Cancer Res Treat [JOURNAL]
Sun
200 papers
Is Adjuvant Chemotherapy Necessary for All Patients with pT3N0 Rectal Cancer after Upfront Surgery? A Multicenter Retrospective Study.
Kang KM, Lee HY, Ahn HM … +11 more , Oh HK, Kim DW, Kang SB, Lee DW, Park SC, Oh JH, Kim MJ, Park JW, Ryoo SB, Jeong SY, Park KJ
Cancer Res Treat · 2026 May · PMID 42086077 · Publisher ↗
PURPOSE: The role of adjuvant chemotherapy (ACT) in pathologic T3N0 (pT3N0) rectal cancer, which has a favorable prognosis, remains controversial because high-risk groups for recurrence are not well defined. This study i...
PURPOSE: The role of adjuvant chemotherapy (ACT) in pathologic T3N0 (pT3N0) rectal cancer, which has a favorable prognosis, remains controversial because high-risk groups for recurrence are not well defined. This study investigated prognostic factors for survival in this patient group and evaluated the benefit of ACT based on these factors. MATERIALS AND METHODS: This retrospective study analyzed 352 patients with pT3N0 rectal cancer who underwent upfront radical surgery at three referral hospitals between November 2003 and December 2020. A multivariable Cox regression model was used to identify the prognostic factors for 5-year recurrence-free survival (RFS). Patients were categorized as high or low risk based on these factors, and survival outcomes were compared between those who received ACT and those who did not, using the log-rank test. RESULTS: Median follow-up was 52.8 months. 193 (54.8%) patients received ACT. Multivariable analysis revealed that ACT, circumferential resection margin (CRM) ≤ 2mm, vascular invasion, and perineural invasion were independent predictors of 5-year RFS. In patients with ≥ 1 risk factor, ACT significantly improved RFS (92.5% vs. 72.8%, hazard ratio [HR] 0.247, 95% confidence interval [CI] 0.090-0.683, p < 0.01). In those without risk factors, no significant benefit was observed (98.0% vs. 91.6%, HR 0.272, 95% CI 0.057-1.313, p=0.082). CONCLUSION: This study identified CRM ≤ 2mm, vascular invasion, and perineural invasion as high-risk features for recurrence in pT3N0 rectal cancer. ACT improved RFS only in patients with these features. While these findings support risk-based ACT administration in this patient population, further validation of our risk stratification system is needed.
A Phase Ib/II Study of Pemigatinib in Combination with Paclitaxel in Patients with Gastric Cancer with FGFs/FGFRs Alterations.
Jung M, Park SH, Kim H … +12 more , Kim Y, Yun UJ, Hwang J, Kim HS, Lee CK, Kim H, Lee C, Koo DH, Jeung HC, Zang DY, Song EK, Rha SY
Cancer Res Treat · 2026 May · PMID 42086076 · Publisher ↗
PURPOSE: Pemigatinib is a selective inhibitor of fibroblast growth factor receptors (FGFR) 1-3 with demonstrated activity in tumors harboring FGFR2 fusions or amplifications. This phase Ib/II trial assessed the efficacy...
PURPOSE: Pemigatinib is a selective inhibitor of fibroblast growth factor receptors (FGFR) 1-3 with demonstrated activity in tumors harboring FGFR2 fusions or amplifications. This phase Ib/II trial assessed the efficacy and safety of pemigatinib in combination with paclitaxel in patients with recurrent or advanced gastric cancer exhibiting FGFs/FGFRs alterations. MATERIALS AND METHODS: Patients with gastric cancer harboring FGFs/FGFRs aberrations who experienced progression following first-line therapy were enrolled. The phase Ib component established the recommended phase II dose (RP2D); the phase II component evaluated clinical efficacy. RESULTS: Twelve patients were enrolled. The RP2D was determined as pemigatinib 13.5 mg/day (days 1-21) plus paclitaxel 80 mg/m² (days 1, 8, 15) every 4 weeks. Median progression-free and overall survival were 4.4 and 10.5 months, respectively. Patients with FGFR2 amplification (n=6) exhibited prolonged progression-free survival (6.5 vs. 3.5 months, p=0.049), while overall survival did not differ significantly. The objective response and disease control rates were 33.3% and 91.7%, respectively. The most frequent treatment-related adverse events were neutropenia (83.3%, grade ≥3: 58.3%) and hyperphosphatemia (83.3%, grade ≥3: 33.3%). CONCLUSION: Pemigatinib plus paclitaxel demonstrated antitumor activity with an acceptable safety profile in FGFR2-amplified gastric cancer. Further investigation is warranted to elucidate resistance mechanisms and validate these findings in larger cohorts.
