Virtual Library

Start Your Search

Tatsuya Kato



Author of

  • +

    MA12 - Mesothelioma Surgery and Novel Targets for Prognosis and Therapy (ID 913)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Mesothelioma
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 10:30 - 12:00, Room 202 BD
    • +

      MA12.09 - Preclinical Investigations of Folate Receptor Targeted Nanoparticles for Photodynamic Therapy of Malignant Pleural Mesothelioma (ID 11277)

      11:30 - 11:35  |  Presenting Author(s): Tatsuya Kato

      • Abstract
      • Presentation
      • Slides

      Background

      Photodynamic therapy (PDT) following lung-sparing extended pleurectomy (EPD) for malignant pleural mesothelioma (MPM) has been investigated as a potential means to kill residual microscopic cells. High expression of folate receptor 1 (FOLR1) has been reported in MPM, and targeting the FOLR1 has been considered as a new potential strategy. We have developed FOLR1-targeting porphyrin-lipid nanoparticles (folate-porphysomes; FP) for PDT. The inhibition of survival pathways of activated epidermal growth factor (EGFR) also enhance the PDT efficacy. Here, we have combined these approaches by using FP based PDT together with an EGFR-tyrosine kinase inhibitor (EGFR-TKI).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      The frequency of FOLR1 and EGFR expression in MPM was analyzed using tissue microarrays. Confocal microscopy and a cell viability assay were performed to confirm the specificity of FOLR1-targeting cellular uptake and photocytotoxicity in vitro. In vivo fluorescence activation and the therapeutic efficacy were then examined. The effect of EGFR-TKI was assessed in vitro. The in vivo combined anti-tumor effect of EGFR-TKI and FP-PDT was then evaluated.

      4c3880bb027f159e801041b1021e88e8 Result

      FOLR1 and EGFR were expressed in 79 % and 89 % of the MPM samples, respectively. The intracellular uptake of FP corresponded well with FOLR1 expression. When MPM cells were incubated in FP and then irradiated at 671 nm, there was significant in vitro cell kill, which was inhibited in the presence of free folic acid, suggesting the specificity of FPs. FOLR1 targeting resulted in disassembly of the porphysomes and subsequent fluorescence activation in intrathoracic disseminated MPM tumors, as demonstrated by ex vivo tissue imaging. FP-PDT resulted in significant cellular damage and apoptosis in vivo. Furthermore, the combination of pre-treatment with EGFR-TKI plus FP-PDT showed further marked improvement of treatment responses.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Folate-porphysome based PDT shows selective destruction of MPM cells based on FOLR1 targeting, and pre-treatment with EGFR-TKI further enhances the therapeutic response.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    MA23 - Early Stage Lung Cancer: Present and Future (ID 926)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Treatment of Early Stage/Localized Disease
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 10:30 - 12:00, Room 105
    • +

      MA23.10 - Cone-Beam Computed Tomography-Guided Microcoil Localization of Pulmonary Nodules During Video-Assisted Thoracic Surgery (ID 13345)

