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Jang JK, Lee JS, Ryu MH, Yook JH, Park YK, Kim YW, Kim JY, Rha SY, Chung IJ, Kim IH, Oh SC, Yoo CH, Choi JH, Zang DY, Kim G, Lee Y, Noh SH, Kang YK. Diagnostic accuracy of CT-staging of advanced gastric cancer following neoadjuvant chemotherapy. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.4551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4551 Background: Neoadjuvant or perioperative chemotherapy has been accepted as a standard treatment globally in patients (pts) with locally advanced gastric cancer (LAGC). In PRODIGY phase III study (n = 530), we have demonstrated that neoadjuvant chemotherapy with DOS regimen (docetaxel, oxaliplatin, S-1) led to significant tumor downstaging and improved PFS in Korean LAGC pts (Kang, et al. ESMO 2019). Although CT has been performed to re-stage the tumor after neoadjuvant chemotherapy, there has been a relative paucity of diagnostic accuracy data. This study is to evaluate the diagnostic performance of restaging of LAGC after neoadjuvant chemotherapy using CT in PRODIGY study population. Methods: Of 266 pts, who had been diagnosed LAGC of T2-4 or N+ stage as assessed with CT and randomized to neoadjuvant chemotherapy arm (CSC) in PRODIGY study, 214 pts underwent gastrectomy were included in this analysis. The post-chemotherapy T- and N- stage was determined based on CT scan taken just prior to surgery and compared with the pathologic stage (AJCC 7th edition). Two experienced radiologists independently evaluated depth of primary tumor and reached consensus if any discrepancy between two readers. Diameter of short axis of the largest regional lymph node was measured to predict metastatic lymph node. Result of histopathologic T- and N-staging using surgical specimen was used as reference standard. Results: The study cohort consisted of pathologic T0 (n = 22), T1(n = 39), T2(n = 31), T3(n = 79), and T4(n = 43). The overall diagnostic accuracy of CT was 45%. For each T-stage, accuracy of T0,T1,T2,T3, and T4 was 0%, 26%, 29%, 55% and 79%, respectively. Rate of over- and under- staging was 47% and 8%, respectively. Accuracy for prediction of downstaging to early gastric cancer (T0-T1) was 83%. Interobserver agreement of T-staging was moderate (k = 0.41). There were 98 patients of N+ and 116 patients of N- at histopathology. Area under the curve of receiver operating characteristics to differentiate lymph node metastasis was 0.63. Sensitivity and specificity of size criteria of the largest lymph node (cut off value: > 6mm, > 7mm, and > 8mm) to predict pathologic N+ were 90% and 17%, 78% and 34%, and 68% and 51%, respectively. Conclusions: Re-staging using CT after neoadjuvant chemotherapy showed suboptimal accuracy and over-staged residual tumor. However, it predicted downstaging of gastric cancer with high accuracy.
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Affiliation(s)
| | | | | | - Jeong Hwan Yook
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Young-Kyu Park
- Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | | | | | - Sun Young Rha
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Ik-Joo Chung
- Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - In-Ho Kim
- Catholic University of Korea, Seoul, South Korea
| | | | - Chang Hak Yoo
- Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin-Hyuk Choi
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, South Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Gyunji Kim
- Sanofi R&D Clinical Study Unit, Seoul, South Korea
| | - YeonJu Lee
- Sanofi R&D Clinical Study Unit, Seoul, South Korea
| | - Sung Hoon Noh
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
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Kim M, Zang DY, Lee J, Park JY, Chung Y, Lee YK. Mixed Phenotype Acute Leukemia that Evolved from Myelodysplastic Syndrome with Excess Blasts. Lab Med 2020; 51:288-295. [PMID: 31504737 DOI: 10.1093/labmed/lmz054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Myelodysplastic syndrome (MDS) that evolves into acute leukemia with blasts of mixed phenotypes has rarely been reported and has no distinct diagnostic category. Herein, we describe a 79-year-old Korean female patient with MDS-excess blasts (MDS-EB) that evolved into acute leukemia; the blasts simultaneously expressed B-lymphoid and myeloid antigens. The patient was diagnosed with MDS-EB with blasts of myeloid lineage coexpressing a few B-lymphoid antigens with 7q and 20q abnormalities. The disease progressed to acute leukemia with blasts carrying more B-lymphoid antigens, which was immunophenotypically compatible with B-lymphoid/myeloid acute leukemia. Unlike previously reported patients whose blast populations are bilineal, our patient is the first with biphenotypic acute leukemia that progressed from MDS. The diagnosis of our patient introduces the possibility that many other types of biphenotypic acute leukemia may have gone undiagnosed and encourages hematologists to designate a specific diagnostic category for this type of disease, so that it can more readily be detected and studied in the future.
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Affiliation(s)
- Miyoung Kim
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Jiwon Lee
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Ji-Young Park
- Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Yousun Chung
- Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Young Kyung Lee
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
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Kim BJ, Kim YJ, Sohn SH, Kim B, Sul HJ, Kim HS, Zang DY. Tivantinib inhibits the VEGF signaling pathway and induces apoptosis in gastric cancer cells with c-MET or VEGFA amplification. Invest New Drugs 2020; 38:1633-1640. [PMID: 32361789 DOI: 10.1007/s10637-020-00940-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/15/2020] [Indexed: 12/25/2022]
Abstract
Tivantinib has been described as a selective inhibitor of c-Met and is being studied in various types of cancer. In this study, we evaluated the effects of tivantinib on the suppression of gastric cancer (GC) cell migration and apoptosis. We also examined the mechanism of action of tivantinib by oncogenic pathway analysis. We applied an RNA-sequencing approach in 34 GC patients to identify oncogenes that are differentially expressed in GC tissues. To examine the inhibitory effect of tivantinib on GC cells, we conducted apoptosis analysis using an annexin V-APC/PI apoptosis detection kit and trans-well migration assay with human GC cell lines. For oncogenic pathway analysis, Western blot and quantitative real-time PCR analysis were used to detect the expression of proteins and genes before and after tivantinib exposure. In the RNA-sequencing analysis of 34 GC patients, c-Met and VEGFA genes were expressed and positively correlated with each other. Cell migration and apoptosis analysis demonstrated that tivantinib induced the best inhibition effect in SNU620, MKN45 (carries VEGFB mutation), AGS, and MKN28 cells, but not in KATO III (carries VEGFB and VEGFC mutations) cells. Oncogenic pathway analysis showed that tivantinib, in addition to c-Met signaling pathway inhibition, also inhibits VEGF signaling and MYC expression in VEGFA-expressing GC cells. We found that tivantinib has anti-cancer activity not only in GC cells overexpressing c-Met but also in non-c-Met GC cells by inhibition of the VEGF signaling pathway.
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Affiliation(s)
- Bum Jun Kim
- Division of Internal Medicine, National Army Capital Hospital, The Armed Forces Medical Command, Sungnam, 13574, Republic of Korea
| | - Yoo Jin Kim
- Hallym Translational Research Institute, Hallym University College of Medicine, Anyang-si, Gyeonggi-do, 14068, Republic of Korea
| | - Sung-Hwa Sohn
- Hallym Translational Research Institute, Hallym University College of Medicine, Anyang-si, Gyeonggi-do, 14068, Republic of Korea
| | - Bohyun Kim
- Hallym Translational Research Institute, Hallym University College of Medicine, Anyang-si, Gyeonggi-do, 14068, Republic of Korea
| | - Hee Jung Sul
- Hallym Translational Research Institute, Hallym University College of Medicine, Anyang-si, Gyeonggi-do, 14068, Republic of Korea
| | - Hyeong Su Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Gyeonggi-do, 14068, Republic of Korea
| | - Dae Young Zang
- Hallym Translational Research Institute, Hallym University College of Medicine, Anyang-si, Gyeonggi-do, 14068, Republic of Korea. .,Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Gyeonggi-do, 14068, Republic of Korea.
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Sohn SH, Kim B, Sul HJ, Choi BY, Kim HS, Zang DY. Foretinib Inhibits Cancer Stemness and Gastric Cancer Cell Proliferation by Decreasing CD44 and c-MET Signaling. Onco Targets Ther 2020; 13:1027-1035. [PMID: 32099405 PMCID: PMC7006849 DOI: 10.2147/ott.s226951] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 01/17/2020] [Indexed: 12/13/2022] Open
Abstract
Purpose CD44 isoforms are highly expressed in cancer stem cells, initiating tumor growth and sustaining tumor self-renewal. Among these isoforms, CD44 variant 9 (CD44v9) is overexpressed in chronic inflammation-induced cancer. CD44 and the mesenchymal-to-epithelial transition (MET) receptor tyrosine kinase are coactivated in some gastric cancers (GCs). In this study, we characterized MET and CD44 expression and signaling in human GC cell lines and analyzed differences in the susceptibility of these lines to foretinib. Patients and Methods We analyzed cell viability and the rate of apoptotic cells using MTS assays and flow cytometry, respectively. Gene and protein expression were assessed by quantitative reverse-transcription polymerase chain reaction (qRT-PCR) and immunoblotting, respectively. Results Foretinib treatment resulted in dose-dependent inhibition of growth in c-MET-amplified MKN45 and SNU620 cells with concomitant induction of apoptosis, but not in c-MET-reduced MKN28 and AGS cells. Foretinib treatment also significantly reduced phosphor-c-MET, phosphor-AKT, beta-catenin, and COX-2 protein expression in MKN45 and SNU620 cells. Interestingly, foretinib significantly reduced CD44, CD44v9, COX-2, OCT3/4, CCND1, c-MYC, VEGFA, and HIF-1a gene expression in CD44 and MET coactivated MKN45 cells and increased CD44s gene expression; in contrast, these drugs were only slightly active against SNU620 cells. Conclusion The results of this study indicate that foretinib could be a therapeutic agent for the prevention or treatment of GCs positive for CD44v9 and c-MET.
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Affiliation(s)
- Sung-Hwa Sohn
- Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea
| | - Bohyun Kim
- Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea
| | - Hee Jung Sul
- Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea
| | - Bo Youn Choi
- Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea
| | - Hyeong Su Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Gyeonggi-do 14068, Republic of Korea
| | - Dae Young Zang
- Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang 14066, Republic of Korea.,Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Gyeonggi-do 14068, Republic of Korea
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55
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Do YR, Kwak JY, Kim JA, Kim HJ, Chung JS, Shin HJ, Kim SH, Bunworasate U, Choi CW, Zang DY, Oh SJ, Jootar S, Reksodiputro AH, Lee WS, Mun YC, Kong JH, Caguioa PB, Kim H, Park J, Kim DW. Long-term data from a phase 3 study of radotinib versus imatinib in patients with newly diagnosed, chronic myeloid leukaemia in the chronic phase (RERISE). Br J Haematol 2020; 189:303-312. [PMID: 32012231 PMCID: PMC7187446 DOI: 10.1111/bjh.16381] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/25/2019] [Indexed: 12/22/2022]
Abstract
In the phase 3 study RERISE, patients with newly diagnosed chronic myeloid leukaemia in chronic phase demonstrated significantly faster and higher rates of major molecular response (MMR) with twice‐daily radotinib 300 mg (n = 79) or 400 mg (n = 81) than with once‐daily imatinib 400 mg (n = 81) after 12 months. With ≥48 months’ follow‐up, MMR was higher with radotinib 300 mg (86%) or 400 mg (83%) than with imatinib (75%). Among patients with BCR‐ABL1 ≤ 10% at three months, MMR and molecular response 4·5 (MR4·5) were achieved within 48 months by more radotinib‐treated patients (300 mg: 84% and 52%, respectively; 400 mg: 74% and 44%, respectively) than imatinib‐treated patients (71% and 44%, respectively). Estimated overall and progression‐free survival rates at 48 months were not significantly different between imatinib (94% and 94%, respectively) and radotinib 300 mg (99% and 97%, respectively) or 400 mg (95% and 93%, respectively). The treatment failure rate was significantly higher with imatinib (19%) than with radotinib 300 mg (6%; P = 0·0197) or 400 mg (5%; P = 0·0072). Safety profiles were consistent with previous reports; most adverse events occurred within 12 months. Radotinib continues to demonstrate robust, deep molecular responses, suggesting that treatment‐free remission may be attainable.
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Affiliation(s)
- Young Rok Do
- Dongsan Medical Center, Keimyung University, Daegu, South Korea
| | - Jae-Yong Kwak
- Chonbuk National University Medical School & Hospital, Jeonju, South Korea
| | - Jeong A Kim
- St. Vincent Hospital, The Catholic University of Korea, Suwon, South Korea
| | - Hyeoung Joon Kim
- Chonnam National University, Hwasun Hospital, Hwasun, South Korea
| | | | - Ho-Jin Shin
- Pusan National University Hospital, Busan, South Korea
| | - Sung-Hyun Kim
- Dong-A University Medical Center, Busan, South Korea
| | - Udomsak Bunworasate
- King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | | | - Dae Young Zang
- Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Suk Joong Oh
- Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Saengsuree Jootar
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Won Sik Lee
- Inje University Busan Paik Hospital, Busan, South Korea
| | - Yeung-Chul Mun
- Ewha Womans University College of Medicine, Seoul, South Korea
| | - Jee Hyun Kong
- Wonju Severance Christian Hospital, Wonju, South Korea
| | | | - Hawk Kim
- Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Jinny Park
- Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Dong-Wook Kim
- Seoul St. Mary's Hematology Hospital, Leukemia Research Institute, The Catholic University of Korea, Seoul, South Korea
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56
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Lee JS, Rhee TM, Pietrasz D, Bachet JB, Laurent-Puig P, Kong SY, Takai E, Yachida S, Shibata T, Lee JW, Park HC, Zang DY, Jeon K, Lee J, Kim M, Kim HS, Kang HJ, Lee YK. Circulating tumor DNA as a prognostic indicator in resectable pancreatic ductal adenocarcinoma: A systematic review and meta-analysis. Sci Rep 2019; 9:16971. [PMID: 31740696 PMCID: PMC6861312 DOI: 10.1038/s41598-019-53271-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/28/2019] [Indexed: 01/10/2023] Open
Abstract
Circulating tumor DNA (ctDNA) is a promising prognostic biomarker in various cancers. Due to the high recurrence rate of resectable pancreatic ductal adenocarcinoma (PDAC), effective strategies for prognostic stratification are necessary. Yet, for resectable PDAC, prognostic impact of ctDNA lacks systemic evidence. We sought to investigate the prognostic significance of baseline ctDNA and postoperative ctDNA in patients with resectable PDAC. PubMed, EMBASE, and the Cochrane library were searched up to March 2019. Five studies met the inclusion criteria, and 375 patients were pooled for the meta-analysis. Positive ctDNA significantly indicated poor overall survival (at baseline, hazard ratio [HR] 2.27, 95% confidence interval [CI] 1.13-4.56; postoperative, HR 3.66, 95% CI 1.45-9.28). Patients with detectable ctDNA showed the trend to have higher risk for disease recurrence than those without detectable ctDNA (at baseline, HR 1.96, 95% CI 0.65-5.87; postoperative, HR 2.20, 95% CI 0.99-4.87). The results were consistent regardless of pre- or post-operative ctDNA. There was no significant heterogeneity among the included studies. In conclusion, our meta-analysis revealed that ctDNA, either at baseline or postoperative, might be a useful prognostic biomarker for stratifying risk of death and recurrence in resectable PDAC.
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Affiliation(s)
- Jee-Soo Lee
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Tae-Min Rhee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Daniel Pietrasz
- Université Paris Sorbonne Cité, Centre Universitaire des Saints-Péres, Paris, France
| | - Jean-Baptiste Bachet
- Sorbonne Université, Hôpitaux Universitaires Pitié-Salpétrière, APHP, Paris, France
| | | | - Sun-Young Kong
- Department of Laboratory Medicine, Center for Diagnostic Oncology, National Cancer Center, Goyang, Korea
| | - Erina Takai
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Shinichi Yachida
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Tatsuhiro Shibata
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Jung Woo Lee
- Department of Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hyoung-Chul Park
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kibum Jeon
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jiwon Lee
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Miyoung Kim
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Han-Sung Kim
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hee Jung Kang
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Young Kyung Lee
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
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Kim TY, Han HS, Lee KW, Zang DY, Rha SY, Park YI, Kim JS, Lee KH, Park SH, Song EK, Jung SA, Lee N, Kim YH, Cho JY, Bang YJ. A phase I/II study of poziotinib combined with paclitaxel and trastuzumab in patients with HER2-positive advanced gastric cancer. Gastric Cancer 2019; 22:1206-1214. [PMID: 30945121 DOI: 10.1007/s10120-019-00958-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 03/27/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Poziotinib (HM781-36B) is an irreversible pan-HER tyrosine kinase inhibitor which targets EGFR, HER2, and HER4. This prospective, multicenter, open-label, phase I/II study determined the maximum tolerated dose (MTD) and evaluated the safety and efficacy of poziotinib combined with paclitaxel and trastuzumab in patients with HER2-positive advanced gastric cancer (GC). METHODS Patients with HER2-positive GC previously treated with one line of chemotherapy received oral poziotinib (8 mg or 12 mg) once daily for 14 days, followed by 7 days off. Paclitaxel (175 mg/m2 infusion) and trastuzumab (8 mg/kg loading dose, then 6 mg/kg infusion) were administered concomitantly with poziotinib on day 1 every 3 weeks. RESULTS In the phase I part, 12 patients were enrolled (7 at dose level 1, 5 at dose level 2). One patient receiving poziotinib 8 mg and 2 receiving poziotinib 12 mg had dose-limiting toxicities (DLTs); all DLTs were grade 4 neutropenia, one with fever. The most common poziotinib-related adverse events were diarrhea, rash, stomatitis, pruritus and loss of appetite. The MTD of poziotinib was determined to be 8 mg/day and this was used in the phase II part which enrolled 32 patients. Two patients (6.3%) had complete responses and 5 (15.6%) had partial responses (objective response rate 21.9%). Median progression-free survival and overall survival were 13.0 weeks (95% CI 9.8-21.9) and 29.5 weeks (95% CI 17.9-59.2), respectively. CONCLUSIONS The MTD of poziotinib combined with paclitaxel and trastuzumab was 8 mg/day. This combination yielded promising anti-tumor efficacy with manageable toxicity in previously treated patients with HER2-positive GC.
