Publications by authors named "Yuto Matsushita"
Nivolumab plus ipilimumab (NIVO+IPI) has a long-term response rate of 30% for patients with metastatic renal cell carcinoma (mRCC). However, 20% of patients develop primary resistant disease (PRD) to NIVO+IPI and show poor survival outcomes. In this study, we aimed to evaluate the effect of PRD as a second-line treatment in patients with mRCC.
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- Enfortumab Vedotin (EV) is an effective treatment for advanced urothelial carcinoma (UC) patients who have already undergone other therapies, but there’s limited understanding of the factors that impact patient outcomes.
- A retrospective study was conducted to identify clinical factors affecting progression-free survival (PFS) and overall survival (OS) in these patients, leading to the development of a new risk classification model based on identified prognostic factors.
- The study found that high levels of C-reactive protein and hypercalcemia were significant predictors of patient outcomes, allowing for the classification of patients into three distinct risk groups, which showed notable differences in survival rates.
Article Synopsis
- Combined treatment of lenvatinib and pembrolizumab is a standard first-line therapy for advanced renal cell carcinoma (aRCC) patients, and this study aimed to evaluate its effectiveness and safety in Japanese patients who hadn't received prior treatment.
- A total of 50 treatment-naïve aRCC patients were analyzed, revealing a 66% overall response rate, with 14% achieving complete responses and 52% having partial responses; the patients were classified into risk groups showing varied response rates.
- The study concluded that the combined regimen's real-world efficacy and safety profiles are comparable to those seen in previous randomized clinical trials, with a notable incidence of adverse events in the patient population.
Article Synopsis
- This study looked at women with bladder cancer who had surgery to remove their bladder and other reproductive organs to see how many still had problems with their reproductive organs.
- Out of 417 women, some had their uterus and vaginal wall saved, but about 9% showed signs of cancer in their reproductive areas.
- The researchers concluded that doctors need to think carefully about whether to save these organs during surgery because there's a risk that cancer could still affect them.
Purpose: Metastatic non-clear cell renal cell carcinoma (nccRCC) is a heterogeneous disease with a poor prognosis and is treated with immunotherapy (IO)-based combinations according to the clear cell renal cell carcinoma. Tyrosine-kinase inhibitors (TKIs), such as cabozantinib and axitinib, are commonly used as the 2nd line therapy after 1st line IO combination therapy, but their efficacy as 2nd line TKI therapy for nccRCC is unknown. In this study, we performed a retrospective multicenter analysis of nccRCC patients who were previously treated with IO combination therapy and received 2nd line TKIs.
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- The study aimed to identify preoperative factors that predict poor outcomes from holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic hyperplasia (BPH).
- Out of 159 patients, 33.3% exhibited poor therapeutic efficacy three months post-surgery, with factors like high intravesical prostatic protrusion (IPP), overactive bladder (OAB), and other symptoms linked to worse outcomes.
- The findings suggest that assessing the presence of OAB and measuring IPP is crucial for determining which BPH patients are likely to benefit from HoLEP.
Article Synopsis
- A study was conducted on 16 patients with advanced or metastatic retroperitoneal sarcoma to evaluate the effectiveness and safety of doxorubicin monotherapy, which is commonly recommended in treatment guidelines.
- The results showed a 18.8% partial response rate, with the majority of patients experiencing stable disease, while the median progression-free survival was 8 months and overall survival was 24 months.
- Although severe adverse effects were common, such as neutropenia, the treatment was generally safe, with no gastrointestinal issues or treatment-related deaths reported.
Article Synopsis
- This study compared the effectiveness of two second-line treatments, cabozantinib and axitinib, for patients with metastatic clear cell renal cell carcinoma (ccRCC) who previously received nivolumab-ipilimumab therapy.
- A total of 48 patients were treated with cabozantinib and 60 with axitinib, revealing a median progression-free survival (PFS) of 11.0 months for cabozantinib and 9.5 months for axitinib, with overall response rates being quite similar (37.5% vs. 38.3%).
