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Kawamura M.,Nishisaitama Chuo National Hospital | Nakano S.,Kawaguchi Municipal Medical Center | Kyoda S.,Jikei University School of Medicine | Tabei I.,Jikei University School of Medicine | And 2 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2013

A recent foreign clinical trial showed albumin-bound paclitaxel (260 mg/m2 tri-weekly) to have a better response for metastatic breast cancer (MBC) than did treatment with paclitaxel alone (175 mg/m2 tri-weekly). It was sometimes difficult to control the occurrence of side effects, such as neutropenia and neuropathy, especially after many treatments. The effect of low-dose albumin-bound paclitaxel (180-220 mg/m2 tri-weekly) was evaluated in 8 patients with MBC. The overall response rate was 62.5% (CR 1, PR 4), and 2 cases had Grade 3/4 toxicity (Grade 3 neutropenia); however, all patients were manageable. In addition, there was a good response rate (50%, PR 3) among the patients previously treated with paclitaxel. Because patient's "care" is as important as the "cure" in the treatment of MBC, an effective and well-tolerated regimen is recommended for patients with this disease. Low-dose albumin-bound paclitaxel was effective with reduced side effects, even after PTX treatment. Therefore, albumin-bound paclitaxel may be an optional treatment for MBC after any treatment. Source


Takano M.,National Defense Medical College | Goto T.,National Defense Medical College | Hirata J.,National Defense Medical College | Furuya K.,National Defense Medical College | And 6 more authors.
European Journal of Gynaecological Oncology | Year: 2013

Introduction: Genotyping of UGT1A1 could be useful for prediction of severe toxicities for patients treated with irinotecan; however, genotype-based recommended dose (RD) has not been established. The aim of the present study was to determine the RD of irinotecan in combination with cisplatin (CPT-P) for individuals with or without UGT1A1 polymorphisms. Materials and Methods: According to polymorphisms of UGT1A1*28,*6, and*27, RDs were determined by three-case cohort methods for patients with wild-type and heterotype, and by inter-patient dose escalation for homotype patients. Pharmacokinetic studies were also evaluated. During May 2009 and July 2011, 18 Japanese patients were enrolled; 16 patients with ovarian carcinoma, and two cases with cervical cancer. The RD of irinotecan was determined as 50 mg/m 2 for the patients with wild-type, 40 mg/m2 for those with heterotype, and 30 mg/m2 for homotype UGT1A1 genotype. Results: Patients with homotype UGTlAl alleles had a significantly lower glucuronidation ratio in comparison with UGT1A1 wild-type and heterotype cases. Conclusion: UGT1A1 genotype-based RDs of irinotecan in CPT-P therapy were determined. Further studies to investigate efficacy of the RD including response evaluation are needed to confirm the present results. Source


Sugiyama T.,Mie University | Watanabe H.,Shiga University of Medical Science | Takimoto H.,Japan National Institute of Public Health | Yoshida A.,Nishisaitama Chuo National Hospital | And 4 more authors.
Current Nutrition and Food Science | Year: 2011

Gestational diabetes mellitus (GDM) is a common metabolic disorder during pregnancy. GDM can cause significant problems including some perinatal complications, neonatal complications, and metabolic disorders to offspring in later life. The primary management mode for women with GDM is nutritional therapy. Some women with GDM need diet therapy alone, and some women require both diet therapy and insulin. Thus far, there is no universal dietary management of GDM, because there have been no universal diagnostic criteria and genomic backgrounds differ according to ethnicity. However, some consensus guidelines exist. This review details these consensus guidelines for the optimal nutritional management for GDM.© 2011 Bentham Science Publishers Ltd. Source


Yoshikawa T.,National Defense Medical College | Takano M.,National Defense Medical College | Kita T.,Nara Prefectural Nara Hospital | Kudoh K.,Nishisaitama Chuo National Hospital | And 6 more authors.
European Journal of Gynaecological Oncology | Year: 2012

The normal serum CA125 half-life and distribution of the normal serum nadir CA125 value in patients with epithelial ovarian carcinoma (EOC) have not been determined yet. Among patients with EOC, 41 patients met the inclusion criteria of the present study: the patients that underwent complete cytoreductive surgery and six cycles of platinum-containing chemotherapy, and who had no recurrent disease more than five years. Serum CA125 half-life (T 1/2) during primary surgery and primary chemotherapy was calculated and serum nadir CA125 level was evaluated by logarithmic-transformed serum CA125. Median value of nadir CA125 was 7 U/ml (range 3-20 U/ml), and the mean In (serum nadir CA125) was 1.96 ± 0.45. Mean T 1/2 was 10.4 days in all patients, and T 1/2 value was associated with the preoperative serum levels of CA125. Predicted slope of CA125 regression curve was also influenced by the preoperative CA125 value. The present study provides fundamental information with regard to normal half-life time and normal nadir of CA125 in EOC patients. Source


Takano M.,National Defense Medical College | Kikuchi Y.,Ohki Memorial Kikuchi Cancer Clinic for Women | Kudoh K.,Nishisaitama Chuo National Hospital | Goto T.,National Defense Medical College | And 6 more authors.
International Journal of Clinical Oncology | Year: 2011

Clear cell carcinoma (CCC) of the ovary is well-known to be chemotherapy resistant compared with other histologic subtypes. An inhibitor against the mammalian target of rapamycin, temsirolimus (TEM) has been reported to be effective in renal CCC. Therefore, we investigated the effects of TEM in patients with CCC of the ovary. Six patients with CCC of the ovary who had been heavily pretreated by more than 4 regimens were given TEM: the cycle consisted of weekly TEM (10 mg/m 2) for 3 weeks followed by 1 week off. The treatment was continued until development of either progressive disease, or unmanageable adverse effects. Response evaluation was based upon the Response Evaluation Criteria in Solid Tumors version 1.0. Adverse effects were analyzed according to Common Terminology Criteria for Adverse Events version 3.0. The median cycle of weekly TEM was 3 (range 2-14). Among five cases in which responses could be evaluated, partial response was observed in one case (20%) and stabilized disease was seen in another case (20%). There were no toxicities greater than grade 3, and no case developed severe toxicity requiring discontinuation of weekly TEM. The patient who showed a partial response obtained a progression-free period of 14 months. In conclusion, weekly TEM shows a potential therapeutic benefit for patients with CCC of the ovary. Further studies including a translational approach are needed to select candidates for whom TEM therapy would be beneficial. © Japan Society of Clinical Oncology 2011. Source

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