Japanese journal of clinical oncology最新文献

{"title":"Sentinel lymph node biopsy mapped with carbon nanoparticle suspensions in patients with cervical cancer: a systematic review and meta-analysis.","authors":"Ting Qu, Guangfu Zeng, Jinmei Yang, Kexin Tang, Ping Xie, Xiaohai Tang","doi":"10.1093/jjco/hyaf063","DOIUrl":"https://doi.org/10.1093/jjco/hyaf063","url":null,"abstract":"<p><strong>Background: </strong>The mapping technique significantly influences the detection rate of sentinel lymph nodes in cervical cancer. This study aims to evaluate the clinical efficacy of carbon nanoparticle suspensions (CNSs) in guiding sentinel lymph node biopsy (SLNB) for cervical cancer patients.</p><p><strong>Methods: </strong>Systematic search of China National Knowledge Infrastructure, Cqvip, Wanfang, PubMed, EMBASE, Web of Science, and the Cochrane Library from inception until June 2024. Studies on cervical cancer patients receiving SLNB with CNSs are included. An individual participant data meta-analysis was conducted. The protocol was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42024569290).</p><p><strong>Results: </strong>In total, 26 publications involving 1671 patients were analyzed. The overall detection rate of CNSs in SLNB for cervical cancer was 0.92, with bilateral and unilateral detection rates of 0.74 and 0.20, respectively. This detection rate exhibited a correlation with lesion size and the administration of neoadjuvant chemotherapy. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 0.93 (95% CI: 0.88-0.96, I2 = 35.89%), 1.00 (95% CI: 0.98-1.00, I2 = 90.01%), 216.84 (95% CI: 40.47-1161.85, I2 = 77.68%), and 0.07 (95% CI: 0.05-0.12, I2 = 54.96%), respectively. The area under the curve of the summary receiver operating characteristic curve was 0.97. No significant differences were found in subgroup analyses based on the method, time, and dose of CNS injection. However, significant publication bias was detected among the included studies based on Deeks' funnel plot [Slope (Bias) = -15.61, P = .001]. Nonetheless, sensitivity analysis confirmed the reliability and stability of the results.</p><p><strong>Conclusions: </strong>This meta-analysis highlights the accuracy and feasibility of using CNSs for SLNB in patients with cervical cancer, particularly for lesions <2.0 cm and patients untreated with neoadjuvant chemotherapy.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upfront liquid biopsy in patients with advanced solid tumors who were not feasible for tissue-based next-generation sequencing.","authors":"Akito Fukuda, Takaaki Mizuno, Tatsuya Yoshida, Kuniko Sunami, Takashi Kubo, Takafumi Koyama, Kan Yonemori, Takuji Okusaka, Ken Kato, Yuichiro Ohe, Yasushi Yatabe, Noboru Yamamoto","doi":"10.1093/jjco/hyaf065","DOIUrl":"https://doi.org/10.1093/jjco/hyaf065","url":null,"abstract":"<p><strong>Background: </strong>Liquid biopsy has been developed as an alternative to tissue-based sequencing for detecting genomic alterations in solid tumors. However, the clinical utility of liquid biopsy in patients with solid tumors for whom tissue-based next-generation sequencing (NGS) is infeasible has not been well-characterized, particularly in previously untreated individuals.</p><p><strong>Methods: </strong>This prospective study evaluated the clinical impact of liquid biopsy, focusing on six solid tumor types. Overall, 109 patients were enrolled and underwent liquid biopsy using Guardant360 (Guardant Health, Redwood City, CA, USA). Among these, 94 (86.3%) patients were previously untreated.</p><p><strong>Results: </strong>The most common cancer type was non-small cell lung cancer (n = 57, 52.3%), followed by pancreatic (n = 35, 32.1%), biliary tract (n = 8, 7.3%), gastric (n = 5, 4.6%), colorectal (n = 3, 2.8%), and triple-negative breast (n = 1, 0.9%) cancers. The success rate of liquid biopsy was 99.1%, and the median turnaround time from blood collection to results was 7 days (range: 5-22 days). Actionable alterations were detected in 31 (28.4%) patients, and 8.3% of them received matched therapy based on alterations identified by liquid biopsy. Among previously untreated patients, actionable mutations were identified in 29.8%, and 8.5% received matched therapy.</p><p><strong>Conclusions: </strong>In patients with advanced solid tumors for which tissue-based NGS is not feasible, performing upfront liquid biopsy could lead to the detection of actionable alterations and help guide targeted therapies.