Cancer Research and Treatment

Original Articles

General

The Survival and Financial Benefit of Investigator-Initiated Trials Conducted by Korean Cancer Study Group: Bum Jun Kim, Chi Hoon Maeng, Bhumsuk Keam, Young-Hyuck Im, Jungsil Ro, Kyung Hae Jung, Seock-Ah Im, Tae Won Kim, Jae Lyun Lee, Dae Seog Heo, Sang-We Kim, Keunchil Park, Myung-Ju Ahn, Byoung Chul Cho, Hoon-Kyo Kim, Yoon-Koo Kang, Jae Yong Cho, Hwan Jung Yun, Byung-Ho Nam, Dae Young Zang; Cancer Res Treat. 2025;57(1):39-46. Published online July 10, 2024; DOI: https://doi.org/10.4143/crt.2024.421

Abstract PDF PubReader ePub: Purpose
The Korean Cancer Study Group (KCSG) is a nationwide cancer clinical trial group dedicated to advancing investigator-initiated trials (IITs) by conducting and supporting clinical trials. This study aims to review IITs conducted by KCSG and quantitatively evaluate the survival and financial benefits of IITs for patients.
Materials and Methods
We reviewed IITs conducted by KCSG from 1998 to 2023, analyzing progression-free survival (PFS) and overall survival (OS) gains for participants. PFS and OS benefits were calculated as the difference in median survival times between the intervention and control groups, multiplied by the number of patients in the intervention group. Financial benefits were assessed based on the cost of investigational products provided.
Results
From 1998 to 2023, KCSG conducted 310 IITs, with 133 completed and published. Of these, 21 were included in the survival analysis. The analysis revealed that 1,951 patients in the intervention groups gained a total of 2,558.4 months (213.2 years) of PFS and 2,501.6 months (208.5 years) of OS, with median gains of 1.31 months in PFS and 1.58 months in OS per patient. When analyzing only statistically significant results, PFS and OS gain per patients was 1.69 months and 3.02 months, respectively. Investigational drug cost analysis from six available IITs indicated that investigational products provided to 252 patients were valued at 10,400,077,294 won (approximately 8,046,481 US dollars), averaging about 41,270,148 won (approximately 31,930 US dollars) per patient.
Conclusion
Our findings, based on analysis of published research, suggest that IITs conducted by KCSG led to survival benefits for participants and, in some studies, may have provided financial benefits by providing investment drugs.

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Gastrointestinal cancer

A Phase 3 Randomized Clinical Trial to Compare Efficacy and Safety between Combination Therapy and Monotherapy in Elderly Patients with Advanced Gastric Cancer (KCSG ST13-10): Keun-Wook Lee, Dae Young Zang, Min-Hee Ryu, Hye Sook Han, Ki Hyang Kim, Mi-Jung Kim, Sung Ae Koh, Sung Sook Lee, Dong-Hoe Koo, Yoon Ho Ko, Byeong Seok Sohn, Jin Won Kim, Jin Hyun Park, Byung-Ho Nam, In Sil Choi; Cancer Res Treat. 2023;55(4):1250-1260. Published online May 25, 2023; DOI: https://doi.org/10.4143/crt.2023.333

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study evaluated whether combination therapy is more effective than monotherapy in elderly patients with metastatic or recurrent gastric cancer (MRGC) as first-line chemotherapy.
Materials and Methods
Elderly (≥ 70 years) chemo-naïve patients with MRGC were allocated to receive either combination therapy (group A: 5-fluorouracil [5-FU]/oxaliplatin, capecitabine/oxaliplatin, capecitabine/cisplatin, or S-1/cisplatin) or monotherapy (group B: 5-FU, capecitabine, or S-1). In group A, starting doses were 80% of standard doses, and they could be escalated to 100% at the discretion of the investigator. Primary endpoint was to confirm superior overall survival (OS) of combination therapy vs. monotherapy.
Results
After 111 of the planned 238 patients were randomized, enrollment was terminated due to poor accrual. In the full-analysis population (group A [n=53] and group B [n=51]), median OS of combination therapy vs. monotherapy was 11.5 vs. 7.5 months (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.56 to 1.30; p=0.231). Median progression-free survival (PFS) was 5.6 vs. 3.7 months (HR, 0.53; 95% CI, 0.34 to 0.83; p=0.005). In subgroup analyses, patients aged 70-74 years tended to have superior OS with combination therapy (15.9 vs. 7.2 months, p=0.056). Treatment-related adverse events (TRAEs) occurred more frequently in group A vs. group B. However, among severe TRAEs (≥ grade 3), there were no TRAEs with a frequency difference of > 5%.
Conclusion
Combination therapy was associated with numerically improved OS, although statistically insignificant, and a significant PFS benefit compared with monotherapy. Although combination therapy showed more frequent TRAEs, there was no difference in the frequency of severe TRAEs.