      11:35 - 11:40  |  Author(s): Tatsuya Kato

      • Abstract
      • Presentation
      • Slides

      Background

      The standard procedure at our institution for intraoperative localization of non-palpable small lung nodules is computed tomography (CT)-guided microcoil placement prior to video-assisted thoracic surgery (VATS). Typically, microcoil placement is performed in the radiology suite followed by transfer to the operation room (OR). Our institution has built the Guided Therapeutics (GTx) OR, which includes a robotic cone-beam CT (CBCT). The GTx OR allows imaging and therapy to occur in one location. This can improve workflow and reduce patient transportation, which may increase the risk for microcoil dislodgement or the development of pneumothorax/hemothorax. Our objective was to determine the safety and efficacy of CBCT-guided microcoil placement for nodule localization during VATS.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This is a single center phase I clinical trial (NCT02496624). Patients with small lung nodules who were candidates for standard CT-guided microcoil localization were enrolled. CBCT was used to generate a 3D reconstruction. The lesion was then segmented using Syngo iGuide software. This reconstruction was next integrated into the digital workspace and automatically registered onto the fluoroscopic images, creating ‘augmented fluoroscopy’. The microcoil was placed percutaneously using ‘augmented’ guidance, proximal to the lesion, using local anesthetic. Patients were subsequently induced into general anesthesia, intubated, and positioned for VATS. Minimally invasive resection of the nodule together with the microcoil was performed under standard fluoroscopic guidance.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 11 patients were enrolled (mean age 70 ± 11SD). The average tumor size on CT was 1.3 cm (range 0.9-1.7). The average deepest depth from the pleural surface was 2.3 cm (1.3-3.8). The average CBCT-guided intervention time was 39 minutes (25-54), and VATS procedural time was 54 minutes (14-78). We were able to detect and successfully resect all nodules. Average total radiation dose was in an acceptable low range (8307 μGy*m2, range, 2402–18,371). There were no intraoperative complications. Average post-operative length of stay was 1.8 days. A pathological diagnosis was made for all patients: 8 primary lung cancers and 3 lung metastases. All surgical margins were negative on final pathology.

      8eea62084ca7e541d918e823422bd82e Conclusion

      CBCT-guided microcoil insertion followed by VATS was safe, with short operative times, short length of stay and 100% diagnostic yield. With the GTx OR’s real-time guidance capabilities, surgeons can operate with increased confidence of finding and removing the target lesion. This technique will become increasingly important in the future with growing numbers of small nodules being detected on CT by lung cancer screening programs.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    OA08 - Mesothelioma: Immunotherapy and microRNA for Diagnosis and Treatment (ID 907)

    • Event: WCLC 2018
    • Type: Oral Abstract Session
    • Track: Mesothelioma
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 15:15 - 16:45, Room 201 BD
    • +

      OA08.01 - Long-Term Efficacy and Safety of Nivolumab in Second- or Third-Line Japanese Malignant Pleural Mesothelioma Patients (Phase II: MERIT Study) (ID 11833)

      15:15 - 15:25  |  Author(s): Tatsuya Kato

      • Abstract
      • Presentation
      • Slides

      Background

      Malignant Pleural Mesothelioma (MPM) is a rare and highly aggressive malignancy with poor prognosis and no treatment is approved for patients (pts) progressing after 1st line pemetrexed-platinum doublet. Here, we report latest analysis of MERIT study in previously treated Japanese MPM pts to update the previous report (WCLC 2017, Goto Y, et al).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This open-label study enrolled advanced or metastatic MPM pts previously treated with up to two regimens of chemotherapy including pemetrexed-platinum doublet. Enrollment criteria also included histologically-confirmed, unresectable MPM without prior surgery, measurable lesion and ECOG performance status 0-1. There was no restriction of PD-L1 status. Pts received Nivolumab 240 mg flat dose Q2W until progression or unacceptable toxicity. Primary endpoint was objective response rate (ORR) (modified RECIST by independent review committee, expected response rate was 19.2%); secondary endpoints included disease control rate (DCR), duration of response (DOR), progression-free survival (PFS), overall survival (OS) and safety.

