Cancer Research and Treatment

Original Articles

A Prospective, Single-Cohort, Open, Multi-Center, Observational Study of Sublingual Fentanyl for Breakthrough Cancer Pain: Effectiveness, Safety, and Tolerability in Korean Cancer Patients: Youn Seon Choi, Su-Jin Koh, Woo Kyun Bae, Se Hyung Kim, Seong Hoon Shin, So Yeon Oh, Sang Byung Bae, Yaewon Yang, Eun-Kee Song, Yoon Young Cho, Pyung Bok Lee, Ho-Suk Oh, MinYoung Lee, Jin Seok Ahn; Received June 13, 2024 Accepted December 24, 2024 Published online December 26, 2024; DOI: https://doi.org/10.4143/crt.2024.557 [Accepted]

Abstract PDF: Purpose
Fentanyl, a highly lipophilic opioid, was developed as a sublingual fentanyl tablet (SFT) for the management of breakthrough cancer pain (BTcP), and its efficacy and safety were confirmed in a randomized, controlled study. We investigated the effectiveness and safety of SFT administered to alleviate BTcP in a real-world setting.
Materials and Methods
In this prospective, open, single-cohort study, conducted in 13 referral hospitals in South Korea, opioid-tolerant cancer patients receiving around-the-clock opioids for persistent cancer pain were enrolled if the individual had BTcP ≥ 1 episode/day during the preceding week. The primary outcome was the SFT titration success rate.
Results
Among 113 patients evaluated for effectiveness, 103 patients (91.2%) had a successful titration of SFT, with an effective dose range between 100 µg and 400 µg. The most frequent dose was 100 µg, administered to 65.0%, 72.1%, and 81.8% of the patients at Week 1, 4, and 12, respectively. The proportion of patients achieving the personalized pain goal assessed in the first week was 75.2%. The mean change in pain intensity measured with a numeric rating scale at 30 and 60 minutes after taking SFT was -2.57 and -3.62, respectively (p<0.0001 for both). The incidence rate of adverse events related to SFT among 133 patients included for safety evaluation was 9.0% (12/133), which included vomiting (3.0%), nausea (2.3%), and headache (1.5%).
Conclusion
In a real-world setting, SFT provides rapid and effective analgesia in BTcP, even at the lowest dose (100 μg), and the safety profile was acceptable.

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Clinical Impact of TP53 Mutations in Patients with Head and Neck Cancer Who Were Treated with Targeted Therapies or Immunotherapy: Eun Joo Kang, Shinwon Hwang, Yun-Gyoo Lee, Jong-Kwon Choi, Seong Hoon Shin, Yoon Hee Choi, Keun-Wook Lee, Hyun Woo Lee, Min Kyoung Kim, Seung Taek Lim, Hwan Jung Yun, Sang-Gon Park, Sangwoo Kim, Sung-Bae Kim, Hye Ryun Kim; Received August 28, 2024 Accepted December 21, 2024 Published online December 23, 2024; DOI: https://doi.org/10.4143/crt.2024.836 [Accepted]

Abstract PDF: Purpose
TP53 mutations are common in head and neck squamous cell carcinoma (HNSCC). We evaluated their clinical impact in patients treated with targeted agents or immunotherapy in the KCSG HN15-16 TRIUMPH trial.
Materials and Methods
We analyzed clinical characteristics and outcomes of patients with TP53 mutations in the TRIUMPH trial, a multicenter, biomarker-driven umbrella trial in Korea. Patients were assigned to treatment groups based on genomic profiles: Group 1, alpelisib; Group 2, poziotinib; Group 3, nintedanib; and Group 4, abemaciclib. If there was no identifiable target, the patients were allocated to Group 5 (durvalumab ± tremelimumab).
Results
TP53 mutations were detected in 116/179 patients (64.8%), more frequently in HPV-negative and non-oropharyngeal cancers. Patients with TP53 mutations exhibited shorter progression-free survival (PFS) than TP53 wild-type in all the patients (1.7 vs. 3.8 months, p=0.002) and in those who received targeted treatments (2.5 vs. 7.3 months, p=0.009). Furthermore, TP53 mutations were strongly associated with poor overall survival than TP53 wild-type in all the patients (11.1 vs. 28.8 months, p=0.005) and in Group 5 (8.1 vs. 33.0 months, p=0.001).
Conclusion
TP53 mutations were associated with aggressive clinical characteristics and poor survival, particularly in HNSCC patients treated with immunotherapy.

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Phase II Trial of Neoadjuvant Docetaxel/Cisplatin/5-Fluorouracil Combined with Pegteograstim for Unresectable, Locally Advanced Sinonasal Squamous Cell Carcinoma: KCSG HN18-07: Bhumsuk Keam, Ho Jung An, Seong Hoon Shin, Min Kyoung Kim, Jung Hae Cho, Seyoung Seo, Sung-Bae Kim; Received October 24, 2024 Accepted December 13, 2024 Published online December 16, 2024; DOI: https://doi.org/10.4143/crt.2024.1025 [Accepted]

