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Suzuki T, Matsuura K, Suzuki Y, Okumura F, Nagura Y, Sobue S, Matoya S, Miyaki T, Kimura Y, Kusakabe A, Narahara S, Tokunaga T, Nagaoka K, Kuroyanagi K, Kawamura H, Kuno K, Fujiwara K, Nojiri S, Kataoka H, Tanaka Y. Serum CXCL10 levels at the start of the second course of atezolizumab plus bevacizumab therapy predict therapeutic efficacy in patients with advanced BCLC stage C hepatocellular carcinoma: A multicenter analysis. Cancer Med 2023; 13:e6876. [PMID: 38133557 PMCID: PMC10807580 DOI: 10.1002/cam4.6876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND & AIMS Relationships of serum C-C motif chemokine ligand 5 (CCL5) and C-X-C motif chemokine ligand 10 (CXCL10) levels with hot immune features have been reported in patients with hepatocellular carcinoma (HCC). Therefore, we examined the utility of their levels for predicting the efficacy of atezolizumab plus bevacizumab (Atez/Bev) in patients with HCC. DESIGN In total, 98 patients with HCC treated with Atez/Bev were enrolled, and their initial responses were evaluated at least once via dynamic computed tomography or magnetic resonance imaging. Serum CCL5 and CXCL10 levels were assessed by enzyme-linked immunosorbent assay before treatment and at the start of the second course of Atez/Bev therapy, and their relationships with treatment efficacy were determined. RESULTS No analyzed factor was associated with the initial therapeutic response. Among the 56 patients with Barcelona Clinic Liver Cancer (BCLC) stage C, serum CXCL10 levels at the beginning of course two (CXCL10-2c) tended to be higher in responders than in non-responders in the initial evaluation, and its optimal cutoff level of 690 pg/mL could be used to stratify patients regarding overall survival (OS; high vs. low: not reached vs. 17.6 months, p = 0.034) and progression-free survival (high vs. low: 13.6 vs. 5.1 months, p = 0.014). In multivariate analysis, high CXCL10 levels and neutrophil-to-lymphocyte ratios at the start of course two and Child-Pugh stage A at baseline were independent predictive factors of improved OS. CONCLUSIONS Serum CXCL10-2c levels were predictive of Atez/Bev efficacy in patients with BCLC stage C HCC.
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Affiliation(s)
- Takanori Suzuki
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Kentaro Matsuura
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Yuta Suzuki
- Department of GastroenterologyGifu Prefectural Tajimi HospitalGifuJapan
| | - Fumihiro Okumura
- Department of GastroenterologyGifu Prefectural Tajimi HospitalGifuJapan
| | - Yoshihito Nagura
- Department of GastroenterologyKasugai Municipal HospitalKasugaiJapan
| | - Satoshi Sobue
- Department of GastroenterologyKasugai Municipal HospitalKasugaiJapan
| | - Sho Matoya
- Department of GastroenterologyToyokawa City HospitalToyokawaJapan
| | - Tomokatsu Miyaki
- Department of GastroenterologyToyokawa City HospitalToyokawaJapan
| | - Yoshihide Kimura
- Department of GastroenterologyNagoya City University West Medical CenterNagoyaJapan
| | - Atsunori Kusakabe
- Department of GastroenterologyJapanese Red Cross Aichi Medical Center Nagoya Daini HospitalNagoyaJapan
| | - Satoshi Narahara
- Department of Gastroenterology and Hepatology, Faculty of Life SciencesKumamoto UniversityKumamotoJapan
| | - Takayuki Tokunaga
- Department of Gastroenterology and Hepatology, Faculty of Life SciencesKumamoto UniversityKumamotoJapan
| | - Katsuya Nagaoka
- Department of Gastroenterology and Hepatology, Faculty of Life SciencesKumamoto UniversityKumamotoJapan
| | - Keita Kuroyanagi
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Hayato Kawamura
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Kayoko Kuno
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Kei Fujiwara
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Shunsuke Nojiri
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Hiromi Kataoka
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Yasuhito Tanaka
- Department of Gastroenterology and Hepatology, Faculty of Life SciencesKumamoto UniversityKumamotoJapan
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Tahata Y, Hikita H, Mochida S, Enomoto N, Ido A, Kuroda H, Miki D, Kurosaki M, Hiasa Y, Sakamori R, Kawada N, Yamashita T, Suda G, Yatsuhashi H, Yoshiji H, Kato N, Takami T, Nakao K, Matsuura K, Asahina Y, Itoh Y, Tateishi R, Nakamoto Y, Kakazu E, Terai S, Shimizu M, Ueno Y, Akuta N, Miyazaki M, Nozaki Y, Kabayama M, Sobue S, Moriuchi A, Miyaki T, Kodama T, Tatsumi T, Yamada T, Takehara T. Posttreatment liver function, but not baseline liver function stratifies patient survival after direct-acting antiviral treatment in decompensated cirrhosis with hepatitis C virus. J Gastroenterol 2023; 58:1211-1221. [PMID: 37831182 PMCID: PMC10657790 DOI: 10.1007/s00535-023-02039-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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/27/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND The prognosis of cirrhosis is clearly stratified by liver function. Although direct-acting antiviral (DAA) has recently been used to eliminate hepatitis C virus (HCV), it is not clear whether liver function stratifies the prognosis of decompensated cirrhotic patients treated with DAA. METHODS A total of 206 HCV-associated decompensated cirrhotic patients who started DAA from February 2019 to December 2021 at 31 Japanese hospitals were prospectively registered. RESULTS The median age was 68, and the proportions of patients with Child-Pugh class A (CP-A), CP-B and CP-C were 10% (20/206), 76% (156/206) and 15% (30/206), respectively. Twenty-six patients died, and two patients underwent liver transplantation (LT); the 2- and 3-year LT-free survival rates were 90.0% and 83.2%, respectively. We examined factors associated with LT-free survival using 2 models including either CP class (Model 1) or MELD score (Model 2). In multivariate Cox proportional hazard analysis, CP class at 12 weeks after the end of treatment (EOT) in Model 1 and MELD score at 12 weeks after the EOT in Model 2 were significant factors, while baseline CP class or MELD score was not. Two-year LT-free survival rates were 100%, 91.6% and 60.4% for patients with CP-A, CP-B and CP-C at 12 weeks after the EOT and 95.2% and 69.6% for patients with MELD < 15 and MELD ≥ 15 at 12 weeks after the EOT, respectively. CONCLUSIONS The prognosis of decompensated cirrhotic patients receiving DAA was stratified by liver function at 12 weeks after the EOT, not by baseline liver function.
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Affiliation(s)
- Yuki Tahata
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hayato Hikita
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Satoshi Mochida
- Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama, Japan
| | - Nobuyuki Enomoto
- First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Akio Ido
- Digestive and Lifestyle Diseases, Department of Human and Environmental Sciences, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan
| | - Hidekatsu Kuroda
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
| | - Daiki Miki
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masayuki Kurosaki
- Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Ryotaro Sakamori
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Norifumi Kawada
- Department of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Taro Yamashita
- Department of Gastroenterology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Goki Suda
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Hiroshi Yatsuhashi
- Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Hitoshi Yoshiji
- Department of Gastroenterology, Nara Medical University, Nara, Japan
| | - Naoya Kato
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Taro Takami
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Ube, Japan
| | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Nagasaki University of Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kentaro Matsuura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yasuhiro Asahina
- Department of Gastroenterology and Hepatology, Department of Liver Disease Control, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryosuke Tateishi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Eiji Kakazu
- The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata, Japan
| | - Masahito Shimizu
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yoshiyuki Ueno
- Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Norio Akuta
- Department of Hepatology, Toranomon Hospital, Tokyo, Japan
| | | | - Yasutoshi Nozaki
- Department of Gastroenterology, Kansai Rosai Hospital, Hyogo, Japan
| | - Masayuki Kabayama
- Department of Gastroenterology, Kagoshima Prefectural Oshima Hospital, Kagoshima, Japan
| | - Satoshi Sobue
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Akihiro Moriuchi
- Department of Gastroenterology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Tomokatsu Miyaki
- Department of Gastroenterology, Toyokawa City Hospital, Toyokawa, Japan
| | - Takahiro Kodama
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tomohide Tatsumi
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tomomi Yamada
- Department of Medical Innovation, Osaka University Hospital, Suita, Osaka, Japan
| | - Tetsuo Takehara
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
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Matoya S, Suzuki T, Matsuura K, Suzuki Y, Okumura F, Nagura Y, Sobue S, Kuroyanagi K, Kusakabe A, Koguchi H, Hasegawa I, Miyaki T, Tanaka Y, Kondo H, Kimura Y, Ozasa A, Kawamura H, Kuno K, Fujiwara K, Nojiri S, Kataoka H. The neutrophil-to-lymphocyte ratio at the start of the second course during atezolizumab plus bevacizumab therapy predicts therapeutic efficacy in patients with advanced hepatocellular carcinoma: A multicenter analysis. Hepatol Res 2023. [PMID: 36723964 DOI: 10.1111/hepr.13886] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 02/02/2023]
Abstract
AIM Atezolizumab plus bevacizumab (Atez/Bev) therapy is expected to have good therapeutic efficacy for patients with advanced hepatocellular carcinoma (HCC). However, the clinical indicators that predict therapeutic efficacy have not been established. We retrospectively investigated whether the neutrophil-to-lymphocyte ratio (NLR) during Atez/Bev therapy could predict therapeutic efficacy. METHOD In total, 110 patients with HCC were enrolled; they were treated with Atez/Bev therapy and evaluated for their initial response by dynamic CT or MRI at least once between October 2020 and July 2022. RESULTS Of the 110 patients with HCC at the initial evaluation, two (2%) showed a complete response (CR), 22 (20%) partial response (PR), 62 (56%) stable disease (SD), and 24 (21%) progressive disease (PD). The NLR at the start of the second course (NLR-2c) increased from CR + PR to SD to PD. There was no significant association between the baseline NLR and the initial therapeutic response. Patients with CR + PR had lower NLR-2c values than those with SD + PD (p < 0.001) and the optimal cut-off value of NLR-2c was 1.97. Patients with NLR-2c <1.97 had better overall survival and progression-free survival (PFS) than those with NLR-2c ≥1.97 (p = 0.005 for overall survival; p < 0.001 for PFS). A multivariate analysis showed that female sex, higher PIVKA-II levels at baseline, and higher values of NLR-2c were significantly associated with poorer PFS. CONCLUSIONS The NLR-2c value predicts the initial therapeutic response and prognosis of patients with HCC treated with Atez/Bev therapy.
