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Altan M, Soto F, Xu T, Wilson N, Franco-Vega MC, Simbaqueba Clavijo CA, Shannon VR, Faiz SA, Gandhi S, Lin SH, Lopez P, Zhong L, Akhmedzhanov F, Godoy MCB, Shroff GS, Wu J, Khawaja F, Kim ST, Naing A, Heymach JV, Daniel-Macdougall C, Liao Z, Sheshadri A. Pneumonitis After Concurrent Chemoradiation and Immune Checkpoint Inhibition in Patients with Locally Advanced Non-small Cell Lung Cancer. Clin Oncol (R Coll Radiol) 2023; 35:630-639. [PMID: 37507279 DOI: 10.1016/j.clon.2023.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 02/03/2023] [Revised: 06/20/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
AIMS Pneumonitis is a common and potentially deadly complication of combined chemoradiation and immune checkpoint inhibition (CRT-ICI) in patients with locally advanced non-small cell lung cancer (LA-NSCLC). In this study we sought to identify the risk factors for pneumonitis with CRT-ICI therapy in LA-NSCLC cases and determine its impact on survival. MATERIALS AND METHODS We conducted a retrospective chart review of 140 patients with LA-NSCLC who underwent curative-intent CRT-ICI with durvalumab between 2018 and 2021. Pneumonitis was diagnosed by a multidisciplinary team of clinical experts. We used multivariable cause-specific hazard models to identify risk factors associated with grade ≥2 pneumonitis. We constructed multivariable Cox proportional hazard models to investigate the impact of pneumonitis on all-cause mortality. RESULTS The median age of the cohort was 67 years; most patients were current or former smokers (86%). The cumulative incidence of grade ≥2 pneumonitis was 23%. Among survivors, 25/28 patients had persistent parenchymal scarring. In multivariable analyses, the mean lung dose (hazard ratio 1.14 per Gy, 95% confidence interval 1.03-1.25) and interstitial lung disease (hazard ratio 3.8, 95% confidence interval 1.3-11.0) increased the risk for pneumonitis. In adjusted models, grade ≥2 pneumonitis (hazard ratio 2.5, 95% confidence interval 1.0-6.2, P = 0.049) and high-grade (≥3) pneumonitis (hazard ratio 8.3, 95% confidence interval 3.0-23.0, P < 0.001) were associated with higher all-cause mortality. CONCLUSIONS Risk factors for pneumonitis in LA-NSCLC patients undergoing CRT-ICI include the mean radiation dose to the lung and pre-treatment interstitial lung disease. Although most cases are not fatal, pneumonitis in this setting is associated with markedly increased mortality.
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Affiliation(s)
- M Altan
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - F Soto
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - T Xu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - N Wilson
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M C Franco-Vega
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C A Simbaqueba Clavijo
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - V R Shannon
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S A Faiz
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S Gandhi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S H Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P Lopez
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Zhong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - F Akhmedzhanov
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M C B Godoy
- Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - G S Shroff
- Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J Wu
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - F Khawaja
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S T Kim
- Department of Rheumatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A Naing
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J V Heymach
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Daniel-Macdougall
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A Sheshadri
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Yoshino T, Cervantes A, Bando H, Martinelli E, Oki E, Xu RH, Mulansari NA, Govind Babu K, Lee MA, Tan CK, Cornelio G, Chong DQ, Chen LT, Tanasanvimon S, Prasongsook N, Yeh KH, Chua C, Sacdalan MD, Sow Jenson WJ, Kim ST, Chacko RT, Syaiful RA, Zhang SZ, Curigliano G, Mishima S, Nakamura Y, Ebi H, Sunakawa Y, Takahashi M, Baba E, Peters S, Ishioka C, Pentheroudakis G. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with metastatic colorectal cancer. ESMO Open 2023; 8:101558. [PMID: 37236086 PMCID: PMC10220270 DOI: 10.1016/j.esmoop.2023.101558] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 03/20/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/28/2023] Open
Abstract
The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with metastatic colorectal cancer (mCRC), published in late 2022, were adapted in December 2022, according to previously established standard methodology, to produce the Pan-Asian adapted (PAGA) ESMO consensus guidelines for the management of Asian patients with mCRC. The adapted guidelines presented in this manuscript represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with mCRC representing the oncological societies of China (CSCO), Indonesia (ISHMO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO), co-ordinated by ESMO and the Japanese Society of Medical Oncology (JSMO). The voting was based on scientific evidence and was independent of the current treatment practices, drug access restrictions and reimbursement decisions in the different Asian countries. The latter are discussed separately in the manuscript. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with mCRC across the different countries of Asia, drawing on the evidence provided by both Western and Asian trials, whilst respecting the differences in screening practices, molecular profiling and age and stage at presentation, coupled with a disparity in the drug approvals and reimbursement strategies, between the different countries.
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Affiliation(s)
- T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
| | - A Cervantes
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - H Bando
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - E Martinelli
- Oncology Unit, Department of Precision Medicine, Università degli Studi della Campania 'L. Vanvitelli', Naples, Italy
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - R-H Xu
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center and State Key Laboratory of Oncology in South China, Guangzhou, China
| | - N A Mulansari
- Hematology-Medical Oncology Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital/Universitas Indonesia, Jakarta, Indonesia
| | - K Govind Babu
- Department of Medical Oncology, HCG Hospital and St. John's Medical College, Bengaluru, India
| | - M A Lee
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C K Tan
- Department of Oncology and Nuclear Medicine, Thomson Hospital Kota Damansara, Selangor, Malaysia
| | - G Cornelio
- Department of Medical Oncology, University of the Philipppines-Philippine General Hospital, St. Lukes Cancer Institute-Global City, The Philippines
| | - D Q Chong
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - L-T Chen
- Department of Internal Medicine, Kaohsiung Medical University Hospital and Centre for Cancer Research, Kaohsiung Medical University, Kaohsiung; National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - S Tanasanvimon
- Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok
| | - N Prasongsook
- Division of Medical Oncology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - K-H Yeh
- Department of Oncology, National Taiwan University Hospital, Taipei; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - C Chua
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - M D Sacdalan
- Department of Surgery, University of the Philippines-College of Medicine and University of the Philippines-Philippine General Hospital, Manila, The Philippines
| | - W J Sow Jenson
- Department of Radiotherapy & Oncology, Aurelius Hospital, Nilai, Malaysia
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Centre, Seoul, South Korea
| | - R T Chacko
- Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu, India
| | - R A Syaiful
- Department of Surgery, Dr Cipto Mangunkusumo National General Hospital, University of Indonesia, Jakarta, Indonesia
| | - S Z Zhang
- Department of Colorectal Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - G Curigliano
- Istituto Europeo di Oncologia, IRCCS, Milan; Department of Oncology and Haematology, University of Milano, Milan, Italy
| | - S Mishima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Y Nakamura
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - H Ebi
- Division of Molecular Therapeutics, Aichi Cancer Center Research Institute, Nagoya
| | - Y Sunakawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki
| | - M Takahashi
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai
| | - E Baba
- Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Peters
- Oncology Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - C Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
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Vesely BD, Bonvillian JP, King MA, Kim ST, Gangopadhyay P, Blazek CD. Opioid Prescribing Patterns of Foot and Ankle Surgeons: Single State Review. J Foot Ankle Surg 2022; 61:1071-1075. [PMID: 35346575 DOI: 10.1053/j.jfas.2022.01.022] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/06/2021] [Accepted: 01/11/2022] [Indexed: 02/03/2023]
Abstract
The United States is currently in an opioid crisis. In order improve the amount of misuse and overdoses from opioids, some institutions have begun to create protocols based off of state and federal opioid prescription regulations. Our purpose is to analyze the current opioid prescribing patterns in foot and ankle surgery and create an institutional protocol. A survey on current opioid prescribing patterns based on the podiatric surgery was sent out from November 20, 2020 to January 11, 2021 to all members of the North Carolina Foot and Ankle Society. One-hundred surgeons participated in the survey. The most commonly prescribed postoperative pain medication was Hydrocodone/acetaminophen 5 mg/325 mg and the most common quantity was between 21 and 30 tablets. The most common medication for local blocks reported was bupivacaine and lidocaine mixed performed as a block closest to the surgical site. We recommend creating an institutional based opioid protocol for foot and ankle surgeries based off of the procedure performed by the surgeon. We recommend limiting prescriptions to under 30 tablets and utilizing a local or regional pain block for podiatric surgeries.
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Affiliation(s)
- Bryanna D Vesely
- Resident Physician, Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC.
| | - John P Bonvillian
- Attending Physician, Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Matthew A King
- Resident Physician, Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Seiha T Kim
- Attending Physician, Department of Anesthesia, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Paula Gangopadhyay
- Assistant Professor, Department of Orthopaedic Surgery, Wake Forest Medical Center, Winston-Salem, NC
| | - Cody D Blazek
- Attending Physician, Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC
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Catenacci DVT, Kang YK, Yoon HH, Shim BY, Kim ST, Oh DY, Spira AI, Ulahannan SV, Avery EJ, Boland PM, Chao J, Chung HC, Gardner F, Klempner SJ, Lee KW, Oh SC, Peguero J, Sonbol MB, Shen L, Moehler M, Sun J, Li D, Rosales MK, Park H. Margetuximab with retifanlimab as first-line therapy in HER2+/PD-L1+ unresectable or metastatic gastroesophageal adenocarcinoma: MAHOGANY cohort A. ESMO Open 2022; 7:100563. [PMID: 36029651 PMCID: PMC9588876 DOI: 10.1016/j.esmoop.2022.100563] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 06/08/2022] [Accepted: 07/17/2022] [Indexed: 12/12/2022] Open
Abstract
Background Human epidermal growth factor receptor 2 (HER2)-positive metastatic gastric and gastroesophageal adenocarcinoma (GEA) is globally treated with chemotherapy plus trastuzumab. Novel therapeutic strategies strive to not only optimize efficacy, but also limit toxicities. In MAHOGANY cohort A, margetuximab, an Fc-engineered, anti-HER2 monoclonal antibody (mAb) was combined with retifanlimab, an anti-programmed cell death protein 1 mAb, in the first-line HER2-positive/programmed death-ligand 1 (PD-L1)-positive GEA. Patients and methods MAHOGANY cohort A part 1 is a single-arm trial to evaluate margetuximab plus retifanlimab in patients with HER2 immunohistochemistry 3+, PD-L1-positive (combined positive score ≥1%), and non-microsatellite instability-high tumors. Primary objectives for cohort A were safety/tolerability and the confirmed objective response rate (ORR). Results As of 3 August 2021, 43 patients were enrolled and received margetuximab/retifanlimab. Nine grade 3 treatment-related adverse events (TRAEs) were reported in eight (18.6%) patients and eight serious TRAEs in seven (16.3%) patients. There were no grade 4/5 TRAEs. Three patients discontinued margetuximab/retifanlimab because of immune-related adverse events. The ORR by independent assessment was 53% [21/40 (95% confidence interval (CI) 36.1-68.5)], with a median duration of response of 10.3 months (95% CI 4.6-not evaluable); disease control rate was 73% [29/40 (95% CI 56.1-85.4)]. The study sponsor discontinued the study in advance of the planned enrollment when it became apparent that the study design would no longer meet the requirements for drug approval because of recent advances in the treatment of GEA. Conclusions The chemotherapy-free regimen of combined margetuximab/retifanlimab as first-line treatment in double biomarker-selected patients demonstrated a favorable toxicity profile compared with historical outcomes using chemotherapy plus trastuzumab. The ORR observed in this study compares favorably versus ORR observed with other chemotherapy-free approaches. The margetuximab/retifanlimab regimen has a favorable toxicity profile versus historical chemotherapy-based regimens in GEA. The margetuximab/retifanlimab regimen as first-line therapy for GEA met the prespecified boundary for antitumor activity. The 53% ORR [21/40 (95% CI 36.1-68.5)] in the combined regimen compared favorably with other chemotherapy-free approaches. Median duration of response was 10.3 months (95% CI 4.57-not evaluable) and disease control rate was 73% [29/40 (95% CI 56.1-85.4)]. The study was discontinued for business reasons as chemotherapy-based regimens remain the dominant therapy for GEA.
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Affiliation(s)
- D V T Catenacci
- Department of Medicine, The University of Chicago Medical Centre, Chicago, USA.
| | - Y-K Kang
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - H H Yoon
- Division of Medical Oncology, Mayo Clinic Comprehensive Cancer Center, Rochester, USA
| | - B Y Shim
- Medical Oncology, The Catholic University of Korea St. Vincent's Hospital, Suwon, Republic of Korea
| | - S T Kim
- Hematology and Oncology, Samsung Medical Center, Seoul, Republic of Korea
| | - D-Y Oh
- Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Republic of Korea
| | - A I Spira
- Virginia Cancer Specialists Research Institute, Fairfax, USA
| | - S V Ulahannan
- University of Oklahoma Health Sciences Center - Stephenson Cancer Center, Oklahoma City, USA
| | - E J Avery
- Division of Hematology and Oncology, Nebraska Hematology-Oncology, Lincoln, USA
| | - P M Boland
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, USA
| | - J Chao
- Department of Medical Oncology & Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, USA
| | - H C Chung
- Department of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - F Gardner
- Medical Oncology, Florida Cancer Specialists, Cape Coral, USA
| | - S J Klempner
- Mass General Hospital Cancer Center, Massachusetts General Hospital, Boston, USA
| | - K-W Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam
| | - S C Oh
- Oncology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - J Peguero
- Medical Oncology, Oncology Consultants, Houston, USA
| | - M B Sonbol
- Internal Medicine Department, Mayo Clinic Cancer Center, Phoenix, USA
| | - L Shen
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - M Moehler
- Johannes-Gutenberg University, Mainz, Germany
| | - J Sun
- MacroGenics, Inc., Rockville, USA
| | - D Li
- MacroGenics, Inc., Rockville, USA
| | | | - H Park
- Department of Medicine, Washington University School of Medicine, St. Louis, USA
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Akelman MR, Kim ST, Waterman BR. Editorial Commentary: Multimodal, Opioid-Free Pain Management After Rotator Cuff Repair May Be Safe and Effective, and Decreases the Risk of Drug Abuse. Arthroscopy 2022; 38:1086-1088. [PMID: 35369913 DOI: 10.1016/j.arthro.2022.01.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/21/2022] [Accepted: 01/30/2022] [Indexed: 02/02/2023]
Abstract
In 2020, approximately 94,000 people died in the United States due to drug overdose, a grim 78% increase since release of the American Academy of Orthopaedic Surgeons (AAOS) information statement on opioid abuse nearly 5 years ago. Annual opioid-related mortality rates now far surpass those stemming from either car crashes or gun violence. Multiple risk factors exist for opioid misuse and abuse, including a major risk factor under the orthopaedic surgeon's control-exposure to opioid medication. Prescription protocols that decrease a patient's access to narcotic medication could lead to a decrease in overall opioid abuse, while also avoiding second-order effects, such as drug diversion. Multimodal, nonopioid pain protocols often employ peripheral nerve blocks, acetaminophen, nonsteroidal anti-inflammatory medication (NSAIDs), gabapentinoids, and antispasmodic muscle relaxants, and this has yielded promising results after arthroscopic rotator cuff surgery. As good stewards of the musculoskeletal community, we should proactively employ evidence-based practices for establishing realistic postoperative patient expectations, common analgesic care pathways, and standardized pill counts stratified by procedure type.
