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32 citation(s) found for "Fujiwara, Yu".

Incidence and treatment-modifying impact of immune checkpoint inhibitor–associated peripheral edema: a systematic review and meta-analysis
Markus, Anneliese , Tsuchiya, K, Takahashi, Toshiaki , Elias, Evelyn , Koseki, Mako , Nishimura, Yoshito, Rohs, Nicholas, Fujiwara, Yu , Nishimura, Yoshito , Fujiwara, Yu , Nishimura, Yoshito

JNCI Cancer Spectrum | May 30, 2026 | Volume: 10 | Issue: 4 | Pages: No page available

10.1093/jncics/pkag058 | PMID 42234870 Get It

Abstract Background Immune-related adverse events disrupt immune checkpoint inhibitor therapy and impact quality of life. Peripheral edema is common among patients with cancer, however the causality of peripheral edema can be unclear in the context of multidrug regimens. Methods PubMed/MEDLINE, Embase, and Web of Science were searched to identify phase 3 randomized controlled trials (RCTs) evaluating immune checkpoint inhibitors reporting peripheral edema incidence. The incidence of edema was calculated according to adverse event, immune checkpoint inhibitor, and treatment patterns. A random-effects meta-analysis pooled odds ratios (ORs) of edema incidence between immune checkpoint inhibitor and non–immune checkpoint inhibitor groups. A systematic review characterizing the interventions for immune-related peripheral edema was also conducted. Results From 58 RCTs (22 590 patients), treatment-related peripheral edema (grade 1-5) occurred in 2.80% (n = 195 of 6969) of patients receiving immune checkpoint inhibitor monotherapy, 4.96% (n = 112 of 2257) of patients receiving immune checkpoint inhibitor with chemotherapy, and 8.73% (n = 205 of 2349) of patients receiving immune checkpoint inhibitor with targeted therapy. Meta-analysis showed immune checkpoint inhibitor monotherapy had lower treatment-related peripheral edema incidence compared with chemotherapy (OR = 0.45, 95% CI = 0.27 to 0.73; P = .001, I2 = 69%) with the lowest relative incidence among programmed cell death protein 1 vs chemotherapy (OR = 0.41, 95% CI = 0.23 to 0.73; P = .003) and immune checkpoint inhibitor vs taxane chemotherapy (OR = 0.32, 95% CI = 0.18 to 0.58; P < .001). A systematic review of treatment outcomes for immune-related peripheral edema among 40 patients (19 studies) revealed 82.5% (n = 33 of 40) of cases received glucocorticoid treatment, and immune checkpoint inhibitors were permanently discontinued in 35% (n = 14 of 40). Conclusions Peripheral edema is a rare but potentially serious adverse event associated with immune checkpoint inhibitors. Immune checkpoint inhibitors likely confer less peripheral edema risk than taxane therapy. To avoid unnecessary treatment interruptions, treatment discontinuation requires careful consideration, particularly when edema develops following immune checkpoint inhibitor combination therapy.
Safety and efficacy of immunotherapy rechallenge in solid tumors after discontinuation of immune checkpoint inhibitors for immune-related adverse events: A systematic review and meta-analysis.
Fujiwara, Yu, Sekiya, Mataichi , Tokunaga, Kota, Aijaz, Ayesha, Nishimura, Yoshito, Cortellini, Alessio, Naqash, Abdul Rafeh , Naqash, Abdul Rafeh , Fujiwara, Yu , Nishimura, Yoshito , Horita, Nobuyuki , Cortellini, Alessio

Journal of Clinical Oncology | May 27, 2026 | Volume: 44 | Issue: 16_suppl | Pages: 11127-11127

