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Saito Y, Yamaguchi R, Suzuki T, Sato J, Nishijima N, Saito S, Aoyama J, Taniuchi N, Seike M, Katsumata N. Interstitial lung disease with prolonged fever that occurred during long-term administration of olaparib in a 74-year-old ovarian cancer patient: Radiological features and considerations for preventing delayed diagnosis. Radiol Case Rep 2024; 19:2100-2105. [PMID: 38645548 PMCID: PMC11026925 DOI: 10.1016/j.radcr.2024.02.064] [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: 01/10/2024] [Revised: 02/12/2024] [Accepted: 02/15/2024] [Indexed: 04/23/2024] Open
Abstract
A 74-year-old woman, who had been receiving olaparib for the treatment of ovarian cancer for more than a year, visited the emergency department complaining of a fever that had lasted for 1 month. She had been taking antipyretics and antibiotics for her fever, but without any effect. Although she had no symptoms other than fever, she had stopped taking olaparib for 1 week before her visit because she had developed anemia caused by myelosuppression from olaparib. After discontinuing olaparib, her maximum body temperature decreased. On admission, chest X-ray revealed no abnormalities, but chest CT showed diffuse ground-glass opacities. Chest CT taken 5 days later showed partial improvement; therefore, we diagnosed her with interstitial lung disease (ILD) associated with olaparib. After short-term steroid treatment, the ground-glass opacities disappeared, and the patient became afebrile. The CT scan taken for tumor evaluation 2 days before the onset of fever showed a few centrilobular nodular opacities and small patchy ground-glass opacities. These findings could indicate early lesions of ILD, but they seemed inconspicuous and nonspecific, and it might have been difficult to diagnose ILD then. To date, few cases of ILD associated with olaparib have been reported. However, based on previous reports, fever is often seen, and CT findings mainly comprise diffuse ground-glass opacities, and in some cases, centrilobular nodular shadows. Thus, in conjunction with the findings of the present case, these characteristics may be representative of olaparib-induced ILD.
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Affiliation(s)
- Yoshinobu Saito
- Department of Pulmonary Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Rei Yamaguchi
- Department of Pulmonary Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Takahiro Suzuki
- Department of Pulmonary Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Junpei Sato
- Department of Pulmonary Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Nobuhiko Nishijima
- Department of Pulmonary Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Sho Saito
- Department of Pulmonary Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Junichi Aoyama
- Department of Pulmonary Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Namiko Taniuchi
- Department of Pulmonary Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Masahiro Seike
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
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Amano N, Narumi S, Aizu K, Miyazawa M, Okamura K, Ohashi H, Katsumata N, Ishii T, Hasegawa T. Single-Exon Deletions of ZNRF3 Exon 2 Cause Congenital Adrenal Hypoplasia. J Clin Endocrinol Metab 2024; 109:641-648. [PMID: 37878959 DOI: 10.1210/clinem/dgad627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/27/2023]
Abstract
CONTEXT Primary adrenal insufficiency (PAI) is a life-threatening condition characterized by the inability of the adrenal cortex to produce sufficient steroid hormones. E3 ubiquitin protein ligase zinc and ring finger 3 (ZNRF3) is a negative regulator of Wnt/β-catenin signaling. R-spondin 1 (RSPO1) enhances Wnt/β-catenin signaling via binding and removal of ZNRF3 from the cell surface. OBJECTIVE This work aimed to explore a novel genetic form of PAI. METHODS We analyzed 9 patients with childhood-onset PAI of biochemically and genetically unknown etiology using array comparative genomic hybridization. To examine the functionality of the identified single-exon deletions of ZNRF3 exon 2, we performed three-dimensional (3D) structure modeling and in vitro functional studies. RESULTS We identified various-sized single-exon deletions encompassing ZNRF3 exon 2 in 3 patients who showed neonatal-onset adrenal hypoplasia with glucocorticoid and mineralocorticoid deficiencies. Reverse-transcriptase polymerase chain reaction (RT-PCR) analysis showed that the 3 distinct single-exon deletions were commonly transcribed into a 126-nucleotide deleted mRNA and translated into 42-amino acid deleted protein (ΔEx2-ZNRF3). Based on 3D structure modeling, we predicted that interaction between ZNRF3 and RSPO1 would be disturbed in ΔEx2-ZNRF3, suggesting loss of RSPO1-dependent activation of Wnt/β-catenin signaling. Cell-based functional assays with the TCF-LEF reporter showed that RSPO1-dependent activation of Wnt/β-catenin signaling was attenuated in cells expressing ΔEx2-ZNRF3 as compared with those expressing wild-type ZNRF3. CONCLUSION We provided genetic evidence linking deletions encompassing ZNRF3 exon 2 and congenital adrenal hypoplasia, which might be related to constitutive inactivation of Wnt/β-catenin signaling by ΔEx2-ZNRF3.
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Affiliation(s)
- Naoko Amano
- Department of Pediatrics, Keio University School of Medicine, Tokyo, 160-8582, Japan
- Department of Pediatrics, Saitama City Hospital, Saitama, 336-8522, Japan
| | - Satoshi Narumi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, 160-8582, Japan
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, 157-8535, Japan
| | - Katsuya Aizu
- Division of Endocrinology and Metabolism, Saitama Children's Medical Center, Saitama, 330-8777, Japan
| | - Mari Miyazawa
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, 781-8555, Japan
| | - Kohji Okamura
- Department of Systems BioMedicine, National Center for Child Health and Development, Tokyo, 157-8535, Japan
| | - Hirofumi Ohashi
- Division of Medical Genetics, Saitama Children's Medical Center, Saitama, 330-8777, Japan
| | - Noriyuki Katsumata
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, 157-8535, Japan
| | - Tomohiro Ishii
- Department of Pediatrics, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Tomonobu Hasegawa
- Department of Pediatrics, Keio University School of Medicine, Tokyo, 160-8582, Japan
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Shinkai M, Katsumata N, Kawai S, Kuyama S, Sasaki O, Yanagita Y, Yoshida M, Uneda S, Tsuji Y, Harada H, Nishida Y, Sakamoto Y, Himeji D, Arioka H, Sato K, Katsuki R, Shomura H, Nakano H, Ohtani H, Sasaki K, Adachi T. Phase III study of bilayer sustained-release tramadol tablets in patients with cancer pain: a double-blind parallel-group, non-inferiority study with immediate-release tramadol capsules as an active comparator. Support Care Cancer 2023; 32:69. [PMID: 38157081 PMCID: PMC10756890 DOI: 10.1007/s00520-023-08242-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/06/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE We investigated whether twice-daily administration of a bilayer tablet formulation of tramadol (35% immediate-release [IR] and 65% sustained-release) is as effective as four-times-daily IR tramadol capsules for managing cancer pain. METHODS This randomized, double-blind, double-dummy, active-comparator, non-inferiority study enrolled opioid-naïve patients using non-steroidal anti-inflammatory drugs or acetaminophen (paracetamol) to manage cancer pain and self-reported pain (mean value over 3 days ≥ 25 mm on a 100-mm visual analog scale [VAS]). Patients were randomized to either bilayer tablets or IR capsules for 14 days. The starting dose was 100 mg/day and could be escalated to 300 mg/day. The primary endpoint was the change in VAS (averaged over 3 days) for pain at rest from baseline to end of treatment/discontinuation. RESULTS Overall, 251 patients were randomized. The baseline mean VAS at rest was 47.67 mm (range: 25.6-82.7 mm). In the full analysis set, the adjusted mean change in VAS was - 22.07 and - 19.08 mm in the bilayer tablet (n = 124) and IR capsule (n = 120) groups, respectively. The adjusted mean difference was - 2.99 mm (95% confidence interval [CI] - 7.96 to 1.99 mm). The upper 95% CI was less than the predefined non-inferiority margin of 7.5 mm. Other efficacy outcomes were similar in both groups. Adverse events were reported for 97/126 (77.0%) and 101/125 (80.8%) patients in the bilayer tablet and IR capsule groups, respectively. CONCLUSION Twice-daily administration of bilayer tramadol tablets was as effective as four-times-daily administration of IR capsules regarding the improvement in pain VAS, with comparable safety outcomes. CLINICAL TRIAL REGISTRATION JapicCTI-184143/jRCT2080224082 (October 5, 2018).
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Affiliation(s)
| | | | | | - Shoichi Kuyama
- National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan
| | | | | | | | - Shima Uneda
- Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | | | | | | | | | | | | | | | - Ryo Katsuki
- National Hospital Organization Ureshino Medical Center, Saga, Japan
| | - Hiroki Shomura
- Japan Community Health Care Organization Hokkaido Hospital, Hokkaido, Japan
| | - Hideshi Nakano
- Department of Clinical Development, Nippon Zoki Pharmaceutical Co., Ltd., Osaka, Japan
| | - Hideaki Ohtani
- Department of Clinical Development, Nippon Zoki Pharmaceutical Co., Ltd., Osaka, Japan
| | - Kazutaka Sasaki
- Department of Clinical Development, Nippon Zoki Pharmaceutical Co., Ltd., Osaka, Japan
| | - Takeshi Adachi
- Department of Clinical Development, Nippon Zoki Pharmaceutical Co., Ltd., Osaka, Japan
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Mizuno M, Ito K, Nakai H, Kato H, Kamiura S, Ushijima K, Nagao S, Takano H, Okadome M, Takekuma M, Tokunaga H, Nagase S, Aoki D, Coleman RL, Nishimura Y, Ratajczak CK, Hashiba H, Xiong H, Katsumata N, Enomoto T, Okamoto A. Veliparib with frontline chemotherapy and as maintenance in Japanese women with ovarian cancer: a subanalysis of efficacy, safety, and antiemetic use in the phase 3 VELIA trial. Int J Clin Oncol 2023; 28:163-174. [PMID: 36534262 PMCID: PMC9823063 DOI: 10.1007/s10147-022-02258-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/18/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND The phase 3 VELIA trial evaluated veliparib with carboplatin/paclitaxel and as maintenance in patients with high-grade serous ovarian carcinoma. METHODS Patients with previously untreated stage III-IV high-grade serous ovarian carcinoma were randomized 1:1:1 to control (placebo with carboplatin/paclitaxel and placebo maintenance), veliparib-combination-only (veliparib with carboplatin/paclitaxel and placebo maintenance), or veliparib-throughout (veliparib with carboplatin/paclitaxel and veliparib maintenance). Randomization stratification factors included geographic region (Japan versus North America or rest of the world). Primary end point was investigator-assessed median progression-free survival. Efficacy, safety, and pharmacokinetics were evaluated in a subgroup of Japanese patients. RESULTS Seventy-eight Japanese patients were randomized to control (n = 23), veliparib-combination-only (n = 30), and veliparib-throughout (n = 25) arms. In the Japanese subgroup, median progression-free survival for veliparib-throughout versus control was 27.4 and 19.1 months (hazard ratio, 0.46; 95% confidence interval, 0.18-1.16; p = 0.1 [not significant]). In the veliparib-throughout arm, grade 3/4 leukopenia, neutropenia, and thrombocytopenia rates were higher for Japanese (32%/88%/32%) versus non-Japanese (17%/56%/28%) patients. Grade 3/4 anemia rates were higher in non-Japanese (65%) versus Japanese (48%) patients. Early introduction of olanzapine during veliparib monotherapy maintenance phase may help prevent premature discontinuation of veliparib, via its potent antiemetic efficacy. CONCLUSIONS Median progression-free survival was numerically longer in Japanese patients in the veliparib-throughout versus control arm, consistent with results in the overall study population. Pharmacokinetics were comparable between Japanese and non-Japanese patients. Data for the subgroup of Japanese patients were not powered to show statistical significance but to guide further investigation.
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Affiliation(s)
- Mika Mizuno
- Department of Gynecology, Aichi Cancer Center Hospital, Nagoya-Shi, Aichi, 464-8681, Japan.
- Faculty of Medicine, Department of Obstetrics and Gynecology, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima City, 890-8520, Japan.
| | - Kimihiko Ito
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki-Shi, Hyogo, 660-8511, Japan
| | - Hidekatsu Nakai
- Department of Obstetrics and Gynecology, Kindai University, Faculty of Medicine, Osakasayama-Shi, Osaka, 589-8511, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, Hokkaido Cancer Center, Sapporo-Shi, Hokkaido, 003-0804, Japan
| | - Shoji Kamiura
- Department of Gynecology, Osaka International Cancer Institute, Osaka-Shi, Osaka, 541-8567, Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, Kurume University Hospital, Kurume-Shi, Fukuoka, 830-0011, Japan
| | - Shoji Nagao
- Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi-Shi, Hyogo, 673-8558, Japan
| | - Hirokuni Takano
- Department of Obstetrics and Gynecology, Jikei University Kashiwa Hospital, Kashiwa-Shi, Chiba, 277-0004, Japan
| | - Masao Okadome
- Gynecology Service, National Hospital Organization (NHO) Kyushu Cancer Center, Fukuoka-Shi, Fukuoka, 811-1395, Japan
| | - Munetaka Takekuma
- Department of Gynecology, Shizuoka Cancer Center, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Hideki Tokunaga
- Department of Gynecology, Tohoku University Hospital, Sendai-Shi, Miyagi, 980-8574, Japan
| | - Satoru Nagase
- Department of Obstetrics Gynecology, Yamagata University, Faculty of Medicine, Yamagata-Shi, Yamagata, 990-9585, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Robert L Coleman
- Department of Gynecologic Oncology, US Oncology Research, The Woodlands, TX, USA
| | | | | | | | | | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, Kawasaki-Shi, Kanagawa, 211-8533, Japan
| | - Takayuki Enomoto
- Japanese Gynecologic Oncology Group, Shinjuku-Ku, Tokyo, 162-0825, Japan
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8510, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Minato-Ku, Tokyo, 105-8461, Japan
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Naiki Y, Miyado M, Horikawa R, Katsumata N, Takada S, Akutsu H, Onodera M, Fukami M. LBODP008 Gene Therapy For Congenital Adrenal Hyperplasia With AAV Vectors Into Fibroblasts, IPS Cells And Model Mice. J Endocr Soc 2022. [DOI: 10.1210/jendso/bvac150.084] [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: 11/05/2022] Open
Abstract
Abstract
Background
Congenital adrenal hyperplasia (CAH) is due to defects of steroid synthetic enzymes, which includes microsomal and mitochondrial P450s. Microsomal P450s include 21-hydroxylase and 17α-hydroxylase/17-lyase. 21-hydroxylase deficiency (21-OHD), in which CYP21A2 is mutated or deleted, is the most common cause of CAH and results in underproduction of glucocorticoids and mineralocorticoids, and overproduction of androgens. 11β-hydroxylase deficiency (11β-OHD), which is a defect of a mitochondrial P450, is the second common cause of CAH. Patients with CAH are treated with oral steroid supplementation, but optimal control of blood steroid levels remains difficult. Thus, new therapeutic approaches are still needed. Intravenous adeno-associated virus (AAV)-mediated administration of human CYP21A2 into adult 21-OHD patients has been reported at the ENDO 2021 meeting. In this study, we examined the effects of induction of causative genes with an AAV vector into fibroblasts from patients and iPS cells and adrenal glands of model mice.
