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1.
Gene ; 766: 145134, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-32898605

RESUMO

BACKGROUND: Artesunate (ART) has been used extensively as anti-malarial drugs worldwide. Besides, it has also been reported to have anti-cancer activities. This study was aimed to explore the anti-cancer activity of ART in combination with cisplatin (CIS) on A549 cells. METHODS: Cells were cultured with different concentrations of ART and/or CIS for 24, 48, or 72 h to test the anti-proliferative effects by CCK-8 assay. Colony formation assay and EdU staining were also performed. TUNEL staining was used to illustrate the morphologic changes. Cell cycle and apoptosis were determined by flow cytometry assay, and Western blot analysis was conducted to detect the expression of apoptosis- and proliferation-related proteins. Caspase activities were determined by colorimetric assay kit. Moreover, the synergistic effect of ART with CIS in A549 cell xenograft model was also determined. RESULTS: ART significantly inhibited cell proliferation in dose- and time-dependent manners. Collectively, the combination treatment remarkably decreased colony formation rates and increased the rates of TUNEL-positive cells compared with mono-treatment. Mechanistically, the combination treatment influenced the expression of Bcl-2, Bax, p-P53, Caspase-3/7, Caspase-9, CyclinB1, P34, P21, and synergistically regulated the activity of P38/JNK/ERK1/2 MAPK pathway. In mice A549 xenograft tumors, the combination strategy significantly increased the anti-cancer efficacy of ART and CIS alone, consistent with the in vitro observations. CONCLUSIONS: ART exhibited significant anti-tumor effect on A549 cells and this efficiency could be enhanced by combination with CIS.


Assuntos
Antineoplásicos/farmacologia , Artesunato/farmacologia , Cisplatino/farmacologia , Neoplasias Pulmonares/tratamento farmacológico , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Células A549 , Animais , Apoptose/efeitos dos fármacos , Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Sinergismo Farmacológico , Feminino , Humanos , Neoplasias Pulmonares/metabolismo , Camundongos , Camundongos Nus , Inibidores de Proteínas Quinases/farmacologia
2.
Gene ; 766: 145151, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-32950635

RESUMO

Smoking tobacco is the major hazard for lung cancer in Indian subcontinent especially men, compare to woman where, other important risk factors such as air pollutions are responsible. So, the aim of the study is to compare chronic smokers (CS) and non-smokers living in areas with air quality categorized as poor (AQI 201-300) or moderate (AQI 101-200). We measured the expression of non-small cell lung cancer (NSCLC) biomarkers;. IDH1, CEA, Cyfra21-1, and TPA through quantitative Real-Time PCR (qRT-PCR) and compared the levels of upregulation of the transcripts in stage IIIa NSCLC over control benign tissues among the smoking and AQI settings. Though the all biomarkers were significantly up-regulated in tumor tissues compared to control benign tissues, the fold change increase of IDH1 and CEA was highest in CS-poor/moderate AQI, followed by non-smokers-poor AQI and non-smokers moderate AQI. This indicates the aggressiveness and poor prognosis in CS living in either poor or moderate AQI areas. The level of Cyfra21-1 was lower in in the CS groups in comparison to non-smokers in the poor AQI area. This suggest higher Lung Squamous cell carcinoma histology in non-smokers living areas with poor AQI. Hence, we conclude that poor air quality can be as injurious for lung cancers as chronic smoking.


Assuntos
Antígenos de Neoplasias/genética , Antígeno Carcinoembrionário/genética , Carcinoma Pulmonar de Células não Pequenas/genética , Isocitrato Desidrogenase/genética , Queratina-19/genética , Neoplasias Pulmonares/genética , Fumar/genética , Poluição do Ar , Biomarcadores Tumorais/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas/genética , Feminino , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , não Fumantes , Prognóstico , Fumantes , Transcriptoma/genética
3.
J Infect Chemother ; 27(1): 99-102, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33023821

