1
|
Yano Y, Yamamoto A, Mimura T, Kushida S, Hirohata S, Yoon S, Hirano H, Kim SK, Hatazawa Y, Momose K, Hayashi H, Kado T, Nishi K, Tanaka H, Matsuura T, Yoshida R, Asaji N, Yasutomi E, Shiomi Y, Minami A, Komatsu S, Fukumoto T, Ueda Y, Kodama Y. Factors associated with the response to atezolizumab/bevacizumab combination therapy for hepatocellular carcinoma. JGH Open 2023; 7:476-481. [PMID: 37496817 PMCID: PMC10366485 DOI: 10.1002/jgh3.12932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/26/2023] [Accepted: 06/05/2023] [Indexed: 07/28/2023]
Abstract
Background and Aim The purpose of this study was to analyze factors associated with the overall survival (OS) of atezolizumab/bevacizumab combination therapy for advanced hepatocellular carcinoma (aHCC). We also assessed the OS of patients with ineffective therapy and those who discontinued treatment owing to adverse events (AEs). Methods This retrospective multicenter study involved 139 patients with aHCC who received atezolizumab/bevacizumab combination therapy between November 2020 and September 2022. Results The median duration of treatment was 136.5 days, and the median observation period was 316 days. The overall response rate was 40%, and the disease control rate was 78% according to mRECIST criteria. Grade ≥2 AEs occurred in 63 patients (43%) and led to treatment discontinuation in 16 patients. Multivariate analysis revealed that treatment response and occurrence of grade ≥2 AEs after therapy, as well as low level of albumin-bilirubin (ALBI) grade and low level of des-gamma carboxy prothrombin (DCP) before therapy, were extracted as factors that contributed to OS. Log-rank tests with the Kaplan-Meier method showed significant differences in OS among these factors. The OS of patients who discontinued owing to AEs was significantly shorter than that of other patients. Conclusion Not only factors before therapy but also treatment response and the appearance of AEs are involved in OS for atezolizumab/bevacizumab combination therapy. Although the development of AEs also contributed to OS, appropriate management of AEs is important to avoid discontinuing treatment with this combination.
Collapse
Affiliation(s)
- Yoshihiko Yano
- Division of GastroenterologyKobe University Graduate School of MedicineKobeJapan
| | - Atsushi Yamamoto
- Division of GastroenterologyKobe University Graduate School of MedicineKobeJapan
| | | | | | | | - Seitetsu Yoon
- Hyogo Prefectural Kakogawa Medical CenterKakogawaJapan
| | | | | | | | | | | | | | | | | | - Takanori Matsuura
- Division of GastroenterologyKobe University Graduate School of MedicineKobeJapan
| | - Ryutaro Yoshida
- Division of GastroenterologyKobe University Graduate School of MedicineKobeJapan
| | - Naoki Asaji
- Division of GastroenterologyKobe University Graduate School of MedicineKobeJapan
| | - Eiichiro Yasutomi
- Division of GastroenterologyKobe University Graduate School of MedicineKobeJapan
| | - Yuuki Shiomi
- Division of GastroenterologyKobe University Graduate School of MedicineKobeJapan
| | - Akihiro Minami
- Division of GastroenterologyKobe University Graduate School of MedicineKobeJapan
| | - Shohei Komatsu
- Division of Hepato‐Biliary‐Pancreatic SurgeryKobe University Graduate School of MedicineKobeJapan
| | - Takumi Fukumoto
- Division of Hepato‐Biliary‐Pancreatic SurgeryKobe University Graduate School of MedicineKobeJapan
| | - Yoshihide Ueda
- Division of GastroenterologyKobe University Graduate School of MedicineKobeJapan
| | - Yuzo Kodama
- Division of GastroenterologyKobe University Graduate School of MedicineKobeJapan
| |
Collapse
|
2
|
Yano Y, Yamamoto A, Minami A, Momose K, Mimura T, Kim SK, Hayashi H, Kado T, Hirano H, Hirohata S, Yoon S, Nishi K, Tei H, Tanaka H, Oouchi S, Matsuura T, Yasutomi E, Hatazawa Y, Shiomi Y, Ueda Y, Kodama Y. Significance of post‐progression therapy after tyrosine kinase inhibitors for advanced hepatocellular carcinoma. JGH Open 2022; 6:427-433. [PMID: 35774348 PMCID: PMC9218537 DOI: 10.1002/jgh3.12772] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 12/04/2022]
Abstract
