Publications by authors named "Toshiki Uchida"

Background: Despite several attempts to improve the prognosis of patients with diffuse large B-cell lymphoma (DLBCL), the rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) regimen remains the standard of care in previously untreated DLBCL. A randomized phase II/III study (JCOG0601) was performed to investigate the efficacy of dose-dense weekly rituximab combined with standard CHOP (RW-CHOP). Herein, we report the final results of JCOG0601 as a post hoc assessment after an 8-year follow-up.

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Follicular lymphoma (FL) is the second most common subtype of non-Hodgkin lymphoma (NHL) in Japan, the United States, and Western Europe. Parsaclisib is a potent, selective next-generation PI3Kδ inhibitor that has demonstrated clinical efficacy and tolerability in phase II studies of patients with relapsed or refractory (R/R) B-cell NHL, including FL. We report results from CITADEL-213 (NCT04434937), a phase II study evaluating the efficacy and safety of parsaclisib in Japanese patients with R/R FL.

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Background: Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal large B-cell lymphoma for which prognosis is typically poor without a timely diagnosis. To explore the safety and efficacy of standard chemotherapy combined with central nervous system (CNS)-directed therapy, we conducted a multicentre, single-arm, phase 2 trial in untreated IVLBCL patients without CNS involvement at diagnosis (PRIMEUR-IVL). In the primary analysis, the PRIMEUR-IVL study demonstrated 2-year progression-free survival (PFS) of 76% and 2-year overall survival (OS) of 92% with a low incidence (3%) of secondary CNS involvement (sCNSi).

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Zandelisib, a selective, potent PI3Kδ inhibitor, demonstrated favourable outcomes in patients with relapsed or refractory follicular lymphoma in a global phase II study. This phase II study evaluated the efficacy and safety of zandelisib for relapsed or refractory follicular lymphoma or marginal zone lymphoma. Sixty-one patients received zandelisib orally at 60 mg daily continuously in the first two 28-day cycles, followed by intermittent dosing on Days 1-7 following each cycle until progressive disease or unacceptable toxicity.

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Background: In a global phase I/II study (GO29781; NCT02500407), single-agent mosunetuzumab had a manageable safety profile and induced durable complete responses in patients with relapsed/refractory (R/R) B-cell non-Hodgkin lymphoma, including in patients with R/R follicular lymphoma (FL). In this analysis, the efficacy and safety of mosunetuzumab monotherapy were evaluated in an expansion cohort, FLMOON-1, in Japanese patients with R/R FL who had received  ≥ 2 prior lines of therapy in a phase I study (JO40295, jRCT2080223801).

Methods: Mosunetuzumab was administered intravenously at the recommended phase II dose (with cycle 1 step-up dosing) for eight cycles or up to 17 cycles, or until disease progression or unacceptable toxicity.

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Introduction: Pegcetacoplan, the first approved proximal complement C3 inhibitor, showed superiority to eculizumab in improving hemoglobin levels and clinical outcomes in the phase 3 PEGASUS study in patients with paroxysmal nocturnal hemoglobinuria (PNH) and inadequate response to eculizumab.

Methods: This analysis evaluates the efficacy and safety of pegcetacoplan for Japanese patients in PEGASUS, as they are known for different clinicopathologic features compared to non-Asian patients. Ten Japanese patients were enrolled to receive pegcetacoplan (n = 5) or eculizumab (n = 5) during the 16-week randomized controlled period.

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Article Synopsis
  • A subgroup analysis from the Asian phase II study of darinaparsin focused on its efficacy and safety in 37 Japanese patients with relapsed or refractory peripheral T-cell lymphoma (PTCL).
  • The Japanese PTCL patients primarily had different histopathological types, with a median age of 70, and a high percentage having previously received various treatment regimens.
  • The study found that the overall response rate for Japanese patients was 22.2%, similar to the 19.3% seen in the overall population, indicating that darinaparsin is a potentially effective and safe treatment for this specific group.
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Cyclic thrombocytopenia (CTP) is characterized by periodic platelet count fluctuations and is commonly misdiagnosed as immune thrombocytopenia (ITP) because of their similar clinical characteristics. Here, we present the case of a 74-year-old man with CTP diagnosed by weekly platelet count measurements. The patient initially developed mild bleeding symptoms with a platelet count of 0.

