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N. Tezuka



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    MO18 - NSCLC - Targeted Therapies IV (ID 116)

    • Event: WCLC 2013
    • Type: Mini Oral Abstract Session
    • Track: Medical Oncology
    • Presentations: 1
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      MO18.04 - MUC1-targeted dendritic cell-based vaccines in patients with standard treatments-refractory non-small-cell lung cancer (ID 3215)

      16:15 - 17:45  |  Author(s): N. Tezuka

      • Abstract
      • Presentation
      • Slides

      Background
      MUC1, a tumor antigen, has been considered to be a promising target antigen for cancer immunotherapy because it possesses a potent immunogenicity. It is processed and presented by antigen-presenting cells in a MHC-unrestricted pattern. Dendritic cell-based vaccine immunotherapy can elicit antigen-specific cytotoxic T lymphocytes in tumor-bearing hosts, and activated cytotoxic T lymphocytes are expected to attack cancer cells. In this study, we evaluated the efficacy of MUC1-targeted dendritic cell-based vaccine immunotherapy in patients with standard treatments-refractory advanced non-small-cell lung cancer (NSCLC).

      Methods
      The eligibility criteria of this immunotherapy were as follows: histologic or cytologic evidence of NSCLC that express MUC1 protein abundantly; an Eastern Cooperative Oncology Group performance status of 0-2; advanced stage of diseases refractory to any standard cancer treatments. The dendritic cells were prepared from peripheral blood mononuclear cells with cytokines interleukin-4 and granulocyte macrophage colony stimulating factor, pulsed with MUC1 peptides, and subsequently administered to patients by subcutaneous injection. The vaccinations were repeated bi-weekly, and assessable patients were received at least 6 vaccinations. Tumor response was assessed according to the Response Evaluation Criteria in Solid Tumors. Adverse events were graded according to National Cancer Institute Common Toxicity Criteria.

      Results
      From June 2005 to December 2012, 36 patients were treated with dendritic cell-based vaccines, and 25 patients (69.4%) with median age of 61 years (range, 49-84 years) were assessable for tumor responses. The cohort consisted of 14 males and 11 females, and 22 patients had adenocarcinomas; 2 patients with squamous cell carcinomas and 1 patient with pleomorphic carcinoma. Among these patients, neither complete response nor partial response was obtained. Fourteen patients had progressive disease as the best response, and 10 patients had stable disease, yielding overall disease control rate of 40.0% (95%CI=20.8-59.2). Median survival time after the vaccines was 10.0 months, and 1-year survival rate was 32.3%. Adverse events related to the vaccines were less frequent. Immunological responses could be monitored in five patients, showing that MUC1-specific cytotoxic responses of effector immune cells were achieved in all of those patients, and the population of regulatory T lymphocytes in peripheral blood cells was decreased after the vaccines.

      Conclusion
      MUC1-targeted dendritic cell-based vaccine immunotherapy is feasible, and has a potential to control the diseases in patients with refractory NSCLC.

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    P2.24 - Poster Session 2 - Supportive Care (ID 157)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P2.24-017 - 5 cases of long-term survival in posterior spinal fixation surgery against vertebral metastasis of lung cancer (ID 1251)

      09:30 - 16:30  |  Author(s): N. Tezuka

      • Abstract

      Background
      Recently, with the progress of treatment, the patients showing prolonged survival has increased in advanced lung cancer. Even though local treatments for the patients with vertebral metastasis, such as radiation therapy and/or surgery, are considered with effective, the indication of the treatment has not been determined. We report 5 cases who underwent posterior spinal fixation, they could maintain ADL(Activities of Daily Livings) well and could keep a long-term prognosis.

      Methods
      Between December 2012 and June 2004, we objectively evaluate postoperative state and prognosis of the 5 cases that underwent the posterior spinal fixation surgery for vertebral metastasis in advanced lung cancer.

      Results
      5 patients were underwent this surgery, 3 were male and 2 were female and the average age was 58.9 years. We added the surgery to remove the pressure of the spine in 3 cases, fortunately there was no spinal invasion in these 5 cases. We preformed chemoradiotherapy in 4 cases and chemotherapy alone in 1 case. EGFR mutation was positive in 2 cases. All patients were possible to ambulate in early postoperative day, and they showed improvement of neurological symptoms of paralysis. It was possible to maintain a relatively well ADL.

      Conclusion
      There may be an excessive burden to perform the surgery for the patients with vertebral metastasis in advanced lung cancer, the surgery for selecting patients may have been able to improve neurological symptoms such as paralysis. Therefore, we thought that the surgical procedure for the patients who are possible to survive long term period might have been one of the important treatment methods because of maintaining possibly their ADL well.

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    P3.07 - Poster Session 3 - Surgery (ID 193)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P3.07-033 - Surgical treatments for NSCLC of female patients under 50 years old (ID 2704)

      09:30 - 16:30  |  Author(s): N. Tezuka

      • Abstract

      Background
      The number of patients with non-small cell lung cancer (NSCLC) has been increasing for some decades. The patients are predominantly male and over 50 years old in age, whereas female patients under 50 years old are relatively small cohort in NSCLC. Therefore, the characteristics of these female patients remain to be unclear.

      Methods
      In this study, we examined the clinico-pathological characteristics of female patients under 50 years old who had received surgical treatments for NSCLC. Female patients who had been under 50 years old and received curative surgical resection for NSCLC in our hospital from January 2000 to December 2010 were involved in this study. The clinico-pathological characteristics of them were examined retrospectively and compared with those of relative male patients in the similar criteria. Both overall survival (OS) and disease-free survival (DFS) times after surgery were obtained by Kaplan-Meier analysis, and differences between two cohorts were analyzed by log-lank test.

      Results
      In total, 13 female patients with median age of 43 years old (range: 40-49 years old) and 12 male patients with median age of 43years old (range: 31-49 years old) were received curative surgical resection for NSCLC in this period. All of the female patients were never-smokers, whereas 11 male patients (91.7%) were current smokers. Twelve female patients were free from symptoms at the diagnosis of NSCLC, however, 5 male patients had some symptoms related to NSCLC (a rate of symptom-free patients; female vs male = 92.3% vs 58.3%). Pathological stages of female NSCLC were as follows; 1A: 9, 1B: 1, 2A: 1, 3A: 1, 3B: 1. All cases of female NSCLC (100.0%) were diagnosed with adenocarcinomas histologically; mixed subtype: 6, papillary: 2, bronchiolo-alveolar cell carcinomas (BAC): 5 cases. In males, 8 patients (66.7%) were diagnosed with adenocarcinomas including 1 BAC case. The rates of OS and DFS at 5 years after surgery of female patients were 100.0% and 74.6%, respectively, with the median observation period was 69.0 months (range: 17-148 months). On the other hand, the rates of OS and DFS at 5 years after surgery of male patients were 74.6% and 58.3%, respectively, demonstrating that OS in female patients seemed to be long as compared with that in male patients (P=0.302).

      Conclusion
      More patients who were free from symptoms, never-smokers and with BAC subtype were included in female than male patients in this study. These characteristics of female patients would have contributed to the better prognosis of them after surgery. In the NSCLC patients under 50 years old, the prognosis of female patients who received curative surgery is likely to be better than that of male patients.