Cancer Research and Treatment

Original Articles

Hematologic malignancy

Outcomes in Refractory Diffuse Large B-Cell Lymphoma: Results from Two Prospective Korean Cohorts: Jun Ho Yi, Seong Hyun Jeong, Seok Jin Kim, Dok Hyun Yoon, Hye Jin Kang, Youngil Koh, Jin Seok Kim, Won-Sik Lee, Deok-Hwan Yang, Young Rok Do, Min Kyoung Kim, Kwai Han Yoo, Yoon Seok Choi, Whan Jung Yun, Yong Park, Jae-Cheol Jo, Hyeon-Seok Eom, Jae-Yong Kwak, Ho-Jin Shin, Byeong Bae Park, Seong Yoon Yi, Ji-Hyun Kwon, Sung Yong Oh, Hyo Jung Kim, Byeong Seok Sohn, Jong Ho Won, Dae-Sik Hong, Ho-Sup Lee, Gyeong-Won Lee, Cheolwon Suh, Won Seog Kim; Cancer Res Treat. 2023;55(1):325-333. Published online April 22, 2022; DOI: https://doi.org/10.4143/crt.2022.008

Purpose
Diffuse large B-cell lymphoma (DLBCL) is the most common hematologic malignancy worldwide. Although substantial improvement has been achieved by the frontline rituximab-based chemoimmunotherapy, up to 40%-50% of patients will eventually have relapsed or refractory disease, whose prognosis is extremely dismal.
Materials and Methods
We have carried out two prospective cohort studies that include over 1,500 DLBCL patients treated with rituximab plus CHOP (#NCT01202448 and #NCT02474550). In the current report, we describe the outcomes of refractory DLBCL patients. Patients were defined to have refractory DLBCL if they met one of the followings, not achieving at least partial response after 4 or more cycles of R-CHOP; not achieving at least partial response after 2 or more cycles of salvage therapy; progressive disease within 12 months after autologous stem cell transplantation.
Results
Among 1,581 patients, a total of 260 patients met the criteria for the refractory disease after a median time to progression of 9.1 months. The objective response rate of salvage treatment was 26.4%, and the complete response rate was 9.6%. The median overall survival (OS) was 7.5 months (95% confidence interval, 6.4 to 8.6), and the 2-year survival rate was 22.1%±2.8%. The median OS for each refractory category was not significantly different (p=0.529).
Conclusion
In line with the previous studies, the outcomes of refractory DLBCL patients were extremely poor, which necessitates novel approaches for this population.

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PI3Kδ inhibitor linperlisib combined with gemcitabine and oxaliplatin for relapsed or refractory diffuse large B-cell lymphoma: a multicenter, single-arm phase Ib/II trial
Peng Sun, Hong Cen, Haiyan Yang, Rui Huang, Zhen Cai, Xuekui Gu, Hanying Bao, Zusheng Xu, Zuhong Xu, Zhi-Ming Li
Cancer Cell International.2025;[Epub] CrossRef
Improving access to chimeric antigen receptor T-cells for refractory or relapsing diffuse large B cell lymphoma therapy in Asia
Ya Hwee Tan, Dok Hyun Yoon, Andrew J. Davies, Christian Buske, Yang Liang Boo, Nagavalli Somasundaram, Francesca Lim, Shin Yeu Ong, Anand Jeyasekharan, Koji Izutsu, Won Seog Kim, Jason Yongsheng Chan
Discover Oncology.2025;[Epub] CrossRef
Recent advances in cellular immunotherapy for lymphoid malignancies
Haerim Chung, Hyunsoo Cho
Blood Research.2023; 58(4): 166. CrossRef
Sphingosine 1-phosphate receptor, a new therapeutic direction in different diseases
Hongyu Chen, Junmin Wang, Caiyun Zhang, Peilun Ding, Shuxia Tian, Junming Chen, Guang Ji, Tao Wu
Biomedicine & Pharmacotherapy.2022; 153: 113341. CrossRef

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Pegfilgrastim Prophylaxis Is Effective in the Prevention of Febrile Neutropenia and Reduces Mortality in Patients Aged ≥ 75 Years with Diffuse Large B-Cell Lymphoma Treated with R-CHOP: A Prospective Cohort Study: Seong Hyun Jeong, Seok Jin Kim, Dok Hyun Yoon, Yong Park, Hye Jin Kang, Youngil Koh, Gyeong-Won Lee, Won-Sik Lee, Deok-Hwan Yang, Young Rok Do, Min Kyoung Kim, Kwai Han Yoo, Yoon Seok Choi, Hwan Jung Yun, Jun Ho Yi, Jae-Cheol Jo, Hyeon-Seok Eom, Jae-Yong Kwak, Ho-Jin Shin, Byeong Bae Park, Shin Young Hyun, Seong Yoon Yi, Ji-Hyun Kwon, Sung Yong Oh, Hyo Jung Kim, Byeong Seok Sohn, Jong Ho Won, Se-Hyung Kim, Ho-Sup Lee, Cheolwon Suh, Won Seog Kim; Cancer Res Treat. 2022;54(4):1268-1277. Published online December 30, 2021; DOI: https://doi.org/10.4143/crt.2021.1168

