Cancer Research and Treatment

Review Article

Precision Oncology Clinical Trials: A Systematic Review of Phase II Clinical Trials with Biomarker-Driven, Adaptive Design: Hyerim Ha, Hee Yeon Lee, Jee Hyun Kim, Do Yeun Kim, Ho Jung An, SeungJin Bae, Hye-sung Park, Jin Hyoung Kang; Cancer Res Treat. 2024;56(4):991-1013. Published online May 7, 2024; DOI: https://doi.org/10.4143/crt.2024.128

Abstract PDF Supplementary Material PubReader ePub: Novel clinical trial designs are conducted in the precision medicine era. This study aimed to evaluate biomarker-driven, adaptive phase II trials in precision oncology, focusing on infrastructure, efficacy, and safety. We systematically reviewed and analyzed the target studies. EMBASE and PubMed searches from 2015 to 2023 generated 29 eligible trials. Data extraction included infrastructure, biomarker screening methodologies, efficacy, and safety profiles. Government agencies, cancer hospitals, and academic societies with accumulated experiences led investigator-initiated precision oncology clinical trials (IIPOCTs), which later guided sponsor-initiated precision oncology clinical trials (SIPOCTs). Most SIPOCTs were international studies with basket design. IIPOCTs primarily used the central laboratory for biomarker screening, but SIPOCTs used both central and local laboratories. Most of the studies adapted next-generation sequencing and/or immunohistochemistry for biomarker screening. Fifteen studies included an independent central review committee for outcome investigation. Efficacy assessments predominantly featured objective response rate as the primary endpoint, with varying results. Nine eligible studies contributed to the United States Food and Drug Administration’s marketing authorization. Safety monitoring was rigorous, but reporting formats lacked uniformity. Health-related quality of life and patient-reported outcomes were described in some protocols but rarely reported. Our results reveal that precision oncology trials with adaptive design rapidly and efficiently evaluate anticancer drugs’ efficacy and safety, particularly in specified biomarker-driven cohorts. The evolution from IIPOCT to SIPOCT has facilitated fast regulatory approval, providing valuable insights into the precision oncology landscape.

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Special Articles

Life-Sustaining Treatment States in Korean Cancer Patients after Enforcement of Act on Decisions on Life-Sustaining Treatment for Patients at the End of Life: Young-Woong Won, Hwa Jung Kim, Jung Hye Kwon, Ha Yeon Lee, Sun Kyung Baek, Yu Jung Kim, Do Yeun Kim, Hyewon Ryu; Cancer Res Treat. 2021;53(4):908-916. Published online June 2, 2021; DOI: https://doi.org/10.4143/crt.2021.325

Abstract PDF PubReader ePub

Purpose
In Korea, the “Act on Hospice and Palliative Care and Decisions on Life-sustaining Treatment for Patients at the End of Life” was enacted on February 4, 2018. This study was conducted to analyze the current state of life-sustaining treatment decisions based on National Health Insurance Service (NHIS) data after the law came into force.
Materials and Methods
The data of 173,028 cancer deaths were extracted from NHIS qualification data between November 2015 and January 2019.
Results
The number of cancer deaths complied with the law process was 14,438 of 54,635 cases (26.4%). The rate of patient self-determination was 49.0%. The patients complying with the law process have used a hospice center more frequently (28% vs. 14%). However, the rate of intensive care unit (ICU) admission was similar between the patients who complied with and without the law process (ICU admission, 23% vs. 21%). There was no difference in the proportion of patients who had undergone mechanical ventilation and hemodialysis in the comparative analysis before and after the enforcement of the law and the analysis according to the compliance with the law. The patients who complied with the law process received cardiopulmonary resuscitation at a lower rate.
Conclusion
The law has positive effects on the rate of life-sustaining treatment decision by patient’s determination. However, there was no sufficient effect on the withholding or withdrawing of life-sustaining treatment, which could protect the patient from unnecessary or harmful interventions.

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Characteristics and outcomes of patients with do-not-resuscitate and physician orders for life-sustaining treatment in a medical intensive care unit: a retrospective cohort study
Song-I Lee, Ye-Rin Ju, Da Hyun Kang, Jeong Eun Lee
BMC Palliative Care.2024;[Epub] CrossRef
Characteristics of Life-Sustaining Treatment Decisions: National Data Analysis in South Korea
Jiyeon Choi, Heejung Jeon, Ilhak Lee
Asian Bioethics Review.2024; 16(1): 33. CrossRef
Recent Trends in the Withdrawal of Life-Sustaining Treatment in Patients with Acute Cerebrovascular Disease : 2017–2021
Seung Hwan Kim, Ji Hwan Jang, Young Zoon Kim, Kyu Hong Kim, Taek Min Nam
Journal of Korean Neurosurgical Society.2024; 67(1): 73. CrossRef
The Impact of Withdrawing or Withholding of Life-Sustaining Treatment: A Nationwide Case-Control Study Based on Medical Cost Analysis
Claire Junga Kim, Do-Kyong Kim, Sookyeong Mun, Minkook Son
Journal of Korean Medical Science.2024;[Epub] CrossRef
For the Universal Right to Access Quality End-of-Life Care in Korea: Broadening Our Perspective After the 2018 Life-Sustaining Treatment Decisions Act
Hye Yoon Park, Min Sun Kim, Shin Hye Yoo, Jung Lee, In Gyu Song, So Yeon Jeon, Eun Kyung Choi
Journal of Korean Medical Science.2024;[Epub] CrossRef
Differences in end-of-life care patterns between types of hospice used for cancer patients: a retrospective cohort study
Il Yun, Eun-Cheol Park, Chung Mo Nam, Jaeyong Shin, Suk-Yong Jang, Sung-In Jang
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Epidemiology of patients who died in the emergency departments and need of end-of-life care in Korea from 2016 to 2019
Sun Young Lee, Young Sun Ro, Sang Do Shin, Eunsil Ko, Seong Jung Kim
Scientific Reports.2023;[Epub] CrossRef
Use of high‐flow nasal cannula oxygen therapy for patients with terminal cancer at the end of life
Jung Sun Kim, Jeongmi Shin, Nam Hee Kim, Sun Young Lee, Shin Hye Yoo, Bhumsuk Keam, Dae Seog Heo
Cancer Medicine.2023; 12(13): 14612. CrossRef
Preferred versus Actual Place of Care and Factors Associated with Home Discharge among Korean Patients with Advanced Cancer: A Retrospective Cohort Study
In Young Hwang, Yohan Han, Min Sun Kim, Kyae Hyung Kim, Belong Cho, Wonho Choi, Yejin Kim, Shin Hye Yoo, Sun Young Lee
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Healthcare resource utilization and medical costs in patients with terminal cancer during best supportive care
Dong-Won Kang, Yoon-Bo Shim, Eui-Kyung Lee, Mi-Hai Park, Wen-Chi Chou
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Aggressiveness of care in the last days of life in the emergency department of a tertiary hospital in Korea
Jung Sun Kim, Sun Young Lee, Min Sung Lee, Shin Hye Yoo, Jeongmi Shin, Wonho Choi, Yejin Kim, Hyung Sook Han, Jinui Hong, Bhumsuk Keam, Dae Seog Heo
BMC Palliative Care.2022;[Epub] CrossRef
Effect of life-sustaining treatment decision law on pediatric in-hospital cardiopulmonary resuscitation rate: A Korean population-based study
Jaeyoung Choi, Ah Young Choi, Esther Park, Meong Hi Son, Joongbum Cho
Resuscitation.2022; 180: 38. CrossRef
Association of perceived life satisfaction with attitudes toward life-sustaining treatment among the elderly in South Korea: a cross-sectional study
Il Yun, Hyunkyu Kim, Eun-Cheol Park, Suk-Yong Jang
BMC Palliative Care.2022;[Epub] CrossRef
Willingness of patients with cancer pain to participate in end-of-life decisions: a multi-center cross-sectional study from three coastal provinces in southern China
Xi Ke, Hongyu Zhu, Yu Zhang, Ling Yang, Simei Shi, Fang Zhu, Huiyu Luo
BMC Palliative Care.2022;[Epub] CrossRef
The Law Changes Behaviors: Is It Just Enough?
Dae Ho Lee
Cancer Research and Treatment.2021; 53(4): 895. CrossRef

