Publications by authors named "Kazuyoshi Ohkawa"
Hemolytic anemia is a rare and unique complication of alectinib, not observed with other anaplastic lymphoma kinase (ALK) inhibitors. Here, we present a case of an ALK fusion-positive non-small-cell lung cancer (NSCLC) patient who developed liver failure due to diffuse liver metastasis at initial diagnosis. Treatment was initiated with low-dose alectinib, but the patient developed severe hemolytic anemia.
View Article and Find Full Text PDFTreatment strategies for preventing liver fibrosis have not yet been established. Letrozole, widely used for breast cancer, has recently been reported to suppress liver fibrosis in murine models. Therefore, we aimed to validate the suppressive effects of letrozole on liver fibrosis in the clinical setting.
View Article and Find Full Text PDFAntiapoptotic protein, including Mcl-1, expression is frequently observed in pancreatic cancer. Gemcitabine plus nabpaclitaxel (GnP) is the standard chemotherapy for metastatic pancreatic cancer (MPC); however, predictive markers for its efficacy remain unestablished. This study evaluated the association between GnP's therapeutic effects and Mcl-1 expression in tissue samples obtained using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic tumor or percutaneous ultrasound-guided biopsy for metastatic liver tumor.
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- * An abscopal effect, where treatment effects occur in non-irradiated areas, can be linked to radiation-induced immune responses, but its clinical significance in immunotherapy is still unclear due to limited cases.
- * A case study showed that after stereotactic body radiotherapy (SBRT), the combination of atezolizumab and bevacizumab led to a complete response in a patient with advanced HCC, highlighting the potential of combining these therapies post-radiotherapy for improving treatment outcomes.
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- The study investigated the detection of gBRCA mutations in pancreatic cancer patients and the effectiveness of olaparib maintenance therapy for those mutations.
- Out of 84 patients tested, 11.9% had gBRCA mutations, with a higher mutation rate found in individuals with a family history of Hereditary Breast and Ovarian Cancer (HBOC).
- Most patients who received olaparib after platinum-based chemotherapy showed positive responses, with a median treatment duration of 17.5 months for chemotherapy and 11 months for olaparib maintenance therapy.
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- The study aimed to assess the effectiveness and safety of nanvuranlat, an L-type amino acid transporter 1 inhibitor, as a treatment for advanced biliary tract cancers that are hard to treat.
- Conducted across 14 Japanese medical centers, the trial involved 211 patients, with 105 eligible participants randomly assigned to receive either nanvuranlat or a placebo, focusing on progression-free survival (PFS) as the main measure of success.
- Results showed that nanvuranlat significantly improved PFS compared to placebo, although overall survival rates were similar, suggesting the need for further research, especially in specific cancer subtypes like intrahepatic and extrahepatic cholangiocarcinoma.
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- The study investigates how self-expandable metallic stents (SEMSs) affect radiation doses compared to plastic stents (PSs) during biliary decompression, using a water-equivalent phantom for evaluation.
- Results show that SEMSs generally cause smaller dose differences in radiation delivery compared to PSs, particularly in proximal and distal locations, which is statistically significant.
- However, significant dose variations were noted at the surfaces of the radiopaque markers on SEMSs, suggesting that while SEMSs can be used safely in patients undergoing radiation therapy, careful monitoring of dose distribution is essential.
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- The study aimed to evaluate the safety of combining atezolizumab and bevacizumab (Atezo/Bev) immunotherapy with direct oral anticoagulants (DOACs) due to concerns about increased bleeding risks.
- It involved 141 patients with unresectable hepatocellular carcinoma (HCC) or advanced lung cancer, analyzing bleeding events in those on DOACs versus those not on any antithrombotics.
- Results indicated no significant differences in bleeding rates between patients using DOACs and those not using antithrombotics, suggesting that using DOACs with Atezo/Bev may be safe with proper monitoring.
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- - Pancreatic acinar cell carcinoma (PACC) is a rare cancer that doesn't have its own specific treatment, so therapies are adapted from those used for pancreatic ductal adenocarcinoma (PDAC).
- - The case study discusses an older patient with recurrent PACC who achieved long-term survival through systemic chemotherapy, chemoradiotherapy, and maintenance therapy guided by a pathogenic BRCA2 variant.
- - The study highlights that BRCA variants are more common in PACC patients compared to those with PDAC, affecting treatment decisions and outcomes, and emphasizes the importance of early genomic testing in PACC treatment.
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- Patients with advanced pancreatic cancer often suffer from taste disturbances (dysgeusia) and zinc deficiency during chemotherapy, prompting a study on the effects of zinc supplementation.
- A study involving 33 patients evaluated the impact of zinc acetate hydrate over 12 weeks, finding significant increases in serum zinc levels and gradual improvement in taste issues—a 42.4% improvement by the end of the study.
- The results suggest that zinc supplementation not only enhances taste perception but may also help maintain nutritional status, as evidenced by stable serum albumin levels in patients who responded to treatment.
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- Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is important for diagnosing pancreatic cancer and initiating targeted therapies, but sample insufficiency is a common issue that needs to be addressed.
- A study conducted at the Osaka International Cancer Institute involved 42 patients, comparing the effectiveness of oil blotting paper versus filter paper for fixing EUS-TA samples for analysis.
- Results showed that samples fixed with oil blotting paper had significantly larger tissue areas and a higher frequency of abundant tumor cells, suggesting it enhances sample adequacy for molecular testing.
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- * Involving 29 patients, 14 locoregional treatments were applied, resulting in all patients achieving either complete response or salvage status.