</p><p><strong>Clinical trial registry: </strong>UMIN Clinical Trials Registry (UMIN000041722).</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient characteristics, treatment patterns, and survival outcomes in patients with castration-resistant prostate cancer: results from the J-CaP registry.","authors":"Mizuki Onozawa, Taketo Kawai, Shiro Hinotsu, Atsushi Saito, Takeshi Mitomi, Satoshi Uno, Haruki Kume","doi":"10.1093/jjco/hyaf061","DOIUrl":"https://doi.org/10.1093/jjco/hyaf061","url":null,"abstract":"<p><strong>Background: </strong>The optimal treatment sequence of approved therapies for castration-resistant prostate cancer (PC) is unclear. This study assessed real-world patient characteristics, treatment patterns, and effectiveness in patients with castration-resistant PC in Japan.</p><p><strong>Methods: </strong>Using data from the Japan Study Group of Prostate Cancer registry (2016-2018), this retrospective study included patients with ≥1 record of: primary androgen-deprivation therapy for hormone-sensitive PC and clinical progression to castration-resistant PC during primary androgen-deprivation therapy. The primary outcomes were patient characteristics, treatment patterns, and treatment duration. Other outcomes were overall survival (OS), cancer-specific survival (CSS), time to disease progression, and time to second disease progression.</p><p><strong>Results: </strong>A total of 600 patients were included. The mean age was 75.3 (SD: 7.9) years at PC diagnosis. The median prostate-specific antigen level was 135.5 (IQR: 37.3-542.2) ng/mL. The most common first-line castration-resistant PC treatments were enzalutamide (30%), docetaxel (20%), abiraterone (18%), flutamide (12%), and bicalutamide (8.7%). The most common second-line treatments were enzalutamide (28.5%), abiraterone (21.9%), and docetaxel (16.6%). The median treatment duration for enzalutamide, docetaxel, abiraterone, and flutamide was 254.0, 176.0, 197.0, and 111.5 days, respectively. Across all treatments, the median OS, CSS, time to disease progression, and second disease progression was 1028.0, 1239.0, 616.0, and 887.0 days, respectively.</p><p><strong>Conclusion: </strong>Androgen receptor signaling inhibitors and docetaxel were the most common first- and second-line castration-resistant PC treatments. Enzalutamide was the preferred androgen receptor signaling inhibitor with the longest treatment duration.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A single-center retrospective study of malignant ectomesenchymoma in children.","authors":"Yiran Meng, Yan Su, Ge Zhang, Wei Yang, Zhe Li, Yuanhu Liu, Yanzhen Li, Zhang Xuexi, Qiaoyin Liu, Nian Sun, Zhiyong Liu, Shengcai Wang, Xin Ni","doi":"10.1093/jjco/hyaf040","DOIUrl":"https://doi.org/10.1093/jjco/hyaf040","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to summarize the clinical and pathological characteristics of Malignant Ectomesenchymoma (MEM) and provide an overview of the available treatment options.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on data from 11 children diagnosed with MEM at Beijing Children's Hospital between 2012 and 2023.</p><p><strong>Results: </strong>The study included nine male and two female patients, with a median age of 3 years (range, 1.5-11.0 years). The most commonly affected sites were the head and neck (45.6%), followed by the limbs (27.2%) and the pelvis/abdomen (27.2%). Nine children presented with localized MEM, while two had metastatic disease at the time of diagnosis. Among the nine children who underwent surgery, four received a combination of radiotherapy and chemotherapy, while five were treated with chemotherapy alone. Two children received only conservative treatment. The median follow-up period was 5.8 years (range, 0.7-12.3 years). Children who received both radiotherapy and chemotherapy had a significantly lower relapse rate compared to those treated with chemotherapy alone (2/6 vs. 5/5, P = 0.046). Additionally, children with FOXO1(+) tumors had lower survival rates than those with FOXO1(-) tumors (0/2 vs. 7/8). The 5-year overall survival rate was 79%, while the event-free survival rate was 14%.</p><p><strong>Conclusions: </strong>Combining chemotherapy with local treatments such as surgery and radiotherapy can improve the prognosis for children with MEM. Radiotherapy may be beneficial in reducing the incidence of adverse effects in patients with MEM.