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J. Hanaoka



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    ORAL 18 - Non PD1 Immunotherapy and Angiogenesis (ID 114)

    • Event: WCLC 2015
    • Type: Oral Session
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      ORAL18.02 - MUC1-Targeted Dendritic Cell-Based Vaccine Immunotherapy in Patients with Standard Treatments-Refractory Non-Small-Cell Lung Cancer (ID 1193)

      10:45 - 12:15  |  Author(s): J. Hanaoka

      • Abstract
      • Presentation
      • Slides

      Background:
      MUC1, a tumor antigen, has been considered to 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 had been proven to express MUC1 abundantly; an Eastern Cooperative Oncology Group performance status of 0-2; advanced stage of diseases refractory for other standard cancer treatments. The dendritic cells were prepared from peripheral blood mononuclear cells with cytokines interleukin-4 and granulocyte macrophage colony stimulating factor, were pulsed with MUC1 peptides, and subsequently administered to patients subcutaneously. 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 and March 2015, 42 patients were treated with dendritic cell-based vaccines, and 29 patients (69.0%) with median age of 61 years (range, 49-84 years) were assessable for tumor responses. The cohort consisted of 18 males and 11 females. As their histological types, 24 patients had adenocarcinomas; 4 patients with squamous cell carcinomas and 1 patient with pleomorphic carcinoma. Among these assessable patients, neither complete response nor partial response was obtained. Seventeen patients had progressive disease as the best response, and 11 patients had stable disease, yielding overall disease control rate of 39.2% (95%CI=20.3-55.6). Median survival time after the vaccines was 10.0 months, and 1-year survival rate was 39.6%. Adverse events related to the vaccines were less frequent. Immunological responses were able to 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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    P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P2.02-012 - Prediction of Postoperative Pulmonary Function Using CT Volumetry (ID 2515)

      09:30 - 17:00  |  Author(s): J. Hanaoka

      • Abstract
      • Slides

      Background:
      According to some guidelines, prediction of postoperative pulmonary function is important in preoperative assessment for the lung cancer resection. Generally, it used to be calculated the function by Segmental method (S method) or Subsegmental method (SS method). But, the volume of pulmonary (sub) segments varies between individuals. The purpose of this study is to evaluate the efficacy of the prediction of postoperative pulmonary function using CT volumetry.

      Methods:
      This study included 29 cases who were performed segmentectomy or (bi) lobectomy for primary lung cancer from August 2013 to June 2014. Actual pulmonary function obtained at 6 months postoperation (VC, %VC, FVC, %FVC, FEV1.0, %FEV1.0, DLco’, % DLco’, DLco’/Na’, %DLco’/Na’) was compared with the predicted pulmonary function calculated by S method, SS method and CT volumetry method (CTV method), respectively. CTV method was calculated by Image analysis software (Synapse Vincent; Fuji Film, Japan) which used the preoperative chest CT scan data (mediastinum conditions, 0.5mm thickness).

      Results:
      The median age of patient was 69 years old, ranging 47 to 83 years old. Seven patients underwent thoracotomy and 22 underwent VATS. Upper lobectomy or upper and middle bilobectomy / upper segmentectomy / middle or lower lobectomy / lower segmentectomy were 12/3/10/4 cases, respectively. These 3 methods were found to have a good correlation with actual pulmonary function. In particular, the CTV method’s function was better correlated with actual VC, %VC, FVC, %FVC, FEV1.0, %FEV1.0(r = 0.909, 0.839, 0.913, 0.849, 0.935, 0.875, respectively). On the other hand, SS method’s function has better correlated with actual DLco’, DLco’/Na’, %DLco’/Na’ (r=0.916, 0.817, 0.789, respectively). The cases of upper lobectomy or upper segmentectomy (U group) were found to overestimate on DLco’/Na’, %DLco’/Na’ (t =4.714, 4.634). The other cases (non-U group) were found to overestimate on FVC, FEV1.0, %FEV1.0 (t=2.446, 3.797, 5.657) .

      Conclusion:
      CTV method may be better correlated evaluation of the ventilation ability than conventional methods, but the evaluation of the diffusion ability is not. Therefore, in the poor pulmonary function case, it is necessary to selectively use these methods in order to make more accurate predictions. And, you should take care that there is pulmonary function to be overestimated or underestimated by the location.

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