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Durand NC, Kim HG, Patel VN, Turnbull MT, Siegel JL, Hodge DO, Tawk RG, Meschia JF, Freeman WD, Zubair AC. Mesenchymal Stem Cell Therapy in Acute Intracerebral Hemorrhage: A Dose-Escalation Safety and Tolerability Trial. Neurocrit Care 2023:10.1007/s12028-023-01897-w. [PMID: 38114796 DOI: 10.1007/s12028-023-01897-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/26/2023] [Accepted: 11/15/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND We conducted a preliminary phase I, dose-escalating, safety, and tolerability trial in the population of patients with acute intracerebral hemorrhage (ICH) by using human allogeneic bone marrow-derived mesenchymal stem/stromal cells. METHODS Eligibility criteria included nontraumatic supratentorial hematoma less than 60 mL and Glasgow Coma Scale score greater than 5. All patients were monitored in the neurosciences intensive care unit for safety and tolerability of mesenchymal stem/stromal cell infusion and adverse events. We also explored the use of cytokines as biomarkers to assess responsiveness to the cell therapy. We screened 140 patients, enrolling 9 who met eligibility criteria into three dose groups: 0.5 million cells/kg, 1 million cells/kg, and 2 million cells/kg. RESULTS Intravenous administration of allogeneic bone marrow-derived mesenchymal stem/stromal cells to treat patients with acute ICH is feasible and safe. CONCLUSIONS Future larger randomized, placebo-controlled ICH studies are necessary to validate this study and establish the effectiveness of this therapeutic approach in the treatment of patients with ICH.
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Affiliation(s)
- Nisha C Durand
- Center for Regenerative Biotherapeutics, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
- Human Cellular Therapy Laboratory, Mayo Clinic, Jacksonville, FL, USA.
| | - H G Kim
- Clinical Research Intern Scholar Program, Mayo Clinic, Jacksonville, FL, USA
| | - Vishal N Patel
- Division of Neuroradiology, Mayo Clinic, Jacksonville, FL, USA
| | - Marion T Turnbull
- Research Collaborator in the Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Jason L Siegel
- Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - David O Hodge
- Biostatistics Unit, Mayo Clinic, Jacksonville, FL, USA
| | - Rabih G Tawk
- Department of Neurologic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | | | - W David Freeman
- Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA
- Department of Neurologic Surgery, Mayo Clinic, Jacksonville, FL, USA
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Abba C Zubair
- Center for Regenerative Biotherapeutics, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
- Department of Laboratory Medicine and Pathology, Center for Regenerative Biotherapeutics, Mayo Clinic, Jacksonville, FL, USA
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Go SI, Choi BH, Park MJ, Park S, Kang MH, Kim HG, Kang JH, Jeong EJ, Lee GW. Prognostic impact of pretreatment skeletal muscle index and CONUT score in diffuse large B-cell Lymphoma. BMC Cancer 2023; 23:1071. [PMID: 37932700 PMCID: PMC10629181 DOI: 10.1186/s12885-023-11590-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Although the prognostic value of the Controlling Nutritional Status (CONUT) score in diffuse large B-cell lymphoma (DLBCL) has been reported in several previous studies, its clinical relevance for the presence of sarcopenia has not been assessed. METHODS In this study, 305 DLBCL patients were reviewed. They were categorized into normal/mild (n = 219) and moderate/severe (n = 86) CONUT groups. Sarcopenia was assessed using the L3-skeletal muscle index measured by baseline computed tomography imaging. Based on CONUT score and sarcopenia, patients were grouped: A (normal/mild CONUT and no sarcopenia), B (either moderate/severe CONUT or sarcopenia, but not both), and C (both moderate/severe CONUT and sarcopenia). RESULTS The moderate/severe CONUT group showed higher rates of ≥ grade 3 febrile neutropenia, thrombocytopenia, non-hematologic toxicities, and early treatment discontinuation not related to disease progression, compared to the normal/mild CONUT group. The moderate/severe CONUT group had a lower complete response rate (58.1% vs. 80.8%) and shorter median overall survival (18.5 vs. 162.6 months) than the normal/mild group. Group C had the poorest prognosis with a median survival of 8.6 months, while groups A and B showed better outcomes (not reached and 60.1 months, respectively). Combining CONUT score and sarcopenia improved the predictive accuracy of the Cox regression model (C-index: 0.763), compared to the performance of using either CONUT score (C-index: 0.754) or sarcopenia alone (C-index: 0.755). CONCLUSIONS In conclusion, the moderate/severe CONUT group exhibited treatment intolerance, lower response, and poor prognosis. Additionally, combining CONUT score and sarcopenia enhanced predictive accuracy for survival outcomes compared to individual variables.
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Affiliation(s)
- Se-Il Go
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Bong-Hoi Choi
- Department of Nuclear Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Mi Jung Park
- Department of Radiology, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Sungwoo Park
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Gangnam-ro 79 Jinju, Jinju, 52727, Korea
| | - Myoung Hee Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Hoon-Gu Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Jung Hun Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Gangnam-ro 79 Jinju, Jinju, 52727, Korea
| | - Eun Jeong Jeong
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Gangnam-ro 79 Jinju, Jinju, 52727, Korea
| | - Gyeong-Won Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Gangnam-ro 79 Jinju, Jinju, 52727, Korea.
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Kim KH, Lee JH, Lee M, Kim HG, Do YR, Park Y, Oh SY, Shin HJ, Kim WS, Park SK, Kong JH, Park MR, Yang DH, Kwak JY, Kang HJ, Mun YC, Won JH. Busulfan, Melphalan, and Etoposide (BuME) Showed an Equivalent Effect to Busulfan, Cyclophosphamide, and Etoposide (BuCE) as Conditioning Therapy for Autologous Stem Cell Transplantation in Patients with Relapsed or High-Risk Non-Hodgkin's Lymphoma: A Multicenter Randomized Phase II Study bythe Consortium for Improving Survival of Lymphoma (CISL). Cancer Res Treat 2023; 55:304-313. [PMID: 35381164 PMCID: PMC9873313 DOI: 10.4143/crt.2022.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 01/03/2022] [Accepted: 03/29/2022] [Indexed: 02/04/2023] Open
Abstract
PURPOSE High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard management for relapsed or high-risk non-Hodgkin's lymphoma (NHL). We reported the busulfan, melphalan, and etoposide (BuME) conditioning regimen was effective in patients with relapsed or high-risk NHL. Moreover, the busulfan, cyclophosphamide, and etoposide (BuCE) conditioning regimen has been used widely in ASCT for NHL. Therefore, based on these encouraging results, this randomized phase II multicenter trial compared the outcomes of BuME and BuCE as conditioning therapies for ASCT in patients with NHL. MATERIALS AND METHODS Patients were randomly assigned to receive either BuME (n=36) or BuCE (n=39). The BuME regimen was comprised of busulfan (3.2 mg/kg/day, intravenously) administered on days -7, -6, and -5, etoposide (400 mg/m2 intravenously) on days -5 and -4, and melphalan (50 mg/m2/day intravenously) on days -3 and -2. The BuCE regimen was comprised of busulfan (3.2 mg/kg/day intravenously) on days -7, -6, and -5, etoposide (400 mg/m2/day intravenously) on days -5 and -4, and cyclophosphamide (50 mg/kg/day intravenously) on days -3 and -2. The primary endpoint was 2-year progression-free survival (PFS). RESULTS Seventy-five patients were enrolled. Eleven patients (30.5%) in the BuME group and 13 patients (33.3%) in the BuCE group had disease progression or died. The 2-year PFS rate was 65.4% in the BuME group and 60.6% in the BuCE group (p=0.746). There were no non-relapse mortalities within 100 days after transplantation. CONCLUSION There were no significant differences in PFS between the two groups. Therefore, busulfan-based conditioning regimens, BuME and BuCE, may be important treatment substitutes for the BCNU-containing regimens.
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Affiliation(s)
- Kyoung Ha Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul,
Korea
| | - Jae Hoon Lee
- Deparment of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon,
Korea
| | - Mark Lee
- Department of Internal Medicine, Konkuk University Medical Center and School of Medicine, Seoul,
Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju,
Korea
| | - Young Rok Do
- Division of Hematology-Oncology, Department of Medicine, Dongsan Medical Center, Keimyung University, Daegu,
Korea
| | - Yong Park
- Division of Hematology/Oncology, Department of Internal Medicine, Korea University School of Medicine, Seoul,
Korea
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan,
Korea
| | - Ho-Jin Shin
- Division of Hematology-Oncology, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan,
Korea
| | - Won Seog Kim
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Seong Kyu Park
- Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon,
Korea
| | - Jee Hyun Kong
- Division of Oncology and Hematology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju,
Korea
| | - Moo-Rim Park
- Department of Internal Medicine, Wonkwang University School of Medicine, Iksan,
Korea
| | - Deok-Hwan Yang
- Department of Hematology/Oncology, Chonnam National University Hwasun Hospital, Hwasun,
Korea
| | - Jae-Yong Kwak
- Division of Hematology/Oncology, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju,
Korea
| | - Hye Jin Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Science, Seoul,
Korea
| | - Yeung-Chul Mun
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul,
Korea
| | - Jong-Ho Won
- Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul,
Korea
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Go SI, Park S, Kang MH, Kim HG, Kang JH, Kim JH, Lee GW. Endothelial activation and stress index (EASIX) as a predictive biomarker in small cell lung cancer. Cancer Biomark 2022; 35:217-225. [PMID: 36120771 DOI: 10.3233/cbm-220032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/15/2022]
Abstract
BACKGROUND Endothelial activation and insult may contribute to the aggressive clinical course of small-cell lung cancer (SCLC); however, no predictive biomarker for this pathogenesis has been identified. OBJECTIVE To evaluate the clinical impact of the endothelial activation and stress index (EASIX) in SCLC. METHODS In this retrospective study, the EASIX was calculated from measurements of serum lactate dehydrogenase, creatinine, and platelet levels. A total of 264 patients with SCLC treated with platinum-based chemotherapy were stratified into high and low EASIX groups. RESULTS Complete and objective response rates in the limited-stage (LD) were 19.5% vs. 33.3% (P= 0.050) and 85.4% vs. 97.9% (P= 0.028) in the high and low EASIX groups, respectively. There was no significant difference in the response rate between the two groups in the extensive-stage (ED). The median overall survival was 9.8 vs. 40.5 months in LD (P< 0.001) and 7.2 vs. 11.9 months in ED (P< 0.001) in the high and low EASIX groups, respectively. In multivariate analyses, a high EASIX level was an independent prognostic factor for worse progression-free and overall survival irrespective of stage. CONCLUSION EASIX may be a potential predictive biomarker of SCLC.
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Affiliation(s)
- Se-Il Go
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Sungwoo Park
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Myoung Hee Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Hoon-Gu Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Jung Hun Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Jung Hoon Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Gyeong-Won Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
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Ahn SY, Son SK, Lee GH, Kim I, Cheong JW, Lee WS, Kim BS, Jo DY, Jung CW, Seong CM, Lee JH, Yuh YJ, Kim MK, Ryoo HM, Park MR, Cho SH, Kim HG, Zang DY, Park J, Kim H, Lee S, Kim SH, Chang MH, Lee HS, Choi CW, Kwon J, Lim SN, Oh SJ, Joo I, Kim DW. Safety and efficacy of nilotinib in adult patients with chronic myeloid leukemia: a post-marketing surveillance study in Korea. Blood Res 2022; 57:144-151. [PMID: 35678158 PMCID: PMC9242833 DOI: 10.5045/br.2022.2021137] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/30/2021] [Revised: 11/09/2021] [Accepted: 05/04/2022] [Indexed: 12/02/2022] Open
Abstract
Background Nilotinib is a tyrosine kinase inhibitor approved by the Ministry of Food and Drug Safety for frontline and 2nd line treatment of Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML). This study aimed to confirm the safety and efficacy of nilotinib in routine clinical practice within South Korea. Methods An open-label, multicenter, single-arm, 12-week observational post-marketing surveillance (PMS) study was conducted on 669 Korean adult patients with Ph+ CML from December 24, 2010, to December 23, 2016. The patients received nilotinib treatment in routine clinical practice settings. Safety was evaluated by all types of adverse events (AEs) during the study period, and efficacy was evaluated by the complete hematological response (CHR) and cytogenetic response. Results During the study period, AEs occurred in 61.3% (410 patients, 973 events), adverse drug reactions (ADRs) in 40.5% (271/669 patients, 559 events), serious AEs in 4.5% (30 patients, 37 events), and serious ADRs in 0.7% (5 patients, 8 events). Furthermore, unexpected AEs occurred at a rate of 6.9% (46 patients, 55 events) and unexpected ADRs at 1.2% (8 patients, 8 events). As for the efficacy results, CHR was achieved in 89.5% (442/494 patients), and minor cytogenetic response or major cytogenetic response was achieved in 85.8% (139/162 patients). Conclusion This PMS study shows consistent results in terms of safety and efficacy compared with previous studies. Nilotinib was well tolerated and efficacious in adult Korean patients with Ph+ CML in routine clinical practice settings.
