1
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Watanabe S, Shimoi T, Nishikawa T, Kawachi A, Okuma HS, Tokura M, Yazaki S, Mizoguchi C, Arakaki M, Saito A, Kita S, Yamamoto K, Kojima Y, Sudo K, Noguchi E, Yoshida A, Kawai A, Fujiwara Y, Yonemori K. Lymphocyte-to-monocyte ratio as a prognostic and potential tumor microenvironment indicator in advanced soft tissue sarcoma treated with first-line doxorubicin therapy. Sci Rep 2023; 13:10734. [PMID: 37400504 DOI: 10.1038/s41598-023-37616-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/24/2023] [Indexed: 07/05/2023] Open
Abstract
Prognostic value of hematologic indices and their association with the tumor microenvironment (TME) remain unclear in advanced soft tissue sarcoma (STS). We aimed to evaluate their prognostic value and correlation with the TME status in advanced STS treated with first-line doxorubicin (DXR) therapy. Clinical data and three hematological indices, including lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio, and neutrophil-to-lymphocyte ratio, were collected from 149 patients with advanced STS. The TME status was pathologically examined by CD3, CD68, and CD20 staining of resected tumor slides. In a multivariate Cox analysis, low LMR and absence of primary tumor resection were independently associated with worse overall survival (OS) (HR 3.93, p = 0.001; HR 1.71, p = 0.03). A prognostic model using these variables predicted OS with greater area under curves than those obtained using Systemic Inflammatory Score and Glasgow Prognostic Score. The LMR significantly correlated with the tumoral CD3/CD68-positive cell ratio in surgical specimens (R = 0.959, p = 0.04). In conclusion, LMR was a prognostic factor in advanced STS treated with first-line DXR therapy. LMR could partially reflect anti-tumor immunity in the TME and have the prognostic value. The potential role of LMR as an indicator of TME status warrants further investigation.
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Affiliation(s)
- Sho Watanabe
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
- Division of Cancer Immunology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center East, 5-1, Kashiwanoha 6, Kashiwa, Chiba, 277-8577, Japan
| | - Tatsunori Shimoi
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Tadaaki Nishikawa
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Asuka Kawachi
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hitomi Sumiyoshi Okuma
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Momoko Tokura
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shu Yazaki
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Chiharu Mizoguchi
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Motoko Arakaki
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Ayumi Saito
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shosuke Kita
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kasumi Yamamoto
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yuki Kojima
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kazuki Sudo
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Emi Noguchi
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Akihiko Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kan Yonemori
- Department of Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo, 104-0045, Japan
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2
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Koyama T, Shimizu T, Kojima Y, Sudo K, Okuma HS, Shimoi T, Ichikawa H, Kohsaka S, Sadachi R, Hirakawa A, Yoshida A, Ando RM, Ueno T, Yanagaki M, Matsui N, Nakamura K, Yamamoto N, Yonemori K. Clinical activity and exploratory resistance mechanism of milademetan, an MDM2 inhibitor, in intimal sarcoma with MDM2 amplification: an open-label phase 1b/2 study. Cancer Discov 2023:CD-23-0419. [PMID: 37369013 DOI: 10.1158/2159-8290.cd-23-0419] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/02/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
Intimal sarcoma is an extremely rare life-threatening malignant neoplasm. Murine double minute 2 (MDM2) amplification is observed in > 70% of intimal sarcomas. Milademetan, an MDM2 inhibitor, may provide a clinical benefit in this patient population. We conducted a phase 1b/2 study in patients with MDM2-amplified wild-type TP53 intimal sarcoma as a sub-study of a large nationwide registry for rare cancers in Japan. Milademetan (260 mg) was administered orally once daily for three days every 14 days, twice in a 28-day cycle. Of 11 patients enrolled, 10 were included in the efficacy analysis. Two patients (20%) showed durable responses for >15 months. Anti-tumor activity correlated with TWIST1 amplification (P = 0.028) and negatively with CDKN2A loss (P = 0.071). Acquired TP53 mutations were detected in sequential liquid biopsies as a novel exploratory resistance mechanism to milademetan. These results suggest that milademetan could be a potential therapeutic strategy for intimal sarcoma.