Abstract PDF: Purpose
The role of neoadjuvant chemotherapy in locally advanced sinonasal squamous cell carcinoma (SNSCC) has not been established prospectively. We conducted a phase II trial of neoadjuvant chemotherapy (NAC) with docetaxel/cisplatin/5-fluorouracil (TPF) in this population.
Materials and Methods
Eligible patients had unresectable, locally advanced SNSCC, defined as T3/4 stage or potential compromise of critical organ function on surgery. Three TPF (docetaxel 75 mg/m² and cisplatin 75 mg/m² on day 1, 5-fluorouracil 1,000 mg/m² on days 1–4 every 3 weeks) cycles were administered with prophylactic pegteograstim. The primary outcome was the overall response rate (ORR); the secondary outcomes included 2-year progression-free survival (PFS), eyeball preservation rate, and safety.
Results
Among 28 patients screened, 25 were evaluable for efficacy (one screen-failure; two evaluable for safety only). The confirmed ORR was 72.0%. The definitive post-NAC treatment comprised chemoradiotherapy (n=15) and surgery (n=10). With a median follow-up of 25.5 months, median PFS was not reached and the 2-year PFS rate was 60.4%. Response to NAC was related to prolonged PFS (p=0.038). No patient underwent eyeball exenteration at the data cutoff point. Treatment-related adverse events of grade ≥3 were neutropenia (48.1%) including febrile neutropenia (14.8%), followed by acute kidney injury (22.2%), nausea/vomiting (11.1%), anemia (7.4%), thrombocytopenia (7.4%), and enterocolitis (3.7%).
Conclusion
TPF NAC showed a promising efficacy and might help preserve critical structures in this population, which needs to be validated in a large prospective trial (KCT0003377).

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Head and Neck cancer

Induction Chemotherapy as a Prognostication Index and Guidance for Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: The Concept of Chemo-Selection (KCSG HN13-01): Yun-Gyoo Lee, Eun Joo Kang, Bhumsuk Keam, Jin-Hyuk Choi, Jin-Soo Kim, Keon Uk Park, Kyoung Eun Lee, Hyo Jung Kim, Keun-Wook Lee, Min Kyoung Kim, Hee Kyung Ahn, Seong Hoon Shin, Hye Ryun Kim, Sung-Bae Kim, Hwan Jung Yun; Cancer Res Treat. 2022;54(1):109-117. Published online April 27, 2021; DOI: https://doi.org/10.4143/crt.2020.1329

Abstract PDF PubReader ePub

Purpose
Certain patient subgroups who do not respond to induction chemotherapy (IC) show inherent chemoresistance in locally advanced head and neck squamous cell carcinoma (LA-HNSCC). This study aimed to assess the prognostic value of IC, and role of IC in guiding the selection of a definitive locoregional therapy.
Materials and Methods
Out of the 445 patients in multi-institutional LA-HNSCC cohort, 158 (36%) receiving IC were enrolled. The study outcome was to assess overall survival (OS) through IC responsiveness and its role to select subsequent treatments.
Results
Among 135 patients who completed subsequent treatment following IC, 74% responded to IC (complete response in 17% and partial response in 58%). IC-non-responders showed 4.5 times higher risk of mortality than IC-responders (hazard ratio, 4.52; 95% confidence interval, 2.32 to 8.81; p < 0.001). Among IC-responders, 84% subsequently received definitive concurrent chemoradiotherapy (CCRT) and OS was not differed by surgery or CCRT (p=0.960). Regarding IC-non-responders, 54% received CCRT and 46% underwent surgery, and OS was poor in CCRT (24-month survival rate of 38%) or surgery (24-month survival rate of 63%).
Conclusion
Response to IC is a favorable prognostic factor. For IC-responders, either surgery or CCRT achieved similar survival probabilities. For IC-non-responder, multidisciplinary approach was warranted reflecting patients’ preference, morbidity, and prognosis.

