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Nakano Y, Nishida K, Okamoto N, Gohma I, Yasuhara Y. Anti-MDA5 Antibody-Positive Clinically Amyopathic Dermatomyositis Associated With Multiple Heterologous Carcinomas: A Case Report. Cureus 2024; 16:e54660. [PMID: 38523968 PMCID: PMC10960095 DOI: 10.7759/cureus.54660] [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] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Dermatomyositis (DM), an autoimmune disorder, is linked to increased malignancy risk. A 53-year-old man with anti-melanoma differentiation-associated gene 5 (MDA5)-positive clinically amyopathic dermatomyositis (CADM) and rapidly progressing interstitial lung disease (RP-ILD) developed heterochronous gastric and colorectal cancers. Early endoscopic screenings led to successful curative resections, preventing recurrence. Despite low cancer incidence assumptions in patients with anti-MDA5-positive RP-ILD, this case advocates for reevaluation and periodic cancer screenings to enhance management, considering the improved survival with intensive therapy. Vigilance for multiple carcinomas at various time points is vital in CADM management.
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Affiliation(s)
- Yoshio Nakano
- Respiratory Medicine, Sakai City Medical Center, Osaka, JPN
| | - Koji Nishida
- Respiratory Medicine, Sakai City Medical Center, Osaka, JPN
| | - Norio Okamoto
- Respiratory Medicine, Sakai City Medical Center, Osaka, JPN
| | - Iwao Gohma
- Respiratory Medicine, Sakai City Medical Center, Osaka, JPN
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Okamoto N, Mineta S, Mishima K, Fujiyama Y, Wakabayashi T, Fujita S, Sakamoto J, Wakabayashi G. Comparison of short-term outcomes of robotic and laparoscopic transabdominal peritoneal repair for unilateral inguinal hernia: a propensity-score matched analysis. Hernia 2023; 27:1131-1138. [PMID: 36595086 DOI: 10.1007/s10029-022-02730-7] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/19/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE This study aimed to compare perioperative outcomes of robotic and laparoscopic transabdominal peritoneal repair (TAPP) for unilateral inguinal hernia. METHODS This single institutional retrospective cohort study used de-identified data of patients who underwent robotic TAPP (R-TAPP) or laparoscopic TAPP (L-TAPP) for unilateral inguinal hernia between January 1, 2016 and October 31, 2021. Two cohorts were propensity matched, and data were analyzed. The learning curve was evaluated in the R-TAPP group. RESULTS Among 938 patients analyzed, 704 were included. After propensity-score matching, 80 patients were included in each group. The difference in operative time between R-TAPP and L-TAPP groups was 10 min (99.5 and 89.5 min, p = 0.087); however, console/laparoscopic time was similar (67 and 66 min, p = 0.71). The dissection time for medial-type hernia in the R-TAPP group was marginally shorter than that in the L-TAPP group (17 and 27 min, p = 0.056); however, there was no difference for lateral-type hernia (38.5 and 40 min p = 0.37). Perioperative variables, including estimated blood loss, postoperative hospital stay, and postoperative pain, had no significant difference, and chronic pain, which needed medication or intervention, was not observed in each group. The number of cases needed to achieve plateau performance was 7-10 in the R-TAPP group. CONCLUSION This study suggests that R-TAPP was safely introduced, and its perioperative outcomes were not inferior to those of L-TAPP. A shorter dissection time for medial-type hernia might be due to the robot's advantages, and a fast-learning curve could help with the early standardization of the procedure.
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Affiliation(s)
- N Okamoto
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan.
| | - S Mineta
- Department of Surgery, Chiba Tokusyukai Hospital, Funabashi, Japan
| | - K Mishima
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| | - Y Fujiyama
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| | - T Wakabayashi
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| | - S Fujita
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| | - J Sakamoto
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| | - G Wakabayashi
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
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Nakano Y, Sekinada D, Masuda G, Nishio C, Nishida K, Okamoto N, Gohma I, Esa Y. Clarithromycin-induced eosinophilic granulomatosis with polyangiitis: A case report. Respir Med Case Rep 2023; 44:101878. [PMID: 37305218 PMCID: PMC10249010 DOI: 10.1016/j.rmcr.2023.101878] [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: 03/24/2023] [Revised: 04/26/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023] Open
Abstract
A 75-year-old man presented to our hospital with chronic sinusitis, bronchiectasis, and chronic lower respiratory tract infections. He began taking erythromycin in August, X-2. The chronic lower respiratory tract infection gradually worsened, and clarithromycin was started on May 11, X. He became aware of fever and numbness in his lower legs on June 4, X. The sign occurred soon after oral clarithromycin and blood tests showed an elevated eosinophil count and C-reactive protein (CRP) levels, positive MPO-ANCA antibodies, and positive for drug-induced lymphocyte stimulation test (DLST); we diagnosed eosinophilic granulomatosis with polyangiitis (EGPA) associated with clarithromycin administration.
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Affiliation(s)
- Yoshio Nakano
- Department of Respiratory Medicine, Sakai City Medical Center, 1-1-1, Ebaraji-cho, West Ward, Sakai City, Osaka Prefecture, 593-8304, Japan
| | - Daisuke Sekinada
- Department of Respiratory Medicine, Sakai City Medical Center, 1-1-1, Ebaraji-cho, West Ward, Sakai City, Osaka Prefecture, 593-8304, Japan
| | - Gen Masuda
- Department of Respiratory Medicine, Sakai City Medical Center, 1-1-1, Ebaraji-cho, West Ward, Sakai City, Osaka Prefecture, 593-8304, Japan
| | - Chihiro Nishio
- Department of Respiratory Medicine, Sakai City Medical Center, 1-1-1, Ebaraji-cho, West Ward, Sakai City, Osaka Prefecture, 593-8304, Japan
| | - Koji Nishida
- Department of Respiratory Medicine, Sakai City Medical Center, 1-1-1, Ebaraji-cho, West Ward, Sakai City, Osaka Prefecture, 593-8304, Japan
| | - Norio Okamoto
- Department of Respiratory Medicine, Sakai City Medical Center, 1-1-1, Ebaraji-cho, West Ward, Sakai City, Osaka Prefecture, 593-8304, Japan
| | - Iwao Gohma
- Department of Respiratory Medicine, Sakai City Medical Center, 1-1-1, Ebaraji-cho, West Ward, Sakai City, Osaka Prefecture, 593-8304, Japan
| | - Yoshiki Esa
- Department of Neurology, Sakai City Medical Center, 1-1-1, Ebaraji-cho, West Ward, Sakai City, Osaka Prefecture, 593-8304, Japan
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Nakano Y, Sekinada D, Kuze Y, Okamoto N, Gohma I, Yasuhara Y. A case of thoracic
SMARCA4
‐Deficient
undifferentiated tumor successfully treated with combination
Ipilimumab–Nivolumab. Clin Case Rep 2022; 10:e6745. [PMCID: PMC9748223 DOI: 10.1002/ccr3.6745] [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: 10/03/2022] [Revised: 11/22/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Yoshio Nakano
- Department of Respiratory Medicine Sakai City Medical Center Sakai City Japan
| | - Daisuke Sekinada
- Department of Respiratory Medicine Sakai City Medical Center Sakai City Japan
| | - Yusuke Kuze
- Department of Respiratory Medicine Sakai City Medical Center Sakai City Japan
| | - Norio Okamoto
- Department of Respiratory Medicine Sakai City Medical Center Sakai City Japan
| | - Iwao Gohma
- Department of Respiratory Medicine Sakai City Medical Center Sakai City Japan
| | - Yumiko Yasuhara
- Department of Pathology Sakai City Medical Center Sakai City Japan
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Ramanan A, Quartier P, Okamoto N, Meszaros G, Araujo J, Wang Z, Liao R, Crowe B, Zhang X, Decker R, Keller S, Brunner H, Ruperto N. LB0002 BARICITINIB IN JUVENILE IDIOPATHIC ARTHRITIS: A PHASE 3, DOUBLE-BLIND, PLACEBO-CONTROLLED, WITHDRAWAL, EFFICACY AND SAFETY STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5091a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundBaricitinib is a JAK1/2 selective inhibitor approved for the treatment of rheumatoid arthritis. Juvenile idiopathic arthritis (JIA) is a group of diseases characterized by immune mediated chronic arthritis which often requires treatment with conventional synthetic or biologic disease-modifying antirheumatic drugs (cs or b-DMARDs).ObjectivesTo investigate baricitinib efficacy and safety in pediatric patients with JIA and an inadequate response to cs or b-DMARDs.MethodsThis Phase 3 multicenter, double-blind, withdrawal, efficacy, and safety study, enrolled patients (pts) age 2 to <18 years with extended oligo- or poly-articular JIA, ERA, or JPsA, per ILAR criteria, and an inadequate response to ≥1 cs and/or b-DMARDs (NCT03773978). There were 3 periods: a 2-week (wk) pharmacokinetic/safety assessment (PKS), a 12-wk open-label lead-in (OLLI), and an up-to 32-wk double-blind withdrawal (DBW). Dosage and safety were confirmed in the PKS and then pts, including those from the PKS, enrolled in the OLLI, receiving age-based, oral, once daily doses of baricitinib. Pts with a JIA-ACR30 response at wk12, end of OLLI, entered the DBW to be randomized 1:1 to continued baricitinib or newly started placebo (PBO) and remained until flare or up to wk32. Primary endpoint was time to flare during the DBW. Secondary endpoints included JIA-ACR30/50/70/90 response rates at wk12, and proportion of pts with a flare during the DBW. Survival curves were estimated using the Kaplan-Meier method.ResultsOf 220 pts enrolled, 29 participated in the PKS, 219 entered the OLLI, and 163 entered the DBW. The JIA-ACR30/50/70/90 response at wk12 was 76.3%/63.5%/46.1%/20.1%, respectively. During the DBW, time of flare was significantly shorter with PBO vs baricitinib (hazard ratio 0.24 [95% CI 0.13,0.45], p<0.001; Figure 1). The proportion of pts with a flare during the DBW was significantly lower for baricitinib vs PBO (14 (17.1%) vs. 41 (50.6%), p<0.001). In the PKS and OLLI periods, 126 (57.3%) pts reported ≥1 treatment emergent adverse event (TEAE), while 6 (2.7%) reported ≥1 serious adverse event (SAE); Table 1. In the DBW, 38 (46.9%) and 54 (65.9%) pts reported ≥1 TEAE for PBO and baricitinib, respectively, whereas those with ≥1 SAE were 3 (3.7%) and 4 (4.9%). The mean wks of exposure was higher in the baricitinib vs PBO group during DBW (26.34 vs 18.91) due to study design. There were no deaths, cardiovascular events or uveitis and 1 case of herpes zoster.
Table 1.Safety dataEvents, N (%)PKS and OLLI (N=220)Events, N (%)DBW Placebo (N=81)DBW Baricitinib (N=82)Discontinuations due to AEs2 (0.9)2 (2.5)1 (1.2)TEAEs126 (57.3)38 (46.9)54 (65.9)most common TEAEsNasopharyngitis19 (8.6)URTI1 (1.2)9 (11.0)Headache14 (6.4)Headache3 (3.7)9 (11.0)Arthralgia12 (5.5)Nasopharyngitis3 (3.7)6 (7.3)URTI11 (5.0)Arthralgia3 (3.7)6 (7.3)Nausea11 (5.0)Oropharyngeal pain1 (1.2)5 (6.1)SAEs6 (2.7)3 (3.7)4 (4.9)All reported SAEsArthralgia1 (0.5)COVID-1901 (1.2)Joint Destruction1 (0.5)Gastroenteritis01 (1.2)Joint Effusion1 (0.5)Headache01 (1.2)JIA1 (0.5)Pulmonary Embolism01 (1.2)Musculoskeletal Chest Pain1 (0.5)Bronchospasm1 (1.2)0Decreased Appetite1 (0.5)JIA1 (1.2)0Suicide Attempt1 (1.2)0Potential opportunistic infections2 (0.9)1 (1.2)1 (1.2)Herpes virus1 (0.5)Herpes virus1 (1.2)0Herpes zoster1 (0.5)Candida01 (1.2)URTI= Upper Respiratory Tract InfectionConclusionBaricitinib significantly reduced time to and frequency of JIA flares in pts with JIA versus PBO, and improved JIA-ACR scores in the majority of pts within 12wks. Safety findings were consistent with the known safety profile in adult rheumatoid arthritis indications. These findings support baricitinib as a treatment for signs and symptoms of JIA with an inadequate response to cs or b-DMARDs.References[1]Giannini EH, et. al. Preliminary definition of improvement in juvenile arthritis. Arthritis Rheum 1997; 40: 1202-1209.[2]Brunner HI, et. al. Preliminary definition of disease flare in juvenile rheumatoid arthritis. J Rheumatol 2002; 29(5):1058-64.Disclosure of InterestsAthimalaipet Ramanan Consultant of: Eli Lilly and Company, Abbvie, Roche, UCB, Novartis, Pfizer, and Sobi, Grant/research support from: Eli Lilly and Company, Pierre Quartier Consultant of: Eli Lilly and Company, Abbvie, Amgen, BMS, Novartis, Novimmune, Pfizer, Swedish Orphan Biovitrum, SANOFI, Speakers bureau: Abbvie, Novartis, Pfizer, Swedish Orphan Biovitrum, Nami Okamoto Consultant of: Swedish Orphan Biovitrum, Eli Lilly and Company, Speakers bureau: AbbVie, Eli Lilly and Company, Sanofi, Asahi Kasei Medical, Mitsubishi Tanabe Pharma, Bristol Myers Squibb, Pfizer Japan, Ayumi Pharma, Eisai, Torii Pharma, GlaxoSmithKline, Kyorin Pharma, Novartis, Chugai Pharmaceutical, Teijin Pharma, Gabriella Meszaros Employee of: Eli Lilly and Company, Joana Araujo Employee of: Eli Lilly and Company, Zhongkai Wang Employee of: Eli Lilly and Company, Ran Liao Employee of: Eli Lilly and Company, Brenda Crowe Employee of: Eli Lilly and Company, Xin Zhang Employee of: Eli Lilly and Company, Rodney Decker Employee of: Eli Lilly and Company, Stuart Keller Employee of: Eli Lilly and Company, Hermine Brunner Consultant of: AbbVie, Astra Zeneca-Medimmune, Biogen, Boehringer, Bristol-Myers Squibb, Celgene, Eli Lilly, EMD Serono, Idorsia, Cerocor, Janssen, GlaxoSmithKline, F. Hoffmann-La Roche, Merck, Novartis, R-Pharm, Sanofi, Speakers bureau: Novartis, Pfizer, GlaxoSmithKline, Nicolino Ruperto Consultant of: Eli Lilly and Company, Ablynx, Amgen, Astrazeneca-Medimmune, Aurinia, Bayer, Bristol Myers and Squibb, Cambridge Healthcare Research (CHR), Celgene, Domain therapeutic, Eli-Lilly, EMD Serono, Glaxo Smith and Kline, Idorsia, Janssen, Novartis, Pfizer, Sobi, UCB, Speakers bureau: Eli Lilly and Company, Glaxo Smith and Kline, Pfizer, Sobi, UCB
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Masuhiro K, Tamiya M, Fujimoto K, Koyama S, Naito Y, Osa A, Hirai T, Suzuki H, Okamoto N, Shiroyama T, Nishino K, Adachi Y, Nii T, Kinugasa-Katayama Y, Kajihara A, Morita T, Imoto S, Uematsu S, Irie T, Okuzaki D, Aoshi T, Takeda Y, Kumagai T, Hirashima T, Kumanogoh A. Bronchoalveolar lavage fluid reveals factors contributing to the efficacy of PD-1 blockade in lung cancer. JCI Insight 2022; 7:157915. [PMID: 35389889 PMCID: PMC9090256 DOI: 10.1172/jci.insight.157915] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 12/29/2021] [Accepted: 04/01/2022] [Indexed: 11/17/2022] Open
Abstract
Bronchoalveolar lavage is commonly performed to assess inflammation and identify responsible pathogens in lung diseases. Findings from bronchoalveolar lavage might be used to evaluate the immune profile of the lung tumor microenvironment (TME). To investigate whether bronchoalveolar lavage fluid (BALF) analysis can help identify patients with non–small cell lung cancer (NSCLC) who respond to immune checkpoint inhibitors (ICIs), BALF and blood were prospectively collected before initiating nivolumab. The secreted molecules, microbiome, and cellular profiles based on BALF and blood analysis of 12 patients were compared with regard to therapeutic effect. Compared with ICI nonresponders, responders showed significantly higher CXCL9 levels and a greater diversity of the lung microbiome profile in BALF, along with a greater frequency of the CD56+ subset in blood T cells, whereas no significant difference in PD-L1 expression was found in tumor cells. Antibiotic treatment in a preclinical lung cancer model significantly decreased CXCL9 in the lung TME, resulting in reduced sensitivity to anti–PD-1 antibody, which was reversed by CXCL9 induction in tumor cells. Thus, CXCL9 might be associated with the lung TME microbiome, and the balance of CXCL9 and lung TME microbiome could contribute to nivolumab sensitivity in patients with NSCLC. BALF analysis can help predict the efficacy of ICIs when performed along with currently approved examinations.