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Kim R, Kwon M, An M, Kim ST, Smith SA, Loembé AB, Mortimer PGS, Armenia J, Lukashchuk N, Shah N, Dean E, Park WY, Lee J. Phase II study of ceralasertib (AZD6738) in combination with durvalumab in patients with advanced/metastatic melanoma who have failed prior anti-PD-1 therapy. Ann Oncol 2021; 33:193-203. [PMID: 34710570 DOI: 10.1016/j.annonc.2021.10.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [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: 09/28/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Modulating the DNA damage response and repair (DDR) pathways is a promising strategy for boosting cancer immunotherapy. Ceralasertib (AZD6738) is an oral inhibitor of the serine/threonine protein kinase ataxia telangiectasia and Rad3-related protein, which is crucial for DDR. PATIENTS AND METHODS This phase II trial evaluated ceralasertib plus durvalumab for the treatment of patients with metastatic melanoma who had failed anti-programmed cell death protein 1 therapy. RESULTS Among the 30 patients, we observed an overall response rate of 31.0% and a disease control rate of 63.3%. Responses were evident across patients with acral, mucosal, and cutaneous melanoma. The median duration of response was 8.8 months (range, 3.8-11.7 months). The median progression-free survival was 7.1 months (95% confidence interval, 3.6-10.6 months), and the median overall survival was 14.2 months (95% confidence interval, 9.3-19.1 months). Common adverse events were largely hematologic and manageable with dose interruptions and reductions. Exploratory biomarker analysis suggested that tumors with an immune-enriched microenvironment or alterations in the DDR pathway were more likely to respond to the study treatment. CONCLUSION We conclude that ceralasertib in combination with durvalumab has promising antitumor activity among patients with metastatic melanoma who have failed anti-programmed cell death protein 1 therapy, and constitute a population with unmet needs.
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Affiliation(s)
- R Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M Kwon
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - M An
- Samsung Advanced Institute of Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S A Smith
- Oncology R&D, AstraZeneca, Cambridge, UK
| | - A B Loembé
- Oncology R&D, AstraZeneca, Cambridge, UK
| | | | - J Armenia
- Oncology R&D, AstraZeneca, Cambridge, UK
| | | | - N Shah
- Oncology R&D, AstraZeneca, Cambridge, UK
| | - E Dean
- Oncology R&D, AstraZeneca, Cambridge, UK
| | - W-Y Park
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Geninus Inc., Seoul, Korea
| | - J Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Korea.
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Turner JD, Cortese KT, Kim ST, McKee ZL, Jaffe D, Henshaw DS, Dobson SW, Weller R, Edwards CJ, Reynolds JW, Russell G. Mean plasma bupivacaine concentrations following pectoral nerve blocks (PECS II). Reg Anesth Pain Med 2021; 47:194-195. [PMID: 34610964 DOI: 10.1136/rapm-2021-102984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/10/2021] [Indexed: 11/03/2022]
Affiliation(s)
- James D Turner
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Kevin T Cortese
- Internal Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Seiha T Kim
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Zachary L McKee
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Doug Jaffe
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Daryl S Henshaw
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Sean W Dobson
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Robert Weller
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Christopher J Edwards
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - J Wells Reynolds
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Greg Russell
- Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
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Byeon S, Cho HJ, Jang KT, Kwon M, Lee J, Lee J, Kim ST. Molecular profiling of Asian patients with advanced melanoma receiving check-point inhibitor treatment. ESMO Open 2020; 6:100002. [PMID: 33399091 PMCID: PMC7910729 DOI: 10.1016/j.esmoop.2020.100002] [Citation(s) in RCA: 5] [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: 07/22/2020] [Revised: 10/21/2020] [Accepted: 11/02/2020] [Indexed: 12/24/2022] Open
Abstract
Objective Melanoma is major medical challenge and being able to monitor treatment response is critical. This study aimed to use molecular profiling of Asian patients with advanced melanoma who were receiving treatment with check-point inhibitors (CPIs) to identify novel biomarkers of tumor response. Methods Next-generation sequencing (NGS) was performed using tumor specimens collected from 178 Asian patients with metastatic melanoma receiving CPIs. The NGS data and clinical-pathological factors were analyzed for potential genetic biomarkers of tumor response to CPI treatment. Results The most common melanoma subtype was acral melanoma (40%), followed by cutaneous melanoma (32%), mucosal melanoma (26%), and others (2%). For calculation of treatment efficacy, 164 of the patients could be evaluated. The overall response rate was 45.7%, of which 41 cases exhibited complete responses (25.0%) and 34 showed partial responses (20.7%). There were no significant differences in tumor responses based on melanoma subtype (P = 0.295). Genetically, NRAS mutations, TP53 mutations, and NF2 deletions were significantly associated with resistance to CPIs (P < 0.05). In contrast, MYC and RPS6KB1 amplifications were associated with responsiveness to CPIs (P < 0.05). Median progression-free survival (PFS) for patients treated with CPIs was 5.9 months (95% CI, 3.8-8.05 months). Univariate analysis identified TP53 and BRAF mutations, NF2 deletions, and BIRC2 amplifications as poor prognostic factors for PFS (P < 0.05). Conclusions This study determined the integrated genomic profiles of Asian patients with metastatic melanoma receiving CPIs and identified candidate biomarkers that reflected treatment outcomes. The molecular characterization of Asian melanoma patients receiving check-point inhibitors (CPIs) using NGS has not been reported. NRAS and TP53 mutations and NF2 deletions were significantly associated with resistance to CPIs. MYC and RPS6KB1 amplifications were associated with responsiveness to CPIs. TP53 and BRAF mutations, NF2 deletions, and BIRC2 amplifications were poor prognostic factors for progression-free survival. This is the largest integrated genomic study to date that identifying novel biomarkers of CPIs in Asian melanoma patients.
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Affiliation(s)
- S Byeon
- Department of Medicine, Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - H J Cho
- Department of Medicine, Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Precision Medicine Research Institute, Samsung Medical Center, Seoul, Korea
| | - K-T Jang
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M Kwon
- Department of Medicine, Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Lee
- Department of Medicine, Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Lee
- Department of Medicine, Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S T Kim
- Department of Medicine, Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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9
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Park SH, Lim DH, Sohn TS, Lee J, Zang DY, Kim ST, Kang JH, Oh SY, Hwang IG, Ji JH, Shin DB, Yu JI, Kim KM, An JY, Choi MG, Lee JH, Kim S, Hong JY, Park JO, Park YS, Lim HY, Bae JM, Kang WK. A randomized phase III trial comparing adjuvant single-agent S1, S-1 with oxaliplatin, and postoperative chemoradiation with S-1 and oxaliplatin in patients with node-positive gastric cancer after D2 resection: the ARTIST 2 trial ☆. Ann Oncol 2020; 32:368-374. [PMID: 33278599 DOI: 10.1016/j.annonc.2020.11.017] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [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: 10/11/2020] [Revised: 11/22/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Adjuvant chemotherapy and chemoradiotherapy are some of the standards of care for gastric cancer (GC). The Adjuvant chemoRadioTherapy In Stomach Tumors (ARTIST) 2 trial compares two adjuvant chemotherapy regimens and chemoradiotherapy in patients with D2-resected, stage II or III, node-positive GC. PATIENTS AND METHODS The ARTIST 2 compared, in a 1:1:1 ratio, three adjuvant regimens: oral S-1 (40-60 mg twice daily 4 weeks on/2 weeks off) for 1 year, S-1 (2 weeks on/1 week off) plus oxaliplatin 130 mg/m2 every 3 weeks (SOX) for 6 months, and SOX plus chemoradiotherapy 45 Gy (SOXRT). Randomization was stratified according to surgery type (total or subtotal gastrectomy), pathologic stage (II or III), and Lauren histologic classification (diffuse or intestinal/mixed). The primary endpoint was disease-free survival (DFS) at 3 years; a reduction of 33% in the hazard ratio (HR) for DFS with SOX or SOXRT, when compared with S-1, was considered clinically meaningful. The trial is registered at clinicaltrials.gov (NCT0176146). RESULTS A total of 546 patients were recruited between February 2013 and January 2018 with 182, 181, and 183 patients in the S-1, SOX, and SOXRT arms, respectively. Median follow-up period was 47 months, with 178 DFS events observed. Estimated 3-year DFS rates were 64.8%, 74.3%, and 72.8% in the S-1, SOX, and SOXRT arms, respectively. HR for DFS in the control arm (S-1) was shorter than that in the SOX and SOXRT arms: S-1 versus SOX, 0.692 (P = 0.042) and S-1 versus SOXRT, 0.724 (P = 0.074). No difference in DFS was found between SOX and SOXRT (HR 0.971; P = 0.879). Adverse events were as anticipated in each arm, and were generally well-tolerated and manageable. CONCLUSIONS In patients with curatively D2-resected, stage II/III, node-positive GC, adjuvant SOX or SOXRT was effective in prolonging DFS, when compared with S-1 monotherapy. The addition of radiotherapy to SOX did not significantly reduce the rate of recurrence after D2 gastrectomy.
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Affiliation(s)
- S H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D H Lim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - T S Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D Y Zang
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Gyeonggi-do, Korea
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J H Kang
- Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - S Y Oh
- Department of Hematology-Oncology, Dong-A University, Busan, Korea
| | - I G Hwang
- Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - J H Ji
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - D B Shin
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - J I Yu
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K-M Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Y An
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M G Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J H Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Y Hong
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J O Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y S Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Y Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J M Bae
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - W K Kang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Sundar R, Huang KK, Qamra A, Kim KM, Kim ST, Kang WK, Tan ALK, Lee J, Tan P. Epigenomic promoter alterations predict for benefit from immune checkpoint inhibition in metastatic gastric cancer. Ann Oncol 2020; 30:424-430. [PMID: 30624548 PMCID: PMC6442650 DOI: 10.1093/annonc/mdy550] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [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] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Utilization of alternative transcription start sites through alterations in epigenetic promoter regions causes reduced expression of immunogenic N-terminal peptides, which may facilitate immune evasion in early gastric cancer. We hypothesized that tumors with high alternate promoter utilization would be resistant to immune checkpoint inhibition in metastatic gastric cancer. PATIENTS AND METHODS Two cohorts of patients with metastatic gastric cancer treated with immunotherapy were analyzed. The first cohort (N = 24) included patients treated with either nivolumab or pembrolizumab. Alternate promoter utilization was measured using the NanoString® (NanoString Technologies, Seattle, WA, USA) platform on archival tissue samples. The second cohort was a phase II clinical trial of patients uniformly treated with pembrolizumab (N = 37). Fresh tumor biopsies were obtained, and transcriptomic analysis was carried out on RNAseq data. Alternate promoter utilization was correlated to T-cell cytolytic activity, objective response rate and survival. RESULTS In the first cohort 8 of 24 (33%) tumors were identified to have high alternate promoter utilization (APhigh), and this was used to define the APhigh tertile of the second cohort (13 APhigh of 37). APhigh tumors exhibited decreased markers of T-cell cytolytic activity and lower response rates (8% versus 42%, P = 0.03). Median progression-free survival was lower in the APhigh group (55 versus 180 days, P = 0.0076). In multivariate analysis, alternative promoter utilization was an independent predictor of immunotherapy survival [hazard ratio 0.29, 95% confidence interval 0.099-0.85, P = 0.024). Analyzing tumoral evolution through paired pre-treatment and post-treatment biopsies, we observed consistent shifts in alternative promoter utilization rate associated with clinical response. CONCLUSION A substantial proportion of metastatic gastric cancers utilize alternate promoters as a mechanism of immune evasion, and these tumors may be resistant to anti-PD1 immune checkpoint inhibition. Alternate promoter utilization is thus a potential mechanism of resistance to immune checkpoint inhibition, and a novel predictive biomarker for immunotherapy. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT#02589496.
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Affiliation(s)
- R Sundar
- Department of Haematology-Oncology, National University Health System, Singapore; Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - K K Huang
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore
| | - A Qamra
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore
| | - K-M Kim
- Department of Pathology and Translational Genomics
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W K Kang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - A L K Tan
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore
| | - J Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - P Tan
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore; Biomedical Research Council, Agency for Science, Technology and Research, Singapore; Cancer Science Institute of Singapore, National University of Singapore, Singapore; SingHealth/Duke-NUS Institute of Precision Medicine, National Heart Centre Singapore, Singapore, Singapore.
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11
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Kim ST, Banks KC, Pectasides E, Kim SY, Kim K, Lanman RB, Talasaz A, An J, Choi MG, Lee JH, Sohn TS, Bae JM, Kim S, Park SH, Park JO, Park YS, Lim HY, Kim NKD, Park W, Lee H, Bass AJ, Kim K, Kang WK, Lee J. Impact of genomic alterations on lapatinib treatment outcome and cell-free genomic landscape during HER2 therapy in HER2+ gastric cancer patients. Ann Oncol 2019; 29:1037-1048. [PMID: 29409051 PMCID: PMC5913644 DOI: 10.1093/annonc/mdy034] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background To identify predictive markers for responders in lapatinib-treated patients and to demonstrate molecular changes during lapatinib treatment via cell-free genomics. Patients and methods We prospectively evaluated the efficacy of combining lapatinib with capecitabine and oxaliplatin as first line neoadjuvant therapy in patients with previously untreated, HER2-overexpressing advanced gastric cancer. A parallel biomarker study was conducted by simultaneously performing immunohistochemistry and next-generation sequencing (NGS) with tumor and blood samples. Results Complete response was confirmed in 7/32 patients (21.8%), 2 of whom received radical surgery with pathologic-confirmed complete response. Fifteen partial responses (46.8%) were observed, resulting in a 68.6% overall response rate. NGS of the 16 tumor specimens demonstrated that the most common co-occurring copy number alteration was CCNE1 amplification, which was present in 40% of HER2+ tumors. The relationship between CCNE1 amplification and lack of response to HER2-targeted therapy trended toward statistical significance (66.7% of non-responders versus 22.2% of responders harbored CCNE1 amplification; P = 0.08). Patients with high level ERBB2 amplification by NGS were more likely to respond to therapy, compared with patients with low level ERBB2 amplification (P = 0.02). Analysis of cfDNA showed that detectable ERBB2 copy number amplification in plasma was predictive to the response (100%, response rate) and changes in plasma-detected genomic alterations were associated with lapatinib sensitivity and/or resistance. The follow-up cfDNA genomics at disease progression demonstrated that there are emergences of other genomic aberrations such as MYC, EGFR, FGFR2 and MET amplifications. Conclusions The present study showed that HER2+ GC patients respond differently according to concomitant genomic aberrations beyond ERBB2, high ERBB2 amplification by NGS or cfDNA can be a positive predictor for patient selection, and tumor genomic alterations change significantly during targeted agent therapy.
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Affiliation(s)
- S T Kim
- Division of Hematology-Oncolog, Department of Medicine, Samsung Medical Center, Seoul, Korea; Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K C Banks
- Department of Medical Affair, Guardant Health, Dana-Farber Cancer Institute, Boston, USA
| | - E Pectasides
- Division of Molecular and Cellular Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - S Y Kim
- Division of Hematology-Oncolog, Department of Medicine, Samsung Medical Center, Seoul, Korea; Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K Kim
- Division of Hematology-Oncolog, Department of Medicine, Samsung Medical Center, Seoul, Korea; Sungkyunkwan University School of Medicine, Seoul, Korea
| | - R B Lanman
- Department of Medical Affair, Guardant Health, Dana-Farber Cancer Institute, Boston, USA
| | - A Talasaz
- Department of Medical Affair, Guardant Health, Dana-Farber Cancer Institute, Boston, USA
| | - J An
- Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - M G Choi
- Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - J H Lee
- Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - T S Sohn
- Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - J M Bae
- Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - S Kim
- Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - S H Park
- Division of Hematology-Oncolog, Department of Medicine, Samsung Medical Center, Seoul, Korea; Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J O Park
- Division of Hematology-Oncolog, Department of Medicine, Samsung Medical Center, Seoul, Korea; Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y S Park
- Division of Hematology-Oncolog, Department of Medicine, Samsung Medical Center, Seoul, Korea; Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Y Lim
- Division of Hematology-Oncolog, Department of Medicine, Samsung Medical Center, Seoul, Korea; Sungkyunkwan University School of Medicine, Seoul, Korea
| | - N K D Kim
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea
| | - W Park
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea
| | - H Lee
- Sungkyunkwan University School of Medicine, Seoul, Korea; Division of Gastroenterolog, Department of Medicine, Samsung Medical Center, Seoul, Korea
| | - A J Bass
- Division of Molecular and Cellular Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - K Kim
- Pathology and Translational Genomics, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W K Kang
- Division of Hematology-Oncolog, Department of Medicine, Samsung Medical Center, Seoul, Korea; Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Lee
- Division of Hematology-Oncolog, Department of Medicine, Samsung Medical Center, Seoul, Korea; Sungkyunkwan University School of Medicine, Seoul, Korea.