RESUMO

We present three patients affected by pulmonary squamous cell carcinoma, metastatic esophageal cancer and advanced non-Hodgkin lymphoma, who incurred in coronavirus 2019 (COVID-19) infection during the early phase of epidemic wave in Italy. All patients presented with fever. Social contact with subject positive for COVID-19 was declared in only one of the three cases. In all cases, laboratory findings showed lymphopenia and elevated C-reactive protein (CRP). Chest x-ray and computed tomography showed bilateral ground-glass opacities, shadowing, interstitial abnormalities, and "crazy paving" pattern which evolved with superimposition of consolidations in one patient. All patients received antiviral therapy based on ritonavir and lopinavir, associated with hydroxychloroquine. Despite treatment, two patients with advanced cancers died after 39 and 17 days of hospitalization, while the patient with lung cancer was dismissed at home, in good conditions.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/uso terapêutico , Lopinavir/uso terapêutico , Neoplasias/complicações , Pneumonia Viral/tratamento farmacológico , Ritonavir/uso terapêutico , Idoso , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/tratamento farmacológico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Surtos de Doenças , Quimioterapia Combinada , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/tratamento farmacológico , Evolução Fatal , Humanos , Itália , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamento farmacológico , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
Kyobu Geka ; 73(11): 961-963, 2020 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-33130725

RESUMO

The case is 77 years old, female. She was referred to a local doctor with a chief complaint of cough and wheezing and was treated as asthma. However, symptoms did not improve and she was referred to our hospital. She had a history of right upper lobectomy for lung cancer about 2 years before, with the pathological diagnosis of adenosquamous cell carcinoma, pT1aN0M0, stage I A. Chest computed tomography (CT) scan showed a pedunculated polypoid mass almost occupying the lumen in the trachea immediately above the tracheal bifurcation, and the emergency bronchoscopic resection using a high-frequency snare under general anesthesia was performed. Postoperatively, 50 Gray of radiotherapy was added.


Assuntos
Carcinoma Adenoescamoso , Neoplasias Pulmonares , Neoplasias da Traqueia , Idoso , Carcinoma Adenoescamoso/diagnóstico por imagem , Carcinoma Adenoescamoso/cirurgia , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Recidiva Local de Neoplasia , Traqueia , Neoplasias da Traqueia/diagnóstico por imagem , Neoplasias da Traqueia/cirurgia
6.
Kyobu Geka ; 73(11): 968-971, 2020 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-33130727

RESUMO

A 57-year-old woman was referred to our hospital for investigation of multiple tiny nodules in the lung fields bilaterally on computed tomography (CT). Video-assisted thoracoscopic lung biopsy was performed to diagnose the pulmonary lesions. Histological analysis showed nodular lesions with interstitial proliferation of uniform, round to oval cells with variable widening of the alveolar septa. Immunohistochemically, the cells were positive for EMA, CD56 and the progesterone receptor, but negative for chromogranin and synaptophysin. The diagnosis was "diffuse pulmonary meningotheliomatosis", with multiple diffuse "minute pulmonary meningothelial-like nodules". Diffuse pulmonary meningotheliomatosis should be kept in mind when we encounter small nodular shadows on a CT scan.


Assuntos
Neoplasias Pulmonares , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Pulmão , Neoplasias Pulmonares/diagnóstico por imagem , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
7.
Kyobu Geka ; 73(10): 812-818, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130771

RESUMO

In Japan, where the population is aging, the number of elderly lung cancer cases is expected to increase. Therefore, we retrospectively compared and examined about elderly lung cancer. METHOD: There were 1,283 patients undergoing surgery for lung cancer between 2009 and 2018 at our institution. We classified them into 75~85 years old, 85 years old or older, and younger than 75 years, and examined the patient background, surgical procedure, and perioperative complications. RESULT: 96.2% of 75~85 years group and 100% of 85 years old or older group had some history. There was a significant difference between the ages of 85 years old or older in PS 1 and above. There was a significant difference in limited resection between the 2 elderly groups compared to younger than 75 years group. The perioperative complication rates were 75~85 years old group (23.2%), 85 years old or older (30.9%), and younger than 75 years group (23.2%), with no significant difference. There were significant differences in postoperative delirium and chronic respiratory failure in 75~85 years group and 85 years old or older compared with younger than 75 years group. We performed a multivariate analysis of risk factors for complications. Males, PS 1 or higher, approach[ thoracotomy, video-assisted thoracic surgery (VATS)], and limited resection were considered to be independent factors. The 5-year survival rate was 70.9% in 75~85 years group, 39.3% in 85 years old or older group, and 81.0% in younger than 75 years group, and was significantly lower in 85 years old or older group. CONCLUSION: Elderly patients need to be aware of postoperative delirium and chronic respiratory failure. It is possible that the complication rate can be reduced by performing a thorough evaluation of operative resistance and selecting an appropriate surgical procedure in the elderly.


