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Park I, Park K, Park S, Ahn Y, Ahn J, Choi H, Song C, Ahn H, Hong J, Lee J. Recist Response of the Primary Lesion in Metastatic Renal Cell Carcinomas Treated with Sunitinib: Does the Primary Lesion have to be regarded as a Target Lesion? Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33405-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Park J, Ryu M, Kim H, Ryoo B, Park I, Park Y, Oh S, Yook J, Kim B, Kang Y. Identification of Risk Factors of Relapse after Curative Surgical Resection in Stage I Gastric Cancer. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33254-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Kang Y, Ryu M, Lee J, Park I, Park J, Ryoo B. A Phase II Study of Dovitinib in Patients with Metastatic or Unresectable Gastrointestinal Stromal Tumors After Failure of Two or More Tyrosine Kinase Inhibitors. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34064-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Yoo C, Ryu M, Ryoo B, Koo D, Park I, Kang Y. A Phase I Dose-Finding Study of Vorinostat (V) Combined with Capecitabine (X) and Cisplatin (P) as First-Line Therapy in Patients with advanced Gastric Cancer. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33277-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Locasale JW, Melman T, Song SS, Yang X, Swanson KD, Cantley LC, Asara JM, Wong ET, Adams S, Braidy N, Teo C, Guillemin G, Philippe M, Carole C, David T, Eric G, Isabelle NM, de Paula Andre M, Marylin B, Olivier C, L'Houcine O, Dominique FB, Leukel P, Seliger C, Vollmann A, Jachnik B, Bogdahn U, Hau P, Liu X, Kumar VS, McPherson CM, Chow L, Kendler A, Dasgupta B, Piya S, White E, Klein S, Jiang H, Lang F, Alfred Yung WK, Gomez-Manzano C, Fueyo J, Vartanian A, Guha A, Fenton KE, Abdelwahab M, Scheck AC, Guo D, Reinitz F, Youssef M, Hong C, Nathanson D, Akhavan D, Kuga D, Amzajerdi AN, Soto H, Zhu S, Babic I, Iwanami A, Tanaka K, Gini B, DeJesus J, Lisiero DD, Huang T, Prins R, Wen P, Robbins HI, Prados M, DeAngelis L, Mellinghoff I, Mehta M, James CD, Chakravarti A, Cloughesy T, Tontonoz P, Mischel P, Phillips J, Mukherjee J, Cowdrey C, Wiencke J, Pieper RO, Bachoo R, Marin-Valencia I, Cho S, Rakheja D, Hatanpaa K, Mashimo T, Vemireddy V, Kapur P, Good L, Sun X, Pascual J, Takahashi M, Togao O, Raisanen J, Maher EA, DeBerardinis R, Malloy C, Maher EA, Bachoo R, Marin-Valencia I, Hatanpaa K, Choi C, Mashimo T, Raisanen J, Mathews D, Pascual J, Madden C, Mickey B, Malloy C, DeBerardinis R, Mukherjee J, Zheng S, Phillips J, Cowdrey C, Ronen S, Wiencke J, Pieper RO, Park I, Jalbert LE, Ito M, Ozawa T, James CD, Phillips JJ, Vigneron DB, Pieper RO, Ronen SM, Nelson SJ. METABOLIC PATHWAYS. Neuro Oncol 2011; 13:iii69-iii72. [PMCID: PMC3199168 DOI: 10.1093/neuonc/nor153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023] Open
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Ko D, You J, Chung Y, Park Y, Park I. 4 The Usefulness of Bedside Ultrasonography for Acute Epiglottitis in Emergency Department: Preliminary Study. Ann Emerg Med 2011. [DOI: 10.1016/j.annemergmed.2011.06.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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You J, Chung Y, Chung S, Park I, Kim S. 277 Liver Trauma Diagnosis With Contrast-Enhanced Ultrasound: Interobserver Variability between Radiologist and Emergency Physician in an Animal Study. Ann Emerg Med 2011. [DOI: 10.1016/j.annemergmed.2011.06.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Park I, Lee K, Sun H, Kim S, Lee J, Jeon G. High accuracy predictions of IVF prognosis attained using a combination of AMH and day 3 FSH/LH ratio. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.07.738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Park I, Park RW, Lim SK, Lee W, Shin JS, Yu S, Shin GT, Kim H. Rectal culture screening for vancomycin-resistant enterococcus in chronic haemodialysis patients: false-negative rates and duration of colonisation. J Hosp Infect 2011; 79:147-50. [PMID: 21764175 DOI: 10.1016/j.jhin.2011.04.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2010] [Accepted: 04/08/2011] [Indexed: 10/18/2022]
Abstract