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12
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Pietrantonio F, Di Nicolantonio F, Schrock AB, Lee J, Morano F, Fucà G, Nikolinakos P, Drilon A, Hechtman JF, Christiansen J, Gowen K, Frampton GM, Gasparini P, Rossini D, Gigliotti C, Kim ST, Prisciandaro M, Hodgson J, Zaniboni A, Chiu VK, Milione M, Patel R, Miller V, Bardelli A, Novara L, Wang L, Pupa SM, Sozzi G, Ross J, Di Bartolomeo M, Bertotti A, Ali S, Trusolino L, Falcone A, de Braud F, Cremolini C. RET fusions in a small subset of advanced colorectal cancers at risk of being neglected. Ann Oncol 2019. [PMID: 29538669 DOI: 10.1093/annonc/mdy090] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Recognition of rare molecular subgroups is a challenge for precision oncology and may lead to tissue-agnostic approval of targeted agents. Here we aimed to comprehensively characterize the clinical, pathological and molecular landscape of RET rearranged metastatic colorectal cancer (mCRC). Patients and methods In this case series, we compared clinical, pathological and molecular characteristics of 24 RET rearranged mCRC patients with those of a control group of 291 patients with RET negative tumors. RET rearranged and RET negative mCRCs were retrieved by systematic literature review and by taking advantage of three screening sources: (i) Ignyta's phase 1/1b study on RXDX-105 (NCT01877811), (ii) cohorts screened at two Italian and one South Korean Institutions and (iii) Foundation Medicine Inc. database. Next-generation sequencing data were analyzed for RET rearranged cases. Results RET fusions were more frequent in older patients (median age of 66 versus 60 years, P = 0.052), with ECOG PS 1-2 (90% versus 50%, P = 0.02), right-sided (55% versus 32%, P = 0.013), previously unresected primary tumors (58% versus 21%, P < 0.001), RAS and BRAF wild-type (100% versus 40%, P < 0.001) and MSI-high (48% versus 7%, P < 0.001). Notably, 11 (26%) out of 43 patients with right-sided, RAS and BRAF wild-type tumors harbored a RET rearrangement. At a median follow-up of 45.8 months, patients with RET fusion-positive tumors showed a significantly worse OS when compared with RET-negative ones (median OS 14.0 versus 38.0 months, HR: 4.59; 95% CI, 3.64-32.66; P < 0.001). In the multivariable model, RET rearrangements were still associated with shorter OS (HR: 2.97; 95% CI, 1.25-7.07; P = 0.014), while primary tumor location, RAS and BRAF mutations and MSI status were not. Conclusions Though very rare, RET rearrangements define a new subtype of mCRC that shows poor prognosis with conventional treatments and is therefore worth of a specific management.
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Affiliation(s)
- F Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.
| | - F Di Nicolantonio
- Department of Oncology, University of Torino, Candiolo, Italy; ECMO, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - A B Schrock
- Clinical Development, Foundation Medicine, Inc., Cambridge, USA
| | - J Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - F Morano
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Fucà
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P Nikolinakos
- Medical Oncology, University Cancer & Blood Center, Athens
| | - A Drilon
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J F Hechtman
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - K Gowen
- Clinical Development, Foundation Medicine, Inc., Cambridge, USA
| | - G M Frampton
- Clinical Development, Foundation Medicine, Inc., Cambridge, USA
| | - P Gasparini
- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - D Rossini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - C Gigliotti
- Department of Oncology, University of Torino, Candiolo, Italy; ECMO, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - S T Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M Prisciandaro
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - J Hodgson
- Medical Oncology, University Cancer & Blood Center, Athens
| | - A Zaniboni
- Department of Medical Oncology, Fondazione Poliambulanza, Brescia, Italy
| | - V K Chiu
- Department of Internal Medicine, University of New Mexico, Albuquerque, USA
| | - M Milione
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Patel
- Department of Diagnostics, Ignyta, Inc., San Diego, USA
| | - V Miller
- Clinical Development, Foundation Medicine, Inc., Cambridge, USA
| | - A Bardelli
- Department of Oncology, University of Torino, Candiolo, Italy; ECMO, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - L Novara
- ECMO, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - L Wang
- Department of Pathology, St Jude Children's Research Hospital, Memphis, USA
| | - S M Pupa
- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Sozzi
- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - J Ross
- Clinical Development, Foundation Medicine, Inc., Cambridge, USA
| | - M Di Bartolomeo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Bertotti
- Department of Oncology, University of Torino, Candiolo, Italy; ECMO, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - S Ali
- Clinical Development, Foundation Medicine, Inc., Cambridge, USA
| | - L Trusolino
- Department of Oncology, University of Torino, Candiolo, Italy; ECMO, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - A Falcone
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - F de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - C Cremolini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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13
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Welby JP, Kim ST, Carr CM, Lehman VT, Rydberg CH, Wald JT, Luetmer PH, Nasr DM, Brinjikji W. Carotid Artery Tortuosity Is Associated with Connective Tissue Diseases. AJNR Am J Neuroradiol 2019; 40:1738-1743. [PMID: 31558499 DOI: 10.3174/ajnr.a6218] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 07/31/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE There is a general assumption in the cerebrovascular literature that there is an association between carotid artery tortuosity and connective tissues disease; however, this has not been firmly established. The purpose of this study was to determine the prevalence of carotid artery tortuosity in patients with connective tissue diseases relative to matched controls. MATERIALS AND METHODS Patients with previous CTA or MRA and a diagnosis of connective tissue diseases were identified and compared with a cohort of age-matched controls. Radiologists blinded to the diagnosis reviewed the images and evaluated the presence of carotid artery tortuosity (including loops, kinks, or coils). Continuous variables were compared using the Student t test, and categoric variables with χ2 tests. RESULTS One hundred forty-three patients with connective tissue disease and 143 controls were included in this study. Specific diagnoses included Marfan (n = 33), nonvascular Ehlers-Danlos (n = 36), Ehlers-Danlos vascular-type (n = 32), neurofibromatosis type 1 (n = 26), and Loeys-Dietz (n = 16) syndromes. The presence of carotid tortuosity was 44% in connective tissue disease and 16% in controls (P < .001). Of tortuosity manifestations, coils were most prevalent (23% versus 3%; P < .001). Among the various connective tissue diseases, the rates of any carotid tortuosity were 88% for Marfan syndrome, 63% for Loeys-Dietz syndrome, 42% for neurofibromatosis type 1, and 19% for both vascular- and nonvascular-type Ehlers-Danlos syndrome. The positive predictive value of the combination of aortic aneurysm and carotid tortuosity being associated with connective tissue disease was 95.4%. The specificity was 98.6%. CONCLUSIONS Carotid artery tortuosity is highly associated with connective tissue diseases, particularly Marfan syndrome, Loeys-Dietz syndrome, and neurofibromatosis type 1. Such findings are relevant in risk assessment for vascular complications in connective tissue disease, endovascular treatment planning, and in understanding the pathomechanisms of vascular tortuosity in general.
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Affiliation(s)
- J P Welby
- From the Mayo Clinic Alix School of Medicine (J.P.W.)
| | - S T Kim
- Department of Radiology (S.T.K.), University of California, San Francisco, San Francisco, California
| | - C M Carr
- Departments of Radiology (C.M.C., V.T.L., C.H.R., J.T.W., P.H.L., W.B.)
| | - V T Lehman
- Departments of Radiology (C.M.C., V.T.L., C.H.R., J.T.W., P.H.L., W.B.)
| | - C H Rydberg
- Departments of Radiology (C.M.C., V.T.L., C.H.R., J.T.W., P.H.L., W.B.)
| | - J T Wald
- Departments of Radiology (C.M.C., V.T.L., C.H.R., J.T.W., P.H.L., W.B.)
| | - P H Luetmer
- Departments of Radiology (C.M.C., V.T.L., C.H.R., J.T.W., P.H.L., W.B.)
| | | | - W Brinjikji
- Departments of Radiology (C.M.C., V.T.L., C.H.R., J.T.W., P.H.L., W.B.)
- Neurosurgery (W.B.), Mayo Clinic, Rochester, Minnesota
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14
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Wu M, Moser BA, Steeves TM, Figueroa A, Wallace BM, Kim ST, Esser-Kahn AP, Steinhardt RC. Photon upconversion for the enhancement of microfluidic photochemical synthesis. RSC Adv 2019; 9:26172-26175. [PMID: 35531036 PMCID: PMC9070398 DOI: 10.1039/c9ra03468d] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 05/08/2019] [Accepted: 08/02/2019] [Indexed: 11/21/2022] Open
Abstract
Photochemical transformations are greatly improved in yield by fluidic reactor technology. However, the delivery of synthetically-active light to the reactants is a challenge. Here, we use upconversion in a bio-inspired microreactor to augment the flux of critical wavelengths of light. This new technology increased of a model reaction by converting a greater portion of sunlight to photochemically-available photons. Photochemical transformations are greatly improved in yield by fluidic reactor technology.![]()
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Affiliation(s)
- M Wu
- University of California, Irvine Irvine CA 92697 USA
| | - B A Moser
- University of Chicago Chicago IL 60637 USA
| | | | - A Figueroa
- University of California, Irvine Irvine CA 92697 USA
| | - B M Wallace
- University of California, Irvine Irvine CA 92697 USA
| | - S T Kim
- Syracuse University Syracuse NY 13244 USA
| | | | - R C Steinhardt
- University of Chicago Chicago IL 60637 USA.,Syracuse University Syracuse NY 13244 USA
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15
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Kim ST, Kang JH, Lee J, Lee HW, Oh SY, Jang JS, Lee MA, Sohn BS, Yoon SY, Choi HJ, Hong JH, Kim MJ, Kim S, Park YS, Park JO, Lim HY. Capecitabine plus oxaliplatin versus gemcitabine plus oxaliplatin as first-line therapy for advanced biliary tract cancers: a multicenter, open-label, randomized, phase III, noninferiority trial. Ann Oncol 2019; 30:788-795. [PMID: 30785198 DOI: 10.1093/annonc/mdz058] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [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] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Capecitabine plus oxaliplatin (XELOX) has shown modest activity and tolerable toxicity in a phase II trial for biliary tract cancers (BTCs). Meanwhile, gemcitabine plus oxaliplatin (GEMOX) has been the reference arm in recent phase II and III trials for BTCs. We aimed to investigate the efficacy of XELOX versus GEMOX as first-line therapy for advanced BCTs. PATIENTS AND METHODS In this open-label, randomized, phase III, noninferiority trial, we randomly selected patients with metastatic BCTs to receive GEMOX (gemcitabine 1000 mg/m2 on days 1 and 8, and oxaliplatin 100 mg/m2 on day 1) or XELOX (capecitabine 1000 mg/m2, twice daily, on days 1-14 and oxaliplatin 130 mg/m2 on day 1) as first-line treatment, given every 3 weeks, totaling eight cycles. The primary end point was to prove the noninferiority of XELOX to GEMOX in terms of 6-month progression-free survival (PFS) rate. RESULTS In total, 114 patients randomly received GEMOX and 108 randomly received XELOX. The median PFS was 5.3 months for the GEMOX group and 5.8 months for the XELOX group. The 6-month PFS rate was 44.5% for the GEMOX group and 46.7% for the XELOX group. The 95% confidence interval of the 6-month PFS rate difference between both groups was -12% to 16%, meeting the criteria for noninferiority of XELOX to GEMOX. There was no difference in objective response (P=0.171) and median overall survival (P=0.131) between both groups. The most common grade three to four adverse events were neutropenia and thrombocytopenia. No patient died of treatment-related causes. The XELOX group had significantly lower frequencies of hospital visits than the GEMOX group (P<0.001). CONCLUSION XELOX showed significant noninferiority to GEMOX in terms of 6-month PFS rate. Thus, XELOX could be an alternative first-line treatment of BCTs. TRIAL REGISTRATION This study was registered in ClinicalTrials.gov (number NCT01470443).
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Affiliation(s)
- S T Kim
- Division of Hemato-oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
| | - J H Kang
- Division of Hemato-oncology, Department of Medicine, Gyeongsang National University Hospital, Jinju
| | - J Lee
- Division of Hemato-oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
| | - H W Lee
- Division of Hemato-oncology, Department of Medicine, Ajou University School of Medicine, Suwon
| | - S Y Oh
- Division of Hemato-oncology, Department of Medicine, Dong-A University School of Medicine, Busan
| | - J S Jang
- Division of Hemato-oncology, Department of Medicine, Chung-Ang University College of Medicine, Seoul
| | - M A Lee
- Division of Hemato-oncology, Department of Medicine, Seoul St Mary's Hospital, Catholic University, Seoul
| | - B S Sohn
- Division of Hemato-oncology, Department of Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul
| | - S Y Yoon
- Division of Hemato-oncology, Department of Medicine, Konkuk University Medical Center, Seoul
| | - H J Choi
- Division of Hemato-oncology, Department of Medicine, Yonsei University College of Medicine, Seoul
| | - J H Hong
- Division of Hemato-oncology, Department of Medicine, Incheon St Mary's Hospital, Catholic University, Incheon
| | - M-J Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea
| | - S Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea
| | - Y S Park
- Division of Hemato-oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
| | - J O Park
- Division of Hemato-oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
| | - H Y Lim
- Division of Hemato-oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
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16
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Heo YJ, Jeong HW, Baek JW, Kim ST, Jeong YG, Lee JY, Jin SC. Pointwise Encoding Time Reduction with Radial Acquisition with Subtraction-Based MRA during the Follow-Up of Stent-Assisted Coil Embolization of Anterior Circulation Aneurysms. AJNR Am J Neuroradiol 2019; 40:815-819. [PMID: 30975655 DOI: 10.3174/ajnr.a6035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 03/11/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Time-of-flight MR angiography, though widely used after coil embolization, is associated with limitations owing to magnetic susceptibility and radiofrequency shielding following stent-assisted coil embolization. We evaluated the pointwise encoding time reduction with radial acquisition (PETRA) sequence in subtraction-based MRA (qMRA) using an ultrashort TE relative to TOF-MRA during the follow-up of stent-assisted coil embolization for anterior circulation aneurysms. MATERIALS AND METHODS Twenty-five patients (3 men and 22 women; mean age, 59.1 ± 14.0 years) underwent stent-assisted coil embolization for anterior circulation aneurysms and were retrospectively evaluated using TOF-MRA and PETRA qMRA data from the same follow-up session. Two neuroradiologists independently reviewed both MRA findings and subjectively graded flow within the stents (relative to the latest DSA findings) and occlusion status (complete occlusion or neck/aneurysm remnant). Interobserver and intermodality agreement for TOF-MRA and PETRA qMRA were evaluated. RESULTS The mean score for flow visualization within the stents was significantly higher in PETRA qMRA than in TOF-MRA (P < .001 for both observers), and good interobserver agreement was reported (κ = 0.63). The aneurysm occlusion status of PETRA qMRA (observer 1, 92.0%; observer 2, 88.0%) was more consistent with DSA than with TOF-MRA (observer 1, 76.0%; observer 2, 80.0%), and there was a better intermodality agreement between DSA and PETRA qMRA than between DSA and TOF-MRA. CONCLUSIONS These findings indicate that PETRA qMRA is a useful follow-up technique for patients who have undergone stent-assisted coil embolization for anterior circulation aneurysms.