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Affiliation(s)
- Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Hye Sook Han
- Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Keun-Wook Lee
- Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Dae Young Zang
- Hallym University Sacred Heart Hospital, Anyang-si, South Korea
| | - Sun Young Rha
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Jin-Soo Kim
- Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Se Hoon Park
- Sungkyunkwan University Samsung Medical Center, Seoul, South Korea
| | - Eun-Kee Song
- Chonbuk National University Medical School, Jeonju, South Korea
| | - Soo-A Jung
- Hanmi Pharmaceutical Co., Ltd., Seoul, South Korea
| | - NaMi Lee
- Hanmi Pharmaceutical Co., Ltd., Seoul, South Korea
| | | | | | - Yung-Jue Bang
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
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Kim YJ, Cho AR, Sul HJ, Kim B, Kim AY, Kim HS, Seo JB, Koh Y, Zang DY. The effects of crizotinib in a transgenic Drosophila model expressing the human TPM4-ALK fusion gene or TPM4. Biol Open 2019; 8:8/7/bio044362. [PMID: 31278140 PMCID: PMC6679403 DOI: 10.1242/bio.044362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Anaplastic lymphoma kinase (ALK) fusion events lead to constitutive activation of the ALK kinase domain, thereby functioning as oncogenic drivers. These fusion proteins have been identified in numerous cancers. Crizotinib, a small molecule inhibitor of c-Met and ALK, is a Food and Drug Administration-approved drug with reported efficacy in the treatment of cancer. Tropomyosins (TPMs) are a family of actin filament-binding proteins. Altered TPM expression has been found in a variety of human tumors. Inhibitors of cancer-associated TPMs and actin-targeting compounds have been developed, but anti-actin agents have cardiac and respiratory muscle toxicities. In this study, we investigated the sensitivities of human TPM4 (hTPM4), human ALK (hALK), and their fusion gene (hTPM4-hALK) to crizotinib by measuring the lifespan of transgenic Drosophila. Flies overexpressing hTPM4-hALK, hTPM4 and hALK showed decreased lifespans compared with controls. Although crizotinib is an inhibitor of ALK, treatment with crizotinib significantly extended the lifespans of Drosophila expressing hTPM4 and hTPM4-hALK but had no effect on hALK-expressing flies. Autophosphorylation of Tyr1278 is necessary for full activation of the ALK domain. We confirmed that hTPM4-hALK was phosphorylated at Tyr1278 in a ligand-independent manner, and hTPM4-hALK-expressing flies treated with crizotinib showed a decreased level of Tyr1278 phosphorylation compared with untreated hTPM4-hALK-expressing flies, with a greater decrease induced by 1 µM compared with 200 nM crizotinib. Taken together, the results suggest that crizotinib is effective for treating ALK-driven cancer and might be a new therapeutic drug, without cardiac or respiratory muscle toxic effects, for TPM4-expressing cancers. Summary: In this study, we find that crizotinib extends the lifespan of Drosophila overexpressing hTPM4-ALK and hTPM4, which are linked with a variety of human tumors.
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Affiliation(s)
- Yoo Jin Kim
- Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang, 14066, Republic of Korea.,Department of Molecular Medicine, Graduate School of Hallym University, Chuncheon, Gangwon-do, 24252, Republic of Korea
| | - A-Ri Cho
- Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang, 14066, Republic of Korea
| | - Hee Jung Sul
- Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang, 14066, Republic of Korea
| | - Bohyun Kim
- Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang, 14066, Republic of Korea
| | - A-Young Kim
- Department of Biomedical Gerontology, Ilsong Institute of Life Sciences, Hallym University, Anyang, Gyeonggi-do, 14066, Republic of Korea
| | - Hyeong Su Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Gyeonggi-do 14068, Republic of Korea
| | - Jong Bok Seo
- Korea Basic Research Institute Seoul Center, Seoul, 02855, Republic of Korea
| | - Youngho Koh
- Department of Biomedical Gerontology, Ilsong Institute of Life Sciences, Hallym University, Anyang, Gyeonggi-do, 14066, Republic of Korea
| | - Dae Young Zang
- Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang, 14066, Republic of Korea .,Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Gyeonggi-do 14068, Republic of Korea
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Park SH, Zang DY, Han B, Ji JH, Kim TG, Oh SY, Hwang IG, Kim JH, Shin D, Lim DH, Kim KM, An JY, Choi MG, Lee JH, Sohn TS, Bae JM, Kim S, Kim S, Lee J, Kang WK. ARTIST 2: Interim results of a phase III trial involving adjuvant chemotherapy and/or chemoradiotherapy after D2-gastrectomy in stage II/III gastric cancer (GC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.4001] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
4001 Background: Adjuvant chemotherapy and/or chemoradiotherapy have been the standard of care in GC for years, supported by randomized trials. We compared the efficacy of different chemotherapy regimens and chemoradiotherapy in patients with D2-resected, stage II/III, node-positive GC. Methods: From Feb 2013 through Nov 2018, we randomly assigned, in a 1:1:1 ratio, patients with pathologically-staged II or III, node-positive, D2-resected GC, to receive adjuvant S-1 (40-60 mg twice daily 4-weeks-on/2-weeks-off) for one year, S-1 (2-weeks-on/1-week-off) plus oxaliplatin 130 mg/m2 (SOX) for six months, or SOX plus chemoradiotherapy 45 Gy (SOXRT). Randomization was stratified according to the type of surgery (total or subtotal gastrectomy), stage (II or III), and Lauren histologic classification (diffuse or intestinal). The primary endpoint was disease-free survival (DFS). A total of 900 patients had to be enrolled to demonstrate superiority of SOX or SOXRT to S-1 (hazard ratio [HR] 0.667), with 90% power at a two-sided significance level of 5%. Results: A total of 538 patients were included for this interim efficacy analysis. Median age was 58 years, men constituted 65%, and stage II and III were 31% and 69%, respectively. Baseline tumor and patient characteristics were balanced between treatment arms. Adverse events were as anticipated in each arm, generally well-tolerated and manageable. DFS in the control arm (S-1) were significantly shorter than in SOX and SOXRT arms (stratified HR for recurrence): S-1 vs. SOX, 0.617 (P = 0.016) and S-1 vs. SOXRT, 0.686 (P = 0.057). The DFS at 3-years was found to be 65%, 78% and 73% in S-1, SOX and SOXRT arms, respectively. No difference in DFS between SOX and SOXRT was found (HR 0.910, P = 0.667). Based on the results after the observation of 145 recurrence events at the cutoff date of Dec 27, 2018, the independent data monitoring committee considered the results sufficient to meet the endpoint of the trial and recommended early stopping of the trial. Conclusions: In patients with curatively D2-resected, stage II/III, node-positive GC, adjuvant SOX or SOXRT was effective in prolonging DFS, when compared to S-1 monotherapy. Clinical trial information: NCT0176146.
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Affiliation(s)
- Se Hoon Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Boram Han
- Department of Internal Medicine, Hallym University Medical Center, Anyang, South Korea
| | - Jun Ho Ji
- Division of Hemato-Oncology, Department of Internal Medicine, Changwon Samsung Medical Center, Changwon, South Korea
| | - Tae Gyu Kim
- Department of Radiation Oncology, Sungkyunkwan University Samsung Changwon Hospital, Changwon, South Korea
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea
| | - In Gyu Hwang
- Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Jung Hoon Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Dongbok Shin
- Gachon University Gil Medical Center, Incheon, South Korea
| | - Do Hoon Lim
- Department of Radiation Oncology, Sungkyunkwan University Samsung Medical Center, Seoul, South Korea
| | - Kyoung Mee Kim
- Department of Pathology, Samsung Medical Center, Seoul, South Korea
| | | | | | - Jun-Ho Lee
- Samsung Medical Center, Seoul, South Korea
| | | | | | - Sung Kim
- Department of Surgery, Samsung Medical Center, Seoul, South Korea
| | - Seung Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jeeyun Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won Ki Kang
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Kim M, Snowdon J, Weeraratne SD, Felix W, Lim L, Dankwa-Mullan I, Lee YK, Lee E, Jeon K, Lee JS, Zang DY, Kim HJ, Kim HY, Han B. Clinical insights for hematological malignancies from an artificial intelligence decision-support tool. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e13023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13023 Background: Next generation sequencing (NGS) in hematological tumors is increasingly shaping clinical treatment decisions at the point of care. While the impact of NGS panels in solid tumors is largely therapeutic, targeted sequencing in hematological tumors can additionally provide diagnostic and prognostic insights. Additional data generated in hematological tumor sequencing makes manual interpretation and annotation of variants tedious and non-scalable. In this study we compared hematological tumor variant interpretation using an artificial intelligence decision-support system, Watsonä for Genomics (WfG), with expert guided manual curation. Methods: Patients with hematological tumors at Hallym University, College of Medicine between December 2017 and December 2018, were sequenced using the 54 gene Illumina TruSight Myeloid Panel. WfG interpreted and annotated all patients’ sequencing results, a subset of which were assessed manually to ascertain concordance. Results: 54 South Korean patients with hematological malignancies were analyzed (23 Acute Myeloid Leukemia, 12 myeloproliferative neoplasm, 5 myelodysplastic syndrome, 5 multiple myeloma and 9 others). Comparison of manual and WfG interpretation of 10 randomly selected cases yielded 90% (9/10) concordance and identification of 9 clinically actionable variants (33%) not found in manual interpretation. In total, WfG identified that 71% (38/54) of all cases had at least one clinically actionable therapeutic alteration (a variant targeted by a US FDA approved drug, off-label drug, or clinical trial). 33% (18/54) of cases had genes that were targeted by a US FDA approved therapy including JAK2, IDH1, IDH2, and FLT3. In cases without therapeutic alterations, WfG identified diagnostic or prognostic insights in an additional 20% (11/54) of patients. 9% (5/54) had no clinically actionable information. Conclusions: WfG variant interpretation correlated well with manually curated expert opinion and identified clinically actionable insights missed by manual interpretation. WfG has obviated the need for labor-intensive manual curation of clinical trials and therapy, enabling our center to exponentially scale our NGS operations.
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Affiliation(s)
- Miyoung Kim
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | | | | | | | | | | | - Young Kyung Lee
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Eunyup Lee
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Kibum Jeon
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Jee-Soo Lee
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Dae Young Zang
- Division of Hemato-Oncology, Department of Internal Medicine, Hallym University Medical Center, Seoul, South Korea
| | - Hyo Jung Kim
- Department of Hematology-Oncology, Hallym University medical center, Anyang, South Korea
| | - Ho Young Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Boram Han
- Department of Internal Medicine, Hallym University Medical Center, Anyang, South Korea
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Kim M, Weeraratne SD, Snowdon J, Felix W, Lim L, Lee YK, Lee E, Jeon K, Lee J, Zang DY, Han B. Comparative analysis of prognostic molecular signatures in Asian and Caucasian AML populations. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e13025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13025 Background: Next generation sequencing (NGS) studies on various cancer types have revealed clinical insights on the molecular etiology of tumors and defined new treatment paradigms. However, the genomic landscape of a tumor type may be predicated on race. Application of broad-brush findings from one population to another may lead to erroneous treatment decisions. While the majority of published NGS cancer studies focus on Caucasian populations, few studies evaluate the molecular profiles of a tumor type between different demographies. In this study, acute myeloid leukemia (AML) patients of East Asian descent were sequenced at a South Korean hospital, interpreted, and compared with the Caucasian population from The Cancer Genome Atlas (TCGA). Methods: 23 South Korean AML patients were sequenced in 2018 using the 54 gene Illumina TruSight Myeloid Panel at Hallym University, College of Medicine. Orthogonal testing for FLT3-internal tandem duplication (ITD) was done by Sanger sequencing. Watsonä for Genomics (WfG), an artificial intelligence decision-support system, was used for variant interpretation and annotation. Additionally, 181 AML patients of Caucasian descent from the TCGA dataset were analyzed for comparison. Results: WfG identified at least 1 clinically actionable therapeutic alteration in 70% (16/23) of all Asian cohort cases. FLT3-ITD or tyrosine kinase domain (TKD) mutations were reported in 27% (49/181) of cases in the TCGA cohort but only 9% (2/23) of the Asian cohort. DNMT3A mutations were detected in 25% (45/181) and 74% (17/23) of the TCGA and Asian cohorts, respectively. Other oncogenic mutations in AML including NRAS, IDH1, IDH2, CEBPA, TET2, and NPM1 were represented at comparable frequencies between the two populations. Conclusions: Tumor biomarkers that affect prognosis can be informative in the clinical setting. In our study, FLT3 and DNMT3A, predictors of poor prognosis in AML, demonstrated decreased and increased respective frequencies in South Koreans compared to Caucasians, suggesting that some mutational signatures that predict cancer outcome may vary by race.
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Affiliation(s)
- Miyoung Kim
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | | | | | | | | | - Young Kyung Lee
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Eunyup Lee
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Kibum Jeon
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Jiwon Lee
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Dae Young Zang
- Division of Hemato-Oncology, Department of Internal Medicine, Hallym University Medical Center, Seoul, South Korea
| | - Boram Han
- Department of Internal Medicine, Hallym University Medical Center, Anyang, South Korea
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Kim HS, Zang DY, Sohn SH, Kim B, Sul HJ. Effect of tivantinib on VEGF signaling pathways and apoptosis of gastric cancer cells with c-MET or VEGFA amplification. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e14719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14719 Background: VEGFA is the key mediator of angiogenesis in cancer and previous studies reported that VEGFA expression was significantly up-regulated in gastric cancer tissues compared with matched normal tissues. We showed that increased levels of VEGFA are significantly associated with expression of hepatocyte growth factor receptor (MET) (r = 0.6255, P < 0.0001). In addition, it is well known that c-MET is potentially a highly plausible target for cancer therapy in gastric cancer. In this study, cytotoxic activity of tivantinib were evaluated in gastric cancer cells with high c-MET expression or VEGFA amplification. Methods: In this study, Western blot and quantitative real-time PCR analysis were used to detect the expression of protein and genes after treatment of tivantinib. In addition, MTS, flow cytometry, and migration assay were used. Results: Tivantinib inhibited growths of a high c-MET-expressed or VEGFA-amplified cell lines. Furthermore, in migration and apoptosis analysis, tivantinib induced apoptosis of SNU620, MKN45 (carried VEGFB mutation), AGS, and MKN28 cells but not in KATO III (carried VEGFB and VEGFC mutation) cells. We also found that tivantinib inhibited the VEGF signaling pathway and MYC expression in VEGFA-amplified gastric cancer cell lines. Conclusions: The data indicate that tivantinib could be a potential therapeutic agent for the treatment of gastric cancer with high c-MET expression or VEGFA amplification.
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Affiliation(s)
- Hyeong Su Kim
- Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Seoul, South Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Sung-Hwa Sohn
- Hallym Translational Research Institute, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Bohyun Kim
- Hallym Translational Research Institute, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Hee Jung Sul
- Hallym Translational Research Institute, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
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Sohn SH, Kim B, Sul HJ, Kim YJ, Kim HS, Kim H, Seo JB, Koh Y, Zang DY. INC280 inhibits Wnt/β-catenin and EMT signaling pathways and its induce apoptosis in diffuse gastric cancer positive for c-MET amplification. BMC Res Notes 2019; 12:125. [PMID: 30871613 PMCID: PMC6419497 DOI: 10.1186/s13104-019-4163-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 03/06/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Gastric cancer is more open related to genetic predisposition. In our RNA sequencing study on gastric cancer patients, Runt-related transcription factor-3 (RUNX3) expression was significantly down-regulated in gastric cancer. We showed that decreased levels of RUNX3 are significantly associated with c-MET (r = - 0.4216, P = 0.0130). In addition, c-MET expression is a candidate for targeted therapy in gastric cancer. Therefore, in the present study, the anti-cancer effects of the c-MET inhibitor on gastric cancer cells from positive or negative for c-MET amplification were evaluated. RESULTS INC280 treatment inhibits growth of a c-MET-amplified MKN45 (RUNX3-positive) and SNU620 (RUNX3-negative) diffuse type cells. Then, INC280 showed the highest inhibition and apoptotic rates with the lowest IC50s in MKN45 cells but not in c-MET-reduced MKN28 (intestinal type) cells. We also showed that INC280 inhibits the WNT signaling pathway and SNAIL expression in MKN45 cells. The data indicate that INC280 could be used as therapeutic agents for the prevention or treatment of diffuse gastric cancer positive for c-MET amplification.
