M Ando

Nagoya University, Nagoya, Aichi, Japan

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Publications (410)1459.81 Total impact

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    ABSTRACT: Neurokinin-1 (NK-1) receptor antagonist is recommended for chemotherapy-induced nausea and vomiting (CINV) in highly emetogenic chemotherapy (HEC) and has recently been introduced to oncology practice in Japan. However, whether all patients undergoing HEC truly need NK-1 receptor antagonist remains unknown, and increasing medical costs due to uniform use of NK-1 receptor antagonist are a concern. This study was conducted to examine the prevalence of patients who needed aprepitant at the time of its introduction in Japan, and therapeutic and preventive effects of aprepitant on HEC or moderately emetogenic chemotherapy (MEC).
    Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 09/2014;
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    ABSTRACT: The population of elderly patients with lung cancer is increasing worldwide. Although first-line gefitinib is one of the standard treatments for advanced non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutation, few data have been reported regarding gefitinib and elderly patients.
    Cancer Chemotherapy and Pharmacology 08/2014; · 2.80 Impact Factor
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    ABSTRACT: To investigate the efficacy of erlotinib versus docetaxel in previously treated patients with advanced non-small-cell lung cancer (NSCLC) in an epidermal growth factor receptor (EGFR) -unselected patient population.
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 05/2014;
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    ABSTRACT: This randomized phase III trial was conducted to confirm noninferiority of amrubicin plus cisplatin (AP) compared with irinotecan plus cisplatin (IP) in terms of overall survival (OS) in chemotherapy-naive patients with extensive-disease (ED) small-cell lung cancer (SCLC). Chemotherapy-naive patients with ED-SCLC were randomly assigned to receive IP, composed of irinotecan 60 mg/m(2) on days 1, 8, and 15 and cisplatin 60 mg/m(2) on day 1 every 4 weeks, or AP, composed of amrubicin 40 mg/m(2) on days 1, 2, and 3 and cisplatin 60 mg/m(2) on day 1 every 3 weeks. A total of 284 patients were randomly assigned to IP (n = 142) and AP (n = 142) arms. The point estimate of OS hazard ratio (HR) for AP to IP in the second interim analysis exceeded the noninferior margin (HR, 1.31), resulting in early publication because of futility. In updated analysis, median survival time was 17.7 (IP) versus 15.0 months (AP; HR, 1.43; 95% CI, 1.10 to 1.85), median progression-free survival was 5.6 (IP) versus 5.1 months (AP; HR, 1.42; 95% CI, 1.16 to 1.73), and response rate was 72.3% (IP) versus 77.9% (AP; P = .33). Adverse events observed in IP and AP arms were grade 4 neutropenia (22.5% v 79.3%), grade 3 to 4 febrile neutropenia (10.6% v 32.1%), and grade 3 to 4 diarrhea (7.7% v 1.4%). AP proved inferior to IP in this trial, perhaps because the efficacy of amrubicin as a salvage therapy was differentially beneficial to IP. IP remains the standard treatment for extensive-stage SCLC in Japan.
    Journal of Clinical Oncology 03/2014; · 18.04 Impact Factor
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    ABSTRACT: Early prediction of therapeutic outcome is important in determining whether the ongoing therapy is beneficial. In addition to anatomical response as determined by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria, recent studies have indicated that change in tumor glucose use on or after treatment correlates with histopathologic tumor regression and patient outcomes. This Perspective discusses the use of 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) for pharmacodynamic evaluation in a very early phase of treatment to predict clinical outcomes in patients with advanced non-small cell lung cancer. We conducted a study to assess whether early metabolic response determined by FDG-PET correlated with clinical outcomes in patients treated with gefitinib or those treated with carboplatin plus paclitaxel (CP). Early metabolic response to gefitinib, but not CP, correlated with the late metabolic response, anatomical response, progression-free survival and even overall survival. A rapid effect of molecular targeted agents may not be aptly evaluated by the conventional criteria, e.g., RECIST, in a very early phase of treatment before volumetric shrinkage of the tumor. Based on the findings of several studies, as well as the findings from our study, use of FDG-PET might enable prediction of clinical outcomes at a very early stage of treatment, especially in patients treated with molecular targeted agents with rapid clinical efficacy.