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Affiliation(s)
- Y J Heo
- From the Departments of Radiology (Y.J.H., H.W.J., J.W.B.)
| | - H W Jeong
- From the Departments of Radiology (Y.J.H., H.W.J., J.W.B.)
| | - J W Baek
- From the Departments of Radiology (Y.J.H., H.W.J., J.W.B.)
| | - S T Kim
- Neurosurgery (S.T.K., Y.G.J.)
| | | | - J Y Lee
- Internal Medicine (J.Y.L.), Inje University Busan Paik Hospital, Busan, Korea
| | - S-C Jin
- Department of Neurosurgery (S.-C.J.), Inje University Haeundae Paik Hospital, Busan, Korea
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17
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Kim YK, Choi JW, Kim HJ, Kim HY, Park GM, Ko YH, Cha J, Kim ST. Melanoma of the Sinonasal Tract: Value of a Septate Pattern on Precontrast T1-Weighted MR Imaging. AJNR Am J Neuroradiol 2018; 39:762-767. [PMID: 29371259 DOI: 10.3174/ajnr.a5539] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/20/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE Various tumors of the sinonasal tract can exhibit high signal intensity on T1WI. The purpose of this study was to determine the value of a septate pattern on precontrast T1WI for diagnosing sinonasal melanoma. MATERIALS AND METHODS Retrospectively, 3 observers independently reviewed MR images of 31 histologically proved sinonasal melanomas with special attention to the presence or absence of a septate pattern on precontrast T1WI, defined as alternating hyperintense and hypointense striations on precontrast T1WI. For comparison, we evaluated the prevalence of a septate pattern on precontrast T1WI in 106 nonmelanomatous sinonasal malignant tumors with 16 different histologic types. We also tried to identify the histopathologic features responsible for the septate pattern on precontrast T1WI. RESULTS Twenty-seven (87.1%) of 31 sinonasal melanomas showed hyperintense foci on T1WI, among which a septate pattern on precontrast T1WI was seen in 23 (74.2%), while 22 (20.8%) of 106 nonmelanomatous malignant tumors demonstrated hyperintense foci on T1WI, among which only 3 (2.8%) showed a septate pattern on precontrast T1WI. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of a septate pattern on precontrast T1WI for the diagnosis of sinonasal melanoma were 74%, 97%, 88%, 93%, and 92%, respectively. Although limited due to the retrospective nature, 4 of 23 histologically reviewed sinonasal melanomas revealed an uneven distribution of melanin with alternating melanin and fibrous bands within the tumors. CONCLUSIONS A septate pattern on precontrast T1WI might be an adjunctive imaging finding for the diagnosis of sinonasal melanoma. This might be attributed histologically to an uneven distribution of melanin and hemorrhage within the tumors.
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Affiliation(s)
- Y-K Kim
- From the Departments of Radiology (Y.-K.K., H.-J.K., H.Y.K., G.M.P., J.C., S.T.K.)
| | - J W Choi
- Department of Radiology (J.W.C.), Ajou University School of Medicine, Suwon, Korea
| | - H-J Kim
- From the Departments of Radiology (Y.-K.K., H.-J.K., H.Y.K., G.M.P., J.C., S.T.K.)
| | - H Y Kim
- From the Departments of Radiology (Y.-K.K., H.-J.K., H.Y.K., G.M.P., J.C., S.T.K.)
| | - G M Park
- From the Departments of Radiology (Y.-K.K., H.-J.K., H.Y.K., G.M.P., J.C., S.T.K.).,Department of Radiology (G.M.P.), Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Y-H Ko
- Pathology (Y.-H.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Cha
- From the Departments of Radiology (Y.-K.K., H.-J.K., H.Y.K., G.M.P., J.C., S.T.K.).,Department of Radiology and Research Institute of Radiological Science (J.C.), College of Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - S T Kim
- From the Departments of Radiology (Y.-K.K., H.-J.K., H.Y.K., G.M.P., J.C., S.T.K.)
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18
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Lee J, Seo SW, Yang JJ, Jang YK, Lee JS, Kim YJ, Chin J, Lee JM, Kim ST, Lee KH, Lee JH, Kim JS, Kim S, Yoo H, Lee AY, Na DL, Kim HJ. Longitudinal cortical thinning and cognitive decline in patients with early- versus late-stage subcortical vascular mild cognitive impairment. Eur J Neurol 2017; 25:326-333. [PMID: 29082576 DOI: 10.1111/ene.13500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 07/06/2017] [Accepted: 10/20/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Biomarker changes in cognitively impaired patients with small vessel disease are largely unknown. The rate of amyloid/lacune progression, cortical thinning and cognitive decline were evaluated in subcortical vascular mild cognitive impairment (svMCI) patients. METHODS Seventy-two svMCI patients were divided into early stage (ES-svMCI, n = 39) and late stage (LS-svMCI, n = 33) according to their Clinical Dementia Rating Sum of Boxes score. Patients were annually followed up with neuropsychological tests and brain magnetic resonance imaging for 3 years, and underwent a second [11 C] Pittsburgh compound B (PiB) positron emission tomography scan within a mean interval of 32.4 months. RESULTS There was no difference in the rate of increase in PiB uptake or lacune number between the ES-svMCI and LS-svMCI. However, LS-svMCI showed more rapid cortical thinning and cognitive decline than did the ES-svMCI. CONCLUSIONS We suggest that, whilst the rate of change in pathological burden did not differ between ES-svMCI and LS-svMCI, cortical thinning and cognitive decline progressed more rapidly in the LS-svMCI.
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Affiliation(s)
- J Lee
- Department of Neurology, Chungnam National University Hospital, Daejeon, Korea.,Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - S W Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.,Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - J-J Yang
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Y K Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - J S Lee
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Y J Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Gangwon-do, Korea
| | - J Chin
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - J M Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - S T Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K-H Lee
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J H Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J S Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S Kim
- Biostatistics Team, Samsung Biomedical Research Institute, Seoul, Korea
| | - H Yoo
- Biostatistics Team, Samsung Biomedical Research Institute, Seoul, Korea
| | - A Y Lee
- Department of Neurology, Chungnam National University Hospital, Daejeon, Korea
| | - D L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
| | - H J Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
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19
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Kim ST, Kim SY, Klempner SJ, Yoon J, Kim N, Ahn S, Bang H, Kim KM, Park W, Park SH, Park JO, Park YS, Lim HY, Lee SH, Park K, Kang WK, Lee J. Rapamycin-insensitive companion of mTOR (RICTOR) amplification defines a subset of advanced gastric cancer and is sensitive to AZD2014-mediated mTORC1/2 inhibition. Ann Oncol 2017; 28:547-554. [PMID: 28028034 DOI: 10.1093/annonc/mdw669] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Targeting oncogenic genomic aberrations is an established therapeutic strategy in multiple tumor types. Molecular classification has uncovered a number of novel targets, and rapamycin-insensitive companion of mTOR (RICTOR) amplification has been identified in lung cancer. Further investigation assessing the therapeutic potential of RICTOR amplification as a novel target across advanced cancers is needed. Patients and methods Tumor samples from 640 patients with metastatic solid tumors, primarily gastrointestinal and lung cancers were prospectively subjected to a next-generation sequencing (NGS) assay to identify molecular targets. Samples with NGS-detected RICTOR amplification were confirmed with FISH. A RICTOR-amplified patient-derived cell (PDC) line was generated and used to investigate the effectiveness of selective AKT, mTORC1, and mTORC1/2 inhibition. Results NGS identified 13 (2%) of 640 patients with RICTOR-amplified tumors (6 gastric, 3 NSCLC, 1 SCLC, 1 CRC, 1 sarcoma, 1 MUO). Of the 13 patients, seven patients had RICTOR protein overexpression by IHC. The prevalence of RICTOR amplification in gastric cancer by NGS was 3.8% (6/160). FISH testing confirmed amplification (RICTOR/control >2) in 5/13 (38%) of samples, including four gastric cancers and one lung cancer. Treatment of a RICTOR amplified PDC with a selective AKT (AZD5363), selective mTORC1 (everolimus), dual mTORC1/2 (AZD2014), and the multi-target kinase inhibitor pazopanib demonstrated preferential sensitivity to the mTORC1/2 inhibitor (AZD2014). Knockdown of RICTOR reversed PDC sensitivity to AZD2014, validating the importance of RICTOR amplification to the PDC line. Conclusions RICTOR amplification is a rare but therapeutically relevant genomic alteration across solid tumors. Our results support further pre-clinical and clinical investigation with AZD2014 in RICTOR amplified gastric cancer and highlights the importance of genomic profiling.
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Affiliation(s)
- S T Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S Y Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S J Klempner
- The Angeles Clinic and Research Institute, Los Angeles, USA.,Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - J Yoon
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea
| | - N Kim
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea
| | - S Ahn
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea.,Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Bang
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,The Innovative Cancer Medicine Institute, Samsung Medical Center, Seoul, Korea
| | - K-M Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,The Innovative Cancer Medicine Institute, Samsung Medical Center, Seoul, Korea
| | - W Park
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea
| | - S H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J O Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y S Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Y Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S H Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,The Innovative Cancer Medicine Institute, Samsung Medical Center, Seoul, Korea
| | - W K Kang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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20
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Kim JE, Kim KK, Kim SY, Lee J, Park SH, Park JO, Park YS, Lim HY, Kang WK, Kim ST. MAP2K1 Mutation in Colorectal Cancer Patients: Therapeutic Challenge Using Patient-Derived Tumor Cell Lines. J Cancer 2017; 8:2263-2268. [PMID: 28819429 PMCID: PMC5560144 DOI: 10.7150/jca.19582] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/18/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND: The MAP2K1 K57T mutation is known to be a potential mechanism of primary and secondary resistance to EGFR inhibitors in metastatic colorectal cancer (CRC) and has also been reported to promote resistance to BRAF and MEK inhibitors. It is important to overcome therapeutic resistance to EGFR inhibitors to improve the treatment outcomes of metastatic CRC. METHODS: We established patient-derived tumor cells (PDCs) from metastatic lesions that newly appeared during treatment with a BRAF inhibitor (LGX-818) plus an EGFR inhibitor (cetuximab) in a patient with BRAF-mutant CRC. To investigate therapeutic options to overcome acquired resistance due to MAP2K1 mutation in BRAF-mutant CRC, we performed cell viability assays using the PDCs. RESULTS: We tested whether the PDCs were resistant to an EGFR inhibitor (cetuximab) and a BRAF inhibitor (sorafenib) as these cells were established at the time of resistance to the EGFR plus BRAF inhibitors. Moreover, the anti-tumor effect of AZD6244 (MEK inhibitor) was evaluated because PDCs harbored a MAP2K1 mutation at the time of resistance to the EGFR plus BRAF inhibitors. MTT proliferation assays showed that monotherapy with cetuximab, sorafenib, or AZD6244 did not suppress cell viability. We next tested viability of the PDCs to combination treatment with cetuximab plus AZD6244 and sorafenib plus AZD6244. Proliferation of PDCs was significantly inhibited by sorafenib and AZD6244, but not by cetuximab plus AZD6244. Investigation of the combined effect of sorafenib and AZD6244 using the calculated combination index (CI) showed synergistic effects of sorafenib and AZD6244 in combination therapy applied to PDCs with the MAP2K1 K57T mutation. CONCLUSION: Our results suggest that combination treatment with BRAF and MEK inhibitors might be a novel treatment strategy for MAP2K1 K57T-mutant CRC. This finding will be helpful to guide treatment of patients with CRC that is resistant to EGFR inhibitors.
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Affiliation(s)
- J E Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K K Kim
- Department of Molecular Cell Biology, Institute of Basic Science, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon 440-746, Korea
| | - S Y Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J O Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y S Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Y Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W K Kang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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21
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Cho J, Kim SY, Kim YJ, Sim MH, Kim ST, Kim NKD, Kim K, Park W, Kim JH, Jang KT, Lee J. Emergence of CTNNB1 mutation at acquired resistance to KIT inhibitor in metastatic melanoma. Clin Transl Oncol 2017; 19:1247-1252. [PMID: 28421416 DOI: 10.1007/s12094-017-1662-x] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 04/10/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE The KIT inhibitor, imatinib, has shown promising efficacy in patients with KIT-mutated melanoma; however, acquisition of resistance to imatinib occurs rapidly in the majority of patients. The mechanisms of acquired resistance to imatinib in melanoma remain unclear. METHODS We analyzed biopsy samples from paired baseline and post-treatment tumor lesions in one patient with KIT-mutated melanoma who had had an initial objective tumor regression in response to imatinib treatment followed by disease progression 8 months later. RESULTS Targeted deep sequencing from post-treatment biopsy samples detected an additional mutation in CTNNB1 (S33C) with original KIT L576P mutation. We examined the functional role of the additional CTNNB1 S33C mutation in resistance to imatinib indirectly using the Ba/F3 cell model. Ba/F3 cell lines transfected with both the L576P KIT mutation and the CTNNB1 S33C mutation demonstrated no growth inhibition despite imatinib treatment, whereas growth inhibition was observed in the Ba/F3 cell line transfected with the L576 KIT mutation alone. CONCLUSIONS We report the first identification of the emergence of a CTNNB1 mutation that can confer acquired resistance to imatinib. Further investigation into the causes of acquired resistance to imatinib will be essential to improve the prognosis for patients with KIT-mutated melanoma.
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Affiliation(s)
- J Cho
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - S Y Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Y J Kim
- Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Korea.,Samsung Genome Institute, Samsung Medical Center, Seoul, Korea
| | - M H Sim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - N K D Kim
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea
| | - K Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - W Park
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea
| | - J H Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K-T Jang
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Lee
- 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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22
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Yang KY, Kim MJ, Ju JS, Park SK, Lee CG, Kim ST, Bae YC, Ahn DK. Antinociceptive Effects of Botulinum Toxin Type A on Trigeminal Neuropathic Pain. J Dent Res 2016; 95:1183-90. [PMID: 27418174 DOI: 10.1177/0022034516659278] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Previous studies have demonstrated that botulinum toxin type A (BoNT-A) attenuates orofacial nociception. However, there has been no evidence of the participation of the voltage-gated sodium channels (Navs) in the antinociceptive mechanisms of BoNT-A. This study investigated the cellular mechanisms underlying the antinociceptive effects of BoNT-A in a male Sprague-Dawley rat model of trigeminal neuropathic pain produced by malpositioned dental implants. The left mandibular second molar was extracted under anesthesia, followed by a miniature dental implant placement to induce injury to the inferior alveolar nerve. Mechanical allodynia was monitored after subcutaneous injection of BoNT-A at 3, 7, or 12 d after malpositioned dental implant surgery. Subcutaneous injections of 1 or 3 U/kg of BoNT-A on postoperative day 3 significantly attenuated mechanical allodynia, although 0.3 U/kg of BoNT-A did not affect the air-puff threshold. A single injection of 3 U/kg of BoNT-A produced prolonged antiallodynic effects over the entire experimental period. Treatment with BoNT-A on postoperative days 7 and 12, when pain had already been established, also produced prolonged antiallodynic effects. Double treatments with 1 U/kg of BoNT-A produced prolonged, more antiallodynic effects as compared with single treatments. Subcutaneous administration of 3 U/kg of BoNT-A significantly inhibited the upregulation of Nav isoform 1.7 (Nav1.7) expression in the trigeminal ganglion in the nerve-injured animals. These results suggest that antinociceptive effects of BoNT-A are mediated by an inhibition of upregulated Nav1.7 expression in the trigeminal ganglion. BoNT-A is therefore a potential new therapeutic agent for chronic pain control, including neuropathic pain.