- * The combination therapy group showed a significantly higher objective response rate (80%) compared to the atezo/bev alone group (21.1%), and the combination group also experienced longer progression-free and overall survival rates.
Main pancreatic duct (MPD) dilatation is reported to be a risk factor for pancreatic cancer (PC). Although magnetic resonance cholangiopancreatography (MRCP) and ultrasonographic modalities are valuable for monitoring the pancreas, there is limited information on the efficacy of different imaging modalities in measuring MPD diameter. To improve pancreatic imaging, we developed a specialized ultrasound approach focusing on the pancreas (special pancreatic US).
View Article and Find Full Text PDFIntroduction: Portal vein aneurysm (PVA) is a rare saccular or fusiform portal vein dilatation. The management and optimal treatment of PVA remain unknown.
Case Presentation: A 53-year-old man with hepatitis C virus (HCV) infection was diagnosed with PVA measuring 28 mm in diameter.
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- - This study evaluated the effectiveness and safety of atezolizumab plus bevacizumab in treating unresectable hepatocellular carcinoma in real-world settings, involving 222 patients from 19 hospitals.
- - The findings revealed an objective response rate of 22.0% and a median progression-free survival of 5.7 months, with certain factors (like younger age, more tumors, and macrovascular invasion) linked to shorter progression-free survival.
- - Despite a median overall survival not being reached, key risk factors for reduced survival included absence of hyperlipidemia, multiple intrahepatic tumors, macrovascular invasion, and elevated neutrophil-to-lymphocyte ratios, with 36.0% of
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- - Pancreatic acinar cell carcinoma is a rare type of pancreatic cancer, primarily affecting males and occasionally children, with a higher chance of elevated serum lipase levels in patients.
- - This cancer typically presents as large tumors (around 5 cm) in the pancreas, especially at the head, and requires immunostaining for accurate diagnosis; it has a better prognosis than pancreatic ductal adenocarcinoma despite a high recurrence rate after surgery.
- - Genetic testing is crucial for treatment planning, as this type of cancer has a unique genetic profile that suggests sensitivity to certain therapies, such as platinum-based drugs and PARP inhibitors, due to its lack of common mutations found in other pancreatic cancers.
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- The study investigates the effectiveness of chemotherapy for older adults (≥70 years) with metastatic biliary tract cancer (BTC), a common issue since most BTC patients are diagnosed in this age group.
- Using data from a large Japanese cancer registry, researchers analyzed the outcomes of 207 older patients with metastatic BTC to determine how chemotherapy impacts their overall survival compared to best supportive care.
- Results showed that chemotherapy significantly improved survival rates (6.4 months vs. 1.8 months) in patients under 80, while treatment types varied by age; younger patients often received combination therapy, whereas older patients tended to undergo monotherapy.
Background: Nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil (5-FU)/levo-leucovorin (Levo-LV) was approved for unresectable pancreatic cancer (UR-PC) in March 2020 in Japan. Levo-LV is administered by intravenous infusion over 120 min following 90 min intravenous infusion of nal-IRI (conventional method), causing a significant burden on both patients and the outpatient chemotherapy room owing to the prolonged administration time. Thus, from July 2021, we introduced the simultaneous intravenous administration of nal-IRI and Levo-LV (parallel method) with the approval of the institutional regimen committee.
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- Pancreatic cancer (PC) has a poor prognosis, and this study examines how hospital volume affects outcomes in patients with metastatic PC using a decade's worth of data from the Osaka Cancer Registry.
- The research categorizes hospitals into high-volume, middle-volume, and low-volume based on the number of PC diagnoses, analyzing overall survival (OS) rates among these groups.
- Findings show that patients treated at high-volume hospitals have significantly better OS compared to those at middle and low-volume hospitals, indicating that hospital volume is an important factor in treatment outcomes for metastatic PC.
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- - The report emphasizes that multiple myeloma should be considered when diagnosing pancreatic tumors with associated bone lesions.
- - It suggests that examining both the pancreatic tumor and the bone lesions is crucial for accurate diagnosis.
- - By sampling from both areas, healthcare providers can improve their chances of identifying the correct condition.
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- Cytology is a quick method for identifying liver tumors, and this study focused on its effectiveness in diagnosing malignancies through liver biopsies.
- The study involved comparing traditional cytology and on-site cytology with histopathology in patients with liver tumors, finding a high sensitivity (97.6%) for detecting malignancies.
- Results showed that non-HCC tumors had even higher detection rates than HCCs, and on-site cytology proved useful for making quick preliminary diagnoses, which is crucial for patients with advanced cancer who need rapid treatment.
Background And Aim: To investigate the outcomes in eight Japanese patients with cancer treated with mycophenolate mofetil (MMF) and corticosteroids for immune checkpoint inhibitor treatment-induced severe immune-related hepatitis (ir-hepatitis) and the efficacy and safety of MMF.
Methods: We retrospectively examined patient background, treatment course, as well as examination and imaging data using electronic medical records.
Results: The ratio of male to female patients was 7:1, and the median age was 60 years (27-72 years).
The fifth version of the Clinical Practice Guidelines for Hepatocellular Carcinoma was revised by the Japan Society of Hepatology, according to the methodology of evidence-based medicine and partly to the Grading of Recommendations Assessment, Development and Evaluation system, which was published in October 2021 in Japanese. In addition to surveillance-diagnostic and treatment algorithms, a new algorithm for systemic therapy has been created, as multiple drugs for hepatocellular carcinoma can be currently selected. Here, new or revised algorithms and evidence on which the recommendations are based are described.
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