• Tuberculosis and Respiratory Diseases
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• 제87권1호
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• pp.31-39
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• 2024

After the successful development of targeted therapy and immunotherapy for the treatment of advanced-stage non-small cell lung cancer (NSCLC), these innovative treatment options are rapidly being applied in the adjuvant setting for early-stage NSCLC. Some adjuvants that have recently been approved include osimertinib for epidermal growth factor receptor-mutated tumors and atezolizumab and pembrolizumab for selected patients with resectable NSCLC. Numerous studies on various targeted therapies and immunotherapy with or without chemotherapy are currently ongoing in the adjuvant setting. However, several questions regarding optimal strategies for adjuvant treatment remain unanswered. The present review summarizes the available literature, focusing on recent advances and ongoing trials with targeted therapy and immunotherapy in the adjuvant treatment of early-stage NSCLC.

• 동의생리병리학회지
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• 제26권6호
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• pp.980-982
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• 2012

Metastasis to the pancreas from extra-pancreatic primary cancers are rare; they commonly present as a manifestation of widespread disease and rarely as an isolated mass of the pancreas. Examinations showed a pancreatic tumor infiltrating the pancreas tail portion and an endoscopic ultrasound guided percutaneous biopsy proved that the lesion was metastatic from the lung carcinoma. Most metastatic cases of the pancreas tend to be discovered in patients with widely disseminated malignant disease. In addition, patients with pancreatic metastasis are often asymptomatic, the metastatic lesions are found incidentally, and are misdiagnosed as primary pancreatic tumors. This report that patient undergoing chemotherapy for a small cell lung cancer, who 1 year and 3 months later, accidentally diagnosed of solitary pancreas metastasis and confirmed histology by needle biopsy using endoscopic ultrasound.

• 대한의생명과학회지
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• 제25권4호
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• pp.293-301
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• 2019

Combination chemotherapy is more effective than mono-chemotherapy and is widely used in clinical practice for enhanced cancer treatment. In this study, we investigated the potential synergistic effects of acetaminophen, a common component in many cold medicines, and romidepsin, a histone deacetylase (HDAC) inhibitor, in the A549 non-small cell lung cancer (NSCLC) cell line. The combination of acetaminophen and romidepsin also exerted significant cytotoxicity and apoptosis induced by activation of caspase-3 on tumor cells in vitro. Moreover, combination therapy significantly induced increased production of chemokines that stimulate migration of activated T-cells into tumor cells. This mechanism can lead to active T-cell mediated anti-tumor immunity in addition to the direct cytotoxic chemotherapeutic effect. Activated T-cells led to enhanced cytotoxicity in drug-treated A549 cells through interaction with tumor cells. These results suggested that the interaction between the two drugs is synergistic and significant. In conclusion, our data showed that the use of romidepsin and low concentrations acetaminophen could induce effective anti-tumor effects via enhanced tumor immune and direct cytotoxic chemotherapeutic responses. The combination of acetaminophen with romidepsin should be considered as a promising strategy for the treatment of lung cancer.

• 대한두개안면성형외과학회지
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• 제24권5호
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• pp.240-243
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• 2023

Metastasis of lung cancer to the skin is uncommon, presenting in 0.22% to 12% of lung cancer patients, and it is extremely rare for skin metastasis to be the first clinical manifestation of lung cancer. In the few cases where skin metastasis has been reported as the first sign of lung cancer, the patients were typically heavy smokers or had preexisting respiratory diseases and symptoms. This prompted clinicians to consider skin metastasis of a pulmonary malignancy. Large cell neuroendocrine carcinoma (LCNEC) is a rare type of lung cancer that accounts for approximately 3% of lung cancers. LCNEC mainly metastasizes to visceral organs, such as the liver, bone, and brain, and it only shows metastasis to the skin in very rare cases. Herein, we report an unusual case of a metastatic skin lesion as the first sign of primary pulmonary LCNEC, in a 63-year-old woman with no pulmonary symptoms or personal history of smoking or pulmonary disease.

• Tuberculosis and Respiratory Diseases
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• 제41권3호
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• pp.262-269
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• 1994