Infection or colonisation with vancomycin-resistant enterococci (VRE) is common in chronic haemodialysis (HD) patients. However, there is limited information on the duration of VRE colonisation or on the reliability of consecutive negative rectal cultures to determine the clearance of VRE in chronic HD patients. Chronic HD patients from whom VRE was isolated were examined retrospectively. Rectal cultures were collected more than three times, at least one week apart, between 1 June 2003 and 1 March 2010. The results of the sequential VRE cultures and patients' data were analysed. Among 812 patients from whom VRE was isolated, 89 were chronic HD patients and 92 had three consecutive negative cultures. It took 60.7 ± 183.9 and 111.4 ± 155.4 days to collect three consecutive negative cultures in the 83 non-chronic haemodialysis patients and nine chronic HD patients, respectively (P = 0.011). The independent risk factors for more than three negative sequential rectal cultures were glycopeptide usage [odds ratio (OR): 2.155; P = 0.003] and length of hospital stay (OR: 1.009; P = 0.001). After three consecutive negative rectal cultures, two of six chronic HD patients and 10 of 36 non-HD patients were culture positive again. In conclusion, a significant proportion of patients colonised with VRE cannot be detected by three-weekly rectal cultures, and the duration of VRE colonisation in chronic haemodialysis patients tends to be prolonged. These results may be contributing to the continued increase in the prevalence of VRE.
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Howard H, Barandas A, Creegan L, Bauer H, Chow J, Park I, Bolan G. P5-S3.01 Developing a multi-pronged quality improvement (QI) strategy to increase Chlamydia trachomatis (CT) retesting rates: building a framework for success. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Park I, Lee J, Ahn J, Lee D, Song C, Hong J, Kim C, Ahn H. Prognostic factors and survial of advanced renal cell carcinoma with predominant sarcomatoid histology. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
400 Background: Sarcomatoid renal cell carcinoma (SRCC) is known to have aggressive clinical course and poor response to treatment. Very limited data of clinical feature, prognostic factor, and survival are available for advanced disease with predominant sarcomatoid histology. We evaluated clinical features, response to treatment, and prognostic factors for survival. Methods: Between 2001 and 2010, 30 patients with metastatic or recurrent RCC with predominant sarcomatoid histology (sarcomatoid component 30% or more for resected kidney or exclusive sarcomatoid carcinoma on needle biopsy) were treated at our institution. We reviewed these patients' records to identify clinical and pathologic features which could affect survival. The role of nephrectomy and systemic therapy on patient outcome was also investigated. Results: There were 20 male and 10 female patients with a median age of 58 years (range, 43–83). Twenty patients had initially metastatic disease and 16 patients (53%) had ECOG performance status (PS) of 0–1. The most frequent metastatic site was lung (57%) followed by bone (43%) and distant lymph nodes (23%). Fourteen (70%) out of 20 patients with initially metastatic disease underwent primary nephrectomy and six patients also underwent metastasectomy. The median % of sarcomatoid component was 80% (range, 30–100%). All patients (N=10) who received immunotherapy had progressive disease as their best response and only one out of 5 patients treated with sunitinib or everolimus had a partial response. With a median follow-up duration of 22 months, the median survival was 3.6 months (95% CI, 0∼7.5) with 6-month survival rate of 43%. Only ECOG PS had impact on survival (P<0.001: ECOG=0, 14.1 months; ECOG=1, 7.4 months; ECOG=2, 3.2 months, and ECOG=3, 1.64 months). Survivals for initially metastatic disease were not significantly different whether patients underwent nephrectomy or not (2.0 months vs. 3.4 months, HR=0.62, 95% CI, 0.16–2.44 after correcting for potential prognostic factors). Conclusions: Patients with SRCC have a fulminant clinical course and the majority of patients had disease progression irrespective of any treatment. Only performance status dose have impact on overall survival. No significant financial relationships to disclose.