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Affiliation(s)
- K Y Yang
- Department of Oral Physiology, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - M J Kim
- Department of Oral Physiology, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - J S Ju
- Department of Oral Physiology, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - S K Park
- Department of Oral Physiology, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - C G Lee
- Research and Development Division, Hugel, Inc., Chuncheon, Korea
| | - S T Kim
- Department of Orofacial Pain and Oral Medicine, School of Dentistry, Yonsei University, Seoul, Korea
| | - Y C Bae
- Department of Oral Anatomy, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - D K Ahn
- Department of Oral Physiology, School of Dentistry, Kyungpook National University, Daegu, Korea
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23
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Kim ST, Brinjikji W, Kallmes DF. Prevalence of Intracranial Aneurysms in Patients with Connective Tissue Diseases: A Retrospective Study. AJNR Am J Neuroradiol 2016; 37:1422-6. [PMID: 26992822 DOI: 10.3174/ajnr.a4718] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 01/08/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Few studies have examined the prevalence of intracranial aneurysms in connective tissue diseases such as Marfan syndrome, Ehlers-Danlos syndrome, neurofibromatosis type 1, and Loeys-Dietz syndrome. We studied the prevalence of intracranial aneurysms and other intracranial neurovascular pathologies such as arteriovenous malformations and intracranial dissections, in these 4 patient populations. MATERIALS AND METHODS We retrospectively reviewed all patients who had a clinical diagnosis of Marfan syndrome, Ehlers-Danlos syndrome, neurofibromatosis type 1, or Loeys-Dietz syndrome who underwent MRA, CTA, and/or DSA imaging of the intracranial circulation between January 1, 2005, and January 31, 2015. The presence, location, and maximum dimensions of intracranial aneurysms were catalogued. Other neurovascular findings studied included intracranial dissections and arteriovenous fistulas and shunts. Baseline data collected included demographic characteristics (sex, age, smoking history), imaging modality, and cardiovascular comorbidities. RESULTS The prevalence of intracranial saccular and fusiform aneurysms was as follows: 14% (8/59) among patients with Marfan syndrome, 12% (12/99) among patients with Ehlers-Danlos syndrome, 11% (5/47) among patients with neurofibromatosis type 1, and 28% (7/25) among patients with Loeys-Dietz syndrome. Intracranial dissections were found in 2 patients (3%) with Marfan syndrome and 1 patient (1%) with Ehlers-Danlos syndrome. No intracranial dissections were found in patients with neurofibromatosis type 1 or Loeys-Dietz syndrome. CONCLUSIONS Patients with connective tissue disorders, including Marfan syndrome, Ehlers-Danlos syndrome, neurofibromatosis type 1, and Loeys-Dietz syndrome, have a high prevalence of intracranial aneurysms.
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Affiliation(s)
- S T Kim
- From the Mayo Medical School (S.T.K.)
| | - W Brinjikji
- Department of Radiology (W.B., D.F.K.), Mayo Clinic, Rochester, Minnesota.
| | - D F Kallmes
- Department of Radiology (W.B., D.F.K.), Mayo Clinic, Rochester, Minnesota
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24
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Cha J, Kim ST, Nam DH, Kong DS, Kim HJ, Kim YK, Kim HY, Park GM, Jeon P, Kim KH, Byun HS. Differentiation of Hemangioblastoma from Metastatic Brain Tumor using Dynamic Contrast-enhanced MR Imaging. Clin Neuroradiol 2016; 27:329-334. [PMID: 26952018 DOI: 10.1007/s00062-016-0508-1] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 02/18/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE The aim of this study was to differentiate hemangioblastomas from metastatic brain tumors using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and compare the diagnostic performances with diffusion-weighted imaging (DWI) and dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI). METHODS We retrospectively reviewed 7 patients with hemangioblastoma and 15 patients with metastatic adenocarcinoma with magnetic resonance imaging (MRI) including DWI, DSC-MRI, and DCE-MRI. Apparent diffusion coefficient (ADC), relative cerebral blood volume (rCBV), and DCE-MRI parameters (K trans, k ep, v e, and v p) were compared between the two groups. The diagnostic performance of each parameter was evaluated with receiver operating characteristic (ROC) curve analysis. RESULTS v p, k ep, and rCBV were significantly different between patients with hemangioblastoma and those with metastatic brain tumor (p < 0.001, p = 0.005, and p = 0.017, respectively). A v p cutoff value of 0.012 and a rCBV cutoff value of 8.0 showed the highest accuracy for differentiating hemangioblastoma from metastasis. The area under the ROC curve for v p and rCBV was 0.99 and 0.89, respectively. A v p > 0.012 showed 100 % sensitivity, 93.3 % specificity, and 95.5 % accuracy and a rCBV > 8.0 showed 85.7 % sensitivity, 93.3 % specificity, and 90.9 % accuracy for differentiating hemangioblastoma from metastatic brain tumor. CONCLUSION DCE-MRI was useful for differentiating hemangioblastoma from metastatic brain tumor.
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Affiliation(s)
- J Cha
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, 135-710, Seoul, Republic of Korea.,Cardiovascular and Stroke Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S T Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, 135-710, Seoul, Republic of Korea.
| | - D-H Nam
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D-S Kong
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H-J Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, 135-710, Seoul, Republic of Korea
| | - Y K Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, 135-710, Seoul, Republic of Korea
| | - H Y Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, 135-710, Seoul, Republic of Korea
| | - G M Park
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, 135-710, Seoul, Republic of Korea
| | - P Jeon
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, 135-710, Seoul, Republic of Korea
| | - K H Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, 135-710, Seoul, Republic of Korea
| | - H S Byun
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, 135-710, Seoul, Republic of Korea
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25
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Lim SH, Kim TW, Hong YS, Han SW, Lee KH, Kang HJ, Hwang IG, Lee JY, Kim HS, Kim ST, Lee J, Park JO, Park SH, Park YS, Lim HY, Jung SH, Kang WK. A randomised, double-blind, placebo-controlled multi-centre phase III trial of XELIRI/FOLFIRI plus simvastatin for patients with metastatic colorectal cancer. Br J Cancer 2015; 113:1421-6. [PMID: 26505681 PMCID: PMC4815882 DOI: 10.1038/bjc.2015.371] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/22/2015] [Accepted: 10/05/2015] [Indexed: 12/19/2022] Open
Abstract
Background: The purpose of this randomised phase III trial was to evaluate whether the addition of simvastatin, a synthetic 3-hydroxy-3methyglutaryl coenzyme A reductase inhibitor, to XELIRI/FOLFIRI chemotherapy regimens confers a clinical benefit to patients with previously treated metastatic colorectal cancer. Methods: We undertook a double-blind, placebo-controlled phase III trial of 269 patients previously treated for metastatic colorectal cancer and enrolled in 5 centres in South Korea. Patients were randomly assigned (1 : 1) to one of the following groups: FOLFIRI/XELIRI plus simvastatin (40 mg) or FOLFIRI/XELIRI plus placebo. The FOLFIRI regimen consisted of irinotecan at 180 mg m−2 as a 90-min infusion, leucovorin at 200 mg m−2 as a 2-h infusion, and a bolus injection of 5-FU 400 mg m−2 followed by a 46-h continuous infusion of 5-FU at 2400 mg m−2. The XELIRI regimen consisted of irinotecan at 250 mg m−2 as a 90-min infusion with capecitabine 1000 mg m−2 twice daily for 14 days. The primary end point was progression-free survival (PFS). Secondary end points included response rate, duration of response, overall survival (OS), time to progression, and toxicity. Results: Between April 2010 and July 2013, 269 patients were enrolled and assigned to treatment groups (134 simvastatin, 135 placebo). The median PFS was 5.9 months (95% CI, 4.5–7.3) in the XELIRI/FOLFIRI plus simvastatin group and 7.0 months (95% CI, 5.4–8.6) in the XELIRI/FOLFIRI plus placebo group (P=0.937). No significant difference was observed between the two groups with respect to OS (median, 15.9 months (simvastatin) vs 19.9 months (placebo), P=0.826). Grade ⩾3 nausea and anorexia were noted slightly more often in patients in the simvastatin arm compared with with the placebo arm (4.5% vs 0.7%, 3.0% vs 0%, respectively). Conclusions: The addition of 40 mg simvastatin to the XELIRI/FOLFIRI regimens did not improve PFS in patients with previously treated metastatic colorectal cancer nor did it increase toxicity.
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Affiliation(s)
- S H Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - T W Kim
- Division of Hematology-Oncology, Department of Medicine, Asan Medical Center, Seoul, South Korea
| | - Y S Hong
- Division of Hematology-Oncology, Department of Medicine, Asan Medical Center, Seoul, South Korea
| | - S-W Han
- Division of Hematology-Oncology, Department of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - K-H Lee
- Division of Hematology-Oncology, Department of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - H J Kang
- Division of Hematology-Oncology, Department of Medicine, Korea Cancer Center Hospital, Seoul, South Korea
| | - I G Hwang
- Division of Hematology-Oncology, Department of Medicine, Chungang University Hospital, Seoul, South Korea
| | - J Y Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - H S Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - J Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - J O Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - S H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Y S Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - H Y Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - S-H Jung
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.,Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - W K Kang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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26
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Posch C, Cholewa BD, Vujic I, Sanlorenzo M, Ma J, Kim ST, Kleffel S, Schatton T, Rappersberger K, Gutteridge R, Ahmad N, Ortiz/Urda S. Combined Inhibition of MEK and Plk1 Has Synergistic Antitumor Activity in NRAS Mutant Melanoma. J Invest Dermatol 2015; 135:2475-2483. [PMID: 26016894 PMCID: PMC4567913 DOI: 10.1038/jid.2015.198] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 05/08/2015] [Accepted: 05/18/2015] [Indexed: 02/08/2023]
Abstract
About one-third of cancers harbor activating mutations in rat sarcoma viral oncogene homolog (RAS) oncogenes. In melanoma, aberrant neuroblastoma-RAS (NRAS) signaling fuels tumor progression in about 20% of patients. Current therapeutics for NRAS-driven malignancies barely affect overall survival. To date, pathway interference downstream of mutant NRAS seems to be the most promising approach. In this study, data revealed that mutant NRAS induced Polo-like kinase 1 (Plk1) expression, and pharmacologic inhibition of Plk1 stabilized the size of NRAS mutant melanoma xenografts. The combination of mitogen-activated protein kinase/extracellular signal-regulated kinase kinase (MEK) and Plk1 inhibitors resulted in a significant growth reduction of NRAS mutant melanoma cells in vitro, and regression of xenografted NRAS mutant melanoma in vivo. Independent cell cycle arrest and increased induction of apoptosis underlies the synergistic effect of this combination. Data further suggest that the p53 signaling pathway is of key importance to the observed therapeutic efficacy. This study provides in vitro, in vivo, and first mechanistic data that an MEK/Plk1 inhibitor combination might be a promising treatment approach for patients with NRAS-driven melanoma. As mutant NRAS signaling is similar across different malignancies, this inhibitor combination could also offer a previously unreported treatment modality for NRAS mutant tumors of other cell origins.
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Affiliation(s)
- C Posch
- University of California San Francisco, Department of Dermatology, Mt. Zion Cancer Research Center, 2340 Sutter Street N461, 94115 San Francisco – USA
- Brigham and Women's Hospital, Harvard Medical School, Department of Dermatology, 77 Avenue Louis Pasteur, 02115 Boston – USA
- The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna, Department of Dermatology, Juchgasse 25, 1030 Vienna – Austria
| | - BD Cholewa
- University of Wisconsin, Department of Dermatology, 7418 Wisconsin Institutes for Medical Research, 1111 Highland Ave, Madison, WI 53705 – USA
| | - I Vujic
- University of California San Francisco, Department of Dermatology, Mt. Zion Cancer Research Center, 2340 Sutter Street N461, 94115 San Francisco – USA
- The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna, Department of Dermatology, Juchgasse 25, 1030 Vienna – Austria
| | - M Sanlorenzo
- University of California San Francisco, Department of Dermatology, Mt. Zion Cancer Research Center, 2340 Sutter Street N461, 94115 San Francisco – USA
- Department of Medical Sciences, Section of Dermatology, University of Turin – Italy
| | - J Ma
- University of California San Francisco, Department of Dermatology, Mt. Zion Cancer Research Center, 2340 Sutter Street N461, 94115 San Francisco – USA
| | - ST Kim
- University of California San Francisco, Department of Dermatology, Mt. Zion Cancer Research Center, 2340 Sutter Street N461, 94115 San Francisco – USA
| | - S Kleffel
- Brigham and Women's Hospital, Harvard Medical School, Department of Dermatology, 77 Avenue Louis Pasteur, 02115 Boston – USA
| | - T Schatton
- Brigham and Women's Hospital, Harvard Medical School, Department of Dermatology, 77 Avenue Louis Pasteur, 02115 Boston – USA
| | - K Rappersberger
- The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna, Department of Dermatology, Juchgasse 25, 1030 Vienna – Austria
| | - R Gutteridge
- University of Wisconsin, Department of Dermatology, 7418 Wisconsin Institutes for Medical Research, 1111 Highland Ave, Madison, WI 53705 – USA
| | - N Ahmad
- University of Wisconsin, Department of Dermatology, 7418 Wisconsin Institutes for Medical Research, 1111 Highland Ave, Madison, WI 53705 – USA
| | - S Ortiz/Urda
- University of California San Francisco, Department of Dermatology, Mt. Zion Cancer Research Center, 2340 Sutter Street N461, 94115 San Francisco – USA
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27
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Cho H, Kim C, Kim HJ, Ye BS, Kim YJ, Jung NY, Son TO, Cho EB, Jang H, Lee J, Kang M, Shin HY, Jeon S, Lee JM, Kim ST, Choi YC, Na DL, Seo SW. Impact of smoking on neurodegeneration and cerebrovascular disease markers in cognitively normal men. Eur J Neurol 2015; 23:110-9. [PMID: 26264353 DOI: 10.1111/ene.12816] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 10/21/2014] [Accepted: 06/05/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Smoking is a major risk factor for cognitive decline and dementia. However, the exact pathobiology of smoking remains unknown. The effects of smoking on cortical thickness as a biomarker of neurodegeneration or white matter hyperintensities and lacunes as biomarkers of cerebrovascular burden were concurrently evaluated. METHODS Our study included 977 cognitively normal men who visited a health promotion centre and underwent medical check-ups, including 3.0 T magnetic resonance imaging. Participants were categorized into never smoker, past smoker or current smoker groups and pack-years and the years of smoking cessation were used as continuous variables. RESULTS The current smoker group exhibited cortical thinning in frontal and temporo-parietal regions compared with the never smoker group. These effects were particularly prominent in smokers with a high cumulative exposure to smoking in the current smoker group. However, there was no association between smoking and the severity of white matter hyperintensity or number of lacunes. CONCLUSION Our findings indicate that smoking might impact on neurodegeneration rather than cerebrovascular burdens in cognitively normal men, suggesting that smoking might be an important modifiable risk factor for the development of Alzheimer's disease.
