Cancer Research and Treatment

Evaluating Immunotherapy Outcomes in Elderly Patients with Extensive-Stage Small-Cell Lung Cancer (KCSG LU23-15): Yun-Gyoo Lee, Tae-Hwan Kim, Du-Young Kang, Ji Hyun Park, Kyoungmin Lee, Juwhan Choi, Sung Yong Lee, Ji Won Lee, Yoon Ji Choi, Ah-reum Lim, Jung Yoon Choi, Jung Sun Kim, Hee Kyung Ahn, Jin-Hyuk Choi, Eun Joo Kang; Received May 10, 2026 Accepted August 13, 2026 Published online August 14, 2026; DOI: https://doi.org/10.4143/crt.2026.0507 [Accepted]

Abstract PDF: Purpose
Chemoimmunotherapy has improved outcomes in extensive-stage small-cell lung cancer (ES-SCLC), but its benefit in older adults remains uncertain because this population is underrepresented in clinical trials. We evaluated the real-world efficacy of first-line atezolizumab plus etoposide-carboplatin according to age in patients with ES-SCLC.
Materials and Methods
We conducted a multicenter retrospective study across seven Korean institutions and identified patients with ES-SCLC treated between 2016 and 2022 with atezolizumab plus etoposide-carboplatin or etoposide-platinum chemotherapy alone. Patients with recurrence after prior limited-stage disease or incomplete records were excluded. End points were overall response rate (ORR), progression-free survival (PFS), and overall survival (OS), assessed using Kaplan-Meier methods and Cox regression models.
Results
Among 550 identified patients, 538 were included: 247 received atezolizumab plus chemotherapy and 291 received chemotherapy alone. Overall, 111 patients (20.2%) were aged 75–80 and 57 (10.4%) were older than 80years. In the overall population, atezolizumab was associated with improved PFS (hazard ratio [HR], 0.78; 95% CI, 0.65 to 0.93; p=0.006) and OS (HR, 0.76; 95% CI, 0.63 to 0.93; p=0.006). Age-stratified analyses showed significant PFS benefit only in patients aged 70–75 (HR, 0.67; p=0.049) and significant OS benefit only in patients aged 65–70 (HR, 0.65; p=0.044). Beyond 75 years, neither PFS nor OS was significantly improved. Patients aged ≥75years also had lower ORR and more progressive or non-evaluable disease compared with <75years.
Conclusion
The clinical benefit of adding atezolizumab appears attenuated in ES-SCLC patients age 75 years or older, supporting careful selection and age-adapted treatment strategies.

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Possible Ribociclib-Associated Focal Nodular Hyperplasia–Like Lesion Mimicking Liver Metastasis in a Chemotherapy-Naïve Patient: First Case Report: Ece Ulukal Karancı, Armağan Günal, Ahmet Şükrü Alparslan, Banu Öztürk; Received February 22, 2026 Accepted July 11, 2026 Published online July 15, 2026; DOI: https://doi.org/10.4143/crt.2026.0178 [Accepted]

Abstract PDF: Hepatic focal nodular hyperplasia (FNH)–like lesions mimicking metastasis have been reported as rare complications of cytotoxic chemotherapy, but they have not previously been described in association with CDK4/6 inhibitors alone. We present the case of a 32-year-old chemotherapy-naïve woman with de novo hormone receptor (HR)–positive/HER2-negative metastatic breast cancer who was treated with first-line ribociclib and letrozole. After four cycles, imaging revealed a complete response of her bone metastases alongside a newly developed 5.5-cm hepatic lesion suspicious for visceral progression. Liver function tests remained normal. Two ultrasound-guided percutaneous core biopsies, performed three months apart and directly targeting the lesion, confirmed a benign FNH-like lesion without evidence of malignancy. Ribociclib was continued without modification; at last follow-up the patient remained in sustained complete oncologic response, with the hepatic lesion stable in size and no biochemical or clinical evidence of hepatic dysfunction. To our knowledge, this appears to be the first reported case of an FNH-like hepatic lesion temporally associated with ribociclib in a patient who had not received prior cytotoxic chemotherapy. The principal clinical message is that newly detected hepatic lesions arising during otherwise effective targeted therapy do not necessarily reflect disease progression, and that, in radiologically discordant cases, histopathologic confirmation may be required to avoid premature discontinuation or switching of effective treatment.

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Family-Related Factors Influencing Resilience of Korean Adolescents and Young Adults with Childhood Cancer: A Cross-Sectional Design Study: Heeyeon Son, Radion Svynarenko, Seung Min Hahn, Won Kee Ahn, Seung Yeon Kown, Hae Won Lee, Chuhl Joo Lyu, Jung Woo Han, Sungsil Hong; Received March 10, 2026 Accepted July 8, 2026 Published online July 10, 2026; DOI: https://doi.org/10.4143/crt.2026.0250 [Accepted]

Abstract PDF: Purpose
Resilience is an important psychosocial resource for adolescents and young adults (AYAs) with cancer; however, family-related factors influencing resilience among Korean AYAs remain understudied. This study examined the associations between family environment variables (family strength, parent–adolescent communication, and family support) and resilience among Korean AYAs with childhood cancer.
Materials and Methods
In this cross-sectional study, 141 Korean AYAs (ages 11–26 years) completed self-report questionnaires between June 2019 and January 2021. Guided by the Resilience in Illness Model, parent–AYA communication, family strengths, and family support were assessed. Data were analyzed using descriptive statistics, correlations, and hierarchical regression models.
Results
Resilience was positively correlated with all family-related variables. After adjusting for demographic and clinical characteristics, family strengths (β=0.290, p=0.044) and family support (β=0.447, p<0.001) significantly predicted resilience, explaining 34.7% of the variance. Moderation analysis using Hayes’ PROCESS macro showed that that the association between family strength and resilience was stronger among AYAs receiving active treatment (b=1.2416, p<0.001). In addition, the association between family support and resilience was stronger influence among male AYAs and those under treatment (b=0.530, p<0.001).
Conclusion
Family strength and perceived family support are important correlates of resilience among Korean AYAs with childhood cancer, particularly among male AYAs and those undergoing active cancer treatment. These findings highlight the importance of understanding family dynamics and implementing family-centered approaches to support resilience among AYAs throughout the cancer treatment trajectory.

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The Role of Adjuvant Chemotherapy in High-Risk Stage II Colon Cancer with Microsatellite Instability-High or DNA Mismatch Repair Deficiencies: A Multicenter Pooled Analysis (KCSG-CO24-03): Joon Young Hur, Hana Kim, Soon Il Lee, Se Jun Park, Jina Yun, Seok Yun Kang, Cheolsik Kim, Seung-Hoon Beom, Hyeyeong Kim, So-Yeon Jeon, Jaemin Jo, Yongho Noh, Jong Gwang Kim, Hyun Jin Bang; Received February 14, 2026 Accepted May 27, 2026 Published online May 29, 2026; DOI: https://doi.org/10.4143/crt.2026.0156 [Accepted]

Abstract PDF: Purpose
The benefit of adjuvant chemotherapy (CTx) for high-risk stage II microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) colon cancer remains controversial with discordant international guidelines. This study evaluated outcomes comparing adjuvant chemotherapy group versus surgery only group.
Materials and Methods
This multicenter retrospective analysis included 192 patients with high-risk stage II MSI-H/dMMR colon cancer who underwent curative resection between 2010 and 2020. High-risk features included pT4, grade 3-4, lymphovascular invasion, bowel obstruction/perforation, perineural invasion (PNI), inadequate lymph node sampling (<12), or close margins. The primary endpoint was 5-year relapse-free survival (RFS), excluding second primary malignancies to isolate antitumor efficacy.
Results
Of 192 patients, 128 (66.7%) received adjuvant CTx and 64 (33.3%) underwent observation (median follow-up 60.5 months). Five-year RFS (94.0% vs. 83.7%; p=0.001) and OS (98.3% vs. 89.0%; p=0.001) were significantly higher with adjuvant CTx. Multivariate analysis confirmed adjuvant CTx as an independent predictor for RFS (HR 0.249, 95% CI 0.109-0.571; p=0.001) and OS (HR 0.155, 95% CI 0.051-0.470; p=0.001). PNI was also identified as a significant independent predictor of RFS (HR, 3.581; 95% CI, 1.529 to 8.387; p=0.003) and OS (HR, 4.968; 95% CI, 1.654 to 14.930; p=0.004). CTx-related toxicities were clinically manageable, and no treatment-related deaths were reported.
Conclusion
Adjuvant CTx significantly improves RFS and OS in high-risk stage II MSI-H/dMMR colon cancer, particularly in pT4 and PNI patients. These findings provide evidence to bridge NCCN and ESMO guideline discrepancies, supporting risk-stratified adjuvant CTx in this population.