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Park I, Moon E, Hwang JA, Yu S, Kim BW, Wang HJ, Shin GT, Kim H. Does hepatorenal syndrome affect the result of liver transplantation? Clinical observations. Transplant Proc 2011; 42:2563-6. [PMID: 20832544 DOI: 10.1016/j.transproceed.2010.04.049] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Revised: 10/13/2009] [Accepted: 04/21/2010] [Indexed: 12/01/2022]
Abstract
Hepatorenal syndrome (HRS) is a reversible, functional renal failure that occurs in patients with advanced hepatic failure. However, the reported rates of complete recovery of renal function and patient survivals after orthotopic liver transplantation (OLT) are variable. The aim of this study was to compare the outcomes after OLT between patients with HRS and those without HRS (no-HRS). We established exclusion criteria to select study patients who underwent OLT in a single center between January 2005 and October 2008. The exclusion criteria included the following: (1) malignancy, (2) <18 years of age, (3) other than primary OLT, (4) ABO mismatch or hemophilia, (5) no liver cirrhosis, and (6) survival >1 month after OLT. We selected 71 subjects, including 8 HRS and 63 no-HRS patients. No significant differences were observed in the estimated glomerular filtration rate (eGFR) between the 2 groups except for a lower eGFR on the day of and 1 month after OLT in the HRS group: 108.3 ± 40.5 versus 31.4 ± 14.1 mL/min and 85.4 ± 15.0 versus 57.3 ± 12.1 mL/min (P = .000 and P = .014, respectively). The renal function of 6/7 HRS patients who survived >1 year improved. The 1-year patient survival rate after OLT in HRS patients was similar to that without HRS: 95% versus 86% (P = .37). We concluded that HRS had minimal effects on patient survival and return of acceptable renal function.
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Ellingson BM, Pope WB, Lai A, Nghiemphu PL, Cloughesy TF, Juhasz C, Mittal S, Muzik O, Chugani DC, Chakraborty PK, Bahl G, Barger GR, Carrillo JA, Lai A, Nghiemphu P, Tran A, Moftakhar P, Cloughesy TF, Pope WB, Bruggers C, Moore K, Khatua S, Gumerlock MK, Stolzenberg E, Fung KM, Smith ML, Kedzierska K, Chacko G, Epstein RB, Holter J, Parvataneni R, Kadambi A, Park I, Elkhaled A, Essock-Burns E, Khayal I, Butowski N, Lamborn K, Chang S, Nelson S, Sanverdi E, Ozgen B, Oguz KK, Soylemezoglu F, Mut M, Zhu JJ, Pfannl R, Do-Dai D, Yao K, Mignano J, Wu JK, Linendoll N, Beal K, Chan T, Yamamda Y, Holodny A, Gutin PH, Zhang Z, Young RJ, Lupo JM, Essock-Burns E, Cha S, Chang SM, Butowski N, Nelson SJ, Laperriere N, Perry J, Macdonald D, Mason W, Easaw J, Del Maestro R, Kucharczyk W, Hussey D, Greaves K, Moore S, Pouliot JF, Rauschkolb PK, Smith SD, Belden CJ, Lallana EC, Fadul CE, Bosscher L, Slot M, Sanchez E, Uitdehaag BM, Vandertop WP, Peerdeman SM, Blumenthal DT, Bokstein F, Artzi M, Palmon M, Aizenstein O, Sitt R, Gurevich K, Kanner A, Ram Z, Corn B, Ben Bashat D, Slot M, Bosscher L, Sanchez E, Uitdehaag BM, Vandertop WP, Peerdeman SM, Martinez N, Gorniak R, Tartaglino L, Scanlan M, Glass J, Kleijn A, Chen JW, Sun PZ, Buhrman J, Rabkin SD, Weissleder R, Martuza RL, Lamfers ML, Fulci G, Lallana EC, Brong KA, Hekmatyar K, Jerome N, Wilson M, Fadul CE, Kauppinen RA, Mok K, Valenca MM, Sherafat E, Olivier A, Pentsova E, Rosenblum M, Holodny A, Palomba L, Omuro A, Murad GJ, Yachnis AT, Dunbar EM, Essock-Burns E, Li Y, Lupo J, Polley MY, Butowski N, Cha S, Chang S, Nelson S, Kohler N, Quisling R, Dunbar EM, Swanson KR, Gu S, Chakraborty G, Alessio A, Claridge J, Rockne RC, Muzi M, Krohn KA, Spence AM, Alvord EC, Anderson AR, Kinahan P, Boone AE, Rockne RC, Mrugala MM, Swanson KR, Gutova M, Khankaldyyan V, Herrmann KA, Harutyunyan I, Abramyants Y, Annala AJ, Najbauer J, Moats RA, Shackleford GM, Barish ME, Aboody KS. Radiology. