Internists, Radiation Oncology
4 years of experience

Accepting new patients
Massachusetts General Physicians Organization Inc
55 Fruit St
Boston, MA 02114
617-724-1160
Locations and availability (2)

Education ?

Medical School Score Rankings
Harvard University (2006)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Associations
American Society for Therapeutic Radiology and Oncology
Member

Affiliations ?

Dr. Miyamoto is affiliated with 5 hospitals.

Hospital Affilations

Score

Rankings

  • Boston Medical Center
    Medical Oncology
    1 Boston Medical Ctr Pl, Boston, MA 02118
    • Currently 4 of 4 crosses
    Top 25%
  • Massachusetts General Hospital
    Medical Oncology
    55 Fruit St, Boston, MA 02114
    • Currently 4 of 4 crosses
    Top 25%
  • Brigham and Women's Hospital
    Medical Oncology
    75 Francis St, Boston, MA 02115
    • Currently 3 of 4 crosses
    Top 50%
  • Beth Israel Deaconess Medical Center
    Medical Oncology
    330 Brookline Ave, Boston, MA 02215
    • Currently 3 of 4 crosses
    Top 50%
  • Dana-Farber Cancer Institute
    44 Binney St, Boston, MA 02115
    • Currently 2 of 4 crosses
  • Publications & Research

    Dr. Miyamoto has contributed to 10 publications.
    Title Isolation of Circulating Tumor Cells Using a Microvortex-generating Herringbone-chip.
    Date November 2010
    Journal Proceedings of the National Academy of Sciences of the United States of America
    Excerpt

    Rare circulating tumor cells (CTCs) present in the bloodstream of patients with cancer provide a potentially accessible source for detection, characterization, and monitoring of nonhematological cancers. We previously demonstrated the effectiveness of a microfluidic device, the CTC-Chip, in capturing these epithelial cell adhesion molecule (EpCAM)-expressing cells using antibody-coated microposts. Here, we describe a high-throughput microfluidic mixing device, the herringbone-chip, or "HB-Chip," which provides an enhanced platform for CTC isolation. The HB-Chip design applies passive mixing of blood cells through the generation of microvortices to significantly increase the number of interactions between target CTCs and the antibody-coated chip surface. Efficient cell capture was validated using defined numbers of cancer cells spiked into control blood, and clinical utility was demonstrated in specimens from patients with prostate cancer. CTCs were detected in 14 of 15 (93%) patients with metastatic disease (median = 63 CTCs/mL, mean = 386 ± 238 CTCs/mL), and the tumor-specific TMPRSS2-ERG translocation was readily identified following RNA isolation and RT-PCR analysis. The use of transparent materials allowed for imaging of the captured CTCs using standard clinical histopathological stains, in addition to immunofluorescence-conjugated antibodies. In a subset of patient samples, the low shear design of the HB-Chip revealed microclusters of CTCs, previously unappreciated tumor cell aggregates that may contribute to the hematogenous dissemination of cancer.

    Title Toxicity and Outcomes After Chemoradiation for Esophageal Cancer in Patients Age 75 or Older.
    Date November 2010
    Journal Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus / I.s.d.e
    Excerpt

    Randomized trials of chemoradiation for esophageal cancer have included very few patients age > or = 75. In this retrospective study, we describe the outcomes and toxicity of full-dose chemoradiation in elderly patients with esophageal cancer. Patients, age > or = 75, treated with full-dose chemoradiation for esophageal carcinoma from 2002 to 2008 were retrospectively reviewed. Thirty-four patients were identified with a median age of 79.5 (range 75-89). The median Eastern Cooperative Oncology Group performance status was 1 (range 0-3) and the median Adult Comorbidity Evaluation-27 score was 1 (range 0-3). Twenty-eight patients received definitive and six received neoadjuvant chemoradiation. The median radiation dose delivered was 50.4 Gray (range 3.6-68.4 Gray). Platinum-based chemotherapy was used in 79.4% of patients. Fifty percent of the patients completed all planned radiation therapy (RT) and chemotherapy; 85.3% completed RT. Acute toxicity > or = grade 4 occurred in 38.2% of patients, and 70.6% of the patients required hospitalization, emergency department visit, and/or RT break. Median follow-up was 14.5 months among 7 survivors, and median survival was 12.0 months (95% confidence interval [CI]: 9.7 to 24.1 months). The actuarial overall survival at 2 years was 29.7% (95% CI: 16.6 to 52.6%). There were four treatment-related deaths. The median time to any recurrence was 10.4 months. Nineteen patients had a local and/or distant recurrence. In conclusion, elderly patients experienced substantial morbidity from chemoradiation, and long-term survival was low. Future efforts to improve treatment tolerability in the elderly are needed.

