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Breast cancer
Impacts of Subtype on Clinical Feature and Outcome of Male Breast Cancer: Multicenter Study in Korea (KCSG BR16-09)
Jieun Lee, Keun Seok Lee, Sung Hoon Sim, Heejung Chae, Joohyuk Sohn, Gun Min Kim, Kyung-Hee Lee, Su Hwan Kang, Kyung Hae Jung, Jae-ho Jeong, Jae Ho Byun, Su-Jin Koh, Kyoung Eun Lee, Seungtaek Lim, Hee Jun Kim, Hye Sung Won, Hyung Soon Park, Guk Jin Lee, Soojung Hong, Sun Kyung Baek, Soon Il Lee, Moon Young Choi, In Sook Woo
Cancer Res Treat. 2023;55(1):123-135.   Published online March 24, 2022
DOI: https://doi.org/10.4143/crt.2021.1561
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The treatment of male breast cancer (MBC) has been extrapolated from female breast cancer (FBC) because of its rarity despite their different clinicopathologic characteristics. We aimed to investigate the distribution of intrinsic subtypes based on immunohistochemistry, their clinical impact, and treatment pattern in clinical practice through a multicenter study in Korea.
Materials and Methods
We retrospectively analyzed clinical data of 248 MBC patients from 18 institutions across the country from January 1995 to July 2016.
Results
The median age of MBC patients was 63 years (range, 25 to 102 years). Among 148 intrinsic subtype classified patients, 61 (41.2%), 44 (29.7%), 29 (19.5%), and 14 (9.5%) were luminal A, luminal B, human epidermal growth factor receptor 2, and triple-negative breast cancer, respectively. Luminal A subtype showed trends for superior survival compared to other subtypes. Most hormone receptor-positive patients (166 patients, 82.6%) received adjuvant endocrine treatment. Five-year completion of adjuvant endocrine treatment was associated with superior disease-free survival (DFS) in patients classified with an intrinsic subtype (hazard ratio [HR], 0.15; 95% confidence interval [CI], 0.04 to 0.49; p=0.002) and in all patients (HR, 0.16; 95% CI, 0.05 to 0.54; p=0.003).
Conclusion
Distribution of subtypes of MBC was similar to FBC and luminal type A was most common. Overall survival tended to be improved for luminal A subtype, although there was no statistical significance. Completion of adjuvant endocrine treatment was associated with prolonged DFS in intrinsic subtype classified patients. MBC patients tended to receive less treatment. MBC patients should receive standard treatment according to guidelines as FBC patients.

Citations

Citations to this article as recorded by  
  • HER2 expression and pathway status in male breast cancer patients: results of an integrated analysis among 6,150 patients
    Boqiang Lyu, Shidi Zhao, Hui Wang, Shouping Gong, Biyuan Wang
    Scientific Reports.2025;[Epub]     CrossRef
  • Clinicopathologic Features and Prognoses of Male Patients With Breast Cancer
    Meiling Huang, Jingjing Xiao, Changjiao Yan, Rui Ling, Ting Wang
    American Journal of Men's Health.2024;[Epub]     CrossRef
  • 5,844 View
  • 181 Download
  • 3 Web of Science
  • 2 Crossref
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Real-World Clinical Data of Palbociclib in Asian Metastatic Breast Cancer Patients: Experiences from Eight Institutions
Jieun Lee, Hyung Soon Park, Hye Sung Won, Ji Hyun Yang, Hee Yeon Lee, In Sook Woo, Kabsoo Shin, Ji Hyung Hong, Young Joon Yang, Sang Hoon Chun, Jae Ho Byun
Cancer Res Treat. 2021;53(2):409-423.   Published online October 28, 2020
DOI: https://doi.org/10.4143/crt.2020.451
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Use of cyclin-dependent kinase 4/6 inhibitors improved survival outcome of hormone receptor (HR) positive metastatic breast cancer (MBC) patients, including Asian population. However, Asian real-world data of palbociclib is limited. We analyzed the real-world clinical practice patterns and outcome in HR-positive, MBC Asian patients treated with palbociclib.
Materials and Methods
Between April 2017 to November 2019, 169 HR-positive, human epidermal growth factor-2–negative MBC patients treated with letrozole or fulvestrant plus palbocilib were enrolled from eight institutions. Survival outcome (progression-free survival [PFS]), treatment response and toxicity profiles were analyzed.
Results
Median age of letrozole plus palbociclib (145 patients, 85.8%) and fulvestrant plus palbociclib (24 patients, 14.2%) was 58 and 53.5 years, with median follow-up duration of 14.63 months (range 0.2 to 33.9 months). Median PFS (mPFS) of letrozole plus palbociclib and fulvestrant plus palbociclib was 25.6 (95% confidence interval [CI], 19.1 to not reached) and 6.37 months (95% CI, 5.33 to not reached), comparable to previous phase 3 trials. In letrozole plus palbociclib arm, luminal A (hazard ratio, 2.86; 95% CI, 1.20 to 6.80; p=0.017) and patients with good performance (Eastern Cooperative Oncology Group 0-1 [hazard ratio, 3.68; 95% CI, 1.70 to 7.96]) showed better mPFS. In fulvestrant plus palbociclib group, chemotherapy naïve patients showed better mPFS (hazard ratio, 12.51, 95% CI, 1.59 to 99.17; p=0.017). The most common grade 3 or 4 adverse event was neutropenia (letrozole 86.3%, fulvestrant 88.3%).
Conclusion
To our knowledge, this is the first real-world data of palbociclib reported in Asia. Palbociclib showed comparable benefit to previous phase 3 trials in Asian patients during daily clinical practice.