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lee KS, Park I, Ro J, Kang HS, Kim SW, Lee S, Jung SY, Kwon Y. Phase IB study of primary chemotherapy with paclitaxel, gemcitabine, and sunitinib in patients with HER2-negative stage II/III breast cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Han S, Ro J, Paquet A, Huang W, Weidler J, Lee KS, Park I, Oh D, Im S, Kim T. HER2, p95HER2, and HER3 expression and treatment outcome of lapatinib plus capecitabine in HER2-positive, trastuzumab-refractory metastatic breast cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Keam B, Im S, Koh Y, Han S, Oh D, Kang K, Kim T, Park I, Noh D, Bang Y. Use of sequential FDG-PET/CT to guide extent of axillay lymph node dissection in breast cancer receiving neoadjuvant chemotherapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kim S, Ro J, Park I, Lee K, Jeong J. Significance of Viral Reactivation in Hepatitis B Virus Carriers with Early Breast Cancer Receiving Anthracycline- or Taxane-Containing Chemotherapy. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background :It is known that cancer patients in healthy hepatitis B viral (HBV) carrier status are prone to develop hepatic dysfunction during cytotoxic chemotherapy. The objectives of this study were to determine the frequency of healthy HBV carrier status and subsequent viral reactivation resulting in hepatic dysfunction during cytotoxic chemotherapy, and its significance in early breast cancer patients.Methods :Among 3,433 patients with operable breast cancer diagnosed at the National Cancer Center, Korea between January 2001 and March 2009, 3,337 patients were tested for HBsAg. Retrospectively, medical records were reviewed for 139 (4.2%) patients who were positive for HBs Ag.Results :Of 139 patients, 112 patients received anthracycline or taxane based neoadjuvant (n=25) or adjuvant (n=87) combination chemotherapy. Prophylactic lamivudine therapy was administered in 33 patients (29.5%).Thirty of 112 (26.8%) patients developed reactivation of HBV with deterioration of hepatic function during chemotherapy. The rate of reactivaton was not different with or without further taxane therapy (43% vs. 44%, p=0.408).Although there was no significant difference in the rate of chemotherapy delay between two groups, the incidence of early termination of planned chemotherapy was higher in B viral reactivation group (23.3% vs. 4.9%, p=0.008). Within a median follow-up duration of 39 mo (range 1 mo to 95 mo), the rate of disease recurrence was comparable between two groups (10% vs. 18.3%, p=0.390).Lamivudine prophylaxis decreased the rate of HBV reactivation without statistical significance (15.1% vs. 35.4%, p=0.101). Despite more patients without prophylaxis developed G 3/4 AST/ALT elevation (40% vs. 84%, p=0.068), the majority of patients recovered to G 1/2 AST/ALT level within 12 months with anti-viral or supportive treatment (0% vs. 14.3%, p=1.00). One patient without lamivudine prophylaxis developed fulminant hepatic failure after 3rd cycles of neo-adjuvant chemotherapy and received living donor liver transplantation. After that, she received radical mastectomy and maintained adjuvant anti-hormonal therapy.Conclusions :Although lamivudine prophylaxis in HBV healthy carrier decreased the rate of viral reactivation during neo- or adjuvant chemotherapy, the majority of patients irrespective of prophylaxis recovered hepatic function in a year with conservative treatment. Early detection and intensive supportive care are as important as anti-viral prophylaxis in HBV healthy carrier when treated with cytotoxic chemotherapy.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1113.