10.1200/jco.2026.44.16_suppl.11127 Get It

11127 Background: Immune-related adverse events (irAEs) often require treatment discontinuation in patients with cancer receiving immune checkpoint inhibitors (ICIs). Given limited subsequent treatment options, ICI rechallenge is frequently considered. We aimed to estimate the incidence of recurrent irAEs and objective response rates (ORR) in patients receiving ICI rechallenge following prior irAEs. Methods: PubMed, Web of Science, and Embase were searched for studies evaluating ICI rechallenge in patients with advanced solid tumors who previously suspended treatment due to irAEs. Outcomes included the incidence of grade 1-5 (Gr1-5), Gr1-2, and Gr3-5 irAEs, recurrent irAEs, new irAEs, ORR, and disease control rate (DCR). Random-effects meta-analyses and subgroup analyses by cancer type were performed. Meta-regression analysis was conducted to evaluate the impact of the grade and type of initial irAEs on response outcomes. Heterogeneity was assessed using I 2 statistics (≥50% considered high). Results: Thirty-seven studies comprising 1,126 patients with initial irAEs (Gr1-2: 62.8%, Gr3-4: 37.2%) leading to suspension of ICIs were included. The most common initial irAEs in the pooled cohort were hepatitis/liver enzyme elevations (20.5%), pneumonitis (16.1%), and nephritis/acute kidney injury (14.8%). Pooled incidences of Gr1-5, Gr1-2, and Gr3-5 irAEs after ICI rechallenge were 42.2% (95% confidence interval [CI]: 35.3-49.3), 27.1% (95% CI: 22.9-31.7), and 18.8% (95% CI: 14.7-23.8), respectively. Subgroup analysis showed overall higher incidences of irAEs in melanoma (Gr1-5: 54.6%, Gr1-2: 23.2%, Gr3-5: 26.4%) than those in lung cancer (Gr1-5: 39.7%, Gr1-2: 27.4%, Gr3-5: 14.0%) and solid tumors (Gr1-5: 36.7%, Gr1-2: 22.8%, Gr3-5: 20.1%). The same type of irAEs recurred in 23.8% (95% CI: 20.1-28.0) of patients, while new types of irAEs developed in 29.3% (95% CI: 25.2-33.7) of patients undergoing ICI rechallenge. The overall ORR was 45.2% (95% CI: 34.5-56.4), with cancer type-specific ORRs of 60.5% (95% CI: 47.9-71.9) in melanoma, 39.1% (95% CI: 17.4-66.2) in lung cancer, and 39.5% (95% CI: 27.7-52.6) from studies investigating solid tumors. DCR was high across cancer types: 77.3% (95% CI: 67.7-84.7) overall, 68.2% (95% CI: 41.3-86.8) in melanoma, 91.2% (95% CI: 67.7-98.1) in lung cancer, and 72.5% (95% CI: 63.3-80.1) in solid tumors. Meta-regression analysis showed that commonly observed initial irAE types or grades of initial irAEs (Gr1-2 vs. Gr3-4) did not significantly impact ORR or DCR. Conclusions: ICI rechallenge after discontinuation due to irAEs demonstrates clinical activity but carries a substantial risk of both recurrent and new irAEs. These findings highlight the need for predictive biomarkers to optimize patient selection and maximize survival without compromising safety.
LATS1/2-CD38 Metabolic Rewiring Links Senescence to Intraplaque Thrombosis
Kotla, Sivareddy , Ko, Kyung Ae , Chen, Weiqing , Samanthapudi, Venkata Subrahman K, Hoang, Oanh, Mejia, Gilbert F. , Li, Shengyu , Lee, Hani , Zhang, Angie, Cho, Min Soon , Schadler, Keri L., Rivera, Luis Antonio, Samperio, Kay Carlene Tavares, Kim, Jung Hyun , Mendoza, Keila Carolina Ostos , Mariscal-Reyes, Karla N., Deswal, Anita, Fujiwara, Keigi , Koutroumpakis, Efstratios, Gi, Young Jin , Pathania, Rajneesh , Morrell, Craig N. , Lorenzi, Philip L. , Tan, Lin, Mahmud, Iqbal, Chini, Eduardo N., Herrmann, Joerg , Vasquez, Hernan G., Shen, Ying H. , Martin, James F. , Xu, Haodong, Le, Nhat‐Tu , Zhang, Aijun , Hoang, O.N. , Kim, Jung Hyun , Lee, Jonghae , Chen, Weiqing , Samanthapudi, Venkata Subrahmanya Kumar , Hoang, Oanh , Mejia, Gilbert , Li, Shengyu , Lee, Hani , Zhang, Aijun , Cho, Min Soon , Schadler, Keri , Rivera, Luis Antonio , Kim, Jung Hyun , Ostos-Mendoza, Keila C , Deswal, Anita M , Cooke, John P , Fujiwara, Keigi , Palaskas, Nicolas L , Koutroumpakis, Efstratios , Gi, Young Jin , Morrell, Craig , Lorenzi, Philip L , Madhmud, Iqbal , Hanssen, Nordin M J , Afshar-Kharghan, Vahid , Hamilton, Dale J , Yvan-Charvet, Laurent , Chini, Eduardo Nunes , Herrmann, Joerg , Shen, Ying H , Martin, James F , Seeley, Erin , Burks, Jared K , Brookes, Paul S , Wang, Guangyu , Le, Nhat-Tu , Abe, Jun-Ichi , Kotla, Sivareddy , Lee, Jonghae , Imanishi, Masaki , Cooke, John P. , Tan, Lin, Hamilton, Dale J. , Chini, Eduardo N. , Wang, Guangyu

Circulation Research | May 27, 2026 | Volume: 139 | Issue: 2 | Pages: No page available

