Japanese Journal of Cancer and Chemotherapy最新文献

With the emergence of immune checkpoint inhibitors(ICIs)in recent years, the treatment outcomes for unresectable recurrent esophageal cancer have improved markedly. In 5-FU+cisplatin(FP)first-line therapy, 5-FU administration takes 5 days and generally requires hospitalization. However, frequent hospitalization for treatment is a crucial issue that must be resolved in terms of time investment and optimal use of hospital resources. Here, we evaluated the safety and potential adverse effects of the administration of FP therapy in an outpatient setting. After central venous ports were placed in 5 patients, cisplatin was administered using a short hydration method and 5-FU was infused for 120 hours using an infusion pump. No crucial adverse events or major pump-related problems occurred, suggesting the feasibility of this treatment in an outpatient setting. However, the duration of 5-FU administration via the pump varied more than the expected deviation (10%, 12 hours), indicating that the issues require further consideration.

A 63-year-old woman was admitted to our hospital with suspected appendicitis. Abdominal CT revealed an enlarged appendix, and findings consistent with some small nodules. She was diagnosed with appendicitis and successfully treated with antibiotics. Contrast-enhanced CT performed 2 months after discharge revealed a reduction in small nodules, and tumor markers were not elevated. Therefore, we concluded that this case was unlikely to be an appendiceal tumor. Interval appendectomy was performed laparoscopically, and histopathological analysis revealed a low-grade appendiceal mucinous neoplasm(LAMN). Herein, we present this case and review the relevant literature.

A 91-year-old man with thoracic esophageal cancer(pT3N1M0, pStage Ⅲ)and gastric cancer(pT1b2N0M0, pStage ⅠA)underwent esophagectomy. Three years and 4 months postoperatively, chest computed tomography revealed a mass shadow near the aortic arch. Upper gastrointestinal endoscopy revealed a submucosal tumor-like lesion on the left wall of the gastric tube, which was identified as recurrent esophageal cancer. The patient and his family strongly requested nivolumab administration and initiated treatment. The tumor shrank remarkably after 6 months of nivolumab therapy. Although an immune-related adverse event(irAE)was observed, no other adverse events occurred. After 1 year of administration, the tumor did not increase, and remained under control. We suggest that nivolumab therapy is an effective regimen for older patients with recurrent or inoperable esophageal cancer that is difficult to treat with conventional anticancer drugs, provided that strong irAEs do not occur.

Overall assessment of KEYNOTE-164 study, KEYNOTE-158 study and CheckMate 142 study demonstrated the clinical benefits of immune checkpoint inhibitors(ICIs)among patients with mismatch repair deficient(dMMR)/high microsatellite instability(MSI-H)cancer. As a result, ICIs have been approved for treatment of MSI-H solid tumor regardless of the tumor type. However, the frequency of real-world diagnosed dMMR gastrointestinal cancer were rarely reported. Therefore, the results of immunohistochemical staining for DNA mismatch repair proteins was investigated. 175 samples of gastrointestinal cancers were examined between November 2019 and June 2023. Clinical and pathological characteristics were obtained from clinical and histopathological records. In real world populations with high proportion of elderly people, the frequency of diagnosed dMMR gastrointestinal cancer may be high compared with previous reports. Furthermore, based on the deficient pattern of mismatch repair protein and age, most cases classified as dMMR may be sporadic. Right side tumors and female may increase the likelihood of dMMR colorectal cancer. The current results justified immunohistochemical staining for DNA mismatch repair proteins, strongly involved in the appropriate patient selection for ICIs therapy, should be conducted for elderly patients newly diagnosed as gastrointestinal cancer. We believe that further clinical cancer immunology research, and then challenging insight targeting dMMR gastrointestinal cancer will result in future development of novel immunotherapy combination strategies well tolerated even in elderly patients.

We report the case of a 46-year-old Japanese woman diagnosed with Stage Ⅳ right breast cancer, cT1cN1M1(ovarian and peritoneal metastases). We administered bevacizumab+paclitaxel as the first-line treatment. In the 13th course, the peritoneal dissemination progressed, and the regimen was changed to eribulin(1.4 mg/m2)as the second-line treatment. During the second course, abdominal distension developed and was resolved during follow-up. However, abdominal distension and pain were observed from day 9 of the fourth course. Based on the results of blood chemistry and CT scans, she was diagnosed with acute pancreatitis(CT Grade 1)and was admitted to the hospital. After fasting and fluid replacement therapy, her clinical symptoms and laboratory data improved, and was discharged from the hospital 8 days later. She had no history of excessive alcohol consumption and no evidence of biliary disease, and was considered having eribulin-induced pancreatitis.

A 57-year-old man visited our hospital due to abnormal chest X-ray findings. Chest computed tomography(CT)showed amalgamated beaded solid nodules in the right upper lobe of the lung. Lobectomy of the right upper lobe was performed and the nodule was histologically determined to be seminoma. Positron emission tomography(PET)-CT showed high 18F-fluorodeoxyglucose(FDG)uptake in the lung nodules and faint uptake in the left testicle. As ultrasound and palpation detected no tumor in the testes, consent to perform orchiectomy was not obtained. Considering the PET-CT findings, we diagnosed testicular seminoma with solitary pulmonary metastasis, which is extremely rare.

HER2, a member of the human epidermal growth factor receptor(HER)family, exhibits gene amplification, protein overexpression, or both in 13-27% of gastric cancer(GC)cases. Through the activation of downstream Akt and ERK pathways, HER2 promotes the survival and proliferation of gastric cancer cells. The impact of HER2 signaling on the tumor microenvironment(TME)in GC remains unclear, and the heterogeneity of HER2 overexpression in GC tissues is considered a contributing factor. In this study, we focused on differences in the TME between HER2-positive and HER2-negative areas in HER2-positive GC and found that HER2 signaling, particularly the HER2-Akt cascade, may suppress stimulator of interferon genes (STING)expression and reduce CD8+ T cell infiltration in tumor cells. Overall, our findings suggest the potential for a novel therapeutic approach to activate the anti-tumor immune response in HER2-positive GC.