      4c3880bb027f159e801041b1021e88e8 Result

      Thirty-four pts received Nivolumab in this study. Males: 85.2%, median age: 68.0 years (range 43-78), PS 1: 61.8%, epithelial/sarcomatoid/biphasic: 79.4%/8.8%/11.8%, 1 prior regimen: 70.6% and PD-L1 (≧1%)/PD-L1 (<1%)/not evaluable: 58.8%/35.3%/5.9%. At a median follow-up of 16.8 months (range: 1.8-20.2), ORR was 29.4 % (n=10, 95%CI: 16.8-46.2). DCR was 67.6% (n=23, 95%CI: 50.8-80.9). Median DOR was 11.1 months (95%CI: 3.5-16.2). Median PFS was 6.1 months (95%CI: 2.9-9.9) in all pts, 7.2 months (2.8-15.0) in PD-L1 (≧1%) and 2.9 months (1.4-9.3) in PD-L1 (<1%). Median OS was 17.3 months (95%CI: 11.5-NR) in all pts, 17.3 months (8.2-NR) in PD-L1 (≧1%), 11.6 months (5.8-NR) in PD-L1 (<1%), across tissue types, 15.7 months (95%CI: 8.0-NR) in epithelioid and not reached in sarcomatoid/biphasic pts. Six- and 12-month survival rates were 85.3% (95%CI: 68.2-93.6) and 58.8% (95%CI: 40.6-73.2). Twenty-six (76.5%) pts experienced treatment-related adverse event (TRAE), and 11 (32.4%) experienced grade 3/4 TRAEs. Most commonly reported TRAEs were skin disorder (n=6, 17.6%), elevated lipase (n=5, 14.7%), elevated amylase and diarrhea (n=4, 11.8%). Four pts required dose discontinuation because of interstitial pneumonia (n=2, grade2 and 3) and pneumonitis (n=2, grade3).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Nivolumab shows durable long term efficacy and manageable safety profile in Japanese 2nd/3rd line MPM pts.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    P3.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 982)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
    • +

      P3.16-20 - Feasibility of Limited Resection for Peripheral Small-Sized Non-Small Cell Lung Cancer According to FDG Accumulation and Imaging Findings (ID 12913)

      12:00 - 13:30  |  Author(s): Tatsuya Kato

      • Abstract
      • Slides

      Background

      With the progress of diagnostic imaging modalities, such as CT and FDG-PET, the number of resectable lung cancer, particularly small peripheral lung cancer, is increasing. We focused on the SUVmax of FDG-PET as a prognostic factor for lung cancer and established criteria for limited resection on the basis of CT findings and SUVmax. Since 2007, we continuously monitored the recurrence and prognosis of non-small cell lung cancers (NSCLCs) resected using our criteria. Here, we report the results of this study.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Between December 2007 and December 2015, 611 consecutive patients underwent surgery for NSCLC at our institution. Of these, 73patients with cT1aN0M0 who underwent limited resection (partial resection or segmentectomy) were enrolled. The criteria for undergoing limited resection were as follows: ①tumor GGO ratio of ≥0.75and ② tumor SUVmax of ≤1.5. GGO ratio was calculated using the following equation: GGO ratio=[(maximum diameter of the tumor) – (maximum diameter of tumor consolidation)] / (maximum diameter of the tumor). The group that met our criteria and underwent limited resection was designated as intended limited resection group (ILR group), and the group subjected to limited surgery without meeting the criteria treated as control group.

      4c3880bb027f159e801041b1021e88e8 Result

      The study included 35 men and 38 women with a median age of 65 (range, 36–84) years. In total, 51 patients who met our criteria were included in the ILR group, and 21 patients who did not meet the criteria were included in the control group. The control group was selected for limited resection in terms of complications, pulmonary hypofunction, and heart failure. Regarding surgical approach, in the ILR group, 19 patients underwent partial resection and 32 underwent segmentectomy; in the control group, 13 patients underwent partial resection and 8 underwent segmentectomy. According to our criteria, no relapsed cases were reported in the ILR group. Moreover, the 5-year overall survival rates of the ILR and control groups were 100% and 60.5%, respectively, and the disease-free survival rates were 100% and 56.0%, respectively, indicating a significant difference (P < 0.0001). In the control group, 6 patients showed the recurrence of lung cancer.

      8eea62084ca7e541d918e823422bd82e Conclusion

      In this study, we analyzed the feasibility of our criteria for performing limited resection on the basis of CT findings and SUVmax. In the ILR group, no relapsed cases were reported, suggesting that our criteria may be useful in determining patient’s eligibility for undergoing reduction surgery.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.