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大学院医学系研究科（医学専攻等） 医学専攻 腫瘍制御医学系 腎泌尿器科学講座 |
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秋田市本道1-1-1、秋田大学大学院医学系研究科 腎泌尿器科学教室 |
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1961年京都市生まれ、 |
羽渕 友則 (ハブチ トモノリ)
HABUCHI Tomonori
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職務経歴（学内） 【 表示 ／ 非表示 】
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2022年04月-継続中
秋田大学 大学院医学系研究科 研究科長
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2009年04月-継続中
秋田大学 大学院医学系研究科（医学専攻等） 医学専攻 腫瘍制御医学系 教授
研究等業績 【 表示 ／ 非表示 】
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Kobayashi M.
International Journal of Clinical Oncology ( International Journal of Clinical Oncology ) 28 ( 11 ) 1530 - 1537 2023年11月
研究論文（学術雑誌）
BACKGROUND: Although nivolumab plus ipilimumab is the standard treatment for metastatic renal cell carcinoma (RCC), its efficacy and safety in older patients remain unclear. Therefore, this study aimed to assess the clinical outcomes of nivolumab plus ipilimumab for metastatic RCC in patients aged ≥ 75 years. METHODS: We enrolled 120 patients with metastatic RCC treated with nivolumab plus ipilimumab from August 2015 to January 2023. Objective response rates (ORRs) were compared between patients aged < 75 and ≥ 75 years. Progression-free survival (PFS), overall survival (OS), and adverse events were compared between the groups. Adverse events were evaluated according to the Response Evaluation Criteria in Solid Tumors 1.1. RESULTS: Among the patients, 57 and 63 were classified as intermediate and poor risk, respectively, and one could not be classified. The median follow-up duration after the initiation of treatment was 16 months. The patient characteristics between the groups, except for age, were not significantly different. Intergroup differences in ORR (42% vs. 40%; p = 0.818), PFS (HR: 0.820, 95% CI 0.455-1.479; p = 0.510), and median OS (HR: 1.492, 95% CI 0.737-3.020; p = 0.267) were not significant. The incidence of adverse events (50% vs. 67%; p = 0.111) and nivolumab plus ipilimumab discontinuation due to adverse events was not significantly different between the groups (14% vs. 13%; p = 0.877). CONCLUSIONS: The effectiveness of nivolumab plus ipilimumab was comparable between patients with metastatic RCC aged < 75 and those ≥ 75 years with respect to their ORRs, PFS, OS, and adverse event rates.
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The Current Trend of Radiation Therapy for Patients with Localized Prostate Cancer
Numakura K.
Current Oncology ( Current Oncology ) 30 ( 9 ) 8092 - 8110 2023年09月
研究論文（学術雑誌）
A recent approach to radiotherapy for prostate cancer is the administration of high doses of radiation to the prostate while minimizing the risk of side effects. Thus, image-guided radiotherapy utilizes advanced imaging techniques and is a feasible strategy for increasing the radiation dose. New radioactive particles are another approach to achieving high doses and safe procedures. Prostate brachytherapy is currently considered as a combination therapy. Spacers are useful to protect adjacent organs, specifically the rectum, from excessive radiation exposure.
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Numakura K.
Cancer Medicine ( Cancer Medicine ) 12 ( 16 ) 16837 - 16845 2023年08月
研究論文（学術雑誌）
BACKGROUND: Nivolumab plus ipilimumab (NIVO+IPI) is the first-line treatment for patients with metastatic renal cell carcinoma (mRCC). Approximately 40% of patients achieve a durable response; however, 20% develop primary resistant disease (PRD) to NIVO+IPI, about which little is known in patients with mRCC. Therefore, this investigation aimed to evaluate the clinical implication of PRD in patients with mRCC to select better candidates in whom NIVO+IPI can be initiated as first-line therapy. METHODS: This multi-institutional retrospective cohort study used data collected between August 2015 and January 2023. In total, 120 patients with mRCC treated with NIVO+IPI were eligible. Associations between immune-related adverse events and progression-free survival, overall survival (OS), and objective response rate were analyzed. The relationship between other clinical factors and outcomes was also evaluated. RESULTS: The median observation period was 16 months (interquartile range, 5-27). The median age at NIVO+IPI initiation was 68 years in the male-dominant population (n = 86, 71.7%), and most patients had clear cell histology (n = 104, 86.7%). PRD was recorded in 26 (23.4%) of 111 investigated patients during NIVO+IPI therapy. Patients who experienced PRD showed worse OS (hazard ratio: 4.525, 95% confidence interval [CI]: 2.315-8.850, p < 0.001). Multivariable analysis showed that lymph node metastasis (LNM) (odds ratio: 4.274, 95% CI: 1.075-16.949, p = 0.039) was an independent risk factor for PRD. CONCLUSIONS: PRD was strongly correlated with worse survival rates. LNM was independently associated with PRD in patients with mRCC receiving NIVO+IPI as first-line therapy and might indicate that a candidate will not benefit from NIVO+IPI.
