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Background Delayed chemotherapy-induced nausea and vomiting (CINV) is not well controlled in patients with colorectal cancer (CRC) treated with oxaliplatin (L-OHP)-based chemotherapy. Whether adding a neurokinin-1 receptor antagonist to a first-generation 5HT3 antagonist (1st-5HT3RA) and dexamethasone (DEX) is beneficial in patients on L-OHP-based chemotherapy is controversial. It is unclear whether palonosetron (PALO) or aprepitant (APR) is more effective in controlling delayed CINV. We, therefore, investigated whether PALO+DEX (PALO group) or 1st-5HT3RA+DEX+APR (APR group) was more effective in controlling delayed CINV, as well as risk factors for delayed CINV, in patients with CRC treated with L-OHP-based chemotherapy. Methods We pooled data from two prospective observational studies in Japan and one phase III clinical trial and compared the incidence of CINV between the PALO and APR groups using propensity score-matched analysis. Risk factors for CINV were identified using logistic regression models. Results Among the 404 eligible patients, those in the PALO group showed a higher incidence of delayed CINV than those in the APR group (nausea: 43.4% vs. 32.4%, P = 0.061; vomiting: 12.5% vs. 4.4%, P = 0.017). The logistic regression analysis identified alcohol consumption, motion sickness, and PALO+DEX regimen as independent risk factors for delayed nausea, and female sex and PALO+DEX regimen as those for delayed vomiting. Conclusions Treatment with the three antiemetics, including APR, was more effective in controlling delayed CINV than prophylactic treatment with the two antiemetics, including PALO. Thus, patients with CRC receiving L-OHP-based chemotherapy should be treated with three antiemetics, including APR. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Acral melanoma (AM) is an epidemiologically and molecularly distinct entity that is underrepresented in clinical trials on immunotherapy in melanoma. We aimed to analyze the efficacy of anti-programmed cell death 1 (anti-PD-1) antibodies in advanced AM. We retrospectively evaluated unresectable stage III or stage IV AM patients treated with an anti-PD-1 antibody in any line at 21 Japanese institutions between 2014 and 2018. The clinicobiologic characteristics, objective response rate (ORR, RECIST), survival estimated using Kaplan–Meier analysis, and toxicity (Common Terminology Criteria for Adverse Events 4.0.) were analyzed to estimate the efficacy of the anti-PD-1 antibodies. In total, 193 patients (nail apparatus, 70; palm and sole, 123) were included in the study. Anti-PD-1 antibody was used as first-line therapy in 143 patients (74.1%). Baseline lactate dehydrogenase (LDH) was within the normal concentration in 102 patients (52.8%). The ORR of all patients was 16.6% (complete response, 3.1%; partial response, 13.5%), and the median overall survival (OS) was 18.1 months. Normal LDH concentrations showed a significantly stronger association with better OS than abnormal concentrations (median OS 24.9 versus 10.7 months; P < 0.001). Although baseline characteristics were similar between the nail apparatus and the palm and sole groups, ORR was significantly lower in the nail apparatus group [6/70 patients (8.6%) versus 26/123 patients (21.1%); P = 0.026]. Moreover, the median OS in this group was significantly poorer (12.8 versus 22.3 months; P = 0.03). Anti-PD-1 antibodies have limited efficacy in AM patients. Notably, patients with nail apparatus melanoma had poorer response and survival, making nail apparatus melanoma a strong candidate for further research on the efficacy of novel combination therapies with immune checkpoint inhibitors. • Acral melanoma is a distinct entity that is underrepresented in clinical trials on immunotherapy in melanoma. • We retrospectively examined advanced-stage acral melanoma patients treated with an anti-PD-1 antibody. • Anti-PD-1 antibodies have limited efficacy in Japanese acral melanoma patients. • Patients with nail apparatus melanoma had poorer response and survival than patients with palm and sole melanoma. [ABSTRACT FROM AUTHOR]

Background The organ donation rate in Japan is much lower than that in other developed countries for several reasons. An advanced educational program for in-hospital procurement coordinators is a possible solution for this. We introduced a Transplant Procurement Management (TPM) educational program at Hyogo Prefecture, Japan. Methods Ten healthcare professionals at Hyogo Prefecture participated in the Advanced International TPM course to educate themselves on TPM and held 2 TPM Model Organ Procurement Training Workshops at Hyogo Prefecture for in-hospital procurement coordinators. Furthermore, we held 2 workshops outside Hyogo Prefecture and at the same time undertook a pre-workshop questionnaire survey to evaluate the ability and motivation with respect