TERESA YAE TAKAGAKI

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina

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Autor e Coautores FMUSP-HC Normalizados: GILBERTO DE CASTRO JUNIOR ×

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  • article 7 Citação(ões) na Scopus
    Effectiveness and toxicity of adjuvant chemotherapy in patients with non-small cell lung cancer
    (2021) HARADA, Guilherme; NEFFA, Maria Fernanda Batistuzzo Vicentini; BONADIO, Renata Colombo; MENDOZA, Elizabeth Zambrano; CAPARICA, Rafael; LAURICELLA, Leticia Leone; TAKAGAKI, Teresa Yae; ROITBERG, Felipe Santa Rosa; TERRA, Ricardo Mingarini; JR, Gilberto De Castro
    Objective: Adjuvant chemotherapy (AC) improves survival of patients with resected non-small cell lung cancer (NSCLC). However, the cisplatin-vinorelbine regimen has been associated with a significant risk of clinically relevant toxicity. We sought to evaluate the effectiveness, safety, and feasibility of AC for NSCLC patients in a real-world setting. Methods: This was a single-center, retrospective cohort study of patients with stage I-III NSCLC undergoing surgery with curative intent between 2009 and 2018. AC was administered at the discretion of physicians. The patients were divided into two groups: AC group and no AC (control) group. Study outcomes included overall survival (OS) and recurrence-free survival (RFS), as well as the safety profile and feasibility of the cisplatin-vinorelbine regimen in a real-world setting. Results: The study involved 231 patients, 80 of whom received AC. Of those, 55 patients received the cisplatin- vinorelbine regimen. Survival analyses stratified by tumor stage showed that patients with stage II NSCLC in the AC group had better RFS (p = 0.036) and OS (p = 0.017) than did those in the no AC group. Among patients with stage III NSCLC in the AC group, RFS was better (p < 0.001) and there was a trend toward improved OS (p = 0.060) in comparison with controls. Of those who received the cisplatin- vinorelbine regimen, 29% had grade 3-4 febrile neutropenia, and 9% died of toxicity. Conclusions: These results support the benefit of AC for NSCLC patients in a real-world setting. However, because the cisplatin-vinorelbine regimen was associated with alarming rates of toxicity, more effective and less toxic alternatives should be investigated.
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    Radiation Pneumonitis in Patients with Interstitial Lung Disease and Lung Cancer: Report of 6 Cases
    (2020) FREITAS, L. V. de; SERRA, J. P.; NAJAS, G. F.; PRADO, G. F.; KAWASSAKI, A. M.; TAKAGAKI, T. Y.; GABRIELLI, F.; JUNIOR, G. C.; OLIVEIRA, M. R.; KAIRALLA, R. A.; BALDI, B. G.
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    Efficacy and safety of adjuvant chemotherapy in lung cancer: Real-world evidence
    (2019) ROITBERG, F. S. R.; NEFFA, M. F. B. V.; BONADIO, R. R. C. C.; HARADA, G.; MENDOZA, E. Z.; MAK, M. P.; TAKAHASHI, T. K.; MARTINS, R. E.; MESQUITA, C.; SANTINI, F. C.; ARAUJO, P. H. X. N. de; LAURICELLA, L. L.; PRADO, G. F.; TAKAGAKI, T. Y.; MELLO, E. S. de; GABRIELLI, F.; CARVALHO, H. D. A. de Andrade; TERRA, R. M.; CASTRO JR., G. de
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    ERCC1 AND BETA-TUBULIN III IN ADVANCED NSCLC PATIENTS TREATED WITH CISPLATIN-VINORELBINE
    (2012) CASTRO JR., G. de; VICTOR, C. R.; BIGATON, F. J.; TAKAHASHI, T. K.; FEHER, O.; SABER, A. M. Ab'; TAKAGAKI, T. Y.; SIQUEIRA, S. A. C.; CHAMMAS, R.; HOFF, P. M. G.