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Affiliation(s)
| | | | - Yuki Kojima
- National Cancer Center Hospital, Tokyo, Japan
| | - Kazuki Sudo
- National Cancer Center Hospital, Tokyo, Japan
| | | | | | | | - Shinji Kohsaka
- National Cancer Center Research Institute, Tokyo, Tokyo, Japan
| | | | | | | | | | - Toshihide Ueno
- National Cancer Center Research Institute, Tokyo, Tokyo, Japan
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3
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Terada M, Nakamura K, Matsuda T, Okuma HS, Sudo K, Yusof A, Imasa M, Sirachainan E, Anh PT, Fujiwara Y, Yamamoto N, Voon PJ, Chokephaibulkit K, Shibata T, Inoue M, Mano H, Shimoi T, Sriuranpong V, Yonemori K, Shimada K. A new era of the Asian clinical research network: a report from the ATLAS international symposium. Jpn J Clin Oncol 2023:7142725. [PMID: 37099440 DOI: 10.1093/jjco/hyad033] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/04/2023] [Indexed: 04/27/2023] Open
Abstract
This report summarizes the presentations and discussions in the first Asian Clinical Trials Network for Cancers (ATLAS) international symposium that was held on 24 April 2022, in Bangkok, Thailand, and hosted by the National Cancer Center Hospital (NCCH), co-hosted by the Pharmaceuticals and Medical Devices Agency (PMDA), Clinical Research Malaysia (CRM) and the Thai Society of Clinical Oncology (TSCO), and supported by Embassy of Japan in Thailand. Since 2020, the NCCH has conducted the ATLAS project to enhance research environments and infrastructures to facilitate international clinical research and cancer genomic medicine in the Asian region. The purpose of the symposium was to discuss what we can achieve under the ATLAS project, to share the latest topics and common issues in cancer research and to facilitate mutual understanding. Invitees included stakeholders from academic institutions, mainly at ATLAS collaborative sites, as well as Asian regulatory authorities. The invited speakers discussed ongoing collaborative research, regulatory perspectives to improve new drug access in Asia, the status of phase I trials in Asia, the introduction of research activities at the National Cancer Center (NCC) and the implementation of genomic medicine. As the next steps after this symposium, the ATLAS project will foster increased cooperation between investigators, regulatory authorities and other stakeholders relevant to cancer research, and establish a sustainable pan-Asian cancer research group to increase the number of clinical trials and deliver novel drugs to patients with cancer in Asia.
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Affiliation(s)
- Mitsumi Terada
- Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan
| | - Kenichi Nakamura
- Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan
| | - Tomohiro Matsuda
- Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan
| | - Hitomi Sumiyoshi Okuma
- Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuki Sudo
- Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akhmal Yusof
- Clinical Research Malaysia, Kuala Lumpur, Malaysia
| | | | - Ekaphop Sirachainan
- Ramathibodi Comprehensive Cancer Center, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Thai Society of Clinical Oncology, Bangkok, Thailand
| | | | | | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Pei Jye Voon
- Department of Radiotherapy, Oncology and Palliative Medicine, Hospital Umum Sarawak, Sarawak, Malaysia
| | - Kulkanya Chokephaibulkit
- Siriraj Institute of Clinical Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tatsuhiro Shibata
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Manami Inoue
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Hiroyuki Mano
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Tatsunori Shimoi
- Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Virote Sriuranpong
- Thai Society of Clinical Oncology, Bangkok, Thailand
- Department of Medicine, Faculty of Medicine, The King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Kan Yonemori
- Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
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4
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Sanomachi T, Okuma HS, Kitadai R, Kawachi A, Yazaki S, Tokura M, Arakaki M, Saito A, Kita S, Yamamoto K, Maejima A, Kojima Y, Nishikawa T, Sudo K, Shimoi T, Noguchi E, Fujiwara Y, Sugino H, Shiino S, Suto A, Yoshida M, Yonemori K. Low HER2 expression is a predictor of poor prognosis in stage I triple-negative breast cancer. Front Oncol 2023; 13:1157789. [PMID: 37051545 PMCID: PMC10083471 DOI: 10.3389/fonc.2023.1157789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
IntroductionTriple-negative breast cancer (TNBC) is negative for hormone receptors and human epidermal growth factor receptor 2 (HER2). In stage I TNBC, adjuvant therapy or follow-up are performed according to risk factors, but clinical trial data is scarce. In recent years, it has been reported that HER2-low cases (1+/2+ and in situ hybridization negative) have different prognoses than HER2-0 cases. However, the risk of recurrence and risk factors in this HER2-low population for stage I TNBC have not yet been investigated.MethodsHerein, out of 174 patients with TNBC who underwent surgery from June 2004 to December 2009 at the National Cancer Center Hospital (Tokyo), we retrospectively examined 42 cases diagnosed as T1N0M0 TNBC after excluding those treated with preoperative chemotherapy.ResultsAll patients were female, the median age was 60.5 years, and 11 cases were HER2-low and 31 cases were HER2-0. The median follow-up period was 121 months. Postoperative adjuvant therapy was administered in 30 patients and recurrence occurred in 8 patients. HER2-low cases showed a significantly shorter disease-free survival (HR: 7.0; 95% CI: 1.2– 40.2; P=0.0016) and a trend towards shorter overall survival (hazard ratio [HR]: 4.2, 95% confidence interval [CI]: 0.58–31.4) compared with that of HER2-0 cases. HER2 was also identified as a factor for poor prognosis from the point- estimated values in univariate and multivariate analyses after confirming that there was no correlation between the other factors.ConclusionFor patients with stage I TNBC, the HER2-low population had a significantly worse prognosis than the HER2-0 population.