Methods
Fibroblasts from CAH patients were subjected to primary culture. The cells were infected with a serotype-2 AAV vector (AAV2) containing defected genes and cultured in steroid substrate-containing medium for 24 hours. We measured steroid metabolites in the medium by liquid chromatography tandem mass spectrometry and evaluated gene expressions by RT-PCR. In addition, iPS cells were established from fibroblasts of 11β-OHD and differentiated into adrenocortical cells with retinoic acid and cAMP. They were infected with a serotype-9 AAV vector (AAV9) containing CYP11B1 cDNA. Steroid metabolites in the culture medium were measured and gene expressions were evaluated by RT-PCR. 11β-OHD model mice were made by a gene-editing method. We injected AAV9 containing Cyp11b1 cDNA into the adrenal gland and measured serum DOC and corticosterone levels before and every 4 weeks after injection.
Results
AAV2 infected fibroblasts from 21-OHD and 17α-hydroxylase/17-lyase deficiency can metabolite steroid precursors but failed to convert DOC to corticosterone in 11β-OHD. Differentiation into adrenocortical cells from iPS cells of 11β-OHD was confirmed by expression of CYP21A2. AAV9 gene induction of adrenal cortical cells successfully induced 11β-hydroxylase activity. 11β-OHD mice also showed improved steroid synthesis after AAV9 adrenal induction.
Conclusion
These results indicate that extra-adrenal induction of CYP21A2 may ameliorate steroid metabolism in 21-OHD patients. In contrast, 11β-OHD needs AAV9 adrenal induction to treat the steroid abnormality. Our results suggest that specific gene therapeutic strategies are needed to be adapted for each type of CAH.
Presentation: No date and time listed
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Affiliation(s)
- Yasuhiro Naiki
- National Center for Child Health & Development , Tokyo , Japan
| | - Mami Miyado
- National Research Institute for Child Health , Tokyo , Japan
| | - Reiko Horikawa
- National Center for Child Health & Development , Tokyo , Japan
| | | | - Shuji Takada
- National Research Institute for Child Health , Tokyo , Japan
| | - Hidenori Akutsu
- National Research Institute for Child Health , Tokyo , Japan
| | | | - Maki Fukami
- National Research Institute for Child Health , Tokyo , Japan
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Ota T, Katsumata N, Naiki Y, Horikawa R. Novel non-stop variant of the NR0B1 gene in two siblings with adrenal hypoplasia congenita. J Pediatr Endocrinol Metab 2022; 35:1189-1193. [PMID: 35848959 DOI: 10.1515/jpem-2022-0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/23/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Mutations in the dosage-sensitive sex reversal-AHC critical region on the X chromosome, gene 1 (DAX-1, officially NR0B1), cause X-linked adrenal hypoplasia congenita (AHC) and hypogonadotropic hypogonadism (HHG). Salt-losing adrenal insufficiency usually occurs during the neonatal period or early childhood. We report a novel non-stop variant of NR0B1 in two siblings and their unusual clinical course. CASE PRESENTATION The proband was a boy who presented with an unusual form of AHC with neonatal onset of growth failure and mild salt loss, but without cutaneous pigmentation or plasma ACTH elevation. His 4-year-old elder brother had been growing healthily, but carried an AHC diagnosis. A non-stop variant of NR0B1 (p.*471K) was demonstrated in the patients and their mother. CONCLUSIONS We identified a novel non-stop variant of NR0B1 in two siblings. Mild salt loss associated with hyperkalemia is a crucial diagnostic clue for AHC, even without apparent symptoms of glucocorticoid deficiency.
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Affiliation(s)
- Tomoko Ota
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | - Noriyuki Katsumata
- Department of Molecular Endocrinology, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Yasuhiro Naiki
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | - Reiko Horikawa
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
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Naiki Y, Miyado M, Shindo M, Horikawa R, Hasegawa Y, Katsumata N, Takada S, Akutsu H, Onodera M, Fukami M. AAV-mediated gene therapy for patients' fibroblasts, iPS cells, and a mouse model of congenital adrenal hyperplasia. Hum Gene Ther 2022; 33:801-809. [PMID: 35838129 DOI: 10.1089/hum.2022.005] [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: 11/13/2022] Open
Abstract
Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder caused by steroidogenic enzymes containing monogenetic defects. Most steroidogenic enzymes are cytochrome P450 groups that can be categorized as microsomal P450s, including 21-hydroxylase and 17α-hydroxylase/17,20 lyase, and mitochondrial P450s, including 11β-hydroxylase. It has been shown that ectopic administration of Cyp21a1 ameliorates steroid metabolism in 21-hydroxylase-deficient mice. However, the effectiveness of this approach for mitochondrial P450 has not yet been evaluated. In this study, primary fibroblasts from patients with 21-hydroxylase deficiency (CYP21A2D) (n=4), 17α-hydroxylase/17,20 lyase deficiency (CYP17A1D) (n=1), and 11β-hydroxylase deficiency (CYP11B1D) (n=1) were infected with adeno-associated virus type 2 (AAV2) vectors. Steroidogenic enzymatic activity was not detected in the AAV2-infected CYP11B1D fibroblasts. Induced pluripotent stem cells (iPSCs) of CYP11B1D were established and differentiated into adrenocortical cells by induction of the NR5A1 gene. Adrenocortical cells established from iPSCs of CYP11B1D (CYP11B1D-iPSCs) were infected with an adeno-associated virus type 9 (AAV9) vector containing CYP11B1 and exhibited 11β-hydroxylase activity. For an in vivo evaluation, we knocked out Cyp11b1 in mice by using the CRISPR/Cas9 method. Direct injection of Cyp11b1-containing AAV9 vectors into the adrenal gland of Cyp11b1-deficient mice significantly reduced serum 11-deoxycorticosterone/corticosterone ratios at 4 weeks after injection and the effect was prolonged for up to 12 months. This study indicated that CYP11B1D could be ameliorated by gene induction in the adrenal glands, which suggests that a defective-enzyme-dependent therapeutic strategy for CAH would be required. Defects in microsomal P450, including CYP21A2D and CYP17A1D, can be treated with extra-adrenal gene induction. However, defects in mitochondrial P450, as represented by CYP11B1D, may require adrenal gene induction.
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Affiliation(s)
- Yasuhiro Naiki
- National Center for Child Health and Development, 13611, Divisoion of Endocrinology and Metabolism, Setagaya-ku, Tokyo, Japan;
| | - Mami Miyado
- National Center for Child Health and Development Research Center, 543574, Molecular Endocrinology, Setagaya-ku, Tokyo, Japan;
| | - Miyuki Shindo
- National Center for Child Health and Development Research Center, 543574, Division of Laboratory Animal Resources, Setagaya-ku, Tokyo, Japan;
| | - Reiko Horikawa
- National Center for Child Health and Development, 13611, Division of Endocrinology and Metabolism, Setagaya-ku, Tokyo, Japan;
| | - Yuichi Hasegawa
- National Center for Child Health and Development, 13611, Division of Urology, Setagaya-ku, Tokyo, Japan;
| | - Noriyuki Katsumata
- National Center for Child Health and Development Research Center, 543574, Molecular Endocrinology, Setagaya-ku, Tokyo, Japan;
| | - Shuji Takada
- National Center for Child Health and Development Research Center, 543574, Systems BioMedicine, Setagaya-ku, Tokyo, Japan;
| | - Hidenori Akutsu
- National Center for Child Health and Development Research Center, 543574, Reproductive Medicine, Setagaya-ku, Tokyo, Japan;
| | - Masafumi Onodera
- National Center for Child Health and Development Research Center, 543574, Human Genetics, Setagaya-ku, Tokyo, Japan;
| | - Maki Fukami
- National Center for Child Health and Development Research Center, 543574, Molecular Endocrinology, Setagaya-ku, Tokyo, Japan;
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Sugiyama T, Katsumata N, Toita T, Ura M, Shimizu A, Kamijima S, Aoki D. Incidence of fistula occurrence in patients with cervical cancer treated with bevacizumab: data from real-world clinical practice. Int J Clin Oncol 2022; 27:1517-1528. [PMID: 35760943 PMCID: PMC9393147 DOI: 10.1007/s10147-022-02196-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/23/2022] [Indexed: 12/24/2022]
Abstract
Background This study aimed to determine the incidence of pelvic fistulas in cervical cancer patients treated with bevacizumab in Japanese clinical practice. Methods A post-marketing surveillance (PMS) study was conducted between June 2016 and February 2018 to survey physicians who treated advanced or recurrent cervical cancer patients with bevacizumab (according to the product label). The clinical/treatment status of patients with pelvic fistulas was assessed in an additional retrospective case series study. Results 142 patients were included in the PMS study (median age 51 years; 66.9% squamous cell carcinoma; 66.2% recurrent cervical cancer; 64.1% previous radiotherapy). Patients received a median of seven bevacizumab doses. Six patients, all of whom had a history of pelvic irradiation, developed seven fistulas (4.2%; 95% confidence interval, 1.56–8.96), and five patients had also undergone pelvic surgery. The case series study of the patients who developed fistulas indicated that three patients had high cumulative bladder and rectal doses of radiation, and two of them had undergone salvage re-irradiation for pelvic recurrence. The other three patients underwent both radical hysterectomy and adjuvant radiotherapy, but did not receive an excessive radiation dose to the bladder or rectum. Conclusions This study found that the upper limit of the 95% confidence interval for pelvic fistula incidence did not exceed the incidence reported in the GOG 240 study. To ensure an adequate benefit-risk assessment of bevacizumab in cervical cancer patients, a comprehensive evaluation of prior treatment is essential and the possibility of unexpected fistulas, even after careful evaluation, should be considered. Supplementary Information The online version contains supplementary material available at 10.1007/s10147-022-02196-8.
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Affiliation(s)
- Toru Sugiyama
- St. Mary's Hospital, 422 Tsubukuhonmachi, Kurume, Fukuoka, 830-8543, Japan.
| | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School, Musashikosugi Hospital, 1-396 Kosugi-machi, Nakahara-ku, Kawasaki, Kanagawa, 211-8533, Japan
| | - Takafumi Toita
- Radiation Therapy Center, Okinawa Chubu Hospital Okinawa, 281 Miyazato, Uruma, Okinawa, 904-2293, Japan
| | - Masako Ura
- Oncology Lifecycle Management Department, Chugai Pharmaceutical Co., Ltd., 2-1-1 Nihonbashi-Muromachi, Chuo-ku, Tokyo, 103-8324, Japan
| | - Ayaka Shimizu
- Real World Data Science Department, Chugai Pharmaceutical Co., Ltd., 2-1-1 Nihonbashi-Muromachi, Chuo-ku, Tokyo, 103-8324, Japan
| | - Shuichi Kamijima
- Medical Science Department, Chugai Pharmaceutical Co., Ltd., 2-1-1 Nihonbashi-Muromachi, Chuo-ku, Tokyo, 103-8324, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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9
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Hamanishi J, Takeshima N, Katsumata N, Ushijima K, Kimura T, Takeuchi S, Matsumoto K, Ito K, Mandai M, Nakai H, Sakuragi N, Watari H, Takahashi N, Kato H, Hasegawa K, Yonemori K, Mizuno M, Takehara K, Niikura H, Sawasaki T, Nakao S, Saito T, Enomoto T, Nagase S, Suzuki N, Matsumoto T, Kondo E, Sonoda K, Aihara S, Aoki Y, Okamoto A, Takano H, Kobayashi H, Kato H, Terai Y, Takazawa A, Takahashi Y, Namba Y, Aoki D, Fujiwara K, Sugiyama T, Konishi I. Nivolumab Versus Gemcitabine or Pegylated Liposomal Doxorubicin for Patients With Platinum-Resistant Ovarian Cancer: Open-Label, Randomized Trial in Japan (NINJA). J Clin Oncol 2021; 39:3671-3681. [PMID: 34473544 PMCID: PMC8601279 DOI: 10.1200/jco.21.00334] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
[Figure: see text].