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Purpose
Febrile neutropenia (FN) can cause suboptimal treatment and treatment-related mortality (TRM) in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP).
Materials and methods
We conducted a prospective cohort study to evaluate the effectiveness of pegfilgrastim prophylaxis in DLBCL patients receiving R-CHOP, and we compared them with the PROCESS cohort (n=485).
Results
Since January 2015, 986 patients with DLBCL were enrolled. Pegfilgrastim was administered at least once in 930 patients (94.3%), covering 90.3% of all cycles. FN developed in 137 patients (13.9%) in this cohort (23.7% in the PROCESS cohort, p<0.001), and 4.2% of all cycles (10.2% in the PROCESS cohort, p<0.001). Dose delay was less common (≥3 days: 18.1% vs. 23.7%, p=0.015; ≥5 days: 12.0% vs. 18.3%, p=0.023) in this cohort than in the PROCESS cohort. The incidence of TRM (3.2% vs. 5.6%, p=0.047) and infection-related death (1.8% vs. 4.5%, p=0.004) was lower in this cohort than in the PROCESS cohort. The 4-year overall survival (OS) and progression-free survival (PFS) rates of the two cohorts were not different (OS: 73.0% vs. 71.9%, p=0.545; PFS: 69.5% vs. 68.8%, p=0.616). However, in patients aged ≥75 years, the 4-year OS and PFS rates were higher in this cohort than in the PROCESS cohort (OS: 49.6% vs. 33.7%, p=0.032; PFS: 44.2% vs. 30.3% p=0.047).
Conclusion
Pegfilgrastim prophylaxis is effective in the prevention of FN and infection-related death in DLBCL patients receiving R-CHOP, and it also improves OS in patients aged ≥75 years.

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Sarcopenia attenuates the efficacy of PEGylated granulocyte colony-stimulating factor in preventing febrile neutropenia
Se-Il Go, Eun-Jeong Jeong, Woo Je Lee, Sungwoo Park, Mi Jung Park, Gyeong-Won Lee
Supportive Care in Cancer.2025;[Epub] CrossRef

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Case Reports

A Case of Metastatic Low-Grade Endometrial Stromal Sarcoma Treated with Letrozole after Ovarian Ablation by Radiotherapy: Kyung Ho Yang, Jung A Shin, Joo Hyuk Jung, Hae Won Jung, Hye Ran Lee, Sunhee Chang, Ji Yeon Park, Seong Yoon Yi; Cancer Res Treat. 2015;47(4):958-962. Published online February 17, 2015; DOI: https://doi.org/10.4143/crt.2014.154

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A 50-year-old woman was admitted to our hospital due to multiple lung nodules detected incidentally on a chest X-ray. A video-assisted thoracoscopic lung biopsy revealed low-grade endometrial stromal sarcoma (LG-ESS). She had undergone a simple hysterectomy 1 year earlier owing to a diagnosis of adenomyosis. A review of her previous hysterectomy specimen showed not endometriosis but LG-ESS. According to the patient’s levels of serum follicle stimulating hormone and estradiol, she was in the premenopausal state with retained and normally functioning ovaries. She then underwent ovarian ablation by radiotherapy, after which she was administered 2.5 mg of letrozole once per day. Three months later, the size of the metastatic nodules in both lungs had decreased. The patient was followed up for 24 months while continuing on letrozole, and maintained a partial remission. We report herein on a case of metastatic LG-ESS treated with letrozole after ovarian ablation by radiotherapy.

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Preoperative Diagnosis and Chemotherapy of Endometrial Stromal Sarcoma with Ultrasound Image Based on Nano Bubble
Jingjing Bi, Guoyun Li, Juan Chen, Ying Yang, Cimei Li
Journal of Biomedical Nanotechnology.2023; 19(1): 117. CrossRef
Long-Term Outcome of Aromatase Inhibitor Therapy With Letrozole in Patients With Advanced Low-Grade Endometrial Stromal Sarcoma
Munekage Yamaguchi, Chimeddulam Erdenebaatar, Fumitaka Saito, Takeshi Motohara, Yo Miyahara, Hironori Tashiro, Hidetaka Katabuchi
International Journal of Gynecological Cancer.2015; 25(9): 1645. CrossRef