10.1161/circresaha.125.327427 | PMID 42200276 Get It

BACKGROUND: Atherothrombosis, which underlies most acute coronary syndromes and is driven by intraplaque thrombosis, preferentially occurs in regions of disturbed blood flow (d-flow). Although LATS1/2 (large tumor suppressor kinases 1 and 2) are known regulators of endothelial mechanotransduction, the mechanisms by which d-flow connects endothelial senescence, proliferation, and intraplaque thrombosis remain poorly understood. METHODS: We investigated endothelial cell (EC)-specific roles of Lats1/2 using inducible EC-specific knockout mice in a partial carotid ligation model. Spatial multiomics of human and mouse plaques was performed using imaging mass cytometry, COMET sequential immunofluorescence, and spatial metabolomics. RESULTS: Tamoxifen-induced deletion of both Lats1 and Lats2 (homozygous) in ECs caused fatal edema and increased vascular permeability. In contrast, Lats1 het ( ± ) / Lats2 homo ( −/−) -EC-specific knockout mice survived and developed spontaneous atherothrombotic plaques with neovascularization. Spatial proteomics revealed that LATS1/2 loss induced a senescence-associated stemness phenotype driven by CD38 upregulation. Spatial metabolomics showed sulfite and taurine accumulation, indicating SUOX (sulfite oxidase) deficiency. CD38 suppressed SUOX, demonstrated a switch into the reverse mode of mitochondrial complex V, increased succinate dehydrogenase activity, and promoted ATP consumption. Despite ATP depletion, glutamate metabolism and the citric acid cycle flux increased, sustaining EC proliferation under energetic stress. This senescence-associated stemness state promoted both proliferation and senescence, leading to fragile, leaky neovessels and intraplaque thrombotic lesions. Pharmacological CD38 inhibition attenuated these phenotypes. Similar EC states were observed in human plaques. CONCLUSIONS: Loss of Lats1/2 in ECs induces a CD38-associated senescence-associated stemness-like phenotype that promotes intraplaque thrombosis through mitochondrial metabolic reprogramming, including changes consistent with reverse-mode operation of mitochondrial complex V. These findings define a mechanistic link between disturbed flow, endothelial metabolic reprogramming, and intraplaque thrombosis and hemorrhage.
Body mass index and subsequent fracture risk: a meta-analysis to update FRAX
Harvey, Nicholas C. , Johansson, Helena, McCloskey, Eugène , Liu, Enwu , Åkesson, Kristina , Anderson, Fred, Bager, Cecilie L. , Christiansen, Claus, Cooper, Cyrus , Crandall, Carolyn , Cummings, Steven R. , Dawson‐Hughes, Bess , Eisman, John A. , Fujita, Yuki , Fujiwara, Saeko , Glüer, Claus‐Christian , Guðnason, Vilmundur , Hall, Jill, Huisman, Martijn , Iki, Masayuki , Ish‐Shalom, Sophia, Koromani, Fjorda , Kröger, Heikki , Esfahani, Zahra , McGuigan, Fiona E. , Mellström, Dan, Merlijn, Thomas , Nguyen, Tuan V., Ohlsson, Claes , Pasco, Julie A. , Rivadeneira, Fernando, Schei, Berit , Shiroma, Eric J. , Siggeirsdóttir, Kristín , Swart, Karin M. A. , Tamaki, Junko , Staa, Tjeerd van , Wareham, Nicholas J, Yoshimura, Noriko , Zwart, Marta , Kanis, John A, McCloskey, Eugene V , Åkesson, Kristina E , Biver, Emmanuel , Center, Jacqueline R , Cooper, Cyrus , Crandall, Carolyn J , Dawson-Hughes, Bess , Dufour, Alyssa B , Eisman, John A , Ferrari, Serge , Hans, Didier B. , Iki, Masayuki , Karlsson, Magnus K , Khosla, Sundeep , Kiel, Douglas P , Koromani, Fjorda , Kwok, Timothy , Lamy, Olivier , Larijani, Bagher , McGuigan, Fiona E A , Merlijn, Thomas , Ohlsson, Claes , Orwoll, Eric S , Simonsick, Eleanor Marie , Sund, Reijo , Szulc, Pawel , Tamaki, Junko , Wright, Nicole C , Zillikens, M. Carola , Lorentzon, Mattias , Leslie, William D , Azagra, Rafael , Beaudart, Charlotte , Bischoff‐Ferrari, Heike A. , Biver, Emmanuel , Bruyère, Olivier , Cauley, Jane A. , Chapurlat, Roland D , Silva, José António Pereira da , Díez‐Pérez, Adolfo , Elders, Petra J. M. , Ferrari, Serge , Goldshtein, Inbal , Goltzman, David , Hall, Jill, Hoff, Mari , Hollick, Rosemary J , Jones, Graeme , Khosla, Sundeep , Kiel, Douglas P. , Koh, Woon‐Puay , Kotowicz, Mark A. , Langhammer, Arnulf , Lippuner, Kurt , Nordström, Anna , Nordström, Peter , O’Neill, Terence W , Obermayer-Pietsch, Barbara Maria , Orwoll, Eric , Rivadeneira, Fernando , Schott, Anne‐Marie , Sornay‐Rendu, Elisabeth , Szulc, Paweł , Torgerson, David John , Schoor, Natasja M. van , Vila, Joan , Vandenput, Liesbeth , Lorentzon, Mattias , Leslie, William D. , Kanis, John A.

