Japanese journal of clinical oncology最新文献

{"title":"Low-dose add-on methadone for cancer pain management: a retrospective analysis of 102 Japanese patients.","authors":"Tetsumi Sato, Akira Fukutomi, Taiichi Kawamura, Kyohei Kawakami, Tetsu Sato, Yoshiko Kamo, Tomomi Suzuki, Shota Hagiya, Rei Tanaka","doi":"10.1093/jjco/hyae156","DOIUrl":"10.1093/jjco/hyae156","url":null,"abstract":"<p><strong>Background: </strong>Methadone was introduced in 2013 for the treatment of intractable cancer pain in Japan and is indicated for patients receiving opioid doses ≧60 mg/day as an oral morphine equivalent. Low-dose (≦10 mg/day) add-on methadone to prior opioids has been reported from European countries to successfully relieve various types of intractable cancer pain; however, there are few reports of such use in Japan. The aim of this study was to analyze more than a hundred cases with low-dose add-on methadone to treat intractable pain in Japanese cancer patients.</p><p><strong>Methods: </strong>All cases in which 5 or 10 mg/day of methadone was added to prior opioids by the Palliative Care Team or Division of Palliative Medicine in our hospital during the period between April 2016 and September 2023 were extracted and analyzed retrospectively on electrical medical charts.</p><p><strong>Results and conclusions: </strong>A total of 102 cases were extracted with a male-to-female ratio of 60:42, and the age (mean ± SD) was 62.8 ± 14.7 years old. Methadone was introduced in an inpatient setting to 86 patients. The major pathologies that caused intractable pain were spinal metastases in 48, pelvis or pelvic floor lesions in 29 and pleural and/or chest wall lesions in 16. The most common mechanism of pain was the mixture of somatic and neuropathic components. The major opioids administered prior to methadone included tapentadol in 46 patients, hydromorphone in 36 and oxycodone in 19. The dose of the prior opioids [median, (interquartile range: IQR)] was 97, (62.8-167.3) (range: 15-1313) mg/day of oral morphine equivalent. Radiotherapy, chemotherapy and nerve blocks were performed as concomitant therapies in 48, 22 and 11 patients, respectively (with some overlap). The number of rescue doses [median (IQR)] was significantly decreased from three (two to five) on the day before methadone to one (zero to four) after seven days from methadone initiation. The side effects leading to discontinuation of methadone were drowsiness in three cases, nausea in three cases and dizziness in one case (with some overlap). Compared with complete switching from other opioids, low-dose add-on methadone can reduce the possibility of major dose discrepancies and can be quickly adjusted by combined opioid reduction/increase. Low-dose add-on methadone can be an effective and safe method for intractable cancer pain.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"123-130"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583062","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":"68Ga-FAPI PET/CT findings of diffuse malignant peritoneal mesothelioma involving the gastrointestinal tract.","authors":"Huiqin Wu, Ling Li, Chongjiao Li, Yong He","doi":"10.1093/jjco/hyae139","DOIUrl":"10.1093/jjco/hyae139","url":null,"abstract":"","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"198-200"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390594","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":"Prognostic risk score and index including the platelet-to-lymphocyte ratio and lactate dehydrogenase in patients with metastatic or unresectable urothelial carcinoma treated with immune checkpoint inhibitors.","authors":"Keita Kobayashi, Shigeru Sakano, Hiroaki Matsumoto, Mitsutaka Yamamoto, Masahiro Tsuchida, Yasuhide Tei, Kazuhiro Nagao, Kazuo Oba, Seiji Kitahara, Seiji Yano, Satoru Yoshihiro, Yoshiaki Yamamoto, Chietaka Ohmi, Hirotaka Komatsu, Taku Misumi, Jumpei Akao, Koji Shiraishi","doi":"10.1093/jjco/hyae137","DOIUrl":"10.1093/jjco/hyae137","url":null,"abstract":"<p><strong>Background: </strong>Avelumab and pembrolizumab are administered after platinum-based chemotherapy for the treatment of metastatic urothelial carcinoma. We explored the prognostic factors and risk scores for predicting the outcomes of metastatic or unresectable urothelial carcinoma at the start of treatment with immune checkpoint inhibitors.