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Current Status and Cardinal Features of Patient Autonomy after Enactment of the Life-Sustaining Treatment Decisions Act in Korea: Hwa Jung Kim, Yu Jung Kim, Jung Hye Kwon, Young-Woong Won, Ha Yeon Lee, Sun Kyung Baek, Hyewon Ryu, Do Yeun Kim; Cancer Res Treat. 2021;53(4):917-925. Published online June 2, 2021; DOI: https://doi.org/10.4143/crt.2021.324

Abstract PDF PubReader ePub

Purpose
The main purpose of the Life-Sustaining Treatment Decisions Act recently enacted in Korea is to respect the patient’s self-determination. We aimed to investigate the current status and features of patient self-determination after implementation of the law.
Materials and Methods
Between February 2018 and January 2019, 54,635 cancer deaths were identified from the National Health Insurance Service (NHIS) database. We analyzed the characteristics of decedents who complied with the law process by self-determination compared with decedents with family determination and with decedents who did not comply with the law process.
Results
In multivariable analysis, patients with self-determination were younger, were less likely to live in rural areas, were less likely to belong to the highest income quintile, were less likely to be treated in general hospitals, and were more likely to show a longer time from cancer diagnosis compared with patients with family determination. Compared with patients who did not comply with the law process, patients with self-determination were younger, lived in Seoul or capital area, were less likely to belong to the highest income quintile, were treated in general hospitals, were less likely to have genitourinary or hematologic malignancies, scored higher on the Charlson comorbidity index, and showed a longer time from cancer diagnosis. Patients with self-determination were more likely to use hospice and less likely to use intensive care units (ICUs) at the end-of-life (EOL).
Conclusion
Decedents with self-determination were more likely to be younger, reside in the Seoul or capital area, show a longer time from cancer diagnosis, and were less likely to belong to the highest income quintile. They utilized hospice more frequently, and received less ICU care at the EOL.

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The effects of hospice care on healthcare expenditure among cancer patients
Hoyol Jhang, Wonjeong Jeong, Hyun-Soo Zhang, Dong-Woo Choi, Hyejung Kang, Sohee Park
BMC Health Services Research.2023;[Epub] CrossRef
Problems Related to the Act on Decisions on Life-Sustaining Treatment and Directions for Improvement
Dae Seog Heo, Shin Hye Yoo, Bhumsuk Keam, Sang Ho Yoo, Younsuck Koh
The Korean Journal of Hospice and Palliative Care.2022; 25(1): 1. CrossRef
Aggressiveness of care in the last days of life in the emergency department of a tertiary hospital in Korea
Jung Sun Kim, Sun Young Lee, Min Sung Lee, Shin Hye Yoo, Jeongmi Shin, Wonho Choi, Yejin Kim, Hyung Sook Han, Jinui Hong, Bhumsuk Keam, Dae Seog Heo
BMC Palliative Care.2022;[Epub] CrossRef
Use of antimicrobial agents in actively dying inpatients after suspension of life-sustaining treatments: Suggestion for antimicrobial stewardship
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Association of perceived life satisfaction with attitudes toward life-sustaining treatment among the elderly in South Korea: a cross-sectional study
Il Yun, Hyunkyu Kim, Eun-Cheol Park, Suk-Yong Jang
BMC Palliative Care.2022;[Epub] CrossRef
The Law Changes Behaviors: Is It Just Enough?
Dae Ho Lee
Cancer Research and Treatment.2021; 53(4): 895. CrossRef

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Original Articles

General

Analysis of Cancer Patient Decision-Making and Health Service Utilization after Enforcement of the Life-Sustaining Treatment Decision-Making Act in Korea: Dalyong Kim, Shin Hye Yoo, Seyoung Seo, Hyun Jung Lee, Min Sun Kim, Sung Joon Shin, Chi-Yeon Lim, Do Yeun Kim, Dae Seog Heo, Chae-Man Lim; Cancer Res Treat. 2022;54(1):20-29. Published online April 12, 2021; DOI: https://doi.org/10.4143/crt.2021.131

Abstract PDF PubReader ePub

Purpose
This study aimed to confirm the decision-making patterns for life-sustaining treatment (LST) and analyze medical service utilization changes after enforcement of the Life-Sustaining Treatment Decision-Making Act.
Materials and Methods
Of 1,237 patients who completed legal forms for life-sustaining treatment (hereafter called the LST form) at three academic hospitals and died at the same institutions, 1,018 cancer patients were included. Medical service utilization and costs were analyzed using claims data.
Results
The median time to death from completion of the LST form was three days (range, 0 to 248 days). Of these, 517 people died within two days of completing the document, and 36.1% of all patients prepared the LST form themselves. The frequency of use of the intensive care unit, continuous renal replacement therapy, and mechanical ventilation was significantly higher when the families filled out the form without knowing the patient’s intention. In the top 10% of the medical expense groups, the decision-makers for LST were family members rather than patients (28% patients vs. 32% family members who knew and 40% family members who did not know the patient’s intention).
Conclusion
The cancer patient’s own decision-making rather than the family’s decision was associated with earlier decision-making, less use of some critical treatments (except chemotherapy) and expensive evaluations, and a trend toward lower medical costs.

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Characteristics of Life-Sustaining Treatment Decisions: National Data Analysis in South Korea
Jiyeon Choi, Heejung Jeon, Ilhak Lee
Asian Bioethics Review.2024; 16(1): 33. CrossRef
Characteristics and outcomes of patients with do-not-resuscitate and physician orders for life-sustaining treatment in a medical intensive care unit: a retrospective cohort study
Song-I Lee, Ye-Rin Ju, Da Hyun Kang, Jeong Eun Lee
BMC Palliative Care.2024;[Epub] CrossRef
For the Universal Right to Access Quality End-of-Life Care in Korea: Broadening Our Perspective After the 2018 Life-Sustaining Treatment Decisions Act
Hye Yoon Park, Min Sun Kim, Shin Hye Yoo, Jung Lee, In Gyu Song, So Yeon Jeon, Eun Kyung Choi
Journal of Korean Medical Science.2024;[Epub] CrossRef
Comparison of factors influencing the decision to withdraw life-sustaining treatment in intensive care unit patients after implementation of the Life-Sustaining Treatment Act in Korea
Claire Junga Kim, Kyung Sook Hong, Sooyoung Cho, Jin Park
Acute and Critical Care.2024; 39(2): 294. CrossRef
Nurses' engagement in advance care planning practices: A descriptive cross‐sectional study
Sangmin Lee, Naixue Cui, Hyejin Kim
Journal of Clinical Nursing.2024;[Epub] CrossRef
Issues and implications of the life-sustaining treatment decision act: comparing the data from the survey and clinical data of inpatients at the end-of-life process
Eunjeong Song, Dongsoon Shin, Jooseon Lee, Seonyoung Yun, Minjeong Eom, Suhee Oh, Heejung Lee, Jiwan Lee, Rhayun Song
BMC Medical Ethics.2024;[Epub] CrossRef
Development and Feasibility Evaluation of Smart Cancer Care 2.0 Based on Patient-Reported Outcomes for Post-Discharge Management of Patients with Cancer
Jin Ah Kwon, Songsoo Yang, Su-Jin Koh, Young Ju Noh, Dong Yoon Kang, Sol Bin Yang, Eun Ji Kwon, Jeong-Wook Seo, Jin sung Kim, Minsu Ock
Cancer Research and Treatment.2024; 56(4): 1040. CrossRef
Advance Care Planning in South Korea
Yu Jung Kim, Sun-Hyun Kim
Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen.2023; 180: 68. CrossRef
Preferred versus Actual Place of Care and Factors Associated with Home Discharge among Korean Patients with Advanced Cancer: A Retrospective Cohort Study
In Young Hwang, Yohan Han, Min Sun Kim, Kyae Hyung Kim, Belong Cho, Wonho Choi, Yejin Kim, Shin Hye Yoo, Sun Young Lee
Healthcare.2023; 11(13): 1939. CrossRef

