研究者詳細 - 長尾　昌二

論文 - 長尾　昌二

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Propensity score-matched analysis of systemic chemotherapy versus salvage hysterectomy for persistent cervical cancer after definitive radiotherapy/concurrent chemoradiotherapy. 査読国際誌

Munetaka Takekuma, Fumiaki Takahashi, Seiji Mabuchi, Wataru Kudaka, Koji Horie, Mariko Ikeda, Ayumi Shikama, Akira Mitsuhashi, Shoji Nagao, Shiro Suzuki, Mika Mizuno, Shin Nishio, Hideki Tokunaga, Yukinobu Ota, Takahiro Kasamatsu, Ryo Kitagawa, Takafumi Toita, Hiroaki Kobayashi, Mitsuya Ishikawa, Nobuo Yaegashi

BMC cancer 20 ( 1 ) 1169 - 1169 2020年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The aim of the current study was to evaluate oncologic outcomes of patients who were treated with salvage hysterectomy (HT), compared to systemic chemotherapy (CT) for persistent cervical cancer after definitive radiotherapy (RT)/ concurrent chemoradiotherapy (CCRT). METHODS: Patients with persistent cervical cancer treated with definitive RT/CCRT at 35 institutions from 2005 to 2014 were reviewed retrospectively (n = 317). Those who underwent a HT for persistent cervical cancer after definitive RT/CCRT were matched with propensity scores for patients who underwent systemic CT. Oncologic outcomes between the two groups using a propensity score matched-cohort analysis were compared. RESULTS: A total of 142 patients with persistent cervical cancer after definitive RT/CCRT were included after matching (HT: 71, systemic CT: 71). All background factors between HT and CT groups were well balanced. Median overall survival was 3.8 and 1.5 years in the HT and CT groups, respectively (p = 0.00193, hazards ratio [HR] 0.41, 95% confidence interval [CI] 0.23-0.73), Increasing residual tumor size was significantly associated with a high incomplete resection rate (p = 0.016, Odds Ratio 1.11, 95%CI 1.02-1.22). Severe late adverse events occurred in 7 patients (9.9%) in the HT cohort. CONCLUSION: The current study demonstrated that, when compared to systemic CT, the adoption of salvage HT for patients with persistent cervical cancer after definitive RT/CCRT reduced mortality rate by about 60%. This indicates that salvage HT could be curative treatment for those patients. Further prospective clinical trials with regard to salvage HT after RT/CCRT are warranted.

DOI： 10.1186/s12885-020-07672-w

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Suppressive effect upon carboplatin hypersensitivity reaction via pegylated liposomal doxorubicin combination therapy. 査読

Kyoko Shimada, Shoji Nagao, Kazuhiro Suzuki, Takashi Shibutani, Kasumi Yamamoto, Tomoatsu Jimi, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Satoshi Yamaguchi

International journal of clinical oncology 25 ( 9 ) 1718 - 1725 2020年9月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media {LLC}

BACKGROUND: Occurrence of hypersensitivity reaction (HSR) in patients having received multiple doses of carboplatin has been reported. Several studies demonstrated reduction of carboplatin-associated HSR with in combination with pegylated liposomal doxorubicin (PLD). The objective of this study was to determine the suppressive effect on carboplatin-induced HSR via combined treatment with PLD within clinical practice. METHODS: We reviewed the medical records of women with primary or recurrent ovarian, fallopian tube, or peritoneal cancer treated with carboplatin containing regimen at our hospital between January 2009 and March 2019. We compared the incidence of carboplatin-induced HSR among patients who received more than one cycle of PLD plus carboplatin (PLD-C) therapy (i.e., PLD-C group) versus patients who never received PLD-C therapy (non-PLD-C group). RESULTS: A total of 414 women were included in this study (48: PLD-C group, 366: non-PLD-C group). Carboplatin-induced HSR occurred in 34 total patients (8.2%) [1/48 (2.1%) in the PLD-C group and 33/366 (9.0%) in the non-PLD-C group], with a median cycle number of carboplatin administration at onset of HSR being 9. Incidences of carboplatin-induced HSR within the PLD-C versus non-PLD-C group at the 8th, 12th, and 16th cycles of carboplatin administration were 2.2% vs 11.2%, 2.2% vs 28.6%, and 2.2% vs 39.1%, respectively [hazard ratio: 19.2 (95% confidence interval: 9.82-39.4), p < 0.0001]. CONCLUSION: Based on the data analyzed here, a suppressive effect on carboplatin-induced HSR via combination therapy with PLD was confirmed within clinical practice.