Background and Aim Molecular‐targeted therapies such as sorafenib and lenvatinib have long been used as first‐line treatment for advanced hepatocellular carcinoma (aHCC). However, adverse events or limited therapeutic effects may necessitate the change to another therapeutic option, known as post‐progression therapy. To investigate the significance of post‐progression therapy, we analyzed the outcomes of aHCC patients following first‐line molecular‐targeted therapy in a real‐world study. Methods This retrospective, multicenter study involved patients with aHCC who received sorafenib or lenvatinib as first‐line therapy between January 2011 and September 2021. Results In total, 513 patients were analyzed: 309 treated with sorafenib and 204 with lenvatinib. The overall response and disease control rates were 15 and 50%, respectively, in the sorafenib group and 30 and 75%, respectively, in the lenvatinib group (P < 0.001). Kaplan–Meier analysis revealed no significant differences in progression‐free survival and overall survival (OS) between the two treatments. Multivariate analysis revealed that fibrosis‐4 index, disease control rate, post‐progression therapy, and use of an immune checkpoint inhibitor (ICI) were significantly associated with OS. OS was significantly longer in patients who received post‐progression therapy than in those who did not (log‐rank P < 0.001). Most patients who received an ICI as post‐progression therapy had previously received lenvatinib. Among lenvatinib‐treated patients, OS was significantly longer in patients who received an ICI than in patients received another or no post‐progression therapy (P = 0.004). Conclusion The introduction of newer drugs for post‐progression therapy is expected to prolong survival. ICI‐based regimens appear to be effective after lenvatinib.
Collapse
Affiliation(s)
- Yoshihiko Yano
- Division of gastroenterology, Department of internal medicine Kobe University Graduate School of Medicine Kobe Japan
| | - Atsushi Yamamoto
- Division of gastroenterology, Department of internal medicine Kobe University Graduate School of Medicine Kobe Japan
| | - Akihiro Minami
- Department of Gastroenterology Konan Medical Center Kobe Japan
| | - Kenji Momose
- Department of Gastroenterology Osaka Saiseikai Nakatsu Hospital Osaka Japan
| | - Takuya Mimura
- Department of Gastroenterology Hyogo Prefectural Hyogo Cancer Center Kobe Japan
| | - Soo Ki Kim
- Department of internal medicine Kobe Asahi Hospital Kobe Japan
| | - Hiroki Hayashi
- Department of Gastroenterology Kitaharima Medical Center Ono Japan
| | - Takuo Kado
- Department of Gastroenterology Akashi Medical Center Akashi Japan
| | - Hirotaka Hirano
- Department of Gastroenterology Yodogawa Christian Hospital Osaka Japan
| | - Seiya Hirohata
- Department of Gastroenterology Hyogo Prefectural Kakogawa Medical Center Kakogawa Japan
| | - Seitetsu Yoon
- Department of Gastroenterology Hyogo Prefectural Kakogawa Medical Center Kakogawa Japan
| | - Katsuhisa Nishi
- Department of Gastroenterology Hyogo Prefectural Awaji Medical Center Sumoto Japan
| | - Hiroshi Tei
- Department of Gastroenterology Kobe City Medical Center General Hospital Kobe Japan
| | - Hidenori Tanaka
- Department of Gastroenterology Sanda City Hospital Sanda Japan
| | | | - Takanori Matsuura
- Division of gastroenterology, Department of internal medicine Kobe University Graduate School of Medicine Kobe Japan
| | - Eiichiro Yasutomi
- Division of gastroenterology, Department of internal medicine Kobe University Graduate School of Medicine Kobe Japan
| | - Yuri Hatazawa
- Division of gastroenterology, Department of internal medicine Kobe University Graduate School of Medicine Kobe Japan
| | - Yuuki Shiomi
- Division of gastroenterology, Department of internal medicine Kobe University Graduate School of Medicine Kobe Japan
| | - Yoshihide Ueda
- Division of gastroenterology, Department of internal medicine Kobe University Graduate School of Medicine Kobe Japan
| | - Yuzo Kodama
- Division of gastroenterology, Department of internal medicine Kobe University Graduate School of Medicine Kobe Japan
| | | |
Collapse
|
3
|
Yoshida R, Yano Y, Hoshi N, Okamoto N, Sui Y, Yamamoto A, Asaji N, Shiomi Y, Yasutomi E, Hatazawa Y, Hayashi H, Ueda Y, Kodama Y. Acid-treated high-amylose corn starch suppresses high-fat diet-induced steatosis. J Food Sci 2022; 87:2173-2184. [PMID: 35411589 DOI: 10.1111/1750-3841.16146] [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: 09/24/2021] [Revised: 02/17/2022] [Accepted: 03/17/2022] [Indexed: 11/29/2022]
Abstract