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Pilot study for the Psychometric Validation of the Sheffield Profile for Assessment and Referral to Care (SPARC) in Korean Cancer Patients: Jung Hye Kwon, Sun Kyung Baek, Do Yeun Kim, Yu Jung Kim, Myung Ah Lee, Hye Jin Choi, Ja Min Byun, Jin Young Jeong, Sam H Ahmedzai, Geun-Doo Jang; Cancer Res Treat. 2021;53(1):25-31. Published online August 31, 2020; DOI: https://doi.org/10.4143/crt.2020.235

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to validate the Sheffield Profile for Assessment and Referral to Care (SPARC) as an effective tool for screening palliative care needs among Korean cancer patients.
Materials and Methods
The English version of the SPARC was translated by four Korean oncologists and reconciled by a Korean language specialist and a medical oncologist fluent in English. After the first version of the Korean SPARC (K-SPARC) was developed, back-translation into English was performed by a professional translator and bilingual oncologist. The back-translated version was reviewed by the original author (S.H.A.), and modifications were made (ver. 2). The second version of the K-SPARC was tested against other questionnaires, including the Functional Assessment of Cancer Therapy-General (FACT-G) and the Edmonton Symptom Assessment System (ESAS).
Results
Thirty patients were enrolled in the pilot trial. Fifteen were male, and the median age was 64.5 years. Six patients had an Eastern Cooperative Oncology Group performance status of 2 or more. All patients except one were receiving chemotherapy. Regarding internal consistency, the Cronbach’s α scores for physical symptoms, psychological issues, religious and spiritual issues, independency and activity, family and social issues, and treatment issues were 0.812, 0.804, 0.589, 0.843, 0.754, and 0.822, respectively. The correlation coefficients between the SPARC and FACT-G were 0.479 (p=0.007) for the physical domain and –0.130 (p=0.493) for the social domain.
Conclusion
This pilot study indicates that the K-SPARC could be a reliable tool to screen for palliative care needs among Korean cancer patients. A further study to validate our findings is ongoing.

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Translation and linguistic validation of the Sheffield Profile for Assessment and Referral for Care (SPARC) to Colombian Spanish
Socorro Moreno, Cindy V. Mendieta, Esther de Vries, Sam H. Ahmedzai, Karen Rivera, Camilo Cortes-Mora, Jose A. Calvache
Palliative and Supportive Care.2024; : 1. CrossRef
Validation of traditional Chinese version of Sheffield Profile for Assessment and Referral for Care Questionnaire in Taiwanese patients
Ming-Chieh Tsai, Yun-Yun Chou, El-Wui Loh, Ashleigh Peng Lin, Hsueh-Chi Wu, Li-Sin Hsiao, Chia-Li Chang, Shu-Fen Chen, Sam H. Ahmedzai, Ka-Wai Tam
Journal of the Chinese Medical Association.2024; 87(1): 58. CrossRef
Validation of the Spanish translation Sheffield Profile for Assessment and Referral for Care (SPARC-Sp) at the Hospital Universitario San Jose of Popayan, Colombia
Cindy V. Mendieta, Jose A. Calvache, Martín A. Rondón, Carlos Javier Rincón-Rodríguez, Sam H. Ahmedzai, Esther de Vries
Palliative and Supportive Care.2024; : 1. CrossRef
Co-Designing a Strategy for Implementing the SPARC Holistic Needs Assessment Tool in the Colombian Clinical Context
Cindy V. Mendieta, Esther de Vries, Jose Andrés Calvache, Sam H. Ahmedzai, Gillian Prue, Tracey McConnell, Joanne Reid
Healthcare.2023; 11(22): 2917. CrossRef
Outpatient palliative care referral system (PCRS) for patients with advanced cancer: an impact evaluation protocol
Cinzia Brunelli, Ernesto Zecca, Alessandra Pigni, Paola Bracchi, Mariangela Caputo, Silvia Lo Dico, Viviana Fusetti, Antonino Tallarita, Cristiana Bergamini, Marta Brambilla, Alessandra Raimondi, Monica Niger, Salvatore Provenzano, Pierangela Sepe, Sara A
BMJ Open.2022; 12(10): e059410. CrossRef
Unmet needs related to the quality of life of advanced cancer patients in Korea: a qualitative study
Jeehee Pyo, Minsu Ock, Mina Lee, Juhee Kim, Jaekyung Cheon, Juhee Cho, Jung Hye Kwon, Hyeyeoung Kim, Hyeon-Su Im, Young Joo Min, Su-Jin Koh
BMC Palliative Care.2021;[Epub] CrossRef

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Perspectives on Professional Burnout and Occupational Stress among Medical Oncologists: A Cross-sectional Survey by Korean Society for Medical Oncology (KSMO): Yun-Gyoo Lee, Chi Hoon Maeng, Do Yeun Kim, Bong-Seog Kim; Cancer Res Treat. 2020;52(4):1002-1009. Published online July 10, 2020; DOI: https://doi.org/10.4143/crt.2020.190

Abstract PDF PubReader ePub

Purpose
This study aimed to investigate the prevalence and risk factors of burnout and occupational stress among medical oncologists in Korea.
Methods
A survey was conducted of medical oncologists who were members of Korean Society for Medical Oncology (KSMO) using the Korean Occupational Stress Scale, the validated Maslach Burnout Inventory (MBI) and supplemental questions about work and lifestyle factors.
Results
Among 220 active KSMO members, 111 responses were collected. The median age was 42 years (range, 32 to 63 years). Two-thirds of responders worked 6 days per week and half of them worked a total of 60-80 hours per week. Each medical oncologist treated a median of 90-120 patients per week in outpatient clinics and 20-30 patients per week in patient practices. MBI subscales indicated a high level of emotional exhaustion in 74%, a high level of depersonalization in 86%, and a low level of personal accomplishment in 65%: 68% had professional burnout according to high emotional exhaustion and high depersonalization scores. The risk of burnout was higher for medical oncologists aged from 30-39 than 40-49 years, and unmarried than married. Considering personal accomplishment, females had a higher risk of burnout. The median score of occupational stress was 63 (range, 43 to 88). Having night-duty call was the strongest risk factor on more stress. A higher stress score was associated with a higher prevalence of burnout.
Conclusion
Burnout and occupational stress are quite common amongst Korean medical oncologists. Achieving a healthy work-life balance, ensuring balanced workload distribution, and engaging in proper stress relief solutions are necessary.

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Job stress and burnout affecting the mental health of Korean medical faculty members: constructing causality among latent variables
Ji-Hyun Seo, Hwa-ok Bae
Korean Journal of Medical Education.2024; 36(1): 27. CrossRef
Pilotstudie zu beruflicher Gratifikation und Gesundheit
I. Böckelmann, I. Zavgorodnii, O. Litovchenko, M. Krasnoselskyi, B. Thielmann
Zentralblatt für Arbeitsmedizin, Arbeitsschutz und Ergonomie.2024; 74(3): 118. CrossRef
Associations among the workplace violence, burnout, depressive symptoms, suicidality, and turnover intention in training physicians: a network analysis of nationwide survey
Je-Yeon Yun, Sun Jung Myung, Kyung Sik Kim
Scientific Reports.2023;[Epub] CrossRef
Work-Related Stress, Health Status, and Status of Health Apps Use in Korean Adult Workers
Won Ju Hwang, Minjeong Kim
International Journal of Environmental Research and Public Health.2022; 19(6): 3197. CrossRef

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Practice Patterns Regarding Multidisciplinary Cancer Management and Suggestions for Further Refinement: Results from a National Survey in Korea: Yun-Gyoo Lee, Sukjoong Oh, Heejin Kimm, Dong-Hoe Koo, Do Yeun Kim, Bong-Seog Kim, Seung-Sei Lee; Cancer Res Treat. 2017;49(4):1164-1169. Published online February 22, 2017; DOI: https://doi.org/10.4143/crt.2016.517