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Affiliation(s)
- Kentaro Masuhiro
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Motohiro Tamiya
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Kosuke Fujimoto
- Department of Immunology and Genomics, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Shohei Koyama
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yujiro Naito
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Akio Osa
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Hirai
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Takayuki Shiroyama
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazumi Nishino
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yuichi Adachi
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takuro Nii
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yumi Kinugasa-Katayama
- Department of Cellular Immunology, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Akiko Kajihara
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takayoshi Morita
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Seiya Imoto
- Division of Health Medical Intelligence, Human Genome Center, Institute of Medical Science, the University of Tokyo, Tokyo, Japan
| | - Satoshi Uematsu
- Department of Immunology and Genomics, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Takuma Irie
- Division of Cancer Immunology, National Cancer Center, Tokyo, Japan
| | - Daisuke Okuzaki
- Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Osaka, Osaka, Japan
| | - Taiki Aoshi
- Department of Cellular Immunology, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Yoshito Takeda
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Toru Kumagai
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Atsushi Kumanogoh
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
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Johnson M, Doi T, Piha-Paul S, Sen S, Shimizu T, Cheng B, Yoshizuka N, Okamoto N, Okuda Y, Qian X, Serbest G, Hammett T, Brady W, Patel M, Bendell J. 513O A phase I/II multicenter, first-in-human study of DS-7300 (B7-H3 DXd-ADC) in patients (pts) with advanced solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Yoh K, Matsumoto S, Furuya N, Nishino K, Miyamoto S, Oizumi S, Okamoto N, Itani H, Kuyama S, Nakamura A, Nishi K, Fukuda I, Tsuta K, Hayashi Y, Motoi N, Ishii G, Goto K. Comprehensive assessment of PD-L1 expression, tumor mutational burden and oncogenic driver alterations in non-small cell lung cancer patients treated with immune checkpoint inhibitors. Lung Cancer 2021; 159:128-134. [PMID: 34333203 DOI: 10.1016/j.lungcan.2021.07.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/13/2021] [Accepted: 07/21/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Immune checkpoint inhibitors (ICIs) have proven to be effective treatment for lung cancer. However, a precise predictive immuno-oncology biomarker is still under development. We investigated the associations among PD-L1 expression, tumor mutational burden (TMB), and oncogenic driver alterations in advanced non-small cell lung cancer (NSCLC) patients treated with ICIs. MATERIALS AND METHODS This multicenter cohort study included 1017 lung cancer patients. PD-L1 expression using four IHC assays (22C3, 28-8, SP263, SP142), TMB by whole-exome sequencing and oncogenic driver alterations were analyzed comprehensively. Clinical characteristics, treatment and survival data were collected. RESULTS The results of 22C3 and 28-8 for PD-L1 expression showed acceptable concordance (k = 0.89; 95% confidence interval [CI], 0.87-0.92), and the clinical outcomes of ICIs classified according to PD-L1 expression by both assays were also approximately the same. There was slight concordance (k = 0.16; 95% CI, 0.11-0.22) between 22C3 and SP142, and high PD-L1 expression by SP142 was correspond to very high PD-L1 expressions by other assays. Patients with both high PD-L1 expression and high TMB showed a good response to ICIs with the response rate of 64% and median progression-free survival of 9.0 months despite of small population. Common EGFR or STK11 mutations showed a lower rate of high PD-L1 expression and a worse efficacy of ICIs and KRAS mutations had no negative impact on response to ICIs. CONCLUSION Comprehensive assessment of PD-L1 expression, TMB, and oncogenic driver alterations would help to better predict the clinical outcomes of ICIs in NSCLC patients.
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Affiliation(s)
- Kiyotaka Yoh
- Department of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
| | - Shingo Matsumoto
- Department of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kazumi Nishino
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Shingo Miyamoto
- Department of Medical Oncology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Satoshi Oizumi
- Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology and Bronchology, Osaka Habikino Medical Center, Habikino, Japan
| | - Hidetoshi Itani
- Department of Respiratory Medicine, Japanese Red Cross Ise Hospital, Ise, Japan
| | - Shoichi Kuyama
- Department of Respiratory Medicine, Iwakuni Clinical Center, Iwakuni, Japan
| | - Atsushi Nakamura
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Koichi Nishi
- Division of Respiratory Medicine, Ishikawa Prefecutual Central Hospital, Kanazawa, Japan
| | - Ikue Fukuda
- Department of Pulmonary Medicine, Itami City Hospital, Hyogo, Japan
| | - Koji Tsuta
- Department of Pathology and Laboratory Medicine, Kansai Medical University, Osaka, Japan
| | - Yuichiro Hayashi
- Department of Anatomic Pathology, International University of Health and Welfare Narita Hospital, Narita, Japan
| | - Noriko Motoi
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Genichiro Ishii
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, Kashiwa, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
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Fujii T, Atsumi T, Okamoto N, Takahashi N, Tamura N, Nakajima A, Nakajima A, Matsuno H, Tsujimoto N, Nishikawa A, Ishii T, Takeuchi T, Kuwana M, Takagi M. AB0249 SAFETY OF BARICITINIB IN JAPANESE PATIENTS WITH RHEUMATOID ARTHRITIS (RA): THE 2020 INTERIM REPORT FROM ALL-CASE POST MARKETING SURVEILLANCE IN CLINICAL PRACTICE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:An all-case post marketing surveillance (PMS) of baricitinib (Bari), that started in Sep 2017, collects safety and effectiveness for the first 24 wks of treatment and continues to collect serious adverse events (SAEs) for 3 yrs.Objectives:To evaluate Bari safety in RA patients (pt) in clinical practice.Methods:We report pt baseline demographics and adverse events (AEs) up to 24 wks for pts whose case report files for 24-wk data were completed as of Jun 2020.Results:Data from 3445 pts were analyzed (females=80%, mean age=64yr, mean RA duration 12yr). Bari dose regimen was as follows: 4mg, 60%, 2mg, 27%, 4mg→2mg, 5%, 2mg→4mg, 5%, and others, 2%. Concomitant use of MTX and glucocorticoid was 65% and 48%, respectively. 74% continued treatment for 24 wks. AE and SAE were recognized in 887 (26%) and 122 pts (4%), respectively. 6 pts died of pneumonia, aspiration pneumonia, bacterial pneumonia, cerebral infarction/ILD/aspiration pneumonia, adenocarcinoma, and colorectal cancer. Major AEs were as follows: herpes zoster=3%, liver dysfunction=3%, serious infection=1%, anemia=1%, hyperlipidemia=1%, malignancy=0.3%, interstitial pneumonia=0.2%, MACE=0.1%, and VTE=0.1%.Conclusion:Data do not show new safety concerns and encourage guideline-compliant use of Bari.Disclosure of Interests:Takao Fujii Speakers bureau: Chugai Pharmaceutical Co. Ltd.; Eisai Co. Ltd; Eli Lilly Japan K.K.; Janssen Pharmaceutical K.K.; Ono Pharmaceutical Co. Ltd., Consultant of: Asahikasei Pharma Corp, Grant/research support from: Asahikasei Pharma Corp; AbbVie Japan GK; Chugai Pharmaceutical Co. Ltd., Eisai Co. Ltd; Eli Lilly Japan K.K.; Mitsubishi-Tanabe Pharma Co.; Ono Pharmaceutical Co., Ltd., Tatsuya Atsumi Speakers bureau: AbbVie Japan GK; Astellas Pharma Inc.; Bristol-Myers Squibb Co. Ltd; Chugai Pharmaceutical Co. Ltd.; Daiichi Sankyo Co. Ltd.; Eisai Co. Ltd.; Eli Lilly Japan K.K.; Mitsubishi Tanabe Pharma Co.; Pfizer Japan Inc.; Takeda Pharmaceutical Co. Ltd., UCB Japan Co. Ltd., Consultant of: AbbVie Japan GK; AstraZeneca plc.; Boehringer Ingelheim Co. Ltd.; Medical & Biological Laboratories Co. Ltd.; Novartis Pharma K.K.; Ono Pharmaceutical Co. Ltd.; Pfizer Japan Inc., Grant/research support from: Astellas Pharma Inc., Alexion Inc.; Chugai Pharmaceutical Co. Ltd., Daiichi Sankyo Co. Ltd., Mitsubishi Tanabe Pharma Co., Otsuka Pharmaceutical Co., Ltd.Pfizer Japan Inc.; Takeda Pharmaceutical Co. Ltd., Nami Okamoto Speakers bureau: AbbVie Japan GK; Asahikasei Pharma Co.; AYUMI Pharmaceutical Co.Eisai Co. Ltd; Bristol-Myers Squibb Co. Ltd.; Eli Lilly Japan K.K.; Mitsubishi-Tanabe Pharma Co.; Pfizer Japan Inc.Sanofi K.K.; Chugai Pharmaceutical Co. Ltd.; Novartis Pharma Co.; Teijin Pharma Ltd.; Torii Pharmaceutical Co., Ltd., Nobunori Takahashi Speakers bureau: AbbVie Japan GK; Eisai Co. Ltd.; Mitsubishi Tanabe Pharma Co.; Pfizer Japan Inc.; Chugai Pharmaceutical Co., Ltd.; Eli Lilly Japan K.K.; Janssen Pharmaceutical K.K.; UCB Japan Co. Ltd.; Astellas Pharma Inc.; Bristol Myers Squibb Co. Ltd., Grant/research support from: Bristol Myers Squibb Co. Ltd., Naoto Tamura Speakers bureau: AbbVie Japan GK; Bristol Myers Squibb Co. Ltd.; Chugai Pharmaceutical Co. Ltd.; Eisai Co. Ltd.; Eli Lilly Japan K.K.; Glaxo Smith Kline K.K.; Janssen Pharmaceutical K.K.; Mitsubishi-Tanabe Pharma Co.; Novartis Pharma Co., Atsuo Nakajima: None declared, Ayako Nakajima Speakers bureau: AbbVie Japan GK; Actelion Pharmaceuticals Japan Ltd., Asahi Kasei Pharma Co., Astellas Pharma Inc., Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd.,Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., Glaxo Smith Kline K.K., Hisamitsu Pharmaceutical Co. Inc., Kyorin Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Co., Otsuka Pharmaceutical Co. Ltd., Pfizer Japan Inc., Teijin Pharma Ltd., Grant/research support from: Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc., Hiroaki Matsuno Speakers bureau: Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Eli Lilly Japan K.K., Consultant of: Mochida Pharmaceutical Co., Ltd., Grant/research support from: Astellas Pharma Inc., Eli Lilly Japan K.K.; Janssen Pharmaceutical K.K, Naoto Tsujimoto Shareholder of: Eli Lilly, Employee of: Eli Lilly Japan K.K., Atsushi Nishikawa Shareholder of: Eli Lilly, Employee of: Eli Lilly Japan K.K., Taeko Ishii Shareholder of: Eli Lilly, Employee of: Eli Lilly Japan K.K., Tsutomu Takeuchi Speakers bureau: AbbVie Japan GK, Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co, Ltd. Daiichi Sankyo Co., Ltd. Eisai Co., Ltd. Eli Lilly Japan K.K.; Gilead Sciences, Inc. Janssen Pharmaceutical K.K.; Mitsubishi-Tanabe Pharma Co.; Novartis Pharma Co.; Pfizer Japan Inc.; Sanofi K.K.; UCB Japan Co., Ltd., Consultant of: AbbVie Japan GK, Astellas Pharma, Inc.; Chugai Pharmaceutical Co, Ltd.; Eli Lilly Japan K.K.; Eisai Co., Ltd.; Gilead Sciences, Inc.; Janssen Pharmaceutical K.K.; Mitsubishi-Tanabe Pharma Corp., Pfizer Japan Inc., Grant/research support from: AbbVie Japan GK, Asahikasei Pharma Corp., Chugai Pharmaceutical Co, Ltd., DNA Chip Research Inc.; Eisai Co., Ltd., Eli Lilly Japan K.K.; Mitsubishi-Tanabe Pharma Corp., UCB Japan Co., Ltd., Masataka Kuwana Speakers bureau: AbbVie Japan GK, Astellas Pharma Inc., Asahi Kasei Pharma Co., Boehringer-Ingelheim, Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Janssen Pharmaceutical K.K., Medical &Biological Laboratories Co., Ltd.; Mitsubishi Tanabe Pharma Co.; Mochida Pharmaceutical Co., Ltd., Nippon Shinyaku Co., Ltd.; Ono Pharmaceutical Co., Ltd.; Pfizer Japan Inc., Consultant of: Boehringer-Ingelheim, Chugai Pharmaceutical Co., Ltd., Corbus Pharmaceuticals Holdings, Inc.; Medical &Biological Laboratories Co., Ltd.; Mochida Pharmaceutical Co., Ltd., Grant/research support from: Boehringer-Ingelheim, Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Medical &Biological Laboratories Co., Ltd; Mitsubishi Tanabe Pharma Co., Ono Pharmaceutical Co., Ltd., Michiaki Takagi Speakers bureau: Yes, but sponsored lectures without COI in the academic meetings, only.
