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Kim D, Lee S, Lee J, Lee M, Kang J, Kim S, Shin S, Kim H, Heo DS. A multicenter phase II study to evaluate efficacy and safety of gefitinib as the first-line treatment for Korean patients (pts) with advanced pulmonary adenocarcinoma harboring EGFR mutations. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8066 Background: This study (D7913L00056) was designed to prospectively evaluate the efficacy and safety of first-line gefitinib treatment in pts with advanced pulmonary adenocarcinoma harboring EGFR mutations and to explore the molecular factors affecting the efficacy of gefitinib. Methods: Chemo-naïve pts with advanced (stage IIIB/IV/recurrent disease) pulmonary adenocarcinoma underwent direct DNA sequencing of tumor EGFR exons 18, 19 and 21. Pts with EGFR mutations received gefitinib 250 mg/d until disease progression or unacceptable toxicity. The primary end-point was objective response rate (ORR). The protocol planned to accrue 45 pts with EGFR mutations in a single stage. Results: Out of 147 screened pts, 45 pts (31%) had EGFR mutations and received gefitinib. The most common EGFR mutations were in-frame exon 19 deletions (del 19, 29 pts, 64%) and L858R point mutations in exon 21 (L858R, 15 pts, 33%). One patient had atypical mutation of L861Q in exon 21. The ORR by RECIST was 53.3% (95% CI, 38.8 to 67.9) and disease control rate (DCR) including stable disease was 86.7%. Progression free survival (PFS) at 12 months (mo) was 74.6% (95% CI, 58.8 to 85.1). Median PFS was not reached after median 10.1 mo follow-up. Treatment was well tolerated. Six pts experienced grade 3 toxicities including rash, pruritis, and anorexia. No grade 4 toxicities were reported. Subgroup analysis according to the EGFR mutation subtypes was carried out. The ORR and DCR were higher in pts with del 19 than those with L858R (62.1% vs 33.3%; P=0.0705 and 96.6% vs 66.7%; P=0.0062, respectively). All 4 pts with progressive disease had an L858R mutation. No secondary resistant mutations such as T790M were found in those pts. In addition, PFS at 12 mo was significantly better in pts with del 19 than those with L858R (63.2% vs 23.8%, P=0.0034). Conclusions: Gefitinib as the first-line treatment for Korean pts with advanced pulmonary adenocarcinoma harboring EGFR mutations was very effective and well tolerated. Subgroup analysis suggests that the benefit from gefitinib treatment was more prominent in pts with the del 19 mutation. [Table: see text]
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Zatloukal P, Heo DS, Park K, Kang J, Butts C, Bradford D, Graziano S, Huang B, Healey D. Randomized phase II clinical trial comparing tremelimumab (CP-675,206) with best supportive care (BSC) following first-line platinum-based therapy in patients (pts) with advanced non-small cell lung cancer (NSCLC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8071] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
8071 Background: Pts diagnosed with advanced NSCLC with good performance status typically receive platinum-based chemotherapy; however, no approved maintenance therapy exists. Tremelimumab, a fully human anti-CTLA4 mAb, is associated with durable responses in some pts with metastatic melanoma. Methods: This open-label, randomized, multicenter, phase II clinical trial evaluating efficacy and safety of tremelimumab as maintenance therapy was conducted in pts with locally advanced or metastatic NSCLC with ECOG performance status ≤1. Pts treated with ≥4 cycles of first-line platinum-based therapy resulting in either stable disease (SD) or response per RECIST were eligible and were randomized 3–6 weeks after prior therapy. Pts received 15 mg/kg IV tremelimumab Q90D or BSC until disease progression. Primary endpoint was