Abstract PDF PubReader ePub

Purpose
This study was conducted to explore the process and operation of a cancer multidisciplinary team (MDT) after the reimbursement decision in Korea, and to identify ways to overcome the major barriers to effective and sustainable MDTs.
Materials and Methods
Approximately 1,000 cancer specialists, including medical oncologists, surgical oncologists, radiation oncologists, pathologists, and radiologists in general hospitals in Koreawere invited to complete the survey. The questionnaire covered the following topics: organizational structure of MDTs, candidates for consulting, the clinical decision-making initiative, and responsibility for dealing with legal disputes.
Results
We collected a total of 179 responses (18%) from physicians at institutions where an MDT approachwas active. A surgical oncologist (91%), internist (90%),radiologist (89%),radiation oncologist (86%), pathologist (71%), and trainees (20%) regularly participated in MDT operations. Approximately 55% of respondents stated that MDTs met regularly. In cases of a split opinion, the physician in charge (69%) or chairperson (17%) made the final decision, and most (86%) stated they followed the final decision. About 15% and 32% of respondents were “very satisfied” and “satisfied,” respectively, with the current MDT’s operations. Among 38 institutional representatives, 34% responded that the MDT operation became more active and 18% stated an MDT was newly implemented after the reimbursement decision.
Conclusion
The reimbursement decision invigorated MDT operations in almost half of eligible hospitals. Dissatisfaction regarding current MDTs was over 50%, and the high discordance rates regarding risk sharing suggest that it is necessary to revise the current system of MDTs.

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The influence of multidisciplinary team meetings on treatment decisions in advanced bladder cancer
Janneke E.W. Walraven, Theodora M. Ripping, Jorg R. Oddens, Bas W.G. van Rhijn, Catharina A. Goossens‐Laan, Maarten C.C.M. Hulshof, Lambertus A. Kiemeney, J.A. Witjes, Valery E.P.P. Lemmens, Jacobus J.M. van der Hoeven, Ingrid M.E. Desar, Katja K.H. Aben,
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Cancers.2023; 15(2): 471. CrossRef
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Janneke E. W. Walraven, Olga L. van der Hel, J. J. M. van der Hoeven, Valery E. P. P. Lemmens, Rob H. A. Verhoeven, Ingrid M. E. Desar
BMC Health Services Research.2022;[Epub] CrossRef
Understanding the Complexity, Underlying Processes, and Influencing Factors for Optimal Multidisciplinary Teamwork in Hospital-Based Cancer Teams
Melissa Horlait, Saskia Baes, Melissa De Regge, Mark Leys
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Experiences and Perceptions of Gender Discrimination and Equality among Korean Surgeons: Results of a Survey of the Korean Surgical Society
Jihyeon Choi, Jeong-Eun Lee, Bora Choi, Jungook Kim, Seung Eun Lee
Journal of Korean Medical Science.2021;[Epub] CrossRef
Practice patterns of multidisciplinary team meetings in Korean cancer care and patient satisfaction with this approach
Chi Hoon Maeng, Hee Kyung Ahn, Sung Yong Oh, Seungtaek Lim, Bong-Seog Kim, Do Yeun Kim
The Korean Journal of Internal Medicine.2020; 35(1): 205. CrossRef
Treatment strategy and outcomes in locally advanced head and neck squamous cell carcinoma: a nationwide retrospective cohort study (KCSG HN13–01)
Yun-Gyoo Lee, Eun Joo Kang, Bhumsuk Keam, Jin-Hyuk Choi, Jin-Soo Kim, Keon Uk Park, Kyoung Eun Lee, Jung Hye Kwon, Keun-Wook Lee, Min Kyoung Kim, Hee Kyung Ahn, Seong Hoon Shin, Hye Ryun Kim, Sung-Bae Kim, Hwan Jung Yun
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Changes in real-life practice for hepatocellular carcinoma patients in the Republic of Korea over a 12-year period: A nationwide random sample study
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PLOS ONE.2019; 14(10): e0223678. CrossRef

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Survey of Medical Oncology Status in Korea (SOMOS-K): A National Survey of Medical Oncologists in the Korean Association for Clinical Oncology (KACO): Do Yeun Kim, Yun Gyoo Lee, Bong-Seog Kim; Cancer Res Treat. 2017;49(3):588-594. Published online September 23, 2016; DOI: https://doi.org/10.4143/crt.2016.313

Abstract PDF PubReader ePub

Purpose
This study was conducted to investigate the current role of medical oncologists in cancer care with a focus on increasing the recognition of medical oncology as an independent specialty.
Materials and Methods
Questionnaires modified from the Medical Oncology Status in Europe Survey dealing with oncology structure, resources, research, and patterns of care given by medical oncologists were selected. Several modifications were made to the questionnaire after feedback from the insurance and policy committee of the Korean Association for Clinical Oncology (KACO). The online survey was then sent to KACO members.
Results
A total of 214 medical oncologists (45.8% of the total inquiries), including 71 directors of medical oncology institutions, took the survey. Most institutions had various resources, including a medical oncology department (94.1%) and a department of radiation oncology (82.4%). There was an average of four medical oncologists at each institution. Medical oncologists were involved in various treatments from diagnosis to end-of-life care. They were also chemotherapy providers from a wide range of institutions that treated many types of solid cancers. In addition, 86.2% of the institutions conducted research.
Conclusion
This is the first national survey in Korea to show that medical oncologists are involved in a wide range of cancer treatments and care. This survey emphasizes the contributions and proper roles of medical oncologists in the evolving health care environment in Korea.

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Current status of medical oncology in Japan and changes over the most recent 7-year period: results of a questionnaire sent to designated cancer care hospitals
Makoto Arai, Izumi Ohno, Koji Takahashi, Meng Meng Fan, Akinobu Tawada, Chikashi Ishioka, Yuichi Takiguchi
Japanese Journal of Clinical Oncology.2021; 51(11): 1622. CrossRef
Practice patterns of multidisciplinary team meetings in Korean cancer care and patient satisfaction with this approach
Chi Hoon Maeng, Hee Kyung Ahn, Sung Yong Oh, Seungtaek Lim, Bong-Seog Kim, Do Yeun Kim
The Korean Journal of Internal Medicine.2020; 35(1): 205. CrossRef
Surrogate decision making of chemotherapy consent: do we really provide informed consent of chemotherapy for patients?
Jung Hye Kwon, Sun Kyung Baek, Bong-Seog Kim, Su-Jin Koh, Hee Kyung Ahn, Joo Han Lim, Chiyeon Lim, Do Yeun Kim
The Korean Journal of Internal Medicine.2019; 34(3): 626. CrossRef

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A Korean Nationwide Survey for Breakthrough Cancer Pain in an Inpatient Setting: Sun Kyung Baek, Do Yeun Kim, Seok Yun Kang, Sun Jin Sym, Young Sung Kim, June Young Lee; Cancer Res Treat. 2016;48(2):768-774. Published online September 15, 2015; DOI: https://doi.org/10.4143/crt.2015.087

Abstract PDF PubReader ePub

Purpose
We evaluated the prevalence and characteristics of breakthrough cancer pain (BTcP) in Korean patients admitted with cancer pain.
Materials and Methods
In-hospital patients with cancer pain completed a questionnaire concerning severity of background cancer pain (BCP), prevalence and treatment for BTcP, sleep disorders, and satisfaction with cancer pain treatment. Medical records showing medications for BCP and BTcP were also evaluated.
Results
Total 609 patients with controlled BCP enrolled. Mean age of the patients was 59.5 years old, and 59% were male. Of all patients, 177 (29%) complained of BTcP. No clinical characteristic predicted BTcP. Of the 177 patients with BTcP, 56% did not receive treatment for BTcP. Patients with BTcP showed significant association with a sleep disorder and dissatisfaction with pain control, compared to those without BTcP (p < 0.0001 and p=0.0498, respectively). Oxycodone-immediate release was the most commonly used short-acting analgesic, followed by intravenous morphine.
Conclusion
The prevalence of BTcP was 29% in patients admitted with controlled BCP. Although the patients had well-controlled BCP, BTcP showed association with a lower quality of life in patients with cancer. More medical attention is needed for detection and management of BTcP.

