Japanese Journal of Cancer and Chemotherapy最新文献

{"title":"[Creation of Patient Summaries from Electronic Medical Records and Integration of Medical Knowledge via Large Language Models-Next-Generation Medical DX and Drug Discovery Support Opened Up by Natural Language Processing].","authors":"Gen Tamiya","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In Japan, the adoption rate of electronic medical records (EMR) in general hospitals has surpassed 50%, leading to the rapid digitization of medical information. However, core components such as clinical notes and nursing records remain accumulated as unstructured data in \"natural language\" (free text). Consequently, their secondary utilization relies heavily on human interpretation, presenting significant challenges. This paper details the development and utility of a system that automatically generates high-precision patient summaries from EMR free text, leveraging large language models (LLMs) and retrieval-augmented generation (RAG) technologies, which have undergone dramatic evolution in recent years. We developed a medical-specific LLM trained on data accumulated at Tohoku University Hospital and conducted demonstration experiments on: 1) the automated generation of discharge summaries from nursing records, and 2) the extraction of complex cases based on clinical trial eligibility criteria. The results demonstrated that the LLM generated summaries of quality comparable to those created by nurses, suggesting the potential for significant improvements in the efficiency of documentation tasks. Furthermore, in the context of drug discovery support, the system successfully identified cases meeting complex clinical conditions that were impossible to extract using conventional search methods. However, the risk of hallucinations inherent in generative AI was also confirmed, making human oversight (human-in-the-loop) indispensable for clinical implementation.</p>","PeriodicalId":35588,"journal":{"name":"Japanese Journal of Cancer and Chemotherapy","volume":"53 6","pages":"373-378"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Frontiers in Research, Development, and Clinical Application of AI-SaMDs].","authors":"Tomonori Taniguchi, Masaaki Komatsu, Ryuji Hamamoto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Artificial intelligence (AI) technologies are rapidly being introduced into the medical device field, particularly in the form of software as a medical device (AI-SaMD), for which regulatory approvals are increasing. In the United States and Europe, many approved AI-SaMD products have been implemented in medical imaging applications, such as computed tomography (CT) and magnetic resonance imaging (MRI). Similar trends are observed in Japan, where approved AI-SaMD products have been implemented for endoscopy, laparoscopy, and CT. In gastrointestinal endoscopy, several randomized controlled trials have demonstrated that AI-assisted systems improve adenoma detection rate and reduce miss rate, contributing to overall procedural quality. In diagnostic imaging, AI has been used to develop techniques that reduce radiation dose while maintaining diagnostic performance, and has also been explored for use in screening examinations. In surgical assistance, the integration of AI with extended reality (XR) technologies has enabled intraoperative visualization of anatomical structures and instrument tracking, offering novel strategies for navigation. In pathology, deep learning models have shown potential to predict molecular subtypes and treatment responsiveness in malignancies. Collectively, these findings indicate that medical AI is transitioning from research-based technologies toward clinical implementation and, in some domains, commercialization. Future challenges include standardization, explainability, and effective integration into clinical workflows to ensure safe and sustainable adoption.</p>","PeriodicalId":35588,"journal":{"name":"Japanese Journal of Cancer and Chemotherapy","volume":"53 6","pages":"398-401"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Management of ICANS in Patient Treated with Anti-CD19 CAR T-Cell Therapy].","authors":"Risa Nishiyama, Shinichi Makita","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anti-CD19 chimeric antigen receptor (CAR) T-cell therapy has been established as a standard of care in selected patients with relapsed or refractory large B-cell lymphoma (LBCL). Unlike conventional cytotoxic chemotherapy, CAR T-cell therapy has unique immune-related adverse events, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Therefore, successful management of these toxicities are crucial for the safe and effective delivery of CAR T-cell therapy. In particular, severe ICANS can be associated with life-threatening complications