Citations

Citations to this article as recorded by

Clinical decision pathway and management of locally advanced head and neck squamous cell carcinoma: A multidisciplinary consensus in Asia-Pacific
Ye Guo, Torahiko Nakashima, Byoung Chul Cho, Darren W.-T. Lim, Muh-Hwa Yang, Pei-Jen Lou, June Corry, Jin Ching Lin, Guo Pei Zhu, Kyung Hwan Kim, Bin Zhang, Zhiming Li, Ruey-Long Hong, Junice Yi Siu Ng, Ee Min Tan, Yan Ping Liu, Con Stylianou, Carmel Spit
Oral Oncology.2024; 148: 106657. CrossRef
Neoadjuvant programmed cell death 1 blockade combined with chemotherapy for locally advanced head and neck squamous cell carcinoma
Ping Han, Faya Liang, Pan Song, Taowei Wu, Yangyang Li, Ming Gao, Peiliang Lin, Jianming Fan, Xiaoming Huang
Holistic Integrative Oncology.2024;[Epub] CrossRef
Clinical prognostic factors to guide treatment strategy for HPV‑positive oropharyngeal cancer using treatment outcomes of induction chemotherapy: A real‑world experience
Hyun Bang, Hyeon-Jong Kim, Seung Lee, Hyun Shim, Jun Hwang, Woo Bae, Ik-Joo Chung, Sang-Hee Cho
Oncology Letters.2024;[Epub] CrossRef
Role of induction chemotherapy in advanced‐stage olfactory neuroblastoma
Sung‐Woo Cho, Bhumsuk Keam, Keun‐Wook Lee, Ji‐Won Kim, Doo Hee Han, Hyun Jik Kim, Jeong‐Whun Kim, Dong‐Young Kim, Chae‐Seo Rhee, Yun Jung Bae, Ji‐Hoon Kim, Keun‐Yong Eom, Hong‐Gyun Wu, Yong Hwy Kim, Chae‐Yong Kim, Sun Ha Paek, Hyojin Kim, Tae‐Bin Won
International Forum of Allergy & Rhinology.2024; 14(12): 1882. CrossRef
Intra-Arterial Chemotherapy for Locally Advanced Oral Cavity Cancer
B. B. Vyzhigina, M. A. Kropotov, B. I. Dolgushin, D. A. Safarov, I. V. Pogrebnyakov, S. B. Alieva
Journal of oncology: diagnostic radiology and radiotherapy.2024; 7(3): 62. CrossRef
Response to induction chemotherapy as a prognostic indicator in locally advanced head and neck squamous cell carcinoma
Francesca Huwyler, Roland Giger, Ruben Bill, Daniel Rauch, Simon Haefliger
Journal of Cancer Research and Clinical Oncology.2024;[Epub] CrossRef
Response to induction chemotherapy in sinonasal malignancies: A single‐institutional experience
Sarah C. Nyirjesy, Rachel Fenberg, Margaret A. Heller, Ryan T. Judd, Michael M. Li, Brandon Koch, Marcelo Bonomi, Ricardo L. Carrau, Kyle K. VanKoevering
Head & Neck.2023; 45(6): 1445. CrossRef
Human Papillomavirus-Related Non-Metastatic Oropharyngeal Carcinoma: Current Local Treatment Options and Future Perspectives
Michaela Svajdova, Pavol Dubinsky, Tomas Kazda, Branislav Jeremic
Cancers.2022; 14(21): 5385. CrossRef

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Head and Neck Cancer

Outcomes and Biomarkers of Immune Checkpoint Inhibitor Therapy in Patients with Refractory Head and Neck Squamous Cell Carcinoma: KCSG HN18-12: Yun-Gyoo Lee, Hyun Chang, Bhumsuk Keam, Sang Hoon Chun, Jihyun Park, Keon Uk Park, Seong Hoon Shin, Ho Jung An, Kyoung Eun Lee, Keun-Wook Lee, Hye Ryun Kim, Sung-Bae Kim, Myung-Ju Ahn, In Gyu Hwang; Cancer Res Treat. 2021;53(3):671-677. Published online December 7, 2020; DOI: https://doi.org/10.4143/crt.2020.824

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was conducted to determine the effectiveness of immune checkpoint inhibitors (ICIs) in recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) after platinum-containing chemotherapy. We also identified clinical biomarkers which may be predictive of patient prognosis.
Materials and Methods
We analyzed 125 patients with R/M HNSCC who received ICIs, retrospectively. Overall response rate (ORR) was the primary study outcome. Overall survival (OS) and progression-free survival (PFS) were the secondary study outcomes.
Results
The patients received anti–programmed cell death protein-1 (PD-1) (n=73, 58%), anti–programmed death-ligand 1 (PD-L1) (n=24, 19%), or a combination of anti–PD-1/PD-L1 and anti–cytotoxic T-lymphocyte antigen 4 (n=28, 22%). The median age was 57 years (range, 37 to 87). The location of the primary tumor was in the oral cavity in 28% of the cases, followed by oropharynx (27%), hypopharynx (20%), and larynx (12%). The ORR was 15% (19/125). With 12.3 months of median follow-up, median PFS was 2.7 months. Median OS was 10.8 months. A neutrophil-to-lymphocyte ratio (NLR) > 4 was significantly associated with poor response to ICIs (odds ratio, 0.30; p=0.022). A sum of the target lesions > 40 mm (hazard ratio [HR], 1.53; p=0.046] and a NLR > 4 (HR, 1.75; p=0.009) were considered to be predictive markers of short PFS. A poor performance status (HR, 4.79; p < 0.001), a sum of target lesions > 40 mm (HR, 1.93; p=0.025), and an NLR > 4 (HR, 3.36; p < 0.001) were the significant predictors for poor survival.
Conclusion
ICIs exhibited favorable antitumor activity in R/M HNSCC. Clinically, our findings can be used to recognize patients benefit from receiving ICI.