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current treatment strategies for external auditory canal cancer.","authors":"Hirotaka Shinomiya, Takeshi Fujita, Ken-Ichi Nibu","doi":"10.1093/jjco/hyaf058","DOIUrl":"https://doi.org/10.1093/jjco/hyaf058","url":null,"abstract":"<p><p>Auditory canal cancer is a rare form of carcinoma, making it extremely challenging to establish standard treatments through prospective studies. To date, no prospective comparative trials have been conducted, and standard treatment protocols have largely been derived from meta-analyses of case series. Several controversies remain unresolved, including the necessity of prophylactic neck dissection, the criteria for postoperative radiotherapy, and the choice between surgical treatment and chemoradiotherapy for advanced cases. These questions remain difficult to address owing to the rarity of the disease. This article aims to review the existing literature on external auditory canal squamous cell carcinoma, summarize current knowledge, and highlight areas for future research. Early-stage cancers have a favorable prognosis, with surgical treatment and postoperative radiotherapy serving as standard approaches for high-risk groups. The treatment of advanced-stage cancer remains challenging, although oncological outcomes have improved over time. Surgery combined with postoperative radiotherapy is commonly used; however, studies have shown no significant difference in prognosis compared with definitive chemoradiotherapy. Treatment strategies should be tailored to each individual case, with careful consideration of quality of life. Outcomes for inoperable cases remain extremely poor, highlighting the urgent need for new therapeutic strategies.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of osimertinib resumption with dabrafenib and trametinib for elderly patients with EGFR-mutated lung adenocarcinoma harboring acquired BRAF V600E resistant mutation resistant to osimertinib.","authors":"Yusuke Hirata, Nobuyuki Koyama, Joji Kuramoto, Hiroaki Nishimura, Shin Yokosuka, Kouta Shiraishi, Itsuka Matsumoto, Tomoyuki Takahashi, Yoshiki Kuwabara, Yumiko Ogawa-Kobayashi, Satoshi Kikuchi, Kosuke Sakai, Hiroyuki Kyoyama, Gaku Moriyama, Masatoshi Gika, Kazutsugu Uematsu","doi":"10.1093/jjco/hyaf059","DOIUrl":"https://doi.org/10.1093/jjco/hyaf059","url":null,"abstract":"<p><p>Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) provides survival benefits in non-small cell lung cancer (NSCLC) with EGFR mutations. The acquired v-Raf murine sarcoma viral oncogene homolog B (BRAF) mutation is present in ⁓3% of cases as a resistance mechanism to osimertinib, a third-generation EGFR TKI. However, there is no consensus on the optimal therapy for patients with osimertinib-resistant EGFR-mutated NSCLC harboring a BRAF V600E mutation. Here, we present the case of the oldest patient treated with a combination of osimertinib, dabrafenib, and trametinib. In an 81-year-old woman, osimertinib resumption with reduced doses of dabrafenib and trametinib showed therapeutic efficacy with an acceptable safety profile after osimertinib failure. The present case suggests that under active dose modifications of dabrafenib and trametinib, triple TKI therapy exerts therapeutic effects in elderly patients with osimertinib-resistant EGFR-mutated NSCLC and a BRAF V600E mutation.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated serum IL-17 levels and intraoperative hypothermia are risk factors for early postoperative anastomotic leakage in rectal cancer: a prospective observational study.","authors":"Rong Qian, Huai Zhang, Xu Liu, Shuangying Huang, Shengwei Qi, Nana Zhao, HuiJuan Wang, Dan Liao, Man Jin","doi":"10.1093/jjco/hyaf053","DOIUrl":"https://doi.org/10.1093/jjco/hyaf053","url":null,"abstract":"<p><strong>Objective: </strong>In this prospective observational cohort study, we aim to investigate the risk factors for early postoperative anastomotic leakage (AL) in patients undergoing rectal cancer resection.</p><p><strong>Methods: </strong>This study included 459 patients with rectal cancer who underwent treatment at our hospital from January 2021 to October 2022. All patients were hospitalized for 1 week postoperatively and observed for the occurrence of AL. Fasting venous blood samples (5 mL) were collected from all cases 1 day before surgery and 1, 2, and 3 days after surgery, and serum levels of interleukins (IL)-17, IL-6, IL-1β, tumor necrosis factor-α, and C-reactive protein (CRP) were determined using enzyme-linked immunosorbent assay. Demographic, clinical data, intraoperative hypothermia, and nutritional indicators were collected for all patients. Statistical analysis was performed using SPSS 25.0 software.