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Affiliation(s)
- Sung-Hwa Sohn
- 0000000404154154grid.488421.3Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang, 14066 Republic of Korea
| | - Bohyun Kim
- 0000000404154154grid.488421.3Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang, 14066 Republic of Korea
| | - Hee Jung Sul
- 0000000404154154grid.488421.3Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang, 14066 Republic of Korea
| | - Yoo Jin Kim
- 0000000404154154grid.488421.3Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang, 14066 Republic of Korea
| | - Hyeong Su Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do 14086 Republic of Korea
| | - Hongtae Kim
- 0000 0004 0381 814Xgrid.42687.3fSchool of Life Sciences, Ulsan National Institute of Science and Technology, Ulsan, 689-798 Republic of Korea
| | - Jong Bok Seo
- Korea Basic Research Institute Seoul Center, Seoul, 02855 Republic of Korea
| | - Youngho Koh
- 0000 0004 0470 5964grid.256753.0Department of Bio-medical Gerontology, Ilsong Institute of Life Sciences, Hallym University, Anyang, Gyeonggi-do 14066 Republic of Korea
| | - Dae Young Zang
- 0000000404154154grid.488421.3Hallym Translational Research Institute, Hallym University Sacred Heart Hospital, Anyang, 14066 Republic of Korea
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do 14086 Republic of Korea
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Kim M, Zang DY, Han B, Lee J, Chung Y, Park CJ, Lee YK. A Myelodysplastic Syndrome with Concurrent Basophilia and Eosinophilia Lacking Oncogenic Mutations in 54 Relevant Genes. Clin Lab 2019; 65. [PMID: 30775878 DOI: 10.7754/clin.lab.2018.180729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Myelodysplastic syndromes (MDS) with basophilia or eosinophilia are very rare and portend poor prognoses. We present a rare patient who had MDS with excess blasts as well as peripheral basophilia and concurrent bone marrow (BM) basophilia/eosinophilia. She had a complex karyotype including 5q and 7q deletions; however, no oncogenic mutations were observed on next-generation sequencing of 54 genes known to be frequently mutated in acute myeloid leukemia/MDS. Peripheral basophilia resolved after decitabine treatment. Ours is the first report to describe a genome-wide analysis and the use of decitabine to successfully treat basophilia in an MDS patient with concurrent BM basophilia/eosinophilia.
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Kim HS, Kim JH, Jang HJ, Han B, Zang DY. Pathological and Prognostic Impacts of FGFR2 Overexpression in Gastric Cancer: A Meta-Analysis. J Cancer 2019; 10:20-27. [PMID: 30662521 PMCID: PMC6329854 DOI: 10.7150/jca.28204] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 08/15/2018] [Indexed: 12/12/2022] Open
Abstract
Fibroblast growth factor receptor-2 (FGFR2) protein expression by immunohistochemistry has been reported in up to 60% of patients with gastric cancer (GC). However, the clicopathological impacts of high FGFR2 expression have not been consistent among studies. We conducted this meta-analysis to evaluate the pathological and prognostic significance of FGFR2 overexpression in patients with GC. A systematic search of the electronic databases including PubMed, PMC, EMBASE, and Google Scholar was performed. From ten studies, 4,294 patients were included in the pooled analyses of odds ratios (ORs) with 95% confidence intervals (CIs) for pathological features and hazard ratios (HRs) with 95% CIs for overall survival according to the FGFR2 expression status. Compared with tumors showing low FGFR2 expression, GCs with FGFR2 overexpression revealed deeper depth of invasion (pT3-4) (OR = 2.63, 95% CI: 1.70-4.06, p < 0.0001), higher rate of lymph node metastasis (OR = 1.87, 95% CI: 1.31-2.67, p < 0.0001), and more advanced stage (III-IV) (OR = 1.78, 95% CI: 1.07-2.96, p = 0.03). In addition, patients with FGFR2-overexpressed GC showed significantly worse survival than those with FGFR2-low tumor (HR = 1.40, 95% CI: 1.25-1.58, p < 0.00001). In conclusion, this meta-analysis indicates that FGFR2 overexpression is associated with poor pathological features and prognosis in patients with GC.
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Affiliation(s)
- Hyeong Su Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jung Han Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Hyun Joo Jang
- Division of Gastroenterology, Department of Internal Medicine, Dongtan Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Hwasung, Republic of Korea
| | - Boram Han
- Division of Hemato-Oncology, Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Dae Young Zang
- Division of Hemato-Oncology, Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea
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Byun JH, Ahn JB, Kim SY, Kang JH, Zang DY, Kang SY, Kang MJ, Shim BY, Baek SK, Kim BS, Lee KH, Lee SI, Cho SH, Sohn BS, Kim S, Hwang IG, Nam EM, Seo BG, Oh SC, Lee MA, Lee SC, Hong JH, Park YS. The impact of primary tumor location in patients with metastatic colorectal cancer: a Korean Cancer Study Group CO12-04 study. Korean J Intern Med 2019; 34:165-177. [PMID: 29172407 PMCID: PMC6325446 DOI: 10.3904/kjim.2016.348] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 05/17/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND/AIMS Colorectal cancer is associated with different anatomical, biological, and clinical characteristics. We determined the impact of the primary tumor location in patients with metastatic colorectal cancer (mCRC). METHODS Demographic data and clinical information were collected from 1,115 patients from the Republic of Korea, who presented with mCRC between January 2009 and December 2011, using web-based electronic case report forms. Associations between the primary tumor location and the patient's clinical characteristics were assessed, and factors inf luencing overall survival were analyzed using Cox proportional hazards regression models. RESULTS Of the 1,115 patients recruited to the study, 244 (21.9%) had right colon cancer, 483 (43.3%) had left colon cancer, and 388 (34.8%) had rectal cancer. Liver and lung metastases occurred more frequently in patients with left colon and rectal cancer (p = 0.005 and p = 0.006, respectively), while peritoneal and ovarian metastases occurred more frequently in patients with right and left colon cancer (p < 0.001 and p = 0.031, respectively). The median overall survival of patients with tumors originating in the right colon was significantly shorter than that of patients whose tumors had originated in the left colon or rectum (13.7 months [95% confidence interval (CI), 12.0 to 15.5] vs. 18.0 months [95% CI, 16.3 to 19.7] or 19.9 months [95% CI, 18.5 to 21.3], respectively; p = 0.003). Tumor resection, the number of metastatic sites, and primary tumor location correlated with overall survival in the univariate and multivariate analyses. CONCLUSION Primary tumor location influences the metastatic sites and prognosis of patients with mCRC.
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Affiliation(s)
- Jae Ho Byun
- Department of Internal Medicine, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea
| | - Joong Bae Ahn
- Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Young Kim
- Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
| | - Jung Hun Kang
- Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Seok Yun Kang
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Myoung Joo Kang
- Department of Hemato-Oncology, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Byoung Yong Shim
- Department of Internal Medicine, College of Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea
| | - Sun Kyung Baek
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Bong-Seog Kim
- Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Kyung Hee Lee
- Division of OncologyHematology, Department of Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Soon Il Lee
- Department of Internal Medicine, Dankook University Hospital, Cheonan, Korea
| | - Sang-Hee Cho
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Byeong Seok Sohn
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Samyong Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - In Gyu Hwang
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Eun Mi Nam
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Bong-Gun Seo
- Department of Internal Medicine, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea
| | - Sang Cheul Oh
- Division of Oncology-Hematology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Myung-Ah Lee
- Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Sang-Cheol Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Ji Hyung Hong
- Department of Internal Medicine, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea
| | - Young Suk Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Correspondence to Young Suk Park, M.D. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnamgu, Seoul 06351, Korea Tel: +82-2-3410-3454, Fax: +82-2-3410-1754, E-mail:
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Kim JW, Kim JG, Kang BW, Chung IJ, Hong YS, Kim TY, Song HS, Lee KH, Zang DY, Ko YH, Song EK, Baek JH, Koo DH, Oh SY, Cho H, Lee KW. Treatment Patterns and Changes in Quality of Life during First-Line Palliative Chemotherapy in Korean Patients with Advanced Gastric Cancer. Cancer Res Treat 2018; 51:223-239. [PMID: 30584995 PMCID: PMC6333995 DOI: 10.4143/crt.2018.073] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/23/2018] [Indexed: 12/14/2022] Open
Abstract
Purpose The purpose of this study was to evaluate chemotherapy patterns and changes in quality of life (QOL) during first-line palliative chemotherapy for Korean patients with unresectable or metastatic/recurrent gastric cancer (GC). Materials and Methods Thiswas a non-interventional, multi-center, prospective, observational study of 527 patients in Korea. QOL assessments were conducted using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaires (QLQ)-C30 and QLQ-STO22 every 3 months over a 12-month period during first-line palliative chemotherapy. The specific chemotherapy regimens were selected by individual clinicians. Results Most patients (93.2%) received combination chemotherapy (mainly fluoropyrimidine plus platinum) as their first-line palliative chemotherapy. The median progression-free survival and overall survival were 8.2 and 14.8 months, respectively. Overall, “a little” changes (differences of 5-10 points from baseline)were observed in some of the functioning or symptom scales; none of the QOL scales showed either “moderate” or “very much” change (i.e., ≥ 11 point difference from baseline). When examining the best change in each QOL domain from baseline, scales related to some aspects of functioning, global health status/QOL, and most symptoms revealed significant improvements (p < 0.05). Throughout the course of first-line palliative chemotherapy, most patients’ QOL was maintained to a similar degree, regardless of their actual response to chemotherapy. Conclusion This observational study provides important information on the chemotherapy patterns and QOL changes in Korean patientswith advanced GC. Overall, first-line palliative chemotherapy was found to maintain QOL, and most parameters showed an improvement compared with the baseline at some point during the course.
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Affiliation(s)
- Jin Won Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jong Gwang Kim
- Department of Oncology/Hematology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Byung Woog Kang
- Department of Oncology/Hematology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ik-Joo Chung
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine, Hwasun, Korea
| | - Young Seon Hong
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tae-You Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hong Suk Song
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea
| | - Kyung Hee Lee
- Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Medical Center, Hallym University, Anyang, Korea
| | - Yoon Ho Ko
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Eun-Kee Song
- Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| | - Jin Ho Baek
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Dong-Hoe Koo
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So Yeon Oh
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Yangsan, Korea
| | - Hana Cho
- Medical Department of Genzyme, Sanofi Korea, Seoul, Korea
| | - Keun-Wook Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Jung M, Ryu MH, Oh DY, Kang M, Zang DY, Hwang IG, Lee KW, Kim KH, Shim BY, Song EK, Sym SJ, Han HS, Park YL, Kim JS, Lee HW, Lee MH, Koo DH, Song HS, Lee N, Yang SH, Choi DR, Hong YS, Lee KE, Maeng CH, Baek JH, Kim S, Kim YH, Rha SY, Cho JY, Kang YK. Efficacy and tolerability of ramucirumab monotherapy or in combination with paclitaxel in gastric cancer patients from the Expanded Access Program Cohort by the Korean Cancer Study Group (KCSG). Gastric Cancer 2018; 21:819-830. [PMID: 29427038 DOI: 10.1007/s10120-018-0806-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/30/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Ramucirumab improves survival in gastric cancer patients. The efficacy and safety of ramucirumab outside of a clinical trial were evaluated using an expanded access program (EAP). METHODS Advanced gastric cancer patients treated with ramucirumab in combination with paclitaxel or with ramucirumab monotherapy in a Korean EAP were evaluated. Baseline characteristics were assessed for progression-free survival (PFS) and overall survival (OS), and adverse events were evaluated according to the treatment regimen. RESULTS Of 265 patients, 228 received ramucirumab plus paclitaxel, and 37 received ramucirumab monotherapy. Grade 3 or 4 neutropenia was more common with ramucirumab plus paclitaxel than with ramucirumab monotherapy (46.7 vs. 8.1%). Gastrointestinal (GI) perforation developed in seven patients (3.1%) in the ramucirumab plus paclitaxel group. The overall response and disease control rates were 16.6 and 66.3% in the ramucirumab plus paclitaxel group, and 5.4 and 37.8% in the ramucirumab monotherapy group, respectively. PFS and OS were 3.8 and 8.6 months in the ramucirumab plus paclitaxel group, and 1.8 and 6.4 months in the ramucirumab monotherapy group, respectively. In multivariate analysis, alkaline phosphatase, albumin, and neutrophil-to-lymphocyte ratio (NLR) were the independent prognostic factors for PFS, while albumin, NLR, number of metastatic sites, and large amount of ascites were independent prognostic factors for OS. CONCLUSION In the Korean EAP cohort, ramucirumab showed similar efficacy to the results of the previous trials for gastric cancer. However, the level of GI perforation was slightly increased in the ramucirumab plus paclitaxel group.
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Affiliation(s)
- Minkyu Jung
- Division of Medical Oncology, Yonsei Cancer Center, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-gu, Seoul, South Korea
| | - Min-Hee Ryu
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Do Youn Oh
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Myounghee Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - Dae Young Zang
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - In Gyu Hwang
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Keun-Wook Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Ki Hyang Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Byoung Yong Shim
- Department of Medical Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea
| | - Eun Kee Song
- Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, South Korea
| | - Sun Jin Sym
- Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Hye Sook Han
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Young Lee Park
- Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea
| | - Jin Soo Kim
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hyun Woo Lee
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, South Korea
| | - Moon Hee Lee
- Division of Hematology-Oncology, Inha University Hospital and College of Medicine, Incheon, South Korea
| | - Dong-Hoe Koo
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hong Suk Song
- Department of Internal Medicine, Dongsan Medical Center, Keimyung University, Daegu, South Korea
| | - Namsu Lee
- Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Sung Hyun Yang
- Division of Hematology and Oncology, Department of Internal Medicine, Korea Cancer Center Hospital Korea, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Dae Ro Choi
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Chuncheon, South Korea
| | - Young Seon Hong
- Division of Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kyoung Eun Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Chi Hoon Maeng
- Division of Hematology-Oncology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jin Ho Baek
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Samyong Kim
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Yeul Hong Kim
- Department of Internal Medicine, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sun Young Rha
- Division of Medical Oncology, Yonsei Cancer Center, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-gu, Seoul, South Korea.
| | - Jae Yong Cho
- Division of Medical Oncology, Gangnam Severance Hospital, Department of Internal Medicine, Yonsei University College of Medicine, 712 Eonjuro, Gangnam-gu, Seoul, 06237, South Korea.
| | - Yoon-Koo Kang
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Kim HS, Ryu MH, Zang DY, Park SR, Han B, Kang WK, Rha SY, Jung M, Kim JS, Kang BW, Lee KH, Rho SY, Kim JH, Kim KC, Cho JW, Choi DR, Lim H, Kang HS, Soh JS, Kim MJ, Seo J, Kang YK. Phase II study of oxaliplatin, irinotecan and S-1 therapy in patients with advanced gastric cancer: the Korean Cancer Study Group ST14-11. Gastric Cancer 2018; 21:802-810. [PMID: 29372461 DOI: 10.1007/s10120-018-0794-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/11/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Doublet chemotherapy of platinum and 5-fluorouracil is a standard first-line treatment for patients with unresectable gastric cancer. Although the addition of taxane or irinotecan to this regimen has yielded promising efficacy, its use has been limited due to severe toxicities. To overcome this limitation, we evaluated the efficacy and safety of the combination of irinotecan, oxaliplatin, and S-1 (OIS) for the treatment of advanced gastric cancer. METHODS Chemotherapy-naïve patients with pathologically proven advanced gastric adenocarcinoma were assessed for eligibility. Irinotecan (135 mg/m2) and oxaliplatin (65 mg/m2) were administered intravenously on day 1, and S-1 (80 mg/m2/day) was administered orally on days 1-7 of every 2-week cycle. RESULTS Forty-four patients (median age 57 years) were enrolled and all but one patient had a good performance status (ECOG 0 or 1). A total of 529 cycles were administered, with a median of 9.5 (range 1-31) cycles per patient. The overall response rate was 61.4% (95% confidence interval [CI] 46.6-74.3). The median progression-free survival and overall survival were 10.8 months (95% CI 7.6-14.0) and 15.4 months (95% CI 12.6-18.2), respectively. Major toxicities included grade 3/4 neutropenia (38.6%), febrile neutropenia (13.6%), abdominal pain (9.1%), and diarrhea (9.1%). CONCLUSION These data suggest that the OIS regimen is effective and relatively well tolerated in patients with advanced gastric cancer. Given that all the patients treated, but one, had a good performance status, these results must be confirmed in a patient population more representative of regular clinical practice. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02527785.
