Publications by authors named "Boku Narikazu"

Background: Patients with advanced gastric cancer (AGC) have poor survival after first-line treatment containing an anti-programmed death-1/ligand 1 (PD-1/PD-L1) antibody. Accumulating evidence suggests rationales for continuing immunotherapy beyond progression, synergistic effects between immune checkpoint inhibitors and angiogenesis inhibitors, and a preferable combination of steroid-free chemotherapy with immunotherapy. These rationales imply that nanoparticle albumin-bound (nab)-paclitaxel plus ramucirumab in combination with nivolumab (anti-PD-1 antibody) may enhance anti-tumor effects as second-line treatment.

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  • The study examined the prevalence and characteristics of MSI-high tumors in patients with metastatic or recurrent gastric cancer (GC) that had not yet undergone chemotherapy.
  • MSI-high GC was found in 5.6% of patients, with higher prevalence in females, individuals aged 70 and older, tumors located in the lower stomach, HER2-negative cases, and patients without liver metastases.
  • Understanding these MSI-high tumors can enhance clinical practices and inform future research targeting this specific subtype of GC.
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  • Stage IV gastric cancer is typically treated with palliative chemotherapy, but even with improved treatment options, outcomes remain poor, indicating a need for better strategies.
  • There is ongoing debate about whether adding local therapies like surgery can improve management for patients with unresectable stage IV gastric cancer.
  • A phase III clinical trial is being conducted in Japan to investigate if conversion surgery after palliative chemotherapy offers better overall survival compared to chemotherapy alone, with plans to enroll 126 patients over 5 years.
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Introduction: Cell-free and concentrated ascites reinfusion therapy (CART) is frequently used to relieve the symptoms caused by massive ascites due to peritoneal metastasis of gastric cancer, especially in the later stages of its clinical course. Irinotecan (CPT-11) is recommended for third- or later-line chemotherapy according to gastric cancer treatment guidelines. However, the concentrations of anti-cancer drugs in the ascites and the product of CART are not well known, it is considered that some amounts of anti-cancer drugs contained in the product of CART may be readministered and induce severe adverse reactions.

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  • Olanzapine is an atypical antipsychotic that helps prevent nausea and vomiting, particularly after highly emetogenic chemotherapy (HEC), but it can cause side effects like hyperglycemia and drowsiness.
  • A systematic review and meta-analysis assessed the effectiveness of olanzapine combined with standard triplet antiemetic therapy compared to triplet therapy alone, focusing on outcomes like nausea control and adverse effects.
  • Results showed that adding olanzapine significantly improved nausea and vomiting prevention in both acute and delayed phases with minimal adverse effects, indicating it can be beneficial for patients undergoing HEC.
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  • Research lacks a standardized multi-day antiemetic regimen for chemotherapy, making it difficult to assess efficacy and safety.
  • A comprehensive search revealed no direct comparisons between multi-day and single-day antiemetic regimens, with variations in study quality and treatment protocols hindering robust analysis.
  • Preliminary findings indicate that three-drug combination therapies, particularly using aprepitant, may outperform two-drug regimens; further research is needed to better define antiemetic approaches for multi-day chemotherapy.
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Background: To define the optimal chemotherapy regimen for each patient we therefore used tissue from patients to identify molecular prognostic or predictive biomarkers.

Methods: Endoscopic biopsy specimens from primary lesions and surgical specimens on a phase III trial in patients with unresectable advanced or recurrent gastric cancer treated with docetaxel with cisplatin plus S-1 (DCS) or cisplatin plus S-1 (CS), were collected. We measured the mRNA expression of ERCC1 and analyzed SNPs in GSTP1 and ERCC1.

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Background: Gastric cancer (GC) is one of the most common and deadly malignant diseases worldwide. Despite revolutionary advances, the therapeutic efficacy of anti-PD1/PDL1 monoclonal antibodies in advanced GC is still low due to the emergence of innate and acquired resistance to treatment. Myeloid cells represent the majority of human immune cells.

