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Kobayashi K, Masuda N, Mizuno T, Miura K, Tokuda Y, Yoshinami T, Kawaguchi H, Ohtani S, Saeki T, Toi M, Takeuchi M, Ito Y. Phase II trial of biweekly administration with eribulin after three cycles of induction therapy in hormone receptor-positive, HER2-negative metastatic breast cancer (JACCRO BC-03). Breast Cancer Res Treat 2023; 201:409-415. [PMID: 37480384 DOI: 10.1007/s10549-023-07030-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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/28/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE Metastatic breast cancer (MBC) is usually incurable; treatment aims to maximize patients' function and quality of life (QOL). Eribulin is a standard treatment in patients with MBC pretreated with anthracycline and taxane; however, the best administration schedule is unknown. METHODS In this prospective phase II trial of patients with luminal MBC, we administered biweekly eribulin to patients who completed a three-cycle induction treatment. RESULTS Sixty patients with hormone-receptor-positive and HER2-negative MBC were enrolled; 40 obtained stable disease (SD) or better efficacy after induction therapy, after which they were switched to biweekly maintenance administration. The median progression-free survival (PFS) in patients who switched to maintenance therapy was 15.21 weeks (95% CI 9.71-22.14), starting on the first day of maintenance therapy. Overall survival (OS) in patients who switched to maintenance therapy was 21.39 months (95% CI 18.89-32.89). PFS and OS in the whole population starting from the registration date were 19.00 weeks (95% CI 17.00-25.00) and 21.52 months (95% CI 16.23-24.25), respectively. PFS from the enrollment date for patients who received maintenance therapy was 25.29 weeks (95% CI 19.14-32.14). Patients who achieved complete response or partial response during induction therapy had significantly longer PFS compared to patients with SD. CONCLUSION The efficacy of biweekly administration of eribulin at maintenance was nonsignificant. However, less frequent visits are convenient, and reduced dose intensity improves safety. Biweekly administration, besides dose reduction, could be an acceptable option for patients who are unable to maintain a standard regimen.
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Affiliation(s)
- Kokoro Kobayashi
- Department of Breast Medical Oncology, Cancer Institute Hospital of JFCR, Tokyo, Japan.
| | - Norikazu Masuda
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Surgery, Breast Oncology, NHO Osaka National Hospital, Osaka, Japan
| | - Toshiro Mizuno
- Department of Medical Oncology, Mie University Hospital, Tsu, Japan
| | - Kayo Miura
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yutaka Tokuda
- Breast Center, Seirei Yokohama Hospital, Yokohama, Japan
| | - Tetsuhiro Yoshinami
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Hidetoshi Kawaguchi
- Department of Breast Surgery, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Shoichiro Ohtani
- Department of Breast Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Toshiaki Saeki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University Hospital, Kyoto, Japan
| | - Masahiro Takeuchi
- Graduate School of Mathematical Sciences, The University of Tokyo, Tokyo, Japan
| | - Yoshinori Ito
- Department of Breast Medical Oncology, Cancer Institute Hospital of JFCR, Tokyo, Japan
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Takamatsu A, Honda H, Miwa T, Tabuchi T, Taniguchi K, Shibuya K, Tokuda Y. Factors associated with COVID-19 booster vaccine hesitancy: a nationwide, cross-sectional survey in Japan. Public Health 2023; 223:72-79. [PMID: 37619504 DOI: 10.1016/j.puhe.2023.07.022] [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: 03/21/2023] [Revised: 07/09/2023] [Accepted: 07/17/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVES COVID-19 vaccine hesitancy/fatigue is increasing as the pandemic enters the endemic phase. The present study aimed to explore current perceptions about COVID-19 booster vaccination among the Japanese public. STUDY DESIGN This was a cross-sectional study. METHODS This cross-sectional study used data from the Japan COVID-19 and Society Internet Survey conducted in September 2021 and September 2022. The public's perceptions of COVID-19 vaccination and factors associated with COVID-19 booster vaccine hesitancy were analyzed. RESULTS In total, 56,735 respondents were included. In the Japan COVID-19 and Society Internet Survey 2021, 75.1% of the participants (21,126/28,118) had completed the primary vaccination series. In the 2022 survey, 74.1% of the respondents (21,216/28,617) completed the primary series of vaccination with booster doses. The proportion of fear toward COVID-19 and obtaining information about COVID-19 has decreased from 2021 to 2022. Factors independently associated with booster vaccine hesitancy were young age (range: 18-29 years; adjusted odds ratio [aOR]: 6.56), history of COVID-19 (aOR: 1.82), distrust of the Japanese government's COVID-19 prevention measures (aOR: 1.55), lack of confidence in COVID-19 vaccine efficacy (aOR: 1.30), lack of confidence in COVID-19 vaccine safety (aOR: 1.62), low reliance on the COVID-19 vaccine (aOR: 1.92), and belief in COVID-19 conspiracy theories (aOR: 1.77). CONCLUSIONS Providing clear and trustworthy information is critically important, especially targeted and tailored messages for the young generation, to promoting COVID-19 booster vaccination. Policymakers should therefore develop consistent and transparent communication strategies and the ability to respond promptly and flexibly to mitigate the negative impact of COVID-19 on the public while preparing for the next pandemic.
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Affiliation(s)
- A Takamatsu
- Department of Microbiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - H Honda
- Department of Infectious Diseases, Fujita Health University School of Medicine, Aichi, Japan.
| | - T Miwa
- Department of Infectious Diseases, University of Tokyo Hospital, Tokyo, Japan.
| | - T Tabuchi
- Tokyo Foundation for Policy Research, Tokyo, Japan; Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan.
| | - K Taniguchi
- Tokyo Foundation for Policy Research, Tokyo, Japan; National Hospital Organization, Mie Medical Center, Mie, Japan.
| | - K Shibuya
- Tokyo Foundation for Policy Research, Tokyo, Japan.
| | - Y Tokuda
- Tokyo Foundation for Policy Research, Tokyo, Japan; Muribushi Okinawa Center for Teaching Hospitals, Okinawa, Japan.
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Tobe A, Tanaka A, Tokuda Y, Shirai Y, Yamamoto T, Tokoro M, Furusawa K, Ishii H, Usui A, Murohara T. Albuminuria predicts worsening renal function at 1 month after transcatheter aortic valve implantation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1610] [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
Worsening renal function (WRF) at short term after transcatheter aortic valve replacement (TAVR) is reportedly associated with subsequent poor clinical outcomes. We previously reported preoperative albuminuria predicted mid-term WRF after TAVR. However, the impact of albuminuria on short-term WRF after TAVR is unknown.
Methods
Overall, 206 patients who underwent TAVR for severe aortic stenosis were investigated retrospectively. Patients were divided into two groups according to the preoperative urinary albumin-to-creatinine ratio (ACR): high (ACR ≥30 mg/g) and low (ACR <30 mg/g). The incidence of 1-month WRF, defined as a decrease in estimated glomerular filtration rate (eGFR) ≥10% from baseline after TAVR, was investigated.
Results
More than half of the examined patients (n=106/206 [51.5%]) had a high ACR. Patients with a high ACR had significantly lower eGFR at baseline than those with a low ACR (49.3 [32.5–57.8] vs. 51.4 [37.7–65.8] mL/min/1.73 m2, p=0.03). Patients with a high ACR more frequently had acute kidney injury (8.5% vs. 1.0%, p=0.01) and 1-month WRF than those with a low ACR (29.2% vs. 12.0%, p=0.002). Multivariate analysis showed a high ACR was independently associated with 1-month WRF (odds ratio, 3.72; 95% confidence interval, 1.72–8.08; p<0.001). Meanwhile, eGFR <60 mL/min/1.73 m2 was not an independent predictor of 1-month WRF (odds ratio, 0.48; 95% confidence interval, 0.22–1.04, p=0.06).
Conclusions
Patients with preoperative albuminuria (ACR ≥30 mg/g) more frequently developed AKI and 1-month WRF after TAVR. Albuminuria was independently associated with 1-month WRF, suggesting albuminuria to be a universal predictor of deterioration of renal function at various time points.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Tobe
- Nagoya University Hospital, Cardiology , Aichi , Japan
| | - A Tanaka
- Nagoya University Hospital, Cardiology , Aichi , Japan
| | - Y Tokuda
- Nagoya University Hospital, Cardiac Surgery , Aichi , Japan
| | - Y Shirai
- Nagoya University Hospital, Cardiology , Aichi , Japan
| | - T Yamamoto
- Nagoya University Hospital, Cardiac Surgery , Aichi , Japan
| | - M Tokoro
- Nagoya University Hospital, Cardiac Surgery , Aichi , Japan
| | - K Furusawa
- Nagoya University Hospital, Cardiology , Aichi , Japan
| | - H Ishii
- Gunma University Graduate School of Medicine, Cardiology , Maebashi , Japan
| | - A Usui
- Nagoya University Hospital, Cardiac Surgery , Aichi , Japan
| | - T Murohara
- Nagoya University Hospital, Cardiology , Aichi , Japan
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Bansal S, Tokuda Y, Peasley J, Subramanian S. Electrically Induced Liquid Metal Droplet Bouncing. Langmuir 2022; 38:6996-7004. [PMID: 35617048 PMCID: PMC9178922 DOI: 10.1021/acs.langmuir.2c00577] [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] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/10/2022] [Indexed: 06/15/2023]
Abstract
Liquid metals, including eutectic gallium-indium (EGaIn), have been explored for various planar droplet operations, including droplet splitting and merging, promoting their use in emerging areas such as flexible electronics and soft robotics. However, three-dimensional (3D) droplet operations, including droplet bouncing, have mostly been limited to nonmetallic liquids or aqueous solutions. This is the first study of liquid metal droplet bouncing using continuous AC electrowetting through an analytical model, computational fluid dynamics simulation, and empirical validation to the best of our knowledge. We achieved liquid metal droplet bouncing with a height greater than 5 mm with an actuation voltage of less than 10 V and a frequency of less than 5 Hz. We compared the bouncing trajectories of the liquid metal droplet for different actuation parameters. We found that the jumping height of the droplet increases as the frequency of the applied AC voltage decreases and its amplitude increases until the onset of instability. Furthermore, we model the attenuation dynamics of consecutive bouncing cycles of the underdamped droplet bouncing system. This study embarks on controlling liquid metal droplet bouncing electrically, thereby opening a plethora of new opportunities utilizing 3D liquid metal droplet operations for numerous applications such as energy harvesting, heat transfer, and radio frequency (RF) switching.
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Affiliation(s)
| | - Yutaka Tokuda
- City
University of Hong Kong, Kowloon 518057, Hong Kong, China
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Tsuda H, Kurosumi M, Akiyama F, Ohno S, Saji S, Masuda N, Shimomura A, Sato N, Takao S, Ohsumi S, Tokuda Y, Inaji H, Watanabe T. Correction to: Validation of a nuclear grading system for resected stage I-IIIA, high-risk, node-negative invasive breast carcinoma in the N·SAS-BC 01 trial. Breast Cancer 2022; 29:730. [PMID: 35499664 PMCID: PMC9225968 DOI: 10.1007/s12282-022-01367-9] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - Futoshi Akiyama
- Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinji Ohno
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | - Norikazu Masuda
- Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | | | | | | | - Yutaka Tokuda
- Tokai University School of Medicine, Kanagawa, Japan
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Tsuda H, Kurosumi M, Akiyama F, Ohno S, Saji S, Masuda N, Shimomura A, Sato N, Takao S, Ohsumi S, Tokuda Y, Inaji H, Watanabe T. Validation of a nuclear grading system for resected stage I-IIIA, high-risk, node-negative invasive breast carcinoma in the N·SAS-BC 01 trial. Breast Cancer 2022; 29:720-729. [PMID: 35435571 PMCID: PMC9225977 DOI: 10.1007/s12282-022-01350-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND This retrospective observational study validated nuclear grading criteria developed to identify a high-risk group with recurrence rate ≥20-30% and local pathology diagnosis used in a previous multi-institutional randomized N·SAS-BC 01 trial, where the efficacy of adjuvant chemotherapy regimens was evaluated in 733 high-risk node-negative invasive breast cancer patients. METHODS Of 545 patients with long-term follow-up data (median 12.1 years), pathology slides, and local pathology diagnosis, 530 eligible patients were subjected to central pathology review (CPR) for histological type and nuclear grade (NG). Concordance in NGs was compared with local diagnosis. The 10/15-year recurrence-free survival (RFS) and overall survival (OS) rates stratified by NG and histological type were calculated. RESULTS Local diagnoses were invasive ductal carcinoma (IDC)-NG2, IDC-NG3, invasive lobular carcinoma (ILC), and metaplastic carcinoma (MC) in 158/327/38/7 patients, respectively. The 10/15-year RFS rates were 87.2/82.6% for IDC-NG2 and 81.8/75.0% for IDC-NG3 (p = 0.061), and OS rates were 95.0/92.8% for IDC-NG2 and 90.8/85.7% for IDC-NG3 (p = 0.042). CPR graded 485 locally diagnosed IDCs as IDC-NG1/NG2/NG3/unknown in 98/116/267/4 patients, respectively. No significant difference was found among survival curves for the three NG groups. Although the agreement level between local and CPR diagnoses was low (κ = 0.311), both diagnoses identified a patient group with a 15-year recurrence rate ≥ 20%. The 10/15-year RFS rates were 79.4/63.5% for ILC and 68.6%/unknown for MC. CONCLUSIONS The N·SAS grading system identified a patient group with high-risk node-negative invasive breast cancer, suggesting that local diagnosis was performed efficiently in the N·SAS-BC 01 trial. TRIAL REGISTRATION NUMBER UMIN000022571. Date of registration: June 1, 2016.