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Associations between Smoking, Opioid Analgesic Use, and Risk for Chemical Coping in Korean Patients with Advanced Cancer: Eun Hee Jung, Yu Jung Kim, Rony Dev, Koung Jin Suh, Ji-Won Kim, Se Hyun Kim, Jin Won Kim, Keun-Wook Lee, Jee Hyun Kim, Jong Seok Lee, Eduardo Bruera; Received September 20, 2025 Accepted February 2, 2026 Published online February 3, 2026; DOI: https://doi.org/10.4143/crt.2025.1034 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Purpose
We investigated the associations between smoking, pain expression, opioid use, substance use behaviors, coping strategies, and risk of chemical coping in Korean patients with advanced cancer.
Materials and Methods
In this prospective study, 240 patients were enrolled. Demographic and clinical information were obtained from medical records. Smoking status, symptom burden by the Edmonton Symptom Assessment System (ESAS), the Cut down/ Annoyed/Guilty/Eye-opener (CAGE) alcoholism questionnaire results, morphine equivalent daily dose (MEDD), tranquilizers and coffee use, coping strategies, and physician-assessed risk of chemical coping and somatization were assessed using questionnaires and interviews.
Results
Of the 240 patients, 49 (20.4%) were current smokers, 104 (43.3%) were former smokers, and 87 (36.3%) were neversmokers. 161 were male (67.1%); 89.4% (144/161) of these men were current or former smokers, while 88.6% (70/79) of women were never-smokers (p < 0.001). ESAS pain scores did not differ by smoking status (3.0 vs. 2.9 vs. 2.7, p=0.480), but current smokers had higher MEDD (63.5 mg/day vs. 25.1 mg/day vs. 22.3 mg/day, p=0.015). Current smokers were more often CAGE-positive (32.7% vs. 16.3% vs. 2.3%, p < 0.001), heavy coffee drinkers (24.5% vs. 12.5% vs. 0%, p < 0.001) and showed a greater physician-assessed risk of chemical coping (26.5% vs. 8.7% vs. 13.8%, p=0.015).
Conclusion
Among Korean patients with advanced cancer, current smokers were more likely to use higher doses of opioids, have positive CAGE results, and drink more coffee. Close monitoring and appropriate management for the possibility of chemical coping or non-medical opioid use will be important in these patients.

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Circulating Tumor Cell–Based Molecular Responses Stratify EGFR-TKI Efficacy in Patients with EGFR-Mutant Lung Cancer: Seoyoung Lee, Chaeyeon Kim, Chang Gon Kim, Min Hee Hong, Mina Han, Wonrak Son, Gamin Kim, Hyeong Jung Woo, Hyun Young Shin, Jungmin Lee, Minseok S Kim, Hye Ryun Kim; Received June 29, 2025 Accepted January 26, 2026 Published online January 27, 2026; DOI: https://doi.org/10.4143/crt.2025.672 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Purpose
Circulating tumor cell (CTC) is a promising minimally invasive biomarker for epidermal growth factor receptor (EGFR)– mutant non–small cell lung cancer (NSCLC). However, the rarity of CTCs and limitations in their isolation and molecular characterization hinder their clinical utility, particularly in predicting treatment outcomes. This study evaluates the potential of CTC molecular response to predict treatment efficacy and guide therapy in patients with EGFR-mutant NSCLC undergoing EGFR–tyrosine kinase inhibitors (TKI) therapy.
Materials and Methods
Seventy-seven patients with EGFR-mutant NSCLC treated with EGFR-TKIs were enrolled. CTCs were isolated using continuous centrifugal microfluidic technology (Continuous Centrifugal Microfluidics–Circulating Tumor Cell Disc [CCM-CTCD]) and compared with circulating tumor DNA (ctDNA) and tissue biopsy for EGFR mutation analysis. Patients were categorized as CTC molecular responders or non-responders based on a ≥ 44.4% reduction in CTC count from baseline. Progression-free survival (PFS) and tumor burden changes were evaluated.
Results
CTC responders had significantly longer PFS (46.3 vs. 13.6 months, p=0.007) and greater tumor burden reduction (–37.7% vs. –35.2%, p=0.218) compared to non-responders. The CCM-CTCD demonstrated concordance with the cobas test while exhibiting higher sensitivity for EGFR mutation detection among 46 patients who underwent both tests simultaneously. Mutational discordance among tissue, ctDNA, and CTCs highlighted tumor heterogeneity. CTC profiling complemented traditional methods for identifying genomic alterations and predicting early progression.
Conclusion
CTC analysis using CCM-CTCD shows potential as a biomarker for predicting treatment response and prognosis in EGFRmutant NSCLC. Stratification by CTC molecular response may inform risk-adapted treatment; however, its clinical utility remains to be established. Prospective studies are warranted to validate these findings and determine the role of CTC-guided decision-making.

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Pre-treatment Ki-67 Index for Everolimus Efficacy in Patients with Hormone Receptor–Positive and Human Epidermal Growth Factor Receptor 2–Negative Advanced Breast Cancer: A Multicenter Cohort Study: Yujing Tan, Hanfang Jiang, Fei Ma, Bo Lan, Yang Luo, Jiayu Wang, Pin Zhang, Binghe Xu, Weihong Zhao, Ying Fan; Received May 12, 2025 Accepted January 11, 2026 Published online January 14, 2026; DOI: https://doi.org/10.4143/crt.2025.506 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub

Purpose
The study aims to explore the predictive value of the Ki-67 index for everolimus efficacy in patients with hormone receptor–positive and human epidermal growth factor receptor 2–negative (HR+/HER2–) advanced breast cancer (ABC).
Materials and Methods
We collected data on 2,518 cancer patients who received everolimus treatment from three cancer centers in China. Their clinicopathologic characteristics were retrospectively collected. A training cohort and a validation cohort were developed.
Results
A total of 300 patients with HR+/HER2– ABC were included in the study, with 200 patients in the training cohort and 100 patients in the validation cohort. When analyzing the Ki-67 index from 14% to 50%, only the Ki-67 cutoff of 40% was found to be significantly correlated with progression-free survival for patients in the training cohort. Multivariate Cox analyses further showed that Ki-67 index of 40% (p=0.03) was significantly associated with progression-free survival (PFS) in patients treated with everolimus. Patients with Ki-67 less than 40% had an improved PFS of 7.0 months, significantly better than 4.6 months for patients with Ki-67 more than 40% (p=0.03; hazard ratio [HR], 0.67; 95% confidence interval [CI], 0.46 to 0.97). In the validation cohort, patients with a Ki-67 index of less than 40% had a significantly longer PFS of 4.3 months (2.1 vs. 4.3 months, p < 0.001; HR, 0.29; 95% CI, 0.17 to 0.51).
Conclusion
The Ki-67 cutoff value of 40% was identified as an optimal index for predicting the efficacy of everolimus, which may help with the management of everolimus in Chinese patients with HR+/HER2– ABC.

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Efficacy and safety profiles of CDK4/6 inhibitor in patients with hormone receptor-positive and human epidermal growth factor receptor 2-negative (HR+/HER2−) advanced breast cancer (ABC) from the high-altitude versus l
Yujing Tan, Yinyin Ye, Weihong Zhao, Hangfang Jiang, Jiani Wang, Jiuda Zhao, Fei Ma
Cancer Biology & Therapy.2026;[Epub] CrossRef

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Trends in Incidence and Survival of Childhood and Adolescent Cancer in Korea, 2001–2020: Comparison with U.S. SEER Data: Jin Kyung Suh, Eun Hye Park, Meerim Park, Jun Ah Lee, Kyu-won Jung, Hyeon Jin Park; Received July 10, 2025 Accepted December 30, 2025 Published online January 2, 2026; DOI: https://doi.org/10.4143/crt.2025.722 [Epub ahead of print]

Abstract PDF PubReader ePub: Purpose
Childhood cancers are rare but clinically significant. Monitoring incidence and survival trends is essential for evaluating progress in cancer control and identifying areas for improvement.
Materials and Methods
We analyzed cancer incidence and survival trends among individuals aged 0-19 years in Korea using data from the Korea Central Cancer Registry from 2001 to 2020. Cancer types were classified according to the International Classification of Childhood Cancer, third edition (ICCC-3). Age-standardized incidence rates (ASRs) and annual percent changes (APCs) were calculated. Relative survival rates (RSRs) were estimated and compared with data from the United States.
Results
A total of 34,223 cancer cases were identified during the study period. The overall ASR was 151.3 per million person-years, with a significant increasing trend (APC 1.5%). Leukemias were the most common diagnostic group (ASR 43.7), followed by central nervous system tumors and lymphomas. Between 2001-2010 and 2011-2020, the 5-year and 10-year RSRs improved from 75.2% to 84.8% and from 72.7% to 82.7%, respectively. The largest survival gains were observed in leukemia (14.9 percentage points) and neuroblastoma (13.1 percentage points). Compared to Surveillance, Epidemiology, and End Results (SEER) data, Korea showed similar overall survival trends, although differences remained by cancer type and age group.
Conclusion
The incidence of childhood and adolescent cancers in Korea has increased, while survival has significantly improved over the past two decades. These findings highlight substantial progress in pediatric cancer care, while underscoring the need for targeted efforts for specific cancer subtypes and age groups.