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Jung S, Min S, Lee S, Park C, Kwon Y, Kim E, Ko K, Lee K, Park I, Jeong J, Shin K, Lee S, Kim S, Kang H, Ro J. Prognostic Factors for Locoregional Recurrence in Operable Breast Cancer Patients Treated with Preoperative Systemic Chemotherapy. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-1095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: We aimed to evaluate the clinicopathologic factors affecting locoregional recurrence (LRR) in potentially operable breast cancer patients receiving preoperative systemic chemotherapy (PST).Methods: We reviewed the records of 316 breast cancer patients treated with PST (doxorubicin/cyclophosphamide, 101; docetaxel /capecitabine, 103; paclitaxel/gemcitabine, 43; doxorubicin/docetaxel, 69) followed by surgery and adjuvant radiotherapy between 2002 and 2006. The majority of patients had clinical positive axillary lymph nodes. To define the prognostic factors for LRR, age, clinical stage, hormone receptor (HR) and HER2 status, clinical and pathologic response, type of operation, pathological characteristics including tumor size, tumor grade, nodal status, number of positive axillary nodes, size of metastatic lymph node and status of resection margin and tumor multiplicity before and after PST were analyzed.Results: Overall 52 patients (16.5%) in the primary tumor and 87 patients (27.5%) in the axillary nodes achieved a pathologic complete response (pCR), and 206 patients (65.2%) underwent breast conserving surgery (BCS). With a median follow-up of 52.4 month (range: 4.7 - 89.4), total 18 (5.7%) patients developed LRR; 2 of 110 (1.8%) patients with mastectomy vs. 16 of 206 (7.7%) patients with BCS (p=0.04). Other significant factors in the univariate analysis were clinical T stage, HR status, clinical response and tumor multiplicity. A pCR in the primary tumor or node was not a prognostic factor for LRR in this study. In multivariate analysis, clinical T stage (T3/4, HR 7.8; 95% CI, 2.33-26.24; P=0.001), hormone receptor status (negative, HR 6.2; 95% CI, 1.91-20.22; P=0.002) and type of surgery (BCS, HR 9.5; 95% CI, 1.97-46.37; P=0.005) were independent prognostic factors. Among patients with BCS, advanced clinical T stage (HR 12.4; 95% CI, 3.45-44.56; P<0.001), negative hormone receptor (HR 4.74; 95% CI, 1.33-16.96; P=0.02), non-responding disease (HR 6.54; 95% CI, 1.07-40.12; P=0.04) and multiple tumors (HR 4.36; 95% CI, 1.06-17.90; P=0.04) developed more frequent LRR.Conclusions: Significantly more patients with advanced clinical T stage, negative HR status and BCS developed LRR in operable breast cancer treated with PST. Moreover, in patients with BCS after PST, clinically non-responding disease and multiple tumors showed unfavorable prognosis besides the larger tumors and negative hormone receptor.Partly supported by NCC Grant No 0610240
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1095.
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Kim S, Baek N, Kwon B, Kwon Y, Ro J, Park I, Lee E. New HER2 Assay Using Trastuzumab for the Selection of Trastuzumab Responding Breast Cancer: The Positivity Is Significantly Associated with Pathologic Complete Response after Preoperative Chemotherapy. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-6050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:The evaluation of HER2 status is required for trastuzumab therapy in breast cancer. Although there are a few methods for an evaluation of HER2 status, theoretically the better method would be to check trastuzumab uptake itself in the tumor after trastuzumab administration. Therefore, we developed a different HER2 test (QHerceptest) using trastuzumab to improve an accuracy in the selection of patient for trastuzumab therapy.Patients and Methods:31 patients with HER2 positive (IHC 3+: 19 and IHC 2+ with FISH positive: 12) early breast cancer who were enrolled in a phase II preoperative paclitaxel, gemcitabin and trastuzumab (PGH) combination chemotherapy trial were evaluated. The pre-chemotherapy tumor specimens were obtained from the breast mass (n=24) or metastatic lymph nodes (n=7). After completing 6 cycles of PGH therapy, all patients underwent breast conserving surgery or mastectomy. We applied trastuzumab and Quantum dot conjugated goat anti-human IgG (QD-IgG, 655nm, Invitrogen) in the process of immunuhistochemistry for HER2 using formalin-fixed paraffin embedded specimen. After antigen retrieval, trastuzuamb was applied followed by QD-IgG. The result of QHerceptest was scored as negative, weak positive, moderate positive, or strong positive, and its relative uptake (RU) were quantified by imaging analysis program (Q-IHC, http://www.bio-miblab.org).Results:The uptake of trastuzumab by QHerceptest was heterogenous, varying between 1.3% to 193.7%. Twenty one of 31 (67.7%) patients achieved pathologic complete response (pCR): 11 of 12 patients (91.7%) with QHerceptest strong positive tumors, 6 of 9 patients (66.7%) with QHerceptest moderate positive tumors, and 4 of 7 patients (57.1%) with QHerceptest weak positive tumors, and none of 3 patients (9.4%) with QHerceptest negative tumors (p=0.0203). Besides, RU was significantly different between non-pCR and pCR groups (43.9±38.3, 80.8±47.1, p=0.0396)Conclusion:We developed a new HER2 assay using trastuzumab and applied to clinical specimen. This assay showed heterogenous trastuzumab uptake in this patient population. Although the data need to be verified by further study, the assay could possibly eliminate patients among HER2 positive breast cancer who will not get benefit by trastuzumab .This study was supported by NCC Grant No 0710292-2 and NCC Grant No 0610240.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6050.