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Affiliation(s)
- H Cho
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - C Kim
- Department of Preventive Medicine and the Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Korea
| | - H J Kim
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - B S Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Y J Kim
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - N-Y Jung
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - T O Son
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - E B Cho
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Jang
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Lee
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M Kang
- Centre for Health Promotion, Samsung Medical Centre, Seoul, Korea
| | - H-Y Shin
- Centre for Health Promotion, Samsung Medical Centre, Seoul, Korea
| | - S Jeon
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - J-M Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - S T Kim
- Radiology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-C Choi
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - D L Na
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Centre, Samsung Medical Centre, Seoul, Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - S W Seo
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Centre, Samsung Medical Centre, Seoul, Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
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28
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Kim EJ, Park CH, Chang WH, Lee A, Kim ST, Shin YI, Kim YH. The brain-derived neurotrophic factor Val66Met polymorphism and degeneration of the corticospinal tract after stroke: a diffusion tensor imaging study. Eur J Neurol 2015; 23:76-84. [PMID: 26228236 DOI: 10.1111/ene.12791] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 12/11/2014] [Accepted: 06/05/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE A common single nucleotide polymorphism, Val66Met, in the human brain-derived neurotrophic factor (BDNF) gene has a potential role in the pathogenesis and treatment of stroke. The relevance of the BDNF Val66Met polymorphism to long-term stroke outcomes was examined, specifically with respect to changes in corticospinal integrity. METHODS Thirty-five stroke patients with unilateral motor weakness were genotyped within 2 weeks after onset (T1), and changes in the integrity of the ipsilesional corticospinal tract (CST) as well as alterations in motor function at 1 month (T2) and 3 months after onset (T3) were tracked. RESULTS On the basis of the Fugl-Meyer assessment upper extremity score, carriers of the Met allele (Val/Met and Met/Met) showed poorer motor outcomes at T2 and T3 compared to carriers of only the Val allele (Val/Val). For both BDNF allele types, patients exhibited characteristic degeneration of the CST compared to healthy controls. There were no differences between the two genotypes with respect to time-dependent changes in diffusion-tensor-imaging-derived parameters of the CST. However, the two groups showed different relationships between motor outcomes and directional diffusivities according to the elapsed time after onset. Poorer motor function was associated with lower axial diffusivity values for the Val/Val genotype group in the sub-acute phase (T1 and T2) but with higher radial diffusivity values for the Val/Met and Met/Met genotype group in the early chronic phase (T3). CONCLUSIONS Motor recovery in stroke patients may be affected by the BDNF Val66Met polymorphism, possibly through its effects on distinct pathological processes underlying corticospinal degeneration.
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Affiliation(s)
- E-J Kim
- Department of Rehabilitation Medicine, Armed Forces Capital Hospital, Bundang-gu, Seongnam, Korea
| | - C-H Park
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W H Chang
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - A Lee
- Department of Health Science and Technology, Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - S T Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-I Shin
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Y-H Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Health Science and Technology, Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Korea
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Yeom M, Sur BJ, Park J, Cho SG, Lee B, Kim ST, Kim KS, Lee H, Hahm DH. Oral administration of Lactobacillus casei variety rhamnosus partially alleviates TMA-induced atopic dermatitis in mice through improving intestinal microbiota. J Appl Microbiol 2015; 119:560-70. [PMID: 25968453 DOI: 10.1111/jam.12844] [Citation(s) in RCA: 29] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 04/23/2015] [Accepted: 05/08/2015] [Indexed: 01/19/2023]
Abstract
AIMS The purpose of this study was to investigate the effect of Lactobacillus casei variety rhamnosus (LCR35) on Atopic dermatitis (AD)-like symptoms in mice. METHODS AND RESULTS AD-like skin lesions in BALB/C mice were induced by sensitization and subsequent repeated challenges with trimellitic anhydride (TMA) for 10 days. LCR35 was orally administered to the mice once daily throughout the study. In the TMA-induced AD model, orally administered LCR35 suppressed significantly irritant-related scratching behaviour and skin dehydration as well as apparent severity of AD. LCR35 also significantly decreased serum levels of IgE and IL-4, but not IFN-γ, implying the restoration of TMA-induced disruption of Th1/Th2 balance. Quantitative real-time PCR targeting hypervariable regions of 16S rDNA gene of faecal microbiota indicated that the LCR35 treatment increased the population of Bifidobacterium, Lactobacilli, Enterococcus and Bacteroides fragilis group, but decreased those of Clostridium coccoides group. CONCLUSIONS LCR35 has the ability to suppress the development of AD in mice, possibly through the modulation of Th1/Th2 balance and gut microbiota. SIGNIFICANCE AND IMPACT OF THE STUDY LCR35 has a strong potential as a probiotic for preventing AD.
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Affiliation(s)
- M Yeom
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - B J Sur
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - J Park
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - S G Cho
- Department of Science in Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - B Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - S T Kim
- Division of Meridian and Structural Medicine, School of Korean Medicine, Pusan National University, Yangsan, Korea
| | - K S Kim
- Department of Family Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - H Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea.,Department of Science in Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - D H Hahm
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea.,Department of Science in Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
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Kim YJ, Kwon HK, Lee JM, Kim YJ, Kim HJ, Jung NY, Kim ST, Lee KH, Na DL, Seo SW. White matter microstructural changes in pure Alzheimer's disease and subcortical vascular dementia. Eur J Neurol 2015; 22:709-16. [PMID: 25603760 DOI: 10.1111/ene.12645] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 11/12/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Recent studies have demonstrated that Alzheimer's disease (AD) and subcortical vascular dementia (SVaD) have white matter (WM) microstructural changes. However, previous studies on AD and SVaD rarely eliminated the confounding effects of patients with mixed Alzheimer's and cerebrovascular disease pathologies. Therefore, our aim was to evaluate the divergent topography of WM microstructural changes in patients with pure AD and SVaD. METHODS Patients who were clinically diagnosed with AD and SVaD were prospectively recruited. Forty AD patients who were Pittsburgh compound B (PiB) positive [PiB(+) AD] without WM hyperintensities and 32 SVaD patients who were PiB negative [PiB(-) SVaD] were chosen. Fifty-six cognitively normal individuals were also recruited (NC). Tract-based spatial statistics of diffuse tensor imaging were used to compare patterns of fractional anisotropy (FA) and mean diffusivity (MD). RESULTS Compared with the NC group, the PiB(+) AD group showed decreased FA in the bilateral frontal, temporal and parietal WM regions and the genu and splenium of the corpus callosum as well as increased MD in the left frontal and temporal WM region. PiB(-) SVaD patients showed decreased FA and increased MD in all WM regions. Direct comparison between PiB(+) AD and PiB(-) SVaD groups showed that the PiB(-) SVaD group had decreased FA across all WM regions and increased MD in all WM regions except occipital regions. CONCLUSION Our findings suggest that pure AD and pure SVaD have divergent topography of WM microstructural changes including normal appearing WM.
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Affiliation(s)
- Y J Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
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Cha J, Kim ST, Kim HJ, Kim BJ, Kim YK, Lee JY, Jeon P, Kim KH, Kong DS, Nam DH. Differentiation of tumor progression from pseudoprogression in patients with posttreatment glioblastoma using multiparametric histogram analysis. AJNR Am J Neuroradiol 2014; 35:1309-17. [PMID: 24676005 DOI: 10.3174/ajnr.a3876] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The multiparametric imaging can show us different aspects of tumor behavior and may help differentiation of tumor recurrence from treatment related change. Our aim was to differentiate tumor progression from pseudoprogression in patients with glioblastoma by using multiparametric histogram analysis of 2 consecutive MR imaging studies with relative cerebral blood volume and ADC values. MATERIALS AND METHODS Thirty-five consecutive patients with glioblastoma with new or increased size of enhancing lesions after concomitant chemoradiation therapy following surgical resection were included. Combined histograms were made by using the relative cerebral blood volume and ADC values of enhancing areas for initial and follow-up MR imaging, and subtracted histograms were also prepared. The histogram parameters between groups were compared. The diagnostic accuracy of tumor progression based on the histogram parameters of initial and follow-up MR imaging and subtracted histograms was compared and correlated with overall survival. RESULTS Twenty-four pseudoprogressions and 11 tumor progressions were determined. Diagnosis based on the subtracted histogram mode with a multiparametric approach was more accurate than the diagnosis based on the uniparametric approach (area under the receiver operating characteristic curve of 0.877 versus 0.801), with 81.8% sensitivity and 100% specificity. A high mode of relative cerebral blood volume on the subtracted histogram by using a multiparametric approach (relative cerebral blood volume ×ADC) was the best predictor of true tumor progression (P < .001) and worse survival (P = .003). CONCLUSIONS Multiparametric histogram analysis of posttreatment glioblastoma was useful to predict true tumor progression and worse survival.
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Affiliation(s)
- J Cha
- From the Departments of Radiology and Center for Imaging Science (J.C., S.T.K., H.-J.K., B.-j.K., Y.K.K., J.Y.L., P.J., K.H.K.)
| | - S T Kim
- From the Departments of Radiology and Center for Imaging Science (J.C., S.T.K., H.-J.K., B.-j.K., Y.K.K., J.Y.L., P.J., K.H.K.)
| | - H-J Kim
- From the Departments of Radiology and Center for Imaging Science (J.C., S.T.K., H.-J.K., B.-j.K., Y.K.K., J.Y.L., P.J., K.H.K.)
| | - B-J Kim
- From the Departments of Radiology and Center for Imaging Science (J.C., S.T.K., H.-J.K., B.-j.K., Y.K.K., J.Y.L., P.J., K.H.K.)
| | - Y K Kim
- From the Departments of Radiology and Center for Imaging Science (J.C., S.T.K., H.-J.K., B.-j.K., Y.K.K., J.Y.L., P.J., K.H.K.)
| | - J Y Lee
- From the Departments of Radiology and Center for Imaging Science (J.C., S.T.K., H.-J.K., B.-j.K., Y.K.K., J.Y.L., P.J., K.H.K.)
| | - P Jeon
- From the Departments of Radiology and Center for Imaging Science (J.C., S.T.K., H.-J.K., B.-j.K., Y.K.K., J.Y.L., P.J., K.H.K.)
| | - K H Kim
- From the Departments of Radiology and Center for Imaging Science (J.C., S.T.K., H.-J.K., B.-j.K., Y.K.K., J.Y.L., P.J., K.H.K.)
| | - D-S Kong
- Neurosurgery (D.-s.K., D.-H.N.), Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - D-H Nam
- Neurosurgery (D.-s.K., D.-H.N.), Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
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Jung HN, Kim ST, Cha J, Kim HJ, Byun HS, Jeon P, Kim KH, Kim BJ, Kim HJ. Diffusion and perfusion MRI findings of the signal-intensity abnormalities of brain associated with developmental venous anomaly. AJNR Am J Neuroradiol 2014; 35:1539-42. [PMID: 24651815 DOI: 10.3174/ajnr.a3900] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Developmental venous anomalies are the most common intracranial vascular malformation. Increased signal-intensity on T2-FLAIR images in the areas drained by developmental venous anomalies are encountered occasionally on brain imaging studies. We evaluated diffusion and perfusion MR imaging findings of the abnormally high signal intensity associated with developmental venous anomalies to describe their pathophysiologic nature. MATERIALS AND METHODS We retrospectively reviewed imaging findings of 34 subjects with signal-intensity abnormalities associated with developmental venous anomalies. All subjects underwent brain MR imaging with contrast and diffusion and perfusion MR imaging. Regions of interest were placed covering abnormally high signal intensity around developmental venous anomalies on fluid-attenuated inversion recovery imaging, and the same ROIs were drawn on the corresponding sections of the diffusion and perfusion MR imaging. We measured the apparent diffusion coefficient, relative cerebral blood volume, relative mean transit time, and time-to-peak of the signal-intensity abnormalities around developmental venous anomalies and compared them with the contralateral normal white matter. The Mann-Whitney U test was used for statistical analysis. RESULTS The means of ADC, relative cerebral blood volume, relative mean transit time, and TTP of signal-intensity abnormalities around developmental venous anomalies were calculated as follows: 0.98 ± 0.13 10(-3)mm(2)/s, 195.67 ± 102.18 mL/100 g, 16.74 ± 7.38 seconds, and 11.65 ± 7.49 seconds, respectively. The values of normal WM were as follows: 0.74 ± 0.08 10(-3)mm(2)/s for ADC, 48.53 ± 22.85 mL/100 g for relative cerebral blood volume, 12.12 ± 4.27 seconds for relative mean transit time, and 8.35 ± 3.89 seconds for TTP. All values of ADC, relative cerebral blood volume, relative mean transit time, and TTP in the signal-intensity abnormalities around developmental venous anomalies were statistically higher than those of normal WM (All P < .001, respectively). CONCLUSIONS The diffusion and perfusion MR imaging findings of the signal-intensity abnormalities associated with developmental venous anomaly suggest that the nature of the lesion is vasogenic edema with congestion and delayed perfusion.
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Affiliation(s)
- H N Jung
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S T Kim
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - J Cha
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H J Kim
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H S Byun
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - P Jeon
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K H Kim
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - B-J Kim
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H-J Kim
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim HJ, Ye BS, Yoon CW, Noh Y, Kim GH, Cho H, Jeon S, Lee JM, Kim JH, Seong JK, Kim CH, Choe YS, Lee KH, Kim ST, Kim JS, Park SE, Kim JH, Chin J, Cho J, Kim C, Lee JH, Weiner MW, Na DL, Seo SW. Cortical thickness and hippocampal shape in pure vascular mild cognitive impairment and dementia of subcortical type. Eur J Neurol 2014; 21:744-51. [PMID: 24495089 DOI: 10.1111/ene.12376] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [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: 07/26/2013] [Accepted: 12/27/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE The progression pattern of brain structural changes in patients with isolated cerebrovascular disease (CVD) remains unclear. To investigate the role of isolated CVD in cognitive impairment patients, patterns of cortical thinning and hippocampal atrophy in pure subcortical vascular mild cognitive impairment (svMCI) and pure subcortical vascular dementia (SVaD) patients were characterized. METHODS Forty-five patients with svMCI and 46 patients with SVaD who were negative on Pittsburgh compound B (PiB) positron emission tomography imaging and 75 individuals with normal cognition (NC) were recruited. RESULTS Compared with NC, patients with PiB(-) svMCI exhibited frontal, language and retrieval type memory dysfunctions, which in patients with PiB(-) SVaD were further impaired and accompanied by visuospatial and recognition memory dysfunctions. Compared with NC, patients with PiB(-) svMCI exhibited cortical thinning in the frontal, perisylvian, basal temporal and posterior cingulate regions. This atrophy was more prominent and extended further toward the lateral parietal and medial temporal regions in patients with PiB(-) SVaD. Compared with NC subjects, patients with PiB(-) svMCI exhibited hippocampal shape deformities in the lateral body, whilst patients with PiB(-) SVaD exhibited additional deformities within the lateral head and inferior body. CONCLUSIONS Our findings suggest that patients with CVD in the absence of Alzheimer's disease pathology can be demented, showing cognitive impairment in multiple domains, which is consistent with the topography of cortical thinning and hippocampal shape deformity.
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Affiliation(s)
- H J Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Park HU, Kim BI, Kang SM, Kim ST, Choi JH, Ahn HJ. Changes in masticatory function after injection of botulinum toxin type A to masticatory muscles. J Oral Rehabil 2013; 40:916-22. [PMID: 24237358 DOI: 10.1111/joor.12111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2013] [Indexed: 11/26/2022]
Abstract
This study examined changes in masticatory function after botulinum toxin type A (BTX-A) injection using objective and subjective tests during 12 weeks. Also, we compared differences in masticatory function between group in which only masseter muscle (M group) was injected and group in which masseter and temporal muscle (M-T group) were injected. Forty subjects were assigned into two groups; M group (n = 20) and the M-T group (n = 20). The Meditoxin(®) was used as BTX-A injection. The mixing ability index (MAI) was used as the objective indicator, and visual analogue scale (VAS) and food intake ability (FIA) index were used as subjective indicators. Overall, the masticatory function drastically declined after 4 weeks and gradually recovered with time. Compared with the pre-injection state, the masticatory function decreased by 89·2% (MAI), 12·2% (FIA) and 32·2% (VAS) 4 weeks after the injection (P < 0·05). When the results between M group and M-T group were compared, scores of VAS and FIA were significantly different 4 weeks after the injection (P < 0·05), but the MAI score showed no significant difference between two groups. In conclusion, this study showed that masticatory function was significantly decreased after BTX-A injection into the masticatory muscle after 4 and 8 weeks from injection. However, masticatory efficiency measured using MAI could completely recover after 12 weeks. Furthermore, after 8 weeks from the injection, the masticatory function measured after injection into only the masseter muscle was similar to that measured after injection into both masseter and temporal muscle.
