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  • 1
    In: Journal of Surgical Oncology, Wiley, Vol. 110, No. 6 ( 2014-11), p. 745-751
    Abstract: Isoform switching of CD44 is associated with epithelial to mesenchymal transition (EMT) in several cancers; however, the clinical implications of this remain unclear for colorectal cancer (CRC). Methods We measured expression levels of E‐cadherin, vimentin, CD44 standard (CD44s) and CD44 variant 9 (CD44v9) transcripts in 14 CRC cell lines and 150 CRC patients. We determined EMT and CD44 status by calculating vimentin/E‐cadherin and CD44s/CD44v9 expression ratios, respectively. Associations between EMT status and CD44 isoform switching, and between clinicopathological factors and prognosis were analyzed. Results CD44s was highly expressed in mesenchymal‐type cell lines, while CD44v9 was highly expressed in epithelial‐type cell lines. CD44 knockdown resulted in decreased levels of vimentin expression, and significantly reduced proliferation, migration and invasion of cells. In CRC patients, the mesenchymal group and the high CD44 status group exhibited significantly poorer survival than that for the epithelial group (5‐year survival; 62.1% vs. 85.5%, P  = 0.0085) and the low CD44 status group (5‐year survival; 66.1% vs. 85.0%, P  = 0.0251). On multivariate analysis, CD44 status was an independent prognostic factor. Conclusions The status of EMT and CD44 is a critical prognostic factor, with CD44 isoform switching a possible trigger for EMT in CRC. J. Surg. Oncol. 2014 110:745–751 . © 2014 Wiley Periodicals, Inc.
    Type of Medium: Online Resource
    ISSN: 0022-4790 , 1096-9098
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2014
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  • 2
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 74, No. 19_Supplement ( 2014-10-01), p. 1148-1148
    Abstract: Backgrounds: The epithelial to mesenchymal transition (EMT) is well known to play a crucial role in cancer invasion and metastasis and has been actively investigated in colorectal cancer (CRC). In recent years, the isoform switch of CD44, which is recognized to be a cancer stem cell marker, has been reported to associate with EMT, especially in breast cancer and hepatocellular carcinoma. However, the clinical impact of CD44 isoform switch to EMT in CRC is still unknown. Methods: E-cadherin, vimentin, CD44 standard (CD44s) and CD44 variant9 (CD44v9) expression were measured in 14 CRC cell lines and 150 CRC patients by real-time PCR. EMT status and CD44 status was determined by calculating vimentin/E-cadherin and CD44s/CD44v9 expression ratio, respectively. The CRC cell lines and patients were divided into two groups based on the EMT and CD44 status. We examined the association between the EMT status and CD44 isoform switch, and analyzed the correlation with clinicopathological factors and prognosis. Finally, we evaluated the effect of CD44 knockdown by siRNA in CRC cell lines by measuring the proliferation, migration and invasion ability. Results: 1. The CRC cell lines were classified into 8 epithelial, 4 mesenchymal and 2 intermediate type. Of these cell lines, CD44s was highly expressed in mesenchymal type cell lines, whereas, CD44v9 was highly expressed in epithelial type cell lines. 2. The 150 CRC patients were divided into 115 epithelial group and 35 mesenchymal group based on vimentin/E-cadherin expression ratio. Mesenchymal group showed significantly poorer survival than epithelial group (5-year survival rate; epithelial: 85.5% vs. mesenchymal: 62.1%, P = 0.009). EMT status was significantly correlated with invasion depth of tumor (P = 0.036), lymphatic vessel involvement (P = 0.034) and histological grade (P = 0.001). 3. High CD44 status group showed poorer prognosis than low CD44 status group (5- year survival rate; low group: 85.0% vs. high group: 62.1%, P = 0.025). There was a significant correlation between EMT status and CD44 status (r = 0.298, P & lt; 0.001). On multivariate analysis, pathological T4 stage (P = 0.011), liver metastasis positive (P = 0.001), high CA19-9 level (≥37) (P = 0.003) and CD44 status (P = 0.001) were independent prognostic factors for CRC patients. 