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Jung S, Kim H, Min S, Lee S, Park C, Kwon Y, Kim E, Ko K, Lee K, Park I, Shin K, Lee S, Kim S, Kang H, Ro J. Prognosis of Metaplastic Breast Cancer: Poorer Than the Rest of Triple-Negative Breast Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-4057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The biologic behavior of metaplastic breast cancer (MBC) has not been well elucidated due to its rarity and heterogeneity. This study was designed to assess the clinical and tumor characteristics and outcomes of MBC patients as compared with invasive ductal carcinoma (IDC) in general and the triple-negative (TN) subtype.Materials and methods: This study included 35 MBC and 2,839 IDC patients diagnosed at the National Cancer Center, Korea between 2000 and 2008. We, retrospectively, reviewed the clinicopathologic characteristics and clinical outcomes.Results: The mean age was 47.4 years for MBC group and 48.3 years for IDC group. The MBC group presented with larger tumors (≥ T2, 78.8% vs 41.0%; P<0.001), higher histologic grade (grade 3, 92.0% vs 44.6%; P<0.001), fewer ER and PgR positivity (ER+, 14.3% vs 69.0% ; P<0.001 and PgR+, 25.7% vs 66.1%; P<0.001), higher Ki-67 expression (35.5%±26.2% vs 20.6% ±19.8%; P=0.024) and more TN subtypes (48.6% vs 11.9%; P<0.001) than IDC group. Excluding de novo stage IV patients, 14 of 32 (43.7%) MBC patients and 260 of 2782 (9.4%) IDC patents developed disease recurrence with a median follow-up of 36.2 months (range, 4.9-117.8 months). MBC was a poor prognostic factor for disease recurrence in univariate and multivariate analysis (HR 5.19; 95% CI, 2.04-13.18; P=0.001). MBC patients demonstrated aggressive pathologic features and experienced more disease recurrence (HR 4.77; 95% CI, 1.99-11.44; P=0.001) even when compared with 330 patients with TN subtype.Conclusions:Patients with metaplastic breast carcinoma appeared to have inherent aggressive tumor biology with poorer clinical outcomes than those with IDC in general and TN subtype.Partly supported by NCC Grant No 0610240
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4057.
