Okishiro M

Predictive factors for anthracycline-based chemotherapy for human breast cancer

Predictive factors for anthracycline-based chemotherapy have yet to be incorporated into daily practice. Meta-analyses of studies using anthracycline-based treatment regimens have shown an improved prognosis for human epidermal growth factor receptor type 2 (HER2)-positive tumors, but not for HER2-negative tumors compared with results of non-anthracycline regimens. Currently it is believed that the positive association between HER2 status and anthracycline sensitivity is indirect, that is, their association may be mediated through topoisomerase II alpha (TOP2A), a target molecule of anthracyclines, since TOP2A is near HER-2 and co-amplification of the TOP2A gene frequently occurs in HER2-amplified tumors. This strongly suggests that TOP2A gene amplification is a predictive factor for anthracyline-based regimens. The Collaborative Study Group of Scientific Research of the Japanese Breast Cancer Society has demonstrated that TOP2A-positive and BRCA1-negative subsets evaluated by immunohistochemical staining show a significantly higher pathological complete response when treated with preoperative epirubicin-containing regimens. Combining these findings with the observation that triple-negative tumors and basal-like tumors respond to anthracycline treatment suggests that not only HER2-positive tumors but also a distinct subset of HER2-negative tumors may be sensitive to anthracycline-based regimens.

Topoisomerase IIalpha-positive and BRCA1-negative phenotype: Association with favorable response to epirubicin-based regimens for human breast cancers

Epirubicin exerts its anti-tumor effect through binding to topoisomerase IIalpha (TOP2A) and inducing DNA double-strand breaks. BRCA1 is involved in the repair of these breaks. We investigated the relationship between TOP2A or BRCA1 immunohistochemical expression and pathological response in 108 primary breast cancers treated with epirubicin-based regimens. The pCR (pathological complete response) rate for TOP2A-positive (17%) was significantly (P < 0.005) higher than for TOP2A-negative (2%), while the pCR rate for BRCA1-negative (11%) was non-significantly higher than for BRCA1-positive (5%). The pCR rate of TOP2A-positive and BRCA1-negative (30%) was significantly higher than for TOP2A-negative and BRCA1-positive (3%; P < 0.05), or TOP2A-negative and BRCA1-negative (0%; P < 0.005). The TOP2A-positive and BRCA1-negative phenotype associates with a favorable response to epirubicin-based regimens.

Elective laparoscopic surgery for sigmoid colon carcinoma incarcerated within an inguinal hernia: report of a case.

Primary colon carcinoma within an inguinal hernia sac is very rare and most reported cases were found at emergency open surgery for an incarcerated hernia. We report a case of incarcerated sigmoid colon carcinoma diagnosed preoperatively and treated with elective laparoscopic surgery. A 67-year-old man with a 2-year history of swelling of the scrotum and a breast lump was referred to us for surgical treatment of an irreducible left inguinal hernia and a right breast tumor. Blood examination results showed severe anemia. Computed tomography scan and endoscopic biopsy confirmed sigmoid colon carcinoma incarcerated in the left inguinal hernia. Thus, we performed definitive laparoscopic sigmoidectomy and conventional hernia repair for preoperatively diagnosed sigmoid colon carcinoma within an inguinal hernia.

Primary Diffuse Large B‐Cell Lymphoma of the Nipple: A Rare Case of Breast Lymphoma Localized in the Nipple

Shin-ichi Nakatsuka, MD, PhD,* Chieko Uchiyama, MD, Masatsugu Okishiro, MD, PhD, Yuji Takahashi, MD, PhD, Teruaki Nagano, MD,* Hayato Kimura, MD, PhD,* Chiyomi Egawa, MD, PhD, and Koji Hashimoto, MD, PhD *Department of Pathology, Kansai Rosai Hospital, Amagasaki Hyogo, Japan; Department of Surgery, Kansai Rosai Hospital, Amagasaki Hyogo, Japan; Department of Dermatology, Kansai Rosai Hospital, Amagasaki Hyogo, Japan; and Department of Hematology, Kansai Rosai Hospital, Amagasaki Hyogo, Japan

O1-22-4EFFICACY AND QOL OF ERIBULON FOR ADVANCED AND METASTATIC BREAST CANCER

Abstract Background: The purposes of the treatment of advanced and metastatic breast cancer are the prolongation of life and improvement of quality of life. When we treatment metastatic breast cancer, maintaining QOL is very important. In April 2011, eribulin was approved in Japan and the report is carried out for much maintenance of QOL being good. Methods: In this study, we report on efficacy and QOL of eribulin. 35 patients were administered eribulin in our hospital from August 2011 to November 2013. Results: The median age was 60 years (range, 37-79). 28 patients had ER+ and HER2-, one patient had ER+ and HER2+ and 6 patients had the triple negative subtype. Visceral metastasis was observed 71.4%. The median number of the chemotherapy regimens after a recurrence was the 3rd line (range, 1st-6th). 11 cases showed partial response, therefore, the response rate was 31.8% and 4 cases showed long stable disease, therefore, clinical benefit rate was 42.8%. Median progression-free survival was 146 days, and median overall survival was 497 days. About medication, extension of loss in quantity and intervals of administration was observed in 45.7%, and, as for the reason, the neutropenia more than Grade 3 occupied many. The example of a medication stop by an adverse event was not accepted. Cases of Grade 3 hematotoxicity or higher were of neutropenia (45%), leucopenia (31%) but febrile neutrophenia was 2.8%. The non-hematotoxic adverse events were accepted, none were of Grade3 or higher. Conclusions: The curative effect was good although the frequency of loss in quantity and adjournment was comparatively large results. Moreover, there was also no non-hematologic toxicity more than Grade 3, and the curative effect was able to be acquired, maintaining QOL. When AEs appeared, QOL was maintained by performing loss in quantity and extension appropriately, and a possibility that could not spoil a curative effect and it could prescribe it for the patient was suggested.