4. In COL-3-JCK, which is identified to be mesenchymal type, CD44 knockdown by siRNA decreased the vimentin expression at protein level. When the functional analysis were performed, CD44 knockdown significantly reduced the abilities of cell proliferation (P & lt; 0.001), migration (P = 0.004) and invasion (P = 0.025). Discussion: EMT was a critical prognostic factor and CD44 isoform switch might contribute to EMT induction in CRC. These results could support a better understanding of the relationship between EMT and cancer stem cell. Therefore, further investigation of the specific splice isoform of CD44 might lead to novel therapeutic intervention for CRC patients. Citation Format: Naoki Mashita, Suguru Yamada, Naoki Iwata, Mitsuro Kanda, Daisuke Kobayashi, Chie Tanaka, Tsutomu Fujii, Goro Nakayama, Hiroyuki Sugimoto, Masahiko Koike, Shuji Nomoto, Michitaka Fujiwara, Yashuhiro Kodera. Epithelial to mesenchymal transition might be induced via CD44 isoform switch in colorectal cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1148. doi:10.1158/1538-7445.AM2014-1148
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2014
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    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 3
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 4_suppl ( 2020-02-01), p. 95-95
    Abstract: 95 Background: The aim of this study was to evaluate the efficacy and safety of CAPOX with intermittent use of oxaliplatin compared to continuous use of oxaliplatin as an adjuvant setting for colon cancer. Methods: Patients with curative resection of stage II or III colon cancer were randomly assigned to receive either CAPOX with continuous use of oxaliplatin (continuous arm: 8 cycles of CAPOX) or CAPOX with intermittent use of oxaliplatin (intermittent arm: 2 cycles of CAPOX→4 cycles of capecitabine→2 cycles of CAPOX). The primary endpoints were frequency of disease-free survival (DFS) rate at 3-year after surgery and peripheral sensory neuropathy (PSN) at 1-year after surgery. The secondary end points included DFS, overall survival (OS), compliance and safety. Results: A total of 200 patients were enrolled. The intent-to-treat and safety population comprised 100 and 99 patients in the continuous arm, and 100 and 98 patients in the intermittent arm, respectively. After a median follow-up period of 39 months, disease recurrence and death occurred in 37 patients (19%) and 8 patients (4%) in the ITT population, respectively. The 3-year DFS was 78% (95% CI, 70-87%) in the continuous arm and 82% (95% CI, 74-90%) in the intermittent arm (HR, 0.80; 95% CI, 0.42-1.52; p = 0.49). In the patients with stage III disease, the 3-year DFS was 76% (95% CI, 66-86%)in the continuous arm and 80% (95% CI, 71-88) in the intermittent arm(HR, 0.75; 95% CI, 0.38-1.51; p = 0.43). The frequencies of PSF at 1-year after surgery were 58% (95% CI, 48-68%) in the continuous arm and 19% (95% CI, 11-26%) in the intermittent arm (p 〈 0.01), and those at 3-year after surgery were 37% (95% CI, 27-47%) and 9% (3-15%), respectively (p 〈 0.01). Conclusions: CAPOX with planned intermittent use of oxaliplatin could be equally effective as an adjuvant setting for colon cancer, and substantially reduce long-term PSN and potential improve patient quality of life. Clinical trial information: UMIN 000012535.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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  • 4
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 4_suppl ( 2018-02-01), p. 53-53
    Abstract: 53 Background: Hepatic metastasis of gastric cancer has become a growing issue, because effective treatment and specific biomarkers are not available. The aim of this study was to identify a molecule mediating hepatic metastasis, which serves as a diagnostic marker, and to determine its potential as a therapeutic target. Methods: Stable knockdown gastric cancer cells were established using genome editing technique and cell activities were compared to control cells in vitro and in vivo. Tissue expression levels of the candidate molecule were evaluated in 300 patients with gastric cancer and correlated to clinicopathological parameters including patterns of metastasis and recurrences. Results: Global expression analysis revealed that synaptotagmin VII (SYT7) was overexpressed in gastric cancer tissues with hepatic metastasis. Gastric cancer cell lines differentially expressed high levels of SYT7 that positively correlated with those of SNAI1 and TGFB3, and inversely with RGS2. Stable knockout of SYT7 inhibited the proliferation of gastric cancer cells, indicated by increased apoptosis, and decreased cell migration, invasion, and adhesion abilities. The tumorigenicity of SYT7 knockout cells was moderately reduced in a mouse subcutaneous model and more strikingly decreased in a hepatic metastasis model. The protein expression levels of BCL2 and HIF1A were decreased in tumors formed by SYT7 knockout cells, and SYT7 levels in primary gastric cancer tissues were significantly associated with hepatic recurrence, metastasis, and adverse prognosis. Conclusions: SYT7 serves as a target for treating hepatic metastasis of gastric cancer as well as a diagnostic tool.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2018