연구배경: 소세포 폐암은 비소세포 폐암에 비해 병의 진행경과 및 치료에 대한 반응이 상이하게 나타나는데 저자들은 지난 7년간(1986~1992) 본원에서 진단된 소세포 폐암환자들을 대상으로, 그 치료성적에 대해 고찰해 보고자 하였다. 방법: 조직학적 및 세포진 검사상 폐암으로 진단받은 806명 중 소세포 폐암으로 밝혀진 153명의 환자들을 대상으로 하였으며, 병력일지 및 우편물 또는 전화를 통하여 102명의 환자에 대한 생사확인과 사망일지 등을 확인하였고 임상기록을 중심으로 후향적인 방법으로 분석하였다. 결과: 1) 전체 암환자 수는 8,050명 이었으며, 그 중 폐암환자는 806명(10.0%) 이었고 소세포 폐암환자는 153명으로 전체 폐암환자의 19.0%를 차지했으며, 남녀의 비는 129명: 24명(84.3% : 15.7%) 이었다. 2) 소세포 폐암환자의 연령분포는 60대가 60명(39.2%), 50대가 53명(34.6%)으로 3/4 정도의 환자가 50~60대 사이에 발생했다. 3) 다양한 증상 및 증세를 나타냈으며, 반 수 이상의 환자에서 기침, 객담, 호흡곤란 및 흉통이 있었고 진단방법으로는 128명(83.5%)이 기관지 내시경 및 생검으로 진단 되었으며 ECOG에 의한 수행상태는 $H_2$가 59.5%를 차지하였고, 그 다음은 $H_1$이 30.7%를 차지하였다. 병기 및 위치의 분류는 대개가 limited stage(105명, 68.7%)와 central type(134명, 87.6%) 이었다. 4) 화학요법과 병합요법(항암 및 방사선 치료)을 시행한 군의 치료에 대한 반응을 비교해 본 바 병합요법을 시행한 군이 완전관해 및 부분관해율이 63.4%을 보였으며 평균 생존기간은 3주기 이상의 화학요법으로 시행한 환자중 limited stage의 경우 5.3개월 extensive stage는 4.6개월을 보여 양군간에 유이한 차이가 없었으나, limited stage 에서 시행한 병합요법 환자의 경우 15개월 1일의 평균 생존기간을 나타내어 limited stage시의 화학요법과 유이한 차이를 보였다. 5) 치료의 유무와 상관없이 시행한 각 병기간 환자의 중앙 생존기간은 limited stage가 10.9개월 extensive stage가 4.8개월을 보여 양군간의 유이한 차이를 보였다. 결론: 폐암은 현재 국내에서도 점차 증가하는 추세에 있는 악성 종양중의 하나로 본원에서의 최근 7년간 전체 암환자 순위 중 특히 남자의 경우 위암 다음으로 많았으며, 그 중 소세포 폐암의 치료성적에 대해 후향적인 방법으로 고찰하여 보고하는 바이며, 특히 limited stage 시 항암 및 방사선치료가 항암단일요법보다 더 생존율이 높은것으로 나타났는데, 향후 더 정확한 임상고찰을 위해서는 전향적인 연구가 필요하리라 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제70권3호
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• pp.206-217
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• 2011

Background: Transcription factor FOXP3 characterizes the thymically derived regulatory T cells. FOXP3 is expressed by cancer cell itself and FOXP3 expression was induced by TGF-${\beta}$ treatment in pancreatic cancer cell line. However, the expression of FOXP3 expression is not well known in patients with lung cancer. This study was conducted to investigate the expression of FOXP3 in patients with lung cancer and to investigate the regulation of FOXP3 expression by the treatment of TGF-${\beta}$ and DNA methyltransferase inhibitor in lung cancer cell lines. Methods: FOXP3 expression in the tissue of patients with resected non-small cell lung cancer (NSCLC) was evaluated by immunohistochemistry. The regulation of FOXP3 expression was investigated by Western blot and RT-PCR after lung cancer cell lines were stimulated with TGF-${\beta}1$ and TGF-${\beta}2$. The regulation of FOXP3 expression was also investigated by RT-PCR and flow cytometry after lung cancer cell lines were treated with DNA methyltransferase inhibitor (5-AZA-dC). Results: FOXP3 expression was confirmed in 27% of patients with NSCLC. In NCI-H460 cell line, TGF-${\beta}2$ decreased FOXP3 mRNA and protein expressions. In A549 cell line, both TGF-${\beta}1$ and TGF-${\beta}2$ decreased FOXP3 mRNA and protein expressions. 5-AZA-dC increased FOXP3 mRNA expression in NCI-H460 and A549 cell lines. Moreover, 5-AZA-dC increased intracellular FOXP3 protein expression in A549 cell lines. Conclusion: It was shown that FOXP3 is expressed by cancer cell itself in patients with NSCLC. Treatment of TGF-${\beta}2$ and DNA methyltransferase inhibitor seems to be associated with the regulation of FOXP3 expression in lung cancer cell lines.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2089-2094
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• 2014

Background: Although many prognostic factors have been identified for lung cancers, new ones are needed to determine the course of the disease. Recently, a high neutrophil to lymphocyte ratio (NLR) prior to surgery or treatment has been shown to be an indicator of prognosis for cancer. The aim of this study was to investigate the value of NLR as a prognostic factor and the correlation between NLR and other probable clinical prognostic factors in non small cell lung cancer patients prior to treatment. Materials and Methods: Data of patients who were diagnosed with non-small cell lung cancer in our institution were retrospectively reviewed. Demographic and clinicopathologic characteristics were recorded. NLR was calculated before the application of any treatment. Results: A total of 299 patients, 270 (90%) males and 29 (10%) females, were included in the study. Age (p<0.001) stage (p<0.001), Eastern Cooperative Oncology Group performance status (p<0.001), weight loss (p<0.001), anemia (p<0.001), histopatology (p<0.001), NLR ${\geq}3$ (p=0.048), NLR ${\geq}4$ (p=0.025) and NLR ${\geq}5$ (p=0.018) were found to be the prognostic factors. Age, anemia, Eastern Cooperative Oncology Group performance status, the stage, NLR (${\geq}5$) were an independent prognostic factors. There was a positive correlation between NLR and the Eastern Cooperative Oncology Group performance status (0.23, p=0.001), the C reactive protein levels (r=0.36, p<0.001). Conclusions: Prior to treatment high NLR was found as an independent poor prognosis factor. Besides, NLR correlated with Eastern Cooperative Oncology Group performance status and the C reactive protein levels.