DOI： 10.1007/s10147-020-01706-w

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Dose-dense paclitaxel and carboplatin vs. conventional paclitaxel and carboplatin as neoadjuvant chemotherapy for advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer: a retrospective study. 査読

Takashi Shibutani, Shoji Nagao, Kazuhiro Suzuki, Michiko Kaneda, Kasumi Yamamoto, Tomoatsu Jimi, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Kazuko Matsuoka, Tamotsu Sudo, Satoshi Yamaguchi

International journal of clinical oncology 25 ( 3 ) 502 - 507 2020年3月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media {LLC}

BACKGROUND: The purpose of this study was to determine the optimal regimen of neoadjuvant chemotherapy (NAC) for advanced epithelial ovarian, fallopian tube, and peritoneal cancers. METHODS: A clinical information survey involving 171 patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer was conducted. These patients underwent NAC followed by interval debulking surgery at the Hyogo Cancer Center (Hyogo, Japan) between January 2006 and December 2015. RESULTS: The median observation period was 41 (range 4-138) months. Dose-dense paclitaxel and carboplatin (TC) was administered in 101 patients (59%); tri-weekly TC was administered 70 patients (41%). Median progression-free survival was 21 [95% confidence interval (CI) 18-23] months and 15 (95% CI 13-17) months in the dose-dense TC and conventional-TC group [hazard ratio (HR) = 0.69, 95% CI 0.46-0.96; p = 0.02], respectively. The median overall survival was 59 (95% CI 46-72) and 40 (95% CI 32-57) months in the dose-dense TC group and conventional-TC group (HR = 0.72, 95% CI 0.48-1.06; p = 0.09). Multivariate analysis for progression-free survival demonstrated that dose-dense TC represented an independent prognostic factor (HR = 0.70, 95% CI 0.50-0.99; p = 0.04). CONCLUSIONS: Dose-dense TC is a promising regimen of NAC for advanced epithelial ovarian cancer.

DOI： 10.1007/s10147-019-01567-y

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A phase II study of the combination chemotherapy of bevacizumab and gemcitabine in women with platinum-resistant recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. 査読国際誌

Shoji Nagao, Ai Kogiku, Kazuhiro Suzuki, Takashi Shibutani, Kasumi Yamamoto, Tomoatsu Jimi, Miho Kitai, Takaya Shiozaki, Kazuko Matsuoka, Satoshi Yamaguchi

Journal of ovarian research 13 ( 1 ) 14 - 14 2020年2月

担当区分：筆頭著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media {LLC}

INTRODUCTION: Bevacizumab and gemcitabine are key drugs for treating recurrent epithelial ovarian cancer. However, information about the combination of bevacizumab and gemcitabine is insufficient. We conducted a phase II study to assess the feasibility, clinical activity, and toxicity of this combination chemotherapy. METHODS: This study included women with platinum-resistant recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer who received one to three regimens of platinum-based chemotherapy between April 1, 2015 and December 31, 2018. The patients received bevacizumab 15 mg/kg intravenously on day 1 and gemcitabine 1000 mg/m2 intravenously on days 1 and 8 every 21 days until disease progression or unacceptable toxicity. The primary endpoint was the completion rate of three cycles of chemotherapy. This study was registered in the University Medical Information Network (UMIN) Clinical Trials Registry (UMIN000016619). RESULTS: Among the 19 patients, 18 (95%) received ≥3 and 9 (47%) received ≥6 cycles of the study therapy. The objective response rate was 42% (complete response of 16% and partial response of 26%), and the clinical control rate was 84%. Hematological toxicity included neutropenia grade 3/4 in 9 patients (47%), anemia grade 3/4 in 2 (11%), and thrombocytopenia grade 3/4 in 1 (5%). One patient (5%) had grade 3 hypertension, and 1 (5%) had grade 3 protein urea. Possibly related grade 3 pulmonary toxicity was observed in 1 patient. Three patients needed dose reduction of gemcitabine to 800 mg/m2 due to treatment delay by 15 to 21 days on day1. There was no treatment delay more than 14 days on day 8. The median progression-free survival duration was 5.1 months and median overall survival duration was 21.3 months. CONCLUSION: The combination chemotherapy with gemcitabine and bevacizumab was feasible, effective and safe. This combination chemotherapy may be explored in a further randomized trial.