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Platinum and 5-Fluorouracil Salvage Therapy for Severe Liver Crisis in Metastatic Breast Cancer: Efficacy and Analysis of Prognostic Factors: I-Wei Ho, Jiun-I Lai, Chun-Yu Liu, Wei-Chi Lin, Muh-Hwa Yang, Ling-Ming Tseng, Ta-Chung Chao; Received November 18, 2025 Accepted December 28, 2025 Published online December 29, 2025; DOI: https://doi.org/10.4143/crt.2025.1262 [Epub ahead of print]

Abstract PDF PubReader ePub: Purpose
Metastatic breast cancer (MBC) with severe hepatic dysfunction due to liver crisis presents a significant treatment challenge, as conventional chemotherapy often requires dose modifications, leading to reduced efficacy. The combination of platinum, 5-fluorouracil, and folinate (PFL) offers a rational treatment strategy. This study evaluates the efficacy and safety of PFL in MBC patients with liver crisis and explores predictive markers for treatment response.
Materials and Methods
This retrospective cohort study, conducted at Taipei Veterans General Hospital, Taiwan, included 44 MBC patients with bilirubin ≥ 3 mg/dL treated between January 2015 and June 2024. Outcomes included bilirubin response rate (≥ 50% reduction from baseline), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events. The area under the curve analysis was used to determine the optimal cutoff for liver function assessment models, and Cox regression identified independent prognostic factors.
Results
Among the 44 patients, 47.7% achieved a bilirubin response within a median of 19 days. Overall, the median PFS and OS were 1.4 and 1.9 months, respectively, but improved to 4.6 and 7.8 months in those achieving bilirubin response. The objective response rate was 22.7%, and the disease control rate was 29.5%. A fibrosis-4 (FIB-4) score < 9.1 predicted a 65% bilirubin response rate, while FIB-4 > 9.1 was also an independent predictor of OS. Grade 3 adverse events occurred in 36.4% of patients.
Conclusion
The PFL regimen is effective in MBC patients with severe liver crisis with hyperbilirubinemia. A FIB-4 score < 9.1 may serve as a potential prognostic factor for bilirubin response and is associated with improved survival outcomes.

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Utilization, Reimbursement, and Barriers to Accessing Sequencing Tests for Cancer Care in the Asia-Pacific Region: KSMO Initiatives to Address Cancer Care Inequity: Omali Pitiyarachchi, Aaron C. Tan, Tawasapon Thambamroong, Rogelio Velasco Jr, Yuji Uehara, Daphne Lee, Hsiang-Fong Kao, Vivek Agarwala, Yueh Ni Lim, Dimas Priantono, Ardhi Rahman Ahani, Kyaw Zin Win, Young Saing Kim, Changhoon Yoo; Received August 20, 2025 Accepted December 18, 2025 Published online December 19, 2025; DOI: https://doi.org/10.4143/crt.2025.896 [Epub ahead of print]

Abstract PDF PubReader ePub: Purpose
The Asia Pacific region is marked by healthcare diversity and economic disparity.
Materials and Methods
To understand the utilization and reimbursement practices of next-generation sequencing (NGS) and other sequencing methods relevant to oncology clinical practice in the region, a semi-structured survey was undertaken of respondents from 11 countries represented by the Korean Society of Medical Oncology (KSMO) 2024 Young Oncologist Forum alumni.
Results
While 79% of respondents reported access to NGS at their institution, full government reimbursement was uncommon and varied by test type and clinical setting. Japan and South Korea offered the most comprehensive public coverage, including for circulating tumor DNA–based liquid biopsy. Lower- and upper-middle–income countries, such as the Philippines, Indonesia, and India, reported no government reimbursement, thus relying on user-pay methods or private insurance payments. One marked barrier to NGS reimbursement was the prohibitive cost of tests (100%), followed by a limited budget to fund testing (78.6%), and then by policy or regulatory restrictions (50.0%). On a similar note, insurance coverage (92.9%) and patient income (85.7%) were key concerns regarding access and equity to tests. Test reimbursement (or lack thereof) and cost were cited almost universally as the most elevated concerns by the respondents.
Conclusion
The findings demonstrated a wide disparity in access, funding and reimbursement of sequencing tests across the region. Addressing cost, improving reimbursement mechanisms, and building infrastructure capacity will be critical for the equitable integration of NGS into routine cancer care in the Asia-Pacific.

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The Application of Contrast-Enhanced Ultrasound Combined with Indocyanine Green Lymphography in the Management of Secondary Upper Limb Lymphedema: Xilong Gong, Lina Wang, Fang Liu, Jiao Zhang, Hui Xiao, Ying Hou, Xuhui Guo, Zhenzhen Liu; Received August 1, 2025 Accepted November 17, 2025 Published online November 18, 2025; DOI: https://doi.org/10.4143/crt.2025.813 [Epub ahead of print]

Abstract PDF PubReader ePub

Purpose
This study aimed to assess the clinical efficacy of contrast-enhanced ultrasound (CEUS) combined with indocyanine green (ICG) lymphography for the treatment of breast cancer–related lymphedema (BCRL).
Materials and Methods
Fifty-two patients with BCRL who underwent lymphaticovenous anastomosis between March 2022 and March 2024 were enrolled, of whom 22 underwent preoperative functional lymphatic vessel localization using ICG lymphography (ICG-L) alone and 30 received CEUS combined with ICG lymphography. Treatment efficacy was evaluated using bioimpedance spectroscopy for segmental water content analysis, calculation of the upper extremity lymphedema (UEL) index, and administration of the Lymphedema Quality of Life Questionnaire (LYMQOL). Surgical parameters were also analyzed.
Results
Baseline characteristics were comparable between the groups. However, at both 6 and 12 months postoperatively, patients in the CEUS+ICG group demonstrated significantly improved outcomes compared to those in the ICG-only group, including: Reduced segmental water differences (6 months: 344.3 vs. 474.6 mL, p=0.022; 12 months: 284.3 vs. 403.6 mL, p=0.016); Lower UEL index (6 months: 124.2 vs. 134.1, p=0.001; 12 months: 123.8 vs. 131.9, p=0.011); Improved LYMQOL scores (6 months: 48.7 vs. 56.6, p=0.003; 12 months: 47.6 vs. 54.2, p=0.007). Additionally, the CEUS+ICG group achieved a significantly higher anastomosis success rate (83.2% vs. 63.3%, p < 0.001) and reduced procedural time per anastomosis (48.9 vs. 61.6 minutes, p=0.002).
Conclusion
The combination of CEUS and ICG-L is associated with precise preoperative lymphatic mapping, a reduction in unnecessary incisions, as well as better anastomosis success rates and postoperative decongestion outcomes.

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Factors influencing the incidence of postoperative lymphedema in patients with locally advanced triple-negative breast cancer
Zhi-yong Liu, Ran Chen
World Journal of Surgical Oncology.2026;[Epub] CrossRef

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Changes in Uptake, Participant Disparities, and Screening Outcomes of the Korean National Lung Cancer Screening Program: A Five-Year Experience: Chang Kyun Choi, Na-Young Lee, Mina Suh, Kui Son Choi, Yeol Kim; Received January 15, 2025 Accepted November 6, 2025 Published online November 10, 2025; DOI: https://doi.org/10.4143/crt.2025.067 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Purpose
Low-dose computed tomography (LDCT) is effective in reducing lung cancer mortality among high-risk smokers. The Korean National Lung Cancer Screening Program (KNLCS), the world’s first nationwide lung cancer screening initiative using LDCT, was launched in 2019. This study aimed to evaluate the KNLCS uptake rates in relation to participants’ economic status and changes in positive screening rates across screening rounds.
Materials and Methods
Data from the National Health Insurance Service (NHIS) and the National Cancer Screening Information System for 2019-2023 were analyzed. Eligible participants in the KNLCS were current smokers aged 54-74 years with a smoking history of at least 30 pack-years. The KNLCS provides counseling by physicians on screening results and smoking cessation. Screening uptake rates, counseling rates, and Lung CT Screening Reporting and Data System (Lung-RADS) distributions were assessed.
Results
Screening uptake rates increased from 24.7% in 2019 to 51.2% in 2023 (p < 0.001). Economic disparities were observed, with higher-income groups showing consistently higher uptake rates than lower-income groups. Screening positive rates have decreased from 9.1% in 2019 to 7.0% in 2023 due to the increasing proportion of subsequent screening participants. The interinstitutional variance in Lung-RADS category 4 decreased significantly over the years (p < 0.001).
Conclusion
The KNLCS rapidly increased screening uptake rates by systematically inviting eligible participants. Positive screening rates decreased primarily due to a reduction in Lung-RADS category 3 findings in subsequent rounds.