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Affiliation(s)
- Sho Matoya
- Department of Gastroenterology, Toyokawa City Hospital, Toyokawa, Japan
| | - Takanori Suzuki
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kentaro Matsuura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yuta Suzuki
- Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Gifu, Japan
| | - Fumihiro Okumura
- Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Gifu, Japan
| | - Yoshihito Nagura
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Satoshi Sobue
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Keita Kuroyanagi
- Department of Gastroenterology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Atsunori Kusakabe
- Department of Gastroenterology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Hiroki Koguchi
- Department of Gastroenterology, Chukyo Hospital, Nagoya, Japan
| | - Izumi Hasegawa
- Department of Gastroenterology, Chukyo Hospital, Nagoya, Japan
| | - Tomokatsu Miyaki
- Department of Gastroenterology, Toyokawa City Hospital, Toyokawa, Japan
| | - Yoshito Tanaka
- Department of Gastroenterology, Nagoya City East Medical Center, Nagoya, Japan
| | - Hiromu Kondo
- Department of Gastroenterology, Nagoya City East Medical Center, Nagoya, Japan
| | - Yoshihide Kimura
- Department of Gastroenterology, Nagoya City University West Medical Center, Nagoya, Japan
| | - Atsushi Ozasa
- Department of Gastroenterology, Asahi Rousai Hospital, Owariasahi, Japan
| | - Hayato Kawamura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kayoko Kuno
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kei Fujiwara
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shunsuke Nojiri
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiromi Kataoka
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Suzuki T, Matsuura K, Urakabe K, Okumura F, Kawamura H, Sobue S, Matoya S, Miyaki T, Kimura Y, Kato D, Kusakabe A, Tanaka Y, Ozasa A, Nagura Y, Fujiwara K, Nojiri S, Hagiwara S, Kusumoto S, Inoue T, Tanaka Y, Kataoka H. Outcome of nucleos(t)ide analog cessation in patients with treatment for prevention of or against hepatitis B virus reactivation. Hepatol Res 2022; 53:289-300. [PMID: 36461885 DOI: 10.1111/hepr.13864] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/19/2022] [Accepted: 11/30/2022] [Indexed: 02/08/2023]
Abstract
AIM We retrospectively investigated patients with administration of nucleos(t)ide analogs (NAs) for prevention of or against hepatitis B virus (HBV) reactivation, and their clinical outcomes after cessation of the NA. METHODS We enrolled 180 patients who were positive for HBsAg when they started immunosuppressive therapy or chemotherapy and an NA was administered to prevent HBV reactivation (HBV carrier group), and 82 patients with resolved HBV infection who started administration of an NA after HBV reactivation (de novo HBV group). Cessation of the NA depended on each physician's judgment without definite criteria. RESULTS A total of 27 patients in the HBV carrier group and 22 in the de novo HBV group stopped NA therapy. In the HBV carrier group, 16 patients experienced virological relapse, which was defined as HBV DNA levels ≥20 IU/ml, and one with hematological disease had an alanine aminotransferase flare after cessation of NA. Of the 16 patients, the NA was reintroduced in three, whereas, the remaining 13 had low levels of HBV DNA and no alanine aminotransferase flare. In the de novo HBV group, virological relapse occurred in six patients, and one with hematological disease had an alanine aminotransferase flare after cessation of the NA. The NA was reintroduced in four of the six patients. CONCLUSIONS We may be able to consider to cease NA therapy proactively in HBV carriers and resolved patients with non-hematological disease, if their primary diseases are under remission after completion of immunosuppressive therapy or chemotherapy. However, careful follow up is necessary after stopping NA therapy.
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Affiliation(s)
- Takanori Suzuki
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kentaro Matsuura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kenji Urakabe
- Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Gifu, Japan
| | - Fumihiro Okumura
- Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Gifu, Japan
| | - Hayato Kawamura
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Satoshi Sobue
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Sho Matoya
- Department of Gastroenterology, Toyokawa City Hospital, Toyokawa, Japan
| | - Tomokatsu Miyaki
- Department of Gastroenterology, Toyokawa City Hospital, Toyokawa, Japan
| | - Yoshihide Kimura
- Department of Gastroenterology, Nagoya City University West Medical Center, Nagoya, Japan
| | - Daisuke Kato
- Department of Gastroenterology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Atsunori Kusakabe
- Department of Gastroenterology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Yoshito Tanaka
- Department of Gastroenterology, Nagoya City East Medical Center, Nagoya, Japan
| | - Atsushi Ozasa
- Department of Gastroenterology, Asahi Rousai Hospital, Owariasahi, Japan
| | - Yoshihito Nagura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kei Fujiwara
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shunsuke Nojiri
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shinya Hagiwara
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shigeru Kusumoto
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takako Inoue
- Department of Clinical Laboratory Medicine, Nagoya City University Hospital, Nagoya, Japan
| | - Yasuhito Tanaka
- Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiromi Kataoka
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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5
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Tahata Y, Hikita H, Mochida S, Enomoto N, Kawada N, Kurosaki M, Ido A, Miki D, Yoshiji H, Takikawa Y, Sakamori R, Hiasa Y, Nakao K, Kato N, Ueno Y, Yatsuhashi H, Itoh Y, Tateishi R, Suda G, Takami T, Nakamoto Y, Asahina Y, Matsuura K, Yamashita T, Kanto T, Akuta N, Terai S, Shimizu M, Sobue S, Miyaki T, Moriuchi A, Yamada R, Kodama T, Tatsumi T, Yamada T, Takehara T. Liver-related events after direct-acting antiviral therapy in patients with hepatitis C virus-associated cirrhosis. J Gastroenterol 2022; 57:120-132. [PMID: 35059853 DOI: 10.1007/s00535-021-01845-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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: 09/13/2021] [Accepted: 12/20/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Direct-acting antiviral (DAA) therapy enables a high rate of sustained virologic response (SVR) in patients with hepatitis C virus associated cirrhosis. However, the impact of DAA therapy on liver-related events in patients with cirrhosis is unclear. METHODS A total of 350 patients with compensated and decompensated cirrhosis administered DAA therapy at 29 Japanese hospitals were enrolled (Child-Pugh class A [CP-A]: 195 patients, CP-B: 131 patients and CP-C: 24 patients). RESULTS The SVR rates of patients with CP-A, CP-B and CP-C were 96.9%, 93.1% and 83.3%, respectively (p = 0.006). Seventy patients developed hepatocellular carcinoma (HCC), and male sex, previous HCC treatment, platelet counts < 10.0 × 104/µl, alpha-fetoprotein levels ≥ 5.0 ng/ml and CP-C were identified as significant factors in the multivariate analysis. The cumulative HCC occurrence/recurrence rates at 1 year were 6.6%/45.2%. The cumulative rate of decompensated cirrhotic events requiring hospital admission at 1 year was 9.1%. In the multivariate analysis, CP-B and CP-C were identified as significant factors. During the median observation period of 14.9 months, 13 patients died and one patient received liver transplant. The overall survival rates at 1 year were 98.4% in patients with CP-A, 96.4% in those with CP-B and 85.6% in those with CP-C (CP-A vs. CP-B: p = 0.759, CP-A vs. CP-C: p = 0.001 and CP-B vs. CP-C: p = 0.005). CONCLUSIONS HCC development and mortality in patients with CP-B were not different from those with CP-A. On the other hand, in patients with CP-C, the development of HCC and decompensated cirrhotic events requiring hospital admission, and death were frequent. TRIAL REGISTRATION University Hospital Medical Information Network (UMIN000036150).
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Affiliation(s)
- Yuki Tahata
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hayato Hikita
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Satoshi Mochida
- Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama, Japan
| | - Nobuyuki Enomoto
- First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Norifumi Kawada
- Department of Hepatology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Masayuki Kurosaki
- Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - Akio Ido
- Digestive and Lifestyle Diseases, Department of Human and Environmental Sciences, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan
| | - Daiki Miki
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hitoshi Yoshiji
- Department of Gastroenterology, Nara Medical University, Nara, Japan
| | - Yasuhiro Takikawa
- Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
| | - Ryotaro Sakamori
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Nagasaki University of Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoya Kato
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshiyuki Ueno
- Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Hiroshi Yatsuhashi
- Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryosuke Tateishi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Goki Suda
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Taro Takami
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yasuhiro Asahina
- Department of Gastroenterology and Hepatology, Department of Liver Disease Control, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kentaro Matsuura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Taro Yamashita
- Department of General Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Tatsuya Kanto
- The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
| | - Norio Akuta
- Department of Hepatology, Toranomon Hospital, Tokyo, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata, Japan
| | - Masahito Shimizu
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Satoshi Sobue
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Tomokatsu Miyaki
- Department of Gastroenterology, Toyokawa City Hospital, Toyokawa, Japan
| | - Akihiro Moriuchi
- Department of Gastroenterology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Ryoko Yamada
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Takahiro Kodama
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tomohide Tatsumi
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tomomi Yamada
- Department of Medical Innovation, Osaka University Hospital, Suita, Osaka, Japan
| | - Tetsuo Takehara
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
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Iio E, Matsuura K, Shimada N, Atsukawa M, Itokawa N, Abe H, Kato K, Takaguchi K, Senoh T, Eguchi Y, Nomura H, Yoshizawa K, Kang JH, Matsui T, Hirashima N, Kusakabe A, Miyaki T, Fujiwara K, Matsunami K, Tsutsumi S, Iwakiri K, Tanaka Y. TLL1 variant associated with development of hepatocellular carcinoma after eradication of hepatitis C virus by interferon-free therapy. J Gastroenterol 2019; 54:339-346. [PMID: 30382363 DOI: 10.1007/s00535-018-1526-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 08/29/2018] [Accepted: 10/24/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND The aim of this study is to ascertain whether the TLL1 variant at rs17047200 is associated with the development of HCC after achieving sustained virological response (SVR) by interferon (IFN)-free therapy for chronic hepatitis C (CHC). METHODS A total of 1029 Japanese CHC patients with the following inclusion criteria were enrolled: (i) achieved SVR by IFN-free therapy, (ii) followed up at least 1 year from the end of treatment (EOT) (median 104 weeks), (iii) no history of hepatocellular carcinoma (HCC) by 1 year from the EOT. RESULTS Nineteen patients developed HCC (HCC group) and 1010 did not (non-HCC group). The proportion of rs17047200 AT/TT was significantly higher in the HCC group than the non-HCC group (47.4% vs. 20.1%, P = 0.008). Multivariate analysis showed that higher levels of α-fetoprotein, FIB-4 and rs17047200 AT/TT were independent risk factors for developing HCC (HR = 3.22, P = 0.021 for α-fetoprotein > 4.6 ng/ml; HR = 3.89, P = 0.036 for FIB-4 > 2.67; HR = 2.80, P = 0.026 for rs17047200 AT/TT). Cumulative incidence of HCC was significantly higher in patients with rs17047200 AT/TT than in those with AA (P = 0.006). Comparing clinical characteristics according to the TLL1 genotypes, patients with rs17047200 AT/TT had significantly lower platelet counts and higher levels of FIB-4 than those with AA (P = 0.011 and 0.032, respectively). CONCLUSIONS The TLL1 variant was independently associated with HCC development after HCV eradication by IFN-free regimen. It might be involved in hepatic fibrogenesis and thereby carcinogenesis.
