Publications by authors named "Daisuke Kawakita"
Article Synopsis
- Pembrolizumab, an immune checkpoint inhibitor, shows effectiveness in treating recurrent and metastatic salivary gland carcinoma (SGC), but no predictive biomarkers for its efficacy have been established prior to this study.
- A study involving 27 patients identified optimal cut-off values for the combined positive score (CPS) and tumor proportion score (TPS) of PD-L1, which were found to significantly predict treatment outcomes.
- The overall response rate for SGC was 25.9%, with higher response rates in patients with high CPS and TPS, and a lower platelet-lymphocyte ratio correlated with improved progression-free survival, while the treatment demonstrated a good safety profile with no severe adverse events.
Background: The purpose of this study is to elucidate whether total pharyngolaryngectomy (TPL) or chemoradiotherapy (CRT) provides a better prognostic outcome in patients with T4aM0 hypopharyngeal carcinoma (HPSCC) using a nationwide database.
Methods: All data were obtained from the Head and Neck Cancer Registry of Japan, and information from patients who were newly diagnosed with T4aM0 HPSCC between 2011 and 2015 was extracted. The primary endpoint was disease-specific survival (DSS), and the secondary endpoint was overall survival (OS).
Many researchers have focused on the role of the autonomic nervous system in the tumor microenvironment. Autonomic nerves include the sympathetic and parasympathetic nerves, which are known to induce cancer growth and metastasis. However, in salivary duct carcinoma (SDC), a rare and highly malignant tumor, the issue should be investigated from both biological and therapeutic perspectives.
View Article and Find Full Text PDFObjectives: The aim of present study was to evaluate the clinical efficacy of hyperbaric oxygen therapy (HBOT) as a primary therapy combined with standard systemic corticosteroid treatment for sudden sensorineural hearing loss (SSNHL) compared to treatment without the use of HBOT (non-HBOT) through clinical data and advanced analytical approaches.
Study Design: Case-control study.
Methods: Conducted across three Japanese medical centers involving 298 SSNHL patients diagnosed between 2020 and 2023.
Article Synopsis
- A study in Japan compared two treatment intervals for nivolumab (480 mg every 4 weeks vs. 240 mg every 2 weeks) to evaluate their efficacy, safety, and economic impact on cancer patients, as prior real-world data was lacking.
- The analysis of 126 patients showed no significant differences in overall survival or adverse event rates between the two groups, indicating similar effectiveness and safety.
- However, the 4-week treatment interval had lower medical costs (excluding drug costs) than the 2-week interval, suggesting a potential economic advantage for using the longer treatment period.
Background: Pembrolizumab alone or combined with chemotherapy is the standard of care for first-line treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) with positive programmed death-ligand 1 combined positive scores. However, data on second-line chemotherapy following pembrolizumab are scarce.
Methods: A single-center, retrospective study was conducted to determine the efficacies of pembrolizumab and pembrolizumab plus chemotherapy as first-line treatments and the efficacy of second-line chemotherapy for patients with R/M HNSCC who were refractory or intolerant to first-line treatment.
Article Synopsis
- Salivary duct carcinoma (SDC) has a low 5-year survival rate of 40%, and the impact of brain metastasis (BM) on patient outcomes is not well understood.
- A study of 464 SDC patients revealed that 14% had BM, with a median overall survival (mOS) of 13.1 months, and several factors linked to poorer survival, including performance status and uncontrolled disease.
- A new prognostic tool, the SDC-graded prognostic assessment (GPA) score, shows varying mOS estimates based on different scores, demonstrating its effectiveness in estimating outcomes for patients with BM.
Background: It is unclear witch regimen is optimal as salvage chemotherapy (SCT) after immune checkpoint inhibitor (ICI) monotherapy for recurrent or metastatic head and neck cancer (RM-HNC).
Methods: This study enrolled 109 patients. Overall survival (OS) and progression-free survival 2 (PFS2) were compared between patients stratified by SCT regimen.
Article Synopsis
- - The study investigates the effectiveness of concurrent chemotherapy with radiotherapy (CRT) compared to radiation therapy (RT) alone for elderly patients with head and neck cancer in Japan.
- - Among patients aged 70 and older, CRT was more commonly used, and those aged 75 and older showed better overall survival rates with CRT, although progression-free survival rates were similar for both treatments.
- - The researchers concluded that, despite the frequent use of CRT in older patients, its effectiveness remains uncertain, indicating the need for more thorough trials to clarify whether CRT is actually better than RT alone for this demographic.
Advances in diagnostic techniques and treatment modalities have impacted head and neck cancer (HNC) prognosis, but their effects on subsite-specific prognosis remain unclear. This study aimed to assess subsite-specific trends in mid- and long-term survival for HNC patients diagnosed from 1993 to 2011 using data from population-based cancer registries in Japan. We estimated the net survival (NS) for HNC by subsite using data from 13 prefectural population-based cancer registries in Japan.
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- * Among 614 patients analyzed, those who experienced irAEs had significantly higher eosinophil counts before treatment compared to those who did not experience irAEs, especially in anti-PD-1 and anti-CTLA-4 therapy groups.
- * The research concluded that a pre-treatment eosinophil count of 3.0% or higher is an independent risk factor for developing irAEs across various cancers treated with ICIs.