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Disease Burden and Treatment Pattern of Advanced or Recurrent Endometrial Cancer in Korea: A Nationwide Database (DIRECTION) Study: Hyun-Woong Cho, Se Ik Kim, Min-Ji Bae, Kyoung-Eun Kwon, Choung Won Jung, Young Eun Lee, Ji Yoon Ahn, Kidong Kim; Received January 15, 2025 Accepted October 16, 2025 Published online October 20, 2025; DOI: https://doi.org/10.4143/crt.2025.065 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Purpose
Advanced/recurrent endometrial cancer (EC) patients have a poor prognosis, with higher recurrence and mortality than early-stage. However, as the real-world disease burden in these patients remains unclear, we aimed to investigate systemic anticancer therapy (SACT) patterns, healthcare resource utilization (HCRU), and costs in advanced/recurrent EC patients.
Materials and Methods
This nationwide population-based study used Korean claims data from 2008 to 2022. Adult patients with advanced/recurrent EC who received first-line SACT were included. For advanced EC, first-line SACT was defined as the initial therapy following EC diagnosis, while for recurrent EC it was defined as the initial therapy after recurrence following completion of primary therapy. We analyzed SACT patterns, prognosis, all cause- and EC-related HCRU, and costs.
Results
A total of 2,704 EC patients were included. The most commonly used SACT was platinum-based regimen. From the first to third line, median values of SACT-free interval (18.40, 5.03, and 3.22 months) and time to next treatment (TTNT, 25.43, 9.27 and 6.44 months) showed decreasing trends. All-cause/EC-related HCRU and costs were increased with SACT progression; all-cause inpatient visits and total costs increased from 0.58 to 1.04 times per-patient-per-month (PPPM) and from $1,197.96 to $2,354.37 USD PPPM.
Conclusion
This study demonstrated significant variability in SACT regimen sequence, highlighting the lack of consensus on standard treatment after disease relapse. Shorter TTNT and SACT-free intervals and higher HCRU and costs in later lines indicate worsening prognosis and increasing disease burden. These findings suggest the urgent need for more effective treatments, including new therapeutic agents, to address the unmet clinical needs of advanced/recurrent EC patients.

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Response to Neoadjuvant Systemic Therapy May Serve as an Indicator for Omitting Post–Breast-Conserving Surgery Radiation Therapy in Women with Early-Stage Breast Cancer: Chaofan Li, Yusheng Wang, Mengjie Liu, Shiyu Sun, Yiwei Jia, Jingkun Qu, Shuqun Zhang, Chong Du; Received June 1, 2025 Accepted September 7, 2025 Published online September 10, 2025; DOI: https://doi.org/10.4143/crt.2025.584 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Purpose
To avoid unnecessary toxicities and optimize the allocation of healthcare resources, it is crucial to adequately select patients with extremely low recurrence risk to downgrade or eliminate radiation therapy (RT).
Materials and Methods
From the Surveillance, Epidemiology, and End Results database, clinical data of 7,291 female patients with early-stage breast cancer who underwent neoadjuvant systemic therapy (NST) and breast-conserving surgery (BCS) were collected for this study. The patients were stratified by their response to NST, and the long-term survival, and risk of recurrence were assessed using Cox regression analysis and Fine-Gray competing risk models for those with and without post-BCS RT, respectively.
Results
Our results showed that female patients with early-stage breast cancer who achieved complete response (CR) to NST, omitting post-BCS RT achieved the same overall survival and disease-free survival as those who received the post-BCS RT, and the omission did not increase the risk of recurrence or breast cancer–specific death. For patients who did not achieve CR to NST, five clinical indicators (including age, N category, grade, response to NST, and molecular subtype) were employed to construct a nomogram for clinical prediction of overall survival, thereby identification of patients at relatively low recurrence risk. The validated results affirmed our model’s ability to accurately discriminate high- and low-risk patients and its promising clinical application value.
Conclusion
Post-BCS RT can be omitted for women with early-stage breast cancer who achieved CR to NST. For those who failed to achieve CR to NST, a nomogram was constructed for clinicians to decide whether to omit post-BCS RT or not based on individualized assessment.

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Analysis of T-Cell Subsets Using Multiplex Immunohistochemistry and Clinical Outcomes of Immune Checkpoint Inhibitors in Advanced Gastric Cancer Patients: Tae-Yong Kim, Jeesun Yoon, Dae-Won Lee, Yoonjin Kwak, Hye Seung Lee, Do-Youn Oh; Received April 28, 2025 Accepted September 7, 2025 Published online September 9, 2025; DOI: https://doi.org/10.4143/crt.2025.458 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub

Purpose
As immunotherapy has become essential in the treatment of gastric cancer (GC), there has been growing interest in T-cells, which play a key role in immunotherapy. In this study, we evaluated the impact of T-cell subsets on immune responsiveness to immune checkpoint inhibitors (ICIs) in GC using multiplex immunohistochemistry (mIHC).
Materials and Methods
Eighty-four GC patients treated with ICIs were enrolled, and we repeated the staining-scanning-stripping procedure nine times to assess different kinds of T-cells or cell-surface immune checkpoints in a single tissue section.
Results
The proportions of patients with microsatellite instability (MSI)–high, Epstein-Barr virus (EBV), and non-MSI/non-EBV were 8.3%, 3.6%, and 88.1%. A high cytotoxic T-cell (T_cyto) density was related to longer overall survival (OS). GC with a high ratio of T_cyto/total T-cells (T_total) and a low ratio of regulatory T-cells (T_reg)/T_total showed better OS. A high density of programmed death-1 (PD-1)– or TIM-3–expressing T_cyto were also associated with longer OS than a low density of those. Among memory T-cells (T_mem) subsets, GC with a high ratio of memory T_cyto/T_mem and a low ratio of memory T_reg/T_mem showed prolonged OS. Better tumor responses were observed in GC with a high ratio of T_cyto/T_total and memory T_cyto/T_mem.
Conclusion
T-cell subsets within the tumor microenvironment were associated with the clinical efficacy of ICIs in GC. PD-1– or TIM-3–expressing T-cells were also associated with response to ICIs, while T_mem subsets were associated with survival. mIHC is a feasible method for evaluating T-cell subsets in archival gastric tumor tissue.

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T cell-mediated immune function in gastric cancer: a bibliometric overview of the last 20 years (2006-2025)
Tao Wang, Li-Li Li, Chun-Yan Wang, Wen-Jing Sui, Mai-Qing Yang
Frontiers in Oncology.2026;[Epub] CrossRef

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1 Crossref

Breast cancer

Impact of High Lymph Node Burden on Brain Metastases in Patients Who Achieved Pathological Complete Response after Neoadjuvant Chemotherapy in HER2-Positive Breast Cancer: Seung Ah Lee, Ki Jo Kim, Do Youn Woen, Su Min Lee, Kawon Oh, Cho Eun Lee, Woong Ki Park, Ji Won Yoo, Dong Seung Shin, Jai Min Ryu, Se Kyung Lee, Byung Joo Chae, Jonghan Yu, Seok Won Kim, Seok Jin Nam, Ji-Yeon Kim, Yeon Hee Park, Eun Young Ko, Eun Sook Ko, Jeong Eon Lee; Cancer Res Treat. 2026;58(3):780-789. Published online July 8, 2025; DOI: https://doi.org/10.4143/crt.2025.219

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aims to investigate the clinical characteristics, outcomes, and predictors of brain metastases in human epidermal growth factor receptor 2 (HER2)–positive advanced breast cancer patients who achieved pathological complete response (pCR) following neoadjuvant chemotherapy (NAC). This research seeks to inform surveillance strategies and optimize management for high-risk subgroups.
Materials and Methods
A retrospective analysis of 1,757 patients (2008-2022) classified them into pCR (n=914) and non-pCR (n=843) groups post-NAC. Collected data included demographics, clinical features, and metastasis parameters. Survival outcomes and brain metastasis predictors were assessed using Kaplan-Meier curves, Cox models, and logistic regression.
Results
Among pCR patients, brain metastases accounted for 54.2% of distant metastases, significantly affecting overall survival (p < 0.001). Median distant metastasis-free survival was shorter for brain metastases (13.4 months) compared to extracranial metastases (31.1 months) in the pCR group (p=0.005). Positive supraclavicular node (SCN) fine needle aspiration (FNA) and clinical N3 (cN3) category were the strongest predictors of brain metastases (SCN FNA: odds ratio [OR], 12.9; p < 0.001; cN3: OR, 12.1; p < 0.001). Multivariable Cox regression analysis revealed that positive SCN FNA and cN3 category were strong predictors of reduced distant metastasis-free survival (SCN FNA: hazard ratio, 2.5; 95% confidence interval [CI], 1.3 to 3.6; p < 0.001; cN3: hazard ratio, 11.3; 95% CI, 4.9 to 33.0; p < 0.001).
Conclusion
This study highlights the challenges of brain metastases in HER2-positive pCR patients, emphasizing the need for tailored therapeutic strategies and enhanced surveillance. High lymph node burden prior to NAC is a significant factor in risk assessment. Therefore, it may be advisable to recommend post-surgery surveillance for high-risk patients.

