scholarly journals Efficacy and safety of nivolumab in Japanese patients with first recurrence of glioblastoma: an open-label, non-comparative study

Author(s):  
Tomokazu Aoki ◽  
Naoki Kagawa ◽  
Kazuhiko Sugiyama ◽  
Toshihiko Wakabayashi ◽  
Yoshiki Arakawa ◽  
...  

Abstract Background An open-label, non-comparative study assessed the efficacy and safety of nivolumab in Japanese patients with first recurrence glioblastoma. Methods Patients with first recurrence of histologically confirmed World Health Organization Grade IV glioma, after treatment with temozolomide and radiotherapy, received nivolumab 3 mg/kg every 2 weeks until confirmed disease progression (Response Assessment in Neuro-Oncology criteria) or toxicity. Primary endpoint was 1-year overall survival rate assessed by Bayesian approach. The prespecified efficacy criterion was that the Bayesian posterior probability threshold for exceeding the 1-year overall survival of bevacizumab (34.5%) from the Japanese phase 2 study (JO22506) would be 93%. Results Of the 50 enrolled patients, 44 (88.0%) had recurrent malignant glioma (glioblastoma, gliosarcoma), and of these, 26 (59.1%) had at least one measurable lesion at baseline. The Bayesian posterior mean 1-year overall survival (90% Bayesian credible intervals) with nivolumab was 54.4% (42.27–66.21), and the Bayesian posterior probability of exceeding the threshold of the 1-year overall survival rate of bevacizumab (34.5%) was 99.7%. Median (90% confidence interval) overall and progression-free survival was 13.1 (10.4–17.7) and 1.5 (1.4–1.5) months, respectively. One partial response was observed (objective response rate 1/26 evaluable patients [3.8%]). Treatment-related adverse event rates were 14.0% for Grade 3–4 and 2.0% for Grade 5; most adverse events resolved and were manageable. Conclusions The 1-year overall survival with nivolumab monotherapy in Japanese patients with glioblastoma met the prespecified efficacy criterion. The safety profile of nivolumab was consistent with that observed in other tumor types. Clinical Trial Registration JapicCTI-152967.

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi2-vi3
Author(s):  
Naoki Kagawa ◽  
Tomokazu Aoki ◽  
Kazuhiko Sugiyama ◽  
Toshihiko Wakabayashi ◽  
Yoshiki Arakawa ◽  
...  

Abstract BACKGROUND The anti-programmed cell death protein 1 (PD-1) immune checkpoint antibody, nivolumab, may be beneficial in patients with recurrent glioblastoma. OBJECTIVE This open-label, non-comparative study assessed the efficacy and safety of nivolumab in Japanese patients with first recurrence of glioblastoma. METHODS Patients with a first recurrence of histologically confirmed World Health Organization (WHO) Grade IV glioma, after treatment with temozolomide plus radiotherapy, received nivolumab 3 mg/kg every 2 weeks until confirmed disease progression based on Response Assessment in Neuro-Oncology (RANO) criteria or development of toxicity. The primary endpoint was 1-year overall survival rate (1y-OS) assessed using a Bayesian approach. The prespecified efficacy criteria were that the Bayesian posterior mean 1y-OS with nivolumab would be 49%, and the Bayesian posterior probability threshold for exceeding the 1y-OS of bevacizumab (34.5%) from the Japanese Phase II study (JO22506) would be 93%. RESULTS Of the 50 patients enrolled, 44 (93.5%) had recurrent malignant glioma (glioblastoma and gliosarcoma), 26 (59.1%) had measurable disease, and 4 (9.1%) received corticosteroids at baseline. The posterior mean (90% Bayesian credible intervals) 1y-OS with nivolumab was 54.35% (42.27–66.21), and the observed posterior probability of exceeding the 1y-OS of bevacizumab (34.5%, JO22506) was 99.7%. The median (90% confidence interval) overall and progression-free survival (PFS) was 13.09 months (10.38, 17.68) and 1.45 months (1.41, 1.54), respectively. One partial response was observed (objective response rate [ORR] 1/26 evaluable patients [3.8%]). The grade 3–5 treatment-related adverse event rate was 16.0%; most adverse events resolved and were manageable. CONCLUSION The 1y-OS with nivolumab monotherapy in Japanese patients was higher than that in the bevacizumab group in the JO22506 study. However, PFS and ORR were not improved compared with JO22506. The safety profile of nivolumab was consistent with that observed in other tumor types.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Naoyoshi Yamamoto ◽  
Mio Nakajima ◽  
Hirohiko Tsujii ◽  
Tadashi Kamada