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Affiliation(s)
| | | | - Futoshi Akiyama
- Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinji Ohno
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | - Norikazu Masuda
- National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | | | | | | | - Yutaka Tokuda
- Tokai University School of Medicine, Kanagawa, Japan
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Mutsuga M, Okumura T, Morimoto R, Kondo T, Ito H, Uchida W, Terazawa S, Tokuda Y, Narita Y, Murohara T, Usui A. Impact of an Improved Standardized Strategy and Individually Tailored Protocol for Heartmate II and Heartmate 3 Left Ventricular Assist Devices on the Incidence of Driveline Infections. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1236] [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: 12/01/2022] Open
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Mori H, Tokuda Y. De-Training Effects Following Leucine-Enriched Whey Protein Supplementation and Resistance Training in Older Adults with Sarcopenia: A Randomized Controlled Trial with 24 Weeks of Follow-Up. J Nutr Health Aging 2022; 26:994-1002. [PMID: 36437767 DOI: 10.1007/s12603-022-1853-1] [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: 10/24/2022]
Abstract
OBJECTIVES This study aimed to evaluate the effectiveness of de-training after a combined intervention of leucine-enriched whey protein supplementation and resistance training on skeletal muscle mass and strength in older adults with sarcopenia. DESIGN A randomized controlled trial. SETTING A community in Hyogo, Japan. PARTICIPANTS The study included older adults aged ≥ 65 years who were screened for sarcopenia at the Care Center from, a community in Hyogo, Japan. The participants were randomly allocated to one of three groups: whey protein supplementation after resistance training (RT + PRO; n = 27), resistance training only (RT; n = 27), and whey protein supplementation only (PRO; n = 27). INTERVENTIONS An intervention program was conducted over a period of 24 weeks. The program included RT and/or PRO supplementation twice a week for 24 weeks, followed by a de-training period for another 24 weeks. PRO supplementation included 11.0 g of protein and 2,300 mg of leucine. The total energy and protein intake amounts for the participants in all groups were controlled to achieve at least 30 kcal/kg ideal body weight (IBW)/day and 1.2 g/kg IBW/day, respectively, during the intervention and de-training periods. MEASUREMENTS The primary outcomes, such as mean change of appendicular skeletal muscle mass index (ΔASMI), and secondary outcomes, such as handgrip strength (ΔHGS), were measured at baseline, the end of intervention, and at 12 and 24 weeks of de-training. RESULTS Compared to baseline, ASMI and HGS increased significantly at the end of the intervention period in the RT+PRO group (ASMI and HGS, p < 0.01); however, there were no significant differences in ΔASMI and ΔHGS between each group. At 24 weeks of the de-training period, ΔASMI and ΔHGS were higher in the RT + PRO group than in the RT group (p < 0.05 and p < 0.01, respectively). CONCLUSION We demonstrated that combined intervention of RT and PRO showed long-term maintenance in treating sarcopenia than RT only at 24 weeks after de-training. Therefore, PRO intake after RT may be useful in the treatment of sarcopenia in older adults.
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Affiliation(s)
- H Mori
- Hiroyasu Mori, Institute of Advanced Medical Sciences, Tokushima University, Kuramoto-Cho 3-18-15, Tokushima-City, Tokushima-Prefecture, 770-8503, Japan, Tel: +81-88-633-7587; Fax: +81-88-633-7589, E-mail:
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Tobe A, Tanaka A, Tokuda Y, Akita S, Fujii T, Miki Y, Furusawa K, Ishii H, Usui A, Murohara T. Incidental findings on computed tomography for preoperative assessment before transcatheter aortic valve implantation in japanese patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Extra-cardiovascular incidental findings (IFs) on preoperative computed tomography (CT) are frequently observed in transcatheter aortic valve implantation (TAVI) candidates. However, the backgrounds of TAVI candidates and comorbidities differ based on the race and/or country, and data on IFs in a specific population are not always applicable to another.
Objective
To assess the prevalence, type, and clinical impact of IFs in Japanese TAVI candidates.
Methods
This was a retrospective, single-center, observational study. CT reports of 257 TAVI candidates were reviewed, and IFs were classified as (a) insignificant: findings that did not require further investigation, treatment, or follow-up; (b) intermediate: findings that needed to be followed up or were considered for further investigation but did not affect the planning of TAVI; and (c) significant: findings that required further investigation immediately or affected the planning of TAVI.
Results
At least one IF was found in 254 patients (98.8%). Insignificant, intermediate, and significant IFs were found in 253 (98.4%), 153 (59.5%), and 34 (13.2%) patients, respectively. Newly indicated significant IFs were found in 19 patients (7.4%). In 2 patients (0.8%), TAVI was canceled because of significant IFs. In patients who consequently underwent TAVI, the presence of significant IFs was not associated with the duration from CT performance to TAVI [28 (19–40) days vs. 27 (19–43) days, p=0.74] and all-cause mortality during the median follow-up period of 413 (223–805) days (p=0.44).
Conclusion
Almost all Japanese TAVI candidates had at least one IF, and the prevalence of significant IFs was not negligible. Although the presence of significant IFs was not associated with mid-term mortality, appropriate management of IFs was considered important.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Tobe
- Nagoya University Hospital, Cardiology, Aichi, Japan
| | - A Tanaka
- Nagoya University Hospital, Cardiology, Aichi, Japan
| | - Y Tokuda
- Nagoya University Hospital, Cardiac Surgery, Aichi, Japan
| | - S Akita
- Nagoya University Hospital, Cardiac Surgery, Aichi, Japan
| | - T Fujii
- Nagoya University Hospital, Cardiac Surgery, Aichi, Japan
| | - Y Miki
- Nagoya University Hospital, Cardiology, Aichi, Japan
| | - K Furusawa
- Nagoya University Hospital, Cardiology, Aichi, Japan
| | - H Ishii
- Fujita Health University Bantane Hospital, Cardiology, Aichi, Japan
| | - A Usui
- Nagoya University Hospital, Cardiac Surgery, Aichi, Japan
| | - T Murohara
- Nagoya University Hospital, Cardiology, Aichi, Japan
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Tobe A, Tanaka A, Tokuda Y, Akita S, Fujii T, Miki Y, Furusawa K, Ishii H, Usui A, Murohara T. Regression of electrocardiographic left ventricular hypertrophy after transcatheter aortic valve replacement for aortic stenosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The changes in electrocardiographic left ventricular hypertrophy (ECG-LVH) after transcatheter aortic valve replacement (TAVR) are not fully elucidated.
Methods
This retrospective single-center study investigated 156 patients who underwent TAVR for severe aortic stenosis. Twelve-leads ECGs obtained before and at 2 days and 1, 6 and 12 months after TAVR were analyzed. Patients with an implanted pacemaker, with a bundle branch block before or after TAVR or whose electrocardiogram at any measuring point was not available were excluded. As an assessment of ECG-LVH, Sokolow-Lyon voltage, Cornell voltage, Cornell product and Peguero–Lo Presti voltage were evaluated.
Results
Finally, 64 patients were included. Sokolow-Lyon voltage, Cornell voltage, Cornell product and Peguero–Lo Presti voltage significantly decreased between 1 and 6 months after TAVR compared to baseline. The prevalence of ECG-LVH criteria for each parameter decreased as well. QRS duration significantly decreased at 6 months after TAVR and the number of patients with strain pattern decreased significantly at 1 month when compared to baseline. When the patients were divided into two groups, those with and without ECG-LVH at baseline, ECG-LVH parameter values decreased significantly, especially in patients with ECG-LVH at baseline.
Conclusion
Regression of ECG-LVH after TAVR was demonstrated as per various criteria of ECG-LVH. The voltages and prevalence of ECG-LVH decreased significantly between 1 and 6 months after TAVR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Tobe
- Nagoya University Hospital, Cardiology, Aichi, Japan
| | - A Tanaka
- Nagoya University Hospital, Cardiology, Aichi, Japan
| | - Y Tokuda
- Nagoya University Hospital, Cardiac Surgery, Aichi, Japan
| | - S Akita
- Nagoya University Hospital, Cardiac Surgery, Aichi, Japan
| | - T Fujii
- Nagoya University Hospital, Cardiac Surgery, Aichi, Japan
| | - Y Miki
- Nagoya University Hospital, Cardiology, Aichi, Japan
| | - K Furusawa
- Nagoya University Hospital, Cardiology, Aichi, Japan
| | - H Ishii
- Fujita Health University Bantane Hospital, Cardiology, Aichi, Japan
| | - A Usui
- Nagoya University Hospital, Cardiac Surgery, Aichi, Japan
| | - T Murohara
- Nagoya University Hospital, Cardiology, Aichi, Japan
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Ohno S, Saji S, Masuda N, Tsuda H, Akiyama F, Kurosumi M, Shimomura A, Sato N, Takao S, Ohsumi S, Tokuda Y, Inaji H, Watanabe T, Ohashi Y. Relationships between pathological factors and long-term outcomes in patients enrolled in two prospective randomized controlled trials comparing the efficacy of oral tegafur-uracil with CMF (N·SAS-BC 01 trial and CUBC trial). Breast Cancer Res Treat 2020; 186:135-147. [PMID: 33259001 PMCID: PMC7940338 DOI: 10.1007/s10549-020-06018-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/12/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE To evaluate the efficacies of cyclophosphamide, methotrexate, and fluorouracil (CMF) and tegafur-uracil (UFT) as adjuvant therapy in patients with resected stage I-IIIA breast cancer by immunohistochemistry (IHC)-based subtype and to determine the relationships between clinicopathological factors and long-term outcomes. METHODS A pooled analysis of the randomized controlled N·SAS-BC 01 and CUBC studies was conducted. Expression of hormone receptors (HRs; estrogen and progesterone receptors), human epidermal growth factor receptor 2 (HER2), and Ki67were assessed by IHC. Tumor-infiltrating lymphocytes (TILs) and nuclear/histological grades were determined by hematoxylin and eosin staining. Relapse-free survival (RFS) and overall survival (OS) were estimated by Kaplan-Meier analysis and hazard ratios were determined by Cox model adjusted for baseline tumor size and nodal status. RESULTS A total of 689 patients (342 CMF and 347 UFT) were included in the analyses with a median follow-up of 11.1 years. There was no significant difference in RFS or OS between the two cohorts (RFS: 0.96 [95% confidence interval: 0.71-1.30], log-rank test p = 0.80; OS: 0.93 [0.64-1.35], p = 0.70). There was no difference in RFS or OS between the two cohorts for HR+/HER2- and HR+/HER2+ subtypes. RFS was significantly longer in patients treated with UFT compared with CMF in patients with HR-/HER2+ subtype (0.30 [0.10-0.88], p = 0.03). A high TILs level was associated with a better OS compared with low TILs level (p = 0.02). CONCLUSIONS This long-term follow-up study showed that RFS and OS were similar in patients with luminal-type breast cancer treated with CMF and UFT.
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Affiliation(s)
- Shinji Ohno
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
| | | | - Norikazu Masuda
- National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | - Futoshi Akiyama
- Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | | | | | | | | | - Yutaka Tokuda
- Tokai University School of Medicine, Kanagawa, Japan
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Narui K, Ishikawa T, Oba MS, Hasegawa Y, Kaise H, Kawate T, Yamada A, Yamada K, Suzuki Y, Niikura N, Kohno N, Kimoto T, Sugae S, Kosaka Y, Miyashita M, Okamura T, Shimizu D, Tanino H, Tanabe M, Morita S, Endo I, Tokuda Y. Prediction of pathological complete response after neoadjuvant chemotherapy in breast cancer by combining magnetic resonance imaging and core needle biopsy. Surg Oncol 2020; 35:447-452. [PMID: 33045629 DOI: 10.1016/j.suronc.2020.10.002] [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: 06/19/2020] [Revised: 09/22/2020] [Accepted: 10/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Pathological complete response (pCR) is often achieved by neoadjuvant chemotherapy (NAC), particularly in hormone receptor-negative breast cancer. Contrast-enhanced magnetic resonance imaging (cMRI) is the most reliable imaging modality to evaluate the pathological effect of NAC. Ultrasonography is indispensable to collect representative specimens from the target lesion by core needle biopsy (CNB). This study aimed to evaluate the accuracy of predicting pCR by adding CNB after NAC, in cases with complete clinical response (cCR) diagnosed by cMRI. METHODS In this prospective multicentre study, we evaluated patients diagnosed with cCR by cMRI after NAC. Ultrasound-guided CNB (uCNB) using a 14G needle was performed without clip markers under general anaesthesia as planned surgery. Specimens collected by uCNB were compared to those resected surgically and were categorized as (i) no carcinoma (ypT0), (ii) no invasive carcinoma and only residual carcinoma in situ (ypTis) and (iii) residual invasive carcinoma. The concordance of pathological results between the uCNB and surgical specimens was evaluated. RESULTS Of the 83 patients evaluated, 41 (49.4%) and 17 (20.5%) of them had ypT0 and ypTis, respectively. The false negative rates (FNR), sensitivity and specificity for predicting ypT0 by uCNB were 50.0%, 50.0%, 100%, respectively, and those for predicting ypT0+ypTis were 28.0%, 72.0% and 98.3%, respectively. The concordance rates were 74.7% (62/83) for ypT0 and 90.4% (75/83) for ypT0+ypTis. CONCLUSION In cCR cases diagnosed by cMRI, uCNB was not accurate enough to predict pCR. Additional modalities like clip placements and/or thicker core needles may be required for better prediction.