    Clinical Lung Cancer 01/2014; · 2.04 Impact Factor
  • Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 01/2014; 9(1):e7-e8. · 4.55 Impact Factor
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    ABSTRACT: Objective The role of combined endobronchial ultrasound-guided transbrinchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with a single scope is poorly understood. The purpose of the present study was to elucidate the roles of EBUS-TBNA and EUS-FNA with a single scope in the preoperative hilar/mediastinal staging of non-small cell lung cancer. Methods A total of 150 patients with potentially resectable known or suspected non-small cell lung cancer were enrolled in this prospective study. EBUS-TBNA was performed followed by EUS-FNA with an EBUS scope for N2/N3 nodes >5 mm in the shortest diameter on ultrasound images in a single session. Results EBUS-TBNA was performed for 257 lymph nodes, and EUS-FNA for 176 lymph nodes. A total of 146 patients had a final diagnosis of non-small cell lung cancer. Thirty-three of them (23%) had N2 and/or N3 node metastases. The sensitivity of EBUS-TBNA, EUS-FNA and the combined approach per patient was 52%, 45% and 73%, respectively (EBUS-TBNA vs combined approach: p = 0.016 using McNemar test). The negative predictive value was 88%, 86% and 93%, respectively. Two cases (1%) of severe cough resulted from EBUS-TBNA. Conclusions The combined endoscopic approach with EBUS-TBNA and EUS-FNA is a safe and accurate method for the preoperative hilar/mediastinal staging of non-small cell lung cancer, and better than each technique by itself.
    The Journal of Thoracic and Cardiovascular Surgery. 01/2014;
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    ABSTRACT: Non-small cell lung cancer (NSCLC) in never smokers has emerged as a global public health issue. The cause is still unclear, and few studies have focused on the prevalence of human papillomavirus (HPV) in the never smokers. We performed a systematic search of PubMed for articles of HPV infection in human subjects with NSCLC up to September 2012. Although smoking status was not fully reported in all studies, we contacted the authors by e-mail to supplement this information. Differences in the distribution of patients with and without HPV infection were tested with the Chi squared test. We identified 46 eligible articles, including 23 from Asian countries (N=2337 NSCLC cases), 19 from European countries (N=1553) and 4 from North and South America (N=160). The HPV prevalence was 28.1% (95% confidence interval (CI) 26.6-30.3%), 8.4% (95% CI 7.1-9.9%) and 21.3% (95% CI 15.2-28.4%), respectively. Eleven studies from East Asia (N=1110) and 4 from Europe (N=569) provided information on smoking status. The number of never smoker was 392 patients (33.9%) in East Asia and 54 patients (14.8%) in Europe. The HPV prevalence in East Asian countries was similar between never and ever smokers (33.9% vs 39.2%, P=0.080). Based on the literature confirming the presence of HPV in lung cancer in never smokers, the virus plays a role in carcinogenesis in the disease. There were different patterns of HPV prevalence between Asian and European countries in the never smokers as well as in ever smokers.