Assuntos
Neoplasias Pulmonares , Pneumonectomia , Idoso , Idoso de 80 Anos ou mais , Humanos , Japão , Neoplasias Pulmonares/cirurgia , Masculino , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida , Toracotomia , Resultado do Tratamento
8.
Kyobu Geka ; 73(10): 819-823, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130772

RESUMO

Completion pneumonectomy (CP) is the complete removal of lung tissue remaining after an initial ipsilateral partial pulmonary resection and is one of the most invasive operations in the field of general thoracic surgery. Mortality and morbidity rates are higher after CP than standard pneumonectomy. CP is a highly demanding procedure, usually due to major pleural and sometimes pericardial dense adhesions from previous surgery or infection. Intra-pericardial control of the pulmonary artery and veins is recommended to avoid vessel injury. Therefore, this operative intervention should be performed only by experienced thoracic surgeons on carefully selected patients in order to improve postoperative outcomes. Preoperative pulmonary and cardiac functions are decreased by the previous procedure. In addition, the rate of complications is high because of excessive operative invasiveness. Therefore, preoperative assessment, surgical indication, low invasive surgical technique, and good postoperative management are very important elements when CP is performed. On the other hands, CP may be a reasonable option for postoperative lung cancer recurrence or new primaries only in carefully selected patients, in whom the potential oncological benefits overweigh the surgical risk. This article reviews these operative knack and pitfalls.


Assuntos
Neoplasias Pulmonares , Pneumonectomia , Humanos , Neoplasias Pulmonares/cirurgia , Complicações Pós-Operatórias/prevenção & controle
9.
Kyobu Geka ; 73(10): 824-828, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130773

RESUMO

In case of direct invasion to the large vessel of lung cancer, combined resection of the involved lobe and the large vessel with its reconstruction are needed for complete resection. It is most important to secure the center side of the invaded blood vessel during this operation. The approach to thoracic cavity is decided according to the approach of the center side of the invaded vessel. The cases of invasion to superior vena cava, subclavian artery, pulmonary artery, and pulmonary vein are discussed. The method of securing and clamping the above vessels are also important in case of injury of these vessels during surgery. After clamping the center side of the injured vessel, blood flow will be decreased and repairing the vessel will be accomplished with calm. Therefore, the method of securing the center side of the vessels is a technique should to be mastered for all thoracic surgeons.


Assuntos
Neoplasias Pulmonares , Procedimentos Cirúrgicos Pulmonares , Humanos , Neoplasias Pulmonares/cirurgia , Invasividade Neoplásica , Veia Cava Superior
10.
Kyobu Geka ; 73(10): 829-833, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130774

RESUMO

While cases of surgical resection for primary lung cancers are increasing, lung cancer requiring vertebrectomy is rare. A high complication rate and recurrence rate have been reported after surgical resection for lung cancer with vertebral invasion. However, select patients who achieve complete resection after effective preoperative chemoradiotherapy show a better survival rate than others. Preoperative computed tomography and magnetic resonance imaging are necessary to consider surgical strategies and how to resect and reconstruct the vertebral body and chest wall with a clear margin before surgery. A 3-dimensional imaging or simulation model is useful for such ends. Several surgical approaches have been developed, such as the transmanubrial, posterior, posterolateral, or the combination thereof. Proper vertebrectomy( total, hemi, part of a vertebra, or only the transverse process of a vertebra) and reconstruction approaches should be decided in conjunction with orthopedic surgeons. While evidence is lacking, establishing proper surgical indications and developing effective strategies to achieve complete resection with a clear margin are the most critical points in lung cancer requiring vertebrectomy.


