Five-weekly SP therapy combined with trastuzumab therapy showed a good antitumor response and acceptable toxicity in HER2-positive advanced GC/EGJC. Serum neuregulin 1 might be associated with the efficacy of this treatment regimen.

FOLFOXIRI plus bevacizumab is considered a standard initial therapy for metastatic colorectal cancer (mCRC). However, few prospective trials have evaluated triplet therapy plus bevacizumab in patients with RAS mutant mCRC. Patients with an age of 20 to 75 years, and unresectable, measurable tumors harboring RAS mutation were given first-line treatment with bevacizumab (5 mg/kg on day 1) plus modified-FOLFOXIRI (irinotecan 150 mg/m2, oxaliplatin 85 mg/m2, levofolinate 200 mg/m2, and fluorouracil 2400 mg/m2 as a 46-h continuous infusion on day 1, repeated every 2 weeks). The primary endpoint was the objective response rate (ORR) as evaluated by an external review board. Progression-free survival (PFS), overall survival, early tumor shrinkage (ETS), depth of response (DpR), and safety were secondary endpoints. Among 64 patients who were enrolled between October 2014 and August 2016, 62 were evaluable for efficacy (right-sided tumors in 27%). ORR and disease control rate were 75.8% (95% confidence interval [CI] 65.1-86.5) and 96.8%, respectively. ETS was 73.8%, and median DpR was 49.2%. Median PFS was 11.5 (95% CI 9.5-14.0) months as of the cut-off date of September 2017. Adverse events of grade 3 or 4 were neutropenia (54%), hypertension (32%), diarrhea (13%), anorexia (11%), peripheral neuropathy (2%), and febrile neutropenia (5%). In conclusion, this prospective trial demonstrated for the first time that FOLFOXIRI plus bevacizumab is an active first-line treatment for patients with RAS mutant mCRC. Modified-FOLFOXIRI plus bevacizumab might become an alternative regimen of triplet chemotherapy for mCRC in Japan.

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We studied the effect of lithium on the release of T3, T4, and cAMP from perifused mouse thyroids and on cAMP content in thyroid pieces. Lithium significantly inhibited T3 and T4 release from TSH-stimulated mouse thyroids. This inhibitory effect on thyroid hormone release was dependent on the concentration of lithium. Under continuous stimulation with TSH and 3-isobutyl-1-methylxanthine, both cAMP release and cAMP content were significantly decreased by lithium. In addition, we studied the effect of lithium on (Bu)2cAMP-stimulated thyroid hormone release. T3 and T4 release was stimulated by (Bu)2cAMP in a similar way to TSH. Lithium significantly inhibited (Bu)2 cAMP-stimulated T3 and T4 release from perifused mouse thyroids. These results suggest that lithium inhibits the action of TSH in the thyroid gland by both suppression of cAMP production and inhibition at a step beyond cAMP generation.