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Affiliation(s)
- H U Park
- Department of Oral Medicine, TMJ and Orofacial Pain Clinic, College of Dentistry, Yonsei University, Seoul, Korea
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Suh KS, Kang DY, Lee KH, Han SH, Park JB, Kim ST, Jang MS. Evolution of urticarial vasculitis: a clinical, dermoscopic and histopathological study. J Eur Acad Dermatol Venereol 2013; 28:674-5. [PMID: 23998438 DOI: 10.1111/jdv.12263] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 08/03/2013] [Accepted: 08/07/2013] [Indexed: 02/03/2023]
Affiliation(s)
- K S Suh
- Department of Dermatology, Kosin University College of Medicine, Busan, Korea
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Shin YS, Seo JY, Oh SH, Kim JH, Kim ST, Park YB, Moon HS. The effects of ErhBMP-2-/EGCG-coated BCP bone substitute on dehiscence around dental implants in dogs. Oral Dis 2013; 20:281-7. [PMID: 23651333 DOI: 10.1111/odi.12109] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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: 12/31/2012] [Revised: 03/11/2013] [Accepted: 04/01/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The purpose was to evaluate the effect of Escherichia coli-derived recombinant human bone morphogenetic protein-2 (ErhBMP-2)-/epigallocatechin-3-gallate (EGCG)-coated biphasic calcium phosphate (BCP) and titanium barrier membrane on dehiscence defects in dogs. MATERIALS AND METHODS In five mongrel dogs, the dehiscence bony defects around dental implants were surgically created and in total three implants were placed at edentulous ridge of which teeth had been extracted 12 weeks before. For the control group, BCP was applied to the dehiscence defect. For experimental groups, ErhBMP-2-coated BCP and ErhBMP-2-/EGCG-coated BCP were applied. The newly designed titanium barrier membrane was used to apply all the defects. The defects were evaluated histologically and histometrically after 12 weeks. The comparative statistics of the groups were obtained through Kruskal-Wallis test. RESULTS In bone-to-implant contact (BIC), bone density (BD), bone regeneration height (BRH), and bone mineralization apposition rate (BMAR), differences among groups were not found. ErhBMP-2/EGCG group appeared to have higher value. In fluorescence analysis, bone remodeling around graft material was more active in the ErhBMP-2/EGCG group. CONCLUSION Within the limit of this study, it is reasonable to assume that BMP-2-/EGCG-coated biphasic BCP and the newly designed titanium membrane were more beneficial in dehiscence defect healing with increased bone remodeling.
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Affiliation(s)
- Y S Shin
- Department of Conservative Dentistry, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
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Finn RS, Crown JP, Lang I, Boer K, Bondarenko IM, Kulyk SO, Ettl J, Patel R, Pinter T, Schmidt M, Shparyk Y, Thummala AR, Voytko NL, Breazna A, Kim ST, Randolph S, Slamon DJ. Abstract S1-6: Results of a randomized phase 2 study of PD 0332991, a cyclin-dependent kinase (CDK) 4/6 inhibitor, in combination with letrozole vs letrozole alone for first-line treatment of ER+/HER2− advanced breast cancer (BC). Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-s1-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: PD 0332991, a selective inhibitor of CDK 4/6, prevents cellular DNA synthesis by blocking cell cycle progression. Preclinical studies in a BC cell line panel identified the luminal ER subtype, elevated expression of cyclin D1 and Rb protein, and reduced p16 expression as being associated with sensitivity to PD 0332991 (Finn et al. 2009). Synergistic activity was also observed in vitro when combined with tamoxifen. After determination of the recommended phase 2 dose in combination with letrozole (letrozole 2.5 mg QD plus PD 0332991 125 mg QD on Schedule 3/1), a randomized phase 2 study comparing letrozole alone (L) to letrozole plus PD 0332991 (L+P) was initiated.
Methods: The phase 2 portion of the study was designed as a two-part study; Part 1 enrolled post- menopausal women with ER+/HER2− advanced BC; Part 2 in addition to ER+/HER2− as eligibility criteria, screened for CCND1 amplification and/or loss of p16 by FISH. The primary endpoint is progression-free survival (PFS); secondary endpoints include response rate, overall survival, safety, and correlative biomarker studies. In both parts, post-menopausal women with ER+/HER2− advanced BC were randomized 1:1 to receive letrozole either with or without PD 0332991. Pts continue on assigned study treatment until disease progression, unacceptable toxicity, or consent withdrawal, and are followed for tumor assessments every 2 months.
Results: 66 pts were randomized in Part 1 and 99 pts in Part 2. Preliminary results from Part 1 of this study have been previously reported (IMPAKT Breast Cancer Conference, Abstract #292, Finn et al. May 2012) demonstrating a significant improvement in median PFS in the L+P vs. L arm (HR = 0.35; 95% CI, 0.17 to 0.72; p = 0.006). With the additional 99 pts randomized in Part 2 (N = 165), the statistically significant improvement in median PFS (26.2 vs. 7.5 months, respectively) continues to be observed with a HR=0.32 (95% CI, 0.19 to 0.56) with p <0.001. The response rate for the L+P arm (n = 84) was 31% vs. 26% for the L arm (n = 81) and the clinical benefit rate was 68% vs. 44%, respectively. The most commonly reported treatment-related AEs in the combination arm were neutropenia, leukopenia, anemia, and fatigue. The updated results from the combined Part 1 and Part 2 group will be presented in December 2012.
Conclusions: The combination of PD 0332991 and letrozole is well tolerated and shows encouraging clinical benefit, confirming the sensitivity of ER+ BC to PD 0332991 observed in preclinical models. A phase 3 trial in this setting will commence in 2013.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr S1-6.
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Affiliation(s)
- RS Finn
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - JP Crown
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - I Lang
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - K Boer
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - IM Bondarenko
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - SO Kulyk
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - J Ettl
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - R Patel
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - T Pinter
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - M Schmidt
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - Y Shparyk
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - AR Thummala
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - NL Voytko
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - A Breazna
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - ST Kim
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - S Randolph
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - DJ Slamon
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
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Patil S, Figlin RA, Hutson TE, Michaelson MD, Negrier S, Kim ST, Huang X, Motzer RJ. Q-TWiST analysis to estimate overall benefit for patients with metastatic renal cell carcinoma treated in a phase III trial of sunitinib vs interferon-α. Br J Cancer 2012; 106:1587-90. [PMID: 22568998 PMCID: PMC3349250 DOI: 10.1038/bjc.2012.149] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [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] [Indexed: 11/17/2022] Open
Abstract
Background: In a randomised phase III trial of treatment-naive patients with metastatic renal cell carcinoma, sunitinib showed significant improvement in progression-free survival (PFS) compared with interferon (IFN)-α. We assessed between-treatment differences in overall benefit using a quality-adjusted Time Without Symptoms of disease progression or Toxicity of treatment (TWiST; Gelber and Goldhirsch) analysis. Methods: In this analysis, in which only grade 3/4 treatment-related toxicities were included, overall survival was partitioned into three health states: toxicity (time with toxicity after randomisation and before progression), time without symptoms of disease progression or toxicity, and time from progression until death. Between-treatment differences in the mean duration of each state were calculated. A threshold utility analysis was used to assess quality-adjusted TWiST (Q-TWiST) outcomes. Results: Q-TWiST scores showed that quality-adjusted survival time was greater with sunitinib than with IFN-α, even though certain grade 3/4 toxicities occurred more frequently with sunitinib. For both treatments, the mean number of days with toxicity was small compared with PFS. This effect was more pronounced with sunitinib in which time spent without progression or toxicity was 151 days greater than with IFN-α. Conclusion: Patients randomised to sunitinib had longer clinical benefit, defined as Q-TWiST scores, than patients randomised to IFN-α.
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Affiliation(s)
- S Patil
- Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
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Finn RS, Crown JP, Boer K, Lang I, Parikh RJ, Patel R, Schmidt M, Hagenstad C, Lim H, Pinter T, Amadori D, Chan D, Dichmann RA, Walshe J, Breazna A, Kim ST, Randolph S, Slamon DJ. P1-17-05: Preliminary Results of a Randomized Phase 2 Study of PD 0332991, a Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor, in Combination with Letrozole for First-Line Treatment of Patients (pts) with Post-Menopausal, ER+, HER2−Negative (HER2–) Advanced Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p1-17-05] [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: 11/16/2022]
Abstract
Abstract
Background: PD 0332991 is an orally bioavailable selective inhibitor of CDK 4/6 and prevents cellular DNA synthesis by prohibiting progression of the cell cycle from G1 into the S phase. Preclinical evaluations suggest that reduction in CDKN2A (p16) expression and cyclin D1 (CCND1) overexpression confer susceptibility to PD 0332991 (Finn 2009). In addition, PD 0332991 was synergistic in combination with tamoxifen in vitro in ER+ human breast cancer cell lines. Based on these observations, a phase 1/2 study in combination with letrozole as first-line therapy for advanced ER+ post-menopausal breast cancer was initiated. The phase 1 part of the study (completed) determined the recommended phase 2 dose to be PD 0332991 125 mg QD on Schedule 3/1 (3 weeks on treatment followed by 1-week off treatment) in combination with letrozole 2.5 mg QD. The combination was generally well tolerated and encouraging antitumor activity was observed. We present preliminary data from the randomized Phase 2 portion comparing letrozole alone to letrozole plus PD 0332991.
Methods: The Phase 2 portion of the study is designed as a two-part study; we present data from Part 1. In both parts, eligible patients are randomized 1:1 to letrozole 2.5 mg QD alone (control) or PD 0332991 125 mg QD on schedule 3/1 and letrozole 2.5 mg QD (treatment, tx). Part 1enrolled post-menopausal women with ER+, HER2− cancer using only ER+, HER2−as a selection criteria. Part 2 is now enrolling post-menopausal women with ER+, HER2− breast cancer with CCND1 amplification and/or loss of p16 by FISH (target N=150). The primary endpoint is progression-free survival (PFS); secondary endpoints include overall survival, response rate, safety, and correlative studies. Pts are stratified for disease site and length from prior adjuvant therapy. Pts continue assigned study treatment until disease progression, unacceptable toxicity, or consent withdrawal and are followed every 2 months to assess disease status. Tumor tissue was required for participation.
Results: 66 patients have been randomized in Part 1. At the time of data cut-off (April 2011) median duration of treatment is 20 (range 4–64) wks for control and 27 (2-59) wks for tx. Dose reductions occurred in 9 pts on the tx arm and none on the control arm. There are no complete responses. The number of partial responses for pts with measurable disease are similar between arms (4/22 control vs 5/24 in tx). The number of pts with stable disease> 24 weeks was higher in the tx arm (5 vs 8). The number of pts with best response of progressive disease is lower in the treatment arm (2 vs 6). PFS data are immature. Twelve pts remain on control vs. 21 on tx. As in the Phase I portion of the study, the most common treatment-related AEs were neutropenia and leucopenia without febrile neutropenia. Biomarker studies for CCND1 amplification, p16 loss, RB status, and Ki67 are ongoing.
Conclusion: The combination of PD 0332991 and letrozole is well tolerated as first-line treatment of ER+, HER2− post-menopausal breast cancer. Updated efficacy data and biomarker data will be presented.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-17-05.
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Affiliation(s)
- RS Finn
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - JP Crown
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - K Boer
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - I Lang
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - RJ Parikh
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - R Patel
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - M Schmidt
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - C Hagenstad
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - H Lim
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - T Pinter
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - D Amadori
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - D Chan
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - RA Dichmann
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - J Walshe
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - A Breazna
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - ST Kim
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - S Randolph
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
| | - DJ Slamon
- 1University of California at Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Szent Margit Korhaz, Budapest, Hungary; National Institute of Oncology, Budapest, Hungary; Comprehensive Cancer Centers of Nevada, Henderson, NV; Comprehensive Blood and Cancer Center, Bakersfield, CA; University Hospital Mainz, Mainz, Germany; Suburban Hematology-Oncology Associates, Lawrenceville, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Petz Aladár Megyei Okato Korhaz, Gyor, Hungary; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Cancer Care Associates Medical Group, Redondo Beach, CA; Central Coast Medical Oncology Corporation, Santa Maria, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, New York, NY
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Park KH, Gil EY, Choi YJ, Kim ST, Cho KR, Seo JH, Lee ES, Kim IS, Disis ML. P1-01-07: ErbB-2 Peptide Vaccination Suppresses Spontaneous Tumorigenesis and Tumor Stem Cell Expansion in MMTV-PyVT Transgenic Mouse. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p1-01-07] [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: 11/16/2022]
Abstract
Abstract
Immunization targeting ErbB-2 could have considerable therapeutic potential by controlling growth and metastasis of highly aggressive tumor cells in the earlier preclinical and clinical studies. Just a few studies have examined preventive potential of ErbB-2 vaccines in preclinical studies. However, animal model systems used in the previous studies were tumor transplantation or neu-transgenic mouse, which were not relevant to human HER-2 positive breast tumorigenesis. In this study, active immunotherapy against tumor antigen ErbB-2/neu for primary prevention of breast cancer was tested using FVB/N-Tg (MMTV-PyVT) transgenic mice model. Mice were grouped to receive either ErbB-2 peptide vaccine, immune adjuvant only, tetanus toxoid, or PBS every 2 weeks for 3 times and monthly thereafter. The MMTV-PyVT transgenic mice in control groups (PBS, immune adjuvant only, or tetanus toxoid peptide) developed spontaneous mammary adenocarcinomas in 12 to 15 weeks, but vaccination against ErbB-2 strongly suppressed tumor formation by 30 weeks of observation. Further pathologic examination showed complete prevention of tumorigenesis was observed in ErbB-2 vaccinated mice, whereas the mice in control groups developed highly aggressive ErbB-2 overexpressing tumors similar to human breast cancer. The tumor protective effect of peptide vaccination was associated with induction of ErbB-2-specific humoral immune responses as well as T cell responses. Additionally, role of signal through ErbB-2 pathway and the relationship with stemness of cancer cells were determined by Aldefluor assay, mammosphere formation assay using Mouse mammary carcinoma (MMC) cells in vitro, and level of nestin expression determined by Western blot analysis. Further analysis of mammosphere formation capacity of MMC cells using immune sera showed that sera from ErbB2 vaccinated mice had a significant inhibitory effect on mammosphere formation in ErbB-2 overexpressing MMC cells. These results suggest that ErbB-2 targeting by cancer vaccination might be useful adjuvant to standard therapy, helping to prevent relapse in patients with ErbB-2-overexpressing tumors by suppressing stem/progenitor cell population.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-01-07.
