Publications by authors named "Takeshi Isobe"

Article Synopsis
  • There is limited research on how effective and safe the tyrosine kinase inhibitors osimertinib (OSI) and gefitinib (GEF) are for treating EGFR mutation-positive non-small cell lung cancer (NSCLC) in patients with low performance status (PS).
  • A study reviewed data from 113 patients, comparing the safety and efficacy of OSI and GEF, showing overall response rates of approximately 69% for GEF and 66% for OSI, with median progression-free survival being 6.9 months for GEF and 9.2 months for OSI.
  • Results indicated that OSI offered better overall survival (20.9 months) compared to GEF (13.0 months
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Background: Tyrosine kinase inhibitors (TKIs) inhibit receptor-mediated signals in cells. Axitinib is a TKI with high specificity for vascular endothelial growth factor receptors (VEGFRs).

Aim: We determined whether axitinib could induce senescence in human cancer cells and be lysed by the senolytic drug ABT-263.

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A 61-year-old man presented to our hospital with a chief complaint of chronic cough. He was diagnosed with lung squamous cell carcinoma at clinical stage cT2aN3M1a. He received chemotherapy up to the fourth line, but both the primary tumor and lymph node metastases increased in size.

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  • This study focuses on determining the D-dimer cut-off value for predicting venous thromboembolism in Japanese patients diagnosed with advanced lung cancer.
  • A multicenter observational study involved 1,008 lung cancer patients, identifying 62 with venous thromboembolism at diagnosis and analyzing their D-dimer levels.
  • The research found a D-dimer cut-off value of 3.3 μg/ml, suggesting that patients with levels at or above this may have venous thromboembolism, marking a significant finding in this patient population.
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  • A large-scale study in Japan aimed to evaluate the effectiveness of comprehensive genomic profiling (CGP) for diagnosing digestive cancers, including data from 547 patients with various cancer types.
  • The study developed a scoring system to identify significant genomic alterations, finding high detection rates for potentially actionable genomic changes (99.5%) and actionable alterations (62.5%).
  • The results highlighted that most digestive cancers were adenocarcinomas, and a proposed classification flowchart could help improve diagnosis, demonstrating CGP's clinical utility in managing digestive cancers.
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Lung cancer is a type of cancer that can metastasize to the lungs, brain, bones, liver, adrenal glands, and other organs; however, the occurrence of brain metastases is the most common event. Symptoms of brain metastasis include motor dysfunction, mental dysfunction, seizures, headaches, nausea, and vomiting, and significantly reduce the quality of life of cancer patients. Brain metastases are a poor prognostic factor, and controlling them is extremely important for prolonging prognosis and improving the quality of life.

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  • The study investigates the risk factors for hemorrhagic events in patients with advanced lung cancer undergoing treatment, finding a significant occurrence in 11.4% of participants.
  • Venous thromboembolism (VTE) and poorer performance status are identified as major risk factors for bleeding, while female sex and a specific cancer stage (M1a) are linked to a reduced risk.
  • The research emphasizes the need to monitor bleeding risks in patients receiving anticoagulant therapy for cancer-related thromboembolism.
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Primary lung cancer with pulmonary alveolar proteinosis (PAP) is a rare condition. We present a case of a patient with primary lung cancer with PAP treated with an immune checkpoint inhibitor (ICI). A 62-year-old man was diagnosed with autoimmune PAP 8 years prior to current admission.

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Article Synopsis
  • A 71-year-old man with advanced lung adenocarcinoma was treated with chemotherapy and immunotherapy, specifically carboplatin, pemetrexed, and pembrolizumab, starting in June 2020.
  • He continued maintenance therapy with pemetrexed and pembrolizumab until November 2022, but developed fever and severe fatigue in December 2022, with inconclusive tests for the cause of infection.
  • The patient was suspected to have immune-related cytokine release syndrome (CRS) and improved after being treated with prednisolone, highlighting that CRS can occur long after starting immune checkpoint inhibitor therapy.
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  • Older patients (over 75) with severe respiratory failure have a high mortality rate and struggle with daily activities, notably those who are frail.
  • A study at Shimane University Hospital analyzed the outcomes of 32 patients who were intubated and ventilated, comparing frail individuals to self-sufficient ones, finding that 50% of frail patients died compared to 33% of self-sufficient patients.
  • The results highlight the poor prognosis for frail patients, underscoring the need for careful evaluation before initiating intensive care treatments like intubation and ventilation.
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Background: Antimicrobial use (AMU) is closely related to the emergence of antimicrobial-resistant (AMR) bacteria. Meanwhile, long-term care hospitals (LTCHs) have been pointed out to be important reservoirs for AMR. However, evidence illustrating the association between AMU and AMR in LTCHs is lacking compared to that of acute care hospitals.