    detail.hit.zdb_id: 2005181-5
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  • 5
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 4_suppl ( 2018-02-01), p. 416-416
    Abstract: 416 Background: Several studies have shown that nutritional support is important to reduce chemotherapy-related toxicities and improve tolerance to chemotherapy, but little is known about the nutritional influence of neoadjuvant therapy (NAT) for pancreatic cancer. The aim of this study was to assess the influence of NAT on nutritional status and the effectiveness of postoperative nutritional support in patients with NAT for pancreatic cancer. Methods: Between 2010 and 2017, 169 consecutive patients who underwent pancreatoduodenectomy of pancreatic cancer were enrolled, and divided into the neoadjuvant group (NAG, n = 70) and the control group (CG, n = 99). We assessed the change of nutritional index (body weight, albumin and rapid turnover proteins; retinol binding protein, prealbumin and transferrin), inflammatory index, and inflammation-based prognostic scores during NAT. Perioperative change of rapid turnover proteins at the point of pre-operation, postoperative day (POD) 5, POD12 and POD21, and perioperative and oncological outcomes between NAG and CG were evaluated. Finally, we divided NAG into nutrition group (n = 27) who received postoperative enteral immunonutrition from POD 1 to POD 21 and without nutrition group (n = 41), and compared perioperative change of rapid turnover proteins between two groups. Results: After NAT, the retinol binding protein, prealbumin, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and prognostic nutrition index significantly got worse in NAG (P 〈 0.05). The recovery of rapid turnover proteins after POD5 was significantly worse in NAG compared to CG (P 〈 0.05). There was no significant difference in the incidence of postoperative complications and time to adjuvant therapy between two groups. The recovery of retinol binding protein and prealbumin after POD12 was significantly better in nutrition group compared to without nutrition group (P 〈 0.05). Conclusions: NAT for pancreatic cancer could decrease nutritional status and its postoperative recovery. Postoperative enteral nutrition could be effective in patients with NAT for pancreatic cancer. Based on these results, we plan to perform the nutritional support at earlier stage of therapy.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2018
    detail.hit.zdb_id: 2005181-5
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  • 6
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 4_suppl ( 2018-02-01), p. 523-523
    Abstract: 523 Background: Gemcitabine plus nab-paclitaxel (GnP) treatment is recommended for metastatic pancreatic adenocarcinoma (PDAC), and has been widely spread in our clinics. However, the usefulness for the patients with locally advanced PDAC is still controversial. We designed the phase I study to assess the toxicity and decide the recommended dose based on dose-limiting toxicity (DLT) of concurrent chemoradiotherapy using GnP for unresectable locally advanced (UR-LA) PDAC. Methods: UR-LA PDAC patients were enrolled in this clinical trial. The patients received the GnP on days 1, 8 and 15 every 28 days, and the cycles were repeated until PD. The patients were scheduled to receive gemcitabine (mg/m 2 ) and nab-paclitaxel (mg/m 2 ) at 5 dose levels: 400/75 (level 0), 600/75 (level 1), 600/100 (level 2), 800/100 (level 3) and 800/125 (level 4). Radiation therapy was delivered as a total dose of 50.4 Gy in 28 fractions, 1.8Gy per day. DLT was defined as grade 4 leucopenia or neutropenia ≥ 3 days, grade 3 neutropenia with fever ≥ 38℃, grade 3 or 4 thrombopenia, grade 3 non-hematological toxicity and 〉 14 days delay of treatment. Response and disease control rate, safety, adverse events, PFS and OS were evaluated. Results: Twelve patients were enrolled in this study. Treatment was well tolerated, and every 12 patients completed radiotherapy of 50.4 Gy. Our recommended dose was level 3, gemcitabine 800 mg/m 2 and nab-paclitaxel 100 mg/m 2 . One patient experienced the DLT. The response rate was 41.7% and disease control rate was 75% (PR: 5, SD: 4, PD: 3). Median OS was 9.0 months. Among 12 patients, 6 (50%) patients underwent conversion surgery, and the pathological CR was observed in 2 patients. Conclusions: The concurrent chemoradiotherapy using GnP for UR-LA PDAC can be delivered safely and the high rate of conversion surgery was observed in our clinical trial. Based on this results, we will proceed the phase-II study. Clinical trial information: UMIN000020475.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2018