Citations

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Impact of PIK3CA and cell cycle pathway genetic alterations on durvalumab efficacy in patients with head and neck squamous cell carcinoma: Post hoc analysis of TRIUMPH study
Dong Hyun Kim, Seung Taek Lim, Hye Ryun Kim, Eun Joo Kang, Hee Kyung Ahn, Yun-Gyoo Lee, Der Sheng Sun, Jung Hye Kwon, Sang-Cheol Lee, Hyun Woo Lee, Min Kyoung Kim, Bhumsuk Keam, Keon-Uk Park, Seong-Hoon Shin, Hwan Jung Yun
Oral Oncology.2024; 151: 106739. CrossRef
Characterization of macrophages in head and neck squamous cell carcinoma and development of MRG-based risk signature
Lei Liu, Qiang Liu
Scientific Reports.2024;[Epub] CrossRef
Inflammatory markers as prognostic markers in patients with head and neck squamous cell carcinoma treated with immune checkpoint inhibitors: a systematic review and meta-analysis
Quan Wang, Xiangzhi Yin, Shengxia Wang, Haijun Lu
Frontiers in Oncology.2024;[Epub] CrossRef
Predictive value of early dynamic changes of NLR and PLR for the efficacy of immune checkpoint inhibitor in head and neck squamous cell carcinoma
Dong Hyun Kim, Seo Yoon Jang, Bhumsuk Keam
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology.2024; 138(6): 763. CrossRef
Neutrophil‐to‐Lymphocyte Ratio and Pembrolizumab Outcomes in Oral Cavity Squamous Cell Carcinoma
Angeline A. Truong, Rex H. Lee, Xin Wu, Alain P. Algazi, Hyunseok Kang, Ivan H. El‐Sayed, Jonathan R. George, Chase M. Heaton, William R. Ryan, Yena Jeon, Mi‐Ok Kim, Patrick K. Ha, Katherine C. Wai
Otolaryngology–Head and Neck Surgery.2024;[Epub] CrossRef
Diagnostic Predictors of Immunotherapy Response in Head and Neck Squamous Cell Carcinoma
Piero Giuseppe Meliante, Federica Zoccali, Marco de Vincentiis, Massimo Ralli, Carla Petrella, Marco Fiore, Antonio Minni, Christian Barbato
Diagnostics.2023; 13(5): 862. CrossRef
Patterns of recurrence in head and neck squamous cell carcinoma to inform personalized surveillance protocols
Catherine T. Haring, Lulia A. Kana, Sarah M. Dermody, Collin Brummel, Jonathan B. McHugh, Keith A. Casper, Steven B. Chinn, Kelly M. Malloy, Michelle Mierzwa, Mark E. P. Prince, Andrew J. Rosko, Jennifer Shah, Chaz L. Stucken, Andrew G. Shuman, J. Chad Br
Cancer.2023; 129(18): 2817. CrossRef
Immunotherapy with PD-1 Inhibitor Nivolumab in Recurrent/Metastatic Platinum Refractory Head and Neck Cancers—Early Experiences from Romania and Literature Review
Camil Ciprian Mireștean, Mihai Cosmin Stan, Michael Schenker, Constantin Volovăț, Simona Ruxandra Volovăț, Dragoș Teodor Petru Iancu, Roxana Irina Iancu, Florinel Bădulescu
Diagnostics.2023; 13(16): 2620. CrossRef
Integrating Cutting-Edge Methods to Oral Cancer Screening, Analysis, and Prognosis
Sagar Dholariya, Ragini D. Singh, Amit Sonagra, Dharamveer Yadav, Bhairavi N. Vajaria, Deepak Parchwani
Critical Reviews™ in Oncogenesis.2023; 28(2): 11. CrossRef
Neutrophil–lymphocyte ratio and platelet–lymphocyte ratio as potential predictive markers of treatment response in cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis
Tibera K. Rugambwa, Omar Abdihamid, Xiangyang Zhang, Yinghui Peng, Changjing Cai, Hong Shen, Shan Zeng, Wei Qiu
Frontiers in Oncology.2023;[Epub] CrossRef
Characterization of Age-Associated, Neutrophil-to-Lymphocyte Ratio (NLR) and Systemic Immune-Inflammatory Index (SII) as Biomarkers of Inflammation in Geriatric Patients with Cancer Treated with Immune Checkpoint Inhibitors: Impact on Efficacy and Surviva
Khalil Choucair, Caroline Nebhan, Alessio Cortellini, Stijn Hentzen, Yinghong Wang, Cynthia Liu, Raffaele Giusti, Marco Filetti, Paolo Antonio Ascierto, Vito Vanella, Domenico Galetta, Annamaria Catino, Nour Al-Bzour, Azhar Saeed, Ludimila Cavalcante, Pam
Cancers.2023; 15(20): 5052. CrossRef
A systematic review and meta-analysis of prognostic indicators in patients with head and neck malignancy treated with immune checkpoint inhibitors
Dengxiong Kang, Siping Liu, Xin Yuan, Shenxiang Liu, Zhengrong Zhang, Zhilian He, Xudong Yin, Haiyan Mao
Journal of Cancer Research and Clinical Oncology.2023; 149(20): 18215. CrossRef
Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio during immune checkpoint inhibitor treatment in recurrent or metastatic head and neck squamous cell carcinoma patients
Jun-Liang Li, Tsai-Ling Hsieh, Ming-Che Ou, Frank Cheau-Feng Lin, Stella Chin-Shaw Tsai
Oral Oncology.2022; 126: 105729. CrossRef
Neutrophil‐to‐lymphocyte ratio as a prognostic marker for head and neck squamous cell carcinoma treated with immune checkpoint inhibitors: Meta‐analysis
Yukinori Takenaka, Ryohei Oya, Norihiko Takemoto, Hidenori Inohara
Head & Neck.2022; 44(5): 1237. CrossRef
Safety and Efficacy of Influenza Vaccination in Patients Receiving Immune Checkpoint Inhibitors. Systematic Review with Meta-Analysis
Maria A. Lopez-Olivo, Valeria Valerio, Aliza R. Karpes Matusevich, Marianela Brizio, Michelle Kwok, Yimin Geng, Maria E. Suarez-Almazor, Ines Colmegna
Vaccines.2022; 10(8): 1195. CrossRef
Identification of Immune-Related LncRNA Pairs for Predicting Prognosis and Immunotherapeutic Response in Head and Neck Squamous Cell Carcinoma
Xueying Wang, Kui Cao, Erliang Guo, Xionghui Mao, Lunhua Guo, Cong Zhang, Junnan Guo, Gang Wang, Xianguang Yang, Ji Sun, Susheng Miao
Frontiers in Immunology.2021;[Epub] CrossRef
Roles of Major RNA Adenosine Modifications in Head and Neck Squamous Cell Carcinoma
Xing-xing Huo, Shu-jie Wang, Hang Song, Ming-de Li, Hua Yu, Meng Wang, Hong-xiao Gong, Xiao-ting Qiu, Yong-fu Zhu, Jian-ye Zhang
Frontiers in Pharmacology.2021;[Epub] 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