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Affiliation(s)
- Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Takashi Ishikawa
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan.
| | - Mari S Oba
- Department of Medical Statistics, Toho University, Tokyo, Japan
| | - Yoshie Hasegawa
- Department of Breast Surgery, Hirosaki Municipal Hospital, Hirosaki, Japan
| | - Hiroshi Kaise
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takahiko Kawate
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Akimitsu Yamada
- Department of Gastroenterological Surgery, Yokohama City University, Yokohama, Japan
| | - Kimito Yamada
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Yasuhiro Suzuki
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Naoki Niikura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Norio Kohno
- Department of Breast Surgery, Kobe Kaisei Hospital, Kobe, Japan
| | - Takeo Kimoto
- Department of Breast Surgery, Kobe Kaisei Hospital, Kobe, Japan
| | - Sadatoshi Sugae
- Department of Gastroenterological Surgery, Yokohama City University, Yokohama, Japan
| | - Yoshimasa Kosaka
- Department of Breast and Endocrine Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | | | - Takuho Okamura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Daisuke Shimizu
- Department of Breast Surgery, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Hirokazu Tanino
- Department of Breast and Endocrine Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Mikiko Tanabe
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University, Yokohama, Japan
| | - Yutaka Tokuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan
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Tokuda Y, Okamura T, Maruta M, Orita M, Noguchi M, Suzuki T, Matsuki H. Prospective randomized study evaluating the usefulness of a surgical smoke evacuation system in operating rooms for breast surgery. J Occup Med Toxicol 2020; 15:13. [PMID: 32508970 PMCID: PMC7249301 DOI: 10.1186/s12995-020-00259-y] [Citation(s) in RCA: 8] [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: 01/02/2020] [Accepted: 04/13/2020] [Indexed: 11/13/2022] Open
Abstract
Background No prospective evaluation of surgical smoke evacuation systems has yet been conducted anywhere in the world. A prospective randomized study was conducted to clarify the usefulness of a surgical smoke evacuation system in terms of reducing the quantity of environmental pollutants found in operating room air and reducing the occupational exposure of doctors and nurses involved in surgical procedures to surgical smoke, volatile organic compounds, formaldehyde, etc. Methods Operating room environment conditions with and without the use of a surgical smoke evacuation system were measured, and the personal exposure levels of doctors and nurses involved in surgical procedures were also surveyed. Use of the evacuation system was determined randomly, and the procedures involved were breast-conserving surgery and mastectomy, which were treated as stratification factors. Results The average total volatile organic compound concentration in the operating room was significantly lower when the evacuation system was used compared with when it was not used. The findings were similar for formaldehyde concentration. Multiple regression analysis for healthcare professionals’ personal exposure levels showed that the evacuation system was a factor that significantly impacted their formaldehyde and acetaldehyde personal exposure levels, which were greatly reduced by the use of the system. Conclusion This study’s findings demonstrate the effectiveness of the evacuation systems, which should increase awareness that their benefits take priority over the drawbacks. Trial registration The study was conducted after explaining to participants that it was a study of operating room environments in which their participation was voluntary and obtaining their consent. The study was also approved by the Tokai University Hospital clinical research review committee (no. 5R-022) and registered with the UMIN registry (UMIN000029092) on 13, September, 2017- retrospectively registered.
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Affiliation(s)
- Yutaka Tokuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan.,Breast Center, Seirei Yokohama Hospital, Yokohama, Japan
| | - Takuho Okamura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Miki Maruta
- Tokai University Hospital Department of Nursing, Isehara, Japan
| | - Mutsuko Orita
- Tokai University Hospital Department of Nursing, Isehara, Japan
| | - Miyuki Noguchi
- Department of Materials and Life Sciences, Seikei University, Musashino, Japan
| | - Toshiyasu Suzuki
- Department of Anesthesiology, Tokai University School of Medicine, Isehara, Japan
| | - Hideaki Matsuki
- Department of Nursing, Tokai University School of Medicine, Isehara, Japan
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Saji S, Ohno S, Masuda N, Tsuda H, Akiyama F, Kurosumi M, Shimomura A, Sato N, Takao S, Ohsumi S, Tokuda Y, Inaji H, Watanabe T, Ohashi Y. Abstract P2-14-17: Pooled analysis of long-term outcome of patients enrolled in two trials comparing the efficacy of oral tegafur-uracil with CMF (N-SAS-BC01 and CUBC trials). Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p2-14-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Two randomized controlled trials comparing the efficacy of oral tegafur-uracil (UFT) (2 years) with that of classical cyclophosphamide, methotrexate, and fluorouracil (CMF) (6 courses) were conducted in patients with resected early breast cancer (N-SAS-BC01 trial [Watanabe et al, J Clin Oncol 2009] and CUBC trial [Park et al, Br J Cancer 2009]). Pooled analysis of these two randomized controlled trials using individual patient data has been published (Ohashi et al, Breast Cancer Res Treat 2010) and long-term follow-up data has also been reported (Yonemori et al, SABCS 2018). However, because the pathological factors evaluated in those studies are insufficient and based on old criteria, a re-evaluation using the current standard pathological factors is requited to use the data in the clinical practice.
Methods: Paraffin-embedded sections of surgically excised tumor tissue were available for patients with resected stage I-IIIA breast cancer. The expression of estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2) and the Ki67 labeling index were assessed by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), and the grades of TILs were evaluated by hematoxylin and eosin (H&E) staining by pathology central review. The relationship of these pathological factors to relapse free survival (RFS) and overall survival (OS) was evaluated using long-term follow-up data. Hazard ratios were determined using the Cox model adjusted for clinical characteristics, namely tumor size and nodal status. Survival curves were estimated by the Kaplan-Meier method. This study is registered with the University Hospital Medical Information Network (UMIN), Japan (UMIN000022571).
Results: Paraffin-embedded sections were available from 689 of the total of 1,057 (65.2%) patients (CMF, n=342; UFT n=347). The median follow-up time was 11.1 years (12.1 years in the N-SAS-BC 01 trial and 8.3 years in the CUBC trial). Baseline characteristics were similar in each group. The 10-year RFS and OS was 79.9%, 87.7% in the CMF arm, and 77.1%, 88.8% in the UFT arm, respectively. The hazard ratio (UFT vs. CMF) was 0.962 (95% CI 0.712-1.300) for RFS and 0.929 (95% CI 0.639-1.350) for OS. Table 1 shows the 10-year RFS and OS in each IHC-defined breast cancer subtype. 10-year OS in UFT arm and in CMF arm were similar in Hormone receptor (HR) + groups. Although this is not expected, there is a positive signal of benefit of UFT in HR-HER2+ group (RFS; hazard ratio 0.296 (95% CI 0.100-0.878)). High TILs were associated with better prognosis in all patient group (vs. low TILs: hazard ratio 0.347 (95% CI 0.140-0.855)), however in HR+ HER2- group, there was no association between TIL status and prognosis (High vs. low: hazard ratio 0.787 (95% CI 0.240-2.581)). TILs status could not predict the benefit of UFT in the subset analysis of all patient group and of each subtype group.
Conclusion: This long-term follow-up study using randomized controlled trials shows that RFS and OS are similar in luminal type patients treated with UFT and CMF.
Funding: Taiho Pharmaceutical CO., LTD.
Table 1. 10-year RFS and OS in each IHC-defined breast cancer subtypeUFT (%)CMF (%)hazard ratio (UFT vs. CMF)10-year RFSHormone receptor (HR)+ HER2-76.7 (n=210)81.2 (n=210)1.034 (95%CI: 0.705-1.517)HR+ HER2+71.4 (n=26)73.7 (n=42)1.237 (0.499-3.069)HR- HER2+81.2 (n=29)68.4 (n=29)0.296 (0.100-0.878)HR- HER2-78.2 (n=73)84.7 (n=59)1.263 (0.596-2.675)10-year OSHR+ HER2-91.0 (n=210)89.5 (n=210)0.907 (0.551-1.491)HR+ HER2+83.9 (n=26)82.6 (n=42)0.993 (0.345-2.856)HR- HER2+90.9 (n=29)78.9 (n=29)0.335 (0.081-1.394)HR- HER2-84.6 (n=73)89.4 (n=59)1.455 (0.628-3.367)
Citation Format: Shigehira Saji, Shinji Ohno, Norikazu Masuda, Hitoshi Tsuda, Futoshi Akiyama, Masafumi Kurosumi, Akihiko Shimomura, Nobuaki Sato, Shintaro Takao, Shozo Ohsumi, Yutaka Tokuda, Hideo Inaji, Toru Watanabe, Yasuo Ohashi. Pooled analysis of long-term outcome of patients enrolled in two trials comparing the efficacy of oral tegafur-uracil with CMF (N-SAS-BC01 and CUBC trials) [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-14-17.
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Affiliation(s)
| | - Shinji Ohno
- 2Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Norikazu Masuda
- 3National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | - Futoshi Akiyama
- 2Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | | | | | | | - Shozo Ohsumi
- 9National Hospital Organization Shikoku Cancer Center, Ehima, Japan
| | - Yutaka Tokuda
- 10Tokai University School of Medicine, Kanagawa, Japan
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Miyashita M, Niikura N, Tokuda Y. ASO Author Reflections: Impact of Radiotherapy for Breast Cancer is Changing in the Modern Era. Ann Surg Oncol 2019; 26:780-781. [PMID: 31605336 DOI: 10.1245/s10434-019-07941-4] [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: 09/27/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Minoru Miyashita
- Department of Breast and Endocrine Surgical Oncology, Tohoku University School of Medicine, Sendai, Japan.
| | - Naoki Niikura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yutaka Tokuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan
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Narui K, Ishikawa T, Shimizu D, Yamada A, Tanabe M, Sasaki T, Oba MS, Morita S, Nawata S, Kida K, Mogaki M, Doi T, Tsugawa K, Ogata H, Ota T, Kosaka Y, Sengoku N, Kuranami M, Niikura N, Saito Y, Suzuki Y, Suto A, Arioka H, Chishima T, Ichikawa Y, Endo I, Tokuda Y. Anthracycline could be essential for triple-negative breast cancer: A randomised phase II study by the Kanagawa Breast Oncology Group (KBOG) 1101. Breast 2019; 47:1-9. [DOI: 10.1016/j.breast.2019.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 05/25/2019] [Accepted: 06/10/2019] [Indexed: 01/16/2023] Open
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Miyashita M, Niikura N, Kumamaru H, Miyata H, Iwamoto T, Kawai M, Anan K, Hayashi N, Aogi K, Ishida T, Masuoka H, Iijima K, Masuda S, Tsugawa K, Kinoshita T, Tsuda H, Nakamura S, Tokuda Y. Role of Postmastectomy Radiotherapy After Neoadjuvant Chemotherapy in Breast Cancer Patients: A Study from the Japanese Breast Cancer Registry. Ann Surg Oncol 2019; 26:2475-2485. [DOI: 10.1245/s10434-019-07453-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Indexed: 11/18/2022]
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Yonemori K, Ohsumi S, Takao S, Tokuda Y, Ito Y, Nakagami K, Takahashi M, Yoshidome K, Nakayama T, Yamaguchi Y, Ohashi Y, Inaji H, Watanabe T. Abstract P1-13-09: Long-term follow-up of two randomized controlled trials (N-SAS-BC01 trial and CUBC trial) comparing oral tegafur-uracil (UFT) versus classical cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) as adjuvant therapy in early breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-13-09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Two randomized controlled trials comparing the efficacy of oral tegafur-uracil (UFT) (2 years) with that of classical cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) (6 courses) were conducted in patients with resected early breast cancer. UFT is an oral fluoropyrimidine that combines tegafur, a prodrug of 5-fluorouracil, with uracil in a 1:4 molar ratio. One study was the N-SAS-BC01 trial (Watanabe et al, J Clin Oncol 2009), which was conducted in patients with high-risk node-negative breast cancer (n=733). The other was the CUBC trial (Park et al, Br J Cancer 2009), which was performed in patients with node-positive breast cancer (n=377). We reported the pooled analysis of these two randomized control trials using individual patient data (Ohashi et al, Breast Cancer Res Treat 2010). This pooled analysis showed that UFT was non-inferior to CMF in terms of inhibiting recurrence of estrogen receptor (ER)-positive early breast cancer. In addition, an exploratory subgroup analysis showed that UFT may be more effective in ER-positive patients who were 50 years or older. The present study was conducted to investigate the long-term efficacy of UFT or CMF in patients with early breast cancer.
Methods: Long-term follow-up data for disease recurrence and survival were collected. Hazard ratios (HR) were determined using the Cox model stratified by study and adjusted for clinical characteristics, namely age, tumor size, nodal status, histological type, ER, and progesterone receptor (PgR). Survival curves were estimated by the Kaplan-Meier method. Hochberg multiplicity adjustment was applied in the previous pooled analysis, and non-inferiority of UFT versus CMF was shown in terms of relapse-free survival (RFS) in the ER-positive patient group. We investigated the non-inferiority of UFT in the same patient group with updated data. Restricted mean survival time (RMST) was calculated to consider the relative efficacy of UFT. This study is registered with JapicCTI-163321.
Results: In total, 1,057 patients were analyzed (CMF, n=528; UFT n=529). The median follow-up time was 11.1 years (12.1 years in the N-SAS-BC 01 trial and 8.3 years in the CUBC trial). Table 1 shows the 10-year RFS and overall survival (OS) in all patients and ER-positive patients. The difference in RMST between arms at 20 years in terms of RFS was -2.7 months in all patients and 3.4 months in ER-positive patients. Table 2 shows the HR for RFS according to ER status and age.
