki Inoue
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan.,Department of Respiratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Hirono Tsutsumi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kentaro Tanaka
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Iwama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshimasa Shiraishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Aiko Hirayama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takayuki Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Ando
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Maako Nakajima
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Seiji Shinozaki
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroaki Ogata
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuyasu Uryu
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Okamura
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shinichi Kimura
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Ogawa
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keiichi Ota
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuto Yoneshima
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hamada
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoichi Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Isamu Okamoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Shiraishi Y, Hata A, Inui N, Okada M, Morise M, Akiyoshi K, Takeda M, Watanabe Y, Sugawara S, Shinagawa N, Kubota K, Saeki T, Tamura T. A phase III, randomized, double-blind, multicenter, active control study of fosnetupitant for the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving cisplatin-based highly emetogenic chemotherapy (HEC): CONSOLE. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.12099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12099 Background: Fosnetupitant (FN) is a phosphorylated pro-drug of netupitant that has high binding affinity for the neurokinin-1 (NK-1) receptor and a long half-life of 70 h. This phase 3 study is the first head-to-head study to compare two NK-1 receptor antagonists, FN and fosaprepitant (FA), in combination with palonosetron and dexamethasone for the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving highly emetogenic chemotherapy (JapicCTI-194611). Methods: Patients scheduled to receive cisplatin (≥70 mg/m2) -based chemotherapy were randomly assigned 1:1 to receive FN 235 mg or FA 150 mg, in combination with palonosetron 0.75 mg and dexamethasone (9.9 mg on day 1, 6.6 mg on days 2-4). The stratification factors were sex, age category (<55 vs. ≥55 years), and site. The primary endpoint was the complete response (CR; no emetic events and no rescue medication) rate, stratified by sex and age category, during the overall phase (0-120 h) to show the non-inferiority (margin, -10%) of FN to FA. The secondary endpoints were: CR rate, complete protection rate, total control rate, no nausea rate, no emetic events rate in each period [i.e., acute (0-24 h), delayed (24-120 h), overall, 0-168 h and 120-168 h], time to treatment failure, and safety, including injection site reactions (ISRs). Assessment of efficacy was continued until 168 h after the initiation of cisplatin. Some eligible patients were evaluated for safety and efficacy of FN for up to four cycles. Results: Between February 2019 and March 2020, total 795 patients were enrolled in the study. The study drug was administered to 785 patients (n=392 in FN vs. n=393 in FA), and all of them were evaluated for efficacy and safety. Baseline characteristics were generally balanced between the two groups. The adjusted overall CR rate was 75.2% in FN vs. 71.0% in FA [MH common risk difference, 4.1%; 95% CI, -2.1% to 10.3%), thus demonstrating non-inferiority of FN to FA. Regarding the other secondary endpoints of efficacy until 168 h, FN was favorable against FA, especially the CR rate during 0-168 h (73.2% in FN vs. 66.9% in FA) (Table). The incidence rates of treatment-related adverse events were 22.2% in FN vs. 25.4% in FA, whereas those of ISRs with any cause or with treatment-related were 11.0% or 0.3% in FN vs 20.6% or 3.6% in FA, respectively ( p<0.001). Conclusions: FN demonstrated non-inferiority to FA, with a favorable safety profile and lower risk for ISRs. For the period beyond 120 h after initiation of chemotherapy, FN may have the potential to improve the prevention of “beyond delayed” CINV. Clinical trial information: JapicCTI-194611. [Table: see text]
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Affiliation(s)
- Yoshimasa Shiraishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akito Hata
- Department of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
| | - Naoki Inui
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Morihito Okada
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
| | - Masahiro Morise
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kohei Akiyoshi
- Department of Clinical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Masayuki Takeda
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Yasutaka Watanabe
- Department of Thoracic Oncology, Saitama Cancer Center, Saitama, Japan
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Naofumi Shinagawa
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Toshiaki Saeki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Tomohide Tamura
- Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
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Hoyer K, Hablesreiter R, Inoue Y, Yoshida K, Briest F, Christen F, Kakiuchi N, Yoshizato T, Shiozawa Y, Shiraishi Y, Striefler JK, Bischoff S, Lohneis P, Putter H, Blau O, Keilholz U, Bullinger L, Pelzer U, Hummel M, Riess H, Ogawa S, Sinn M, Damm F. A genetically defined signature of responsiveness to erlotinib in early-stage pancreatic cancer patients: Results from the CONKO-005 trial. EBioMedicine 2021; 66:103327. [PMID: 33862582 PMCID: PMC8054140 DOI: 10.1016/j.ebiom.2021.103327] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 12/18/2022] Open
Abstract
