St. Marianna University School of Medicine (聖マリアンナ医科大学, Sei-marianna ika daigaku) is a private university in Miyamae-ku, Kawasaki, Kanagawa Prefecture, Japan. Established in 1971, it is a medical school affiliated with the Roman Catholic Church. In addition to medical studies, the school offers a degree in comparative religious studies. The school is also the first in Asia to be approved as a medical center for the FIFA world soccer association, and is the medical provider for the Japan national football team..
Abstract We analyzed the impact of the diagnosis-to-treatment interval (DTI) on survival in patients with CD5-positive diffuse large B-cell lymphoma (CD5 + DLBCL), using a data set of newly diagnosed patients. Among the 336 eligible patients, 247 (74%) received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone), and 89 (26%) were treated with dose-adjusted (DA)-EPOCH-R (etoposide, prednisolone, vincristine, cyclophosphamide, doxorubicin, and rituximab). The median DTI was 18 days (range 0–118). The short DTI (≤ 14 days) group included 135 patients (40%), and the long DTI (> 14 days) group included 201 patients (60%). Compared with the long DTI group, the short DTI group had more aggressive disease characteristics. Both the progression-free survival (PFS) (P = 0.01) and the overall survival (OS) (P < 0.01) were significantly inferior in the short DTI group compared with those in the long DTI group. Among 89 patients who received DA-EPOCH-R, no significant differences in PFS (P = 0.92) or OS (P = 0.86) were observed between the two groups. Multivariate analysis revealed that no DA-EPOCH-R was a risk factor for PFS in the short DTI group (P = 0.06). A short DTI was a negative prognostic factor in our CD5 + DLBCL cohort. DA-EPOCH-R could be considered a potential treatment option for patients with a short DTI.
Multidisciplinary care (MDC), where a team of various health professionals provides guidance to patients, is an effective approach for chronic kidney disease (CKD) and has been reimbursed by Japanese public healthcare insurance in 2024. To sustainably achieve medical benefits with limited resources, we examined the cost-effectiveness of MDC in Japan. A Markov model from a healthcare system perspective was used to evaluate the cost-effectiveness of adding MDC to the standard treatment for CKD in Japan over lifetime. Each cohort with an initial CKD stage (G3a, G3b, and G4) was analyzed. The parameters were based on previous studies including Chronic Kidney Disease Japan Cohort study. An incremental cost-effectiveness ratio (ICER) of < 5,000,000 Japanese yen (JPY) per quality-adjusted life-year (QALY) was considered cost-effective. One-way deterministic analyses, probabilistic sensitivity analyses, and scenario analyses were conducted to ensure the robustness of the results. Adding MDC to the standard treatment for CKD decreased cost by 10.66 million, 8.42 million, 4.21 million JPY and increased utility by 9.52, 8.70, 7.17 QALYs in CKD G3a, G3b, and G4 cohort, respectively, suggesting that it was a dominant strategy. Sensitivity analyses showed that adding MDC was cost-effective in more than 99
Second-line FOLFIRI plus ramucirumab (RAM) is one of standard treatments for metastatic colorectal cancer (mCRC) following progression on anti-EGFR therapy in RAS wild-type tumors. However, biomarkers for RAM efficacy remain unclear. We conducted a translational analysis to evaluate the association of plasma biomarkers, including angiogenesis-related factors (AFs) and RAS mutations in circulating tumor DNA (ctDNA), with clinical outcomes. This biomarker study was embedded within the JACCRO CC-16 trial, which enrolled patients with mCRC with RAS wild-type tumors receiving FOLFIRI plus RAM after anti-EGFR therapy. Plasma samples were collected at baseline, day 15, and post-treatment. RAS status in ctDNA was analyzed using BEAMing digital PCR; AFs were assessed using Luminex multiplex assay. Associations with progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) were analyzed. Among 41 evaluable patients with RAS wild-type tumors, RAS mutations were detected in ctDNA at pretreatment in 44