    Lung cancer (Amsterdam, Netherlands) 10/2013; · 3.14 Impact Factor
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    ABSTRACT: New InsightsSESSION TYPE: Original Investigation SlidePRESENTED ON: Sunday, October 27, 2013 at 04:15 PM - 05:15 PMPURPOSE: The purpose of this study was to compare the tolerance, efficacy and safety of EBUS-TBNA versus EUS-B-FNA for the diagnosis of hilar/mediastinal/parenchymal lesions which can be accessible through both the trachea/bronchus and esophagus.METHODS: One hundred ten patients who had hilar/mediastinal/parenchymal lesions adjacent to both the trachea/bronchus and esophagus were enrolled in this study and randomized to undergo EBUS-TBNA or EUS-B-FNA under local anesthesia with lidocaine and conscious sedation with intravenous midazolam. Patients quantified tolerance and operators charted the quality of examination using a 100-mm visual analogue scale (VAS).RESULTS: The specific diagnosis was made in 50 of 55 patients (91%) in the EBUS-TBNA group and in 48 of 55 patients (87%) in the EUS-B-FNA group. EUS-B-FNA was associated with shorter duration of the procedure (mean 16 min vs 12 min, p < 0.001), lower doses of midazolam (mean 4.3 vs 4 mg, p = 0.047) and lidocaine (mean 306 vs 189 mg, p < 0.001), less frequent oxygen desaturations (23/55 vs 2/55, p < 0.001), lower scores of cough (p = 0.04), pain (p = 0.03), dyspnea (p = 0.02) according to the patient's VAS, and higher operator's satisfaction according to the operator's VAS (p = 0.001), compared with EBUS-TBNA. There was no significant difference in patient's comfort, satisfaction, vomiting and willingness to have a repeat procedure, according to the patient's VAS. Mediastinal abscess occurred in 1 of the EBUS-TBNA group and 2 of the EUS-B-FNA group.CONCLUSIONS: Both EBUS-TBNA and EUS-B-FNA provide high accuracy with good tolerance, though the occurrence of infectious complications should be monitored carefully. EUS-B-FNA has the advantage of less frequent respiratory symptoms or oxygen desaturations during the procedure.CLINICAL IMPLICATIONS: EUS-B-FNA may be a useful alternative to EBUS-TBNA in the diagnosis of lesions located adjacent to both the trachea/bronchus and esophagus.DISCLOSURE: The following authors have nothing to disclose: Masahide Oki, Hideo Saka, Chiyoe Kitagawa, Yoshihito Kogure, Misaki Ryuge, Saori Oka, Takashi Adachi, Rie Tsuboi, Masashi Nakahata, Kazumi Hori, Masahiko AndoNo Product/Research Disclosure Information.
    Chest 10/2013; 144(4_MeetingAbstracts):822A. · 7.13 Impact Factor
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    ABSTRACT: Previous studies suggest that dendritic cells and macrophages play an important role in inflammation of eosinophilic pneumonia. The mechanism of dendritic cell and macrophage accumulation into the lung, however, is unknown. Here, we hypothesized that CCR7 ligands, CCL19 and CCL21, contribute to the accumulation of dendritic cells and alveolar macrophages in the inflamed lung of patients with eosinophilic pneumonia. Concentrations of the CCR7 ligands as well as CCL16, CCL17 and CCL22 in the bronchoalveolar lavage fluid of 53 patients with eosinophilic pneumonia, 29 patients with sarcoidosis, 18 patients with idiopathic pulmonary fibrosis and 12 healthy volunteers were measured by enzyme-linked immunosorbent assay. Cell sources of CCR7 ligands and CCR7-expressing cells in the bronchoalveolar lavage fluid were evaluated by immunocytochemistry. CCL19 and CCL21 levels in the bronchoalveolar lavage fluid were significantly higher in patients with eosinophilic pneumonia than in controls. Levels of CCL19, but not CCL21, were statistically correlated with the levels of CCL16, CCL17 and CCL22 in patients with eosinophilic pneumonia. Immunocytochemistry revealed CCL19 expression in dendritic cells, macrophages and T-lymphocytes harvested from patients with eosinophilic pneumonia, and CCR7 expression in dendritic cells and macrophages. Levels of CCL19, but not CCL21, were significantly decreased after remission in patients with eosinophilic pneumonia. After provocation tests, CCL19 levels were elevated in all patients with eosinophilic pneumonia. These findings indicate that CCL19 rather than CCL21 may contribute to the accumulation of dendritic cells and macrophages in the inflamed lungs of patients with eosinophilic pneumonia.