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Affiliation(s)
- Junzo Hamanishi
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nobuhiro Takeshima
- Department of Gynecology, Cancer Institute Hospital of JFCR, Tokyo, Japan.,Current affiliation: Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Otawara, Japan
| | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Satoshi Takeuchi
- Department of Obstetrics and Gynecology, Iwate Medical University Hospital, Iwate, Japan.,Current affiliation: Department of Gynecology, Kobe Tokushukai Hospital, Kobe, Japan
| | - Koji Matsumoto
- Department of Medical Oncology, Hyogo Cancer Center, Akashi, Japan
| | - Kimihiko Ito
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan
| | - Masaki Mandai
- Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osakasayama, Japan.,Current affiliation: Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hidekatsu Nakai
- Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Noriaki Sakuragi
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Current affiliation: Department of Gynecology, Otaru General Hospital, Otaru, Japan
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Hidenori Kato
- Department of Gynecology, Hokkaido Cancer Center, Sapporo, Japan
| | - Kosei Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Kan Yonemori
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Mika Mizuno
- Department of Obstetrics and Gynecology, Aichi Cancer Center Hospital, Nagoya, Japan.,Current affiliation: Department of Obstetrics and Gynecology, Kagoshima University Hospital, Kagoshima, Japan
| | - Kazuhiro Takehara
- Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Hitoshi Niikura
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Current affiliation: Department of Obstetrics and Gynecology, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Takashi Sawasaki
- Department of Obstetrics and Gynecology, National Hospital Organization Kure Medical Center, Kure, Japan.,Current affiliation: SAWASAKI Obstetrics Gynecology Clinic, Kure, Japan
| | - Sari Nakao
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba Hospital, Tsukuba, Japan
| | - Toshiaki Saito
- Gynecology Service, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Satoru Nagase
- Department of Obstetrics and Gynecology, Yamagata University Hospital, Yamagata, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St Marianna University School of Medicine, Kawasaki, Japan
| | - Takashi Matsumoto
- Department of Obstetrics and Gynecology, Ehime University Hospital, Toon, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University Hospital, Tsu, Japan
| | - Kenzo Sonoda
- Department of Obstetrics and Gynecology, Kyushu University Hospital, Fukuoka, Japan.,Current affiliation: Department of Gynecologic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Satomi Aihara
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University Hospital, Saga, Japan.,Current affiliation: Department of Medical Oncology, Eguchi Hospital, Saga, Japan
| | - Yoichi Aoki
- Department of Obstetrics and Gynecology, University of the Ryukyus Hospital, Okinawa, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University Hospital, Tokyo, Japan
| | - Hirokuni Takano
- Department of Obstetrics and Gynecology, The Jikei University Kashiwa Hospital, Kashiwa, Japan
| | - Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University Hospital, Kashihara, Japan.,Current affiliation: Ms Clinic MayOne, Kashihara, Japan
| | - Hisamori Kato
- Department of Gynecology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yoshito Terai
- Department of Gynecologic Oncology, Osaka Medical College Hospital, Takatsuki, Japan.,Current affiliation: Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Yusuke Takahashi
- Oncology Clinical Development Unit, Ono Pharmaceutical Co, Ltd, Osaka, Japan
| | | | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Keiichi Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University Hospital, Iwate, Japan.,Current affiliation: Department of Obstetrics and Gynecology, St Mary's Hospital, Kurume, Japan
| | - Ikuo Konishi
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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10
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Nishimura M, Sakai H, Onoe T, Boku S, Yokoyama T, Kadokura G, Morita S, Katsumata N, Matsumoto K. 4-step, 2-h carboplatin desensitization in Japanese patients with ovarian cancer: a prospective study. Int J Clin Oncol 2021; 26:1553-1560. [PMID: 34037884 PMCID: PMC8286943 DOI: 10.1007/s10147-021-01935-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/08/2021] [Indexed: 12/04/2022]
Abstract
BACKGROUND Carboplatin is a key drug for ovarian cancer. However, it sometimes induces hypersensitivity reactions (HSRs) that result in the discontinuation of the treatment. Although various desensitization protocols have been reported in previous retrospective studies, a limited number of prospective studies have analyzed these protocols. METHODS Patients with platinum-sensitive relapsed ovarian cancer who experienced carboplatin-induced HSRs were treated with diluted solutions of 1/1000, 1/100, 1/10 and an undiluted solution of carboplatin over a 1-h period. If no HSRs occurred within the first two cycles, a short protocol regimen over a 30-min period per solution was followed. The primary endpoint was treatment completion rate. RESULTS Between May 2015 and September 2018, 21 patients were enrolled from two institutions. One patient experienced platinum-sensitive recurrence after the desensitization protocol; thus, 22 sessions were analyzed. Epinephrine use, treatment-related death, and intensive care unit (ICU) admissions did not occur. The median number of desensitization cycles was 6 (range 1-6). Two sessions were discontinued early because of grade 2 dysgeusia and grade 2 malaise. Treatment in two (9.1%) patients was discontinued because of HSR development. The treatment completion rate was 90.9%. Six (27.3%) sessions met the criteria for transition to the short protocol regimen. In 14 (63.6%) sessions, HSRs were observed during infusion of the undiluted solution. The median progression-free survival and overall survival were 14.8 and 23.8 months, respectively. CONCLUSION This 4-step, 2-h carboplatin desensitization protocol is safe and feasible. Patients require careful monitoring with a rapid response to HSRs, especially during the administration of undiluted solutions.
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Affiliation(s)
- Meiko Nishimura
- Department of Medical Oncology, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
| | - Hideki Sakai
- Department of Medical Oncology, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
| | - Takuma Onoe
- Department of Medical Oncology, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
| | - Shogen Boku
- Department of Medical Oncology, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
- Cancer Treatment Center, Kansai Medical University Hospital, Osaka, Japan
| | - Takaaki Yokoyama
- Department of Medical Oncology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
| | - Genmu Kadokura
- Department of Medical Oncology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
- Department of Medical Oncology, Suwa Central Hospital, Nagano, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
| | - Koji Matsumoto
- Department of Medical Oncology, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan.
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11
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Katsumata N. [Clinical Guidelines for Cancer Chemotherapy under COVID-19 in the World]. Gan To Kagaku Ryoho 2021; 48:992-995. [PMID: 34404063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A risk of COVID-19 infection for cancer patients is reported slightly high compared with general citizens. Among patients with cancer and COVID-19, severe illness and mortality is slightly high and associated with general risk factors and risk factors unique to patients with cancer. Cancer therapy should not be stopped or postponed under COVID-19 because cancer will be fatal disease if delaying or stopping cancer treatment. Clinical guidelines for cancer chemotherapy is discussed under COVID-19 in this article.
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12
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Onuma S, Fukuoka T, Miyoshi Y, Fukui M, Satomura Y, Yasuda K, Kimura T, Tachibana M, Bessho K, Yamamoto T, Tanaka H, Katsumata N, Fukami M, Hasegawa T, Ozono K. Two girls with a neonatal screening-negative 21-hydroxylase deficiency requiring treatment with hydrocortisone for virilization in late childhood. Clin Pediatr Endocrinol 2021; 30:143-148. [PMID: 34285457 PMCID: PMC8267553 DOI: 10.1297/cpe.30.143] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/20/2021] [Indexed: 11/09/2022] Open
Abstract
Herein, we report two girls with a neonatal screening (NS)-negative 21-hydroxylase
deficiency (21-OHD) requiring treatment with hydrocortisone due to virilization that
developed in late childhood. Patient 1 was born prematurely on the 30th gestational week
with normal external genitalia at birth. She passed the NS for 21-OHD. At 6 yr of age, she
was referred to a hospital for evaluation of premature pubarche and clitoromegaly. Her
diagnosis was central precocious puberty, and GnRH agonist was initiated. However, her
symptoms did not improve despite treatment for over 4 years. She was then referred to our
hospital where she was diagnosed with 21-OHD. Although she was started on hydrocortisone
therapy, her adult height reached only 140 cm (−3.4 SD). Patient 2 was delivered at 37
weeks of gestation and passed the NS for 21-OHD. She was referred to a hospital because of
premature pubarche at the age of 6 yr. She was diagnosed with 21-OHD, and hydrocortisone
replacement therapy was initiated. Her present height at 13 yr of age is 148 cm (−1.3 SD).
These cases reminded us that the possibility of 21-OHD should be considered when patients
show premature pubarche or precocious puberty, even if they passed the NS test for
21-OHD.
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Affiliation(s)
- Shinsuke Onuma
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomoya Fukuoka
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoko Miyoshi
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Health and Nutrition, Faculty of Health and Nutrition, Osaka Shoin Women's University, Osaka, Japan
| | - Miho Fukui
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshinori Satomura
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kie Yasuda
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takeshi Kimura
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Makiko Tachibana
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuhiko Bessho
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Hiroyuki Tanaka
- Department of Pediatrics, Okayama Saiseikai General Hospital, Okayama, Japan
| | - Noriyuki Katsumata
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Maki Fukami
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Tomonobu Hasegawa
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
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13
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Ansai SI, Umebayashi Y, Katsumata N, Kato H, Kadono T, Takai T, Namiki T, Nakagawa M, Soejima T, Koga H, Sugaya M. Japanese Dermatological Association Guidelines: Outlines of Guidelines for Cutaneous Squamous Cell Carcinoma 2020. J Dermatol 2021; 48:e288-e311. [PMID: 33963604 DOI: 10.1111/1346-8138.15889] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 03/08/2021] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 01/04/2023]
Abstract
In consideration of the development of treatment options for squamous cell carcinoma (SCC), the Japanese Skin Cancer Society issued the first guidelines of SCC in 2007 and revised them in 2015. Here, we report the English version of the 2020 edition of the Japanese SCC guidelines. The first half of this article is an overview of SCC including actinic keratosis and Bowen's disease, and the second half discusses three clinical questions: (i) treatment of actinic keratosis; (ii) determination of the resection margin of the primary lesion; and (iii) treatment of radically incurable cases, as contemporary problems encountered in treating SCC. In these evaluations, all processes were implemented according to the Grading of Recommendations, Assessment, Development, Evaluation system. Also, items of recommendation concerning each clinical question were determined by a multidisciplinary expert panel consisting of dermatologists, plastic/reconstructive surgeons, radiologists, and oncologists through a comprehensive literature search and systematic reviews.
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Affiliation(s)
- Shin-Ichi Ansai
- Division of Dermatology and Dermatopathology, Nippon Medical School Musashi Kosugi-Hospital, Kawasaki, Japan
| | - Yoshihiro Umebayashi
- Department of Dermatology, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School Musashi Kosugi-Hospital, Kawasaki, Japan
| | - Hiroshi Kato
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takafumi Kadono
- Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Toshihiro Takai
- Department of Dermatology, Hyogo Cancer Center, Akashi, Japan
| | - Takeshi Namiki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Nakagawa
- Department of Plastic and Reconstructive Surgery, Shizuoka Prefectural Cancer Center, Nagaizumi, Japan
| | | | - Hiroshi Koga
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - Makoto Sugaya
- Department of Dermatology, International University of Health and Welfare, Narita, Japan
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14
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Hori Y, Kubota A, Yokose T, Furukawa M, Matsushita T, Katsumata N, Oridate N. Prognostic Role of Tumor-Infiltrating Lymphocytes and Tumor Budding in Early Oral Tongue Carcinoma. Laryngoscope 2021; 131:2512-2518. [PMID: 33955550 PMCID: PMC8518756 DOI: 10.1002/lary.29589] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/02/2021] [Accepted: 04/14/2021] [Indexed: 12/15/2022]
Abstract
Objectives/Hypothesis Occult lymph metastasis is an important prognosticator for the treatment of early oral tongue squamous cell carcinoma (SCC). The objective of this study was to evaluate the prognostic significance of tumor‐infiltrating lymphocytes (TILs) in early oral tongue SCC. The combination of the TIL subtype and intermediate‐ or high‐grade budding scores was investigated as a prognostic marker for occult neck metastases. Study Design Retrospective study. Methods Specimens from 62 patients with early oral tongue SCC treated with only primary surgery were analyzed by immunohistochemistry for CD4+, CD8+, FoxP3+, and CD45RO+ T cells and CD163+ macrophages. The highest number of each TIL subtype was counted in two areas of parenchyma and stroma in the tumor (Tumor) and peripheral stroma of the invasion margin. Results Based on multivariate analysis, a high density of Tumor CD163+ macrophages served as the poorest prognostic factor for regional control (RC) and disease‐free survival (DFS). Patients with both a high density of Tumor CD163+ macrophages and an intermediate‐ or a high‐grade budding score had a poor prognosis for RC according to the log‐rank test. Conclusions In summary, each TIL subtype may use different mechanisms during early and advanced stages of oral tongue SCC. A high density of Tumor CD163+ macrophages was determined to be a risk factor for RC and DFS as well as an additional stratification factor for RC in patients with intermediate‐ or high‐grade budding scores. Therefore, identifying TIL subtypes in daily clinical practice can help determine a more successful and individualized therapeutic approach for early oral tongue SCC. Level of Evidence Step 4 (Level 4) Laryngoscope, 131:2512–2518, 2021
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Affiliation(s)
- Yukiko Hori
- Department of Otorhinolaryngology, Shinshu Ueda Medical Center, Ueda, Nagano, Japan.,Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Akira Kubota
- Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.,Department of Otorhinolaryngology, Hiro Yama Clinic, Tokyo, Japan
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Madoka Furukawa
- Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Takeshi Matsushita
- Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.,Department of Otorhinolaryngology, Yokosuka General Hospital Uwamachi, Yokosuka, Kanagawa, Japan
| | - Noriyuki Katsumata
- Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Nobuhiko Oridate
- Department of Otolaryngology Head and Neck Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
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15
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Ishii T, Tajima T, Kashimada K, Mukai T, Tanahashi Y, Katsumata N, Kanno J, Hamajima T, Miyako K, Ida S, Hasegawa T. Clinical Features of 57 Patients with Lipoid Congenital Adrenal Hyperplasia: Criteria for Nonclassic Form Revisited. J Clin Endocrinol Metab 2020; 105:5896589. [PMID: 32835366 DOI: 10.1210/clinem/dgaa557] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 08/14/2020] [Indexed: 02/13/2023]
Abstract
CONTEXT Lipoid congenital adrenal hyperplasia (LCAH) is caused by mutations in STAR. Classic (CLCAH) and nonclassic (NCLCAH) forms were reported as total and partial deficiencies, respectively, of adrenal and gonadal steroid hormones. The rarity of LCAH has precluded large-scale epidemiological and clinical investigations. OBJECTIVE To determine the epidemiological and clinical characteristics of 2 forms of LCAH. DESIGN A multicenter cross-sectional cohort study in Japan on December 1, 2017. PARTICIPANTS Fifty-seven patients with LCAH (median age, 23.7 years; range, 0.0-47.5 years). MAIN OUTCOME MEASURES Patient demographics, STAR genotype, Quigley grade, endocrinological and imaging data, treatment, and prognosis. RESULTS Fifty-three and 4 patients fulfilled definite and probable diagnostic criteria for LCAH, respectively. When NCLCAH was defined as either Quigley grade 1 in XY karyotype, no episode of salt losing or requirement of fludrocortisone, or onset of primary adrenal insufficiency (PAI) at 1 year or older, patients were divided into groups of 43 patients with CLCAH (75.4%), 11 with NCLCAH (19.3%), and 3 with unclassified LCAH (5.3%). All of the patients with CLCAH and 7/11 NCLCAH (63.6%) were treated with fludrocortisone. CLCAH was diagnosed at a significantly younger age than NCLCAH (median, 0.0 vs 4.0 years). STAR-Arg272Cys or -Met225Thr was identified only in NCLCAH (8/11, 72.7%). CONCLUSIONS We demonstrated the relative proportions and clinical and molecular characteristics of NCLCAH and CLCAH in Japan. These criteria for NCLCAH correspond to all previously published cases and our cases whose masculinization of the external genitalia, ability of mineralocorticoid production, and onset of PAI were described.