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Affiliation(s)
- Tomomi Sanomachi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hitomi Sumiyoshi Okuma
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
- *Correspondence: Hitomi Sumiyoshi Okuma,
| | - Rui Kitadai
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Asuka Kawachi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Shu Yazaki
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Momoko Tokura
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Motoko Arakaki
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ayumi Saito
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Shosuke Kita
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kasumi Yamamoto
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Aiko Maejima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Kojima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tadaaki Nishikawa
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuki Sudo
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsunori Shimoi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Emi Noguchi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hirokazu Sugino
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Sho Shiino
- Department of Breast Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Akihiko Suto
- Department of Breast Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Masayuki Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Kan Yonemori
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
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5
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Okuma HS, Yoshida H, Kobayashi Y, Arakaki M, Mizoguchi C, Inagaki L, Pei Jye V, Malik Bin Ismail A, Fen Soo Hoo H, Yusak S, Severino B Imasa M, Nguyen Huy T, Thai Anh T, Kohsaka S, Mano H, Yonemori K, Nakamura K, Yatabe Y. Molecular pathology quality control in Southeast Asia: Results of a Multiregional Quality Assurance Study from MASTER KEY Asia. Cancer Sci 2023. [PMID: 36919757 DOI: 10.1111/cas.15790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023] Open
Abstract
Tissue specimen quality assurance is a major issue of precision medicine for rare cancers. However, the laboratory standards and quality of pathological specimens prepared in Asian hospitals remain unknown. To understand the methods in Southeast Asian oncology hospitals and to clarify how pre-analytics affect the quality of formalin-fixed paraffin-embedded (FFPE) specimens, a questionnaire surveying pre-analytical procedures (Part I), quality assessment of immunohistochemistry staining (IHC) and DNA/RNA extracted from the representative FFPE specimen from each hospital (Part II), and quality of DNA/RNA extracted from FFPE of rare cancer patients for genomic sequencing (Part III), were conducted. Quality measurements for DNA/RNA included ΔΔCt, DV200, and cDNA yield. Six major cancer hospitals from Malaysia, Philippines, and Vietnam participated. One hospital showed unacceptable quality for the DNA/RNA assessment, but improved by revising laboratory procedures. Only 57% (n=73) of the 128 rare cancer patients' specimens met both DNA and RNA quality criteria for Next-Generation Sequencing. Median DV200 was 80.7% and 64.3% for qualified and failed RNA, respectively. Median ΔΔCt was 1.25 for qualified and 4.89 for failed DNA. Longer storage period was significantly associated with poor DNA (fail:qualify = 1579:321 days, p<0.001) and RNA (fail:qualify = 1070:280 days, p<0.001). After improvement of pre-analytical factors, the qualification rate increased for hospitals A and E from 41.5% to 70.5% and 62.5% to 86%, respectively. This is the first report to elucidate the pre-analytical laboratory procedures of main Southeast Asian oncology hospitals. An external quality assessment program may improve factors associated with tumor FFPE specimen quality.
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Affiliation(s)
- Hitomi Sumiyoshi Okuma
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.,Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan.,Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshihisa Kobayashi
- Division of Molecular Pathology, National Cancer Center Research Institute, Tokyo, Japan
| | - Motoko Arakaki
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Chiharu Mizoguchi
- Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan.,Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Lina Inagaki
- Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan
| | - Voon Pei Jye
- Department of Radiotherapy, Oncology and Palliative Care, Hospital Umum Sarawak (Sarawak General Hospital), Kuching Sarawak, Malaysia
| | - Adam Malik Bin Ismail
- Department of Pathology, Hospital Umum Sarawak (Sarawak General Hospital), Kuching Sarawak, Malaysia
| | - Hwoei Fen Soo Hoo
- Consultant Clinical Oncologist and Training Lead, Penang General Hospital, Pulau Pinang, Malaysia
| | - Suhana Yusak
- Department of Radiotherapy & Oncology, National Cancer Institute, Malaysia
| | | | - Thinh Nguyen Huy
- Pathology Department, Ho Chi Minh City Oncology Hospital, Vietnam
| | - Tu Thai Anh
- Pathology Department, Ho Chi Minh City Oncology Hospital, Vietnam
| | - Shinji Kohsaka
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Hiroyuki Mano
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Kan Yonemori
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.,Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan
| | - Kenichi Nakamura
- Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan.,Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Yasushi Yatabe
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
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6
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Sanomachi T, Sumiyoshi Okuma H, Yonemori K. COVID arm that appeared in the contralateral upper extremity after mRNA-1273 booster inoculation. Int Cancer Conf J 2023; 12:216-219. [PMID: 36843626 PMCID: PMC9939858 DOI: 10.1007/s13691-023-00598-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/04/2023] [Indexed: 02/25/2023] Open
Abstract
We report the findings of a 60-year-old female patient with metastatic breast cancer who presented with severe edema and neuralgia in the contralateral arm after receiving the third COVID-19 vaccine dose. The patient did not report any reaction to the first two doses of the BNT162b2 (Pfizer-BioNTech) vaccine. However, after a booster dose with the mRNA-1273 (Moderna) vaccine, the patient developed a high fever persisting for one week after the shot, and sequential severe swelling, inflammation, and pain in the contralateral arm lasting for three weeks.
