Akinori Takeda

Increased vascular endothelial growth factor in acute eosinophilic pneumonia

Acute eosinophilic pneumonia (AEP) is associated with the presence of diffuse pulmonary infiltrates on the chest radiograph and an increased number of eosinophils and an elevation of interleukin (IL)‐5 levels in bronchoalveolar lavage (BAL) fluid. Vascular endothelial growth factor (VEGF) is a constitutively expressed protein encoded by messenger ribonucleic acid in human eosinophils and is released following stimulation with IL‐5. However, the roles of IL‐5 and VEGF in the pathogenesis or activity of this disease have not been clarified. The authors investigated the cells and the levels of these two factors in BAL fluid in five AEP patients and five normal controls before and after corticosteroid treatment. The absolute number of eosinophils·mL−1, IL‐5 and VEGF levels in patients before treatment were higher than in controls (53.8 versus 0.3×104·mL−1, 490.1 versus 5.2 pg·mL−1 and 643.0 versus 133.9 pg·mL−1, respectively). IL‐5 and VEGF rapidly decreased to the control level in parallel with clinical improvement. The relationship between eosinophilia and IL‐5 and VEGF levels was strongly significant. Elevated interleukin‐5 in the lung may initiate the recruitment of eosinophils and enhance the release of mediators, such as vascular endothelial growth factor from eosinophils, which, in turn, increases the permeability of blood vessels.

Abstract 903: Long-term survivors in advanced non-small cell lung cancer

Background: It is known that chemotherapy for advanced non small-cell lung cancer (NSCLC) improves the prognosis, however, with regard to 2-year survival rate of inoperable stage III/IV patients is up to 20%. The contribution of chemotherapies for survival is not fully satisfied yet. Purpose: The aim of this study is to evaluate the rate of long-term survival of more than 2 years in patients with advanced NSCLC and elucidate clinical factors that affect long-term survival in those patients. Methods: We retrospectively reviewed 103 patients with inoperable, stage III/IV NSCLC treated with chemotherapy from January 2005 to December 2006 at Dohoku National Hospital. These included 69 adenocarcinomas, 22 squamous cell carcinomas, 9 large cell carcinomas and 3 others. These patients were divided into two groups: those who survived more than 2 years (long-term survivors; LTS) and the others (non long-term survivors; non LTS). We analyzed the prognostic factors that affect the survival in this setting. The difference of characteristics between two groups was tested with the Mann-Whitney U test, the chi-square test or Fisher9s exact test. Survival curves were calculated according to Kaplan-Meier method. The correlations of variables with survival were analyzed by multivariate analysis using a Cox proportional hazards model. Results: There were 27 (26.2%) patients who survived more than 2 years (LTS). All of them had performance status (PS) 0 or 1. These LTS included 13 females, 11 non-smoker, 21 adenocarcinomas and 17 stage IV disease. LTS showed significant correlation with gender, smoking status, intrapulmonary metastases, response of 1st-line chemotherapy (SD or better), and response of gefitinib (SD or better) (p=0.0008, p=0.0457, p=0.0317, p=0.0004 and p=0.0026, respectively). Patients who respond to initial chemotherapy (SD or better) as well as gefitinib showed favorable course. Univariate analyses showed that PS 0-1, intrapulmonary metastases, response of 1st-line chemotherapy (SD or better), response of gefitinib (SD or better) were significantly associated with better prognosis (p=0.0036, p=0.0203, p Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 903.