    Background: Platinum-containing chemotherapy remains as the standard treatment in advanced/metastatic non-small-cell lung cancer (NSC LC) patients (pts). Increased ERCC 1 expression has been associated with resistance to platinum-based therapies, and beta-tubulin III (TUBB 3) was shown to be involved in resistance to antimicrotubule agents. Here we studied these tumor markers in NSC LC pts treated with cisplatin-vinorelbine and correlated their expression with survival. Methods: It is a retrospective study on pts diagnosed with advanced/metastatic NSC LC (TNM 6th ed), consecutively identified. All pts were treated with cisplatin 80 mg/m2 d1 and vinorelbine 30 mg/m2 d1, d8, d15, every 21 days, 4–6 cycles, in our Institution, between Sep/2002 and Oct/2008. ERCC 1 (clone 8F1) and TUBB 3 (clone TUJ1) expression were evaluated by immunohistochemistry, and biomarker expression was considered as high when more than 10% of tumor cells presented moderate to strong staining, nuclear or cytoplasmic, respectively. Overall survival (OS) was estimated by the Kaplan-Meier method and curves were compared with log-rank. Results: 142 pts were studied; median age 63 y (34-87), 67% male and 86% current smokers. Adenocarcinoma (ADC, 58 pts, 43%), followed by squamous cell carcinoma (SCC , 50 pts, 37%) were the most frequent histologic types. 100 pts (71%) were staged as IV and 34 pts (24%) as IIIB. The median number of cycles was 4 (1-7). Median OS was 7.9 mo. Overall, high ERCC 1 expression was observed in 61/104 pts (59%) and high TUBB 3 expression in 55/109 pts (51%). According to histologic types, low ERCC 1 expression was observed in 7/42 SCC pts (16%) and in 35/63 ADC pts (56%) (p=0.0004). Among ADC pts, 1-y OS rate was 28% and 47% in pts which tumors presented with high and low ERCC 1 expression, respectively (HR 1.57, 95% CI 0.9-2.7, p=0.08). TUBB 3 expression neither presented any difference between SCC and ADC types, nor any prognostic impact in terms of OS. Conclusions: Low ERCC 1 expression was observed more frequently in pts with advanced lung ADC and it was a favorable prognostic factor in ADC pts treated with cisplatin-vinorelbine.
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    EGFR GENOTYPING AND EPIDEMIOLOGY, CLINICAL AND PATHOLOGICAL FEATURES IN 191 PATIENTS WITH METASTATIC PULMONARY ADENOCARCINOMA IN SAO PAULO - BRAZIL.
    (2013) CASTRO JR., Gilberto; TAKAHASHI, Tiago K.; CAIRES-LIMA, Rafael; PROTASIO, Bruno M.; MAIA, Manuel C. D. F.; SOARES, Ibere C.; ROITBERG, Felipe S. R.; MARINI, Andrea M.; MARTINS, Renata E.; TAKAGAKI, Teresa Y.; ARAUJO, Pedro H. X. N.; TERRA, Ricardo M.; SHIANG, Christina; SIQUEIRA, Sheila A. C.; MELLO, Evandro S.; ALVES, Venancio A.; HOFF, Paulo M.
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    REFERRAL OF LUNG CANCER PATIENTS TO SPECIALIZED CLINICAL ONCOLOGY CARE: INSTITUTO DO CANCER DO ESTADO DE SAO PAULO 2010-2011
    (2012) CAIRES-LIMA, Rafael; TAKAHASHI, Tiago K.; MAK, Milena P.; ROITBERG, Felipe S. R.; TEIXEIRA, Carlos H. A.; MESQUITA, Cristiane S.; MARINI, Andrea M.; MARTINS, Renata E.; TAKAGAKI, Tereza Y.; ARAUJO, Pedro N.; FEHER, Olavo; HOFF, Paulo M.; CASTRO JR., Gilberto De
    Background: Lung cancer is the leading cause of death from malignancy in Western countries. To achieve better outcomes and improve quality of care, it is essential to know both patients and disease characteristics. Here we aim to describe epidemiological and tumor characteristics and their impact on survival outcomes, of patients admitted at Instituto do Câncer de Estado de São Paulo (ICESP) between January 2010 and July 2011. Methods: It is a retrospective, descriptive, and uninstitutional study, of patients diagnosed histologically with lung cancer, consecutively admitted at ICESP between January 2010 and July 2011. Overall survival was the main endpoint. Frequencies were compared using chi-square test. Survival was estimated using the Kaplan-Meier methods, and the curves were compared by the log-rank test. This study was approved by the local IRB. Results and Conclusion: 232 patients (pts) were included in this analysis: median age 65y (24-91), 57% male, 56% ECOG 0 - 1, and 83% previous or current smokers. Non small cell lung cancer (NSCLC) was the most common histologic type (213 pts, 92%). Small cell lung cancer (SCLC) was diagnosed in 18 pts (7.6%) and only one (0.4%) was a case of a carcinoid tumor. Regarding NSCLC histologic subtypes, adenocarcinoma was the most common (130 pts, 61%), followed by squamous cell carcinoma (63 pts, 30%) and large cell carcinoma (5 pts, 2%). In 17 pts (7%), it was not possible to determine the subtype, even with immunohistochemistry. In terms of staging, 155 pts (71%) with NSCLC presented metastatic disease (stage IV) at diagnosis, 27 pts (12%) were staged as IIIB, 15 pts (10%) IIIA, 8 pts (3.5%) II and 8 pts (3.5%) I. Among patients with SCLC, six (33%) had localized disease (LD) and 12 (67%) had extensive disease (ED). Analyzing only stage IV NSCLC pts, 123 (79%) were treated with first line chemotherapy, 56 (36%)with second line and 13 (8%) with third line systemic therapies; ECOG 0 - 2 NSCLC pts were more likely to be exposed to second-line therapies (46% vs 36%; p = 0.0002). In a median follow-up of 9.5 mo, median overall survival (mOS) was 9 mo for all pts in this analysis. Regarding NSCLC, in patients with stage I and II mOS was not reached (100% and 68% in 2 years for stage I and II, respectively). In patients with stage IIIA, IIIB and IV, the median OS was 15.2, 11.4 and 7 mo, respectively (p-trend = 0.0002). According to ECOG-PS, mOS was 11.3, 6.3, 4.1, and 2.2 mo for NSCLC pts with ECOG 1, 2, 3 and 4, respectively (p-trend < 0.0001). For SCLC pts, mOS was 12.9 mo among those with LD versus 4.9 mo in ED (HR 3.1; 95% CI 1.1 - 8.6; p = 0.02). Lung cancer survival rate remains poor. As expected, clinical stage and performance status were important prognostic factors. Primary prevention strategies (quitting smoking) and early diagnosis (screening) may be useful in this scenario.