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Affiliation(s)
- Hyeong Su Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Republic of Korea
| | - Min-Hee Ryu
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Republic of Korea. .,Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang-si, 14086, Republic of Korea.
| | - Sook Ryun Park
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Boram Han
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Republic of Korea
| | - Won Ki Kang
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sun Young Rha
- Department of Medical Oncology, Yonsei Cancer Center, College of Medicine Yonsei University, Seoul, Republic of Korea
| | - Minkyu Jung
- Department of Medical Oncology, Yonsei Cancer Center, College of Medicine Yonsei University, Seoul, Republic of Korea
| | - Jin-Soo Kim
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Byung Woog Kang
- Department of Oncology/Hematology, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Kyung-Hee Lee
- Department of Hematology-Oncology, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Sang-Young Rho
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Jung Han Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Republic of Korea
| | - Kab Choong Kim
- Department of Surgery, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Republic of Korea
| | - Ji Woong Cho
- Department of Surgery, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Republic of Korea
| | - Dae Ro Choi
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Republic of Korea
| | - Hyun Lim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Republic of Korea
| | - Ho Suk Kang
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Republic of Korea
| | - Jae Seung Soh
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Republic of Korea
| | - Min-Jeong Kim
- Department of Radiology, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Republic of Korea
| | - Jinwon Seo
- Department of Pathology, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Republic of Korea
| | - Yoon-Koo Kang
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kim HS, Kim JH, Jang HJ, Han B, Zang DY. Clinicopathologic Significance of VHL Gene Alteration in Clear-Cell Renal Cell Carcinoma: An Updated Meta-Analysis and Review. Int J Mol Sci 2018; 19:ijms19092529. [PMID: 30149673 PMCID: PMC6165550 DOI: 10.3390/ijms19092529] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 08/18/2018] [Accepted: 08/24/2018] [Indexed: 01/10/2023] Open
Abstract
The von Hippel-Lindau (VHL) gene is inactivated frequently in sporadic clear-cell renal cell carcinomas (ccRCCs) by genetic alteration (mutation, loss of heterozygosity, or promoter hypermethylation). However, the pathological or prognostic significance of VHL gene alteration has not been well defined. We conducted this meta-analysis to evaluate the association between VHL alteration and clinopathologic findings in ccRCCs. We performed a systematic computerized search of online databases, including PubMed, EMBASE, Web of Science, and Google Scholar (up to July 2018). From ten studies, 1,082 patients were included in the pooled analyses of odds ratios (ORs) with 95% confidence intervals (CIs) for pathological features (nuclear grade and disease stage) or hazard ratios (HRs) with 95% CIs for overall survival (OS). VHL alteration was not significantly associated with nuclear grade (OR = 0.79, 95% CI: 0.59–1.06, p = 0.12) or disease stage (OR = 1.07, 95% CI: 0.79–1.46, p = 0.65). There was also no significant correlation between VHL alteration and OS (HR = 0.75, 95% CI: 0.43–1.29, p = 0.30). When we pooled HRs for OS according to the VHL alteration types, the combined HRs were 0.72 (95% CI: 0.47–1.11, p = 0.14) for VHL mutations and 1.32 (95% CI: 0.70–2.47, p = 0.39) for methylation. In conclusion, this meta-analysis indicates that VHL gene alteration is not significantly associated with the pathological features and survival in patients with ccRCC.
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Affiliation(s)
- Hyeong Su Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Korea.
| | - Jung Han Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Korea.
| | - Hyun Joo Jang
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Korea.
| | - Boram Han
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Korea.
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Korea.
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Lee KW, Maeng CH, Kim TY, Zang DY, Kim YH, Hwang IG, Oh SC, Chung JS, Song HS, Kim JW, Jeong SJ, Cho JY. A Phase III Study to Compare the Efficacy and Safety of Paclitaxel Versus Irinotecan in Patients with Metastatic or Recurrent Gastric Cancer Who Failed in First-line Therapy (KCSG ST10-01). Oncologist 2018; 24:18-e24. [PMID: 30126861 PMCID: PMC6324622 DOI: 10.1634/theoncologist.2018-0142] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/28/2018] [Indexed: 01/13/2023] Open
Abstract
Lessons Learned. Irinotecan could not be proven noninferior to paclitaxel as a second‐line treatment for patients with metastatic or recurrent gastric cancer. The failure to demonstrate noninferiority may have been a result of insufficient patient enrollment. Both agents were tolerable but showed different toxicity profiles.
Background. This phase III study compared the efficacy and safety of paclitaxel versus irinotecan in patients with metastatic or recurrent gastric cancer (MRGC) who had experienced disease progression following first‐line chemotherapy. Methods. Patients were randomized to receive either paclitaxel (70 mg/m2; days 1, 8, 15, every 4 weeks) or irinotecan (150 mg/m2 every other week). The primary endpoint was progression‐free survival (PFS). Results. This study was stopped early due to low accrual rate. A total of 112 patients were enrolled; 54 were allocated to paclitaxel and 58 to irinotecan. Median PFS for the paclitaxel and irinotecan groups was 3.5 and 2.1 months, respectively (hazard ratio [HR], 1.27; 95% confidence interval [CI], 0.86–1.88; p = .234). Noninferiority of irinotecan to paclitaxel was not proved because the upper boundary of the 95% CI (1.88) exceeded the predefined upper margin of noninferiority (1.32). Median overall survival (OS) was 8.6 months in the paclitaxel group and 7.0 months in the irinotecan group (HR, 1.39; 95% CI, 0.91–2.11; p = .126). Among toxicities greater than or equal to grade 3, neutropenia (11.5%) was the most common, followed by peripheral neuropathy (7.7%) in the paclitaxel group, and neutropenia (34.5%) followed by nausea, vomiting, and anemia (8.6%, respectively) in the irinotecan group. Conclusion. Although paclitaxel showed numerically longer PFS and OS compared with irinotecan, this was statistically insignificant. Both irinotecan and paclitaxel are valid second‐line treatment options in MRGC.
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Affiliation(s)
- Keun-Wook Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Chi Hoon Maeng
- Division of Medical Oncology-Hematology, Department of Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Tae-You Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Young Zang
- Division of Hematology and Oncology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Yeul Hong Kim
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - In Gyu Hwang
- Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sang Cheul Oh
- Division of Hematology/Oncology, Internal Medicine Department, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea
| | - Joo Seop Chung
- Department of Internal Medicine, Hemato-Oncology, Pusan National University Hospital, College of Medicine Pusan National University, Busan, Korea
| | - Hong Suk Song
- Section of Hemato-Oncology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jin Won Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Su Jin Jeong
- Statistics Support Department, Medical Science Research Institute, Kyung Hee University Hospital, Seoul, Korea
| | - Jae Yong Cho
- Department of Medical Oncology, Division of Internal Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
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Park SH, Lee J, Lim DH, Kim KM, An JY, Choi MG, Lee JH, Sohn TS, Bae JM, Kim S, Ji JH, Hwang IG, Kang JH, Zang DY, Shin DB, Oh SY, Kang WK. Results from the safety interim analysis of the Adjuvant chemoRadioTherapy In Stomach Tumors 2 (ARTIST 2) randomized, multi-center clinical trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e16029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Se Hoon Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South)
| | - Jeeyun Lee
- Samsung Medical Center, Seoul, Korea, Republic of (South)
| | - Do Hoon Lim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South)
| | - Kyoung-Mee Kim
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South)
| | - Ji Yeong An
- Samsung Medical Center, Seoul, Republic of Korea
| | - Min-Gew Choi
- Samsung Medical Center, Seoul, Republic of Korea
| | - Jun-Ho Lee
- Samsung Medical Center, Seoul, Republic of Korea
| | - Tae Sung Sohn
- Samsung Medical Center, Seoul, Korea, Republic of (South)
| | - Jae-Moon Bae
- Samsung Medical Center, Seoul, Korea, Republic of (South)
| | - Sung Kim
- Department of Surgery, Samsung Medical Center, Seoul, Korea, Republic of (South)
| | - Jun Ho Ji
- Samsung Changwon Hospital, Changwon, Korea, Republic of (South)
| | - In Gyu Hwang
- Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Jung Hun Kang
- Gyengsang National University Hospital, Jinju, Korea, Republic of (South)
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Dong Bok Shin
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea, Republic of (South)
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea, Republic of (South)
| | - Won Ki Kang
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South)
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Noh H, Jung SY, Kwak J, Kim S, Oh SJ, Zang DY, Lee S, Park HL, Jo DJ, Shin JS, Do YR, Kim D, Lee JI. Determination of a radotinib dosage regimen based on dose-response relationships for the treatment of newly diagnosed patients with chronic myeloid leukemia. Cancer Med 2018; 7:1766-1773. [PMID: 29577681 PMCID: PMC5943471 DOI: 10.1002/cam4.1436] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/13/2018] [Accepted: 02/17/2018] [Indexed: 01/14/2023] Open
Abstract
Radotinib is a second-generation BCR-ABL1 tyrosine kinase inhibitor approved for the treatment of chronic myeloid leukemia in chronic phase (CP-CML). Here, using the data from a Phase 3 study conducted in patients with newly diagnosed CP-CML, the dose-efficacy as well as dose-safety relationship analyses were performed to determine a safe and effective initial dosage regimen of radotinib. A significant positive association was detected between the starting dose of radotinib adjusted for body weight (Dose/BW) and the probability of dose-limiting toxicity (≥grade 3 hematologic and nonhematologic toxicity) (P = 0.003). In contrast, a significant inverse association was discovered between Dose/BW and the probability of major molecular response (BCR-ABL1/ABL1 ≤ 0.1%) when controlled for sex (P = 0.033). Moreover, frequent dose interruptions and reductions secondary to radotinib toxicities occurred in the Phase 3 study, resulting in nearly half (44%) of patients receiving a reduced dose at a 12-month follow-up. In conclusion, the results of this study demonstrate the need for initial radotinib dose attenuation to improve the long-term efficacy and safety of radotinib. Hence, the authors suggest a new upfront radotinib dose of 400 mg once daily be tested in patients with newly diagnosed CP-CML.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Benzamides/administration & dosage
- Benzamides/adverse effects
- Dose-Response Relationship, Drug
- Drug Dosage Calculations
- Female
- Fusion Proteins, bcr-abl/genetics
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Middle Aged
- Molecular Weight
- Pyrazines/administration & dosage
- Pyrazines/adverse effects
- Treatment Outcome
- Young Adult
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Affiliation(s)
- Hayeon Noh
- Department of PharmacyCollege of PharmacyYonsei UniversityIncheonKorea
| | - Su Young Jung
- Department of PharmacyCollege of PharmacySeoul National UniversitySeoulKorea
- Research Institute of Pharmaceutical SciencesSeoul National UniversitySeoulKorea
| | - Jae‐Yong Kwak
- Chonbuk National University Medical School & HospitalJeonjuKorea
| | - Sung‐Hyun Kim
- Department of Internal MedicineDong‐A University College of MedicineBusanKorea
| | - Suk Joong Oh
- Department of Internal MedicineKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea
| | - Dae Young Zang
- Department of Internal MedicineHallym University Sacred Heart HospitalAnyangKorea
| | - Suhyun Lee
- Department of PharmacyCollege of PharmacySeoul National UniversitySeoulKorea
- Research Institute of Pharmaceutical SciencesSeoul National UniversitySeoulKorea
| | - Hye Lin Park
- Central Research InstituteIL‐YANG Pharmaceutical Co., Ltd.YonginKorea
| | - Dae Jin Jo
- Central Research InstituteIL‐YANG Pharmaceutical Co., Ltd.YonginKorea
| | - Jae Soo Shin
- Central Research InstituteIL‐YANG Pharmaceutical Co., Ltd.YonginKorea
| | - Young Rok Do
- Department of MedicineDongsan Medical CenterKeimyung UniversityDaeguKorea
| | - Dong‐Wook Kim
- Seoul St. Mary's HospitalLeukemia Research InstituteThe Catholic University of KoreaSeoulKorea
| | - Jangik I. Lee
- Department of PharmacyCollege of PharmacySeoul National UniversitySeoulKorea
- Research Institute of Pharmaceutical SciencesSeoul National UniversitySeoulKorea
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Kim SY, Joo J, Kim TW, Hong YS, Kim JE, Hwang IG, Kim BG, Lee KW, Kim JW, Oh HS, Ahn JB, Zang DY, Kim DY, Oh JH, Baek JY. A Randomized Phase 2 Trial of Consolidation Chemotherapy After Preoperative Chemoradiation Therapy Versus Chemoradiation Therapy Alone for Locally Advanced Rectal Cancer: KCSG CO 14-03. Int J Radiat Oncol Biol Phys 2018; 101:889-899. [PMID: 29976501 DOI: 10.1016/j.ijrobp.2018.04.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 04/01/2018] [Accepted: 04/04/2018] [Indexed: 02/08/2023]
Abstract
PURPOSE Preoperative chemoradiation therapy (CRT) followed by total mesorectal excision (TME) in locally advanced rectal cancer is the standard of care. To date, the role of consolidation chemotherapy after CRT has rarely been addressed through randomized trials. This study aimed to evaluate the efficacy of CRT followed by consolidation chemotherapy compared with CRT alone. METHODS AND MATERIALS This study enrolled patients with adenocarcinoma of the rectum and cT3 or cT4 disease with any N category and no metastasis. In arm A (control arm), we planned CRT (50.4 Gy in 28 fractions) with capecitabine followed by TME. In arm B, 2 cycles of capecitabine and oxaliplatin were administered 1 week after the completion of CRT before TME (capecitabine, 1700 mg/m2 per day from day 1 to 14, and oxaliplatin, 100 mg/m2 on day 1, every 3 weeks). The downstaging rate (the proportion of ypT0 to ypT2 and ypN0M0) was the primary endpoint, which was to be tested with a 1-sided type I error of 15% and with 85% power. RESULTS From September 2014 to February 2016, 110 patients (56 in arm A and 54 in arm B) were randomized and 108 (55 in arm A and 53 in arm B) started CRT. TME was conducted per protocol in 96 patients (52 in arm A and 44 in arm B). In arms A and B, downstaging was achieved in 21.2% and 36.4% (P = .077), respectively, and the pathologic complete response rate was 5.8% and 13.6% (P = .167), respectively. Grade ≥3 adverse events occurred in 3.6% of patients in arm A and 9.4% of patients in arm B during the preoperative treatment phase and in 1.9% and 9.0%, respectively, during the postoperative recovery phase. CONCLUSIONS Consolidation chemotherapy with 2 cycles of capecitabine and oxaliplatin demonstrated a marginal improvement in the downstaging rate. However, a phase 3 trial of this strategy is discouraged because of the high dropout rate and safety issues.
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Affiliation(s)
- Sun Young Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jungnam Joo
- Biometric Research Branch, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Tae Won Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong Sang Hong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong Eun Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - In Gyu Hwang
- Division of Hematology/Oncology, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Beom Gyu Kim
- Department of Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Keun-Wook Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Ji-Won Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Ho-Suk Oh
- Department of Internal Medicine, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Joong Bae Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dae Young Zang
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Dae Yong Kim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Jae Hwan Oh
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Ji Yeon Baek
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
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Lee CK, Jung M, Kim HS, Jung I, Shin DB, Kang SY, Zang DY, Kim KH, Lee MH, Kim BS, Lee KH, Cheong JH, Hyung WJ, Noh SH, Chung HC, Rha SY. S-1 Based Doublet as an Adjuvant Chemotherapy for Curatively Resected Stage III Gastric Cancer: Results from the Randomized Phase III POST Trial. Cancer Res Treat 2018; 51:1-11. [PMID: 29397659 PMCID: PMC6333977 DOI: 10.4143/crt.2018.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 01/30/2018] [Indexed: 11/21/2022] Open
Abstract
Purpose We conducted a randomized, multicenter, phase III trial to compare S-1 plus docetaxel (DS) with S-1 plus cisplatin (SP) as adjuvant chemotherapy for stage III gastric cancer patients. Materials and Methods Stage III gastric cancer patients who had received curative gastrectomy with D2 lymphadenectomy were randomized into equal groups to receive adjuvant chemotherapy of eight cycles of DS (S-1 70 mg/m2/day on days 1-14 plus docetaxel 35 mg/m2on days 1 and 8) every 3 weeks or SP (S-1 70 mg/m2/day on days 1-14 plus cisplatin 60 mg/m2on day 1) every 3 weeks. The primary endpoint was 3-year disease-free survival (DFS) rate. Results Between November 2010 and July 2013, 153 patients (75 patients to DS and 78 patients to SP) were enrolled from 8 institutions in Korea. After the capecitabine plus oxaliplatin was approved based on the CLASSIC study, itwas decided to close the study early. With a median follow-up duration of 56.9 months, the 3-year DFS rate between two groups was not significantly different (49.14% in DS group vs. 52.5% in SP group). The most common grade 3-4 adverse event was neutropenia (42.7% in DS and 38.5% in SP, p=0.351). SP group had more grade 3-4 anemia (1.3% vs. 11.5%, p=0.037), whereas grade 3-4 hand-foot syndrome (4.1% vs. 0%, p=0.025) and mucositis (10.7% vs. 2.6%, p=0.001) were more common in DS group. Fifty-one patients (68%) in DS group and 52 (66.7%) in SP group finished planned treatment. Conclusion Our findings suggest that SP or DS is an effective and tolerable option for patients with curatively resected stage III gastric cancer.