    Allergy 09/2013; · 5.88 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate whether consolidation chemotherapy (CCT) after concurrent chemo-radiotherapy is beneficial for patients with locally advanced non-small-cell lung cancer (LA-NSCLC). We systematically searched PubMed for phase II/III trials published before December 31, 2011, examining survival of LA-NSCLC treated with concurrent chemo-radiotherapy. Median overall survival and other study characteristics were collected from each study and pooled. We extracted log-transformed hazards and standard errors under the assumption that survival follows an exponential distribution, and computed a pooled median overall survival and a 95% confidence interval (CI) using random-effects model. Collected trial arms were categorized as having CCT or not having it, CCT+ and CCT-, respectively. Forty-one studies were identified including seven phase III studies and 34 phase II studies with 45 arms (CCT+: 25; CCT-: 20). Clinical data were comparable for clinical stage, performance status, cancer histology, sex, and median age between the two groups. There was no statistical difference in pooled mOS between CCT+ (19.0 month; 95% CI, 17.3-21.0) and CCT- (17.9 month; 95% CI, 16.1-19.9). Predicted hazard ratio of CCT+ to CCT- was 0.94 (95% CI, 0.81-1.09; p = 0.40). There were no differences between the two groups with regard to grade 3-5 toxicities in pneumonitis, esophagitis, and neutropenia. These models estimated that addition of CCT could not lead to significant survival prolongation or risk reduction in death for LA-NSCLC patients. The pooled analysis based on a publication basis failed to provide evidence that CCT yields significant survival benefit for LA-NSCLC.
    Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 07/2013; · 4.55 Impact Factor
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    ABSTRACT: Rationale: Identification of patients with drug-resistant pathogens at initial diagnosis is essential for treatment of pneumonia. Objectives: To elucidate clinical features of community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP), and to clarify risk factors for drug-resistant pathogens in patients with CAP and HCAP. Methods: A prospective observational study was conducted in hospitalized patients with pneumonia at 10 institutions in Japan. Pathogens identified as not susceptible to ceftriaxone, ampicillin-sulbactam, macrolides, and respiratory fluoroquinolones were defined as CAP drug-resistant pathogens (CAP-DRPs). Measurements and Main Results: In total, 1,413 patients (887 CAP and 526 HCAP) were analyzed. CAP-DRPs were more frequently found in patients with HCAP (26.6%) than in patients with CAP (8.6%). Independent risk factors for CAP-DRPs were almost identical in patients with CAP and HCAP. These included prior hospitalization (adjusted odds ratio [AOR], 2.06; 95% confidence interval [CI], 1.23–3.43), immunosuppression (AOR, 2.31; 95% CI, 1.05–5.11), previous antibiotic use (AOR, 2.45; 95% CI, 1.51–3.98), use of gastric acid–suppressive agents (AOR, 2.22; 95% CI, 1.39–3.57), tube feeding (AOR, 2.43; 95% CI, 1.18–5.00), and nonambulatory status (AOR, 2.45; 95% CI, 1.40–4.30) in the combined patients with CAP and HCAP. The area under the receiver operating characteristic curve for counting the number of risk factors was 0.79 (95% CI, 0.74–0.84). Conclusions: The clinical profile of HCAP was different from that of CAP. However, physicians can predict drug resistance in patients with either CAP or HCAP by taking account of the cumulative number of the risk factors. Read More: http://www.atsjournals.org/doi/abs/10.1164/rccm.201301-0079OC#.UmfeA_mbOz4
    American Journal of Respiratory and Critical Care Medicine 07/2013; 188(8):985-995. · 11.04 Impact Factor
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    ABSTRACT: We present the rationale for the Japan Molecular Epidemiology for Lung Cancer study designed to elucidate molecular mechanisms of carcinogenesis in smokers and never-smokers with non-small-cell lung cancer. This prospective, ongoing, multicenter study is being conducted nationwide in Japan. Although there is no doubt that active smoking is the major cause of lung cancer, the contribution of other possible factors, including environmental tobacco or wood smoke, human papilloma virus, radon, occupational exposures, and genetic susceptibility, is highly likely, based on studies of never-smokers with non-small-cell lung cancer. Because of the predominance of women in the never-smoker subgroup, the role of female hormones in lung cancer development has also been considered. We hypothesize that driver mutations, which are critical for the development of lung cancer, are triggered by the environmental factors with or without the influence of the hormone. The SWOG-led intergroup molecular epidemiology study S0424 was conducted to focus on these issues by using a detailed questionnaire and specimen collection in statistically significant cohorts of smokers and never-smokers from both sexes. The Japan Molecular Epidemiology for Lung Cancer study follows and extends the S0424 molecular epidemiology concept in principle by using a similar approach that will facilitate future comparisons between the studies but with a greater focus on more recently defined driver mutations and broad genomic sequencing.