Citations

Citations to this article as recorded by  
  • Efficacy and Safety of Cyclin-Dependent Kinase 4/6 Inhibitors in Patients with Breast Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials and Real-World Studies
    Hui-Chen Su, Ho-Wei Lin, Ka-Wai Tam
    Targeted Oncology.2025; 20(1): 71.     CrossRef
  • Palbociclib in Older Patients with Advanced/Metastatic Breast Cancer: A Systematic Review
    Etienne Brain, Connie Chen, Sofia Simon, Vinay Pasupuleti, Kathleen Vieira Pfitzer, Karen A. Gelmon
    Targeted Oncology.2024; 19(3): 303.     CrossRef
  • Real-world progression-free survival and overall survival of palbociclib plus endocrine therapy (ET) in Japanese patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer in the first-line or second-l
    Tetsuhiro Yoshinami, Shigenori E. Nagai, Masaya Hattori, Takuho Okamura, Kenichi Watanabe, Takahiro Nakayama, Hiroko Masuda, Michiko Tsuneizumi, Daisuke Takabatake, Michiko Harao, Hiroshi Yoshino, Natsuko Mori, Hiroyuki Yasojima, Chiya Oshiro, Madoka Iwas
    Breast Cancer.2024; 31(4): 621.     CrossRef
  • The Effect of C-Reactive Protein/Lymphocyte Ratio (CLR) on PFS in Metastatic Breast Cancer Patients Treated with CDK4/6 Inhibitors: A Novel Biomarker
    Mehmet Buyukbayram, Zekeriya Hannarici, Yakup Duzkopru, Aykut Turhan, Alperen Caglar, Pınar Coban Esdur, Mehmet Bilici, Salim Tekin, Doğan Yazılıtaş
    Breast Cancer: Targets and Therapy.2024; Volume 16: 329.     CrossRef
  • The treatment pattern of advanced HR-positive and HER2-negative breast cancer in central southern China: a hospital-based cross-sectional study
    Zhe-Yu Hu, Binliang Liu, Ning Xie, Xiaohong Yang, Liping Liu, Huawu Xiao, Jing Li, Hui Wu, Jianxiang Gao, Jun Lu, Xuming Hu, Min Cao, Zhengrong Shui, Can Tian, Quchang Ouyang
    BMC Cancer.2024;[Epub]     CrossRef
  • Palbociclib in HR-Positive, HER2-Negative Advanced/Metastatic Breast Cancer: A Systematic Scoping Review of Real-World Evidence from Countries Outside of Western Regions that Are Underrepresented in Clinical Trials
    Amit Rauthan, Ankita Jain, Manmohan Singh, Mehmet A. N. Sendur
    Oncology and Therapy.2024; 12(3): 395.     CrossRef
  • Real-world comparison of palbociclib, abemaciclib, and dalpiciclib as first-line treatments for Chinese HR+/HER2−metastatic breast cancer patients: a multicenter study (YOUNGBC-28)
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    Therapeutic Advances in Medical Oncology.2024;[Epub]     CrossRef
  • Palbociclib plus endocrine therapy in hormone receptor-positive and HER2 negative metastatic breast cancer: a multicenter real-world study in the northwest of China
    Jiao Yang, Bing Zhao, Xiaoling Ling, Donghui Li, Jiuda Zhao, Yonggang Lv, Guangxi Wang, Xinlan Liu, Nanlin Li, Jin Yang
    BMC Cancer.2023;[Epub]     CrossRef
  • A real-world study of the first use of palbociclib for the treatment of advanced breast cancer within the UK National Health Service as part of the novel Ibrance® Patient Program
    Carlo Palmieri, Alison Musson, Catherine Harper-Wynne, Duncan Wheatley, Gianfilippo Bertelli, Iain R. Macpherson, Mark Nathan, Ellie McDowall, Ajay Bhojwani, Mark Verrill, Joe Eva, Colm Doody, Ruhe Chowdhury
    British Journal of Cancer.2023; 129(5): 852.     CrossRef
  • Real-world effectiveness of palbociclib plus fulvestrant in advanced breast cancer: Results from a population-based cohort study
    Fábio Cardoso Borges, Filipa Alves da Costa, Adriana Ramos, Catarina Ramos, Catarina Bernardo, Cláudia Brito, Alexandra Mayer-da-Silva, Cláudia Furtado, Arlindo R. Ferreira, Diogo Martins-Branco, Ana Miranda, António Lourenço
    The Breast.2022; 62: 135.     CrossRef
  • The Impact of Real-World Alternative Dosing Strategies of Palbociclib on Progression-Free Survival in Patients with Metastatic Breast Cancer
    Fulbert Fu, Jessica Kano, Julia Ma, Mera Guindy
    Current Oncology.2022; 29(3): 1761.     CrossRef
  • Treatment patterns, effectiveness, and patient‐reported outcomes of palbociclib therapy in Chinese patients with advanced breast cancer: A multicenter ambispective real‐world study
    Lesang Shen, Jun Zhou, Yiding Chen, Jinhua Ding, Haiyan Wei, Jian Liu, Wenjie Xia, Bojian Xie, Xiaohong Xie, Xujun Li, Yuechu Dai, Guobing Zhang, Xia Qiu, Chao Li, Shanshan Sun, Wuzhen Chen, Dihe Gong, Hengyu Li, Jian Huang, Xia Jiang, Chao Ni
    Cancer Medicine.2022; 11(22): 4157.     CrossRef
  • Starting dose selection of palbociclib in Chinese patients with breast cancer based on population kinetic–pharmacodynamic model of neutropenia
    Weizhe Jian, Junsheng Xue, Qingyu Yao, Rong Chen, Ye Yao, Mopei Wang, Tianyan Zhou
    Cancer Chemotherapy and Pharmacology.2022; 90(6): 489.     CrossRef
  • Early Application of Palbociclib Plus Endocrine Therapy in HR+/HER2− Metastatic Breast Cancer: A Better Choice Based on Data From the Chinese Population
    Yusi Zhang, Wenlin Chen, Shuanglong Chen, Qingmo Yang, Zhong Ouyang
    Technology in Cancer Research & Treatment.2022;[Epub]     CrossRef
  • Real-world Treatment Patterns and Clinical Outcomes Associated With Palbociclib Combination Therapy: A Multinational, Pooled Analysis From the Ibrance Real World Insights Study
    Katie Mycock, Kent A. Hanson, Gavin Taylor-Stokes, Gary Milligan, Christian Atkinson, Debanjali Mitra, Salena Preciado, Ernest H. Law
    Clinical Therapeutics.2022; 44(12): 1588.     CrossRef
  • Multicentric real world evidence with palbociclib in hormone positive HER2 negative metastatic breast cancer in Indian population
    Chaturbhuj Agrawal, Pankaj Goyal, Amit Agarwal, Rupal Tripathi, Chandragouda Dodagoudar, Saphalta Baghmar, Archana Sharma, Ullas Batra, Vineet Talwar, Sumit Goyal, Rajeev Kumar, Dinesh Chandra Doval
    Scientific Reports.2021;[Epub]     CrossRef
  • Which Clinicopathologic Parameters Suggest Primary Resistance to Palbociclib in Combination With Letrozole as the First-Line Treatment for Hormone Receptor-Positive, HER2-Negative Advanced Breast Cancer?
    Ji-Yeon Kim, Jung Min Oh, Yeon Hee Park, Jin Seok Ahn, Young-Hyuck Im
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • 9,949 View
  • 380 Download
  • 19 Web of Science
  • 17 Crossref
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Prospective Validation of The Korean Cancer Study Group Geriatric Score (KG)-7, a Novel Geriatric Screening Tool, in Older Patients with Advanced Cancer Undergoing First-line Palliative Chemotherapy
Jin Won Kim, Se Hyun Kim, Yun-Gyoo Lee, In Gyu Hwang, Jin Young Kim, Su-Jin Koh, Yoon Ho Ko, Seong Hoon Shin, In Sook Woo, Soojung Hong, Tae-Yong Kim, Ji Yeon Baek, Hyun Jung Kim, Hyo Jung Kim, Myung Ah Lee, Jung Hye Kwon, Yong Sang Hong, Hun-Mo Ryoo, Kyung Hee Lee, Jee Hyun Kim
Cancer Res Treat. 2019;51(3):1249-1256.   Published online January 2, 2019
DOI: https://doi.org/10.4143/crt.2018.451
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to prospectively validate the Korean Cancer Study Group Geriatric Score (KG)-7, a novel geriatric screening tool, in older patients with advanced cancer planned to undergo first-line palliative chemotherapy.
Materials and Methods
Participants answered the KG-7 questionnaire before undergoing geriatric assessment (GA) and first-line palliative chemotherapy. The performance of KG-7 was evaluated by calculating the sensitivity (SE), specificity (SP), positive and negative predictive value (PPV and NPV), balanced accuracy (BA), and area under the curve (AUC).
Results
The baseline GA and KG-7 results were collected from 301 patients. The median age was 75 years (range, 70 to 93 years). Abnormal GA was documented in 222 patients (73.8%). Based on the ≤ 5 cut-off value of KG-7 for abnormal GA, abnormal KG-7 score was shown in 200 patients (66.4%). KG-7 showed SE, SP, PPV, NPV, and BA of 75.7%, 59.7%, 84.4%, 46.0%, and 67.7%, respectively; AUC was 0.745 (95% confidence interval, 0.687 to 0.803). Furthermore, patients with higher KG-7 scores showed significantly longer survival (p=0.006).
Conclusion
KG-7 appears to be adequate in identifying patients with abnormal GA prospectively. Hence, KG-7 can be a useful screening tool for Asian countries with limited resources and high patient volume.