Assuntos
Neoplasias Pulmonares , Neoplasias da Coluna Vertebral , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Recidiva Local de Neoplasia , Pneumonectomia , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/cirurgia , Coluna Vertebral , Resultado do Tratamento
11.
Kyobu Geka ; 73(10): 834-839, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130775

RESUMO

Carinal resection with lung resection is a rare surgical procedure with high risk. In-hospital mortality rates for carinal reconstruction and sleeve pneumonectomy were 6.5% and 16.7%, respectively. Thus, thoracic surgeons need to learn the procedure for patients who need the surgery. This time, we will account for preoperative evaluation, intraoperative advice, and postoperative management in carinal resection with right upper lobectomy presenting 2 cases in our hospital. Case 1 had a high caliber mismatch of bronchial stumps because of partial carinal resection, which was corrected by simple sutures of the anterior cartilage. That allowed us to perform sleeve right upper lobectomy avoiding carinal reconstruction. Case 2 was a case in which lung and bronchial tissue sticking to mediastinum due to obstructive pneumonia prevented us from anastomosing intermediate bronchus to the trachea or left main bronchus. We had to choose sleeve right pneumonectomy, and a fistula on the anastomotic site occurred later resulting in a bad course. We hope our experiences aid future patients who need the carinal resection.


Assuntos
Neoplasias Pulmonares , Procedimentos Cirúrgicos Torácicos , Brônquios , Humanos , Neoplasias Pulmonares/cirurgia , Pneumonectomia , Traqueia
12.
Kyobu Geka ; 73(10): 840-844, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130776

RESUMO

Interstitial lung diseases (ILDs) are associated with an increased risk of lung cancer, and pulmonary resection is well known to be associated with high postoperative morbidity and mortality in lung cancer patients. Postoperative mortality rate of acute exacerbation( AE) was reported 33.3~100%. Sex, CRP, KL-6, %vital capacity( VC), forced expiratory volume in 1 second( FEV1.0), history of AE, preoperative steroid use, and surgical procedures were identified as possible risk factors of AE in the univariate analyses by the data obtained from patients with non-small cell lung cancer who had undergone pulmonary resection and presented with a clinical diagnosis of ILD between January 2000 and December 2009 at 64 institutions throughout Japan. Multivariate analysis using these factors identified surgical procedures except for wedge resection, history of AE, KL-6, %VC, and male sex as independent risk factors. A score by risk prediction for AE was 5 X (history of AE)+4 X (CT:UIP pattern)+3 X (gender:male)+3 X (preoperative steroid use)+2 X (KL-6>1,000 U/ml)+1 X (VC≤80%). The predicted probability of risk score 15~22 is>0.25, and risk score 11~14 is 0.1~0.25. We can use a simple risk scoring system comprising seven parameters to identify high risk patients for AE, and provide essential information to support fair and objective clinical decision-making by thoracic surgeons.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Doenças Pulmonares Intersticiais , Neoplasias Pulmonares , Progressão da Doença , Humanos , Japão , Doenças Pulmonares Intersticiais/complicações , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/cirurgia , Masculino , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X
13.
Kyobu Geka ; 73(10): 845-850, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130777

RESUMO

Pulmonary dysfunction with lung cancer has been shown a major postoperative risk factor in patients undergoing thoracic surgery. Preoperative physiological assessment according to guideline by American College of Chest Physicians (ACCP) or European Respiratory Society( ERS)/European Society of Thoracic Surgeons (ESTS) is important to select patients due to evaluate the risk of lung resection for a lung cancer patient. Moreover, for lung cancer patients undergoing thoracic surgery with pulmonary dysfunction, circulatory function evaluation is important in addition to preoperative respiratory management and rehabilitation. Thoracic surgery for patients with pulmonary dyfunction should be selected to assess preoperative pulmonary function and to predict postoperative complications.