and poor neurological outcomes. ICANS is thought to develop as a result of excessive cytokine production associated with CAR T-cell activation, as well as on-target/off-tumor effect of CD19 expression. Clinically, it presents with a broad spectrum of neurological manifestations, ranging from mild symptoms such as cognitive impairment and aphasia to severe manifestations including seizures, depressed level of consciousness, and cerebral edema. Because clinical findings are often nonspecific, the diagnosis of ICANS can be challenging. Nevertheless, given its potential for rapid progression, early recognition and careful monitoring are essential for optimal clinical management. With regard to treatment corticosteroids have been the mainstay of treatment for ICANS in Japan. Recently, however, prophylactic and therapeutic interventions using the interleukin-1 receptor antagonist, anakinra, have attracted attention as a novel treatment option, particularly in Western countries. In this review, we summarize the currently available data on ICANS associated with anti-CD19 CAR T-cell therapy, focusing on its pathophysiology, clinical features, diagnostic approach, and management strategies.</p>","PeriodicalId":35588,"journal":{"name":"Japanese Journal of Cancer and Chemotherapy","volume":"53 6","pages":"367-372"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Employment Status Breast Cancer Patients Received Dose-Dense EC (Epirubicin plus Cyclophosphamide) Therapy].","authors":"Yoshitake Shinohara, Yuzuru Inoue, Yuko Tashima, Arisa Harada, Etsuko Hosoda, Yuichi Yokoyama, Tetsuya Ueki, Masako Nagata, Seiichiro Tateishi, Keiji Hirata, Fumiaki Tanaka","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>To support the employment of breast cancer patients, it is important to reveal the factors that influence the side effects of chemotherapy on employment. However, there are still a few reports on the factors regarding the side effects of breast cancer chemotherapy and employment. In this study, we report on the employment status of patients with first-episode breast cancer who were treated with dd EC before surgery.</p><p><strong>Subjects: </strong>Patients who underwent cancer treatment at Hospital of the University of Occupational and Environmental Health between January 2023 and December 2024 and met the following inclusion criteria. 1 ) Patients with first-episode breast cancer, 2 ) Patients who received dd EC as preoperative cancer chemotherapy, 3 ) Patients who were earning wages from employment at the start of treatment, 4 ) Patients who continued to work at the start of treatment.</p><p><strong>Methods: </strong>We retrospectively investigated side effects and employment status within 30 days of the start of dd EC therapy based on electronic medical record data.</p><p><strong>Results: </strong>Ten patients continued to work at the start of chemotherapy. The 10 patients who continued to work completed the planned course. There were no postponements of treatment due to side effects during the planned treatment period. There were no changes in work duties for any of the patients; one of the 10 patients voluntarily made work adjustments. There were no adjustments to the work environment for any of the patients. Four out of 10 patients had their working hours and schedule changed after consultation between the patient and the company.</p><p><strong>Conclusion: </strong>Our hospital has established the department of support for balancing work and medical treatment, which determines the appropriateness of work for patients who visit the hospital, as well as the School and Work Support Center to assist patients in balancing work and medical treatment. Since side effects were limited to Grade 2, it is thought that patients were able to continue working by taking the initiative in discussing with their workplaces and taking mitigating measures such as shortening their working hours.</p>","PeriodicalId":35588,"journal":{"name":"Japanese Journal of Cancer and Chemotherapy","volume":"53 6","pages":"413-417"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[HER2-Positive Breast Cancer Brain Metastasis Recurred after Whole-Brain Radiotherapy and Successfully Treated with Trastuzumab Deruxtecan].","authors":"Sara Ozaki, Naoko Iwamoto, Miho Miyake, Rikako Hashimoto, Hiroko Masuda, Noriko Nakatsugawa, Takashi Kuwayama","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 50-year-old female patient noticed a mass and pain in her left breast, and needle biopsy revealed mucinous carcinoma that was negative for hormone receptors and positive for HER2/neu. After further examination, she was diagnosed with left breast cancer, cT3N2aM1 (bone), cStage Ⅳ, and was scheduled to start trastuzumab + pertuzumab + docetaxel (HPD) and