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Affiliation(s)
- Seo-Yeon Ahn
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Sang Kyun Son
- Department of Hematology-Oncology, School of Medicine, Kyungpook National University, Daegu, Department of Internal Medicine, Seoul, Korea
| | - Gyu Hyung Lee
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Inho Kim
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - June-Won Cheong
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Won Sik Lee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Byung Soo Kim
- Division of Hematology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Deog-Yeon Jo
- Department of Internal Medicine, College of Medicine, Chungnam National Univeristy, Daejeon, Korea
| | - Chul Won Jung
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chu Myoung Seong
- Department of Hematology and Oncology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Jae Hoon Lee
- Division of Hematology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Young Jin Yuh
- Department of Internal Medicine, Inje University, Sanggye-Paik Hospital, Seoul, Korea
| | - Min Kyoung Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Hun-Mo Ryoo
- Division of Hematology-Oncology, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea
| | - Moo-Rim Park
- Department of Hematology-Oncology, Wonkwang University School of Medicine, Iksan, Korea
| | - Su-Hee Cho
- Division of Hematology-Oncology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Dae Young Zang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jinny Park
- Division of Hematology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Hawk Kim
- Division of Hematology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seryeon Lee
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sung-Hyun Kim
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Myung Hee Chang
- Division of Oncology-Hematology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Ho Sup Lee
- Division of Oncology-Hematology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Chul Won Choi
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Jihyun Kwon
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sung-Nam Lim
- Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea
| | - Suk-Joong Oh
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Dong-Wook Kim
- Department of Hematology, Uijeongbu Eulji Medical Center, Leukemia Omics Research Institute, Eulji University Uijeongbu Campus, Uijeongbu, Korea
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Won JH, Kim KH, Yoon SY, Lee JH, Lee M, Kim HG, Do YR, Park Y, Oh SY, Shin HJ, Kim WS, Park SK, Kong J, Park MR, Yang DH, Kwak JY, Kang HJ, Mun YC. Busulfan, Melphalan, and Etoposide (BuME) Showed an Equivalent Effect to Busulfan, Cyclophosphamide, and Etoposide (BuCE) As Conditioning Therapy for Autologous Transplantation in Patients with Relapsed or High Risk Non-Hodgkin Lymphoma: A Multicenter Randomized Phase II Study By the Consortium for Improving Survival of Lymphoma (CISL). Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00683-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Go SI, Park MJ, Park S, Kang MH, Kim HG, Kang JH, Kim JH, Lee GW. Cachexia index as a potential biomarker for cancer cachexia and a prognostic indicator in diffuse large B-cell lymphoma. J Cachexia Sarcopenia Muscle 2021; 12:2211-2219. [PMID: 34676685 PMCID: PMC8718032 DOI: 10.1002/jcsm.12837] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/19/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Cancer cachexia is known to adversely affect the clinical course in patients with malignant lymphoma. The cachexia index (CXI) is a potential biomarker of cancer cachexia, and its implications for the prognosis and treatment outcome of lung cancer and aggressive lymphoma has been assessed in previous studies. METHODS A total of 267 patients diagnosed with diffuse large B-cell lymphoma who were treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) immunochemotherapy were retrospectively reviewed. The CXI was calculated as the skeletal muscle index (SMI) × serum albumin/neutrophil-lymphocyte ratio (NLR). Although previous studies measured the SMI using the muscles of the L3 vertebral level, the present study used both the L3 vertebral muscles and the pectoralis muscles (PM) at the T4 vertebral level to measure the SMI. Depending on the type of muscles used, the CXI was termed the L3-CXI or PM-CXI. Using sex-specific cutoff values for CXI, the patients were categorized as follows: (i) high-CXI group (high L3-CXI and high PM-CXI), (ii) intermediate-CXI group (high L3-CXI and low PM-CXI), and (iii) low-CXI group (low L3-CXI and low PM-CXI). RESULTS Complete responses to R-CHOP were obtained in 145/173 (83.8%), 25/36 (69.4%), and 27/57 (47.4%) patients in the high-CXI, intermediate-CXI, and low-CXI groups, respectively (P < 0.001). Treatment-related anaemia (15.6%, 30.6%, and 26.3%, P = 0.038), thrombocytopenia (21.4%, 36.1%, and 43.9%, P < 0.001), febrile neutropenia (23.7%, 44.4%, and 36.8%, P = 0.022), and any nonhaematologic toxicity (31.2%, 44.4%, and 54.4%, P = 0.001) of Grade 3 or more were more common in the lower CXI groups than in the higher-CXI groups. Early treatment discontinuation for reasons other than lymphoma progression also occurred more frequently in the low-CXI group (24/57, 42.1%) compared with the intermediate-CXI (5/36, 13.9%) and high-CXI (18/173, 10.4%) groups (P < 0.001). Median overall survival in the high-CXI, intermediate-CXI, and low-CXI groups was not reached, 50.6 months, and 14.5 months, respectively (p < 0.001). Multivariable analysis showed that low CXI was an independent negative prognostic factor for overall survival (hazard ratio 2.103, 95% confidence interval 1.278-3.460, P = 0.003). CONCLUSIONS We suggest that in patients with diffuse large B-cell lymphoma, the CXI is a biomarker for cancer cachexia that can predict survival, treatment response, treatment-related toxicity, and compliance with R-CHOP. Patients were more clearly stratified by this new CXI category compared with the classifications described in previous studies.
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Affiliation(s)
- Se-Il Go
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea
| | - Mi Jung Park
- Department of Radiology, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Sungwoo Park
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Myoung Hee Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea
| | - Hoon-Gu Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea
| | - Jung Hun Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Jung Hoon Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Gyeong-Won Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
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Park H, Kim I, Kim HJ, Shin DY, Lee SY, Kwon OH, Kim DY, Lee KH, Ahn JS, Park J, Sohn SK, Lee JO, Cheong JW, Kim KH, Kim HG, Kim H, Lee YJ, Nam SH, Do YR, Park SG, Park SK, Bae SH, Song HH, Oh D, Jung CW, Park S. Ultra-deep sequencing mutation analysis of the BCR/ABL1 kinase domain in newly diagnosed chronic myeloid leukemia patients. Leuk Res 2021; 111:106728. [PMID: 34673444 DOI: 10.1016/j.leukres.2021.106728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/28/2021] [Revised: 10/06/2021] [Accepted: 10/11/2021] [Indexed: 11/28/2022]
Abstract
Ultra-deep sequencing detects low-frequency genetic mutations with high sensitivity. We used this approach to prospectively examine mutations in the BCR/ABL1 tyrosine kinase from patients with newly diagnosed, chronic-phase chronic myeloid leukemia (CML) treated with the tyrosine kinase inhibitor nilotinib. Between May 2013 and November 2014, 50 patients from 18 institutions were enrolled in the study. We screened 103 somatic mutations and found that mutations in the P-loop domain were the most frequent (173/454 mutations in the P-loop) and noted the presence of the V299 L mutation (dasatinib-resistant/nilotinib-sensitive) in 98 % of patients (49/50). No patients had Y253H, E255 V, or F359 V/C/I mutations, which would recommend dasatinib rather than nilotinib treatment. The S417Y mutation was associated with lower achievement of a major molecular response (MMR) at 6 months, and the V371A mutation was associated with reduced MMR and MR4.5 durations (MMR for 2 years: 100 % for no mutation vs. 75 % for mutation, P=0.039; MR4.5 for 15 months: 94.1 % vs. 25 %, P=0.002). Patients with known nilotinib-resistant mutations had lower rates of MR4.5 achievement. In conclusion, ultra-deep sequencing is a sensitive method for genetic-based treatment decisions. Based on the results of these mutational analyses, nilotinib treatment is a promising option for Korean patients with CML.
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Affiliation(s)
- Hyunkyung Park
- Department of Internal Medicine, Seoul National University Hospital, Biomedical Research Institute, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Inho Kim
- Department of Internal Medicine, Seoul National University Hospital, Biomedical Research Institute, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
| | - Hyeong-Joon Kim
- Department of Internal Medicine, Chonnam National University, Hwasun Hospital, Hwasun, South Korea.
| | - Dong-Yeop Shin
- Department of Internal Medicine, Seoul National University Hospital, Biomedical Research Institute, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | | | | | - Dae-Young Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyoo-Hyung Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae-Sook Ahn
- Department of Internal Medicine, Chonnam National University, Hwasun Hospital, Hwasun, South Korea
| | - Jinny Park
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea
| | - Sang-Kyun Sohn
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
| | - Jeong-Ok Lee
- Department of Internal Medicine, Seoul National University, Bundang Hospital, Seongnam, South Korea
| | - June-Won Cheong
- Department of Internal Medicine, Yonsei University, Severance Hospital, Seoul, South Korea
| | - Kyoung Ha Kim
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Hawk Kim
- Department of Internal Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Yoo Jin Lee
- Department of Internal Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Seung-Hyun Nam
- Department of Internal Medicine, VHS Medical Center, Seoul, South Korea
| | - Young Rok Do
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Sang-Gon Park
- Department of Internal Medicine, Chosun University Hospital, Gwangju, South Korea
| | - Seong Kyu Park
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Sung Hwa Bae
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, South Korea
| | - Hun Ho Song
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Doyeun Oh
- Department of Internal Medicine, CHA Bundang Medical Center, Seongnam, South Korea
| | - Chul Won Jung
- Department of Internal Medicine, Samsung Medical Center, Seoul, South Korea
| | - Seonyang Park
- Department of Internal Medicine, Inje University, Haeundae Paik Hospital, Busan, South Korea
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9
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Park K, Kim JS, Kim JH, Kim YC, Kim HG, Cho EK, Jin JY, Kim M, Märten A, Kang JH. An open-label expanded access program of afatinib in EGFR tyrosine kinase inhibitor-naïve patients with locally advanced or metastatic non-small cell lung cancer harboring EGFR mutations. BMC Cancer 2021; 21:802. [PMID: 34253172 PMCID: PMC8274031 DOI: 10.1186/s12885-021-08445-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 01/13/2021] [Accepted: 05/28/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Afatinib is approved globally for EGFR-TKI treatment-naïve patients with EGFR mutation-positive non-small cell lung cancer (NSCLC). In this Korean expanded access program, we evaluated its 'real-world' safety and efficacy. METHODS EGFR-TKI treatment-naïve patients with EGFR mutation-positive NSCLC received afatinib 40 mg/day until disease progression or other withdrawal criteria. Dose reductions were permitted for adverse events (AEs). The primary endpoint was the number of patients with AEs (CTCAE version 3.0). Other endpoints included progression-free survival (PFS), overall response rate (ORR), duration of response (DOR), and changes in investigator-assessed cancer-related symptoms. RESULTS Eighty-eight patients received afatinib, including 27 (31%) with brain metastases and 16 (18%) with uncommon EGFR mutations. Median PFS was 17.0 months (95% confidence interval [CI] 12.9-23.3 months). Grade 3 treatment-related AEs (TRAEs) were reported in 51 (58%) patients; the most common were diarrhea (22%) and rash/acne (20%). No grade > 3 TRAEs were reported. AEs leading to dose reduction occurred in 49 (56%) patients. Treatment discontinuation due to TRAEs occurred in 4 (5%) patients. ORR was 81% overall, 89% in patients with brain metastases, and 55% in patients with uncommon mutations (excluding T790M/exon 20 insertions). Median DOR was 15.1 months (95% CI 12.4-21.4 months). Cancer-related symptoms were improved/unchanged/worsened in 34-66%/36-66%/0-3% of patients over the first year. CONCLUSIONS No unexpected safety signals for afatinib were observed. AEs were manageable; the treatment discontinuation rate was low. Afatinib showed encouraging efficacy in a broad patient population including those with brain metastases or tumors harboring uncommon EGFR mutations. TRIALS REGISTRATION ClinicalTrials.gov NCT01931306 ; 29/08/2013.
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Affiliation(s)
- Keunchil Park
- Division of Hematology-Oncology, Department of Medicine Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, South Korea.
| | - Jin-Soo Kim
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Joo-Hang Kim
- CHA Bundang Medical Center, CHA University, Gyeonggi-do, Seongnam, South Korea
| | - Young-Chul Kim
- Chonnam National University Medical School, CNU Hwasun Hospital, Gwangju, South Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Eun Kyung Cho
- Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Jong-Youl Jin
- Bucheon St Mary's Hospital, The Catholic University of Korea, Bucheon, South Korea
| | - Miyoung Kim
- Boehringer Ingelheim Korea Ltd, Seoul, South Korea
| | - Angela Märten
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - Jin-Hyoung Kang
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
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10
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Hong MH, Heo SG, Lee YG, Kim HS, Park KU, Kim HG, Ko YH, Chung IJ, Min YJ, Kim MK, Kim KR, Yoo J, Kim TM, Kim HR, Cho BC. Phase 2 study of afatinib among patients with recurrent and/or metastatic esophageal squamous cell carcinoma. Cancer 2020; 126:4521-4531. [PMID: 32749686 DOI: 10.1002/cncr.33123] [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: 03/13/2020] [Accepted: 06/26/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND The objective of the current study was to investigate the clinical activity of, safety of, and predictive biomarkers for afatinib, an irreversible pan-ErbB kinase inhibitor, in patients with recurrent and/or metastatic esophageal squamous cell carcinoma (R/M-ESCC). METHODS Patients with R/M-ESCC that was refractory to platinum-based chemotherapy were enrolled in the current multicenter, single-arm, phase 2 study and received afatinib at a dose of 40 mg/day. The primary endpoint was the objective response rate. Secondary endpoints included progression-free survival, overall survival, the disease control rate, and the safety profile. To identify predictive biomarkers, single-nucleotide variations, short insertions/deletions, and somatic copy number alterations were assessed using whole-exome sequencing and their associations with clinical outcomes were analyzed. RESULTS Among 49 enrolled patients, the objective response rate and disease control rate were 14.3% and 73.3%, respectively. With a median follow-up of 6.6 months, the median progression-free survival and overall survival were 3.4 months and 6.3 months, respectively. Treatment-related adverse events were noted to have occurred in 33 patients (67.3%), with the majority being of grade 1 to 2 (adverse events were graded and recorded based on the National Cancer Institute Common Terminology Criteria for Adverse Events [version 4.03]). Whole-exome sequencing demonstrated that the ESCC genomes of patients who demonstrated a response to afatinib were enriched with genomic alterations of TP53 and epidermal growth factor receptor (EGFR). As a predictive marker, a score derived from TP53 disruptive mutations and EGFR amplifications and/or missense mutations demonstrated a significant association with the response to afatinib. The score based on the mutational status of EGFR and TP53 achieved a performance of an area under the curve of 0.86 in predicting the sensitivity of afatinib. CONCLUSIONS The results of the current study demonstrated that afatinib can confer modest clinical benefits with manageable toxicity in patients with platinum-resistant R/M-ESCC. Identification of TP53 alterations and EGFR amplifications may serve as predictive markers with which to identify patients with R/M-ESCC who may benefit from afatinib. LAY SUMMARY Esophageal squamous cell carcinoma (ESCC) is a type of cancer with a dismal prognosis and very limited treatment options. The clinical efficacy of afatinib was evaluated in patients with recurrent and/or metastatic ESCC, with adverse events demonstrating the modest efficacy with manageable toxicity of this irreversible, pan-ErbB kinase inhibitor. Whole-exome sequencing analysis of 41 cases of ESCC further revealed that the patients harboring epidermal growth factor receptor (EGFR) amplifications and disruptive TP53 mutations are more likely to benefit from treatment with afatinib. The results of the current study have highlighted the clinical value of EGFR and TP53 as predictive biomarkers of platinum-resistant recurrent and/or metastatic ESCC for afatinib sensitivity.
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Affiliation(s)
- Min Hee Hong
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Seong Gu Heo
- JE-UK Institute for Cancer Research, JEUK Company Ltd, Gumi-City, Kyungbuk, Korea
| | - Yun-Gyoo Lee
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School 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
| | - Keon Uk Park
- Division of Hematology/Oncology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Yoon Ho Ko
- Division of Oncology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ik-Joo Chung
- Department of Hemato-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Young Joo Min
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Min Kyoung Kim
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Kyu Ryung Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jinseon Yoo
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tae-Min Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hye Ryun Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Byoung Chul Cho
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.,JE-UK Institute for Cancer Research, JEUK Company Ltd, Gumi-City, Kyungbuk, Korea
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11
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Go SI, Kim HG, Kang MH, Park S, Lee GW. Prognostic model based on the geriatric nutritional risk index and sarcopenia in patients with diffuse large B-cell lymphoma. BMC Cancer 2020; 20:439. [PMID: 32423395 PMCID: PMC7236094 DOI: 10.1186/s12885-020-06921-2] [Citation(s) in RCA: 11] [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: 03/03/2020] [Accepted: 04/30/2020] [Indexed: 12/26/2022] Open
Abstract
Background Systemic inflammation and cachexia are associated with adverse clinical outcomes in diffuse large B-cell lymphoma (DLBCL). The Geriatric Nutritional Risk Index (GNRI) is one of the main parameters used to assess these conditions, but its efficacy in DLBCL is inconclusive. Methods We retrospectively reviewed 228 DLBCL patients who were treated with R-CHOP immunochemotherapy (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone). The patients were stratified according to GNRI score (> 98, 92 to 98, 82 to < 92, and < 82) as defined in previous studies. Additionally, the extent of sarcopenia was categorized as sarcopenia-both, sarcopenia-L3/PM alone, and non-sarcopenia-both according to skeletal muscle index. Results Survival curves plotted against a combination of GNRI and sarcopenia scores revealed two clear groups as follows: high cachexia risk (HCR) group (GNRI < 82, sarcopenia-both, or GNRI 82–92 with sarcopenia-L3/PM alone) and low cachexia risk (LCR) group (others). The HCR group had a lower complete response rate (46.5% vs. 86.6%) and higher frequency of treatment-related mortality (19.7% vs. 3.8%) and early treatment discontinuation (43.7% vs. 8.3%) compared with the LCR group. The median progression-free survival (PFS) (not reached vs. 10.3 months, p < 0.001) and overall survival (OS) (not reached vs. 12.9 months, p < 0.001) were much shorter in the HCR group than in the LCR group. On multivariable analyses, the HCR group was shown to be an independent negative prognostic factor for PFS and OS after adjusting the National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI). Conclusions A combined model of GNRI and sarcopenia may provide prognostic information independently of the NCCN-IPI in DLBCL.