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Gastrointestinal cancer

Nivolumab Plus Chemotherapy versus Placebo Plus Chemotherapy in Korean Patients with HER2-Negative, Untreated, Unresectable Advanced or Recurrent Gastric or Gastroesophageal Junction Cancer: Subgroup Analysis of a Randomized, Multicenter, Double-Blind Phase 3 Trial (ATTRACTION-4): Yoon-Koo Kang, Min-Hee Ryu, Do-Youn Oh, Sang Cheul Oh, Sun Young Rha, Keun-Wook Lee, Ik Joo Chung, Sung Yong Oh, Sun Jin Sym, Won Ki Kang, Jong Gwang Kim, Byoung Yong Shim, In-Ho Kim, Jin Young Kim, Eun-Kee Song, Hyo-Jin Lee, Seok Yun Kang, Dong-Hoe Koo, So Yeon Oh; Cancer Res Treat. 2026;58(3):846-859. Published online July 2, 2025; DOI: https://doi.org/10.4143/crt.2024.913

Abstract PDF Supplementary Material PubReader ePub

Purpose
We report the safety and efficacy of nivolumab+chemotherapy for first-line treatment of advanced or recurrent gastric or gastroesophageal junction cancer in the Korean subpopulation of the ATTRACTION-4 clinical trial.
Materials and Methods
ATTRACTION-4 (NCT02746796) was a double-blind, randomized, placebo-controlled clinical trial of patients aged ≥ 20 years with histologically confirmed unresectable advanced or recurrent gastric or gastroesophageal junction cancer. Patients received nivolumab or placebo, both combined with physician-choice chemotherapy (oxaliplatin plus oral S-1 [tegafur–gimeracil–oteracil] [SOX] or oral capecitabine [CAPOX]).
Results
Overall, 464 patients were initially screened in Korea and 291 were randomized to nivolumab+chemotherapy (total/SOX/CAPOX: 148/66/82 patients) or placebo+chemotherapy (total/SOX/CAPOX: 143/61/82 patients). Centrally assessed progression-free survival (median, 14.75 vs. 8.34 months; hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.39 to 0.73; p < 0.001), overall survival (19.7 vs. 14.9 months; HR, 0.78; 95% CI, 0.60 to 1.02; p=0.065), overall response rate (54.7% vs. 47.6%), and duration of response (16.03 vs. 9.86 months) favored nivolumab+chemotherapy vs. placebo+chemotherapy. Grade ≥ 3 treatment-related adverse events (TRAEs) (56.1% vs. 44.1%), and any-grade endocrine (9.5% vs. 4.2%), hepatic (23.0% vs. 14.7%), hypersensitivity and infusion reactions (15.5% vs. 7.0%), renal (4.1% vs. 0.7%), and skin (44.6% vs. 23.1%) TRAEs tended to be more frequent in the nivolumab+chemotherapy group.
Conclusion
These findings demonstrate the clinical benefit of nivolumab combined with chemotherapy (either SOX or CAPOX) for first-line treatment of gastric cancer/gastroesophageal junction cancer in Korean patients.

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Claudin18.2 promote gastric cancer proliferation by activating MCM2/5
Bowen Zheng, Miao Fu, Fanzhuoran Lou, Yuting He, Lingying Zhao, Xintian Huang, Xiaowen Xie, Weijuan Tan, Quan Chen, Wenqing Zhang, Yongxiang Hong, Kaiyi Rong, Yuyan Lu, Ping Zhan, Jingke Tu, Huibo Shi, Tianhui Hu, Li Xiao
Scientific Reports.2026;[Epub] CrossRef
Skin toxicity induced by chemotherapy or molecular targeted therapy combined with immune checkpoint inhibitors in Asian patients: A literature review by the Japanese Pharmacist-led Oncodermatology Study Team
Yohei Iimura, Junichi Higuchi, Akimitsu Maeda, Kazuhiro Shimomura, Hirotoshi Iihara, Hironori Fujii, Takuya Iwamoto, Yoshitaka Saito, Hisanaga Nomura, Keiko Komori, Hidenori Tokuda, Ryuta Urakawa, Tatsuya Sumiya, Ryosuke Yanai, Mariko Kono, Masaki Ihira,
International Journal of Clinical Oncology.2026; 31(6): 957. CrossRef
Overcoming diagnostic pitfalls in primary gastric squamous cell carcinoma: the imperative of adequate sampling in an elderly female patient, case report
Wanhui Dong, Li Cheng, Jing Xu, Sheng Xu, Yuling Yin, Qingming Sun, Yong Wu, Yuling Leng
Frontiers in Oncology.2025;[Epub] CrossRef
Zolbetuximab Plus Chemotherapy as First-Line Treatment in Patients with Claudin 18.2-Positive, HER2-Negative, Locally Advanced Unresectable or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma: Korean Population Subgroup—Combined Efficacy and
Keun-Wook Lee, Sang Cheul Oh, Jong Gwang Kim, Sun Jin Sym, Byoung Yong Shim, Seok Yun Kang, In-Ho Kim, Jwa Hoon Kim, Hong Jae Chon, Sang-Hee Cho, Eun-Kee Song, Do-Youn Oh, Jin-Soo Kim, Young Iee Park, Won Ki Kang, Hyung-Don Kim, Janise Lee, Miri Yi, Min-H
Cancer Research and Treatment.2025;[Epub] CrossRef

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Lung and Thoracic cancer

Anticancer Treatment Influences TREM2 in Tumor-Associated Macrophages in Lung Cancer: Yoon Jin Cha, Eun Hye Lee, Chi Young Kim, Yong Jun Choi, Min Kyung Park, Sang Hoon Lee, Eun Young Kim, Yoon Soo Chang; Cancer Res Treat. 2026;58(2):465-480. Published online June 23, 2025; DOI: https://doi.org/10.4143/crt.2024.1245

Abstract PDF Supplementary Material PubReader ePub: Purpose
The triggering receptor expressed on myeloid cells 2 (TREM2) creates an immunosuppressive environment, but the effects of anticancer treatment on TREM2 and the tumor microenvironment (TME) are not well established. This study investigates the impact of chemotherapy on TREM2-expressing macrophages within the lung adenocarcinoma TME.
Materials and Methods
Using single-cell RNA sequencing datasets of paired normal-appearing lung tissue (NL) and tumor (Tu), human and mouse lung cancer tissue, and THP-1 cells, we observed the effects of anticancer drugs on them.
Results
Myeloid cells (MY) were the second-most abundant non-epithelial component in the Tu, though less prevalent than in NL. Specific MY subclusters abundant in Tu showed overexpression of TREM2. In lung cancer-induced Kras-G12D mice, M2 proportion increased in Tu compared to NL; cisplatin increased TREM2+ M2 proportion in Tu. TREM2+ cells in Tu showed interactions with cell clusters showing characteristics of interstitial macrophage such as mo-lineage, mono-Mc, and CD163/LGMN cells via FN:CD44 and MIF:CD74+CXCR4, suggesting that they influence the recruitment of those cells to Tu and TME reshape. In M0-state THP-1 cells, cisplatin and osimertinib treatments induced polarization towards M1 and M2 states and increased TREM2 expression. Cisplatin promoted uptake of phosphatidylserine-coated latex beads by M0 cells, whereas osimertinib reduced uptake by polarized macrophages. These findings suggest anticancer treatments impact the lung immune microenvironment by altering the TREM2+ cells.
Conclusion
Given TREM2’s central inhibitory role in the tumor immune environment, effects of chemotherapeutic agents should be considered in developing TREM2-targeting therapies.