Resistant starch (RS) has been reported to improve steatosis as well as obesity. Type 4 resistant starch (RS4), a chemically modified starch, is particularly hard to digest and suggesting higher efficacy. However, because the effects of RS4 on steatosis are not yet fully understood, the effects of RS4 on steatosis were examined using a murine high-fat diet model. Seven-week-old male mice were divided into three groups and fed a normal diet, a high-fat diet (HFD), or a high-fat diet with added RS (HFD + RS). Amylofiber SH® produced from acid-treated corn starch was used as the dietary RS. At 22 weeks old, hepatic steatosis and short chain fatty acid (SCFA) content and gut microbiota in cecum stool samples were analyzed. The ratio of body weight to 7 weeks was significantly suppressed in the HFD + RS group compared to the HFD group (132.2 ± 1.4% vs. 167.2 ± 3.9%, p = 0.0076). Macroscopic and microscopic steatosis was also suppressed in the HFD + RS group. Analysis of cecum stool samples revealed elevated SCFA levels in the HFD + RS group compared with the HFD group. Metagenome analysis revealed that Bifidobacterium (17.9 ± 1.9% vs. 3.6 ± 0.7%, p = 0.0019) and Lactobacillus (14.8 ± 3.4% vs. 0.72 ± 0.23%, p = 0.0045), which degrade RS to SCFA, were more prevalent in the HFD + RS group than the HFD group. In conclusion, RS4 suppressed steatosis, and increased Bifidobacterium and Lactobacillus, and SCFAs. RS4 may prevent steatosis by modulating the intestinal environment.
Collapse
Affiliation(s)
- Ryutaro Yoshida
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Yoshihiko Yano
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Namiko Hoshi
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Norihiro Okamoto
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Yunlong Sui
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Atsushi Yamamoto
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Naoki Asaji
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Yuuki Shiomi
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Eiichiro Yasutomi
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Yuri Hatazawa
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Hiroki Hayashi
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Yoshihide Ueda
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Yuzo Kodama
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine
| |
Collapse
|
4
|
Yamamoto A, Yano Y, Ueda Y, Yasutomi E, Hatazawa Y, Hayashi H, Yoshida R, Asaji N, Shiomi Y, Tobimatsu K, Sakai A, Kodama Y. Clinical features of immune-mediated hepatotoxicity induced by immune checkpoint inhibitors in patients with cancers. J Cancer Res Clin Oncol 2020; 147:1747-1756. [PMID: 33222015 DOI: 10.1007/s00432-020-03448-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 10/29/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The risk factors and clinical characteristics of ICI-induced immune-mediated hepatotoxicity (IMH) are not fully understood. Thus, the present study sought to clarify the clinical features of IMH. METHODS All patients treated with ICIs between September 2014 and April 2019 at our institution were included. Clinical data were retrospectively collected from medical records. The frequency of grade ≥ 2 liver damage, clinical characteristics, and risk factors for developing IMH were examined. RESULTS Overall, 250 patients (median age 71 years; range 30-87 years; 202 males and 48 females) were included in the analyses. Forty-five patients had elevated transaminase levels (> threefold the upper limit of normal). Of these, 21 were considered to have IMH. The remaining 24 patients had other causes of elevated transaminase levels. Steroids were administered to 13/21 patients with IMH. Although all patients exhibited improvement, IMH was not associated with the anticancer efficacy of the ICIs or OS. A multivariable analysis revealed that IMH was significantly associated with malignant melanoma (odds ratio [OR] 11.6; 95% confidence interval [CI] 3.5-38.0; P = 0.0002) and ipilimumab-nivolumab combination therapy (OR 61.2; 95% CI 7.9-1275.3; P < 0.0001). CONCLUSION Immune-mediated hepatotoxicity occurred in 9.5% of patients treated with ICIs. Appropriate therapeutic interventions are important to avoid affecting the patient's prognosis, and accurate diagnosis of IMH is essential for this purpose. The frequency of IMH varied according to the type of cancer and the drug used, and was significantly higher in patients with malignant melanoma and in patients given ipilimumab-nivolumab combination therapy.