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Affiliation(s)
- Choong-Kun Lee
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Minkyu Jung
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Hyo Song Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Inkyung Jung
- Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Bok Shin
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - Seok Yun Kang
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Dae Young Zang
- Division of Hemato-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, Korea
| | - Ki Hyang Kim
- Division of HematologyOncology, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Moon Hee Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Bong-Seog Kim
- Division of HematoOncology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Kyung Hee Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jae-Ho Cheong
- Department of Surgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Woo Jin Hyung
- Department of Surgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Hoon Noh
- Department of Surgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Cheol Chung
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.,Song-Dang Institutefor Cancer Research, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Young Rha
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.,Song-Dang Institutefor Cancer Research, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
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Yoo C, Han B, Kim HS, Kim KP, Kim D, Jeong JH, Lee JL, Kim TW, Kim JH, Choi DR, Ha HI, Seo J, Chang HM, Ryoo BY, Zang DY. Multicenter Phase II Study of Oxaliplatin, Irinotecan, and S-1 as First-line Treatment for Patients with Recurrent or Metastatic Biliary Tract Cancer. Cancer Res Treat 2018; 50:1324-1330. [PMID: 29334603 PMCID: PMC6192931 DOI: 10.4143/crt.2017.526] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 01/04/2018] [Indexed: 12/28/2022] Open
Abstract
Purpose Although gemcitabine plus cisplatin has been established as the standard first-line chemotherapy for patients with advanced biliary tract cancer (BTC), overall prognosis remains poor. We investigated the efficacy of a novel triplet combination of oxaliplatin, irinotecan, and S-1 (OIS) for advanced BTC. Materials and Methods Chemotherapy-naive patientswith histologically documented unresectable or metastatic BTC were eligible for this multicenter, single-arm phase II study. Patients received 65 mg/m2 oxaliplatin (day 1), 135 mg/m2 irinotecan (day 1), and 40 mg/m2 S-1 (twice a day, days 1-7) every 2 weeks. Primary endpoint was objective response rate. Targeted exome sequencing for biomarker analysis was performed using archival tissue. Results In total, 32 patients were enrolled between October 2015 and June 2016. Median age was 64 years (range, 40 to 76 years), with 24 (75%) male patients; 97% patients had metastatic or recurrent disease. Response rate was 50%, and median progression-free survival and overall survival (OS) were 6.8 months (95% confidence interval [CI], 4.8 to 8.8) and 12.5 months (95% CI, 7.0 to 18.0), respectively. The most common grade 3-4 adverse events were neutropenia (32%), diarrhea (6%), and peripheral neuropathy (6%). TP53 and KRAS mutations were the most frequent genomic alterations (42% and 32%, respectively), and KRAS mutations showed a marginal relationship with worse OS (p=0.07). Conclusion OIS combination chemotherapy was feasible and associated with favorable efficacy outcomes as a first-line treatment in patients with advanced BTC. Randomized studies are needed to compare OIS with gemcitabine plus cisplatin.
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Affiliation(s)
- Changhoon Yoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Boram Han
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hyeong Su Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Kyu-Pyo Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deokhoon Kim
- Asan Institute for Life Science, University of Ulsan College of Medicine, Seoul, Korea.,Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Ho Jeong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Lyun Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Won Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Han Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Dae Ro Choi
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hong Il Ha
- Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Jinwon Seo
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Heung-Moon Chang
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Baek-Yeol Ryoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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Lee KW, Zang DY, Ryu MH, Kim KH, Kim MJ, Han HS, Koh SA, Park JH, Kim JW, Nam BH, Choi IS. Comparison of efficacy and tolerance between combination therapy and monotherapy as first-line chemotherapy in elderly patients with advanced gastric cancer: Study protocol for a randomized controlled trial. Contemp Clin Trials Commun 2017; 8:55-61. [PMID: 29696197 PMCID: PMC5898575 DOI: 10.1016/j.conctc.2017.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 08/11/2017] [Accepted: 08/15/2017] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The combination of a fluoropyrimidine [5-fluorouracil (5-FU), capecitabine, or S-1] with a platinum analog (cisplatin or oxaliplatin) is the most widely accepted first-line chemotherapy regimen for metastatic or recurrent advanced gastric cancer (AGC), based on the results of clinical trials. However, there is little evidence to guide chemotherapy for elderly patients with AGC because of under-representation of this age group in clinical trials. Thus, the aim of this study is to determine the optimal chemotherapy regimen for elderly patients with AGC by comparing the efficacies and safeties of combination therapy versus monotherapy as first-line chemotherapy. METHODS This study is a randomized, controlled, multicenter, phase III trial. A total of 246 elderly patients (≥70 years old) with metastatic or recurrent AGC who have not received previous palliative chemotherapy will be randomly allocated to a combination therapy group or a monotherapy group. Patients randomized to the combination therapy group will receive fluoropyrimidine plus platinum combination chemotherapy (capecitabine/cisplatin, S-1/cisplatin, capecitabine/oxaliplatin, or 5-FU/oxaliplatin), and those randomized to the monotherapy group will receive fluoropyrimidine monotherapy (capecitabine, S-1, or 5-FU). The primary outcome is the overall survival of patients in each treatment group. The secondary outcomes include progression-free survival, response rate, quality of life, and safety. DISCUSSION We are conducting this pragmatic trial to determine whether elderly patients with AGC will obtain the same benefit from chemotherapy as younger patients. We expect that this study will help guide decision-making for the optimal treatment of elderly patients with AGC.
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Key Words
- 5-FU, 5-fluorouracil
- ADL, activities of daily living
- AGC, advanced gastric cancer
- AST/ALT, aspartate aminotransferase/alanine aminotransferase
- CCr, creatinine clearance
- CGA, comprehensive geriatric assessment
- CI, confidence interval
- CRF, case report form
- CT, computed tomography
- Chemotherapy
- DSMB, data safety monitoring board
- ECOG, Eastern Cooperative Oncology Group
- EORTC QLQ-C30, European Organization for Research and Treatment of Cancer core quality of life questionnaire
- EORTC QLQ-STO22, European Organization for Research and Treatment of Cancer quality of life questionnaire-gastric
- Elderly
- FAS, full analysis set
- Gastric cancer
- HER-2, human epidermal growth factor receptor-2
- HR, hazard ratio
- IADL, independent activities of daily living
- IIT, intent to treat
- KCSG, Korean Cancer Study Group
- KG-7, Korean Cancer Study Group geriatric tool
- KPS, Karnofsky performance status
- NCI CTCAE, National Cancer Institute Common Terminology Criteria for Adverse Events
- OS, overall survival
- PFS, progression-free survival
- PPS, per-protocol set
- PS, performance status
- QoL, quality of life
- RCT, randomized controlled trial
- RECIST, Response Evaluation Criteria in Solid Tumors
- RR, response rate
- Randomized controlled trial
- SAE, serious adverse event
- SEER, Surveillance, Epidemiology, and End Results
- UNL, upper normal limit
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Affiliation(s)
- Keun-Wook Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Min-Hee Ryu
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ki Hyang Kim
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, South Korea
| | - Mi-Jung Kim
- Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Hye Sook Han
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Sung Ae Koh
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, South Korea
| | - Jin Hyun Park
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Jin Won Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Byung-Ho Nam
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - In Sil Choi
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
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Kwak JY, Kim SH, Oh SJ, Zang DY, Kim H, Kim JA, Do YR, Kim HJ, Park JS, Choi CW, Lee WS, Mun YC, Kong JH, Chung JS, Shin HJ, Kim DY, Park J, Jung CW, Bunworasate U, Comia NS, Jootar S, Reksodiputro AH, Caguioa PB, Lee SE, Kim DW. Phase III Clinical Trial (RERISE study) Results of Efficacy and Safety of Radotinib Compared with Imatinib in Newly Diagnosed Chronic Phase Chronic Myeloid Leukemia. Clin Cancer Res 2017; 23:7180-7188. [PMID: 28939746 DOI: 10.1158/1078-0432.ccr-17-0957] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/27/2017] [Accepted: 09/15/2017] [Indexed: 11/16/2022]
Abstract
Purpose: Radotinib is a second-generation BCR-ABL1 tyrosine kinase inhibitor (TKI) approved in Korea for chronic phase chronic myeloid leukemia (CML-CP) in patients newly diagnosed or with insufficient response to other TKIs. This study was conducted to evaluate the efficacy and safety of radotinib as first-line therapy for CML-CP.Experimental Design: This multinational, open-label study assigned patients (1:1:1) to one of two twice-daily radotinib doses, or imatinib daily. The primary endpoint was major molecular response (MMR) by 12 months.Results: Two hundred forty-one patients were randomized to receive radotinib 300 mg (n = 79) or 400 mg twice-daily (n = 81), or imatinib 400 mg daily (n = 81). MMR rates by 12 months were higher in patients receiving radotinib 300 mg (52%) or radotinib 400 mg twice-daily (46%) versus imatinib (30%; P = 0.0044 and P = 0.0342, respectively). Complete cytogenetic response (CCyR) rates by 12 months were higher for radotinib 300 mg (91%) versus imatinib (77%; P = 0.0120). Early molecular response at 3 months occurred in 86% and 87% of patients receiving radotinib 300 mg and radotinib 400 mg, respectively, and 71% of those receiving imatinib. By 12 months, no patients had progression to accelerated phase or blast crisis. Most adverse events were manageable with dose reduction.Conclusions: Radotinib demonstrated superiority over imatinib in CCyR and MMR in patients newly diagnosed with Philadelphia chromosome-positive CML-CP. This trial was registered at www.clinicaltrials.gov as NCT01511289 Clin Cancer Res; 23(23); 7180-8. ©2017 AACR.
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Affiliation(s)
- Jae-Yong Kwak
- Chonbuk National University Medical School & Hospital, Jeonju, South Korea
| | - Sung-Hyun Kim
- Dong-A University Medical Center, Busan, South Korea
| | - Suk Joong Oh
- Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dae Young Zang
- Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Hawk Kim
- Ulsan University Hospital, Ulsan, South Korea
| | - Jeong-A Kim
- St. Vincent Hospital, The Catholic University of Korea, Suwon, South Korea
| | - Young Rok Do
- Dongsan Medical Center, Keimyung University, Daegu, South Korea
| | - Hyeoung Joon Kim
- Chonnam National University, Hwasun Hospital, Hwasun, South Korea
| | | | | | - Won Sik Lee
- Inje University Busan Paik Hospital, Busan, South Korea
| | - Yeung-Chul Mun
- Ewha Womans University Mokdong Hospital, Seoul, South Korea
| | - Jee Hyun Kong
- Wonju Severance Christian Hospital, Wonju, South Korea
| | | | - Ho-Jin Shin
- Pusan National University Hospital, Busan, South Korea
| | - Dae-Young Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jinny Park
- Gachon University Gil Medical Center, Seoul, South Korea
| | - Chul Won Jung
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Udomsak Bunworasate
- King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | | | - Saengsuree Jootar
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | | | - Sung-Eun Lee
- Seoul St. Mary's Hospital, Leukemia Research Institute, The Catholic University of Korea, Seoul, South Korea
| | - Dong-Wook Kim
- Seoul St. Mary's Hospital, Leukemia Research Institute, The Catholic University of Korea, Seoul, South Korea.
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Kim BJ, Kim JH, Kim HS, Zang DY. Prognostic and predictive value of VHL gene alteration in renal cell carcinoma: a meta-analysis and review. Oncotarget 2017; 8:13979-13985. [PMID: 28103578 PMCID: PMC5355155 DOI: 10.18632/oncotarget.14704] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 12/28/2016] [Indexed: 11/25/2022] Open
Abstract
The von Hippel-Lindau (VHL) gene is often inactivated in sporadic renal cell carcinoma (RCC) by mutation or promoter hypermethylation. The prognostic or predictive value of VHL gene alteration is not well established. We conducted this meta-analysis to evaluate the association between the VHL alteration and clinical outcomes in patients with RCC. We searched PUBMED, MEDLINE and EMBASE for articles including following terms in their titles, abstracts, or keywords: 'kidney or renal', 'carcinoma or cancer or neoplasm or malignancy', 'von Hippel-Lindau or VHL', 'alteration or mutation or methylation', and 'prognostic or predictive'. There were six studies fulfilling inclusion criteria and a total of 633 patients with clear cell RCC were included in the study: 244 patients who received anti-vascular endothelial growth factor (VEGF) therapy in the predictive value analysis and 419 in the prognostic value analysis. Out of 663 patients, 410 (61.8%) had VHL alteration. The meta-analysis showed no association between the VHL gene alteration and overall response rate (relative risk = 1.47 [95% CI, 0.81-2.67], P = 0.20) or progression free survival (hazard ratio = 1.02 [95% CI, 0.72-1.44], P = 0.91) in patients with RCC who received VEGF-targeted therapy. There was also no correlation between the VHL alteration and overall survival (HR = 0.80 [95% CI, 0.56-1.14], P = 0.21). In conclusion, this meta-analysis indicates that VHL gene alteration has no prognostic or predictive value in patients with clear cell RCC.
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Affiliation(s)
- Bum Jun Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Jung Han Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Hyeong Su Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Dae Young Zang
- Division of Hemato-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea
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Lee JH, Kim H, Joo YD, Lee WS, Bae SH, Zang DY, Kwon J, Kim MK, Lee J, Lee GW, Lee JH, Choi Y, Kim DY, Hur EH, Lim SN, Lee SM, Ryoo HM, Kim HJ, Hyun MS, Lee KH. Prospective Randomized Comparison of Idarubicin and High-Dose Daunorubicin in Induction Chemotherapy for Newly Diagnosed Acute Myeloid Leukemia. J Clin Oncol 2017. [PMID: 28632487 DOI: 10.1200/jco.2017.72.8618] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose We compared two induction regimens, idarubicin (12 mg/m2/d for 3 days) versus high-dose daunorubicin (90 mg/m2/d for 3 days), in young adults with newly diagnosed acute myeloid leukemia (AML). Patients and Methods A total of 299 patients (149 randomly assigned to cytarabine plus idarubicin [AI] and 150 assigned to cytarabine plus high-dose daunorubicin [AD]) were analyzed. All patients received cytarabine (200 mg/m2/d for 7 days). Results Complete remission (CR) was induced in 232 patients (77.6%), with no difference in CR rates between the AI and AD arms (80.5% v 74.7%, respectively; P = .224). At a median follow-up time of 34.9 months, survival and relapse rates did not differ between the AI and AD arms (4-year overall survival, 51.1% v 54.7%, respectively; P = .756; cumulative incidence of relapse, 35.2% v 25.1%, respectively; P = .194; event-free survival, 45.5% v 50.8%, respectively; P = .772). Toxicity profiles were also similar in the two arms. Interestingly, overall and event-free survival times of patients with FLT3 internal tandem duplication (ITD) mutation were significantly different (AI v AD: median overall survival, 15.5 months v not reached, respectively; P = .030; event-free survival, 11.9 months v not reached, respectively; P = .028). Conclusion This phase III trial comparing idarubicin with high-dose daunorubicin did not find significant differences in CR rates, relapse, and survival. Significant interaction between the treatment arm and the FLT3-ITD mutation was found, and high-dose daunorubicin was more effective than idarubicin in patients with FLT3-ITD mutation.
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Affiliation(s)
- Je-Hwan Lee
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Hawk Kim
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Young-Don Joo
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Won-Sik Lee
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Sung Hwa Bae
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Dae Young Zang
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Jihyun Kwon
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Min Kyoung Kim
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Junglim Lee
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Gyeong Won Lee
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Jung-Hee Lee
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Yunsuk Choi
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Dae-Young Kim
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Eun-Hye Hur
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Sung-Nam Lim
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Sang-Min Lee
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Hun Mo Ryoo
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Hyo Jung Kim
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Myung Soo Hyun
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
| | - Kyoo-Hyung Lee
- Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Eun-Hye Hur, and Kyoo-Hyung Lee, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Hawk Kim and Yunsuk Choi, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Young-Don Joo and Sung-Nam Lim, Haeundae Paik Hospital, Inje University College of Medicine; Won-Sik Lee and Sang-Min Lee, Busan Paik Hospital, Inje University College of Medicine, Busan; Sung Hwa Bae and Hun Mo Ryoo, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine; Min Kyoung Kim and Myung Soo Hyun, Yeungnam University Hospital, Yeungnam University College of Medicine; Junglim Lee, Daegu Fatima Hospital, Daegu; Dae Young Zang and Hyo Jung Kim, Hallym University Sacred Heart Hospital, Hallym University, Anyang; Jihyun Kwon, Chungbuk National University Hospital, Cheongju; and Gyeong Won Lee, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Republic of Korea
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Han B, Kim HS, Choi DR, Shim BY, Lee KH, Kim JW, Kim JH, Kim JH, Kim HY, Song H, Park CK, Moon SH, Kim JH, Jeon JY, Lee JW, Zang DY. Updated results of a phase II study of gemcitabine, erlotinib, and S-1 in patients with advanced pancreatic cancer. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e15778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15778 Background: Gemcitabine-based chemotherapy is considered as a standard front-line treatment for patients with advanced pancreatic cancer. Although addition of erlotinib or S-1 to gemcitabine has yielded better outcomes, it has showed just modest improvement in survival. To overcome this limitation, we evaluated the efficacy and safety of the combination of gemcitabine, erlotinib, and S-1 for the treatment of advanced pancreatic cancer. Methods: Chemotherapy-naïve patients with pathologically proven locally advanced, recurrent or metastatic pancreatic adenocarcinoma were assessed for eligibility. Gemcitabine at 1,000 mg/m2 was administered intravenously on day 1, and 8, erlotinib at 100 mg/day was administered on days 1-21, and S-1 at 60 mg/m2 was administered on days 1-14 every 21 days and continued to maximum of 8 cycles of treatment. Dose escalation of S-1 to 80 mg/m2was permitted from second cycle for pre-defined tolerable patients. Results: Thirty-seven patients (median age 61.5 years) were enrolled. A total of 140 cycles of chemotherapy were administered (median of 3.8; range 1–8 cycles). Toxicities were evaluated in 36 patients, and the responses were evaluated in 32 patients. Major grade 3/4 toxicities included neutropenia (25%), febrile neutropenia (2.8%), fatigue (22.2%), infection (8.3%), vomiting (5.6%), and mucositis (5.6%). The overall response rate was 12.5% [95% confidence interval (CI), 5.1-28.9%] and disease control rate was 71.9% (95% CI, 56.8-86.3%). The median progression-free survival and overall survival were 3.7 months (95% CI, 2.8-4.6 months) and 6.7 months (95% CI, 3.4-9.9 months), respectively. Conclusions: The combination of gemcitabine, erlotinib, and S-1 provided an acceptable toxicity profile and modest clinical benefits in patients with advanced pancreatic cancer. Clinical trial information: NCT01693419.