Citations

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Effectiveness of first-line combination chemotherapy in older patients with unresectable advanced gastric cancer: a retrospective study
Ryuya Yamamoto, Yoko M. Nakao, Satomi Yoshida, Koji Kawakami
International Journal of Clinical Oncology.2026;[Epub] CrossRef
Anlotinib plus toripalimab as a first-line treatment in patients with advanced gastric cancer and performance status 2: the phase II APICAL-GC trial
Ke Liu, Bao-Dong Qin, Shi-Qi Chen, Xue Zhong, Xiao-Peng Duan, Ying Wu, Zhan Wang, Yan Ling, Li Sun, Chen-Yang Ye, Dong-Min Shi, Ning Gao, Xiao-Dong Jiao, Yuan-Sheng Zang
Nature Communications.2025;[Epub] CrossRef
Systemic therapy strategies for elderly patients with gastric cancer
Yukiya Narita, Kei Muro
Therapeutic Advances in Medical Oncology.2025;[Epub] CrossRef
Enhancing Anticancer Treatment Efficacy With Lycopene: A Comprehensive Review of Clinical and Preclinical Evidence
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Investigating the Feasibility of Targeted Next-Generation Sequencing to Guide the Treatment of Head and Neck Squamous Cell Carcinoma: Sun Min Lim, Sang Hee Cho, In Gyu Hwang, Jae Woo Choi, Hyun Chang, Myung-Ju Ahn, Keon Uk Park, Ji-Won Kim, Yoon Ho Ko, Hee Kyung Ahn, Byoung Chul Cho, Byung-Ho Nam, Sang Hoon Chun, Ji Hyung Hong, Jung Hye Kwon, Jong Gwon Choi, Eun Joo Kang, Tak Yun, Keun-Wook Lee, Joo-Hang Kim, Jin Soo Kim, Hyun Woo Lee, Min Kyoung Kim, Dongmin Jung, Ji Eun Kim, Bhumsuk Keam, Hwan Jung Yun, Sangwoo Kim, Hye Ryun Kim; Cancer Res Treat. 2019;51(1):300-312. Published online May 9, 2018; DOI: https://doi.org/10.4143/crt.2018.012

Abstract PDF Supplementary Material PubReader ePub

Purpose
Head and neck squamous cell carcinoma (HNSCC) is a deadly disease in which precision medicine needs to be incorporated. We aimed to implement next-generation sequencing (NGS) in determining actionable targets to guide appropriate molecular targeted therapy in HNSCC patients.
Materials and Methods
Ninety-three tumors and matched blood samples underwent targeted sequencing of 244 genes using the Illumina HiSeq 2500 platform with an average depth of coverage of greater than 1,000×. Clinicopathological data from patients were obtained from 17 centers in Korea, and were analyzed in correlation with NGS data.
Results
Ninety-two of the 93 tumors were amenable to data analysis. TP53 was the most common mutation, occurring in 47 (51%) patients, followed by CDKN2A (n=23, 25%), CCND1 (n=22, 24%), and PIK3CA (n=19, 21%). The total mutational burden was similar between human papillomavirus (HPV)–negative vs. positive tumors, although TP53, CDKN2A and CCND1 gene alterations occurred more frequently in HPV-negative tumors. HPV-positive tumors were significantly associated with immune signature-related genes compared to HPV-negative tumors. Mutations of NOTCH1 (p=0.027), CDKN2A (p < 0.001), and TP53 (p=0.038) were significantly associated with poorer overall survival. FAT1 mutations were highly enriched in cisplatin responders, and potentially targetable alterations such as PIK3CA E545K and CDKN2A R58X were noted in 14 patients (15%).
Conclusion
We found several targetable genetic alterations, and our findings suggest that implementation of precision medicine in HNSCC is feasible. The predictive value of each targetable alteration should be assessed in a future umbrella trial using matched molecular targeted agents.