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Affiliation(s)
- Se-Il Go
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea.,Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Hoon-Gu Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea.,Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Myoung Hee Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea.,Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Sungwoo Park
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Gangnam-ro 79, Jinju, 52727, Republic of Korea
| | - Gyeong-Won Lee
- Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea. .,Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Gangnam-ro 79, Jinju, 52727, Republic of Korea.
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12
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Lee GW, Go SI, Kim DW, Kim HG, Kim JH, An HJ, Jang JS, Kim BS, Hahn S, Heo DS. Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive-stage disease small cell lung cancer: Results from a randomized controlled trial. Thorac Cancer 2019; 11:62-71. [PMID: 31707767 PMCID: PMC6938749 DOI: 10.1111/1759-7714.13229] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 08/30/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Clinical impact of the Geriatric Nutritional Risk Index (GNRI) in patients with extensive-stage disease small cell lung cancer (ED-SCLC) have not previously been reported. METHODS This study analyzed 352 patients enrolled in a previous randomized phase III trial comparing the efficacy of irinotecan plus cisplatin with that of etoposide plus cisplatin as the first-line therapy for ED-SCLC. GNRI values were calculated using serum albumin levels and actual and ideal bodyweights. Patients with a GNRI > 98, 92-98, and <92 were grouped into no, low, and moderate/major risk groups, respectively. RESULTS The objective response rates were 63.2%, 52.6%, and 49.2% in the no, low, and moderate/major risk groups, respectively (P = 0.024). The median progression-free survival (PFS) was shorter in patients with a lower GNRI than in those with a higher GNRI (no vs. low vs. moderate/major risk group; 6.5 vs. 5.8 vs. 5.9 months, respectively; P = 0.028). There were significant differences in median overall survival (OS) according to GNRI (no vs. low vs. moderate/major risk group; 13.2 vs. 10.3 vs. 8.4 months, respectively; P < 0.001). Multivariate analysis revealed that being in the moderate/major risk group was an independent poor prognostic factor for PFS (hazard ratio [HR]: 1.300, 95% confidence interval [CI]: 1.012-1.670; P = 0.040) and OS (HR: 1.539; 95% CI: 1.069-2.216; P = 0.020). CONCLUSIONS This prospective study shows that a low GNRI value was associated with a poor prognosis, and it supports the relationship between systemic inflammation, nutritional status, and clinical outcomes in patients with ED-SCLC.Key points SIGNIFICANT FINDINGS OF THE STUDY: The lower GNRI group had a low response rate to chemotherapy for ED-SCLC. The HRs for PFS and OS were 1.300 and 1.539 in the patients with GNRI < 92. WHAT THIS STUDY ADDS Low GNRI is associated with poor prognosis in ED-SCLC.
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Affiliation(s)
- Gyeong-Won Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Se-Il Go
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Dong-Wan Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Joo-Hang Kim
- Department of Internal Medicine, Division of Medical Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Ho Jung An
- Division of Medical Oncology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joung Soon Jang
- Division of Hematology/Oncology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Bong-Seog Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Seokyung Hahn
- Medical Research Collaborating Center, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Seog Heo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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13
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Kim HG, Yang J, Na YJ. 1569 The Efficacy and Safety of Long-Term Management of Uterine Fibroids with Ulipristal Acetate. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Kim DY, Jung WS, Choi JW, Choung J, Kim HG. Evaluating Tissue Contrast and Detecting White Matter Injury in the Infant Brain: A Comparison Study of Synthetic Phase-Sensitive Inversion Recovery. AJNR Am J Neuroradiol 2019; 40:1406-1412. [PMID: 31345940 DOI: 10.3174/ajnr.a6135] [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] [Received: 03/23/2019] [Accepted: 06/17/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE Synthetic MR imaging enables the acquisition of phase-sensitive inversion recovery images. The aim of this study was to compare the image quality of synthetic phase-sensitive inversion recovery with that of other sequences in infants. MATERIALS AND METHODS Brain MR imaging with 3D T1-weighted fast-spoiled gradient recalled, synthetic T1WI, and synthetic phase-sensitive inversion recovery of 91 infants was compared. Contrast between unmyelinated WM and myelinated WM and between unmyelinated WM and cortical GM was calculated. Qualitative evaluation of image quality and myelination degree was performed. In infants with punctate white matter injuries, the number of lesions was compared. RESULTS The contrast between unmyelinated WM and myelinated WM was higher in synthetic phase-sensitive inversion recovery compared with fast-spoiled gradient recalled or synthetic T1WI (P < .001). Compared with synthetic T1WI, synthetic phase-sensitive inversion recovery showed higher gray-white matter differentiation (P < .001) and myelination degree in the cerebellar peduncle (P < .001). The number of detected punctate white matter injuries decreased with synthetic phase-sensitive inversion recovery compared with fast-spoiled gradient recalled sequences (1.2 ± 3.2 versus 3.4 ± 3.6, P = .001). CONCLUSIONS Synthetic phase-sensitive inversion recovery has the potential to improve tissue contrast and image quality in the brain MR imaging of infants. However, we have to be aware that synthetic phase-sensitive inversion recovery has limited value when assessing punctate white matter injuries compared with 3D fast-spoiled gradient recalled imaging.
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Affiliation(s)
- D Y Kim
- From the Department of Radiology (D.Y.K., W.S.J., J.W.C., H.G.K.)
| | - W S Jung
- From the Department of Radiology (D.Y.K., W.S.J., J.W.C., H.G.K.)
| | - J W Choi
- From the Department of Radiology (D.Y.K., W.S.J., J.W.C., H.G.K.)
| | - J Choung
- Biomedical Informatics (J.C.), Ajou University School of Medicine, Suwon, Republic of Korea.,Office of Biostatistics (J.C.), Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Republic of Korea
| | - H G Kim
- From the Department of Radiology (D.Y.K., W.S.J., J.W.C., H.G.K.) .,Department of Radiology (H.G.K.), Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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15
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Kim DW, Lee DH, Han JY, Lee J, Cho BC, Kang JH, Lee KH, Cho EK, Kim JS, Min YJ, Cho JY, An HJ, Kim HG, Lee KH, Kim BS, Jang IJ, Yoon S, Han O, Noh YS, Hong KY, Park K. Safety, tolerability, and anti-tumor activity of olmutinib in non-small cell lung cancer with T790M mutation: A single arm, open label, phase 1/2 trial. Lung Cancer 2019; 135:66-72. [PMID: 31447004 DOI: 10.1016/j.lungcan.2019.07.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/03/2019] [Accepted: 07/08/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim of this phase 1/2 study was to evaluate the safety, tolerability, pharmacokinetics and antitumor activity of olmutinib in patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) who had failed ≥ 1 previous line of EGFR-tyrosine kinase inhibitor (TKI) therapy. MATERIALS AND METHODS Phase 1 consisted of dose-escalation and four dose-expansion parts (1: olmutinib 300 mg once daily; 2A: 800 mg once daily [EGFR T790 M mutation-positive patients]; 2B: 500 mg twice daily [EGFR T790 M mutation-positive]; 3: 800 mg once daily [EGFR T790 M mutation-negative]). In phase 2, EGFR T790 M mutation-positive patients received olmutinib 800 mg once daily. Data from expansion part 2A and phase 2 were integrated (`pooled phase 2'). Each olmutinib cycle was 21 days. Outcomes included: tumor response, treatment-emergent adverse events (TEAEs), pharmacokinetic parameters. RESULTS Overall, 272 patients received at least one olmutinib dose: dose-escalation (n = 66), expansion parts (n = 165), phase 2 (n = 41). In pooled phase 2, the overall objective response rate, confirmed by independent review, was 55.1% (38/69 evaluable patients; 95% CI, 42.6-67.1). All responses were partial responses; 23 patients had stable disease. Estimated median progression-free survival was 6.9 (95% CI, 5.6-9.7) months; estimated median overall survival was not reached. The most frequent treatment-related AEs were diarrhea (59.2% of patients), pruritus (42.1%), rash (40.8%), and nausea (39.5%). CONCLUSION Olmutinib showed effective clinical activity with a manageable safety profile, indicating therapeutic potential for T790M-positive NSCLC patients who have failed ≥ 1 previous line of EGFR-TKI therapy.
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Affiliation(s)
- Dong-Wan Kim
- Seoul National University Hospital, Seoul, South Korea.
| | - Dae Ho Lee
- University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Ji-Youn Han
- Center for Lung Cancer, National Cancer Center, Goyang, South Korea
| | - Jongseok Lee
- Seoul National University Bundang Hospital, Seoul, South Korea
| | - Byoung Chul Cho
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Hyoung Kang
- Catholic University of Korea, Seoul St Mary's Hospital, Seoul, South Korea
| | - Ki Hyeong Lee
- Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Eun Kyung Cho
- Gil Medical Center, Gachon University School of Medicine, Incheon, South Korea
| | - Jin-Soo Kim
- Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Young Joo Min
- University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Jae Yong Cho
- Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, South Korea
| | - Ho Jung An
- Catholic University of Korea, St Vincent's Hospital, Seoul, South Korea
| | - Hoon-Gu Kim
- Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Kyung Hee Lee
- Yeungnam University Medical Center, Daegu, South Korea
| | - Bong-Seog Kim
- Veterans Health Service Medical Center, Seoul, South Korea
| | - In-Jin Jang
- Seoul National University and Hospital, Seoul, South Korea
| | - Seonghae Yoon
- Seoul National University Bundang Hospital, Seoul, South Korea; Seoul National University and Hospital, Seoul, South Korea
| | - OakPil Han
- Hanmi Pharmaceutical Co., Ltd., Seoul, South Korea
| | - Young Su Noh
- Hanmi Pharmaceutical Co., Ltd., Seoul, South Korea; Department of Pharmaceutical Biochemistry, College of Pharmacy, Kyung Hee University, Seoul, South Korea
| | | | - Keunchil Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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16
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Lee GW, Park SW, Go SI, Kim HG, Kim MK, Min CK, Kwak JY, Bae SB, Yoon SS, Lee JJ, Kim KH, Nam SH, Mun YC, Kim HJ, Bae SH, Shin HJ, Lee JH, Park JS, Jeong SH, Lee MH, Lee HS, Park KW, Lee WS, Lee SM, Lee JO, Hyun MS, Jo DY, Lim SN, Lee JH, Kim H, Cho DY, Do YR, Kim JA, Park SK, Kim JS, Kim SJ, Yi HG, Moon JH, Choi CW, Kim SH, Kim BS, Park MR, Shim H, Song MK, Kim Y, Kim K. The Derived Neutrophil-to-Lymphocyte Ratio Is an Independent Prognostic Factor in Transplantation Ineligible Patients with Multiple Myeloma. Acta Haematol 2018; 140:146-156. [PMID: 30253397 DOI: 10.1159/000490488] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 01/29/2018] [Accepted: 05/20/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND The neutrophil-to-lymphocyte ratio (NLR) is an independent prognostic marker in solid and hematological cancers. While the derived NLR (dNLR) was shown to be non-inferior to the NLR in large cohorts of patients with different cancer types, it has not been validated as a prognostic marker for multiple myeloma (MM) to date. METHODS Between May 22, 2011 and May 29, 2014, 176 patients with MM from 38 centers who were ineligible for autologous stem cell transplantation were analyzed. The dNLR was calculated using complete blood count differential data. The optimal dNLR cut-off value according to receiver operating characteristic analysis of overall survival (OS) was 1.51. All patients were treated with melphalan and prednisone combined with bortezomib. RESULTS The complete response rate was lower in the high dNLR group compared to the low dNLR group (7 vs. 26.1%, respectively; p = 0.0148); the corresponding 2-year OS rates were 72.2 and 84.7%, respectively (p = 0.0354). A high dNLR was an independent poor prognostic factor for OS (hazard ratio 2.217, 95% CI 1.015-4.842; p = 0.0458). CONCLUSION The dNLR is a readily available and cheaply obtained parameter in clinical studies, and shows considerable potential as a new prognostic marker for transplantation-ineligible patients with MM.
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Affiliation(s)
- Gyeong-Won Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Sung Woo Park
- Department of Internal Medicine, Gyeongsang National University Hospital, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Se-Il Go
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Changwon, Republic of Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Changwon, Republic of Korea
| | - Min Kyoung Kim
- Department of Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Chang-Ki Min
- Division of Hematology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jae-Yong Kwak
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Sang-Byung Bae
- Department of Internal Medicine, Soonchunhyang University Hospital, Cheonan, Republic of Korea
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Je-Jung Lee
- Department of Hematology/Oncology, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea
| | - Ki Hwan Kim
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Seung-Hyun Nam
- Department of Internal Medicine, VHS Medical Center, Seoul, Republic of Korea
| | - Yeung-Chul Mun
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Hyo Jung Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Sung Hwa Bae
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Ho-Jin Shin
- Department of Internal Medicine, Division of Hematology/Oncology, School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Jung-Hee Lee
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Joon Seong Park
- Department of Hematology/Oncology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seong Hyun Jeong
- Department of Hematology/Oncology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Mark Hong Lee
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Ho Sup Lee
- Department of Hematology/Oncology, Kosin University College of Medicine, Busan, Republic of Korea
| | - Keon Woo Park
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Won-Sik Lee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Sang Min Lee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Jeong-Ok Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Myung Soo Hyun
- Department of Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Deog Yeon Jo
- Department of Hematology/Oncology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Sung-Nam Lim
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Jae Hoon Lee
- Division of Hematology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Hawk Kim
- Division of Hematology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Do-Yeun Cho
- Department of Internal Medicine, Konyang University Hospital, Daejeon, Republic of Korea
| | - Young Rok Do
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Jeong-A Kim
- Department of Hematology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seong Kyu Park
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Soo-Jeong Kim
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyeon Gyu Yi
- Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Joon Ho Moon
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Chul Won Choi
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sung-Hyun Kim
- Department of Internal Medicine, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Byung Soo Kim
- Department of Hematology, Korea University Medical Center, Korea University College of Medicine, Seoul, Republic of Korea
| | - Moo-Rim Park
- Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Hyeok Shim
- Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Moo-Kon Song
- Department of Hemato-Oncology, Hanyang University Hanmaeum Changwon Hospital, Changwon, Republic of Korea
| | - Youngdoe Kim
- Medical Affairs, Janssen Korea, Seoul, Republic of Korea
| | - Kihyun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Kim HG, Lee JH, Choi JW, Han M, Gho SM, Moon Y. Multidelay Arterial Spin-Labeling MRI in Neonates and Infants: Cerebral Perfusion Changes during Brain Maturation. AJNR Am J Neuroradiol 2018; 39:1912-1918. [PMID: 30213808 DOI: 10.3174/ajnr.a5774] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/08/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Arterial spin-labeling with multiple postlabeling delays can correct transit times. We tried to evaluate CBF in neonates and infants using multidelay arterial spin-labeling. MATERIALS AND METHODS Multidelay arterial spin-labeling was applied to 13 preterm neonates (mean postmenstrual age, 34.9 weeks), 13 term-equivalent-age neonates (mean postmenstrual age, 39.2 weeks), and 6 infants (mean postmenstrual age, 57.8 weeks). Transit time-corrected CBF in the caudate, thalamus, frontal GM, occipital GM, frontal WM, and occipital WM was measured, and relative CBF compared with the whole-brain CBF was calculated. Inter- and intragroup comparisons were performed among the 3 age groups. A correlation and nonlinear regression analysis were performed between postmenstrual age and CBF. RESULTS Intergroup comparisons showed significantly higher whole-brain CBF in infants (38.3 mL/100 g/min) compared with preterm (15.5 mL/100 g/min) and term-equivalent-age (18.3 mL/100 g/min) neonates (P < .001). In the intragroup comparison, all 3 groups showed significantly higher relative CBF values in the occipital WM (63.6%-90.3%) compared with the frontal WM (46.3%-73.9%). In term-equivalent-age neonates, the occipital GM (120.8%) had significantly higher relative CBF values than the frontal GM (103.5%). There was a significant negative correlation between postmenstrual age and the relative CBF of the thalamus (r = - 0.449, P = .010). There were significant positive relationships between postmenstrual age and the relative CBF of the frontal WM (R 2 = 0.298, P = .001) and occipital WM (R 2 = 0.452, P < .001). CONCLUSIONS Multidelay arterial spin-labeling with transit time-corrected CBF showed developmental changes and regional differences of CBF in neonates and infants.