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Affiliation(s)
- Boram Han
- Hallym University Medical Center, Anyang, South Korea
| | - Hyeong Su Kim
- Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
| | - Dae Ro Choi
- Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea
| | - Byoung Yong Shim
- St. Vincent's Hospital, The Catholic University of Kore, Seoul, Republic of Korea
| | - Kyung Hee Lee
- Department of Hemato-Oncology, Yeungnam University Hospital, Daegu, South Korea
| | - Jin Won Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jung Han Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Jung Hoon Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - Ho Young Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Hunho Song
- Kang-Dong Sacred Heart Hospital, Hallym University Medical Center, Seoul, South Korea
| | | | - Sung Hoon Moon
- Hallym University Medical Center, Anyang, Republic of Korea
| | - Jong Hyeok Kim
- Hallym University Medical Center, Anyang, Republic of Korea
| | - Jang Yong Jeon
- Hallym University Medical Center, Anyang, Republic of Korea
| | - Jung Woo Lee
- Hallym University Medical Center, Anyang, Republic of Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
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Kim SY, Kim TW, Hong YS, Kim JE, Lee KW, Kim JW, Hwang IG, Kim BG, Ahn JB, Oh HS, Zang DY, Joo J, Kim DY, Oh JH, Baek JY. A randomized phase II trial of consolidation chemotherapy after preoperative chemoradiation (preop CRT) versus CRT alone for locally advanced rectal cancer (LARC). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.3606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3606 Background: In LARC, preop CRT followed by total mesorectal excision (TME) is a standard of care. Recently consolidation chemotherapy after CRT was shown to be safe and to improve pathologic complete response (pCR) rate in LARC. We aimed to evaluate downstaging (DS) rate (the proportion of ypT0-2N0M0) of CRT followed by consolidation chemotherapy (capecitabine and oxaliplatin: CapOx) compared to that of CRT alone. Methods: Patients (pts) with adenocarcinoma of rectum(≤ 12cm from anal verge), ECOG PS 0 or 1, and cT3-4NxM0 were enrolled. CRT (50-50.4Gy/25-28fx) with Cap (825mg/m2/day for 5 days per week throughout CRT) followed by TME was planned in Arm A (control arm). In Arm B, 2 cycles of CapOx was given a week after completion of CRT before TME (Cap 850mg/m2/day from day 1 to day 14; Ox 100mg/m2on day 1; q 3w). 110 pts (55 per arm) were needed to show improvement of DS rate in per-protocol population (PP set) from 30% to 50% in arm B with one-sided α = 0.15, 1- β = 0.85, and follow-up loss in 5%. Results: From 9/2014 Sep to 2/2016, 110 (56 in arm A; 54 in arm B) were enrolled; 108 (55 in arm A; 53 in arm B) were randomized and started study treatment. Median age was 56 years; male/ECOG PS 1/cT4 was 76%/70%/18%. 100 pts (54 in arm A; 46 in arm B) completed CRT ± CapOx and surgery (R0 or R1 resection), while 8 (1 in arm A, 7 in arm B) dropped out mainly due to consent withdrawal. 2 of each arm underwent non-TME; that leaves 96 (52 in arm A and 44 in arm B) in PP set. Relative dose intensity of CapOx was 96% (Cap) and 95% (Ox). The main treatment outcome is described in table. The mean interval days between completion of CRT and surgery was significantly longer in arm B (52.9 vs 61.3, p < 0.0001). Conclusions: 2 cycles of CapOx after completion of CRT was feasible and safe, and it showed improvement in DS rate, even with high dropout rates (13%). Clinical trial information: NCT01952951. [Table: see text]
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Affiliation(s)
- Sun Young Kim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Tae Won Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong Sang Hong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong Eun Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Keun Wook Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ji-Won Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - In Gyu Hwang
- Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Beom Gyu Kim
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Joong Bae Ahn
- Department of Internal Medicine, Cancer Metastasis Research Center, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ho-Suk Oh
- Department of Internal Medicine, Gangneung Asan Hospital, Seoul, Republic of Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Jungnam Joo
- Biometric Research Branch, Division of Cancer Epidemiology and Prevention, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Dae Yong Kim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Jae Hwan Oh
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Ji Yeon Baek
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
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Kim JW, Lee KW, Kim KP, Lee JH, Hong YS, Kim JE, Kim SY, Park SR, Nam BH, Cho SH, Chung IJ, Park YS, Oh HS, Lee MA, Kang HJ, Park YI, Song EK, Han HS, Lee KT, Shin DB, Kang JH, Zang DY, Kim JH, Kim TW. Efficacy and Safety of FOLFIRI Regimen in Elderly Versus Nonelderly Patients with Metastatic Colorectal or Gastric Cancer. Oncologist 2017; 22:293-303. [PMID: 28209749 DOI: 10.1634/theoncologist.2016-0166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 10/23/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Irinotecan-based chemotherapy is a standard backbone of therapy in patients with metastatic colorectal cancer (CRC) or gastric cancer (GC). However, there is still a paucity of information concerning the efficacy and safety of irinotecan-based regimens in elderly patients. PATIENTS AND METHODS Using the patient cohort (n = 1,545) from the UGT1A1 genotype study, we compared the efficacy and safety between elderly and nonelderly patients with metastatic CRC (n = 934) or GC (n = 611) who received first- or second-line FOLFIRI (irinotecan, leucovorin, and 5-fluorouracil) chemotherapy. RESULTS Despite lower relative dose intensity in elderly patients, progression-free survival and overall survival were similar between elderly (age ≥70 years) and nonelderly (<70 years) patients in the CRC cohort (hazard ratio [HR], 1.117; 95% confidence interval [CI], 0.927-1.345; p = .244, and HR, 0.989; 95% CI, 0.774-1.264; p = .931, respectively) and the GC cohort (HR, 1.093; 95% CI, 0.854-1.400; p = .479, and HR, 1.188; 95% CI, 0.891-1.585; p = .241, respectively). In both cohorts, febrile neutropenia (22.1% vs. 14.6% in CRC cohort and 35.2% vs. 22.5% in GC cohort) and asthenia (grade 3: 8.4% vs. 1.7% in CRC cohort and 5.5% vs. 2.9% in GC cohort) were more frequent in elderly patients. In the CRC cohort, mucositis and anorexia were more frequent in elderly patients. In the GC cohort, nausea and vomiting were less frequent in elderly patients. CONCLUSION The efficacy of the FOLFIRI regimen was similar between elderly and nonelderly patients in both the CRC and the GC cohorts. However, special attention should be paid to elderly patients because of increased risk for febrile neutropenia and asthenia. The Oncologist 2017;22:293-303 IMPLICATIONS FOR PRACTICE: The efficacy of FOLFIRI (irinotecan, leucovorin, and 5-fluorouracil) chemotherapy in elderly patients with metastatic colorectal cancer or gastric cancer was similar to that in nonelderly patients. However, special attention should be paid to elderly patients because of the increased risk for febrile neutropenia and asthenia. These data suggest that the FOLFIRI regimen could be considered as a standard backbone of therapy in elderly patients with metastatic colorectal cancer or gastric cancer and that the clinical decision between doublet and singlet chemotherapy may not be based solely on age. However, the data require further assessment of frailty and performance status.
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Affiliation(s)
- Ji-Won Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Keun-Wook Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyu-Pyo Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ju Hyun Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yong Sang Hong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong-Eun Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun Young Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Sook Ryun Park
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Byung-Ho Nam
- Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Sang-Hee Cho
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Ik-Joo Chung
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Young Suk Park
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ho-Suk Oh
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Myung-Ah Lee
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hye Jin Kang
- Division of Hematology/Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Young Iee Park
- Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Eun-Kee Song
- Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| | - Hye Sook Han
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Kyu Taeg Lee
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Dong Bok Shin
- Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jung Hun Kang
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Jee Hyun Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Tae Won Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Han B, Kim HS, Choi DR, Shim B, Lee KH, Kim JW, Kim JH, Kim JH, Song H, Park CK, Moon SH, Kim JH, Jeon JY, Lee JW, Zang DY. A phase II study of gemcitabine, erlotinib, and S-1 in patients with advanced pancreatic cancer. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
476 Background: Gemcitabine-based chemotherapy is considered as a standard front-line treatment for patients with advanced pancreatic cancer. Although addition of erlotinib or S-1 to gemcitabine has yielded better outcomes, it has showed just modest improvement in survival. To overcome this limitation, we evaluated the efficacy and safety of the combination of gemcitabine, erlotinib, and S-1 for the treatment of advanced pancreatic cancer. Methods: Chemotherapy-naïve patients with pathologically proven locally advanced, recurrent or metastatic pancreatic adenocarcinoma were assessed for eligibility. Gemcitabine at 1,000 mg/m2 was administered intravenously on day 1, and 8, erlotinib at 100 mg/day was administered on day 1-21, and S-1 at 60 mg/m2 was administered on days 1-14 every 21 days and continued to maximum of 8 cycles of treatment. Dose escalation of S-1 to 80 mg/m2 was permitted from second cycle for pre-defined tolerable patients. Results: Thirty-seven patients (median age 61.5 years) were enrolled. A total of 140 cycles of chemotherapy were administered (median of 3.8; range 1–8 cycles). Toxicities were evaluated in 36 patients, and the responses were evaluated in 31 patients. Major grade 3/4 toxicities included neutropenia (25%), febrile neutropenia (2.8%), fatigue (22.2%), infection (8.3%), vomiting (5.6%), and mucositis (5.6%). The overall response rate was 12.9% [95% confidence interval (CI), 5.1-28.9%] and disease control rate was 74.2% (95% CI, 56.8-86.3%). The median progression-free survival and overall survival were 3.4 months (95 % CI, 2.3-4.5 months) and 5.7 months (95 % CI, 3.9-7.6 months), respectively. Conclusions: The combination of gemcitabine, erlotinib, and S-1 provided an acceptable toxicity profile and modest clinical benefits in patients with advanced pancreatic cancer. Clinical trial information: NCT01693419.
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Affiliation(s)
- Boram Han
- Hallym University Medical Center, Anyang, South Korea
| | - Hyeong Su Kim
- Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
| | - Dae Ro Choi
- Hallym University Medical Center, Hallym University College of Medicine, Chuncheon, South Korea
| | - Byoungyong Shim
- St. Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea
| | - Kyung Hee Lee
- Division of Oncology-Hematology, Department of Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | - Jin Won Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Jung Han Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Jung Hoon Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - Hunho Song
- Kang-Dong Sacred Heart Hospital, Hallym University Medical Center, Seoul, South Korea
| | - Choong Kee Park
- Hallym University Medical Center, Anyang-Si, Republic of Korea
| | - Sung Hoon Moon
- Hallym University Medical Center, Anyang-Si, Republic of Korea
| | - Jong Hyeok Kim
- Hallym University Medical Center, Anyang-Si, Republic of Korea
| | - Jang Yong Jeon
- Hallym University Medical Center, Anyang-Si, Republic of Korea
| | - Jung Woo Lee
- Hallym University Medical Center, Anyang-Si, Republic of Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
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Abstract
481 Background: Although pancreatic cancers are common in older age-groups, treatment approaches and outcomes are understudied in this population. We undertook this study to compare treatment outcomes for older patients with metastatic pancreatic cancer. Methods: Data from 167 patients aged 70 years or over with metastatic pancreatic cancer from January 2010 to July 2015, were analyzed. The clinic-pathologic variables and treatment outcome retrospectively reviewed. Results: One hundred and sixty three patients were identified. Among them, only 22.1% (n=36) patients receive palliative chemotherapy. The median age was 74.0 years old (range: 70-84) in the groups of chemotherapy as compared with 78.6 years old (range: 70-94.6) in the groups of supportive care. The median survival was 9.2 months (range: 1.0-24.9) in the chemotherapy group as compared with 2.3 month (range: 0.1-31.8) in the supportive care group. Among chemotherapy group, 50% (n=18) patients receive gemcitabine-based double therapy. Nine patients (30%) receive 2nd line chemotherapy. In group of supportive care, 55.8% (n=74) were survival less than 3 months. However, the median survival except for early deaths (less than 3 months) was 6.5 months. Conclusions: The current results showed that older patient with metastatic pancreatic cancer received chemotherapy less likely. However, the survival benefit from the chemotherapy was comparable outcome with historical data. Further study of identifying older patients who would benefit from cytotoxic chemotherapy was needed.
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Affiliation(s)
- Hyun Ae Jung
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea
| | | | - Boram Han
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Ho Young Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Hyo Jung Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Joo Young Jung
- Hallym University Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong, South Korea
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Lee CK, Jung M, Kim HS, Jung I, Shin DB, Kang SY, Zang DY, Kim KH, Lee MH, Kim BS, Lee KH, An JY, Kim HI, Cheong JH, Hyung WJ, Noh SH, Chung HC, Rha SY. An update on the randomized phase III POST trial: S-1 based doublet as an adjuvant chemotherapy for curatively resected stage III gastric cancer. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.4042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Choong-kun Lee
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Minkyu Jung
- Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyo Song Kim
- Department of Internal Medicine, Division of Medical Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Dong Bok Shin
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea
| | - Seok Yun Kang
- Ajou University School of Medicine, Suwon, South Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Ki Hyang Kim
- Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Moon Hee Lee
- Inha University School of Medicine, Incheon, South Korea
| | | | - Kyung Hee Lee
- Division of Oncology-Hematology, Department of Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | - Ji Yeong An
- Yonsei University College of Medicine, Seoul, South Korea
| | - Hyoung-Il Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae-Ho Cheong
- Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Woo Jin Hyung
- Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Hoon Noh
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | - Hyun Cheol Chung
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Sun Young Rha
- Yonsei University Severance Hospital, Seoul, Korea, The Republic of
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Lee SE, Choi SY, Song HY, Kim SH, Choi MY, Park JS, Kim HJ, Kim SH, Zang DY, Oh S, Kim H, Do YR, Kwak JY, Kim JA, Kim DY, Mun YC, Lee WS, Chang MH, Park J, Kwon JH, Kim DW. Imatinib withdrawal syndrome and longer duration of imatinib have a close association with a lower molecular relapse after treatment discontinuation: the KID study. Haematologica 2016; 101:717-23. [PMID: 26888022 DOI: 10.3324/haematol.2015.139899] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/17/2016] [Indexed: 12/16/2022] Open
Abstract
The aim of the Korean Imatinib Discontinuation Study was to identify predictors for safe and successful imatinib discontinuation. A total of 90 patients with a follow-up of ≥12 months were analyzed. After a median follow-up of 26.6 months after imatinib discontinuation, 37 patients lost the major molecular response. The probability of sustained major molecular response at 12 months and 24 months was 62.2% and 58.5%, respectively. All 37 patients who lost major molecular response were retreated with imatinib therapy for a median of 16.9 months, and all achieved major molecular response again at a median of 3.9 months after resuming imatinib therapy. We observed newly developed or worsened musculoskeletal pain and pruritus in 27 (30%) patients after imatinib discontinuation. Imatinib withdrawal syndrome was associated with a higher probability of sustained major molecular response (P=0.003) and showed a trend for a longer time to major molecular response loss (P=0.098). Positivity (defined as ≥ 17 positive chambers) of digital polymerase chain reaction at screening and longer imatinib duration before imatinib discontinuation were associated with a higher probability of sustained major molecular response. Our data demonstrated that the occurrence of imatinib withdrawal syndrome after imatinib discontinuation and longer duration of imatinib were associated with a lower rate of molecular relapse. In addition, minimal residual leukemia measured by digital polymerase chain reaction had a trend for a higher molecular relapse. (Trial registered at ClinicalTrials.gov: NCT01564836).