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  • Palonosetron is a second-generation anti-nausea drug that might be more effective than first-generation medications, and this study explores how dexamethasone (DEX) works with it during chemotherapy.
  • Researchers compared the effects of giving DEX for 1 day versus 3 days in preventing nausea and vomiting after moderately emetogenic chemotherapy (MEC), using data from studies published between 1990 and 2020.
  • The findings showed that while the 3-day DEX group had a higher rate of no vomiting, there were no major differences in most anti-nausea effects, suggesting that DEX treatment could be shortened to just 1 day when paired with palonosetron.
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  • Advanced gastric cancer (AGC) has a poor prognosis, with median survival under 14 months, and there are limited effective molecular targeted therapies available.
  • The study developed a deep phosphoproteome analysis from quick endoscopic biopsies, identifying three subtypes of AGC based on phosphorylation signaling and indicating dynamic changes in cancer cell behavior during treatment.
  • The research focuses on targeting AXL in relation to epithelial-mesenchymal transition (EMT) signaling and offers valuable insights for future therapeutic strategies and biomarkers for AGC.
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  • - The study focuses on the effectiveness and safety of dexamethasone-sparing antiemetic therapies, particularly neurokinin-1 antagonists (NKRA), for preventing chemotherapy-induced nausea and vomiting (CINV) in patients undergoing highly emetogenic chemotherapy (HEC).
  • - A systematic review of literature identified and analyzed two studies involving anthracycline-cyclophosphamide and cisplatin-based regimens; while no significant differences in vomiting prevention were found, some outcomes related to nausea showed variability.
  • - The review concludes that dexamethasone-sparing antiemetic therapies can be effective in preventing CINV for HEC, particularly in patients receiving anthracycline-cyclophosphamide
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  • * Most patients received paclitaxel-based treatments (49%), followed by fluoropyrimidines plus platinum (44%), and irinotecan (7%), with overall response rates of 28.7% and disease control rates of 54.1%.
  • * Results indicated a median progression-free survival (PFS) of 5.1 months and overall survival (OS) of 12.9 months, with the combination of paclitaxel and ramucirumab
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  • Chemotherapy-induced nausea and vomiting (CINV) negatively impacts patient quality of life, leading to a study that evaluated the effectiveness of adding neurokinin-1 receptor antagonists (NK1RAs) to existing antiemetic treatments for patients undergoing moderately emetogenic chemotherapy (MEC).
  • A systematic review of clinical studies identified 15 randomized controlled trials involving over 4,400 patients, revealing that triplet antiemetic regimens including NK1RAs significantly improved complete response and complete control of nausea compared to doublet regimens, without increasing adverse events.
  • While the addition of NK1RA shows promise for enhancing antiemetic efficacy in carboplatin-based chemotherapy, further research is needed
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  • The study analyzed the use and costs of first-line chemotherapy for advanced/recurrent gastric cancer (AGC) in Japan, focusing on patients with HER2-negative AGC treated in 2022.
  • A total of 2113 patients were evaluated, revealing that expensive chemotherapy regimens (costing over 500,000 JPY per month) primarily included triplet therapy with fluoropyrimidine, oxaliplatin, and the immune inhibitor nivolumab.
  • The findings showed that these costly regimens were utilized by 67% of patients, including a significant portion of older patients, highlighting the need for more research on the economic implications of such drugs.
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  • Nivolumab combined with chemotherapy has become the standard treatment for advanced HER2-negative gastric cancer, with a focus on understanding its long-term effects through clinical trials.
  • In the ATTRACTON-4 trial, conducted across Japan, South Korea, and Taiwan, patients were assigned to either nivolumab or a placebo alongside common chemotherapy regimens, with the primary goals being progression-free survival and overall survival.
  • After three years, the nivolumab group showed longer progression-free survival but similar overall survival compared to the placebo group, with a significant majority of patients who responded completely to treatment remaining alive, indicating its effective and safe use in this setting.
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Purpose: As long-term survival improves after allogeneic hematopoietic stem cell transplantation (HSCT), the risk for secondary solid cancers, including colon cancer, also increases. However, the pathogenesis of secondary solid cancers in post-HSCT patients remains unclear. This study aimed to investigate the involvement of local immunity in colon carcinogenesis in post-HSCT patients by assessing the infiltrating T cells in colon adenomas as premalignant lesions of colon cancer in adenoma-carcinoma sequence.

