Phase II study of niraparib in recurrent or persistent rare fraction of gynecologic malignancies with homologous recombination deficiency (JGOG2052) / 부인종양

Background@#Poly (adenosine diphosphate)-ribose polymerase (PARP) inhibitors for tumors with homologous recombination deficiency (HRD), including pathogenic mutations in BRCA1/2, have been developed. Genomic analysis revealed that about 20% of uterine leiomyosarcoma (uLMS) have HRD, including 7.5%–10% of BRCA1/2 alterations and 4%–6% of carcinomas of the uterine corpus, and 2.5%–4% of the uterine cervix have alterations of BRCA1/2. Preclinical and clinical case reports suggest that PARP inhibitors may be effective against those targets. The Japanese Gynecologic Oncology Group (JGOG) is now planning to conduct a new investigator-initiated clinical trial, JGOG2052. @*Methods@#JGOG2052 is a single-arm, open-label, multi-center, phase 2 clinical trial to evaluate the efficacy and safety of niraparib monotherapy for a recurrent or persistent rare fraction of gynecologic malignancies with BRCA1/2 mutations except for ovarian cancers. We will independently consider the effect of niraparib for uLMS or other gynecologic malignancies with BRCA1/2 mutations (cohort A, C) and HRD positive uLMS without BRCA1/2 mutations (cohort B). Participants must have 1–3 lines of previous chemotherapy and at least one measurable lesion according to RECIST (v.1.1). Niraparib will be orally administered once a day until lesion exacerbation or unacceptable adverse events occur. Efficacy will be evaluated by imaging through an additional computed tomography scan every 8 weeks. Safety will be measured weekly in cycle 1 and every 4 weeks after cycle 2 by blood tests and physical examinations. The sample size is 16–20 in each of cohort A and B, and 31 in cohort C. Primary endpoint is the objective response rate.

A Survey Using a Terminal Care Attitude Scale Intended for Oncologists and Palliative Care Staff

Purpose: This study aimed to analyze the terminal care attitudes of healthcare members engaged in palliative care and the factors associated with these attitudes. Methods: We conducted a survey for healthcare members engaging in palliative care including oncologists and palliative care doctors using the Japanese version of the Frommelt Attitudes Toward Care of the Dying (FATCOD B-J), a scale that measures the attitude of medical stuff toward the care of dying patients. Results: A total of 223 (response rate=42.2%) responses were obtained and analyzed. Multiple regression analysis using the FATCOD B-J total score as the objective variable showed that 30s had lower partial regression coefficients than 40s (−3.8). Higher “satisfaction from work” and “interest in palliative care” were associated with greater partial regression coefficients (+5.7, +6.2). Conclusion: A sense of satisfaction and interest in palliative care may be important to cultivate terminal care attitudes among health care providers involved in palliative care.

Dose distributions of high-precision radiotherapy treatment: A comparison between the CyberKnife and TrueBeam systems

Background: several high-precision stereotactic radiation therapy modalities are currently used in clinical settings. We aimed to evaluate whether the CyberKnife [CK] or TrueBeam [TB] radiation treatment systems were more appropriate for treating targets of various morphologies according to the physical properties of each device

Materials and Methods: spheres [diameter = 5-50 mm], as well as triangular prisms and cubes [length of a side = 10-50 mm], were used as virtual targets for each treatment delivery system. A phantom with dosimetry film was irradiated to evaluate the flatness and gradient of the radiation treatment from each modality

Results: the homogeneity index [HI] for the spherical targets was significantly higher [dose distribution was more homogeneous] using the TB than when using the CK [1.9 vs. 1.4; p = 0.002]. There were no significant differences between treatment modalities in the HI for more complex shapes. The HI increased monotonically as the virtual target diameter increased for the CK [p = 0.048]. The flatness parameter was lower for the TB than for the CK [1.4 vs. 1.1; p < 0.001]

Conclusion: the CK is particularly robust for delivering therapeutic radiation to small targets, while the TB is more suitable for targets with a simple shape or when the HI is a critical treatment factor

[Phylogenetic analysis of badrashbu species using DNA polymorphism]

The name "badrashbu" has been applied to some species of Dracocephalum [Labiatae] in Iran. Dracocephalum kotschyi is an indigenous herbaceous plant, used in folk medicine as a flavor in Iran. D. subcapitatum grows in both Iran and Turkmenistan. D. arguense is another species of Badrashbu found in Japan. In this study we aimed to examine the phylogenetic relationship between some Dracocephalum species. Randomly amplified polymorphic DNA analysis [RAPD], a molecular biological method, and analysis of volatile extracts [GC] were used. Genetic distances were calculated to construct phylogenetic dendrograms of closely related samples. Based on the results the genetic distance between two samples of D. kotschyi was fond to be short and their RAPD banding patterns were quite similar, also there was a close relationship between two samples of D. arguense. Gas chromatography analysis supported the taxonomic classification. Iranian samples of D. subcapitatum and D. kotschyi contained of limonene- 10- al which could not be detected in Japanese samples of D. arguense. D. subcapitatum show very close relationship to D. kotschyi rather than D. arguense in both phylogenetic and chemotaxonomic aspects