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Aims: Long-term administration of pemetrexed (PEM) in patients with lung cancer can cause renal damage, leading to treatment discontinuation. Previous reports have suggested that specific single nucleotide polymorphisms (SNPs) in the folylpolyglutamate synthase (FPGS) gene affect therapeutic efficacy; however, whether the FPGS SNPs affect renal function is unclear. Identifying SNPs related to renal damage during PEM administration may help predict the decrease in renal function caused by PEM.

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Emphysema limits airflow and causes irreversible progression of chronic obstructive pulmonary disease (COPD). Strain differences must be considered when selecting mouse models of COPD, owing to disease complexity. We previously reported that a novel C57BL/6JJcl substrain, the Mayumi-Emphysema (ME) mouse, exhibits spontaneous emphysema; however, the other characteristics remain unknown.

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A 59-year-old man presented with esophageal achalasia complicated by lipoid pneumonia. Dysphagia and diffuse ground-glass shadows on computed tomography led to the diagnosis of esophageal achalasia. An analysis of bronchoalveolar lavage (BAL) revealed yellow BAL fluid, with two distinct layers.

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Purpose: In Japan, both a 23-valent pneumococcal polysaccharide vaccine (PPSV23) and a 13-valent pneumococcal conjugate vaccine (PCV13) are available. Although randomized controlled trials have examined the effects of pneumococcal vaccines, few epidemiological studies have investigated the onset of pneumococcal pneumonia in general practice. In Izumo, Shimane Prefecture, Japan, a public subsidy for PPSV23 inoculation began in November 2012.

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Background: Asthma is a highly heterogeneous airway disease, and the clinical characteristics of patients with asthma with preserved and reduced physical activity are poorly understood.

Objective: We aimed to investigate the risk factors and clinical phenotypes associated with reduced physical activity in a wide range of patients with asthma.

Methods: We conducted a prospective observational study of 138 patients with asthma, including patients with asthma without chronic obstructive pulmonary disease (COPD) (n = 104) and asthma-COPD overlap (n = 34), and 42 healthy controls.

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An 83-year-old woman with RET fusion-positive advanced lung adenocarcinoma was administered selpercatinib 320 mg/day. Despite the shrinking of the tumour, fever, fatigue, and anorexia developed on day 17. Selpercatinib administration was interrupted.

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An 82-year-old man was treated with ipilimumab and nivolumab for malignant pleural mesothelioma. Although he was previously treated with prednisolone (1 mg/kg/day) for immune-related adverse event (irAE) hepatitis by a previous doctor, he still had worsening liver function and was transferred to our hospital. Blood tests and imaging findings were negative for autoimmune and infectious hepatitis, and liver biopsy results were consistent with irAE hepatitis.

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Endocytoscopy enables real-time observation of lesions at ultra-magnification. In the gastrointestinal and respiratory fields, endocytoscopic images are similar to hematoxylin-eosin-stained images. This study aimed to compare the nuclear features of pulmonary lesions in endocytoscopic and hematoxylin-eosin-stained images.

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Despite recent advances in cancer treatments, pancreatic cancer has a dismal prognosis globally. Early detection of cancer cells and effective treatments for recalcitrant tumors are required, but the innovative therapeutic tools remain in development. Cancer-specific antigens expressed only on cancer cells may help resolve these problems, and antibodies to such antigens have potential in basic research and clinical applications.

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Background: Endocytoscopy (ECS) provides a magnification of approximately 450× for real-time observation of lesion nuclei. Using ECS, we aimed to evaluate whether sufficient samples for diagnosis can be obtained during bronchoscopy. We also investigated whether ECS can enable two-class diagnosis of malignant or non-malignant transbronchial biopsy specimens in real-time during bronchoscopy.

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In recent years, the combination of platinum-based chemotherapy and immune checkpoint inhibitors (ICIs) has become the standard treatment for patients with lung cancer. Hepatitis is one of the common toxicities following ICI/chemotherapy. When drug-induced hepatitis occurs, the suspected drug must be discontinued.

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Article Synopsis
  • Management of cancer-associated venous thromboembolism (VTE) is crucial for treating advanced lung cancer, but a reliable VTE risk assessment method is currently lacking.
  • The Rising-VTE/NEJ037 study assessed VTE risk among 1008 patients with advanced lung cancer using the Khorana score, but results showed it had low predictive power for this population.
  • Factors such as female sex, adenocarcinoma type, and specific blood markers were more effective in identifying VTE risk, suggesting that alternative methods like prothrombin fragment 1 + 2 may be better suited for Japanese patients.
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We performed endocytoscopy (ECS) for the ex vivo evaluation of mesothelioma in specimens biopsied during medical thoracoscopy in three patients. We evaluated 19 biopsy specimens based on the density of nuclei and irregularity in the nuclei shape using ECS and compared them with the histopathological findings. All 10 specimens considered malignant based on ECS were diagnosed as malignant based on histopathology.

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