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Peritoneal tumor dissemination and subsequent malignant tumor ascites (MTA) occur unexpectedly and repeatedly in patients with gastrointestinal (GI) cancers, and worsen quality of life and prognosis of the patients. Various treatments have been clinically developed for these patients, while most of the MTA cases are refractory to the treatments. Thus, effective treatments are urgently needed to improve the clinical outcomes.

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Purpose: To investigate circulating tumor DNA (ctDNA) RAS mutant (MT) incidence before salvage-line treatment and the clinicopathological features and molecular biological factors associated with the efficacy of anti-epithelial growth factor receptor (EGFR) monoclonal antibody (mAb) rechallenge for tissue RAS/BRAF wild type (WT) metastatic colorectal cancer (mCRC).

Methods: This multi-institutional retrospective observational study included 74 patients with mCRC with tissue RAS/BRAF WT refractory to first-line chemotherapy containing anti-EGFR mAb. ctDNA RAS status was assessed using the OncoBEAM™ RAS CRC Kit.

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  • In Asia, adjuvant chemotherapy combined with nivolumab post-gastrectomy is being assessed for effectiveness and safety in treating pathological stage III gastric or gastro-oesophageal junction cancer.
  • The ATTRACTION-5 trial involved a randomized, double-blind study across 96 hospitals in East Asia, enrolling patients aged 20-80 with confirmed stage IIIA-C cancer following specific surgeries.
  • Patients were divided into two groups to receive either nivolumab with chemotherapy or a placebo with chemotherapy, with the main focus on measuring relapse-free survival and analyzing safety data.
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Trastuzumab deruxtecan (T-DXd) has demonstrated remarkable efficacy as a third- or later-line chemotherapy for human epidermal growth factor receptor 2 (HER2)-positive advanced gastric and gastroesophageal junction adenocarcinomas. However, it may cause pneumonitis, and its efficacy in rare histologies such as gastric adenocarcinoma with enteroblastic differentiation (GAED) remains unclear. A 74-year-old woman with unresectable HER2-positive GAED and lung metastasis received T-DXd as a fifth-line chemotherapy.

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  • - The Japan Society of Clinical Oncology updated its 2023 Clinical Practice Guidelines for Antiemesis to incorporate recent findings on antiemetics and cancer treatments, reflecting the latest advancements in the field
  • - A thorough literature search from 1990 to 2020 was conducted to guide the update, leading to the development of 13 background questions, 12 clinical questions, and three future research questions
  • - The updated guidelines aim to enhance understanding and decision-making about antiemetic therapy for both patients and healthcare providers
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  • The study evaluated the effectiveness of non-drug therapies for managing anticipatory chemotherapy-induced nausea and vomiting (CINV) in cancer patients, focusing on the impact of past chemotherapy experiences.
  • Out of 107 studies reviewed, six were suitable for inclusion, highlighting three key non-pharmacologic treatments: systematic desensitization, hypnotherapy, and yoga therapy; systematic desensitization showed significant positive results in reducing nausea and vomiting.
  • Despite promising findings for systematic desensitization, concerns about study quality and inconsistent reporting of side effects indicate a need for more rigorous research before these methods are widely adopted in clinical practice.
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Introduction: Older patients with cancer are less likely to express their treatment preferences than younger patients. Question prompt lists (QPLs) facilitate communication between patients and physicians. Geriatric assessment (GA) is recommended when older patients with cancer make treatment decisions.

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