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General

Awareness and Practice of Dietary Recommendations for Cancer Prevention among Participants of the 2023 Korean National Cancer Prevention for Dietary Awareness and Practice Survey: Yoonjoo Choi, Hyein Jung, Byungmi Kim; Cancer Res Treat. 2026;58(2):393-406. Published online June 18, 2025; DOI: https://doi.org/10.4143/crt.2024.642

Abstract PDF Supplementary Material PubReader ePub: Purpose
Most cancers are preventable by improving dietary habits; therefore, individuals with poor dietary behaviors should be encouraged to adopt more active steps to prevent cancer. We surveyed Korean adults to identify the awareness and practice of the recommended guidelines for dietary factors.
Materials and Methods
The 2023 Korean National Cancer Prevention for Dietary Awareness and Practice Survey was a cross-sectional online survey of 4,000 adults aged 20–69. The survey included questions on sociodemographics, lifestyle, and awareness and practice of five dietary recommendations (consuming fruits and vegetables, consuming a balanced diet, avoiding salt, charred foods, and alcohol intake).
Results
Despite more than 90.0% being aware that each dietary recommendation can be a risk determinant for cancer, the practice rate for recommendations showed lower rates than recognition. Especially, in both males and females, the younger (odds ratio [OR], 1.971 in males and 4.863 in females), with no nutritional education (OR, 2.715 in males and 2.093 in females), and the obese (OR, 1.451 in males and 1.579 in females) had higher odds of significant non-adherents (failed to comply with 3-5 recommendations) than participants who were older, had nutritional education, and normal body mass index, respectively.
Conclusion
Although there is high awareness of dietary recommendations for cancer prevention, participants who were younger, had no nutritional education, or were obese showed poor adherence to cancer-preventive dietary practices. Our findings highlight the need for targeted interventions to improve the dietary habits of this at-risk population.

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Genitourinary cancer

Efficacy and Safety of Ifosfamide and Mesna in Metastatic Castration-Resistant Prostate Cancer after Taxane-Based Chemotherapy and Novel Hormonal Therapy Failure: Chang Gon Kim, Yeo Gyeong Ko, Jongjin Yoon, Chung Lee, Seung Hoon Beom, Young-Deuk Choi, Woong Kyu Han, Won Sik Ham, Hyunho Han, Jongsoo Lee, Ji Eun Heo, Daeseong Kim, Eun Sil Baek, Sangwoo Kim, Minsun Jung, Sang Joon Shin; Cancer Res Treat. 2026;58(2):603-612. Published online June 9, 2025; DOI: https://doi.org/10.4143/crt.2025.155

Abstract PDF Supplementary Material PubReader ePub: Purpose
Limited treatment options exist for patients with metastatic castration-resistant prostate cancer (mCRPC) after the failure of taxane-based chemotherapy and novel hormonal therapy. Here, we report the safety and efficacy of ifosfamide and mesna in patients with mCRPC after the failure of taxane-based chemotherapy and novel hormonal therapy (NCT06236789).
Materials and Methods
Patients with histologically confirmed prostate cancer who had failed taxane-based chemotherapy and novel hormonal therapy received ifosfamide 2,500 mg/m² and mesna 1,500 mg/m² on days 1–3, repeated every 21 days. Safety, objective response rate, disease control rate, reduction in serum prostate-specific antigen (PSA) concentration by >50% (PSA₅₀) or >90% (PSA₉₀), radiographic progression-free survival (rPFS), and overall survival (OS) were analyzed.
Results
A total of 47 patients with mCRPC were included in the study. The median number of lines of treatment was 5 (range, 3 to 7). All patients were previously administered docetaxel and novel hormonal therapies including abiraterone (51.1%) and/or enzalutamide (61.7%). Thirty-eight patients (80.9%) were administered cabazitaxel. The objective response and disease control rates were 21.3% and 80.9%, respectively. PSA50 and PSA90 were achieved in 31.9% and 10.6%, respectively. During a median follow-up duration of 54.3 months, rPFS and OS were 5.0 and 9.0 months, respectively. All the patients experienced treatment-related adverse events of any grades; however, no new safety signs were detected. Genomic biomarker analysis revealed that alterations in the TP53 pathway were associated with inferior rPFS and OS.
Conclusion
Ifosfamide and mesna showed appreciable efficacy and manageable safety profiles in heavily treated patients with mCRPC.

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Lung and Thoracic cancer

Comparison of Surveillance with Low-Dose and Contrast-Enhanced Chest Computed Tomography in Patients Disease-Free for 2 Years after Curative Resection for Lung Cancer: Bubse Na, Ji Hyeon Park, Kwon Joong Na, Samina Park, Chang Hyun Kang, Young Tae Kim, In Kyu Park; Cancer Res Treat. 2026;58(2):454-464. Published online June 5, 2025; DOI: https://doi.org/10.4143/crt.2025.256

Abstract PDF Supplementary Material PubReader ePub: Purpose
Low-dose chest computed tomography (LDCT) is recommended for surveillance 2–3 years after curative resection of non-small cell lung cancer (NSCLC); however, supporting clinical evidence is limited. This study compared LDCT with contrast-enhanced chest computed tomography (CECT) in terms of recurrence detection and overall survival (OS) in patients 2 years after curative resection of NSCLC.
Materials and Methods
Among patients who underwent curative resection for NSCLC between January 2011 and December 2017 and survived for 2 years without recurrence, 2,083 patients were included. Comparisons between the LDCT and CECT groups were performed in both the entire cohort and propensity score-matched cohort. The primary outcome was the difference in overall survival. Secondary outcomes included time-to-recurrence, recurrence-free survival, and post-recurrence survival in each group.
Results
In the propensity score-matched population, the 5-year OS (96.0% for LDCT, 98.0% for CECT, p=0.097) and recurrence-free survival (RFS) (95.4% for LDCT, 96.0% for CECT, p=0.761) did not differ. The OS and RFS did not differ in subgroup analyses stratified by pathologic stage and histologic type. In the competing risk analysis, the overall 5-year cumulative incidence of recurrence did not differ between the two groups (4.56% for LDCT, 3.93% for CECT, p=0.765). When stratified by pathologic stage and histologic type, there was no significant difference in the cumulative incidence of recurrence. The distribution of recurrence sites did not differ between groups.
Conclusion
Similar OS and RFS were observed in LDCT and CECT surveillance in patients who achieved a 2-year disease-free status after curative resection for NSCLC.

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General

Association of Physical Activity with Dementia Risk in Cancer Survivors: A Korean Nationwide Cohort Study: Su Kyoung Lee, Minji Han, Sangwoo Park, Sun Jae Park, Jihun Song, Hye Jun Kim, Jaewon Kim, Hyeokjong Lee, Hyun-Young Shin, Kyae Hyung Kim, Sang Min Park; Cancer Res Treat. 2026;58(1):48-60. Published online March 27, 2025; DOI: https://doi.org/10.4143/crt.2024.901

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to investigate the impact of physical activity on dementia risk among cancer survivors in South Korea.
Materials and Methods
This retrospective, population-based cohort study included 344,152 cancer survivors identified from the National Health Insurance Service database in South Korea. The mean follow-up time was 5.81 years. Different levels of physical activity post-cancer diagnosis, ranging from inactive to highly active, were assessed. The primary outcome was the incidence of overall dementia, Alzheimer’s disease, and vascular dementia. Secondary outcomes included dementia risk stratified by cancer type and treatment (chemotherapy and radiation).
Results
Of the total participants, 24,363 (7.08%) developed dementia. The risk of overall dementia decreased sequentially across the exercise groups compared to the inactive group: insufficiently active (adjusted hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.86 to 0.92), active (adjusted HR, 0.85; 95% CI, 0.83 to 0.88), and highly active (adjusted HR, 0.79; 95% CI, 0.76 to 0.82). This inverse relationship between exercise and dementia risk was statistically significant across various cancer types and was consistent regardless of age, comorbidities, and whether or not excluding the first 1, 2 years.
Conclusion
Among cancer survivors in South Korea, increased physical activity post-diagnosis was associated with a significantly lower risk of dementia. These findings underscore the importance of promoting physical activity in cancer survivors for cognitive health.