Citations

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Clinical Features of Male Breast Cancer: Experiences from Seven Institutions Over 20 Years
Ji Hyung Hong, Kyung Sun Ha, Yun Hwa Jung, Hye Sung Won, Ho Jung An, Guk Jin Lee, Donghoon Kang, Ji Chan Park, Sarah Park, Jae Ho Byun, Young Jin Suh, Jeong Soo Kim, Woo Chan Park, Sang Seol Jung, Il Young Park, Su-Mi Chung, In Sook Woo
Cancer Res Treat. 2016;48(4):1389-1398.   Published online April 11, 2016
DOI: https://doi.org/10.4143/crt.2015.410
AbstractAbstract PDFPubReaderePub
Purpose
Breast cancer treatment has progressed significantly over the past 20 years. However, knowledge regarding male breast cancer (MBC) is sparse because of its rarity. This study is an investigation of the clinicopathologic features, treatments, and clinical outcomes of MBC.
Materials and Methods
Clinical records of 59 MBC patients diagnosed during 1995-2014 from seven institutions in Korea were reviewed retrospectively.
Results
Over a 20-year period, MBC patients accounted for 0.98% among total breast cancer patients, and increased every 5 years. The median age of MBC patientswas 66 years (range, 24 to 87 years). Forty-three patients (73%) complained of a palpable breast mass initially. The median symptom duration was 5 months (range, 1 to 36 months). Mastectomy was performed in 96% of the patients. The most frequent histology was infiltrating ductal carcinoma (75%). Ninety-one percent of tumors (38/43) were estrogen receptor–positive, and 28% (11/40) showed epidermal growth factor receptor 2 (HER-2) overexpression. After curative surgery, 42% of patients (19/45) received adjuvant chemotherapy; 77% (27/35) received hormone therapy. Five out of ten patients with HER-2 overexpressing tumors did not receive adjuvant anti–HER-2 therapy, while two out of four patients with HER-2 overexpressing tumors received palliative trastuzumab for recurrent and metastatic disease. Letrozole was used for one patient in the palliative setting. The median overall survival durations were 7.2 years (range, 0.6 to 17.0 years) in patients with localized disease and 2.9 years (range, 0.6 to 4.3 years) in those with recurrent or metastatic disease.
Conclusion
Anti–HER-2 and hormonal therapy, except tamoxifen, have been underutilized in Korean MBC patients compared to female breast cancer patients. With the development of precision medicine, active treatment with targeted agents should be applied. Further investigation of the unique pathobiology of MBC is clinically warranted.

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    Current Radiology Reports.2017;[Epub]     CrossRef
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    Soon-Chan Kwon, Dae-Young Yoo, Minho Ko, Kwon-Young Lee, Ho-Hyun Kwak, In-Chul Park, In-Koo Hwang, Jung-Hoon Choi, Jin-Young Chung
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    Ruixin Xu, Jianbin Li, Yingjie Zhang, Hongbiao Jing, Youzhe Zhu
    Medicine.2017; 96(51): e9312.     CrossRef
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Case Report
Tumor Lysis Syndrome in a Patient with Metastatic Colon Cancer after Treatment with 5-Fluorouracil/Leucovorin and Oxaliplatin: Case Report and Literature Review
Hyung Duk Kim, Kyung Sun Ha, In Sook Woo, Yun Hwa Jung, Chi Wha Han, Tae-Jung Kim
Cancer Res Treat. 2014;46(2):204-207.   Published online April 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.2.204
AbstractAbstract PDFPubReaderePub

Development of tumor lysis syndrome (TLS) may occur after chemotherapy or spontaneously in bulky or rapidly growing tumors. This syndrome is frequent but preventable in patients with hematologic malignancies. TLS following therapy has been reported infrequently in various types of solid tumors. TLS associated with oxaliplatin containing chemotherapy in a solid tumor has never been reported. A 59-year-old man received 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) chemotherapy for metastatic colon cancer. Development of TLS occurred three days after administration of chemotherapy. Two days later, his abnormal laboratory findings were recovered with appropriate management. To the best of our knowledge, the current case is the first report on development of acute TLS following oxaliplatin containing chemotherapy in a patient with colon cancer. We also review the literature on tumor lysis syndrome in patients with colorectal cancer.

