• Title/Summary/Keyword: advanced cancer

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Recent Progress in Immunotherapy for Advanced Gastric Cancer (진행성 위암에 대한 면역 요법의 최신 지견)

  • Byeong Seok Sohn
    • Journal of Digestive Cancer Research
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    • v.10 no.1
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    • pp.22-30
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    • 2022
  • Immune checkpoint inhibition has been established as a new treatment option for various types of carcinoma, and many clinical trials are being actively conducted as a treatment for advanced or metastatic gastric cancer, either as a monotherapy with an immune checkpoint inhibitor or as a combination therapy with standard chemotherapy. In the CheckMate-649 clinical trial to confirm the efficacy of the combination of nivolumab and chemotherapy (FP) in advanced gastric cancer and gastroesophageal junction cancer, nivolumab group showed improvement in overall survival in programmed death ligand 1-positive cancer patients compared with placebo group. Also, the combination therapy of pembrolizumab, trastuzumab and chemotherapy (FP) in first-line treatment was tested through the KEYNOTE-811 trial. The pembrolizumab group showed 22.7% of improvement in objective response rate compared with placebo group. Accordingly, the combination of nivolumab/pembrolizumab with standard chemotherapy was approved for the first-line treatment. In KEYNOTE-059 trials for patients with progressive disease after at least two lines of chemotherapy, pembrolizumab monotherapy showed improvement in objective response rate and overall survival, and the use of pembrolizumab was approved for the third-line or more treatment. In this article, we review the result of clinical trials related to immune checkpoint inhibitors that have been recently introduced in the treatment of gastric cancer.

Oncological Treatment of Advanced Gastric Cancer (진행성 위암의 항암 약물 요법에 대하여)

  • Hee Seok Moon;Hyun Yong Jeong
    • Journal of Digestive Cancer Research
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    • v.6 no.1
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    • pp.16-24
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    • 2018
  • Gastric cancer is not a single, uniform disease, but rather heterogeneous in nature. It is generally not possible to cure patients with inoperable advanced or metastatic stomach cancer. In the absence of chemotherapy, the median survival time is 3 to 6 months. Therefore, several studies have confirmed the superiority of chemotherapy to the best supportive treatment, in terms of improving the quality of life and prolonging life. Various chemotherapies have been used in the past to treat advanced gastric cancer. Recently, various target therapies and immunotherapy have been introduced. However, compared to other malignancies, the quality of life and life expectancy remain relatively poor in patients with gastric cancer. We expect to overcome these difficulties in the future, with better elucidation of the molecular biology of gastric cancer.

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Preoperative Plasma Fibrinogen Level Is a Useful Predictor of Adjacent Organ Involvement in Patients with Advanced Gastric Cancer

  • Lee, Sang-Eok;Lee, Jun-Ho;Ryu, Keun-Won;Nam, Byung-Ho;Cho, Soo-Jeong;Lee, Jong-Yeul;Kim, Chan-Gyoo;Choi, Il-Ju;Kook, Myeong-Cherl;Park, Sook-Ryun;Kim, Young-Woo
    • Journal of Gastric Cancer
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    • v.12 no.2
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    • pp.81-87
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    • 2012
  • Purpose: The aim of the present study was to assess the association between the pre-operative plasma fibrinogen level and the adjacent organ involvement in advanced gastric cancer. Materials and Methods: A total of 923 pre-operative plasma samples were obtained from 923 patients diagnosed clinically as having advanced gastric cancer, and fibrinogen levels were measured by immunoassay. Associations between fibrinogen levels and clinicopathologic findings (depth of tumor, adjacent organ involvement, and lymph node metastasis), along with survival were examined by univariate and multivariate analyses. Results: Tumor size, tumor depth, and the presence of lymph node metastasis were found to be positively correlated with the preoperative plasma fibrinogen levels (P<0.001). Fifty (5.4%) patients had adjacent organ involvement. Lymphatic invasion (P<0.001), tumor size (P<0.001), clinical T (depth of invasion) stage (P<0.001), and clinical nodal stage (P=0.018) were found to be associated with adjacent organ involvement. Univariate and multivariate regression analyses showed that a preoperatively elevated plasma fibrinogen level was associated with adjacent organ involvement (P<0.001, 0.028), and Kaplan-Meier analysis showed that it was associated with poorer survival (P<0.001). Conclusions: Plasma fibrinogen was found to be a clinically useful marker of adjacent organ involvement and overall survival. When a high fibrinogen level is encountered, preoperatively, adjacent organ involvement should be suspected in clinically advanced gastric cancer.