Abstract PDF Supplementary Material PubReader ePub

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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Comparison of two frailty screening tools in older patients with colorectal cancer
Han Zhao, Xinlin Lu, Senshuang Zheng, Danmei Wei, Lizhong Zhao, Yuan Wang, Geertruida H. de Bock, Wenli Lu
BMC Geriatrics.2023;[Epub] CrossRef
Prevalence and Predictive Factors for Upfront Dose Reduction of the First Cycle of First-Line Chemotherapy in Older Adults with Metastatic Solid Cancer: Korean Cancer Study Group (KCSG) Multicenter Study
In Gyu Hwang, Minsuk Kwon, Jin Won Kim, Se Hyun Kim, Yun-Gyoo Lee, Jin Young Kim, Su-Jin Koh, Yoon Ho Ko, Seong Hoon Shin, Soojung Hong, Tae-Yong Kim, Sun Young Kim, Hyun Jung Kim, Hyo Jung Kim, Myung Ah Lee, Jung Hye Kwon, Yong Sang Hong, Kyung Hee Lee,
Cancers.2021; 13(2): 331. CrossRef
A single-arm feasibility study of gradual dose de-escalation of antiemetic dexamethasone for older patients receiving chemotherapy
Koung Jin Suh, Seonghae Yoon, Jin Won Kim, Seo Hyun Yoon, Ji-Won Kim, Se Hyun Kim, Yu Jung Kim, Keun-Wook Lee, Jong Seok Lee, Jee Hyun Kim
Journal of Geriatric Oncology.2021; 12(6): 922. CrossRef
Predictive Value of Geriatric Oncology Screening and Geriatric Assessment in Older Patients with Solid Cancers: Protocol for a Danish prospective cohort study (PROGNOSIS-G8)
Helena Møgelbjerg Ditzel, Ann-Kristine Weber Giger, Cecilia Margareta Lund, Henrik Jørn Ditzel, Afsaneh Mohammadnejad, Per Pfeiffer, Jesper Ryg, Trine Lembrecht Jørgensen, Marianne Ewertz
Journal of Geriatric Oncology.2021; 12(8): 1270. CrossRef
The Globalization of Geriatric Oncology: From Data to Practice
Ravindran Kanesvaran, Supriya Mohile, Enrique Soto-Perez-de-Celis, Harpreet Singh
American Society of Clinical Oncology Educational Book.2020; (40): e107. CrossRef

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Special Article

Development of a Community-Based Palliative Care Model for Advance Cancer Patients in Public Health Centers in Busan, Korea: Sook-Nam Kim, Soon-Ock Choi, Seong Hoon Shin, Ji-Sun Ryu, Jeong-Won Baik; Cancer Res Treat. 2017;49(3):559-568. Published online October 18, 2016; DOI: https://doi.org/10.4143/crt.2016.276

Abstract PDF PubReader ePub

Purpose
A feasible palliative care model for advance cancer patients is needed in Korea with its rapidly aging population and corresponding increase in cancer prevalence. This study describes the process involved in the development of a community-based palliative care (CBPC) model implemented originally in a Busan pilot project.
Materials and Methods
The model development included steps I and II of the pilot project, identification of the service types, a survey exploring the community demand for palliative care, construction of an operational infrastructure, and the establishment of a service delivery system. Public health centers (including Busan regional cancer centers, palliative care centers, and social welfare centers) served as the regional hubs in the development of a palliative care model.
Results
The palliative care project included the provision of palliative care, establishment of a support system for the operations, improvement of personnel capacity, development of an educational and promotional program, and the establishment of an assessment system to improve quality. The operational infrastructure included a service management team, provision teams, and a support team. The Busan Metropolitan City CBPC model was based on the principles of palliative care as well as the characteristics of public health centers that implemented the community health projects.
Conclusion
The potential use of the Busan CBPC model in Korea should be explored further through service evaluations.