Assuntos
Neoplasias Pulmonares , Procedimentos Cirúrgicos Pulmonares , Cirurgia Torácica , Humanos , Pulmão , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/cirurgia , Fatores de Risco
14.
Kyobu Geka ; 73(10): 866-869, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130781

RESUMO

The number of patients receiving hemodialysis has increased, and a proportionate increase of such patients with malignant tumor is expected. Hemodialysis patients are associated with a special condition, which is an obstacle during surgery. Surgery for dialysis patients is associated with high risk due to heart failure, respiratory failure, bleeding tendency, and immunosuppression. Therefore, dialysis patients should undergo sufficient preoperative evaluation and course of dialysis before surgery. In addition, minimally invasive surgery are required to reduce a risk of postoperative complication, and recently video-assisted thoracic surgery is performed. To reduce bleeding, using nafamostat mesilate on hemodialysis is also important management method. Careful infusion is necessary because volume overload causes the most dangerous complications, heart failure and pulmonary edema. Because dialysis patients are easily infected, sufficient care must be taken for wound infection, pneumonia, and empyema. Dialysis patients require careful perioperative management, but standard surgery is possible. However, prognosis for lung cancer with hemodialysis patient is not satisfactory. Future research on postoperative therapy including anticancer drugs is expected.


Assuntos
Neoplasias Pulmonares , Cirurgia Torácica , Humanos , Prognóstico , Diálise Renal , Cirurgia Torácica Vídeoassistida
15.
Gan To Kagaku Ryoho ; 47(9): 1287-1291, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130685

RESUMO

There have been many reports on the association between tumor infiltrating lymphocytes and cancer prognosis. It is known that tumor infiltrating lymphocytes contain not only cytotoxic T lymphocytes but also bystander lymphocytes and immunosuppressive cells. In most of previous reports, tumor infiltrating lymphocytes were defined as CD3 or CD8 T cells. It is generally thought that patients with cancer rich in tumor infiltrating lymphocytes have a good prognosis. Most tumor infiltrating lymphocytes are thought to be cytotoxic T lymphocytes. It is also reported that cancer rich in tumor infiltrating lymphocytes is responsive to immune checkpoint inhibitors. In recent years, several reports revealed clonal replacement in tumor infiltrating lymphocytes after administration of immune checkpoint inhibitors. This change was also detectable in peripheral blood. From the viewpoint of lung cancer treatment, combination of immune checkpoint inhibitors and chemotherapy became the standard therapy. We need to understand the tumor immune microenvironment in order to select the best treatment regimen for each patient. However, it is often difficult to obtain an adequate amount of tissue biopsy sample in standard of care. It is hoped that we can understand the tumor immune microenvironment using the peripheral blood. Thus, studying the association between treatment response, tumor infiltrating lymphocytes, and peripheral blood is considered to be important to research and develop peripheral blood biomarkers in lung cancer.


Assuntos
Neoplasias Pulmonares , Linfócitos do Interstício Tumoral , Biomarcadores Tumorais , Linfócitos T CD8-Positivos , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Prognóstico , Linfócitos T Citotóxicos , Microambiente Tumoral
16.
Gan To Kagaku Ryoho ; 47(9): 1303-1306, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130688

RESUMO

Recently, immune checkpoint inhibitors(ICI)has been developed considerably. ICI has already been approved for malignant melanoma, lung cancer and renal cancer. We expected ICI to be taken for many cancers in the future. Therefore, the development of biomarker for them are needed. The recent large phase Ⅲ study IMbrave 150 evaluated atezolizumab plus bevacizumab vs sorafenib as the first treatment for patients with unresectable hepatocellular carcinoma(HCC). IMbrave 150 demonstrated statistically significant and clinically meaningful improvements in both OS and RFS for atezolizumab plus bevacizumab compared with sorafenib in HCC patients. A paradigm shift in the treatment of unresectable HCC is about to occur. In this article, we discussed the significance and biomarkers of tumor immunity in HCC microenvironment.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Neoplasias Pulmonares , Bevacizumab , Carcinoma Hepatocelular/tratamento farmacológico , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Sorafenibe , Microambiente Tumoral
17.
Gan To Kagaku Ryoho ; 47(9): 1355-1357, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130699

RESUMO

A 54-year-old man with a history of smoking developed infectious bullae at the apex of his left lung and underwent long-term antimicrobial treatment. The bullae gradually reduced in size along with a slight left pleural thickening. Left back pain relapsed after a year, and CT revealed a rapid increase in pleural thickening. Left upper lobectomy led to the diagnosis of pulmonary polymorphic carcinoma. Chronic inflammation due to infection could contribute to carcinogenesis; therefore, post-inflammatory changes should be carefully followed-up.


