Ikemura, Shinnosuke

写真a

Affiliation

School of Medicine, Department of Internal Medicine (Pulmonary Medicine) (Shinanomachi)

Position

Instructor
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Papers 【 Display / hide 】

  • Efficacy of afatinib or osimertinib plus cetuximab combination therapy for non-small-cell lung cancer with EGFR exon 20 insertion mutations

    Hasegawa H., Yasuda H., Hamamoto J., Masuzawa K., Tani T., Nukaga S., Hirano T., Kobayashi K., Manabe T., Terai H., Ikemura S., Kawada I., Naoki K., Soejima K.

    Lung Cancer (Lung Cancer)  127   146 - 152 2019.01

    ISSN  01695002

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    © 2018 Elsevier B.V. Objectives: Epidermal growth factor receptor (EGFR) mutation-positive lung cancer accounts for a significant subgroup of non-small cell lung cancers (NSCLC). Approximately 4–10% of EGFR mutations in NSCLC are EGFR exon 20 insertion mutations, which are reportedly associated with resistance to EGFR tyrosine kinase inhibitor (EGFR-TKI) treatment. NSCLC patients carrying these mutations are rarely treated with EGFR-TKIs. The purpose of this study was to evaluate the efficacy of afatinib or osimertinib plus cetuximab combination therapy in experimental NSCLC models with EGFR exon 20 insertion mutations. Materials and methods: The EGFR mutations examined in this study were A763_Y764insFQEA, Y764_V765insHH, A767_V769dupASV, and D770_N771insNPG. Ba/F3 cells constitutively expressing wild type or mutated EGFR were used to determine the efficacy of afatinib or osimertinib plus cetuximab combination therapy in vitro. To determine the efficacy of the combination therapy in vivo, female BALB/c-nu mice were injected subcutaneously with 1 million Ba/F3 cells carrying EGFR A767_V769dupASV or Y764_V765insHH. Results: We observed a mild but significant (P < 0.05) additive effect of the combination therapy against several EGFR exon 20 insertion mutations in vitro. Regarding EGFR A767_V769dupASV and EGFR Y764_V765insHH, cetuximab and afatinib single treatment did not induce significant inhibition of tumor formation; however, afatinib plus cetuximab combination treatment induced significant (P < 0.05) tumor growth inhibition without significant body weight loss or skin rash. Conclusion: The combination therapy induced a more potent inhibitory effect against several EGFR exon 20 insertion mutations than either therapy alone. Cetuximab can potentially increase the efficacy of afatinib or osimertinib in NSCLC with EGFR exon 20 insertion mutations.

  • A case of pulmonary adenocarcinoma showing rapid progression of peritoneal dissemination after immune checkpoint inhibitor therapy

    Shinozaki T., Iwami E., Ikemura S., Matsuzaki T., Nakajima T., Hashimoto K., Terashima T.

    BMC Cancer (BMC Cancer)  18 ( 1 )  2018.05

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    © 2018 The Author(s). Background: Immune checkpoint inhibitors are standard treatments for non-small cell lung cancer. Unique cases with paradoxical acceleration of the disease after immunotherapy have been reported. These have been described as cases of hyperprogressive disease. Case presentation: A 76-year-old man was diagnosed with pulmonary adenocarcinoma with pleural dissemination and liver and adrenal metastases. Genomic analysis revealed neither EGFR mutations nor ALK translocations. Immunohistochemical analysis revealed a programmed death-ligand 1 tumor proportion score of 23%. Chemotherapy with carboplatin, paclitaxel, and bevacizumab resulted in Grade 3 skin eruption and disease progression. Pembrolizumab was initiated as a second-line treatment. However, peritoneal dissemination and ascites developed. The patient died 2weeks later. The autopsy revealed widespread peritoneal dissemination and an extensive hemorrhagic infarction. Conclusion: This was a rare case of hyperprogressive disease with rapid progression of peritoneal dissemination after pembrolizumab treatment.

  • Lymph node collision tumor consisting of metastatic pulmonary adenocarcinoma and diffuse large b-cell lymphoma

    Ikemura S., Moriyama M., Matsumoto K., Nakayama S., Matsuzaki T., Nakajima T., Sasaki A., Miyauchi J., Terashima T.

    Internal Medicine (Internal Medicine)  57 ( 8 ) 1135 - 1139 2018

    ISSN  09182918

    　View Summary

    © 2018 The Japanese Society of Internal Medicine. A 67-year-old man presented with a fever and general malaise. Computed tomography showed multiple nodules in the lungs and liver, associated with mediastinal and para-aortic lymphadenopathy. Bone marrow aspiration revealed diffuse large B-cell lymphoma (DLBCL). Renal and liver dysfunction and pancytopenia inhibited chemotherapy administration; the patient subsequently died of multiorgan failure. An autopsy revealed pulmonary adenocarcinoma with metastases to the lungs, liver, and adrenal glands; the DLBCL spread to the liver, spleen, and bone marrow. Adenocarcinoma and DLBCL collision was observed in the mediastinal and para-aortic lymph nodes. This was a rare case of collision metastasis occurring in the lymph node.

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Papers, etc., Registered in KOARA 【 Display / hide 】

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Research Projects of Competitive Funds, etc. 【 Display / hide 】

  • 患者由来オルガノイドを用いた、病理診断、遺伝子解析、治療有効性に関する研究

    2020.04
    -
    2023.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Principal investigator

  • BRAF遺伝子変異陽性肺癌の臨床像、薬剤感受性に関する研究

    2018.04
    -
    2020.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Early-Career Scientists , Principal investigator

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