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Okamoto N, Ohama H, Matsui M, Fukunishi S, Higuchi K, Asai A. Hepatic F4/80 + CD11b + CD68 - cells influence the antibacterial response in irradiated mice with sepsis by Enterococcus faecalis. J Leukoc Biol 2021; 109:943-952. [PMID: 33899953 DOI: 10.1002/jlb.4a0820-550rr] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/15/2022] Open
Abstract
Gut-associated sepsis is a major problem in patients undergoing abdominal radiation therapy; the majority of pathogens causing this type of sepsis are translocated from the gut microbiota. While treating sepsis, bacterial clearance must be achieved to ensure patient survival, and the hepatic immune response is responsible for this process. In particular, Kupffer cells play a crucial role in the hepatic immune response against infectious agents. Recently, two populations of Kupffer cells have been described: liver-resident macrophages (Mϕ) (F4/80+ CD11b- CD68+ cells) and hepatic Mϕ derived from circulating monocytes (F4/80+ CD11b+ CD68- cells). We examined the properties of both types of hepatic Mϕ obtained from irradiated and normal mice and their role in sepsis. Hepatic F4/80+ CD11b- CD68+ cells from both normal and irradiated mice did not show any antibacterial activity. However, F4/80+ CD11b+ CD68- cells from normal mice behaved as effector cells against sepsis by Enterococcus faecalis, although those from irradiated mice lost this ability. Moreover, hepatic F4/80+ CD11b+ CD68- cells from normal infected mice were shown to be IL-12+ IL-10- CD206- CCL1- (considered M1Mϕ), and hepatic F4/80+ CD11b- CD68+ cells from the same mice were shown to be IL-12- IL-10+ CD206+ CCL1- (considered M2aMϕ). When normal mice were exposed to radiation, hepatic F4/80+ CD11b+ CD68- cells altered their phenotype to IL-12- IL-10+ CD206- CCL1+ (considered M2bMϕ), independent of infection, but hepatic F4/80+ CD11b- CD68+ cells remained IL-12- IL-10+ CD206+ CCL1- (M2aMϕ). In addition, hepatic F4/80+ CD11b+ CD68- cells from irradiated mice acquired antibacterial activity upon treatment with CCL1 antisense oligodeoxynucleotides. Therefore, the characteristics of hepatic F4/80+ CD11b+ CD68- cells play a key role in the antibacterial response against gut-associated sepsis.
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Affiliation(s)
- Norio Okamoto
- 2nd Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
| | - Hideko Ohama
- 2nd Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
| | - Masahiro Matsui
- 2nd Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
| | - Akira Asai
- 2nd Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
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11
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Hirashima T, Noda Y, Suzuki H, Nasu S, Tanaka A, Morishita N, Ryota N, Iwata K, Okada Y, Okamoto N. Extracellular Water-to-total Body Water Ratio as an Objective Biomarker for Frailty in Lung Cancer Patients. Anticancer Res 2021; 41:1655-1662. [PMID: 33788762 DOI: 10.21873/anticanres.14928] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Our previous study revealed the association between extracellular water-to-total body water ratio (ECW/TBW) and the therapeutic durability of chemotherapy and/or immune checkpoint inhibitors in advanced lung cancer. We retrospectively examined the usefulness of ECW/TBW in detecting frailty compared to other bioelectrical impedance (BIA) parameters in a larger number of patients. PATIENTS AND METHODS Lung cancer patients underwent BIA before anti-cancer therapy at our hospital between June 1, 2018 and July 31, 2020. RESULTS Of 99 patients, 26 were assigned to ECW/TBW≥0.4 (higher group: HG) and 57 to ECW/TBW<0.4 (lower group: LG). ECW/TBW increased significantly with performance deterioration and ageing. HG patients had significantly shorter time-to-treatment failure (TTF) than LG patients. In patients with performance status 0-1, those in the HG had shorter TTF than those in the LG. ECW/TBW was the only independent predictor of TTF according to multivariate analysis. CONCLUSION ECW/TBW is an objective biomarker for detecting frailty among lung cancer patients.
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Affiliation(s)
- Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan;
| | - Yoshimi Noda
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan.,Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Shingo Nasu
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Noriko Ryota
- Department of Nursing, Osaka Habikino Medical Center, Osaka, Japan
| | - Kaori Iwata
- Department of Nursing, Osaka Habikino Medical Center, Osaka, Japan
| | - Yukari Okada
- Department of Nursing, Osaka Habikino Medical Center, Osaka, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
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12
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Tamiya M, Tamiya A, Suzuki H, Taniguchi Y, Katayama K, Minomo S, Nakao K, Takeuchi N, Matsuda Y, Naito Y, Shiroyama T, Okamoto N, Okishio K, Kumagai T, Atagi S, Imamura F, Hirashima T. Phase 2 study of bevacizumab plus carboplatin/nab-paclitaxel followed by bevacizumab plus nab-paclitaxel for non-squamous non-small cell lung cancer with malignant pleural effusion. Invest New Drugs 2021; 39:1106-1112. [PMID: 33544282 DOI: 10.1007/s10637-021-01076-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/25/2021] [Indexed: 01/01/2023]
Abstract
Objectives Vascular endothelial growth factor plays an important role in the pathogenesis of malignant pleural effusion (MPE). We previously showed the efficacy of bevacizumab (Bev) plus carboplatin (CBDCA)/paclitaxel (PTX) in the treatment of non-small lung cell cancer (NSCLC) with MPE. However, the toxicities were a little severe, and the efficacy was not satisfied sufficiently. Therefore, we conducted a phase II study for NSCLC with MPE to evaluate the efficacy and safety of Bev plus CBDCA/nab-PTX, which is a new combination therapy. Methods Chemotherapy-naive non-squamous (SQ) NSCLC patients with MPE participated in the study. A single aspiration (not allowing chest tube drainage) was allowed before chemotherapy. Patients received a maximum of six cycles of Bev (15 mg/kg, day1) plus CBDCA (AUC 6, day1)/nab-PTX (100 mg/m2, day1, 8) every 3 weeks followed by Bev (15 mg/kg, day1) plus nab-PTX (100 mg/m2, day1, 8) every 3 weeks without disease progression or unacceptable severe toxicities. The primary endpoint was objective response rate (ORR). Results The study enrollment was ceased because of suspension of the registration period (as scheduled) after 12 of 20 planned patients were treated successfully between March 2014 and February 2018. The ORR was 58.3 % (95 % CI, 27.7-84.8 %), and the disease control rate was 100 % (95 % CI, 73.5-100 %). Eight patients received maintenance therapy. Median progression-free and overall survival times were 14.4 and 26.9 months, respectively. Most patients experienced hematological toxicities, including ≥ grade 3 neutropenia and anemia; none experienced severe bleeding events and grade 5 toxicities. Conclusion The combination of Bev plus CBDCA/nab-PTX, a novel combination, might have efficacy with acceptable toxicities in chemotherapy-naïve non-SQ NSCLC patients with MPE.Trial Registration University Hospital Medical Information Network in Japan (UMIN) Clinical Trials Registry (No. UMIN000013329) registered on 4th March 2014.
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Affiliation(s)
- Motohiro Tamiya
- Department of Thoracic Oncology, Osaka International Cancer Institute, Chuo-ku Otemae 3-1- 69, Osaka City, Osaka, 541-8567, Japan.
| | - Akihiro Tamiya
- Department of Thoracic Oncology, Kinki-Chuo Chest Medical Center, Kitaku Nagasone-cho 1180, Sakai City, Osaka, 591-8555, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Malignancy, Osaka Habikino Medical Center, Habikino 3-7-1, 583-8588, Habikino City, Osaka, Japan
| | - Yoshihiko Taniguchi
- Department of Thoracic Oncology, Kinki-Chuo Chest Medical Center, Kitaku Nagasone-cho 1180, Sakai City, Osaka, 591-8555, Japan
| | - Kanako Katayama
- Department of Thoracic Oncology, Kinki-Chuo Chest Medical Center, Kitaku Nagasone-cho 1180, Sakai City, Osaka, 591-8555, Japan
| | - Shojiro Minomo
- Department of Thoracic Oncology, Kinki-Chuo Chest Medical Center, Kitaku Nagasone-cho 1180, Sakai City, Osaka, 591-8555, Japan
| | - Keiko Nakao
- Department of Thoracic Oncology, Kinki-Chuo Chest Medical Center, Kitaku Nagasone-cho 1180, Sakai City, Osaka, 591-8555, Japan
| | - Naoko Takeuchi
- Department of Thoracic Oncology, Kinki-Chuo Chest Medical Center, Kitaku Nagasone-cho 1180, Sakai City, Osaka, 591-8555, Japan
| | - Yoshinobu Matsuda
- Department of Thoracic Oncology, Kinki-Chuo Chest Medical Center, Kitaku Nagasone-cho 1180, Sakai City, Osaka, 591-8555, Japan
| | - Yujiro Naito
- Department of Respiratory Medicine and Clinical Immunology, Osaka University, Yamadaoka 2-15, 565-0871, Suita City, Osaka, Japan
| | - Takayuki Shiroyama
- Department of Respiratory Medicine and Clinical Immunology, Osaka University, Yamadaoka 2-15, 565-0871, Suita City, Osaka, Japan
| | - Norio Okamoto
- Department of Thoracic Malignancy, Osaka Habikino Medical Center, Habikino 3-7-1, 583-8588, Habikino City, Osaka, Japan
| | - Kyoichi Okishio
- Department of Clinical Research Center, Kinki-Chuo Chest Medical Center, Kitaku Nagasone- cho 1180, Sakai City, Osaka, 591-8555, Japan
| | - Toru Kumagai
- Department of Thoracic Oncology, Osaka International Cancer Institute, Chuo-ku Otemae 3-1- 69, Osaka City, Osaka, 541-8567, Japan
| | - Shinji Atagi
- Department of Clinical Research Center, Kinki-Chuo Chest Medical Center, Kitaku Nagasone- cho 1180, Sakai City, Osaka, 591-8555, Japan
| | - Fumio Imamura
- Department of Thoracic Oncology, Osaka International Cancer Institute, Chuo-ku Otemae 3-1- 69, Osaka City, Osaka, 541-8567, Japan
| | - Tomonori Hirashima
- Department of Thoracic Malignancy, Osaka Habikino Medical Center, Habikino 3-7-1, 583-8588, Habikino City, Osaka, Japan
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Nasu S, Kawahara K, Han Y, Okamoto N, Tamura Y, Suzuki H, Shiroyama T, Samejima Y, Kanai T, Noda Y, Tanaka A, Morishita N, Ueda K, Hashimoto S, Hirashima T, Nagai T. Transbronchial Cryobiopsy for Miliary Tuberculosis Mimicking Hypersensitivity Pneumonitis. Intern Med 2021; 60:445-448. [PMID: 32963150 PMCID: PMC7925263 DOI: 10.2169/internalmedicine.4511-20] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Miliary tuberculosis is a potentially lethal type of tuberculosis that results from the hematogenous dissemination of Mycobacterium tuberculosis bacilli. We herein describe the case of a 34-year-old man that presented with a one-month history of cough and fever, while his sputum smear results were negative. Chest computed tomography revealed bilateral centrilobular ground-glass opacification (GGO), suggestive of hypersensitivity pneumonitis; thus, bronchoscopy was performed. Cryobiopsy specimens revealed necrotic granulomas. A re-examination of sputum after bronchoscopy identified Mycobacterium tuberculosis, and miliary tuberculosis was diagnosed. A cryobiopsy might be useful for diagnosing miliary tuberculosis pathologically, particularly when miliary nodules may be masked by GGO.
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Affiliation(s)
- Shingo Nasu
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Kunimitsu Kawahara
- Department of Pathology Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Japan
| | - Yuki Han
- Department of Infectious Diseases, Osaka Habikino Medical Center, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Yoshitaka Tamura
- Department of Infectious Diseases, Osaka Habikino Medical Center, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | | | - Yumiko Samejima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Tomohiro Kanai
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Yoshimi Noda
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Kayo Ueda
- Department of Pathology Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Japan
| | - Shoji Hashimoto
- Department of Infectious Diseases, Osaka Habikino Medical Center, Japan
| | | | - Takayuki Nagai
- Department of Infectious Diseases, Osaka Habikino Medical Center, Japan
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14
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Hirashima T, Kanai T, Suzuki H, Yoshida H, Matsusita A, Kawasumi H, Nasu S, Tanaka A, Morishita N, Kawahara K, Tamura Y, Okamoto N. Significance of Pre-treatment Interferon-gamma Release in Patients With Non-small-cell Lung Cancer Receiving Immune Checkpoint Inhibitors. Anticancer Res 2020; 40:6971-6978. [PMID: 33288591 DOI: 10.21873/anticanres.14721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/10/2020] [Accepted: 10/12/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM We retrospectively investigated the significance of pre-treatment interferon-gamma release (IGR) as a biomarker for predicting the efficacy of immune checkpoint inhibitor treatment (ICI-tx). PATIENTS AND METHODS This study included non-small-cell lung cancer patients who received ICI-tx between January 1, 2016 and April 30, 2019. IGR was measured using the positive control of an enzyme-linked immunosorbent assay. We defined the pre-treatment cut-off level of IGR as 10 IU/ml. RESULTS Fifty-four patients were divided into two groups; those with an IGR ≤10 IU/ml (lower group: LG) (n=15) and those with >10 IU/ml (higher group: HG) (n=39). The time to treatment failure (TTF) in the HG was significantly longer than that in the LG. In multivariate analyses, C-reactive protein and IGR levels were significant risk factors for TTF. CONCLUSION Pre-treatment IGR level of >10 IU/ml is recommended to identify those patients who will respond favourably to ICI-tx.