UFT (%)CMF (%)UFT to CMF; HR (95% CI)10-year RFSall patients74.477.11.02 (0.81–1.30)ER-positive patients75.075.10.91 (0.66–1.27)10-year OSall patients86.886.90.98 (0.72–1.34)ER-positive patients89.987.90.86 (0.54–1.37)
Age <50 yearsAge ≥50 yearsER negative1.76 (0.95–3.26)0.93 (0.58–1.51)ER positive1.29 (0.74–2.23)0.76 (0.50–1.16)
Conclusion: This study shows that UFT was shown to be non-inferior to CMF in terms of RFS in ER-positive early breast cancer. This result is similar to that of the previous pooled analysis.
Sponsor: Taiho Pharmaceutical Co., LTD
Citation Format: Yonemori K, Ohsumi S, Takao S, Tokuda Y, Ito Y, Nakagami K, Takahashi M, Yoshidome K, Nakayama T, Yamaguchi Y, Ohashi Y, Inaji H, Watanabe T. Long-term follow-up of two randomized controlled trials (N-SAS-BC01 trial and CUBC trial) comparing oral tegafur-uracil (UFT) versus classical cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) as adjuvant therapy in early breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-13-09.
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Affiliation(s)
- K Yonemori
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - S Ohsumi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - S Takao
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Tokuda
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Ito
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - K Nakagami
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - M Takahashi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - K Yoshidome
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - T Nakayama
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Yamaguchi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Ohashi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - H Inaji
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - T Watanabe
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
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19
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Fujiwara Y, Mukai H, Saeki T, Ro J, Lin YC, Nagai SE, Lee KS, Watanabe J, Ohtani S, Kim SB, Kuroi K, Tsugawa K, Tokuda Y, Iwata H, Park YH, Yang Y, Nambu Y. A multi-national, randomised, open-label, parallel, phase III non-inferiority study comparing NK105 and paclitaxel in metastatic or recurrent breast cancer patients. Br J Cancer 2019; 120:475-480. [PMID: 30745582 PMCID: PMC6461876 DOI: 10.1038/s41416-019-0391-z] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [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: 08/10/2018] [Revised: 01/09/2019] [Accepted: 01/17/2019] [Indexed: 12/02/2022] Open
Abstract
Background NK105 is a novel nanoparticle drug delivery formulation that encapsulates paclitaxel (PTX) in polymeric micelles. We conducted an open-label phase III non-inferiority trial to compare the efficacy and safety of NK105 and PTX in metastatic or recurrent breast cancer. Methods Patients were randomly assigned in a 1:1 ratio to receive either NK105 (65 mg/m2) or PTX (80 mg/m2) on days 1, 8 and 15 of a 28-day cycle. The primary endpoint was progression-free survival (PFS), with a non-inferiority margin of 1.215. Results A total of 436 patients were randomised and 211 patients in each group were included in the efficacy analysis. The median PFS was 8.4 and 8.5 months for NK105 and PTX, respectively (adjusted hazard ratio: 1.255; 95% confidence interval: 0.989–1.592). The median overall survival and overall response rates were 31.2 vs. 36.2 months and 31.6% vs. 39.0%, respectively. The two groups exhibited similar safety profiles. The incidence of peripheral sensory neuropathy (PSN) was 1.4% vs. 7.5% (≥Grade 3) for NK105 and PTX, respectively. The patient-reported outcomes of PSN were significantly favourable for NK105 (P < 0.0001). Conclusions The primary endpoint was not met, but NK105 had a better PSN toxicity profile than PTX. Clinical trial registration ClinicalTrials.gov: NCT01644890
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Affiliation(s)
- Yasuhiro Fujiwara
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hirofumi Mukai
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, Chiba, Japan.
| | - Toshiaki Saeki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Jungsil Ro
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Yung-Chang Lin
- Division of Haematology and Oncology, Chang-Gung Memorial Hospital, Linko, Taoyuan, Taiwan
| | | | - Keun Seok Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | | | - Shoichiro Ohtani
- Department of Breast Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Sung Bae Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Katsumasa Kuroi
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Koichiro Tsugawa
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yutaka Tokuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yeon Hee Park
- Division of Hematology-Oncology, Samsung Medical Center, Seoul, Korea
| | - Youngsen Yang
- Division of Hematology-Oncology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Yoshihiro Nambu
- Pharmaceuticals Group, Nippon Kayaku Co., Ltd., Tokyo, Japan
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20
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Osaki A, Inoue K, Sakai H, Yamada K, Minato K, Ohyanagi F, Tokuda Y, Ikeda N, Kagamu H, Kubota K, Tamura T, Saeki T. A dose-finding randomized Phase II study of oral netupitant in combination with palonosetron .75 mg intravenous for the prevention of chemotherapy-induced nausea and vomiting in Japanese patients receiving highly emetogenic chemotherapy. Jpn J Clin Oncol 2019; 49:121-129. [PMID: 30576544 DOI: 10.1093/jjco/hyy161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 11/27/2018] [Indexed: 11/14/2022] Open
Abstract
Objective Netupitant is a novel, selective neurokinin-1 receptor antagonist used for prevention of chemotherapy-induced nausea and vomiting, a distressing side effect of chemotherapy. This double-blind, randomized, Phase II study investigated the dose-response of oral netupitant in Japanese patients receiving highly emetogenic chemotherapy. Methods Chemotherapy-naïve patients were randomized (1:1:1) to a single oral netupitant 30-, 100- or 300-mg dose before chemotherapy initiation. Patients received concomitant palonosetron (0.75 mg intravenously [i.v.] Day 1) and dexamethasone (9.9 mg i.v. Day 1, 8 mg orally Days 2-4). Results Overall, 402 patients (30 mg: 134; 100 mg: 135; 300 mg: 133) were treated and evaluable for efficacy and safety. The primary endpoint of overall (0-120 h after chemotherapy administration) complete response (CR) rate (no emesis, no rescue medication) was 64.2%, 60.0% and 54.9% in the 30-, 100- and 300-mg arms, respectively, without statistical significance for dose-response. The safety profile of netupitant was comparable in the three arms. The plasma concentrations of netupitant and its metabolites increased with the dose increase from 30 mg to 300 mg. Conclusions No dose-response relationship of netupitant in terms of overall CR rate was observed in this study. Netupitant was well tolerated at all doses without clinically harmful safety signals observed. Clinical trial registration JapicCTI-142 483.
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Affiliation(s)
- Akihiko Osaki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Saitama
| | - Kenichi Inoue
- Division of Breast Oncology, Saitama Cancer Center, Saitama
| | - Hiroshi Sakai
- Department of Thoracic Oncology, Saitama Cancer Center, Saitama
| | - Kazuhiko Yamada
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka
| | - Koichi Minato
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Gunma
| | - Fumiyoshi Ohyanagi
- Department of Thoracic Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo.,Division of Pulmonary Medicine, Clinical Department of Internal Medicine, Jichi Medical University Saitama Medical Center, Saitama
| | - Yutaka Tokuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa
| | | | - Hiroshi Kagamu
- Department of Respiratory Medicine and Infectious Disease, Niigata University Medical and Dental Hospital, Niigata.,Department of Respiratory Medicine, Saitama Medical University International Medical Center, Saitama
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo
| | - Tomohide Tamura
- Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Toshiaki Saeki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Saitama
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21
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Tsuda B, Miyamoto A, Mizuno M, Yokoyama K, Oshitanai R, Terao M, Morioka T, Niikura N, Okamura T, Saito Y, Suzuki Y, Kametani Y, Tokuda Y. A detailed evaluation method of CD4 + T cell subsets. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy375.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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22
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Omote K, Nagai T, Asakawa N, Komoriyama H, Kato Y, Aikawa T, Tokuda Y, Kamiya K, Nishida M, Kudo Y, Fukushima A, Iwano H, Yokota T, Anzai T. P2812Long-term prognostic significance of liver stiffness non-invasively measured by the virtual touch quantification in patients with acute decompensated heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2812] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Omote
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Nagai
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - N Asakawa
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - H Komoriyama
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Y Kato
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Aikawa
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Y Tokuda
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - K Kamiya
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - M Nishida
- Hokkaido University, Diagnostic Center for Sonography and Division of Laboratory and Transfusion Medicine, Hokkaido Unive, Sapporo, Japan
| | - Y Kudo
- Hokkaido University, Diagnostic Center for Sonography and Division of Laboratory and Transfusion Medicine, Hokkaido Unive, Sapporo, Japan
| | - A Fukushima
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - H Iwano
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Yokota
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Anzai
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
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23
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Omote K, Nagai T, Asakawa N, Aikawa T, Tokuda Y, Kato Y, Kamiya K, Komoriyama H, Nishida M, Kudo Y, Fukushima A, Iwano H, Yokota T, Anzai T. P3734Clinical value of a non-invasive measurement of increased liver stiffness by using virtual touch quantification for predicting elevated right atrial pressure in heart failure patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3734] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Omote
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Nagai
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - N Asakawa
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Aikawa
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Y Tokuda
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Y Kato
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - K Kamiya
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - H Komoriyama
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - M Nishida
- Hokkaido University, Diagnostic Center for Sonography and Division of Laboratory and Transfusion Medicine, Sapporo, Japan
| | - Y Kudo
- Hokkaido University, Diagnostic Center for Sonography and Division of Laboratory and Transfusion Medicine, Sapporo, Japan
| | - A Fukushima
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - H Iwano
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Yokota
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Anzai
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
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24
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Affiliation(s)
- T Watari
- From the Postgraduate Clinical Training Centre, Shimane University Hospital, Shimane
| | - Y Tokuda
- Okinawa Muribushi Project for Teaching Hospitals, Okinawa, Japan
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25
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Morioka T, Niikura N, Kumaki N, Masuda S, Iwamoto T, Yokoyama K, Ogiya R, Oshitanai R, Terao M, Tsuda B, Okamura T, Saito Y, Suzuki Y, Tokuda Y. Comparison of Ki-67 labeling index measurements using digital image analysis and scoring by pathologists. Breast Cancer 2018; 25:768-777. [PMID: 29959636 DOI: 10.1007/s12282-018-0885-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 06/26/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Routine analysis of Ki-67 is not widely recommended for clinical decision-making because of poor reproducibility. Furthermore, counting numerous cells can be laborious for pathologists. Digital image analysis for immunohistochemical analysis was recently developed; however, the clinical efficacy of the Ki-67 index obtained using image analysis is unknown. METHODS We retrospectively identified female patients with breast cancer with immunohistochemical Ki-67 and survival data using the pathology database at the Tokai University, Japan. Ki-67 expression was scored by three pathologists. Slides were scanned and converted to virtual slides; Ki-67-positive cells were counted using image analysis. Ki-67 indices obtained by the pathologist's scoring and image analysis were evaluated by 2 × 2 analysis. Relationships between Ki-67 index and survival outcomes were evaluated using the Kaplan-Meier method and compared using the log-rank test. RESULTS Based on the 2 × 2 analysis, Ki-67 index obtained using image analysis was moderately correlated with the pathologist's scoring for all patients (κ 0.41; sensitivity, 0.573; specificity, 0.878). Poorer relapse-free survival was associated with high Ki-67 index than with low Ki-67 index for estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and stage I or II patients scored by pathologists (p < 0.001) and obtained using image analysis (p = 0.031). CONCLUSIONS The Ki-67 indices obtained using image analysis were moderately correlated with those scored by pathologists. Digital image analysis can be effective for measuring Ki-67 values, because they are associated with relapse-free survival in estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and patients at stage I or II.
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Affiliation(s)
- Toru Morioka
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Naoki Niikura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan.
| | - Nobue Kumaki
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Shinobu Masuda
- Department of Pathology, Nihon University School of Medicine, Tokyo, Japan
| | - Takayuki Iwamoto
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Kozue Yokoyama
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Rin Ogiya
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Risa Oshitanai
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Mayako Terao
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Banri Tsuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Takuho Okamura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Yuki Saito
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Yasuhiro Suzuki
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Yutaka Tokuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
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26
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Minagi Y, Ono T, Hori K, Fujiwara S, Tokuda Y, Murakami K, Maeda Y, Sakoda S, Yokoe M, Mihara M, Mochizuki H. Cover Image. J Oral Rehabil 2018. [DOI: 10.1111/joor.12640] [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: 11/29/2022]
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27
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Affiliation(s)
- H Nagano
- Division of General Internal Medicine, Department of Medicine, Tokyo Joto Hospital, Japan Community Health Care Organization, 1360071 Tokyo, Japan
| | - K Kamata
- Emerging and Re-Emerging Infectious Diseases Unit, National Institute for Infectious Diseases "Lazzaro Spallanzani," Via Portuense, 292, 00149 Rome, Italy
| | - Y Tokuda
- Muribushi Project for Teaching Hospitals, 9012132 Okinawa, Japan
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28
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Seki T, Miyamoto A, Ohshima S, Ohno Y, Yasuda A, Tokuda Y, Ando K, Kametani Y. Expression of glucocorticoid receptor shows negative correlation with human B-cell engraftment in PBMC-transplanted NOGhIL-4-Tg mice. Biosci Trends 2018; 12:247-256. [PMID: 29806632 DOI: 10.5582/bst.2018.01083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The humanized mouse system is a promising tool for analyzing human immune responses in vivo. Recently, we developed a new humanized mouse system using the severely immunodeficient NOD/Shi-scid-IL2rγnull (NOG)-hIL-4-Tg mouse, which enabled us to evaluate the human humoral immune response after peripheral blood mononuclear cell (PBMC) transplantation. However, the mechanism by which hIL-4 enhances antigen-specific IgG production in these mice is not clear. In this study, we analyzed the relationship between human lymphocyte subsets and the expression level of the glucocorticoid receptor (GR) to clarify the humoral immune condition in human PBMC-transplanted NOG-hIL-4 mice. The results showed that the human GR mRNA level was significantly lower in NOG-hIL-4-Tg splenocytes than in conventional NOG splenocytes after immunization. Whereas no obvious difference of the proportion of T helper-cell subsets was observed between the NOG and NOG-hIL-4-Tg mouse strains, the B-cell proportion and antigen-specific IgG concentration in plasma showed strong negative correlations with the GR mRNA level. These results suggest that the GR expression level was changed in PBMCs in the humanized NOG-hIL-4-Tg mice, which may support B-cell survival and function in the mouse system.