Citations

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Lifestyle Risk Prediction Model for Prostate Cancer in a Korean Population: Sung Han Kim, Sohee Kim, Jae Young Joung, Whi-An Kwon, Ho Kyung Seo, Jinsoo Chung, Byung-Ho Nam, Kang Hyun Lee; Cancer Res Treat. 2018;50(4):1194-1202. Published online December 21, 2017; DOI: https://doi.org/10.4143/crt.2017.484

Abstract PDF Supplementary Material PubReader ePub

Purpose
The use of prostate-specific antigen as a biomarker for prostate cancer (PC) has been controversial and is, therefore, not used by many countries in their national health screening programs. The biological characteristics of PC in East Asians including Koreans and Japanese are different from those in the Western populations. Potential lifestyle risk factors for PC were evaluated with the aim of developing a risk prediction model.
Materials and Methods
A total of 1,179,172 Korean men who were cancer free from 1996 to 1997, had taken a physical examination, and completed a lifestyle questionnaire, were enrolled in our study to predict their risk for PC for the next eight years, using the Cox proportional hazards model. The model’s performance was evaluated using the C-statistic and Hosmer‒Lemeshow type chi-square statistics.
Results
The risk prediction model studied age, height, body mass index, glucose levels, family history of cancer, the frequency of meat consumption, alcohol consumption, smoking status, and physical activity, which were all significant risk factors in a univariate analysis. The model performed very well (C statistic, 0.887; 95% confidence interval, 0.879 to 0.895) and estimated an elevated PC risk in patients who did not consume alcohol or smoke, compared to heavy alcohol consumers (hazard ratio [HR], 0.78) and current smokers (HR, 0.73) (p < 0.001).
Conclusion
This model can be used for identifying Korean and other East Asian men who are at a high risk for developing PC, as well as for cancer screening and developing preventive health strategies.

Citations

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Taewon Hwang, Hyungseok Oh, Jung Ah Lee, Eo Jin Kim
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Incorporating Erlotinib or Irinotecan Plus Cisplatin into Chemoradiotherapy for Stage III Non-small Cell Lung Cancer According to EGFR Mutation Status: Youngjoo Lee, Ji-Youn Han, Sung Ho Moon, Byung-Ho Nam, Kun Young Lim, Geon Kook Lee, Heung Tae Kim, Tak Yun, Hye Jin An, Jin Soo Lee; Cancer Res Treat. 2017;49(4):981-989. Published online January 6, 2017; DOI: https://doi.org/10.4143/crt.2016.522

Abstract PDF Supplementary Material PubReader ePub

Purpose
Concurrent chemoradiotherapy (CCRT) is the standard care for stage III non-small cell lung cancer (NSCLC) patients; however, a more effective regimen is needed to improve the outcome by better controlling occult metastases. We conducted two parallel randomized phase II studies to incorporate erlotinib or irinotecan-cisplatin (IP) into CCRT for stage III NSCLC depending on epidermal growth factor receptor (EGFR) mutation status.
Materials and Methods
Patients with EGFR-mutant tumors were randomized to receive three cycles of erlotinib first and then either CCRT with erlotinib followed by erlotinib (arm A) or CCRT with IP only (arm B). Patients with EGFR unknown or wild-type tumors were randomized to receive either three cycles of IP before (arm C) or after CCRT with IP (arm D).
Results
Seventy-three patients were screened and the study was closed early because of slow accrual after 59 patients were randomized. Overall, there were seven patients in arm A, five in arm B, 22 in arm C, and 25 in arm D. The response rate was 71.4% and 80.0% for arm A and B, and 70.0% and 73.9% for arm C and D. The median overall survival (OS) was 39.3 months versus 31.2 months for arm A and B (p=0.442), and 16.3 months versus 25.3 months for arm C and D (p=0.050). Patients with sensitive EGFR mutations had significantly longer OS than EGFR-wild patients (74.8 months vs. 25.3 months, p=0.034). There were no unexpected toxicities.
Conclusion
Combined-modality treatment by molecular diagnostics is feasible in stage III NSCLC. EGFR-mutant patients appear to be a distinct subset with longer survival.

