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Shuichi Yoneda

Publications and source records attributed to Shuichi Yoneda.

9 recordsLinked to original sources

Once-weekly epoetin-beta improves hemoglobin levels in cancer patients with chemotherapy-induced anemia: A randomized, double-blind, dose-finding study.

OBJECTIVE: To determine a recommended dose of once-weekly epoetin-beta administration for anemic cancer patients receiving myelosuppressive chemotherapy, we conducted a multicenter, randomized, double-blind trial. METHODS: A total of 86 patients with malignant lymphoma or lung cancer who received chemotherapy containing platinum, taxanes or anthracyclines were enrolled in the study. Patients were randomly assigned into groups that received three dose levels of epoetin-beta (9000, 18,000 or 36,000 IU) administered subcutaneously once a week for 12 weeks. The primary endpoint was change in hemoglobin, while the secondary endpoints were quality of life (QOL) assessed by Functional Assessment of Cancer Therapy-Anemia (FACT-An) questionnaire and transfusion requirements. RESULTS: Among the 69 patients (per protocol set population) assessable for efficacy, hemoglobin level change in the 36,000 IU group was significantly greater than that in the 9000 IU group (1.75 +/- 2.15 versus 0.04 +/- 1.98 g/dl; P = 0.009), and a significant dose-response relationship was observed for the change in hemoglobin level (P = 0.003). Although changes in FACT-An Total Fatigue subscale (Fatigue subscale) scores were similar for the three dosage groups, there was a statistically significant correlation (r = 0.435, P < 0.001) between the change in hemoglobin levels and the change in Fatigue subscale scores. The proportion of transfused patients was significantly smaller in the 36 000 IU group compared with that in the 9000 IU group (P = 0.022, not adjusted for pre-study transfusions). The incidence of adverse events was similar in the three dosage groups. CONCLUSIONS: Once-weekly epoetin-beta 36,000 IU for 12 weeks was well tolerated and significantly increased hemoglobin levels in anemic cancer patients receiving chemotherapy.

Adult↗

[Meningeal carcinomatosis in patients with lung cancer].

Of the 1548 patients with primary lung cancer who were admitted to our hospital from January 2001 through March 2005, 37 in whom meningeal carciomatosis was diagnosed on cytologic examination of cerebrospinal fluid or magnetic resonance imaging of the brain and spinal cord were studied retrospectively. The most common histologic type was adenocarcinoma, diagnosed in 70% of those patients. The results of cytologic examination of cerebrospinal fluid were positive in 71%. The time from the date of diagnosis of lung cancer to the date of diagnosis of meningeal carcinomatosis ranged from -2 days to 8 years (median, 407 days). Survival from the date of diagnosis of meningeal carcinomatosis ranged from 10 to 392 days (median, 106 days). Treatment for meningeal carcinomatosis was decided on the basis of the patient's general condition and the contorol status of the primary lesion. Radiotherapy, systemic chemotherapy, and palliative therapy were combined. Gefitinib was most often used for chemotherapy after the onset of meningeal carcinomatosis, and 60% of the patients given gefitinib had stable disease. One of these patients (adenocarcinoma) survived for longer than 1 year. Further investigatons are needed to establish standard treatments, including the use of gefitinib, that can improve the quality of life and prolong the survival of patients with meningeal carcinomatosis.

Adenocarcinoma↗

Phase III randomized trial of docetaxel plus cisplatin versus vindesine plus cisplatin in patients with stage IV non-small-cell lung cancer: the Japanese Taxotere Lung Cancer Study Group.

PURPOSE: Few randomized trials have demonstrated survival benefit of combination chemotherapy involving new agents plus cisplatin compared with classic combination chemotherapy in advanced non-small-cell lung cancer (NSCLC). The primary aim of this study was to test whether docetaxel plus cisplatin (DC) improves survival compared with vindesine plus cisplatin (VdsC) in patients with previously untreated stage IV NSCLC. PATIENTS AND METHODS: Eligible, stage IV, chemotherapy-naive patients (n = 311) were randomly assigned to receive docetaxel 60 mg/m(2) intravenously on day 1 plus cisplatin 80 mg/m(2) intravenously on day 1 of a 3- or 4-week cycle, or vindesine 3 mg/m(2) intravenously on days 1, 8, and 15 plus cisplatin 80 mg/m(2) intravenously on day 1 of a 4-week cycle. Cross-over administration of docetaxel and vindesine was prohibited for both treatment groups. RESULTS: Overall, 302 patients were eligible for evaluation. The DC arm demonstrated significant improvements compared with the VdsC arm in overall response rates (37% v 21%, respectively; P <.01) and median survival times (11.3 v 9.6 months, respectively; P =.014). Two-year survival rates were 24% for the DC arm compared with 12% for the VdsC arm. The physical domain of the Quality of Life for Cancer Patients Treated with Anticancer Drugs measure was significantly better in the DC arm than in the VdsC arm (P =.020). Toxicity was predominantly hematologic and was more severe in the VdsC arm. CONCLUSION: As first-line treatment for stage IV NSCLC, DC resulted in greater clinical benefit in terms of response rate (with marked improvements in overall and 2-year survival rates) and quality of life than did treatment with VdsC.