</p><p><strong>Methods: </strong>This retrospective study included patients with metastatic or unresectable urothelial carcinoma treated with avelumab or pembrolizumab after platinum-based chemotherapy between January 2017 and December 2022. Prognostic factors, including patient and tumor characteristics and blood data at the initiation of immune checkpoint inhibitor therapy, were examined.</p><p><strong>Results: </strong>This study included 36 and 207 patients treated with avelumab and pembrolizumab, respectively, for metastatic or unresectable urothelial carcinoma. Eastern Cooperative Oncology Group performance status, presence of visceral metastases, platelet-to-lymphocyte ratio and lactate dehydrogenase levels were independent prognostic factors for predicting overall survival. The median overall survival of patients in the risk-score model was 58.5 months (score zero), 27.9 months (one), 13.1 months (two) and 3.9 months (three or higher). The C-index for overall survival was 0.718 for the newly developed risk score compared with 0.679 for the Bellmunt score and 0.703 for the Bellmunt-C-reactive protein score. Additionally, the C-index for overall survival using the immune prognostic index derived from lactate dehydrogenase and the platelet-to-lymphocyte ratio was 0.646 compared with 0.615 for the Lung Immune Prognostic Index.</p><p><strong>Conclusions: </strong>A risk score that includes the platelet-to-lymphocyte ratio and lactate dehydrogenase may serve as a useful model for predicting prognosis following the initiation of immune checkpoint inhibitors in patients with metastatic or unresectable urothelial carcinoma.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"148-157"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380773","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":"Optimal timing for initiating androgen receptor signaling inhibitor therapy in patients with nonmetastatic castration-resistant prostate cancer: a multicenter collaborative study.","authors":"Shuhei Hara, Fumihiko Urabe, Kojiro Tashiro, Yuma Goto, Yuya Iwamoto, Takashi Ohtsuka, Wataru Fukuokaya, Yu Imai, Kosuke Iwatani, Mahito Atsuta, Keiichiro Mori, Taro Igarashi, Koichi Aikawa, Takafumi Yanagisawa, Shoji Kimura, Masaya Murakami, Shunsuke Tsuzuki, Brendan A Yanada, Kenichi Hata, Akira Furuta, Hiroki Yamada, Jun Miki, Takahiro Kimura","doi":"10.1093/jjco/hyae146","DOIUrl":"10.1093/jjco/hyae146","url":null,"abstract":"<p><strong>Objective: </strong>We determined the optimal timing for initiating androgen receptor signaling inhibitor (ARSI) therapy in patients with nonmetastatic castration-resistant prostate cancer (nmCRPC) and assessed its impact on oncological outcomes.</p><p><strong>Materials and methods: </strong>This retrospective study included 145 nmCRPC patients who received enzalutamide, apalutamide or darolutamide at the Jikei University Hospital or its affiliated institutions between May 2014 and November 2022. Patients were stratified based on prostate-specific antigen (PSA) doubling time (PSADT) at CRPC diagnosis and PSA levels at ARSI initiation. Oncological outcomes, including progression-free survival (PFS), metastasis-free survival (MFS), cancer-specific survival and overall survival, were assessed using the Kaplan-Meier curve and Cox regression analysis.</p><p><strong>Results: </strong>The median age of the patients was 73 (interquartile range [IQR]: 52-88) years, and the median follow-up duration was 36 (IQR: 2-104) months. The median PSA level at ARSI initiation was 5.4 (IQR: 2.2-48) ng/ml, and 44.8% of patients had a PSADT <3 months. Multivariate analysis revealed that PSADT and PSA levels at ARSI initiation were independent MFS predictors. Patients with a PSADT ≤3 months and a PSA level ≥5.4 ng/ml experienced significantly reduced PFS and MFS. Notably, ARSI initiation at a PSA level ≥5.4 ng/ml was associated with worse outcomes, suggesting the potential benefit of earlier intervention.</p><p><strong>Conclusions: </strong>Patients with rapid PSADT are at increased risk of early disease progression, suggesting that immediate treatment may be warranted. In addition, initiating therapy at a PSA level <5.4 ng/ml may be associated with improved patient outcomes in patients with low PSADT.