Publications by authors named "Kazumasa Komura"

Background: This study investigated the characteristics of prostate-specific antigen (PSA) dynamics when androgen receptor signaling inhibitor (ARSI), or vintage agent (bicalutamide) was used for patients with metastatic hormone-sensitive prostate cancer (mHSPC).

Patients And Methods: A total of 213 mHSPC patients from each of the ARSI and bicalutamide groups treated between 2015 and 2022 were selected from multiple institutions using propensity score-matched analysis to align backgrounds. PSA progression-free survival (PFS) and overall survival (OS) were assessed.

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Background: Androgen-receptor signaling inhibitors (ARSIs) become the new standard of care for metastatic hormone-sensitive prostate cancer (mHSPC). It is unknown whether time to castration resistance (TTCR), when using the first-line ARSIs, offers predictive value in mHSPC. We sought to assess the clinical outcomes for mHSPC patients treated with first-line ARSIs focusing on the TTCR.

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Hyper progressive disease (HPD) is a paradoxical phenomenon characterized by accelerated tumor growth following treatment with immune checkpoint inhibitors. However, the pathogenic causality and its predictor remain unknown. We herein report a fatal case of HPD in a 50-year-old man with metastatic bladder cancer.

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Background: Robotic three-dimensional magnified visual effects and field of view stabilization have enabled precise surgical operations. Intracorporeal anastomosis in right-sided colorectal cancer surgery is expected to shorten operation times, avoid paralytic ileus, and shorten wound lengths; however, there are few reports of intracorporeal anvil fixation for intestinal anastomosis in left-sided colorectal cancer surgery. Herein, we introduce a simple, novel procedure for using robotic purse-string suture (RPSS) in intracorporeal anastomosis with the double-stapling technique in rectal and sigmoid cancer surgery and report short-term outcomes.

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Background: Metastatic nonclear cell renal cell carcinoma (nccRCC) is a heterogeneous disease with poor prognosis. The clinical characteristics and prognostic factors of immuno-oncology (IO) combination therapy for nccRCC are not well known. This study analyzed patients with metastatic nccRCC treated with IO combination therapy.

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Article Synopsis
  • Immune checkpoint inhibitor (ICI) combination therapies are standard treatments for metastatic renal cell carcinoma (mRCC), but there are limited comparative studies using real-world data to assess their effectiveness.
  • The study analyzed records from 320 clear cell RCC patients to compare outcomes between those treated with ICI+ICI versus ICI+tyrosine kinase inhibitor (TKI) combinations.
  • Results showed that while overall survival was similar for both treatments, the progression-free survival was significantly longer for ICI+TKI, and patients on ICI+ICI had a higher rate of progressive disease, although treatment-related side effects varied between the two groups.
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  • The study compares the oncological outcomes of sentinel lymph node biopsy (SNB) and pelvic lymphadenectomy (PLD) in patients with early-stage cervical cancer.
  • A total of 104 patients, with tumor sizes mainly ≤2 cm, underwent laparoscopic or robot-assisted radical hysterectomy, showing that only one patient in the SNB group had lymph node metastasis compared to nine in the PLD group.
  • Follow-up results indicated a 100% disease-free survival (DFS) rate for the SNB group and a 91.5% rate for the PLD group, suggesting that SNB is adequate for patients with smaller tumors, potentially making PLD unnecessary.
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Background: Enfortumab vedotin (EV), an antibody-drug conjugate that targets Nectin-4, is used for patients with metastatic urothelial carcinoma who have experienced progression on platinum-based chemotherapy and checkpoint inhibitors. Despite the widespread use of the drug, evidence remains scarce regarding clinical indicators that can predict the response to EV treatment.

Objective: We aimed to explore the predictive value of clinical indicators derived from peripheral blood tests for treatment responses to EV.

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: The application of personalized cancer treatment based on genetic information and surgical samples has begun in the field of cancer medicine. However, a biopsy may be painful for patients with advanced diseases that do not qualify for surgical resection. Patient-derived xenografts (PDXs) are cancer models in which patient samples are transplanted into immunodeficient mice.

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Article Synopsis
  • Enfortumab vedotin (EV) is an antibody-drug conjugate used for treating metastatic urothelial carcinoma (UC) in patients who previously underwent immune checkpoint inhibitor (ICI) treatment, specifically avelumab or pembrolizumab.
  • A study involving 100 patients revealed that while progression-free survival (PFS) was better for those treated with EV after avelumab, overall survival (OS) rates were not significantly different between the two treatment groups.
  • Key prognostic factors affecting outcomes included histological variants, liver metastasis, low serum albumin, and high serum CRP levels, with cachexia patients experiencing particularly poor prognosis.
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  • - Enfortumab vedotin (EV) is an antibody-drug conjugate used for patients with metastatic urothelial carcinoma (mUC) who have progressed on checkpoint inhibitors (CPIs); however, there's limited evidence comparing EV directly with re-challenging chemotherapy in real-world settings.
  • - In a study of 350 mUC patients, those treated with EV showed an objective response rate (ORR) of 48% and a median overall survival (OS) of 29 months, compared to 14 months for re-challenging chemotherapy and 8 months for continuing CPIs beyond progression.
  • - While there was no significant difference in overall survival or progression-free survival between EV and re-challenging chemotherapy, the duration
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Patient-derived xenograft (PDX) models retain the characteristics of tumors and are useful tools for personalized therapy and translational research. In this study, we aimed to establish PDX models for uterine corpus malignancies (UC-PDX) and analyze their similarities. Tissue fragments obtained from 92 patients with uterine corpus malignancies were transplanted subcutaneously into immunodeficient mice.