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Affiliation(s)
- Tomomi Sanomachi
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, Department of International Clinical Development, Clinical Research Support Office, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, Japan
| | - Hitomi Sumiyoshi Okuma
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, Department of International Clinical Development, Clinical Research Support Office, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, Japan
| | - Kan Yonemori
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, Department of International Clinical Development, Clinical Research Support Office, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, Japan
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7
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Takamizawa S, Yazaki S, Kojima Y, Yoshida H, Kitadai R, Nishikawa T, Shimoi T, Sudo K, Okuma HS, Tanioka M, Noguchi E, Uno M, Ishikawa M, Kato T, Fujiwara Y, Yonemori K. High mesothelin expression is correlated with non-squamous cell histology and poor survival in cervical cancer: a retrospective study. BMC Cancer 2022; 22:1215. [PMID: 36434635 PMCID: PMC9701073 DOI: 10.1186/s12885-022-10277-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/02/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Mesothelin (MSLN) is a cell-surface glycoprotein found in various solid tumours. Cancer therapies targeting MSLN have been developed in recent years; however, the available information on MSLN expression in cervical cancer is limited. This study aimed to evaluate MSLN expression in various histological types of cervical cancer and examine its relationship with prognosis. METHODS This retrospective study included patients with cervical cancer who underwent primary surgery between January 2000 and December 2020 at our institution. MSLN expression was evaluated by immunohistochemistry using clone SP74 and defined as positive if MSLN was expressed at any intensity. High MSLN expression was defined as an intensity of ≥ 2 + in ≥ 30% of tumour cells. The association between MSLN expression and clinicopathological factors was evaluated. RESULTS Overall, 123 patients were identified, and 140 tumour samples, including 17 paired primary and metastatic samples, were evaluated. Concerning histological type, 67 patients had squamous cell carcinoma (SCC), whereas 56 had non-SCC. MSLN expression was observed in 98.4% (121/123) of primary tumours. High MSLN expression was observed in 63.4% of samples (78/123), but it differed between the histological types (49.2% for SCC vs. 80.4% for non-SCC, p < 0.001). There was a significant correlation between MSLN expression in primary and metastatic lesions (Rs = 0.557, p = 0.015). In patients with common histological types, overall survival (OS) was shorter in the high MSLN expression group than in the low MSLN expression group (hazard ratio, 3.53; 95% confidence interval, 1.16-15.3, p = 0.03). CONCLUSIONS MSLN was highly expressed in patients with cervical cancer, especially in those with non-SCC. High MSLN expression in the primary lesion was significantly associated with poor OS, and its expression was maintained in metastatic lesions. Our findings indicate that MSLN may be an attractive therapeutic target for cervical cancer. TRIAL REGISTRATION Retrospectively registered. 2014-393. 1 June 2015.
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Affiliation(s)
- Shigemasa Takamizawa
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Shu Yazaki
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Yuki Kojima
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Hiroshi Yoshida
- grid.272242.30000 0001 2168 5385Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Rui Kitadai
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Tadaaki Nishikawa
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Tatsunori Shimoi
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Kazuki Sudo
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Hitomi Sumiyoshi Okuma
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Maki Tanioka
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Emi Noguchi
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Masaya Uno
- grid.272242.30000 0001 2168 5385Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Mitsuya Ishikawa
- grid.272242.30000 0001 2168 5385Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Tomoyasu Kato
- grid.272242.30000 0001 2168 5385Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Fujiwara
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Kan Yonemori
- grid.272242.30000 0001 2168 5385Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
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8
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Yazaki S, Kojima Y, Yoshida H, Takamizawa S, Kitadai R, Nishikawa T, Shimoi T, Sudo K, Saito A, Okuma HS, Tanioka M, Noguchi E, Uno M, Ishikawa M, Kato T, Fujiwara Y, Ohe Y, Yonemori K. High expression of folate receptor alpha is associated with poor prognosis in patients with cervical cancer. J Gynecol Oncol 2022; 33:e82. [PMID: 36245230 PMCID: PMC9634091 DOI: 10.3802/jgo.2022.33.e82] [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: 06/02/2021] [Revised: 08/03/2021] [Accepted: 08/11/2022] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Folate receptor α (FRα) is a membrane protein expressed in various solid tumors but has limited expression in normal cells. Therefore, FRα is an attractive target for cancer treatment. This study aimed to investigate the relationship between FRα expression and the clinicopathological characteristics and survivals of cervical cancer. METHODS This retrospective study included patients with cervical cancer who underwent primary surgery between 2000 and 2020 at our institution. Immunohistochemical staining of FRα was performed using an anti-folate-binding protein/FBP antibody. FRα-positive staining was defined as ≥5% of tumor staining and FRα-high as ≥50% tumor staining with ≥2+ intensity. The association between FRα expression and survival was assessed using multivariate Cox regression analysis, adjusting for established prognostic factors. RESULTS Overall, 123 patients were identified, and 140 tumor samples, including 17 paired primary and metastatic samples, were evaluated. As histological types, 67 patients had squamous cell carcinoma (SCC), and 56 patients had non-SCC. All primary tumors were FRα-positive. High FRα expression was observed in 25% of the cases and differed according to histology (SCC vs. non-SCC, 14.9% vs. 37.5%, p=0.004). FRα expression was significantly higher in metastatic tumors than in primary (170 [IQR, 140-205] vs. 125 [IQR, 110-150], p=0.0006). High FRα expression was significantly associated with worse overall survival (hazard ratio, 6.73; 95% confidence interval, 2.21-20.53; p=0.001). CONCLUSION In cervical cancer, FRα expression was elevated in metastatic tumors and high expression was associated with a worse prognosis. Our study supports the development of FRα-targeted therapy for advanced cervical cancer.