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MESH Headings
- Adolescent
- Adrenal Hyperplasia, Congenital/diagnosis
- Adrenal Hyperplasia, Congenital/drug therapy
- Adrenal Hyperplasia, Congenital/genetics
- Adult
- Child
- Child, Preschool
- Cross-Sectional Studies
- Disorder of Sex Development, 46,XY/diagnosis
- Disorder of Sex Development, 46,XY/drug therapy
- Disorder of Sex Development, 46,XY/genetics
- Female
- Fludrocortisone/therapeutic use
- Humans
- Infant
- Infant, Newborn
- Japan
- Middle Aged
- Mineralocorticoids/therapeutic use
- Mutation
- Phenotype
- Phosphoproteins/genetics
- Prognosis
- Young Adult
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Affiliation(s)
- Tomohiro Ishii
- Research Committee on Disorders of Adrenal Hormones, Research on Intractable Diseases, Health and Labour Sciences Research Grants, Tokyo, Japan
- Disorders of Sex Development and Adrenal Disorders Committee, the Japanese Society for Pediatric Endocrinology, Fushimi-ku, Kyoto, Japan
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Toshihiro Tajima
- Research Committee on Disorders of Adrenal Hormones, Research on Intractable Diseases, Health and Labour Sciences Research Grants, Tokyo, Japan
- Department of Pediatrics, Jichi Medical University Tochigi Children's Medical Center, Shimotsuke, Tochigi, Japan
| | - Kenichi Kashimada
- Research Committee on Disorders of Adrenal Hormones, Research on Intractable Diseases, Health and Labour Sciences Research Grants, Tokyo, Japan
- Disorders of Sex Development and Adrenal Disorders Committee, the Japanese Society for Pediatric Endocrinology, Fushimi-ku, Kyoto, Japan
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tokuo Mukai
- Research Committee on Disorders of Adrenal Hormones, Research on Intractable Diseases, Health and Labour Sciences Research Grants, Tokyo, Japan
- Disorders of Sex Development and Adrenal Disorders Committee, the Japanese Society for Pediatric Endocrinology, Fushimi-ku, Kyoto, Japan
- Department of Pediatrics, Asahikawa-Kosei General Hospital, Asahikawa, Hokkaido, Japan
| | - Yusuke Tanahashi
- Research Committee on Disorders of Adrenal Hormones, Research on Intractable Diseases, Health and Labour Sciences Research Grants, Tokyo, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Noriyuki Katsumata
- Research Committee on Disorders of Adrenal Hormones, Research on Intractable Diseases, Health and Labour Sciences Research Grants, Tokyo, Japan
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Junko Kanno
- Disorders of Sex Development and Adrenal Disorders Committee, the Japanese Society for Pediatric Endocrinology, Fushimi-ku, Kyoto, Japan
- Department of Pediatrics, Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Takashi Hamajima
- Disorders of Sex Development and Adrenal Disorders Committee, the Japanese Society for Pediatric Endocrinology, Fushimi-ku, Kyoto, Japan
- Department of Endocrinology and Metabolism, Aichi Children's Health and Medical Center, Obu, Aichi, Japan
| | - Kenichi Miyako
- Disorders of Sex Development and Adrenal Disorders Committee, the Japanese Society for Pediatric Endocrinology, Fushimi-ku, Kyoto, Japan
- Department of Endocrinology and Metabolism, Fukuoka Children's Hospital, Fukuoka, Fukuoka, Japan
| | - Shinobu Ida
- Disorders of Sex Development and Adrenal Disorders Committee, the Japanese Society for Pediatric Endocrinology, Fushimi-ku, Kyoto, Japan
- Department of Pediatric Gastroenterology and Endocrinology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
| | - Tomonobu Hasegawa
- Research Committee on Disorders of Adrenal Hormones, Research on Intractable Diseases, Health and Labour Sciences Research Grants, Tokyo, Japan
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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Omatsu K, Hamanishi J, Katsumata N, Nishio S, Sawada K, Takeuchi S, Aoki D, Fujiwara K, Sugiyama T, Konishi I. 807O Nivolumab versus gemcitabine or pegylated liposomal doxorubicin for patients with platinum-resistant (advanced or recurrent) ovarian cancer: Open-label, randomized trial in Japan (NINJA trial). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.946] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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17
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Fujiwara K, Chou HH, Kim JW, Tan D, Tamura K, Katsumata N, Harano K, Hasegawa K, Hume S, Jones E, Goble S, Sullivan L, Shih D, Coleman R, McNeish I, Monk B, Kristeleit R. ATHENA (GOG-3020/ENGOT-ov45): A randomised, double-blind, placebo-controlled phase III study of the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib + the PD-1 inhibitor nivolumab following frontline platinum-based chemotherapy in ovarian cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz426.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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18
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Yonemori K, Matsumoto T, Nagao S, Katsumata N, Oda K, Watari H, Tokunaga H, Fujiwara H, Yokota H, Hirasawa T, Nakamura T, Aizawa M, Okubo T, Fujiwara K. Avelumab in platinum-resistant/refractory ovarian cancer (PRROC): phase 3 results from JAVELIN Ovarian 200. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz339.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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19
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Horigome A, Okubo R, Hamazaki K, Kinoshita T, Katsumata N, Uezono Y, Xiao JZ, Matsuoka YJ. Association between blood omega-3 polyunsaturated fatty acids and the gut microbiota among breast cancer survivors. Benef Microbes 2019; 10:751-758. [PMID: 31965846 DOI: 10.3920/bm2019.0034] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Omega-3 polyunsaturated fatty acids (PUFAs) are essential nutrients demonstrated to have health benefits, such as decreasing the risk of coronary heart disease, improving parameters associated with metabolic syndrome, and decreasing anxiety symptoms and depression risk. Previous intervention studies indicated the association between blood or tissue PUFA levels and the gut microbiota; however, the details remain incompletely elucidated. We conducted a cross-sectional study to examine the association between PUFAs and the gut microbiota among breast cancer survivors. Adults who had been diagnosed with invasive breast cancer more than one year ago and were not currently undergoing chemotherapy were enrolled. Capillary blood and faecal samples were obtained to assess the blood PUFA levels and gut microbiota compositions. The mean age (n=124) was 58.7 years, and 46% of the participants had a history of chemotherapy. Multiple regression analysis controlling for possible confounders indicated that an increased relative abundance of Actinobacteria was significantly associated with increased levels of docosahexaenoic acid (DHA, beta=0.304, q<0.01). At the genus level, the abundance of Bifidobacterium was positively associated with the level of DHA (beta=0.307, q<0.01). No significant association between omega-6 PUFAs and the relative abundances of gut microbiota members was observed. In addition, analyses stratified by the history of chemotherapy indicated significant associations of PUFA levels with the abundance of some bacterial taxa, including the phylum Actinobacteria (DHA, beta=0.365, q<0.01) and Bacteroidetes (EPA, beta=-0.339, q<0.01) and the genus Bifidobacterium (DHA, beta=0.368, q<0.01) only among participants without a history of chemotherapy. These findings provide the first evidence of positive associations between the abundances of Bifidobacterium among the gut microbiota and the levels of omega-3 PUFAs in the blood. Further studies are required to gain additional insight into these associations in healthy subjects as well as into the causality of the relationship.
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Affiliation(s)
- A Horigome
- Next Generation Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama City, Kanagawa 252-8583, Japan
| | - R Okubo
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - K Hamazaki
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama City, Toyama 930-0194, Japan
| | - T Kinoshita
- Department of Breast Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - N Katsumata
- Next Generation Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama City, Kanagawa 252-8583, Japan
| | - Y Uezono
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - J Z Xiao
- Next Generation Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama City, Kanagawa 252-8583, Japan
| | - Y J Matsuoka
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
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20
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Tamura K, Hasegawa K, Katsumata N, Matsumoto K, Mukai H, Takahashi S, Nomura H, Minami H. Efficacy and safety of nivolumab in Japanese patients with uterine cervical cancer, uterine corpus cancer, or soft tissue sarcoma: Multicenter, open-label phase 2 trial. Cancer Sci 2019; 110:2894-2904. [PMID: 31348579 PMCID: PMC6726684 DOI: 10.1111/cas.14148] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [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: 03/22/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 12/21/2022] Open
Abstract
Nivolumab is a human monoclonal antibody against the immune checkpoint receptor programmed death‐1, inhibiting binding to programmed death‐ligand 1 or 2 (PD‐L1 or PD‐L2). This phase 2 study evaluated the efficacy and safety of nivolumab in patients with advanced/recurrent uterine cervical cancer, uterine corpus cancer, or soft tissue sarcoma (STS). Patients received nivolumab 240 mg at 2‐week intervals. Primary endpoint was objective response rate; secondary endpoints included overall survival, progression‐free survival, and safety. PD‐L1 expression and microsatellite‐instability (MSI) status were analyzed as potential efficacy biomarkers. Objective response rate was 25%, 23%, and 0% in patients with cervical cancer (n = 20), corpus cancer (n = 22), and STS (n = 21), respectively. The lower 80% confidence intervals of objective response rates in patients with cervical or corpus cancer exceeded the threshold rate (5%); the primary endpoint was met in cervical and corpus cancer, but not in STS. Median progression‐free survival was 5.6, 3.4, and 1.4 months, and 6‐month overall survival was 84%, 73%, and 86% in cervical cancer, corpus cancer, and STS, respectively. The objective response rate was higher in patients with cervical cancer with PD‐L1‐positive (n = 5/15; 33%) versus PD‐L1‐negative (n = 0/5; 0%) tumors. The two patients with corpus cancer classified as MSI‐high responded; the six patients classified as microsatellite stable did not respond. Overall, nivolumab showed acceptable toxicity in all cohorts, with evidence of clinical activity in uterine cervical or corpus cancer, but not in STS. PD‐L1 expression in cervical cancer and MSI‐high in corpus cancer may predict clinical activity of nivolumab in these cancers.
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Affiliation(s)
- Kenji Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kosei Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Koji Matsumoto
- Department of Medical Oncology, Hyogo Cancer Center, Hyogo, Japan
| | - Hirofumi Mukai
- Department of Breast and Medical Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - Hiroyuki Nomura
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Hironobu Minami
- Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
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21
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Abstract
Determination of serum levels of GH and IGF-I is crucial for the diagnosis and treatment of GH deficiency and disorders related to GH excess such as acromegaly and pituitary gigantism. However, significant discrepancies in measured GH values among the methods were observed around the world. In Japan, the Study Committee for GH and Its Related Factors of The Foundation for Growth Science standardized GH values measured with various commercially available GH assay kits by creating formulas to adjust them to their averages. The committee also established reference values for IGF-I in Japanese subjects at all ages from childhood to adulthood. Internationally, collaborators have been working on the harmonization of GH measurements.
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Affiliation(s)
- Noriyuki Katsumata
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan, E-mail:
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22
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Ishii T, Hori N, Amano N, Aya M, Shibata H, Katsumata N, Hasegawa T. Pubertal and Adult Testicular Functions in Nonclassic Lipoid Congenital Adrenal Hyperplasia: A Case Series and Review. J Endocr Soc 2019; 3:1367-1374. [PMID: 31286101 PMCID: PMC6608554 DOI: 10.1210/js.2019-00086] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/10/2019] [Indexed: 11/19/2022] Open
Abstract
Lipoid congenital adrenal hyperplasia (LCAH) is caused by mutations in STAR and characterized by a defect in steroidogenesis and lipid droplet accumulation in steroidogenic cells. Patients with 46,XY and classic LCAH will typically present with female-type external genitalia. However, those with nonclassic LCAH will have masculinized external genitalia. The rarity of the nonclassic form has precluded the clarification of the long-term outcomes of testicular function in nonclassic LCAH. We report the cases of three adult males with nonclassic LCAH in whom primary adrenal insufficiency had been diagnosed at 5 days, 4 years, and 5 years of age. All exhibited complete male external genitalia and had completed pubertal development without androgen replacement. The endocrinological data showed preserved gonadal function in patients 1 and 2 and hypergonadotropic hypogonadism in patient 3. Semen analyses showed normozoospermia in patient 1 and mild oligozoospermia in patient 2. Electron microscopic analysis of a testicular biopsy specimen from patient 2 at 13 years of age revealed prominent lipid accumulation in the cytosol of Leydig cells. Patients 1 and 2 shared the same compound heterozygous mutations in STAR (p.Glu258* and p.Arg272Cys). Patient 3 possessed a heterozygous dominant-negative mutation in STAR (p.Gly22_Leu59del). A functional assay of a variant STAR-Arg272Cys determined the residual activity as 35% of the wild-type STAR. The results from the present case series and a review of four previously reported adult cases indicate that testosterone synthesis can be preserved in most males with nonclassic LCAH to complete pubertal development and induce germ cell maturation despite lipid accumulation in the Leydig cells.