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Comparison of treatment regimens for unresectable stage III epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer
Xin Dai, Qian Xu, Lei Sheng, Xue Zhang, Miao Huang, Song Li, Kai Huang, Jiahui Chu, Jian Wang, Jisheng Li, Yanguo Liu, Jianyuan Zhou, Shulun Nie, Lian Liu
Chinese Medical Journal.2025; 138(14): 1687. CrossRef
Targeted treatment for unresectable EGFR mutation-positive stage III non-small cell lung cancer: Emerging evidence and future perspectives
Terufumi Kato, Ignacio Casarini, Manuel Cobo, Corinne Faivre-Finn, Fiona Hegi-Johnson, Shun Lu, Mustafa Özgüroğlu, Suresh S. Ramalingam
Lung Cancer.2024; 187: 107414. CrossRef
The ASCENT Trial: a phase 2 study of induction and consolidation afatinib and chemoradiation with or without surgery in stage III EGFR-mutant NSCLC
Allison E B Chang, Andrew J Piper-Vallillo, Raymond H Mak, Michael Lanuti, Alona Muzikansky, Julia Rotow, Pasi A Jänne, Mari Mino-Kenudson, Scott Swanson, Cameron D Wright, David Kozono, Paul Marcoux, Zofia Piotrowska, Lecia V Sequist, Henning Willers
The Oncologist.2024; 29(7): 609. CrossRef
Management of Non-Metastatic Non-Small Cell Lung Cancer (NSCLC) with Driver Gene Alterations: An Evolving Scenario
Valeria Fuorivia, Ilaria Attili, Carla Corvaja, Riccardo Asnaghi, Ambra Carnevale Schianca, Pamela Trillo Aliaga, Ester Del Signore, Gianluca Spitaleri, Antonio Passaro, Filippo de Marinis
Current Oncology.2024; 31(9): 5121. CrossRef
Management of Oncogene Driven Locally Advanced Unresectable Non-small Cell Lung Cancer
Jerold Loh, Jia Li Low, Manavi Sachdeva, Peter QJ Low, Rachel Su Jen Wong, Yiqing Huang, Puey Ling Chia, Ross A Soo
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Gels.2023; 9(12): 953. CrossRef
Nuclear accumulation of KPNA2 impacts radioresistance through positive regulation of the PLSCR1‐STAT1 loop in lung adenocarcinoma
Wei‐Chao Liao, Tsung‐Jen Lin, Yu‐Chin Liu, Yu‐Shan Wei, Guan‐Ying Chen, Hsiang‐Pu Feng, Yi‐Feng Chang, Hsin‐Tzu Chang, Chih‐Liang Wang, Hsinag‐Cheng Chi, Chun‐I Wang, Kwang‐Huei Lin, Wei‐Ting Ou Yang, Chia‐Jung Yu
Cancer Science.2022; 113(1): 205. CrossRef
Erlotinib Versus Etoposide/Cisplatin With Radiation Therapy in Unresectable Stage III Epidermal Growth Factor Receptor Mutation-Positive Non-Small Cell Lung Cancer: A Multicenter, Randomized, Open-Label, Phase 2 Trial
Ligang Xing, Gang Wu, Luhua Wang, Jiancheng Li, Jianhua Wang, Zhiyong Yuan, Ming Chen, Yaping Xu, Xiaolong Fu, Zhengfei Zhu, You Lu, Chun Han, Tingyi Xia, Conghua Xie, Guang Li, Shenglin Ma, Bing Lu, Qin Lin, Guangying Zhu, Baolin Qu, Wanqi Zhu, Jinming Y
International Journal of Radiation Oncology*Biology*Physics.2021; 109(5): 1349. CrossRef
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M. Or, B. Liu, J. Lam, S. Vinod, W. Xuan, R. Yeghiaian-Alvandi, E. Hau
Scientific Reports.2021;[Epub] CrossRef
Tyrosine Kinase Inhibitor Therapy in Unresectable Locally Advanced NSCLC: Keep Holding Our Breaths or Time to Take a Breather?
Aruz Mesci, Theodoros Tsakiridis, Anand Swaminath
Journal of Thoracic Oncology.2021; 16(10): 1607. CrossRef
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Eunsook Choi, Sunhee Park
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Miguel J Sotelo, José Luis García, Cesar Torres-Mattos, Héctor Milián, Carlos Carracedo, María Ángeles González-Ruiz, Xabier Mielgo-Rubio, Juan Carlos Trujillo-Reyes, Felipe Couñago
World Journal of Clinical Oncology.2021; 12(10): 912. CrossRef
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Can Wu, Chunlu Wang, Lu Sun, Keming Xu, Wenying Zhong
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Ruifeng Liu, Shihong Wei, Qiuning Zhang, Xueliang Zhang, Hongtao Luo, Jinhui Tian, Yi Li, Long Ge, Xiaohu Wang
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Role of Anti-EGFR Targeted Therapies in Stage III Locally Advanced Non-small Cell Lung Cancer: Give or Not to Give?
Sanjal Desai, Chul Kim, Irina Veytsman
Current Oncology Reports.2019;[Epub] CrossRef