Journal of Bone and Mineral Research | August 12, 2025 | Volume: 40 | Issue: 10 | Pages: 1144-1155

10.1093/jbmr/zjaf091 | PMID 40795319 Get It

Abstract The aim of this international meta-analysis was to quantify the predictive value of BMI for incident fracture and relationship of this risk with age, sex, follow-up time, and BMD. A total of 1 667 922 men and women from 32 countries (63 cohorts), followed for a total of 16.0 million person-years were studied. 293 325 had FN BMD measured (2.2 million person-years follow-up). An extended Poisson model in each cohort was used to investigate relationships between WHO-defined BMI categories (Underweight: <18.5 kg/m2; Normal: 18.5-24.9 kg/m2; Overweight: 25.0-29.9 kg/m2; Obese I: 30.0-34.9 kg/m2; Obese II: ≥35.0 kg/m2) and risk of incident osteoporotic, major osteoporotic and hip fracture (HF). Inverse-variance weighted β-coefficients were used to merge the cohort-specific results. For the subset with BMD available, in models adjusted for age and follow-up time, the hazard ratio (95% CI) for HF comparing underweight with normal weight was 2.35 (2.10-2.60) in women and for men was 2.45 (1.90-3.17). Hip fracture risk was lower in overweight and obese categories compared to normal weight [obese II vs normal: women 0.66 (0.55-0.80); men 0.91 (0.66-1.26)]. Further adjustment for FN BMD T-score attenuated the increased risk associated with underweight [underweight vs normal: women 1.69 (1.47-1.96); men 1.46 (1.00-2.13)]. In these models, the protective effects of overweight and obesity were attenuated, and in both sexes, the direction of association reversed to higher fracture risk in Obese II category [Obese II vs Normal: women 1.24 (0.97-1.58); men 1.70 (1.06-2.75)]. Results were similar for other fracture outcomes. Underweight is a risk factor for fracture in both men and women regardless of adjustment for BMD. However, while overweight/obesity appeared protective in base models, they became risk factors after additional adjustment for FN BMD, particularly in the Obese II category. This effect in the highest BMI categories was of greater magnitude in men than women. These results will inform the second iteration of FRAX®.
Downregulation of LATS1/2 Drives Endothelial Senescence-Associated Stemness (SAS) and Atherothrombotic Lesion Formation
Kotla, Sivareddy , Ko, Kyung Ae , Chen, Weiqing , Samanthapudi, Venkata Subrahman K, Hoang, O.N. , Mejia, Gilbert, Li, Shengyu , Schadler, Keri , Rivera, Luis Antonio, Samperio, Kay Carlene Tavares, Kim, Jung Hyun , Mendoza, Keila Carolina Ostos , Mariscal-Reyes, Karla N., Fujiwara, Keigi , Gi, Young Jin , Pathania, Rajneesh , Morrell, C Jane, Lorenzi, Philip L. , Tan, Lin , Chini, Eduardo N. , Herrmann, Joerg, Vasquez, Hernan G., Shen, Ying H. , Martin, James F. , Le, Nhat‐Tu , Kim, Jung Hyun , Lee, Jonghae , Chen, Weiqing , Hoang, Oanh , Mejia, Gilbert , Schadler, Keri , Ostos-Mendoza, Keila C , Deswal, Anita M , Cooke, John P , Fujiwara, Keigi , Palaskas, Nicolas L , Koutroumpakis, Efstratios , Lorenzi, Philip L , Madhmud, Iqbal , Hanssen, Nordin M J , Shen, Ying H , Martin, James F , Seeley, Erin , Burks, Jared K , Brookes, Paul S , Wang, Guangyu , Le, Nhat-Tu , Abe, Jun-Ichi , Kotla, Sivareddy , Kim, Jung Hyun , Lee, Jonghae , Rivera, Luis Antonio, Imanishi, Masaki , Cooke, John P. , Morrell, Criag, Yvan-Charvet, Laurent , Herrmann, Joerg, Xu, Haodong , Wang, Guangyu

No container title available | June 22, 2025 | Volume: No volume available | Issue: No issue available | Pages: No page available