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Angiomatoid Fibrous Histiocytoma as a Second Tumor in a Young Adult with Testicular Cancer: Han-Sang Lee, Taewan Kim, Jin-Sook Kim, Hye Ran Lee, Mee Joo, Ji Yeon Park, Seong Yoon Yi; Cancer Res Treat. 2013;45(3):239-243. Published online September 30, 2013; DOI: https://doi.org/10.4143/crt.2013.45.3.239

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Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumor, with a low-grade malignant potential, occurring predominantly in children and young adults. Association between AFH and other malignancies has been rarely reported. A 27-year-old man who presented with a palpable abdominal mass was diagnosed as having testicular cancer with multiple liver and lung metastases. At 16 months after chemotherapy, a follow-up computed tomographic scan revealed a supraclavicular mass measuring 3 cm in size, which was suspected to be a recurrence. The patient underwent surgical excision, and the mass was pathologically diagnosed as a AFH. The patient has had no local recurrence and no distant metastasis for 12 months after resection. To the best of our knowledge, this is the first case report of AFH as a second tumor in a patient with testicular cancer.

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Angiomatoid fibrous histiocytoma in the spinal canal of T3-T4: a case report and literature review
Jiangwei Ding, Gang Zhou, Yang Dong, XinXiao Li, Lei Wang, Baorui Guo, Caibin Gao, Siying Xu, Feng Wang, Tao Sun
British Journal of Neurosurgery.2023; 37(5): 1069. CrossRef
Endobronchial Primary Pulmonary Angiomatoid Fibrous Histiocytoma in a Patient with Testicular Germ Cell Tumor: An Evidence Against Somatic Transformation
Mehmet Çetin, Kubra Katipoglu, İlteriş Türk, Şeref Özkara, Kemal Kosemehmetoglu, Pınar Bıçakçıoğlu
International Journal of Surgical Pathology.2022; 30(6): 662. CrossRef
Angiomatoid Fibrous Histiocytoma: Case Presentation with Review of Literature
Gerardo Cazzato, Anna Colagrande, Antonietta Cimmino, Mariella Silecchia, Teresa Lettini, Leonardo Resta, Giuseppe Ingravallo
Osteology.2021; 1(3): 112. CrossRef
Primary angiomatoid fibrous histiocytoma of the lung with mediastinal lymph node metastasis
Chee Kiang Tay, Mariko Siyue Koh, Angela Takano, Marie Christine Aubry, William R. Sukov, Andrew L. Folpe
Human Pathology.2016; 58: 134. CrossRef
Angiomatoid Fibrous Histiocytoma: The Current Status of Pathology and Genetics
Khin Thway, Cyril Fisher
Archives of Pathology & Laboratory Medicine.2015; 139(5): 674. CrossRef
Imaging of childhood angiomatoid fibrous histiocytoma with pathological correlation
Ali Yikilmaz, Bo-Yee Ngan, Oscar M. Navarro
Pediatric Radiology.2015; 45(12): 1796. CrossRef

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Original Article

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

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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.

Citations

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Medication Prescriptions for Chronic Diseases in Terminal Cancer Patients in Korea: A Real-World Study
Mina Kim, Yonghwan Kim, Jae-Min Park
Journal of Hospice and Palliative Care.2025; 28(1): 18. CrossRef
Impact of palliative care at end-of-life Covid-19 patients – a small-scale pioneering experience
João Luís Rodrigues-Ribeiro, Luísa Castro, Filipa Pinto-Ribeiro, Rui Nunes
BMC Palliative Care.2024;[Epub] CrossRef
Deprescribing in hospitalized patients with cancer: A clinical pharmacist-initiated multidisciplinary intervention
Razan Sakran, Michael Litvak, Nissim Haim, Daniel Kurnik
Journal of Oncology Pharmacy Practice.2024;[Epub] CrossRef
Treatment patterns and out-of-hospital healthcare resource utilisation by patients with advanced cancer living with pain: An analysis from the Stop Cancer PAIN trial
Nikki McCaffrey, Seong Leang Cheah, Tim Luckett, Jane L. Phillips, Meera Agar, Patricia M. Davidson, Frances Boyle, Tim Shaw, David C. Currow, Melanie Lovell, Ali Montazeri
PLOS ONE.2023; 18(2): e0282465. CrossRef
Examining Final-Administered Medication as a Measure of Data Quality: A Comparative Analysis of Death Data with the Central Cancer Registry in Republic of Korea
Yae Won Tak, Jeong Hyun Han, Yu Jin Park, Do-Hoon Kim, Ji Seon Oh, Yura Lee
Cancers.2023; 15(13): 3371. CrossRef
Consultation-Based Deprescribing Service to Optimize Palliative Care for Terminal Cancer Patients
Minoh Ko, Sunghwan Kim, Sung Yun Suh, Yoon Sook Cho, In-Wha Kim, Shin Hye Yoo, Ju-Yeun Lee, Jung Mi Oh
Journal of Clinical Medicine.2023; 12(23): 7431. CrossRef
Prescription Change in Older Adults Patients with End-Stage Cancer after Transition to Palliative Care
Ji Ae Heo, Youn Seon Choi, Jae Young Park, Jung Sik Son
Korean Journal of Clinical Geriatrics.2023; 24(3): 115. CrossRef
Use of potentially inappropriate medication in older patients with lung cancer at the end of life
Laurien Ham, Eric C.T. Geijteman, Mieke J. Aarts, Josephina G. Kuiper, Peter W.A. Kunst, Natasja J.H. Raijmakers, Loes E. Visser, Lia van Zuylen, Edwin J. Brokaar, Heidi P. Fransen
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Tatiana Peralta, Maria Margarida Castel-Branco, Paulo Reis-Pina, Isabel Vitória Figueiredo, Marília Dourado
BMC Palliative Care.2022;[Epub] CrossRef
Preferences and Attitudes of Cardiologists in Management of Patients with Cancer
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Analysis of Drugs Prescribed for Terminal Cancer Patients Two Weeks before Death in a Palliative Care Unit
Hyeon Sik Yun, Youn Seon Choi, Su Hyun Kim, Yoo Jeong Lee, Jae young Park
Korean Journal of Family Practice.2022; 12(5): 346. CrossRef
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Deprescription in Advanced Cancer Patients
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Prescription and Deprescription of Medication During the Last 48 Hours of Life: Multicenter Study in 23 Acute Geriatric Wards in Flanders, Belgium
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Medical Journal of Australia.2015; 202(7): 373. CrossRef
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Case Report