    Title Outcomes and Tolerability of Chemoradiation Therapy for Pancreatic Cancer Patients Aged 75 Years or Older.
    Date July 2010
    Journal International Journal of Radiation Oncology, Biology, Physics
    Excerpt

    To review the outcomes and tolerability of full-dose chemoradiation in elderly patients aged 75 years or older with localized pancreatic cancer.

    Title Isolation and Characterization of Circulating Tumor Cells from Patients with Localized and Metastatic Prostate Cancer.
    Date July 2010
    Journal Science Translational Medicine
    Excerpt

    Rare circulating tumor cells (CTCs) are present in the blood of patients with metastatic epithelial cancers but have been difficult to measure routinely. We report a quantitative automated imaging system for analysis of prostate CTCs, taking advantage of prostate-specific antigen (PSA), a unique prostate tumor-associated marker. The specificity of PSA staining enabled optimization of criteria for baseline image intensity, morphometric measurements, and integration of multiple signals in a three-dimensional microfluidic device. In a pilot analysis, we detected CTCs in prostate cancer patients with localized disease, before surgical tumor removal in 8 of 19 (42%) patients (range, 38 to 222 CTCs per milliliter). For 6 of the 8 patients with preoperative CTCs, a precipitous postoperative decline (<24 hours) suggests a short half-life for CTCs in the blood circulation. Other patients had persistent CTCs for up to 3 months after prostate removal, suggesting early but transient disseminated tumor deposits. In patients with metastatic prostate cancer, CTCs were detected in 23 of 36 (64%) cases (range, 14 to 5000 CTCs per milliliter). In previously untreated patients followed longitudinally, the numbers of CTCs declined after the initiation of effective therapy. The prostate cancer-specific TMPRSS2-ERG fusion was detectable in RNA extracted from CTCs from 9 of 20 (45%) patients with metastatic disease, and dual staining of captured CTCs for PSA and the cell division marker Ki67 indicated a broad range for the proportion of proliferating cells among CTCs. This method for analysis of CTCs will facilitate the application of noninvasive tumor sampling to direct targeted therapies in advanced prostate cancer and warrants the initiation of long-term clinical studies to test the importance of CTCs in invasive localized disease.

    Title Xrhamm Functions in Ran-dependent Microtubule Nucleation and Pole Formation During Anastral Spindle Assembly.
    Date January 2005
    Journal Current Biology : Cb
    Excerpt

    BACKGROUND: The regulated assembly of microtubules is essential for bipolar spindle formation. Depending on cell type, microtubules nucleate through two different pathways: centrosome-driven or chromatin-driven. The chromatin-driven pathway dominates in cells lacking centrosomes. RESULTS: Human RHAMM (receptor for hyaluronic-acid-mediated motility) was originally implicated in hyaluronic-acid-induced motility but has since been shown to associate with centrosomes and play a role in astral spindle pole integrity in mitotic systems. We have identified the Xenopus ortholog of human RHAMM as a microtubule-associated protein that plays a role in focusing spindle poles and is essential for efficient microtubule nucleation during spindle assembly without centrosomes. XRHAMM associates both with gamma-TuRC, a complex required for microtubule nucleation and with TPX2, a protein required for microtubule nucleation and spindle pole organization. CONCLUSIONS: XRHAMM facilitates Ran-dependent, chromatin-driven nucleation in a process that may require coordinate activation of TPX2 and gamma-TuRC.

    Title The Kinesin Eg5 Drives Poleward Microtubule Flux in Xenopus Laevis Egg Extract Spindles.
    Date January 2005
    Journal The Journal of Cell Biology
    Excerpt

    Although mitotic and meiotic spindles maintain a steady-state length during metaphase, their antiparallel microtubules slide toward spindle poles at a constant rate. This "poleward flux" of microtubules occurs in many organisms and may provide part of the force for chromosome segregation. We use quantitative image analysis to examine the role of the kinesin Eg5 in poleward flux in metaphase Xenopus laevis egg extract spindles. Pharmacological inhibition of Eg5 results in a dose-responsive slowing of flux, and biochemical depletion of Eg5 significantly decreases the flux rate. Our results suggest that ensembles of nonprocessive Eg5 motors drive flux in metaphase Xenopus extract spindles.