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Affiliation(s)
- Shu Yazaki
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.,Department of Cancer Medicine, Jikei University Graduate School of Medicine, Tokyo, Japan
| | - Yuki Kojima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Rui Kitadai
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tadaaki Nishikawa
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsunori Shimoi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuki Sudo
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ayumi Saito
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Maki Tanioka
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Emi Noguchi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masaya Uno
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Mitsuya Ishikawa
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Tomoyasu Kato
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichiro Ohe
- Department of Cancer Medicine, Jikei University Graduate School of Medicine, Tokyo, Japan
| | - Kan Yonemori
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
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9
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Okuma HS, Yonemori K, Kojima Y, Tanioka M, Sudo K, Noguchi E, Hijioka S, Wakakuwa K, Kato K, Hirakawa A, Kuchiba A, Kubo T, Ichikawa H, Yoshida A, Yatabe Y, Nakamura K, Mano H, Yamamoto N, Fujiwara Y. Clinical Utility of Circulating Tumor DNA in Advanced Rare Cancers. Front Oncol 2021; 11:732525. [PMID: 34900683 PMCID: PMC8652216 DOI: 10.3389/fonc.2021.732525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose Patients with advanced/relapsed rare cancers have few treatment options. Analysis of circulating tumor DNA in plasma may identify actionable genomic biomarkers using a non-invasive approach. Patients and Methods Rare cancer patients underwent prospective plasma-based NGS testing. Tissue NGS to test concordance was also conducted. Plasma DNA alterations were assessed for incidence, functional impact, therapeutic implications, correlation to survival, and comparison with tissue NGS. Results Ninety-eight patients were analyzed. Diseases included soft-tissue sarcoma, ovarian carcinoma, and others. Mean turn-around-time for results was 9.5 days. Seventy-six patients had detectable gene alterations in plasma, with a median of 2.8 alterations/patient. Sixty patients had a likely pathogenic alteration. Five received matched-therapy based on plasma NGS results. Two developed known resistance mutations while on targeted therapy. Patients with an alteration having VAF ≥5% had a significantly shorter survival compared to those of lower VAF. Tissue NGS results from eleven of 22 patients showed complete or partial concordance with plasma NGS. Conclusion Plasma NGS testing is less invasive and capable of identifying alterations in advanced rare cancers in a clinically meaningful timeframe. It should be further studied as a prospective enrollment assay in interventional studies for patients with rare advanced stage cancers. Clinical Registration [https://www.umin.ac.jp/ctr/index-j.htm], identifier UMIN000034394.
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Affiliation(s)
- Hitomi Sumiyoshi Okuma
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.,Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Kan Yonemori
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Kojima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Maki Tanioka
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuki Sudo
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Emi Noguchi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Susumu Hijioka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Keiko Wakakuwa
- Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Ken Kato
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akihiro Hirakawa
- Division of Biostatistics and Data Science, Clinical Research Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Aya Kuchiba
- Biostatistics Division, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan
| | - Takashi Kubo
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Hitoshi Ichikawa
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasushi Yatabe
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Kenichi Nakamura
- Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyuki Mano
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.,Chief Executive, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
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10
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Okuma HS, Yonemori K, Kojima Y, Tanioka M, Sudo K, Noguchi E, Hijioka S, Wakakuwa K, Kato K, Ichikawa H, Hirakawa A, Kuchiba A, Shibata T, Sukigara T, Nakamura K, Yamamoto N. Potentially targetable alterations identified in circulating tumor DNA (ctDNA) from patients (pts) with advanced rare cancers. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e15540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15540 Background: People with rare cancers have limited treatment options. In April 2017, the MASTER KEY Project, a prospective registry study with multiple clinical trials embedded, was established to promote treatment development for rare cancers. ctDNA analysis by next-generation sequencing (NGS) has provided new insight into personalized medicine; however, reports are focused on common cancers. Using our platform, we examined the feasibility of ctDNA NGS analysis for rare solid cancers. Methods: Prospectively consented pts with advanced rare cancers enrolled in MASTER KEY had ctDNA NGS testing (Guardant360, Guardant Health). Alterations were assessed for incidence according to cancer type, functional impact, and therapeutic implications. Results: From Nov 2018 to Jan 2019, 98 samples from 100 consented pts were analyzed. Diseases included soft tissue sarcoma (39); cancers of the ovary (12) and salivary gland (9); neuroendocrine tumors (8); carcinoma of unknown primary (6); carcinosarcoma (5); mesothelioma (4); gastrointenstinal stromal tumor (3); and olfactory neuroblastoma (2). All pts were Japanese, male/female = 40/58, median age 53, ECOG performance status 0/1/2/3 = 56/41/0/1, prior pharmacotherapy yes/no = 77/21. 76% of pts (75/98) had at least 1 alteration detected (median 2.8/pt; range: 0-9), with variant allelic frequency of 0.1-73.3%; 61%(60/98) of pts had a likely pathogenic variant, most commonly TP53 (43), KRAS (11), and NRAS (6); 36% (36/98) had a potentially actionable variant, such as BRCA1/2 (6), EGFR (6), PIK3CA (6), ARID1A (5), FGFR1/2/3 (4), and other homologous recombination deficiency genes. Known resistant mutations such as ROS1 G2032R and RAS mutations were detected in patients on a ROS inhibitor and a BRAF inhibitor, respectively, which suggested drug resistance prior to clinical diagnostic imaging. Mean turn-around-time from blood collection was 9.5 days. Conclusions: ctDNA testing is capable of rapidly identifying alterations that lead to clinical decision making in pts with advanced rare cancers, who have a crucial lack of treatment options compared to common cancer pts. Clinical trial information: UMIN000034394.