Fluorouracil (FU) exerts its antitumor activity by inhibiting folate-mediated one-carbon metabolism. Evidence that folate may play a role in the carcinogenic process via folate-mediated one-carbon metabolism has given rise to the hypothesis that pre-diagnostic folate intake may induce heterogeneous chemosensitivity to FU-containing induction chemotherapy (IC) in head and neck cancer. To assess this hypothesis, we conducted a cohort study to investigate whether the association between prediagnostic dietary folate intake and cancer survival differed between treatment regimens with and without FU-containing IC in 504 cases of locally advanced (stage III/IV) HNSCC, using an epidemiologic database combined with clinical data.
View Article and Find Full Text PDFDosimetric and radiobiological analyses of a de-escalation strategy for elective nodal regions in human papillomavirus-associated oropharyngeal cancer.
Tech Innov Patient Support Radiat Oncol
December 2023
Article Synopsis
- Researchers studied a new treatment method for patients with a certain type of throat cancer caused by HPV.
- They used two different plans for giving radiation, one standard and one with less radiation (called de-escalation), to see which was safer.
- The results showed that the de-escalation plan had fewer harmful side effects, helping to keep patients' quality of life better.
Objective: This study aimed to analyze the nationwide prognosis of patients with nasopharyngeal carcinoma who underwent definitive radiotherapy in Japan, utilizing the National Head and Neck Cancer Registry data.
Methods: A total of 741 patients diagnosed with primary nasopharyngeal carcinoma were screened from 2011 to 2014. The inclusion criteria were histologically proven nasopharyngeal squamous cell carcinoma, receiving definitive radiotherapy, and no distant metastases.
Background/aim: The 8 edition of the American Joint Committee on Cancer staging system classifies oropharyngeal cancer (OPC) by the expression of p16. The discrepancy observed in this system between pathological and clinical N-stages in p16-positive OPC has provoked controversy. Therefore, this study investigated prognostic factors not included in the new staging system for p16-positive OPC patients.
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- Adenoid cystic carcinoma (AdCC) of the salivary gland is a slow-growing cancer that can sometimes spread to distant sites, although not commonly through lymph nodes.
- A study of 175 patients without lymph node metastasis identified key prognostic factors that influence disease free survival (DFS), distant metastasis free survival (DMFS), and overall survival (OS), particularly focusing on positive surgical margins and tumor stage.
- The findings showed that patients with no positive prognostic factors (PS0) had significantly better 10-year survival rates compared to those with one or more positive factors (PS1, PS2), indicating the importance of these factors in predicting patient outcomes.
Article Synopsis
- - The "Japanese Clinical Practice Guidelines for Head and Neck Cancer - 2022 Update" aims to review and update standard diagnosis and treatment approaches based on the latest evidence in the field.
- - Developed by a diverse committee of experts, including surgeons, oncologists, and rehabilitation specialists, these guidelines are based on the previous 2018 edition and include input from public feedback.
- - The guidelines address 59 clinical questions across 13 categories, with a focus on six specific clinical questions and their corresponding recommendations and comments.
Article Synopsis
- Salivary duct carcinoma (SDC) is an aggressive salivary gland cancer, and recent advancements in immunotherapy targeting immune checkpoints (like PD1 and CTLA4) show promise for treatment.
- * The study analyzed 175 SDC cases, focusing on various immune markers and their correlation with tumor behavior, indicating that high levels of certain markers (CD8, PD-L1, etc.) relate to more aggressive cancer features and worse outcomes.
- * Interestingly, there were no cases with microsatellite instability (MSI-high), suggesting that a mix of immune activity in SDC may hinder effective T-cell function and highlight potential strategies for immune checkpoint combination therapies.*
Approximately 60% of adenoid cystic carcinoma (AdCC) cases are positive for MYB::NFIB or MYBL1::NFIB, whereas MYB/MYBL1 oncoprotein, a key driver of AdCC, is overexpressed in most cases. Juxtaposition of superenhancer regions in NFIB and other genes into the MYB/MYBL1 locus is an attractive oncogenic hypothesis for AdCC cases, either negative or positive for MYB/MYBL1::NFIB. However, evidence supporting this hypothesis is insufficient.
View Article and Find Full Text PDFThis sentinel node (SN) biopsy trial aimed to assess its effectiveness in identifying predictive factors of micrometastases and to determine whether elective neck dissection is necessary in oral squamous cell carcinoma. This retrospective study included 55 patients from three previous trials, with positive SNs. The relationship between the sizes of the metastatic focus and metastasis in non-sentinel node (NSN) was investigated.
View Article and Find Full Text PDFBackground: A multicenter, randomized controlled phase III trial was conducted on sentinel lymph node biopsy (SLNB) and elective neck dissection for T1 (depth of invasion ≥ 4 mm)-T2N0M0 oral cavity squamous cell carcinoma. This study identified factors associated with poor prognosis in patients who underwent SLNB based on a subgroup analysis of this trial.
Methods: We analyzed 418 sentinel lymph nodes (SLNs) from 132 patients who underwent SLNB.
We previously reported that regulatory T (Treg) cells expressing CTLA-4 on the cell surface are abundant in head and neck squamous cell carcinoma (HNSCC). The role of expanded Treg cells in the tumor microenvironment of HNSCC remains unclear. In this study, we reveal that the tumor microenvironment of HNSCC is characterized by the high expression of genes related to Treg cells, dendritic cells (DCs), and interleukin (IL)-17-related molecules.
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