Multimodal Knowledge Graph-Guided RAG-LLM for Clinical Decision Support in Pediatric Leukemia.
Song JK, Youk DB, Kim H … +1 more , Hwang SH
Cancer Res Treat · 2026 Apr · PMID 42025216 · Publisher ↗
PURPOSE: This study aims to develop and evaluate a multimodal, knowledge graph-guided retrieval-augmented generation (RAG) framework for clinical decision support in pediatric acute leukemia. MATERIALS AND METHODS: Autho...
PURPOSE: This study aims to develop and evaluate a multimodal, knowledge graph-guided retrieval-augmented generation (RAG) framework for clinical decision support in pediatric acute leukemia. MATERIALS AND METHODS: Authoritative pediatric hematology-oncology textbooks were decomposed into text, tables, and figures. Visual and tabular elements were converted into structured textual descriptions using a multimodal large language model (LLM). A biomedical knowledge graph was constructed using LightRAG with gpt-oss-20b and Qwen3 embeddings. System performance was evaluated using 10 clinical questions, with responses generated by the RAG system and GPT-4.5. Nine medical experts (4 pediatric hematology-oncology specialists, 3 nurse specialists, and 2 medical students) conducted blind evaluations, complemented by two LLM evaluators (Claude Sonnet 4.5 and Gemini 3). RESULTS: The knowledge graph comprised 10,062 nodes and 15,876 edges. In expert evaluation, RAG was preferred in 47.8% of 90 paired comparisons versus 35.6% for GPT-4.5, with higher completeness scores (3.84 vs 3.51, p = 0.016). RAG showed significant advantage for ETP-ALL immunophenotype definition (p = 0.016). LLM-based evaluation consistently favored RAG: Claude Sonnet 4.5 preferred RAG in 6 of 10 questions, and Gemini 3 in 9 of 10 (Fast mode) and 7 of 10 (Thinking mode). CONCLUSION: Multimodal graph-based RAG is feasible for clinical decision support in pediatric leukemia. RAG showed complementary strengths to foundation model LLMs, providing added value for questions requiring evidence-dependent information. Unlike LLMs with static training knowledge, RAG can incorporate updated guidelines and protocols without model retraining, particularly relevant in rapidly evolving fields. Further validation regarding privacy and regulatory issues is required before clinical deployment.
Toward Sustainable Care in HER2-Positive Metastatic Breast Cancer: Emerging Evidence for Treatment De-escalation.
Lee MX, Lee SC
Cancer Res Treat · 2026 Apr · PMID 42025215 · Publisher ↗
Major advances in the management of HER2-positive (HER2+) metastatic breast cancer (MBC) have been achieved through treatment intensification with novel HER2-targeted agents and combination strategies, resulting in subst...
Major advances in the management of HER2-positive (HER2+) metastatic breast cancer (MBC) have been achieved through treatment intensification with novel HER2-targeted agents and combination strategies, resulting in substantial survival gains. However, indefinite exposure to systemic therapy imposes cumulative toxicity, financial strain, and quality-of-life burdens. In contrast, the concept of treatment de-escalation, aimed at maintaining disease control with less intensive therapy, has only recently emerged as a complementary paradigm. This review highlights two evolving avenues of treatment de-escalation. First, in hormone receptor-positive (HR+)/ HER2+ disease, randomized trials have demonstrated that combining HER2 blockade with endocrine therapy and CDK4/6 inhibitors can overcome endocrine resistance, offering a chemotherapy-sparing approach with outcomes comparable to chemotherapy or antibody-drug conjugates. Second, in long-term responders, retrospective analyses and ongoing prospective trials are evaluating whether discontinuation of prolonged maintenance HER2 therapy can safely reduce treatment burden while preserving disease control, with the added potential for effective rechallenge upon relapse. Together, these developments suggest that treatment de-escalation represents a rational and necessary treatment strategy. Future progress will depend on biomarker-driven patient selection and prospective validation. Redefining success in HER2+ MBC to include not only survival but also quality of life and sustainability represents an important step toward patient-centered cancer care.