</p><p><strong>Results: </strong>AL patients had significantly lower hemoglobin, albumin (ALB) levels, and a higher proportion of intraoperative hypothermia compared to patients in the non-AL group (P < .05). On the first, second, and third days after surgery, patients in the AL group had significantly higher levels of serum CRP, IL-1β, and IL-17 compared to the non-AL group. Pearson's correlation analysis showed a positive correlation between serum IL-17 levels and CRP levels. Serum IL-17 had the highest predictive value for early AL, with an area under the curve (AUC) of 0.755 cutoff value of 94.77 pg/mL, a sensitivity of 70.1%, and a specificity of 66.0%. Moreover, logistic regression analysis indicated that intraoperative hypothermia, decreased ALB levels, and increased CRP, IL-1β, and IL-17 levels on the first day after surgery were identified as risk factors for early AL in rectal cancer patients.</p><p><strong>Conclusions: </strong>This study found a significant elevation of IL-17 levels in the serum of patients who experienced early postoperative AL. Furthermore, intraoperative hypothermia and elevated IL-17 levels on the first day after surgery were identified as risk factors for early postoperative AL in rectal cancer patients.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organ-specific tumor response to enfortumab vedotin in metastatic urothelial carcinoma: a multicenter retrospective study.","authors":"Fumihiko Urabe, Yuki Taneda, Naoki Uchida, Hirokazu Kagawa, Katsuki Muramoto, Yuma Goto, Yuhei Koike, Shuhei Hara, Takashi Ohtsuka, Minoru Nakazono, Mimu Ishikawa, Yu Imai, Kosuke Iwatani, Sotaro Kayano, Mahito Atsuta, Koichi Aikawa, Kojiro Tashiro, Takaya Sasaki, Jun Miki, Takahiro Kimura","doi":"10.1093/jjco/hyaf060","DOIUrl":"https://doi.org/10.1093/jjco/hyaf060","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in treatment options for metastatic urothelial carcinoma (mUC), therapeutic choices remain limited for patients with disease refractory to platinum-based chemotherapy (PBC) and immune checkpoint inhibitors (ICIs). Enfortumab vedotin (EV) has demonstrated significant efficacy in later lines of therapy for mUC; however, its organ-specific responses remain uncertain.</p><p><strong>Methods: </strong>We conducted a retrospective study of 69 patients with mUC who received EV following treatment with PBC and ICIs. Efficacy was assessed using Response Evaluation Criteria in Solid Tumors, with organ-specific response rates (OSRR) and organ-specific disease control rates (OSCR) calculated across different metastatic sites. Multivariate Cox regression analysis was performed to identify independent predictors of disease progression and survival.</p><p><strong>Results: </strong>The median progression-free survival (PFS) was 8.3 months, whereas the median overall survival (OS) was 18.0 months. The objective response rate (ORR) was 53.6%, and the disease control rate (DCR) was 82.6%. OSCR was ≥70% across all metastatic sites, confirming the broad efficacy of EV. Liver metastases exhibited the highest OSRR at 66.7%, whereas bone metastases had the lowest OSRR at 12.5%. Tumor burden reduction was significantly lower in bone metastases compared to other metastatic sites. Disease progression was predominantly observed at target lesions, with a median time to progression of 3 months. Eastern Cooperative Oncology Group performance status and serum C-reactive protein levels were identified as significant independent predictors of PFS and OS.</p><p><strong>Conclusion: </strong>EV exhibited favorable organ-specific tumor responses in mUC, with particularly high efficacy against liver metastasis. However, response rates were lower in bone metastases. No significant differences in organ-specific overall survival were observed.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and hospital factors for outcomes of completely resected, node-negative nonsmall cell lung cancer.","authors":"Yasushi Goto, Hiroyuki Sakurai, Kiyotaka Yoh, Kazuya Takamochi, Takehito Shukuya, Tomoyuki Hishida, Masahiro Tsuboi, Koichi Yoshida, Yasuhisa Ohde, Sakae Okumura, Masataka Taguri, Hideo Kunitoh","doi":"10.1093/jjco/hyaf057","DOIUrl":"https://doi.org/10.1093/jjco/hyaf057","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate outcomes of early-stage nonsmall cell lung cancer (NSCLC) patients in relation to patient and hospital factors.