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Affiliation(s)
- Tomohiro Ishii
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Naoaki Hori
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.,Department of Pediatrics, Ota Memorial Hospital, Ota, Japan
| | - Naoko Amano
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Misaki Aya
- Department of Pediatrics, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Noriyuki Katsumata
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Tomonobu Hasegawa
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
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23
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Miyako K, Mushimoto Y, Katsumata N. MON-261 Investigation of GNAS1 Gene Mutations and Expression Patterns of Fibroblast Growth Factor 23 Protein in McCune-Albright Syndrome. J Endocr Soc 2019. [PMCID: PMC6550652 DOI: 10.1210/js.2019-mon-261] [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: 11/19/2022] Open
Abstract
McCune-Albright syndrome (MAS) is characterized by the clinical triad of polyostotic fibrous dysplasia, café-au-lait spots and gonadotropin-releasing hormone-independent precocious puberty, caused by somatic activating mutations of the GNAS1 gene in a mosaic distribution. Overproduction of FGF23 (fibroblast growth factor 23) secreted by bone lesions has been recently reported to be responsible for hypophosphatemic vitamin D-resistant rickets in this disease. This study aimed to analyze the GNAS1 gene in bone lesions of MAS and to investigate the expression patterns of FGF23 protein. Patient and methods: The patient was a 12-year-old boy with MAS. He had polyostotic fibrous dysplasia, hypophosphatemia, café-au-lait spots, and hyperthyroidism and was receiving methimazole. He underwent surgical interventions 3 times for distortions of long bones. We analyzed GNAS1 gene by using peripheral blood cells, resected bone, and muscle tissues. To evaluate FGF23 expression, we performed immunohistochemistry using the resected bone tissue and RT-PCR using the resected bone and muscle tissues along with the measurement of FGF23 in the pre- and post-operative serum. Results: Although no mutations in the GNAS1 gene were found in either peripheral blood cells or muscle tissue, a known activating mutation of p.R201H was heterozygously detected in the bone tissue. Although immunohistochemistry for FGF23 was negative in the first specimen of resected bone tissue, FGF23 mRNA was detected by RT-PCR in the second specimen, but not in muscle tissue. Changes in serum FGF23 levels after each bone resection were as follows: 100 → 54 pg/ml (1 day after first resection), 74 → 102 pg/ml (2 weeks after second resection), and 102 → 85 pg/ml (2 days after third resection). There were no changes in the serum phosphorus level, %TRP, or TmP/GFR after surgery. Discussion and conclusion: We detected GNAS1 gene mutation in only the bone lesion, reflecting its mosaic distribution. The reason why FGF23 mRNA was detected in the second resected bone tissue on RT-PCR despite the negative immunohistochemistry in the first one was attributed to differences in sensitivity between the methods or site-specific expression patterns. The serum level of FGF23 decreased through 2 days after surgery, but did not enter the normal range, and hypophosphatemia did not improve. Fibrous dysplasia was suggested to spread to the entire bone. Moreover, FGF23 increased 2 weeks after surgery probably because the production recovered in the remained lesion. Bone resection did not effectively decrease the FGF23 level.
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Affiliation(s)
| | | | - Noriyuki Katsumata
- Dept of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, , Japan
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24
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Ogasawara R, Katsumata N, Toyooka T, Akaishi Y, Yokoyama T, Kadokura G. Reliability of Cancer Treatment Information on the Internet: Observational Study. JMIR Cancer 2018; 4:e10031. [PMID: 30559090 PMCID: PMC6315260 DOI: 10.2196/10031] [Citation(s) in RCA: 8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 09/22/2018] [Accepted: 10/10/2018] [Indexed: 11/26/2022] Open
Abstract
Background Finding the correct medical information in a flood of information from the internet is a significant issue for patients with cancer. Objective We investigated the reliability of the information on cancer treatment methods available on the internet based on an evaluation by medical oncologists, medical students, and cancer survivors. Methods Using Google and Yahoo as the search engines, we carried out the information search using 2 keywords, “cancer treatment” and “cancer cure,” and the top 20 information sites were identified. A similar search was conducted on 5 types of cancer. The reliability of the information presented was rated on a 3-level scale (A, B, or C). Level A referred to reliable sites (providing information complying with the clinical practice guidelines for various types of cancer), Level B included sites not falling under either Level A or Level C, and Level C comprised dangerous or harmful sites (providing information on treatment not approved by the regulatory authority in Japan and bombastic advertisements without any relevant clinical evidence). The evaluation was conducted by medical oncologists, medical students, and cancer survivors. The consistency of the information reliability level rating between the medical students or cancer survivors with that of the medical oncologists was assessed by using the kappa value. Results A total of 247 sites were evaluated for reliability. The ratings provided by the medical students’ group were as follows: Level A, 12.1% (30/247); Level B, 56.3% (139/247); and Level C, 31.6% (78/247). The ratings provided by the cancer survivors’ group were as follows: Level A, 16.8% (41/244); Level B, 44.7% (109/244); and Level C, 38.5% (94/244). The ratings provided by the oncologists’ group were as follows: Level A, 10.1% (25/247); Level B, 51.4% (127/247); and Level C, 38.5% (95/247). The intergroup rating consistency between the medical students’ group and oncologists’ group was 87.4% (216/247, kappa=0.77) and that between the cancer survivors’ group and oncologists’ group was 76.2% (186/244, kappa=0.61). Conclusions Of the investigated sites providing information on cancer treatment on the internet, the percentage of sites that seemed to provide harmful information was much higher than that of sites providing reliable information. The reliability level rating was highly consistent between the medical students’ group and the medical oncologists’ group and also between the cancer survivors’ group and the medical oncologists’ group.
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Affiliation(s)
| | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, Kawasaki City, Japan
| | | | | | - Takaaki Yokoyama
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, Kawasaki City, Japan
| | - Gemmu Kadokura
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, Kawasaki City, Japan
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25
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Katsumata N, Tamura K, Hasegawa K, Matsumoto K, Mukai H, Takahashi S, Nomura H, Minami H. Efficacy and safety of nivolumab in patients with uterine cervical cancer, uterine corpus cancer, or soft-tissue sarcoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy374.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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26
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Aoki Y, Ochiai K, Lim S, Aoki D, Kamiura S, Lin H, Katsumata N, Cha SD, Kim JH, Kim BG, Hirashima Y, Fujiwara K, Kim YT, Kim SM, Chung HH, Chang TC, Kamura T, Takizawa K, Takeuchi M, Kang SB. Phase III study of cisplatin with or without S-1 in patients with stage IVB, recurrent, or persistent cervical cancer. Br J Cancer 2018; 119:530-537. [PMID: 30072745 PMCID: PMC6162273 DOI: 10.1038/s41416-018-0206-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 12/26/2017] [Revised: 06/18/2018] [Accepted: 07/10/2018] [Indexed: 12/29/2022] Open
Abstract
Background This open-label phase III trial evaluated efficacy and safety of S-1 plus cisplatin vs. cisplatin alone as first-line chemotherapy in patients with stage IVB, recurrent, or persistent cervical cancer. Methods Patients were randomised (1:1) to S-1 plus cisplatin (study group) or cisplatin alone (control group). In each cycle, cisplatin 50 mg/m2 was administered on Day 1 in both groups. S-1 was administered orally at 80–120 mg daily on Days 1–14 of a 21-day cycle in the study group. The primary endpoint was overall survival (OS). Results A total of 375 patients were enrolled, of whom 364 (188, study group; 176, control group) received treatment. Median OS was 21.9 and 19.5 months in the study and control groups, respectively (log-rank P = 0.125; hazard ratio [HR] 0.84, 95% confidence interval [CI] 0.67–1.05). Median progression-free survival (PFS) was 7.3 and 4.9 months in the study and control groups, respectively (HR 0.62, 95% CI 0.48–0.80, P < 0.001). The adverse event (AE) rate increased in the study group despite the absence of any unexpected AEs. Conclusions S-1 plus cisplatin did not show superiority over cisplatin alone in OS but significantly increased PFS in patients with stage IVB, recurrent, or persistent cervical cancer. Since the standard therapy has changed in the course of this study, further studies are warranted to confirm the clinical positioning of S-1 combined with cisplatin for this population.
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Affiliation(s)
- Yoichi Aoki
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan
| | - Kazunori Ochiai
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-19-18, Nishishimbashi, Minato-ku, Tokyo, 105-8471, Japan.
| | - Soyi Lim
- Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Korea
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Shoji Kamiura
- Department of Gynecology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, Osaka, 541-8567, Japan
| | - Hao Lin
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Ta-Pei Road, Niao-Sung District, Kaohsiung, 83301, Taiwan
| | - Noriyuki Katsumata
- Department of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugi-cho, Nakahara-ku, Kawasaki-shi, Kanagawa, 211-8533, Japan
| | - Soon-Do Cha
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, 194 Dong San Dong, Daegu, 700-712, Korea
| | - Jae-Hoon Kim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Byoung-Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Gangnam-gu, Seoul, 135-710, Korea
| | - Yasuyuki Hirashima
- Department of Gynecology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - Keiichi Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Young-Tak Kim
- Department of Obstetrics and Gynecology, Asan Medical Center, 388-1 Pungnap-2dong, Songpa-gu, Seoul, 138-736, Korea
| | - Seok Mo Kim
- Department of Obstetrics and Gynecology, Chonnam National University Hwasun Hospital, 160 Ilsimri Hwasun-eup, Hwasun, Jeonnam, 519-809, Korea
| | - Hyun Hoon Chung
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 50 Ilwon-Dong, Gangnam-gu, Seoul, 135-710, Korea
| | - Ting-Chang Chang
- Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital and Chang Gung University Medical College, No.5, Fu-Shin Street, Kueishan County, Taoyuan, 33305, Taiwan
| | - Toshiharu Kamura
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka, 830-0011, Japan
| | - Ken Takizawa
- Department of Gynecology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-10-6, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Masahiro Takeuchi
- Department of Clinical Medicine (Biostatistics), Kitasato University School of Pharmacy, Shirokane 5-9-1, Minato-ku, Tokyo, 108-8641, Japan
| | - Soon-Beom Kang
- Department of Obstetrics and Gynecology, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05080, Korea
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27
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Koizumi K, Hosiai M, Katsumata N, Toda T, Kise H, Hasebe Y, Kono Y, Sunaga Y, Yoshizawa M, Watanabe A, Moriguchi T, Matsuda K, Sugita K. P3794Plasma exchange regulates CD14+CD16+ activated monocytes and CD4+CD25+FOXP3+ regulatory T cells in Kawasaki disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Koizumi
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - M Hosiai
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - N Katsumata
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - T Toda
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - H Kise
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - Y Hasebe
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - Y Kono
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - Y Sunaga
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - M Yoshizawa
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - A Watanabe
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - T Moriguchi
- Faculty of Medicine, University of Yamanashi, Department of Emergency and Critical Care Medicine, Chuo, Yamanashi, Japan
| | - K Matsuda
- Faculty of Medicine, University of Yamanashi, Department of Emergency and Critical Care Medicine, Chuo, Yamanashi, Japan
| | - K Sugita
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
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Hasegawa K, Tamura K, Katsumata N, Matsumoto K, Takahashi S, Mukai H, Nomura H, Minami H. Efficacy and safety of nivolumab (Nivo) in patients (pts) with advanced or recurrent uterine cervical or corpus cancers. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.5594] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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)
- Kosei Hasegawa
- Saitama Medical University International Medical Center, Hidaka, Japan
| | | | | | | | - Shunji Takahashi
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | | | - Hironobu Minami
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
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Sakai H, Katsumata N, Takahashi M. Providing written information increases patient satisfaction: a web-based questionnaire survey of Japanese cancer survivors. Jpn J Clin Oncol 2017; 47:611-617. [PMID: 28369566 DOI: 10.1093/jjco/hyx043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 03/08/2017] [Indexed: 12/22/2022] Open
Abstract
Purpose The Institute of Medicine (IOM) of the United States recommends that all cancer survivors be provided with a survivorship care plan (SCP), which includes a patient treatment summary and a follow-up care plan. However, SCPs have not been widely adopted in Japan. To provide basic data necessary for implementing SCPs in Japan, we aimed to investigate the forms of clinical and survivorship-related information that Japanese cancer survivors receive from their healthcare providers, and to examine whether written information increases their satisfaction. Methods We performed a cross-sectional online survey of cancer survivors who underwent acute cancer treatment and had at least one follow-up with a physician in the past year. Cancer survivors provided the elements and forms (verbally and/or written) of information they received, as well as the degree of satisfaction with the information provided. Results Responses were obtained from 545 cancer survivors. Information elements such as surgical procedure (98.3%), surgical outcome (98.1%), and names of administered chemotherapy agents (97.8%) were commonly provided, whereas mental care resources and providers (29.7%), effects on marital relationship and sexual health (35.7%), and effects on fertility (43.4%) were less common. A large proportion of cancer survivors received verbal information only. For 18 of 20 elements, except for effects on fertility and duration of hormonal therapy, satisfaction was significantly higher when both forms of information were provided (P < 0.05). Conclusions Providing written and verbal explanations of clinical and survivorship-related information can better meet the needs of Japanese cancer survivors.