Is Complete Mesocolic Excision with Central Vascular Ligation Necessary for Suspected Early-stage Right-sided Colon Cancer?
Choi MJ, Kim DW, Jun YK … +5 more , Lee JA, Lee J, Ahn HM, Oh HK, Kang SB
Cancer Res Treat · 2026 Apr · PMID 41986934 · Publisher ↗
PURPOSE: To assess lymph node status in patients undergoing additional surgery after endoscopic resection to evaluate the need for complete mesocolic excision with central vascular ligation for clinically suspected early...
PURPOSE: To assess lymph node status in patients undergoing additional surgery after endoscopic resection to evaluate the need for complete mesocolic excision with central vascular ligation for clinically suspected early-stage right-sided colon cancer. MATERIALS AND METHODS: This retrospective study, conducted at a single institution using a prospectively collected database, comprised patients who underwent additional surgery following endoscopic intervention between May 2003 and March 2022. The primary outcomes were the rate and location of lymph node metastases, including peritumoral, pericolic, and superior mesenteric lymph nodes. The secondary outcome was recurrence-free survival. RESULTS: Among 119 patients, pathological examination identified 5 (4.2%) with Tis requiring surgery owing to uncheckable margins or tumor depth, 106 (89.1%) with stage T1 tumors, and 8 (6.7%) with stage T2 tumors. The nodal stage was N0 in 107 patients (89.9%) and N1 in 12 (10.1%) patients. The mean number of harvested lymph nodes was 39.7, including 7.6 ± 6.9 peritumoral, 31.5 ± 14.4 pericolic, and 4.0 ± 3.8 superior mesenteric nodes. All metastatic lymph nodes were in the peritumoral and pericolic regions. At a mean follow-up of 48.2 months, recurrence occurred in one (0.8%) patient, who developed liver metastases 24 months postoperatively. CONCLUSION: For patients with clinically suspected early-stage right-sided colon cancer who initially underwent endoscopic resection, the risk of superior mesenteric node metastases is very low. D2 lymph node dissection alone may be sufficient rather than routine application of complete mesocolic excision with central vascular ligation, which might be reconsidered in these patients.
Therapeutic Potential of Engineered Stem Cell Line with Chemokine Receptors and TRAIL/CD::UPRT in Glioblastoma Treatment.
Ahn S, Lee SM, Kim HJ … +3 more , Park SA, Sung YC, Jeun SS
Cancer Res Treat · 2026 Mar · PMID 41927038 · Publisher ↗
PURPOSE: Glioblastoma (GBM) is an aggressive primary brain tumor marked by a poor prognosis and limited effectiveness of current therapies, which are often accompanied by substantial recurrence rates. To address this cha...
PURPOSE: Glioblastoma (GBM) is an aggressive primary brain tumor marked by a poor prognosis and limited effectiveness of current therapies, which are often accompanied by substantial recurrence rates. To address this challenge, we developed BM03, an engineered mesenchymal stem cell (MSC) line specifically designed for glioblastoma therapy. BM03 is structured to enhance migration to GBM sites and deliver targeted, multimodal gene-based therapies. MATERIALS AND METHODS: This cell line was developed by transducing bone marrow-derived MSCs with lentiviral vectors to enable (1) continuous growth through immortalization, (2) tumor-targeted migration via GBM-associated chemokine receptors CCR2 and CXCR4, and (3) direct tumoricidal effects through TRAIL and CD::UPRT gene expression for apoptosis and prodrug activation. RESULTS: BM03 demonstrated strong chemotaxis toward GBM cells in both in vitro and in vivo models, facilitated by CCR2 and CXCR4 co-expression, which was maintained through tetracycline transactivator (tTA)-mediated transcriptional control. The combination of TRAIL and CD::UPRT showed significant cytotoxicity, effectively overcoming TRAIL resistance in GBM cells and exhibiting enhanced antitumor effects in a GBM mouse xenograft model. Moreover, repeated BM03 administration, particularly when combined with temozolomide (TMZ), resulted in sustained tumor regression and improved survival. CONCLUSION: To enhance clinical relevance, we evaluated intraventricular administration, which effectively bypasses the blood-brain barrier and targets dispersed GBM lesions. This study establishes BM03 as a potent, safe, and multifunctional stem cell platform with potential to advance targeted GBM therapy through improved migration, multimodal cytotoxicity, and a strategic administration route for enhanced therapeutic efficacy.