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Affiliation(s)
- Toshiro Seki
- Department of Internal Medicine, Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine
| | - Asuka Miyamoto
- Department of Molecular Life Science, Division of Basic Medical Science, Tokai University School of Medicine.,Department of Breast and Endocrine Surgery, Tokai University School of Medicine
| | - Shino Ohshima
- Department of Molecular Life Science, Division of Basic Medical Science, Tokai University School of Medicine
| | - Yusuke Ohno
- Department of Molecular Life Science, Division of Basic Medical Science, Tokai University School of Medicine
| | - Atsushi Yasuda
- Department of Internal Medicine, Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine
| | - Yutaka Tokuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine
| | - Kiyoshi Ando
- Department of Hematology and Oncology, Tokai University School of Medicine
| | - Yoshie Kametani
- Department of Molecular Life Science, Division of Basic Medical Science, Tokai University School of Medicine.,Institute of Advanced Biosciences, Tokai University
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29
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Ogiya R, Niikura N, Sagara Y, Tokuda Y. Varying prognostic impact of molecular subtype among young patients with de novo stage IV breast cancer: A population-based cohort study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e13090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Rin Ogiya
- Kanagawa Breast Oncology Group, Isehara, Japan
| | | | | | - Yutaka Tokuda
- The Department of Breast and Enodcrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
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30
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Minagi Y, Ono T, Hori K, Fujiwara S, Tokuda Y, Murakami K, Maeda Y, Sakoda S, Yokoe M, Mihara M, Mochizuki H. Relationships between dysphagia and tongue pressure during swallowing in Parkinson's disease patients. J Oral Rehabil 2018; 45:459-466. [DOI: 10.1111/joor.12626] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Y. Minagi
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation; Graduate School of Dentistry; Osaka University; Suita Japan
| | - T. Ono
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation; Graduate School of Dentistry; Osaka University; Suita Japan
- Division of Comprehensive Prosthodontics; Graduated School of Medical and Dental Sciences; Niigata University; Niigata Japan
| | - K. Hori
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation; Graduate School of Dentistry; Osaka University; Suita Japan
- Division of Comprehensive Prosthodontics; Graduated School of Medical and Dental Sciences; Niigata University; Niigata Japan
| | - S. Fujiwara
- Division of Comprehensive Prosthodontics; Graduated School of Medical and Dental Sciences; Niigata University; Niigata Japan
| | - Y. Tokuda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation; Graduate School of Dentistry; Osaka University; Suita Japan
| | - K. Murakami
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation; Graduate School of Dentistry; Osaka University; Suita Japan
| | - Y. Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation; Graduate School of Dentistry; Osaka University; Suita Japan
| | - S. Sakoda
- Department of Neurology; Toneyama National Hospital; Toyonaka Japan
| | - M. Yokoe
- Department of Neurology; Toyonaka City Hospital; Toyonaka Japan
| | - M. Mihara
- Department of Neurology; Osaka University Graduate School of Medicine; Suita Japan
| | - H. Mochizuki
- Department of Neurology; Osaka University Graduate School of Medicine; Suita Japan
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31
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Iwamoto T, Katagiri T, Niikura N, Miyoshi Y, Kochi M, Nogami T, Shien T, Motoki T, Taira N, Omori M, Tokuda Y, Fujiwara T, Doihara H, Gyorffy B, Matsuoka J. Immunohistochemical Ki67 after short-term hormone therapy identifies low-risk breast cancers as reliably as genomic markers. Oncotarget 2018; 8:26122-26128. [PMID: 28412725 PMCID: PMC5432244 DOI: 10.18632/oncotarget.15385] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 01/31/2017] [Indexed: 01/10/2023] Open
Abstract
Background The purpose of this study was to test whether immunohistochemical (IHC) Ki67 levels after short-term preoperative hormone therapy (post-Ki67) predict similar numbers of patients with favorable prognoses as genomic markers. Results Thirty paired cases (60 samples) were enrolled in this study. Post-Ki67 levels were significantly lower than pre-treatment Ki67 levels (P < 0.001). Post-Ki67 predicted more low-risk cases (83.3%, 25/30) than pre-genomic surrogate signature(GSS) (66.7%: 20/30), but the difference in predictive power was not significant (P = 0.233). Proliferation (MKI67, STK15, Survivin, CCNB1, and MYBL2) and estrogen (ER, PGR, BCL2, and SCUBE2) related signatures were significantly downregulated after therapy (P < 0.001 and 0.041, respectively). Materials and Methods Core needle biopsy specimens of primary breast cancer were collected at Okayama University Hospital from hormone receptor-positive and human epidermal growth factor 2-negative patients that subsequently received two weeks of neoadjuvant hormone therapy. Paired post-treatment specimens from surgical samples were also collected. IHC Ki67 levels and GSS were compared between pre- and post-hormone treatment samples. Changes of gene expression pattern in short-term hormone therapy were also assessed. Conclusions IHC based post-Ki67 levels may have distinct predictive power compared with the naïve IHC Ki67. Future studies with larger cohorts and longer follow-up periods may be needed to validate our results.
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Affiliation(s)
- Takayuki Iwamoto
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.,Department of Gastroenterological Surgery, Okayama University Hospital, Okayama, Japan
| | - Toyomasa Katagiri
- Division of Genome Medicine, Institute for Genome Research, Tokushima University, Tokushima, Japan
| | - Naoki Niikura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Yuichiro Miyoshi
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Mariko Kochi
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.,Department of Gastroenterological Surgery, Okayama University Hospital, Okayama, Japan
| | - Tomohiro Nogami
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Takayuki Motoki
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.,Department of Gastroenterological Surgery, Okayama University Hospital, Okayama, Japan
| | - Naruto Taira
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Masako Omori
- Department of Pathology, Okayama University Hospital, Okayama, Japan
| | - Yutaka Tokuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Toshiyoshi Fujiwara
- Department of Gastroenterological Surgery, Okayama University Hospital, Okayama, Japan
| | - Hiroyoshi Doihara
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Balazs Gyorffy
- MTA TTK Lendület Cancer Biomarker Research Group, Budapest, Hungary.,nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Junji Matsuoka
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.,Department of Gastroenterological Surgery, Okayama University Hospital, Okayama, Japan.,Department of Palliative and Supportive Medicine, Okayama University Hospital, Okayama, Japan
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Miyashita M, Niikura N, Kumamaru H, Miyata H, Ishida T, Kinoshita T, Tsuda H, Nakamura S, Tokuda Y. Abstract P2-11-11: Role of postmastectomy radiotherapy after neoadjuvant chemotherapy in breast cancer patients: A study from the Japanese breast cancer registry. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-11-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Postmastectomy radiotherapy (PMRT) has been shown to be beneficial in node-positive breast cancer patients. However, the role of PMRT for patients receiving modern neoadjuvant chemotherapy (NAC) are controversial. We aimed to evaluate the efficacy of radiotherapy for breast cancer patients treated with NAC and mastectomy in the Japanese Breast Cancer Registry.
Methods:
Patients who received NAC and mastectomy for cT1-4 cN0-2 M0 breast cancer were included in this analysis. We assessed locoregional recurrence (LRR), distant disease-free survival (DDFS), and overall survival (OS) using the Kaplan-Meier method and compared them between the groups with and without PMRT by nodal status after NAC; ypN0, ypN1, and ypN2-3. We also performed multivariable cox regression analysis to evaluate the association of radiotherapy and these outcomes adjusting for baseline patient and cancer characteristics.
Results:
Of the 145,530 patients registered from 2004 to 2009, we identified 3,226 patients who met our inclusion criteria with the 5-year follow-up information including 1,299 ypN0, 1,036 ypN1, and 879 ypN2-3 cases. PMRT was performed in 185 patients (14.2%) with ypN0, 265 patients (25.6%) with ypN1, and 543 patients (61.8%) with ypN2-3. There was no difference in LRR, DDFS, and OS between the groups with and without radiotherapy for ypN1 patients who received NAC (P=0.72, P=0.29, and P=0.36, respectively). For patients with ypN2-3 breast cancer, radiotherapy significantly improved LRR (P<0.001), DDFS (P=0.01), and OS (P<0.001) on univariate analysis. No difference in LRR, DDFS, and OS was observed for ypN0 patients (P=0.81, P=0.15, and P=0.05, respectively). In multivariable analysis, the use of radiotherapy was independently associated with improved LRR [hazard ratio (HR): 0.608, 95% confidence interval (CI): 0.452–0.818, P=0.001] and OS [HR: 0.685, 95% CI: 0.531–0.885, P=0.004] for ypN2-3 patients.
Effect of PMRT on locoregional recurrence by the ypN subgroupsypN subgroupHazard ratio95%CI Low95%CI HighP valueypN00.8550.4581.5960.623ypN10.8320.5491.2620.387ypN2-30.6080.4520.8180.001
Effect of PMRT on overall survival by the ypN subgroupsypN subgroupHazard ratio95%CI Low95%CI HighP valueypN01.3250.8412.0870.224ypN10.8800.5991.2930.514ypN2-30.6850.5310.8850.004
Radiotherapy was not associated with OS among patients with ypN0 [HR: 1.325, 95% CI: 0.841–2.087, P=0.224] and ypN1 [HR: 0.880, 95% CI: 0.599–1.293, P=0.514]. There was no significant difference in DDFS with the addition of radiotherapy for all ypN subgroups.
Conclusions:
The results from this nationwide database study of breast cancer patients following modern NAC showed that PMRT did not improve survival for patients with ypN1 and ypN0. Radiotherapy might be only beneficial for ypN2-3 breast cancer patients who received NAC and mastectomy in the modern era. Randomized clinical trials are needed to optimize the use of PMRT for breast cancer patients treated with neoadjuvant chemotherapy.
Citation Format: Miyashita M, Niikura N, Kumamaru H, Miyata H, Ishida T, Kinoshita T, Tsuda H, Nakamura S, Tokuda Y. Role of postmastectomy radiotherapy after neoadjuvant chemotherapy in breast cancer patients: A study from the Japanese breast cancer registry [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-11-11.
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Affiliation(s)
- M Miyashita
- Graduate School of Medicine, Tohoku University; Tokai University School of Medicine; Graduate School of Medicine, Tokyo University; Keio University; National Cancer Center Hospital; National Defense Medical College; Showa University
| | - N Niikura
- Graduate School of Medicine, Tohoku University; Tokai University School of Medicine; Graduate School of Medicine, Tokyo University; Keio University; National Cancer Center Hospital; National Defense Medical College; Showa University
| | - H Kumamaru
- Graduate School of Medicine, Tohoku University; Tokai University School of Medicine; Graduate School of Medicine, Tokyo University; Keio University; National Cancer Center Hospital; National Defense Medical College; Showa University
| | - H Miyata
- Graduate School of Medicine, Tohoku University; Tokai University School of Medicine; Graduate School of Medicine, Tokyo University; Keio University; National Cancer Center Hospital; National Defense Medical College; Showa University
| | - T Ishida
- Graduate School of Medicine, Tohoku University; Tokai University School of Medicine; Graduate School of Medicine, Tokyo University; Keio University; National Cancer Center Hospital; National Defense Medical College; Showa University
| | - T Kinoshita
- Graduate School of Medicine, Tohoku University; Tokai University School of Medicine; Graduate School of Medicine, Tokyo University; Keio University; National Cancer Center Hospital; National Defense Medical College; Showa University
| | - H Tsuda
- Graduate School of Medicine, Tohoku University; Tokai University School of Medicine; Graduate School of Medicine, Tokyo University; Keio University; National Cancer Center Hospital; National Defense Medical College; Showa University
| | - S Nakamura
- Graduate School of Medicine, Tohoku University; Tokai University School of Medicine; Graduate School of Medicine, Tokyo University; Keio University; National Cancer Center Hospital; National Defense Medical College; Showa University
| | - Y Tokuda
- Graduate School of Medicine, Tohoku University; Tokai University School of Medicine; Graduate School of Medicine, Tokyo University; Keio University; National Cancer Center Hospital; National Defense Medical College; Showa University
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Ito Y, Tsuda T, Minatogawa H, Kano S, Sakamaki K, Ando M, Tsugawa K, Kojima Y, Furuya N, Matsuzaki K, Fukuda M, Sugae S, Ohta I, Arioka H, Tokuda Y, Narui K, Tsuboya A, Suda T, Morita S, Boku N, Yamanaka T, Nakajima TE. Placebo-Controlled, Double-Blinded Phase III Study Comparing Dexamethasone on Day 1 With Dexamethasone on Days 1 to 3 With Combined Neurokinin-1 Receptor Antagonist and Palonosetron in High-Emetogenic Chemotherapy. J Clin Oncol 2018; 36:1000-1006. [PMID: 29443652 DOI: 10.1200/jco.2017.74.4375] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [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
Purpose We evaluated the noninferiority of dexamethasone (DEX) on day 1, with sparing on days 2 and 3, combined with neurokinin-1 receptor antagonist (NK1-RA) and palonosetron (Palo) compared with the 3-day use of DEX in highly-emetogenic chemotherapy (HEC). Patients and Methods Patients who were scheduled to receive HEC (cisplatin ≥ 50 mg/m2 or anthracycline plus cyclophosphamide) were randomly assigned to receive either DEX on days 1 to 3 (Arm D3) or DEX on day 1 and placebo on days 2 and 3 (Arm D1) combined with NK1-RA and Palo. The primary end point was complete response (CR), defined as no emesis and no rescue medications during the overall (0 to 120 h) phase. The noninferiority margin was set at -15.0% (Arm D1 - Arm D3). Results A total of 396 patients-196 and 200 patients in Arms D3 and D1, respectively-were evaluated. CR rates during the overall period were 46.9% for Arm D3 and 44.0% for Arm D1 (95% CI, -12.6% to 6.8%; P = .007). CR rates during the acute (0 to 24 h) phase were 63.3% and 64.5% for Arms D3 and D1, respectively (95% CI, -8.1% to 10.6%; P < .001), and they were 56.6% and 51.5%, respectively, during the delayed (24 to 120 h) phase (95% CI, -14.8% to 4.6%; P = .023). Hot flushes and tremors were observed more frequently as DEX-related adverse events on days 4 and 5 in Arm D3, whereas anorexia, depression, and fatigue were observed more frequently on days 2 and 3 in Arm D1. As an indication of quality of life, global health status was similar in both arms. Conclusion Antiemetic DEX administration on days 2 and 3 can be spared when combined with NK1-RA and Palo in HEC.