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Darinaparsin is a novel organic arsenical compound of dimethylated arsenic conjugated to glutathione, with antitumor activity and a mechanism of action markedly different from other available agents. This phase 2, nonrandomized, single-arm, open-label study evaluated the efficacy and safety of intravenous darinaparsin (300 mg/m2 over 1 hour, once daily for 5 consecutive days, per 21-day cycle) and its pharmacokinetics at multiple doses in 65 Asian patients with relapsed or refractory peripheral T-cell lymphoma (PTCL). The primary end point was the overall response rate (ORR).

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Article Synopsis
  • - Tucidinostat, an oral HDAC inhibitor, was tested in a phase IIb study for its effectiveness and safety in treating relapsed/refractory peripheral T-cell lymphoma, with 55 patients enrolled between March 2017 and March 2019.
  • - The study found an overall response rate of 46%, with significant responses in various PTCL subtypes, and a notable 88% response rate in angioimmunoblastic T-cell lymphoma.
  • - While some patients experienced adverse events like thrombocytopenia and neutropenia, most were manageable, suggesting tucidinostat could be a promising new option for treatment.
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The safety, efficacy, and pharmacokinetics of copanlisib were evaluated in this phase Ib/II study in Japanese patients with relapsed/refractory indolent non-Hodgkin lymphoma (NHL). The primary endpoint was safety at the recommended dose; efficacy endpoints included objective response rate (ORR), progression-free survival (PFS), and overall survival. In phase Ib, patients received copanlisib 45 mg intravenously on days 1, 8, and 15 of a 28-day cycle, and when tolerated, consecutive patients received copanlisib 60 mg.

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A multicenter phase II study was conducted in 44 elderly (≥ 65 years) Japanese patients with newly diagnosed acute myeloid leukemia (AML) to evaluate whether azacitidine is also effective and feasible in Japanese AML patients. The 28 patients with AML with poor-risk cytogenetics and/or myelodysplasia-related changes (unfavorable AML) were randomly assigned to receive either azacitidine or conventional care regimens (CCR), and the other 16 patients without unfavorable AML received azacitidine alone. The primary endpoint was overall survival.

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Background: Copanlisib, an intravenous pan-class I PI3K inhibitor, showed efficacy and safety as monotherapy in patients with relapsed or refractory indolent non-Hodgkin lymphoma who had received at least two therapies. The CHRONOS-3 study aimed to assess the efficacy and safety of copanlisib plus rituximab in patients with relapsed indolent non-Hodgkin lymphoma.

Methods: CHRONOS-3 was a multicentre, double-blind, randomised, placebo-controlled, phase 3 study in 186 academic medical centres across Asia, Australia, Europe, New Zealand, North America, Russia, South Africa, and South America.

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Article Synopsis
  • E7777 is a new recombinant protein treatment made from components of diphtheria toxin and interleukin-2, designed for targeting T-cell lymphomas with improved effectiveness compared to existing options.
  • A phase II clinical study involved 37 patients with relapsed or resistant forms of peripheral T-cell lymphoma (PTCL) and cutaneous T-cell lymphoma (CTCL), showing a 36% objective response rate and median progression-free survival of 3.1 months.
  • While side effects like increased liver enzymes and hypoalbuminemia occurred, they were generally manageable, indicating E7777 has a favorable safety profile for patients undergoing treatment.
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Rituximab plus cyclophosphamide-doxorubicin-vincristine-prednisone (R-CHOP) is the standard of care for untreated diffuse large B-cell lymphoma (DLBCL). However, the schedule for rituximab administration has not been optimized. To compare standard R-CHOP with CHOP plus dose-dense weekly rituximab (RW-CHOP) in patients with untreated DLBCL, we conducted a phase 2/3 study (JCOG0601, jRCTs031180139).