Background high recurrence rates of up to 75% within 2 years in pancreatic ductal adenocarcinoma (PDAC) patients resected for cure indicate a high medical need for clinical prediction tools and patient specific treatment approaches. Addition of the EGFR inhibitor erlotinib to adjuvant chemotherapy failed to improve outcome but its efficacy in some patients warrants predictors of responsiveness. Patients and Methods we analysed tumour samples from 293 R0-resected patients from the randomized, multicentre phase III CONKO-005 trial (gemcitabine ± erlotinib) with targeted sequencing, copy number, and RNA expression analyses. Findings a total of 1086 mutations and 4157 copy-number aberrations (CNAs) with a mean of 17.9 /tumour were identified. Main pathways affected by genetic aberrations were the MAPK-pathway (99%), cell cycle control (92%), TGFβ signalling (77%), chromatin remodelling (71%), and the PI3K/AKT pathway (65%). Based on genetic signatures extracted with non-negative matrix factorization we could define five patient clusters, which differed in mutation patterns, gene expression profiles, and survival. In multivariable Cox regression analysis, SMAD4 aberrations were identified as a negative prognostic marker in the gemcitabine arm, an effect that was counteracted when treated with erlotinib (DFS: HR=1.59, p = 0.016, and OS: HR = 1.67, p = 0.014). Integration of differential gene expression analysis established SMAD4 alterations with low MAPK9 expression (n = 91) as a predictive biomarker for longer DFS (HR=0.49; test for interaction, p = 0.02) and OS (HR = 0.32; test for interaction, p = 0.001). Interpretation this study identified five biologically distinct patient clusters with different actionable lesions and unravelled a previously unappreciated association of SMAD4 alteration status with erlotinib effectiveness. Confirmatory studies and mechanistic experiments are warranted to challenge the hypothesis that SMAD4 status might guide addition of erlotinib treatment in early-stage PDAC patients.
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Affiliation(s)
- K Hoyer
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - R Hablesreiter
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Inoue
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - K Yoshida
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - F Briest
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - F Christen
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - N Kakiuchi
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Yoshizato
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Shiozawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Shiraishi
- Laboratory of DNA information Analysis, Human Genome Centre, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - J K Striefler
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - S Bischoff
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - P Lohneis
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Pathology, Berlin, Germany; Institute of Pathology, University of Cologne, Cologne, Germany
| | - H Putter
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - O Blau
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - U Keilholz
- Charité Comprehensive Cancer Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - L Bullinger
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - U Pelzer
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - M Hummel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Pathology, Berlin, Germany
| | - H Riess
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - S Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto, Japan; Department of Medicine, Centre for Haematology and Regenerative Medicine, Karolinska Institute, Stockholm, Sweden
| | - M Sinn
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany; Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Damm
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany; German Cancer Consortium (DKTK), partner site Berlin, Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Takao T, Tanaka K, Shiraishi Y, Ota K, Yoneshima Y, Iwama E, Okamoto I. Osimertinib-induced Syndrome of Inappropriate Secretion of Antidiuretic Hormone. Clin Lung Cancer 2021; 22:e784-e785. [PMID: 33839042 DOI: 10.1016/j.cllc.2021.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Tomoaki Takao
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kentaro Tanaka
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshimasa Shiraishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keiichi Ota
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuto Yoneshima
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Iwama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Isamu Okamoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Ibusuki R, Yoneshima Y, Hashisako M, Matsuo N, Harada T, Tsuchiya-Kawano Y, Kishimoto J, Ota K, Shiraishi Y, Iwama E, Tanaka K, Oda Y, Okamoto I. Association of thyroid transcription factor–1 (TTF-1) expression with efficacy of PD-1/PD-L1 inhibitors plus pemetrexed and platinum chemotherapy in advanced non-squamous non-small cell lung cancer. Transl Lung Cancer Res 2021; 11:2208-2215. [PMID: 36519019 PMCID: PMC9742625 DOI: 10.21037/tlcr-22-393] [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] [Received: 05/27/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022]
Abstract
Background Thyroid transcription factor-1 (TTF-1) expression in advanced non-squamous non-small cell lung cancer (NSCLC) has been associated with the efficacy of pemetrexed plus platinum chemotherapy. However, the relation between TTF-1 expression and efficacy of the combination of programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors plus pemetrexed and platinum chemotherapy, a standard first-line treatment regimen for advanced non-squamous NSCLC, has remained unclear. Methods We retrospectively evaluated TTF-1 expression in tumor tissue of patients with advanced or recurrent non-squamous NSCLC treated with PD-1/PD-L1 inhibitors plus pemetrexed and platinum chemotherapy in the first-line setting. Clinical characteristics and pathological data for each patient were assessed, and progression-free survival (PFS) was evaluated. Bias due to patient background was minimized by application of inverse probability of treatment weighting (IPTW) analysis. Results A total of 122 patients, 75 (61.5%) of whom were positive for TTF-1 immunostaining in tumor specimens, was included in this multicenter study. At the time of analysis, 89 (73.0%) patients had experienced progression events and 44 (36.1%) had died [median follow-up 14.6 months (range, 0.53-29.5 months)]. PFS was longer for TTF-1-positive patients than for TTF-1-negative patients [median, 12.2 vs. 6.0 months; hazard ratio (HR) =0.63 (95% CI: 0.37-1.06); log-rank P=0.028]. IPTW-adjusted PFS was significantly longer for TTF-1-positive than for TTF-1-negative patients [HR =0.62 (95% CI: 0.46-0.83); log-rank P=0.024]. Conclusions TTF-1 expression in advanced non-squamous NSCLC can serve as a basis for prediction of PFS in patients treated with PD-1/PD-L1 inhibitors plus pemetrexed and platinum chemotherapy in the first-line setting.