Comparative Effectiveness of Tafasitamab Plus Lenalidomide versus Ifosfamide, Carboplatin, Etoposide-Based Chemotherapy for Relapsed/Refractory Diffuse Large B-cell Lymphoma: An External Control Arm Study.
Jung K, Kim JH, Lim H … +5 more , Kim S, Hyun BJ, Yoo SH, Shin JY, Kim SJ
Cancer Res Treat · 2026 Mar · PMID 41927037 · Publisher ↗
PURPOSE: L-MIND trial has demonstrated efficacy of tafasitamab plus lenalidomide in patients with relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL). However, real-world evidence comparing tafasitamab plus len...
PURPOSE: L-MIND trial has demonstrated efficacy of tafasitamab plus lenalidomide in patients with relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL). However, real-world evidence comparing tafasitamab plus lenalidomide to standard salvage therapies remains limited. Therefore, we conducted an external control arm study to evaluate clinical effectiveness of tafasitamab plus lenalidomide compared with ICE (ifosfamide, carboplatin, etoposide) regimen in South Korea. MATERIALS AND METHODS: Individual patient-level data from L-MIND trial and Samsung Medical Center-Lymphoma Cohort Studies (SMC-LCS) registry in South Korea were analyzed to identify DLBCL patients who received tafasitamab plus lenalidomide or ICE as second- to fourth-line therapy. Primary endpoint was overall survival (OS), while secondary endpoints included progression-free survival (PFS), time to next treatment (TTNT), duration of response (DoR), objective response rate (ORR), and complete response rate (CRR). After applying inverse probability of treatment weighting (IPTW), time-to-event and binary outcomes were analyzed using Cox and logistic regression models, respectively. RESULTS: A total of 76 patients in L-MIND and 39 patients in SMC-LCS were analyzed. After IPTW, median OS was 34.1 months (95% CI, 18.6-NR) for tafasitamab plus lenalidomide and 6.4 months (0.3-13.9) for ICE (hazard ratio [HR], 0.33; 95% CI, 0.20-0.53). HRs were 0.33 (95% CI, 0.20-0.54) for PFS, 0.42 (0.26-0.66) for TTNT, and 0.17 (0.08-0.35) for DoR. Odds ratios were 3.17 (1.37-7.32) for ORR, and 2.87 (1.06-7.78) for CRR. CONCLUSION: Tafasitamab plus lenalidomide showed favorable outcomes over ICE, suggesting a clinically meaningful treatment option for r/r DLBCL in South Korea.
Synergistic Antitumor Activity of Combination Therapy with a MET TKI Vabametkib and a Third-Generation EGFR TKI Lazertinib in MET-Amplified EGFR-Mutant NSCLC.
Kim DK, Park JW, Cho HB … +7 more , Choi SJ, Lee SS, Kim Y, Lee JB, Lim SM, Yu MR, Cho BC
Cancer Res Treat · 2026 Mar · PMID 41927036 · Publisher ↗
PURPOSE: Third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKIs) improved outcomes in EGFR-mutant non-small cell lung cancer (NSCLC); however, the subsequent development of resistance emph...