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Affiliation(s)
- Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Tomohiro Kanai
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan.,Department of Respiratory Medicine. Osaka General Medical Center, Osaka, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Hiroko Yoshida
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Akane Matsusita
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Hiromi Kawasumi
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Shingo Nasu
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Kunimitsu Kawahara
- Department of Clinical Pathology, Osaka Habikino Medical Center, Osaka, Japan
| | - Yoshitaka Tamura
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
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15
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Asai A, Yasuoka H, Matsui M, Okamoto N, Fukunishi S, Higuchi K. Exacerbation of liver dysfunction in non-alcoholic steatohepatitis patients during the coronavirus disease 2019 (COVID-19) pandemic. J Clin Biochem Nutr 2020; 68:243-245. [PMID: 34025027 PMCID: PMC8129973 DOI: 10.3164/jcbn.20-136] [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: 08/17/2020] [Accepted: 09/17/2020] [Indexed: 11/22/2022] Open
Abstract
Many people were forced to stay at home, including non-alcoholic steatohepatitis (NASH) patients, however it is unclear how this home-life has affected the prognosis of NASH. In this study, we examined the influences of living at home during the coronavirus disease 2019 (COVID-19) pandemic NASH patients. In this study, we compared the clinical parameters of NASH patients without COVID-19 infection 3 months before with those 3 months after the declaration of a state of emergency. In the results, the changes of aspartate transaminase and alanine aminotransferase in the 3 months before (aspartate transaminase, -3.6 ± 13.8 U/L; alanine aminotransferase, -6.8 ± 19.5 U/L) was significantly exacerbated in the 3 months after (aspartate transaminase, 2.3 ± 7.5 U/L; alanine aminotransferase, 1.7 ± 10.4 U/L). Furthermore, the changes of the fibrosis-4 index in the 3 months before (-0.27 ± 0.84) was also significantly exacerbated in the 3 months after (0.38 ± 0.96). In conclusion, liver dysfunctions in NASH patients were exacerbated due to the emergency declaration and outing restriction which accompanied COVID-19.
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Affiliation(s)
- Akira Asai
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Hidetaka Yasuoka
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Masahiro Matsui
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Norio Okamoto
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
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Shutta R, Nishino M, Kawamura A, Ukita K, Nakamura H, Yasumoto K, Tsuda M, Okamoto N, Tanaka A, Matsunaga Y, Yano M, Egami Y, Tanouchi J. Negative impact of ultra-thin strut on neointimal coverage condition within one year after implantation as compared to thin sturt in biogradable-polymer sirorimus eluting stents. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0319] [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
BIOSCIENCE randomized trial which compared biodegradable-polymer sirolimus-eluting stents with ultra-thin (60μm) strut (ultra-thin BP-SES) and durable-polymer everolimus-eluting stents with thin (81μm) strut (thin DP-EES) have reported that definite stent thrombosis within 1 year had more frequently occurred in ultra-thin BP-SES (0.9%) than in thin DP-EES group (0.4%) although it was not statistically significant. It suggests that neointimal coverage after stent implantation within 1 year might be different between ultra-thin BP-SES and thin DP-EES. Recently, two types of biogradable-polymer sirorimus eluting stents, thin (80μm) strut type (thin BP-SES) and ultra-thin (60μm) strut type (ultra-thin BP-SES), can be available in clinical settings.
Purpose
We compared neointimal coverage conditions between ultra-thin BP-SES and thin BP-SES by optical coherence tomography (OCT).
Methods
Consecutive Forty-six patients who underwent 21 ultra-thin BP-SESs or 25 thin BP-SESs implantation were enrolled. We compared incidences of acute coronary syndrome, type B2/C lesion, atherectomy device use, stent size, stent length, maximum inflation pressure, and 8-month follow-up OCT parameters including proportions of uncovered struts (%Uncovered), malapposed struts, (%Mallaposed) and mean neointimal hyperplasia thickness (mean NHT) between the two groups.
Results
%Uncovered and %malapposed were significantly higher and mean NHT was significantly lower in ultra-thin BP-SES than in thin BP-SES (Table). The other parameters were similar between the two groups.
Conclusion
Ultra-thin BP-SES showed worse neointimal coverage as compared to thin BP-SES within 1 year after stent implantation, which may increase stent thrombosis.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Shutta
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - M Nishino
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - A Kawamura
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - K Ukita
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - H Nakamura
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - K Yasumoto
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - M Tsuda
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - N Okamoto
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - A Tanaka
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | | | - M Yano
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Y Egami
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - J Tanouchi
- Osaka Rosai Hospital, Sakai, Osaka, Japan
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17
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Okamoto N, Shutta R, Yanagawa K, Matsuhiro Y, Nakamura H, Yasumoto K, Tsuda M, Tanaka A, Matsunaga Y, Yano M, Yamato M, Egami Y, Tanouchi J, Nishino M. Real-world clinical impact of external elastic lamina-based stent sizing criteria using optical coherence tomography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2470] [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
Introduction
ILUMIEN III trial has reported that non-inferiority of optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) to intravascular ultrasound-guided PCI for postprocedural minimum stent area. In the trial, external elastic lamina (EEL)-based stent sizing criteria was introduced, however OCT has limitations including incomplete visualization of EEL in severale lesions.
Purpose
The aim of the study is to investigate real-world clinical impact of EEL-based stent sizing criteria.
Methods
The study included consecutive patients who underwent OCT-guided percutaneous coronary intervention (PCI) for de novo lesions in our institution between September 2016 and April 2018. EEL visibility, mean EEL diameter, mean lumen diameter and plaque morphology were assessed at proximal and distal references. The plaque morphology at references was categorized according to its most prevalent component as follows: normal, fibrous plaque, lipid plaque, and calcified plaque. Both references were divided into 3 groups according to visibility of EEL.
Results
Among 205 lesions, 31 lesions had artifacts at references (16 proximal and 17 distal references). EEL visibility was summarized in a table. Out of 174 lesions with both analyzable references, 111 lesions (63.8%) had >180-degree EEL visibility at both references. Proportion of plaque morphology were significantly different among 3 groups at proximal and distal references as shown in a figure.
Conclusions
EEL-based stent sizing criteria was usable for 63.8% of all the lesions. Vessel size and plaque morphology were significantly associated with EEL visibility.
Proportion of plaque morphology
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Okamoto
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - R Shutta
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - K Yanagawa
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - Y Matsuhiro
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - H Nakamura
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - K Yasumoto
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - M Tsuda
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - A Tanaka
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - Y Matsunaga
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - M Yano
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - M Yamato
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - Y Egami
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - J Tanouchi
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - M Nishino
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
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18
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Yano M, Nishino M, Nakamura H, Matsuhiro Y, Yasumoto K, Tsuda M, Okamoto N, Tanaka A, Matsunaga-Lee Y, Yamato M, Egami Y, Shutta R, Tanouchi J. Difference of myocardial injury, inflammation and early recurrence after pulmonary vein isolation among laser balloon ablation, radiofrequency catheter ablation and cryoballoon ablation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0574] [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
Pulmonary vein isolation (PVI) has become well-established as the main therapy for patients with drug-refractory paroxysmal atrial fibrillation (PAF) and various isolation methods including radiofrequency ablation (RFA), cryoballoon ablation (CBA) and laser balloon ablation (LBA) were available. Pathological findings in each ablation methods such as myocardial injury and inflammation are thought to be different. High sensitive cardiac troponin I (hs-TnI), subunit of cardiac troponin complex, is a sensitive and specific marker of myocardium injury. High-sensitive C-reactive protein (hs-CRP) is a biomarker of inflammation and is elevated following cardiomyocyte necrosis. Relationship between myocardial injury and inflammation after ablation using RFA, CBA and LBA and early recurrence of atrial fibrillation (ERAF) remains unclear.
Methods
We enrolled consecutive PAF patients from Osaka Rosai Atrial Fibrillation (ORAF) registry who underwent PVI from January 2019 to October 2019. We compared the clinical characteristics including age, gender, hypertension, diabetes mellitus, history of heart failure, CHADS2Vasc score, renal function, serum BNP level and echocardiographic parameters including left ventricular dimensions, left atrial diameter (LAD) and left ventricular ejection fraction (LVEF) between RFA, CBA and LBA groups. We investigated the difference of relationship between myocardial injury marker (hs-TnI), inflammation markers (white blood cell change (DWBC) from post to pre PVI, neutrophil-to-lymphocyte ratio change (DNLR) from after to before PVI and hs-CRP) at 36–48 hours after PVI and ERAF (<3 months after PVI) between each group.
Results
We enrolled 187 consecutive PAF patients who underwent PVI. RFA, CBA and LBA groups comprised 108, 57 and 22 patients, respectively. There were no significant differences of age, gender, hypertension, diabetes mellitus, history of heart failure, CHADS2Vasc score, renal function, serum BNP level and echocardiographic parameters between each group. Serum hs-TnI in RFA group and LBA group were significantly lower than in CBA group (2.643 ng/ml vs 5.240ng/ml, 1.344 ng/ml vs 5.240 ng/ml, p<0.001, p=0.002, respectively, Figure). DWBC was significantly higher in LBA group than CBA group (1157.3/μl vs 418.4/μl, p=0.045). DNLR did not differ between each group. Hs-CRP in RFA group and LBA group were significantly higher than in CBA group (1.881 mg/dl vs 1.186 mg/dl, 2.173 mg/dl vs 1.186 mg/dl, p=0.010, p=0.003, respectively, Figure). Incidence of ERAF was significantly higher in LBA group than RFA group (36.4% vs 16.7%, p=0.035). Incidence of ERAF tended to be higher in LBA group than CBA group (36.4% vs 19.3%, p=0.112).
Conclusion
LBA may cause less myocardial injury than RFA and CBA, on the contrary LBA may cause more inflammation than CBA. Incidence of ERAF in LBA was highest between each procedure.
Inflammation markers and ERAF
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Yano
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - M Nishino
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - H Nakamura
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - Y Matsuhiro
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - K Yasumoto
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - M Tsuda
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - N Okamoto
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - A Tanaka
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | | | - M Yamato
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - Y Egami
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - R Shutta
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - J Tanouchi
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
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19
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Ukita K, Kawamura A, Nakamura H, Yasumoto K, Tsuda M, Okamoto N, Tanaka A, Matsunaga Y, Yano M, Egami Y, Shutta R, Nishino M, Tanouchi J. Outcome of contact force-guided radiofrequency catheter ablation or second generation cryoballoon ablation for paroxysmal atrial fibrillation: propensity score matched analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0571] [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
Little has been reported on the outcome of contact force (CF)-guided radiofrequency catheter ablation (RFCA) and second generation cryoballoon ablation (CBA).
Purpose
The purpose of this study was to compare the outcome of CF-guided RFCA and second generation CBA for paroxysmal atrial fibrillation (PAF).
Methods
We enrolled the consecutive 364 patients with PAF who underwent initial ablation between September 2014 and July 2018 in our hospital. We compared the late recurrence of atrial tachyarrhythmia more than three months after ablation between RFCA group and CBA group. All RFCA procedures were performed using CF-sensing catheter and all CBA procedures were performed using second generation CB.
Results
There were significant differences in background characteristics: chronic kidney disease, serum brain natriuretic peptide level, and left ventricular ejection fraction. After propensity score matched analysis (Table), atrial tachyarrhythmia free survival was significantly higher in CBA group than in RFCA group (Figure).
Conclusions
Second generation CBA showed a significantly lower late recurrence rate compared to CF-guided RFCA.
Kaplan-Meier Curve
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Ukita
- Osaka Rosai Hospital, Sakai, Japan
| | | | | | | | - M Tsuda
- Osaka Rosai Hospital, Sakai, Japan
| | | | - A Tanaka
- Osaka Rosai Hospital, Sakai, Japan
| | | | - M Yano
- Osaka Rosai Hospital, Sakai, Japan
| | - Y Egami
- Osaka Rosai Hospital, Sakai, Japan
| | - R Shutta
- Osaka Rosai Hospital, Sakai, Japan
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20
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Kini A, Okamoto N, Barman N, Vengrenyuk Y, Yasumura K, Bhatheja S, Kapur V, Hasan C, Sweeny J, Baber U, Mehran R, Stone G, Sharma S. Side branch FFR after provisional stenting: simplified approach based on OCT frame count. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1467] [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/Introduction
Treatment of bifurcation coronary artery lesions remains a major challenge in interventional cardiology. Side branch (SB) stenoses are frequently observed after stent implantation in bifurcation lesions, although angiographically narrowed SBs may not be functionally significant. Fractional flow reserve (FFR), a pressure-derived index of the hemodynamic significance of a coronary artery stenosis, may be useful in determining whether additional intervention is required in jailed SBs. Angiography and intravascular ultrasound (IVUS) derived parameters have showed poor diagnostic accuracy in predicting the functional significance of jailed SBs.
Purpose
The aim of the present study was to use high resolution optical coherence tomography (OCT) imaging to predict functionally significant SB stenoses after provisional stenting defined as SB FFR ≤0.80.
Methods
Seventy-one patients with 71 calcified bifurcation lesions with angiographically intermediate SB stenoses undergoing provisional stenting were enrolled in the prospective study. OCT pullbacks were performed before and after stent placement, and SB FFR was measured after main vessel stenting. SB ostium area (SBOA) was assessed using three-dimensional OCT cut-plane analysis off-line. In addition, we developed a simplified approach to SB ostium assessment based on SB ostium frame count using two-dimensional OCT pullback not requiring off-line 3D reconstruction. For the analysis, consecutive frames were counted between the most distal and most proximal take-off of the SB frames.
Results
Similar to previous studies, quantitative coronary angiography findings were not associated with the functional significance of SBs after main vessel stenting. In contrast, SBOA assessed by 3D-OCT after provisional stenting strongly correlated with post-procedure SB FFR. The optimal cut-off value for the SBOA area to predict a SB FFR ≤0.80 was 0.76 mm2 (sensitivity 82%, specificity 89% and area under the curve of 0.92 (95% CI: 0.84–0.99). A simplified approach to SB ostium assessment using OCT frame count yielded a sensitivity of 82%, specificity 89% and area under the curve 0.92 (95% CI: 0.84 to 0.99) with a cut-off of 4.5 frames allowing detection of functionally significant SB stenoses during the procedure in real time. Figure 1 shows a receiver-operating characteristic curve for SB FFR ≤0.8 and a representative case with SB FFR = 0.66 after provisional stenting and SB ostium frame count equal 3 (Frame 1 to 3)
Conclusion(s)
Assessment of SB using either 3D OCT off-line reconstruction or a simplified approach based on OCT frame count can detect SB branches with FFR ≤0.80 with high sensitivity and specificity. The developed approaches may represent a useful tool to assess provisional stent outcomes.