• Radiation Oncology Journal
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• 제37권3호
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• pp.149-155
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• 2019

In metastatic non-small cell lung cancer (NSCLC), the role of radiotherapy (RT) has been limited to palliation to alleviate the symptoms. However, with the development of advanced RT techniques, recent advances in immuno-oncology therapy targeting programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) and targeted agents for epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) translocation allowed new roles of RT in these patients. Within this metastatic population, there is a subset of patients with a limited number of sites of metastatic disease, termed as oligometastasis that can achieve long-term survival from aggressive local management. There is no consensus on the definition of oligometastasis; however, most clinical trials define oligometastasis as having 3 to 5 metastatic lesions. Recent phase II randomized clinical trials have shown that ablative RT, including stereotactic ablative body radiotherapy (SABR) and hypofractionated RT, to primary and metastatic sites improved progression-free survival (PFS) and overall survival (OS) in patients with oligometastatic NSCLC. The PEMBRO-RT study, a randomized phase II study comparing SABR prior to pembrolizumab therapy and pembrolizumab therapy alone, revealed that the addition of SABR improved the overall response, PFS, and OS in patients with advanced NSCLC. The efficacy of RT in oligometastatic lung cancer has only been studied in phase II studies; therefore, large-scale phase III studies are needed to confirm the benefit of local ablative RT in patients with oligometastatic NSCLC. Local intensified RT to primary and metastatic lesions is expected to become an important treatment paradigm in the near future in patients with metastatic lung cancer.

• Journal of Chest Surgery
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• 제55권6호
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• pp.470-477
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• 2022

Background: Upfront surgery followed by systemic treatment is recommended to treat clinical stage I-IIA small cell lung cancer (SCLC), but data on the clinical outcomes are sparse. Thus, this study evaluated the stage migration and long-term prognosis of surgically treated clinical stage I-IIA SCLC. Methods: We retrospectively reviewed 49 patients with clinical stage I-IIA SCLC who underwent upfront surgery between 2000 and 2020. Additionally, we re-evaluated the TNM (tumor-node-metastasis) staging according to the eighth edition of the American Joint Committee on Cancer staging system for lung cancer. Results: The clinical stages of SCLC were cIA in 75.5%, cIB in 18.4%, and cIIA in 6.1% of patients. A preoperative histologic diagnosis was made in 65.3% of patients. Lobectomy and systematic lymph node dissection were performed in 77.6% and 83.7% of patients, respectively. The pathological stages were pI in 67.3%, pII in 24.5%, pIII in 4.1%, and pIV in 4.1% of patients. The concordance rate between clinical and pathological stages was 44.9%, and the upstaging rate was 49.0%. The 5-year overall survival (OS) rate was 67.8%. No significant difference in OS was found between stages pI and pII. However, the OS for stages pIII/IV was significantly worse than for stages pI/II (p<0.001). Conclusion: In clinical stage I-IIA SCLC, approximately half of the patients were pathologically upstaged, and OS was favorable after upfront surgery, particularly in pI/II patients. The poor prognosis of pIII/IV patients indicates the necessity of intensive preoperative pathologic mediastinal staging.

• Molecules and Cells
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• 제37권6호
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• pp.457-466
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• 2014

Proteomic analysis is helpful in identifying cancerassociated proteins that are differentially expressed and fragmented that can be annotated as dysregulated networks and pathways during metastasis. To examine metastatic process in lung cancer, we performed a proteomics study by label-free quantitative analysis and N-terminal analysis in 2 human non-small-cell lung cancer cell lines with disparate metastatic potentials - NCI-H1703 (primary cell, stage I) and NCI-H1755 (metastatic cell, stage IV). We identified 2130 proteins, 1355 of which were common to both cell lines. In the label-free quantitative analysis, we used the NSAF normalization method, resulting in 242 differential expressed proteins. For the N-terminal proteome analysis, 325 N-terminal peptides, including 45 novel fragments, were identified in the 2 cell lines. Based on two proteomic analysis, 11 quantitatively expressed proteins and 8 N-terminal peptides were enriched for the focal adhesion pathway. Most proteins from the quantitative analysis were upregulated in metastatic cancer cells, whereas novel fragment of CRKL was detected only in primary cancer cells. This study increases our understanding of the NSCLC metastasis proteome.