Potential Predictors of Sensitivity to Pemetrexed as First-line Chemotherapy for Patients with Advanced Non-Squamous NSCLCs

  • Lu, Yan-Yan;Huang, Xin-En;Xu, Lin;Liu, De-Gan;Cao, Jie;Wu, Xue-Yan;Liu, Jin;Xiang, Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2005-2008
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    • 2013
  • Background: Pemetrexed (PEM) is effective in first-line treatment for patients with non-squamous non-small cell lung cancer (NSCLC). However there are currently no definitive determinants to certify which patients could benefit from PEM. To improve the efficacy of PEM combined with platinum as first-line therapy for advanced non-squamous NSCLC, we conducted this retrospective study to detect potential determinants of this regimen. Methods: We recruited 109 patients with advanced non-squamous NSCLC who received PEM with a platinum as first-line therapy from June 2006 to February 2013 in Jiangsu Cancer Hospital. Multiple variables (age, sex, smoking, degree of cell differentiation, hemoglobin, platinum drugs combined, positions of metastasis) were selected. Logistic regression analysis was used to analyse relationships between these variables and tumor response. Result: In univariate analysis, we found that age and platinum significantly influenced the results of PEM therapy (P<0.05). In multivariable analysis, no factors were independently significant. Conclusion: Our analysis did not suggest that the age, sex, metastasis of liver or other organs, hemoglobin, smoking history and pathological differentiation are associated with the response of PEM. We should conduct further analyses with larger sample size to reconfirm this issue.

A Survey of Robotic Technologies for Diagnosis and Treatment of Prostate Cancer (전립선 암 진단 및 치료를 위한 로봇기술 응용 현황)

  • Ahn, Bum-Mo;Park, Ki-Han;Lee, Hyo-Sang;Kim, Jung
    • Journal of Institute of Control, Robotics and Systems
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    • v.16 no.9
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    • pp.852-859
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    • 2010
  • Robotic techniques can be one of the promised solutions to address the prostate cancer which is one of the most important public health problems in medical fields. Despite several past and on-going dedicated researches, the systematic techniques and completed theories have not been established well. Therefore we review the state-of-the-art literature on the applications of engineering technologies with particular focus on diagnosis and treatment of prostate cancer. The current status of the elastography and systematic DRE are presented as novel diagnostic tools, and an overview of the applied technologies to address the limits of the treatment (radical prostectomy and brachytherapy) is reviewed.

Detection of Metastases of Primary Hepatocellular Carcinoma with $^{99m}Tc-HIDA$ Scintigraphy ($^{99m}Tc-HIDA$를 이용(利用)한 원발성간세포암전이(原發性肝細胞癌轉移) 병소(病巢)의 진단(診斷))

  • Hong, Kee-Suk;Hong, Seong-Woon;Lee, Jhin-Oh;Kang, Tae-Woong;Huh, Dai-Suk
    • The Korean Journal of Nuclear Medicine
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    • v.17 no.1
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    • pp.85-87
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    • 1983
  • $^{99m}Tc-Sulfur$ Colloid is concentrated in Kupffer cells of the liver, whereas the new biliary agents such as $^{99m}Tc-HIDA$ are processed by hepatic parenchymal cells. The distant metastatic lesiors in skull and lung of the primary hepatocellular carcinoma in 38-year old Korean male were detected with $^{99m}Tc-HIDA$ scintigraphy. The chest PA, skull bone X-ray and radionuclide scintigraphic studies are illustrated. This observation suggests that $^{99m}Tc-HIDA$ scintigraphy is useful for detection of distant metastases of primary hepatocellular carcinoma.

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Treatment Patterns, Costs, and Survival among Medicare-Enrolled Elderly Patients Diagnosed with Advanced Stage Gastric Cancer: Analysis of a Linked Population-Based Cancer Registry and Administrative Claims Database

  • Karve, Sudeep;Lorenzo, Maria;Liepa, Astra M;Hess, Lisa M;Kaye, James A;Calingaert, Brian
    • Journal of Gastric Cancer
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    • v.15 no.2
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    • pp.87-104
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    • 2015
  • Purpose: To assess real-world treatment patterns, health care utilization, costs, and survival among Medicare enrollees with locally advanced/unresectable or metastatic gastric cancer receiving standard first-line chemotherapy. Materials and Methods: This was a retrospective analysis of the Surveillance, Epidemiology, and End Results-Medicare linked database (2000~2009). The inclusion criteria were as follows: (1) first diagnosed with locally advanced/unresectable or metastatic gastric cancer between July 1, 2000 and December 31, 2007 (first diagnosis defined the index date); (2) ${\geq}65$ years of age at index; (3) continuously enrolled in Medicare Part A and B from 6 months before index through the end of follow-up, defined by death or the database end date (December 31, 2009), whichever occurred first; and (4) received first-line treatment with fluoropyrimidine and/or a platinum chemotherapy agent. Results: In total, 2,583 patients met the inclusion criteria. The mean age at index was $74.8{\pm}6.0years$. Over 90% of patients died during follow-up, with a median survival of 361 days for the overall post-index period and 167 days for the period after the completion of first-line chemotherapy. The mean total gastric cancer-related cost per patient over the entire post-index follow-up period was United States dollar (USD) $70,808{\pm}56,620$. Following the completion of first-line chemotherapy, patients receiving further cancer-directed treatment had USD 25,216 additional disease-related costs versus patients receiving supportive care only (P<0.001). Conclusions: The economic burden of advanced gastric cancer is substantial. Extrapolating based on published incidence estimates and staging distributions, the estimated total disease-related lifetime cost to Medicare for the roughly 22,200 patients expected to be diagnosed with this disease in 2014 approaches USD 300 millions.