Figure 1
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Boston Scientific; St. Jude Medical
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Affiliation(s)
- A Kini
- Mount Sinai Medical Center, New York, United States of America
| | - N Okamoto
- Mount Sinai Medical Center, New York, United States of America
| | - N Barman
- Mount Sinai Medical Center, New York, United States of America
| | - Y Vengrenyuk
- Mount Sinai Medical Center, New York, United States of America
| | - K Yasumura
- Mount Sinai Medical Center, New York, United States of America
| | - S Bhatheja
- Mount Sinai Medical Center, New York, United States of America
| | - V Kapur
- Mount Sinai Medical Center, New York, United States of America
| | - C Hasan
- Mount Sinai Medical Center, New York, United States of America
| | - J Sweeny
- Mount Sinai Medical Center, New York, United States of America
| | - U Baber
- Mount Sinai Medical Center, New York, United States of America
| | - R Mehran
- Mount Sinai Medical Center, New York, United States of America
| | - G Stone
- Mount Sinai Medical Center, New York, United States of America
| | - S Sharma
- Mount Sinai Medical Center, New York, United States of America
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21
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Yano M, Nishino M, Yanagawa K, Nakamura H, Matsuhiro Y, Yasumoto K, Tsuda M, Okamoto N, Tanaka A, Matsunaga-Lee Y, Yamato M, Egami Y, Shutta R, Tanouchi J. Clinical characteristics and outcomes after pulmonary vein isolation in atrial fibrillation patients with complete right bundle branch block. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0579] [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: 11/15/2022] Open
Abstract
Abstract
Background
Complete right bundle branch block (CRBBB) is one of the most frequent alterations of the electrocardiogram (ECG). Several studies have shown that CRBBB was a risk factor for cardiovascular diseases and the appearance of CRBBB in patients hospitalized for exacerbated heart failure (HF) was associated with a worse prognosis. Various alternations of ECG such as early repolarization pattern and intraventricular conduction disturbance were associated with high recurrence ratio of atrial fibrillation (AF) after pulmonary vein isolation (PVI). However clinical outcome after PVI in patients with CRBBB remains unclear.
Methods
We enrolled consecutive AF patients who underwent PVI from September 2014 to November 2018 rom Osaka Rosai Atrial Fibrillation (ORAF) registry. We excluded patients with other wide QRS (left bundle branch block, ventricular pacing and unclassified intraventricular conduction disturbance) and divided into 2 groups; CRBBB (QRS duration ≥120msec) group and no-CRBBB (QRS duration <120) group. We compared the clinical characteristics including age, gender, hypertension, diabetes mellitus, history of heart failure, history of stroke, CHADS2Vasc score, paroxysmal AF (PAF), renal function, plasma brain natriuretic peptide (BNP) level and echocardiographic parameters including left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs), left atrial diameter (LAD) and left ventricular ejection fraction (LVEF) between the 2 groups. We also compared the incidence of late recurrence of AF/atrial tachycardia (AT) between the 2 groups. We investigated whether CRBBB was an independent predictor of late recurrence of AF/AT after PVI by multivariate Cox analysis.
Results
We enrolled 736 consecutive AF patients who underwent PVI. CRBBB patients comprised 55 patients (7.5%). There were no significant differences of age, gender, hypertension, diabetes mellitus, history of heart failure, history of stroke, CHADS2Vasc score, PAF, renal function, plasma BNP level and echocardiographic parameters (LVDd, LVDs, LVEF and LAD) between the 2 groups. Incidence of AF/AT recurrence after PVI was significantly higher in CRBBB group than no-CRBBB group (Figure). CRBBB was an independently and significantly associated with late recurrence of AF/AT after PVI by multivariate Cox analysis (hazard ratio: 1.923, 95% CI: 1.190–2.961, p=0.009) in addition to female (p<0.001), no-PAF (p=0.005) and left atrial diameter (p=0.042).
Conclusion
CRBBB may be a strong predictor of AF/AT late recurrence after PVI.
AF/Ar recurrence after PVI
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Yano
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - M Nishino
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - K Yanagawa
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - H Nakamura
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - Y Matsuhiro
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - K Yasumoto
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - M Tsuda
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - N Okamoto
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - A Tanaka
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | | | - M Yamato
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - Y Egami
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - R Shutta
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - J Tanouchi
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
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22
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Yasumoto K, Egami Y, Ukita K, Yanagawa K, Nakamura H, Matsuhiro Y, Tsuda M, Okamoto N, Tanaka A, Matsunaga-Lee Y, Yano M, Yamato M, Shutta R, Nishino M, Tanouchi J. Ablation index guide pulmonary vein isolation can reduce early recurrence of atrial fibrillation: a propensity score-matched analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0575] [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
Ablation index (AI) is a novel marker of ablation lesion quality for radiofrequency ablation (RFA). It has been reported that AI guided pulmonary vein isolation (PVI) reduced pulmonary vein reconnection and late recurrence of atrial fibrillation (AF). However, little is known about the impact of AI guided PVI on early recurrence of AF (ERAF).
Purpose
The aim of this study is to clarify whether AI guided PVI can reduce ERAF.
Methods
From September 2014 to August 2019, consecutive AF patients who underwent 1st session PVI were enrolled. We compared prevalence of ERAF between AI guided PVI group (AI group) and conventional contact force guided PVI group (CF group) using propensity score-matched analysis, which adjusted patient backgrounds (age, sex, and body mass index (BMI)), type of AF, the history of heart failure, hypertension, diabetes and stroke, laboratory findings including estimated glomerular filtration rate (eGFR) and b-type natriuretic peptide (BNP), and echocardiographic parameters including left ventricular ejection fraction (LVEF) and left atrial diameter.
Results
Total 711 patients were enrolled. AI group comprised 233 patients and CF group comprised 233 patients. Prevalence of ERAF were significantly lower in AI group than in CF group significantly (21.5% vs 36.1%, p=0.001, Table).
Conclusions
AI guided PVI can reduce ERAF as compared to conventional method.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Yasumoto
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - Y Egami
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - K Ukita
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - K Yanagawa
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - H Nakamura
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - Y Matsuhiro
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - M Tsuda
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - N Okamoto
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - A Tanaka
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - Y Matsunaga-Lee
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - M Yano
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - M Yamato
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - R Shutta
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - M Nishino
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - J Tanouchi
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
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23
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Nagai N, Isaka T, Deguchi S, Minami M, Yamaguchi M, Otake H, Okamoto N, Nakazawa Y. In Situ Gelling Systems Using Pluronic F127 Enhance Corneal Permeability of Indomethacin Nanocrystals. Int J Mol Sci 2020; 21:ijms21197083. [PMID: 32992931 PMCID: PMC7582645 DOI: 10.3390/ijms21197083] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 09/03/2020] [Revised: 09/17/2020] [Accepted: 09/22/2020] [Indexed: 02/06/2023] Open
Abstract
We previously designed an ophthalmic dispersion containing indomethacin nanocrystals (IMC-NCs), showing that multiple energy-dependent endocytoses led to the enhanced absorption of drugs from ocular dosage forms. In this study, we attempted to prepare Pluronic F-127 (PLF-127)-based in situ gel (ISG) incorporating IMC-NCs, and we investigated whether the instillation of the newly developed ISG incorporating IMC-NCs prolonged the precorneal resident time of the drug and improved ocular bioavailability. The IMC-NC-incorporating ISG was prepared using the bead-mill method and PLF-127, which yielded a mean particle size of 50–150 nm. The viscosity of the IMC-NC-incorporating ISG was higher at 37 °C than at 10 °C, and the diffusion and release of IMC-NCs in the IMC-NC-incorporating ISG were decreased by PLF-127 at 37 °C. In experiments using rabbits, the retention time of IMC levels in the lacrimal fluid was enhanced with PLF-127 in the IMC-NC-incorporating ISG, whereby the IMC-NC-incorporating ISG with 5% and 10% PLF-127 increased the transcorneal penetration of the IMCs. In contrast to the results with optimal PLF-127 (5% and 10%), excessive PLF-127 (15%) decreased the uptake of IMC-NCs after instillation. In conclusion, we found that IMC-NC-incorporating ISG with an optimal amount of PLF-127 (5–10%) resulted in higher IMC corneal permeation after instillation than that with excessive PLF-127, probably because of the balance between higher residence time and faster diffusion of IMC-NCs on the ocular surface. These findings provide significant information for developing ophthalmic nanomedicines.
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Affiliation(s)
- Noriaki Nagai
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan; (T.I.); (S.D.); (M.M.); (M.Y.); (H.O.)
- Correspondence: ; Tel.: +81-6-4307-3638
| | - Takumi Isaka
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan; (T.I.); (S.D.); (M.M.); (M.Y.); (H.O.)
| | - Saori Deguchi
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan; (T.I.); (S.D.); (M.M.); (M.Y.); (H.O.)
| | - Misa Minami
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan; (T.I.); (S.D.); (M.M.); (M.Y.); (H.O.)
| | - Mizuki Yamaguchi
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan; (T.I.); (S.D.); (M.M.); (M.Y.); (H.O.)
| | - Hiroko Otake
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan; (T.I.); (S.D.); (M.M.); (M.Y.); (H.O.)
| | - Norio Okamoto
- Okamoto Eye Clinic, 5-11-12-312 Izumicho, Suita, Osaka 564-0041, Japan;
| | - Yosuke Nakazawa
- Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan;
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Yokohama K, Asai A, Matsui M, Okamoto N, Yasuoka H, Nishikawa T, Ohama H, Tsuchimoto Y, Inoue Y, Fukunishi S, Uchiyama K, Higuchi K. Liver dysfunction is associated with poor prognosis in patients after immune checkpoint inhibitor therapy. Sci Rep 2020; 10:14470. [PMID: 32879383 PMCID: PMC7468148 DOI: 10.1038/s41598-020-71561-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 03/08/2020] [Accepted: 07/20/2020] [Indexed: 12/24/2022] Open
Abstract
Immune-related adverse events (irAEs) are induced by immune checkpoint inhibitors (ICIs). Liver is one of the main target organs which irAEs occur and we investigated the influence of liver dysfunction on prognosis of patients after ICIs. From July 2014 to December 2018, 188 patients with diverse cancers who received ICIs (nivolumab or pembrolizumab) were enrolled. Twenty-nine patients experienced liver dysfunction of any grades after ICIs. Progression-free survival (PFS) was significantly shorter in the liver dysfunction-positive group than in the liver dysfunction-negative group, and a similar result was obtained for Overall survival (OS). Multiple logistic regression analysis revealed liver metastasis and alanine aminotransferase before ICIs were associated with a higher incidence of liver dysfunction after ICIs. Regardless of liver metastasis, PFS and OS were significantly shorter in the liver dysfunction-positive group. In conclusion, this study suggests liver dysfunction is associated with poor prognosis in patients after ICIs with diverse cancers.
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Affiliation(s)
- Keisuke Yokohama
- Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigakumachi, Takatsuki, Osaka, 569-8686, Japan
| | - Akira Asai
- Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigakumachi, Takatsuki, Osaka, 569-8686, Japan.
| | - Masahiro Matsui
- Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigakumachi, Takatsuki, Osaka, 569-8686, Japan
| | - Norio Okamoto
- Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigakumachi, Takatsuki, Osaka, 569-8686, Japan
| | - Hidetaka Yasuoka
- Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigakumachi, Takatsuki, Osaka, 569-8686, Japan
| | | | - Hideko Ohama
- Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigakumachi, Takatsuki, Osaka, 569-8686, Japan
| | - Yusuke Tsuchimoto
- Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigakumachi, Takatsuki, Osaka, 569-8686, Japan
| | - Yoshihiro Inoue
- Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Japan
| | - Shinya Fukunishi
- Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigakumachi, Takatsuki, Osaka, 569-8686, Japan
| | - Kazuhisa Uchiyama
- Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigakumachi, Takatsuki, Osaka, 569-8686, Japan
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Samejima Y, Iuchi A, Kanai T, Noda Y, Nasu S, Tanaka A, Morishita N, Suzuki H, Okamoto N, Harada H, Ezumi A, Ueda K, Kawahara K, Hirashima T. Development of Severe Heart Failure in a Patient with Squamous Non-small-cell Lung Cancer During Nivolumab Treatment. Intern Med 2020; 59:2003-2008. [PMID: 32448839 PMCID: PMC7492128 DOI: 10.2169/internalmedicine.4550-20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Cardiac side effects associated with immune checkpoint inhibitors (ICIs) are an uncommon but serious complication with a relatively high mortality. We experienced a case of cardiomyopathy induced by nivolumab. Echocardiography showed diffuse hypo-kinesis of the left ventricular cardiac wall and a significant decrease in the ejection fraction, like dilated cardiomyopathy. The myocardial biopsy showed non-inflammatory change; cardiac function gradually improved after treatment of acute heart failure without a corticosteroid. Although non-inflammatory left ventricular dysfunction induced by ICIs is rare, it is a reported cardiovascular toxicity. Physicians should consider this complication when treating patients with ICIs for malignant diseases.
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Affiliation(s)
- Yumiko Samejima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Atsuhiko Iuchi
- Department of Cardiovascular Medicine, Osaka Habikino Medical Center, Japan
| | - Tomohiro Kanai
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Yoshimi Noda
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Shingo Nasu
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Hiroshi Harada
- Department of Cardiovascular Medicine, Osaka Habikino Medical Center, Japan
| | - Akira Ezumi
- Department of Cardiovascular Medicine, Osaka Habikino Medical Center, Japan
| | - Kayo Ueda
- Department of Clinical Pathology, Osaka Habikino Medical Center, Japan
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Noda Y, Suzuki H, Kanai T, Samejima Y, Nasu S, Tanaka A, Morishita N, Okamoto N, Hirashima T. The Association Between Extracellular Water-to-Total Body Water Ratio and Therapeutic Durability for Advanced Lung Cancer. Anticancer Res 2020; 40:3931-3937. [PMID: 32620634 DOI: 10.21873/anticanres.14384] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 04/23/2020] [Accepted: 05/26/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Extracellular water-to-total body water ratio (ECW/TBW) measured by bioelectrical impedance analysis (BIA) reportedly predicts clinical outcomes of various diseases. The aim of this retrospective study was to examine the association between ECW/TBW and therapeutic durability of chemotherapy and/or immune checkpoint inhibitors in advanced lung cancer. PATIENTS AND METHODS Patients with advanced lung cancer underwent BIA before chemotherapy and/or treatment with immune checkpoint inhibitors at our hospital between June 2018 and November 2019. RESULTS Of 75 patients, 18 with ECW/TBW ≥0.4 were assigned to the overhydrated group (OH-G) and 57 patients ECW/TBW <0.4 were assigned to the non-overhydrated group (NOH-G). The median time-to-treatment failure was significantly shorter in the OH-G than in the NOH-G (p=0.003). Multivariate analysis revealed that ECW/TBW ≥0.4 predicted treatment failure [hazard ratio (HR)=2.508, 95% confidence interval (CI)=1.19-5.27; p=0.01]. CONCLUSION The ECW/TBW may be an objective parameter for predicting therapeutic durability in advanced lung cancer.