DOI： 10.1186/s13048-020-0617-y

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Leptomeningeal metastases arising from gynecological cancers. 査読

Hiroko Yano, Shoji Nagao, Satoshi Yamaguchi

International journal of clinical oncology 25 ( 2 ) 391 - 395 2020年2月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Most cases of leptomeningeal metastasis (LM) arise from solid tumors, such as breast cancer, lung cancer, or malignant melanoma. LM arising from gynecological cancers are extremely rare. Longer survival owing to recent advances in chemotherapy and other treatments has contributed to the increased frequency of gynecological cancers metastasizing to the central nervous system (CNS). Detailed information regarding LM is scarce; therefore, we conducted a study concerning LM arising from primary gynecological cancers. METHODS: Among 24 patients with CNS metastases from gynecological cancer treated at our hospital between January 2011 and August 2018, those who were eventually diagnosed with LM were included in this retrospective study. RESULTS: Among 24 patients with CNS metastases, five patients (20.8%) were diagnosed with LM. The primary cancer was endometrial in two, cervical in one, and peritoneal in two patients. Of these five patients, three developed LM as a complication 1-11 months after the treatment of brain metastases; one patient had multiple brain metastases diagnosed at the same time as LM, and one had LM alone, without accompanying brain metastases. The median survival after the diagnosis of LM was 23 (12-69) days, while the median survival of 24 patients after the initial diagnosis of CNS metastases was 106 (13-959) days. CONCLUSION: Although LM arising from gynecological cancers is considered rare, identification of LM may be important to predict prognosis and develop new therapeutic strategies.

DOI： 10.1007/s10147-019-01556-1

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[Ⅳ.Endometrial Cancer].

Shoji Nagao

Gan to kagaku ryoho. Cancer & chemotherapy 47 ( 2 ) 247 - 251 2020年2月

Olaparib plus Bevacizumab as First-Line Maintenance in Ovarian Cancer. 査読国際誌

Isabelle Ray-Coquard, Patricia Pautier, Sandro Pignata, David Pérol, Antonio González-Martín, Regina Berger, Keiichi Fujiwara, Ignace Vergote, Nicoletta Colombo, Johanna Mäenpää, Frédéric Selle, Jalid Sehouli, Domenica Lorusso, Eva M Guerra Alía, Alexander Reinthaller, Shoji Nagao, Claudia Lefeuvre-Plesse, Ulrich Canzler, Giovanni Scambia, Alain Lortholary, Frederik Marmé, Pierre Combe, Nikolaus de Gregorio, Manuel Rodrigues, Paul Buderath, Coraline Dubot, Alexander Burges, Benoît You, Eric Pujade-Lauraine, Philipp Harter

The New England journal of medicine 381 ( 25 ) 2416 - 2428 2019年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Olaparib has shown significant clinical benefit as maintenance therapy in women with newly diagnosed advanced ovarian cancer with a BRCA mutation. The effect of combining maintenance olaparib and bevacizumab in patients regardless of BRCA mutation status is unknown. METHODS: We conducted a randomized, double-blind, international phase 3 trial. Eligible patients had newly diagnosed, advanced, high-grade ovarian cancer and were having a response after first-line platinum-taxane chemotherapy plus bevacizumab. Patients were eligible regardless of surgical outcome or BRCA mutation status. Patients were randomly assigned in a 2:1 ratio to receive olaparib tablets (300 mg twice daily) or placebo for up to 24 months; all the patients received bevacizumab at a dose of 15 mg per kilogram of body weight every 3 weeks for up to 15 months in total. The primary end point was the time from randomization until investigator-assessed disease progression or death. RESULTS: Of the 806 patients who underwent randomization, 537 were assigned to receive olaparib and 269 to receive placebo. After a median follow-up of 22.9 months, the median progression-free survival was 22.1 months with olaparib plus bevacizumab and 16.6 months with placebo plus bevacizumab (hazard ratio for disease progression or death, 0.59; 95% confidence interval [CI], 0.49 to 0.72; P<0.001). The hazard ratio (olaparib group vs. placebo group) for disease progression or death was 0.33 (95% CI, 0.25 to 0.45) in patients with tumors positive for homologous-recombination deficiency (HRD), including tumors that had BRCA mutations (median progression-free survival, 37.2 vs. 17.7 months), and 0.43 (95% CI, 0.28 to 0.66) in patients with HRD-positive tumors that did not have BRCA mutations (median progression-free survival, 28.1 vs. 16.6 months). Adverse events were consistent with the established safety profiles of olaparib and bevacizumab. CONCLUSIONS: In patients with advanced ovarian cancer receiving first-line standard therapy including bevacizumab, the addition of maintenance olaparib provided a significant progression-free survival benefit, which was substantial in patients with HRD-positive tumors, including those without a BRCA mutation. (Funded by ARCAGY Research and others; PAOLA-1 ClinicalTrials.gov number, NCT02477644.).