progression-free survival (PFS) at 3 months. Secondary endpoints included safety, objective response rate, and 1-year survival. Results: Eighty-seven pts received tremelimumab (n=44) or BSC (n=43). Nine (20.9%; 90% CI: 11.4%, 33.7%) pts receiving tremelimumab and 6 (14.3%; 90% CI: 6.4%, 26.3%) pts receiving BSC were progression free at 3 months. Among pts receiving tremelimumab, there were 2 (4.8%) partial responses and 7 (16.6%) SDs, compared with 0 and 6 (14.3%) pts receiving BSC, respectively. Treatment-related adverse events (AEs) were observed in 27 (61.4%) pts receiving tremelimumab and 3 (7.0%) receiving BSC. Nine pts (20.5%) receiving tremelimumab reported grade 3 or 4 AEs compared with 0 patients receiving BSC. The most common grade 3 or 4 AEs attributed to tremelimumab were diarrhea and colitis (n=4, 9.1%). Conclusions: In pts with advanced NSCLC and good performance status receiving platinum-based first-line therapy, single-agent tremelimumab was tolerable, with safety consistent with prior studies. Although PFS analysis did not demonstrate superiority of tremelimumab over BSC, the 4.8% objective response rate seen only in the investigational arm may support future combination studies. Analysis of 1-year survival is forthcoming. [Table: see text]
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Hong S, Roh S, Koh Y, Won H, Shim B, Byun J, Lee M, Woo I, Kang J, Hong Y. Prognostic significance of metabolic adaptation for hypoxic environment in oral squamous cell carcinoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6082 Background: During tumor growth, tumor adapts the hypoxic environment and increases glycolysis. This metabolic switch is related to the aggressive malignant behavior. We investigated the connection between the biomarkers related to the glycolytic metabolism (HIF-1α, PDK-1, LDH-5) and clinicopathologic characteristics in oral cavity and oropharynx squamous cell carcinoma (SCC). Methods: Eligibility criteria was the patients diagnosed oral SCC, received curative radical resection and had available tissue samples. Immunohistochemical stain of the HIF-1α, PDK-1, and LDH-5 was done. Statistical analysis was performed to compare biomarkers between patients and time point. Results: Overall 74 patients were enrolled and stage grouping of the patients was as follows: stage I, 25 (33.8%) patients; stage II 17 (23.0%); stage III 8 (10.8%); stage IV 24 (32.4%). 25 patients were relapsed and 5-year disease-free survival (DFS) rate was 61.4%. High expression of HIF-1α was related to the advanced T stage (p = 0.029), more invasive tumor (p = 0.003) and tumor recurrence (p = 0.037). High expression of PDK-1 was related to the advanced N stage (p = 0.026) and high expression of LDH-5 was related to the lymphatics invasion (p = 0.028), advanced N stage (p = 0.020) and more invasive tumor (p = 0.015). The high expression of HIF-1α, PDK-1, and LDH-5 showed a significant correlation to each other. 16 (21.6%) patients were highly expressed all three markers. High expression of all three markers correlated with more invasive tumor (p = 0.004) and tumor recurrence (p = 0.017). In survival analysis, high expression of HIF-1α and LDH-5 associated with shorter DFS in log rank test (p = 0.002 and p = 0.016, respectively). High expression of all three markers was also associated with shorter DFS (p = 0.002). In multivariate Cox regression analysis, high expression of all three markers was strong independent prognostic factor for DFS (p = 0.021). Conclusions: The oral SCC which glycolytic metabolism was changed showed a more invasive and aggressive phenotype. Taken together, biomarkers related tumor metabolism may be independent prognostic markers for the DFS in the patients with oral SCC. No significant financial relationships to disclose.