Adult↗

Phase II study of bi-weekly docetaxel and carboplatin with concurrent thoracic radiation therapy followed by consolidation chemotherapy with docetaxel plus carboplatin for stage III unresectable non-small cell lung cancer.

OBJECTIVE: Docetaxel and carboplatin (DC) have demonstrated activity as radiation sensitizers in pre-clinical studies. The aim of this phase II study was to evaluate the efficacy and toxicity of DC with concurrent thoracic radiation therapy (TRT) followed by consolidation chemotherapy with DC for stage III unresectable non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Thirty-three previously untreated patients with inoperable, locally advanced (LA) NSCLC received docetaxel 30 mg/m2 over 1 h and carboplatin at an AUC of 3 every 2 weeks for six courses--four courses during concurrent chemoradiotherapy and two courses following completion of radiotherapy. Concurrent TRT was performed in 2-Gy daily fractions to a total dose of 60 Gy. RESULTS: Among 32 evaluable patients, the overall response rate was 91%, with two complete responses (CR) and 27 partial responses (PR). Median survival time by intention-to-treat analysis was 27 months, with survival rates of 76% at 1 year and 61% at 2 years. Serious side effects were generally limited to grade 3 neutropenia in 6%, grades 3 and 4 pulmonary toxicity in 6 and 3%, respectively, and grade 3 esophagitis in 3% of patients. CONCLUSIONS: DC with concurrent TRT followed by consolidation chemotherapy was highly active with manageable toxicity in patients with stage III unresectable NSCLC.

Adult↗

[Lung cancer].

Tumor markers are defined as substances which are produced by cancer cells or non-cancer cells reactive to cancer cells, and reflect the cancer status, such as its presence, characteristics, and volume. Clinically, many tumor markers are useful not only to assess the presence/absence of cancer, the primary site, histology, stage, and recurrence, but also to monitor the anti-cancer therapy. Tumor markers for lung cancer play only supporting roles because of their limited sensitivity and specificity, but they are clinically essential to daily medical oncology. This review addresses 6 important tumor markers for lung cancer, namely, CEA, SLX, CYFRA, SCC, ProGRP, and NSE.

Antigens, Neoplasm↗

Phase I studies of nogitecan hydrochloride for Japanese.

BACKGROUND: SmithKline Beecham synthesized camptothecin analogs and identified nogitecan hydrochloride (topotecan) with a broad spectrum of antitumor activity and less toxicity than camptothecin. Because preclinical and overseas clinical data indicated the antitumor effect of nogitecan hydrochloride with a 5-day repeat-dose schedule, we carried out phase I studies in Japan to determine the maximum tolerated dose (MTD), pharmacokinetics, and antitumor effect of nogitecan hydrochloride. METHODS: Phase I studies of nogitecan hydrochloride given by single and 5-day repeat dosing were carried out in patients with various solid tumors at 15 medical institutions in Japan. Pharmacokinetic evaluations were performed for both single and 5-day repeated dosing. RESULTS: The dose-limiting factor (DLF) was reversible leucopenia, and the maximum tolerated dose (MTD) was higher than 22.5 mg/m2 in the single-dose study. In the 5-day repeat-dose study, the DLF was also reversible leucopenia, and the MTD was estimated to be 1.5 mg/m2 per day. The plasma concentration of nogitecan hydrochloride increased with increasing dose, and the half-life after single dosing ranged from 3 to 5h. There was no evidence of accumulation or delayed excretion during 5-day repeat dosing. CONCLUSION: Based on these results and the finding that there were responders among patients treated at 1.5 mg/m2 per day by 5-day repeat dosing in overseas studies, 5-day repeat dosing of 1.2mg/m2 per day, one dose level lower than the MTD, was selected for phase II studies in Japan.

Adult↗

[Small cell lung cancer].

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Antineoplastic Combined Chemotherapy Protocols↗

Weekly administration of irinotecan (CPT-11) plus cisplatin for non-small cell lung cancer.

BACKGROUND: Weekly administration of irinotecan plus cisplatin was evaluated for untreated patients with non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Sixty mg/m(2) of irinotecan plus 30 mg/m(2) of cisplatin were administered on days 1, 8 and 15 every 4 weeks. Patients with no evidence of disease progression were treated with at least two cycles (8 weeks). Of the 39 patients, 29 were provided an antidiarrheal program consisting of sodium bicarbonate and magnesium oxide. RESULTS: There were 13 partial responses and an overall response rate of 33.3% [95% CI: 20%-50%]. The median time to progression and survival were 64 days and 12.8 months, respectively. Grade 4 neutropenia occurred in 15.4% of the patients, and Grade 3 and 4 diarrhea was observed in 12.8% and 2.6%, respectively. The incidence of leukopenia of grade 3-4 was significantly lower in patients provided with the antidiarrheal program due to lack of decrease in the lymphocyte count. CONCLUSION: This phase II study indicated that weekly irinotecan plus cisplatin administration was a promising treatment for untreated NSCLC.

Adult↗