    Clinical Lung Cancer 05/2013; · 2.04 Impact Factor
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    ABSTRACT: INTRODUCTION:: Smoking status is one of the prognostic factors in advanced non-small-cell lung cancer (NSCLC). Currently, adenocarcinoma (Ad) histology is considered a predictive factor in advanced NSCLC. We investigated the correlation between histology or smoking status and survival of NSCLC patients receiving chemotherapy. METHODS:: We retrospectively reviewed clinical data from stage IIIB or IV NSCLC patients who started first-line chemotherapy at affiliated institutions of West Japan Oncology Group from 2004 to 2005. We also collected information on pack-years of cigarette smoking and years since cessation. Overall survival was compared using log-rank test, and Cox regression analysis was used to identify independent prognostic factors. RESULTS:: In total, 2542 consecutive patients were enrolled at 40 institutions. Of those, 71 were excluded because of unknown smoking history. The median overall survival of nonsmoking Ad patients (593 days) was longer than that of smoking Ad, nonsmoking non-Ad, and smoking non-Ad patients (384, 374, and 319 days, respectively; p < 0.001). In Cox regression with sex, age, stage, performance, and treatment as covariates, we found significant interaction (p = 0.039) between histology (Ad/non-Ad) and smoking status (smoker/nonsmoker); smoking conferred a hazard ratio of 1.34 (95% confidence interval, 1.15-1.55) in Ad, but only 0.99 (0.75-1.31) in non-Ad. Higher pack-years and shorter period since cessation were significantly associated with poorer survival in Ad (p < 0.001), but not in non-Ad (p ≥ 0.434). CONCLUSION:: Ad histology is associated with better prognosis, and only smoking status had a prognostic impact in Ad.
    Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 04/2013; · 4.55 Impact Factor
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    ABSTRACT: Background: Although rapid on-site cytologic evaluation (ROSE) is widely used during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), its role remains unclear. Objectives: The purpose of the present study was to evaluate the efficacy of ROSE during EBUS-TBNA in the diagnosis of lung cancer. Methods: One hundred and twenty patients highly suspected of having lung cancer who had hilar/mediastinal lymphadenopathy or a tumor adjacent to the central airway were enrolled in this study and randomized to undergo EBUS-TBNA with or without ROSE. Results: Twelve patients with visible endobronchial lesions were excluded in the analysis. Thus, a total of 108 patients (55 in the ROSE group, 53 in the non-ROSE group) were analyzed. Additional procedures including EBUS-TBNA for lesions other than the main target lesion and/or transbronchial biopsy in the same setting were performed in 11% of patients in the ROSE group and 57% in the non-ROSE group (p < 0.001). Mean puncture number was significantly lower in the ROSE group (2.2 vs. 3.1 punctures, p < 0.001), and mean bronchoscopy time was similar between both groups (22.3 vs. 22.1 min, p = 0.95). The sensitivity and accuracy for diagnosing lung cancer were 88 and 89% in the ROSE group, and 86 and 89% in the non-ROSE group, respectively. No complications were associated with the procedures. Conclusions: ROSE during EBUS-TBNA is associated with a significantly lower need for additional bronchoscopic procedures and puncture number.