DOI： 10.1056/NEJMoa1911361

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Landscape of systemic therapy for ovarian cancer in 2019: Primary therapy. 査読国際誌

Keiichi Fujiwara, Kosei Hasegawa, Shoji Nagao

Cancer 125 Suppl 24 4582 - 4586 2019年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

According to the statement from the 5th Ovarian Cancer Consensus Conference in 2015, the primary systemic chemotherapy for advanced ovarian cancer is a combination of paclitaxel plus carboplatin administered every 3 weeks (PCq3w). Optional alternatives include weekly dose-dense paclitaxel, in combination and maintenance therapy with bevacizumab, and intraperitoneal chemotherapy. Since then, in addition to the PCq3w strategy, there has been emerging new evidence, especially for poly(adenosine diphosphate-ribose) polymerase inhibitors. Moreover, there are multiple randomized, phase 3 trials testing the addition of antiangiogenic and/or immune checkpoint inhibitors in this patient population. In this article, current and future perspectives of systemic chemotherapy for advanced ovarian cancer are discussed.

DOI： 10.1002/cncr.32475

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Recurrence, death, and secondary malignancy after ovarian conservation for young women with early-stage low-grade endometrial cancer. 査読国際誌

Koji Matsuo, James C Cripe, Katherine C Kurnit, Michiko Kaneda, Audrey S Garneau, Gretchen E Glaser, Aaron Nizam, Rachel M Schillinger, Michelle L Kuznicki, Akira Yabuno, Shiori Yanai, Denise M Garofalo, Jiro Suzuki, Jessica D St Laurent, Ting-Tai Yen, Annie Y Liu, Masako Shida, Mamoru Kakuda, Tetsuro Oishi, Shin Nishio, Jenna Z Marcus, Sosuke Adachi, Tetsuji Kurokawa, Malcolm S Ross, Max P Horowitz, Marian S Johnson, Min K Kim, Alexander Melamed, Karime K Machado, Kosuke Yoshihara, Yoshio Yoshida, Takayuki Enomoto, Kimio Ushijima, Shinya Satoh, Yutaka Ueda, Mikio Mikami, Bobbie J Rimel, Rebecca L Stone, Whitfield B Growdon, Aikou Okamoto, Saketh R Guntupalli, Kosei Hasegawa, Mian M K Shahzad, Dwight D Im, Marina Frimer, Bobbie S Gostout, Frederick R Ueland, Shoji Nagao, Pamela T Soliman, Premal H Thaker, Jason D Wright, Lynda D Roman

Gynecologic oncology 155 ( 1 ) 39 - 50 2019年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE: To examine the association between ovarian conservation and oncologic outcome in surgically-treated young women with early-stage, low-grade endometrial cancer. METHODS: This multicenter retrospective study examined women aged <50 with stage I grade 1-2 endometrioid endometrial cancer who underwent primary surgery with hysterectomy from 2000 to 2014 (US cohort n = 1196, and Japan cohort n = 495). Recurrence patterns, survival, and the presence of a metachronous secondary malignancy were assessed based on ovarian conservation versus oophorectomy. RESULTS: During the study period, the ovarian conservation rate significantly increased in the US cohort from 5.4% to 16.4% (P = 0.020) whereas the rate was unchanged in the Japan cohort (6.3-8.7%, P = 0.787). In the US cohort, ovarian conservation was not associated with disease-free survival (hazard ratio [HR] 0.829, 95% confidence interval [CI] 0.188-3.663, P = 0.805), overall survival (HR not estimated, P = 0.981), or metachronous secondary malignancy (HR 1.787, 95% CI 0.603-5.295, P = 0.295). In the Japan cohort, ovarian conservation was associated with decreased disease-free survival (HR 5.214, 95% CI 1.557-17.464, P = 0.007) and an increased risk of a metachronous secondary malignancy, particularly ovarian cancer (HR 7.119, 95% CI 1.349-37.554, P = 0.021), but was not associated with overall survival (HR not estimated, P = 0.987). Ovarian recurrence or metachronous secondary ovarian cancer occurred after a median time of 5.9 years, and all cases were salvaged. CONCLUSION: Our study suggests that adoption of ovarian conservation in young women with early-stage low-grade endometrial cancer varies by population. Ovarian conservation for young women with early-stage, low-grade endometrial cancer may be potentially associated with increased risks of ovarian recurrence or metachronous secondary ovarian cancer in certain populations; nevertheless, ovarian conservation did not negatively impact overall survival.