10.1101/2025.06.19.660635 | PMID 40667385 Get It

ABSTRACT Background Atherothrombosis, the main event leading to acute coronary syndrome (ACS), is strongly linked to disturbed blood flow (d-flow) regions. Although the involvement of the Hippo pathway and its kinases Large Tumor Suppressor Kinase 1and 2 (LATS 1 and 2) in mechanical stress responses is known, the mechanisms by which d-flow simultaneously induces senescence, proliferation, and atherothrombosis remain unclear. Methods The role of endothelial cells (EC)-specific LATS1/2 was examined using EC specific knock-out (EKO) mice in a partial left carotid ligation (PLCL) model. Plaque spatial multi-omics analysis was performed by integrating imaging mass cytometry, sequential immunofluorescence (COMET™), and spatial metabolomics at the single-cell level in human and mouse atherosclerotic plaques. Results In tamoxifen-inducible Lats1 homo( -/- ) / Lats2 homo( -/- ) EC-specific knockout (EKO) mice, deletion of LATS1/2 induced by tamoxifen led to fatal outcomes, characterized by severe systemic edema and markedly increased vascular permeability. In contrast, Lats1 het(+ /- ) / Lats2 homo( -/- ) -EKO mice survived and developed atherothrombotic plaques exhibiting neovascularization even without further additional dietary or genetic intervention. Spatial proteomics analysis revealed that LATS1/2 depletion in ECs triggered a senescence-associated stemness (SAS) phenotype, primarily driven by CD38 upregulation. Complementary spatial metabolomics profiling demonstrated a significant increase in sulfite and taurine within LATS1/2-deficient plaques, indicating lowered sulfite oxidase (SUOX) activity. Mechanistically, CD38 upregulation was found to suppress SUOX expression, induce the reverse mode of mitochondrial complex V, and increase succinate dehydrogenase (SDH) activity along with ATP consumption. Paradoxically, despite ATP depletion, this metabolic disturbance enhanced glutamate metabolism and the tricarboxylic acid (TCA) cycle, sustaining EC proliferation under energetically stressed conditions. The combined effect of LATS1/2 deletion and CD38 activation established a unique EC phenotype defined by increased SAS, leading to proliferation, senescence, and eventual cell death. These pathological processes culminated in the formation of atherothrombotic plaques, which were attenuated by inhibition of CD38. Notably, a similar phenotype—marked by metabolically active ECs—was observed in human atherothrombotic plaques, suggesting translational relevance. Conclusion Loss of LATS1/2 in ECs induces SAS state that promotes excessive EC proliferation, senescent cell accumulation, and the development of structurally fragile, leaky neo vessels—hallmarks of atherothrombotic lesions. CD38-mediated SUOX deficiency further amplifies this pathological process by inducing mitochondrial dysfunction, depleting ATP, and triggering compensatory upregulation of glutamate and TCA cycle metabolism. These findings identify a novel LATS1/2–CD38–SUOX axis in ECs that orchestrates SAS-driven atherothrombosis. Targeting CD38 may represent a promising therapeutic strategy to mitigate vascular dysfunction and plaque instability in high-risk ACS patients. Graphical abstract Under normal physiological conditions, LATS1/2 and Lamin A work together to suppress CD38 expression. Lamin A binds directly to the CD38 promoter to repress transcription, and LATS1/2 interact with Lamin A to reinforce this suppression. This collaboration helps maintain low CD38 activity and preserves cellular NAD⁺ levels. However, under disturbed flow (d-flow), both LATS1/2 and Lamin A are downregulated. The loss of this dual repression leads to increased CD38 NADase expression. Elevated CD38 accelerates NAD⁺ consumption, causing NAD⁺ depletion—a hallmark of cellular senescence. Reduced NAD⁺ disrupts key metabolic and stress-response pathways, contributing to the onset of the senescent state. At the same time, CD38 suppresses sulfite oxidase (SUOX), leading to sulfite accumulation and mitochondrial redox imbalance. This shift activates the reverse mode of mitochondrial Complex V, which decreases ATP production and increases mitochondrial ROS, intensifying metabolic and oxidative stress in endothelial cells (ECs). In response, ECs compensate by upregulating succinate dehydrogenase (SDH), enhancing TCA cycle activity and glutamate metabolism. This metabolic adaptation provides the biosynthetic building blocks needed for cell growth and proliferation. As a result, ECs adopt a paradoxical phenotype: they show classical features of stress-induced senescence (such as NAD⁺ depletion, oxidative stress, and cell cycle arrest signals), while simultaneously undergoing metabolic activation and proliferation, also mediated by YAP. This defines a non-canonical endothelial program known as senescence-associated stemness (SAS), characterized by the formation of abnormal, proliferative, yet fragile neovessels. These dysfunctional vessels contribute to atherothrombosis, setting this process apart from the more stable lesions typical of conventional atherosclerosis.
The incidence and therapeutic regimen altering effects of immune checkpoint inhibitor–associated peripheral edema: A systematic review and meta-analysis.
Markus, Anneliese , Tsuchiya, K, Elias, Evelyn , Koseki, Mako , Rohs, Nicholas, Nishimura, Yoshito, Fujiwara, Yu

Journal of Clinical Oncology | May 28, 2025 | Volume: 43 | Issue: 16_suppl | Pages: No page available