    Respiration 04/2013; · 2.62 Impact Factor
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    ABSTRACT: BackgroundA phase III study (Lung Cancer Evaluation of TS-1) previously demonstrated noninferiority in terms of overall survival (OS) at interim analysis for carboplatin-S-1 compared with carboplatin-paclitaxel for first-line treatment of advanced non-small-cell lung cancer (NSCLC).Patients and methodsA total of 564 patients were randomly assigned to receive either carboplatin on day 1 plus oral S-1 on days 1-14 or carboplatin-paclitaxel on day 1 every 21 days. Updated results and post hoc subgroup analysis according to tumor histology are presented.ResultsThe updated analysis revealed a median OS of 15.2 months in the carboplatin-S-1 arm and 13.1 months in the carboplatin-paclitaxel arm, with a hazard ratio (HR) of 0.956 [95% confidence interval (CI) 0.793-1.151], consistent with the previous primary analysis. Median OS was 14.0 months in the carboplatin-S-1 arm and 10.6 months in the carboplatin-paclitaxel arm (HR 0.713; 95% CI 0.476-1.068) for patients with squamous cell carcinoma (SCC), with corresponding values of 15.5 and 13.9 months (HR 1.060; 95% CI 0.859-1.308) for those with non-SCC.Conclusions These results establish the efficacy and safety of carboplatin-S-1 in patients with advanced NSCLC regardless of tumor histology.
    Annals of Oncology 12/2012; · 7.38 Impact Factor
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    ABSTRACT: SESSION TYPE: Pneumonia Treatment and Antibiotic ResistancePRESENTED ON: Monday, October 22, 2012 at 04:00 PM - 05:30 PMPURPOSE: To achieve appropriate initial empirical antibiotic treatment for patients with pneumonia, the assessment methods of risk factors (RFs) for drug-resistant pathogens, which are useful to prescribe antibiotics, need to be developed. The aims of the present study are to compare the epidemiology of community-acquired pneumonia (CAP), healthcare-associated pneumonia (HCAP), and hospital-acquired pneumonia (HAP), and to clarify the RFs of resistant pathogens for commonly-used antibiotics for CAP in patients with CAP and HCAP.METHODS: A prospective observational study was conducted on hospitalized patients with pneumonia (March-December, 2010; UMIN000003306). Identified pathogens which were not susceptible to β-lactams (CTRX or SBT/ABPC), macrolides (AZM or CAM), and fluoroquinolones (LVFX, MFLX, or GRNX) were defined as CAP-ABXs-resistant pathogens. We focused on assessing their RFs in CAP and HCAP patients.RESULTS: A total of 1591 patients (CAP: 898, HCAP: 586, and HAP: 107) were enrolled. In patients with identified pathogens, the proportion of CAP-ABXs-resistant pathogens in CAP, HCAP, and HAP were 9.7%, 31.4%, and 34.4%, respectively. Independent RFs for CAP-ABXs-resistant pathogens in combined patients with CAP and HCAP were prior hospitalization (OR: 2.5, 95% CI: 1.6-4.0), previous use of antibiotics (3.1, 2.0-4.9), use of gastric antacid (2.0, 1.3-3.1), tube feeding (2.3, 1.2-4.5), and poor functional status (2.8, 1.7-4.5). These RFs were almost identical in each CAP and HCAP group, except immunosuppression in CAP patients. The 88% of CAP patients and 30% of HCAP had ≤1 of the above 5 RFs, and their proportion of CAP-ABXs-resistant pathogens were less than 10%.CONCLUSIONS: The proportion of CAP-ABXs-resistant pathogens in HCAP is close to that in HAP. However, there are common RFs for CAP-ABXs-resistant pathogens in CAP and HCAP patients. If the number of these RFs is ≤1, administration of unnecessary broad-spectrum antibiotics could be avoided in CAP and HCAP patients.CLINICAL IMPLICATIONS: From the point of view of RFs for CAP-ABXs-resistant pathogens, the assessment methods of their RFs could be unified in CAP and HCAP patients.DISCLOSURE: The following authors have nothing to disclose: Yuichiro Shindo, Ryota Ito, Daisuke Kobayashi, Masahiko Ando, Motoshi Ichikawa, Tetsuya Yagi, Yasuteru Sugino, Joe Shindoh, Tomohiko Ogasawara, Fumio Nomura, Hideo Saka, Masashi Yamamoto, Hiroyuki Taniguchi, Ryujiro Suzuki, Hiroshi Saito, Takashi Kawamura, Yoshinori HasegawaNo Product/Research Disclosure InformationThe Institute for Advanced Research, Nagoya University, Nagoya, Japan.