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Breakthrough pain among cancer patients at oncology units in Northern Ethiopia; a multi-center study
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Predicting tolerability of high-dose fentanyl buccal tablets in cancer patients
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PLOS ONE.2023; 18(1): e0280212. CrossRef
Knowledge and practice of the management of breakthrough cancer pain among general practitioners providing palliative care in Shanghai, China: a cross-sectional survey
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Effect of a theory-driven educational intervention on the level of knowledge, attitudes, and assessment practices regarding breakthrough cancer pain (BTCP) management among medical nurses in Hong Kong
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Significance of descriptive symptoms and signs and clinical parameters as predictors of neuropathic cancer pain
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Interference with daily functioning by breakthrough pain in patients with cancer
Jung Hun Kang, Su-Jin Koh, So Yeon Oh, Rock Bum Kim, Seong Hoon Shin, Yun-Gyoo Lee, Bong-Seog Kim, Hun Mo Ryoo, So Young Yoon, Joung Soon Jang, Ho-Suk Oh, Young Jin Choi, Moon Hee Lee, Kyung-Hee Lee
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The Korean Journal of Internal Medicine.2018; 33(3): 577. CrossRef

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Case Report

Successful Treatment of Intractable Bleeding Caused by Radiation-Induced Hemorrhagic Gastritis Using Oral Prednisolone: A Case Report: Hyong Geun Yun, Hong Yong Kim, Do Yeun Kim, Yun Jeong Lim; Cancer Res Treat. 2015;47(2):334-338. Published online August 28, 2014; DOI: https://doi.org/10.4143/crt.2013.114

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Radiation-induced hemorrhagic gastritis is an intractable and dangerous condition. We describe a 59-year-old female patient with radiation-induced hemorrhagic gastritis. The patient underwent postoperative radiation therapy with a dose of 54 Gy in 30 fractions after a radical operation for a Klatskin tumor. Radiation volume included the gastric antrum. Approximately three months after radiation therapy, she was admitted for melena and anemia. Esophagogastroduodenoscopy showed an area of bleeding in the gastric antrum that was so diffuse that effective laser coagulation was not feasible. After failure of various treatments and transfusion of 7,040 mL of packed red blood cells, we successfully stopped the hemorrhage using oral prednisolone treatment. Based on this case, we think that oral prednisolone treatment can be tried as a first treatment for potentially life-threatening radiation-induced hemorrhagic gastritis.

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Clinical course and treatment of radiation-induced hemorrhagic gastritis: a case series study
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Growth hormone used to control intractable bleeding caused by radiation-induced gastritis
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Correspondence

Reply to Commentary on “A Nationwide Survey of Knowledge of and Compliance with Cancer Pain Management Guidelines by Korean Physicians”: Do Yeun Kim, Si-Young Kim; Cancer Res Treat. 2014;46(4):426-426. Published online July 31, 2014; DOI: https://doi.org/10.4143/crt.2014.123R

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Original Articles

A Nationwide Survey of Knowledge of and Compliance with Cancer Pain Management Guidelines by Korean Physicians: Do Yeun Kim, Jin Seok Ahn, Kyung Hee Lee, Young Chul Kim, Juneyoung Lee, Si-Young Kim; Cancer Res Treat. 2014;46(2):131-140. Published online April 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.2.131

Abstract PDF PubReader ePub

Purpose

Although cancer pain is prevalent, under-treatment still remains a problem. Knowledge of and compliance with guidelines for management of cancer pain were analyzed for exploration of physician-related barriers to cancer pain management. In addition, physicians' knowledge and its correlation with cancer pain control were audited.

Materials and Methods

From July 8 to December 2, 2010, a nationwide survey of house staff enquired about their knowledge of cancer pain control guidelines, and the medical records of patients under their care were analyzed.

Results

In total, 180 physicians participated in the study. Their average score for knowledge was 14.6 (range, 7 to 19; maximum possible, 20). When the knowledge score was divided into low, medium, and high scores, patients receiving care from physicians with high levels of knowledge tended to have better cancer pain control (p<0.001). Of the total patients with severe pain, 19.5% were not prescribed strong opioids, and 40% were not prescribed any medication for breakthrough pain.

Conclusion

Physicians' knowledge of guidelines for control of cancer pain showed an association with improvement of pain management. Overall adherence to the guidelines was lacking. Continuous interventions such as education and audits regarding cancer pain control guidelines for physician are needed.

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Michael A. Smith, Kyle C. Quirk, D'Anna C. Saul, Phillip E. Rodgers, Maria J. Silveira
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Physician’s Attitude toward Treating Breakthrough Cancer Pain in Korea
Min Seok Seo, Jae Yong Shim, Youn Seon Choi, Do Yeun Kim, In Gyu Hwang, Sun Kyung Baek, Jin Young Shin, Juneyoung Lee, Chang Geol Lee
The Korean Journal of Hospice and Palliative Care.2017; 20(1): 18. CrossRef
Commentary on “A Nationwide Survey of Knowledge of and Compliance with Cancer Pain Management Guidelines by Korean Physicians”
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Cancer Research and Treatment.2014; 46(4): 425. CrossRef

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Evaluation of Prescribing Medications for Terminal Cancer Patients near Death: Essential or Futile: Hye Ran Lee, Seong Yoon Yi, Do Yeun Kim; Cancer Res Treat. 2013;45(3):220-225. Published online September 30, 2013; DOI: https://doi.org/10.4143/crt.2013.45.3.220

Abstract PDF PubReader ePub

PURPOSE
The purpose of this study is to evaluate the prescription of essential or futile medications for terminal cancer patients during their final admission.
MATERIALS AND METHODS
We conducted a retrospective review of the medical charts of terminally ill cancer patients admitted to the Hemato-oncology Department of two teaching hospitals from March 1, 2007 to December 31, 2009. Essential medications were based on the drugs listed by the International Association for Hospice and Palliative Care, while futile medications were defined when short-term benefit to patients with respect to survival, quality of life, or symptom control was not anticipated.
RESULTS
A total of 196 patients were included. Among essential medications, strong opioids were the most frequently prescribed drugs during the last admission (62.2% fentanyl, 44.3% morphine), followed by megestrol (46.0%), and metoclopramide (37.2%); 51% of gastric protectors were prescribed with potential futility. Anti-hypertensive and antiglycemic agents were administered to those who experienced arterial blood pressure below 90 mm Hg (47.3%) or presented with a single measurement of fasting glucose below 50 mg/dL (10.7%), respectively. Statins were prescribed to 6.1% (12/196) of patients, and 75% of those prescriptions were regarded as futile.
CONCLUSION
Our data suggest that effective prescription of essential medications and withdrawal from futile medications should be actively reconciled for improvement of a patient's end-of-life care.

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Case Report

A Case of Gemcitabine and Cisplatin Associated Posterior Reversible Encephalopathy Syndrome: Eun Jin Kwon, Se Won Kim, Kwang Ki Kim, Hyung Suk Seo, Do Yeun Kim; Cancer Res Treat. 2009;41(1):53-55. Published online March 31, 2009; DOI: https://doi.org/10.4143/crt.2009.41.1.53

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A 58-year-old female receiving gemcitabine and cisplatin chemotherapy for stage IV gallbladder cancer developed the clinicoradiologic syndrome, posterior reversible encephalopathy syndrome (PRES). Just before the 4th gemcitabine chemotherapy cycle, she was admitted to the hospital with complaints of headache, dizziness, and generalized tonic-clonic seizures. A MRI was performed on the day when the seizure developed, and the findings showed patchy cortical and subcortical T2 hyperintensity without enhancement that involved both occipital and parietal lobes. Phenytoin loading and maintenance was started for prevention of recurrent seizures, which was successful. The follow-up brain MRI obtained 10 days after the seizure attack showed completely resolved radiologic findings. After the MRI findings revealed complete resolution, phenytoin maintenance was stopped. Even with discontinuation of phenytoin, she had no seizures or other clinical manifestations.

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Original Articles

Discrepant Views of Korean Medical Oncologists and Cancer Patients on Complementary and Alternative Medicine: Do Yeun Kim, Bong-Seog Kim, Kyung Hee Lee, Myung Ah Lee, Young Seon Hong, Sang Won Shin, Soon Nam Lee; Cancer Res Treat. 2008;40(2):87-92. Published online June 30, 2008; DOI: https://doi.org/10.4143/crt.2008.40.2.87

Abstract PDF PubReader ePub

Purpose

This study was designed to evaluate the communication gap between Korean medical oncologists and cancer patients on complementary and alternative medicine (CAM).