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Affiliation(s)
- Etsuko Iio
- Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Kentaro Matsuura
- Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | | | | | - Norio Itokawa
- Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Hiroshi Abe
- Shinmatsudo Central General Hospital, Chiba, Japan
| | - Keizo Kato
- Shinmatsudo Central General Hospital, Chiba, Japan
| | | | | | | | | | | | | | | | - Noboru Hirashima
- National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | | | | | - Kei Fujiwara
- Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Kayoko Matsunami
- Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Susumu Tsutsumi
- Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Yasuhito Tanaka
- Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan.
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Matsumoto K, Futamura M, Miyaki T, Iwasa T, Imoto S, Doi M, Tokunaga S, Aogi K, Yoshimura K, Takano T. A phase 2 study evaluating dose dense AC (ddAC) followed by dose dense paclitaxel (ddP) supported by 3.6 mg peg-filgrastim (ddAC-ddP3.6) for patients (pts) with primary breast cancer (PBC) in Japan -WJOG9016B-. Breast 2019. [DOI: 10.1016/s0960-9776(19)30103-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Nakamura R, Yamamoto N, Miyaki T, Itami M. Abstract P3-03-22: Prognostic impact of axillary lymph node status after neoadjuvant chemotherapy for patients with breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-03-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND:
Patients were stratified by final pathological axillary status: ypN0, ypN1, pN0 or pN1.
The prognostic impact of lymph node involvement after neoadjuvant chemotherapy (NAC) for breast cancer is not straightforward. The aim of this study was to compare overall survival (OS) between pathologically
node-positive T1,T2 T3 breast cancer patients treated with NAC, with ypN0 or ypN1 and those treated without NAC with pN0 or pN1.
METHODS:
A total of 3903 consecutive patients with operable breast cancer were prospectively identified at our institution between April 2006 and December 2017. Patients with suspicious axillary LN of breast cancer were assessed using preoperative imaging, underwent fine-needle aspiration cytology or core needle biopsy.
The patients in this study were divided into four groups as follows: the ER(+), the ER(+)/HER2(+) , the HER2(+) and the Triple negative (TN) group.
We evaluate the prognostic impact of the ypN0, ypN1 (with one to three positive lymph nodes after NAC), pN0 and pN1 with no NAC.
The main outcome measures DFS and OS were analyzed using Kaplan–Meier survival analysis.
Result
A number of 270 and 3633 patients were included for NAC and non NAC, respectively. Pathologic nodal status was ypN0 in 58%, ypN1 in 42% for NAC and pN0 in 76%, pN1 in 24% of patients for non NAC.
Overall, 10-year DFS and OS was 81%, 93% in ypN0, 67%, 80% in ypN1, in 90%, 97%, in pN0 and 83%, 94% in pN1 (p <0.001).
In subgroup analysis, 10-year DFS of ypN0, ypN1, pN0 and pN1 was 86%,77%,95% and 80% in the ER group, 91%,56%,93%,and 76% in the ER/HER2 group,89%,55%,91% and 80% in the HER2 group, 85%,59%,92% and 80% in the TN group.
10 years DFS for the ER group were significantly different between ypN0 and pN0 (HR, 2.42 (1.03–4.86, p = 0.04) but were not significantly different between ypN0 and pN0 for the ER/HER2 group (HR 3.58 (0.2–6.88, p = 0.66), for the HER2 group (HR 2.6 (0.78–7.65, p = 0.10) and for the TN group (HR 1.22(0.56–2.38, p = 0.58), respectively).
In all group, DFS for ypN1 was inferior to ypN0.
Conclusions
In the ER group treated with NAC, DFS for ypN0 be inferior to pN0 with adjuvant treatment. In the HER2, the ERHER2 and the TN group treated with NAC, ypN0 is similar to pN0 with adjuvant chemotherapy.
Axillary nodal status ypN1 in each subgroup is associated with a less favorable prognosis compared to ypN0. In conclusion, the HER2 or TN group is highest for predicting ypN0, shown to be most prognostic of long-term survival similar to the patients with pN0. They could be omitted the axillary dissection.
Citation Format: Nakamura R, Yamamoto N, Miyaki T, Itami M. Prognostic impact of axillary lymph node status after neoadjuvant chemotherapy for patients with breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-22.
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Affiliation(s)
| | | | - T Miyaki
- Chiba Cancer Center, Chiba, Japan
| | - M Itami
- Chiba Cancer Center, Chiba, Japan
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Nakamura R, Yamamoto N, Miyaki T. Impact on disease-free survival (DFS) of the surgical waiting time (SWT) for patients (Pts) with early breast cancer (BC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.249] [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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Nakamura R, Yamamoto N, Miyaki T, Teranaka R, Itami M. Abstract P3-02-01: Impact of prognoses on the discrepancies in histological grade of breast cancer between core needle biopsy and surgical excision specimen. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-02-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: The high reliability and utility of core needle biopsy (CNB) have been previously described. Histological grade in CNB is one of the main determinants of the need for neoadjuvant systemic therapy. Our aim in this study was to clarify the host and histopathological factors influencing the discrepancies in histological grade (HG) between CNB and surgically excision specimen (SES).
Methods: A total of 1342 operable invasive breast carcinoma biopsies were assessed and compared with surgical specimens in our hospital. Patients who required neoadjuvat chemotherapy were excluded. Histological grade (tubule formation, nuclear pleomorphism and mitotic index) was assessed between paired CNB and SET samples.
ER and PgR status were determined using immunohistochemistry(IHC). HER2 status was determined using IHC and scored from 0 to 3+. Fluorescence in-situ hybridization analysis was carried out in HER2 2+ cases. The cut off point for ER and PgR positivity was set at 1%.
Results: The clinicopathological characteristics of tumors showed in
Clinico-pathological characteristics of 1342 patients and tumors by discordance group between CNB and SES for histological grade LL groupHH groupHL groupLLHgroupp valupTT1a31 (94%)0(0%)2(6%)0(0%)0.001 T1b162(92%)4(2%)1(1%)10(6%) T1c421(79%)43(8%)14(3%)52(10%) T2335(68%)63(13%)10(2%)82(17%) T352(68%)8(10%)2(3%)15(19%) T425(71%)4(11%)0(0%)6(17%) pNnegtive668(78%)73(9%)13(2%)101(12%)0.08 positive358(74%)49(10%)16(3%)64(13%) lynegative600(79%)6(4(8%)14(2%)85(11%)0.18 positive426(74%)58(10%)15(3%)80(14%) vnegative799(80%)81(5%)23(2%)98(10%)0.001 positive227(67%)41(12%)6(2%)67(20%) ER/PgRmegative82(33%)83(33%)13(5%)72(29%)0.001 positive944(86%)39(4%)16(1%)93(9%) HER2negative932(80%)86(7%)22(2%)121(10%)0.001 positive94(52%)36(20%)7(4%)44(24%) CNB;core needle biopsy, SES;surgical excision specimen, HH group (high grade in CNB/high grade in SES), LL group (low grade in CNB/low grade in SES), HL group (high grade in CNB/low grade in SES) and LH group (low grade in CNB/high grade in SES)
. The concordance rates of HG of luminal type, HER2 type luminal HER2 type and Triple negative type in CNB and SES were 91%, 64%, 73% and 66%, respectively (p>0.001). Factors of discrepancy were T size, vessel invasion and ER/HER2 status for HG. The discrepancy factors were assessed with univariate and multivariate analysis. The underestimate and overestimate rates of HG in CNB compared to SES were7.5% and 1.3% in ER(+)HER2(-) type, 32%, and 3.1% in HER2 type, 22% and 4.3% in ER(+) HER2(+) type and 29% and 5.5% in Triple negative type(TN), respectively. The concordance rates of tubule formation, nuclear pleomorphism and mitotic index in CNB and SES were 81%, 97% and 93% in luminal type, 85%, 66% and 33% in HER2 type, 77%, 87% and 83% in luminal HER2 type and 82%, 67% and 73% in TN type respectively.
Conclusions: Using the largest known dataset to date of paired samples from a single institution, we evaluated the accuracy of CNB and the discrepancy factors between CNB and SES in breast cancer patients.
We conclude that CNB for histological grade assessment in patients with HER2 positive or TN breast cancer before neoadjuvant treatment should be used with caution.
Citation Format: Nakamura R, Yamamoto N, Miyaki T, Teranaka R, Itami M. Impact of prognoses on the discrepancies in histological grade of breast cancer between core needle biopsy and surgical excision specimen [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-02-01.
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Affiliation(s)
- R Nakamura
- Chiba Cancer Center, Chiba, Japan; Chiba Cancer Center, Japan
| | - N Yamamoto
- Chiba Cancer Center, Chiba, Japan; Chiba Cancer Center, Japan
| | - T Miyaki
- Chiba Cancer Center, Chiba, Japan; Chiba Cancer Center, Japan
| | - R Teranaka
- Chiba Cancer Center, Chiba, Japan; Chiba Cancer Center, Japan
| | - M Itami
- Chiba Cancer Center, Chiba, Japan; Chiba Cancer Center, Japan
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11
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Iwata H, Masuda N, Kim SB, Inoue K, Rai Y, Fujita T, Shen ZZ, Chiu JW, Ohtani S, Takahashi M, Yamamoto N, Miyaki T, Sun Q, Yen-Shen L, Xu B, Yap YS, Bustam AZ, Lee JR, Zhang B, Bryce R, Chan A. Abstract P1-13-11: Neratinib in the extended adjuvant treatment of patients from Asia with early-stage HER2+ breast cancer after trastuzumab-based therapy: Exploratory analyses from the phase III ExteNET trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-13-11] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Current breast cancer knowledge is based largely on studies conducted in western populations. Their findings may not be generalizable to Asian women because of ethnic, genetic and lifestyle differences. Neratinib (N) is an irreversible tyrosine kinase inhibitor of HER1, 2 and 4. The international, randomized, placebo (P)-controlled phase III ExteNET trial showed that 1 year (yr) of N after trastuzumab (T)-based adjuvant therapy significantly improved 2-yr invasive disease-free survival (iDFS) in patients (pts) with early-stage HER2+ breast cancer (HR 0.67; 95% CI 0.50–0.91; p=0.009) [Chan et al. Lancet Oncol 2016]. The significant iDFS benefit with N was shown to be durable after 5 yrs' follow-up (HR 0.73; 95% CI 0.57-0.92; p=0.008) [Martin et al. ESMO 2017]. We report efficacy and safety findings from pts enrolled from Asian centers (China, Hong Kong, Japan, Korea, Malaysia, Singapore, and Taiwan) on the ExteNET trial to better characterize the effects of N in Asian women.