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"158-163"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465692","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":"En bloc upper and lower lobe bisegmentectomy for non-small-cell lung cancer invading the fissure.","authors":"Atsushi Kosuge, Yukihiro Yoshida, Masaya Yotsukura, Shun-Ichi Watanabe","doi":"10.1093/jjco/hyae140","DOIUrl":"https://doi.org/10.1093/jjco/hyae140","url":null,"abstract":"<p><strong>Background: </strong>The optimal surgical procedure for tumors extending deep into the lung parenchyma of the opposite lobe beyond the fissure remains controversial. The current study aimed to examine whether en bloc upper and lower lobe bisegmentectomy can be an option for such tumors.</p><p><strong>Methods: </strong>This study included patients who underwent surgery for cN0 non-small-cell lung cancer invading the adjacent lobe beyond the fissure between the upper and lower lobes. The perioperative and long-term outcomes of the bisegmentectomy and extended lobectomy/pneumonectomy groups were compared.</p><p><strong>Results: </strong>The bisegmentectomy group included five patients who underwent right S2 + S6 segmentectomy and four patients who underwent left S1 + 2 + S6 segmentectomy. The bisegmentectomy and extended lobectomy/pneumonectomy groups had similar perioperative outcomes. The median surgical duration, volume of blood loss and length of hospital stay of the bisegmentectomy group were 175 min, 79 mL and 5 days, respectively. In the bisegmentectomy group, one patient with a tumor without a ground-glass component on computed tomography scan had brain metastasis and died. The remaining eight patients with tumors with ground-glass components on computed tomography scan were alive without recurrence at a median follow-up of 7.2 years. In the extended lobectomy/pneumonectomy group, all patients experienced recurrence and died at a median follow-up of 3.9 years.</p><p><strong>Conclusions: </strong>En bloc upper and lower lobe bisegmentectomy can be a safe and feasible option for tumors with a ground-glass component on computed tomography scan in patients with non-small-cell lung cancer invading the adjacent lobe beyond the fissure.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":"55 2","pages":"194-197"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188013","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":"Multicenter randomized phase III study of high-dose therapy with autologous stem cell transplantation versus observation for patients with newly diagnosed peripheral T-cell lymphoma who achieved complete metabolic response after induction therapy (JCOG2210, TRANSFER study).","authors":"Ryosuke Kita, Kazuyuki Shimada, Ryunosuke Machida, Tetsuya Sekita, Keita Sasaki, Kenji Ishitsuka, Haruhiko Fukuda, Dai Maruyama, Wataru Munakata, Hirokazu Nagai","doi":"10.1093/jjco/hyae144","DOIUrl":"10.1093/jjco/hyae144","url":null,"abstract":"<p><p>Patients with peripheral T-cell lymphoma demonstrated a poor prognosis after obtaining a complete response with induction treatment compared to those with B-cell lymphoma. Once it relapsed, curative treatment is frequently limited to invasive treatments with significant treatment-related mortality, including allogeneic stem cell transplantation. The limitations of these treatment choices indicate the necessity for developing optimal consolidation therapies to prevent relapse. This multicenter randomized phase III trial aims to confirm the superiority of the high-dose therapy with autologous stem cell transplantation over observation alone in terms of progression-free survival for patients with newly diagnosed peripheral T-cell lymphoma who achieved complete metabolic response after induction therapy. A total of 140 patients from 52 hospitals will be enrolled in Japan over 5.5 years. This trial is registered in the Japan Registry of Clinical Trials as jRCTs031240169 (https://jrct.niph.go.jp/latest-detail/jRCTs031240169).