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Subsequent Upper Urinary Tract Carcinoma Related to Worse Survival in Patients Treated with BCG
Numakura K.
Cancers ( Cancers ) 15 ( 7 ) 2023年04月
研究論文（学術雑誌）
Upper urinary tract urothelial carcinoma (UTUC) after intravesical bacillus Calmette-Guerin (BCG) therapy is rare, and its incidence, clinical impact, and risk factors are not fully understood. To elucidate the clinical implications of UTUC after intravesical BCG therapy, this retrospective cohort study used data collected between January 2000 and December 2019. A total of 3226 patients diagnosed with non-muscle-invasive bladder cancer (NMIBC) and treated with intravesical BCG therapy were enrolled (JUOG-UC 1901). UTUC impact was evaluated by comparing intravesical recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) rates. The predictors of UTUC after BCG treatment were assessed. Of these patients, 2873 with a medical history that checked UTUC were analyzed. UTUC was detected in 175 patients (6.1%) during the follow-up period. Patients with UTUC had worse survival rates than those without UTUC. Multivariate analyses revealed that tumor multiplicity (odds ratio [OR], 1.681; 95% confidence interval [CI], 1.005-2.812; p = 0.048), Connaught strain (OR, 2.211; 95% CI, 1.380-3.543; p = 0.001), and intravesical recurrence (OR, 5.097; 95% CI, 3.225-8.056; p < 0.001) were associated with UTUC after BCG therapy. In conclusion, patients with subsequent UTUC had worse RFS, CSS, and OS than those without UTUC. Multiple bladder tumors, treatment for Connaught strain, and intravesical recurrence after BCG therapy may be predictive factors for subsequent UTUC diagnosis.
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Ozaki K.
World Journal of Urology ( World Journal of Urology ) 41 ( 1 ) 67 - 75 2023年01月
研究論文（学術雑誌）
PURPOSE: We compared the real-world efficacy and medical costs for treatment with upfront docetaxel (DOC) and abiraterone acetate (ABI) up to progression-free survival 2 (PFS2) in patients with metastatic hormone-sensitive prostate cancer (mHSPC). METHODS: This multicenter retrospective study included 340 patients with mHSPC treated with either upfront DOC or upfront ABI between October 2015 and December 2021. We compared PFS2 and medical costs between the two treatment groups. PFS2 was defined as the time from first-line therapy to progression on second-line therapy. Medical costs were estimated using the National Health Insurance drug prices in 2022 in Japan. RESULTS: The upfront DOC and ABI groups included 107 and 233 patients, respectively. The incidence of metastatic castration-resistant PC progression was significantly higher in the upfront DOC group compared with the incidence in the upfront ABI group. However, no significant differences in PFS2 were observed between the two treatment groups. Monthly medical costs per patient were significantly higher in the upfront ABI group ($3453) compared with the costs in the upfront DOC group ($1239, P < 0.001). The cost differences were significantly influenced by differences in the length of androgen deprivation therapy monotherapy (DOC group, 13.4 months vs. ABI group, 0.0 months). CONCLUSIONS: We observed a significant cost benefit in the upfront DOC group in Japanese real-world practice, while the PFS2 rates were similar between the groups. Upfront DOC was a more cost-effective option for men with mHSPC who were eligible for toxic chemotherapy.
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Fujiyama N.
Clinical and Experimental Nephrology ( Clinical and Experimental Nephrology ) 27 ( 12 ) 1010 - 1020 2023年12月
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Okamoto T.
Journal of Nephrology ( Journal of Nephrology ) 36 ( 9 ) 2613 - 2620 2023年12月
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Fujiyama N.
Clinical and Experimental Nephrology ( Clinical and Experimental Nephrology ) 27 ( 12 ) 1021 - 1022 2023年12月
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Sasagawa H.
Journal of Cancer Research and Clinical Oncology ( Journal of Cancer Research and Clinical Oncology ) 149 ( 16 ) 15091 - 15094 2023年11月
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Horie S.
International Journal of Clinical Oncology ( International Journal of Clinical Oncology ) 28 ( 11 ) 1538 - 1544 2023年11月
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A nation-wide laparoscopic skills qualification: A thirteen-year experience in Japan
Matsuda T. ( 担当： その他 )
Endourology Progress: Technique, Technology and training 2019年01月 ISBN: 9789811334641
For laparoscopic and robotic surgeries, the surgeons’ competency is important to keep high quality of surgical treatment. Japanese Society of Endourology (JSE) and the Japanese Urological Association established a urological laparoscopic skills evaluation system called the Endoscopic Surgical Skill Qualification (ESSQ) System in Urological Laparoscopy in 2004. By 2016, a total of 1463 urologists had qualified from a total of 2561 applicants after skills assessment on non-edited videos by two referees, resulting in a pass rate of 57.1%. Details of the system and the skill assessment results are shown. Prospectively collected surgical outcomes of 2590 laparoscopic urologic operations performed by 130 qualified doctors 5 years post-qualification were excellent, demonstrating the good predictive validity of the ESSQ System. The reliability of video assessments by referees was analyzed statistically on 1220 videos which had fixed points by two referees. The results showed moderate reliability for the video assessments by the referees, but the final qualification rates showed no significant differences among the referees, which indicated that the video assessments by the referees were fair for all applicants. In the 13 years since the launch of the ESSQ System, it has become the goal of young urologists in Japan who learn laparoscopic surgery. According to a nation-wide survey by JSE, open conversion rates and major complication rates have dramatically decreased during these 26 years since 1990.