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Affiliation(s)
- Yoshimi Noda
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Tomohiro Kanai
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Yumiko Samejima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Shingo Nasu
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
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Nasu S, Suzuki H, Shiroyama T, Tanaka A, Samejima Y, Kanai T, Noda Y, Morishita N, Okamoto N, Hirashima T. Safety and efficacy of afatinib for the treatment of non-small-cell lung cancer following osimertinib-induced interstitial lung disease: A retrospective study. Invest New Drugs 2020; 38:1915-1920. [PMID: 32542461 DOI: 10.1007/s10637-020-00963-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/11/2020] [Indexed: 12/28/2022]
Abstract
Background Osimertinib is one of the first-line treatments for advanced non-small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations. However, the occurrence rate of osimertinib-induced interstitial lung disease (ILD) is particularly high in Japanese patients and little information on subsequent cancer treatment options after recovery from osimertinib-induced ILD is currently available. Thus, this study aims to determine the safety and efficacy of afatinib for the treatment of NSCLC following osimertinib-induced ILD. Methods We retrospectively investigated the clinical courses of all NSCLC patients with EGFR mutations at our facility between August 2018 and September 2019, who received osimertinib as first-line treatment and were subsequently treated with afatinib after developing osimertinib-induced ILD. Results Forty-two patients received osimertinib treatment at our facility during the study period, and four patients received afatinib after developing osimertinib-induced ILD. All events of ILD improved either spontaneously or with steroid therapy before the initiation of afatinib. For the four patients who were retrospectively reviewed, the overall response rate to afatinib therapy was 75%, and the disease control rate was 100%. During the study period, no ILD recurrence was observed in any of the four patients. Conclusions According to our study findings, afatinib treatment after osimertinib-induced ILD is considered safe and effective and it can be used as one of the treatment options for NSCLC following osimertinib-induced ILD.
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Affiliation(s)
- Shingo Nasu
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583- 8588, Japan.
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583- 8588, Japan
| | - Takayuki Shiroyama
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583- 8588, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583- 8588, Japan
| | - Yumiko Samejima
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583- 8588, Japan
| | - Tomohiro Kanai
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583- 8588, Japan
| | - Yoshimi Noda
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583- 8588, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583- 8588, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583- 8588, Japan
| | - Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583- 8588, Japan
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Kanai T, Suzuki H, Yoshida H, Matsushita A, Kawasumi H, Samejima Y, Noda Y, Nasu S, Tanaka A, Morishita N, Hashimoto S, Kawahara K, Tamura Y, Okamoto N, Tanaka T, Hirashima T. Significance of Quantitative Interferon-gamma Levels in Non-small-cell Lung Cancer Patients' Response to Immune Checkpoint Inhibitors. Anticancer Res 2020; 40:2787-2793. [PMID: 32366425 DOI: 10.21873/anticanres.14251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 03/23/2020] [Accepted: 03/26/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM We aimed to study the association between the quantitative interferon-gamma (IFN-γ) levels and clinical outcomes in non-small-cell lung cancer (NSCLC) patients receiving immune checkpoint inhibitors (ICIs). PATIENTS AND METHODS Sample collection for IFN-γ release assay (IGRA) was performed within 14 days before treatment (T1), on day 22±7 (T3), and on day 43±7 (T4). The stored specimens over 10 IU/ml in IGRA were re-examined using the dilution method (with saline as the dilution medium). The patients were classified into Lower and Higher groups by 7.06 IU/ml as a cut-off of IFN-γ levels at T1. RESULTS Median progression-free survival in the Higher group was significantly longer than that in the Lower group. IFN-γ levels in the non-progression disease group were significantly higher than those in the progression disease group. IFN-γ levels at T1 in patients with immune-related adverse events were significantly lower compared to those at T3. CONCLUSION IFN-γ could be a biomarker for NSCLC patients receiving ICIs.
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Affiliation(s)
- Tomohiro Kanai
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Hiroko Yoshida
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Akane Matsushita
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Hiromi Kawasumi
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Yumiko Samejima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Yoshimi Noda
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Shingo Nasu
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Shoji Hashimoto
- Department of Allergy, Osaka Habikino Medical Center, Osaka, Japan
| | - Kunimitsu Kawahara
- Department of Clinical Pathology, Osaka Habikino Medical Center, Osaka, Japan
| | - Yoshitaka Tamura
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Toshio Tanaka
- Department of Allergy, Osaka Habikino Medical Center, Osaka, Japan
| | - Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
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Yoh K, Matsumoto S, Furuya N, Nishino K, Miyamoto S, Oizumi S, Okamoto N, Itani H, Kuyama S, Nakamura A, Hayashi Y, Motoi N, Ishii G, Goto K. Impact of SWI/SNF complex mutations in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors: Immuno-oncology biomarker study in LC-SCRUM-Japan (LC-SCRUM-IBIS). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.9530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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
9530 Background: The SWI/SNF chromatin remodeling complex is reported to be involved in sensitivity and resistance to immune checkpoint inhibitor (ICI). However, their role in non-small cell lung cancer (NSCLC) remains unclear. We examined the relationship between SWI/SNF complex mutations and clinical outcomes of ICI in patients with NSCLC. Methods: Of 1017 lung cancer patients enrolled in LC-SCRUM-IBIS, 350 patients were analyzable for whole-exome sequencing (WES). WES data were used to analyze the presence of mutations in 29 major subunits of the SWI/SNF complexes. ARID1A and SMARCA4 mutations were also evaluated in a targeted NGS panel (Oncomine comprehensive assay, OCA). PD-L1 expression by 22C3, tissue tumor mutational burden (tTMB) by WES, STK11 and KEAP1 mutations by WES or OCA were also assessed. Durable clinical benefit (DCB) including CR, PR and SD > 6 mos to ICI, progression-free survival (PFS) and overall survival (OS) were compared in status of each of SWI/SNF complex mutations and other factors. Results: At least one mutation in any subunits of the SWI/SNF complex was present in 28% of NSCLC patients. The most common mutated subcomplexes were SMARCA4 (12%), BAF (7%: ARID1A, 4%), non-canonical BAF (3%), PBAF (3%), and SMARCA2 (2%). Of 101 NSCLC patients treated with PD-1/PD-L1 inhibitors, SMARCA4 mutations tended to be associated with lower DCB (16 vs 31%) and shorter median PFS (1.9 vs 3.6 m) and OS (7.4 vs 18.1m). Patients with ARID1A mutations tended to have better clinical outcomes (DCB, 40 vs 28%) compared to those without mutations. No significant associations were found between PD-L1 expression and SMARCA4 or ARID1A mutations. Patients with STK11/KEAP1 mutations had lower rate of PD-L1 expression (TPS > 50%) (18% vs 48%, P = 0.03) and worse clinical outcomes (DCB, 6 vs 33%) compared to those without mutations. There was no significant association between a tTMB status and clinical outcome. Conclusions: SMARCA4 and ARID1A mutations appear to affect clinical outcomes of ICI in NSCLC patients. These findings indicate that SWI/SNF complex mutations may serve as a predictive biomarker for ICI in NSCLC patients.
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Affiliation(s)
- Kiyotaka Yoh
- National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Naoki Furuya
- St. Marianna University School of Medicine, Kawasaki, Japan
| | | | | | - Satoshi Oizumi
- National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | | | | | | | | | | | | | - Genichiro Ishii
- Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Koichi Goto
- National Cancer Center Hospital East, Kashiwa, Japan
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Yasuoka H, Asai A, Matsui M, Okamoto N, Nishikawa T, Ohama H, Tsuchimoto Y, Fukunishi S, Higuchi K. PD-L1+PD-L2+ monocytes from patients with hepatocellular carcinoma may be associated with a poor prognosis. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.164.6] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
The prognosis of patients with hepatocellular carcinoma (HCC) is poor. Anti–programmed death-1 (PD-1) antibodies (Abs) has been approved to treat HCC. Some PD-1 ligands (PD-L1 and PD-L2) negative tumors respond to anti–PD-1 Abs. This response may be caused by the expression of PD-1 ligands on non-tumor cells. PD-1 ligands were recently found to be expressed on monocytes (CD14+ cells) from diverse cancer patients. In this study, we investigate the expression of PD-1 ligands on CD14+ cells from HCC patients and the role of CD14+ cells in an antitumor response.
From October 2017 to June 2019, 67 patients with HCC were enrolled. The expression of PD-L1 and PD-L2 on CD14+ cells was analyzed by flow cytometry. Their prognosis was evaluated by overall survival (OS). Tumoricidal activities of both CD14+ and CD8+ cells were calculated by LDH release assay.
In the results, CD14+ cells from the patients expressed PD-L1 (4.5–95.5%) and PD-L2 (1.6–90.2%). We set cut-off values as the mean values of PD-L1 (50.2%) and PD-L2 (50.5%) expression. In addition, according to the cut-off value, we classified patients as those either with PD-L1+PD-L2+CD14+ cells or other types of CD14+ cells. The OS of patients with PD-L1+PD-L2+CD14+ cells was significantly shorter than that of patients with other types of CD14+ cells (p = 0.0145). The tumoricidal activity of CD8+ cells from patients with PD-L1+PD-L2+CD14+ cells was suppressed by co-cultivation with syngeneic CD14+ cells. Furthermore, anti–PD-1 Ab restored the tumoricidal activity of CD8+ cells.
In conclusions, some patients with HCC have PD-L1+PD-L2+CD14+ cells that suppress their antitumor response of CD8+ cells. These inhibitory functions of CD14+ cells may be associated with a poor prognosis in such patients.
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Affiliation(s)
- Hidetaka Yasuoka
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Akira Asai
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Masahiro Matsui
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Norio Okamoto
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Tomohiro Nishikawa
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Hideko Ohama
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Yusuke Tsuchimoto
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Shinya Fukunishi
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Kazuhide Higuchi
- 1The second department of internal medicine, Osaka Medical College, Japan
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31
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Okamoto N, Asai A, Matsui M, Yasuoka H, Nishikawa T, Yokohama K, Nakamura K, Ohama H, Tsuchimoto Y, Fukunishi S, Tsuda Y, Higuchi K. Characterization of macrophages in the liver of total body irradiated mice. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.82.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Two hepatic macrophage (MΦ) populations have been described in the inflamed liver: F4/80+CD11b+ cells and F4/80+CD68+ cells. In normal conditions, hepatic F4/80+CD11b+ cells are involved in host antibacterial resistance. However, these cells in total body irradiated mice (TBI mice) are unfunctional for the elimination of bacteria translocated from intestinal tracts. In this study, the properties of hepatic MΦ populations in TBI mice were characterized. Normal mice and mice 7 days after exposure to 4 Gy of X-rays were infected i.v. with 107 CFU/mouse of Enterococcus faecalis (E. faecalis). Three day after infection, F4/80+CD11b+ cells and F4/80+CD68+ cells isolated from the liver of these mice were cultured for 24 hrs, and culture fluids were assayed for IL-12, IL-10 and CCL1 by ELISA. NSG mice were inoculated i.v. with these MΦ preparations (2 × 105 cells/mouse), then infected i.v. with 5 × 104 CFU/mouse of E. faecalis. In the results, all TBI mice died within 2 weeks, while all normal mice survived. IL-12 was produced by F4/80+CD11b+ cells from normal mice, but not by both MΦ preparations from TBI mice. IL-10 was produced by F4/80+CD68+ cells from TBI mice (529.9 ± 272.6 pg/ml) and normal mice (445.8 ± 147.7 pg/ml). Large amounts of IL-10 (912.1 ± 103.7 pg/ml) was produced by F4/80+CD11b+ cells from TBI mice, and these cells produced CCL1 (327.5 ± 9.1 pg/ml), while other MΦ preparations did not. NSG mice inoculated with F4/80+CD11b+ cells from normal mice were resistant to infection; however, NSG mice inoculated with F4/80+CD11b+ cells from TBI mice did not. These results indicate hepatic F4/80+CD11b+ cells are polarized to M2bMΦ in response to total body irradiation, and these MΦ are involved in the decreased host antibacterial resistance in TBI mice.
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Affiliation(s)
- Norio Okamoto
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Akira Asai
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Masahiro Matsui
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Hidetaka Yasuoka
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Tomohiro Nishikawa
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Keisuke Yokohama
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Ken Nakamura
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Hideko Ohama
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Yusuke Tsuchimoto
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Shinya Fukunishi
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Yasuhiro Tsuda
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Kazuhide Higuchi
- 1The second department of internal medicine, Osaka Medical College, Japan
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Matsui M, Asai A, Okamoto N, Nishikawa T, Ohama H, Tsuchimoto Y, Fukunishi S, Higuchi K. Changes in the gut microbiota caused by ASBTi suppress intrahepatic steatosis and inflammation in a mouse model of non-alcoholic fatty liver disease (NAFLD). The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.75.20] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Although the estimated prevalence of NAFLD is approximately 25%, an effective treatment has not been established. Recently, gut microbiota has been shown to affect the pathogenesis of NAFLD. In this study, the protective effect of Apical Sodium-dependent Bile acid Transporter inhibitor (ASBTi) against NAFLD was investigated in mice fed a high-fat diet for 12 weeks (HFD mice) via changing their gut microbiota. ASBTi mice were mice treated with ASBTi (2.5 μmol/kg/day) during HFD feeding. For fecal microbiota transplantation (FMT), stools were collected from HFD mice and ASBTi mice. Fecal materials obtained from HFD mice and ASBTi mice were transplanted to normal mice, fed HFD for 12 weeks, and designated as HFD-FMT mice and ASBTi-FMT mice, respectively. Microbiota in these groups of mice were analyzed by 16S rRNA gene sequencing. The degrees of hepatic steatosis and inflammation in these mice were determined pathologically. The shannon index of the microbiota from ASBTi mice (3.31±0.19) and ASBTi-FMT mice (3.29±0.18) was significantly high as compared to that from HFD mice (2.90±0.19) and HFD-FMT mice (2.89±0.16). Steatosis and inflammation in the liver of HFD mice and HFD-FMT mice were shown to be pathologically severe and NAFLD Activity Score (NAS) was 7.67±0.58 in HFD mice and 5.67±2.08 in HFD-FMT mice. However, those in the liver of ASBTi mice and ASBTi-FMT mice were improved and NAS was reduced in ASBTi mice (1.67±0.58) and in ASBTi-FMT mice (2.67±0.58). These results suggest that changes in the gut microbiota caused by ASBTi suppress intrahepatic steatosis and inflammation in NAFLD mice. Elobixibat can be expected to prevent fatty liver.