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Affiliation(s)
- KH Park
- 1Korea University College of Medicine, Seoul, Korea; Korea University College of Medicine; University of Washington, Seattle, WA
| | - EY Gil
- 1Korea University College of Medicine, Seoul, Korea; Korea University College of Medicine; University of Washington, Seattle, WA
| | - YJ Choi
- 1Korea University College of Medicine, Seoul, Korea; Korea University College of Medicine; University of Washington, Seattle, WA
| | - ST Kim
- 1Korea University College of Medicine, Seoul, Korea; Korea University College of Medicine; University of Washington, Seattle, WA
| | - KR Cho
- 1Korea University College of Medicine, Seoul, Korea; Korea University College of Medicine; University of Washington, Seattle, WA
| | - JH Seo
- 1Korea University College of Medicine, Seoul, Korea; Korea University College of Medicine; University of Washington, Seattle, WA
| | - ES Lee
- 1Korea University College of Medicine, Seoul, Korea; Korea University College of Medicine; University of Washington, Seattle, WA
| | - IS Kim
- 1Korea University College of Medicine, Seoul, Korea; Korea University College of Medicine; University of Washington, Seattle, WA
| | - ML Disis
- 1Korea University College of Medicine, Seoul, Korea; Korea University College of Medicine; University of Washington, Seattle, WA
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Abstract
BACKGROUND Though mucosal cysts in the paranasal sinuses (PSMCs) are common findings on radiographic images, the nature of PSMCs and risk factors for the development of PSMCs have not yet been determined. The aim of this study was to evaluate the characteristics of PSMCs using brain magnetic resonance (MR) imaging. METHODOLOGY/PRINCIPAL A total of 6831 subjects who underwent health checkup including brain MR imaging were included in this study. The characteristics of PSMCs, including their location, number and size, as well as the presence of obstruction of the sinus ostium and sinusitis, were analysed using brain MR images. Structured questionnaires and medical records were reviewed to evaluate the smoking status and comorbid medical conditions. RESULTS The overall prevalence of PSMCs was 7.4% and was significantly higher in females than in males. PSMCs were most commonly found in the maxillary sinus, most of which were located unilaterally as a solitary cyst. Large cysts were associated with obstruction of the sinus ostium and subsequent sinusitis. Smoking was a single important risk factor for developing PSMCs. No significant associations were found between symptoms (nasal/respiratory) and the presence of PSMCs. CONCLUSIONS The prevalence of PSMCs was 7.4% and decreased with age. Large cysts may lead to obstruction of the sinus and subsequent sinusitis. Smoking was an important risk factor for PSMCs, and the total amount of smoking correlated with cyst size. Most subjects were asymptomatic, and specific treatment was not performed.
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Affiliation(s)
- I J Moon
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
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Kim MJ, Seo SW, Lee KM, Kim ST, Lee JI, Nam DH, Na DL. Differential diagnosis of idiopathic normal pressure hydrocephalus from other dementias using diffusion tensor imaging. AJNR Am J Neuroradiol 2011; 32:1496-503. [PMID: 21700790 DOI: 10.3174/ajnr.a2531] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Because DTI can provide good markers of white matter pathology, it could be useful in differentiating white matter changes of INPH from those of other dementias. The aim of this study was, by using DTI, to compare the characteristic white matter changes in INPH with those in AD, subcortical vascular dementia, and healthy control subjects. MATERIALS AND METHODS Sixteen patients with presurgical INPH, 10 with AD, 10 with subcortical vascular dementia, and 20 healthy control subjects underwent DTI. All patients with INPH showed clinical improvement after shunt surgery, and 9 of them also underwent postshunting DTI. Regions of interest were selected at the periventricular white matter, the anterior limb of the internal capsule, the posterior limb of the internal capsule, the genu and the splenium of the corpus callosum, the superior longitudinal fasciculus, and the inferior longitudinal fasciculus. FA and MD were obtained from each region of interest and were compared among the groups. RESULTS Presurgical INPH showed significantly higher FA than all the other groups in the posterior limb of the internal capsule, which was decreased after shunt surgery. Presurgical MD of the INPH group was higher than that in the AD and healthy control groups but lower than that in the subcortical vascular dementia group in the anterior periventricular white matter, the anterior limb of the internal capsule, and the superior longitudinal fasciculus. In differentiating INPH, the sensitivity and specificity of FA in the posterior limb of the internal capsule was 87.5% and 95.0%, respectively. CONCLUSIONS Patients with shunt-responsive INPH showed higher FA in the posterior limb of the internal capsule compared with healthy controls and those in other groups of dementia that was reversible with shunt surgery. With this parameter, shunt-responsive INPH could be distinguished from AD, subcortical vascular dementia, and healthy conditions with high diagnostic accuracy.
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Affiliation(s)
- M J Kim
- Department of Neurology, Seoul National University Boramae Hospital, Seoul, Republic of Korea
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Kim E, Kim HJ, Kim YD, Woo KI, Lee H, Kim ST. Subconjunctival fat prolapse and dermolipoma of the orbit: differentiation on CT and MR imaging. AJNR Am J Neuroradiol 2011; 32:465-7. [PMID: 21163882 DOI: 10.3174/ajnr.a2313] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Subconjunctival fat prolapse and dermolipoma of the orbit are unfamiliar to radiologists and yet should be differentiated because their treatments are different. The purpose of this study was to investigate the CT and MR imaging findings that distinguish these 2 conditions. MATERIALS AND METHODS Between 1995 and 2009, we found 33 patients (27 men, 6 women; mean age, 63 years) with surgically proved subconjunctival fat prolapse and 27 patients (3 males, 24 females; mean age, 17 years) with dermolipoma in our hospital. Among them, 8 patients with subconjunctival fat prolapse and 6 patients with dermolipoma underwent CT and/or MR imaging examinations. We retrospectively reviewed CT scans and MR images in these patients. RESULTS In all of the 8 patients with subconjunctival fat prolapse, CT and MR images demonstrated the herniated fat at the superotemporal epibulbar area, continuous with the intraconal fat, extending forward between the lateral wall of the globe medially and the lateral rectus muscle and the lacrimal gland laterally, either bilaterally (n = 7) or unilaterally (n = 1). In contrast, all 6 patients with dermolipoma had a unilateral, crescent- (n = 5), or triangle-shaped (n = 1) fatty mass at the temporal or superotemporal epibulbar area, which lay on the lateral wall of the globe, anterior to the insertion of the lateral rectus muscle and medial to the lacrimal gland, without connection to the intraconal fat. CONCLUSIONS The characteristic CT and MR imaging findings may help easily differentiate subconjunctival fat prolapse and dermolipoma, both of which usually present as an epibulbar fatty mass in the lateral canthal area.
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Affiliation(s)
- E Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kong DS, Kim ST, Kim EH, Lim DH, Kim WS, Suh YL, Lee JI, Park K, Kim JH, Nam DH. Diagnostic dilemma of pseudoprogression in the treatment of newly diagnosed glioblastomas: the role of assessing relative cerebral blood flow volume and oxygen-6-methylguanine-DNA methyltransferase promoter methylation status. AJNR Am J Neuroradiol 2011; 32:382-7. [PMID: 21252041 DOI: 10.3174/ajnr.a2286] [Citation(s) in RCA: 136] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Methylation of the MGMT gene promoter is associated with a favorable prognosis in adult patients with GBM treated with TMZ. We determined the incidence of pseudoprogression according to the MGMT methylation status and the potential value of DSC perfusion MR images for predicting pseudoprogression. MATERIALS AND METHODS New or enlarged enhancing lesions after CCRT in adult patients with newly diagnosed GBMs were prospectively assessed by measuring their rCBV by using DSC perfusion MR images. Tumor tissue was assayed to determine MGMT promoter methylation status. All patients were regularly followed up at an interval of 2 months by MR images, including DSC perfusion MR images. RESULTS Ninety eligible patients were enrolled in this study. After CCRT, new or enlarged enhanced lesions were found in 59 of 90 patients, which were subsequently classified as pseudoprogression (26 patients, 28.9%) and real progression (33 patients, 36.7%). Overall, there was a significant difference in the mean rCBV between pseudoprogression and real tumor progression (P = .003). The ROC curve revealed that an rCBV ratio >1.47 had an 81.5% sensitivity and a 77.8% specificity. The unmethylated MGMT promoter group had a significant difference of mean rCBV between pseudoprogression and real progression (P = .009), though the methylated MGMT promoter group had no significant difference (P = .258). CONCLUSIONS The current study suggests that rCBV measured by DSC perfusion MR images has a differential impact on the predictability of pseudoprogression in patients with GBM.
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Affiliation(s)
- D-S Kong
- Department of Neurosurgery, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea
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Abstract
The aim of this study was to identify and diagnose headache in a temporomandibular joint and orofacial pain clinic population using the second edition of The International Classification of Headache Disorder criteria. In 502 temporomandibular disorder and orofacial pain patients, 246 patients (49%) were diagnosed with tension-type headache (TTH), followed by migraine without aura (14.5%), probable migraine (12.9%), migraine with aura (7%), probable TTH (4.8%) and cluster headache (0.2%). The prevalence of headaches was compared between male and female patients, and the prevalence of migraine was found to be higher in women than in men. In evaluating by age, the prevalence of migraine was highest in patients in their 20s and 30s and declined as age increased above 40. TTH showed the highest rate throughout all age groups, but it also decreased as age increased. In this study, the prevalence of migraine was lower than that reported in Dr Kim et al.'s study, and the prevalence of TTH much higher than that reported in the previous study. Of the headache patients, 81.1% presented with masseter muscle pain and 47.8% with temporal muscle pain. This finding suggests that pericranial muscle pain may be an inducing factor of primary headache.
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Affiliation(s)
- J-K Kang
- Department of Oral Medicine and Orofacial Pain, College of Dentistry, Wonkwang University, Iksan, Korea
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Kim ST, Marquard K, Stephens S, Louden E, Allsworth J, Moley KH. Adiponectin and adiponectin receptors in the mouse preimplantation embryo and uterus. Hum Reprod 2010; 26:82-95. [PMID: 21106494 DOI: 10.1093/humrep/deq292] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adiponectin (Adipoq), a protein secreted by adipocytes in inverse proportion to the adipose mass present, modulates energy homeostasis and increases insulin sensitivity. Tissue Adipoq signaling decreases in settings of maternal diabetes, polycystic ovary syndrome (PCOS) and endometriosis, conditions which are associated with reproductive difficulty. Our objective was to define the expression and hormonal regulation of Adipoq and its receptors in the mouse preimplantation embryo and uterus. METHODS AND RESULTS By real-time quantitative PCR, mRNA transcripts for Adipoq, AdipoR1, AdipoR2, Ppara, Ppard, FATP1 (SLC27A1) and acyl CoA oxidase (Acox1) were identified in mouse 2-cell and 8-cell embryos, while blastocyst stage embryos and trophoblast stem (TS) cells expressed mRNA for all genes except Adipoq. Protein expression of Adipoq, AdipoR1, AdipoR2, the insulin sensitive transporters GLUT8 (Slc2A8), GLUT12 (Slc2A12) and p-PRKAA1 was identified by immunofluorescence staining in all stages of preimplantation embryos including the blastocyst. In situ hybridization demonstrated the presence of Adipoq, AdipoR1 and AdipoR2 mRNA in the mouse decidual cells of the implantation site and in artificially decidualized cells, and the expression of these proteins was confirmed by western blotting. Flow cytometry confirmed cell surface expression of AdipoR1 and AdipoR2 in TS cells and decidual cells. CONCLUSIONS These results suggest for the first time that Adipoq signaling may play an important role in preimplantation embryo development and uterine receptivity by autocrine and paracrine methods in the mouse. Implantation failures and pregnancy loss, specifically those experienced in women with maternal metabolic conditions such as diabetes, obesity and PCOS, may be the result of aberrant Adipoq and AdipoR1 and AdipoR2 expression and suboptimal decidualization in the uterus.
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Affiliation(s)
- S T Kim
- Department of Obstetrics and Gynecology, Washington University in St Louis, St Louis, MO 63110, USA
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Patil S, Figlin RA, Hutson TE, Michaelson MD, Négrier S, Kim ST, Huang X, Motzer RJ. Prognostic factors for progression-free and overall survival with sunitinib targeted therapy and with cytokine as first-line therapy in patients with metastatic renal cell carcinoma. Ann Oncol 2010; 22:295-300. [PMID: 20657034 DOI: 10.1093/annonc/mdq342] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Analysis of prognostic factors for progression-free survival (PFS) and overall survival (OS) was performed using final data from a randomized phase III trial of sunitinib versus interferon-α (IFN-α) as first-line metastatic renal cell carcinoma (RCC) therapy. DESIGN A multivariate Cox regression model analyzed baseline variables for prognostic significance. Each variable was investigated univariately and then multivariately using a stepwise algorithm. RESULTS Each treatment arm comprised 375 patients. For sunitinib, multivariate analysis of PFS identified five independent predictors, including serum lactate dehydrogenase (LDH) level, presence of ≥2 metastatic sites, no prior nephrectomy, Eastern Cooperative Oncology Group (ECOG) performance status, and baseline platelet count, while multivariate analysis of OS identified serum LDH level, corrected serum calcium level, time from diagnosis to treatment, hemoglobin level, ECOG performance status, and presence of bone metastasis as predictors. For IFN-α, LDH level and presence of ≥2 metastatic sites were common predictors of PFS to those for sunitinib, as were all predictors of OS except ECOG status. CONCLUSIONS This analysis identified prognostic factors for PFS and OS with sunitinib as first-line metastatic RCC therapy and confirmed that the Memorial Sloan-Kettering Cancer Center model is applicable in the era of targeted therapy.
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Affiliation(s)
- S Patil
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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Cella D, Michaelson MD, Bushmakin AG, Cappelleri JC, Charbonneau C, Kim ST, Li JZ, Motzer RJ. Health-related quality of life in patients with metastatic renal cell carcinoma treated with sunitinib vs interferon-alpha in a phase III trial: final results and geographical analysis. Br J Cancer 2010; 102:658-64. [PMID: 20104222 PMCID: PMC2837567 DOI: 10.1038/sj.bjc.6605552] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [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] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In a randomised phase III trial, sunitinib significantly improved efficacy over interferon-alpha (IFN-alpha) as first-line therapy for metastatic renal cell carcinoma (mRCC). We report the final health-related quality of life (HRQoL) results. METHODS Patients (n=750) received oral sunitinib 50 mg per day in 6-week cycles (4 weeks on, 2 weeks off treatment) or subcutaneous IFN-alpha 9 million units three times weekly. Health-related quality of life was assessed with nine end points: the Functional Assessment of Cancer Therapy-General and its four subscales, FACT-Kidney Symptom Index (FKSI-15) and its Disease-Related Symptoms subscale (FKSI-DRS), and EQ-5D questionnaire's EQ-5D Index and visual analogue scale. Data were analysed using mixed-effects model (MM), supplemented with pattern-mixture models (PMM), for the total sample and the US and European Union (EU) subgroups. RESULTS Patients receiving sunitinib reported better scores in the primary end point, FKSI-DRS, across all patient populations (P<0.05), and in nine, five, and six end points in the total sample, in the US and EU groups respectively (P<0.05). There were no significant differences between the US and EU groups for all end points with the exception of the FKSI item 'I am bothered by side effects of treatment' (P=0.02). In general, MM and PMM results were similar. CONCLUSION Patients treated with sunitinib in this study had improved HRQoL, compared with patients treated with IFN-alpha. Treatment differences within the US cohort did not differ from those within the EU cohort.
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Affiliation(s)
- D Cella
- Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA.
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Kim YH, Chang WH, Bang OY, Kim ST, Park YH, Lee PKW. Long-term effects of rTMS on motor recovery in patients after subacute stroke. J Rehabil Med 2010; 42:758-64. [DOI: 10.2340/16501977-0590] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
p57kip2, a KIP family cyclin-dependent kinase (Cdk) inhibitor, blocks the cell cycle by acting on multiple cyclin-Cdk complexes. To investigate the role of p57kip2 in human fertility, the expression of p57kip2 was investigated in testes from normal and obstructive azoospermic male patients who were positive for p57kip2 mRNA. In the seminiferous tubule, strong immunoreactivity of p57kip2 was found in nuclei of early spermatocytes, but not in the spermatogonia. The p57kip2 immunoreactivity in spermatocytes was markedly heterogeneous. Preleptotene spermatocytes showed strong p57kip2 immunoreactivity, but no visible signal was found in late pachytene spermatocytes. Nuclei of the elongating spermatids was also positive for p57kip2 immunoreactivity. Taken together, this suggests that p57kip2 may play a role in the regulation of meiotic progression of early spermatocytes and cell cycle arrest and differentiation of spermatids. p57kip2 immunoreactivity was found in the perinuclear region of the peritubular cells, but not in the Sertoli cells. In Leydig cells, moderate immunoreactivity of p57kip2 was largely found in the cytoplasm, suggesting the noble function of p57kip2 in the differentiation of adult Leydig cells.
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Affiliation(s)
- S T Kim
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA
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