DOI： 10.1016/j.ygyno.2019.08.007

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A phase II randomized controlled study of pegylated liposomal doxorubicin and carboplatin vs. gemcitabine and carboplatin for platinum-sensitive recurrent ovarian cancer (GOTIC003/intergroup study). 査読

Hiroyuki Fujiwara, Kimio Ushijima, Shoji Nagao, Yuji Takei, Muneaki Shimada, Masashi Takano, Kiyoshi Yoshino, Yoshiaki Kawano, Yasuyuki Hirashima, Satoru Nagase, Shin Nishio, Tadaaki Nishikawa, Kimihiko Ito, Tadahiro Shoji, Eizo Kimura, Tadao Takano, Toru Sugiyama, Junzo Kigawa, Keiichi Fujiwara, Mitsuaki Suzuki

International journal of clinical oncology 24 ( 10 ) 1284 - 1291 2019年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: To compare the efficacy, safety, and tolerability profiles of pegylated liposomal doxorubicin and carboplatin (PLDC) with those of gemcitabine and carboplatin (GC) for the treatment of patients with platinum-sensitive recurrent ovarian cancer. METHODS: Ovarian cancer patients with recurrence > 6 months after first-line platinum and taxane-based therapies were randomly assigned to PLDC [pegylated liposomal doxorubicin 30 mg/m2 plus carboplatin area under the curve (AUC) 5 mg/mL/min on day 1] every 4 weeks or GC (gemcitabine 1000 mg/m2 on days 1 and 8 plus carboplatin AUC 4 mg/mL/min on day 1) every 3 weeks for at least 6 cycles. The primary endpoint was progression-free survival, and overall response rate, overall survival, toxicity, and dose administration were secondary endpoints. RESULTS: One-hundred patients (49 PLDC; 51 GC) were randomly assigned. Over a median follow-up of 24 months, the median progression-free survival was 12.0 months (95% CI 9.2-15.0) for PLDC and 9.8 months (8.9-12.3) for GC [HR 0.69 (0.455-1.047)] with a difference of 2.2 months. The response rate was 57.1% (41.0-72.3) for PLDC and 56.4% (39.6-72.2) for GC. No obvious differences in toxicity (G3/4) were noted between arms. The median relative dose intensity of planned dose per week was 88.9% for pegylated liposomal doxorubicin and 53.1% for gemcitabine (p < 0.0001). CONCLUSIONS: PLDC and GC are both good treatment candidates for platinum-sensitive recurrent ovarian cancer patients; however, the dose intensity was lower for GC than for PLDC. PLDC had a more favorable risk-benefit profile than that of GC for patients.

DOI： 10.1007/s10147-019-01471-5

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放射線治療をうけた子宮頸部の扁平上皮癌患者の血清SCC値が予後に与える影響について

塩崎隆也, 太田真見子, 島田京子, 鈴木一弘, 澁谷剛志, 自見倫敦, 矢野紘子, 北井美穂, 松岡和子, 須藤保, 長尾昌二, 山口聡

日本癌治療学会学術集会抄録集 57回 P32 - 4 2019年10月

Phase II trial of paclitaxel, carboplatin, and bevacizumab for advanced or recurrent cervical cancer. 査読国際誌

Kazuhiro Suzuki, Shoji Nagao, Takashi Shibutani, Kasumi Yamamoto, Tomoatsu Jimi, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Kazuko Matsuoka, Satoshi Yamaguchi