Methods: Pts with early-stage HER2+ breast cancer were randomly assigned to oral N 240 mg/day or P for 1 yr after standard primary therapy and T-based adjuvant therapy. Antidiarrheal prophylaxis was not required by protocol. Data concerning disease recurrences were collected prospectively during yr 1-2 post-randomization, and from medical records during yr 3–5 post-randomization. Primary endpoint: iDFS. HR (95% CI) estimated using Cox proportional-hazards models stratified by nodal status, hormone-receptor status and prior T regimen. Data cut-off: 2-yr analysis, July 2014; 5-yr analysis, March 2017. Clinicaltrials.gov:NCT00878709.
Results: Of 2840 randomized pts (N, n=1420; P, n=1420), 341 (12%) were enrolled from Asian centers (N, n=165; P, n=176). Baseline characteristics: median age 53 yr; hormone receptor-positive 48%. Median treatment duration was similar in both groups (N, 351 days; P, 352 days). iDFS events in Asian vs ITT populations are shown in the Table.
Primary 2-yr analysisa5-yr analysis NPNPAsian population, n165176165176iDFS events, n10151222HR (95% CI)b0.71 (0.31-1.57)0.54 (0.26-1.08)P-value (2-sided)0.4040.085ITT population, n1420142014201420iDFS events, n67106116163HR (95% CI)b0.66 (0.49-0.90)0.73 (0.57-0.92)P-value (2-sided)0.0080.008a. Primary study endpoint; b. Neratinib vs placebo
The incidence of grade 3/4 diarrhea with N was slightly higher in Asian pts (46.1% vs ITT, 39.8%). All other grade 3/4 adverse events with N were rare among Asian pts (elevated ALT, mucosal inflammation, 2 pts each; other events, 1 pt each). Compliance with N in Asian pts was also improved (71% vs ITT, 61%).
Conclusions: In Asian pts enrolled into ExteNET, compliance with N was better and the magnitude of N effect was similar or greater that that observed in the ITT population. Although N-related grade 3/4 diarrhea was more common in Asian pts than in the ITT population, all other grade 3/4 events were rare. Despite small pt numbers, our analyses suggest that the findings from ExteNET are applicable to Asian pts, and support the conclusion that N reduces disease recurrences in Asian pts with early-stage HER2+ breast cancer after T-based adjuvant therapy.
Citation Format: Iwata H, Masuda N, Kim S-B, Inoue K, Rai Y, Fujita T, Shen Z-Z, Chiu JW, Ohtani S, Takahashi M, Yamamoto N, Miyaki T, Sun Q, Yen-Shen L, Xu B, Yap YS, Bustam AZ, Lee JR, Zhang B, Bryce R, Chan A. Neratinib in the extended adjuvant treatment of patients from Asia with early-stage HER2+ breast cancer after trastuzumab-based therapy: Exploratory analyses from the phase III ExteNET trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-13-11.
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Affiliation(s)
- H Iwata
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - N Masuda
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - S-B Kim
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - K Inoue
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - Y Rai
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - T Fujita
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - Z-Z Shen
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - JW Chiu
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - S Ohtani
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - M Takahashi
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - N Yamamoto
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - T Miyaki
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - Q Sun
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - L Yen-Shen
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - B Xu
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - YS Yap
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - AZ Bustam
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - JR Lee
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - B Zhang
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - R Bryce
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
| | - A Chan
- Aichi Cancer Center, Nagoya, Japan; Osaka National Hospital, Osaka, Japan; Asan Medical Centre; Saitama Cancer Center; Hakuaikai Sagara Hospital, Japan; Jichi Medical University Hospital, Japan; Shanghai Cancer Center; Queen Mary Hospital, Hong Kong; Hiroshima City Hiroshima Citizens Hospital, Japan; Hokkaido Cancer Center, Japan; Chiba Cancer Center, Japan; Peking Union Medical College Hospital, China; National Taiwan University Hospital, Taiwan; Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Cancer Centre Singapore, Singapore; University Malaya Medical Centre, Malaysia; Puma Biotechnology Inc; Breast Cancer Research Centre-Western Australia and Curtin University
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12
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Jinno N, Naitoh I, Nagura Y, Fujioka K, Mizuno Y, Momose J, Ooyama M, Hayashi K, Miyaki T, Nakamura M, Joh T. Percutaneous Transhepatic Self-expanding Metallic Stent Placement for the Treatment of Malignant Afferent Loop Obstruction. Intern Med 2018; 57:333-337. [PMID: 29093418 PMCID: PMC5827311 DOI: 10.2169/internalmedicine.9382-17] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
We report the case of a 71-year-old man with afferent loop obstruction (ALO) after Roux-en-Y reconstruction due to gastric cancer. Computed tomography showed a distended afferent loop and a dilatated bile duct. We could not reach the stricture site in the afferent loop using a gastroscope. We performed percutaneous transhepatic biliary drainage (PTBD) and placed a self-expanding metallic stent (SEMS) in the duodenal stricture through the PTBD route. Although an endoscopic approach is preferable, when PTBD can be performed, percutaneous transhepatic SEMS placement might be an alternative option for treating ALO in cases in which it is not possible to reach the site of stenosis with an endoscope.
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Affiliation(s)
- Naruomi Jinno
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
- Department of Gastroenterology, Toyokawa Municipal Hospital, Japan
| | - Itaru Naitoh
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Yoshihito Nagura
- Department of Gastroenterology, Toyokawa Municipal Hospital, Japan
| | | | - Yusuke Mizuno
- Department of Gastroenterology, Nagoya Daini Red Cross Hospital, Japan
| | - Junko Momose
- Department of Gastroenterology, Toyokawa Municipal Hospital, Japan
| | - Makoto Ooyama
- Department of Gastroenterology, Toyokawa Municipal Hospital, Japan
| | - Kazuki Hayashi
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Tomokatsu Miyaki
- Department of Gastroenterology, Toyokawa Municipal Hospital, Japan
| | - Makoto Nakamura
- Department of Gastroenterology, Toyokawa Municipal Hospital, Japan
| | - Takashi Joh
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
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13
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Iio E, Shimada N, Takaguchi K, Senoh T, Eguchi Y, Atsukawa M, Tsubota A, Abe H, Kato K, Kusakabe A, Miyaki T, Matsuura K, Matsunami K, Shinkai N, Fujiwara K, Nojiri S, Tanaka Y. Clinical evaluation of sofosbuvir/ledipasvir in patients with chronic hepatitis C genotype 1 with and without prior daclatasvir/asunaprevir therapy. Hepatol Res 2017; 47:1308-1316. [PMID: 28332272 DOI: 10.1111/hepr.12898] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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: 01/23/2017] [Revised: 03/02/2017] [Accepted: 03/20/2017] [Indexed: 12/17/2022]
Abstract
AIM This study explored treatment outcomes of sofosbuvir (SOF)/ledipasvir (LDV) therapy for chronic hepatitis C patients with and without prior daclatasvir (DCV)/asunaprevir (ASV) therapy. METHODS Overall, 530 Japanese patients who were infected with hepatitis C virus genotype 1 received SOF/LDV therapy for 12 weeks, and resistance-associated variants (RAVs) in the hepatitis C virus non-structural protein (NS)5A and NS5B regions were assessed at baseline and virological relapse by direct sequencing. RESULTS Sustained virological response (SVR) rates did not significantly differ between patients with and without NS5A Y93H/N (94.2% [113/120] vs. 97.7% [345/353]), but the SVR rate was significantly lower in patients with prior DCV/ASV therapy compared to those without (69.2% [18/26] vs. 98.4% [496/504], P < 0.001). Among 26 patients with prior DCV/ASV therapy, the prevalence of NS5A multi-RAVs (≥2) was similar between responders and non-responders (61% [11/18] vs. 75% [5/8]), but all patients without RAVs achieved SVR. Multivariate analysis showed that prior DCV/ASV therapy and history of hepatocellular carcinoma were independently associated with treatment failure (odds ratio, 37.55; 95% confidence interval, 10.78-130.76; P < 0.001 for prior DCV/ASV therapy; odds ratio, 4.42; 95% confidence interval, 1.09-18.04; P = 0.03 for the history of HCC). All SOF/LDV failure patients (n = 8) with prior DCV/ASV treatment had two or more factors of cirrhosis, IL28B unfavorable genotype, and baseline NS5A multi-RAVs. The multiple NS5A RAVs had increased but NS5B substitutions, C316N/A207T/A218S or L159F, had not changed at the time of relapse. CONCLUSIONS Prior DCV/ASV therapy is associated with failure of SOF/LDV therapy due to multiple RAVs.
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Affiliation(s)
- Etsuko Iio
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | | | | | | | | | | | - Hiroshi Abe
- Jikei University School of Medicine, Katsushika Medical Center, Tokyo, Japan
| | - Keizo Kato
- Jikei University School of Medicine, Tokyo, Japan.,Shinmatsudo Central General Hospital, Matsudo, Japan
| | | | | | - Kentaro Matsuura
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kayoko Matsunami
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Noboru Shinkai
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kei Fujiwara
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shunsuke Nojiri
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yasuhito Tanaka
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Mizoshita T, Katano T, Tanida S, Hirano A, Miyaki T, Ozeki K, Suzuki Y, Sugimura N, Kataoka H, Joh T. Prospective comparison of preference and efficacy of adalimumab and infliximab for treating ulcerative colitis naive to antitumor necrosis factor therapy. Medicine (Baltimore) 2017; 96:e7800. [PMID: 28796080 PMCID: PMC5556246 DOI: 10.1097/md.0000000000007800] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
There have been few reports on 2 tumor necrosis factor alpha inhibitors, infliximab and adalimumab, with respect to patient preference and efficacy in ulcerative colitis (UC).We used questionnaires to evaluate the preference and reasons for drug choice between infliximab and adalimumab in UC patients naive to antitumor necrosis factor alpha therapy. We also analyzed the efficacy of infliximab and adalimumab prospectively and endoscopically before treatment and at 14 and 54 weeks.Of the 25 UC patients, infliximab and adalimumab were chosen by 10 (40%) and 15 (60%), respectively. Patients who favored infliximab considered "fear of syringes" (7/10, 70%) as the most important influencing factor, whereas patients who favored adalimumab considered "ease of administration" (10/15, 66.7%) and "time required for therapy" (10/15, 66.7%) as the most important factors. There were no statistical differences in remission induction and maintenance between the infliximab and adalimumab groups with regard to response, remission, mucosal healing, steroid-free, and steroid-free remission rates at weeks 14 and 54.The efficacy of adalimumab in remission induction and maintenance was equivalent to that of infliximab in UC patients naive to antitumor necrosis factor alpha therapy in this prospective study, but more patients preferred adalimumab.