Citations

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Palliative Care for Cancer Patients in Asia: Challenges and Countermeasures
Yu Wang, Xinqing Zhang, Yilin Huang, Xiangyu Ma
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The contribution of the nursing profession to the establishment of social justice: A grounded theory study
Fariba Hosseinzadegan, Hosein Habibzadeh, Madineh Jasemi
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Nasrin Galehdar, Heshmatolah Heydari
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So Young Kim
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Developing an integrated model of community-based palliative care into the primary health care (PHC) for terminally ill cancer patients in Iran
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Parichat Dokmai, Natthani Meemon, Seung Chun Paek, Supakarn Tayjasanant
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Community Care for Cancer Patients in Rural Areas: An Integrated Regional Cancer Center and Public Health Center Partnership Model
Jung Hun Kang, Chang Yoon Jung, Ki-Soo Park, Jung Sik Huh, Sung Yong Oh, Jung Hye Kwon
The Korean Journal of Hospice and Palliative Care.2021; 24(4): 226. CrossRef
Differences in medical costs for end-of-life patients receiving traditional care and those receiving hospice care: A retrospective study
Ya-Ting Huang, Ying-Wei Wang, Chou-Wen Chi, Wen-Yu Hu, Rung Lin, Chih-Chung Shiao, Woung-Ru Tang, Chun Chieh Yeh
PLOS ONE.2020; 15(2): e0229176. CrossRef
Exploring health care providers’ perceptions about home-based palliative care in terminally ill cancer patients
Heshmatolah Heydari, Suzanne Hojjat-Assari, Mohammad Almasian, Pooneh Pirjani
BMC Palliative Care.2019;[Epub] CrossRef
Structural Analysis on Quality of Life for Terminal Cancer Patients provided Hospice and Palliative Care Services in Community Health Centers
Sook-Nam Kim, Soon-Ock Choi, Ji-Seon Ryu, Jung-Rim Kim
The Korean Journal of Health Service Management.2019; 13(4): 163. CrossRef
Evaluation of Outcomes of the Busan Community-based Palliative Care Project in Korea
Soon-Ock Choi, Sook-Nam Kim, Seong-Hoon Shin, Ji-Seon Ryu, Jeong-Won Baik, Jung-Rim Kim, Nae-Hyeon Kim
Asian Nursing Research.2018; 12(4): 286. CrossRef

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Original Articles

Phase II Study of Irinotecan and Cisplatin Combination Chemotherapy in Metastatic, Unresectable Esophageal Cancer: Miso Kim, Bhumsuk Keam, Tae-Min Kim, Hoon-Gu Kim, Jin-Soo Kim, Sung Sook Lee, Seong Hoon Shin, Min Kyoung Kim, Keon Uk Park, Dong-Wan Kim, Hwan Jung Yun, Jong Seok Lee, Dae Seog Heo; Cancer Res Treat. 2017;49(2):416-422. Published online July 28, 2016; DOI: https://doi.org/10.4143/crt.2016.121

Abstract PDF PubReader ePub

Purpose
The objective of this multicenter phase II study was to evaluate the efficacy and safety of irinotecan and cisplatin combination chemotherapy in metastatic, unresectable esophageal cancer.
Materials and Methods
Patients were treated with irinotecan 65 mg/m² and cisplatin 30 mg/m² on days 1 and 8 of each 21-day treatment cycle. The primary endpoint was response rate, and secondary endpoints were survival, duration of response, initial metabolic response rate, and toxicity.
Results
A total of 27 patients with squamous cell histology were enrolled in the study. The median age of the patients was 61 years. The objective response rate of the 20 patients in the perprotocol group was 30.0% (90% confidence interval [CI], 13.2 to 46.9). The median follow-up duration was 10.0 months, and the median progression-free survival and overall survival were 4.5 months (95% CI, 1.6 to 6.2) and 8.8 months (95% CI, 4.7 to 10.5), respectively. Four of 13 patients (30.8%) evaluated showed initial metabolic response. The median duration of response for partial responders was 5.0 months (range, 3.4 to 8.0 months). The following grade 3/4 treatment-related hematologic toxicities were reported: neutropenia (40.7%), anaemia (22.2%), and thrombocytopenia (7.4%). Two patients experienced febrile neutropenia. The most common grade 3/4 non-hematologic toxicities were asthenia (14.8%) and diarrhoea (11.1%).
Conclusion
Irinotecan and cisplatin combination chemotherapy showed modest anti-tumour activity and manageable toxicity for patients with metastatic, unresectable esophageal cancer.

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Frequency and Outcome of Neuroleptic Rotation in the Management of Delirium in Patients with Advanced Cancer: Seong Hoon Shin, David Hui, Gary Chisholm, Jung Hun Kang, Julio Allo, Janet Williams, Eduardo Bruera; Cancer Res Treat. 2015;47(3):399-405. Published online November 24, 2014; DOI: https://doi.org/10.4143/crt.2013.229

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Purpose
The response to haloperidol as a first-line neuroleptic and the pattern of neuroleptic rotation after haloperidol failure have not been well defined in palliative care. The purpose of this study was to determine the efficacy of haloperidol as a first-line neuroleptic and the predictors associated with the need to rotate to a second neuroleptic. Materials and Methods We conducted a retrospective review of the charts of advanced cancer patients admitted to our acute palliative care unit between January 2012 and March 2013. Inclusion criteria were a diagnosis of delirium and first-line treatment with haloperidol. Results Among 167 patients with delirium, 128 (77%) received only haloperidol and 39 (23%) received a second neuroleptic. Ninety-one patients (71%) who received haloperidol alone improved and were discharged alive. The median initial haloperidol dose was 5 mg (interquartile ranges [IQR], 3 to 7 mg) and the median duration was 5 days (IQR, 3 to 7 days). The median final haloperidol dose was 6 mg (IQR, 5 to 7 mg). A lack of treatment efficacy was the most common reason for neuroleptic rotation (87%). Significant factors associated with neuroleptic rotation were inpatient mortality (59% vs. 29%, p=0.001), and being Caucasian (87% vs. 62%, p=0.014). Chlorpromazine was administered to 37 patients (95%) who were not treated successfully by haloperidol. The median initial chlorpromazine dose was 150 mg (IQR, 100 to 150 mg) and the median duration was 3 days (IQR, 2 to 6 days). Thirteen patients (33%) showed reduced symptoms after the second neuroleptic. Conclusion Neuroleptic rotation from haloperidol was only required in 23% of patients with delirium and was associated with inpatient mortality and white race.