to organ donation. To evaluate the effectiveness of the workshops, we conducted post-workshop and 3-months-after workshop questionnaire surveys. Results The results of the pre-workshop survey revealed that in-hospital procurement coordinators lacked the knowledge regarding the entire organ donation process, the current status of organ donation in Japan, and the definition of brain death. Moreover, they did not completely understand the meaning of “organ donation.” The results of the post-workshop questionnaire survey showed that the educational program was effective to improve the knowledge and skills of organ donation and motivated behavioral changes among the participants. Conclusions The survey results showed that our TPM model educational program offered sufficient knowledge and skills to increase organ donation at Hyogo Prefecture. We will continue this program and make an effort to further contribute to the Japanese organ donation activities. [ABSTRACT FROM AUTHOR]

Background Chemotherapy-induced neutropenia (CIN) is a dose-limiting toxicity of many chemotherapy agents. Recently, CIN has been associated with longer survival time in various types of cancer, suggesting a role as a prognostic factor. However, no large-scale study has yet investigated the utility of CIN as a prognostic factor in small cell lung cancer. We therefore conducted this multicenter retrospective observational study to investigate the utility of CIN as a prognostic factor for overall survival (OS) in patients with extensive-disease small-cell lung cancer (ED-SCLC) treated with chemotherapy. Methods Clinical data, including data on CIN onset during chemotherapy, were collected from electronic medical records of patients with ED-SCLC who received standard-dose irinotecan and cisplatin (IP regimen) as primary therapy at 14 participating institutions across Japan between January 1, 2012 and December 31, 2016. Landmark analysis, with the association between OS and neutropenia as the primary endpoint was performed with 102 patients who completed all four cycles of the IP regimen and whose OS was ≥112 days. Univariate analysis using the log-rank test and multivariate analysis using the Cox proportional hazards model with factors previously identified as possible prognostic factors as covariates were also performed to examine the association between CIN and OS. Results Analysis of median OS by grade among patients who developed CIN revealed significantly longer survival in the group with grade 4 CIN (633 days, 95% confidence interval [CI]: 379–757) than in the group with grade 0 to 3 CIN (444 days, 95% CI: 360–505) (P = 0.0279). Multivariate analysis suggested that lactate dehydrogenase (LDH) of ≥ 230 IU/L (hazard ratio [HR]: 2.937; 95% CI: 1.739–4.958, P < 0.001) and grade 0 to 3 CIN (HR: 2.096; 95% CI: 1.151–3.818, P = 0.0156) are independent poor prognostic factors for ED-SCLC. Conclusions Onset of grade 4 CIN was associated with longer OS in patients with ED-SCLC. Our results also show that both LDH and CIN may be prognostic factors in patients treated using the IP regimen. Clinical trial identification This study was approved by the Institutional Review Board of our institution (approval no: T29-8-30-2-3). Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Objectives Japanese universities are required to improve both international and Japanese students' mental health, because the number of international students increases annually. Moreover, mental health data for graduate school students in Japan are lacking. Therefore, the present study attempted to examine differences in graduate school students' mental health according to major, grade, and nationality. Methods A total of 587 students from a Japanese university, which only offers graduate school education, completed the Japanese version of Kessler 6 (K6) as part of their regular health assessments; 542 students agreed to the use of their data for research purposes. Results The K6 scores were analyzed using a 3-way (major × grade × nationality) between-subjects ANOVA, and a significant second-order interaction (F(6, 518) = 2.68, p < .05) was observed. As a subsequent 2-way (major × nationality) ANOVA, performed according to grade, only showed an interaction for first-grade master's degree students (M1; F(2, 167) = 7.88, p < .01), comparisons between Japanese and international students were made according to major. For one major, Japanese students' K6 scores tended to be higher relative to those observed in international students (t(36) = 1.98, p < .10). In contrast, international students' K6 scores for another major were significantly higher than were those of Japanese students (t(86) = 3.31, p < .01). Conclusions Japanese and international M1 students' K6 scores differed significantly. University staff should take these differences into account and examine ways to support students. [ABSTRACT FROM AUTHOR]