Gynecologic oncology 154 ( 3 ) 554 - 557 2019年9月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE: We evaluated the efficacy and safety of the combination of paclitaxel, carboplatin, and bevacizumab in patients with advanced or recurrent cervical cancer. METHODS: Subjects included patients with advanced or recurrent cervical cancer not amenable to curative treatment with surgery or radiation therapy. Treatment consisted of paclitaxel 175 mg/m2, carboplatin area under the curve 6 mg/mL/min, and bevacizumab 15 mg/kg every 21 days until disease progression, complete remission, or limiting toxicity. The primary endpoint was the objective response. RESULTS: In total, 34 patients received a median of 6 treatment cycles (range 2-25). The median follow-up period was 18.5 months (range 2-29). The objective response was 88% (95% confidence interval: 72.5%-96.7%). Seventeen patients (50%) experienced complete response, whereas 13 patients experienced (38%) partial response with a median duration of 6 months. Grades 3 and 4 hematologic toxicities manifested as neutropenia in 14 (41.2%), leukopenia in 14 (41.2%), anemia in 11 (32.4%), and thrombocytopenia in 9 (26.5%) patients. One patient who underwent prior pelvic irradiation developed grade 2 rectovaginal fistula. CONCLUSION: The combination of paclitaxel, carboplatin, and bevacizumab is effective and safe in patients with advanced or recurrent cervical cancer.

DOI： 10.1016/j.ygyno.2019.05.018

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Endometrial carcinoma in a 14-year-old: A case report. 査読国際誌

Hajime Uda, Miho Kitai, Ai Kogiku, Anna Kobayashi, Toshiko Sakuma, Shoji Nagao, Satoshi Yamaguchi

Gynecologic oncology reports 29 7 - 9 2019年8月

記述言語：英語

•We present a case of endometrial carcinoma (EC) in a 14-year-old girl with no risk factors for EC.•The patient received MPA therapy and endometrial curettage.•At 47 weeks after her last MPA treatment, she has had no recurrence.•EC should be considered in diagnosing juveniles with sustained abnormal uterine bleeding, even those without risk factors.

DOI： 10.1016/j.gore.2019.05.006

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子宮体癌の腹腔鏡下手術における系統的骨盤リンパ節郭清省略についての検討

成田萌, 太田真見子, 山本幸代, 島田京子, 鈴木一弘, 中澤浩志, 澁谷剛志, 山本香澄, 自見倫敦, 矢野紘子, 北井美穂, 塩崎隆也, 松岡和子, 長尾昌二, 山口聡

日本産科婦人科内視鏡学会雑誌 35 ( Suppl.I ) 162 - 162 2019年8月

卵巣成熟嚢胞性奇形種との鑑別が困難であった子宮脂肪平滑筋腫の1例

島田京子, 北井美穂, 太田真見子, 山本幸代, 成田萌, 鈴木一弘, 中澤浩志, 渋谷剛志, 山本香澄, 自見倫敦, 矢野紘子, 塩崎隆也, 松岡和子, 長尾昌二, 山口聡

日本産科婦人科内視鏡学会雑誌 35 ( Suppl.I ) 241 - 241 2019年8月

鏡視下手術導入における子宮全摘術の習熟度

長尾昌二, 太田真見子, 山本幸代, 成田萌, 島田京子, 中澤浩志, 鈴木一弘, 渋谷剛志, 山本香澄, 自見倫敦, 矢野紘子, 北井美穂, 塩崎隆也, 松岡和子, 山口聡

日本産科婦人科内視鏡学会雑誌 35 ( Suppl.I ) 125 - 125 2019年8月

Correlation between pre-operative and final histological diagnosis on endometrial cancer. 査読国際誌

Takaya Shiozaki, Maiko Miwa, Toshiko Sakuma, Kazuhiro Suzuki, Ai Kogiku, Kasumi Yamamoto, Tokihiro Senda, Hiroko Yano, Miho Kitai, Kazuko Matsuoka, Tamotsu Sudo, Shoji Nagao, Satoshi Yamaguchi