Citations

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    Helena S Gouveia, Sílvia O Lopes, Ana Luísa Faria
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  • Tumor lysis syndrome in a patient with metastatic colon cancer after treatment with oxaliplatin and 5-Fu
    Ruo-Han Tseng, Ching-Hsu Wu, Kuan-Lin Wu, Guan-Min Lai, Jen-Tsun Lin
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    Zaw W. Myint, Emaculate Verla-Tebit, Benjamin B. Cho, Sherry A. Goodner, Edward B. Stelow, Geoffrey R. Weiss, Paula M. Fracasso
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    Bilal Farooqi, Josh Simmons, Zhonglin Hao
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    Hemant Goyal, Harinder Sawhney, Swetha Bekara, Umesh Singla
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  • Fluorouracil/folinic acid/oxaliplatin

    Reactions Weekly.2014; 1505(1): 17.     CrossRef
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Original Articles
Up-regulation of the DR5 Expression by Proteasome Inhibitor MG132 Augments TRAIL-Induced Apoptosis in Soft Tissue Sarcoma Cell Lines
Hee-Jeong Cheong, Kyu Sang Lee, In Sook Woo, Jong-Ho Won, Jae Ho Byun
Cancer Res Treat. 2011;43(2):124-130.   Published online June 30, 2011
DOI: https://doi.org/10.4143/crt.2011.43.2.124
AbstractAbstract PDFPubReaderePub
PURPOSE
Current chemotherapeutics for treating locally advanced or metastatic soft tissue sarcomas (STS) are limited. Accordingly, the present in vitro study was conducted to evaluate the effects of treatment of STS cells with tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) applied as a single agent or in combination with a proteasome inhibitor, MG132.
MATERIALS AND METHODS
Sensitivity to TRAIL and activity of TRAIL-induced apoptotic pathways were analyzed in four STS cell lines: HTB-82 (rhabdomyosarcoma), HT-1080 (fibrosarcoma), HTB-93 (synovial sarcoma), and HTB-94 (chondrosarcoma). Reduction of the dye dimethylthiazolyl 2,5 diphenyltetrazolium bromide (MTT) was used to evaluate cytotoxic activity; western blots were used to evaluate TRAIL-induced apoptosis.
RESULTS
TRAIL induced apoptosis in HTB-93 cells, but had little effect in HTB-82, HT-1080, or HTB-94 cells. Expression of TRAIL receptor-1 and -2 did not correlate with sensitivity to TRAIL. Co-incubation of cells with TRAIL and a proteasome inhibitor, MG132, augmented the apoptotic effect of TRAIL in both TRAIL-sensitive and TRAIL-resistant cells. This effect was due to up-regulation of TRAIL receptors and members of the pro-apoptotic BCL-2 family by MG132.
CONCLUSION
These data show that combining TRAIL with MG132 enhances apoptosis and overcomes TRAIL resistance. This restoration of TRAIL sensitivity occurs through an increase in the expression of death receptor 5 and of pro-apoptotic BCL-2 family members such as BAX.

Citations

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    Chiara Boccellato, Markus Rehm
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    Giorgia Gazzaroli, Andrea Angeli, Arianna Giacomini, Roberto Ronca
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    BMC Cancer.2019;[Epub]     CrossRef
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    Mengxiong Wang, Mary E. Law, Bradley J. Davis, Elham Yaaghubi, Amanda F. Ghilardi, Renan B. Ferreira, Chi-Wu Chiang, Olga A. Guryanova, Daniel Kopinke, Coy D. Heldermon, Ronald K. Castellano, Brian K. Law
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    Shyan‐Yuan Kao, Vitor Y.R. Soares, Arthur G. Kristiansen, Konstantina M. Stankovic
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    Akira Maekawa, Kenichi Kohashi, Masaaki Kuda, Kunio Iura, Takeaki Ishii, Makoto Endo, Tetsuya Nakatsura, Yukihide Iwamoto, Yoshinao Oda
    BMC Cancer.2016;[Epub]     CrossRef
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    Santiago Rello-Varona, David Herrero-Martín, Laura Lagares-Tena, Roser López-Alemany, Núria Mulet-Margalef, Juan Huertas-Martínez, Silvia Garcia-Monclús, Xavier García del Muro, Cristina Muñoz-Pinedo, Oscar Martínez Tirado
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    Hye Jin Jung, Misun Cho, Yonghyo Kim, Gyoonhee Han, Ho Jeong Kwon
    Journal of Medicinal Chemistry.2014; 57(19): 7990.     CrossRef
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    Hye Jin Jung, Yonghyo Kim, Junghwa Chang, Sang Won Kang, Jeong Hun Kim, Ho Jeong Kwon
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    Simone Fulda
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Clinical Characteristics of Primary Peritoneal Carcinoma
Sang Young Roh, Sook Hee Hong, Yoon Ho Ko, Tae Hee Kim, Myung Ah Lee, Byoung Yong Shim, Jae Ho Byun, In Sook Woo, Jin Hyoung Kang, Young Seon Hong, Kyung Shik Lee
Cancer Res Treat. 2007;39(2):65-68.   Published online June 30, 2007
DOI: https://doi.org/10.4143/crt.2007.39.2.65
AbstractAbstract PDFPubReaderePub
Purpose

The goal of this study was to determine the clinical and therapeutic characteristics of women with a primary peritoneal carcinoma (PPC).

Materials and Methods

A retrospective clinical study was conducted to evaluate 22 women diagnosed with a PPC from 1993 to 2007 at the Hospitals of The Catholic University of Korea. Diagnoses were based on the Gynecologic Oncology Group criteria and clinical data. We collected patient clinicopathological data including age, presenting symptoms, pretreatment CA-125 values (U/ml), clinical stage (based on the FIGO stage), performance status (using the Eastern Cooperative Oncology Group scale), whether cytoreductive surgery was optimal or not, types of chemotherapy and response to treatment. We evaluated the clinical characteristics and response to treatment, time to treatment failure and overall survival.

Results

The median overall survival of all patients was 23.1 months. The estimated 3-year survival rate was 29% (SE, 13%). The response rate to first-line platinum-based chemotherapy was 79% and the median time to treatment failure was 9.9 months (95% confidence interval, 1.38~18.4 months). By univariate and multivariate analysis, performance status was the only significant factor associated with overall survival (p<0.05).

Conclusion

We evaluated the clinical characteristics and treatment response of patients with a primary peritoneal carcinoma. Our results showed that it is possible to achieve long-term survival in patients with PPC. A further clinical study is to need to establish clinical characteristics and treatment outcomes.