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Affiliation(s)
- H G Kim
- From the Departments of Radiology (H.G.K., J.W.C., M.H.)
| | | | - J W Choi
- From the Departments of Radiology (H.G.K., J.W.C., M.H.)
| | - M Han
- From the Departments of Radiology (H.G.K., J.W.C., M.H.)
| | - S-M Gho
- MR Clinical Research and Development (S.-M.G.), GE Healthcare Korea, Seoul, Korea
| | - Y Moon
- Office of Biostatistics (Y.M.), Institute of Medical Sciences, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea
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18
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Go SI, Jeon H, Park SW, Kang MH, Kim HG, Lee GW. Low pre-treatment nutritional index is significantly related to poor outcomes in small cell lung cancer. Thorac Cancer 2018; 9:1483-1491. [PMID: 30209884 PMCID: PMC6209777 DOI: 10.1111/1759-7714.12862] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 07/11/2018] [Revised: 08/10/2018] [Accepted: 08/11/2018] [Indexed: 12/31/2022] Open
Abstract
Background The importance of nutritional status and chronic inflammation has been emphasized in cancer. We investigated the impact of Onodera's prognostic nutritional index (OPNI) on clinical outcomes in small cell lung cancer (SCLC) patients. Methods Data from 220 SCLC patients treated with first‐line platinum‐based chemotherapy from 2006 to 2017 were retrospectively reviewed. The OPNI was calculated as 10 × serum albumin level (g/dL) + 0.005 × absolute lymphocyte count (/mm3). Patients with an OPNI of > 45, 40–45, or < 40 were categorized in high, intermediate, or low OPNI groups, respectively. Results The proportion of non‐responders to first‐line therapy increased as the OPNI decreased (high, intermediate, low OPNI groups: 6.7%, 18.0%, and 30.8%, respectively; P < 0.001). Early discontinuation of first‐line therapy because of treatment toxicity occurred more frequently in the lower OPNI groups (high, intermediate, low OPNI groups: 5.8%, 21.3%, and 25.6%, respectively; P < 0.001). The one‐year progression‐free and overall survival rates in the high, intermediate, and low OPNI groups were 29%, 19%, and 3%, and 61%, 46%, and 23%, respectively. In multivariate analyses, the low OPNI group was independently associated with poor progression‐free (hazard ratio 1.592; 95% confidence interval 1.009–2.511; P = 0.046) and overall (hazard ratio 1.911; 95% confidence interval 1.208–3.024; P = 0.006) survival compared to the high OPNI group. Conclusion SCLC patients with an OPNI < 40 showed a low tolerance to chemotherapy and a poor prognosis. Further evaluation is needed to validate these findings.
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Affiliation(s)
- Se-Il Go
- Department of Internal Medicine, Division of Hematology-Oncology, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, South Korea.,Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - Hankyu Jeon
- Department of Internal Medicine, Division of Hematology-Oncology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - Sung Woo Park
- Department of Internal Medicine, Division of Hematology-Oncology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - Myoung Hee Kang
- Department of Internal Medicine, Division of Hematology-Oncology, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, South Korea.,Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Division of Hematology-Oncology, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, South Korea.,Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - Gyeong-Won Lee
- Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, South Korea.,Department of Internal Medicine, Division of Hematology-Oncology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, South Korea
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19
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Yoo KH, Lee SJ, Cho J, Lee KH, Park KU, Kim KH, Cho EK, Choi YH, Kim HR, Kim HG, Ahn HJ, Lee HY, Yun HJ, Kang JH, Jeong J, Choi MY, Jung SH, Sun JM, Lee SH, Ahn JS, Park K, Ahn MJ. A Randomized, Open-Label, Phase II Study Comparing Pemetrexed Plus Cisplatin Followed by Maintenance Pemetrexed versus Pemetrexed Alone in Patients with Epidermal Growth Factor Receptor (EGFR)-Mutant Non-small Cell Lung Cancer after Failure of First-Line EGFR Tyrosine Kinase Inhibitor: KCSG-LU12-13. Cancer Res Treat 2018; 51:718-726. [PMID: 30177585 PMCID: PMC6473296 DOI: 10.4143/crt.2018.324] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 05/31/2018] [Accepted: 08/24/2018] [Indexed: 12/16/2022] Open
Abstract
Purpose The optimal cytotoxic regimens have not been established for patients with non-small cell lung cancer (NSCLC) who develop disease progression on first-line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI). Materials and Methods We conducted a multi-center randomized phase II trial to compare the clinical outcomes between pemetrexed plus cisplatin combination therapy followed by maintenance pemetrexed (PC) and pemetrexed monotherapy (P) after failure of first-line EGFR-TKI. The primary objective was progression-free survival (PFS), and secondary objectives included overall response rate (ORR), overall survival (OS), health-related quality of life (HRQOL), and safety and toxicity profiles. Results A total of 96 patientswere randomized, and 91 patientswere treated at 14 centers in Korea. The ORR was 34.8% (16/46) for the PC arm and 17.8% (8/45) for the P arm (p=0.066). With 23.4 months of follow-up, the median PFS was 5.4 months in the PC arm and 6.4 months in the P arm (p=0.114). The median OS was 17.9 months and 15.7 months in PC and P arms, respectively (p=0.787). Adverse events ≥ grade 3 were reported in 12 patients (26.1%) in the PC arm and nine patients (20.0%) in the P arm (p=0.491). The overall time trends of HRQOL were not significantly different between the two arms. Conclusion The outcomes of pemetrexed therapy in NSCLC patients with disease progression after firstline EGFR-TKI might not be improved by adding cisplatin.
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Affiliation(s)
- Kwai Han Yoo
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Su Jin Lee
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinhyun Cho
- Division of Hematology-Oncology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Ki Hyeong Lee
- Division of Medical Oncology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Keon Uk Park
- Department of Hematology/Oncology, Keimyung Unversity Dongsan Hospital, Daegu, Korea
| | - Ki Hwan Kim
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Eun Kyung Cho
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Yoon Hee Choi
- Division of Hematology and Oncology, Department of Internal Medicine, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
| | - Hye Ryun Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Hoon-Gu Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Heui June Ahn
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Ha Yeon Lee
- Division of Hematology and Oncology, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Hwan Jung Yun
- Division of Hematology/Oncology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jin-Hyoung Kang
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jaeheon Jeong
- Division of Medical Oncology and Hematology, Department of Internal Medicine, Kyunghee University Hospital, Seoul, Korea
| | - Moon Young Choi
- Division of Hematology and Oncology, Department of Internal Medicine, Inje University Paik Hospital, Busan, Korea
| | - Sin-Ho Jung
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Jong-Mu Sun
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se-Hoon Lee
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Seok Ahn
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keunchil Park
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung-Ju Ahn
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim SH, Go SI, Seo J, Kang MH, Park SW, Kim HG, Lee GW. Prognostic impact of pretreatment albumin to globulin ratio in patients with diffuse large B-cell lymphoma treated with R-CHOP. Leuk Res 2018; 71:100-105. [PMID: 30048838 DOI: 10.1016/j.leukres.2018.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 04/19/2018] [Revised: 07/09/2018] [Accepted: 07/16/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE We evaluated the clinical implications of the albumin to globulin ratio (AGR) in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). METHODS Data of 232 patients with DLBCL treated with first-line R-CHOP from 2004 to 2017 were reviewed retrospectively. Patients with AGR values ≥1.22 and <1.22 were assigned to the high and low AGR groups, respectively. Treatment response, treatment-related toxicity, and survival were compared according to the AGR. RESULTS The complete response rate was significantly lower in the low AGR group than in the high AGR group (59.1% vs. 81.3%; p < 0.001). Treatment-related mortality was also more frequent in the low AGR group than in the high AGR group (14.0% vs. 4.3%; p = 0.009). The low AGR group (median overall survival [OS] = 26.87 months; 95% confidence interval [CI] = 4.19-49.55) showed a significant decrease in OS compared to the high AGR group (median OS = 148.83 months; 95% CI = 76.26-221.41; p < 0.001). Progression-free survival (PFS) also decreased significantly in the low AGR group (median PFS = 14.29 months; 95% CI = 2.58-26.01) compared to the high AGR group (median PFS = 148.83 months; 95% CI = 76.21-221.45; p < 0.001). In a multivariate analysis, low AGR was an independent poor prognostic factor for OS and PFS. CONCLUSIONS Pretreatment AGR was useful for predicting treatment response, treatment-related toxicity, and prognosis in patients with DLBCL treated with R-CHOP. Further large prospective studies will be necessary to validate our findings.
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Affiliation(s)
- Seok-Hyun Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Se-Il Go
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Jangho Seo
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Myoung Hee Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Sung Woo Park
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Hoon-Gu Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Gyeong-Won Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Gyeongsang Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
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21
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Shin J, Koh Y, Yoon SH, Cho JY, Kim DY, Lee KH, Kim HJ, Ahn JS, Kim YK, Park J, Sohn SK, Moon JH, Lee YJ, Yoon S, Lee JO, Cheong JW, Kim KH, Kim SH, Kim HG, Kim H, Nam SH, Do YR, Park SG, Park SK, Bae SH, Song HH, Shin DY, Oh D, Kim MK, Jung CW, Park S, Kim I. A phase 4 study of nilotinib in Korean patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase: ENESTKorea. Cancer Med 2018; 7:1814-1823. [PMID: 29577674 PMCID: PMC5943463 DOI: 10.1002/cam4.1450] [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: 11/06/2017] [Revised: 02/12/2018] [Accepted: 02/26/2018] [Indexed: 11/12/2022] Open
Abstract
Although nilotinib has improved efficacy compared to imatinib, suboptimal response and intolerable adverse events (AEs) limit its effectiveness in many patients with chronic myeloid leukemia in chronic phase (CML-CP). We investigated the 2-year efficacy and safety of nilotinib and their relationships with plasma nilotinib concentrations (PNCs). In this open-label, multi-institutional phase 4 study, 110 Philadelphia chromosome-positive CML-CP patients were treated with nilotinib at a starting dose of 300 mg twice daily. Molecular responses (MRs) and AEs were monitored for up to 24 months. The 24-month cumulative MR4.5 rate was evaluated as the primary endpoint. Plasma samples were collected from 94 patients to determine PNCs, and the per-patient mean was used to categorize them into four mean PNC (MPNC) groups. Cumulative MR rates and safety were compared between groups. With a median follow-up of 22.2 months, the 24-month cumulative MR4.5 rate was 56.2% (95% confidence interval, 44.0%-8.3%), and the median time to MR4.5 was 23.3 months. There were no significant differences in the cumulative rates of major molecular response, MR4 , and MR4.5 between MPNC groups. One patient died due to acute viral hepatitis, and two developed hematological or cytogenetic relapse, while no progression to accelerated or blast phase was observed. Safety results were consistent with previous studies with no new safety signal identified. Across the MPNC groups, there was no significant linear trend in the frequency of AEs. Nilotinib is highly effective for the treatment of CML-CP with manageable AEs. The measurement of PNC has no predictive value for patient outcomes and is thus not found to be clinically useful. This study is registered with clinicaltrials.gov, Number NCT03332511.
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Affiliation(s)
- Junghoon Shin
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Youngil Koh
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Seo Hyun Yoon
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul, Korea
| | - Joo-Youn Cho
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul, Korea
| | - Dae-Young Kim
- Department of Internal Medicine, Asan Medical Center, Seoul, Korea
| | - Kyoo-Hyung Lee
- Department of Internal Medicine, Asan Medical Center, Seoul, Korea
| | - Hyeong-Joon Kim
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Jae-Sook Ahn
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Yeo-Kyeoung Kim
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Jinny Park
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Sang-Kyun Sohn
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Joon Ho Moon
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yoo Jin Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Seonghae Yoon
- Clinical Trials Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jeong-Ok Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - June-Won Cheong
- Department of Internal Medicine, Severance Hospital, Seoul, Korea
| | - Kyoung Ha Kim
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Sung-Hyun Kim
- Department of Internal Medicine, Dong-A University Hospital, Busan, Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Hawk Kim
- Department of Internal Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Seung-Hyun Nam
- Department of Internal Medicine, VHS Medical Center, Seoul, Korea
| | - Young Rok Do
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Sang-Gon Park
- Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea
| | - Seong Kyu Park
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sung Hwa Bae
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea
| | - Hun Ho Song
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Dong-Yeop Shin
- Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Doyeun Oh
- Department of Internal Medicine, CHA Bundang Medical Center, Seongnam, Korea
| | - Min Kyoung Kim
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Chul Won Jung
- Department of Internal Medicine, Samsung Medical Center, Seoul, Korea
| | - Seonyang Park
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Inho Kim
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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22
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Kim MK, Kim K, Min CK, Kwak JY, Bae SB, Yoon SS, Lee JJ, Kim KH, Nam SH, Mun YC, Kim HJ, Bae SH, Shin HJ, Lee JH, Park JS, Jeong SH, Lee MH, Kim YS, Lee HS, Park KW, Lee WS, Lee SM, Lee JO, Hyun MS, Jo DY, Lim SN, Lee JH, Cho DY, Do YR, Kim JA, Park SK, Kim JS, Kim SJ, Kim H, Yi HG, Moon JH, Choi CW, Kim SH, Joo YD, Kim HG, Kim BS, Park MR, Song MK, Kim SY. A prospective, open-label, multicenter, observational study to evaluate the efficacy and safety of bortezomib-melphalan-prednisone as initial treatment for autologous stem cell transplantation-ineligible patients with multiple myeloma. Oncotarget 2018; 8:37605-37618. [PMID: 28402945 PMCID: PMC5514934 DOI: 10.18632/oncotarget.16790] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 01/10/2017] [Indexed: 11/25/2022] Open
Abstract
Bortezomib-melphalan-prednisone (VMP) showed superior efficacy versus MP as first-line treatment for transplantation-ineligible multiple myeloma (MM). This study investigated the efficacy of VMP for Korean patients with MM. Overall, 177 MM patients received 9 cycles of VMP in this prospective, multicenter, observational study. The primary endpoint was 2-year progression-free survival (PFS). Thirty-nine (22%) patients were aged ≥ 75 years and 83 (47.4%) patients had International Staging System stage III. A median of 5 cycles were delivered. Overall response rate (ORR) was 72.9%, and complete response (CR) rate was 20.3%. With a median follow-up of 11.9 months, median PFS was 17 months. The 2-year PFS and overall survival (OS) rates were 29.2% and 80.0%, respectively. Median OS was not reached. PFS was significantly different depending on performance status (Eastern Cooperative Oncology Group < 2 vs. ≥ 2; p = 0.0002), β2-microglobulin level (< 5.5 vs. ≥ 5.5 mg/L; p = 0.0481), and cumulative dose of bortezomib (< 35.1 vs. ≥ 35.1 mg/m2; p < 0001). The common adverse events (AEs) were in line with the well-known toxicity profiles associated with VMP. In conclusion, VMP is a feasible and effective front-line treatment for transplant-ineligible older patients with MM in Korea. Continuing therapy with prompt adjustment of treatment according to AEs may be important to improve outcomes of elderly patients.