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 29 ( 5 ) 886 - 889 2019年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE: We conducted a retrospective study to evaluate the correlation between pre-operative and post-operative histological diagnoses on endometrial cancer, and to describe the treatments and outcomes when post-operative diagnoses are downgraded from pre-operative histology. METHODS: Patients who underwent surgery for endometrial cancer in our facility between 2010 and 2013 were enrolled in the study. The definition of downgrade discordance is in accordance with the following criteria: 1) the pre-operative and post-operative histological diagnoses were both endometrioid and the final pathology was a lower grade than the pre-operative pathology and 2) the pre-operative diagnosis was not endometrioid, whereas the post-operative diagnosis was endometrioid grade 2 or less. RESULTS: A total of 250 patients were enrolled, and the concordance rates were 56% for endometrioid adenocarcinoma grade 1 (EMG1), 67% for EMG2, 67% for EMG3, 82% for carcinosarcoma, 71% for serous carcinoma, and 67% for clear cell carcinoma. Eighteen cases (6.6%) were identified as downgrade discordancy. Of the 18 patients, the triage for adjuvant therapy remained the same for 15 cases (83%), all of whom had no evidence of disease at their last visit. Three cases had discordances with respect to triage for adjuvant therapy; the therapies were triaged based on post-operative diagnosis. Of these patients one had a recurrence. CONCLUSIONS: Good correlation was observed between pre-operative and final histological diagnoses of endometrioid carcinoma (56%-67%) and type 2 carcinoma (67%-82%). Approximately 7% (18/250) of patients had downgrade discordancy; however, triage for adjuvant therapy did not change for approximately 80% (15/18) of the patients with downgrade discordancy. Further studies are needed to evaluate the effectiveness of triages that are based on post-operative diagnoses.

DOI： 10.1136/ijgc-2018-000041

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ハイボリュームセンターでの開腹広汎子宮全摘術の治療成績と予後

北井美穂, 宇田元, 太田真見子, 島田京子, 鈴木一弘, 澁谷剛志, 山本香澄, 自見倫敦, 矢野紘子, 塩崎隆也, 松岡和子, 長尾昌二, 山口聡

日本婦人科腫瘍学会雑誌 37 ( 3 ) 483 - 483 2019年6月

[Ⅲ.Surgery for Platinum Sensitive Recurrent Epithelial Ovarian Cancer]. 査読

Shoji Nagao

Gan to kagaku ryoho. Cancer & chemotherapy 46 ( 2 ) 240 - 243 2019年2月

Phase I Study of Multiple Epitope Peptide Vaccination in Patients With Recurrent or Persistent Cervical Cancer. 査読国際誌

Kosei Hasegawa, Yuji Ikeda, Yuko Kunugi, Akira Kurosaki, Yuichi Imai, Shunsuke Kohyama, Shoji Nagao, Eito Kozawa, Koji Yoshida, Takuya Tsunoda, Yusuke Nakamura, Keiichi Fujiwara

Journal of immunotherapy (Hagerstown, Md. : 1997) 41 ( 4 ) 201 - 207 2018年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

Cancer immunotherapy has now been established as a leading standard therapeutic option in a subset of patients with cancer. In this study, we conducted a phase I dose-escalation trial using a mixture of 5 peptides to vaccinate cervical cancer patients with HLA-A*2402. The primary endpoints were safety and determination of a recommended vaccine dose, and the secondary endpoints were evaluations of immunologic responses and clinical efficacy. All patients had recurrent or persistent disease and had failed to respond to or were intolerant to prior standard chemotherapy. Peptides derived from forkhead box protein M1 (FOXM1), maternal embryonic leucine zipper kinase (MELK), Holliday junction-recognition protein, and vascular endothelial growth factor receptors 1 and 2 were administered to 9 patients in a 3 patient-cohort design, with doses of 0.5, 1, or 2 mg of each of the individual peptides in a mixture with incomplete Freund's adjuvant. The major adverse events were anemia and injection site reactions, which were seen in 77.8% (7/9) and 66.7% (6/9) of patients, respectively. Grade 3 anemia was observed in 1 patient. No dose-limiting toxicity of the vaccine was observed. Seven (78%) patients achieved stable disease, and the median progression-free survival was 3.3 months (102 d). Interferon-γ enzyme-linked immunospot assays for each of the 5 antigens showed that 8 (89%) and 7 (78%) patients had high T-cell responses to FOXM1 and MELK, respectively. In conclusion, we demonstrated that this 5-peptide vaccine was tolerable, and that FOXM1 and MELK could be promising targets for immunotherapy in patients with cervical cancer.

DOI： 10.1097/CJI.0000000000000214

PubMed

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