10.1200/jco.2025.43.16_suppl.e14601 Get It

e14601 Background: Immune checkpoint inhibitors (ICIs) provide a long-term survival benefit across multiple cancer types, however immune-related adverse events (irAEs) occasionally disrupt treatments and impact quality of life. Peripheral edema from ICIs can occur due to increased peripheral vascular permeability. Thus, we aimed to evaluate the incidence and outcomes of ICI-related peripheral edema. Methods: MEDLINE, Embase, and Web of Science were searched to identify phase 3 randomized controlled trials (RCTs) reporting peripheral edema events in patients treated with ICIs. Incidence rates of peripheral edema were analyzed based on treatment patterns (monotherapy/combination therapy) and ICI subtypes (PD-1/PD-L1/CTLA-4). A random effect model meta-analysis was utilized to calculate pooled odds ratios of edema incidence between treatment groups. Finally, a systematic review was conducted to summarize treatment outcomes of peripheral edema associated with ICIs. Results: Overall, 58 RCTs comprising 22,590 patients were identified for the incidence analysis. Peripheral edema as treatment-related adverse events (TRAE) (Grade 1-5) occurred in 2.80% of patients receiving ICI monotherapy (n = 195/6969; PD-1 inhibitors: 2.22% [n = 104/4694], PD-L1: 3.73% [n = 58/1557], CTLA-4: 4.60% [n = 33/718]), 4.96% (n = 112/2257) of patients receiving ICI with chemotherapy, and 8.73% (n = 205/2349) of patients receiving ICI with molecular-targeted therapy. Grade 3-5 TRAE peripheral edema occurred in 0.19% (n = 13/6969) of patients treated with ICI monotherapy. Meta-analysis showed ICI monotherapy had lower TRAE peripheral edema compared to chemotherapy (OR = 0.45, 95% CI [0.27, 0.73], p = 0.001). Subgroup analysis based on ICI subtypes showed high heterogeneity in subgroups (p , I 2 = 87.1%), but PD-1 inhibitors were associated with lower incidence than chemotherapy (OR = 0.41, 95% CI [0.23, 0.73], ). Subgroup analysis of chemotherapy regimens revealed that taxane chemotherapy was associated with a higher incidence of TRAE peripheral edema than ICI monotherapy (OR = 0.32, 95% CI [0.18, 0.58], p = < 0.001), but the edema incidence was comparable between ICI monotherapy and non-taxane chemotherapy (OR = 1.05, 95% CI [0.53, 2.08], p = 0.13). A systematic review of irAE peripheral edema treatment outcomes identified 19 studies comprising 40 patients. In total, 82.5% (n = 33/40) of cases received glucocorticoid treatment, with 55.0% (n = 22/40) requiring a high dose (≥ 1 mg/kg/day) of prednisone. ICI was discontinued in 77.5% of patients (n = 31/40) due to peripheral edema with permanent discontinuation in 35% (n = 14/40). Conclusions: Peripheral edema is an occasional but clinically significant side effect of ICI therapy. Management of irAE edema can result in permanent ICI discontinuation, which has implications for cancer treatment outcomes.
Arthralgia in patients with cancer receiving immune checkpoint inhibitors: a systematic review and meta-analysis
Estaris, Jonathan, Koseki, Mako , Elias, Evelyn , Chesta, Fnu , Takaoka, Kensuke , Shao, Theresa, Nishimura, Yoshito , Horita, Nobuyuki , Fujiwara, Yu

Immunotherapy | May 8, 2025 | Volume: 17 | Issue: 6 | Pages: 437-446

10.1080/1750743x.2025.2501519 | PMID 40337868 Get It

Trends in adverse effects of medical treatment in Paediatric populations in the United States: A global burden of disease study, 2000–2019
Fujiwara, Shintaro , Leibovitch, Emily , Nishimura, Yoshito , Woo, Russell , Bhagavathula, Akshaya Srikanth , Nishimura, Yoshito , Bhagavathula, Akshaya Srikanth , Harada, Ko , Otsuka, Fumio

Paediatric and Perinatal Epidemiology | September 3, 2024 | Volume: 38 | Issue: 8 | Pages: 692-699