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Park I, Ro J, Lee K, Kim S, Lee Y. Single Nucleotide Polymorphisms of CYP19A1, rs10459592 and rs4775936 Predict Clinical Benefit of Letrozole in Patients with Metastatic Breast Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-2117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BackgroundThe CYP19A1 gene encodes the enzyme aromatase, which is involved in the production of estrogen in various tissues. We evaluated the efficacy of an aromatase inhibitor, letrozole in metastatic breast cancer patients according to DNA polymorphisms of the aromatase gene CYP19A1.Patients and methodsPatients (n=113) with hormone receptor positive metastatic breast cancer were treated with letrozole. Monthly GnRH agonist was added in premenopausal patients. DNA was isolated from peripheral blood samples and was genotyped for 50 polymorphisms of CYP19A1 by iPLEX Gold assay based on matrix-associated laser desorptional ionization, time-of-flight mass spectrometry.ResultsAmong 50 examined single nucleotide polymorphisms (SNP), 10 SNPs were revealed as monomorphic for Korean population. After trimming of the data using HWE test, rs10459592 (T/G) and rs4775936 (C/T), which were located in exon I.6 of CYP19A, were significantly associated in an over-dominant model with higher disease control rate (CR+PR+SD≥ 6months) (HR=2.82 [95% CI 1.21-6.59], p=0.0149; HR=2.62 [95% CI 1.12-6.10], p=0.0238, respectively). In linkage disequilibrium analysis, these were strongly linked (D'=1.0, r2=0.936), and subsequent haplotype analysis showed a statistical significance with regard to higher disease control rate (HR=2.61 [95% CI 1.12-6.1], p=0.0238). Median time to progression (TTP) with a median follow-up of 85.7 months (range 9.7-107.4 months) was improved in patients having over-dominant form of rs10459592 without statistical significance (median 7.74 months [95% CI 6.48-9.00] vs. median 12.07 months [95% CI 8.87-15.26], p=0.147). In multivariate analysis, rs10459592 (HR=2.81 [95% CI 1.12-7.06], p=0.027) was an independent factor affecting disease control rate besides age (HR=1.06 [95% CI 1.01-1.12], p=0.019) and HER2 positivity (HR=0.25 [95% CI 1.12-7.06], p=0.027).ConclusionIn patients with hormone responsive metastatic breast cancer treated with aromatase inhibitor, letrozole, the presence of SNPs in the exon I.6 of CYP19A1, rs10459592 and rs4775936 were significantly associated with improved treatment efficacy. Although further study is needed, our data present possible candidate markers for the letrozole treatment in metastatic breast cancer. (NCC grant number 0910320-1)
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2117.
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Keam B, Kim H, Im S, Im S, Han S, Han S, Oh D, Oh D, Kim J, Kim J, Lee S, Lee S, Chie E, Chie E, Han W, Han W, Kim D, Kim D, Cho N, Moon W, Kim T, Kim T, Park I, Noh D, Noh D, Heo D, Heo D, Ha S, Ha S, Bang Y, Bang Y. Single Nucleotide Polymorphism (SNP) in RASSF1 and Clinical Outcomes of Breast Cancer Patients Treated with Neoadjuvant Docetaxel/Doxorubicin Chemotherapy. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-6061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
PurposeThe tumor suppressor gene RASSF1 (Ras association domain family member 1) regulates cell cycle, progression, apoptosis, and microtubule stability, and is inactivated by promoter hypermethylation in breast cancer. We analyzed the SNPs in RASSF1 and their predictive and prognostic value in stage II or III breast cancer patients who received neoadjuvant docetaxel/doxorubicin chemotherapyMethodsA total of 139 stage II or III breast cancer patients who received neoadjuvant docetaxel/doxorubicin chemotherapy were enrolled in this study. The patients received three cycles of neoadjuvant chemotherapy followed by curative surgery, and received additional three cycles of docetaxel/doxorubicin chemotherapy as an adjuvant. Germline DNA from peripheral blood mononuclear cells was extracted. The genotypes were performed using Illumina GoldenGate® Assay. We analyzed 3 SNPs in RASSF1 genes: rs3213621 T>C in 3'UTR, rs2073499 G>A in intron, and rs2073498 C>A in exon 3 Ala133Ser.ResultsThe overall radiologic response rate (RR) for neoadjuvant chemotherapy was 79.8% and 10 patients (7.2%) achieved a pathologic complete remission (pCR). None of the SNPs were correlated with radiologic RR or pCR rate. SNP in intron of RASSF1 (rs2073499) was associated with relapse free survival (RFS). RFS was longer in GA/AA genotype than GG genotype (Hazard ratio [HR]=0.374, p=0.034) After adjusting age and hormone status, prognostic value of RASSF1 SNP remained significant (HR=0.393, p=0.050). Other two SNPs were not significantly associated with RFS.ConclusionsThe GA/AA genotype in SNP of RASSF1 (rs2073499) is associated with significantly longer RFS than the GG genotype. Further research is warranted to identify the biologic characteristics of RASSF1.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6061.