</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"183-188"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465691","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":"Quality of life improvement after radiotherapy for bone metastases assessed using real-world data: a secondary analysis of a Nationwide Multicenter Cohort Study.","authors":"Nobuko Utsumi, Tetsuo Saito, Naoto Shikama, Takeo Takahashi, Hideyuki Harada, Naoki Nakamura, Shuichi Ueno, Akifumi Notsu, Hiroki Shirato, Kazunari Yamada, Haruka Uezono, Yutaro Koide, Hikaru Kubota, Takuya Yamazaki, Kei Ito, Joichi Heianna, Yukinori Okada, Ayako Tonari, Norio Katoh, Hitoshi Wada, Yasuo Ejima, Kayo Yoshida, Takashi Kosugi, Shigeo Takahashi, Takafumi Komiyama, Nobue Uchida, Misako Miwa, Miho Watanabe, Hisayasu Nagakura, Hiroko Ikeda, Isao Asakawa, Naoyuki Shigematsu","doi":"10.1093/jjco/hyae150","DOIUrl":"10.1093/jjco/hyae150","url":null,"abstract":"<p><strong>Objective: </strong>Single-center studies or randomized controlled trials have evaluated the impact of radiotherapy for bone metastases on quality of life (QOL). We investigated the real-world impact of radiotherapy for bone metastases on QOL using nationwide multicenter cohort data.</p><p><strong>Methods: </strong>We conducted a prospective observational study at 26 centers in Japan. Of 333 patients who received radiotherapy for bone metastases between December 2020 and March 2021, 232 (70%) were enrolled in the study. Patient-reported QOL was evaluated at enrollment and at two- and six-month follow-up using the European Organization for Research and Treatment of Cancer (EORTC) QOL Questionnaire Core 15-Palliative and the EORTC QOL Questionnaire Bone Metastases module (QLQ-BM22). Possible predictors (patient-, tumor -, and treatment-related factors) of QOL improvement were screened using logistic regression models.</p><p><strong>Results: </strong>QOL scores showed significant improvement at two-month follow-up in seven (global health status/QOL, emotional functioning, pain, insomnia, painful sites, pain characteristics and functional interference) of the 14 scales. Of these seven scales, mean improvement ≥ the minimal clinically important difference (defined by a change of 10 or more on the 0 to 100 scale) was seen in four scales (pain, insomnia, pain characteristics and functional interference). We did not find any predictors of QOL improvement in the functional interference scale of QLQ-BM22.</p><p><strong>Conclusion: </strong>Radiotherapy for bone metastases performed in daily practice is effective in improving some scales of QOL.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"140-147"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545497","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":"Early progressive disease within 2 years in isocitrate dehydrogenase (IDH)-mutant astrocytoma may indicate radiation necrosis.","authors":"Yukie Ozeki, Mai Honda-Kitahara, Shunsuke Yanagisawa, Masamichi Takahashi, Makoto Ohno, Yasuji Miyakita, Miu Kikuchi, Tomoyuki Nakano, Tomohiro Hosoya, Hirokazu Sugino, Kaishi Satomi, Akihiko Yoshida, Hiroshi Igaki, Yuko Kubo, Koichi Ichimura, Hiromichi Suzuki, Kenkichi Masutomi, Akihide Kondo, Yoshitaka Narita","doi":"10.1093/jjco/hyae151","DOIUrl":"10.1093/jjco/hyae151","url":null,"abstract":"<p><strong>Background: </strong>Isocitrate dehydrogenase-mutant astrocytoma without cyclin-dependent kinase inhibitor 2A/B (CDKN2A/B) homozygous deletion typically follows a slow clinical course. However, some cases show early progression on magnetic resonance imaging, and these characteristics remain under-reported. This study aimed to elucidate the characteristics of isocitrate dehydrogenase-mutant astrocytoma showing early progression on magnetic resonance imaging.</p><p><strong>Methods: </strong>This retrospective study included 52 cases of primary astrocytoma, isocitrate dehydrogenase-mutant, Central Nervous System (CNS) 5 World Health Organization grade 2-3 according to the World Health Organization 2021 classification. Patients underwent surgery followed by radiation therapy and/or chemotherapy at our institution from 2006 to 2019. Progression-free survival and overall survival were analyzed.</p><p><strong>Results: </strong>There were 24 and 28 grade 2 and grade 3 astrocytomas, respectively. The median patient age was 38 years. Forty-three patients underwent radiotherapy. Progression was diagnosed by magnetic resonance imaging in 22 patients with initial radiotherapy. Thirteen of the 22 patients underwent surgery, and seven of the 13 patients received surgery within 24 months of the initial radiotherapy. Histopathologically, radiation necrosis was confirmed in four of these seven patients (57.1%). The true progression-free survival rate, excluding radiation necrosis, at 2 years after surgery was 91.3% for grade 2 astrocytoma and 88.5% for grade 3 astrocytoma. The 5-year overall survival rate was 85.7% for grade 2 tumours and 76.4% for grade 3 tumours.