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Affiliation(s)
- Min Kyoung Kim
- Department of Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kihyun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang-Ki Min
- Division of Hematology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jae-Yong Kwak
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Sang-Byung Bae
- Department of Internal Medicine, Soonchunhyang University Hospital, Cheonan, Korea
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Je-Jung Lee
- Department of Hematology/Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Ki Hwan Kim
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Seung-Hyun Nam
- Department of Internal Medicine, VHS Medical Center, Seoul, Korea
| | - Yeung-Chul Mun
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyo Jung Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Sung Hwa Bae
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Ho-Jin Shin
- Department of Internal Medicine, Division of Hematology/Oncology, School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jung-Hee Lee
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Seong Park
- Department of Hematology/Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Seong Hyun Jeong
- Department of Hematology/Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Mark Hong Lee
- Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Yang-Soo Kim
- Department of Hematology/Oncology, Kosin University College of Medicine, Busan, Korea
| | - Ho Sup Lee
- Department of Hematology/Oncology, Kosin University College of Medicine, Busan, Korea
| | - Keon Woo Park
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Won-Sik Lee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Sang Min Lee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Jeong-Ok Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| | - Myung Soo Hyun
- Department of Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Deog Yeon Jo
- Department of Hematology/Oncology, Chungnam National University Hospital, Daejeon, Korea
| | - Sung-Nam Lim
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jae Hoon Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Do-Yeun Cho
- Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Young Rok Do
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Jeong-A Kim
- Department of Hematology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong Kyu Park
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Soo-Jeong Kim
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hawk Kim
- Division of Hematology and Cellular Therapy, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Hyeon Gyu Yi
- Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Joon Ho Moon
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Chul Won Choi
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sung-Hyun Kim
- Department of Internal Medicine, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Young-Don Joo
- Department of Hemato-Oncology, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Byung Soo Kim
- Department of Hematology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea
| | - Moo-Rim Park
- Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Korea
| | - Moo-Kon Song
- Department of Hemato-Oncology, Hanyang University Hanmaeum Changwon Hospital, Changwon, Korea
| | - Su-Youn Kim
- Medical Affairs, Janssen Korea, Seoul, Korea
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Kim DW, Kim HG, Kim JH, Park K, Kim HK, Jang JS, Kim BS, Kang JH, Lee KH, Kim SW, Ryoo HM, Kim JS, Lee KH, Kwon JH, Choi JH, Shin SW, Hahn S, Heo DS. Randomized Phase III Trial of Irinotecan Plus Cisplatin versus Etoposide Plus Cisplatin in Chemotherapy-Naïve Korean Patients with Extensive-Disease Small Cell Lung Cancer. Cancer Res Treat 2018. [PMID: 29529858 PMCID: PMC6334001 DOI: 10.4143/crt.2018.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 12/19/2022] Open
Abstract
Purpose This randomized phase III study was designed to compare the efficacy and safety of irinotecan plus cisplatin (IP) over etoposide plus cisplatin (EP) in Korean patients with extensive-disease small-cell lung cancer (SCLC). Materials and Methods Patients were randomly assigned to receive IP, composed of irinotecan 65 mg/m2 intravenously on days 1 and 8+cisplatin 70 mg/m2 intravenously on day 1 every 3 weeks, or EP, composed of etoposide 100 mg/m2 intravenously on days 1, 2, 3+cisplatin 70 mg/m2 intravenously on day 1, every 3 weeks for a maximum of six cycles, until disease progression, or until unacceptable toxicity occurred. The primary endpoint was overall survival. Results A total of 362 patients were randomized to IP (n=173) and EP (n=189) arms. There were no significant differences between IP and EP arms for the median overall survival (10.9 months vs. 10.3 months, p=0.120) and the median progression-free survival (6.5 months vs. 5.8 months, p=0.115). However, there was a significant difference in response rate (62.4% vs. 48.2%, p=0.006). The pre-planned subgroup analyses showed that IP was associated with longer overall survival in male (11.3 months vs. 10.1 months, p=0.036), < 65 years old (12.7 months vs. 11.3 months, p=0.024), and Eastern Cooperative Oncology Group performance status 0/1 (12.4 months vs. 10.9 months, p=0.040) patient groups. The severity of treatment-related adverse events such as grade 3/4 anemia, nausea and diarrhea was more frequent in patients treated with IP. Conclusion The IP chemotherapy did not significantly improve the survival compared with EP chemotherapy in Korean patients with extensive-disease SCLC.
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Affiliation(s)
- Dong-Wan Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hoon-Gu Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Joo-Hang Kim
- Department of Internal Medicine, Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Keunchil Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Seoul, Korea
| | - Hoon-Kyo Kim
- Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Joung Soon Jang
- Division of Hematology/Oncology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Bong-Seog Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Jin-Hyoung Kang
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, Seoul, Korea
| | - Kyung Hee Lee
- Department of Hematology-Oncology, Yeungnam University Medical Center, Daegu, Korea
| | - Sang-We Kim
- Division of Oncology, Department of Internal Medicine, Asan Medical Center, Seoul, Korea
| | - Hun Mo Ryoo
- Department of Internal Medicine, Daegu Catholic University Hospital, Daegu, Korea
| | - Jin-Soo Kim
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Ki Hyeong Lee
- Division of Medical Oncology, Chungbuk National University Hospital, Chungju, Korea
| | - Jung Hye Kwon
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Jin-Hyuk Choi
- Department of Hematology-Oncology, Ajou University Hospital, Suwon, Korea
| | - Sang Won Shin
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Seokyung Hahn
- Medical Research Collaborating Center, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Seog Heo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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Sun JM, Lee KH, Kim BS, Kim HG, Min YJ, Yi SY, Yun HJ, Jung SH, Lee SH, Ahn JS, Park K, Ahn MJ. Pazopanib maintenance after first-line etoposide and platinum chemotherapy in patients with extensive disease small-cell lung cancer: a multicentre, randomised, placebo-controlled Phase II study (KCSG-LU12-07). Br J Cancer 2018; 118:648-653. [PMID: 29381690 PMCID: PMC5846070 DOI: 10.1038/bjc.2017.465] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 08/21/2017] [Revised: 11/24/2017] [Accepted: 11/27/2017] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND We investigated whether pazopanib maintenance following first-line chemotherapy would improve survival in patients with extensive disease small-cell lung cancer (ED-SCLC). METHODS This study is a randomised, placebo-controlled, phase II study that enroled ED-SCLC patients who had not progressed after four cycles of etoposide plus platinum therapy. Eligible patients were randomly assigned (1 : 1 ratio) to either placebo or pazopanib 800 mg per day until progression or unacceptable toxicity. The primary end point was progression-free survival (PFS). RESULTS 97 patients were enroled and randomly assigned; 2 patients did not receive study drugs. In total, 95 patients received maintenance therapy (pazopanib, n=48; placebo, n=47) and were included in the analyses. Grade 3 toxicities for pazopanib maintenance were thrombocytopenia (10.4%, including one case with grade 4 toxicity), liver enzyme elevation (10.4%), fatigue (6.3%), and hypertension (6.3%). Median PFS was 3.7 months for pazopanib maintenance and 1.8 months for placebo (hazard ratio 0.44, 95% confidence interval: 0.29-0.69, P<0.0001). CONCLUSIONS Pazopanib maintenance significantly prolonged PFS in patients with ED-SCLC. Given the toxicity profiles, however, relevant biomarkers to select patients for benefit from pazopanib should be further investigated.
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Affiliation(s)
- Jong-Mu Sun
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Ki Hyeong Lee
- Division of Medical Oncology, Department of Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, Korea
| | - Bong-Seog Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul 05368, Korea
| | - Hoon-Gu Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon 51472, Korea
| | - Young Joo Min
- Division of Hematology and Oncology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea
| | - Seong Yoon Yi
- Division of Hematology-Oncology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang 10380, Korea
| | - Hwan Jung Yun
- Division of Hematology-Oncology, Department of Medicine, Chungnam National University Hospital, Daejeon 35015, Korea
| | - Sin-Ho Jung
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC 27710, USA
| | - Se-Hoon Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Jin Seok Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Keunchil Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Myung-Ju Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
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25
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Go SI, Lee WS, Kang MH, Song HN, Kim MJ, Lee MJ, Kim HG, Lee GW, Kang JH, Lee JH, Kang KM, Jeon KN, Cho JM, Jung WT, Ko GH. Response to Concurrent Chemoradiotherapy as a Prognostic Marker in Elderly Patients with Locally Advanced Esophageal Cancer. Tumori 2018; 98:225-32. [DOI: 10.1177/030089161209800208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background Little is known about chemoradiotherapy in elderly patients with locally advanced esophageal cancer. We compared the efficacy and toxicity of chemoradiotherapy in elderly and non-elderly patients with locally advanced esophageal cancer and determined the variables affecting the treatment outcome in the elderly patients with locally advanced esophageal cancer who had received chemoradiotherapy. Methods Fifty-seven elderly patients (age ≥65 years) and 30 non-elderly patients (age <65 years) were reviewed retrospectively. Results The median age of the elderly group was 69 years and in the non-elderly group, 56.5 years. Although treatment compliance appeared to be poor, the response rate and median survival were similar in both the groups (elderly versus non-elderly; 84.4% vs 87.5%, and 11.2 months vs11.3 months) and so were G3/4 hematologic and non-hematologic toxicities. The treatment-related mortality of the elderly patients appeared to be higher than that of the non-elderly group (7.0% vs 3.3%), but did not reach statistical significance. In prognostic factor analysis, a major response to chemoradiotherapy was a good prognostic indicator in the elderly group (response versus non-response; median overall survival times of 19.5 vs 5.4 months, respectively, P <0.001). Conclusions The study suggests that chemoradiotherapy for locally advanced esophageal cancer in elderly patients, even though treatment compliance appears to be poor, is as safe and effective as in non-elderly patients and that the response to chemoradiotherapy is related to prognosis in elderly patients.
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Affiliation(s)
- Se-Il Go
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Won Sup Lee
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Myung Hee Kang
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Haa-Na Song
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Moon Jin Kim
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Min Jeong Lee
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Gyeong Won Lee
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jung Hun Kang
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jeong-Hee Lee
- Department of Pathology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ki Mun Kang
- Department of Radiation Oncology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Kyung-Nyeo Jeon
- Department of Radiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jae Min Cho
- Department of Radiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Woon Tae Jung
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Gyung Hyuck Ko
- Department of Pathology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
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Choi YJ, Kim HS, Park SH, Kim BS, Kim KH, Lee HJ, Song HS, Shin DY, Lee HY, Kim HG, Lee KH, Lee JL, Park KH. Phase II Study of Dovitinib in Patients with Castration-Resistant Prostate Cancer (KCSG-GU11-05). Cancer Res Treat 2018; 50:1252-1259. [PMID: 29334610 PMCID: PMC6192917 DOI: 10.4143/crt.2017.438] [Citation(s) in RCA: 24] [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: 09/15/2017] [Accepted: 12/28/2017] [Indexed: 12/21/2022] Open
Abstract
Purpose Fibroblast growth factor (FGF) signals are important in carcinogenesis and progression of prostate cancer. Dovitinib is an oral, pan-class inhibitor of vascular endothelial growth factor receptor (VEGFR), platelet-derived growth factor receptor, and fibroblast growth factor receptor (FGFR). We evaluated the efficacy and toxicity of dovitinib in men with metastatic castration resistant prostate cancer (mCRPC). Materials and Methods This study was a single-arm, phase II, open-label, multicenter trial of dovitinib 500 mg/day (5-days-on/2-days-off schedule). The primary endpoint was 16-week progression-free survival (PFS). Secondary endpoints were overall survival (OS), toxicity and prostate-specific antigen (PSA) response rate. Biomarker analyses for VEGFR2, FGF23, and FGFR2 using multiplex enzyme-linked immunosorbent assay was performed. Results Forty-four men were accrued from 11 hospitals. Eighty percent were post-docetaxel. Median PSA was 100 ng/dL, median age was 69, 82% had bone metastases, and 23% had liver metastases. Median cycles of dovitinib was 2 (range, 0 to 33). Median PFS was 3.67 months (95% confidence interval [CI], 1.36 to 5.98) and median OS was 13.70 months (95% CI, 0 to 27.41). Chemotherapy-naïve patients had longer PFS (17.90 months; 95% CI, 9.23 to 28.57) compared with docetaxel-treated patients (2.07 months; 95% CI, 1.73 to 2.41; p=0.001) and the patients with high serum VEGFR2 level over median level (7,800 pg/mL) showed longer PFS compared with others (6.03 months [95% CI, 4.26 to 7.80] vs. 1.97 months [95% CI, 1.79 to 2.15], p=0.023). Grade 3 related adverse events were seen in 40.9% of patients. Grade 1-2 nausea, diarrhea, fatigue, anorexia, and all grade thrombocytopenia are common. Conclusion Dovitinib showed modest antitumor activity with manageable toxicities in men with mCRPC. Especially, patients who were chemo-naïve benefitted from dovitinib.