    Chest 10/2012; 142(4_MeetingAbstracts):150A. · 7.13 Impact Factor
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    ABSTRACT: Interstitial lung disease (ILD) is an adverse drug reaction (ADR) of concern in Japanese patients with non-small-cell lung cancer (NSCLC) receiving erlotinib. To investigate erlotinib safety and efficacy in Japanese patients, a large-scale surveillance study was implemented. All patients with recurrent/advanced NSCLC receiving erlotinib in Japan were enrolled (December 2007-October 2009). During the 12-month observation period, adverse-event data were collected; any adverse event where erlotinib could not be excluded as a causative factor was termed an ADR. An independent review committee assessed ILD-like events. Overall survival and progression-free survival were also assessed. Interim data were analyzed for patients registered before June 30, 2008. In total, 10,708 patients were enrolled, 3743 by June 30, 2008, with data available for 3488 patients. Overall ADR incidence was 81.8% (mostly grade 1/2); skin disorders (68.5%) including rash (63.0%) were most common. However, 81.8% of patients who experienced rash recovered or improved. ILD-like events, diagnosed by local physicians, were reported in 189 patients. The independent review committee confirmed ILD (all grades) in 158 patients (4.5% of interim population) with a mortality rate of 1.6% (55 patients). Significant ILD risk factors included concomitant or previous ILD, smoking history, concomitant or previous lung infection, and Eastern Cooperative Oncology Group performance status 2 to 4. Median overall survival and progression-free survival were 260 and 64 days, respectively. These interim data support the clinical benefits of erlotinib in Japanese NSCLC patients with no new safety signals. The risk/benefit balance for erlotinib in recurrent/advanced NSCLC remains favorable.
    Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 05/2012; 7(8):1296-303. · 4.55 Impact Factor
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    ABSTRACT: In endobronchial ultrasound-guided transbronchial biopsy (EBUS-TBB), techniques using a thin bronchoscope or a guide sheath have been proposed for accurate biopsy instrument reinsertion into the bronchial route indicated by a radial ultrasonic probe. The purpose of this study was to compare the diagnostic yields of these techniques for peripheral pulmonary lesions. Patients with suspected peripheral pulmonary lesions were included in this prospective, randomized, noninferiority study and assigned to undergo EBUS-TBB under fluoroscopic guidance using a prototype 3.4-mm thin bronchoscope or a 4.0-mm bronchoscope with a guide sheath. A total of 205 patients were enrolled and randomized, of whom 203 patients (101 thin bronchoscopic method; 102 guide sheath method) were included in the analysis. Diagnostic histologic specimens were obtained in 65% (41% for benign and 75% for malignant lesions) of the thin bronchoscopy group and 62% (25% for benign and 71% for malignant lesions) of the guide sheath group. Diagnostic performance of the thin bronchoscopic method was confirmed to be noninferior to the guide sheath method (difference in diagnostic yields, 3.6%; 90% confidence interval, -7.5 to 14.7%). Mean procedure time was significantly shorter in the thin bronchoscopy group than the guide sheath group (27 versus 33 minutes; p = 0.002). Complications including pneumothorax, moderate bleeding, and pneumonia occurred in 5% and 2% in the respective groups (p = 0.28). EBUS-TBB using the thin bronchoscope was noninferior to the guide sheath method for the diagnosis of peripheral pulmonary lesions and was associated with shorter procedural time.
    Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 12/2011; 7(3):535-41. · 4.55 Impact Factor
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    ABSTRACT: To evaluate the efficacy and feasibility of the consolidation therapy of the oral fluoropyrimidine agent S-1 after concurrent chemoradiotherapy for unresectable stage III non-small cell lung cancer (NSCLC). Eligible patients had unresectable stage III NSCLC with performance status of 0 or 1. Chemoradiotherapy at a total dose of 60 Gy consisted of cisplatin (80 mg/m(2)) on days 1 and 29, vinorelbine (20 mg/m(2)) on days 1, 8, 29 and 36. Sequential consolidation S-1 therapy was commenced at a dose of 80-120 mg twice daily on day 57 with two cycles of 4 weeks administration and 2 weeks withdrawal. Of the 66 patients, 65 were evaluated. Chemoradiotherapy was completed in 57 (87.7%) patients, and S-1 consolidation therapy was administered in 45 (69.2%) and completed in 31 (47.6%). Grade 3 pneumonitis developed in three patients with one dying of it. The response rate was 61.5% (95% confidence interval [CI], 48.6-73.3%). The median progression-free survival was 10.2 (95%CI, 8.6-13.7) months and median survival time 21.8 (95%CI, 15.6-27.6) months. The 1- and 3-year survival rates were 73.9% and 34.0%, respectively. Chemoradiotherapy with cisplatin and vinorelbine followed by S-1 consolidation demonstrated a reasonable overall survival in patients with stage III NSCLC. However, less than half of the patients completed this regimen, and the additional effect of S-1 was marginal compared with historical control. We concluded that chemoradiotherapy alone is still the recommended standard treatment for patients.
    European journal of cancer (Oxford, England: 1990) 12/2011; 48(5):672-7. · 4.12 Impact Factor

Publication Stats

5k Citations
1,459.81 Total Impact Points


  • 2013–2014
    • Nagoya University
      • Center for Advanced Medicine and Clinical Research
      Nagoya, Aichi, Japan
  • 1994–2013
    • Oita University
      • • Faculty of Medicine
      • • Department of Radiology
      • • Third Department of Internal Medicine
      Ōita, Ōita, Japan
  • 2012
    • Kinki University
      Ōsaka, Ōsaka, Japan
  • 2011
    • National Hospital Organization Nagoya Medical Center
      • Department of Respiratory Medicine
      Nagoya, Aichi, Japan
  • 2006–2011
    • Kyoto University
      Kioto, Kyōto, Japan
    • Aichi Cancer Center
      Ōsaka, Ōsaka, Japan
    • Osaka City University
      Ōsaka, Ōsaka, Japan
  • 1987–2008
    • Kumamoto University
      • • School of Medicine
      • • Department of Neurology
      • • Department of Obstetrics and Gynecology
      • • Department of Microbiology
      Kumamoto, Kumamoto Prefecture, Japan
  • 2002
    • Tokyo Medical and Dental University
      • Department of Human Pathology
      Edo, Tōkyō, Japan
  • 1997–2000
    • Osaka University
      • Department of Radiology
      Ōsaka-shi, Osaka-fu, Japan
    • First Solar
      Tempe, Arizona, United States
  • 1999
    • University of British Columbia - Vancouver
      • Department of Radiology
      Vancouver, British Columbia, Canada
  • 1996–1997
    • Umeå University
      • Department of Medical Biochemistry and Biophysics
      Umeå, Västerbotten, Sweden
    • Kumamoto Municipal Citizens Hospital
      Kumamoto, Kumamoto Prefecture, Japan
  • 1988
    • Shinshu University
      • Division of Applied Biochemistry
      Shonai, Nagano, Japan
  • 1986–1988
    • Fujita Health University
      • Department of Physiology
      Nagoya, Aichi, Japan