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    Samer Ganam, Ayesha Khan, Nicole Riddle, Joseph A Sujka, Christopher G DuCoin
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    Pradnya Neelakanta Reddy, Eugene J S D'Souza, Avinash Anand
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    Abdelali Guellil, Rachid Jabi, Mohamed Yassine Mabrouk, Laila Bouzayan, Abdelali Merhoum, Gérald Del Gallo, Claire Godart, Mohammed Bouziane
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    Shunichi Kawamura, Toshio Kubo, Kenji Takada, Ryota Sunami, Sachi Okawa, Yoshitaka Iwamoto, Atsuko Hirabae, Akihiko Taniguchi, Yoshinobu Maeda, Katsuyuki Kiura, Masahiro Tabata
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    Claire Filippini, Sarah Smyth, Hooman Soleymani Majd, Catherine Johnson
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    Jin Wook Lee, Eun Taek Park
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    Dong Mi, Yuexiang Zhang
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    Jingping Yuan, Liang He, Bing Han, Yan Li
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    WOO-SUNG YUN, JUNG-MIN BAE
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    Ji-Woon Lee, Sang-Gon Park
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Autologous Stem Cell Transplantation using a Modified TAM Conditioning Regimen for Clinically Aggressive Non-Hodgkin's Lymphoma
Sook Hee Hong, Young Seon Hong, In Sook Woo, Yoon Ho Koh, Sang Young Rho, Ji Yean Peak, Myung Ah Lee, Byoung Yong Shim, Jae Ho Byun, Ji Chan Park, Jong Wook Lee, Woo Sung Min, Chun Choo Kim
Cancer Res Treat. 2007;39(2):54-60.   Published online June 30, 2007
DOI: https://doi.org/10.4143/crt.2007.39.2.54
AbstractAbstract PDFPubReaderePub
Purpose

High-dose chemotherapy (HDT) and autologous stem cell transplantation (ASCT) have been used for the treatment of clinically aggressive non-Hodgkin's lymphoma (NHL). However, the superiority of specific conditioning regimens has not yet been established. The present study evaluated the efficacy and toxicity of a conditioning regimen involving fractionated total body irradiation (TBI), and the use of Ara-C and melphalan (TAM) for clinically aggressive NHL.

Materials and Methods

Between March 2002 and December 2004, 31 patients with aggressive NHL received fractionated TBI with a dose of 12 Gy over 3 days, and were administered 9 g/m2 Ara-C and 100 mg/m2 melphalan followed by autologous peripheral blood stem Cell Transplantation at the Catholic Hematopoietic Stem cell transplantation Center Korea. Patients that responded to first line chemotherapy and achieved complete remission (CR), or were in a first sensitive relapse were defined as having less advanced disease, while the other patients were defined as having more advanced disease.

Results

Objective responses were obtained in 24 of 31 patients (77.4%), comprising complete remission in 19 patients (61.3%) and partial remission in 5 (16.1%) patients. The median follow-up time was 28 months (range 1~62 months). At 3 years, the overall survival and event-free survival (EFS) rates were 62.3% and 47.3%, respectively. Patients with less advanced disease and more advanced disease showed 3-year EFS rates of 73.3% and 22.5 %, respectively (p=0.006). Early (within the first 100 days) treatment-related mortality occurred in 3 (9.7%) patients. Of the 31 total patients, 15 (48.4%) developed grade 3 mucositis, 22 (70.9%) developed neutropenic fever, and two (6.5%) developed interstitial pneumonia syndrome>grade 3.

Conclusion

The modified TAM conditioning regimen and ASCT appear to be a feasible treatment regimen for clinically aggressive NHL, particularly for patients with less advanced disease.