10.1111/ppe.13116 | PMID 39225176 Get It

AbstractBackgroundAdverse effects of medical treatment (AEMT) pose significant risks to paediatric patients. However, the mortality trends associated with AEMT in this population have been unclear.ObjectiveWe aimed to clarify the trends in the incidence, disability‐adjusted life years (DALYs) and mortality rates of AEMT for children in the US from 2000 to 2019.MethodsData were retrieved from the Global Burden of Disease study 2019. We estimated age‐standardized incidence, DALYs and mortality rates of paediatric AEMT per 100,000 children in the US using a Bayesian meta‐regression model. We also analysed incidence, DALYs and mortality in different age groups, and employed Joinpoint regression models to assess the age‐ and sex‐specific trends.ResultsThe number of deaths due to AEMT in children, the number of cases, and DALYs were 105.1, 551,076 and 145,555 in 2019, decreased by 37.5%, 6% and 28% from those in 2000, respectively. Age‐standardized mortality rates decreased across all age groups, while the incidence increased across all age groups with an average annual percentage change (AAPC) of 2.2% in those children <1 year and 4.5% in 5–9 years of age. The increases in DALYs over time was higher in children aged 1–4 years (AAPC: 0.51, 95% CI: 0.47, 0.62) and 5–9 years (AAPC: 0.33, 95% CI: 0.15, 0.50), with the 1–4 year age group being the highest.ConclusionThe study reveals declining AEMT mortality but rising incidence and DALYs, emphasizing a disproportionate burden in <1, 1–4 and 5–9 years. To develop effective mitigation strategies, future research is warranted to identify the causes of increased AEMT in children, especially young males.
Anlotinib versus placebo as adjuvant therapy for completely resected high-grade soft tissue sarcomas: Interim results of a phase 2, double-blinded, randomized controlled trial.
Wang, Chunmeng , Hu, Xianglin , Huang, Wending, Zhang, Jianrong , Sun, Zhengwang , Chen, Mo , Zhang, S, Yu, Lin , Sun, Yang-bai , Yang, Lingge , Xu, Yu , Zheng, Biqiang , Fujiwara, Tomohiro , Chen, Yong , Houdek, Matthew T. , Yan, Wangjun

Journal of Clinical Oncology | June 13, 2024 | Volume: 42 | Issue: 16_suppl | Pages: 11562-11562

10.1200/jco.2024.42.16_suppl.11562 Get It

11562 Background: High-grade soft tissue sarcomas (STS) pose a therapeutic challenge due to the high risk of recurrence, even following complete resection. Anlotinib is a multi-targeted tyrosine kinase inhibitor blocking angiogenesis pathways of VEGFR, FGFR, and PDGFR. Given a promising efficacy for treating patients with unresectable advanced STS in previous trials, we evaluated the role of anlotinib as adjuvant therapy for completely resected high-grade STS. Methods: In a single-center, double-blinded, randomized, controlled trial, eligible patients were those adults who had not received adjuvant chemotherapy regimens after complete resection of high-grade STS. Patients were randomly assigned in a 1:1 ratio to receive either oral 12 mg anlotinib or placebo once daily on days 1-14 every 3 weeks as a cycle, with up to six cycles until disease recurrence, unmanageable toxicity or death. The primary endpoints included 1-year, 2-year disease-free survival (DFS). Results: Between June 2019 and November 2023, 88 patients were randomly assigned to receive anlotinib (n=44) or placebo (n=44). With a median follow-up of 25.99 months at data accrual cutoff on Jan 15, 2024, the 1-year and 2-year DFS rates were 88% and 77% in the anlotinib group, compared to 64% and 58% in the placebo group. Compared to patients in the placebo group, patients in the anlotinib group had a reduced risk of disease recurrence (HR 0.47 [95% CI 0.22~1.00, P= 0.0445]). The median DFS was not reached. Based on tumor histology, the greatest improvement in DFS with anlotinib versus placebo was observed in patients with myxofibrosarcoma (1-year DFS rate: 82% versus 61%; 2-year DFS rate: 64% versus 43%, HR 0.54 [95% CI 0.17~1.65], P= 0.2698) and undifferentiated pleomorphic sarcoma (1-year DFS rate: 86% versus 67%; 2-year DFS rate: 78% versus 67%, HR 0.58 [95% CI 0.12~2.87], P= 0.4971). Thirty-eight patients experienced adverse events (AEs; 34 with grade 1~2, 4 with grade 3): 28 patients (64%) in the anlotinib group versus 10 patients (23%) in the placebo group ( P<0.001). Three patients discontinued anlotinib, including two for proteinuria/hematuresis (2/44, 5%) and one for secondary poor surgical wound healing (1/44, 2%). Conclusions: Current results suggest anlotinib could lower disease recurrence risk in patients with completely resected high-grade STS, with an acceptable toxicity profile. Clinical trial information: NCT03951571 . [Table: see text]
Abstract GS02-07: Loco-Regional Irradiation in Patients with Biopsy-proven Axillary Node Involvement at Presentation Who Become Pathologically Node-negative After Neoadjuvant Chemotherapy: Primary Outcomes of NRG Oncology/NSABP B-51/RTOG 1304
Mamounas, Eleftherios P. , Bandos, Hanna , White, Julia, Julian, Thomas B. , Torres, Mylin A. , Vicini, Frank A. , McCloskey, Susan A. , Gupta, Nilendu , Abu-Rustum, Nadeem, Gandhi, Saumil , Tendulkar, Rahul D. , Fujiwara, Keiichi , Seaward, Samantha A. , Irvin, William , Mutter, Robert W. , Boileau, Jean-François , Muskovitz, Andrew A., Weiss, Anna , Walter, Curran, Seaward, Samantha A , Mamounas, Eleftherios P. , Khan, Atif J. , Shaitelman, Simona Flora , Ganz, Patricia A. , Li, X. Allen , Lucas, Peter C. , Abu‐Rustum, Nadeem R. , Coleman, Robert L. , Fujiwara, Keiichi, Higgins, Kristin Ann , Jagsi, Reshma , Wolmark, Norman