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Affiliation(s)
- Tsutomu Mizoshita
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences
| | - Takahito Katano
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences
| | - Satoshi Tanida
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences
| | - Atsuyuki Hirano
- Department of Gastroenterology, Nagoya City West Medical Center
| | | | - Keiji Ozeki
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences
| | - Yuka Suzuki
- Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital
| | - Naomi Sugimura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences
- Department of Gastroenterology, Nagoya Memorial Hospital, Nagoya, Japan
| | - Hiromi Kataoka
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences
| | - Takashi Joh
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences
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15
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Iio E, Shimada N, Abe H, Atsukawa M, Yoshizawa K, Takaguchi K, Eguchi Y, Nomura H, Kuramitsu T, Kang JH, Matsui T, Hirashima N, Tsubota A, Kusakabe A, Hasegawa I, Miyaki T, Shinkai N, Fujiwara K, Nojiri S, Tanaka Y. Efficacy of daclatasvir/asunaprevir according to resistance-associated variants in chronic hepatitis C with genotype 1. J Gastroenterol 2017; 52:94-103. [PMID: 27236547 DOI: 10.1007/s00535-016-1225-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [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: 03/11/2016] [Accepted: 05/11/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND The present study explored the treatment outcome of daclatasvir (DCV) and asunaprevir (ASV) therapy combining oral direct-acting antiviral agents (DAAs) for chronic hepatitis C (HCV) including liver cirrhosis according to resistance-associated variants (RAVs) in NS3/NS5A region. METHODS Overall, 641 patients enrolled in Japan with HCV-1b received DCV and ASV for 24 weeks. Baseline drug-resistant mutations L31F/I/M/V, Q54H, P58S, A92K, and Y93H in the HCV NS5A region and V36A, T54A/S, Q80K/L/R, R155K/T/Q, A156S/V/T, and D168A/E/H/T/V in the HCV NS3/4A region were assessed by direct sequencing. RESULTS Overall, 86.9 % (543/625) of patients had SVR12, which was significantly higher in NS5A 93Y (wild) (88.3 %) compared with NS5A 93H at baseline (48.0 %), indicating the SVR12 rate was significantly lower in patients with 93H mutations. Additionally, 66.7 % (18/27) of patients with prior triple therapy including simeprevir (SMV) failure had virological failure. The virological failure rate of DCV/ASV therapy after SMV failure was significantly higher in those with preexisting NS3/4A 168 substitutions compared with without substitutions at baseline [84.2 % (16/19) vs. 28.6 % (2/7), p = 0.014]. The number of patients with multiple RAVs or deletions in NS5A increased from 0 to 85 % in failed patients. Alanine aminotransferase elevation was a frequent adverse event causing discontinuation of DCV/ASV therapy, although 87.5 % (14/16) patients achieved SVR12, subsequently. CONCLUSIONS History of SMV therapy and pre-existing NS5A Y93H were associated with virological failure of DCV/ASV therapy, resulting in the emergence of multiple RAVs. Patients with RAVs at baseline should be assessed to optimize future DAA therapies.
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Affiliation(s)
- Etsuko Iio
- Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, Japan
| | | | - Hiroshi Abe
- Jikei University School of Medicine Katsushika Medical Center, Tokyo, Japan
| | | | | | | | | | | | | | | | | | - Noboru Hirashima
- National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | | | | | - Izumi Hasegawa
- Japan Community Health Care Organization, Chukyo Hospital, Nagoya, Japan
| | | | - Noboru Shinkai
- Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, Japan
| | - Kei Fujiwara
- Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, Japan
| | - Shunsuke Nojiri
- Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, Japan
| | - Yasuhito Tanaka
- Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, Japan.
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Nakamura R, Yamamoto N, Fujisaki K, Teranaka R, Miyaki T, Ikebe D. Ultrasound-guided core needle biopsy could replace sentinel lymph nodes biopsy for patients with suspicious node positive breast cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw364.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Wang X, Tsujimura H, Miyaki T, Kumagai K. 293P Primary breast lymphoma: a report of 17 cases from a single institute. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv526.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Miyaki T, Nakamura R, Shiina N, Wang X, Tsujimura H, Kumagai K, Yamamoto N. 109P Breast cancer patients with bone marrow metastases: a single institution review. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv519.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Nakamura R, Yamamoto N, Oukubo Y, Miyaki T, Itami M. P340 Sentinel lymph node biopsy can be safely performed in patients with suspicious lymph node. Breast 2015. [DOI: 10.1016/s0960-9776(15)70370-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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20
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Iijima S, Matsuura K, Watanabe T, Onomoto K, Fujita T, Ito K, Iio E, Miyaki T, Fujiwara K, Shinkai N, Kusakabe A, Endo M, Nojiri S, Joh T, Tanaka Y. Influence of genes suppressing interferon effects in peripheral blood mononuclear cells during triple antiviral therapy for chronic hepatitis C. PLoS One 2015; 10:e0118000. [PMID: 25706116 PMCID: PMC4338062 DOI: 10.1371/journal.pone.0118000] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/03/2015] [Indexed: 01/16/2023] Open
Abstract
The levels of expression of interferon-stimulated genes (ISGs) in liver are associated with response to treatment with pegylated interferon (PEG-IFN) plus ribavirin (RBV). However, associations between the responses of ISGs to IFN-based therapy and treatment efficacy or interleukin-28B (IL28B) genotype have not yet been determined. Therefore, we investigated the early responses of ISGs and interferon-lambdas (IFN-λs) in peripheral blood mononuclear cells (PBMCs) during PEG-IFN/RBV plus NS3/4 protease inhibitor (PI) therapy. We prospectively enrolled 50 chronic hepatitis C patients with HCV genotype 1, and collected PBMCs at baseline, 8 and 24 h after the initial administration of PEG-IFN/RBV/PI. Levels of mRNAs for selected ISGs and IFN-λs were evaluated by real-time PCR. All 31 patients with a favorable IL28B genotype and 13 of 19 with an unfavorable genotype achieved sustained virological responses (SVR). Levels of mRNA for A20, SOCS1, and SOCS3, known to suppress antiviral activity by interfering with the IFN signaling pathway, as well as IRF1 were significantly higher at 8 h in patients with an unfavorable IL28B genotype than in those with a favorable one (P = 0.007, 0.026, 0.0004, 0.0006, respectively), especially in the non-SVR group. Particularly, the fold-change of IRF1 at 8 h relative to baseline was significantly higher in non-SVR than in SVR cases with an unfavorable IL28B genotype (P = 0.035). In conclusion, levels of several mRNAs of genes suppressing antiviral activity in PBMCs during PEG-IFN/RBV/PI differed according to IL28B genotypes, paralleling treatment efficacy.
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Affiliation(s)
- Sayuki Iijima
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kentaro Matsuura
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Infectious Disease and Immunogenetics Section, Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, United States of America
| | - Tsunamasa Watanabe
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Koji Onomoto
- Laboratory of Molecular Genetics, Institute for Virus Research, Kyoto University, Kyoto, Japan
| | - Takashi Fujita
- Laboratory of Molecular Genetics, Institute for Virus Research, Kyoto University, Kyoto, Japan
| | - Kyoko Ito
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Etsuko Iio
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tomokatsu Miyaki
- Division of Internal Medicine, Toyokawa City Hospital, Toyokawa, Japan
| | - Kei Fujiwara
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Noboru Shinkai
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Atsunori Kusakabe
- Division of Gastroenterology, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Mio Endo
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shunsuke Nojiri
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takashi Joh
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yasuhito Tanaka
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Matsuura K, Watanabe T, Iijima S, Murakami S, Fujiwara K, Orito E, Iio E, Endo M, Kusakabe A, Shinkai N, Miyaki T, Nojiri S, Joh T, Tanaka Y. Serum interferon-gamma-inducible protein-10 concentrations and IL28B genotype associated with responses to pegylated interferon plus ribavirin with and without telaprevir for chronic hepatitis C. Hepatol Res 2014; 44:1208-1216. [PMID: 24372894 DOI: 10.1111/hepr.12294] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 12/12/2013] [Accepted: 12/16/2013] [Indexed: 02/06/2023]
Abstract
AIM Several studies have shown that high pretreatment concentrations of serum interferon-γ-inducible protein-10 (IP-10) are correlated with non-response to pegylated interferon (PEG-IFN) plus ribavirin (RBV) for chronic hepatitis C (CHC). However, there are few reports on their effect on the Asian population. METHODS We enrolled 104 Japanese genotype 1 CHC individuals treated with PEG-IFN/RBV and 45 with PEG-IFN/RBV/telaprevir, and evaluated the impact of pretreatment serum IP-10 concentrations on their virological responses. RESULTS The pretreatment serum IP-10 concentrations were not correlated with IL28B genotype. The receiver-operator curve analysis determined the cut-off value of IP-10 for predicting a sustained virological response (SVR) as 300 pg/mL. In multivariate analysis, the IL28B favorable genotype and IP-10 concentration of less than 300 pg/mL were independent factors for predicting SVR. In a subgroup of patients with the IL28B favorable genotype, the SVR rate was higher in the patients with IP-10 of less than 300 than in those with 300 pg/mL or more, whereas no patient with the IL28B unfavorable genotype and IP-10 of 300 pg/mL or more achieved SVR. Among the patients treated with PEG-IFN/RBV/telaprevir, low pretreatment concentrations of serum IP-10 were associated with a very rapid virological response, defined as undetectable HCV RNA at week 2 after the start of therapy. CONCLUSION Pretreatment serum IP-10 concentrations are associated with treatment efficacy in PEG-IFN/RBV and with early viral kinetics of hepatitis C virus in PEG-IFN/RBV/telaprevir therapy.