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Skeletal complications in patients with CRPC
Inoue T. ( 担当： その他 )
Hormone Therapy and Castration Resistance of Prostate Cancer 2018年05月 ISBN: 9789811070129
Skeletal complications in patients with prostate cancer can result in significant morbidity. There is a relatively high prevalence of bone metastasis and reduction of bone mineral density due to androgen deprivation therapy, and together, these can result in the development of multiple skeletal complications in patients with prostate cancer. The relatively long survival (median, 3-4 years) after bone metastases with multiple skeletal complications makes a significant negative impact on patients' functional status, quality of life, and social resource utilization. To evaluate skeletal complications, the term "skeletal-related events (SREs)" has frequently been used in most randomized trials conducted previously. SREs usually include pathological bone fracture, spinal cord compression, surgery to bone, and radiotherapy to the bone. Recently, symptomatic skeletal events (SSEs), including only symptomatic events, is the recommended term for use in clinical trials. Local therapies for skeletal complications, such as radiation and surgery, are usually performed to reduce local symptoms, such as bone pain or neurological deficits, leading to improvement of the health-related quality of life. Systemic therapies, such as radiopharmaceuticals, bisphosphonates, and monoclonal antibodies against the receptor activator of the nuclear factor-kappa B ligand, are administered to reduce presymptomatic and symptomatic skeletal complications.
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Intermittent chemotherapy with docetaxel for metastatic castration-resistant prostate cancer
Narita S. ( 担当： その他 )
Hormone Therapy and Castration Resistance of Prostate Cancer 2018年05月 ISBN: 9789811070129
The optimal schedule of docetaxel chemotherapy for castration-resistant prostate cancer is unknown, although continuous administration is accepted as the standard. However, several disadvantages, including side effects, costs, and development of resistant clones, need to be considered during continuous administration of docetaxel. Intermittent docetaxel therapy represents an appealing option to address these issues. Previous studies have reported that intermittent docetaxel therapy is associated with favorable outcomes, with successful chemotherapy holidays and maintained Quality of Life (QOL). However, limitations of these studies include a wide variation in study design and schedule and a lack of randomized trials comprising a large number of patients allowing comparison of outcomes with continuous administration. This chapter summarizes current data on intermittent docetaxel therapy in androgen-independent and castration-resistant prostate cancer from previous literature and examines future directions regarding the use of this strategy as a therapeutic option for advanced prostate cancer.
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ベッドサイド泌尿器科学
吉田, 修, 小川, 修, 岡田, 裕作, 荒井, 陽一, 寺地, 敏郎, 松田, 公志, 筧, 善行, 羽渕, 友則 ( 担当： その他 )
南江堂 2013年05月 ISBN: 9784524250370
その他
科研費（文科省・学振）獲得実績 【 表示 ／ 非表示 】
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食と肥満による腸内細菌叢異常と泌尿器癌進展と治療抵抗性の分子機構解明と制御
基盤研究(B)
研究期間: 2021年04月 - 2025年03月 代表者: 羽渕 友則, 堂前 直, 嘉島 相輝, 南條 博, 土谷 順彦, 大山 力, 沼倉 一幸
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Adiposity亢進に伴う腫瘍免疫微少環境変化と泌尿器癌進展の分子機構解明
基盤研究(A)
研究期間: 2016年04月 - 2021年03月 代表者: 羽渕 友則, 南條 博, 土谷 順彦, 大山 力, 沼倉 一幸, 前野 淳
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前立腺癌の過剰診断と過剰治療を回避する糖鎖バイオマーカーの実用化
基盤研究(A)
研究期間: 2015年04月 - 2020年03月 代表者: 大山 力, 羽渕 友則, 畠山 真吾, 坪井 滋, 盛 和行, 米山 徹, 橋本 安弘, 米山 高弘, 古家 琢也, 飛澤 悠葵
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免疫学的ハイリスク腎移植における抗CD20抗体投与後のB細胞免疫応答機構の解明
基盤研究(C)
研究期間: 2015年04月 - 2019年03月 代表者: 齋藤 満, 羽渕 友則, 佐藤 滋, 南条 博, 井上 高光, 山本 竜平, 水戸部 陽子
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日本人前立腺癌患者に対するホルモン療法の有害事象の検証と対策
基盤研究(C)
研究期間: 2015年04月 - 2018年03月 代表者: 三塚 浩二, 安達 尚宣, 荒井 陽一, 川崎 芳英, 喜屋武 淳, 佐藤 友紀, 折笠 一彦, 宮里 実, 青木 大志, 成田 伸太郎, 古家 琢也, 栃木 達夫, 羽渕 友則, 大山 力