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    SURGICAL AND CLINICAL TREATMENT OF MALIGNANT PLEURAL MESOTHELIOMA: RETROSPECTIVE ANALYSIS OF 15 YEARS
    (2014) TERRA, Ricardo Mingarini; BIBAS, Benoit Jacques; COSTA, Priscila Berenice; TAMAGNO, Mauro Federico Luis; TAKAGAKI, Teresa Yae; BEYRUTI, Ricardo; CASTRO JR., Gilberto De; PEGO-FERNANDES, Paulo
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    CNS Metastases of Pulmonary Adenocarcinoma Harboring EGFR-Activating Mutations: a Multidisciplinary Approach, Including EGFR-TKis
    (2017) HARADA, G.; BONADIO, R.; MARTA, G.; TAKAHASHI, T.; TAKAGAKI, T.; CASTRO JR., G. De
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    EGFR ACTIVATING MUTATIONS IN NSCLC: IMPORTANCE OF ROUTINE TESTING
    (2012) TAKAHASHI, Tiago K.; SOARES, Ibere C.; MARINI, Andrea M.; MAK, Milena P.; TEIXEIRA, Carlos H.; ROITBERG, Felipe S. R.; TAKAGAKI, Teresa Y.; MARTINS, Renata E.; MESQUITA, Cristiane; HOFF, Paulo M. G.; CASTRO JR., Gilberto
    Background: EGFR activating mutations in NSCLC confer better prognosis and are also predictive of response to both chemotherapy and EGFR-tyrosine kinase inhibitors. Therefore, EGFR genotyping in NSCLC patients (pts) is very helpful in treatment decision. Here we report the first 25 pts whose tumors samples were tested for EGFR activating mutations in our Institution. Methods: It is an observational study on all consecutively tested NSCLC samples from pts treated at ICESP. Briefly, all samples were formalin-fixed and paraffin-embedded. Tumor areas were selected and macrodissected, followed by whole DNA extraction and amplification by PCR. DNA sequencing (exons 18, 19, 20 and 21) was performed by Sanger´s methodology. Frequencies were compared by Fisher´s exact test. Results and Conclusion: Results: 25 tumor samples were tested from Aug/2011 up to now: 20 pts were caucasian, 13 were male, 14 ex-smoker, 10 never smoker; 15 pts ECOG-PS 0-1 and 5 PS 2. Regarding histologic subtype, 22 were classified as adenocarcinoma and 2 SCC. Staging: 3 IIIA, 2 IIIB and 20 IV. Activating mutations were detected in 6 pts (24%): 4 in exon 19 (del 19), 1 in exon 21 (L858R) and in 1 pt two mutations were found (T790M and L858R). The frequency of these activating mutations was not related to gender (p=0.378), race (p=0.540) or smoking habits (p=0.350). In a short follow-up of 6 mo., no deaths occurred in pts whose samples were positive for activating mutations. Conclusions: In this very selected population, the frequency of EGFR activating mutations was 24%, with no correlation with gender, race or smoking habits. This reinforces the importance of testing EGFR activating mutations in all pts with lung adenocarcinoma. Disclosure: No significant relationships.
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    ERLOTINIB IN METASTATIC PULMONARY ADENOCARCINOMAS HARBOURING EGFR ACTIVATING MUTATIONS, IN SAO PAULO - BRAZIL
    (2013) CAIRES-LIMA, Rafael; PROTASIO, Bruno M.; TAKAHASHI, Tiago K.; MAK, Milena P.; NAKAZATO, Denyei; MESQUITA, Cristiane S.; TAKAGAKI, Teresa Y.; SOARES, Ibere C.; MELLO, Evandro S.; ALVES, Venancio A.; HOFF, Paulo M.; CASTRO JR., Gilberto