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Affiliation(s)
- Sung-Eun Lee
- Department of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Soo Young Choi
- Department of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Hye-Young Song
- Department of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Soo-Hyun Kim
- Department of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Mi-Yeon Choi
- Department of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Joon Seong Park
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Hyeoung-Joon Kim
- Department of Hematology-Oncology, Chonnam National University Hwasun, Hospital, Busan, Korea
| | - Sung-Hyun Kim
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea
| | - Sukjoong Oh
- Division of Hematology-Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Hawk Kim
- Division of Hematology and Cellular Therapy, Ulsan University Hospital, University of Ulsan College of Medicine, Daegu, Korea
| | - Young Rok Do
- Division of Hematology-Oncology, School of Medicine, Keimyung University, Daegu, Korea
| | - Jae-Yong Kwak
- Division of Hematology-Oncology, Chonbuk National University Medical School, Jeonju, Korea
| | - Jeong-A Kim
- Department of Hematology, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Dae-Young Kim
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yeung-Chul Mun
- Department of Hematology, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Won Sik Lee
- Department of Internal Medicine, Inje University College of Medicine, Inje University Busan Paik Hospital, Ilsan, Korea
| | - Myung Hee Chang
- Department of Hematology-Oncology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Jinny Park
- Department of Hematology, Gachon University Gil Hospital, Incheon, Korea
| | - Ji Hyun Kwon
- Department of Hematology-Oncology, Chungbuk National University Hospital, Cheongju, Korea
| | - Dong-Wook Kim
- Department of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea Catholic Leukemia Research Institute, The Catholic University of Korea, Seoul, Korea
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Zang DY, Jung HA, Han B, Kim JH, Choi DR, Kim HS, Jang G, Kwon JH, Kim HY, Kim JH, Jung JY, Kim HJ, Yoon H, Park YS, Lee HW, Kang SY, Cho JW, Song HH. Longitudinal follow-up of quality of life in gastrointestinal cancer patients after curative surgery in South Korea. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.4_suppl.697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
697 Background: Early detection of cancer and improved treatment have led to higher survival rates and an increasing number of long-term survivors in oncology practice. But there are few longitudinal Quality of Life (QoL) studies in patients who experienced cancer surgery. To investigate the longitudinal change in QoL of elderly gastrointestinal cancer patients, we designed prospective study for QoL in resected gastrointestinal cancer patients. Methods: A prospective longitudinal cohort study was designed. Patients from Hallym, Ajou, and Samsung medical center in South Korea were enrolled consecutively from February to September of 2012. Patients over 55 years old who received curative resection due to gastrointestinal cancer were included. They were given questionnaires every 6 months since then, and we’ve been using EORTC QLQ C-30 as quality of life scale. We selected patients using propensity score matching(PSM). The mean scores of the patients completing the interview at the 3 time points were compared using mixed model. Results: A total of 353 patients with gastrointestinal cancer were interviewed at baseline. We dichotomized patients into 2 groups ( < 70 years old vs. > = 70 years old). There were significant difference in ECOG performance status between 2 groups. After balancing with PSM, we selected 272 patients. Overall QoL did not show significant difference between 2 groups at baseline interview. After repeated interview, the score of global health status, physical functioning, and pain showed significantly higher in younger group ( < 70 years old). But other items didn't show significant difference.Especially patients in both group felt financial difficulty increased. Conclusions: Although the elderly gastrointestinal cancer patients showed lower score in global health status, physical function, they preserved relatively well in other functional status after curative surgery. Most patients felt increased financial burden.
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Affiliation(s)
- Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Hyun Ae Jung
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea
| | - Boram Han
- Hallym University Medical Center, Anyang, South Korea
| | - Jung Hoon Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - Dae Ro Choi
- Hallym University Medical Center, Hallym University College of Medicine, Chuncheon, South Korea
| | - Hyeong Su Kim
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
| | - Geundoo Jang
- Kang-Dong Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
| | - Jung Hye Kwon
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
| | - Ho Young Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Jung Han Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Joo Young Jung
- Hallym University Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong, South Korea
| | - Hyo Jung Kim
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Hyunsook Yoon
- Department of Social Welfare, Hallym University, Chuncheon, South Korea
| | | | | | - Seok Yun Kang
- Ajou University School of Medicine, Suwon, South Korea
| | - Ji Woong Cho
- Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Hun Ho Song
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
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Park YH, Yi HG, Kim CS, Hong J, Park J, Lee JH, Kim HY, Kim HJ, Zang DY, Kim SH, Park SK, Hong DS, Lee GJ, Jin JY. Clinical Outcome and Predictive Factors in the Response to Splenectomy in Elderly Patients with Primary Immune Thrombocytopenia: A Multicenter Retrospective Study. Acta Haematol 2016; 135:162-71. [PMID: 26771656 DOI: 10.1159/000442703] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 11/22/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND Because many physicians seem reluctant to recommend splenectomy for elderly patients with immune thrombocytopenia (ITP), we investigated the safety and efficacy of splenectomy and the predictive factors for response in these patients. METHODS 184 patients with primary ITP were retrospectively analyzed based on age at splenectomy: an elderly group (≥60 years, n = 52) and a younger group (<60 years, n = 132). RESULTS There was no difference in the response rate of elderly versus younger patients (80.7 vs. 80.3%, p = 0.466). Relapse (45.2 vs. 22.6%, p = 0.006), complications, and median postoperative stay (9.5 vs. 7 days, p = 0.019) were significantly higher in the elderly group. The 5-year relapse-free survival of responders was 51.8% in the elderly group and 76.3% in the younger group (p = 0.002). Response to any treatment before splenectomy (HR 2.9, 95% CI: 1.24-6.80, p = 0.014) and platelet count on postoperative day 14 ≥200 × 109/l (HR 31.43, 95% CI: 4.15-238.28, p = 0.001) were independent factors for a favorable response. CONCLUSIONS Age ≥60 years did not influence the response to splenectomy but was associated with increased relapse and postoperative complications. Splenectomy could provide a durable long-term response for elderly ITP patients.
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Affiliation(s)
- Young Hoon Park
- Department of Internal Medicine at Inha University Hospital, Inha University School of Medicine, Incheon, Korea
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Noh H, Park MS, Kim SH, Oh SJ, Zang DY, Park HL, Cho DJ, Kim DW, Lee JI. Optimization of radotinib doses for the treatment of Asian patients with chronic myelogenous leukemia based on dose-response relationship analyses. Leuk Lymphoma 2015; 57:1856-64. [DOI: 10.3109/10428194.2015.1113278] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Kim JH, Zang DY, Chung IJ, Cho SH, Park KU, Oh HS, Lee KH, Lee BH, Kim MJ, Park CK, Han B, Kim HS, Choi DR, Song HH, Jung JY. A Muti-center, Randomized Phase II Study of Oxaliplatin and S-1 versus Capecitabine and Oxaliplatin in Patients with Metastatic Colorectal Cancer. J Cancer 2015; 6:1041-8. [PMID: 26366218 PMCID: PMC4565854 DOI: 10.7150/jca.12819] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 07/27/2015] [Indexed: 12/27/2022] Open
Abstract
Background: Capecitabine plus oxaliplatin (XELOX) is considered one of the primary chemotherapy regimens for patients with metastatic colorectal cancer (CRC). Oxaliplatin plus S-1 (OS) has also demonstrated significant efficacy in CRC. We performed this randomized phase II study to evaluate the efficacy and toxicity of XELOX versus OS as first-line chemotherapy in patients with metastatic CRC. Methods: Patients were assigned randomly to receive either OS or XELOX chemotherapy. Oxaliplatin was administered intravenously to all patients at a dose of 130 mg/m2 on day 1. Patients received either S-1 (40 mg/m2) or capecitabine (1,000 mg/m2), twice a day for 2 weeks, followed by a 1-week rest. Results: Forty-two patients were assigned to the OS arm and 44 to the XELOX arm. The overall response rate was 33.3% (95% CI, 18.8-47.2) in the OS arm and 40.9% (95% CI, 25.5-54.4) in the XELOX arm (P = 0.230). The disease control rate was significantly higher in the OS arm than the XELOX arm [92.9% (95% CI, 83.7-100) versus 77.3% (95% CI, 64.5-89.4), P = 0.044]. With a median follow up of 17.9 months, the median progression-free survival was 6.1 months in the OS arm and 7.4 months in the XELOX arm, respectively (P = 0. 599). The median survival time was 18.7 months in the OS arm and 20.1 months in the XELOX arm (P = 0.340). The most common grade 3/4 hematologic toxicity was thrombocytopenia in both arms (19.0% for OS and 28.6% for XELOX). Grade 3/4 neutropenia was observed more frequently in the XELOX arm than the OS arm (16.7% vs. 2.4%, P = 0.026). Conclusion: Both OS and XELOX were effective and well tolerated in patients with metastatic CRC. Our results indicate that the combination of oxaliplatin and S-1 is a possible additional therapeutic strategy for such patients.
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Affiliation(s)
- Jung Han Kim
- 1. Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Dae Young Zang
- 1. Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Ik-Joo Chung
- 2. Department of Internal Medicine, Chonnam National University College of Medicine, Gwangju, South Korea
| | - Sang-Hee Cho
- 2. Department of Internal Medicine, Chonnam National University College of Medicine, Gwangju, South Korea
| | - Keon Uk Park
- 3. Department of Internal Medicine, Keimyung University College of Medicine, Daegu, South Korea
| | - Ho-Suck Oh
- 4. Department of Internal Medicine, Gangneung Asan Hospital, Gangneung, South Korea
| | - Kyung Hee Lee
- 5. Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | - Bong Hwa Lee
- 6. Department of Surgery, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Min-Jeong Kim
- 7. Department of Radiology, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Choong Kee Park
- 1. Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Boram Han
- 1. Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Hyeong Su Kim
- 1. Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Dae Ro Choi
- 1. Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Hun Ho Song
- 1. Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Joo Young Jung
- 1. Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
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Bang YJ, Im SA, Lee KW, Cho JY, Song EK, Lee KH, Kim YH, Park JO, Chun HG, Zang DY, Fielding A, Rowbottom J, Hodgson D, O'Connor MJ, Yin X, Kim WH. Randomized, Double-Blind Phase II Trial With Prospective Classification by ATM Protein Level to Evaluate the Efficacy and Tolerability of Olaparib Plus Paclitaxel in Patients With Recurrent or Metastatic Gastric Cancer. J Clin Oncol 2015; 33:3858-65. [PMID: 26282658 DOI: 10.1200/jco.2014.60.0320] [Citation(s) in RCA: 218] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Gastric cancer cell lines, particularly those with low levels of ataxia telangiectasia mutated (ATM), a key activator of DNA damage response, are sensitive to the poly (ADP-ribose) polymerase inhibitor olaparib. We compared the efficacy of olaparib plus paclitaxel (olaparib/paclitaxel) with paclitaxel alone in patients with recurrent or metastatic gastric cancer and assessed whether low ATM expression is predictive of improved clinical outcome for olaparib/paclitaxel. PATIENTS AND METHODS In this phase II, double-blind study (Study 39; NCT01063517), patients were randomly assigned to oral olaparib 100 mg twice per day (tablets) plus paclitaxel (80 mg/m(2) per day intravenously on days 1, 8, and 15 of every 28-day cycle) or placebo plus paclitaxel (placebo/paclitaxel), followed by maintenance monotherapy with olaparib (200 mg twice per day) or placebo. The study population was enriched to 50% for patients with low or undetectable ATM levels (ATMlow). Primary end point was progression-free survival (PFS). RESULTS One hundred twenty-three of 124 randomly assigned patients received treatment (olaparib/paclitaxel, n = 61; placebo/paclitaxel, n = 62). The screening prevalence of ATMlow patients was 14%. Olaparib/paclitaxel did not lead to a significant improvement in PFS versus placebo/paclitaxel (overall population: hazard ratio [HR], 0.80; median PFS, 3.91 v 3.55 months, respectively; ATMlow population: HR, 0.74; median PFS, 5.29 v 3.68 months, respectively). However, olaparib/paclitaxel significantly improved overall survival (OS) versus placebo/paclitaxel in both the overall population (HR, 0.56; 80% CI, 0.41 to 0.75; P = .005; median OS, 13.1 v 8.3 months, respectively) and the ATMlow population (HR, 0.35; 80% CI, 0.22 to 0.56; P = .002; median OS, not reached v 8.2 months, respectively). Olaparib/paclitaxel was generally well tolerated, with no unexpected safety findings. CONCLUSION Olaparib/paclitaxel is active in the treatment of patients with metastatic gastric cancer, with a greater OS benefit in ATMlow patients. A phase III trial in this setting is under way.
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Affiliation(s)
- Yung-Jue Bang
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China.
| | - Seock-Ah Im
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Keun-Wook Lee
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Jae Yong Cho
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Eun-Kee Song
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Kyung Hee Lee
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Yeul Hong Kim
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Joon Oh Park
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Hoo Geun Chun
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Dae Young Zang
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Anitra Fielding
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Jacqui Rowbottom
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Darren Hodgson
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Mark J O'Connor
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Xiaolu Yin
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
| | - Woo Ho Kim
- Yung-Jue Bang, Seock-Ah Im, and Woo Ho Kim, Seoul National University College of Medicine; Jae Yong Cho, Yonsei University College of Medicine, Gangnam Severance Hospital; Yeul Hong Kim, Anam Hospital, Korea University College of Medicine; Joon Oh Park, Samsung Medical Center, Sungkyunkwan University School of Medicine; Hoo Geun Chun, Seoul St Mary's Hospital, Catholic University of Korea, Seoul; Keun-Wook Lee, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Eun-Kee Song, Chonbuk National University Medical School, Jeonju; Kyung Hee Lee, Yeungnam University Hospital, Daegu; Dae Young Zang, Hallym University Sacred Heart Hospital, Anyang, Korea; Anitra Fielding, Jacqui Rowbottom, Darren Hodgson, and Mark J. O'Connor, AstraZeneca, Macclesfield, United Kingdom; and Xiaolu Yin, Innovation Centre, AstraZeneca, Shanghai, China
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Ryu MH, Baba E, Lee KH, Park YI, Boku N, Hyodo I, Nam BH, Esaki T, Yoo C, Ryoo BY, Song EK, Cho SH, Kang WK, Yang SH, Zang DY, Shin DB, Park SR, Shinozaki K, Takano T, Kang YK. Comparison of two different S-1 plus cisplatin dosing schedules as first-line chemotherapy for metastatic and/or recurrent gastric cancer: a multicenter, randomized phase III trial (SOS). Ann Oncol 2015. [PMID: 26216386 DOI: 10.1093/annonc/mdv316] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Five-weekly S-1 plus cisplatin (SP5) is one of the standard first-line regimens for advanced gastric cancer (GC), proven in a Japanese phase III study. To enhance the dose intensity of cisplatin, 3-weekly S-1 plus cisplatin (SP3) was developed. PATIENTS AND METHODS This multicenter, randomized, open-label, phase III study evaluated whether SP3 (S-1 80 mg/m(2)/day on days 1-14 and cisplatin 60 mg/m(2) on day 1) was noninferior/superior to SP5 (S-1 80-120 mg/day on days 1-21 and cisplatin 60 mg/m(2) on day 1 or 8) in terms of progression-free survival (PFS). Chemotherapy-naive patients with metastatic, recurrent gastric or gastroesophageal junction adenocarcinoma were randomized 1 : 1 to receive either SP3 or SP5. The trial is registered at ClinicalTrials.gov (NCT00915382). RESULTS Between February 2009 and January 2012, 625 patients were randomized at 42 sites in Korea and Japan. With a median follow-up duration of 32.4 months (range, 13.3-48.6 months) in surviving patients, SP3 was not only noninferior but also superior to SP5 in terms of PFS [median 5.5 versus 4.9 months; hazard ratio (HR) = 0.82; 95% confidence interval (CI) 0.68-0.99; P = 0.0418 for superiority). There was no difference in overall survival (OS) between the groups (median 14.1 versus 13.9 months; HR = 0.99; 95% CI 0.81-1.21; P = 0.9068). In patients with measurable disease, the response rates were 60% in the SP3 arm and 50% in the SP5 arm (P = 0.065). Both regimens were generally well tolerated, but grade 3 or higher anemia (19% versus 9%) and neutropenia (39% versus 9%) were more frequent in SP3. CONCLUSIONS SP3 is superior to SP5 in terms of PFS. However, since the improvement in PFS was only slight and there was no difference in OS, both SP3 and SP5 can be recommended as first-line treatments for patients with advanced GC.