The clinical results after carbon ion radiotherapy for the metastatic lung tumors believed to be in the state of oligo-recurrence were evaluated. One hundred and sixteen lesions in 91 patients with lung cancer metastasis were treated with carbon ion radiotherapy at our institute from April 1997 to February 2011. Regarding the prescribed dose, total dose ranged between 40 gray equivalents (GyE) and 80 GyE, and fraction size ranged from 1 to 16 fractions. After a median followup period of 2.3 years (range, 0.3–13.1 years), the statistical overall survival rate and local control rate were 71.2% and 91.9% at 2 years after treatment, respectively. Treatment-related side effects were not a clinical problem. When classified by the primary organ, there were 49 cases of lung cancer, 20 cases of colorectal cancer, and 22 cases of others. The overall survival rate and local control rate for lung metastasis cases from lung cancer at 2 years after treatment were 81.5% and 92.4%, respectively, and 65.0% and 92.0% regarding lung metastasis from colorectal cancer. Carbon ion beam therapy for the metastatic lung tumors is a safe therapy, and the therapeutic effect is comparable to the outcome obtained from reported surgical resections.


Author(s):  
M.V. Markovtseva ◽  
E.N. Zgural'skaya

The generally accepted staging for chronic lymphocytic leukemia (CLL) suggested by K. Rai and J. Binet allows calculating the median survival depending on the size of the tumor mass. However, in real clinical practice, the overall survival rate may differ significantly from the calculated median. Thus, the search for parameters affecting the overall survival rate of CLL patients is really relevant. The aim of the study was to assess general clinical parameters as predictors of survival in CLL patients. Materials and Methods. The authors examined 60 CLL men (stages A–C according to Binet) with known overall survival rate. Data mining was used to identify significant factors affecting the overall survival in such patients. Patients were divided into two non-overlapping classes: K1 (actual survival was less than the predicted median survival) and K2 (actual survival was more or equal to the predicted median survival). Results. The most significant differences between the classes were obtained for glomerular filtration rate. If the parameter value is more than 76.5 ml/min/1.73 m2, we can say that the patient will overcome the median survival for the corresponding CLL stage according to Binet. Otherwise, the overall survival of a CLL patient will be less than the estimated one. Conclusion. If during diagnosing glomerular filtration rate of a CLL patient is more than 76.5 ml/min/1.73 m2, it can be considered as a predictor of overcoming the median survival according to Binet. The results of the studies obtained are patented. Patent RU 2725877 C1, July 7, 2020. Keywords: overall survival in CLL patients, men, glomerular filtration rate, data mining. Общепризнанные системы стадирования хронического лимфолейкоза (ХЛЛ) К. Rai и J. Binet позволяют рассчитать медиану выживаемости пациента в зависимости от величины опухолевой массы. Однако в реальной клинической практике параметр общей выживаемости пациента может значимо отличаться от расчетной медианы. Ввиду этого поиск параметров, влияющих на показатель общей выживаемости пациентов с ХЛЛ, представляет особую актуальность. Цель исследования – оценить возможность использования общеклинических параметров в качестве предикторов выживаемости больных ХЛЛ. Материалы и методы. Ретроспективно проанализированы данные 60 мужчин с ХЛЛ стадии A–C по Binet c известной общей выживаемостью. Для выявления значимых факторов, влияющих на общую выживаемость пациентов, использовали метод интеллектуального анализа данных. Пациенты были разделены на два непересекающихся класса: K1 (фактическая выживаемость меньше прогнозируемой медианы выживаемости) и K2 (фактическая выживаемость больше или равна прогнозируемой медиане выживаемости). Результаты. Наиболее значимые различия между классами были получены по показателю скорости клубочковой фильтрации. При значении параметра более 76,5 мл/мин/1,73 м2 можно говорить о том, что пациент преодолеет расчетные данные медианы выживаемости для соответствующей стадии ХЛЛ по Binet. В противном случае общая выживаемость пациента ХЛЛ будет меньше расчетной. Выводы. Наличие у пациента с ХЛЛ на момент постановки диагноза скорости клубочковой фильтрации более 76,5 мл/мин/1,73 м2 можно рассматривать в качестве предиктора преодоления расчетного параметра медианы выживаемости по Binet. Результаты полученных исследований запатентованы. Патент RU 2725877 C1 от 7.07.2020. Ключевые слова: общая выживаемость при ХЛЛ, мужчины, скорость клубочковой фильтрации, интеллектуальный анализ данных.