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  • A nationwide retrospective study was conducted involving 116 hepatitis B virus (HBV) surface antigen-positive patients and 278 HBV-negative patients with diffuse large B-cell lymphoma (DLBCL) who received rituximab-based chemotherapy in Japan between 2004 and 2014.
  • The study found a higher incidence of HBV reactivation-related hepatitis in HBsAg-positive patients (8.0%) compared to HBsAg-negative patients (0.4%), with non-nucleos(t)ide analogue (non-NA) patients experiencing the worst outcomes (33.3% incidence).
  • Prophylactic treatment with entecavir (ETV) significantly reduced the chances of HBV-related complications and mortality in
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  • Two phase I studies evaluated the safety, efficacy, and pharmacokinetics of darinaparsin in Japanese and Korean patients with relapsed/refractory peripheral T-cell lymphoma.
  • Of the 23 patients treated, 78% experienced drug-related adverse events, with lymphopenia, neutropenia, and thrombocytopenia being the most common severe effects.
  • The studies suggest that darinaparsin is well-tolerated and potentially effective, with the recommended dosage for further testing set at 300 mg/m2/day for 5 consecutive days in 3-week cycles.
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The efficiency of upfront consolidation with high-dose chemotherapy/autologous stem-cell transplantation (HDCT/ASCT) for newly diagnosed high-risk diffuse large B-cell lymphoma (DLBCL) may be influenced by induction chemotherapy. To select better induction chemotherapy regimens for HDCT/ASCT, a randomized phase II study was conducted in high-risk DLBCL patients having an age-adjusted International Prognostic Index (aaIPI) score of 2 or 3. As induction chemotherapy, 6 cycles of R-CHOP-14 (arm A) or 3 cycles of R-CHOP-14 followed by 3 cycles of CHASER (arm B) were planned, and patients who responded proceeded to HDCT with LEED and ASCT.

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  • HBV reactivation poses a risk for patients undergoing treatment with anti-CD20 antibodies for lymphoma, and this study analyzed an ultra-high sensitivity HBsAg test to improve preemptive antiviral treatment in those with resolved HBV infections.
  • Among 252 patients, 22 experienced HBV reactivation, with the new assay identifying significantly more cases compared to the conventional method, particularly detecting precore mutants linked to higher reactivation rates.
  • Key findings indicated that low anti-HBs titer, detectable HBV DNA below quantification, and positive HBsAg results from the ultra-sensitive assay were strong independent risk factors for HBV reactivation, suggesting its utility in monitoring patients at risk.
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  • Intravascular large B-cell lymphoma (IVLBCL) is a rare type of cancer without standard treatments, prompting this study to explore the effectiveness of an experimental therapy combining R-CHOP and high-dose methotrexate with intrathecal chemotherapy.
  • The PRIMEUR-IVL trial was conducted across 22 hospitals in Japan, involving 38 patients aged 20-79 years with untreated IVLBCL, focusing on their safety and potential response to the new treatment protocol over a planned follow-up.
  • Initial findings show that 37 patients were eligible for the study, with a median follow-up period of around 3.9 years, indicating that the trial is still ongoing to evaluate long-term outcomes and effectiveness.
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Inotuzumab ozogamicin (InO) is a targeted treatment for adults with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL). InO was previously studied in INO-VATE, an international, open-label, randomized phase 3 trial comparing InO against standard of care (SoC). In the present subgroup analysis, we evaluated outcomes in the 55 Asian patients who were randomized in INO-VATE (31 InO and 24 SoC).

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This multicenter, phase I, open-label dose escalation study evaluated safety, tolerability, pharmacokinetics, and preliminary anti-tumor activity of inebilizumab in Japanese patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL), chronic lymphocytic leukemia (CLL), follicular lymphoma (FL), or multiple myeloma (MM) who were ineligible for hematopoietic stem cell transplantation. Patients received inebilizumab 2, 4, or 8 mg/kg intravenously on days 1 and 8 of the first 28-day cycle, and once every 28 days thereafter, with a 12 mg/kg cohort added. Twenty patients (11 FL, six DLBCL, two CLL, and one MM) received inebilizumab at four dose levels (2 mg/kg cohort, n = 3; 4 mg/kg cohort, n = 7; 8 mg/kg cohort, n = 4; 12 mg/kg cohort, n = 6).

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