- Although both treatments had comparable safety profiles, cabozantinib showed improved efficacy in patients considered to have poor-risk characteristics, suggesting it
Objectives: In a primary analysis of data from the BRIGHT study (UMIN000035712), photodynamic diagnosis-assisted transurethral resection of bladder tumor (PDD-TURBT) using oral 5-aminolevulinic acid hydrochloride reduced residual tumors in high-risk non-muscle invasive bladder cancer (NMIBC). We aimed to evaluate the effectiveness of PDD-TURBT for intravesical recurrence after a second transurethral resection for high-risk NMIBC.
Methods: High-risk NMIBC patients initially treated with PDD-TURBT (PDD group) were prospectively registered between 2018 and 2020.
Objectives: The aim of this study was to compare clinical outcomes between patients receiving second TUR after initial white-light transurethral resection of bladder tumor (WL-TURBT) and initial photodynamic diagnosis (PDD)-assisted TURBT.
Methods: A total of 1007 patients were divided into four groups based on the treatment pattern: WL-TURBT with second TUR (161 patients, WL-second group) or without second TUR (540 patients, WL-alone group) and PDD-TURBT with second TUR (112 patients, PDD-second group) or without second TUR (194 patients, PDD-alone group). Oncologic outcomes (bladder cancer recurrence, progression, urothelial cancer-specific mortality) and rates of residual tumor and risk stratification of non-muscle-invasive bladder cancer (NMIBC) after second TUR were evaluated.
Article Synopsis
- The study examines the effects of combining immune checkpoint inhibitors (ICIs), specifically anti-PD-1 antibodies, with different doses of cisplatin on urothelial cancer in a mouse model.
- Findings revealed that high-dose cisplatin led to larger tumor volumes compared to low-dose cisplatin, but combining cisplatin with anti-PD-1 significantly inhibited tumor growth more than either treatment alone.
- The results suggest that using a lower dose of cisplatin with ICIs could be more effective for preserving immune function and enhancing antitumor responses in patients with urothelial cancer.
Introduction: A newly developed surgical robot system, hinotori, with various unique advantages has been in clinical use in Japan; however, there have not been any studies of robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy using hinotori.
Case Presentation: We describe two male patients aged 67 and 76 years old with right renal cell carcinoma and a level II and I inferior vena cava tumor thrombus, respectively, undergoing robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy using hinotori. Both operations were successfully completed with a purely robotic procedure without any major perioperative complications, resulting in the following findings: time using robotic system, 158 and 156 min; total operative time, 228 and 214 min; estimated blood loss, 535 and 200 mL, respectively.
Objective: To analyse the impact of histological discordance of subtypes (subtypes or divergent differentiation [DD]) in specimens from transurethral resection (TUR) and radical cystectomy (RC) on the outcome of the patients with bladder cancer receiving RC.
Patients And Methods: We analysed data for 2570 patients from a Japanese nationwide cohort with bladder cancer treated with RC between January 2013 and December 2019 at 36 institutions. The non-urinary tract recurrence-free survival (NUTR-FS) and overall survival (OS) stratified by TUR or RC specimen histology were determined.
Article Synopsis
- The study investigates the link between adverse events (AEs) from cabozantinib and progression-free survival (PFS) in patients with metastatic renal cell carcinoma (mRCC).
- A total of 40 patients were analyzed, revealing that hypertension was the only AE associated with longer PFS, while most patients experienced at least one AE.
- The findings indicate that treatment-induced hypertension could be a significant indicator of better PFS in this patient population.
Article Synopsis
- The study evaluated the outcomes for patients with metastatic renal cell carcinoma (mRCC) who received second-line targeted kinase inhibitors (TKIs) after first-line immunotherapy (IO), comparing different therapy groups.
- A total of 243 mRCC patients were analyzed, revealing similar response rates and progression-free survival (PFS) periods between the two therapy groups, indicating no significant differences in outcomes.
- Non-clear cell renal cell carcinoma (non-CCRCC), high C-reactive protein (CRP), and low albumin levels were identified as key independent prognostic factors for poor PFS and overall survival (OS), allowing for the development of a more accurate risk classification system for these patients.
Article Synopsis
- The study explores the initial use of the hinotori surgical robot for robot-assisted radical nephroureterectomy (RANU) in eight patients with upper urinary tract tumors.