Citations

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  • Comparison of regional arterial chemotherapy and systemic intravenous chemotherapy for advanced pancreatic cancer: a systematic review and meta-analysis
    Chengqing Li, Wenyi Guo, Shihong Chen, Jianwei Xu, Feng Li, Lei Wang
    Journal of Pancreatology.2022; 5(2): 49.     CrossRef
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  • 55 Download
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A Phase II Study of Ifosfamide, Carboplatin, and Epirubicin (ICE) Combination Chemotherapy for Extensive Disease of Small Cell Lung Cancer
Jae Ho Byun, In Sook Woo, Hun Ho Song, Keun Seok Lee, Jin Seok Ahn, Dae Young Jang, Jung Ae Lee, Young Lee Park, Young Suk Park
Cancer Res Treat. 2002;34(6):416-420.   Published online December 31, 2002
DOI: https://doi.org/10.4143/crt.2002.34.6.416
AbstractAbstract PDF
PURPOSE
To evaluate the efficacy and safety of ifosfamide, carboplatin and epirubicin (ICE) combination chemotherapy for extensive disease small cell lung cancer (SCLC) patients, who had received no previous chemotherapy, we performed phase II trial between August 1998 and January 2001.
MATERIALS AND METHODS
The study group comprised of 21 patients. Ifosfamide, 1,500 mg/m2, was given with mesna, 900 mg/m2, intravenously for 12 hours on days 1, 2 and 3, and carboplatin, 4.5 mg/ml/min, for target AUC, and epirubicin, 60 mg/m2, were given intravenously for 90 minutes on day 1. The cycle of treatment was repeated at 4 week intervals.
RESULTS
Twenty-one patients with extensive disease SCLC were treated at Hallym University between August 1998 and January 2001. One patient was unable to be evaluated because of lost to follow-up. Of the 20 patients able to be evaluated, an objective response was observed in 13 (65%). There were no complete responses. The median response duration, time to progression and median overall survival were 15.4, 18.3 and 34 weeks, respectively. Toxicities were acceptable, with dose reduction for myelosuppression necessary in only a minority of the patients. A total of 85 cycles of chemotherapy were given to the patients. The median number of cycles completed was 4. Grade III and IV hematological toxicities included anemia (4.7%), neutropenia (3.5%) and thrombocytopenia (3.5%). Most non-hematological toxicities were grade I or II.
CONCLUSION
These results suggested that ICE combination chemotherapy for extensive disease SCLC is effective, and can be safely administered with acceptable toxicities.
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Expression of p53, bcl-2 Protein in Small Cell Lung Cancer (SCLC) Cell Lines in Relation to Sensitivity to Chemotherapy
In Sook Woo, Myung Jae Park, Young Seok Park, Sung Won Jung, Mi Ae Yeo, Soo Hyun Park, Si Young Kim, Hwi Joong Yoon, Kyung Sam Cho, Jae Kyung Park, Young Il Kim
J Korean Cancer Assoc. 2000;32(5):904-910.
AbstractAbstract PDF
PURPOSE
Sensitivity of tumor cells to chemotherapeutic regimen may be accentuated by their abnormal expression of oncogene. p53 is required for the efficient activation of apoptosis following irradiation or treatment with chemotherapeutic agents. The aim of this study was to evaluate the relationship between chemosensitivity and apoptosis related proteins such as p53, bcl-2 in small cell lung cancer cell lines. MATERIAL AND METHODS: Six human small cell lung cancer cell lines, NCI-H69, NCI-H128, NCI-H1436, NCI-H1092, derived from untreated and treated patients were tested for chemo sensitivity and the expression of the p53, bcl-2 genes were examined in each cell lines with western blot analysis. We used 4 drugs including adriamycin, cisplatin, vincristine and VP-16.
RESULTS
NCI-H128 was the most sensitive cell line to four drugs. NCI-H82 and NCI-H1092 were highly resistant to VP-16, adriamycin and vincristine and determination of an IC50 was not possible. In western blot analysis, NCI-H128 alone was strong positive to p53 monoclonal antibody and the rest of cell lines were negative. All but NCI-H128 were positive to bcl-2 monoclonal antibody. NCI-H128 which was strong positive to p53 and negative to bcl-2. NCI-H1092 was strong positive to bcl-2 and negative to p53 monoclonal antibody.
CONCLUSION
We were not able to explain the expression of p53 in small cell lung cancer cell lines in relation to senitivity to anti-cancer chemotherapeutic agents. But the expression of bcl-2 in small cell lung cancer cell lines was correlated with the chemosensitivity well.
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Efficacy of Combination Chemotherapy with Vinorelbine, Ifosfamide, and Cisplatin in Patients with Advanced Non-Small Cell Lung Cancer
Heung Moon Chang, Jung Ae Lee, Jin Seok Ahn, In Sook Woo, Young Iee Park, Jee Woong Son, Seung Joon Lee, Dong Kyu Kim, Eun Kyung Mo, Myung Jae Park, Myung Goo Lee, In Gyu Hyun, Ki Suck Jung, Young Suk Park
J Korean Cancer Assoc. 2000;32(3):612-618.
AbstractAbstract PDF
PURPOSE
To evaluate the efficacy and toxicity of combination chemotherapy with vinorelbine, ifosfamide, and cisplatin in patients with advanced non-small cell lung cancer.
MATERIALS AND METHODS
Patients with unresectable, pathologically proven non-small cell lung cancer who had no prior chemotherapy were eligible. Patients received vinorelbine (25 mg/m2, iv., D1 & 8), ifosfamide (1.5 g/m2, iv., D1-3 with mesna), and cisplatin (60 mg/m2, iv., D1). The treatment was repeated every 3 weeks.
RESULTS
Between degrees Ctober, 1997 and June, 1999, 26 patients were enrolled. Median age was 61. 1 patient had stage IIIA, 13 had stage IIIB, and 12 had stage IV. Patients with adendegrees Carcinoma were 15, squamous cell carcinoma were 11. Of 22 evaluable patients, objective responses were observed in 9 patients (response rate: 40.9%, CR: 1 (4.5%), PR 8 (36.4%)). Median duration of response was 48 weeks. Median overall survival was 52 weeks. Grade 3-4 leukopenia was observed in 10.2% of the 88 courses. There was 1 death related to febrile neutropenia. Non- hematologic toxicities were mild.
CONCLUSION
We concluded that combination chemotherapy with vinorelbine, ifosfamide, and cisplatin was effective and tolerable in patients with advanced non-small cell lung cancer, and phase III randomized trial is needed to compare this regimen to other cisplatin-based regimens.
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Case Report
A Case of Paraneoplastic Membranous Nephropathy Associated with Adenocarcinoma of the Lung
Ji Hyun Kim, Hyung Won Yang, Sung Hee Kwon, In Sook Woo, Young Iee Park, Myung Jae Park, No Won Jun, Jung Woo Noh, Jung Won Sim, Hye Kyung Ahn, Hyun Soon Lee
J Korean Cancer Assoc. 1998;30(4):737-742.
AbstractAbstract PDF
The paraneoplastic nephrotic syndrome can be diagnosed by clinical and immunologic features. We have had a case of paraneoplastic nephrotic syndrome in the patients with aadeno-carcinoma of the lung, whose diagnosis was made by excluding other causes of nephrotic syndrome. The type of renal lesion was membranous glomerulopathy which commonly occurs in carcinoma. The quantity of proteinuria in this patient had decreased according to the improvement of lung cancer with combination chemotherapy. After fourth chemotherapy he was refractory to treatment, and unfortunately he had passed away with cardiac tamponade.
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Original Articles
