Cisplatin-Based Neoadjuvant Chemotherapy for Invasive Bladder Cancer

Between February 1988 and March 1993, 24 patients with locally advanced bladder cancer (stages T2-4N0-3M0) were included in this study. Combination chemotherapy consisting of methotrexate, vinblastine, epirubicin (doxorubicin) and cisplatin (M-VAC) was given to the patients in a neoadjuvant setting.　　 The clinical stage was T2N0M0 in eight patients, T3aN0M0 in three, T3bN0M0 in seven, T4N0M0 in five and T4N3M0 in one. After chemotherapy, total cystectomy was performed in 20 patients and partial cystectomy 4. Of 24 patients, one (4%) showed a pathological complete response, and eight (33%) had a pathological partial response, for an overall response rate of 38% (95% confidence limits 20 to 57%). Nine patients who achieved a pathological response to chemotherapy had a significantly higher survival rate than the nonresponders (p<0.01). In the relationship between the clinical stage and the response to chemotherapy, clinical T2 and T3a diseases were more likely to respond to chemotherapy than clinical T3b and T4 diseases, with a response rate of 64% and 15%, respectively. While a positive relationship between the pathological response and survival was observed, adequate follow-up is needed to assess the ability of neoadjuvant chemotherapy to improve the prognosis of patients with locally advanced bladder cancer

Lack of Information Underlies Women's Perceptions of Erectile Dysfunction (ED) Drugs in Japan

Introduction: Some Japanese women are known to have negative attitudes toward erectile dysfunction (ED) drugs, but the environment underlying these perceptions is unclear. Aim: To reveal the underlying environment that shapes women's perceptions of ED drugs in Japan. Methods: A web-based questionnaire was conducted through an internet-based market research company. A total of 2,593 women in five age groups (20s, 30s, 40s, 50s, and 60s or older) were randomly invited to participate in this study, with an almost equal number in each age group. The questionnaire contained 30 items related to individual background and sexual information, concerns about the image of ED drugs, ED drug-related perceptions, and attitude toward sexual information media. Main Outcome Measures: The women's attitude and the independent predictors that affect their partner's use of ED drugs were clarified. Results: Answers were obtained from 1,077 women, of whom 35.4% (n=381) had a negative image of ED drugs. Although 69.5% (n=749) agreed that a sexual relationship with a male partner was important, only 26.7% (n=288) agreed that this remained important if ED drugs were used. However, 56.7% (n=611) and 57.7% (n=621) of respondents, respectively, answered that they would allow their partner's use of ED drugs if they imagined that they understood the safety and effectiveness of ED drugs and that their quality of life was improved by their partner's use of the drugs. Lack of information about ED drugs was a significant predictor for acceptance of a partner's use of ED drugs among women with a negative image of ED drugs, since they were more likely to accept the use of these drugs if they were convinced about their safety and effectiveness or positive effect on quality of life. Conclusion: Lack of information about ED drugs may influence the perception of women in Japan regarding these drugs

Women's perception of male erectile dysfunction drugs in the general population

Objective: The aim of this study is to investigate trends in women's perception of male erectile dysfunction (ED) drugs in the general population. Methods: We designed an online questionnaire survey and randomly invited an initial total of 2370 women to respond to it from a database population that included 450,000 men and women recruited through an Internet-based market research company. The 17 items of the questionnaire comprised 9 items related to socio-cultural background and 8 items related to the perception of ED drugs, ED itself, and sexual relations. Results: A total of 1262 women (53.20f those initially invited), ranging in age from 20 to 77 years, participated. Among the participants, 83.3% were aware of the existence of ED drugs, but only 12.00028951199754436howed some interest in them, 46.4-0x1.4b3a0b6a4aap-149nd 43.21024570420f the participants claimed to have an unfavorable image of ED drugs, and of men using ED drugs, respectively. Among the participants, 45.2{???����ated that if their partners suffered from ED at present or in the future, they would not desire their partners to use ED drugs, and 25.5e?=tated that they would not accept it. Multiple logistic regression analysis revealed that higher age had a negative impact on knowledge, interest and image of ED drugs, the image of men using ED drugs, and the importance of sexual relations. Conclusions: Our findings reveal that a high proportion of women have a negative perception of ED drugs and associated issues in Japan

Significance of timing of therapeutic line on effectiveness of nivolumab for metastatic renal cell carcinoma

Abstract. Objectives. This study aimed to clarify the significance of therapeutic timing on the effectiveness of nivolumab for treating metastatic renal cell carcinoma. Marterials and methods. Fifty-eight patients with metastatic renal cell carcinoma treated with nivolumab monotherapy were retrospectively studied. Patients who were treated with nivolumab as second-line therapy were included in the second-line group, while the others were included in the later-line group. The clinicopathological characteristics, effects of nivolumab, and prognoses of these groups were compared. Results. Twenty and thirty-eight patients were included in the second-line and later-line groups, respectively. There were no significant differences in the distribution of International Metastatic Renal Cell Carcinoma Database Consotium risk and other clinicopathological characteristics between the 2 groups. The proportion of patients whose objective best response was progressive disease in the second-line group was significantly lower than that in the later-line group (15% vs. 50%, p = 0.0090). The 50% progression-free survival with nivolumab in the second-line group was significantly better than that in the later-line group (not reached and 5 months, p = 0.0018). Multivariate analysis showed that the second-line setting was an independent predictive factor for better progression-free survival (p = 0.0028, hazard ratio = 0.108). The 50% overall survival after starting nivolumab in the second-line and later-line groups was not reached and 27.8 months, respectively (p = 0.2652). Conclusions. The therapeutic efficacy of nivolumab as second-line therapy is expected to be better than that of later therapy