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Affiliation(s)
- Masahiro Matsui
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Akira Asai
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Norio Okamoto
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Tomohiro Nishikawa
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Hideko Ohama
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Yusuke Tsuchimoto
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Shinya Fukunishi
- 1The second department of internal medicine, Osaka Medical College, Japan
| | - Kazuhide Higuchi
- 1The second department of internal medicine, Osaka Medical College, Japan
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Nagai N, Ishii M, Seiriki R, Ogata F, Otake H, Nakazawa Y, Okamoto N, Kanai K, Kawasaki N. Novel Sustained-Release Drug Delivery System for Dry Eye Therapy by Rebamipide Nanoparticles. Pharmaceutics 2020; 12:E155. [PMID: 32075200 PMCID: PMC7076486 DOI: 10.3390/pharmaceutics12020155] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/07/2020] [Accepted: 02/13/2020] [Indexed: 01/02/2023] Open
Abstract
The commercially available rebamipide ophthalmic suspension (CA-REB) was approved for clinical use in patients with dry eye; however, the residence time on the ocular surface for the traditional formulations is short, since the drug is removed from the ocular surface through the nasolacrimal duct. In this study, we designed a novel sustained-release drug delivery system (DDS) for dry eye therapy by rebamipide nanoparticles. The rebamipide solid nanoparticle-based ophthalmic formulation (REB-NPs) was prepared by a bead mill using additives (2-hydroxypropyl-β-cyclodextrin and methylcellulose) and a gel base (carbopol). The rebamipide particles formed are ellipsoid, with a particle size in the range of 40-200 nm. The rebamipide in the REB-NPs applied to eyelids was delivered into the lacrimal fluid through the meibomian glands, and sustained drug release was observed in comparison with CA-REB. Moreover, the REB-NPs increased the mucin levels in the lacrimal fluid and healed tear film breakup levels in an N-acetylcysteine-treated rabbit model. The information about this novel DDS route and creation of a nano-formulation can be used to design further studies aimed at therapy for dry eye.
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Affiliation(s)
- Noriaki Nagai
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan; (M.I.); (R.S.); (F.O.); (H.O.); (N.K.)
| | - Miyu Ishii
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan; (M.I.); (R.S.); (F.O.); (H.O.); (N.K.)
| | - Ryotaro Seiriki
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan; (M.I.); (R.S.); (F.O.); (H.O.); (N.K.)
| | - Fumihiko Ogata
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan; (M.I.); (R.S.); (F.O.); (H.O.); (N.K.)
| | - Hiroko Otake
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan; (M.I.); (R.S.); (F.O.); (H.O.); (N.K.)
| | - Yosuke Nakazawa
- Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan;
| | - Norio Okamoto
- Okamoto Eye Clinic, 5-11-12-312 Izumicho, Suita, Osaka 564-0041, Japan;
| | - Kazutaka Kanai
- Department of Small Animal Internal Medicine, School of Veterinary Medicine, University of Kitasato, Towada, Aomori 034-8628, Japan;
| | - Naohito Kawasaki
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan; (M.I.); (R.S.); (F.O.); (H.O.); (N.K.)
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Hirashima T, Kanai T, Suzuki H, Yoshida H, Matsushita A, Kawasumi H, Samejima Y, Noda Y, Nasu S, Tanaka A, Morishita N, Hashimoto S, Kawahara K, Tamura Y, Okamoto N, Tanaka T. The Levels of Interferon-gamma Release as a Biomarker for Non-small-cell Lung Cancer Patients Receiving Immune Checkpoint Inhibitors. Anticancer Res 2019; 39:6231-6240. [PMID: 31704852 DOI: 10.21873/anticanres.13832] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/09/2019] [Accepted: 10/10/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The present study aimed to prospectively examine the usefulness of interferon-gamma (IFN-γ) release (IGR) as a biomarker in non-small-cell lung cancer patients receiving immune checkpoint inhibitor treatment (ICI-Tx). PATIENTS AND METHODS IGR was measured using enzyme-linked immunosorbent assay at four time points: within 14 days before ICI-Tx (T1), and 8±3 (T2), 22±7 (T3), and 43±7 (T4) days after ICI-Tx. RESULTS Twenty-nine patients were divided into three groups based on IFN-γ levels in the IGR-positive control: Group-1 (n=8) with <10 IU/ml at T1, Group-2 (n=12) with a decrease in IFN-γ levels to <10 IU/ml at T3 and/or T4, and Group-3 (n=9) without changes in IFN-γ levels. Early progression and ICI-induced interstitial pneumonitis were frequently observed in Group-1 and Group-2, respectively. Group-3 exhibited more treatment cycles than the other groups. All three groups showed clear differences in clinical outcomes. CONCLUSION IFN-γ levels could be a biomarker for ICI-Tx.
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Affiliation(s)
- Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Tomohiro Kanai
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Hiroko Yoshida
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Akane Matsushita
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Hiromi Kawasumi
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Yumiko Samejima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Yoshimi Noda
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Shingo Nasu
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Shoji Hashimoto
- Department of Allergy, Osaka Habikino Medical Center, Osaka, Japan
| | - Kunimitsu Kawahara
- Department of Clinical Pathology, Osaka Habikino Medical Center, Osaka, Japan
| | - Yoshitaka Tamura
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Toshio Tanaka
- Department of Allergy, Osaka Habikino Medical Center, Osaka, Japan
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Nasu S, Okamoto N, Suzuki H, Shiroyama T, Tanaka A, Samejima Y, Kanai T, Noda Y, Morita S, Morishita N, Ueda K, Kawahara K, Hirashima T. Comparison of the Utilities of Cryobiopsy and Forceps Biopsy for Peripheral Lung Cancer. Anticancer Res 2019; 39:5683-5688. [PMID: 31570467 DOI: 10.21873/anticanres.13766] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 07/23/2019] [Revised: 08/05/2019] [Accepted: 08/07/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM This study aimed to compare the efficacies of cryobiopsy and forceps biopsy for peripheral lung cancer detection. PATIENTS AND METHODS A retrospective review of peripheral lung cancer cases between December 2017 and April 2019 was conducted. Forceps biopsy was performed followed by cryobiopsy using a guide sheath (GS). Diagnostic yields were compared between cryobiopsy and forceps biopsy. RESULTS A total of 53 lung cancer lesions were evaluated. The diagnostic yields of forceps biopsy and cryobiopsy were 86.8% and 81.1%, respectively. Univariate and multivariate analyses indicated that cryobiopsy with a GS was significantly associated with increased diagnostic yield (odds ratio(OR)=11.6; p=0.044). Among the four patients who tested positive on cryobiopsy and negative on forceps biopsy, one had diffused pulmonary metastases and the others showed intratumoural air bronchograms. CONCLUSION Cryobiopsy using a GS can significantly increase diagnostic yield and help identify lesions with intratumoural air bronchograms and external wall lesions.
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Affiliation(s)
- Shingo Nasu
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
| | - Takayuki Shiroyama
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
| | - Yumiko Samejima
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
| | - Tomohiro Kanai
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
| | - Yoshimi Noda
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
| | - Satomu Morita
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
| | - Kayo Ueda
- Department of Pathology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
| | - Kunimitsu Kawahara
- Department of Pathology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
| | - Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization, Osaka Habikino Medical Center, Osaka, Japan
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Masuhiro K, Koh G, Takata S, Nasu S, Takada H, Morita S, Tanaka A, Shiroyama T, Morishita N, Suzuki H, Okamoto N, Kawasumi H, Konishi C, Hirashima T. A case of successful concurrent anti-cancer treatment in a patient who developed follicular lymphoma during treatment with afatinib for advanced lung adenocarcinoma. Respir Med Case Rep 2019; 28:100862. [PMID: 31194139 PMCID: PMC6554495 DOI: 10.1016/j.rmcr.2019.100862] [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: 02/12/2019] [Revised: 05/24/2019] [Accepted: 05/24/2019] [Indexed: 11/25/2022] Open
Abstract
The present report describes the case of a 64-year-old woman with advanced lung adenocarcinoma expressing mutant epidermal growth factor receptor (EGFR). The patient developed follicular lymphoma during treatment with the EGFR-tyrosine kinase inhibitor afatinib. Standard immunochemotherapy for follicular lymphoma was introduced in addition to continuing treatment with afatinib for lung cancer. Immunochemotherapy was effective and improved the patient's performance status while afatinib controlled the progression of lung cancer. Our case study suggests that it is safe to introduce standard immunochemotherapy for patients who develop malignant lymphoma while continuing treatment with tyrosine kinase inhibitors for lung adenocarcinoma expressing mutant EGFR.
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Key Words
- ALK, anaplastic lymphoma kinase
- Afatinib
- CT, computed tomography
- Double primary malignant tumors
- EGFR-TKIs, epidermal growth factor receptor-tyrosine kinase inhibitors
- FL, follicular lymphoma
- Follicular lymphoma
- LAD, lung adenocarcinoma
- Lung cancer
- Metachronous
- NSCLC, non-small cell lung cancer
- R-CHOP, cyclophosphamide, doxorubicin, vincristine, predonisone with rituximab
- Synchronous
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Affiliation(s)
- Kentaro Masuhiro
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Genju Koh
- Department of Oncology, Yao Tokushukai General Hospital, Osaka, Japan
| | - So Takata
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Shingo Nasu
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Hiromune Takada
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Satomu Morita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Takayuki Shiroyama
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Hiromi Kawasumi
- Department of Clinical Laboratory, Osaka Habikino Medical Center, Osaka, Japan
| | - Chihiro Konishi
- Department of Pharmacy, Yao Tokushukai General Hospital, Osaka, Japan
| | - Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
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Oizumi S, Yoh K, Matsumoto S, Miyamoto S, Furuya N, Sasada S, Okamoto N, Hayashi Y, Tsuta K, Motoi N, Ishii G, Goto K. Assessment of PD-L1 expression and oncogenic gene status in patients with small-cell lung cancer: Immuno-oncology biomarker study in LC-SCRUM-Japan. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.8558] [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
8558 Background: The clinical impact of PD-L1 expression and oncogenic gene status in patients with small cell lung cancer (SCLC) is not well characterized. We initiated this immuno-oncology biomarker study as part of nationwide genomic screening by LC-SCRUM-Japan (LC-SCRUM-IBIS). Methods: Tumor samples from lung cancer patients enrolled in LC-SCRUM-IBIS were primarily subjected to targeted next-generation sequencing (NGS) with Oncomine™ Comprehensive Assay. The PD-L1 expression was also analyzed by 4 immunohistochemistry (IHC) assays for 22C3, 28-8, SP263 and SP142. At this analysis, 22C3, 28-8, and SP263 were assessed in tumor cells (TC) as positive in > 1%, and SP142 in both TC and tumor-infiltrating immune cells (IC) as positive in > TC1/IC1, as previously reported. The association of PD-L1 expression, oncogenic gene status and clinical outcome was investigated in SCLC patients. Results: Between Feb 2017 and May 2018, 1017 lung cancer patients were enrolled in LC-SCRUM-IBIS. Among them, 933 patients had adequate tumor samples including 101 SCLC and 832 non-small cell lung cancer. Of 101 SCLC patients, the results of PD-L1 expression by 4 IHC assays were 18% in 22C3, 17% in 28-8, 11% in SP263 and 8% in SP142, respectively. Targeted NGS showed that 8 patients had at least one targetable oncogenic alterations, including 3 PIK3CA and 1 KRAS as mutations and 3 PTEN and 1 TSC2 as inactivating mutations. PD-L1 expression by 22C3 was associated with good performance status (P = 0.05) and the presence of oncogenic alterations (P = 0.004). PD-L1 status was not associated with response to cytotoxic chemotherapy and progression-free survival and overall survival in first-line treatment of SCLC patients. Conclusions: The frequency of PD-L1 expression in SCLC patients was relatively lower compared with that reported in other solid tumors. PD-L1 status by TC in 22C3 appears to be not correlated with clinical outcomes for cytotoxic chemotherapy of SCLC patients. Further investigation is needed to explore a predictive biomarker for immune checkpoint inhibitors. Updated results will be presented at the meeting.
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Affiliation(s)
- Satoshi Oizumi
- National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Kiyotaka Yoh
- National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | - Naoki Furuya
- Department of Internal Medicine, Division of Respiratory Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | | | | | | | | | | | - Genichiro Ishii
- Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Koichi Goto
- National Cancer Center Hospital East, Kashiwa, Japan
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Nagai N, Iwai Y, Deguchi S, Otake H, Kanai K, Okamoto N, Shimomura Y. Therapeutic Potential of a Combination of Magnesium Hydroxide Nanoparticles and Sericin for Epithelial Corneal Wound Healing. Nanomaterials (Basel) 2019; 9:nano9050768. [PMID: 31109118 PMCID: PMC6567023 DOI: 10.3390/nano9050768] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 05/13/2019] [Accepted: 05/15/2019] [Indexed: 01/31/2023]
Abstract
We previously found the instillation of sericin to be useful as therapy for keratopathy with or without diabetes mellitus. In this study, we investigated whether a combination of solid magnesium hydroxide nanoparticles (MHN) enhances epithelial corneal wound healing by sericin using rabbits, normal rats and type 2 diabetes mellitus rats with debrided corneal epithelium (ex vivo and in vivo studies). Ophthalmic formulations containing sericin and MHN (N-Ser) were prepared using a bead mill method. The mean particle size of the N-Ser was 110.3 nm at the time of preparation, and 148.1 nm one month later. The instillation of N-Ser had no effect on the amount of lacrimal fluid in normal rabbits (in vivo), but the MHN in N-Ser was found to expand the intercellular space in ex vivo rat corneas. In addition, the instillation of N-Ser increased the phosphorylation of Extracellular Signal-regulated Kinase (ERK)1/2, a factor involved in cell adhesion and cell proliferation in the corneal epithelium, in comparison with the instillation of sericin alone. The combination with MHN enhanced epithelial corneal wound healing by sericin in rat debrided corneal epithelium (in vivo). This study provides significant information to prepare potent drugs to cure severe keratopathy, such as diabetic keratopathy.
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Affiliation(s)
- Noriaki Nagai
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan.
| | - Yoshie Iwai
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan.
| | - Saori Deguchi
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan.
| | - Hiroko Otake
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan.
| | - Kazutaka Kanai
- Department of Small Animal Internal Medicine, School of Veterinary Medicine, University of Kitasato, Towada, Aomori 034-8628, Japan.
| | - Norio Okamoto
- Okamoto Eye Clinic, 5-11-12-312 Izumicho, Suita, Osaka 564-0041, Japan.
| | - Yoshikazu Shimomura
- Department of Ophthalmology, Fuchu Hospital, 1-10-17 Hikocho, Izumi, Osaka 594-0076, Japan.