PURPOSE: Third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKIs) improved outcomes in EGFR-mutant non-small cell lung cancer (NSCLC); however, the subsequent development of resistance emphasizes the necessity of overcoming this therapeutic limitation. MET amplification is one of the major resistance mechanism in EGFR-mutant NSCLC, bypassing EGFR inhibition by activating cell survival, proliferation, and metastasis. Combining MET- and EGFR-TKIs is thus emerging as a promising therapeutic strategy to overcome resistance to EGFR TKIs. MATERIALS AND METHODS: This study aimed to investigate the combination of the selective MET TKI vabametkib and a third-generation EGFR TKI lazertinib in MET-amplified EGFR TKI resistance models. Inhibition of downstream signaling and cell proliferation by vabametkib plus lazertinib were evaluated in osimertinib-resistance NSCLC cell lines (HCC827-AR) and patient-derived organoid (YUO-010) by western blot and Cell Titer-Glo assay. RESULTS: In vitro studies demonstrated that vabametkib plus lazertinib synergistically inhibited EGFR/MET phosphorylation, leading to markedly enhanced anti-proliferative effects through downstream PI3K/AKT and MAPK pathway blockade. To investigate the antitumor effects in in vivo, we employed two patient-derived xenograft (PDX) models (YHIM-1035(1) and YHIM-1053) harboring MET amplification, as characterized by whole-exome sequencing or droplet digital PCR (ddPCR). Consistent with the in vitro findings, treatment with vabametkib plus lazertinib produced pronounced suppression of tumor growth in both models through a synergistic mechanism. CONCLUSION: These findings establish vabametkib plus lazertinib as a promising strategy for MET-amplified NSCLC, currently under evaluation in an ongoing phase II clinical trial (NCT05541822).
Prediction of Cancer Incidence and Mortality in Korea, 2026.
Jung KW, Kang MJ, Park EH … +5 more , Yun EH, Kim HJ, Kim JE, Choi KS, Yang HK
Cancer Res Treat · 2026 Apr · PMID 41881852 · Full text
PURPOSE: This study aimed to project cancer incidence and mortality for 2026 to estimate Korea's current cancer burden. MATERIALS AND METHODS: Cancer incidence data from 1999 to 2023 were obtained from the Korea National...
PURPOSE: This study aimed to project cancer incidence and mortality for 2026 to estimate Korea's current cancer burden. MATERIALS AND METHODS: Cancer incidence data from 1999 to 2023 were obtained from the Korea National Cancer Incidence Database, while cancer mortality data from 1993 to 2024 were acquired from the Ministry of Data and Statistics. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and then by the projected age-specific rates by the anticipated age-specific population for 2026. A joinpoint regression model was applied to identify significant changes in trends, using only the most recent trend data for predictions. RESULTS: A total of 308,876 new cancer cases and 86,317 cancer deaths are expected in Korea in 2026. The most commonly diagnosed cancer is projected to be thyroid cancer, followed by the colorectal, lung, breast, prostate and stomach cancers. These six cancers are expected to account for 63.5% of all newly diagnosed cancers. Lung cancer is expected to be the leading cause of cancer-related deaths, followed by liver, colorectal, pancreatic, gallbladder, and stomach cancers, together comprising 65.9% of all cancer deaths. CONCLUSION: Korea's cancer burden continues to shift toward malignancies prevalent in older populations. The sustained increase in prostate cancer among men and the rising mortality impact of pancreatic cancer reflect structural changes in the national cancer profile amid rapid population aging.
Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2023.
Park EH, Jung KW, Choi SH … +8 more , Park NJ, Kang MJ, Yun EH, Kim HJ, Kim JE, Choi KS, Yang HK, Community of Population-Based Regional Cancer Registries
Cancer Res Treat · 2026 Apr · PMID 41881851 · Full text
PURPOSE: The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2023, with international comparisons. MATERIALS AND METHODS: C...
PURPOSE: The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2023, with international comparisons. MATERIALS AND METHODS: Cancer incidence, survival, and prevalence rates were calculated using the Korea National Cancer Incidence Database (1999-2023), with survival follow-up until December 31, 2024. Mortality data were obtained from the Ministry of Data and Statistics, while international comparisons were based on GLOBOCAN data. RESULTS: In 2023, 288,613 newly diagnosed cancer cases (age-standardized rate [ASR], 288.6 per 100,000) and 85,271 deaths from cancer (ASR, 64.3 per 100,000) were reported. Among the incident cases, 145,452 (50.4%) were aged 65 years or older. Prostate cancer became the most common cancer among men for the first time. The proportion of localized-stage cancers increased from 45.6% in 2005 to 51.8% in 2023. Korea had the lowest cancer mortality among countries with similar incidence rates and the lowest mortality-to-incidence ratios for stomach, colorectal, and breast cancer. The 5-year relative survival rate (2019-2023) was 73.7% overall and 92.7% for localized-stage cancers. Over 2.73 million prevalent cases were identified in 2023, representing 5.3% of the Korean population. CONCLUSION: These findings indicate that Korea's cancer control efforts have contributed to early detection and improved survival outcomes. As Korea enters a super-aged society in 2025, cancer burden will continue to increase, requiring sustained and adaptive cancer control strategies.