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Affiliation(s)
- Kentaro Matsuura
- Department of Virology, Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Infectious Disease and Immunogenetics Section, Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
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Miyaki T, Tsujimura H, Kumagai K, Nakamura R, Yoshii A, Okubo Y, Iwase T, Nakagawa A, Yamamoto N. Does Administration Order of Sequential Fec- Docetaxel As Adjuvant Chemotherapy for Breast Cancer Affect on the Toxicities? : a Retrospective Analysis from a Single-Center. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu327.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kusakabe A, Tanaka Y, Iio E, Murakami S, Matsuura K, Shinkai N, Miyaki T, Fujiwara K, Nojiri S, Orito E, Joh T. A case of a HBV carrier with HDV superinfection treated by PEG-IFN. Kanzo 2014; 55:653-660. [DOI: 10.2957/kanzo.55.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
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Nojiri S, Kusakabe A, Fujiwara K, Shinkai N, Matsuura K, Iio E, Miyaki T, Joh T. Noninvasive evaluation of hepatic fibrosis in hepatitis C virus-infected patients using ethoxybenzyl-magnetic resonance imaging. J Gastroenterol Hepatol 2013; 28:1032-9. [PMID: 23432660 DOI: 10.1111/jgh.12181] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Liver biopsy is the gold standard test to determine the grade of fibrosis, but there are associated problems. Because gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid is secreted partially in hepatocytes and bile, it is possible that ethoxybenzyl-magnetic resonance imaging (EOB-MRI) correlates with liver function and liver fibrosis. The aim of this study was to compare the fibrosis seen in liver biopsy samples to the signal intensity of the hepatobiliary phase measured on EOB-MRI in hepatitis C virus (HCV)-infected patients. METHODS Two hundred twenty-four (estimation 149, validation 75) HCV-infected patients with histologically proven liver tissue who underwent EOB-MRI were studied. Overall, fibrosis staging was 15/24/19/46/45 for F0/F1/F2/F3/F4, respectively. A 1.5-Tesla magnetic resonance system was used, and the regions of interest of the liver were measured. Four methods were used: (i) relative enhancement: (post-enhanced signal intensity [SI] - pre-enhanced intensity)/pre-enhanced intensity; (ii) liver-to-intervertebral disk ratio (LI): post-enhanced (liver SI/interdisc SI)/pre-enhanced (liver SI/inter disc SI); (iii) liver-to-muscle ratio: post-enhanced (liver SI/muscle SI)/pre-enhanced (liver SI/muscle SI); and (iv) liver-to-spleen ratio: post-enhanced (liver SI/spleen SI)/pre-enhanced (liver SI/spleen SI). RESULTS To discriminate F0-1 versus F2-4 or F0-2 versus F3-4 or F0-3 versus F4, LI at 25 min (LI25) had the highest area under receiver operating characteristic (0.88, 0.87, and 0.87, respectively) in these four methods and also in the validation set. CONCLUSION LI at 25 min seems to be a useful method to determine the staging of fibrosis as a non-invasive method in HCV-infected hepatitis or cirrhosis patients.
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Affiliation(s)
- Shunsuke Nojiri
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
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Kusakabe A, Nojiri S, Iio E, Matsuura K, Shinkai N, Miyaki T, Joh T. Case-control study of the RFA therapeutic effect of newly developed 4D US and conventional 2D US. J Med Ultrason (2001) 2013; 40:39-46. [PMID: 27276923 DOI: 10.1007/s10396-012-0388-1] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 06/09/2012] [Indexed: 01/21/2023]
Abstract
PURPOSE For radiofrequency ablation (RFA) therapy of hepatocellular carcinoma (HCC), accurate positioning of the inserted needle in the index tumor seems to be an important factor affecting therapeutic effect. In a case-control study, we compared the therapeutic effect of RFA using 4D and 2D ultrasonography (US) to evaluate whether 4D US is more effective. METHODS Twenty subjects treated with percutaneous RFA using 4D US (4D group) and 20 subjects using conventional 2D US (2D group), who were matched for age, sex, and HCC diameter, were enrolled in this study. Aplio XG was used as the US system and PVT-375MV as the newly developed 4D US probe. The therapeutic effect of RFA was classified into four grades (A-D: "Grade A" is "absolutely curative"). RESULTS In the 2D group, Grade A was achieved in 12 subjects (60 %). In contrast, Grade A was achieved in 19 subjects (95 %) in the 4D group. The proportion of cases in which Grade A was achieved was significantly higher in the 4D group (P < 0.01). CONCLUSIONS By using a 4D US device for RFA, more accurate insertion could be achieved and more effective therapy could be performed.
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Affiliation(s)
- Atsunori Kusakabe
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan
| | - Shunsuke Nojiri
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan.
| | - Etsuko Iio
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan
| | - Kentaro Matsuura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan
| | - Noboru Shinkai
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan
| | - Tomokatsu Miyaki
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan
| | - Takashi Joh
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan
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Nojiri S, Kusakabe A, Fujiwara K, Shinkai N, Matsuura K, Iio E, Miyaki T, Nomura T, Sobue S, Sano H, Hasegawa I, Ohno T, Takahashi Y, Orito E, Joh T. Clinical factors related to long-term administration of sorafenib in patients with hepatocellular carcinoma. Cancer Manag Res 2012; 4:423-9. [PMID: 23293537 PMCID: PMC3534393 DOI: 10.2147/cmar.s38684] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Sorafenib has been approved in the indication of unresectable hepatocellular carcinoma, but there are many cases in which administration of the drug is discontinued due to severe side effects. In this study, we compared the characteristics of patients who continued and discontinued sorafenib. Methods Ninety-six patients (75 men and 21 women) were initiated on sorafenib from July 2009 through September 2011. The patient characteristics of interest included gender, age, etiology, Child-Pugh classification, treatment history and frequency, and levels of α-fetoprotein, des- gamma-carboxy prothrombin, aspartate amino acid transferase, and alanine aminotransferase. Duration of administration of sorafenib and reasons for its discontinuation were compared. Results Median overall survival was 11.8 months. Discontinuation of sorafenib within 90 days was identified as an independent prognostic factor for overall survival on multivariate analysis (P < 0.0001). Transarterial chemoembolization performed six times or more (P = 0.013) was also identified as an independent factor contributing to discontinuation of sorafenib within 90 days in multivariate analysis. Patients who received sorafenib for ≥90 days had significantly longer overall survival than those who discontinued it (P < 0.0001). Conclusion Prolonged treatment with sorafenib is an important factor in achieving extended overall survival. We recommend starting sorafenib before latent liver damage has occurred as a result of too many transarterial chemoembolization procedures.
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Affiliation(s)
- Shunsuke Nojiri
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya
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Watanabe T, Sugauchi F, Kusumoto S, Shinkai N, Iio E, Matsuura K, Kusakabe A, Miyaki T, Nojiri S, Tanaka Y. A case report of successful therapy with tenofovir for a multi-drug resistant chronic hepatitis B patient complicated with malignant lymphoma. Kanzo 2012; 53:35-41. [DOI: 10.2957/kanzo.53.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
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Nojiri S, Kusakabe A, Shinkai N, Matsuura K, Iio E, Miyaki T, Joh T. Factors influencing distant recurrence of hepatocellular carcinoma following combined radiofrequency ablation and transarterial chemoembolization therapy in patients with hepatitis C. Cancer Manag Res 2011; 3:267-72. [PMID: 21847355 PMCID: PMC3154966 DOI: 10.2147/cmr.s22073] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The purpose of this study was to clarify important risk factors for distant recurrence of hepatocellular carcinoma in patients positive for hepatitis C and without local recurrence. METHODS A total of 212 patients (145 males and 67 females) underwent radiofrequency ablation and transcatheter arterial embolization or transcatheter arterial chemoembolization at initial development of hepatocellular carcinoma. All patients were positive for hepatitis C. Child-Pugh classification was A in 115 and B in 97. The indication for radiofrequency ablation was the presence of up to three tumors ≤ 3 cm. The distant recurrence rate was analyzed using the Kaplan-Meier method and tested by Wilcoxon's method. RESULTS Cumulative distant recurrence rates at years 1, 3, and 5 were 19%, 62%, and 79%, respectively. On univariate analysis, a ≥ 3 cm tumor, ≥ 50 ng/mL α-fetoprotein level, and < 3.6 g/dL serum albumin level were significant risk factors for distant recurrence, but only a serum albumin level < 3.6 g/dL (P = 0.004) was identified as significant on multivariate analysis. In the group with a pretreatment albumin level ≥ 3.6 g/dL, the distant recurrence rate was compared between patients in whom the albumin level rose, remained unchanged, or decreased by < 0.3 g/dL, and those in whom the level decreased by ≥ 0.3 g/dL. The rate was significantly higher in the latter, with a one-year recurrence rate of 7% versus 15% (P = 0.04). CONCLUSION Distant recurrence was significantly decreased in patients with a high serum albumin level. Distant recurrence was more likely to occur in patients with a decreased albumin level, although the pretreatment level was high. Thus, strict follow-up after treatment for hepatocellular carcinoma is necessary in patients with low serum albumin levels.
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Affiliation(s)
- Shunsuke Nojiri
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Miyaki T, Nojiri S, Shinkai N, Kusakabe A, Matsuura K, Iio E, Takahashi S, Yan G, Ikeda K, Joh T. Pitavastatin inhibits hepatic steatosis and fibrosis in non-alcoholic steatohepatitis model rats. Hepatol Res 2011; 41:375-85. [PMID: 21276150 DOI: 10.1111/j.1872-034x.2010.00769.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [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: 12/13/2022]
Abstract
AIM Non-alcoholic steatohepatitis (NASH) may progress to liver cirrhosis, and NASH patients with liver cirrhosis are at risk of developing hepatocellular carcinoma. Statins, 3-hydroxy-3-methyglutaryl-coenzyme A reductase inhibitors, are well known to reduce low-density lipoprotein cholesterol and reduce the incidence of coronary heart disease and other major vascular events by anti-inflammatory and antifibrotic effects, and antiproliferative properties in colorectal cancers have also been reported. Recently, statins have been reported to improve hepatic steatosis; however, the effect on fibrosis is controversial. METHODS The effects of pitavastatin (one of the strongest statins) were examined using a choline-deficient L-amino acid-defined (CDAA) diet liver fibrosis model. RESULTS Pitavastatin significantly attenuated increases in serum aspartate aminotransferase, alanine aminotransferase, hepatic steatosis, oxidative stress, pre-neoplastic lesions (glutathione S-transferase placental form-positive lesions), expression of cytokines, such as tumor necrosis factor-α and transforming growth factor-β1, and the expression of tissue inhibitor of metalloproteinase-1, tissue inhibitor of metalloproteinase-2 and type I procollagen genes followed by attenuating fibrosis of the liver of CDAA-fed rats. CONCLUSION These results indicate that pitavastatin may inhibit steatosis, hepatic fibrosis and carcinogenesis in rat model of NASH.