Assuntos
Carcinoma , Pneumopatias , Neoplasias Pulmonares , Vesícula , Humanos , Pulmão , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade
18.
Gan To Kagaku Ryoho ; 47(9): 1363-1365, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130701

RESUMO

We present an unusual case of late-onset acute pneumonitis developing 21 months after pembrolizumab monotherapy. An 80-year-old male with primary, pulmonary, squamous cell carcinoma underwent right lower lobectomy and lymph node dissection(ND2a-2); the postoperative pathological stage was ⅢA(pT2bN2M0)and the PD-L1 tumor proportion score 70%. Six months after surgery, he developed mediastinal lymph node(#2R), bilateral pulmonary, and hepatic metastases; pembrolizumab was administered every 3 weeks as a first-line treatment. A partial response was evident after 3 courses; we thus continued the monotherapy. However, after 28 courses(21 months)of pembrolizumab, we discontinued the regimen because acute pneumonitis(Grade 3)developed; we prescribed prednisolone at 50 mg/day. The acute pneumonitis shadow improved and prednisolone was tapered over 2 months. The patient exhibited no new lesion and no progressive disease 6 months after pembrolizumab was discontinued.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Pulmonares , Pneumonia , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/cirurgia , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/cirurgia , Masculino , Recidiva Local de Neoplasia , Pneumonia/induzido quimicamente , Pneumonia/tratamento farmacológico
19.
Gan To Kagaku Ryoho ; 47(9): 1367-1369, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130702

RESUMO

A 51-year-old male underwent total gastrectomy for esophagogastric junction cancer(T3N0M0, Stage ⅡA). He was diagnosed with an alpha-fetoprotein(AFP) producing tumor and hepatoid adenocarcinoma. One month after radical surgery, computed tomography(CT) showed lung metastasis, and the patient's serum AFP level was high. He underwent chemotherapy( S-1 and wPTX/RAM)and eventually died 4 months after surgery.


Assuntos
Neoplasias Hepáticas , Neoplasias Pulmonares , Neoplasias Gástricas , Junção Esofagogástrica/cirurgia , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia , alfa-Fetoproteínas
20.
Gan To Kagaku Ryoho ; 47(10): 1411-1414, 2020 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-33130731

RESUMO

NKT cells are innate lymphocytes that express an invariant T cell receptor. Since activated NKT cells exert strong anti-tumor responses, NKT cells have been intensively studied for the purpose of their application to cancer immunotherapeutic approaches. Although human peripheral blood contained a very low fraction of NKT cells, and decreased number of NKT cells was also demonstrated in cancer-bearing patients, peripheral blood NKT cells can be activated by ligand-pulsed antigen presenting cells, and can produce a large amount of interferon-γ upon activation. The clinical trials of adoptive transfer of autologous NKT cells were already performed in patients with non-small cell lung cancer, and with head and neck cancer at Chiba University to show its effectiveness and limitation. Meanwhile, RIKEN reported NKT cell regeneration using iPS cell technology in mice, and subsequently established a protocol for regenerating NKT cells from human peripheral blood NKT cells using iPS cell technology. It was confirmed that the iPS cell-derived NKT cells (iPS-NKT) have sufficient expansion c apacity and potent direct and indirect cytotoxic activity in the humanized mice models, which suggests their therapeutic competence. We are currently planning an investigator-initiated clinical trial of allogeneic iPS-NKT cell therapy for head and neck cancer.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Células-Tronco Pluripotentes Induzidas , Neoplasias Pulmonares , Células T Matadoras Naturais , Animais , Humanos , Imunoterapia , Camundongos
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