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Affiliation(s)
| | - Kan Yonemori
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Kojima
- National Cancer Center Hospital, Tokyo, Japan
| | | | - Kazuki Sudo
- National Cancer Center Hospital, Tokyo, Japan
| | - Emi Noguchi
- National Cancer Center Hospital, Tokyo, Japan
| | - Susumu Hijioka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Ken Kato
- National Cancer Center Hospital, Tokyo, Japan
| | | | - Akihiro Hirakawa
- Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Taro Shibata
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | | | | | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
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11
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Okuma HS, Yonemori K. [Ⅲ.MASTER KEY Project-A Platform Study for Rare Cancers]. Gan To Kagaku Ryoho 2020; 47:436-440. [PMID: 32381910] [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: 06/11/2023]
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12
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Amaya Y, Yonemori K, Okuma HS, Narita S, Hirakawa A, Okita N, Sukigara T, Kanai M, Muto M, Nakamura K, Fujiwara Y. ROCK Trial (NCCH1709): Nivolumab monotherapy in Rare cancer patients with mismatch repair deficiency biomarker: phase II. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz343.088] [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: 11/15/2022] Open
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13
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Okuma HS, Kubo T, Ichikawa H, Kohno T, Mizuno T, Kojima Y, Sunami K, Shimomura A, Iwasa S, Kondo S, Fujiwara Y, Yonemori K, Tamura K, Yamamoto N. Targeted-sequencing in rare cancers and the impact on patient treatment. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e14755] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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
e14755 Background: Rare cancers lack standard or investigational therapeutic options. Next-generation sequencing (NGS) has provided new insight into personalized medicine. We sought to catalog genetic alterations detected from tissue NGS in rare cancers and to assess their clinical utility. Methods: This was a single-center series with patients (pts) who had been referred to the National Cancer Center Hospital (Tokyo, Japan). Patients with a metastatic/unresectable disease who underwent comprehensive genomic profiling of their tumor for the purpose of precision treatment were first identified (approved by the NCCH institutional review board). Among them, pts diagnosed as rare cancers, defined as an incidence of < 6/100,000 pts/year, were included in this study. Prospectively consentedpts had tissue NGS testing (NCC Oncopanel) for point mutations, select indels, copy number amplifications, fusions. Alterations were assessed for incidence according to cancer type, functional impact, therapeutic implications. Results: Between July 2013 to April 2016, 289 pts were enrolled. 217 pts with sufficient tissue sample succeeded in sequencing. 78% (169/217) had a least one alteration most likely pathogenic. Most common alterations were TP53, PIK3CA, BRCA2, KRAS, MYC, ERBB2, RB1, CCND1, and ARID1A. 114/289 pts (39%) were classified as rare cancers: gynecological cancers (44 pts), cholangiocarcinoma (20), sarcomas (16), NET (9), thymic carc. (6), mesothelioma (3), CUP (2), urachal carc. (2), GIST (1), thyroid carc. (1), other super-rare cancers (10). 86 pts succeeded in sequencing; 72 % (62/86) had a variant most likely pathogenic. Most common alterations were TP53, KRAS, BRCA2, FBXW7, NF1, PIK3CA, ALK, BRCA1, and CCND1. 23 pts (27%) of rare cancer pts received a targeted drug of which 9 (10%) were “matched” to a detected alteration. Response rate to the “matched” therapy was CR/PR/SD/PD = 0/1/5/3 (ORR 11%). Conclusions: Genomic alterations were equally detected in rare cancers as well as common cancers, however showed different alteration profiles. Rare cancer pts receiving “matched” therapy and the response rate to those remain low, suggesting a need for a more efficient treatment development platform. Clinical trial information: UMIN000011141.