Collapse
Affiliation(s)
- Atsushi Yamamoto
- Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yoshihiko Yano
- Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Yoshihide Ueda
- Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Eiichiro Yasutomi
- Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yuri Hatazawa
- Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroki Hayashi
- Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Ryutaro Yoshida
- Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Naoki Asaji
- Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yuuki Shiomi
- Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kazutoshi Tobimatsu
- Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Arata Sakai
- Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yuzo Kodama
- Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| |
Collapse
|
5
|
Hatazawa Y, Yano Y, Okada R, Tanahashi T, Hayashi H, Hirano H, Minami A, Kawano Y, Tanaka M, Fukumoto T, Murakami Y, Yoshida M, Hayashi Y. Quasispecies variant of pre-S/S gene in HBV-related hepatocellular carcinoma with HBs antigen positive and occult infection. Infect Agent Cancer 2018; 13:7. [PMID: 29434654 PMCID: PMC5797373 DOI: 10.1186/s13027-018-0179-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/26/2018] [Indexed: 12/15/2022] Open
Abstract
Background Hepatocellular carcinoma (HCC) can develop in patients who are negative for the hepatitis B surface antigen (HBsAg) in serum but positive for hepatitis B virus (HBV) DNA in the liver, referred to as occult HBV infection (OBI). Previous reports showed that HBV variants in OBI-related HCC are different from those in HBsAg-positive HCC. In the present study, HBV quasispecies based on the pre-S/S gene in OBI-related HCC patients were examined by high throughput sequencing and compared with those in HBsAg-positive HCC. Methods Nineteen tissue samples (9 OBI-related and 10 HBsAg-positive non-cancerous tissues) were collected at the time of surgery at Kobe University Hospital. The quasispecies with more than 1% variation in the pre-S/S region were isolated and analysed by ultra-deep sequencing. Results There were no significant differences in the major HBV populations, which exhibit more than 20% variation within the entire pre-S/S region, between OBI-related HCC and HBsAg-positive HCC. However, the prevalences of major populations with pre-S2 region mutations and of minor populations with polymerized human serum albumin-binding domain mutations were significantly higher in OBI-related HCC than in HBsAg-positive HCC. Moreover, the major variant populations associated with the B-cell epitope, located within the pre-S1 region, and the a determinant domain, located in the S region, were detected frequently in HBsAg-positive HCC. The minor populations of variants harbouring the W4R, L30S, Q118R/Stop, N123D and S124F/P mutations in the pre-S region and the L21F/S and L42F/S mutations in the S region were detected more frequently in OBI-related HCC than in HBsAg-positive HCC. Conclusions Ultra-deep sequencing revealed that the B-cell epitope domain in the pre-S1 region and alpha determinant domain in the S region were variable in HBsAg-positive HCC, although the quasispecies associated with the pre-S2 region were highly prevalent in OBI-related HCC. Trial registration Ref: R000034382/UMIN000030113; Retrospectively registered 25 November 2017.
Collapse
Affiliation(s)
- Yuri Hatazawa
- 1Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017 Japan
| | - Yoshihiko Yano
- 1Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017 Japan.,2Division of Molecular Medicine & Medical Genetics, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Rina Okada
- 1Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017 Japan
| | - Toshihito Tanahashi
- Department of Internal Medicine, Tokushima Prefectural Naruto Hospital, Tokushima, Japan
| | - Hiroki Hayashi
- 1Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017 Japan
| | - Hirotaka Hirano
- 1Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017 Japan
| | - Akihiro Minami
- 1Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017 Japan
| | - Yuki Kawano
- 1Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017 Japan
| | - Motofumi Tanaka
- 4Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takumi Fukumoto
- 4Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshiki Murakami
- 5Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masaru Yoshida
- 1Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017 Japan
| | - Yoshitake Hayashi
- 2Division of Molecular Medicine & Medical Genetics, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
6
|
Yano Y, Seo Y, Hayashi H, Hatazawa Y, Hirano H, Minami A, Kawano Y, Saito M, Ninomiya T, Sugano M, Yamada H, Kitajima N, Yoon S, Hayashi Y. Factors associated with the decrease in hepatitis B surface antigen titers following interferon therapy in patients with chronic hepatitis B: Is interferon and adefovir combination therapy effective? Biomed Rep 2017; 7:257-262. [PMID: 28819561 DOI: 10.3892/br.2017.944] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 07/15/2017] [Indexed: 12/15/2022] Open
Abstract