Materials and Methods

Cross sectional studies utilized the responses of 59 medical oncologists and 211 patients. To understand the communication gap, perceived reasons and nondisclosure of CAM use, reactions of physicians to disclosure, and expectations for CAM were analyzed. Data were compared with use of the chi-squared test.

Results

Both medical oncologists and patients were in accord that CAM use would privde the patients with a feeling of hope. The medical oncologists believed more often than patients to attribute CAM use for control over medical care decisions, for the treatment of an incurable disease or as a nontoxic approach (p<0.05). Regarding reasons for nondisclosure, medical oncologists were more likely to think that physicians would not understand the use of CAM, discontinue treatment or disapprove of the use of CAM (p<0.0001). Patients attributed nondisclosure mainly to the lack of questioning about CAM. Medical oncologists were more likely to warn of the risks with CAM use and less likely to encourage the use of CAM than perceived by patients (p=0.01). Patients expected that CAM could cure disease, extend survival, relieve symptoms and improve the immune system or quality of life more often than medical oncologists (p<0.05).

Conclusion

Given the discrepant views of medical oncologists and patients on the use of CAM, medical oncologists should be aware of the discrepancies and attempt to resolve any differences.

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Information and Training Needs Regarding Complementary and Alternative Medicine: A Cross-sectional Study of Cancer Care Providers in Germany
Gudrun E. Klein, Corina Guethlin
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China’s cancer patients’ perceptions, attitudes and participation in clinical trials of complementary and alternative medicine: A multi-center cross-sectional study
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National survey of China's oncologists' knowledge, attitudes, and clinical practice patterns on complementary and alternative medicine
Geliang Yang, Richard Lee, Huiqing Zhang, Wei Gu, Peiying Yang, Changquan Ling
Oncotarget.2017; 8(8): 13440. CrossRef
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Sang Hyuck Kim, Dong Wook Shin, You-Seon Nam, So Young Kim, Hyung-kook Yang, Be Long Cho, Keeho Park, Heui-Sug Jo, Chang-Yeol Yim, Sin Kam, Jong-Hyock Park
Complementary Therapies in Medicine.2016; 28: 29. CrossRef
Survey of Policies and Guidelines on Antioxidant Use for Cancer Prevention, Treatment, and Survivorship in North American Cancer Centers
Gyeongyeon Hong, Jennifer White, Lihong Zhong, Linda E. Carlson
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National Survey of US Oncologists' Knowledge, Attitudes, and Practice Patterns Regarding Herb and Supplement Use by Patients With Cancer
Richard T. Lee, Andrea Barbo, Gabriel Lopez, Amal Melhem-Bertrandt, Heather Lin, Olufunmilayo I. Olopade, Farr A. Curlin
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Amal Al-Omari, Mohammad Al-Qudimat, Amid Abu Hmaidan, Luna Zaru
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Investigation into the Use of Complementary and Alternative Medicine and Factors Affecting Use in Korean Patients with Brain Tumors
Yong Soon Shin, Jeong A Lee, So Hyun Bae, Su Youn Lee, Min Kyeong Jang
Journal of Korean Academy of Fundamentals of Nursing.2013; 20(2): 147. CrossRef
Complementary and alternative medicine use and assessment of quality of life in Korean breast cancer patients: a descriptive study
Eunyoung Kang, Eun Joo Yang, Sun-Mi Kim, Il Yong Chung, Sang Ah Han, Do-Hoon Ku, Soek-Jin Nam, Jung-Hyun Yang, Sung-Won Kim
Supportive Care in Cancer.2012; 20(3): 461. CrossRef
Validation of the Korean Integrative Medicine Attitude Questionnaire (IMAQ)
Jung-Ha Kim, Jung-Bok Lee, Duk-Chul Lee
Korean Journal of Family Medicine.2011; 32(3): 197. CrossRef

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An Evaluation of Nutrition Support for Terminal Cancer Patients at Teaching Hospitals in Korea: Do Yeun Kim, Sang Min Lee, Kyoung Eun Lee, Hye Ran Lee, Jee Hyun Kim, Keun-Wook Lee, Jong Seok Lee, Soon Nam Lee; Cancer Res Treat. 2006;38(4):214-217. Published online December 31, 2006; DOI: https://doi.org/10.4143/crt.2006.38.4.214

Abstract PDF PubReader ePub

Purpose

We wanted to analyze the use of nutrition support for terminal cancer patients, the effect of discussing withdrawal of nutrition support and do-not-resuscitate (DNR) consent on the use of intravenous nutrition during the patient's last week of life and at the time of death.

Materials and Methods

The study involved 362 patients with terminal cancer from four teaching hospitals, and they all died between January 1 2003 and December 31 2005. The basic demographic data, the use of intravenous nutrition during the patient's last week of life and at death, discussion of terminal nutrition withdrawal and DNR consent were evaluated.

Results

In the week before death, the patients received artificial nutrition such as total parenteral nutrition (31%), intravenous albumin infusion (25%), and feeding tube placements (9%). A discussion concerning withdrawal of nutrition support was limited to 25 (7%) patients. DNR consent was obtained from 294 (81%) patients. None of the patients were directly involved in any of these decisions. The discussion about withdrawal of terminal nutrition and DNR consent with the patient's surrogates did not have any effect on reducing the use of parenteral nutrition.

Conclusion

The majority of patients dying of terminal cancer were still given potentially futile nutritional support. Modern clinical guidelines and ethical education about nutritional support at the end of life care is urgently needed in Korean medical practice to provide proper administration of terminal nutrition for end of life care.

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Libby Sallnow, Richard Smith, Sam H Ahmedzai, Afsan Bhadelia, Charlotte Chamberlain, Yali Cong, Brett Doble, Luckson Dullie, Robin Durie, Eric A Finkelstein, Sam Guglani, Melanie Hodson, Bettina S Husebø, Allan Kellehear, Celia Kitzinger, Felicia Marie Kn
The Lancet.2022; 399(10327): 837. CrossRef
A National Study of Life-Sustaining Treatments in South Korea: What Factors Affect Decision-Making?
So-Youn Park, Bomyee Lee, Jeong Yeon Seon, In-Hwan Oh
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The Trend of Aggressive Treatments in End-of-Life Care for Older People With Dementia After a Policy Change in Taiwan
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Implication of the Life-Sustaining Treatment Decisions Act on End-of-Life Care for Korean Terminal Patients
Jung Sun Kim, Shin Hye Yoo, Wonho Choi, Yejin Kim, Jinui Hong, Min Sun Kim, Hye Yoon Park, Bhumsuk Keam, Dae Seog Heo
Cancer Research and Treatment.2020; 52(3): 917. CrossRef
Nutrition Intervention through Interdisciplinary Medical Treatment in Hospice Patients: From Admission to Death
Hyelim Kang, Yu Jin Yang, Juyeon Park, Gyu Jin Heo, Jeong-Im Hong, Hye-Jin Kim
Clinical Nutrition Research.2018; 7(2): 146. CrossRef
Evidence for overuse of medical services around the world
Shannon Brownlee, Kalipso Chalkidou, Jenny Doust, Adam G Elshaug, Paul Glasziou, Iona Heath, Somil Nagpal, Vikas Saini, Divya Srivastava, Kelsey Chalmers, Deborah Korenstein
The Lancet.2017; 390(10090): 156. CrossRef
A Randomized Phase II Study To Assess the Effectiveness of Fluid Therapy or Intensive Nutritional Support on Survival in Patients with Advanced Cancer Who Cannot be Nourished via Enteral Route
So Yeon Oh, Hyun Jung Jun, Sung Jae Park, In Ki Park, Ga Jin Lim, Yeonsil Yu, Sung-Ja Cho, Aeran Song
Journal of Palliative Medicine.2014; 17(11): 1266. CrossRef
Evaluation of parenteral nutritional support in the surgical and medical wards of a referral teaching hospital
Samaneh Bairami, Sepideh Elyasi, Hossein Khalili, Saeed Reza Jamali-Moghadam
DARU Journal of Pharmaceutical Sciences.2012;[Epub] CrossRef
Awareness and Attitude Change after End-of-Life Care Education for Medical Students
Hyun Kyung Kim, Eunmi Nam, Kyoung Eun Lee, Soon Nam Lee
The Korean Journal of Hospice and Palliative Care.2012; 15(1): 30. CrossRef
Charactersitics and issues of guideline to withdrawal of a life-sustaining therapy
Younsuck Koh, Dae-Seog Heo, Young Ho Yun, Jeong-Lim Moon, Hyoung Wook Park, Ji Tae Choung, Hyo Sung Jung, Bark Jang Byun, Yoon-Seong Lee
Journal of the Korean Medical Association.2011; 54(7): 747. CrossRef
Nasogastric feeding at the end of life: A virtue ethics approach
Lalit Krishna
Nursing Ethics.2011; 18(4): 485. CrossRef
Chinese Familial Tradition and Western Influence: A Case Study in Singapore on Decision Making at the End of Life
Zheng Jie Marc Ho, Lalit Kumar Radha Krishna, Chung Pheng Alethea Yee
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The Prognostic Significance of the Overexpression of HER-2/ neu in Korean Gastric Carcinomas and the In Vitro Effects of Anti-HER-2/neu Antibody on Cell Growth in the Gastric Carcinoma Cell Lines: Seock Ah Im, Kyung Eun Lee, Eunmi Nam, Seung Hyun Nam, Do Yeun Kim, Chu Myong Seong, Hae Young Park, Woon Sup Han, Ju Young Seoh, Soon Nam Lee; Cancer Res Treat. 2003;35(2):109-116. Published online April 30, 2003; DOI: https://doi.org/10.4143/crt.2003.35.2.109