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  • 7
    In: Annals of Surgical Oncology, Springer Science and Business Media LLC, Vol. 23, No. 2 ( 2016-2), p. 611-618
    Type of Medium: Online Resource
    ISSN: 1068-9265 , 1534-4681
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
    detail.hit.zdb_id: 2074021-9
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  • 8
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 32, No. 3_suppl ( 2014-01-20), p. 302-302
    Abstract: 302 Background: The aim of this study was to investigate the efficacy and safety of neoadjuvant chemoradiotherapy (NACRT) with S-1 (oral fluoropyrimidine) followed by surgery for the treatment of borderline resectable pancreatic cancer that involved the major visceral artery or the portal venous system. Methods: Twenty-eight patients with pancreatic cancers that abutted the SMA in 10, the CHA in 7, the both SMA and CHA in 1, and occluded the SMV/PV in 10 were treated with NACRT at a single institution. Radiation therapy was delivered at a total dose of 50.4 Gy in 28 fractions. S-1 was administered orally at a dose of 80 mg/m(2)/day for 14 consecutive days followed by a 7-day rest period during radiation therapy. After radiotherapy and 2 courses of S-1, restaging was done to evaluate secondary resectability. Results: Of the all patients, 25 underwent a full course of NACRT, and NACRT terminated in 3 patients because of grade 3 leukopenia in 2 and tumor bleeding in 1. Partial response was achieved in 3 patients and stable disease in 22. Twenty-four patients (86%) underwent surgical resection, and all had margin-negative (R0) resections. Only two patients (8%) had major morbidity as Clavien-Dindo’s classification III or more, and there was no operative or in-hospital mortality. Pathological examination revealed that more than 50% of tumor cells had disappeared in 14 cases and all cases achieved Evans’ score IIa and more. Conclusions: Neoadjuvant chemoradiation with S-1 was feasible and promising therapy for borderline resectable pancreatic cancer that involves the major artery or the portal venous system.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2014
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  • 9
    In: Annals of Surgical Oncology, Springer Science and Business Media LLC, Vol. 23, No. 6 ( 2016-6), p. 1934-1940
    Type of Medium: Online Resource
    ISSN: 1068-9265 , 1534-4681
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
    detail.hit.zdb_id: 2074021-9
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  • 10
    In: Pancreas, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. 10 ( 2018-11), p. 1350-1356
    Abstract: This study aimed to clarify the correlation between image classification and the pathological degree of portal system invasion (PSI) and to evaluate the prognostic impact of PSI in pancreatic cancer (PC). Methods Pancreatic cancer patients with surgical resections (head, n = 244; body and tail, n = 80) were enrolled in this study. Results Based on imaging findings, portal vein (PV) invasion was classified as type A (absent), B (unilateral narrowing), C (bilateral narrowing), or D (stenosis or obstruction with collaterals). Splenic vein (SPV) invasion was classified as type α (absent), β (stenosis), or γ (obstruction). The pathological grade of venous invasion was classified as grade 0 (no invasion), 1 (tunica adventitia), 2 (tunica media), or 3 (tunica intima). In PV and SPV invasions, image classification and pathological grade showed significant correlation (PV: ρ = 0.696; SPV: ρ = 0.681). Patients with PV invasion deeper than type B exhibited significantly poorer survival than type A ( P 〈 0.0001). In contrast, there was no difference in survival among types α, β, and γ. Conclusions Image classification was correlated with the pathological grade of PSI in PC. Although not applicable for SPV invasion, image classification of PV invasion is a robust indicator for PC prognosis.
    Type of Medium: Online Resource
    ISSN: 1536-4828 , 0885-3177
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2053902-2
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