denosumab. However, she was urgently admitted to the hospital due to pain caused by bone metastasis, and radiation therapy was performed. After discharge from the hospital, she was started on HPD and zoledronic acid treatment. After 6 doses of HPD, because of Grade 2 lower leg edema, treatment was continued with trastuzumab + pertuzumab (HP) and zoledronic acid only. Eighteen months after the first presentation, she complained of nausea and headache and was diagnosed with breast cancer brain metastasis. Therefore, whole brain irradiation was performed. HP was continued after radiation therapy, but headaches reappeared 33 months after the first presentation, accompanied by recurrence of brain metastasis. Trastuzumab deruxtecan was initiated, and the lesions had almost disappeared on the MRI scan 3 months later. The treatment is ongoing without any major adverse events.</p>","PeriodicalId":35588,"journal":{"name":"Japanese Journal of Cancer and Chemotherapy","volume":"53 6","pages":"418-421"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[FGFR2 Fusion Gene-Positive Solid Tumors].","authors":"Toshio Kokuryo, Takashi Mizuno, Shunsuke Onoe, Masaki Sunagawa, Nobuyuki Watanabe, Taisuke Baba, Mihoko Yamada, Keisuke Kurimoto, Shoji Kawakatsu, Tomoki Ebata","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fibroblast growth factor receptors (FGFR) are tyrosine kinases that regulate cellular responses including proliferation, survival, and migration. FGFR fusion genes arose from chromosomal translocations or deletions, lead to ligand-independent constitutive signal activation and contribute to carcinogenesis and cancer progression. FGFR2 fusion genes are identified in 7.4-13.6% of intrahepatic cholangiocarcinoma and 3.6% of perihilar cholangiocarcinoma. They are also reported in colorectal, prostate, and breast cancers, though at lower frequencies. Diagnosis methods are RT-PCR, RNA sequencing, FISH, and NGS. Comprehensive genomic profiling (CGP) tests are available clinically. Three FGFR inhibitors are currently approved. Pemigatinib (approved in 2021) demonstrated a response rate of 35.5%, futibatinib (approved in 2023) showed a response rate of 42%, and tasurgratinib (approved in 2024) achieved a response rate of 30.2%. The most common adverse event is hyperphosphatemia. Alopecia, diarrhea, nail disorders, and retinal detachment are also required attention. Polyclonal on-target resistance to pan-FGFR inhibitors and increasing of FGFR2 kinase domain resistance mutations based on treatment history has been reported. Novel therapeutics, such as highly selective FGFR2 inhibitors and next-generation inhibitors, are developed and are expected to improve prognosis for patients with FGFR2 fusion-positive solid tumors.</p>","PeriodicalId":35588,"journal":{"name":"Japanese Journal of Cancer and Chemotherapy","volume":"53 5","pages":"327-331"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recent Advances in the Treatment of HER2-Altered Solid Tumors].","authors":"Toshio Suzuki","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Between 2024 and early 2026, HER2-directed oncology has rapidly evolved from a strategy confined to HER2-overexpressing malignancies to a histology-agnostic framework that accommodates diverse HER2 alterations, including amplification/overexpression, low-ultralow protein expression, and activating ERBB2 mutations. Antibody-drug conjugates (ADCs), led by trastuzumab deruxtecan, have established clinically meaningful activity across multiple solid tumors in HER2 IHC 3+ populations and have further expanded into HER2-low and ultralow expression settings, supporting the concept of HER2 as a biological continuum rather than a binary biomarker. In parallel, combination approaches integrating anti-HER2 ADCs with immune checkpoint inhibitors have shown encouraging signals in selected tumor types, underscoring potential immunomodulatory contributions of HER2 targeting. For ERBB2 tyrosine kinase domain (TKD) -activating mutations-particularly in non-small cell lung cancer-highly selective oral tyrosine kinase inhibitors (TKIs) have produced substantial response rates with favorable tolerability, consolidating mutation-defined therapy as a distinct clinical paradigm alongside protein expression-driven strategies. In gastroesophageal adenocarcinoma, treatment options beyond trastuzumab-based regimens continue to diversify: ADC-based standards in later lines are being complemented by next-generation HER2 antibodies, including recent phase Ⅲ evidence supporting anbenitamab after prior trastuzumab exposure, which may further inform sequencing decisions. Collectively, these advances highlight an emerging precision model in which therapeutic selection and rational sequencing are guided by integrated assessment of HER2 protein expression, ERBB2 genomic status, prior HER2-directed exposure, and toxicity risk (notably ADC-associated interstitial lung disease). Standardization of high-fidelity diagnostic workflows-spanning IHC/ISH quality assurance, re-biopsy when feasible, and context-appropriate use of circulating tumor DNA-will be essential to ensure consistent patient identification and to enable optimal deployment of ADCs, TKIs, and antibody-based therapies across histologic boundaries.