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Background: Living kidney transplant donors are classified as stage 3 chronic kidney disease after kidney donation. For this reason, we provide daily lifestyle guidance, such as blood pressure and weight management before surgery, and dietary counseling focused on salt restriction. We emphasize providing lifestyle guidance after kidney donation.

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Replenishing tumor-suppressor miRNAs (TS-miRNAs) is a potential next-generation nucleic acid-based therapeutic approach. Establishing an effective miRNA delivery system is essential to successful TS-miRNA therapy. To overcome vulnerability to RNA nucleases, we previously developed a chemically modified miRNA143-3p (CM-miR-143).

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  • - Bladder cancer (BC) patients can experience shrinkage due to radiation-induced fibrosis, and specific microRNAs (miRNAs) are linked to this injury and overall survival.
  • - In a study of three Japanese BC patients, certain miRNAs (such as hsa-miR-130a and hsa-miR-200c) were highly expressed in those with fibrotic bladder shrinkage compared to patients with intact bladder function.
  • - Analysis of 409 BC patients revealed that high expression of specific miRNAs correlated with significantly longer median survival, indicating a potential role for these miRNAs in predicting patient outcomes and targeting profibrotic cytokines.
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Background: The incidence and prognosis of colorectal cancer are associated with lifestyle, family history, and genetic predisposition. Record linkage between cancer registries and biospecimen data would enable us to conduct clinical epidemiological studies on incidence or prognosis including genome information. In this study, we conducted a systematic review of clinical epidemiological studies of colorectal cancer using record linkage between cancer registries and biospecimen data and examined the possibilities for future use of this linkage.

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  • * This study investigated the expression of the cancer/testis antigen PRAME in patients with CIS, which had not been extensively researched before.
  • * Results showed that PRAME was expressed in 43.4% of patients with CIS, suggesting it could be a valuable diagnostic marker and a potential therapeutic target for difficult-to-treat cases.
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Objectives: To explore the characteristics of patients and assess the effectiveness of enfortumab vedotin (EV) in those with treatment-resistant advanced urothelial cancer in a real-world setting.

Patients And Methods: A multicenter observational study was conducted on 103 evaluable patients with advanced urothelial cancer who received EV. Outcomes were assessed by radiographic response, progression-free survival (PFS), and overall survival (OS), with treatment-related adverse events (trAEs).

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  • There is currently limited understanding of how alterations in fibroblast growth factor receptor 3 (FGFR3) affect bladder cancer (BLCA) and its tumor microenvironment (TME).
  • A study involving multi-omics analysis of BLCA tissues showed that aFGFR3 alterations are found in 44% of non-muscle invasive cases and 15% of muscle-invasive cases, affecting their immune response and tumor characteristics.
  • Notably, the LumP subtype in aFGFR3 cases responded significantly better to checkpoint inhibitors compared to their intact FGFR3 counterparts, suggesting that FGFR3 status influences treatment outcomes in bladder cancer.
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A limited number of patients with lung squamous cell carcinoma (SCC) benefit clinically from molecular targeted drugs because of a lack of targetable driver alterations. We aimed to understand the prevalence and clinical significance of lysine-specific demethylase 5D (KDM5D) copy number loss in SCC and explore its potential as a predictive biomarker for ataxia-telangiectasia and Rad3-related (ATR) inhibitor treatment. We evaluated KDM5D copy number loss in 173 surgically resected SCCs from male patients using fluorescence in situ hybridization.

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Purpose: This study investigates the utility of ureteroscopic surgery (URS) as an alternative to radical nephroureterectomy (RNU) in managing upper tract urothelial carcinoma (UTUC), with a focus on survival outcomes and re-evaluation of current the European Association of Urology guidelines criteria.

Methods: We conducted a retrospective, multi-institutional review of 143 UTUC patients treated with URS (n = 35) or RNU (n = 108). Clinicopathological factors were analyzed, and survival outcomes were assessed using Kaplan-Meier analysis and Cox proportional-hazards models.

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Background: Immune checkpoint inhibitors can cause various immune-related adverse events (irAEs). This study aimed to evaluate the association between the incidence of irAEs and oncological outcomes of metastatic renal cell carcinoma (mRCC) treated with nivolumab plus ipilimumab as first-line therapy.

Patients And Methods: We retrospectively analyzed data from 69 patients with mRCC treated with nivolumab plus ipilimumab as first-line therapy between September 2018 and September 2021 at 4 institutions.

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Article Synopsis
  • The study aimed to identify simple indicators from daily clinical practice that can predict the objective response to pembrolizumab in metastatic urothelial carcinoma patients, which is known for leading to better survival outcomes.
  • The analysis of 220 patients revealed that changes in the neutrophil-lymphocyte ratio (NLR) and the presence of liver metastasis were significant predictors of treatment response.
  • The risk model created categorized patients into favorable, intermediate, and poor risk groups, correlating with different objective response rates and overall survival outcomes, suggesting that those in the "poor risk" category might benefit from alternative therapies.
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  • * In a study of 50 platinum-refractory mUC patients, 24% had TLS, but no significant difference in NLR between groups with or without TLS was found.
  • * The research showed that lower NLR patients with TLS had longer overall survival and progression-free survival, while these benefits were not seen in higher NLR patients, suggesting that the presence of TLS may correlate with better treatment outcomes in specific patient groups.
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