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Affiliation(s)
- Yuka Ito
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Takashi Tsuda
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroko Minatogawa
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Sayaka Kano
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Kentaro Sakamaki
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Masahiko Ando
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Koichiro Tsugawa
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuyuki Kojima
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Naoki Furuya
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Kunihiro Matsuzaki
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Mamoru Fukuda
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Sadatoshi Sugae
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Ichiro Ohta
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Hitoshi Arioka
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Yutaka Tokuda
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Kazutaka Narui
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Ayako Tsuboya
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Takashi Suda
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Morita
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Narikazu Boku
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Takeharu Yamanaka
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
| | - Takako Eguchi Nakajima
- Yuka Ito, Hiroko Minatogawa, and Sayaka Kano, St Marianna University School of Medicine Hospital; Takashi Tsuda, Koichiro Tsugawa, Yasuyuki Kojima, Naoki Furuya, Kunihiro Matsuzaki, Mamoru Fukuda, and Takako Eguchi Nakajima, St Marianna University School of Medicine; Ayako Tsuboya, Kawasaki Municipal Tama Hospital, Kawasaki; Kentaro Sakamaki and Takeharu Yamanaka, Yokohama City University School of Medicine; Sadatoshi Sugae and Ichiro Ohta, Yokohama City University Hospital; Hitoshi Arioka, Yokohama Rosai Hospital; Kazutaka Narui, Yokohama City University Medical Center, Yokohama; Masahiko Ando, Nagoya University Hospital, Nagoya; Yutaka Tokuda, Tokai University School of Medicine, Kanagawa; Takashi Suda, Takahata Public Hospital, Takahata-Chou; Satoshi Morita, Graduate School of Medicine, Kyoto University, Kyoto; and Narikazu Boku, National Cancer Center Hospital, Tokyo, Japan
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Terao M, Niikura N, Suzuki Y, Sengoku N, Arioka H, Ishikawa T, Tsugawa K, Tokuda Y. Management of Breast Cancer in Adjuvant Chemotherapy Settings in the Kanagawa Breast Oncology Group. Tokai J Exp Clin Med 2017; 42:147-155. [PMID: 29228411] [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] [Received: 05/26/2017] [Accepted: 08/09/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Many different options for adjuvant chemotherapy are recommended in guidelines for the treatment of breast cancer. Therapeutic strategies vary among physicians. The major goals for this project were to gain a better understanding of how biomarkers are integrated into practice and how physicians select adjuvant chemotherapy. METHODS We assembled a questionnaire with 23 example scenarios of breast cancer cases, including 6 items relevant to postoperative adjuvant therapy. During October-November 2012, the questionnaire was submitted to 131 physicians engaged in breast cancer treatment in Kanagawa Prefecture, Japan. RESULTS Forty-eight physicians responded to the questionnaire, 46 of whom provided valid responses. Their responses revealed a notable lack of consensus regarding therapeutic choices. We analyzed 6 scenarios relevant to postoperative adjuvant therapy. In general, the selection of postoperative adjuvant therapy appeared to be based on hormone sensitivity, human epidermal growth factor receptor 2 (HER2) expression, lymph node metastasis, tumor size, histological/nuclear grade, vascular/lymphatic system invasion, Ki67 level, Oncotype DX score, and the patient's age. CONCLUSION Given the varied therapeutic choices that we observed, clinical research is needed to provide appropriate, unified therapeutic strategies.
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Affiliation(s)
- Mayako Terao
- Department of Endocrine and Breast Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Tsuda B, Miyamoto A, Yokoyama K, Ogiya R, Oshitanai R, Terao M, Morioka T, Niikura N, Okamura T, Miyako H, Saito Y, Suzuki Y, Kametani Y, Tokuda Y. B-cell populations are expanded in breast cancer patients compared with healthy controls. Breast Cancer 2017; 25:284-291. [PMID: 29204848 PMCID: PMC5906508 DOI: 10.1007/s12282-017-0824-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/29/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Historically, humoral immunity was considered unimportant in anti-tumor immunity, and the differentiation and anti-tumor activity of B cells in breast cancer are poorly understood. However, it was recently discovered that B cells participate in tumor immunity through both antibody production and immunosuppressive mechanisms. We analyzed the expression of B-cell differentiation markers in detail using fluorescence-activated cell sorting to investigate the relationship between B-cell subsets and breast cancer etiology. METHODS Blood samples were taken from breast cancer patients and healthy donors, and peripheral blood mononuclear cells were collected. B cells at various stages of differentiation were identified by the expression of combinations of the cell surface markers CD5, CD19, CD21, CD24, CD27, CD38, CD45, and IgD. Statistical analysis of the proportions of each B-cell subtype in the different patient groups was then performed. RESULTS Twenty-seven breast cancer patients and 12 controls were considered. The proportion of total B cells was significantly higher in cancer patients than in controls (11.51 ± 2.059 vs 8.905 ± 0.379%, respectively; p = 0.001). Breast cancer patients were then classified as High-B or Low-B for further analysis. A significantly higher proportion of memory B cells was found in the High-B group than in the Low-B or control groups (p = 0.003 and p = 0.043, respectively). CONCLUSIONS Breast cancer patients generally have a higher proportion of B cells than healthy controls, but this is highly variable. Analysis of the major B-cell surface markers indicates that memory B cells in particular are significantly expanded, or more robust, in breast cancer patients.
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Affiliation(s)
- Banri Tsuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Asuka Miyamoto
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Kozue Yokoyama
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Rin Ogiya
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Risa Oshitanai
- Department of Breast and Endocrine Surgery, Tokai University Hachioji Hospital, Hachioji, Japan
| | - Mayako Terao
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Toru Morioka
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Naoki Niikura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Takuho Okamura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | | | - Yuki Saito
- Department of Breast and Endocrine Surgery, Tokai University Hachioji Hospital, Hachioji, Japan
| | - Yasuhiro Suzuki
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Yoshie Kametani
- Department of Molecular Life Science, Division of Basic Medical Science, Tokai University School of Medicine, Isehara, Japan
| | - Yutaka Tokuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
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Okamura T, Tokuda Y. [II. Maintaining Relative Dose Intensity in Adjuvant Chemotherapy for Early Breast Cancer]. Gan To Kagaku Ryoho 2017; 44:2077-2081. [PMID: 29361621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Takuho Okamura
- Dept. of Breast and Endocrine Surgery, Tokai University Schoolof Medicine
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Affiliation(s)
- T Watari
- Postgraduate Clinical Training Center, Shimane University Hospital, Shimane, Japan
| | - Y Tokuda
- Okinawa Muribushi Project for Teaching Hospitals, Urasoe City, Okinawa, Japan
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Ogiya R, Niikura N, Kumaki N, Yasojima H, Iwasa T, Kanbayashi C, Oshitanai R, Tsuneizumi M, Watanabe KI, Matsui A, Fujisawa T, Saji S, Masuda N, Tokuda Y, Iwata H. Comparison of immune microenvironments between primary tumors and brain metastases in patients with breast cancer. Oncotarget 2017; 8:103671-103681. [PMID: 29262592 PMCID: PMC5732758 DOI: 10.18632/oncotarget.22110] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/20/2017] [Indexed: 12/22/2022] Open
Abstract
Background Immune checkpoint inhibitors are reported to be effective in patients with brain metastases. However, detailed characteristics of the brain metastasis immune microenvironment remain unexplored. Results The median tumor-infiltrating lymphocyte (TIL) category in brain metastases was 5% (1–70%). In 46 pair-matched samples, the percentages of TILs were significantly higher in primary breast tumors than in brain metastases (paired t-test, P < 0.01). The numbers of CD4/CD8/Foxp3-positive cells were significantly higher in primary breast tumors than in brain metastases (paired t-test, P < 0.05 for all antibodies). In patients with triple-negative breast cancer specifically, low TIL numbers were associated with significantly shorter overall survival compared to high TIL numbers (log-rank test, P = 0.04). Materials and Methods We retrospectively identified 107 patients with breast cancer and brain metastases who had undergone surgery between 2001 and 2012 at 8 institutions, and collected 191 samples including brain metastases alone and primary tumors with pair-matched brain metastasis samples. Hematoxylin and eosin-stained slides were evaluated for TILs and categorized according to the extent of staining. Immunohistochemistry for CD4, CD8, Foxp3, PD-L1, PD-L2, and HLA class I was also performed. Conclusions There are significantly fewer TILs in brain metastases than in primary breast tumors.
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Affiliation(s)
- Rin Ogiya
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Naoki Niikura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Nobue Kumaki
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiroyuki Yasojima
- Department of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Tsutomu Iwasa
- Department of Medical Oncology, Kindai University School of Medicine, Osaka, Japan
| | - Chizuko Kanbayashi
- Department of Breast Oncology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Risa Oshitanai
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Michiko Tsuneizumi
- Department of Breast Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Ken-Ichi Watanabe
- Department of Breast Surgery, Hokkaido Cancer Center, Sapporo, Japan
| | - Akira Matsui
- Department of Surgery, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
| | - Tomomi Fujisawa
- Department of Breast Oncology, Gunma Prefectural Cancer Center, Gunma, Japan
| | - Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - Norikazu Masuda
- Department of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Yutaka Tokuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
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Tokuda Y. A major breakthrough in systemic therapy for breast cancer over the fifteen years. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx573.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Suzuki Y, Yokoyama K, Terao M, Morioka T, Tsuda B, Niikura N, Okamura T, Yamada E, Imagawa K, Akamatsu T, Tokuda Y, Kumaki N. Pyoderma Gangrenosum after Breast Mastectomy and Primary Rectus Abdominis Flap Reconstruction. Tokai J Exp Clin Med 2017; 42:133-138. [PMID: 28871582] [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] [Received: 05/26/2017] [Accepted: 07/05/2017] [Indexed: 06/07/2023]
Abstract
Pyoderma gangrenosum is an intractable disease of unknown cause involving recurrent ulcerative lesions on the skin, and may accompany ulcerative colitis, rheumatoid arthritis, leukemia, systemic lupus erythematosus, and other conditions. Here, we report a rare case of pyoderma gangrenosum in the thoracic abdomen following post-mastectomy reconstructive surgery. A 39-year-old presented at the hospital with a complaint of left papilla erosion. Skin biopsy at the site revealed invasive skin cancer, with Paget-like progression in the cancerous nipple and suspected malignancy of skin appendages. After partial mastectomy including the areola, invasive ductal breast carcinoma was diagnosed. The patient underwent a subsequent full mastectomy with simultaneous sentinel lymph node biopsy and primary breast reconstructive surgery using a rectus abdominis myocutaneous flap. Two weeks post-surgery, healing of the abdominal surgical wound was found to be delayed, and suture abscess was suspected. Despite localized treatment, an ulcerative lesion developed in the thoracic region, and pyoderma gangrenosum was diagnosed following skin biopsy. After the introduction of steroid pulse therapy, no progression of the lesion was observed. This report describes the disease characteristics, diagnosis, and treatment of post-surgical pyoderma gangrenosum and discusses the case in the context of previous literature.
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Affiliation(s)
- Yasuhiro Suzuki
- Division of Breast and Endocrine Surgery, Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Saeki T, Mukai H, Ro J, Lin YC, Fujiwara Y, Nagai S, Lee K, Watanabe J, Ohtani S, Kim S, Kuroi K, Tsugawa K, Tokuda Y, Iwata H, Park Y, Yang Y, Nambu Y. A global phase III clinical study comparing NK105 and paclitaxel in metastatic or recurrent breast cancer patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shimomura A, Niikura N, Fukatsu Y, Sawaki M, Ogiya R, Yasojima H, Fujisawa T, Yamamoto M, Tsuneizumi M, Kitani A, Watanabe J, Matsui A, Takahashi Y, Takashima S, Shien T, Tamura K, Saji S, Masuda N, Tokuda Y, Iwata H. Durable complete response in HER2-positive breast cancer: A multicenter retrospective analysis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kumaki N, Okamatsu C, Tokuda Y, Nakamura N. Breast Cancer in Patients of Rheumatoid Arthritis with Methotrexate Therapy Mimicking Histopathological Changes after Neoadjuvant Chemotherapy. Tokai J Exp Clin Med 2017; 42:104-108. [PMID: 28681371] [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] [Received: 05/01/2017] [Accepted: 05/24/2017] [Indexed: 06/07/2023]
Abstract
Two breast cancer patients with a history of treatment for long-term rheumatoid arthritis (RA) had histological findings similar to histological changes seen in resected mammary gland specimens following neoadjuvant chemotherapy (NAC). The first patient was a 64-year-old woman who visited our hospital after feeling a lump in her left breast. The second patient was a 68-year-old woman who visited our hospital for an indentation in her left nipple. They were diagnosed with breast cancer following detailed examinations and underwent mastectomy. Both patients had a history of RA and were being treated with Methotrexate. The histological diagnoses of these patients were invasive ductal carcinoma, but frequent dispersal of cancer cell nests, stromal fibrosis, elastosis, edema and inflammatory cell infiltration were seen. Fibrosis was also found in the dissected lymph node. These histological findings were extremely similar to changes that occur in the mammary gland tissue after NAC; however, these patients had not undergone NAC. Methotrexate, which was being administered as an anti-rheumatic drug to the two patients, might have played a role similar to that of metronomic chemotherapy, which involves the continuous use of low-dose anti-cancer drugs, resulting in histological changes similar to those seen after NAC.