</p><p><strong>Summary background data: </strong>Results of randomized controlled trials (RCTs) may not be applicable to daily practice.</p><p><strong>Methods: </strong>Outcomes of patients who had undergone curative surgery for node-negative NSCLC were retrospectively evaluated. They were either participants in an RCT (JCOG0707) or those excluded from it. \"Excluded patients\" were either ineligible to (\"ineligible cohort\") or eligible but did not participate (\"eligible cohort\") in the RCT. Correlations between hospital volume, study forwardness, and patient outcomes were also analyzed.</p><p><strong>Results: </strong>A total of 5921 patients, 917 in JCOG0707, were evaluated. The overall survival (OS) of the eligible cohort (n = 2616) was similar to the JCOG0707 cohort with an adjusted hazard ratio (aHR) of 1.01 (P = .90), while that of the ineligible cohort (n = 2388) was significantly worse, with an aHR of 1.67 (P < .0001). Both deaths from lung cancer and from other causes led to the inferior outcome. The OS of patients in the ineligible cohort, excluded from the trial due solely to the presence of concomitant malignancy (n = 704), was significantly worse than OS in the eligible cohort, but disease-specific survivals were not significantly different. Hospital volume did not affect OS (high vs low: aHR 0.91, P = .13), but high-volume hospitals had lower \"other-cause\" mortality (aHR 0.79, P = .02).</p><p><strong>Conclusions: </strong>RCT-ineligible patients had worse OS, and their excess mortalities are mainly attributed to nonlung-cancer-specific deaths.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two cases of protein-losing enteropathy induced by zolbetuximab in patients with unresectable advanced gastric cancer.","authors":"Yoshitomo Yanagimoto, Kazuyoshi Yamamoto, Keigo Hara, Yasunori Masuike, Yuki Ushimaru, Masanori Kitamura, Keiichiro Honma, Norihiro Matsuura, Takahito Sugase, Takashi Kanemura, Ryota Mori, Masatoshi Kitakaze, Masataka Amisaki, Masahiko Kubo, Yosuke Mukai, Hisateru Komatsu, Toshinori Sueda, Yoshinori Kagawa, Junichi Nishimura, Hiroshi Wada, Kunihito Goto, Masayoshi Yasui, Takeshi Omori, Hiroshi Miyata","doi":"10.1093/jjco/hyaf055","DOIUrl":"https://doi.org/10.1093/jjco/hyaf055","url":null,"abstract":"<p><p>The GLOW and SPOTLIGHT trials have demonstrated the efficacy of chemotherapy plus zolbetuximab for HER2-negative, claudin-18 isoform 2 (CLDN18.2)-positive unresectable advanced or recurrent gastric cancer (AGC)/gastroesophageal junction cancer. However, data on adverse events in real-world clinical practice are still insufficient. Specifically, gastritis and protein-losing enteropathy (PLE), which were not evident in either trials, are not generally recognized. This paper reports on the notable clinical course and examination findings of two cases of PLE observed in patients with unresectable AGC who were administered zolbetuximab. Case 1 involved a 66-year-old woman with HER2-negative, CLDN18.2-positive unresectable advanced gastric cancer (cT4aN1M1) with peritoneal dissemination. As a fifth-line treatment, she underwent combination therapy with capecitabine, oxaliplatin, and zolbetuximab (CAPEOX + Zolbe). Case 2 involved a 58-year-old woman with HER2-negative, CLDN18-positive gastric cancer (pT1aN3bM1) with extra-regional lymph node metastasis. After undergoing robot-assisted distal gastrectomy, she commenced CAPEOX + Zolbe therapy. In both cases, following the initiation of CAPEOX + Zolbe therapy, serum albumin levels decreased from 3.5 g/dL pre-treatment to 2.2 g/dL. Upper gastrointestinal endoscopy revealed diffuse redness and edema of the gastric mucosa. Pathological histological examination of the gastric mucosal biopsy also revealed findings consistent with PLE. A technetium-99m-labeled human serum albumin scintigraphy demonstrated leakage of Tc-99m albumin into the gastrointestinal tract, leading to a diagnosis of PLE. In the two cases we experienced, we observed gastritis and PLE caused by zolbetuximab. These adverse events are not widely recognized among clinicians. However, when hypoalbuminemia occurs during zolbetuximab administration, this diagnosis should be considered.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}