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Affiliation(s)
- Tomokatsu Miyaki
- Departments of Gastroenterology and MetabolismExperimental Pathology and Tumor BiologyCell Biology and Anatomy, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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30
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Nojiri S, Nakao H, Sugauchi F, Miyaki T, Senda K, Sasaki M, Kataoka H, Kamiya T, Nakazawa T, Ohara H, Orito E, Joh T. Effect of ursodeoxycholic acid on serum liver enzymes and bile acid metabolism in chronic active hepatitis C virus infection. Hepatol Res 2009; 39:21-30. [PMID: 18721155 DOI: 10.1111/j.1872-034x.2008.00406.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM Many reports have revealed ursodeoxycholic acid (UDCA) to be effective against chronic hepatitis C virus (HCV). However, some cases resist this therapy and the mechanism of action remains unclear. In this study, UDCA was administered to patients with chronic HCV and the correlation between the bile acids of the biliary bile and serum and the drug efficacy was investigated. METHODS Fifteen patients were given 600 mg/day of UDCA for more than 24 weeks. The serum bile acid concentrations and biliary and serum bile acid were collected before and after 24 weeks of UDCA treatment, and composition determined by high-performance liquid chromatography. RESULTS The treatment was effective in nine cases (ALT decreased to less than twice the normal values 80 IU/L) and ineffective in six cases. There was no significant difference in the serum bile acid concentrations before and after UDCA treatment between the values of both cases. After UDCA treatment, the serum percentage of UDCA (effective, 62.5 +/- 2.0; ineffective, 53.5 +/- 2.5, (P = 0.02)) and the percentage of chenodeoxycholic acid (CDCA) showed no remarkable changes. In the biliary bile the percentage of CDCA (effective, 30.9 +/- 2.0; ineffective, 20.0 +/- 3.0, (P = 0.007)) and the percentage of UDCA showed no remarkable changes. CONCLUSION In the effective cases, the percentage of UDCA in the serum and the percentage of CDCA in biliary bile were significantly higher than in the ineffective cases. This indicates that, when effective, CDCA decreases in hepatocytes and this reduction contributes to hepatoprotection.
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Affiliation(s)
- Shunsuke Nojiri
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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31
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Yamamoto K, Iwata F, Nakamura A, Iwashima Y, Miyaki T, Yamada H, Kurachi M, Sato Y, Tsukada K, Takeuchi T, Joh T, Yokoyama Y, Itoh M. Tonsillar tuberculosis associated with pulmonary and laryngeal foci. Intern Med 2002; 41:664-6. [PMID: 12211539 DOI: 10.2169/internalmedicine.41.664] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 11/06/2022] Open
Abstract
Tonsillar tuberculosis is one of the uncommon forms of extrapulmonary tuberculosis. We report a case of tonsillar tuberculosis associated with pulmonary and laryngeal foci. A 23-year-old female was admitted for evaluation of hoarseness and difficulty in swallowing. Bilateral palatine tonsils were enlarged, and a tonsillectomy was performed. Since a histological study revealed tonsillar tuberculosis, antituberculous agents were administered. After the treatment the pulmonary lesions detected with chest computed tomography were improved, and her symptoms were relieved. The possibility of tonsillar tuberculosis should be considered when unexplained enlarged tonsil is observed in patients with pulmonary tuberculosis.
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Affiliation(s)
- Koji Yamamoto
- Department of Internal Medicine, NTT West Tokai Hospital, Nagoya
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32
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Dianou D, Miyaki T, Asakawa S, Morii H, Nagaoka K, Oyaizu H, Matsumoto S. Methanoculleus chikugoensis sp. nov., a novel methanogenic archaeon isolated from paddy field soil in Japan, and DNA-DNA hybridization among Methanoculleus species. Int J Syst Evol Microbiol 2001; 51:1663-1669. [PMID: 11594593 DOI: 10.1099/00207713-51-5-1663] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A strictly anaerobic, irregularly coccoid, methanogenic archaeon, strain MG62T (= JCM 10825T = DSM 13459T), was isolated from paddy field soil in Chikugo, Fukuoka, Japan. The cells stained gram-negative, were 1.0-2.0 microm in diameter, were lysed by SDS and hypotonic solutions and were flagellated. Motility was not observed. The strain was able to use H2/CO2, 2-propanol/CO2, formate, 2-butanol/CO2 and cyclopentanol/CO2 as substrates for methanogenesis, but did not utilize acetate, ethanol, methanol or methylamines. The optimum temperature and pH were 25-30 degrees C and 6.7-7.2. Analysis of lipid component parts (core lipids, phospholipid polar head groups and glycolipid sugar moieties) showed the characteristic pattern of members of the family Methanomicrobiaceae except for the absence of glucose as a glycolipid sugar moiety. The G+C content of the DNA was 62.2 mol %. Sequence analysis of the 16S rDNA revealed that the strain belonged to the genus Methanoculleus. The strain had DNA-DNA hybridization values of less than 50% with type strains of Methanoculleus species. On the basis of phenotypic, genotypic and phylogenetic characteristics, the name Methanoculleus chikugoensis sp. nov. is proposed for strain MG62T (= JCM 10825T = DSM 13459T). The DNA hybridization study also revealed the close relationships of three species, Methanoculleus olentangyi, Methanoculleus bourgensis and Methanoculleus oldenburgensis, among Methanoculleus species.
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Miyaki T, Sakai T. [Morphology and significance of the left portal vein in human]. Kaibogaku Zasshi 2001; 76:281-91. [PMID: 11494513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The aberrant course of a left gastric vein directly entering the liver has been reported as the left portal vein in a few cases. The authors adopted the name of 'left portal vein' for this vein and gave a brief historical summary of the left portal vein and its significance. The left gastric vein does not enter the gastropancreatic ligament from the lesser curvature, but the vein runs toward the liver alongside the hepatic ramus of vagus nerve in the hepatogastric ligament. The vein either joins the branch of the portal vein or supplies a small area of the liver after reaching the left side of the hepatic hilus. The left portal vein has already been described as the term of 'V. portae sinistra' in the bird. Many vascular vessels are found in the hepatogastric ligament. In this ligament the hepatic ramus of vagus nerve always runs toward the liver and the artery exists at a frequency of 30%. Either the left hepatic artery arising from a left gastric artery runs alongside the nerve in the ligament at a frequency of 20% or the accessory left gastric artery arising from a hepatic artery runs in a reverse direction at a frequency of 10%. Both arteries do not coexist. Moreover, the left gastric vein exits in the hepatogastric ligament in several cases and enters the liver as the left portal vein. Besides, an anastomosis of a portal vein with the renal vein rarely exists in front of the cardiac region of the ligament in cirrhosis. The aberrant left gastric vein is derived from the hepatic afferent vein through the hepatogastric ligament and exists as the left portal vein.
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Affiliation(s)
- T Miyaki
- Department of Anatomy, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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Naito I, Yamamoto K, Nakashima H, Miyaki T, Higashi K. [Bronchial asthma complicated with mediastinal, epidural emphysema]. Nihon Naika Gakkai Zasshi 2000; 89:1182-4. [PMID: 10892194] [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] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- I Naito
- Department of Internal Medicine, Kosai General Hospital
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35
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Affiliation(s)
- Itaru Naito
- Department of Internal Medicine, Kosai General Hospital
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Abstract
Congenital bile duct cysts are now a well-documented anomaly of the biliary tree, and have become more common in Japan. Familial occurrence of congenital bile duct cysts, however, is extremely rare, with only six reported cases in the literature. We report a familial pattern of congenital bile duct cysts in a mother and her daughter. A 33-year-old female was admitted for evaluation of right upper quadrant abdominal pain and fever 6 days after an uneventful delivery of her second child. A computed tomography (CT) and ultrasound scan (US) revealed an obstructed biliary tract. Percutaneous transhepatic biliary drainage was then performed, and a cholangiogram revealed a Scholtz type B choledochocele without an anomalous connection of the pancreaticobiliary ducts. Endoscopic US demonstrated that the choledochocele was associated with a stone in the cyst. A pylorus-preserving pancreatoduodenal resection was performed, and a histological study revealed that the choledochocele was lined by biliary mucosa without evidence of malignancy. The newborn infant had an abdominal tumour. An US and CT revealed a congenital bile duct cyst. An operation was performed and the intraoperative cholangiogram showed an Alonso-Lej type I congenital bile duct cyst with an anomalous connection of the pancreaticobiliary ducts. Whether congenital bile duct cysts are hereditary remains to be elucidated.
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Affiliation(s)
- F Iwata
- Department of Internal Medicine, Kosai General Hospital, Shizuoka, Japan
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Kudo Y, Shibata S, Miyaki T, Aono T, Oyaizu H. Peculiar archaea found in Japanese paddy soils. Biosci Biotechnol Biochem 1997; 61:917-20. [PMID: 9178572] [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: 02/04/2023]
Abstract
Archaeal 16S rDNA clones retrieved from paddy soil DNA were sequenced. Among 100 clones, 88 clones were assigned to methanogens and nine clones were assigned to crenarchaeota. However, three of the nine clones were phylogenetically far from the cultured crenarchaeota and closely related to marine planktonic archaea. The other three clones showed extremely novel 16S rDNA sequences and were phylogenetically far from both Crenarchaeola and Euryarchaeota. This paper reports the ubiquitous presence of crenarchaeotal and extremely novel clones in paddy soils.
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Affiliation(s)
- Y Kudo
- Graduate School of Agriculture and Agricultural Life Sciences, University of Tokyo, Japan
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Morishima K, Miyaki T, Ito H. A rare case of a kidney with an widely opened hilus and supernumerary renal vessels. Kaibogaku Zasshi 1996; 71:215-8. [PMID: 8831188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
This is an autopsy case reporting variation in the left kidney of a 87-year-old Japanese woman. The kidney in question possessed a widely opened hilus, was located in a lower position than usual, and was supplied and drained by multiple vessels. Major findings are as follows: 1. The left kidney, diamond-shaped, was situated lower than usual. 2. The hilus of this kidney was widely opened, facing anteriorly. 3. It was supplied by, in addition to an ordinal renal artery, 4 supernumerary arteries arising from the lower portion of the abdominal aorta and was drained by one ordinary and one supernumerary vein, the latter of which opened into the lumbar vein.
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Affiliation(s)
- K Morishima
- Department of Anatomy, Nippon Medical School, Tokyo, Japan
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Abstract
Gross morphology of the pancreas and distribution of pancreatic ducts were investigated in 12 Jcl: Wistar rats. The pancreas consisted of a body and two (right and left) lobes. The pancreatic body was located along the cranial part of the duodenum. The right lobe extended into the duodenal ligament, while the left lobe extended toward the spleen into the gastrolienal ligament. In 9 animals, the number of ducts ranged between 3 and 10. Each duct joined the hepatoenteric duct. Two (right and left) large ducts found in all animals drained the right and left lobes. Other ducts observed in more than a half of the animals drained either the body or a part of the lobe.