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What Is the Ideal Tumor Regression Grading System in Rectal Cancer Patients after Preoperative Chemoradiotherapy?: Soo Hee Kim, Hee Jin Chang, Dae Yong Kim, Ji Won Park, Ji Yeon Baek, Sun Young Kim, Sung Chan Park, Jae Hwan Oh, Ami Yu, Byung-Ho Nam; Cancer Res Treat. 2016;48(3):998-1009. Published online October 22, 2015; DOI: https://doi.org/10.4143/crt.2015.254

Abstract PDF PubReader ePub

Purpose
Tumor regression grade (TRG) is predictive of therapeutic response in rectal cancer patients after chemoradiotherapy (CRT) followed by curative resection. However, various TRG systems have been suggested, with subjective categorization, resulting in interobserver variability. This study compared the prognostic validity of four different TRG systems in order to identify the most ideal TRG system. Materials and Methods This study included 933 patients who underwent preoperative CRT and curative resection. Primary tumors alone were graded according to the American Joint Committee on Cancer (AJCC), Dworak, and Ryan TRG systems, and both primary tumors and regional lymph nodes were graded according to a modified Dworak TRG system. The ability of each TRG system to predict recurrence-free survival (RFS) and overall survival (OS) was analyzed using chisquare and C statistics.
Results
All four TRG systems were significantly predictive of both RFS and OS (p < 0.001 each), however none was a better predictor of prognosis than ypStage. Among the four TRGs, the mDworak TRG system was a better predictor of RFS and OS than the AJCC, Dworak, and Ryan TRG systems, and both the chi-square and C statistics were higher for the former, although the differences were not statistically significant. The combination of ypStage and the modified Dworak TRG better predicted RFS and OS than ypStage alone. Conclusion The modified Dworak TRG system for evaluation of entire tumors including regional lymph nodes is a better predictor of survival than current TRG systems for evaluation of the primary tumor alone.

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A Phase II Study of Weekly Paclitaxel Plus Gemcitabine as a Second-Line Therapy in Patients with Metastatic or Recurrent Small Cell Lung Cancer: Tak Yun, Heung Tae Kim, Ji-Youn Han, Sung Jin Yoon, Hyae Young Kim, Byung-Ho Nam, Jin Soo Lee; Cancer Res Treat. 2016;48(2):465-472. Published online May 26, 2015; DOI: https://doi.org/10.4143/crt.2015.061

Abstract PDF PubReader ePub

Purpose
Paclitaxel (P) and gemcitabine (G) are clinically synergistic in small cell lung cancer (SCLC). We evaluated the efficacy of PG as a salvage treatment for SCLC patients whose disease progressed after a platinum-containing regimen.
Materials and Methods
Eligibility included histologically confirmed SCLC, one dimensionally measurable disease, Eastern Cooperative Oncology Group performance status 0-2, and progressive disease after platinum-based chemotherapy. Treatment consisted of P (80 mg/m2) and G (1,000 mg/m2) on days 1 and 8 of each cycle of 21 days until disease progression.
Results
Thirty-three patients seen between December 2005 and February 2009 were selected into this study. Thirty patients (91%) had received irinotecan-platinum, and three had received etoposide-platinum. Sixteen patients (49%) had a treatment-free interval of less than 3 months. The overall response rate was 30.3% (29.4% in sensitive relapse and 31.3% in refractory relapse). The median time to progression was 12.0 weeks and median overall survival (OS) 31.0 weeks, with a 1-year OS rate of 30.3%. Toxicities were moderate and manageable with 18.2% grade (G) 4 neutropenia, 24.2% G3 thrombocytopenia, 6.1% G3 sensory neuropathy, and 3% G3 asthenia. One patient developed febrile neutropenia.
Conclusion
Second-line paclitaxel and gemcitabine were well-tolerated and moderately active in SCLC patients previously treated with platinum-based chemotherapy.