    Title Layering Defect in P35 Deficiency is Linked to Improper Neuronal-glial Interaction in Radial Migration.
    Date January 2004
    Journal Nature Neuroscience
    Excerpt

    Several genes essential for neocortical layering have been identified in recent years, but their precise roles in this process remain to be elucidated. Mice deficient in p35--an activator of cyclin-dependent kinase 5 (Cdk5)--are characterized by a neocortex that has inverted layering. To decipher the physiological mechanisms that underlie this defect, we compared time-lapse recordings between p35(-/-) and wild-type cortical slices. In the p35(-/-) neocortex, the classic modes of radial migration--somal translocation and locomotion--were largely replaced by a distinct mode of migration: branched migration. Branched migration is cell-autonomous, associated with impaired neuronal-glial interaction and rare in neurons of scrambler mice, which are deficient in Dab1. Hence, our findings suggest that inside-out layering requires distinct functions of Reelin and p35/Cdk5 signaling, with the latter being important for proper glia-guided migration.

    Title Dynamics of the Mitotic Spindle--potential Therapeutic Targets.
    Date December 2003
    Journal Progress in Cell Cycle Research
    Excerpt

    Inhibition of mitosis is a useful strategy for treating diseases involving excessive cell proliferation. Antimitotic drugs currently in clinical use perturb microtubule dynamics and thereby disrupt the function of the mitotic spindle. Protein regulators of microtubule dynamics and microtubule motors are also essential for mitotic spindle function. In this chapter, we evaluate the potential of these proteins as candidate targets for antimitotic drugs. We review in depth a number of proteins of particular interest, highlighting their known functions in mitosis and the effects of their inhibition on cell cycle progression.

    Title Dissecting Cellular Processes Using Small Molecules: Identification of Colchicine-like, Taxol-like and Other Small Molecules That Perturb Mitosis.
    Date May 2000
    Journal Chemistry & Biology
    Excerpt

    BACKGROUND: Understanding the molecular mechanisms of complex cellular processes requires unbiased means to identify and to alter conditionally gene products that function in a pathway of interest. Although random mutagenesis and screening (forward genetics) provide a useful means to this end, the complexity of the genome, long generation time and redundancy of gene function have limited their use with mammalian systems. We sought to develop an analogous process using small molecules to modulate conditionally the function of proteins. We hoped to identify simultaneously small molecules that may serve as leads for the development of therapeutically useful agents. RESULTS: We report the results of a high-throughput, phenotype-based screen for identifying cell-permeable small molecules that affect mitosis of mammalian cells. The predominant class of compounds that emerged directly alters the stability of microtubules in the mitotic spindle. Although many of these compounds show the colchicine-like property of destabilizing microtubules, one member shows the taxol-like property of stabilizing microtubules. Another class of compounds alters chromosome segregation by novel mechanisms that do not involve direct interactions with microtubules. CONCLUSIONS: The identification of structurally diverse small molecules that affect the mammalian mitotic machinery from a large library of synthetic compounds illustrates the use of chemical genetics in dissecting an essential cellular pathway. This screen identified five compounds that affect mitosis without directly targeting microtubules. Understanding the mechanism of action of these compounds, along with future screening efforts, promises to help elucidate the molecular mechanisms involved in chromosome segregation during mitosis.

    Title Molecular Predictors of Local Tumor Control in Early-stage Breast Cancer.
    Date
    Journal Seminars in Radiation Oncology
    Excerpt

    Advances in surgery, radiation therapy, and systemic therapy have resulted in substantial improvements in local and distant tumor control in early-stage breast cancer, which in turn have improved breast cancer-specific and overall mortality. Although outcomes after breast-conserving therapy may be estimated using clinical and pathologic risk factors, more robust predictors of local tumor recurrence are necessary. Recent molecular profiling studies have shown that the risk of local and distant recurrence varies across different molecular subtypes of breast cancer. In addition, several molecular assays have emerged as promising prognostic and predictive markers of local and distant recurrence. The ability to use such molecular markers may allow for better tailoring of therapy and further reduction of recurrence rates and mortality in breast cancer. This is a rapidly evolving field, and prospective validation studies as well as the identification of new markers are needed.

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