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Meiwa, Japan

Tsubamoto H.,Hyogo College of Medicine | Sonoda T.,Kohnan Hospital | Yamasaki M.,Shinko Hospital. | Inoue K.,Meiwa General Hospital
Anticancer Research | Year: 2014

Background: Recurrent ovarian clear cell carcinoma (CCC) rarely responds to cytotoxic agents. Itraconazole is a potent inhibitor of the P-glycoprotein efflux pump, angiogenesis, and the Hedgehog pathway. We evaluated the efficacy of chemotherapy with itraconazole for CCC. Patients and Methods: Medical charts of patients with CCC who had received chemotherapy with itraconazole were retrospectively reviewed. Results: Among nine patients with CCC, five had a history of progression with paclitaxel and carboplatin, and none had received prior treatment with bevacizumab or other targeted therapy. Eight patients received docetaxel (35 mg/m2, day 1) and carboplatin-based (area under the curve, 4 mg·; min-1· mL-1; day 1) chemotherapy with an oral itraconazole solution (400 mg, days -2 to 2), repeated every two weeks. The response rate, median progression-free survival and overall survival were 44% (95% confidence interval [(CI)=12-77%], 544 days (95% CI=82-544 days) and 1,047 days (95% CI=462-1332 days), respectively. Conclusion: Chemotherapy with itraconazole is promising for patients with CCC. Source

Morimoto A.,Hyogo College of Medicine | Tsubamoto H.,Hyogo College of Medicine | Inoue K.,Hyogo College of Medicine | Ikeda Y.,Hyogo College of Medicine | Hirota S.,Meiwa General Hospital
Journal of Obstetrics and Gynaecology Research | Year: 2015

Several cases of the uterus being preserved after diagnosis of endometrial stromal sarcoma (ESS) have been reported. Most of these patients were alive and did not experience relapse, but this might have reflected the short follow-up period, given the indolent recurrence of ESS. We report the first fatal case of ESS 10 years after fertility-sparing management. A specimen obtained from the last operation showed loss of estrogen receptor status and expression of c-kit without c-kit or PDGFR-α gene mutations. © 2014 The Authors. Source

Iida H.,Hyogo College of Medicine | Hata M.,Hyogo College of Medicine | Kakuno A.,Meiwa General Hospital | Hirano H.,Nippon Steel Hirohata Hospital | And 5 more authors.
Oncology Letters | Year: 2011

In this study, the expression of hepatocyte markers, including α-fetoprotein (AFP), HepPar-1 antigen and arginase-1, was examined immunohistochemically in 14 mass-forming peripheral intrahepatic cholangiocarcinomas (ICCs) that arose from the peripheral portion of the biliary tree, and in 14 periductal-infiltrating hilar ICCs that arose from intrahepatic large bile ducts. Only 2 (14.3%) of the 14 hilar ICCs and 2 (14.3%) of the 14 peripheral ICCs expressed AFP or HepPar-1 antigen. Conversely, arginase-1 was expressed in 8 (57.1%) and 11 (78.6%) of the hilar and peripheral ICCs, respectively, and 4 (28.6%) hilar ICCs and 7 (50%) peripheral ICCs expressed arginase-1 in more than 10% of the cancer cells. The expression of arginase-1 did not differ between peripheral ICCs showing major histology of poorly differentiated adenocarcinoma and those showing other major histologies, including well- or moderately differentiated tubular adenocarcinoma or papillary adenocarcinoma. Results of the present study showed that common hepatocyte markers, including AFP and HepPar-1 antigen, are rarely but definitely expressed in hilar and peripheral ICCs, and that a third hepatocyte marker, arginase-1, is expressed at a high rate in both hilar and peripheral ICCs, irrespective of their histology. These results indicate that care should be taken when using arginase-1 as a hepatocyte marker for distinguishing between a poorly differentiated hepatocellular carcinoma and a mass--forming peripheral ICC showing the histology of poorly differentiated adenocarcinoma. Source

Kanai M.,Kyoto University | Hatano E.,Kyoto University | Kobayashi S.,Osaka University | Fujiwara Y.,Exploratory Oncology Research and Clinical Trial Center | And 15 more authors.
Cancer Chemotherapy and Pharmacology | Year: 2015

Purpose: Gemcitabine/cisplatin combination therapy has been the standard palliative chemotherapy for patients with advanced biliary tract cancer (BTC). We aimed to evaluate the efficacy and safety of adding S-1 to gemcitabine/cisplatin combination therapy for patients with advanced BTC. Methods: Patients with histologically or cytologically confirmed unresectable or recurrent BTC were eligible for inclusion. The primary end point was overall survival. Based on the results of our preceding phase I study, gemcitabine and cisplatin were administered intravenously at doses of 1,000 or 25 mg/m2, respectively, on day 1, and oral S-1 was administered daily at a dose of 80 mg/m2 on days 1-7 every 2 weeks. This study was registered with ClinicalTrials.gov (NCT01284413) and the UMIN Clinical Trials Registry (ID 000004468). Results: Fifty patients enrolled between October 2011 and August 2012 were evaluated. After a median follow-up of 15.1 months (range 2.4-24.4 months), the median overall survival time was 16.2 months [95 % confidence interval (CI) 10.2-22.2 months], and the one-year overall survival rate was 59.9 % (95 % CI 46.2-73.5 %). The grade 3-4 hematological toxicities were as follows: neutropenia (32 %), anemia (32 %), thrombocytopenia (10 %), and febrile neutropenia (4 %). The common grade 3-4 non-hematological toxicities were biliary tract infection (14 %), anorexia/nausea (10 %), and fatigue (8 %). Conclusions: Gemcitabine/cisplatin/S-1 combination chemotherapy offered a promising survival benefit with manageable toxicity in patients with advanced BTC. A randomized phase III trial to investigate the efficacy of this regimen compared to gemcitabine/cisplatin combination therapy in patients with advanced BTC is now underway (UMIN000014371/NCT02182778). © Springer-Verlag 2014. Source

Tomomatsu M.,Meiwa General Hospital | Kishimoto M.,Meiwa General Hospital | Iida H.,Meiwa General Hospital | Ikuta S.,Meiwa General Hospital | And 5 more authors.
Acta Hepatologica Japonica | Year: 2014

We report a case of 44-year-old woman, who underwent partial mastectomy with axial lymph node dissection for right breast cancer (Stagellb) in August 2006. She developed jaundice 4 years post-op. Imaging studies showed no significant abnormality. The liver biopsy was then performed, and showed diffuse liver metastasis of breast cancer. Because of her worsening jaundice (T-bil: 24.1 mg/d/), plasma exchange (PE) was performed, which improved her jaundice and performance status markedly, followed by hormone therapy with aromatase inhibitors (AI). Liver function tests and serum tumor markers have been improved she is still alive 3 years after her first visit. There are few reports in the literature about cirrhosis or liver failure of diffuse infiltrative liver metastases, secondary to breast or gastric cancer. Our case suggests the usefulness of PE and hormone therapy for the treatment of diffuse infiltrative liver metastases. © 2014 The Japan Society of Hepatology. Source

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