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Affiliation(s)
- Hitomi Sakai
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital
| | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital
| | - Miyako Takahashi
- Division of Cancer Survivorship Research, Center for Cancer Control and Information Services, National Cancer Center, Japan
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Katsumata N. Standardization of Growth Hormone and Insulin-like Growth Factor-I Measurements. Pediatr Endocrinol Rev 2017; 14 Suppl 1:209-215. [PMID: 28516748 DOI: 10.17458/per.vol14.2017.k.standardizationgrowth] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Measurement of the levels of growth hormone (GH) and its related factor insulin-like growth factor I (IGF-I) is essential for the diagnosis and treatment of GH deficiency (GHD) and conditions related to excess GH such as acromegaly and pituitary gigantism. Measurement of GH levels is also used as an indicator of hypothalamic-pituitary function. Because of the marked variability in GH measurements among kits, the Study Committee for GH and Its Related Factors of The Foundation for Growth Science, Japan standardized GH values measured with various commercially available GH assay kits in Japan. The committee also established IGF-I reference values for Japanese subjects of all ages, from childhood to adulthood. Hopefully, international harmonization of GH measurements will be achieved in the future.
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Affiliation(s)
- Noriyuki Katsumata
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
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Karam A, Ledermann J, Kim JW, Sehouli J, Lu K, Gourley C, Katsumata N, Burger R, Nam BH, Bacon M, Ng C, Pfisterer J, Bekkers R, Casado Herráez A, Redondo A, Fujiwara H, Gleeson N, Rosengarten O, Scambia G, Zhu J, Okamoto A, Stuart G, Ochiai K. Fifth Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup: first-line interventions. Ann Oncol 2017; 28:711-717. [DOI: 10.1093/annonc/mdx011] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Indexed: 11/13/2022] Open
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Ogata H, Saito M, Tsuneizumi M, Kutomi G, Hosoya K, Kawai Y, Sugizaki K, Katsumata N, Senuma K, Kitabatake T, Suda M, Uomori T, Miura K, Kurata M, Nitta Y, Yonemoto N, Matsuoka J. Abstract P5-11-03: Difference between 1st and 2nd generation serotonin receptor antagonists in triplet antiemetic therapy for highly emetogenic chemotherapy in breast cancer patients – according to recent multi-institutional double-blind randomized clinical research on the AC regimen. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-11-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
<Background>
The information presented herein extends our recent study of TTT (Trial for Triplet Antiemetic Therapy).
One of our main clinical questions has been whether a 2nd generation serotonin receptor antagonist (5-HT3ra) would be superior to 1st generation 5-HT3ra when administering triplet antiemetic therapy for the prevention of chemotherapy induced nausea & vomiting (CINV), since a prior Japanese trial demonstrated palonosetron to be superior to granisetron for controlling the delayed phase of CINV induced by highly emetogenic chemotherapy (HEC) and to doublet antiemetic therapy including dexamethasone for anthracycline and cyclophosphamide containing regimens (AC).
<Objectives>
In this study, we assessed the efficacies of 1st and 2nd generation 5-HT3ra agents for use as triplet antiemetic therapy for AC, by monitoring CINV, focusing especially daily CR in the delayed phase.
<Material and method>
Between 2012 and 2015, 491 women with breast cancer receiving AC were recruited from 11 institutions in Japan, and randomly assigned to either single-dose palonosetron (0.75mg) or granisetron (40μg/kg) prior to chemotherapy on day 1, both with dexamethasone (9.9 mg intravenously) and aprepitant (125mg orally) on day 1 followed by additional doses (80mg orally) on days 2 and 3. Age, institution and habitual alcohol intake were used as stratification factors. The primary endpoint was a complete response (CR). Statistical analysis was done by Mantel-Haenszel Method. This trial was registered with UMIN000007882.
<Results>
All 491 patients were included in efficacy analyses (ITT): 246 patients in the palonosetron group and 245 in the granisetron group. We previously reported that the difference in CR during the delayed phase, i.e. 24 hours after the administration of AC, did not reach statistical significance (53.8% vs 58.5%) in MASCC 2016. However, daily CR in the palonosetron group was much higher than that in the granisetron group after 48 hours.
<Conclusions>
Palonosetron showed better efficacy in controlling CINV during the late period of the delayed phase, i.e. 48 hours after AC administration, than granisetron as triplet antiemetic therapy for AC.
<Considerations>
The pattern of CINV reportedly shows two peaks including an acute phase caused by serotonin and a delayed phase caused by substance P, though the pattern of CINV with triplet antiemetic therapy administration might be different if the suppression of each of these peaks were to be achieved more efficiently. CINV may not be divided into two phases in the future, or the borderline area between the acute and delayed phases may require revision. The analysis of the late period of the delayed phase was ad hoc in this trial. However, when conducting studies related to CINV, it might be worthwhile to revise the borderline area between the two phases of CINV to facilitate elucidating the mechanisms underlying this potentially debilitating side effect of chemotherapy.
Citation Format: Ogata H, Saito M, Tsuneizumi M, Kutomi G, Hosoya K, Kawai Y, Sugizaki K, Katsumata N, Senuma K, Kitabatake T, Suda M, Uomori T, Miura K, Kurata M, Nitta Y, Yonemoto N, Matsuoka J. Difference between 1st and 2nd generation serotonin receptor antagonists in triplet antiemetic therapy for highly emetogenic chemotherapy in breast cancer patients – according to recent multi-institutional double-blind randomized clinical research on the AC regimen [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-11-03.
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Affiliation(s)
- H Ogata
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - M Saito
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - M Tsuneizumi
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - G Kutomi
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - K Hosoya
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - Y Kawai
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - K Sugizaki
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - N Katsumata
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - K Senuma
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - T Kitabatake
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - M Suda
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - T Uomori
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - K Miura
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - M Kurata
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - Y Nitta
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - N Yonemoto
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - J Matsuoka
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
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Yokoyama T, Katsumata N. [I. Current Topics of Chemotherapy for Ovarian Cancer]. Gan To Kagaku Ryoho 2017; 44:123-125. [PMID: 28676621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Takaaki Yokoyama
- Dept. of Medical Oncology, Nippon Medical School Musashi Kosugi Hospital
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Katsumata N, Shimatsu A, Tachibana K, Hizuka N, Horikawa R, Yokoya S, Tatsumi KI, Mochizuki T, Anzo M, Tanaka T. Continuing efforts to standardize measured serum growth hormone values in Japan. Endocr J 2016; 63:933-936. [PMID: 27452373 DOI: 10.1507/endocrj.ej16-0198] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Determination of serum growth hormone (GH) levels is mandatory for diagnosis of GH deficiency and excess. In the present study, we, the Study Committee for GH and Its Related Factors, The Foundation for Growth Science, Japan measured GH values in serum samples using all the commercially available kits in Japan. Significant discrepancies in the GH values were observed among the kits in spite of using the unified recombinant human GH-based standards. To deal with the discrepancies, we established a formula using a linear structural relationship model and were able to standardize the GH values. We propose to use the formula to diagnose GH deficiency and excess in Japan.
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Affiliation(s)
- Noriyuki Katsumata
- The Study Committee for GH and Its Related Factors, The Foundation for Growth Science, Tokyo, Japan
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Naiki Y, Miyado M, Horikawa R, Katsumata N, Onodera M, Pang S, Ogata T, Fukami M. Extra-adrenal induction of Cyp21a1 ameliorates systemic steroid metabolism in a mouse model of congenital adrenal hyperplasia. Endocr J 2016; 63:897-904. [PMID: 27432820 DOI: 10.1507/endocrj.ej16-0112] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Congenital adrenal hyperplasia (CAH) due to steroid 21-hydroxylase (21-OH) deficiency (21-OHD) is an autosomal recessive disorder, in which CYP21A2 mutations or deletions result in underproduction of glucocorticoid and mineralocorticoid, and overproduction of androgens. Patients with CAH are treated with oral steroid supplementation, but optimal control of blood steroid levels remains difficult. Thus, new therapeutic approaches are still needed. Previously, adenovirus-mediated administration of human CYP21A2 to adrenal glands rescued the phenotype of a mouse model of 21-OHD. In this study, we examined whether transduction of murine Cyp21a1 in extra-adrenal tissues could rescue steroid metabolism in 21-OHD mice. We transduced primary fibroblasts obtained from 21-OHD mice with a retroviral vector containing Cyp21a1. In vitro assays demonstrated that Cyp21a1-expressing fibroblasts can uptake progesterone from the culture media, convert it to deoxycorticosterone (DOC), and subsequently release DOC back into the media. Autotransplantation of Cyp21a1-expressing fibroblasts into the subcutaneous tissues of the back resulted in a significant reduction in the serum progesterone/DOC ratio in four of six 21-OHD mice at 4 weeks after injection. We also directly injected an adeno-associated viral vector containing Cyp21a1 into the thigh muscles of 21-OHD mice. Serum progesterone/DOC ratios were markedly reduced in all four animals at 4 weeks after injection. These results indicate that extra-adrenal induction of Cyp21a1 ameliorates steroid metabolism in 21-OHD mice. This study suggests a novel therapeutic strategy for congenital adrenal hyperplasia, which warrants further investigations.
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Affiliation(s)
- Yasuhiro Naiki
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
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Shima H, Yatsuga S, Nakamura A, Sano S, Sasaki T, Katsumata N, Suzuki E, Hata K, Nakabayashi K, Momozawa Y, Kubo M, Okamura K, Kure S, Matsubara Y, Ogata T, Narumi S, Fukami M. NR0B1 Frameshift Mutation in a Boy with Idiopathic Central Precocious Puberty. Sex Dev 2016; 10:205-209. [PMID: 27648561 DOI: 10.1159/000448726] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Indexed: 11/19/2022] Open
Abstract
NR0B1 is the causative gene for X-linked adrenal hypoplasia congenita, characterized by adrenal insufficiency, hypogonadotropic hypogonadism, and infertility. We identified an NR0B1 frameshift mutation in a boy with precocious puberty who had no signs of adrenal insufficiency. Blood examination revealed elevated testosterone levels and gonadotropin hyperresponses to gonadotropin releasing hormone (GnRH) stimulation, together with normal adrenal hormone levels. GnRH analog treatment partially ameliorated his clinical features. Molecular analysis identified a p.Glu3fsAla*16 in NR0B1. These results expand the clinical manifestations of NR0B1 mutations to include central precocious puberty without adrenal insufficiency. NR0B1 mutations likely underlie androgen overproduction via GnRH-dependent and -independent mechanisms.
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Affiliation(s)
- Hirohito Shima
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
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Sakai H, Matsuda M, Kadokura G, Katsumata N. [Acute Hyperuricemia and Kidney Injury after Three Cycles of Dose-Dense Chemotherapy for Retroperitoneal Choriocarcinoma -- A Case Report]. Gan To Kagaku Ryoho 2016; 43:263-266. [PMID: 27067696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 32 year-old man was diagnosed with retroperitoneal choriocarcinoma with metastasis to the lungs and liver. One cycle of modified BEP regimen did not sufficiently decrease the hCG. Therefore, we chose the GETUG 13 protocol of dose dense chemotherapy. After 6 days of cisplatin administration(3 cycles), he was diagnosed with acute hyperuricemia and kidney injury. He was treated with intravenous hydration and rasburicase. The hyperuricemia improved after a few days.
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Affiliation(s)
- Hitomi Sakai
- Dept. of Medical Oncology, Nippon Medical School Musashikosugi Hospital
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Kuroki M, Yoneyama K, Watanabe A, Fukami T, Matsushima T, Katsumata N, Takeshita T. Rhabdomyosarcoma of the Uterus: A Case Report. J NIPPON MED SCH 2015; 82:218-9. [PMID: 26568387 DOI: 10.1272/jnms.82.218] [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: 11/19/2022]
Affiliation(s)
- Mutsumi Kuroki
- Department of Obstetrics and Gynecology, Nippon Medical School Musashi Kosugi Hospital
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Harano K, Yonemori K, Hirakawa A, Shimizu C, Katsumata N, Gemma A, Fujiwara Y, Tamura K. The influence of familial factors on the choice of the place of death for terminally ill breast cancer patients: a retrospective single-center study. Breast Cancer 2015; 23:797-806. [PMID: 26439379 DOI: 10.1007/s12282-015-0643-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 09/24/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The social or familial factors influencing the location chosen for end-of-life (EOL) care for terminally ill breast cancer patients are unknown. METHODS We retrospectively analyzed 195 patients with recurrent or progressive breast cancer who received anticancer treatment at the National Cancer Center Hospital between January 2008 and May 2012. Detailed data concerning the patients' demographic, familial, and clinical characteristics were collected, and multivariate and Cox logistic regression analyses were performed to evaluate the impact of these characteristics on the place of EOL care and on survival, respectively. RESULTS Sixty-eight patients (34.9 %) died in a hospital, 26 patients (13.3 %) at home, and 101 patients (51.8 %) in hospice. Most of the patients having caregivers received EOL care at palliative care facilities (hospice or home) [odds ratio (OR) 2.57; 95 % confidence interval (CI) 1-6.6; p = 0.05]. In contrast, patients with factors suggesting a clinically severe status (performance status ≥2, use of opioids, delirium, and ascites) more often received EOL care in a hospital. Among patients who received EOL care at hospice or home, patients with minor children received EOL care at home (OR 0.08; 95 % CI 0.02-0.38; p = 0.001). Patients with brain metastases chose hospice (OR 12.37; 95 % CI 2.25-68.13; p = 0.004). Furthermore, having a caregiver was associated with prolonged survival (hazard ratio 0.62; 95 % CI 0.39-0.97; p = 0.035). CONCLUSION Familial factors such as having children and caregivers significantly influenced the place of EOL care for terminally ill breast cancer patients.