Citations

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Small Cell Lung Cancer
So Yeon Kim, Henry S. Park, Anne C. Chiang
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Shuxin Li, Jianyi Lv, Zhihui Li, Qiuyu Zhang, Jing Lu, Xueyun Huo, Meng Guo, Xin Liu, Changlong Li, Jinghui Wang, Hanping Shi, Li Deng, Zhenwen Chen, Xiaoyan Du
Molecular Cancer.2024;[Epub] CrossRef
Impact of Nab-Paclitaxel Plus PD-1/PD-L1 Inhibitor on Chemorefractory Relapsed Small-Cell Lung Cancer
Fengchun Mu, Bingjie Fan, Haoqian Li, Wenru Qin, Chunni Wang, Bing Zou, Linlin Wang
Future Oncology.2023; 19(19): 1367. CrossRef
Iron oxide nanoparticles induce ferroptosis via the autophagic pathway by synergistic bundling with paclitaxel
Qi Nie, Wenqing Chen, Tianmei Zhang, Shangrong Ye, Zhongyu Ren, Peng Zhang, Jian Wen
Molecular Medicine Reports.2023;[Epub] CrossRef
Current Strategies for Extensive Stage Small Cell Lung Cancer Beyond First-line Therapy
Zhonglin Hao, Janeesh Sekkath Veedu
Clinical Lung Cancer.2022; 23(1): 14. CrossRef
Clinical predictors of survival in patients with relapsed/refractory small-cell lung cancer treated with checkpoint inhibitors: a German multicentric real-world analysis
Jan A. Stratmann, Radha Timalsina, Akin Atmaca, Vivian Rosery, Nikolaj Frost, Jürgen Alt, Cornelius F. Waller, Niels Reinmuth, Gernot Rohde, Felix C. Saalfeld, Aaron Becker von Rose, Fabian Acker, Lukas Aspacher, Miriam Möller, Martin Sebastian
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Functionalized FcRn-targeted nanosystems for oral drug delivery: A new approach to colorectal cancer treatment
Fatima Hameedat, Nuria A. Pizarroso, Natália Teixeira, Soraia Pinto, Bruno Sarmento
European Journal of Pharmaceutical Sciences.2022; 176: 106259. CrossRef
Comparison of two regimens of weekly paclitaxel plus gemcitabine in patients with metastatic breast cancer: propensity score–matched analysis of real-world data
Chengcheng Gong, Yizhao Xie, Yannan Zhao, Yi Li, Jian Zhang, Leiping Wang, Jun Cao, Zhonghua Tao, Xichun Hu, Biyun Wang
Therapeutic Advances in Drug Safety.2022;[Epub] CrossRef
Impact of Nab-Paclitaxel Plus PD-1/PD-L1 Inhibitor Versus Traditional Chemotherapy for Retreatment Small Cell Lung Cancer Patients
Fengchun Mu, Bingjie Fan, Wenru Qin, Shijiang Wang, Bing Zou, Linlin Wang
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FcRn expression in cancer: Mechanistic basis and therapeutic opportunities
Imke Rudnik-Jansen, Kenneth A. Howard
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Nanoparticle Albumin Bound Paclitaxel in the Third-Line Treatment of Recurrent Small Cell Lung Cancer in Real-World Practice: A Single Center Experience
Yuchao Wang, Li Li, Chunhua Xu
Technology in Cancer Research & Treatment.2021;[Epub] CrossRef
Combination therapy with carboplatin and paclitaxel for small cell lung cancer
Atsuto Mouri, Ou Yamaguchi, Sachiko Miyauchi, Ayako Shiono, Harue Utsugi, Fuyumi Nishihara, Yoshitake Murayama, Hiroshi Kagamu, Kunihiko Kobayashi
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Response to and toxicity of gemcitabine for recurrent ovarian cancer according to number of previous chemotherapy regimens
Yuji Takei, Yoshifumi Takahashi, Shizuo Machida, Akiyo Taneichi, Suzuyo Takahashi, Tomomi Nagashima, Hiroyuki Morisawa, Yasushi Saga, Shigeki Matsubara, Hiroyuki Fujiwara
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Second-line treatments of small-cell lung cancers
Nathalie Baize, Isabelle Monnet, Laurent Greillier, Gilles Quere, Mallorie Kerjouan, Henri Janicot, Alain Vergnenegre, Jean Bernard Auliac, Christos Chouaid
Expert Review of Anticancer Therapy.2017; 17(11): 1033. CrossRef