Abstract PDF

PURPOSE
The HER2 gene encodes a 185-kd transmembrane glycoprotein receptor (p185(HER2)) that has partial homology with the epidermal growth factor receptor (EGFR) and shares intrinsic tyrosine kinase activity. The HER2 gene has been found to be amplified in various human cancers and to be associated with poor prognosis. The authors investigated the correlation between clinicopathologic factors and the overexpression of the p185(HER2) in Korean gastric adenocarcinoma patients, and determined whether the antiproliferative effects of anti- p185(HER2) antibody can also be observed on gastric cancer cell lines that overexpress this growth factor receptor. MATERIALS AND METHODS: We evaluated the relationship between p185(HER2) overexpression and clinicopathological features in 94 (M: F=52: 42) gastric adenocarcinoma patients (median age 59 years). Protein expression was analysed by immunohistochemical staining in paraffin embedded tissues with monoclonal antibody for p185(HER2). To explore the role of humanized anti-p185(HER2) monoclonal antibody trastuzumab (Herceptin ) in vitro, the growth curve of Korean gastric cancer cells that overexpress the p185(HER2) protein was studied and a cell cycle analysis was performed. RESULTS: p185(HER2) overexpression correlates positively with lymph node metastasis (p=0.002), distant metastasis (p=0.01), AJCC classification (p=0.01), higher relapse rate p=0.001), and a tendential association with the pT stage (p=0.054). p185(HER2) overexpression was found to be more frequent in advanced gastric cancer than early gastric cancer (54.1% vs 24.2%, p=0.008). Patients with overexpression of p185(HER2) were found to have significantly lower relapse-free (p=0.003) and overall survival (p= 0.0004) than patients without overexpression. Among several Korean gastric cancer cell lines, SNU-1, SNU-5, and SNU-620 overexpress p185(HER2). Trastuzumab inhibited the proliferation of p185(HER2) overexpressed Korean gastric cancer cell line by 21% with down-regulation of p185(HER2) protein expression. DNA fluorescence flow cytometry of propidium iodide-stained nuclei showed a reduction in the fraction of the S phase following treatment with trastuzumab. CONCLUSIONS: Taken together, our observations suggest the potential prognostic significance of p185(HER2) overexpression in Korean gastric adenocarcinoma patients and point to the need for further research on this mechanism. This suggests the possible use of p185(HER2) as a therapeutic target in gastric cancer.

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A case of pathological complete regression in combined modality treatment of resectable Her2/neu-positive gastric cancer
A. V. Avgustinovich, S. G. Afanasyev, L. V. Spirina, E. V. Kaygorodova, R. V. Ermolenko, E. N. Samtsov, I. G. Frolova, O. V. Cheremisina
Siberian journal of oncology.2024; 23(1): 170. CrossRef
The Chinese Society of Clinical Oncology (CSCO): clinical guidelines for the diagnosis and treatment of gastric cancer
Feng‐Hua Wang, Lin Shen, Jin Li, Zhi‐Wei Zhou, Han Liang, Xiao‐Tian Zhang, Lei Tang, Yan Xin, Jing Jin, Yu‐Jing Zhang, Xiang‐Lin Yuan, Tian‐Shu Liu, Guo‐Xin Li, Qi Wu, Hui‐Mian Xu, Jia‐Fu Ji, Yuan‐Fang Li, Xin Wang, Shan Yu, Hao Liu, Wen‐Long Guan, Rui‐Hu
Cancer Communications.2019; 39(1): 1. CrossRef
The neutrophil-to-lymphocyte ratio prechemotherapy and postchemotherapy as a prognostic marker in metastatic gastric cancer
Hyunho Kim, Sang Mi Ro, Ji Hyun Yang, Joon Won Jeong, Ji Eun Lee, Sang Young Roh, In-Ho Kim
The Korean Journal of Internal Medicine.2018; 33(5): 990. CrossRef
Potential Prognostic Significance of p185HER2 Overexpression with Loss of PTEN Expression in Gastric Carcinomas
Seock-Ah lm, Kyung Eun Lee, Eunmi Nam, Do Yeun Kim, Joo-Ho Lee, Ho-Seong Han, Ju-Young Seoh, Hae-Young Park, Min-Sun Cho, Woon Sup Han, Soon Nam Lee
Tumori Journal.2005; 91(6): 513. CrossRef

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Efficacy of Low-dose Paclitaxel and Cisplatin in Patients with Advanced Non-Small Cell Lung Cancer: Byung Su Kim, Do Youn Oh, Yo Han Joh, Do Yeun Kim, Jee Hyun Kim, Se Hoon Lee, Dae Ho Lee, Tae You Kim, Dae Seog Heo, Yung Jue Bang, Noe Kyeong Kim; Cancer Res Treat. 2001;33(6):469-473. Published online December 31, 2001; DOI: https://doi.org/10.4143/crt.2001.33.6.469

Abstract PDF

PURPOSE
To evaluate the efficacy and toxicity of combination chemotherapy with low-dose paclitaxel and cisplatin in patients with advanced non-small cell lung cancer.
MATERIALS AND METHODS
Chemotherapy-naive patients with unresectable, pathologically proven non-small cell lung cancer were eligible for inclusion in the study. Patients received paclitaxel (145 mg/m2 iv 3 hour D1) and cisplatin (60 mg/m2 iv D1) every 3 weeks.
RESULTS
Forty-two patients were enrolled between February 2000 and February 2001. The median age was 53.5 years. Patients with adenocarcinoma numbered 29, squamous cell carcinoma 7, large cell carcinoma 3, and undifferentiated carcinoma 3. Seventeen patients had stage IIIB, 19 had stage IV disease and the remaining 6 displayed recurred disease after previous surgical resection. Four patients terminated treatment early because of hypersensitivity (1) and severe emesis (3). Of the 38 evaluable patients, 14 had PR and the response rate was 36.8%. Among partial responders, 6 patients received additional chest radiation. The median duration of response was 47.9 weeks and the median overall survival was 54.0 weeks. Of the total 176 courses, 14 were delayed, 22 required dose reduction, and grade 3~4 neutropenia occurred in 5.6% of courses. Only one episode of neutropenic fever developed and there were no treatment- related mortalities. Other toxicities were generally mild.
CONCLUSION
The combination chemotherapy with low-dose paclitaxel and cisplatin was effective and tolerable in patients with advanced non-small cell lung cancer.

