Frederiksenmcmahon3421

0112). There were no significant differences in the OS after BM diagnosis between HR FM and LR FM patients. Multivariate analyses for OS after BM revealed that patients with HER2(+)and estrogen receptor(+) tumors had a significantly better survival(risk ratio[RR]=0.644, p=0.0413; RR=0.290, p=0.0251, respectively). Three patients are surviving longer than 10 years after BM, including 2 with L-type and 1 with LH-type tumors, and their FM sites were 1 local, 1 brain, and 1 liver. The present study indicated that subtypes and FM site(HR or LR)had significant impact on the clinical course and prognosis of patients with BM. Focusing on the subtypes and FM site can improve the early detection and treatment results of BM.

We examined the therapeutic effect of adding of pertuzumab in combination with trastuzumab as neoadjuvant chemotherapy for HER2-positive breast cancer.

Overall, 27 patients with HER2-positive breast cancer who had completed neoadjuvant chemotherapy and undergone surgery between January 2014 and January 2020 were included in the study. We performed a retrospective analysis of the relationship between HER2 gene amplification and the therapeutic effect of pertuzumab in this group. For the anti-HER2 treatment, only trastuzumab was administered to all patients until December 2018, and then a combination of trastuzumab and pertuzumab was administered to 4 patients from January 2019.

The case distribution based on histological therapeutic effect was 4 patients with Grade 1, 12 patients with Grade 2, and 11 patients with Grade 3. Patients with immunohistochemistry scores of 3+ and high signal ratios of HER2/ CEP17 in FISH testing tended to have better therapeutic outcomes than other patients.

Outcomes similarpositive breast cancer were indicated by comparison with our cases.Skin complication caused by anti-programmed cell death-1(PD1)antibody is a typical immune-related adverse event. We designed this study to clarify the correlation between risk factors(patient's background and laboratory data)and skin toxicity( rash and eruption, excluding itch)after administration of either nivolumab or pembrolizumab. From February 2016 to January 2018, we evaluated the clinical outcomes of 54 patients who were administered anti-PD1 antibody. The patients were divided into 2 groups 9 patients with skin eruption caused by anti-PD1 antibody(skin eruption group)and 45 patients without skin eruption caused by anti-PD1 antibody(non-skin eruption group). Univariate analysis revealed a significant difference in eosinophil counts in both the groups before anti-PD1 antibody administration(>300/µL)(p=0.020). Factors with p300/µL)may be associated with the appearance of skin eruption.From June 2019, 2 different comprehensive genomic profiling(CGP)test panels were covered by National Health Insurance System in Japan. However, the indication of CGP was solid cancer patients refractory to standard chemotherapy or those without standard of care, while other countries indicate CGP to chemotherapy naIve advanced cancer patients. To be covered by National Health Insurance System, certified core hospital for genomic medicine should hold expert panel with affiliated hospitals. We develop a unique system for expert panel collaborated with SYSMEX Corporation to streamline medical staffs' effort. To provide precision medicine to cancer patients, we have to maximize the merit of CGP and solve several issues.Paradigm shift on the era of next generation sequencing(NGS) NGS completely changed the volume and acquiring speed of the genetic information. Secondary findings obtained by cancer profiling genomic testing should be handled by cooperation of genetic medicine and cancer medicine. Recommendations of the Communication Process on Genomic Medicine was announced for clinical sequencing using Next Generation Sequencer by Japan Agency for Medical Research and Development( AMED)Research Team. Secondary findings to be disclosed are listed up by American College of Medical Genetics and Genomics. Actionability of these 59 genes to be re-accessed on the conditions in Japan.Two genomic profiling assays have been approved by Japanese national health insurance in December 2018. Japanese government assigned core hospitals, which can conduct molecular tumor board, called"expert panel"to make a therapeutic recommendation based on the genomic findings and concentrated the function of cancer genomic medicine. GSK484 datasheet The genomic profiling tests under Japanese national health insurance system must be covered for the entire population. To eliminate regional disparities of such an advanced medicine, the infrastructure to spread cancer genomic medicine for collaborating among hospitals should be established. Here, we introduce our efforts to make regional collaboration in Tohoku University Hospital.The accumulation of gene alteration is the major pathogenicity of any types of cancer. The concept of precision cancer medicine is therefore the individualized treatment based on the driver gene alteration in each case. The cancer gene profiling (CGP) test, so called gene panel test, will be the major clinical examination to identify the driver gene alteration usually using the FFPE tissue from the surgically resected pathological archives, and government insurance system will cover the examination fee for limited number of cancer patients since 2019 in Japan. Although genetic profiling of tumors is a potentially powerful tool to predict drug sensitivity and resistance, its routine use has been limited because physicians are often unfamiliar with interpretation and incorporation of the information into practice. We established a molecular tumor board (MTB)and clinical tumor board(CTB)system to interpret individual patients' tumor genetic profiles and provide treatment recommendations upon the molecular report.Advances in cancer treatment helped in increasing the life expectancy of patients with cancer. However, a concomitant increase in the number of patients with bone metastases can be expected. A new multidisciplinary treatment strategy for patients with metastatic spinal tumors was designed, and has been practiced from 2013 in our hospital. The benefits of liaison treatment for metastatic spinal tumors is useful for early detection and early treatment before the collapse of the stabilization mechanism and the appearance of neurological symptoms, and enables team medical care by various experts. This system is a useful treatment for metastatic spinal tumors, because it enables radiotherapy and/or surgery before the onset of skeletal related events(SRE)and will also help maintain the activities of daily living(ADL)and quality of life(QOL)for patients with metastatic spinal tumors.