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Affiliation(s)
- Kenichi Harano
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan. .,Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-0063, Japan.
| | - Kan Yonemori
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akihiro Hirakawa
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Chikako Shimizu
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-0063, Japan
| | - Akihiko Gemma
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kenji Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
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Sakai H, Katsumata N, Kadokura G. Attitudes and practice patterns for maintaining relative dose intensity of chemotherapy in outpatient clinics: results of a Japanese web-based survey. BMC Cancer 2015; 15:651. [PMID: 26438185 PMCID: PMC4594648 DOI: 10.1186/s12885-015-1651-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 09/15/2015] [Indexed: 02/06/2023] Open
Abstract
Background This analysis was undertaken to evaluate the practice patterns of Japanese physicians regarding curative-intent chemotherapy, especially in outpatient settings, and to define factors negatively affecting the maintenance of relative dose intensity (RDI). Methods We performed a web-based questionnaire survey of Japanese physicians involved in malignant lymphoma chemotherapy (Group ML) or in breast cancer chemotherapy (Group BC). The questionnaire inquired how they manage low-risk febrile neutropenia (FN) caused by initial chemotherapy for diffuse large B-cell lymphoma(DLBCL) or by adjuvant chemotherapy for breast cancer in an outpatient setting. Results Valid responses were obtained from 185 physicians in Group ML and 160 in Group BC. In Group ML, 76 % (n = 141) of the physicians were board-certified hematologists, while 82 % (n = 131) of the physicians in Group BC were board-certified surgeons. A significantly higher proportion of physicians in Group ML responded that “dose reduction is not required for the subsequent course of chemotherapy after the first episode of FN” than in Group BC (ML versus BC; 77 % versus 31 %; P < 0.001). Significantly higher proportions of physicians in Group ML were more likely to prophylactically administer antibiotics or granulocyte-colony stimulating factor (G-CSF; ML versus BC; antibiotics: 36 % versus 26 %, P = 0.049; G-CSF: 25 % versus 16 %, P = 0.047). Eighty six percent (n = 159) of Group ML and 70 % (n = 112) of Group BC responded that “emergency outpatient unit is open at all hours”. Conclusions Japanese physicians are more likely to administer reduced doses of chemotherapy to patients with breast cancer than to patients with malignant lymphoma. Supportive infrastructures should be improved to ensure the provision of adequate chemotherapy to all cancer patients.
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Affiliation(s)
- Hitomi Sakai
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugi-machi, Nakahara-ku, Kawasaki City, Kanagawa, 211-0063, Japan.
| | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugi-machi, Nakahara-ku, Kawasaki City, Kanagawa, 211-0063, Japan.
| | - Genmu Kadokura
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugi-machi, Nakahara-ku, Kawasaki City, Kanagawa, 211-0063, Japan.
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Sakai H, Katsumata N, Matsuda M, Kadokura G. Seeking second opinions in oncology: Adherence of standard of care among first doctors. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e20601] [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)
- Hitomi Sakai
- Nippon Medical School Musashi Kosugi Hospital, Kawasaki City, Japan
| | | | - Masanori Matsuda
- Nippon Medical School Musashi Kosugi Hospital, Kawasaki City, Japan
| | - Genmu Kadokura
- Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
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Kitagawa R, Katsumata N, Shibata T, Kamura T, Kasamatsu T, Nakanishi T, Nishimura S, Ushijima K, Takano M, Satoh T, Yoshikawa H. Paclitaxel Plus Carboplatin Versus Paclitaxel Plus Cisplatin in Metastatic or Recurrent Cervical Cancer: The Open-Label Randomized Phase III Trial JCOG0505. J Clin Oncol 2015; 33:2129-35. [PMID: 25732161 DOI: 10.1200/jco.2014.58.4391] [Citation(s) in RCA: 223] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In metastatic or recurrent cervical cancer, cisplatin-based chemotherapy is standard. The JCOG0505 randomized phase III trial evaluated the clinical benefits of carboplatin-based regimen. PATIENTS AND METHODS Eligible patients had metastatic or recurrent cervical cancer and had ≤ one platinum-containing treatment and no prior taxane. Patients were randomly assigned either to conventional paclitaxel plus cisplatin (TP; paclitaxel 135 mg/m(2) over 24 hours on day 1 and cisplatin 50 mg/m(2) on day 2, repeated every 3 weeks) or paclitaxel plus carboplatin (TC; paclitaxel 175 mg/m(2) over 3 hours and carboplatin area under curve 5 mg/mL/min on day 1, repeated every 3 weeks). Primary end point was overall survival (OS). Planned sample size was 250 patients to confirm the noninferiority of TC versus TP with the threshold hazard ratio (HR) of 1.29. RESULTS Between February 2006 and November 2009, 253 patients were enrolled. The HR of OS was 0.994 (90% CI, 0.79 to 1.25; noninferiority P = .032 by stratified Cox regression). Median OS was 18.3 months with TP versus 17.5 months with TC. Among patients who had not received prior cisplatin, OS was shorter with TC (13.0 v 23.2 months; HR, 1.571; 95% CI, 1.06 to 2.32). One treatment-related death occurred with TC. Proportion of nonhospitalization periods was significantly longer with TC (P < .001). CONCLUSION TC was noninferior to TP and should be a standard treatment option for metastatic or recurrent cervical cancer. However, cisplatin is still the key drug for patients who have not received platinum agents.
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Affiliation(s)
- Ryo Kitagawa
- Ryo Kitagawa, NTT Medical Center Tokyo; Taro Shibata, National Cancer Center; Takahiro Kasamatsu, National Cancer Center Hospital, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kanagawa; Toshiharu Kamura and Kimio Ushijima, Kurume University, Fukuoka; Toru Nakanishi, Aichi Cancer Center Hospital, Aichi; Sadako Nishimura, Osaka City General Hospital, Osaka; Masashi Takano, National Defense Medical College, Saitama; and Toyomi Satoh and Hiroyuki Yoshikawa, University of Tsukuba, Ibaraki, Japan.
| | - Noriyuki Katsumata
- Ryo Kitagawa, NTT Medical Center Tokyo; Taro Shibata, National Cancer Center; Takahiro Kasamatsu, National Cancer Center Hospital, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kanagawa; Toshiharu Kamura and Kimio Ushijima, Kurume University, Fukuoka; Toru Nakanishi, Aichi Cancer Center Hospital, Aichi; Sadako Nishimura, Osaka City General Hospital, Osaka; Masashi Takano, National Defense Medical College, Saitama; and Toyomi Satoh and Hiroyuki Yoshikawa, University of Tsukuba, Ibaraki, Japan
| | - Taro Shibata
- Ryo Kitagawa, NTT Medical Center Tokyo; Taro Shibata, National Cancer Center; Takahiro Kasamatsu, National Cancer Center Hospital, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kanagawa; Toshiharu Kamura and Kimio Ushijima, Kurume University, Fukuoka; Toru Nakanishi, Aichi Cancer Center Hospital, Aichi; Sadako Nishimura, Osaka City General Hospital, Osaka; Masashi Takano, National Defense Medical College, Saitama; and Toyomi Satoh and Hiroyuki Yoshikawa, University of Tsukuba, Ibaraki, Japan
| | - Toshiharu Kamura
- Ryo Kitagawa, NTT Medical Center Tokyo; Taro Shibata, National Cancer Center; Takahiro Kasamatsu, National Cancer Center Hospital, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kanagawa; Toshiharu Kamura and Kimio Ushijima, Kurume University, Fukuoka; Toru Nakanishi, Aichi Cancer Center Hospital, Aichi; Sadako Nishimura, Osaka City General Hospital, Osaka; Masashi Takano, National Defense Medical College, Saitama; and Toyomi Satoh and Hiroyuki Yoshikawa, University of Tsukuba, Ibaraki, Japan
| | - Takahiro Kasamatsu
- Ryo Kitagawa, NTT Medical Center Tokyo; Taro Shibata, National Cancer Center; Takahiro Kasamatsu, National Cancer Center Hospital, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kanagawa; Toshiharu Kamura and Kimio Ushijima, Kurume University, Fukuoka; Toru Nakanishi, Aichi Cancer Center Hospital, Aichi; Sadako Nishimura, Osaka City General Hospital, Osaka; Masashi Takano, National Defense Medical College, Saitama; and Toyomi Satoh and Hiroyuki Yoshikawa, University of Tsukuba, Ibaraki, Japan
| | - Toru Nakanishi
- Ryo Kitagawa, NTT Medical Center Tokyo; Taro Shibata, National Cancer Center; Takahiro Kasamatsu, National Cancer Center Hospital, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kanagawa; Toshiharu Kamura and Kimio Ushijima, Kurume University, Fukuoka; Toru Nakanishi, Aichi Cancer Center Hospital, Aichi; Sadako Nishimura, Osaka City General Hospital, Osaka; Masashi Takano, National Defense Medical College, Saitama; and Toyomi Satoh and Hiroyuki Yoshikawa, University of Tsukuba, Ibaraki, Japan
| | - Sadako Nishimura
- Ryo Kitagawa, NTT Medical Center Tokyo; Taro Shibata, National Cancer Center; Takahiro Kasamatsu, National Cancer Center Hospital, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kanagawa; Toshiharu Kamura and Kimio Ushijima, Kurume University, Fukuoka; Toru Nakanishi, Aichi Cancer Center Hospital, Aichi; Sadako Nishimura, Osaka City General Hospital, Osaka; Masashi Takano, National Defense Medical College, Saitama; and Toyomi Satoh and Hiroyuki Yoshikawa, University of Tsukuba, Ibaraki, Japan
| | - Kimio Ushijima
- Ryo Kitagawa, NTT Medical Center Tokyo; Taro Shibata, National Cancer Center; Takahiro Kasamatsu, National Cancer Center Hospital, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kanagawa; Toshiharu Kamura and Kimio Ushijima, Kurume University, Fukuoka; Toru Nakanishi, Aichi Cancer Center Hospital, Aichi; Sadako Nishimura, Osaka City General Hospital, Osaka; Masashi Takano, National Defense Medical College, Saitama; and Toyomi Satoh and Hiroyuki Yoshikawa, University of Tsukuba, Ibaraki, Japan
| | - Masashi Takano
- Ryo Kitagawa, NTT Medical Center Tokyo; Taro Shibata, National Cancer Center; Takahiro Kasamatsu, National Cancer Center Hospital, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kanagawa; Toshiharu Kamura and Kimio Ushijima, Kurume University, Fukuoka; Toru Nakanishi, Aichi Cancer Center Hospital, Aichi; Sadako Nishimura, Osaka City General Hospital, Osaka; Masashi Takano, National Defense Medical College, Saitama; and Toyomi Satoh and Hiroyuki Yoshikawa, University of Tsukuba, Ibaraki, Japan
| | - Toyomi Satoh
- Ryo Kitagawa, NTT Medical Center Tokyo; Taro Shibata, National Cancer Center; Takahiro Kasamatsu, National Cancer Center Hospital, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kanagawa; Toshiharu Kamura and Kimio Ushijima, Kurume University, Fukuoka; Toru Nakanishi, Aichi Cancer Center Hospital, Aichi; Sadako Nishimura, Osaka City General Hospital, Osaka; Masashi Takano, National Defense Medical College, Saitama; and Toyomi Satoh and Hiroyuki Yoshikawa, University of Tsukuba, Ibaraki, Japan
| | - Hiroyuki Yoshikawa
- Ryo Kitagawa, NTT Medical Center Tokyo; Taro Shibata, National Cancer Center; Takahiro Kasamatsu, National Cancer Center Hospital, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kanagawa; Toshiharu Kamura and Kimio Ushijima, Kurume University, Fukuoka; Toru Nakanishi, Aichi Cancer Center Hospital, Aichi; Sadako Nishimura, Osaka City General Hospital, Osaka; Masashi Takano, National Defense Medical College, Saitama; and Toyomi Satoh and Hiroyuki Yoshikawa, University of Tsukuba, Ibaraki, Japan
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Sugano T, Katsumata N. [Ovarian cancer: TC therapy]. Nihon Rinsho 2015; 73 Suppl 2:604-608. [PMID: 25831831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Sasaki Y, Miwa K, Yamashita K, Sunakawa Y, Shimada K, Ishida H, Hasegawa K, Fujiwara K, Kodaira M, Fujiwara Y, Namiki M, Matsuda M, Takeuchi Y, Katsumata N. A phase I study of farletuzumab, a humanized anti-folate receptor α monoclonal antibody, in patients with solid tumors. Invest New Drugs 2014; 33:332-40. [PMID: 25380636 PMCID: PMC4387250 DOI: 10.1007/s10637-014-0180-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 10/17/2014] [Indexed: 12/13/2022]
Abstract
Farletuzumab is a humanized monoclonal antibody against folate receptor α (FRA). The purpose of the study is to assess safety and tolerability, the pharmacokinetic (PK) profile, and preliminary antitumor effect. Patients with ovarian cancer (OC) or FRA-expressing solid tumors who are resistant to standard treatments were eligible for the study. After single-dose administration for PK assessment, farletuzumab was administered by intravenous injection, repeating every week until disease progression. Dose-limiting toxicities (DLTs) were defined as grade 4 hematological and grade 3/4 nonhematological toxicities. Dose escalation was planned in 4 cohorts (50, 100, 200, and 400 mg/m2). Fourteen patients with OC and two patients with gastric cancer (GC) received farletuzumab infusion. Neither DLTs nor grade 3/4 toxicities were reported in all cohorts. Major adverse events, including grade 1/2 infusion related reaction (15 patients, 93.8 %), headache (seven patients, 43.8 %), and nausea and decreased appetite (five patients each, 31.3 %), were observed and medically managed. AUC and Cmax increased dose-dependently and linear PK profiles were observed. No tumor shrinkage was recorded, but long-term disease stabilization for 25 and 20 months was observed in one patient with clear cell OC (100 mg/m2) and one patient with GC (400 mg/m2), respectively. No cumulative toxicity occurred in any patient. Farletuzumab was well tolerated in Japanese patients with a similar PK profile as compared with the US population. Long-term disease stabilization was observed in a subpopulation of clear cell OC and GC; both of them were resistant and progressive after standard chemotherapies (ClinicalTrials.gov Identifier: NCT01049061).