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Affiliation(s)
- Yoon Ji Choi
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Hye Sook Kim
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Se Hoon Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Bong-Seog Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Kyoung Ha Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hyo Jin Lee
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hong Suk Song
- Division of Hematology/Oncology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Dong-Yeop Shin
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Ha Young Lee
- Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Kyung Hee Lee
- Department of Hemato-oncology, Yeungnam Medical Center, Daegu, Korea
| | - Jae Lyun Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyong Hwa Park
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
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27
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Kim SI, Kim HH, Seong BJ, Jee MG, Lee KS, Kim HG, Kweon KB. Influence of Soil Flooding with Organic Matters Amendment on Reducing the Root Rot Disease and Content of Ginsenosides in Ginseng Crops. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608064] [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: 10/18/2022]
Affiliation(s)
- SI Kim
- Ginseng & Medicinal Plant Research Institute, CNARES, Geumsan-gun, Korea, Republic of (South)
| | - HH Kim
- Ginseng & Medicinal Plant Research Institute, CNARES, Geumsan-gun, Korea, Republic of (South)
| | - BJ Seong
- Ginseng & Medicinal Plant Research Institute, CNARES, Geumsan-gun, Korea, Republic of (South)
| | - MG Jee
- Ginseng & Medicinal Plant Research Institute, CNARES, Geumsan-gun, Korea, Republic of (South)
| | - KS Lee
- Ginseng & Medicinal Plant Research Institute, CNARES, Geumsan-gun, Korea, Republic of (South)
| | - HG Kim
- Department of Applied Biology, Chungnam National University, Daejeon, Korea, Republic of (South)
| | - KB Kweon
- Department of Herbal Crop Research, NIHHS, RDA, Eumseong, Korea, Republic of (South)
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Go SI, Park MJ, Song HN, Kim HG, Kang MH, Kang JH, Kim HR, Lee GW. A comparison of pectoralis versus lumbar skeletal muscle indices for defining sarcopenia in diffuse large B-cell lymphoma - two are better than one. Oncotarget 2017; 8:47007-47019. [PMID: 28388585 PMCID: PMC5564540 DOI: 10.18632/oncotarget.16552] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 02/04/2017] [Accepted: 02/28/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUNDS Sarcopenia is known to be associated with poor clinical outcome in patients with diffuse large B-cell lymphoma (DLBCL). There is no consensus concerning the optimal method to define sarcopenia in DLBCL. METHODS We retrospectively reviewed 193 DLBCL patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy. Sarcopenia was classified by the region where the pretreatment skeletal muscle index (SMI) was measured. RESULTS Both the sarcopenia-L3 and sarcopenia-pectoralis muscle (PM) groups had increased incidences of severe treatment-related toxicities and treatment discontinuation compared with the non-sarcopenia-L3 and non-sarcopenia-PM groups, respectively. The sarcopenia-L3 and non-sarcopenia-L3 groups had 5-year overall survival (OS) rates of 40.5% and 67.8% (p < 0.001), respectively. The sarcopenia-PM and non-sarcopenia-PM groups had 5-year OS rates of 35.9% and 69.0% (p < 0.001), respectively. When the sarcopenia-L3 alone and sarcopenia-PM alone groups were compared, there were no differences in baseline characteristics, treatment toxicity, or survival. In multivariate analysis, when compared with the non-sarcopenia-both group, OS was significantly worse in the sarcopenia-both group (HR, 2.480; 95% CI, 1.284 - 4.792; p = 0.007), but not in patients with either sarcopenia-L3 alone or sarcopenia-PM alone (p = 0.151). CONCLUSIONS L3- and PM-SMIs are equally useful to define sarcopenia, which is related to intolerance to R-CHOP therapy and to worse survival in patients with DLBCL. More prognostic information can be obtained when these two SMIs are combined to define sarcopenia.
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MESH Headings
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Back Muscles/pathology
- Cyclophosphamide/adverse effects
- Cyclophosphamide/therapeutic use
- Doxorubicin/adverse effects
- Doxorubicin/therapeutic use
- Female
- Humans
- Kaplan-Meier Estimate
- Lumbosacral Region
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Neoplasm Metastasis
- Neoplasm Staging
- Pectoralis Muscles/pathology
- Prednisone/adverse effects
- Prednisone/therapeutic use
- Retrospective Studies
- Rituximab
- Sarcopenia/diagnosis
- Sarcopenia/etiology
- Sarcopenia/mortality
- Treatment Outcome
- Vincristine/adverse effects
- Vincristine/therapeutic use
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Affiliation(s)
- Se-Il Go
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea
| | - Mi Jung Park
- Department of Radiology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Haa-Na Song
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Hoon-Gu Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea
- Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Myoung Hee Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea
- Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Jung Hun Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
- Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Hye Ree Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Gyeong-Won Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
- Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
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Lee YH, Choi HS, Jeong H, Kang KM, Song JH, Lee WS, Lee GW, Song HN, Kim HG, Kang MH, Rhee DY, Jeong BK. Neutrophil-lymphocyte ratio and a dosimetric factor for predicting symptomatic radiation pneumonitis in non-small-cell lung cancer patients treated with concurrent chemoradiotherapy. Clin Respir J 2017; 12:1264-1273. [PMID: 28618180 DOI: 10.1111/crj.12660] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 05/11/2017] [Accepted: 05/25/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To identify the factors that predict the progression of radiological radiation pneumonitis (RP) to symptomatic RP, and to evaluate the usefulness of the neutrophil-lymphocyte ratio (NLR) as a marker of RP severity and prognosis in stage III non-small cell lung cancer (NSCLC) patients treated with definitive concurrent chemoradiotherapy (CCRT). MATERIALS AND METHODS We retrospectively reviewed 61 patients treated between January 2010 and December 2015. Patients' demographic characteristics, clinical data, laboratory findings and treatment parameters were analyzed to determine the predictive factors associated with progression from radiological RP to symptomatic RP. RESULTS Forty-seven patients (77%) exhibited radiological RP at a median of 78 days after radiation therapy (RT) completion, and 15 (32%) of these patients developed symptomatic RP. The interval between RT completion and radiological RP presentation was shorter in patients who progressed to symptomatic RP (P = .001); progression was highly probable if this latency period was ≤2 months (P = .002). Stage and RT technique correlated with symptomatic RP development (P = .046 and P = .046, respectively). Among dosimetric factors, a V20 (defined as the lung volume receiving ≥20 Gy) of >30% was the most significant predictor of symptomatic RP (P = .001). The NLR and C-reactive protein level at radiological RP were higher in patients who developed symptomatic RP (P = .067 and P = .012, respectively). On multivariate analysis, a V20 >30% and an NLR at radiological RP >6 were associated with symptomatic RP development. CONCLUSION The NLR at radiological RP is a useful biomarker for predicting symptomatic RP development after CCRT in stage III NSCLC patients.
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Affiliation(s)
- Yun Hee Lee
- Department of Radiation Oncology, Gyeongsang National University School of medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Hoon-Sik Choi
- Department of Radiation Oncology, Gyeongsang National University School of medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Hojin Jeong
- Department of Radiation Oncology, Gyeongsang National University School of medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Ki Mun Kang
- Department of Radiation Oncology, Gyeongsang National University School of medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Jin Ho Song
- Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.,Department of Radiation Oncology, Gyeongsang National University School of medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Won Sup Lee
- Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.,Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Gyeong-Won Lee
- Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.,Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Haa-Na Song
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Myoung Hee Kang
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Dong Yoon Rhee
- Department of Emergency medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Bae Kwon Jeong
- Department of Radiation Oncology, Gyeongsang National University School of medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
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30
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Hong MH, Lee YG, Kim HS, Park KU, Kim HG, Ko YH, Chung IJ, Min YJ, Kim MK, Kim H, Cho BC. Phase II study of afatinib in recurrent and/or metastatic esophageal squamous cell carcinoma (R/M ESCC) (KCSG HN14-18). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.4051] [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
4051 Background: Afatinib, an irreversible pan-ErbB kinase inhibitor showed anti-tumor activity against esophageal cancer in phase I trial. In this multicenter, open-label, single arm phase II study, we aimed to evaluate the activity and safety of afatinib in R/M ESCC. Methods: Patients (pts) who had ECOG PS 0-2 and had progressed on platinum-based chemotherapy for R/M ESCC were enrolled. Pts were treated with afatinib 40mg/day until disease progression, unacceptable toxicity, or patient’s refusal. Primary endpoint was objective response rate (ORR) per RECIST 1.1. The estimated sample size was 49, using a two-stage minimax design to evaluate incremental response rate from 5 to 15%. Secondary endpoints included progression-free survival (PFS), overall survival (OS), disease control rate (DCR), and safety profile. Additionally, we try to identify biomarker to predict efficacy of afatinib with target capture sequencing and gene expression profile as exploratory endpoints. Results: In a total of 49 enrolled pts (median age 60; range 44 -84), ORR and DCR were 14.3 % and 73.3%, respectively. With a median follow-up of 6.6 months, median PFS and OS was 3.4 months (95% CI 2.2-4.6) and 6.6 months (95% CI 5.2-8.0). Median treatment duration and duration of response were 2.8 months (range, 0.4-15.3) and 7.1 months (range, 2.5-13.9), respectively. Dose reduction and interruption occurred in 19 (38.8%) and 15 (30.6 %) pts. Treatment-related adverse events (TRAE) occurred in 33 pts (67.3%) with most common TRAEs being diarrhea (n=22, 44.9%) and acneiform rash (n=12, 24.5%). G3-4 TRAEs were rare, occurring in 7 pts (14.3 %). Conclusions: Afatinib demonstrated modest efficacy with manageable toxicity in platinum-resistant R/M ESCC patients. Given the modest response rate, identification of predictive biomarkers is essential for further clinical investigation of afatinib in R/M ESCC. Those biomarkers are being analyzed and will be presented in the conference (NCT02353936). Clinical trial information: NCT02353936. [Table: see text]
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Affiliation(s)
- Min Hee Hong
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
| | - Yun-Gyoo Lee
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyo Song Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
| | - Keon Uk Park
- Keimyung University School of Medicine, Daegu, South Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Yoon Ho Ko
- Division of Oncology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, Uijeongbu-Si, Gyeonggi-Do, Republic of Korea
| | - Ik-Joo Chung
- Department of Medical Oncology, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea
| | | | - Min Kyoung Kim
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - HyeRyun Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
| | - Byoung Chul Cho
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
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31
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Yoo KH, Cho J, Lee KH, Park KU, Kim KH, Cho EK, Kwon KA, Ahn H, Kim HR, Kim HG, Lee HY, Yun HJ, Kang JH, Jeong J, Choi MY, Jung SH, Sun JM, Ahn JS, Park K, Ahn MJ. P3.02b-053 A Randomized, Open Label, Phase II Study Comparing Pemetrexed plus Cisplatin versus Pemetrexed Alone in EGFR Mutant NSCLC after EGFR-TKI: QOL Data. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kim M, Keam B, Kim TM, Kim HG, Kim JS, Lee SS, Shin SH, Kim MK, Park KU, Kim DW, Yun HJ, Lee JS, Heo DS. Phase II Study of Irinotecan and Cisplatin Combination Chemotherapy in Metastatic, Unresectable Esophageal Cancer. Cancer Res Treat 2016; 49:416-422. [PMID: 27488873 PMCID: PMC5398400 DOI: 10.4143/crt.2016.121] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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] [Received: 03/18/2016] [Accepted: 07/13/2016] [Indexed: 12/22/2022] Open
Abstract
Purpose The objective of this multicenter phase II study was to evaluate the efficacy and safety of irinotecan and cisplatin combination chemotherapy in metastatic, unresectable esophageal cancer. Materials and Methods Patients were treated with irinotecan 65 mg/m2 and cisplatin 30 mg/m2 on days 1 and 8 of each 21-day treatment cycle. The primary endpoint was response rate, and secondary endpoints were survival, duration of response, initial metabolic response rate, and toxicity. Results A total of 27 patients with squamous cell histology were enrolled in the study. The median age of the patients was 61 years. The objective response rate of the 20 patients in the perprotocol group was 30.0% (90% confidence interval [CI], 13.2 to 46.9). The median follow-up duration was 10.0 months, and the median progression-free survival and overall survival were 4.5 months (95% CI, 1.6 to 6.2) and 8.8 months (95% CI, 4.7 to 10.5), respectively. Four of 13 patients (30.8%) evaluated showed initial metabolic response. The median duration of response for partial responders was 5.0 months (range, 3.4 to 8.0 months). The following grade 3/4 treatment-related hematologic toxicities were reported: neutropenia (40.7%), anaemia (22.2%), and thrombocytopenia (7.4%). Two patients experienced febrile neutropenia. The most common grade 3/4 non-hematologic toxicities were asthenia (14.8%) and diarrhoea (11.1%). Conclusion Irinotecan and cisplatin combination chemotherapy showed modest anti-tumour activity and manageable toxicity for patients with metastatic, unresectable esophageal cancer.
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Affiliation(s)
- Miso Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Tae-Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jin-Soo Kim
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sung Sook Lee
- Department of Hematology-Oncology, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Seong Hoon Shin
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Min Kyoung Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Keon Uk Park
- Department of Hematology-Oncology, Keimyung University School of Medicine, Daegu, Korea
| | - Dong-Wan Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hwan Jung Yun
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jong Seok Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dae Seog Heo
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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33
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Park K, Lee JS, Lee KH, Kim JH, Cho BC, Min YJ, Cho JY, Han JY, Kim BS, Kim JS, Lee DH, Kang JH, Cho EK, Kim HG, Lee KH, Kim HK, Jang IJ, Kim HY, Son J, Kim DW. BI 1482694 (HM61713), an EGFR mutant-specific inhibitor, in T790M+ NSCLC: Efficacy and safety at the RP2D. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.9055] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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)
- Keunchil Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, The Republic of
| | - Jong-Seok Lee
- Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea, The Republic of
| | - Ki Hyeong Lee
- Chungbuk National University Hospital, Cheongju, North Chungcheong, Korea, The Republic of
| | - Joo-Hang Kim
- CHA Bundang Medical Center, CHA University, Gyeonggi-Do, South Korea
| | - Byoung Chul Cho
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea, The Republic of
| | - Young Joo Min
- Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | | | - Ji-Youn Han
- National Cancer Center, Goyang, Korea, The Republic of
| | | | - Jin-Soo Kim
- Seoul National University, Boramae Medical Center, Seoul, Korea, The Republic of
| | - Dae Ho Lee
- Asan Medical Center, Seoul, Korea, The Republic of
| | - Jin Hyoung Kang
- Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, The Republic of
| | - Eun Kyung Cho
- Gachon University Gil Medical Center, Incheon, South Korea
| | - Hoon-Gu Kim
- Gyeongsang National University Hospital, Jinju, South Gyeongsang, South Korea
| | - Kyung Hee Lee
- Yeungnam University Medical Center, Gyeonsan, North Gyeongsang, Korea, The Republic of
| | - Hoon Kyo Kim
- St. Vincent's Hospital, Suwon, Korea, The Republic of
| | - In-Jin Jang
- Seoul National University Hospital, Seoul, Korea, The Republic of
| | - Hyo-Yeon Kim
- Hanmi Pharmaceutical Co., Ltd., Seoul, Korea, The Republic of
| | - Jeewoong Son
- Hanmi Pharmaceutical Co., Ltd., Seoul, Korea, The Republic of
| | - Dong-Wan Kim
- Seoul National University Hospital, Seoul, Korea, The Republic of
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34
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Yoo KH, Cho J, Lee KH, Park KU, Kim KH, Cho EK, Kwon KA, Ahn H, Kim H, Kim HG, Lee HY, Yun HJ, Kang JH, Jeong J, Choi MY, Jung SH, Sun JM, Ahn JS, Park K, Ahn MJ. A randomized, open label, phase II study comparing pemetrexed plus cisplatin followed by pemetrexed versus pemetrexed alone in EGFR mutant NSCLC patients who have failed first-line EGFR TKI: KCSG-LU12-13. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.9043] [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)
- Kwai Han Yoo
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, The Republic of
| | - Jinhyun Cho
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ki Hyeong Lee
- Chungbuk National University Hospital, Cheongju, North Chungcheong, Korea, The Republic of
| | - Keon Uk Park
- Keimyung Unversity Dongsan Hospital, Daegu, South Korea
| | - Ki Hwan Kim
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Eun Kyung Cho
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea
| | - Kyung A. Kwon
- Division of Hematology-Oncology, Department of Internal Medicine, Dongnam Institute of Radiological and Medical Sciences, Busan, South Korea
| | | | - HyeRyun Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Ha Yeon Lee
- Kyung Hee University Hospital At Gangdong, Seoul, South Korea
| | - Hwan Jung Yun
- Chungnam National University Hospital, Daejeon, South Korea
| | - Jin-Hyoung Kang
- Division of Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea, The Republic of
| | - Jaeheon Jeong
- Kyung Hee University Medical Center, Seoul, South Korea
| | | | - Sin-Ho Jung
- SAIHST, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea, The Republic of
| | - Jong-Mu Sun
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, The Republic of
| | - Jin Seok Ahn
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, The Republic of
| | - Keunchil Park
- Innovative Cancer Medicine Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Myung-Ju Ahn
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Park CS, Kim TK, Kim HG, Kim YJ, Jeoung MH, Lee WR, Go NK, Heo K, Lee S. Therapeutic targeting of tetraspanin8 in epithelial ovarian cancer invasion and metastasis. Oncogene 2016; 35:4540-8. [PMID: 26804173 DOI: 10.1038/onc.2015.520] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 10/27/2015] [Accepted: 11/12/2015] [Indexed: 11/09/2022]
Abstract
Epithelial ovarian cancer (EOC) invasion and metastasis are complex phenomena that result from the coordinated action of many metastatic regulators and must be overcome to improve clinical outcomes for patients with these cancers. The identification of novel therapeutic targets is critical because of the limited success of current treatment regimens, particularly in advanced-stage ovarian cancers. In this study, we found that tetraspanin 8 (TSPAN8) is overexpressed in about 52% (14/27) of EOC tissues and correlates with poor survival. Using small interfering RNA-mediated TSPAN8 knockdown and a competition assay with purified TSPAN8 large extracellular loop (TSPAN8-LEL) protein, we identified TSPAN8-LEL as a key regulator of EOC cell invasion. Furthermore, monotherapy with TSPAN8-blocking antibody we developed shows that antibody-based modulation of TSPAN8-LEL can significantly reduce the incidence of EOC metastasis without severe toxicity in vivo. Finally, we demonstrated that the TSPAN8-blocking antibody promotes the internalization and concomitant downregulation of cell surface TSPAN8. Collectively, our data suggest TSPAN8 as a potential novel therapeutic target in EOCs and antibody targeting of TSPAN8 as an effective strategy for inhibiting invasion and metastasis of TSPAN8-expressing EOCs.
