Search

Background: TC (a combination of 75 mg/m2 docetaxel and 600 mg/m2 cyclophosphamide q3W) is used for neoadjuvant/adjuvant chemotherapy in the treatment of primary breast cancer. We have recently encountered many cases of skin eruption related to TC therapy, but the effectiveness of prophylactically using anti-allergic drugs remains unclear. In this study, we aimed to determine whether the prophylactic use of anti-allergic drugs could be beneficial for the prevention of TC-related skin toxicity. Methods: We retrospectively investigated the incidence of skin eruption related to TC or a combination of docetaxel, cyclophosphamide, and trastuzumab (HER-TC) among patients with or without prophylactic anti-allergic drug administration by performing a sub-analysis of data from a previous clinical trial. For neoadjuvant chemotherapy (NAC), four cycles of either TC or HER-TC (docetaxel: 75 mg/m2; cyclophosphamide: 600 mg/m2; trastuzumab: 6 mg/kg loading dose, then 8 mg/kg thereafter) were administered intravenously every 3 weeks. 120 mg per day of fexofenadine (an antihistamine) was administered from the first day of TC or HER-TC treatment until three weeks after completion of the four cycles of TC/HER-TC treatment. Results: Four cycles of TC or HER-TC therapy were administered to 94 patients. The incidence of skin eruption with and without prophylactic drug administration was 27.7% (26/38) and 10.6% (10/56), respectively, indicating that prophylactic anti-allergic drug usage did not decrease the incidence of skin eruption. Conclusions: Administration of prophylactic anti-allergic drugs may not be useful for prevention of TC- or HERTC– related skin eruption.

This thesis aims at contributing to the existing studies in the dynamic stochastic general equilibrium model, particularly in the new Keynesian models, on three aspects. It consists of three chapters. Chapter 2 is on “Dynamic new Keynesian Life-Cycle Model.” Chapter 3 is on “Re-thinking Price Stability in an Economy with Endogenous Firm Entry: Real Imperfections under Product Variety.” Chapter 4 is on “Growth Expectation.” Abstracts of each Chapter are as follows. In Chapter 2, we first construct a dynamic new Keynesian model that incorporates life-cycle behavior a la Gertler (1999), in order to study whether structural shocks to the economy have asymmetric effects on heterogeneous agents, namely workers and retirees. We also examine whether considerations of life-cycle and demographic structure alter the dynamic properties of the monetary business cycle model, specifically the degree of amplification in impulse responses. According to our simulation results, shocks indeed have asymmetric impacts on different households and the demographic structure does alter the size of responses against shocks by changing the trade-off between substitution and income effects. In Chapter 3, we re-think price stability in an economy with endogenous firm entry under possible distortions. We first demonstrate that endogenous entry causes real imperfections. Reflecting fluctuations in the number of varieties, the gap between the natural and the efficient level of output is no longer constant and variant to shocks. As a result, the central bank faces a trade-off between stabilizing inflation and welfare-relevant output gap. Then, we show that this results in the non-zero optimal rate of inflation. We further check whether welfare can be enhanced by targeting welfare-based inflation instead of cross-sectional average inflation contrary to the previous findings. Simulations even with such distortions as unknown natural interest rate or no fiscal remedy for efficient non-stochastic steady states, however, support cross-sectional average inflation targeting although there may exist some small gains by referring also to welfare-based inflation rates. Incomplete stabilization may enhance welfare in an economy when agents cannot internalize the externality on the love for variety. Chapter 4 is about the difficulty in producing reasonable business cycles for the expectation shock about higher future technology. For a long time, changes in expectations about the future have been thought to be significant sources of economic fluctuations, as argued by Pigou (1926). Although creating such an expectation-driven cycle (the Pigou cycle) in equilibrium business cycle models was considered to be a difficult challenge, as pointed out by Barro and King (1984), recently, several researchers have succeeded in producing the Pigou cycle by balancing the tension between the wealth effect and the substitution effect stemming from the higher expected future productivity. Seminal research by Christiano et al. (2007a) explains the “stock market boom-bust cycles,” characterized by increases in consumption, labor inputs, investment and the stock prices relating to high expected future technology levels, by introducing investment growth adjustment costs, habit formation in consumption, sticky prices and an inflation-targeting central bank. We, however, show that such a cycle is difficult to generate based on “growth expectation,” which reflect expectations of higher productivity growth rates. Thus, Barro and King’s (1984) prediction still applies.