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Global mammographic asymmetry and short-term breast cancer risk by breast density: a nationwide screening cohort of 5.5 million women
Sangjun Lee, Soyeoun Kim
The Breast.2026; 86: 104708. CrossRef
Interval from Cancer Diagnosis to Depression Onset and Risk of Dementia in Cancer Survivors
Sangjun Lee, Soyeoun Kim
Cancer Epidemiology, Biomarkers & Prevention.2026; 35(8): 1329. CrossRef

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2 Web of Science
2 Crossref

Lung and Thoracic cancer

The Role of Circulating Tumor Cell as a Promising Biomarker in the Evaluation of Pulmonary Nodules: A Prospective Study: Shijie Wang, Changdan Xu, Xiaohong Xu, Weipeng Shao, Guohui Wang, Xiongtao Yang, Liwei Gao, Feng Teng, Hongliang Sun, Yue Zhao, Hongxiang Feng, Guangying Zhu; Cancer Res Treat. 2026;58(1):128-140. Published online March 27, 2025; DOI: https://doi.org/10.4143/crt.2024.841

Abstract PDF Supplementary Material PubReader ePub

Purpose
Our previous study showed that circulating tumor cell (CTC) count combined with gene mutation detection might help differentiate benign and malignant pulmonary nodules (PNs). Herein, we aimed to expand the study cohort and conduct further sequencing analysis.
Materials and Methods
Patients with PNs were included, and CTCs were identified before operation. Low-coverage whole-genome sequencing (LC-WGS) and lung cancer-related targeted gene sequencing were performed on CTCs. The diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curve. The differences in CTC counts among subgroups classified by demographic–clinical characteristics were analyzed. LC-WGS–based copy number variation (CNV) analysis and targeted gene mutation analysis were conducted.
Results
A total of 172 patients were included. CTC count of 2.5 was identified by the ROC curves as the optimal diagnostic cutoff. The sensitivity and specificity of CTC count for differentiating benign and malignant PNs were 54.2% and 78.6%, respectively. The diagnostic sensitivity and specificity of combined CTC count, radiological nodule type, and any malignant imaging features were 84.7% and 71.4%, respectively. The CTC counts were significantly greater in patients with aggressive tumors, later stage, and spread through air spaces. CTCs from malignant cases had more CNVs than those from benign cases.
Conclusion
CTC count can be used in identifying malignant PNs. The diagnostic efficacy can be improved if combined with computed tomography imaging characteristics. Further CNV analysis might help differential diagnosis. Greater CTC count might suggest more aggressive tumors. CTC detection can provide important information and guidance for subsequent management of PNs.

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Integrated CT Radiomics and Circulating Tumor Cell Analysis in Predicting Lung Adenocarcinoma Invasion: A Dual-Center Study with Implications for Personalized Treatment
Qingtao Zhao, Runzhe Wang, Qingxin Zhao, Dahu Ren, Lingxin Kong, Xiaopeng Zhang, Guochen Duan
OncoTargets and Therapy.2026; Volume 19: 1. CrossRef
Establishment of a multi-targeted magnetic combined enrichment system for circulating tumor cells in gastric cancer and analysis of their genomic profiles
Linfei Huang, Yuelu Ruan, Lei Zhu, Jing Xu
Journal of Biomaterials Applications.2026;[Epub] CrossRef

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2 Crossref

General

Presentation of Benefits and Harms in Cancer Screening Guidelines for Koreans: A Systematic Review: Mi Ah Han, Hunju Lee, Kwangmin Kim, Seong Jung Kim, Eu Chang Hwang, Jae Hung Jung; Cancer Res Treat. 2025;57(4):923-931. Published online March 27, 2025; DOI: https://doi.org/10.4143/crt.2024.1151

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study systematically reviewed cancer screening guidelines for the Korean population to evaluate the benefits and harms of the recommended cancer screening practices.
Materials and Methods
We searched international electronic databases from inception to July 2023. Two reviewers independently conducted reference screening and data extraction. Data were extracted based on recommendations from each guideline and presentation of benefits and harms. General characteristics of the cancer screening guidelines, including cancer type, recommended screening methods, certainty of evidence, were collected. Moreover, we obtained key information on the benefits and harms of screening interventions, including the quantification of their relative and absolute effects.
Results
Fifteen recommendations were identified for the use of interventions for the early detection of stomach, liver, colorectal, breast, cervical, and lung cancers in nine guidelines published between 2011 and 2015. Seven guidelines collected evidence through de novo systematic reviews. Eight guidelines presented the certainty of evidence and strength of recommendations. Benefits are presented as relative risks, and harms are presented as absolute risks. Six recommendations presented the absolute effects of both benefits and harms (comparable); eight presented them unevenly, including quantifying benefits relatively but presenting harms as absolute measures (asymmetric); and one presented neither benefits nor harms (incomplete).
Conclusion
More than half of guidelines fail to present the benefits and harms of screening in a balanced manner. To enable users and beneficiaries make informed decisions based on evidence, the benefits and harms supporting recommendations should be given in a transparent and balanced manner.

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151 Download

Breast cancer

Ten-Year Follow-up Clinical Outcomes and the Role of Adjuvant Chemotherapy in HER2-Positive Patients with Microinvasive Breast Cancer: Yeokyeong Shin, Soo-Young Lee, Hyehyun Jeong, Jin-Hee Ahn, Kyung Hae Jung, Sung-Bae Kim, Hee Jeong Kim, Jong Won Lee, Byung Ho Son, BeomSeok Ko, Ji Sun Kim, Il Yong Chung, Hee Jin Lee, Gyungyub Gong, Sae Byul Lee, Jae Ho Jeong; Cancer Res Treat. 2026;58(1):151-158. Published online March 5, 2025; DOI: https://doi.org/10.4143/crt.2024.1120

Abstract PDF Supplementary Material PubReader ePub

Purpose
Although human epidermal growth factor receptor 2 (HER2) positivity is prevalent in microinvasive breast cancer (MIBC), data focused on HER2-positive MIBC are limited. We investigated the clinical course and long-term outcomes of HER2-positive MIBC and evaluated the role of adjuvant chemotherapy.
Materials and Methods
The study included patients with curatively resected pT1mi pN0 HER2-positive breast cancer between January 2000 and January 2020. Treatments and survival outcomes, including invasive breast cancer-free survival (IBCFS), distant recurrence-free survival (DRFS), and overall survival (OS) were analyzed.
Results
The analysis included 799 female patients. The median age was 51 years (range, 23 to 79 years), and 51.6% (n=412) were premenopausal. Multifocality was confirmed in 17.3% (n=138), and estrogen receptor (ER) positivity in 29.8% (n=238). Adjuvant chemotherapy was administered to 17.5% (n=140), with doxifluridine in 96.4% of cases. One patient (0.1%) received trastuzumab. With a median follow-up of 119.0 months (95% confidence interval [CI], 114.0 to 127.0), the 8-year IBCFS, DRFS, and OS were 91.2% (95% CI, 89.1 to 93.3), 97.5% (95% CI, 96.4 to 98.7), and 98.8% (95% CI, 98.0 to 99.6), respectively. No significant differences were observed between patients with and without adjuvant chemotherapy. The lack of differences in IBCFS by chemotherapy was consistent across subgroups, including pre-/postmenopausal patients, grade 1-2/3 tumors, and ER-negative disease.
Conclusion
A clinically meaningful proportion of HER2-positive MIBC patients experience IBCFS events with long-term follow-up. Adjuvant chemotherapy did not improve survival, potentially due to the use of an outdated, ineffective regimen. The role of modern adjuvant regimens, particularly those incorporating HER2-targeted therapy, warrants further exploration.

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Microinvasive carcinoma of the breast
Rachel Han, Edi Brogi
Human Pathology.2025; 162: 105856. CrossRef

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Association between Benign Thyroid Disorders and Breast Cancer Risk in Korean Women: Boyoung Park, Thi Xuan Mai Tran; Cancer Res Treat. 2026;58(1):141-150. Published online February 26, 2025; DOI: https://doi.org/10.4143/crt.2024.787

Abstract PDF PubReader ePub: Purpose
This study aimed to investigate the potential association between thyroid disorders and breast cancer (BC) risk in a cohort of Korean women.
Materials and Methods
Data for this retrospective cohort study were obtained from the Korean National Health Insurance database, including all women aged ≥ 40 who underwent BC screening from 2009 to 2010 in Korea. Thyroid disorders were identified using medical records from 2009 to 2010 and extracted using the International Classification of Diseases, 10th revision (ICD-10) codes for thyroid nodules, hypothyroidism, and hyperthyroidism. BC cases were defined using the ICD-10 codes and tracked until December 2021. A Cox regression model was used to evaluate the association between thyroid disorders and the risk of BC. Additionally, we evaluated the association between well-known risk factors of BC and thyroid disorders using logistic regression analysis.
Results
Among 5,051,633 women, the mean±standard deviation age was 55.2±10.7 years, and the median follow-up was 11.6 years, with 87,784 BC cases recorded. The proportions of patients with thyroid nodules, hypothyroidism, and hyperthyroidism were 2.5%, 1.8%, and 0.9%, respectively. The hazard ratio for BC risk associated with thyroid nodules was 1.16 (95% confidence interval [CI], 1.11 to 1.20), for hypothyroidism was 0.98 (95% CI, 0.93 to 1.03), and for hyperthyroidism was 1.13 (95% CI, 1.06 to 1.21). In both premenopausal and postmenopausal women, an increased risk of BC was significantly associated with thyroid nodules (adjusted hazard ratio [aHR], 1.16 and 1.13) and hyperthyroidism (aHR, 1.11 and 1.16). History of benign breast disease, oral contraceptive use, breastfeeding, menopausal status, and hormone replacement therapy were associated with thyroid nodules and hyperthyroidism.
Conclusion
Our findings suggest an increased risk of BC in women with a history of thyroid nodules and hyperthyroidism, whereas no such association was found in women with hypothyroidism.