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Affiliation(s)
- C S Park
- Laboratory of Molecular Cancer Therapeutics, Scripps Korea Antibody Institute,, Chuncheon-si, Korea
| | - T-K Kim
- Laboratory of Molecular Cancer Therapeutics, Scripps Korea Antibody Institute,, Chuncheon-si, Korea
| | - H G Kim
- New Experimental Therapeutics Branch, Research Institute, National Cancer Center, Goyang-si, Korea
| | - Y-J Kim
- Specific Organs Cancer Branch, Research Institute, National Cancer Center, Goyang-si, Korea
| | - M H Jeoung
- Laboratory of Molecular Cancer Therapeutics, Scripps Korea Antibody Institute,, Chuncheon-si, Korea
| | - W R Lee
- Laboratory of Molecular Cancer Therapeutics, Scripps Korea Antibody Institute,, Chuncheon-si, Korea
| | - N K Go
- Laboratory of Molecular Cancer Therapeutics, Scripps Korea Antibody Institute,, Chuncheon-si, Korea
| | - K Heo
- New Experimental Therapeutics Branch, Research Institute, National Cancer Center, Goyang-si, Korea
| | - S Lee
- Laboratory of Molecular Cancer Therapeutics, Scripps Korea Antibody Institute,, Chuncheon-si, Korea
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36
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Kim HS, Kim SM, Kim H, Pyo KH, Sun JM, Ahn MJ, Park K, Keam B, Kwon NJ, Yun HJ, Kim HG, Chung IJ, Lee JS, Lee KH, Kim DJ, Lee CG, Hur J, Chung H, Park JC, Shin SK, Lee SK, Kim HR, Moon YW, Lee YC, Kim JH, Paik S, Cho BC. Phase II clinical and exploratory biomarker study of dacomitinib in recurrent and/or metastatic esophageal squamous cell carcinoma. Oncotarget 2015; 6:44971-84. [PMID: 26462025 PMCID: PMC4792605 DOI: 10.18632/oncotarget.6056] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 06/25/2015] [Accepted: 09/23/2015] [Indexed: 12/14/2022] Open
Abstract
The purpose of this study was to investigate the clinical activity, safety and predictive biomarkers of dacomitinib, an irreversible pan-HER inhibitor, in patients with recurrent or metastatic esophageal squamous cell carcinoma (R/M-ESCC). Patients, whose diseases were not amenable to curative treatment and had progressed on platinum-based chemotherapy, were treated with dacomitinib 45 mg/day. The primary endpoint was objective response rate by RECISTv 1.1. Predictive biomarker analyses included the characterization of somatic mutations and gene expression using the Ion Torrent AmpliSeq Cancer Hotspot Panel and Nanostring nCounter, and investigation of their relationship with clinical outcomes. Of the 48 evaluable patients, 6 (12.5%) achieved partial responses and 29 (60.4%) had stable disease. The median response duration was 7.1 months. The median progression free survival (PFS) and overall survival (OS) was 3.3 months (95% CI, 2.4-4.3 months) and 6.4 months (95% CI, 4.4-8.4 months). Adverse events were mostly grade 1-2. Gene set enrichment analysis revealed that ERBB signaling pathway is significantly enriched in patients with PFS ≥ 4 months (n = 12) than PFS < 4 months (n = 21) (p < 0.001). Upregulation of ERBB signaling pathway was significantly associated with longer PFS (5.0 vs. 2.9 months, P = 0.016) and OS (10.0 vs. 4.8 months, P = 0.022). The most frequent mutations were TP53 (61%) followed by CDKN2A (8%), MLH1 (8%), FLT3 (8%) and EGFR (8%). Dacomitinib demonstrated clinical efficacy with manageable toxicity in platinum-failed R/M-ESCC. Screening of ERBB pathway-related gene expression profiles may help identify patients who are most likely benefit from dacomitinib.
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Affiliation(s)
- Hyo Song Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Sung-Moo Kim
- Yonsei Cancer Research Institute, JE-UK Laboratory of Molecular Cancer Therapeutics, Seoul, Korea
| | - Hyunki Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoung-Ho Pyo
- Yonsei Cancer Research Institute, JE-UK Laboratory of Molecular Cancer Therapeutics, Seoul, Korea
| | - Jong-Mu Sun
- Department of Hematology-Oncology, Samsung Medical Center, Seoul, Korea
| | - Myung-Ju Ahn
- Department of Hematology-Oncology, Samsung Medical Center, Seoul, Korea
| | - Keunchil Park
- Department of Hematology-Oncology, Samsung Medical Center, Seoul, Korea
| | - Bhumsuk Keam
- Department of Hematology-Oncology, Seoul National University Hospital, Seoul, Korea
| | | | - Hwan Jung Yun
- Division of Hemato-Oncology, Chungnam National University Hospital, Daejeon, Korea
| | - Hoon-Gu Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongnam Regional Cancer Center, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ik-Joo Chung
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Jong Seok Lee
- Department of Hematology-Oncology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyung Hee Lee
- Department of Hematology-Oncology, Yeungnam University Medical Center, Daegu, South Korea
| | - Dae Joon Kim
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Chang-Geol Lee
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Hur
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyunsoo Chung
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Chul Park
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Kwan Shin
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Kil Lee
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Ryun Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Wha Moon
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Chan Lee
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Joo Hang Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Soonmyung Paik
- Division of Pathology NSABP, Pittsburgh, PA, USA
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Byoung Chul Cho
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
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Park BB, Kim WS, Suh C, Shin DY, Kim JA, Kim HG, Lee WS. Salvage chemotherapy of gemcitabine, dexamethasone, and cisplatin (GDP) for patients with relapsed or refractory peripheral T-cell lymphomas: a consortium for improving survival of lymphoma (CISL) trial. Ann Hematol 2015; 94:1845-51. [PMID: 26251158 DOI: 10.1007/s00277-015-2468-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 07/20/2015] [Indexed: 11/24/2022]
Abstract
There is no standard salvage chemotherapy for relapsed or refractory peripheral T-cell lymphomas (PTCLs). Gemcitabine combined with cisplatin has been known as an effective regimen for lymphoma treatment in the salvage setting. We investigated the efficacy and toxicity of gemcitabine, dexamethasone, and cisplatin (GDP) for relapsed or refractory PTCLs in search of a more effective and less toxic therapy. Patients with relapsed or refractory PTCLs with more than one previous regimen were eligible. Treatment consisted of gemcitabine 1000 mg/m(2) intravenously (i.v.) on days 1 and 8, dexamethasone 40 mg orally on days 1-4, and cisplatin 70 mg/m(2) i.v. on day 1, and then every 21 days. Patients could proceed to autologous stem cell transplantation (ASCT) after four cycles of GDP or receive up to six treatment cycles. Twenty-five eligible patients were evaluated for toxicity and response. The diagnoses of participants included 14 cases of PTCL-not otherwise specified (NOS) (56 %) and four cases of angioimmunoblastic T-cell lymphoma (16 %) among others. The median age of the patients was 59 years (range 20-75 years). After treatments with GDP, which delivered a median of four GDP cycles, there were 12 patients with complete responses (CR; 48 %) and six with partial responses (PR; 24 %). The overall response rate (RR) was 72 %. Four patients preceded to ASCT, and three patients finally achieved CR. The median progression free survival was 9.3 months (95 % confidence interval (CI); 4.1-14.6) with a median follow-up duration of 27.1 months. In a total of 86 cycles of GDP, grade 3 or 4 neutropenia and thrombocytopenia occurred in 16.3 and 12.8 % of cycles, respectively. Three patients (3.3 %) experienced febrile neutropenia. GDP is a highly effective and optimal salvage regimen for relapsed or refractory PTCLs and can be administered with acceptable toxicity.
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Affiliation(s)
- Byeong-Bae Park
- Division of Hematology/Oncology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Won Seog Kim
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Republic of Korea.
| | - Cheolwon Suh
- Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Dong-Yeop Shin
- Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical sciences, Seoul, Korea
| | - Jeong-A Kim
- Division of Hematology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, Catholic University of Korea, Suwon, Korea
| | - Hoon-Gu Kim
- Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Won Sik Lee
- Division of Hematology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
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Jung SC, Kim HG, Kuk YI, Ahn HG, Senseman SA, Lee DJ. Bioavailability of the Nano-Unit 14C-Agrochemicals Under Various Water Potential. J Nanosci Nanotechnol 2015; 15:6206-6209. [PMID: 26369226 DOI: 10.1166/jnn.2015.10447] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The study was conducted to investigate the effects of water potential on bioavailability of the nano-unit 14C-cafenstrole, 14C-pretilachlor, 14C-benfuresate, 14C-simetryn and 14C-oxyfluorfen applied with or without dimepiperate or daimuron under various water potential conditions. The highest bioavailable concentration in soil solution (BCSS) was found at 60% soil moisture, while the lowest occurred at 50% soil moisture for soil-applied alone or in combination. All water potential conditions differed significantly from each other with variations in total bioavailable amount in soil solution (TBSS) when either dimepiperate or daimuron were added to the soil, and changes were directly proportional to variations in water potential. Across all treatments, TBSS at 80% soil moisture was three to four times greater than that at 50% soil moisture when applied alone or in combination with dimepiperate or daimuron. Cafenstrole and simetryn had distribution coefficient (Kd) values <64 ml g-1 and a TBSS ranging from 10 to 44 ng g-1 soil, regardless of water potential conditions applied alone or in combination. Pretilachlor and benfuresate had Kd values <15 ml g-1 and a TBSS range of 38 to 255 ng g-1 soil when applied with or without dimepiperate or daimuron.
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Lim SM, Chung WY, Nam KH, Kang SW, Lim JY, Kim HG, Shin SH, Sun JM, Kim SG, Kim JH, Kang CW, Kim HR, Cho BC. An open label, multicenter, phase II study of dovitinib in advanced thyroid cancer. Eur J Cancer 2015; 51:1588-95. [DOI: 10.1016/j.ejca.2015.05.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 05/08/2015] [Indexed: 12/13/2022]
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Song HN, Go SI, Lee WS, Kim Y, Choi HJ, Lee US, Kang MH, Lee GW, Kim HG, Kang JH, Kang YS, Lee JH, Jung JM, Hong SC. Population-Based Regional Cancer Incidence in Korea: Comparison between Urban and Rural Areas. Cancer Res Treat 2015; 48:789-97. [PMID: 26194369 PMCID: PMC4843717 DOI: 10.4143/crt.2015.062] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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: 02/16/2015] [Accepted: 06/17/2015] [Indexed: 12/19/2022] Open
Abstract
Purpose The purpose of this study is to investigate differences in organ-specific cancer incidence according to the region and population size in Korea. Materials and Methods We reviewed the data of the cancer registration program of Gyeongnam Regional Cancer Center between 2008 and 2011. Age-standardized rates of cancer incidence were analyzed according to population size of the region and administrative zone. Results Incidence of thyroid cancer has been increasing rapidly in both urban and rural areas. However, the thyroid cancer incidence was much lower in rural areas than in urban areas and megalopolis such as Seoul. Gastric cancer was relatively more common in rural areas, in megalopolis near the sea (Ulsan, Busan, and Incheon), and other southern provinces (Chungcheongnam-do, Gyeongsangbuk-do, and Gyeongsangnam-do). A detailed analysis in Gyeongsangnam-do revealed that rural areas have relatively low incidence of thyroid and colorectal cancer, and relatively high incidence of gastric and lung cancer compared to urban areas. Conclusion This study suggests that there are some differences in cancer incidence by population size. Thyroid and colorectal cancer incidence was increasing, and gastric and lung cancer was slightly decreasing in urban areas, whereas gastric and lung cancer incidence still remains high in rural areas.
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Affiliation(s)
- Haa-Na Song
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Se-Il Go
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Won Sup Lee
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Yire Kim
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Hye Jung Choi
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Un Seok Lee
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Myoung Hee Kang
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Gyeong-Won Lee
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jung Hun Kang
- Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Yune Sik Kang
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jeong-Hee Lee
- Department of Pathology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jin-Myung Jung
- Department of Neurosurgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Soon Chan Hong
- Department of Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
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Go SI, Lee MJ, Lee WS, Choi HJ, Lee US, Kim RB, Kang MH, Kim HG, Lee GW, Kang JH, Lee JH, Kim SJ. D-Dimer Can Serve as a Prognostic and Predictive Biomarker for Metastatic Gastric Cancer Treated by Chemotherapy. Medicine (Baltimore) 2015; 94:e951. [PMID: 26222870 PMCID: PMC4554111 DOI: 10.1097/md.0000000000000951] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Systemic activation of hemostasis and thrombosis has been implicated in tumor progression and metastasis. D-dimer has been used as an indicator for the thrombosis. Here, we investigated the role of the activation of coagulation in patients with metastatic gastric cancer by measuring D-dimer level.We conducted an observation study of 46 metastatic gastric cancer patients who received palliative chemotherapy (CTx). D-dimer levels were assessed before CTx and at the first response evaluation after CTx.The overall survival (OS) of patients with pretreatment D-dimer levels <1.5 μg/mL was significantly longer than that of patients with D-dimer levels ≥1.5 μg/mL (22.0 vs 7.9 months, P = 0.019). At the first response evaluation, the mean level of D-dimer was significantly decreased by 2.11 μg/mL in patients either with partial response or stable disease (P = 0.011) whereas the mean level of D-dimer, although the difference did not reach statistical significance, was increased by 2.46 μg/mL in patients with progressive disease. In addition, the OS of patients with D-dimer levels <1.0 μg/mL at the first response evaluation was significantly longer than that of patients with D-dimer levels ≥1.0 μg/mL (22.0 vs 7.0 months, P = 0.009). The lower D-dimer levels (<1.0 μg/mL) at the first response evaluation after CTx was independent predictive factor for better survival in multivariate analysis (P = 0.037).This study suggests that D-dimer levels may serve as a biomarker for response to CTx and OS in patients with metastatic gastric cancer.