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Affiliation(s)
| | - Takashi Kubo
- National Cancer Center Research Institute, Tokyo, Japan
| | | | - Takashi Kohno
- National Cancer Center Research Institute, Tokyo, Japan
| | - Takaaki Mizuno
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Kojima
- National Cancer Center Hospital, Tokyo, Japan
| | | | - Akihiko Shimomura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Satoru Iwasa
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | | | - Yutaka Fujiwara
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kan Yonemori
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kenji Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
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14
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Okuma HS, Yonemori K, Seo T, Noguchi E, Wakakuwa K, Kato K, Ichikawa H, Kohno T, Hirakawa A, Kuchiba A, Shibata T, Sukigara T, Nakamura K, Mano H, Nishida T, Fujiwara Y. Circulating tumor DNA molecular profiling in rare cancer patients from the MASTER KEY Project. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e14532] [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
e14532 Background: In April 2017, MASTER KEY Project, composed of a prospective registry study part and a multiple clinical trials part, was established to promote treatment development for rare cancers, which is lacking standard or investigational therapeutic options. Circulating tumor DNA (ctDNA) analysis by next-generation sequencing (NGS) has provided new insight into personalized medicine in a more accessible, non-invasive manner; however, most reports are focused on common cancers. We report genetic alterations detected by ctDNA NGS analysis in rare solid cancers. Methods: Prospectively consented patients (pts), also enrolled in MASTER KEY registry study, had ctDNA NGS testing at a CLIA-certified lab (Guardant360) for point mutations, indels, copy number amplifications, fusions, and microsatellite instability. Alterations were assessed for incidence according to cancer type, functional impact, therapeutic implications, and comparison with tissue NGS. Main inclusion criteria: 1) age ≥16, 2) histological diagnosis of rare cancer (annual incidence less than 6 cases per 100,000 population), cancer of unknown primary (CUP), or rare tissue subtypes of common cancers, 3) active metastatic / unresectable cancer, 4) a written consent. Results: From Nov. 2018 to Jan 2019, 50 pts had Guardant360 testing. Diseases included: soft tissue sarcoma (28), ovarian carc. (7), CUP (4), salivary gland tumor (3), thyroid carc. (2), GIST (1), adrenal cortical carc. (1), rare subtype of GI tract (1), malignant mesothelioma (1), nephroblastoma (1), NET (1), NUT carc. (1). All Japanese, male/female = 14/36, median age 61, ECOG performance status 0/1/2/3 = 30/19/0/1. 76% of pts (38/50) had ≥1 alteration detected, with median number of 2 alterations (range: 0-9), with VAF(0.1-60.3%); 87%(33/38) of those pts had a variant most likely pathogenic; 61% (20/33) of those pts had a variant potential for clinical action. Mean TAT was 10.3 days. 19 pts had tissue NGS testing and in 3 pts, alterations were detected by ctDNA NGS but not by tissue NGS. Updated results of 100 patients will be presented at the conference. Conclusions: Most rare cancer patients with advanced disease had a detectable genomic alteration by Guardant360. Clinical trial information: UMIN000034394.
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Affiliation(s)
| | - Kan Yonemori
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takuji Seo
- National Cancer Center Hospital, Sera, Japan
| | - Emi Noguchi
- National Cancer Center Hospital, Tokyo, Japan
| | | | - Ken Kato
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Takashi Kohno
- National Cancer Center Research Institute, Tokyo, Japan
| | | | - Aya Kuchiba
- Biostatistics Division, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan
| | - Taro Shibata
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | | | - Kenichi Nakamura
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyuki Mano
- Division of Cellular Signaling, National Cancer Center Reseach Institute, Tokyo, Japan
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15
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Okuma HS, Yonemori K, Shimizu T, Goto Y, Honma Y, Morizane C, Noguchi E, Sudo K, Munakata W, Sunami K, Hiraoka N, Kohno T, Hirakawa A, Shibata T, Sukigara T, Kawai A, Yamamoto N, Nakamura K, Nishida T, Fujiwara Y. MASTER KEY project: A basket/umbrella trial for rare cancers in Japan. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps2598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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)
| | | | | | | | | | | | - Emi Noguchi
- National Cancer Center Hospital, Tokyo, Japan
| | - Kazuki Sudo
- National Cancer Center Hospital, Tokyo, Japan
| | | | | | | | - Takashi Kohno
- National Cancer Center Research Institute, Tokyo, Japan
| | | | - Taro Shibata
- Japan Clinical Oncology Group Data Center, National Cancer Center, Tokyo, Japan
| | | | - Akira Kawai
- National Cancer Center Hospital, Tokyo, Japan
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16
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Okuma HS, Horinouchi H, Kitahara S, Asao T, Sunami K, Goto Y, Kanda S, Fujiwara Y, Nokihara H, Yamamoto N, Ohe Y. Comparison of Amrubicin and Weekly Cisplatin/Etoposide/Irinotecan in Patients With Relapsed Small-cell Lung Cancer. Clin Lung Cancer 2017; 18:234-240.e2. [DOI: 10.1016/j.cllc.2016.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 09/05/2016] [Accepted: 09/06/2016] [Indexed: 10/20/2022]
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17