Orbital Infiltration as the First Site of Relapse of Primary Testicular T-cell Lymphoma: Hyun Jung Jun, Won Seog Kim, Ji Hyun Yang, Seong Yoon Yi, Young H. Ko, Jeeyun Lee, Chul Won Jung, Se Woong Kang, Keunchil Park; Cancer Res Treat. 2007;39(1):40-43. Published online March 31, 2007; DOI: https://doi.org/10.4143/crt.2007.39.1.40

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A 43-year-old male presented with a painless left testicular mass. The pathologic diagnosis of the radical orchiectomy specimen was peripheral T-cell lymphoma, unspecified (PTCL-u). According to the Ann Arbor staging system, his initial stage was III because of the right nasopharyngeal involvement. After first-line chemotherapy with four courses of the CHOP regimen and this was followed by involved-field radiotherapy, he achieved complete remission. Two months later, disease recurred to the left ciliary body of the left eye without evidence of involvement at other sites. Although the patient received intensive chemotherapy with autologous hematopoietic stem cell transplantation, he ultimately died of leptomeningeal seeding. Because both the central nervous system (CNS) and the orbit are sanctuary sites for chemotherapy, orbital infiltration of lymphoma should prompt physicians to evaluate involvement of the CNS and to consider performing prophylactic intrathecal chemotherapy as a treatment option.

Citations

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Relapse of Ocular Lymphoma following Primary Testicular Diffuse Large B-cell Lymphoma
Hye Ji Kwon, Joo Yong Lee
Journal of Retina.2023; 8(1): 58. CrossRef
Chronic lymphocytic leukemia and concurrent seminoma in the same testis
Kosuke Miyai, Fumihisa Kumazawa, Kimiya Sato, Hitoshi Tsuda
Journal of Pathology and Translational Medicine.2022; 56(1): 48. CrossRef
Diagnosis, prevention and treatment of central nervous system involvement in peripheral t-cell lymphomas
Natalia Zing, Thais Fischer, Massimo Federico, Carlos Chiattone, Andrés J.M. Ferreri
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Primary testicular T-lymphoblastic lymphoma in a child
Yongren Wang, Jian Li, Yongjun Fang
Medicine.2020; 99(26): e20861. CrossRef
Peripheral T-Cell Lymphoma, Not Otherwise Specified and Concurrent Seminoma in Testis
Junichi Kitagawa, Naoe Goto, Yuhei Shibata, Nobuhiko Nakamura, Hiroshi Nakamura, Nobuhiro Kanemura, Takeshi Hara, Katsuyoshi Takata, Yasuharu Sato, Tadashi Yoshino, Hisashi Tsurumi
Journal of Clinical and Experimental Hematopathology.2015; 55(3): 169. CrossRef
Primary testicular lymphoma
Chan Y. Cheah, Andrew Wirth, John F. Seymour
Blood.2014; 123(4): 486. CrossRef
Testicular lymphoma, intraocular (Vitreoretinal) lymphoma, and brain lymphoma: Involvement of three immunoprivileged sites in one patient
Jacob Pe'er, Jacob M. Rowe, Shahar Frenkel, Eldad J. Dann
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