Citations

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Phase II Study of Low-dose Paclitaxel and Cisplatin as a Second-line Therapy after 5-Fluorouracil/Platinum Chemotherapy in Gastric Cancer
Keun-Wook Lee, Jee Hyun Kim, Tak Yun, Eun Kee Song, Im il Na, Hyunchoon Shin, So Yeon Oh, In Sil Choi, Do-Youn Oh, Dong-Wan Kim, Seock-Ah Im, Tae-You Kim, Jong Seok Lee, Dae Seog Heo, Yung-Jue Bang, Noe Kyeong Kim
Journal of Korean Medical Science.2007; 22(Suppl): S115. CrossRef
Phase II Trial of Low-dose Paclitaxel and Cisplatin in Patients with Advanced Gastric Cancer
Keun-Wook Lee, Seock-Ah Im, Tak Yun, Eun Kee Song, Im il Na, Hyunchoon Shin, In Sil Choi, Do-Youn Oh, Jee Hyun Kim, Dong-Wan Kim, Tae-You Kim, Jong Seok Lee, Dae Seog Heo, Yung-Jue Bang, Noe Kyeong Kim
Japanese Journal of Clinical Oncology.2005; 35(12): 720. CrossRef

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Phase II Trial of Vinorelbine and Cisplatin Chemotherapy in Advanced Non-Small Cell Lung Cancer: Yo Han Joh, Tae You Kim, Im Il Na, Do Youn Oh, Byung Su Kim, Jee Hyun Kim, Do Yeun Kim, Se Hoon Lee, Chul Gyu Yoo, Choon Taek Lee, Young Whan Kim, Dae Seog Heo, Yung Jue Bang, Sung Koo Han, Young Soo Shim, Noe Kyeong Kim; Cancer Res Treat. 2001;33(5):373-376. Published online October 31, 2001; DOI: https://doi.org/10.4143/crt.2001.33.5.373

Abstract PDF

PURPOSE
Platinum-based chemotherapy has conferred a modest but significant survival benefit and the introduction of newer drugs has led to achieve higher response rate in patients with advanced non-small cell lung cancer (NSCLC). We performed a phase II trial in order to evaluate the efficacy and toxicity of combination chemotherapy with vinorelbine (Navelbine) and cisplatin in advanced NSCLC.
MATERIALS AND METHODS
Patients with previously untreated, unresectable stage IIIB or IV NSCLC with measurable lesion (s) were eligible for entry into the study. NP chemotherapy consisted of intravenous vinorelbine 25 mg/m2, on day 1 and 8, and intravenous cisplatin 80 mg/m2 on day 1; this cycle was repeated every three weeks.
RESULTS
A total of 33 patients were enrolled in the study between July 1999 and Feb 2000. Of the 30 patients deemed eligible for analysis, thirteen patients achieved a partial response and thirteen showed a stable disease. The overall response rate was 43.3%. The median duration of response was 5.7 months (95% CI: 2.8~8.5 months). The median time to progression was 7.6 months (95% CI: 5.5~9.7 months) and the overall median survival time was 15.1 months (95% CI: 9.8~20.4 months) in the intent-to-treat analysis. Chemotherapy-related grade 3 or 4 toxicities were anemia in 1.5%, leukopenia in 4.5%, nausea/vomiting in 2.3%, alopecia in 13.3%, and neurotoxicity in 3.3%.
CONCLUSION
The combination of vinorelbine and cisplatin chemotherapy seems to be active and fairly tolerable in patients with advanced NSCLC.

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Clinical research on the efficacy of self-made sichongsan in combination with gefitinib on NSCLC patients with EGFR mutation
Yibo Zhao, Yu Dong, Shu Xing, Xueqi Fu
European Journal of Inflammation.2018;[Epub] CrossRef

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Discrepancies of the Values on the Withholding Futile Interventions between Physician and Family Members of Terminal Cancer Patients: Do Youn Oh, Mi Ra Kim, In Sil Choi, Yo Han Joh, Byung Su Kim, Do Yeun Kim, Jee Hyun Kim, Se Hoon Lee, Tae You Kim, Dae Seog Heo, Yung Jue Bang, Noe Kyeong Kim; Cancer Res Treat. 2001;33(4):350-356. Published online August 31, 2001; DOI: https://doi.org/10.4143/crt.2001.33.4.350

Abstract PDF: PURPOSE
To analyze the controversies surrounding therapeutic decision-making and the withholding of life- sustaining treatments, values held concerning therapeutic interventions of terminal cancer patients are compared between physicians and family members.
MATERIALS AND METHODS
42 advanced or terminal stage cancer patients were enrolled for the study. The questionnaires were administered to the duty doctor and the family of the patients. Questions included whether to use new agents with a 15% partial efficacy and whether to use opioid analgesics, intravenous nutrition, a feeding tube, antibiotics, and hemodialysis. Additionally, we asked about the administration of CPR, ventilator application, and euthanasia. If the family permitted, the same questionnaires were given to the patients.
RESULTS
Of the 42 cases, 5 families refused to answer the questionnaire. Of the available 37 families, only 5 families permitted access to the patients. Of the 5 patients, 2 patients refused the questionnaire. Only 67.6% and 8.1% of families and the patients clearly understood the stage of cancer. The use of a new agent was accepted by 45.2% of the physicians and 45.9% of the families. The rankings of the acceptance of treatment in the physicians and in the families were similar. The concordance rate between the physicians and the families was lowest on ventilator application and CPR. 31% of the physicians and 43.2% of the families agreed on the issue of euthanasia.
CONCLUSION
Values held on issues like therapeutic decision-making and the withholding of life-sustaining treatments in terminal cancer patients are discordant between physicians and family members. In order to resolve controversies on the role of physicians in end-of-life decisions, the values of physicians as well as patients and their family members should be considered in the final decision-making process.

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Clinical Features and Prognosis of Lung Cancer with Brain Metastasis: Kyung Eun Lee, Eun Mi Nam, He Jin Lee, Seung Hyun Nam, Do Yeun Kim, Seock Ah Im, Chu Myung Seong, Soon Nam Lee, Kyung Ja Lee; Cancer Res Treat. 2001;33(3):250-255. Published online June 30, 2001; DOI: https://doi.org/10.4143/crt.2001.33.3.250

Abstract PDF

PURPOSE
Brain metastasis is estimated to occur in 20~40% of solid tumor patients and the most common primary tumor is lung cancer. Even though the prognosis of brain metastasis is grave and the 1-year survival rate is only 15%, symptom palliations are made with whole brain radiation therapy. We retrospectively evaluated the clinical features and prognostic factors of lung cancer with brain metastasis.
MATERIALS AND METHODS
From January 1987 to October 1999, 50 lung cancer patients with brain metastasis underwent whole brain radiation therapy. We reviewed the improvement in neurologic symptoms and survival according to the following parameters; performance status, histological type, presence of brain metastasis at the initial diagnosis of lung cancer, presence of extracranial metastasis, multiplicity of brain lesion, presence of primary lung symptom and treatment modalities.
RESULTS
The most frequent symptom with brain metastasis was a headache (50%). Palliation of the headache and other symptoms was achieved in 81% of the patients. Median overall survival after brain metastasis was 21 weeks and the 1 year survival rate was 15%. Patients without extracranial metastasis had a longer median survival than those with, 38 weeks versus 15 weeks, respectively (p=0.01).
CONCLUSION
In lung cancer with brain metastasis, neurologic symptoms can be palliated with whole brain radiation therapy, and in this study among such patients, absence of extracranial metastasis can be a good prognostic factor.

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Combination of EGFR-Directed Tyrosine Kinase Inhibitors (EGFR-TKI) with Radiotherapy in Brain Metastases from Non-Small Cell Lung Cancer: A 2010–2019 Retrospective Cohort Study
Vineeth Tatineni, Patrick J. O’Shea, Shreya Saxena, Atulya A. Khosla, Ahmad Ozair, Rupesh R. Kotecha, Xuefei Jia, Yasmeen Rauf, Erin S. Murphy, Samuel T. Chao, John H. Suh, David M. Peereboom, Manmeet S. Ahluwalia
Cancers.2023; 15(11): 3015. CrossRef

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