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Okuma HS, Yonemori K. BRCA Gene Mutations and Poly(ADP-Ribose) Polymerase Inhibitors in Triple-Negative Breast Cancer. Advances in Experimental Medicine and Biology 2017; 1026:271-286. [DOI: 10.1007/978-981-10-6020-5_13] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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18
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Okuma HS, Kobayashi Y, Makita S, Kitahara H, Fukuhara S, Munakata W, Suzuki T, Maruyama D, Tobinai K. Disseminated herpes zoster infection initially presenting with abdominal pain in patients with lymphoma undergoing conventional chemotherapy: A report of three cases. Oncol Lett 2016; 12:809-814. [PMID: 27446355 PMCID: PMC4950796 DOI: 10.3892/ol.2016.4683] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 01/26/2015] [Accepted: 03/15/2016] [Indexed: 12/31/2022] Open
Abstract
Visceral disseminated varicella zoster virus (VZV) disease has a high mortality rate, and occurs in immunocompromised hosts, mostly subsequent to allogeneic stem cell transplantation. Only a few cases of this disease that onset during conventional chemotherapy in patients with lymphoma have been reported. The present study reports the cases of 3 patients with disseminated and visceral VZV infection undergoing treatment for follicular lymphoma, diffuse large B-cell lymphoma and peripheral T-cell lymphoma, not otherwise specified. All 3 patients presented with initial symptoms of abdominal pain, and 2 patients demonstrated syndrome of inappropriate antidiuretic hormone and hepatitis. All patients developed widespread cutaneous dissemination, and all had a low cluster of differentiation 4 cell count or lymphocyte count at the time of VZV diagnosis and at least 4 month prior. With intravenous systemic acyclovir therapy (Cases 1 and 3, 1500 mg/day; Case 2, 750 mg/day), the patients achieved complete recovery by day 14 of therapy. Visceral disseminated VZV infection is not limited to patients undergoing stem cell transplantation, and may present with abdominal pain with or without skin eruption. Visceral infection may take a poor clinical course, therefore, in patients with prolonged duration of low lymphocyte count and/or long-term use of steroids, the prophylactic use of acyclovir may be considered.
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Affiliation(s)
- Hitomi Sumiyoshi Okuma
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan; Department of Medical Oncology, Graduate School of Medicine, Chiba University Hospital, Chiba, Chiba 260-8670, Japan
| | - Yukio Kobayashi
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Shinichi Makita
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Hideaki Kitahara
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Suguru Fukuhara
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Wataru Munakata
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Tatsuya Suzuki
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Dai Maruyama
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Kensei Tobinai
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
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19
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Okuma HS, Iwasa S, Shoji H, Takashima A, Okita N, Honma Y, Kato K, Hamaguchi T, Yamada Y, Shimada Y. Irinotecan plus cisplatin in patients with extensive-disease poorly differentiated neuroendocrine carcinoma of the esophagus. Anticancer Res 2014; 34:5037-5041. [PMID: 25202088] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Poorly-differentiated neuroendocrine carcinoma (NEC) of the esophagus is a rare subtype that has a poor prognosis and is distinguished from well-differentiated neuroendocrine neoplasms in accordance with the 2010 World Health Organization classification. Irinotecan-plus-cisplatin (IP) is used as first-line chemotherapy for extensive-disease (ED) small-cell lung cancer and its use is plausible for first-line chemotherapy in ED esophageal NEC. We retrospectively analyzed the efficacy and toxicity of IP for ED esophageal NEC. PATIENTS AND METHODS Patients with ED esophageal NEC treated with IP between 2000 and 2013 were retrospectively identified from our database. The end-points were objective response rate, progression-free survival (PFS) and overall survival (OS). Data on adverse events were also collected. RESULTS An objective response was achieved in 50% (95% confidence interval [CI]: 25% to 75%) of 12 identified patients. Median progression-free survival was 4.0 months (95% CI: 0.9 to 7.6) and overall survival was 12.6 months (95% CI: 4.6 to 28.6). Grade 3/4 hematological toxicities included leukopenia in 50% of patients and neutropenia in 67%. The rate of febrile neutropenia was 25%. No treatment-related deaths were observed. CONCLUSION IP appears acceptable as first-line chemotherapy for ED esophageal NEC.
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Affiliation(s)
- Hitomi Sumiyoshi Okuma
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan Department of Medical Oncology, Graduate School of Medicine, Chiba University Hospital, Chiba, Japan
| | - Satoru Iwasa
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hirokazu Shoji
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Atsuo Takashima
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Natsuko Okita
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshitaka Honma
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Ken Kato
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Tetsuya Hamaguchi
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhide Yamada
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Shimada
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
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