Three Weekly Versus Weekly Cisplatin as Radiosensitizer in Head and Neck Cancer: a Decision Dilemma

  • Negi, Preety;Kingsley, Pamela Alice;Srivastava, Himanshu;Sharma, Surender Kumar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1617-1623
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    • 2016
  • Cisplatin-based concurrent chemoradiation plays an undisputed key role as definitive treatment in unresectable patients with locally advanced squamous cell carcinoma head and neck or as an organ preservation strategy. Treatment with 100 mg/m2 3-weekly cisplatin is considered the standard of care but is often associated with several adverse events. The optimum drug schedule of administration remains to be defined and presently, there is insufficient data limiting conclusions about the relative tolerability of one regimen over the other. This review addresses regarding the optimal dose schedule of cisplatin focusing mainly on three-weekly and weekly dose of cisplatin based concurrent chemoradiotherapy in locally advanced head and neck cancer with an emphasis on mucositis, dermatitis, systemic toxicity, compliance, and treatment interruptions. To derive a definitive conclusion, large prospective randomized trials are needed directly comparing standard 3-weekly cisplatin ($100mg/m^2$) with weekly schedule ($30-40mg/m^2$) of concurrent cisplatin based chemoradiotherapy in locally advanced squamous cell carcinoma head and neck.

Two Cases of Advanced Gastric Carcinoma Mimicking a Malignant Gastrointestinal Stromal Tumor

  • Shin, Ha Song;Oh, Sung Jin;Suh, Byoung Jo
    • Journal of Gastric Cancer
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    • v.15 no.1
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    • pp.68-73
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    • 2015
  • Gastric cancer that mimics a submucosal tumor is rare. This rarity and the normal mucosa covering the protuberant tumor make it difficult to diagnosis with endoscopy. We report two cases of advanced gastric cancer that mimicked malignant gastrointestinal stromal tumors preoperatively. In both cases, the possibility of cancer was not completely ruled out. In the first case, a large tumor was suspected to be cancerous during surgery. Therefore, total gastrectomy with lymph node dissection was performed. In the second case, the first gross endoscopic finding was of a Borrmann type II advanced gastric cancer-like protruding mass with two ulcerous lesions invading the anterior wall of the body. Therefore, subtotal gastrectomy with lymph node dissection was performed. Consequently, delayed treatment of cancer was avoided in both cases. If differential diagnosis between malignant gastrointestinal stromal tumor and cancer is uncertain, a surgical approach should be carefully considered due to the possible risk of adenocarcinoma.

Aspergillus fumigatus-derived demethoxyfumitremorgin C inhibits proliferation of PC3 human prostate cancer cells through p53/p21-dependent G1 arrest and apoptosis induction

  • Kim, Young-Sang;Park, Sun Joo
    • Fisheries and Aquatic Sciences
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    • v.24 no.1
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    • pp.1-9
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    • 2021
  • Human prostate cancer is the second most frequently diagnosed cancer worldwide, and its incidence rate continues to increase. Advanced prostate cancer is more difficult to treat than early forms due to its chemotherapy resistance. There is need for more effective agents that can inhibit the progression of advanced prostate cancer. Demethoxyfumitremorgin C (DMFTC) was isolated from the fermentation extract of the marine fungus Aspergillus fumigatus. Antiproliferative activity of DMFTC against human prostate cancer PC3 cells was examined through cell cycle analysis by flow cytometry, the fluorescent nuclear imaging analysis with propidium iodide (PI), and proteins expression related to cell cycle arrest and apoptosis were investigated via Western blotting. DMFTC inhibited PC3 cells growth through G1 phase cell cycle arrest and apoptosis induction. It activated the tumor suppressor p53 and the Cdk inhibitor p21, which regulate the cell progression into the G1 phase. Additionally, PI-positive late apoptotic non-viable cells were increased and the expression levels of the G1-positive downstream regulators cyclin D, cyclin E, Cdk2, and Cdk4 were decreased by DMFTC treatment. These results suggest that DMFTC induces G1 arrest and apoptosis induction through regulation of p53/p21-dependent cyclin-Cdk complexes, and it may be a useful therapeutic agent for the treatment of human advanced prostate cancer.