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Impact of Molecular Subtype Conversion of Breast Cancers after Neoadjuvant Chemotherapy on Clinical Outcome: Siew Kuan Lim, Moo Hyun Lee, In Hae Park, Ji Young You, Byung-Ho Nam, Byeong Nam Kim, Jungsil Ro, Keun Seok Lee, So-Youn Jung, Young Mee Kwon, Eun Sook Lee; Cancer Res Treat. 2016;48(1):133-141. Published online April 7, 2015; DOI: https://doi.org/10.4143/crt.2014.262

Abstract PDF PubReader ePub

Purpose
The aim of this study was to examine molecular subtype conversions in patients who underwent neoadjuvant chemotherapy (NAC) and analyze their clinical implications.
Materials and Methods
We included consecutive breast cancer patients who received NAC at the National Cancer Center, Korea, between August 2002 and June 2011, and had available data on estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) receptor status prior to NAC. Molecular subtypes, hormone receptor (HR) status, and ER and PR Allred scores before and after NAC were compared, and the long-term outcomes were analyzed.
Results
Of 322 patients, 32 (9.9%) achieved a pathologic complete response after NAC. HR+/HER2– tumors tended to convert into triple negative (TN) tumors (10.3%), whereas 34.6% of TN tumors gained HR positivity to become HR+/HER2– tumors. Clinical outcomes of molecular subtype conversion groups were compared against patients who remained as HR+/HER2– throughout. The HR+/HER2– to TN group had significantly poorer recurrencefree survival (RFS) (hazard ratio, 3.54; 95% confidence interval [CI], 1.60 to 7.85) and overall survival (OS) (hazard ratio, 3.73; 95% CI, 1.34 to 10.38). Patients who remained TN throughout had the worst outcomes (for RFS: hazard ratio, 3.70; 95% CI, 1.86 to 7.36; for OS: hazard ratio, 5.85; 95% CI, 2.53 to 13.51), while those who converted from TN to HR+/HER2– showed improved comparable survival outcomes.
Conclusion
Molecular subtypes of breast cancers changed frequently after NAC, resulting in different tumor prognostication. Tumor subtyping should be repeated after NAC in patients with breast cancer.

Citations

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Robotic Versus Laparoscopic Surgery for Rectal Cancer after Preoperative Chemoradiotherapy: Case-Matched Study of Short-Term Outcomes: Yong Sok Kim, Min Jung Kim, Sung Chan Park, Dae Kyung Sohn, Dae Yong Kim, Hee Jin Chang, Byung-Ho Nam, Jae Hwan Oh; Cancer Res Treat. 2016;48(1):225-231. Published online March 11, 2015; DOI: https://doi.org/10.4143/crt.2014.365

Abstract PDF PubReader ePub

Purpose
Robotic surgery is expected to have advantages over laparoscopic surgery; however, there are limited data regarding the feasibility of robotic surgery for rectal cancer after preoperative chemoradiotherapy (CRT). Therefore, we evaluated the short-term outcomes of robotic surgery for rectal cancer. Materials and Methods Thirty-three patients with cT3N0-2 rectal cancer after preoperative CRT who underwent robotic low anterior resection (R-LAR) between March 2010 and January 2012 were matched with 66 patients undergoing laparoscopic low anterior resection (L-LAR). Perioperative clinical outcomes and pathological data were compared between the two groups.
Results
Patient characteristics did not differ significantly different between groups. The mean operation time was 441 minutes (R-LAR) versus 277 minutes (L-LAR; p < 0.001). The open conversion rate was 6.1% in the R-LAR group and 0% in the L-LAR group (p=0.11). There were no significant differences in the time to flatus passage, length of hospital stay, and postoperative morbidity. In pathological review, the mean number of harvested lymph nodes was 22.3 in R-LAR and 21.6 in L-LAR (p=0.82). Involvement of circumferential resection margin was positive in 16.1% and 6.7%, respectively (p=0.42). Total mesorectal excision (TME) quality was complete in 97.0% in R-LAR and 91.0% in L-LAR (p=0.41). Conclusion In our study, short-term outcomes of robotic surgery for rectal cancer after CRT were similar to those of laparoscopic surgery in respect to bowel function recovery, morbidity, and TME quality. Well-designed clinical trials are needed to evaluate the functional results and longterm outcomes of robotic surgery for rectal cancer.

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