The purpose of antiviral therapy in chronic hepatitis B (CHB) is generally to achieve a decrease and ultimately disappearance of HBs antigen (HBsAg). Interferon (IFN) therapy of CHB appears to be less effective in Asian countries than in European countries, and the advantage of IFN and nucleotide(s) analog (NA) combination therapy has yet to be fully investigated. The present study focused on the factors associated with a decrease in HBs antigen following IFN monotherapy or IFN + NA combination therapy. A total of 35 patients with CHB who received IFN-based therapy (mean ± standard deviation age 36.7±8.5 years; 27 males and 8 females) were enrolled in this study. Of the 35 patients, 21 patients received pegylated IFN monotherapy and 14 patients received IFN and adefovir (ADV) combination therapy. We examined the factors associated with reductions in the HBsAg titer of >1.0 log IU/ml from the initial HBsAg titer to the end of treatment and to 24 weeks after treatment. Although 13 patients (37%) had a reduction in HBsAg of >1.0 IU/ml at the end of treatment, it was only maintained to 24 weeks after treatment in 7 patients (20%). The HBV core-related antigen (HBcrAg) titer before treatment was significantly higher in patients with a decrease in HBsAg at the end of treatment than in patients without a decrease in HBsAg (6.56±0.78 vs. 5.30±1.66 log IU/ml, P<0.05). Moreover, an increase in alanine aminotransferase (ALT) of >2 times from baseline occurred significantly more frequently in patients with a decrease in HBsAg (62 vs. 14%, P<0.05). The proportion of patients with a decrease in HBsAg was significantly greater in patients who received IFN monotherapy than in patients who received IFN and ADV combination therapy (43 vs. 29%, P<0.05). The present results revealed that the HBcr antigen titer before therapy and an on-treatment elevation of ALT (indicative of host instruction flare) are important factors associated with a decrease in HBsAg titers after IFN-based therapy. The efficacy of IFN and ADV combination therapy was not apparent in terms of a reduction in the HBsAg titer.
Collapse
Affiliation(s)
- Yoshihiko Yano
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.,Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | | | - Hiroki Hayashi
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yuri Hatazawa
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Hirotaka Hirano
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Akihiro Minami
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yuki Kawano
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | | | | | | | - Hajime Yamada
- Department of Gastroenterology, Shinko Hospital, Kobe 651-0072, Japan
| | - Naoto Kitajima
- Department of Gastroenterology, Kasai City Hospital, Kasai 675-2393, Japan
| | - Seitetsu Yoon
- Department of Gastroenterology, Kakogawa Municipal Hospital, Kakogawa 675-8555, Japan
| | - Yoshitake Hayashi
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| |
Collapse
|
7
|
Bai F, Yano Y, Kim SR, Seo Y, Miki A, Saito M, Hirano H, Momose K, Minami A, Hatazawa Y, Hayakumo T, Widasari DI, Rinonce HT, Sugano M, Tani S, Yoon S, Imoto S, Azuma T, Hotta H, Hayashi Y. Mutational diversity of NS5A and NS3 during triple therapy (telaprevir, pegylated-interferon-α 2b and ribavirin) for genotype 1b chronic hepatitis C: The Kobe Hepatitis Therapeutic Group. Int J Mol Med 2014; 33:1652-6. [PMID: 24647743 DOI: 10.3892/ijmm.2014.1706] [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: 11/02/2013] [Accepted: 02/26/2014] [Indexed: 11/05/2022] Open
Abstract
Telaprevir, a non-structural (NS)3/4A protease inhibitor, is a direct-acting antiviral drug that inhibits viral replication. Triple therapy with telaprevir, pegylated interferon, and ribavirin is a standard therapeutic regimen for patients with genotype 1b chronic hepatitis C virus (HCV) infection and a high viral load. Several factors, including mutations in the NS5A gene, are important predictors of the efficacy of interferon therapy. In this study, we examined the mutational diversity of NS5A and its impact on the efficacy of triple therapy. We enrolled patients with genotype 1b chronic HCV infection and a high viral load (31 males/17 females; mean age, 57.6 years), who were treated with triple therapy. This study was conducted at Kobe University Hospital and at three affiliated hospitals in Hyogo prefecture, Japan, between November 2011 and June 2013. A sustained viral response after 12 weeks (SVR12) was achieved in 37/48 patients (77%). Based on intent-to-treat analysis, SVR12 was significantly greater in patients with the major allele than in those with the minor allele for the IL28B single nucleotide polymorphism (SNP; 88 vs. 56%; P<0.05). The prevalence of the V2334I mutation in NS5A was significantly higher in patients who achieved SVR12, while that of G2356E was significantly higher in patients who did not achieve SVR12 (P<0.05). Mutations in the NS3 region that are thought to confer resistance to telaprevir were detected in 3/27 patients who achieved SVR12 (Val36, n=3) and in 5/10 patients who did not achieve SVR12 (Val36, n=4; Thr54, n=1). In conclusion, the IL28B SNP and mutations in the NS5A region were associated with the therapeutic response to triple therapy. Half of the patients who did not achieve SVR12 had mutations conferring resistance to telaprevir. However, pre-existing mutations in NS3 did not affect the efficacy of triple therapy.