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Affiliation(s)
- Nobue Kumaki
- Department of Pathology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Kametani Y, Katano I, Miyamoto A, Kikuchi Y, Ito R, Muguruma Y, Tsuda B, Habu S, Tokuda Y, Ando K, Ito M. NOG-hIL-4-Tg, a new humanized mouse model for producing tumor antigen-specific IgG antibody by peptide vaccination. PLoS One 2017; 12:e0179239. [PMID: 28617827 PMCID: PMC5472286 DOI: 10.1371/journal.pone.0179239] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/25/2017] [Indexed: 12/11/2022] Open
Abstract
Immunodeficient mice transplanted with human peripheral blood mononuclear cells (PBMCs) are promising tools to evaluate human immune responses to vaccines. However, these mice usually develop severe graft-versus-host disease (GVHD), which makes estimation of antigen-specific IgG production after antigen immunization difficult. To evaluate antigen-specific IgG responses in PBMC-transplanted immunodeficient mice, we developed a novel NOD/Shi-scid-IL2rγnull (NOG) mouse strain that systemically expresses the human IL-4 gene (NOG-hIL-4-Tg). After human PBMC transplantation, GVHD symptoms were significantly suppressed in NOG-hIL-4-Tg compared to conventional NOG mice. In kinetic analyses of human leukocytes, long-term engraftment of human T cells has been observed in peripheral blood of NOG-hIL-4-Tg, followed by dominant CD4+ T rather than CD8+ T cell proliferation. Furthermore, these CD4+ T cells shifted to type 2 helper (Th2) cells, resulting in long-term suppression of GVHD. Most of the human B cells detected in the transplanted mice had a plasmablast phenotype. Vaccination with HER2 multiple antigen peptide (CH401MAP) or keyhole limpet hemocyanin (KLH) successfully induced antigen-specific IgG production in PBMC-transplanted NOG-hIL-4-Tg. The HLA haplotype of donor PBMCs might not be relevant to the antibody secretion ability after immunization. These results suggest that the human PBMC-transplanted NOG-hIL-4-Tg mouse is an effective tool to evaluate the production of antigen-specific IgG antibodies.
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Affiliation(s)
- Yoshie Kametani
- Department of Molecular Life Science, Division of Basic Medical Science, Tokai University School of Medicine, Isehara, Kanagawa, Japan
- Institute of Advanced Biosciences, Tokai University, Hiratsuka, Kanagawa, Japan
- * E-mail:
| | - Ikumi Katano
- Central Institute for Experimental Animals, Kawasaki, Kanagawa, Japan
| | - Asuka Miyamoto
- Department of Molecular Life Science, Division of Basic Medical Science, Tokai University School of Medicine, Isehara, Kanagawa, Japan
- Department of Breast and Endocrine surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Yusuke Kikuchi
- Department of Molecular Life Science, Division of Basic Medical Science, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Ryoji Ito
- Central Institute for Experimental Animals, Kawasaki, Kanagawa, Japan
| | - Yukari Muguruma
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Banri Tsuda
- Department of Breast and Endocrine surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Sonoko Habu
- Department of Immunology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yutaka Tokuda
- Department of Breast and Endocrine surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Kiyoshi Ando
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Mamoru Ito
- Central Institute for Experimental Animals, Kawasaki, Kanagawa, Japan
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Ogiya R, Niikura N, Kumaki N, Yasojima H, Iwasa T, Kanbayashi C, Oshitanai R, Tsuneizumi M, Watanabe KI, Matsui A, Fujisawa T, Saji S, Tokuda Y, Masuda N, Iwata H. Immune microenvironment in brain metastases of breast cancer. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.1081] [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
1081 Background: In patients with brain metastasis (BM) of melanoma or lung cancer, significant activity of immune checkpoint inhibitors has been reported. However, details of the immune microenvironment in BM has not been unveiled. In this study, we used immunohistochemistry (IHC) to compare primary breast tumors and BM tumor samples with respect to tumor infiltrating lymphocytes (TILs) and tumor characteristics related to the immune system. Methods: We retrospectively identified 107 patients with breast cancer, diagnosed with BM, who had undergone surgery between 2001 and 2012 at 8 institutions. We collected 191 samples which included both BM samples alone and pair-matched samples (primary and BM). Hematoxylin and eosin (H&E) stained slides were evaluated for stromal TILs in 10% increments (0–1%, > 1– < 10%, 10%–100%). IHC was performed using the following primary antibodies: CD4, CD8, Foxp3, PD-L1, PD-L2 and HLA class I. The cells positive for each antibody signal were counted automatically using ImageJ (NIH). The expression of PD-L1, PD-L2, and HLA on the tumor cells was scored as 0 (negative), 1 (weak or focal), or 2 (strong). Results: The median category of TILs of BM tumors was > 1– < 10% (range: 1–30%). Forty-six pair-matched samples were analyzed and the percentage of TILs in the primary breast tumor was significantly higher than that in BM samples (paired t-test, P < 0.01). The number of CD4/CD8/Foxp3 positive cells in primary breast tumor was also significantly higher than in BM samples (paired t-test, P < 0.05 for all categories). The negative/positive conversion occurred with the expression of HLA/PD-L2 on tumor cells (paired t-test, P = 0.03/0.06, respectively). No significant difference was observed in the overall survival (OS) of patients, from initial BM, based on high or low TILs (log-rank test, P = 0.131). However, triple negative breast cancer patients with low TILs had significantly shorter OS compared with patients with high TILs (log-rank test, P = 0.04). Conclusions: We demonstrated that TILs in BM tumors was significantly lower as compared to primary breast tumors. The expression of immune related molecules on tumor cells was converted in BM tumors.
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Affiliation(s)
- Rin Ogiya
- Tokai University School of Medicine, Isehara, Japan
| | | | - Nobue Kumaki
- Tokai University School of Medicine, Kanagawa, Japan
| | | | - Tsutomu Iwasa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | | | | | | | | | | | - Tomomi Fujisawa
- Department of Breast Oncology, Gunma Prefectural Cancer Center, Gunma, Japan
| | - Shigehira Saji
- Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yutaka Tokuda
- The Department of Breast and Enodcrine Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Norikazu Masuda
- Department of Surgery, Breast Oncology, NHO Osaka National Hospital, Osaka, Japan
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Tamura K, Inoue K, Masuda N, Takao S, Kashiwaba M, Tokuda Y, Iwata H, Yamamoto N, Aogi K, Saeki T, Nakayama T, Sato N, Toyama T, Ishida T, Arioka H, Saito M, Ohno S, Yamauchi H, Yamada K, Watanabe J, Ishiguro H, Fujiwara Y. Randomized phase II study of nab-paclitaxel as first-line chemotherapy in patients with HER2-negative metastatic breast cancer. Cancer Sci 2017; 108:987-994. [PMID: 28256066 PMCID: PMC5448660 DOI: 10.1111/cas.13221] [Citation(s) in RCA: 14] [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: 11/18/2016] [Revised: 02/09/2017] [Accepted: 02/26/2017] [Indexed: 02/03/2023] Open
Abstract
Weekly administration of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) has been shown to be a safe and effective treatment for metastatic breast cancer (MBC) in clinical studies. We conducted a multicenter, randomized, open-label phase II study to compare the efficacy and safety of weekly nab-paclitaxel and docetaxel in Japanese patients with human epidermal growth factor receptor 2-negative MBC. The primary endpoint was progression-free survival (PFS). Patients were randomized to receive nab-paclitaxel (150 mg/m2 nab-paclitaxel once per week for 3 of 4 weeks; n = 100) or docetaxel (75 mg/m2 docetaxel every 3 weeks; n = 100). The median PFS by independent radiologist assessment was 9.8 months (90% confidence interval [CI]: 8.5-11.2) for nab-paclitaxel and 11.2 months (90% CI: 8.4-13.8) for docetaxel (hazard ratio: 1.25, P = 0.363), and the median overall survival was 42.4 months and 34.0 months, respectively. The overall response rate was 56.1% for nab-paclitaxel and 52.5% for docetaxel. Adverse events in both treatment arms were similar to previous reports. Neutropenia was the most common adverse event in both arms, with 35.0% of patients in the nab-paclitaxel arm and 89.0% in the docetaxel arm experiencing grade 4 neutropenia. Grade 3 peripheral sensory neuropathy occurred in 22.0% of patients in the nab-paclitaxel and 5.0% in the docetaxel arm. In this study, although weekly nab-paclitaxel 150 mg/m2 did not show superiority in PFS compared with docetaxel, efficacy outcomes were similar in patients treated with weekly nab-paclitaxel and docetaxel.
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Affiliation(s)
- Kenji Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kenichi Inoue
- Division of Breast Oncology, Saitama Cancer Center, Saitama, Japan
| | - Norikazu Masuda
- Department of Surgery, Breast Oncology, NHO Osaka National Hospital, Osaka, Japan
| | - Shintaro Takao
- Department of Breast Surgery, Hyogo Cancer Center, Hyogo, Japan
| | | | - Yutaka Tokuda
- Department of Breast and Endocrine Surgery, Tokai University Hospital, Kanagawa, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan
| | | | - Kenjiro Aogi
- Department of Surgery, Shikoku Cancer Center, Ehime, Japan
| | - Toshiaki Saeki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Takahiro Nakayama
- Department of Breast and Endocrine Surgery, Osaka University Hospital, Osaka, Japan
| | - Nobuaki Sato
- Department of Breast Surgery, Niigata Cancer Center, Niigata, Japan
| | - Tatsuya Toyama
- Department of Breast Surgery, Nagoya City University Hospital, Aichi, Japan
| | - Takanori Ishida
- Department of Surgical Oncology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Hitoshi Arioka
- Department of Medical Oncology, Yokohama Rosai Hospital, Kanagawa, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University Hospital, Tokyo, Japan
| | - Shinji Ohno
- Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan
| | - Hideko Yamauchi
- Department of Breast Surgery, St. Luke's International Hospital, Tokyo, Japan
| | - Kimito Yamada
- Department of Breast Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | | | - Hiroshi Ishiguro
- Department of Target Therapy Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuhiro Fujiwara
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
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Ogiya R, Niikura N, Kumaki N, Bianchini G, Kitano S, Iwamoto T, Hayashi N, Yokoyama K, Oshitanai R, Terao M, Morioka T, Tsuda B, Okamura T, Saito Y, Suzuki Y, Tokuda Y. Abstract P2-04-13: Difference of immune microenvironment between primary and recurrent tumours in breast cancer patients. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-04-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Immune checkpoint therapy only benefits a fraction of patients, thus huge efforts have been made to develop predictive biomarkers to identify those patients. Immune biomarkers like PD-L1 expression are extremely dynamic and the timing of evaluation, on primary or metastatic disease, may be critical. We have already shown that tumour-infiltrating lymphocytes (TILs) decrease during metastatic progression in triple-negative (TN) and human epidermal growth factor-2 positive (HER2+) breast cancers (Ogiya R, ASCO 2015), suggesting that mechanisms of immune escape contribute and favour the metastatic progression. In this work we aimed to characterize the modulation and changes of specific immune markers during the metastatic spread comparing paired samples from primary and recurrent breast cancers.
Methods
We retrospectively identified 25 patients with HER2+ (n = 14) and TN (n = 11) early breast cancer diagnosed between 1990 and 2009 at Tokai University Hospital, and who subsequently experienced a first regional or distant recurrence confirmed by tumour biopsy/resection. Haematoxylin and eosin-stained slides of these paired samples were evaluated for stromal TILs. Immunohistochemical staining was performed using primary antibodies against CD4, CD8, Foxp3, PD-L1, PD-L2, and HLA-class I.
Results
The sites of first recurrence was the skin (n = 7), brain (n = 6), lymph node (n = 4), lung (n = 3), bone (n = 2), and one of each of bone marrow, liver and muscle. Immunohistochemical evaluations could not be performed in 5 primary tumours and 2 recurrent tumours because of the small quantity of the specimens. The percentage of CD8+ T cells staining in the primary tumours was significantly higher (median 16%) than that in recurrent tumours (median 10%) (paired t-test, p = 0.008) Similarly, the percentage of CD4+ T cells staining in the primary tumours was significantly higher (median 40%) than that in recurrent tumours (median 25%) (p = 0.026). The percentage of Foxp3+ T cells was low (<10%) and similar in both primary and recurrent tumours (p = 0.16). PD-L1, PD-L2, and HLA class I antibody expression was not statistically different between primary and recurrent tumours, but conversions from positive to negative and vice versa were observed. PD-L1+ staining (≥1%) was 90% and 85% in primary and metastatic tumours, respectively.