2018 ◽  
Vol 105 ◽  
pp. 114-126 ◽  
Author(s):  
Kenjiro Namikawa ◽  
Yoshio Kiyohara ◽  
Tatsuya Takenouchi ◽  
Hisashi Uhara ◽  
Hiroshi Uchi ◽  
...  

1998 ◽  
Vol 107 (8) ◽  
pp. 680-688 ◽  
Author(s):  
Petra Ambrosch ◽  
Martina Kron ◽  
Wolfgang Steiner

Forty-eight untreated patients with early supraglottic carcinoma (12 patients stage I and 36 patients stage II) had primary carbon dioxide laser microsurgery between 1979 and 1994 with the intent of complete tumor removal with preservation of functionally important structures of the larynx. Ninety-six percent of the patients were treated exclusively by surgery; 4% had laser microsurgery and postoperative radiotherapy. With a median follow-up of 55 months, the 5-year local control rate with the first treatment was 100% for pT1 cases and 89% for pT2 cases. The ultimate local control rate with voice preservation, including patients successfully salvaged after a local recurrence, was 97% for pT2 carcinomas. Five (10%) patients died of tumor (TNM)–related deaths. The 3-year recurrence-free rate and 3-year overall survival rate (Kaplan-Meier) were 87% and 85%; the 5-year recurrence-free rate and 5-year overall survival rate were 83% and 76%, respectively. The results achieved with transoral laser microsurgery in early supraglottic carcinoma are comparable to those of open supraglottic laryngectomy with respect to local control and survival. The functional results are superior, since clinically relevant aspiration did not occur.


2019 ◽  
Vol 30 (1) ◽  
pp. 132-140 ◽  
Author(s):  
Mitsumasa Kishimoto ◽  
Atsuo Taniguchi ◽  
Ayako Fujishige ◽  
Shuhei Kaneko ◽  
Sibylle Haemmerle ◽  
...  