Collapse
Affiliation(s)
- Fugui Bai
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Yoshihiko Yano
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Soo-Ryang Kim
- Department of Gastroenterology, Kobe Asahi Hospital, Kobe, Hyogo 653-0801, Japan
| | - Yasushi Seo
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Akira Miki
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Masaya Saito
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Hirotaka Hirano
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Kenji Momose
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Akihiro Minami
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Yuri Hatazawa
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Takanobu Hayakumo
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Dewiyani Indah Widasari
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Hanggoro Tri Rinonce
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | | | - Satoshi Tani
- Division of Internal Medicine, Konan Hospital, Kobe, Hyogo 658-0064, Japan
| | - Seitetsu Yoon
- Department of Gastroenterology, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, Hyogo 675-8555, Japan
| | | | - Takeshi Azuma
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Hak Hotta
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Yoshitake Hayashi
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| |
Collapse
|
8
|
Fukino S, Fukata T, Inoue A, Hatazawa Y, Morio S. [A surgical case of T-cell non-Hodgkin's lymphoma originating in the wall affected by chronic tuberculous empyema following artificial pneumothorax]. Nihon Kyobu Geka Gakkai Zasshi 1992; 40:113-7. [PMID: 1564342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A 63-year-old male patient underwent artificial pneumothorax for right pulmonary tuberculosis 39 years ago, and thereafter suffered from chronic empyema, though asymptomatic. In December, 1989, he was found to have a 5 cm tumor in his right chest wall. The tumor grew to 15 cm in 2 weeks and was associated with severe pain. A chest CT revealed that the tumor of the chest wall corresponded to the area of the wall affected by empyema. The patient underwent full thickness resection of the chest wall including the tumor and the empyematous wall (20 x 20 cm) on March 7, 1990. The tumor was 11 x 8 x 7 cm large and had developed from the empyematous wall to the lateral side of chest wall. There was no invasion of the thoracic cavity by the empyema. The lesion was pathologically diagnosed as diffuse, large to intermediate T-cell non-Hodgkin's lymphoma. Postoperatively the patient was treated with radiotherapy and VEPA therapy, but the tumor metastasized to both lungs, and the patient died 161 days after surgery. The majority of cases of malignant lymphoma reported to have originated in empyematous chest walls have been of the B-cell type. The T-cell type is rare, and the present case is only the second case reported. Chest CT was an effective method of diagnostic imaging in this disease.
Collapse
MESH Headings
- Chronic Disease
- Empyema, Tuberculous/pathology
- Empyema, Tuberculous/surgery
- Humans
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/surgery
- Lymphoma, T-Cell/pathology
- Lymphoma, T-Cell/surgery
- Male
- Middle Aged
- Pneumothorax, Artificial
- Postoperative Complications/pathology
- Postoperative Complications/surgery
- Tuberculosis, Pulmonary/surgery
Collapse
Affiliation(s)
- S Fukino
- Department of Surgery, Tottori Prefecture Kosei Hospital, Kurayoshi, Japan
| | | | | | | | | |
Collapse
|
9
|
Nakai K, Asano K, Hatazawa Y, Aoyama Y, Okamura R, Tokushima T, Nozu T, Hara H, Mori T, Nakamura K. [Hemodynamics in mitral stenosis (author's transl)]. Nihon Kyobu Geka Gakkai Zasshi 1981; 29:1856-62. [PMID: 7338644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
10
|
Nakamura K, Nakai K, Asano K, Hatazawa Y, Aoyama Y, Okamura R. [Risk factors in mitral valvular surgery (author's transl)]. Nihon Kyobu Geka Gakkai Zasshi 1978; 26:1556-62. [PMID: 731093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|