Korean Colorectal Cancer Screening Guidelines for Asymptomatic, average-Risk Adults: The 2025 Revision.
Kang E, Cha JM, Kang SY … +16 more , Lee K, Kim SY, Kim Y, Seo AN, Kang HJ, Jang JK, Ko KP, Shin A, Sohn DK, Hong Y, Cho EJ, Han M, Kim SY, Lee HJ, Choi CK, Suh M
Cancer Res Treat · 2026 Mar · PMID 41856048 · Publisher ↗
PURPOSE: To develop the 2025 update to the Korean colorectal cancer (CRC) screening guidelines by systematically assessing recent evidence, integrating domestic data, and addressing changes since the 2015 guideline revis...
PURPOSE: To develop the 2025 update to the Korean colorectal cancer (CRC) screening guidelines by systematically assessing recent evidence, integrating domestic data, and addressing changes since the 2015 guideline revision, and accordingly, provide an evidence-based standard for clinicians and policymakers. MATERIALS AND METHODS: A multidisciplinary committee developed the guidelines using the Grading of Recommendations, Assessment, Development and Evaluation methodology. The process involved establishing three Key Questions (KQs) focused on efficacy, accuracy, and optimal age and interval for screening. A systematic review of international guidelines and primary literature (327 studies included) was conducted. A utility-based analysis using the Markov model was also performed to determine optimal screening ages and intervals. RESULTS: The review identified high-certainty evidence for Fecal Immunochemical Test (FIT) in reducing CRC mortality and moderate-certainty evidence for colonoscopy. Evidence for CT colonography (CTC) and stool DNA testing showed very low certainty. Based on this synthesis and cost-utility analysis, the committee conditionally recommends screening for asymptomatic, average-risk adults aged 45-74 years using either colonoscopy every 10 years or FIT every 1-2 years. CTC and stool DNA testing were not recommended owing to insufficient evidence. CONCLUSION: The 2025 Korean Guidelines for Colorectal Cancer Screening provide the latest evidence-based recommendations tailored to the domestic context. By conditionally adopting both colonoscopy and FIT for individuals aged 45-74 years, these guidelines aim to optimize public health outcomes and reduce the colorectal cancer burden in South Korea.
Spatial Interactions of CD103+ Tissue-Resident Memory T Cells in the Tumor Periphery Are Associated with Clinical Outcomes in Triple-Negative Breast Cancer Following Neoadjuvant Chemotherapy.
Lee H, Jeong BK, Gong G … +2 more , Lee M, Lee HJ
Cancer Res Treat · 2026 Mar · PMID 41856047 · Publisher ↗
PURPOSE: Triple-negative breast cancer (TNBC) is an aggressive subtype with poor prognosis. CD103+ tissue-resident memory T (TRM) cells are crucial for anti-tumor immunity in TNBC. We investigated whether their spatial i...