Phase 2 Trial of FLP ( 5-FU , Leucovorin , Cisplatin ) Combination Chemotherapy for Advanced Gastric Cancer
Young Iee Park, Moon Hee Lee, Sung Woo Han, Woo Jung Park, Dong Gyu Kim, Jin Lee, Jin Seok Ahn, Jung Ae Rhee, In Sook Woo, Young Suk Park
J Korean Cancer Assoc. 1998;30(1):55-62.
AbstractAbstract PDF
PURPOSE
Advanced gastric cancer, the most common malignancy in Korea is a kind of systemic disease. At dignosis, 50~80% of patients have systemic cancer. Therefore, the most patients require systemic chemotherapy. Cisplatin and 5-FU have been suggested to be active in the treatment of gastric cancer, a high response rate was observered with a combination of 5-FU infusion and cisplatin, and the biochemical modulation of 5-FU by leucovorin has been demonstrated to enhance the activity of 5-FU in gastrointestinal tract cancer.
MATERIALS AND METHODS
The patients with advanced gastric cancer whose disease had relapsed or unresectable were treated with 5-FU(800 mg/m2 12 hr IV infusion, D 1~5), leucovorin(20 mg/m2 IV, D 1~5, max. 30 mg), cisplatin(100 mg/m2 15min IV dripping, D1). The cycles of treatment were repeated at 3-weeks intervals.
RESULTS
Between Sep. 1994 and Aug. 1996, previously untreated 44 patients(39 eligible patients) were admitted to this study, the median age was 55 years(range 17~73) and male to female ratio was 20:19. The rate of complete remission was 5%(2/39), the rate of partial remission was 21%(8/39). The median-response duration was 26 weeks(5+~38+ ). The median-time to progression was 25 weeks(4+~62+). The range of overall survival time was from 4 to 62+ weeks. 24 weeks survival rate was 71.5% but the median survival time was not reached. The leukopenia and anemia were the main hematologic toxicities. Non-hematologic side effects were nausea, vomiting, diarrhea, stomatitis, peripheral neuropathy. These toxicities were observed commnonly, but tolerable. Two treatment-related deaths were associated with sepsis.
CONCLUSION
Based on these results, FLP combination chemotherapy seems to be a moderate efficacy for advanced gastric cancer with tolerable toxicities. To confirm the efficacy further, the long-term follow up and a large scale of clinical studies are needed.
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Clinicopathologic Comparison of Intermediate or High Grade Peripheral T-Cell Lymphoma with Diffuse B-Cell Lymphoma
Kyung Hae Jung, In Sook Woo, Heung Moon Chang, Dae Seog Heo, Yung Jue Bang, Chul Woo Kim, Seonyang Park, Byoung Kook Kim, Noe Kyeong Kim
J Korean Cancer Assoc. 1997;29(1):136-145.
AbstractAbstract PDF
PURPOSE
Peripheral T-cell lymphoma (PTCL) derived from mature T cells forms morphologically diverse group of non-Hodgkin's lymphomas and the clinicopathologic features remain to be debated. In order to elucidate the specific characteristics of PTCL, comparison with a group of diffuse B-cell lymphomas (DBCL) was done.
MATERIALS AND METHODS
Between Dec. 1989 and Feb. 1993, clinical data of 67 cases of intermediate or high grade NHL identified as T-cell or B-cell origin by immunophenotyping was reviewed.
RESULTS
There were 30 cases of PTCL and 37 cases of DBCL. PTCL had more advanced stage and B symptoms at diagnosis. Frequent sites of extranodal involvement were bone marrow, nasal cavity/paranasal sinus, and skin in PTCL and gastrointestinal tract in DBCL. Based on NCI Working Formulation, 40% of PTCL and 14% of DBCL were high grade. Patients with DBCL had a better 3-year overall survival rate (67% vs 47%), however, there was no difference in complete remission rate and disease-free survival rate between two groups with intensive treatment. A subgroup of PTCL patients who had died earlier was found to have more advanced stage and poor performance status.
CONCLUSION
Although patients with PTCL had worse survival in advanced stage, the outcome of patients with PTCL who received intensive treatment was comparable to that of DBCL.
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5-Fluorouracil, Leucovorin, Ifosfamide and Cisplatin (FLIP) Combination Chemotherapy for Adevanced Non-Small Cell Lung Cancer
Hyun Sik Jeong, Keunchil Park, Jung Ae Lee, Young Iee Park, In Sook Woo, Ki Suk Jung, Young Suk Park, Duk Jhe Shun, Won Seog Kim, Jeong A Kim, Sung Soo Yoon, Won Ki Kang, Hong Ghi Lee, Chan Hyung Park
J Korean Cancer Assoc. 1997;29(1):46-52.
AbstractAbstract PDF
PURPOSE
To evaluate the response rate and toxicity of combination chemotherapy including 5-fluorouracil (F), leucovorin (L), ifosfamide (I) and cisplatin (P) for the previously untreated patients with unresectable stage IIIB or IV non-small cell lung cancer.
MATERIALS AND METHOD
The doses of FLIP were 5-fluorouracil 800 mg/m2 CI days 1-5, leucovorin 20 mg/m2 IV days 1-5, ifosfamide 1000 mg/m2 CI days 1-3, cisplatin 100 mg/m2 IV day 1 respectively. Cycles were repeated every 3 weeks until disease progression. Seventy-three previously untreated patients were enrolled. Age ranged from 30 to 73 (median 56 years); 43 were male, 30 female. Fifty-three patients had performance status (ECOG) 0-1 and 19 performance status 2. Twenty-two patients had stage IIIB and 51 stage IV. Follow-up ranged from 7+ to 160weeks (median 57 weeks).
RESULTS
The overall response rate was 46.7% for 62 evaluable patients. (CR 1 patient, PR 28 patients) Median response duration was 24 weeks (range 1+ to 36+ weeks). Toxicity > Grade II (WHO) included: granulocytopenia 19.8%, anemia 13.5%, nausea and vomiting 31.5% stomatitis 46.5%, neuropathy 24.6%.
CONCLUSION
FLIP chemotherapy was comparable to other combination chemotherapy for advanced non-small cell lung cancer with moderate toxicities.
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A Case of Wilms Tumor in Adult
Byung Chul Hahh, In Sook Woo, Kyung Seuk Kim, Bang Soo Kim, Yoon Seuk Kim, Hueng Seuk Ko, Young Woo Lee, Sang Kee Yang, Mi Kyung Shin
J Korean Cancer Assoc. 1995;27(3):521-527.
AbstractAbstract PDF
Wilms tumor is one of the most common malignant abdominal neoplasm in childhood, but Wilms tumor in adult is extremely rare. The tumor is characterized by a number of karyotypic and congenital associations, including deletons in the short arms of chromosome 1l, snd occasionally trisomy, hemihypertrophy, aniridia and urogenital abnormality. Histologically, the characteristic features are primitive or abortive glomeruli with apparent or poorly formed Bowman spaces, and abortive tubules enclosed within a spindle cell stroma. Optimal treatment of adult Wilms tumor is not established but generally followed that of childhood Wilms tumor include surgery, radiation and chemotherapy. Survival rate is influenced by stage and:hietologic pattern. We report a case of Wilms tumor in 23 year-old female.
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A Phase 2 Study of VP-16 , Ifosfamide Cisplatin ( VIP ) Combination Chemotherapy for Small Cell Lung Cancer
Rok Yun Lee, Young Suk Park, Yun Chang Han, Ho Joong Kim, In Gyu Hyun, Ki Suk Jung, Jung Ae Rhee, In Sook Woo, Young Iee Park, Keun Chil Park, Duk Jhe Shun, Sang Gyu Choi, Do Hoon Oh, Hoon Sik Bae
J Korean Cancer Assoc. 1995;27(4):620-630.
AbstractAbstract PDF