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Naming racism as a root cause of inequities in palliative care research: a scoping review
Kavita Algu, Joshua Wales, Michael Anderson, Mariam Omilabu, Thandi Briggs, Allison M. Kurahashi
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Management of Physical Symptoms in Patients with Advanced Cancer during the Last Weeks and Days of Life
Ahsan Azhar, David Hui
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Chlorpromazine as Treatment for Refractory Agitation Associated with Pediatric Delirium
Shin Young Kim, Shari Simone, Omayma A. Kishk, Ana Lia Graciano, Hyunuk Seung, Sarah Edwards
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Neuroleptic strategies for terminal agitation in patients with cancer and delirium at an acute palliative care unit: a single-centre, double-blind, parallel-group, randomised trial
David Hui, Allison De La Rosa, Annie Wilson, Thuc Nguyen, Jimin Wu, Marvin Delgado-Guay, Ahsan Azhar, Joseph Arthur, Daniel Epner, Ali Haider, Maxine De La Cruz, Yvonne Heung, Kimberson Tanco, Shalini Dalal, Akhila Reddy, Janet Williams, Sapna Amin, Terri
The Lancet Oncology.2020; 21(7): 989. CrossRef
A Scoping Review to Map Empirical Evidence Regarding Key Domains and Questions in the Clinical Pathway of Delirium in Palliative Care
Peter G. Lawlor, Nicole A. Rutkowski, Alistair R. MacDonald, Mohammed T. Ansari, Lindsey Sikora, Franco Momoli, Salmaan Kanji, David K. Wright, Erin Rosenberg, Annmarie Hosie, Jose L. Pereira, David Meagher, Jill Rice, John Scott, Shirley H. Bush
Journal of Pain and Symptom Management.2019; 57(3): 661. CrossRef
Prevalencia de delirium mediante la escala Memorial Delirium Assessment Scale (MDAS) en pacientes oncológicos avanzados ingresados en una Unidad de Cuidados Paliativos. Factores de riesgo, reversibilidad y tratamiento recibido
Verónica Díaz García, Miriam López Pérez, Yolanda Zuriarrain Reyna
Medicina Paliativa.2018; 25(4): 245. CrossRef
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Acute symptomatic complications among patients with advanced cancer admitted to acute palliative care units: A prospective observational study
David Hui, Renata dos Santos, Suresh Reddy, Maria Salete de Angelis Nascimento, Donna S Zhukovsky, Carlos Eduardo Paiva, Shalini Dalal, Everaldo Donizeti Costa, Paul Walker, Heloisa Helena Scapulatempo, Rony Dev, Camila Souza Crovador, Maxine De La Cruz,
Palliative Medicine.2015; 29(9): 826. CrossRef

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Clinical Usefulness of Hydromorphone-OROS in Improving Sleep Disturbances in Korean Cancer Patients: A Multicenter, Prospective, Open-Label Study: Seong Hoon Shin, Ho Sup Lee, Yang Soo Kim, Young Jin Choi, Sung Hyun Kim, Hyuk Chan Kwon, Sung Yong Oh, Jung Hun Kang, Chang Hak Sohn, Sang Min Lee, Jin Ho Baek, Young Joo Min, Choongrak Kim, Joo Seop Chung; Cancer Res Treat. 2014;46(4):331-338. Published online July 21, 2014; DOI: https://doi.org/10.4143/crt.2013.130

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Purpose
To evaluate the efficacy of hydromorphone-OROS (HM-OROS) in reducing sleep disturbance and relieving cancer pain. Materials and Methods One hundred twenty cancer patients with pain (numeric rating scale [NRS] ≥ 4) and sleep disturbance (NRS ≥ 4) were evaluated. The initial HM-OROS dosing was based on previous opioid dose (HM-OROS:oral morphine=1:5). Dose adjustment of the study drug was permitted at the investigator’s discretion. Pain intensity, number of breakthrough pain episodes, and quality of sleep were evaluated. Results A total of 120 patients received at least one dose of HM-OROS; 74 of them completed the final assessment. Compared to the previous opioids, HM-OROS reduced the average pain NRS from 5.3 to 4.1 (p < 0.01), worst pain NRS from 6.7 to 5.4 (p < 0.01), sleep disturbance NRS from 5.9 to 4.1 (p < 0.01), incidence of breakthrough pain at night from 2.63 to 1.53 times (p < 0.001), and immediate-release opioids use for the management of breakthrough pain from 0.83 to 0.39 times per night (p = 0.001). Of the 74 patients who completed the treatment, 83.7% indicated that they preferred HM-OROS to the previous medication. The adverse events (AEs) were somnolence, asthenia, constipation, dizziness, and nausea. Conclusion HM-OROS was efficacious in reducing cancer pain and associated sleep disturbances. The AEs were manageable.