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Malloy DC, Sevigny P, Hadjistavropoulos T, Jeyaraj M, McCarthy EF, Murakami M, Paholpak S, Lee Y, Park I. Perceptions of the effectiveness of ethical guidelines: an international study of physicians. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2009; 12:373-383. [PMID: 19544088 DOI: 10.1007/s11019-009-9212-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Accepted: 06/08/2009] [Indexed: 05/27/2023]
Abstract
The intent of ethics is to establish a set of standards that will provide a framework to modify, regulate, and possibly enhance moral behaviour. Eleven focus groups were conducted with physicians from six culturally distinct countries to explore their perception of formalized, written ethical guidelines (i.e., codes of ethics, credos, value and mission statements) that attempt to direct their ethical practice. Six themes emerged from the data: lack of awareness, no impact, marginal impact, other codes or value statements supersede, personal codes or values dictate, and ethical guidelines are useful. Overall, codes were valued only when they were congruent with existing personal morality. The findings suggest the need to re-evaluate the purpose, content, and delivery of codes for them to improve their function in promoting ethical conduct.
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Yen YF, Kohler SJ, Chen AP, Tropp J, Bok R, Wolber J, Albers MJ, Gram KA, Zierhut ML, Park I, Zhang V, Hu S, Nelson SJ, Vigneron DB, Kurhanewicz J, Dirven HAAM, Hurd RE. Imaging considerations for in vivo 13C metabolic mapping using hyperpolarized 13C-pyruvate. Magn Reson Med 2009; 62:1-10. [PMID: 19319902 PMCID: PMC2782538 DOI: 10.1002/mrm.21987] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2007] [Accepted: 01/11/2009] [Indexed: 12/24/2022]
Abstract
One of the challenges of optimizing signal-to-noise ratio (SNR) and image quality in (13)C metabolic imaging using hyperpolarized (13)C-pyruvate is associated with the different MR signal time-courses for pyruvate and its metabolic products, lactate and alanine. The impact of the acquisition time window, variation of flip angles, and order of phase encoding on SNR and image quality were evaluated in mathematical simulations and rat experiments, based on multishot fast chemical shift imaging (CSI) and three-dimensional echo-planar spectroscopic imaging (3DEPSI) sequences. The image timing was set to coincide with the peak production of lactate. The strategy of combining variable flip angles and centric phase encoding (cPE) improved image quality while retaining good SNR. In addition, two aspects of EPSI sampling strategies were explored: waveform design (flyback vs. symmetric EPSI) and spectral bandwidth (BW = 500 Hz vs. 267 Hz). Both symmetric EPSI and reduced BW trended toward increased SNR. The imaging strategies reported here can serve as guidance to other multishot spectroscopic imaging protocols for (13)C metabolic imaging applications.
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Jeong J, Chae Y, Kim J, Sohn S, Park H, Park J, Yang J, Park I, Lee Y. Association between P53 expression or TP53 codon 72 polymorphism and prognosis in patients with operated invasive breast cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e22175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22175 Background: The present study analyzed the impact of p53 expression and TP53 codon 72 polymorphism on the prognosis in patients with operated invasive breast cancer. Methods: Two hundred thirty-four patients with ductal breast cancer who underwent surgery with curative intent were enrolled in the present study. The tumor expressions of p53, ER, PR, and HER2 were graded immunohistochemically and TP53 codon 72 polymorphism was determined by a PCR-RFLP assay using genomic DNA extracted from paraffin-embedded tissue. Results: The median age was 49 (range, 24–82) years, and 134 (57.3%) patients were premenopause at the time of diagnosis. Pathologic stages after surgery were as follows: stage I (n=77, 32.9%), stage II (n=110, 47.0%), and stage III (n=47, 20.1%). Tumor overexpression of p53 protein was observed in 59 (25.2%) patients and was associated with an unfavorable relapse-free survival (RFS) in an univariate analysis adjusted to age, stage, and menstrual status. In a multivariate analysis, p53 overexpression was an independent prognostic factor for RFS (HR=2.36; 95% CI=1.09–5.13; p=0.030). However, no associations were observed between the genotype of TP53 codon 72 polymorphism and survival or clinicopathologic characteristics. Conclusions: Overexpression of p53 protein can be considered as a prognostic factor for RFS in the breast cancer patients after surgery. No significant financial relationships to disclose.
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