We conducted a phase II trial combining etoposide(VP-16), ifosfamide(IFM), and cisplatin (DDP) in previously untreated patients with histologicaliy confirmed small cell lung cancer (SCLC). Each cycle consisted of VP-16 100mg/m(2) i.v. days 1-3, IFM 1,000mg/m i.v. days 1-2 with mesna, and DDP 100mg/m(2) i.v. day 1. Cycles were repeated at 3 week intervals. Patients of limited SCLC received chest irradiation concurrently with the third cycle of VIP chemotherapy. Patients with complete remission received prophylactic cranial irradiation after the 6th cycle of chemotherapy. Thirty-seven patients were enrolled. Ages ranged from 34 to 76(median 61 years); 32 were male, and 5 female. Nineteen patients had limited disease(LD) and 18 extensive disease(ED). Three patients were not evaluable because of lost to follow up(2 patients) and early death(l patient). Of 34 evaluable patients, 13 patients(LD; 12, ED; I) had complete re- missions, 19 patients(LD: 6,ED; 13) had partial remissions and overall remission rate was 94 %. The median remission duration was 8.6 months(LD; 12.5months, D; 5.1months)..Disease free survival was 14.5 months in patients achieved complete remission. The median dura- tion of follow-up was 21 months (1 to 39 months), and overall median survival was 12.8 months(16.1 months for LD, 8.2 months for ED). Hematologic side effects(WHO Gr>=2) of evaluable 168 cycles of chemotherapy were anemia in 10 occassions(6%), leukopenia in 35 occassions(21%), thrombocytopenia in 27 occassions(16%). Nonhematologic side effects(WHO Gr>=2) included alopecia(91%), nausea and vomiting (80%), peripheral neuropathies (31%), and stomatitis (11%). In conclusion, VIP combination chemotherapy seems to be a safe, effective, and well-tolerated regimen in SCLC.
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A Randomized comparison of Granisetron Plus Dexamethasone and Ondansetron Plus Dexamethasone in the Prevention of High - dose Cisplatin - indu
Jung Ae Rhee, Young Suk Park, In Sook Woo, Young Iee Park, Duk Jhe Shun, Jeong A Kim, Sung Soo Yoon, Won Ki Kang, Keunchil Park, Chan Hyung Park
J Korean Cancer Assoc. 1996;28(4):739-748.
AbstractAbstract PDF
We report the prospective, randomized clinical study comparing granisetron and ondansetron as antiemetics in cancer chemotherapy. This study compares the efficacy and safety of a single dose of granisetron plus dexamethasone(GD) with three doses of ondansetron plus dexamethasone(OD) in the prevention of acute emesis induced by chemotherapy. One hundred one chemotherapy-native patients who received high dose ciaplatin(¡Al00mg /§³)-based combination chemotherapy were stratified by chemotherapeutic regimen. Patients were randomized to receive either 3 mg of granisetron intravenously(i.v.) or 8 mg of ondansetron for three doses i.v. in combination with dexamethasone to prevent emesis in the first 24 hours. In the GD group, a complete response(CR)(i.e., no emetic episode) was achived in 57% cases and a major response(MR)(i.e. ¡A2 emetic episodes) in 24%. In the OD group, a CR was seen in 71% of patients and an MR in 25%. Failure was recored in 7% and 2% of cases in the GD and OD, respectively. No statistically significant difference in any response category was seen between the two groups. Both GD and OD were well tolerated with no severe or unexpected side effects. In summary, these data suggest that single daily dose of granisetron(3mg/day) appeared similarly effective and well tolerated to three daily doses of ondansetron(8mg three times daily) in prevention of acute emesis induced by high dose cisplatin-based combination chemotherapy.
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5-Fluorouracil and Cisplatin ( FP ) Combination Chemotherapy in Advanced Esophageal Cancer
In Sook Woo, Kyung Hae Jung, Young Iee Park, Jung Ae Rhee, Dae Seog Heo, Yung Jue Bang, Noe Kyeong Kim
J Korean Cancer Assoc. 1996;28(5):835-842.
AbstractAbstract PDF
Esophageal Carcinoma is widely disseminated in many patients at the time of diagnosis. Therefore systemic chemotherapy has assumed an important role in the treatment of this disease. We conducted a phase II trial of 5-fluorouracil and cisplatin in 39 patients with advanced esophageal cancer. The regimen consisted of 5-fluorouracil, 1,000 mg/§³/day in 12 hour continuous infusion on day 1 to 5 and cisplatin, 60 mg/§³/day iv on day 1 every three weeks. Response rates were calculated only from 37 patients with measurable disease. The response rate was 39%(complete response 2%, partial response 37%) with a median duration of 4 months (range 2~10 months). Median time of survival for all patients was 9 months(range 1~4 months). The toxicities were moderate. This study demonstrates that combination of 5-fluoriuracil and cisplatin is an efficient and tolerable chemotherapy regimen in patients with advanced esophageal cancer.
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A Phase 2 Study of VP-16 Ifosfamide and Cisplatin ( VIP ) Combination Chemotherapy Plus Early Concurrent Thoracic Irradiation ( TI ) for Limited Small Cell Lung Cancer
In Sook Woo, Young Suk Park, Young Lee Park, Jung Ae Lee, Myung Jae Park, Ki Suk Jung, In Gyn Hyun, Do Hoon Oh, Hoonsik Bae, Won Suk Kim, Keunchil Park, Hojoong Kim
J Korean Cancer Assoc. 1996;28(6):973-981.
AbstractAbstract PDF
The emergence of combination chemotherapy and thoracic irradiation has improved both quality of life and survival in patients with small cell lung cancer. Most patients respond to initial treatment but unfortunately most also subsequqntly relapse and cure for most patients with small cell lung cancer remains elusive because of the develpment of drug resistant SCLC and metastasis to distant organs. The probability that thoracic irradiation would eliminate chemoresistant tumor should be inversely proportional to elapsed time. So early thoracic irradiation is recommended. Ifosfamide, an analogue of cyclophosphamide, is relatively nonmyelosuppressive drug. According to the recent report to evaluate the effect of ifosfamide, VIP(VP-16, ifosfamide, cisplatin)combination chemotherapy is assocated with an improved time to progression and overall survival over VP(VP-16, cisplatin)therapy in patients with extensive SCLC. We studied a phase II trial of VIP combination chemotherapy with early concurrent thoracic irradiation in previously untreated patients with small cell lung cancer. Treatment consisted of VP-l6 100mg/§³ i.v. days 1~3, Ifosfamide 1,000mg/§³ i.v. days 1~2 with mesna and cisplatin 100 mg/§³ i.v, day 1, cycles were repeated every 21 days. Concurrent thoracic irradiation was given as total 40Gy for 4 weeks beginning within 24 hours of cycle l, day l. Eligibility requirements included a histoioaically proven small cell lung cancer with limited stage, measurable disease, adequate renal function, bone marrow reserve. Patient characteristics(N=20) were male 17 patients, female 3 patients, median age 60 years(40~76 years). Responses were seen in all 20 patients including 8 CR's with a median follow up of 8.4 months. Hematologic side effects(WHO Gr¡A3) of evaluable 89 cycles of chemotherapy were anemia in 17 occaisions(19%), leukopenia in 10 occasions(11%). On adverse effects associated with radiation therapy 15 of all patients showed esophagitis but the severity was mild. Radiation pneumonitis was 5 patients(25%). Side effects of the treatment were tolerable and there was no treatment related mortality. In conclusion VIP combination chemotherapy with early concurrent thoracic irradiation in limited SCLC is considered to be an active regimen with acceptable toxicity but it is too early to comment on survival and effects of treatment.
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