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Affiliation(s)
- Ritsu Ibusuki
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuto Yoneshima
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mikiko Hashisako
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Norikazu Matsuo
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Taishi Harada
- Department of Respiratory Medicine, Japan Community Health Care Organization-Kyushu Hospital, Fukuoka, Japan
| | - Yuko Tsuchiya-Kawano
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, Fukuoka, Japan
| | - Junji Kishimoto
- Department of Research and Development of Next Generation Medicine, Kyushu University, Fukuoka, Japan
| | - Keiichi Ota
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshimasa Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Iwama
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kentaro Tanaka
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Isamu Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Yorozu A, Sutani S, Soyano T, Matsumoto H, Toya K, Shiraishi Y, Saito S. Long-term Outcomes of Very-high-risk versus High-risk Prostate Cancer Patients Treated with Brachytherapy-based Treatment. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Shiraishi Y, Tanaka T, Toya K, Yorozu A, Shigematsu N. Machine Learning Algorithms for Late Toxicity Prediction after Prostate Permanent Brachytherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Takei M, Harada K, Miyazaki T, Kohsaka S, Matsushita K, Shiraishi Y, Shinme T, Shindo A, Miyamoto T, Kitano D, Kodera S, Nakano H, Yamamoto T, Takayama M. Effect of air pollution on acute heart failure hospitalization differ across specific heart failure populations. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Several report showed the association between ambient air pollution including particular matter under 2.5um (PM2.5) and increasing rate of hospitalization for heart failure. However, these report analyzed mainly cross-sectional, epidemiological data, thus the reports regarding association between vulnerability to PM2.5 and specific populations in acute heart failure (AHF) were scarce.
Purpose
1. To analyze the association between air pollution and rate of hospitalization for AHF
2. To analyze whether the vulnerability to air pollution differ between specific populations in AHF. Methods
A case-cross over analysis was conducted to 4980 consecutive patients registered for multicenter acute heart failure registry in 2017 in our city Japan. This registry enrolled patients transferred to cardiovascular care unit (80 institutions) via emergency medical services across our city area. Logistic regression analysis were conducted to estimate percentage changes in the rate of acute heart failure hospitalization associated with per 1μg/m3 PM2.5 concentration increase. We also conducted subgroup analysis for patients stratified by age, gender, comorbidities, left ventricular ejection fraction, and clinical scenario.
Results
An increase in 1 μg/m3 PM2.5 concentration corresponded to 2.9% (95% CI 1.2–4.6%) increase in AHF hospitalization. Patients with age younger than 75, without prior heart failure hospitalization, without history of hypertension, without anemia, and with reduced ejection fraction were more susceptible to increase in PM2.5 concentration (Figure).
Conclusions
Increase in PM2.5 concentration was associated with increased rate of AHF hospitalization. Effect of PM2.5 may differ across specific AHF subpopulations.
Figure 1
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): Tokyo Metropolitan Government
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Affiliation(s)
- M Takei
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - K Harada
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - T Miyazaki
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - S Kohsaka
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - K Matsushita
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - Y Shiraishi
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - T Shinme
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - A Shindo
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - T Miyamoto
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - D Kitano
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - S Kodera
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - H Nakano
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - T Yamamoto
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - M Takayama
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
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Inoue H, Tsutsumi H, Shiraishi Y, Okamura K, Ota K, Yoneshima Y, Iwama E, Tanaka K, Okamoto I. Dynamic monitoring of plasma DAMP proteins during various anticancer agents in advanced lung cancer patients. Lung Cancer 2020. [DOI: 10.1183/13993003.congress-2020.1644] [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: 11/05/2022]
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