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Oh S, Kim S, Kwon H, Kim H, Hwang I, Kang J, Lee S, Lee J, Kang W. Leptomeningeal carcinomatosis of gastric cancer: Multicenter retrospective analysis of 54 cases. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15658 Background: Leptomeningeal carcinomatosis occurs in approximately 5% of patients with cancer. The most common cancers involving the leptomeninges are breast and lung cancer. However, gastric adenocarcinoma has been rarely reported with leptomeningeal carcinomatosis (LMC). Methods: We analyzed 54 cases of cytological confirmed gastric LMC at 4 institutions from 1994 to 2007. Results: Male to female ratio was 1.5:1. Median age of these patients was 49 years. The majority of patients had advanced disease at the initial diagnosis of gastric cancer. The clinical or pathologic TNM stages of the primary gastric cancer were IV in 38 patients (70%). The median interval from the diagnosis of the primary malignancy to the diagnosis of LMC was 6.3 months (range, 0 - 73.1 months). Of the initial endoscopic finding available 45 patients, Bormann type III and IV were 23 (51%) and 15 (33%) patients, respectively. Headache (85%) and nausea/vomiting (58%) were most common presenting symptoms of LMC. The intrathecal (IT) chemotherapy was administered to 36 patients - mainly with methotraxate alone (59%) or combination with ara- C/hydrocortisone (41%). Median IT treatment number was 7 (range, 1–18). Concomitant radiotherapy or chemotherapy was done in 25 patients and 10 patients, respectively. 17 patients (46%) were achieved cytological negative conversion. Median OS duration from diagnosis of LMC was 6.7 weeks (95% CI; 4.3–9.1 weeks). Clinically, initial advanced stage was predictive value of poor prognosis (P=0.009). But, Cytology negative conversion was predictive value of relatively longer survival duration (P=0.005). And, not only IT chemotherapy but also intravenous chemotherapy had been shown improvement of survival duration (P=0.010, P=0.005, respectively). Conclusions: Although gastric LMC has dismal prognosis, IT and IV chemotherapy could be help to extend survival duration of gastric LMC. No significant financial relationships to disclose.
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Kang J, Mamuti W, Ito A. [Detection of Cysticercus bovis in a calf injected intravenously with taenia saginata hexacanth]. ZHONGGUO JI SHENG CHONG XUE YU JI SHENG CHONG BING ZA ZHI = CHINESE JOURNAL OF PARASITOLOGY & PARASITIC DISEASES 2009; 17:314. [PMID: 12563869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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Kang J, Perry JK, Pandey V, Fielder GC, Mei B, Qian PX, Wu ZS, Zhu T, Liu DX, Lobie PE. Artemin is oncogenic for human mammary carcinoma cells. Oncogene 2009; 28:2034-45. [PMID: 19363524 DOI: 10.1038/onc.2009.66] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
We report that artemin, a member of the glial cell line-derived neurotrophic factor family of ligands, is oncogenic for human mammary carcinoma. Artemin is expressed in numerous human mammary carcinoma cell lines. Forced expression of artemin in mammary carcinoma cells results in increased anchorage-independent growth, increased colony formation in soft agar and in three-dimensional Matrigel, and also promotes a scattered cell phenotype with enhanced migration and invasion. Moreover, forced expression of artemin increases tumor size in xenograft models and leads to highly proliferative, poorly differentiated and invasive tumors. Expression data in Oncomine indicate that high artemin expression is significantly associated with residual disease after chemotherapy, metastasis, relapse and death. Artemin protein is detectable in 65% of mammary carcinoma and its expression correlates to decreased overall survival in the cohort of patients. Depletion of endogenous artemin with small interfering RNA, or antibody inhibition of artemin, decreases the oncogenicity and invasiveness of mammary carcinoma cells. Artemin is therefore oncogenic for human mammary carcinoma, and targeted therapeutic approaches to inhibit artemin function in mammary carcinoma warrant consideration.
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Abstract
We describe the case of a patient with rapid sequential ST-segment elevation in different areas on the electrocardiogram (ECG) associated with lesions of differing etiologies in the corresponding coronary arteries. Prior reports of ST-segment elevations in multiple areas on the ECG have been from obstructions of single coronary vessels whose distribution overlapped separate areas on the ECG or spasm of multiple coronary arteries. We could find no prior reports of such rapid sequential ST-elevation in different areas on the ECG caused by two differing etiologies.