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Affiliation(s)
- T Miyaki
- Department of Anatomy, Nippon Medical School, Tokyo, Japan
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Abstract
A new species of the genus Kibdelosporangium is described. This soil organism forms long straight spore chains and numerous sporangium-like structures on the aerial mycelium. The new species has type IV cell walls and pattern A whole-cell sugars (meso-diaminopimelic acid, arabinose, and galactose are present), type PII phospholipids, MK-9(H4) as the major menaquinone, and no mycolic acids. On the basis of morphology and chemotaxonomy, the single isolate is assigned to the genus Kibdelosporangium. The isolate differs from two previously described species of the genus in fatty acid composition, the absence of melanin formation, and many physiological and biochemical characteristics and is identified as a new species. Accordingly, the name Kibdelosporangium albatum sp. nov. is proposed for this isolate. The type strain is R761-7 (= ATCC 55061).
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Affiliation(s)
- K Tomita
- Bristol Myers Squibb Research Institute, Tokyo, Japan
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Abstract
The external ear appears only in mammals and possesses a great diversity of forms. In addition, multiple nerves are distributed in the external ear. The nerves which are distributed in the external ear were investigated in humans and in the musk shrew (Suncus murinus) in a macroscopic study. The following results were obtained. Cranial nerves (CN) V, VII, X and cervical nerves supply the auricle and the external meatus in both humans and the musk shrew. Branches of the third division of CN V supply an anterior part of the external meatus and the anterior part of the auricle in both humans and the musk shrew. A branch of CN X, together with a branch of CN VII, supply the posterior parts of the external meatus in humans. In the musk shrew, a branch of CN X, together with a branch of CN VII, supplies the posterior part of the external meatus and the central part and the anterior portion of the auricle. Branches of the cervical nerve supply the posterior part of the auricle. Branches of the cervical nerve supply the posterior part of the external meatus and the central and posterior parts of the auricle in the musk shrew.
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Affiliation(s)
- N Ueno
- Department of Otorhinolaryngology, Nippon Medical School, Tokyo
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Tsunakawa M, Tenmyo O, Tomita K, Naruse N, Kotake C, Miyaki T, Konishi M, Oki T. Quartromicin, a complex of novel antiviral antibiotics. I. Production, isolation, physico-chemical properties and antiviral activity. J Antibiot (Tokyo) 1992; 45:180-8. [PMID: 1313409 DOI: 10.7164/antibiotics.45.180] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A strain of Amycolatopsis orientalis No. Q427-8 (ATCC 53884) was found to produce a complex of new antiviral antibiotics, quartromicin which consisted of at least six components A1, A2, A3, D1, D2 and D3. Structural studies suggested that they are a novel type of molecules unrelated to any known antibiotics. Each component of quartromicin exhibited antiviral activity against herpes simplex virus type 1, influenza virus type A and human immunodeficiency virus.
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Affiliation(s)
- M Tsunakawa
- Bristol-Myers Squibb Research Institute, Tokyo, Japan
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43
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Konishi M, Ohkuma H, Matsumoto K, Saitoh K, Miyaki T, Oki T, Kawaguchi H. Dynemicins, new antibiotics with the 1,5-diyn-3-ene and anthraquinone subunit. I. Production, isolation and physico-chemical properties. J Antibiot (Tokyo) 1991; 44:1300-5. [PMID: 1778782 DOI: 10.7164/antibiotics.44.1300] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Dynemicin A, a novel antibiotic containing the bicyclo[7.3.1]-1,5-diyn-3-ene and 1,4,6-trihydroxyanthraquinone functionalities, was isolated from the culture broth of Micromonospora chersina sp. nov. M956-1. The antibiotic exhibited potent in vitro antibacterial and cytotoxic activity, and in in vivo, it cured mice from lethal Staphylococcus aureus infection and prolonged survival time of mice inoculated with murine tumors. Three satellite components, dynemicins L, M and N, were also isolated from the culture broth and chemically characterized.
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Affiliation(s)
- M Konishi
- Bristol-Myers Squibb Research Institute, Tokyo, Japan
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44
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Naruse N, Tenmyo O, Kawano K, Tomita K, Ohgusa N, Miyaki T, Konishi M, Oki T. Fluvirucins A1, A2, B1, B2, B3, B4 and B5, new antibiotics active against influenza A virus. I. Production, isolation, chemical properties and biological activities. J Antibiot (Tokyo) 1991; 44:733-40. [PMID: 1880063 DOI: 10.7164/antibiotics.44.733] [Citation(s) in RCA: 30] [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] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Five unidentified actinomycete strains produced a series of novel antiviral antibiotics which have a unique 2,6-dialkyl-10-ethyl-3(or 9)-hydroxy-13-tridecanelactam nucleus substituted with 3-amino-3,6-dideoxy-L-talose or 3-amino-3,6-dideoxy-L-mannose(L-mycosamine). The antibiotic components exhibited potent inhibitory activity against influenza virus type A Victoria strain infection in Madin Darby canine kidney cells by the cytopathic effect reduction assay.
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Affiliation(s)
- N Naruse
- Bristol-Myers Squibb Research Institute, Tokyo, Japan
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45
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Hanada M, Ohkuma H, Yonemoto T, Tomita K, Ohbayashi M, Kamei H, Miyaki T, Konishi M, Kawaguchi H, Forenza S. Maduropeptin, a complex of new macromolecular antitumor antibiotics. J Antibiot (Tokyo) 1991; 44:403-14. [PMID: 2032949 DOI: 10.7164/antibiotics.44.403] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Maduropeptin, a complex of new macromolecular antitumor antibiotics, is a metabolite of Actinomadura madurae H710-49. The active components maduropeptins A1, A2 and B are acidic chromopeptides with MW of around 22,500 and composed of 14 types of amino acids and an unstable chromophore. The antibiotics are active in vitro against Gram-positive bacteria and highly cytotoxic to tumor cells. They produced significant prolongation of survival time of mice implanted with P388 leukemia and B16 melanoma.
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Affiliation(s)
- M Hanada
- Bristol-Myers Squibb Research Institute, Tokyo, Japan
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46
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Ishihara Y, Oka M, Tsunakawa M, Tomita K, Hatori M, Yamamoto H, Kamei H, Miyaki T, Konishi M, Oki T. Melanostatin, a new melanin synthesis inhibitor. Production, isolation, chemical properties, structure and biological activity. J Antibiot (Tokyo) 1991; 44:25-32. [PMID: 1672125 DOI: 10.7164/antibiotics.44.25] [Citation(s) in RCA: 30] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Melanostatin, a new antibiotic with melanin synthesis inhibitor activity, was isolated from the fermentation broth of Streptomyces clavifer No. N924-2. Its structure was determined by spectral analysis and degradation experiments. Melanostatin strongly inhibited melanin formation in Streptomyces bikiniensis NRRL B-1049 and B16 melanoma cells.
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Affiliation(s)
- Y Ishihara
- Bristol-Myers Squibb Research Institute, Tokyo, Japan
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47
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Tomita K, Oda N, Ohbayashi M, Kamei H, Miyaki T, Oki T. A new screening method for melanin biosynthesis inhibitors using Streptomyces bikiniensis. J Antibiot (Tokyo) 1990; 43:1601-5. [PMID: 2126003 DOI: 10.7164/antibiotics.43.1601] [Citation(s) in RCA: 32] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A novel screening method for melanin biosynthesis inhibitors using Streptomyces bikiniensis NRRL B-1049 as the indicator organism has been developed. Several known compounds, including tyrosinase inhibitors, were found to inhibit melanin production of S. bikiniensis on agar plates. This screening method was applied to fermentation broths of actinomycetes and several cultures with melanin biosynthesis inhibitory activity were found.
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Affiliation(s)
- K Tomita
- Bristol-Myers Squibb Research Institute, Tokyo, Japan
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48
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Sawada Y, Hatori M, Yamamoto H, Nishio M, Miyaki T, Oki T. New antifungal antibiotics pradimicins FA-1 and FA-2: D-serine analogs of pradimicins A and C. J Antibiot (Tokyo) 1990; 43:1223-9. [PMID: 2258322 DOI: 10.7164/antibiotics.43.1223] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Pradimicin FA-1 was produced via directed biosynthesis with substitution of D-serine for D-alanine in the 15-position of pradimicin A. This substitution was achieved by the addition of D-serine to the culture medium of Actinomadura hibisca P157-2. Likewise, pradimicin FA-2 was co-produced along with pradimicin FA-1 when the pradimicins A and C producing strain, A. hibisca A2493 was grown in D-serine-supplemented medium. The new pradimicin analogs share a common core structure of 5,6-dihydrobenzo[a]naphthacenequinone substituted by D-serine at C-15, but differ in the disaccharide moiety at C-5. Pradimicin FA-1 has an N-methylamino sugar and D-xylose. Pradimicin FA-2 is the des-N-methyl analog of pradimicin FA-1. The in vitro and in vivo antifungal activity of the analogs was comparable to that of pradimicin A.
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Affiliation(s)
- Y Sawada
- Bristol-Myers Research Institute, Ltd., Tokyo Research Center, Japan
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49
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Oka M, Kamei H, Hamagishi Y, Tomita K, Miyaki T, Konishi M, Oki T. Chemical and biological properties of rubiginone, a complex of new antibiotics with vincristine-cytotoxicity potentiating activity. J Antibiot (Tokyo) 1990; 43:967-76. [PMID: 2211364 DOI: 10.7164/antibiotics.43.967] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A novel complex of isotetracenone (angucyclinone) group antibiotics was discovered from the cultured broth of Streptomyces griseorubiginosus No. Q144-2. The antibiotic consisted of six related factors, designated rubiginones A1, A2, B1, B2, C1 and C2. They significantly potentiated cytotoxicity of vincristine (VCR) against VCR-resistant P388 leukemia and Moser cells.
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Affiliation(s)
- M Oka
- Bristol-Myers Research Institute, Ltd., Tokyo Research Center, Japan
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50
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Tomita K, Nishio M, Saitoh K, Yamamoto H, Hoshino Y, Ohkuma H, Konishi M, Miyaki T, Oki T. Pradimicins A, B and C: new antifungal antibiotics. I. Taxonomy, production, isolation and physico-chemical properties. J Antibiot (Tokyo) 1990; 43:755-62. [PMID: 2387769 DOI: 10.7164/antibiotics.43.755] [Citation(s) in RCA: 32] [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] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
New antifungal antibiotics, pradimicins A, B and C were isolated from the culture broth of actinomycete strains proposed as Actinomadura hibisca. They are orange to red pigments containing a benzo[a]naphthacenequinone chromophore substituted with a D-alanine, an aminosugar and a D-xylose (pradimicins A and C).
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Affiliation(s)
- K Tomita
- Bristol-Myers Research Institute, Ltd., Tokyo Research Center, Japan
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