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Affiliation(s)
- Yasutsuna Sasaki
- Department of Medical Oncology, Saitama International Medical Center-Comprehensive Cancer Center, Saitama Medical University, Saitama, Japan,
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Matsumoto K, Katsumata N, Shibata T, Satoh T, Saitou M, Yunokawa M, Takano T, Nakamura K, Kamura T, Konishi I. Phase II trial of oral etoposide plus intravenous irinotecan in patients with platinum-resistant and taxane-pretreated ovarian cancer (JCOG0503). Gynecol Oncol 2014; 136:218-23. [PMID: 25449313 DOI: 10.1016/j.ygyno.2014.10.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 10/22/2014] [Accepted: 10/24/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess the safety and efficacy of the combination of oral etoposide and intravenous irinotecan in patients with platinum-resistant and taxane-pretreated ovarian cancer. METHODS Eligible patients (age, 20-75years; platinum-free interval, ≤28weeks) with an adequate organ function received oral etoposide (50mg/m(2) once a day) from day 1 to day 21 and intravenous irinotecan (70mg/m(2)) on days 1 and 15. The regimen was repeated every 28days up to 6cycles. The primary endpoint was the response rate (RR) with a threshold of 20%. The response was evaluated according to RECIST 1.0 and Gynecologic Cancer Intergroup CA-125 Response Definition, and toxicities were evaluated according to CTCAE version 3.0. This trial was registered at UMIN-CTR as UMIN000001837. RESULTS Between April 1, 2009 and January 20, 2012, 61 patients were enrolled. Sixty patients were eligible. 1 CR and 12 PRs were confirmed; RR was 21.7% (p=0.42, the exact binomial test). PFS and OS were 4.1 and 11.9months, respectively. Major toxicities of ≥grade 3 were neutropenia (60%), anemia (36.7%), thrombocytopenia (11.7%), febrile neutropenia (18.3%), fatigue (13.3%), anorexia (11.7%), and nausea (11.7%). Three patients died from treatment related death (interstitial pneumonia, a pulmonary embolism, and DIC due to infection). Two of these patients were aged ≥65years. CONCLUSIONS Oral etoposide and intravenous irinotecan had a moderate RR but did not meet the primary endpoint. Because of toxicity, we do not recommend this regimen outside of clinical trials. In particular, when considering this regimen for elderly patients, extreme caution is advised.
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Affiliation(s)
| | | | - Taro Shibata
- JCOG Data Center, Multi-institutional Clinical Trial Support Center, National Cancer Center, Japan
| | | | | | | | | | - Kenichi Nakamura
- JCOG Data Center, Multi-institutional Clinical Trial Support Center, National Cancer Center, Japan
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Kadokura G, Sakai H, Onodera K, Konomatsu A, Katsumata N. Safety Profile of the Desensitizing Carboplatin Infusion for Patients Documented Carboplatin Hypersensitivity. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu436.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Harano K, Terauchi F, Katsumata N, Takahashi F, Yasuda M, Takakura S, Takano M, Yamamoto Y, Sugiyama T. Quality-of-life outcomes from a randomized phase III trial of dose-dense weekly paclitaxel and carboplatin compared with conventional paclitaxel and carboplatin as a first-line treatment for stage II-IV ovarian cancer: Japanese Gynecologic Oncology Group Trial (JGOG3016). Ann Oncol 2014; 25:251-7. [PMID: 24356636 DOI: 10.1093/annonc/mdt527] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Dose-dense weekly paclitaxel (Taxol) and carboplatin (dd-TC) improved survival compared with conventional tri-weekly paclitaxel and carboplatin (c-TC) as a first-line chemotherapy for newly diagnosed stage II-IV ovarian cancer in the Japanese Gynecologic Oncology Group 3016 trial. We report the quality-of-life (QoL) results from this trial. PATIENTS AND METHODS A total of 637 patients were randomly assigned to receive c-TC or dd-TC (c-TC, n = 319; dd-TC, n = 312) and were asked to complete a QoL assessment at baseline, just after the third and sixth chemotherapy cycles, and at 12 months after randomization. QoL was assessed using Functional Assessment of Cancer Therapy (FACT)-general (FACT-G), FACT-taxane subscale (FACT-T), and FACT-ovary subscale (FACT-Ov). The overall QoL and that according to each subscale were analyzed using mixed-effects models adjusted for treatment and time. RESULTS Baseline QoL assessment was completed by 204 out of 319 (63.9%) and 200 out of 312 (64.1%) patients in the c-TC and dd-TC groups, respectively. In these groups, the compliance rates with regard to QoL assessment were 74.5% and 73.0%, respectively, after three chemotherapy cycles; 86.8% and 86.9%, respectively, after six chemotherapy cycles; and 74.2% and 71.6%, respectively, at 12 months after randomization. The overall QoL did not differ significantly between the two treatment groups up to 12 months after randomization (P = 0.46). However, QoL according to the FACT-T subscale was significantly lower in the dd-TC group than in the c-TC group (P = 0.02). CONCLUSION dd-TC does not decrease overall QoL compared with c-TC.
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Affiliation(s)
- K Harano
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, Kawasaki
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Fujimori M, Shirai Y, Asai M, Kubota K, Katsumata N, Uchitomi Y. Effect of communication skills training program for oncologists based on patient preferences for communication when receiving bad news: a randomized controlled trial. J Clin Oncol 2014; 32:2166-72. [PMID: 24912901 DOI: 10.1200/jco.2013.51.2756] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The aim of this study was to identify the effects of a communication skills training (CST) program for oncologists, developed based on patient preferences regarding oncologists' communication. PARTICIPANTS AND METHODS Thirty oncologists were randomly assigned to either an intervention group (IG; 2-day CST workshop) or control group (CG). Participants were assessed on their communication performance during simulated consultation and their confidence in communicating with patients at baseline and follow-up. A total of 1,192 patients (response rate, 84.6%) who had consultations with the participating oncologists at baseline and/or follow-up were assessed regarding their distress using the Hospital Anxiety and Depression Scale, satisfaction with the consultation, and trust in their oncologist after the consultation. RESULTS At the follow-up survey, the performance scores of the IG had improved significantly, in terms of their emotional support (P = .011), setting up a supportive environment (P = .002), and ability to deliver information (P = .001), compared with those of the CG. Oncologists in the IG were rated higher at follow-up than those in the CG in terms of their confidence in themselves (P = .001). Patients who met with oncologists after they had undergone the CST were significantly less depressed than those who met with oncologists in the CG (P = .027). However, the CST program did not affect patient satisfaction with oncologists' style of communication. CONCLUSION A CST program based on patient preferences is effective for both oncologists and patients with cancer. Oncologists should consider CST as an approach to enhancing their communication skills.
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Affiliation(s)
- Maiko Fujimori
- Maiko Fujimori, Yuki Shirai, Mariko Asai, and Yosuke Uchitomi, National Cancer Center Hospital East, Kashiwa; Maiko Fujimori, National Cancer Center Hospital and National Institute of Mental Health, National Center for Neurology and Psychiatry; Yuki Shirai, University of Tokyo; Mariko Asai, Teikyo Heisei University; Kaoru Kubota, Nippon Medical School, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kawasaki; and Yosuke Uchitomi, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuki Shirai
- Maiko Fujimori, Yuki Shirai, Mariko Asai, and Yosuke Uchitomi, National Cancer Center Hospital East, Kashiwa; Maiko Fujimori, National Cancer Center Hospital and National Institute of Mental Health, National Center for Neurology and Psychiatry; Yuki Shirai, University of Tokyo; Mariko Asai, Teikyo Heisei University; Kaoru Kubota, Nippon Medical School, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kawasaki; and Yosuke Uchitomi, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Mariko Asai
- Maiko Fujimori, Yuki Shirai, Mariko Asai, and Yosuke Uchitomi, National Cancer Center Hospital East, Kashiwa; Maiko Fujimori, National Cancer Center Hospital and National Institute of Mental Health, National Center for Neurology and Psychiatry; Yuki Shirai, University of Tokyo; Mariko Asai, Teikyo Heisei University; Kaoru Kubota, Nippon Medical School, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kawasaki; and Yosuke Uchitomi, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kaoru Kubota
- Maiko Fujimori, Yuki Shirai, Mariko Asai, and Yosuke Uchitomi, National Cancer Center Hospital East, Kashiwa; Maiko Fujimori, National Cancer Center Hospital and National Institute of Mental Health, National Center for Neurology and Psychiatry; Yuki Shirai, University of Tokyo; Mariko Asai, Teikyo Heisei University; Kaoru Kubota, Nippon Medical School, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kawasaki; and Yosuke Uchitomi, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Noriyuki Katsumata
- Maiko Fujimori, Yuki Shirai, Mariko Asai, and Yosuke Uchitomi, National Cancer Center Hospital East, Kashiwa; Maiko Fujimori, National Cancer Center Hospital and National Institute of Mental Health, National Center for Neurology and Psychiatry; Yuki Shirai, University of Tokyo; Mariko Asai, Teikyo Heisei University; Kaoru Kubota, Nippon Medical School, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kawasaki; and Yosuke Uchitomi, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yosuke Uchitomi
- Maiko Fujimori, Yuki Shirai, Mariko Asai, and Yosuke Uchitomi, National Cancer Center Hospital East, Kashiwa; Maiko Fujimori, National Cancer Center Hospital and National Institute of Mental Health, National Center for Neurology and Psychiatry; Yuki Shirai, University of Tokyo; Mariko Asai, Teikyo Heisei University; Kaoru Kubota, Nippon Medical School, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kawasaki; and Yosuke Uchitomi, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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Takasawa K, Ono M, Hijikata A, Matsubara Y, Katsumata N, Takagi M, Morio T, Ohara O, Kashimada K, Mizutani S. Two novel HSD3B2 missense mutations with diverse residual enzymatic activities for Δ5-steroids. Clin Endocrinol (Oxf) 2014; 80:782-9. [PMID: 24372086 DOI: 10.1111/cen.12394] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 10/22/2013] [Accepted: 12/17/2013] [Indexed: 02/03/2023]
Abstract
CONTEXT Classical 3β-hydroxysteroid dehydrogenase (3β-HSD) deficiency (3β-HSDD) is caused by loss-of-function mutations in the HSD3B2 gene encoding type II 3β-HSD, which has a key role in steroid biosynthesis, converting Δ5-steroids to Δ4-steroids in adrenal glands and gonads. PATIENT A patient (46, XX) was found to have elevated 17-hydroxyprogesterone (17-OHP) [203 nmol/l (normal range: 2·94 ± 0·9 nmol/l)] by newborn screening. Endocrinological examination revealed dramatically increased Δ5-steroids [e.g. 17-OH pregnenolone: 910 nmol/l (normal range: 12·6 ± 10·5 nmol/l)]. The patient had virilization of external genitalia with labial fusion, suggesting classical 3β-HSDD. METHODS AND RESULTS Consistent with the endocrinological data, the patient was a compound heterozygote for two novel missense mutations (p.Y190C and p.S218P) that were identified in HSD3B2. Both Y190 and S218 are conserved among mammals. The mutant proteins had severely impaired residual enzymatic activity in vitro, although both mutants retained higher activity for 17-OH pregnenolone than for the other Δ5-steroids. In a three-dimensional model of the enzyme based on the known structures of similar proteins, both mutations were located extremely close to the predicted substrate-binding pocket. This suggests that the mutations can cause a local conformational change in the substrate-binding pocket, leading to alterations of the binding affinities for Δ5-steroids. CONCLUSIONS We identified two novel missense mutations of HSD3B2 that resulted in unbalanced residual enzymatic activities for Δ5-steroids. As a potential novel mechanism, we propose that the mutations, which differently affect the activity towards different substrates, the effects of these mutations provide novel insights into the pathophysiology of 3β-HSDD.
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Affiliation(s)
- Kei Takasawa
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
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Taniyama TK, Hashimoto K, Katsumata N, Hirakawa A, Yonemori K, Yunokawa M, Shimizu C, Tamura K, Ando M, Fujiwara Y. Can oncologists predict survival for patients with progressive disease after standard chemotherapies? ACTA ACUST UNITED AC 2014; 21:84-90. [PMID: 24764697 DOI: 10.3747/co.21.1743] [Citation(s) in RCA: 15] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Prediction of prognosis is important for patients so that they can make the most of the rest of their lives. Oncologists could predict survival, but the accuracy of such predictions is unclear. METHODS In this observational prospective cohort study, 14 oncologists treating 9 major adult solid malignancies were asked to complete questionnaires predicting survival based on performance status, oral intake, and other clinical factors when patients experienced progressive disease after standard chemotherapies. Clinically predicted survival (cps) was calculated by the oncologists from the date of progressive disease to the predicted date of death. Actual survival (as) was compared with cps using Kaplan-Meier survival curves, and factors affecting inaccurate prediction were determined by logistic regression analysis. The prediction of survival time was considered accurate when the cps/as ratio was between 0.67 and 1.33. RESULTS The study cohort consisted of 75 patients. Median cps was 120 days (interquartile range: 60-180 days), and median as was 121 days (interquartile range: 40-234 days). The participating oncologists accurately predicted as within a 33% range 36% of the time; the survival time was overestimated 36% of time and underestimated 28% of the time. The factors affecting the accuracy of the survival estimate were the experience of the oncologist, patient age, and information given about the palliative care unit. CONCLUSIONS Prediction of cps was accurate for just slightly more than one third of all patients in this study. Additional investigation of putative prognostic factors with a larger sample size is warranted.
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Affiliation(s)
- T K Taniyama
- Department of Breast Oncology and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - K Hashimoto
- Department of Breast Oncology and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - N Katsumata
- Medical Oncology, Musashikosugi Hospital, Nippon Medical School, Kanagawa, Japan
| | - A Hirakawa
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - K Yonemori
- Department of Breast Oncology and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - M Yunokawa
- Department of Breast Oncology and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - C Shimizu
- Department of Breast Oncology and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - K Tamura
- Department of Breast Oncology and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - M Ando
- Department of Clinical Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Y Fujiwara
- Department of Breast Oncology and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
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