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Zhang M, Que B, Nie SP, Kang J, Ma CS. The effect of pre-hospital statins therapy on incidence of in-hospital death and total MACCE in patients with PCI. J Clin Pharm Ther 2008; 33:613-7. [DOI: 10.1111/j.1365-2710.2008.00954.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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359
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Kang J, Wang Z, Jin M, Guo N, Wang T, Du Y, Li R. Study of rat neuronal genes with ordered differential display method. SCIENCE IN CHINA. SERIES C, LIFE SCIENCES 2008; 44:601-9. [PMID: 18763101 DOI: 10.1007/bf02879354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2001] [Indexed: 10/22/2022]
Abstract
Ordered differential display (ODD) was developed recently and has been applied to systematic comparison of expression profiles of genes. It was further improved with the specific complexing property between biotin and streptavidin by the authors. First, random primer and biotinylated oligo (dT) primer were used to make pools of double strand cDNA. Second, streptavidin-coated PCR tube is used to absorb 3'ESTs specifically to avoid the negative effect of other DNA fragments. In the case of 3'ESTs comparison patterns between embryonic brain and body of SD rat, more than forty differentially expressed genes were cloned and identified. The function of rZIC gene, one of the genes identified and cloned, was studied through ethological experiments. The result showed that rZIC gene was associated with locomotion activity of adult mice.
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Choi C, Cho C, Yoo S, Kim M, Yoo H, Yang K, Seo Y, Kang J, Lee D. Image Guided Stereotactic Radiation Therapy in Patients with Isolated Paraaortic Lymph Node Metastasis from Carcinoma of Uterus. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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361
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Shvydka D, Parsai E, Kang J, Pearson D, Feldmeier J. SU-GG-J-142: Patient Scatter Analysis for A New Generation of Portal Imaging Sensors Based On Thin-Film Cadmium Telluride. Med Phys 2008. [DOI: 10.1118/1.2961691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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362
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Hoffman J, Ratamess NA, Ross R, Kang J, Magrelli J, Neese K, Faigenbaum AD, Wise JA. Beta-alanine and the hormonal response to exercise. Int J Sports Med 2008; 29:952-8. [PMID: 18548362 DOI: 10.1055/s-2008-1038678] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The effect of 30 days of beta-alanine supplementation (4.8 g per day) on resistance exercise performance and endocrine changes was examined in eight experienced resistance-trained men. An acute resistance exercise protocol consisting of 6 sets of 12 repetitions of the squat exercise at 70 % of one-repetition maximum (1-RM) with 1.5 minutes of rest between sets was performed before and after each supplemental period. Blood draws occurred at baseline (BL), immediate (IP), 15-minutes (15P) and 30-minutes (30P) postexercise for growth hormone, testosterone and cortisol concentrations. A 22 % (p < 0.05) difference in total number of repetitions performed at the end of 4 weeks of supplementation was seen between beta-alanine (BA) and placebo (PL), and Delta mean power was greater in BA (98.4 +/- 43.8 w) vs. PL (7.2 +/- 29.6 w). Growth hormone concentrations were elevated from BL at IP and 15P for both groups, while cortisol concentrations were greater than BL at all time points for both BA and PL. No group differences were noted. No change from BL was seen in testosterone concentrations for either group. Results indicate that four weeks of beta-alanine supplementation can significantly improve muscular endurance during resistance training in experienced resistance-trained athletes. However, these performance gains did not affect the acute endocrine response to the exercise stimulus.