- All surgeries were completed without converting to open surgery, and there was no major complications, highlighting the technique's safety and effectiveness.
- Results indicated a median operative time of 230 minutes, minimal blood loss, and a median hospital stay of 8 days, showcasing favorable outcomes despite the small sample size.
Article Synopsis
- The study compares the effectiveness of photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT) versus traditional white-light (WL) TURBT in preventing recurrence of non-muscle-invasive bladder cancer (NMIBC) in 1,174 patients.
- It found that PDD-TURBT led to significantly longer recurrence-free survival (RFS) compared to WL-TURBT, both before and after adjusting for other patient factors.
- However, the benefit of PDD was not observed in patients with tumors larger than 30 mm.
Immuno-oncology (IO) combination therapy is utilized as a first-line systemic treatment for advanced renal cell carcinoma. However, evidence supporting the use of cabozantinib after IO combination therapy is lacking. We retrospectively analyzed patients who received second-line cabozantinib after IO combination therapy using the Japanese Urological Oncology Group (JUOG) database.
View Article and Find Full Text PDFObjective: Several guidelines recommended that second transurethral resection should be performed in patients with diagnosis of high-risk non-muscle-invasive bladder cancer. However, therapeutic benefits of second transurethral resection before bacillus Calmette-Guérin intravesical instillation were conflicting amongst previous studies. We investigated the prognostic impact of second transurethral resection before bacillus Calmette-Guérin instillation in high-risk non-muscle-invasive bladder cancer patients.
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- The study aimed to compare the effects and safety of pembrolizumab in patients with metastatic upper tract urothelial carcinoma (UTUC) versus lower tract urothelial carcinoma (LTUC).
- A total of 752 patients were analyzed, revealing no significant differences in progression-free survival (PFS) and overall survival (OS) between UTUC and LTUC groups, although the upper tract group had lower kidney function prior to treatment.
- Patients with renal pelvic urothelial carcinoma showed a poorer prognosis compared to those with ureteral UC and LTUC, indicating potential needs for targeted treatment strategies for this subgroup.
Objectives: The aims of the present study were to describe the perioperative findings of the first series of patients undergoing robot-assisted radical nephrectomy (RARN) with a newly launched platform, the hinotori surgical robot system, and compare the findings with a similar set receiving RARN with the existing system, da Vinci.
Methods: This study included 34 patients, consisting of 13 and 21 undergoing RARN using the hinotori and da Vinci robotic systems, respectively. As a rule, RARN was performed via an intraperitoneal approach employing 3 robotic arms, irrespective of the robotic systems.
Impact on Japanese healthcare economics of photodynamic diagnosis-assisted transurethral resection of bladder tumor for non-muscle invasive bladder cancer: A multicenter retrospective cohort study.
Int J Urol
December 2023
Objectives: Bladder cancer, especially non-muscle invasive bladder cancer (NMIBC), is one of the most costly cancers owing to its long-term management. Photodynamic diagnosis-assisted transurethral resection of bladder tumor (PDD-TURBT) reduces the risk of intravesical recurrence. However, its impact on healthcare economics in Japan remains unclear.
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- The study compared the perioperative outcomes of robot-assisted partial nephrectomy (RAPN) using two different surgical platforms: the newly developed hinotori and the established da Vinci system.
- A total of 303 patients used the da Vinci platform, while 40 used hinotori, with a propensity score-matching method ensuring fair comparison between the two groups.
- The results indicated no significant differences in key surgical outcomes such as operative time and complications, suggesting that the hinotori platform performs similarly to the da Vinci system for RAPN.
Article Synopsis
- Recent studies on advanced renal cell carcinoma (aRCC) using tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) suggest that the timing of these treatments affects their effectiveness.
- A mouse model (RenCa) was used to compare the impact of simultaneous treatment, starting with TKI, or starting with ICI on tumor growth and survival.
- Results showed that simultaneous administration or starting with ICI led to better tumor growth inhibition and longer survival than starting with TKI, indicating that optimal treatment strategy for aRCC may involve using ICI first or simultaneously with TKIs.