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Jana Mlíchová, Zoltán Paluch, Ondřej Šimandl
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Mi-Young Kwon, Ha-Na Cho, Dong-Hoe Koo, Yun-Gyoo Lee, Sukjoong Oh, Seung-Sei Lee
The Korean Journal of Internal Medicine.2018; 33(3): 577. CrossRef
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Richard J. Bodnar
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Journal of Korean Medical Science.2016; 31(12): 1914. CrossRef

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Case Report

Successful Chemotherapy Following Autologous Stem Cell Transplantation in Multiple Myeloma and Multi-organ Dysfunction with Infiltration of Eosinophils: A Case Report: Ho Sup Lee, Lee Chun Park, Seong Hoon Shin, Sang Uk Lee, Hee Kyung Chang, Bang Huh, Gyoo Sik Jung, Mi Hyang Kim, Yang Soo Kim; Cancer Res Treat. 2011;43(3):199-203. Published online September 30, 2011; DOI: https://doi.org/10.4143/crt.2011.43.3.199

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Eosinophils are derived from hematopoietic stem cells. Peripheral blood eosinophilia is defined as an absolute eosinophil count of > or =0.5x10(9)/L. Eosinophilia is classified into primary or clonal eosinophilia, secondary eosinophilia, and idiopathic categories including idiopathic hypereosinophilic syndrome. Both hematopoietic and solid neoplasms may be associated with peripheral blood eosinophilia, but multiple myeloma is rarely associated with eosinophilia. We now report the case of a 31-year-old man with multiple myeloma associated with marked eosinophilia who developed multiple organ dysfunction with infiltration of eosinophils. He recovered after treatment with chemotherapy followed by autologous stem cell transplantation.

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Subepidermal Bullous Dermatosis Associated With IgA Multiple Myeloma
Qiang Zhou, Hao Jiang, Kejian Zhu, Rui Han, Hao Cheng
The American Journal of Dermatopathology.2013; 35(3): e49. CrossRef

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Original Article

Clinical Correlation between Brain Natriutetic Peptide and Anthracyclin-induced Cardiac Toxicity: Ho Sup Lee, Chang Bae Son, Seong Hoon Shin, Yang Soo Kim; Cancer Res Treat. 2008;40(3):121-126. Published online September 30, 2008; DOI: https://doi.org/10.4143/crt.2008.40.3.121

Abstract PDF PubReader ePub

Purpose

Anthracycline can effectively treat hematologic malignancies, but has significant risk of cardiotoxicity. We measured the clinical correlation between brain natriuretic peptide (BNP) and anthracycline-induced cardiotoxicity.

Materials and Methods

Between March 2005 and March 2007, 86 patients with acute leukemia, malignant lymphoma, or multiple myeloma receiving systemic chemotherapy with anthracycline were enrolled in the Department of Hemato-oncology, Kosin University Gospel Hospital. We investigated the relationship between BNP level and cardiotoxicity through echocardiography, electrocardiography, BNP levels, and symptoms of heart failure at each chemotherapy cycle.

Results

Of the 86 participants (mean age, 48.5 years; range 20~65 years), cardiotoxicity developed in 21 patients (24.4%), with 2 patients showing arrhythmia only, 17 patients with transient aspects of heart failure, and 2 patients with chronic heart failure. Cardiotoxicity related to serum BNP level, age, cumulative dose of anthracycline, accompanying chronic disease, and elevated level of troponin-I. Heart failure was more common if BNP levels reached 100 pg/ml at least once.

Conclusions

The clinical correlation between BNP and cardiotoxicity was significant in patients with systemic anthracycline chemotherapy. A prospective clinical trial will be needed to identify the causal relationship between serum BNP level and cardiotoxicity.

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Daniela Cardinale, Fabiani Iacopo, Carlo Maria Cipolla
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Letitia Elena Radu, Roxana Corina Sfetea, Constantin Virgiliu Arion, Anca Colita
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Case Report

Intestinal Perforation in Colorectal Cancers Treated with Bevacizumab (Avastin®): Young Il Choi, Seung Hyun Lee, Byung Kwon Ahn, Sung Uhn Baek, Seun Ja Park, Yang Soo Kim, Seong Hoon Shin; Cancer Res Treat. 2008;40(1):33-35. Published online March 31, 2008; DOI: https://doi.org/10.4143/crt.2008.40.1.33

Abstract PDF PubReader ePub

Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor (VEGF), and it has shown promise as a clinical agent against metastatic colorectal cancer, and particularly in combination with chemotherapy. Bowel perforation is a known risk that's associated with bevacizumab use, but the etiology is unknown. Here we report on two cases of metastatic colorectal cancer in which the patients suffered from intestinal perforation after chemotherapy with bevacizumab. For the first case, a 47 year-old man had rectal cancer with concurrent liver and lung metastasis. He underwent chmotherapy with 5-fluorouracil, irinotecan and bevacizumab. Fever and abdominal pain developed seven days later, and rectal perforation was identified upon exploration 13 days later. For the second case, a 48 year-old woman had sigmoid colon cancer with peritoneal and ovary metastases. After seven days of chemotherapy with 5-fluorouracil, oxaliplatin and bevacizumab, exploratory surgery revealed a perforation at the ileum.

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