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Nasu S, Suzuki H, Moriizumi K, Hara Y, Tanaka S, Takada H, Morita S, Tanaka A, Shiroyama T, Morishita N, Okamoto N, Hirashima T. Re-challenge chemotherapy in patients with sensitive relapse small-cell lung cancer and interstitial lung disease. J Thorac Dis 2019; 11:514-520. [PMID: 30962995 DOI: 10.21037/jtd.2019.01.26] [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] [Indexed: 11/06/2022]
Abstract
Background Treatment modalities for small-cell lung cancer (SCLC) with pre-existing interstitial lung disease (ILD) are limited. Although re-challenge with first-line chemotherapy can be effective for sensitive relapse SCLC, its safety and efficacy are uncertain in cases with ILD. This study aimed to investigate both the efficacy and safety of re-challenge chemotherapy in patients with sensitive relapse SCLC with ILD. Methods Patients with sensitive relapse SCLC with ILD who received re-challenge chemotherapy were studied retrospectively. Sensitive relapse was defined as a treatment-free interval (TFI) of more than 60 days after first-line platinum-based treatment. The endpoints were progression-free survival (PFS), overall survival (OS), and safety. Results Re-challenge platinum and etoposide were administered in 11 patients, with the median re-challenge cycle of 3. The overall response rate was 55%. The median PFS and OS from the time of re-challenge treatment were 4 months (95% CI, 2.9-NA) and 9.2 months (95% CI, 8.0-NA), respectively. One patient developed acute exacerbation of ILD 173 days after the last course of re-challenge treatment. Conclusions Re-challenge chemotherapy can be effective and considered in SCLC patients with pre-existing ILD.
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Affiliation(s)
- Shingo Nasu
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Kazunori Moriizumi
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Yuki Hara
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Satoshi Tanaka
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Hiromune Takada
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Satomu Morita
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Takayuki Shiroyama
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
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Nasu S, Shiroyama T, Morita S, Takata S, Takada H, Masuhiro K, Tanaka A, Morishita N, Suzuki H, Okamoto N, Hirashima T. Osimertinib Treatment Was Unsuccessful for Lung Adenocarcinoma with G719S, S768I, and T790M Mutations. Intern Med 2018; 57:3643-3645. [PMID: 30146570 PMCID: PMC6355418 DOI: 10.2169/internalmedicine.0923-18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Epidermal growth factor receptor (EGFR) T790M mutations are the most frequent mechanism of resistance to first- and second-generation tyrosine kinase inhibitors, and osimertinib is an effective treatment for patients with both EGFR-activating mutations and T790M resistance mutations. We describe the case of a 68-year-old woman with lung adenocarcinoma with G719S, S768I, and T790M mutations in which osimertinib treatment was unsuccessful. The patient died of disease progression one month after discontinuing osimertinib treatment. This case suggests that osimertinib may be ineffective for treating patients with uncommon mutations such as G719S when the patient has also acquired a T790M resistance mutation.
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Affiliation(s)
- Shingo Nasu
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | | | - Satomu Morita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - So Takata
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Hiromune Takada
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Kentaro Masuhiro
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
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Hirashima T, Tamura Y, Han Y, Hashimoto S, Tanaka A, Shiroyama T, Morishita N, Suzuki H, Okamoto N, Akada S, Fujishima M, Kadota Y, Sakata K, Nishitani A, Miyazaki S, Nagai T. Efficacy and safety of concurrent anti-Cancer and anti-tuberculosis chemotherapy in Cancer patients with active Mycobacterium tuberculosis: a retrospective study. BMC Cancer 2018; 18:975. [PMID: 30314434 PMCID: PMC6186130 DOI: 10.1186/s12885-018-4889-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Accepted: 10/02/2018] [Indexed: 12/18/2022] Open
Abstract
Background In our previous study, colorectal cancer (CRC) patients with active Mycobacterium tuberculosis (MTB) tolerated concurrent anti-cancer chemotherapy (anti-CCT) and anti-MTB chemotherapy. In this study, we retrospectively confirmed the efficacy and safety of concurrent chemotherapy in a greater number of patients with different types of malignancies. Methods We enrolled 30 patients who were treated concurrently with anti-CCT and anti-MTB regimens between January 2006 and February 2016. Cancer and MTB treatments were administered according to the approved guidelines. Results Patient demographics included: men/woman: 24/6; median age: 66.5 years; Eastern Cooperative Oncology Group performance status 0–1/2/3–4: 24/4/2; Stage IIB–IIIC/IV/recurrence: 6/22/2; lung cancer (LC)/CRC/other: 15/10/5; and MTB diagnosis (before or during anti-CCT): 20/10 (LC: 8/7; CRC: 8/2; other: 4/1). For anti-CCT, 23 patients received two cytotoxic agents with or without targeted agents and 7 patients received a single cytotoxic or targeted agent. The overall response rate was 36.7%. Regarding anti-MTB chemotherapy, 22 patients received a daily drug combination containing isoniazid, rifampicin, and ethambutol, plus pyrazinamide in 15 of the 22 patients, followed by daily isoniazid and rifampicin; the remaining 8 patients received other combinations. Hematological adverse events of Grade ≥ 3 were observed in 19 (67.9%) of 28 patients; laboratory data were lost for the remaining 2. Grade 3 lymphopenia and higher were significantly more frequent in LC compared to other malignancies (P < 0.005). Non-hematological adverse events of Grade ≥ 3 were observed in 5 (16.7%) of 30 patients. One CRC patient experienced Grade 3 hemoptysis and another 2 experienced Grade 3 anaphylaxis. One patient with cholangiocellular carcinoma and gastric cancer experienced Grade 3 pseudomembranous colitis as a result of a Clostridium difficile infection. One patient (3.3%) died of pemetrexed-induced pneumonitis. The success of the anti-MTB chemotherapy was 70.0%. There were no MTB-related treatment failures. The median overall survival (months, 95.0% confidence interval) was 10.5 (8.7–36.7), 8.7 (4.7–10.0), 36.7 (minimum 2.2), and 14.4 (minimum 9.6) for all patients combined, LC, CRC, and Other malignancies, respectively. LC patients experienced delayed MTB diagnosis and shorter overall survival. Conclusions Concurrent chemotherapy is effective and safe for treating cancer patients with active MTB.
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Affiliation(s)
- Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan.
| | - Yoshitaka Tamura
- Departments of Clinical Laboratory, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Yuki Han
- Departments of Infectious Diseases, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Shoji Hashimoto
- Departments of Infectious Diseases, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Takayuki Shiroyama
- Department of Thoracic Oncology, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Shinobu Akada
- Departments of Gynecology, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Makoto Fujishima
- Departments of Breast Surgery, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Yoshihisa Kadota
- Departments of Thoracic Surgery, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Kazuya Sakata
- Departments of Gastroenterological Surgery, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Akiko Nishitani
- Departments of Gastroenterological Surgery, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Satoru Miyazaki
- Departments of Gastroenterological Surgery, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
| | - Takayuki Nagai
- Departments of Infectious Diseases, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan
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Ikeda T, Ohashi K, Sekine A, Ohe Y, Tsuda T, Kataoka Y, Hara S, Okamoto N, Kodani M, Matsumoto S, Goto K. Tumor mutation burden (TMB) estimation using small-sized targeted next-generation sequencing (NGS) to predict efficacy of immune checkpoint inhibitors (ICIs) for non-small cell lung cancer (NSCLC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.032] [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: 11/14/2022] Open
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Okamoto N, Umemura S, Nakagawa T, Miyamoto S, Kudo K, Nakao M, Kataoka Y, Furuya N, Yokouchi H, Matsumoto S, Udagawa H, Yoh K, Goto K. Large-scale nationwide genomic screening system for small cell lung cancer in Japan (LC-SCRUM-Japan). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy374.013] [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: 11/14/2022] Open
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Kunimasa K, Yoh K, Matsumoto S, Furuya N, Miyamoto S, Oizumi S, Tabata E, Sugawara S, Kodani M, Okamoto N, Hara S, Hayashi Y, Motoi N, Ishii G, Goto K. Immuno-oncology biomarker study in a large cohort of LC-SCRUM-Japan: LC-SCRUM-IBIS. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy374.004] [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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Kawagoe Y, Sato Y, Okamoto N, Ishizuka B, Kawamura K. Maternal STAT3 regulates oocyte maturation and development of early embryos through autophagy. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Shiroyama T, Suzuki H, Tamiya M, Tamiya A, Tanaka A, Okamoto N, Nakahama K, Taniguchi Y, Isa SI, Inoue T, Imamura F, Atagi S, Hirashima T. Clinical Characteristics of Liver Metastasis in Nivolumab-treated Patients with Non-small Cell Lung Cancer. Anticancer Res 2018; 38:4723-4729. [PMID: 30061241 DOI: 10.21873/anticanres.12779] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 06/25/2018] [Accepted: 06/28/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Recent studies have revealed that liver metastasis is associated with poor outcomes after treatment using immune checkpoint inhibitors, although the cause remains unclear. PATIENTS AND METHODS We retrospectively identified 201 patients at three Japanese Centers who received nivolumab for advanced non-small cell lung cancer between December 2015 and July 2016. The patients' baseline clinical characteristics and subsequent outcomes were compared according to liver metastasis status. RESULTS Liver metastasis was associated with inferior progression-free survival (PFS) and a lower response rate. Additionally, liver metastasis was significantly associated with younger age, poorer Eastern Cooperative Oncology Group performance status (ECOG PS), and more metastatic sites. Multivariate analyses revealed that poor PFS was independently associated with poor baseline ECOG PS (p=0.039) and high number of metastatic sites (p=0.007), although liver metastasis (p=0.2) was not. CONCLUSION Baseline clinical characteristics were a strong predictor of outcome in nivolumab-treated patients with liver metastasis.
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Affiliation(s)
- Takayuki Shiroyama
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan .,Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Motohiro Tamiya
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Akihiro Tamiya
- Department of Internal Medicine, Kinki-chuo Chest Medical Center, Osaka, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Kenji Nakahama
- Department of Internal Medicine, Kinki-chuo Chest Medical Center, Osaka, Japan
| | - Yoshihiko Taniguchi
- Department of Internal Medicine, Kinki-chuo Chest Medical Center, Osaka, Japan
| | - Shun-Ichi Isa
- Department of Clinical Research Center, Kinki-chuo Chest Medical Center, Osaka, Japan
| | - Takako Inoue
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Fumio Imamura
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Shinji Atagi
- Department of Clinical Research Center, Kinki-chuo Chest Medical Center, Osaka, Japan
| | - Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
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Shiroyama T, Nasu S, Morita S, Okamoto N. Thoracoscopic Images of Primary Pleural Melanoma. Intern Med 2018; 57:1803. [PMID: 29434129 PMCID: PMC6047978 DOI: 10.2169/internalmedicine.0143-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
| | - Shingo Nasu
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Satomu Morita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Japan
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Masuhiro K, Shiroyama T, Suzuki H, Takata SO, Nasu S, Takada H, Morita S, Tanaka A, Morishita N, Okamoto N, Hirashima T. Impact of Pleural Effusion on Outcomes of Patients Receiving Osimertinib for NSCLC Harboring EGFR T790M. Anticancer Res 2018; 38:3567-3571. [PMID: 29848711 DOI: 10.21873/anticanres.12629] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Osimertinib has demonstrated promising efficacy in patients with epidermal growth factor receptor (EGFR) T790M-positive non-small cell lung cancer (NSCLC). We investigated the efficacy of osimertinib in such patients presenting with pleural effusion, which has been unclear to date. PATIENTS AND METHODS The medical records of all patients treated with osimertinib for advanced NSCLC with EGFR T790M between April 2016 and July 2017 at our Institution were retrospectively reviewed. Time to treatment failure (TTF) and overall survival (OS) were determined as endpoints. RESULTS Twenty-three patients (seven with pleural effusions) were treated with osimertinib. Patients with pleural effusion had significantly shorter median TTF than those without (3.7 vs. 12.8 months, respectively, p=0.021), as well as shorter median OS (7.8 months vs. not attained, respectively, p=0.002). Metastasis to the brain, bone, and liver did not significantly influence our endpoints. CONCLUSION Osimertinib monotherapy is less effective in patients with NSCLC with pleural effusions.
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Affiliation(s)
- Kentaro Masuhiro
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Japan
| | - Takayuki Shiroyama
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Japan
| | - S O Takata
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Japan
| | - Shingo Nasu
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Japan
| | - Hiromune Takada
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Japan
| | - Satomu Morita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Japan
| | - Ayako Tanaka
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Japan
| | - Naoko Morishita
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Japan
| | - Tomonori Hirashima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Japan
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Yoh K, Matsumoto S, Nishino K, Furuya N, Miyamoto S, Oizumi S, Hashimoto S, Sugawara S, Kodani M, Okamoto N, Hara S, Hayashi Y, Motoi N, Ishii G, Goto K. Immuno-oncology biomarker study in a large cohort of LC-SCRUM-Japan: Assessment of PD-L1 expression and tumor mutation burden in non-small cell lung cancer patients treated with immune checkpoint inhibitors. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.9070] [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)
- Kiyotaka Yoh
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Shingo Matsumoto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kazumi Nishino
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | | | - Satoshi Oizumi
- Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Shigeki Hashimoto
- Department of Respiratory Medicine, Ikeda Municipal Hospital, Osaka, Japan
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Masahiro Kodani
- Division of Medical Oncology and Molecular Respirology, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Norio Okamoto
- Department of Pulmonary Medicine, Itami City Hospital, Osaka, Japan
| | - Satoshi Hara
- Respiratory Division, Department of Internal Medicine, Itami City Hospital, Itami, Japan
| | - Yuichiro Hayashi
- Department of Diagnostic Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Noriko Motoi
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Genichiro Ishii
- Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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Ogawa Y, Umemura S, Murakami H, Shingoji M, Kobayashi N, Shimokawaji T, Daga H, Seto T, Okamoto N, Aono H, Fujiwara Y, Hara S, Kanaji N, Matsumoto S, Udagawa H, Yoh K, Goto K. Large-scale nationwide genomic screening system for small cell lung cancer in Japan (LC-SCRUM-Japan). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.8572] [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)
| | - Shigeki Umemura
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Haruyasu Murakami
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | | | | | | | - Haruko Daga
- Department of Clinical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Takashi Seto
- Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Japan
| | - Norio Okamoto
- Department of Thoracic Oncology and Bronchology, Osaka Habikino Medical Center, Habikino, Japan
| | | | - Yutaka Fujiwara
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Hara
- Respiratory Division, Department of Internal Medicine, Itami City Hospital, Itami, Japan
| | - Nobuhiro Kanaji
- Department of Internal Medicine, Division of Hematology, Rheumatology, and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Shingo Matsumoto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hibiki Udagawa
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kiyotaka Yoh
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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