Cancer Research | May 2, 2024 | Volume: 84 | Issue: 9_Supplement | Pages: GS02-07-GS02-07

10.1158/1538-7445.sabcs23-gs02-07 Get It

Abstract Background: The benefit of adjuvant regional nodal irradiation including the chest wall after mastectomy (CWI+RNI) and with whole breast irradiation (WBI+RNI) after breast conserving surgery (BCS) is well established in pts with pathologically positive axillary nodes (pN+). Pts who present with axillary node involvement (cN+), receive neoadjuvant chemotherapy (NC), and are found to be pathologically node-negative at surgery (ypN0), have lower loco-regional recurrence (LRR) rates compared to those who remain pathologically node-positive (ypN+). This phase III, randomized trial aimed to evaluate whether CWI+RNI after mastectomy or addition of RNI to WBI after BCS significantly improves invasive breast cancer recurrence-free interval (IBC-RFI) in cN+ pts found to be ypN0 after NC. Methods: Eligible pts had clinical cT1-3, N1, M0 invasive breast cancer (biopsy-proven N+ by FNA/core needle bx), completed ≥8 wks of NC (and anti-HER2 therapy if HER2+), and were ypN0 after mastectomy or BCS and sentinel node biopsy (SLNB, ≥2 nodes), axillary lymph node dissection (ALND), or both. Pts were randomized to “No RNI” (i.e., observation after mastectomy or WBI after BCS) vs. “RNI” (i.e., CWI+RNI after mastectomy or WBI+RNI after BCS). Primary endpoint was IBC-RFI. Secondary endpoints reported here: LRR-free interval (LRRFI), distant recurrence-free interval (DRFI), disease-free survival (DFS), and overall survival (OS). Study was designed to have 80% power to detect 35% reduction in annual rate of IBC-RFI for an absolute risk reduction of 4.6% (5-yr cumulative rate). Per protocol, final analysis was to occur after 172 events or 10 yrs after study initiation.Here we report the time-driven analysis prespecified in the protocol. Results: From 9/13-12/20, 1,641 pts were enrolled; 1,556 pts were available for primary event analysis; median f/u time 59.5 mos (IQR 40.7-74.1). Pt/tumor characteristics were well balanced between groups. Median age 52 yrs (range 21-84); 31% non-white; 21% cT1, 60% cT2, 19% cT3; 23% triple-negative, 21% HR+/HER2-, 56% HER2+; 58% BCS; 55% SLNB, 45% ALND+/-SLNB; and 78% had breast pathologic complete response. At the time of the analysis, 109 IBC-RFI events (63% of the planned 172) were confirmed (“No RNI”: 59, “RNI”: 50). There was no statistically significant difference between groups for IBC-RFI (HR=0.88, 95%CI 0.60-1.29; p=0.51), 5-yr point estimates: 91.8% for “No RNI” and 92.7% for “RNI.” There were no statistically significant differences between the treatment groups for secondary endpoints. There were no study-related deaths and no unexpected toxicities.Grade 4 toxicity was rare (0.1% with “No RNI”, 0.5% with “RNI”); 6.5% of pts developed grade 3 toxicity in “No RNI” and 10% in “RNI” group. Most common grade 3 toxicity was radiation dermatitis (3.3% in “No RNI,” 5.7% in “RNI”). Conclusion: In pts who present with biopsy-proven axillary node involvement and convert their axillary nodes to ypN0 after NC, CWI+RNI after mastectomy, or WBI+RNI after BCS, did not significantly improve IBC-RFI, LRRFI, DRFI, DFS, or OS. These findings suggest that downstaging involved axillary nodes with NC can result in optimization of adjuvant radiotherapy without adversely affecting oncologic outcomes. Follow-up of pts for long-term outcomes continues. NCT01872975 *EPM and JW are co-first authors. Table 1 Citation Format: Eleftherios Mamounas, Hanna Bandos, Julia White, Thomas Julian, Atif Khan, Simona Shaitelman, Mylin Torres, Frank Vicini, Patricia Ganz, Susan McCloskey, Nilendu Gupta, X. Allen Li, Peter Lucas, Nadeem Abu-Rustum, Saumil Gandhi, Rahul Tendulkar, Robert Coleman, Keiichi Fujiwara, Samantha Seaward, William Irvin, Kristin Higgins, Robert Mutter, Jean-Francois Boileau, Andrew Muskovitz, Reshma Jagsi, Anna Weiss, Curran Walter Jr., Norman Wolmark. Loco-Regional Irradiation in Patients with Biopsy-proven Axillary Node Involvement at Presentation Who Become Pathologically Node-negative After Neoadjuvant Chemotherapy: Primary Outcomes of NRG Oncology/NSABP B-51/RTOG 1304 [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr GS02-07.