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Genitourinary cancer

A Multicenter Phase II Study of Modified FOLFIRINOX for First-Line Treatment for Advanced Urachal Cancer (ULTIMA; KCSG GU20-03): Inkeun Park, Jae Lyun Lee, Shinkyo Yoon, Sang Joon Shin, Seong-Hoon Shin, Jung Hoon Kim, Kwonoh Park, Hyo Jin Lee; Cancer Res Treat. 2026;58(1):284-291. Published online February 13, 2025; DOI: https://doi.org/10.4143/crt.2024.1231

Abstract PDF PubReader ePub

Purpose
This study aimed to assess the efficacy and safety of first-line modified FOLFIRINOX in patients with advanced urachal cancer.
Materials and Methods
The ULTIMA trial (NCT04611724) is a single-arm, open-label, multicenter phase II study evaluating modified FOLFIRINOX (oxaliplatin 85 mg/m² over 2 hours, irinotecan 150 mg/m² over 1.5 hours, leucovorin 400 mg/m² over 2 hours, and 5-fluorouracil 2,400 mg/m² over 46 hours) plus prophylactic pegteograstim in patients with recurrent or metastatic urachal cancer every 2 weeks for up to 12 cycles, or until disease progression or unacceptable toxicity. The primary endpoint was the overall response rate (ORR). Secondary endpoints included progression-free survival (PFS), overall survival (OS), and the incidence of febrile neutropenia.
Results
Between April 2021 and November 2023, 21 patients with advanced urachal cancer were enrolled across five cancer centers. The median age was 50 years (range, 28 to 68 years), with 15 male patients. The most common metastatic site was the lung (47.6%), followed by lymph nodes (38.1%) and peritoneal seeding (33.3%). Two patients and 11 patients achieved a complete and partial response, respectively, yielding an ORR of 61.9%. The study met its primary endpoint in the first stage. With a median follow-up of 23.3 months, the median PFS was 9.3 months (95% confidence interval [CI], 6.7 to 11.9), and the median OS was 19.7 months (95% CI, 14.3 to 25.1). The treatment regimen was well tolerated, with no unexpected adverse events, and no instances of febrile neutropenia or grade 4 adverse events.
Conclusion
In this preliminary analysis of the ULTIMA trial, Modified FOLFIRINOX demonstrated a promising ORR and PFS in patients with advanced urachal cancer. Completing the full study is essential to confirm the potential role of this regimen in the management of advanced urachal cancer.

Citations

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Patient-derived d-MMR/MSI phenotype urachal cancer organoids for personalized drug screening
Kuangen Zhang, Xinyi Li, Zhenting Zhang, Ning Zhang, Xin Yao, Rong Liu
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Robotic Partial Cystectomy and Extended Pelvic Lymph Node Dissection for Node-Positive Urachal Adenocarcinoma in a 34-Year-Old Woman: A Case Report
Stefanie Herrmann, Christian Gilfrich, Stephan Siepmann, Julio Ruben Rodas Garzaro, Fabian Eder, Stephan Schleder, Philipp Aubele, Felix Keil, Matthias May, Anton Kravchuk
Current Oncology.2026; 33(4): 190. CrossRef
Efficacy and safety of camrelizumab plus apatinib in advanced urachal cancer (RUN-SC-0102): a single-arm, multicentre, phase 2 trial in China
Mengyang Ju, Wenfeng Li, Linjun Hu, Xiongjun Ye, Wangjun Yan, Sheng Zhang
eClinicalMedicine.2026; 96: 103978. CrossRef
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Henning Reis, Tibor Szarvas, Gladell P. Paner
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Palliative medicine

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; Cancer Res Treat. 2025;57(4):1231-1239. Published online December 26, 2024; DOI: https://doi.org/10.4143/crt.2024.557

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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 < 0.001 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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Moonho Kim, Yoonseok Choi, Youngjong Cho, Shin-Tae Kim, Hyeonjun Lee, Seong Hun Park
Supportive Care in Cancer.2026;[Epub] CrossRef

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Identifying Trends in Oncology Research through a Bibliographic Analysis of Cancer Research and Treatment: Choong-kun Lee, Jeong Min Choo, Yong Chan Ahn, Jin Kim, Sun Young Rha, Chai Hong Rim, On behalf of the 50th Anniversary Committee of the Korean Cancer Association; Cancer Res Treat. 2025;57(1):11-18. Published online December 5, 2024; DOI: https://doi.org/10.4143/crt.2024.688

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During the celebration of the 50th anniversary of the founding of the Korean Cancer Association, articles published in Cancer Research and Treatment from 2004 to 2023 were assessed based on the subject and design of each study. Based on this analysis, trends in domestic cancer research were inferred and directions were suggested for the future development of Cancer Research and Treatment.

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ATR inhibitors: from targeting the DNA damage response to exploiting synthetic lethality—A paradigm shift in Cancer therapy
Xin Zhou, Qi Qin, Huizhi Yao, Yuxing Fu, Linxiao Wang, Wufu Zhu, Qiaoli Lv
Bioorganic Chemistry.2026; 171: 109538. CrossRef
Up and Down of Cancer Research and Treatment (CRT)’s Journal Impact Factor at the Moment of CRT’s 60th Anniversary
Yong Chan Ahn
Cancer Research and Treatment.2026; 58(3): 695. CrossRef

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General

Associations of Financial Toxicity with Employment Concerns and Cancer-Related Distress: A Cross-Sectional Survey among Korean Working-Age Cancer Survivors: Hyun-Ju Seo, Dal-Lae Jin, Young Ae Kim, Su Jung Lee, Seok-Jun Yoon; Cancer Res Treat. 2025;57(3):659-668. Published online December 3, 2024; DOI: https://doi.org/10.4143/crt.2024.090

Abstract PDF Supplementary Material PubReader ePub

Purpose
Although South Korea’s health insurance has a co-payment-decreasing policy for cancer survivors, information on the extent of financial toxicity and its related factors is limited. We assessed the level of financial toxicity and the association of high levels of financial toxicity with employment concerns after diagnosis and cancer-related distress in working-age cancer survivors.
Materials and Methods
A cross-sectional study was conducted. Study participants were recruited from the National Cancer Survivorship Center between November and December 2022. Financial burden was assessed using the Korean version of the Comprehensive Score for Financial Toxicity, and cancer-related distress was measured using the National Comprehensive Cancer Network Distress Thermometer. Multivariate logistic regression analyses were used to explore the associations between high financial toxicity, cancer-related distress, and changes in employment status after cancer diagnosis.
Results
Of 1,403 working-age cancer survivors, approximately 62% reported high levels of financial distress. Survivors reporting early retirement and taking time off work with the intent to return were more likely to report high financial toxicity (adjusted odds ratio [OR], 1.69; 95% confidence interval [CI], 1.14 to 2.5; and adjusted OR, 2.82; 95% CI, 1.24 to 6.43, respectively) than those with a full-time or part-time job. Moreover, cancer survivors with high distress levels were more likely to report high financial toxicity than those with low distress levels (adjusted OR, 4.36; 95% CI, 3.17 to 5.99).
Conclusion
High financial toxicity is associated with adverse employment concerns and cancer-related distress among working-age cancer survivors. Therefore, developing cancer survivorship interventions within the healthcare system is necessary to ensure improvements in financial well-being.

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Effect of early integration of supportive care in addition to standard care in patients with breast cancer: A randomised controlled trial
Himanshu Varshney, Prateek Maurya, Nishkarsh Gupta, Atul Batra, Ajay Gogia, Brajesh Kumar Ratre, Sachidanand Jee Bharati, Vinod Kumar, Rakesh Garg, Rajiv Kumar Malhotra, Seema Mishra, Sushma Bhatnagar
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Chronic Disease and Future Perceptions of Financial Control
Victoria H. Davis, Guanghao Zhang, Minal R. Patel
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Hea Lim Choi, Jin-Hyung Jung, Hwa-Young Lee, Kyungdo Han, Dong Wook Shin
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The Lancet Regional Health - Western Pacific.2025; 65: 101749. CrossRef
Direct and Indirect Costs of Cancer in Adult Population of Poland in the Period 2021–2023
Izabela Gąska, Aleksandra Czerw, Monika Pajewska, Olga Partyka, Dorota Charkiewicz, Andrzej Deptała, Anna Badowska-Kozakiewicz, Katarzyna Sygit, Ireneusz Dziubek, Paulina Wojtyła-Buciora, Jarosław Drobnik, Piotr Pobrotyn, Dorota Waśko-Czopnik, Tomasz Sowi
Cancers.2025; 17(23): 3725. CrossRef

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