Comparison of positivity rate between primary and recurrent tumours for each antibody Primary tumourRecurrent tumourPTotal breast tumours (N)2023 TILs positivity rate, median (%) CD440%25%.03CD816%10%.01Foxp3<10%<10%.16Expression in tumour cells (N) PD-L1 Strong85.46Weak1015 Negative23 PD-L2 Strong69.78Weak1011 Negative43 HLA Strong46.89Weak1415 Negative22
Conclusions
Tumours at first metastatic recurrence in HER2+ and TN breast cancers have a lower percentage of both CD8+ and CD4+ T cells compared to primary tumours, confirming a potential role of immune escape in tumour progression. Other immune markers, including PD-L1, were not found to change significantly, but negative/positive conversions were observed. This suggest that an evaluation of disease at the time of immunotherapy administration might be more informative. These findings warrant larger confirmation studies.
Citation Format: Ogiya R, Niikura N, Kumaki N, Bianchini G, Kitano S, Iwamoto T, Hayashi N, Yokoyama K, Oshitanai R, Terao M, Morioka T, Tsuda B, Okamura T, Saito Y, Suzuki Y, Tokuda Y. Difference of immune microenvironment between primary and recurrent tumours in breast cancer patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-04-13.
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Affiliation(s)
- R Ogiya
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - N Niikura
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - N Kumaki
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - G Bianchini
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - S Kitano
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - T Iwamoto
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - N Hayashi
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - K Yokoyama
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - R Oshitanai
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - M Terao
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - T Morioka
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - B Tsuda
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - T Okamura
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - Y Saito
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - Y Suzuki
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - Y Tokuda
- Tokai University, School of Medicine, Isehara, Kanagawa, Japan; Ospedale San Raffaele, Milan, Italy; National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
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Okamura T, Niikura N, Yokoyama K, Ogiya R, Oshitanai R, Terao M, Morioka T, Tsuda B, Saito Y, Suzuki Y, Tokuda Y. Abstract P3-13-11: Utility of LigaSureTM vessel-sealing device in axillary dissection for breast cancer surgery: A randomized single center study. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-13-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
Axillary lymph node dissection is standard therapy for patients with positive-node breast cancer, and can be performed with an electrocautery scalpel and suture ligation in most cases. However, knot slipping can occur during suture ligation and this can spread thermal damage to peripheral tissues. The LigaSureTM Small Jaw vessel-sealing system was developed as an alternative to suture ligatures, staplers, and other energy-dependent devices for sealing blood and lymphatic vessels, but its use in axillary dissection for breast cancer is limited. We prospectively compared the duration until drain removal after surgery, total lymph fluid drainage volume, intraoperative blood loss, and incidence of complications after axillary dissections, between this device and conventional methods.
Methods
This prospective randomized study was conducted at the Department of Breast and Endocrine Surgery at Tokai University School of Medicine, Kanagawa, Japan, between October 2011 and March 2015. Major eligibility criteria included (1) pathologically confirmed breast cancer diagnosis, (2) age ≥20 and ≤80 years, and (3) a signed informed consent form. The primary endpoint was duration until drain removal after surgery. The secondary endpoints were total lymph fluid drainage volume, intraoperative blood loss, and incidence of postoperative surgical complications. We defined the criterion for drain removal as a lymph fluid drainage volume of <40 mL/day for two consecutive days.The target accrual was 100 patients, with a two-sided error rate of 5%, and 90% power. The assumed duration until drain removal after surgery was 7.2 days in the control group (conventional use of an electrocautery scalpel and suture ligation) and 5.8 days in the study group (use of the LigaSureTM Small Jaw). This clinical study was approved by the Institutional Review Board of the Tokai University School of Medicine and is registered with UMIN (No. 000013034).
Results
Initially, 100 patients were assigned as eligible; however, two patients were later excluded because of the exclusion criteria. Of 98 patients, 49 were randomized to the study group, and 49 to the control group. The mean duration until drain removal after surgery was 5.2 days in the study group and 5.0 days in the control group (p=0.573). The mean total lymph fluid drainage volumes were 260.3 and 233.5 mL (p=0.502), and the mean intraoperative blood loss volumes were 17.8 and 18.0 mL (p=0.949), for the study and control groups, respectively. No significant differences were found between the two groups regarding drain removal duration, total drainage volume, and intraoperative blood loss volume. Both groups had low incidence rates of postoperative hematoma, wound infection, lymphedema, and pain, and had similar incidence rates of seroma formation after drain removal.
Conclusion
Our study results indicated that the use of the LigaSureTM Small Jaw in axillary dissection for breast cancer was as safe as conventional methods. However, using the LigaSureTM Small Jaw did not improve surgical outcomes such as duration until drain removal and total lymph fluid drainage volume compared with conventional methods.
Citation Format: Okamura T, Niikura N, Yokoyama K, Ogiya R, Oshitanai R, Terao M, Morioka T, Tsuda B, Saito Y, Suzuki Y, Tokuda Y. Utility of LigaSureTM vessel-sealing device in axillary dissection for breast cancer surgery: A randomized single center study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-13-11.
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Affiliation(s)
- T Okamura
- Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - N Niikura
- Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - K Yokoyama
- Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - R Ogiya
- Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - R Oshitanai
- Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - M Terao
- Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - T Morioka
- Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - B Tsuda
- Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Y Saito
- Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Y Suzuki
- Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Y Tokuda
- Tokai University School of Medicine, Isehara, Kanagawa, Japan
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Narui K, Ishikawa T, Shimizu D, Tanabe M, Sasaki T, Oba MS, Morita S, Nawata S, Kida K, Mogaki M, Doi T, Tsugawa K, Ogata H, Ota T, Kosaka Y, Sengoku N, Kuranami M, Saito Y, Suzuki Y, Suto A, Arioka H, Chishima T, Ichikawa Y, Endo I, Tokuda Y. Abstract P5-16-04: A randomized phase II neoadjuvant study comparing docetaxel and cyclophosphamide (TC) with 5-fluorouracil, epirubicin, and cyclophosphamide followed by docetaxel (FEC-D) for hormone receptor-negative breast cancer: The Kanagawa breast oncology group (KBOG) 1101 study. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-16-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: This study aimed to evaluate response to neoadjuvant chemotherapy (NAC) for patients with hormone receptor-negative (HR-negative) breast cancer (BC) to identify subtypes that require anthracycline treatment.
Methods: In total, 103 patients with operable HR-negative BC were registered. They were randomely assigned to administration of 6 cycles of docetaxel (75mg/m2) and cyclophosphamide (600 mg/m2) (TC6) or 3 cycles of 5-fluorouracil (500 mg/m2), epirubicin (100mg/m2), and cyclophosphamide (500mg/m2) followed by 3 cycles of docetaxel (100mg/m2) (FEC-D). Cytokeratin (CK) 5/6 and EGFR expression were used to identify basal and non-basal triple-negative (TN) BC. The primary endpoint was pathological complete response (pCR); secondary endpoints were safety, breast-conserving surgery, disease-free survival, and overall survival. Predictive factors of pCR for each regimen were also evaluated.
Results:
The pCR rate was 36% for FEC-D and 25.5% for TC6, which did not differ significantly (P=0.265). When TN BC was subdivided into basal and non-basal subtypes, the pCR rate in the basal subtype was significantly lower for TC6 (13.6%) than for FEC-D (42.9%) (P=0.033), but did not significantly differ in the non-basal (TC6, 36.4%; FEC-D, 25.0%) and HER2-positive (TC6, 41.7%; FEC-D, 35.7%) cases.
The relative dose intensities of epirubicin and docetaxel in FEC-D and docetaxel in TC6 were 96.3±13.0%, 93.5±14.6%, and 93.9±16.3% (mean±SD), respectively. Occurrence of grade ≥2 adverse events was significant in FEC-D-treated patients. Poor appetite (P<0.001), nausea (P<0.001), vomiting (P<0.001), dysgeusia (P=0.03), and fatigue (P=0.05) were significantly more common for FEC-D than TC6. Patients treated with FEC-D experienced significantly more febrile neutropenia and anemia (P=0.016 and 0.017, respectively).
The rates of breast-conserving surgery were 68.0 and 72.3% for FEC-D and TC6, respectively (P=0.641).
Patients achieved pCR had better DFS (log rank test, P = 0.287) and OS (log rank test, P = 0.069), though not significant. Patients treated with FEC-D had better DFS (log rank test, P = 0.107) and OS (log rank test, P = 0.159), though not significant. Among patients with TN BC, those treated with FEC-D had significantly better DFS (log rank test, P = 0.016) and OS (log rank test, P = 0.034) than treated with TC6.
Low ALDH1 expression and high topo IIα protein expression were strongly correlated with pCR in FEC-D, with odds ratios (ORs) of 4.33 [95% CI, 1.02–18.38] and 4.08 [0.97–17.2], respectively. ALDH1 was also associated with pCR in TC, OR=3.50 [0.84–14.6]. Other factors, including age, tumor size, nodal status, tumor grade, Ki67, p53, and TOP 2A status were not associated with pCR in either regimen.
Conclusions:We found that TC6 was less effective than FEC-D for treating HR-negative BC because it was insufficient for TNBC, particularly for basal BC. This suggests that anthracycline is more important than taxane for basal BC. Additionally, ALDH1 could be a marker for resistance to conventional chemotherapy.
Citation Format: Narui K, Ishikawa T, Shimizu D, Tanabe M, Sasaki T, Oba MS, Morita S, Nawata S, Kida K, Mogaki M, Doi T, Tsugawa K, Ogata H, Ota T, Kosaka Y, Sengoku N, Kuranami M, Saito Y, Suzuki Y, Suto A, Arioka H, Chishima T, Ichikawa Y, Endo I, Tokuda Y. A randomized phase II neoadjuvant study comparing docetaxel and cyclophosphamide (TC) with 5-fluorouracil, epirubicin, and cyclophosphamide followed by docetaxel (FEC-D) for hormone receptor-negative breast cancer: The Kanagawa breast oncology group (KBOG) 1101 study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-16-04.
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Affiliation(s)
- K Narui
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Ishikawa
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - D Shimizu
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - M Tanabe
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Sasaki
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - MS Oba
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - S Morita
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - S Nawata
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - K Kida
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - M Mogaki
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Doi
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - K Tsugawa
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - H Ogata
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Ota
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Kosaka
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - N Sengoku
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - M Kuranami
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Saito
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Suzuki
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - A Suto
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - H Arioka
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Chishima
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Ichikawa
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - I Endo
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Tokuda
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
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Ogiya R, Niikura N, Kumaki N, Bianchini G, Kitano S, Iwamoto T, Hayashi N, Yokoyama K, Oshitanai R, Terao M, Morioka T, Tsuda B, Okamura T, Saito Y, Suzuki Y, Tokuda Y. Comparison of tumor-infiltrating lymphocytes between primary and metastatic tumors in breast cancer patients. Cancer Sci 2017; 107:1730-1735. [PMID: 27727484 PMCID: PMC5198965 DOI: 10.1111/cas.13101] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [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: 07/25/2016] [Revised: 09/29/2016] [Accepted: 10/02/2016] [Indexed: 01/01/2023] Open
Abstract
The presence of tumor-infiltrating lymphocytes (TILs) is associated with favorable long-term outcome in breast cancer. However, little is known about changes in TILs during metastatic progression. To confirm our hypothesis that malignant tumors escape from the host immune system during metastasis, we evaluated the percentage of TILs in paired samples of primary and metastatic breast tumors. We retrospectively identified 25 patients with human epidermal growth factor receptor-2 (HER2+ , n = 14) and triple negative (TN, n = 11) early breast cancer diagnosed between 1990 and 2009 at Tokai University Hospital (Isehara, Japan) and who subsequently experienced regional or distant recurrence confirmed by tumor biopsy/resection. Hematoxylin-eosin-stained slides of these paired samples were evaluated for stromal TILs. Immunohistochemical staining was carried out using primary antibodies against CD4, CD8, Foxp3, programmed cell death ligand 1 (PD-L1), PD-L2, and HLA class I for characterizing the TILs and breast tumors. The percentage of TILs in the primary tumors was significantly higher (average 34.6%) than that in metastatic tumors (average 15.7%) (paired t-test, P = 0.004) and that of CD8+ and CD4+ T cells significantly decreased from primary to metastatic tumors (paired t-test, P = 0.008 and P = 0.026, respectively). The PD-L1, PD-L2, and HLA class I antibody expression changed from positive to negative and vice versa from the primary to the metastatic tumors. Tumors at first metastatic recurrence in HER2+ and TN breast cancers have a lower percentage of TILs and CD8+ and CD4+ T cells compared to primary tumors, which indicates that immune escape plays a role in tumor progression.
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Affiliation(s)
- Rin Ogiya
- Department of Breast and Endocrine Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Naoki Niikura
- Department of Breast and Endocrine Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Nobue Kumaki
- Department of Pathology, School of Medicine, Tokai University, Isehara, Japan
| | | | - Shigehisa Kitano
- Department of Experimental Therapeutics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital, Tokyo, Japan
| | - Takayuki Iwamoto
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Naoki Hayashi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Kozue Yokoyama
- Department of Breast and Endocrine Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Risa Oshitanai
- Department of Breast and Endocrine Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Mayako Terao
- Department of Breast and Endocrine Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Toru Morioka
- Department of Breast and Endocrine Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Banri Tsuda
- Department of Breast and Endocrine Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Takuho Okamura
- Department of Breast and Endocrine Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Yuki Saito
- Department of Breast and Endocrine Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Yasuhiro Suzuki
- Department of Breast and Endocrine Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Yutaka Tokuda
- Department of Breast and Endocrine Surgery, School of Medicine, Tokai University, Isehara, Japan
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