2021 ◽  
Vol 8 (04) ◽  
pp. 219-223
Author(s):  
Niharika Darasani

BACKGROUND Single modality treatment for stage I and stage II squamous cell carcinomas of glottis region gave excellent results. Since a long time these are treated either with definitive radiation therapy or surgical excision with endoscopes. There was not much difference with regard to voice preservation, local recurrence and disease-free survival period. Our aim was to study the clinical presentation and management protocol of glottis carcinoma in a tertiary hospital and observe the final outcome of stage II (T2N0M0) glottis carcinoma and specific factor for survival in patients treated with surgery, radiotherapy and concurrent chemoradiation. METHODS 43 patients of glottis carcinoma stage II (T2N0M0) attending a tertiary teaching hospital between May 2015 and April 2017 were included in the study. Demography and smoking status of subjects were recorded. Staging of the disease was according to American Joint Committee on Cancer (AJCC) Staging System 7th edition. Paraglottic space infiltration was taken as a criteria to upgrade the staging. The overall survival rate, recurrence free survival, disease specific survival rate and laryngeal function preservation rate were calculated. RESULTS Out of 43 patients, males were 90.69 % and 09.30 % were females. Male to female ratio was 10.57 : 1. Mean age was 58.62 ± 2.35 years. 67.44 % were current smokers, 27.90 % were former smokers and 02.32 % were non-smokers. The overall survival scores and disease specific survival was 100 % with 11.62 % locoregional recurrences. The voice preservation was 86.04 %. Radiotherapy was used in 72.09 %, chemoradiation in 18.60 % patients and 11.62 % patients underwent surgery. 11.62 % patients presented with locoregional recurrence during 24 months of follow up. 02.32 % patients had to undergo tracheostomy. CONCLUSIONS The overall survival scores and disease specific survival were 100 % with 11.62 % loco-regional recurrence. Voice preservation was 86.04 %. Proactive prevention rather than escalation of treatment protocol gives better prognosis. KEYWORDS Glottis, Larynx, Supra Glottis, Sub Glottis, Squamous Cell Carcinoma, Chemo Radiation and Trans Oral Laryngeal Surgeries


Liver Cancer ◽  
2021 ◽  
Author(s):  
Jinli Zheng ◽  
Wei Xie ◽  
Yunfeng Zhu ◽  
Li Jiang

Hepatectomy is still as the first-line treatment for the early stage HCC, but the complication rate is higher than p-RFA and the overall survival rate is comparable in these two treatments. Therefore, the patients with small single nodular HCCs could get more benefit from p-RFA, and we need to do further research about p-RFA.


2021 ◽  
Author(s):  
kangming zhu ◽  
yvndi zhang ◽  
hui yvan ◽  
jing li

Abstract BackgroundLiver hepatocellular carcinoma (LIHC) is an important pathological type of liver cancer. The immune infiltration of the tumor microenvironment is negatively correlated with the overall survival rate of LIHC. At present , the role and molecular mechanism of KPNA2 in LIHC have not been elucidated, and the prognostic correlation between the two and the immune infiltration of LIHC are still unclear. Our study evaluated the role of KPNA2 in LIHC through TCGA data.MethodGene expression profiling interactive analysis (GEPIA) is used to analyze the expression of KPNA2 in LIHC. We evaluated the impact of KPNA2 on the survival of LIHC patients through the survival module. Then, We downloaded the LIHC data set from TCGA. Logistic regression was used to analyze the correlation between clinical information and KPNA2 expression. Cox regression analysis was used to analyze the clinicopathological characteristics related to the overall survival rate of TCGA patients. In addition, we used the "correlation" modules of CIBERSORT and GEPIA to explore the correlation between KPNA2 and cancer immune infiltrate. Western blotting was used to detect the expression of KPNA2.ResultUsing logistic regression for univariate analysis, increased KPNA2 expression was significantly correlated with pathological stage, tumor status, and lymph node status. In addition, multivariate analysis showed that down-regulation of KPNA2 expression, negative pathological stage and distant metastasis are independent prognostic factors for good prognosis. Specifically, CIBERSORT analysis was used to establish a negative correlation between the up-regulated expression of KPNA2 and the level of immune infiltration of B cells, NK cells, mast cells, and T cells. In addition, we confirmed this in the "Association" module of GEPIA. The expression of KPNA2 in LIHC tissues was significantly lower than that in adjacent normal tissues by western blotting.ConclusionThe down-regulation of KPNA2 expression is associated with a good prognosis and an increase in the proportion of immune cells in LIHC. These conclusions indicate that KPNA2 is related to the level of immune infiltration of LIHC and can be used as a potential prognostic biomarker of LIHC and a potential target for clinical tumor treatment.


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