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Affiliation(s)
- M-H Ryu
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - E Baba
- Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K H Lee
- Department of Hemato-oncology, Yeungnam University Hospital, Daegu
| | - Y I Park
- Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
| | - N Boku
- Department of Clinical Oncology, St Marianna University School of Medicine, Kawasaki
| | - I Hyodo
- Division of Gastroenterology, University of Tsukuba, Tsukuba, Japan
| | - B-H Nam
- Biometric Research Branch, National Cancer Center, Goyang, Gyeonggi, Korea
| | - T Esaki
- Department of Gastrointestinal and Medical Oncology, National Kyushu Cancer Center, Fukuoka, Japan
| | - C Yoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - B-Y Ryoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - E-K Song
- Division of Hematology/Oncology, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju
| | - S-H Cho
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Gwangju
| | - W K Kang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School Medicine, Seoul
| | - S H Yang
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul
| | - D Y Zang
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang
| | - D B Shin
- Division of Hematology/Oncology, Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - S R Park
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - K Shinozaki
- Division of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima
| | - T Takano
- Department of Medical Oncology, Toranomon Hospital, Minato-ku, Japan
| | - Y-K Kang
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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94
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Lee KW, Lee KH, Zang DY, Park YI, Shin DB, Kim JW, Im SA, Koh SA, Yu KS, Cho JY, Jung JA, Bang YJ. Phase I/II Study of Weekly Oraxol for the Second-Line Treatment of Patients With Metastatic or Recurrent Gastric Cancer. Oncologist 2015; 20:896-7. [PMID: 26112004 DOI: 10.1634/theoncologist.2015-0202] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 06/03/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Oraxol consists of paclitaxel and HM30181A, a P-glycoprotein inhibitor, to increase the oral bioavailability of paclitaxel. This phase I/II study (HM-OXL-201) was conducted to determine the maximum tolerated dose (MTD) and recommended phase II dose (RP2D) of Oraxol. In addition, we investigated the efficacy and safety of Oraxol as second-line chemotherapy for metastatic or recurrent gastric cancer (GC). METHODS In the phase I component, paclitaxel was orally administered at escalating doses (90, 120, or 150 mg/m(2) per day) with a fixed dose (15 mg/day) of HM30181A. Oraxol was administrated 6 times per cycle (days 1, 2, 8, 9, 15, and 16) every 4 weeks. In the phase II component, the efficacy and safety of Oraxol were evaluated. RESULTS In the phase I component, the MTD could not be determined. Based on toxicity and pharmacokinetic data, the RP2D of oral paclitaxel was determined to be 150 mg/m(2). In the phase II component, 4 of 43 patients (9.3%) achieved partial responses. Median progression-free survival and overall survival were 2.6 and 10.7 months, respectively. Toxicity profiles were favorable, and the most common drug-related adverse events (grade ≥3) were neutropenia and diarrhea. CONCLUSION Oraxol exhibited modest efficacy and favorable toxicity profiles as second-line chemotherapy for GC.
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Affiliation(s)
- Keun-Wook Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung Hee Lee
- Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Young Iee Park
- Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Dong Bok Shin
- Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Jin Won Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung Ae Koh
- Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea;
| | - Joo-Youn Cho
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin-A Jung
- Clinical Research Team, Hanmi Pharmaceutical Co., Ltd., Seoul, Republic of Korea
| | - Yung-Jue Bang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea;
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95
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Park JS, Lee SE, Jeong SH, Jang EJ, Choi MY, Kim HJ, Kim YK, Kim SH, Zang DY, Oh S, Koo DH, Kim H, Do YR, Kwak JY, Kim JA, Kim DY, Mun YC, Lee WS, Chang MH, Park J, Kwon JH, Kim DW. Change of health-related profiles after Imatinib cessation in chronic phase chronic myeloid leukemia patients. Leuk Lymphoma 2015; 57:341-347. [PMID: 25947037 DOI: 10.3109/10428194.2015.1049166] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this study was to investigate the changes in health-related profiles including quality-of-life (HRQoL) in the chronic myeloid leukemia (CML) patients who discontinued imatinib (IM). An HRQoL survey composed of 43 parameters about IM-related adverse events (AEs), physical health-related and mental health-related was provided at baseline and 6 months post-discontinuation. A total of 55 patients with a sustained UMRD over 6 months were analyzed. Although the majority of IM-related AEs were significantly improved, unexpectedly pruritus and musculoskeletal pain worsen or newly develop in 29.1% and 21.8% of patients, respectively. The improvements in physical and mental health condition were variable in individual patients. In addition, rapid restorations of the hematological and biochemical parameters were observed. The results showed the changes of HRQoL and laboratory tests in treatment-off patients and the necessity of continuing physical and mental support for some patients in tyrosine kinase inhibitor (TKI)-off studies.
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Affiliation(s)
- Joon Seong Park
- a Department of Hematology-Oncology , Ajou University School of Medicine , Suwon , Korea
| | - Sung-Eun Lee
- b Department of Hematology , Seoul St Mary's Hospital, The Catholic University of Korea , Seoul , Korea
| | - Seong Hyun Jeong
- a Department of Hematology-Oncology , Ajou University School of Medicine , Suwon , Korea
| | - Eun-Jung Jang
- b Department of Hematology , Seoul St Mary's Hospital, The Catholic University of Korea , Seoul , Korea
| | - Mi-Yeon Choi
- b Department of Hematology , Seoul St Mary's Hospital, The Catholic University of Korea , Seoul , Korea
| | - Hyeoung-Joon Kim
- c Department of Hematology-Oncology , Chonnam National University Hwasun, Hospital , Hwasun , Korea
| | - Yeo-Kyeoung Kim
- c Department of Hematology-Oncology , Chonnam National University Hwasun, Hospital , Hwasun , Korea
| | - Sung-Hyun Kim
- d Department of Internal Medicine , Dong-A University College of Medicine , Busan , Korea
| | - Dae Young Zang
- e Department of Internal Medicine , Hallym University College of Medicine , Anyang , Korea
| | - Sukjoong Oh
- f Division of Hematology-Oncology, Department of Internal Medicine , Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University , Seoul , Korea
| | - Dong Hoe Koo
- f Division of Hematology-Oncology, Department of Internal Medicine , Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University , Seoul , Korea
| | - Hawk Kim
- g Division of Hematology and Cellular Therapy, Ulsan University Hospital, University of Ulsan College of Medicine , Ulsan , Korea
| | - Young Rok Do
- h Division of Hematology-Oncology, School of Medicine, Keimyung University , Daegu , Korea
| | - Jae-Yong Kwak
- i Division of Hematology-Oncology, Chonbuk National University Medical School , Jeonju , Korea
| | - Jeong-A Kim
- j Department of Hematology , St Vincent's Hospital, The Catholic University of Korea , Suwon , Korea
| | - Dae-Young Kim
- k Department of Hematology , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea
| | - Yeung-Chul Mun
- l Department of Hematology , School of Medicine, Ewha Womans University , Seoul , Korea
| | - Won Sik Lee
- m Department of Internal Medicine , Inje University College of Medicine, Inje University Busan Paik Hospital , Busan , Korea
| | - Myung Hee Chang
- n Department of Hematology-Oncology , National Health Insurance Service Ilsan Hospital , Ilsan , Korea
| | - Jinny Park
- o Department of Hematology , Gachon University Gil Hospital , Incheon , Korea
| | - Ji Hyun Kwon
- p Department of Hematology-Oncology , Chungbuk National University Hospital , Cheongju , Korea
| | - Dong-Wook Kim
- b Department of Hematology , Seoul St Mary's Hospital, The Catholic University of Korea , Seoul , Korea
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96
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Ryu MH, Cho JY, Zang DY, Lee WK, Lee KW, Shin DB, Nam BH, Lee SS, Lee HW, Kim JG, Kim JS, Hwang IG, Baek JH, Yoo CH, Kang YK. A randomized phase III study of adjuvant capecitabine vs observation in curatively resected stage IB (by AJCC 6 th edition) gastric cancer (CATALYSIS; KCSG ST14-05). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.tps4137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Min-Hee Ryu
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | | | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea
| | - Woon Kee Lee
- Department of General Surgery, Gachon University Gil Medical Center, Incheon, South Korea
| | - Keun-Wook Lee
- Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dong Bok Shin
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea
| | - Byung-Ho Nam
- National Cancer Center, Goyang-si, Gyeonggi-do, South Korea
| | - Sung Sook Lee
- Department of Hematology-Oncology, Inje University Haeundae Paik Hospital, Busan, South Korea
| | | | - Jong Gwang Kim
- Kyungpook National University Medical Center, Daegu, South Korea
| | - Jin-Soo Kim
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - In Gyu Hwang
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Jin Ho Baek
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Chang Hak Yoo
- Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yoon-Koo Kang
- Department of Oncology, Asan Medical Center, Seoul, South Korea
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97
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Lim SN, Han HS, Lee KH, Lee SC, Kim J, Yun J, Park S, Park M, Choe Y, Ryoo HM, Lee K, Cho D, Zang DY, Choi J. A satisfaction survey on cancer pain management using a self-reporting pain assessment tool. J Palliat Med 2015; 18:225-31. [PMID: 25650504 DOI: 10.1089/jpm.2014.0021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pain is one of the most common and distressing symptoms in patients with cancer, with a high prevalence of 90%. Appropriate pain assessment is very important in managing cancer pain. OBJECTIVE The aims of this study were to (1) evaluate patient satisfaction with pain control therapy using a self-reporting pain assessment tool, (2) explore the usefulness of a self-reporting assessment tool for patients and physicians, and (3) evaluate patient perception of pain management and opioid analgesics. METHODS We enrolled a total of 587 South Korean adult cancer patients hospitalized for five days or more. Pain assessment using a self-reporting pain assessment tool was performed by patients themselves from Day 1 to Day 5. The average pain intensity on a numeric rating scale (NRS) and the frequency of breakthrough pain between Day 1 and Day 5 were recorded with a self-reporting pain assessment tool. We evaluated patient satisfaction with pain control and the usefulness of a self-reporting pain assessment tool for patients and physicians on Day 5. RESULTS Among the 587 enrolled patients, 551, excluding 36 patients who violated inclusion criteria, were analyzed. The pain satisfaction rate was 79.5%, and only 6.2% of assessed patients had a negative pain management index (PMI). However, symmetry analysis for pain intensity between patient and physician showed low agreement (kappa=0.21). The patients with dissatisfaction for cancer pain control expressed negative attitudes toward using opioid analgesics and misconceptions regarding pain management. The satisfaction for using a self-reporting pain assessment tool was 79.2% in patients and 86.4% in physicians, respectively. CONCLUSION The use of a self-reporting pain assessment tool as a communication instrument provides an effective foundation for evaluating pain intensity in cancer pain management. A more individualized approach to patient education about pain management may improve patient outcome.
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Affiliation(s)
- Sung-Nam Lim
- 1 Department of Internal Medicine, Haeundae-Paik Hospital, College of Medicine Inje University , Busan, South Korea
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98
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Choi DR, Yoon SN, Kim HS, Kim JH, Kim KY, Kim BC, Choi YK, Kim JB, Han B, Song HH, Zang DY. A phase II study of capecitabine and oral leucovorin as a third-line chemotherapy in patients with metastatic colorectal cancer. Cancer Chemother Pharmacol 2015; 75:639-43. [PMID: 25630415 DOI: 10.1007/s00280-015-2688-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 01/18/2015] [Indexed: 12/27/2022]
Abstract
PURPOSE This study was conducted to evaluate the efficacy and safety of the combination of capecitabine and oral leucovorin (LV) as a third-line chemotherapy for patients with metastatic colorectal cancer (CRC) showing resistance to irinotecan- and oxaliplatin-containing regimens. METHOD Patients who showed disease progression while receiving or within 6 months of discontinuing irinotecan- and oxaliplatin-containing regimens received capecitabine 825 mg/m(2) in combination with oral LV at a fixed dose of 30 mg, twice a day for 2 weeks followed by a 1-week rest. RESULTS Twenty-five patients were enrolled from July 2011 to June 2014. Three patients achieved PR, and 11 showed SD. The overall response rate was 12 %, and disease control rate was 56 %. With a median follow-up of 6.8 months, the median time to progression was 2.8 months and the median overall survival was 7.1 months. The most common non-hematologic toxicity was hand-foot syndrome (40 %), followed by mucositis (28 %) and diarrhea (12 %). Grade 3 hand-foot syndrome occurred in two patients (8 %), and grade 3 mucositis in one. Hematologic toxicities were mild, and only one patient developed grade 3 thrombocytopenia. CONCLUSION The combination of capecitabine and oral LV showed a modest activity and tolerable toxicity profile in metastatic CRC patients pretreated with irinotecan- and oxaliplatin-containing regimens. Oral LV seems to be able to reduce the usual dose of capecitabine when the two drugs are combined.
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Affiliation(s)
- Dae Ro Choi
- Division of Hemato-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Shingilro1, Youngdeungpo-Gu, Seoul, 150-950, Republic of Korea
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99
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Kim JH, Jang HJ, Kim HS, Song HH, Zang DY. Tumor response assessment by measuring the single largest lesion per organ in patients with advanced gastric cancer or colorectal cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.3_suppl.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
766 Background: The Response Evaluation Criteria in Solid Tumors Guidelines version 1.1 (RECIST 1.1) adopted a total of five target lesions to be measured, with a maximum of two lesions per organ. To the best of our knowledge, the criterion of two target lesions per organ in the RECIST 1.1 is arbitrary and has not been supported by any objective evidence. We hypothesized that measuring the single largest lesion in each organ (modified RECIST 1.1; mRECIST 1.1) might show almost the same response classification as measuring two target lesions per organ (RECIST 1.1). Methods: We compared tumor responses according to the modified RECIST 1.1 and RECIST 1.1 using computed tomography in patients with advanced gastric cancer (GC) or colorectal cancer (CRC) who received a first-line chemotherapy. Results: A total of 89 patients who had at least two target lesions in any organ according to the RECIST 1.1 were included: 51 with GC and 38 with CRC. Regardless of the primary sites, the number of target lesions according to the modified RECIST 1.1 was significantly lower than that according to the RECIST 1.1 (p < 0.001). The assessment of tumor responses showed a high concordance between the two criteria, with a kappa value of 0.906 (95% CI, 0.826-0.986). Only five patients (5.6%) showed disagreement in the tumor response assessment between the two criteria: 3 in GC and 2 in CRC. Four patients showed disagreement between PR and SD, and one showed disagreement between SD and PD. The overall response rates of chemotherapy, which were calculated regardless of the primary sites and anti-cancer treatment, were not significantly different between the two criteria (42.7% versus 42.7%, p = 1.0) (Table). Conclusions: The modified RECIST 1.1, with a decreased number of target lesions, was comparable to the original RECIST 1.1 in the assessment of tumor response in patients with advanced GC or CRC. Our results suggest that it may be possible to measure the single largest lesion per organ for assessing tumor response. [Table: see text]
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Affiliation(s)
- Jung Han Kim
- Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
| | - Hyun Joo Jang
- Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
| | - Hyeong Su Kim
- Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
| | - Hun Ho Song
- Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
| | - Dae Young Zang
- Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
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100
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Kim HY, Kim JS, Choi DR, Kim HS, Kwon JH, Jang GD, Kim JH, Jung JY, Song HH, Lee YK, Min SK, Hwang HS, Kim HJ, Zang DY, Kim HJ. The Clinical Utility of FDG PET-CT in Evaluation of Bone Marrow Involvement by Lymphoma. Cancer Res Treat 2014; 47:458-64. [PMID: 25648095 PMCID: PMC4506116 DOI: 10.4143/crt.2014.091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 05/12/2014] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Bone marrow biopsy is a standard method for the evaluation of bone marrow infiltration by lymphoma; however, it is an invasive and painful procedure. Fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) is a noninvasive imaging technique with the potential to detect bone marrow involvement by lymphoma. MATERIALS AND METHODS We retrospectively reviewed medical records of lymphoma patients. All patients were examined by FDG PET-CT and iliac crest bone marrow biopsy for initial staging work-up. RESULTS The study population comprised 94 patients (median age, 60 years; 56 males) with Hodgkin's lymphoma (n=8) or non-Hodgkin's lymphoma (n=86). Maximum standardized uptake values on the iliac crest of patients with lymphoma infiltrated bone marrow were significantly higher than those of patients with intact bone marrow (2.2±1.2 g/mL vs. 1.3±0.4 g/mL; p=0.001). The calculated values for FDG PET-CT during evaluation of bone marrow involvement were as follows: sensitivity 50%, specificity 96%, positive predictive value 80%, negative predictive value 85%, and positive likelihood ratio (LR+) 11.7. The value of LR+ was 16.0 in patients with aggressive subtypes of non-Hodgkin's lymphoma (NHL). CONCLUSION FDG PET-CT could not replace bone marrow biopsy due to the low sensitivity of FDG PET-CT for detection of bone marrow infiltration in lymphoma patients. Conversely, FDG PET-CT had high specificity and LR+; therefore, it could be a useful tool for image-guided biopsy for lymphoma staging, especially for aggressive subtypes of NHL. In addition, unilateral bone marrow biopsy could be substituted for bilateral bone marrow biopsy in lymphoma patients with increased FDG uptake on any iliac crest.
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Affiliation(s)
- Ho Young Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Ju-Seok Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Dae Ro Choi
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hyeong Su Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Jung Hye Kwon
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Geun-Doo Jang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Jung Han Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Joo Young Jung
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hun Ho Song
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Young Kyung Lee
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Soo Kee Min
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hee Sung Hwang
- Department of Nuclear Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hwa Jung Kim
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hyo Jung Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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