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Affiliation(s)
- Se-Il Go
- From the Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea (S-IG, MJL, WSL, HJC, USL, MHK, H-GK, G-WL, JHK); Department of Preventive Medicine and Environmental Health Center, Gyeongsang National University School of Medicine, Jinju, Korea (RBK), Department of Pathology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea (JHL); and Department of Laboratory Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea (SJK)
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Go SI, Lee WS, Lee GW, Kang JH, Kang MH, Song HN, Lee A, Lee US, Choi HJ, Kim HG. Gemcitabine plus vinorelbine as the second-line treatment and beyond in elderly patients with platinum-pretreated advanced non-small cell lung cancer. Chemotherapy 2015; 60:267-73. [PMID: 25926136 DOI: 10.1159/000381636] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/13/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND The efficacy and tolerance of a gemcitabine and vinorelbine (GV) combination as salvage therapy have not been reported in elderly patients with advanced non-small cell lung cancer (NSCLC). METHODS We reviewed elderly patients with advanced NSCLC who had disease progression after one or more chemotherapy regimens, at least one including platinum, and then who were treated with GV as the salvage therapy. RESULTS In total 40 patients were analyzed. GV was at least the third-line chemotherapy in 24 patients (60.0%). Only 2 patients (5.0%) experienced grade 3 febrile neutropenia. Nonhematologic toxicities were generally mild and there was no treatment-related mortality. Among 29 patients evaluable for treatment response, 10 (34.5%) and 9 (31.0%) achieved a partial response and stable disease, respectively. The median overall survival was 10.3 months and the median progression-free survival was 3.1 months. CONCLUSIONS GV in combination is an effective and tolerable salvage regimen in elderly and heavily pretreated patients with advanced NSCLC.
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Affiliation(s)
- Se-Il Go
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea
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Kim IH, Moon JH, Lim SN, Sohn SK, Kim HG, Lee GW, Kim YS, Lee HS, Kwon KY, Kim SH, Park KT, Chung JS, Lee WS, Lee SM, Hyun MS, Kim H, Ryoo HM, Bae SH, Joo YD. Efficacy and safety of deferasirox estimated by serum ferritin and labile plasma iron levels in patients with aplastic anemia, myelodysplastic syndrome, or acute myeloid leukemia with transfusional iron overload. Transfusion 2015; 55:1613-20. [PMID: 25764017 DOI: 10.1111/trf.13036] [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] [Received: 11/15/2014] [Revised: 01/07/2015] [Accepted: 01/07/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patients receiving red blood cell (RBC) transfusions are at risk of iron overload, which can cause significant organ damage and is an important cause of morbidity and mortality. STUDY DESIGN AND METHODS This study was an open-label, single-arm, prospective clinical study to evaluate the efficacy and safety of deferasirox (DFX) in patients with aplastic anemia (AA), myelodysplastic syndrome (MDS), or acute myeloid leukemia (AML). Patients with serum ferritin levels of at least 1000 ng/mL and ongoing transfusion requirements were enrolled. DFX was administered for up to 1 year. A total of 100 patients were enrolled. RESULTS Serum ferritin levels decreased significantly following treatment (from 2000 to 1650 ng/mL, p = 0.004). The median absolute reduction in serum ferritin levels was -65 ng/mL in AA (p = 0.037), -647 ng/mL in lower-risk MDS (MDS-LR; p = 0.007), and -552 ng/mL in higher-risk MDS (MDS-HR)/AML (p = 0.482). Mean labile plasma iron (LPI) levels decreased from 0.24 μmol/L at baseline to 0.03 μmol/L at 1 year in all patients (p = 0.036). The mean LPI reduction in each group was -0.17 μmol/L in AA, -0.21 μmol/L in MDS-LR, and -0.30 μmol/L in MDS-HR/AML. Gastrointestinal disorders were commonly observed among groups (16.0%). DFX was temporarily skipped for adverse events in seven patients (7.0%) and was permanently discontinued in 11 patients (11.0%). CONCLUSION DFX reduced serum ferritin and LPI levels in patients with transfusional iron overload. Despite the relatively high percentage of gastrointestinal side effects, DFX was tolerable in all subgroups.
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Affiliation(s)
- Il-Hwan Kim
- Department of Hemato-Oncology, Inje University Haeundae Paik Hospital, Busan
| | - Joon-Ho Moon
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu
| | - Sung-Nam Lim
- Department of Hemato-Oncology, Inje University Haeundae Paik Hospital, Busan
| | - Sang-Kyun Sohn
- Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu
| | - Hoon-Gu Kim
- Department of Hematology/Oncology, Gyeongsang National University Hospital, Jinju
| | - Gyeong-Won Lee
- Department of Hematology/Oncology, Gyeongsang National University Hospital, Jinju
| | - Yang-Soo Kim
- Department of Hematology/Oncology, Kosin University College of Medicine, Busan
| | - Ho-Sup Lee
- Department of Hematology/Oncology, Kosin University College of Medicine, Busan
| | - Ki-Young Kwon
- Department of Hematology/Oncology, Dongsan Medical Center, Daegu
| | - Sung-Hyun Kim
- Department of Hematology/Oncology, Dong-a University Hospital, Busan
| | - Kyung-Tae Park
- Department of Hematology/Oncology, Sungkyunkwan University Samsung Changwon Hospital, Changwon
| | - Joo-Seop Chung
- Department of Hematology/Oncology, Pusan National University, Busan
| | - Won-Sik Lee
- Department of Hemato-Oncology, Inje University Busan Paik Hospital, Busan
| | - Sang-Min Lee
- Department of Hemato-Oncology, Inje University Busan Paik Hospital, Busan
| | - Myung-Soo Hyun
- Department of Hematology/Oncology, Yeungnam University Medical Center, Daegu
| | - Hawk Kim
- Division of Hematology, Ulsan University Hospital, Ulsan
| | - Hun-Mo Ryoo
- Department of Hematology/Oncology, Daegu Catholic University Medical Center, Daegu, Korea
| | - Sung-Hwa Bae
- Department of Hematology/Oncology, Daegu Catholic University Medical Center, Daegu, Korea
| | - Young-Don Joo
- Department of Hemato-Oncology, Inje University Haeundae Paik Hospital, Busan
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Hong SH, Lee S, Kim HG, Lee HJ, Jung KH, Lee SC, Lee NR, Yun J, Woo IS, Park KH, Kim KH, Kim HY, Rha SY, Byun JH. Phase II study of gemcitabine and vinorelbine as second- or third-line therapy in patients with primary refractory or platinum-resistant recurrent ovarian and primary peritoneal cancer by the Korean Cancer Study Group (KCSG)_KCSG GY10-10. Gynecol Oncol 2015; 136:212-7. [PMID: 25462205 DOI: 10.1016/j.ygyno.2014.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 11/14/2014] [Accepted: 11/18/2014] [Indexed: 12/23/2022]
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Kim DY, Ryu SY, Kim HG, Joo JK, Kang H, Lee JH. Is histologic differentiation a prognostic indicator for gastric carcinoma patients with curative resection? Indian J Cancer 2015; 52:45-7. [DOI: 10.4103/0019-509x.175569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Jamil M, Rhee JT, Kim HG, Ahmad F, Jeon YJ. Thermal neutron response of a boron-coated GEM detector via GEANT4 Monte Carlo code. Appl Radiat Isot 2015; 95:90-93. [PMID: 25464183 DOI: 10.1016/j.apradiso.2014.09.023] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 07/07/2014] [Accepted: 09/29/2014] [Indexed: 11/19/2022]
Abstract
In this work, we report the design configuration and the performance of the hybrid Gas Electron Multiplier (GEM) detector. In order to make the detector sensitive to thermal neutrons, the forward electrode of the GEM has been coated with the enriched boron-10 material, which works as a neutron converter. A total of 5×5cm2 configuration of GEM has been used for thermal neutron studies. The response of the detector has been estimated via using GEANT4 MC code with two different physics lists. Using the QGSP_BIC_HP physics list, the neutron detection efficiency was determined to be about 3%, while with QGSP_BERT_HP physics list the efficiency was around 2.5%, at the incident thermal neutron energies of 25meV. The higher response of the detector proves that GEM-coated with boron converter improves the efficiency for thermal neutrons detection.
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Affiliation(s)
- M Jamil
- Division of International Studies, College of Global Integrated Studies, Konkuk University, Seoul 143-701, South Korea; IAP, High Energy Physics Lab, Department of Physics, Konkuk University, Seoul 143-701, South Korea
| | - J T Rhee
- IAP, High Energy Physics Lab, Department of Physics, Konkuk University, Seoul 143-701, South Korea.
| | - H G Kim
- IAP, High Energy Physics Lab, Department of Physics, Konkuk University, Seoul 143-701, South Korea
| | - Farzana Ahmad
- Department of Chemistry, Konkuk University, Seoul 143-701, South Korea
| | - Y J Jeon
- Department of Chemistry, Konkuk University, Seoul 143-701, South Korea.
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Kim HG, Jang JH, Koh EH. TRIP11-PDGFRB fusion in a patient with a therapy-related myeloid neoplasm with t(5;14)(q33;q32) after treatment for acute promyelocytic leukemia. Mol Cytogenet 2014; 7:103. [PMID: 25606057 PMCID: PMC4299380 DOI: 10.1186/s13039-014-0103-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 10/06/2014] [Accepted: 12/15/2014] [Indexed: 11/23/2022] Open
Abstract
Background Therapy-related myeloid neoplasm after treatment for acute promyelocytic leukemia (APL) is a relatively infrequent but severe complication. Most therapy-related myeloid neoplasms after treatment for APL are classified as therapy-related myelodysplastic syndrome or therapy-related acute myeloid leukemia. Translocation of 5q31-33, PDGFRB occur rarely in therapy-related myeloid neoplasm and there has been two identified PDGFRB partner genes located at 14q32, TRIP11 and KIAA1509. Results The TRIP11-PDGFRB fusion was identified in a patient with therapy-related myeloid neoplasm with t(5;14)(q33;q32) after treatment of APL using conventional cytogenetics, fluorescence in situ hybridization (FISH) and molecular methods. Cytogenetic analysis of the bone marrow aspirate revealed 46, XY, t(5;14)(q33;q32) in all 20 analyzed cells. No other cytogenetic abnormalities were observed. Break-apart FISH analysis demonstrated that rearrangement of PDGFRB at 5q33 was positive in 460 of 500 cells analyzed, while the PML-RARA rearrangement remained undetectable by RT-PCR. Sequencing of RT-PCR products revealed fusion between exon 16 of TRIP11 and exon 11 of PDGFRB. However, the KIAA1509-PDGFRB fusion was not detected by RT-PCR. Conclusion We firstly demonstrated that therapy-related myeloid neoplasm with TRIP11-PDGFRB fusion was identified after treatment of APL.
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Affiliation(s)
- Hoon-Gu Kim
- Departments of Internal Medicine, Gyeongsang National University School of Medicine, 79 Gangnam-ro, Jinju, Korea
| | | | - Eun-Ha Koh
- Departments of Laboratory Medicine, Gyeongsang National University School of Medicine, 79 Gangnam-ro, 660-702 Jinju, Korea ; Institute of Heath Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
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Kang MH, Lee WS, Go SI, Kim MJ, Lee US, Choi HJ, Kim DC, Lee JH, Kim HG, Bae KS, Cho JM. Can thymidine phosphorylase be a predictive marker for gemcitabine and doxifluridine combination chemotherapy in cholangiocarcinoma?: case series. Medicine (Baltimore) 2014; 93:e305. [PMID: 25526478 PMCID: PMC4603134 DOI: 10.1097/md.0000000000000305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Unresectable cholangiocarcinoma is poorly responded to chemotherapy, especially for the case refractory to gemcitabine and cisplatin. Here, we tested whether high expression of thymidine phosphorylase (TP) can be a predictive biomarker for the indicator for gemcitabine and doxifluridine combination chemotherapy in the cholangiocarcinoma refractory to gemcitabine and cisplatin. Immunohistochemical staining for TP was performed with a biopsy specimen. We accepted the result as positive when more than 10% of cancer cells were stained with moderate intensity. Here, we report 2 cases of TP-positive cholangiocarcinoma well controlled with gemcitabine and doxifluridine combination chemotherapy, which had been refractory to the first line treatment with gemcitabine and cisplatin combination chemotherapy.
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Affiliation(s)
- Myoung Hee Kang
- From the Department of Internal Medicine (MHK, WSL, S-IG, MJK, USL, HJC, H-GK); Department of Pathology (DCK, J-HL); and Department of Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea (KSB, JMC)
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Lee WS, Hwang JH, Kim MJ, Go SI, Lee A, Song HN, Lee MJ, Kang MH, Kim HG, Lee JH. Cyclosporine A as a Primary Treatment for Panniculitis-like T Cell Lymphoma: A Case with a Long-Term Remission. Cancer Res Treat 2014; 46:312-6. [PMID: 25038767 PMCID: PMC4132451 DOI: 10.4143/crt.2014.46.3.312] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 12/21/2012] [Accepted: 05/27/2013] [Indexed: 02/05/2023] Open
Abstract
Subcutaneous panniculitis-like T cell lymphoma (SPTL) is a distinctive cutaneous lymphoma characterized by an infiltration of subcutaneous tissue by neoplastic T cells, similar to panniculitis. It is well-established that patients who are diagnosed with SPTL usually respond poorly to chemotherapy, showing fatal outcome. As a first line treatment for SPTL, anthracycline-based chemotherapy was most frequently used. For the treatment of SPTL, the efficacy of cyclosporine A has been recently reported in relapsed SPTL after anthracycline-based chemotherapy. However, it is still not clear whether cyclosporine A can be used as a first-line treatment against SPTL. Here, we report a case of SPTL, which achieved complete remission for nine years after first-line cyclosporine A therapy. This study suggests that cyclosporine A can induce a complete long-term remission as a first-line treatment.
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Affiliation(s)
- Won Sup Lee
- Departments of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
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Hong SH, Byun JH, Lee S, Kim HG, Lee HJ, Jung KH, Lee SC, Lee NR, Yun J, Hong DS, Woo IS, Park KH, Rha SY. Phase II study of gemcitabine and vinorebline in patients with persistent or recurrent platinum-resistant ovarian or primary peritoneal cancer: A study of the Korean Cancer Study Group. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.5568] [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)
- Sook Hee Hong
- Division of Oncology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea, Seoul, South Korea
| | - Jae Ho Byun
- Incheon St. Mary's Hospital, The Catholic University of Korea, Inchoen, South Korea
| | - Soohyeon Lee
- Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hoon-Gu Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Hyo Jin Lee
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Kyung Hae Jung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sang-Cheol Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Na-Ri Lee
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, South Korea
| | - Jina Yun
- Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Dae-Sik Hong
- Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - In Sook Woo
- The Catholic University of Korea Yeouido St. Mary's Hospital, Seoul, South Korea
| | - Kyong Hwa Park
- Division of Hematology and Oncology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sun Young Rha
- Department of Internal Medicine, Yonsei University College of Medicine and Brain Korea 21 Project for Medical Science, Seoul, South Korea
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