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363
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Kang J, Parsai E, Shvydka D. TH-D-AUD C-07: Theoretical Analysis of a New Generation Portal Imaging Sensor Based On Thin-Film CdTe: A Feasibility Study For Clinical High Energy X-Ray Detection. Med Phys 2008. [DOI: 10.1118/1.2962919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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364
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Lee D, Kim S, Park K, Kim J, Lee J, Shin S, Kang J, Suh C, Ahn M, Ahn J. A randomized open-label study of gefitinib versus docetaxel in patients with advanced/metastatic non-small cell lung cancer (NSCLC) who have previously received platinum-based chemotherapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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365
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Lee M, Hong S, Chung E, Koh Y, Kang J, Hong Y, Lee K, Kim D, Kim S. Pathologic characteristics and cell cycle regulatory protein expression as a prognosis marker after curative resection in gall bladder cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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366
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Oh S, Lee G, Kim H, Kim T, Kim H, Kang J. Phase II trial of S-1 in combination with oxaliplatin (SOx) in previously untreated patients with recurrent or inoperable biliary tract cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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367
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Lee G, Kim H, Kang M, Kim T, Kim H, Kang J. Phase II trial of S-1 in combination with gemcitabine in chemo-naïve patients with locally advanced or metastatic pancreatic cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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368
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Kim H, Lee G, Kim H, Lee O, Hwang I, Kang J. A phase II study of S-1 and oxaliplatin as first-line therapy for patients with recurrent or metastatic gastric cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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369
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Kang J, Ko Y, Roh S, Hong S, Lee M, Chae H. Both VEGF and bFGF play an important role in distinctive angiogenic feature of microenvirnment surrounding EBV positive gastric cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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370
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An DH, Jung IS, Kang J, Chang HS, Hong BH, Hong S, Lee MY, Kim Y, Yang TK, Chai JS. The negative hydrogen Penning ion gauge ion source for KIRAMS-13 cyclotron. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2008; 79:02A520. [PMID: 18315141 DOI: 10.1063/1.2812797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The cold-cathode-type Penning ion gauge (PIG) ion source for the internal ion source of KIRAMS-13 cyclotron has been used for generation of negative hydrogen ions. The dc H-beam current of 650 microA from the PIG ion source with the Dee voltage of 40 kV and arc current of 1.0 A is extrapolated from the measured dc extraction beam currents at the low extraction dc voltages. The output optimization of PIG ion source in the cyclotron has been carried out by using various chimneys with different sizes of the expansion gap between the plasma boundary and the chimney wall. This paper presents the results of the dc H-extraction measurement and the expansion gap experiment.
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Kang J, Lee W, Shin S, Kwak Y, Youn Y, Park J. 157: Role of Coronary CT Angiography in the Evaluation of Patients With Chest Pain at Emergency Department According to Pre-Test Risk Group. Ann Emerg Med 2007. [DOI: 10.1016/j.annemergmed.2007.06.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kim K, Kang J, Lee J, Shin J, Rhee J, Suh G, Kwak Y, Shin S, Youn Y, Lee C, Singer A. 64: Before-After Study of a Standardized Written Protocol for the Management of APN: Effect on Admission Rate and Cost. Ann Emerg Med 2007. [DOI: 10.1016/j.annemergmed.2007.06.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lee G, Kim K, Cho Y, Kim H, Hwang I, Kim H, Kang J, Jang J, Lee J. Combination chemotherapy with irinotecan and cisplatin in elderly patients (≥65 years) with extensive-disease small-cell lung cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.18135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
18135 Background: Combination chemotherapy with irinotecan and cisplatin is one of the standard treatments for patients with small-cell lung cancer (SCLC). In elderly patients, however, its efficacy and toxicity has not been well documented. In this Phase II study, we assessed the efficacy and toxicity of combination chemotherapy with irinotecan and cisplatin and examined whether advanced age compromises it in elderly patients with previously untreated extensive-disease small-cell lung cancer (ED-SCLC). Methods: In this study, 43 previously untreated elderly patients (65 years or older) with ED-SCLC were given combination chemotherapy consisting of irinotecan 60mg/m2 on days 1, 8 and 15 and cisplatin 60mg/m2 on days 1. The treatment was repeated every four weeks until patients completed the maximum six cycles. Results: Patients consisted of 34 men and 9 women, whose median age was 70 years (range 65 - 81 years). A complete response and a partial response were observed in 23.3% (10/43) and 58.1% (25/43), respectively. The overall response rate was 81.4% (95% C.I; 69.7 - 93.0%). The overall median survival was 10.3 months (range 7.8 - 12.7 months). The 1-year and 2- year survival rates were 31.8% and 3.4%, respectively. The median progression-free survival was 8.32 months (range 6.8 - 9.8 months). Major toxicities included neutropenia (grade 3 to 4, 55.9%), leukopenia (grade 3 to 4, 46.5%), infection (grade 3 to 4, 37.3%) and diarrhea (grade 3 to 4, 30.3%). Incidence of febrile neutropenia was significantly higher in patients with ECOG performance status 2 compared with ECOG performance 1 (70.7% vs. 5.2%; p < 0.001). There were two treatment related deaths in patients ECOG performance status 2. Conclusions: Our results indicate that combination chemotherapy with irinotecan and cisplatin is an effective treatment for elderly patients with ED-SCLC. However, physicians should be aware of the mortality and morbidity due to myelosuppression following this treatment in elderly ED-SCLC patients with ECOG performance status 2. No significant financial relationships to disclose.