</p>","PeriodicalId":35588,"journal":{"name":"Japanese Journal of Cancer and Chemotherapy","volume":"53 5","pages":"337-341"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Examination of Factors Affecting the Efficacy of Naldemedine Tosilate Tablets for Opioid-Induced Constipation].","authors":"Momoka Inoue, Kokoro Ijima, Mika Kurihara, Munetoshi Sugiura, Anna Kiyomi, Kensuke Yoshida, Kaori Hoshi, Tayu Kishimoto, Yoshikazu Tanaka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Opioid‒induced constipation (OIC) occurs in 60-90% of patients with cancer and can lead to a decline in their quality of life. Naldemedine tosilate tablets (NAL), approved in 2017, improves OIC by specifically binding to the μ-opioid receptor in the gastrointestinal tract. We conducted a study with 66 patients with cancer pain who were administered NAL at Chibaken Saiseikai Narashino Hospital between April 2018 from March 2024. We classified the patients into 2 groups based on their spontaneous bowel movements: a high-response group (39 patients) and a low-response group (27 patients). Data on patient characteristics, pain treatment, and constipation treatment were collected. Multivariate analysis was performed to identify the factors affecting the efficacy of NAL. Pre-NAL constipation (Grade 2 or higher) was a significant factor associated with an odds ratio of 4.383 (p = 0.009). However, caution should be exercised regarding the onset of diarrhea and watery stool formation after NAL administration.</p>","PeriodicalId":35588,"journal":{"name":"Japanese Journal of Cancer and Chemotherapy","volume":"53 5","pages":"342-346"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[BRAF-Mutant Solid Tumor].","authors":"Yoichi Naito","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>BRAF is a serine/threonine kinase that functions as a key component of the RAS/RAF/MEK/ERK (MAPK) signaling pathway and is recognized as an important oncogenic driver across multiple cancers. BRAF mutations are detected in a variety of malignancies including melanoma, thyroid cancer, colorectal cancer, non-small cell lung cancer, and biliary tract cancer. Among them, the V600 mutation results in constitutive activation of the MAPK pathway and promotes tumor growth and survival. BRAF mutations are currently classified into three functional classes (class 1-3) according to their signaling mechanisms and dependency on RAS activation. The development of BRAF inhibitors and MEK inhibitors has significantly improved outcomes in patients with BRAF V600-mutant melanoma, and combination therapy with these agents has become the standard of care. Clinical activity of BRAF/MEK inhibition has also been demonstrated in other malignancies such as non-small cell lung cancer and thyroid cancer. In contrast, BRAF-mutated colorectal cancer shows limited sensitivity to BRAF inhibitor monotherapy due to feedback activation of EGFR signaling, leading to the development of combination strategies including EGFR inhibitors. In recent years, basket trials such as VE-BASKET, NCI-MATCH, and ROAR have demonstrated the efficacy of BRAF-targeted therapies across tumor types, supporting the concept of tumor-agnostic treatment. Current BRAF inhibitors mainly target the active BRAF monomer; however, resistance mediated by RAF dimerization frequently occurs. Novel therapeutic approaches including pan-RAF inhibitors and ERK inhibitors are under development to overcome these resistance mechanisms.</p>","PeriodicalId":35588,"journal":{"name":"Japanese Journal of Cancer and Chemotherapy","volume":"53 5","pages":"332-336"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[RET Fusion-Positive Solid Tumor].","authors":"Kenji Kawada","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Selpercatinib, a RET inhibitor, is covered by insurance for all solid tumors that are positive for the RET fusion gene. The RET fusion gene is positive in 2% of lung cancers and 10-20% of papillary thyroid cancers. In other solid tumors, positivity is less than 0.5%. However, if positive, treatment is expected to be effective, so it is desirable to actively perform cancer gene panel testing.</p>","PeriodicalId":35588,"journal":{"name":"Japanese Journal of Cancer and Chemotherapy","volume":"53 5","pages":"323-326"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}