</p><p><strong>Conclusions: </strong>Radiation necrosis should be considered in cases showing early progression of isocitrate dehydrogenase-mutant astrocytoma, and a second surgery should be performed to confirm true recurrence or radiation necrosis. Astrocytomas with telomerase reverse-transcriptase promoter mutations may relapse relatively early and should be followed up with caution.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"106-112"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806904","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":"Protocol summary of a randomized phase III study: comparing systemic therapy with and without debulking surgery (primary tumour resection) for clinical stage IVA (cT1-2bN0-1M1a) non-small cell lung cancer with radiologically undetermined pleural dissemination JCOG2103 (DEBULK-LUNG).","authors":"Yuta Sekino, Tomoyuki Hishida, Hiroshige Yoshioka, Masashi Wakabayashi, Noriko Mitome, Satoshi Shiono, Hirotsugu Kenmotsu, Kaname Nosaki, Keiju Aokage, Hidehito Horinouchi, Haruhiko Fukuda, Yuichiro Ohe, Shun-Ichi Watanabe","doi":"10.1093/jjco/hyae143","DOIUrl":"10.1093/jjco/hyae143","url":null,"abstract":"<p><p>In patients with non-small cell lung cancer (NSCLC) who present with radiologically undetermined malignant pleural dissemination or incidental surgical diagnosis of the same, surgery is generally not the preferred option; systemic therapy is favoured. However, there is no consensus on incorporating primary site resection into the treatment plan. Retrospective analyses hint at potential benefits of combining systemic therapy with primary site resection, but prospective studies have yet to confirm these findings. Consequently, we have planned a multicentre, open-label, randomized controlled phase III trial to assess the efficacy of adding primary site resection to standard systemic therapy for stage IVA (cT1-2bN0-1M1a) NSCLC patients with radiologically undetermined pleural dissemination. The primary endpoint is overall survival. We aim to enroll 170 patients from 71 institutions over 5 years. This trial is registered at the Japan Registry of Clinical Trials (jRCT) under study number jRCTs031220666.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"176-182"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500631","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":"Impact of trastuzumab emtansine (T-DM1) on spleen volume in patients with HER2-positive metastatic breast cancer.","authors":"Arif Akyildiz, Rashad Ismayilov, Najmaddin Abdurrahimli, Aylin Ormanci, Deniz Can Guven, Murat Tuncel, Mehmet Ruhi Onur, Sercan Aksoy","doi":"10.1093/jjco/hyae141","DOIUrl":"10.1093/jjco/hyae141","url":null,"abstract":"<p><strong>Background: </strong>Trastuzumab emtansine (T-DM1) is a novel therapy for human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer, combining the targeted action of trastuzumab with the cytotoxic effects of emtansine. Although T-DM1 has demonstrated greater efficacy and safety compared to traditional therapies, concerns about hepatotoxicity and spleen-related complications have arisen.</p><p><strong>Methods: </strong>We conducted a retrospective study of 64 HER2-positive metastatic breast cancer patients treated with T-DM1 at our institution. Patients underwent computed tomography or magnetic resonance imaging at baseline and during treatment cycles. Spleen volume, portal vein diameter, and laboratory values were compared between baseline and 12 months after T-DM1 treatment.</p><p><strong>Results: </strong>Median spleen volume significantly increased from 201 cm3 (IQR, 157-275) at baseline to 291 cm3 (IQR, 215-420) after 12 months of T-DM1 treatment (P < 0.001). Spleen enlargement was observed in 87.5% of patients, while no significant alteration was detected in portal vein diameter. The change in spleen volume was positively correlated with changes in serum globulin levels, liver enzymes, and bilirubin levels, but did not impact survival outcomes.</p><p><strong>Conclusions: </strong>T-DM1 therapy in HER2-positive metastatic breast cancer leads to significant spleen enlargement and systemic biochemical changes. Future studies should focus on elucidating the long-term implications of these findings and optimizing monitoring strategies for spleen-related complications.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"100-105"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}