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Ko Y, Jung C, Lee M, Kang J, Hong Y, Lee K. Overexpression of VEGF-C and -D may predict unfavorable outcome in resected non-small cell lung cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.21114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
21114 Background: Correlation of Vascular endothelial growth factor (VEGF)-C, VEGF-D and/or VEGF receptor 3 (VEGFR-3) with lymphatic spread, tissue invasion and poor clinical outcomes has been observed in various cancers. Nodal metastasis is known to one of poor prognostic factors in non-small cell lung cancer (NSCLC). We investigated the correlation of VEGF-C,-VEGF-D and VEGFR-3 with clinicopathologic parameters and patient survival in NSCLC. Methods: Using immunohistochemial staining, we analyzed the protein expressions of VEGF-C, VEGFD and VEGFR-3 on the tissue array specimens from 180 patients with completely resected NSCLC. A 0 to +1 immunohistochemical staining (IHCS) of the cancer cell was defined as negative, +2 to +3 IHCS was as positive. Results: The expressions of VEGF-C, VEGF-D and VEGFR-3 were observed in 28.9%, 32.8% and 30.6% of cases, respectively. In the Cox regression-based multivariate analysis, it was proved that VEGF-C and D proved to be an independent prognostic factors as well as known prognostic factors, such as tumor size and lymph node metastases (VEGF-C, p=0.001; VEGF-D, p=0.014). VEGF-C expression showed statistically significant correlation with the expression of VEGFR-3 (p=0.02). Conclusion: To be taken, the present study revealed that VEGF-C and D expression may predict poor prognosis in resected NSCLC patients. Therefore, these results seems to be worth developing promising targeting inhibitors on lymphangiogenesis which plays major role in locoregional recurrence for surgically NSCLC patinets. No significant financial relationships to disclose.
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Koh S, Lee K, Hong Y, Kang J, Woo I, Lee M, Choi S. Development of symptom assessment tool for terminal cancer patients. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.19634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
19634 Background: A symptom assessment is important to control the terminal cancer patients’ symptoms successfully and improve their quality of life. Our research team has developed the objective assessment method for the terminal patients’ symptoms and compared the results with the patient self-reported outcomes using Memorial Symptom Assessment Scale (MSAS). Methods: From September in 2004, the 121 inpatients without anti-cancer therapy in terminal stage of cancer were evaluated in Kangnam St. Mary's Hospital. The 17 common symptoms were graded as four categories; none(0), mild(1), moderate(2), and severe(3) with reference to NCI-CTC and WHO toxicity criteria. An attending physician assessed 17 symptoms at the similar hour every day. Among the inpatients, those who had clear consciousness and could communicate normally were investigated every week to evaluate the frequency and severity of common symptoms and their distress degree using MSAS. Results: Only 54 patients (44.6%) could be examined to evaluate the symptoms by MSAS. However, the symptoms estimated by our assessment tool were less serious in the terms of severity and distress degree than that patients felt actually. This tendency was shown more obviously in the mental symptoms; Drowsiness (p=0.0001), Nervousness (p=0.0001), and Anxiety (p=0.005). However, the physical symptoms had no statistical difference between the results from patients and physician. Conclusions: Patient-reported outcomes using MSAS could be obtained from 44.6% of the inpatients with terminal cancer every week. However, the objective assessment tool to evaluate the common symptoms of terminal cancer patients can be applied for all patients including the incommunicable, every day. Furthermore, this assessment tool may be more suitable for examining the physical symptoms of terminal cancer patients. No significant financial relationships to disclose.
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