PURPOSE: Triple-negative breast cancer (TNBC) is an aggressive subtype with poor prognosis. CD103+ tissue-resident memory T (TRM) cells are crucial for anti-tumor immunity in TNBC. We investigated whether their spatial interactions with other T-cells influence clinical outcomes, particularly following neoadjuvant chemotherapy (NAC). MATERIALS AND METHODS: This retrospective study analyzed 182 TNBC patients (98 NAC-treated; 84 non-NAC). Using Opal™ multiplex immunohistochemistry data and the Spatial Image Analysis of Tissues (SPIAT) R package, we analysed spatial interactions between CD103+ cells and other T cell subsets (CD45RO, CD8, CD4, PD-1) in central/peripheral tumor regions. Normalized mixing score (NMS) quantified spatial interactions. RESULTS: NMS-based clustering revealed two distinct CD103+ cell interaction patterns-Cluster 1 (low NMS) characterized by weaker and Cluster 2 (high NMS) by stronger spatial interactions between CD103+ and other T cell subsets. In the NAC group, Cluster 2 in the tumor periphery was associated with lower pathologic stage (p=0.002), higher stromal tumor-infiltrating lymphocyte level (p=0.031), and significantly improved recurrence-free survival (p=0.028) and overall survival (p=0.018) compared to Cluster 1. Central tumor region clustering patterns had no association with prognosis. No significant survival-related differences were observed in the non-NAC group according to NMS-based clustering. CONCLUSION: Spatial interaction patterns between CD103+ and other T cell subsets in the tumor periphery influence clinical outcomes in NAC-treated TNBC patients. Analysing such spatial relationships between T cells, rather than their presence alone, may provide additional prognostic information for patients undergoing NAC.
Comparative Clinical and Economic Analysis of Robotic versus Video-assisted thoracoscopic Anatomical Resection for Lung Cancer.
Park JH, Hong YE, Shim H … +7 more , Yun T, Na B, Na KJ, Lee HJ, Park IK, Kim YT, Kang CH
Cancer Res Treat · 2026 Mar · PMID 41856046 · Publisher ↗
PURPOSE: This study aimed to compare the clinical outcomes and costs of robotic-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) in patients undergoing minimally invasive anatomical resection f...
PURPOSE: This study aimed to compare the clinical outcomes and costs of robotic-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) in patients undergoing minimally invasive anatomical resection for primary lung cancer. MATERIALS AND METHODS: A retrospective analysis was conducted on 2,086 patients who underwent surgery at a single institution from January 2017 to July 2020, including 134 RATS and 1,952 VATS cases. Propensity score matching (PSM) was applied, resulting in 268 matched patients (134 RATS and 134 VATS). Cost data were obtained from hospital billing files, encompassing 20 categories, including total hospitalization fees, anesthesia fees, surgery fees, costs of surgical instruments and materials, and general examination fees. RESULTS: After PSM, RATS patients had a shorter median postoperative stay (5 days vs. 6 days, p = 0.009) and lower thoracotomy conversion rate (1.5% vs. 14.9%, p < 0.001) than VATS. However, RATS incurred higher total costs by an average of $1,230 (p < 0.001), mainly due to increased surgical expenses ($1,163, p < 0.001). In multivariate analysis, RATS (12.41%, p < 0.001), neoadjuvant therapy (13.3%, p = 0.005), complications (4.2%, p < 0.001), and length of stay (2.0%, p < 0.001) were found to be associated with higher costs. CONCLUSION: Although RATS has been shown to reduce the thoracotomy conversion rate and length of hospital stay, it incurs higher costs than VATS, primarily due to increased surgical expenses. The justification for RATS should be further evaluated through sustainability and cost-effectiveness studies with long-term follow-up.
Phase II Efficacy and Safety of Pembrolizumab with Platinum Based Chemotherapy in Non-Small Cell Lung Cancer Patients with Untreated, Asymptomatic Brain Metastasis (PHOEBS).
Kim J, Han M, Kim J … +9 more , Park S, Jung HA, Sun JM, Lee SH, Ahn JS, Shin SH, Lee K, Um SW, Ahn MJ
Cancer Res Treat · 2026 Mar · PMID 41856045 · Publisher ↗
PURPOSE: Brain metastases are a serious complication in non-small cell lung cancer (NSCLC). However, data regarding efficacy of immune checkpoint inhibitors and chemotherapy combinations are limited. This phase II study...
PURPOSE: Brain metastases are a serious complication in non-small cell lung cancer (NSCLC). However, data regarding efficacy of immune checkpoint inhibitors and chemotherapy combinations are limited. This phase II study aimed to evaluate the intracranial efficacy and safety of pembrolizumab and chemotherapy in treatment-naïve NSCLC patients with asymptomatic brain metastases. MATERIALS AND METHODS: This single-arm, phase II trial was conducted at Samsung Medical Center, Korea. Eligible patients had stage IV NSCLC with asymptomatic, untreated brain metastases and no epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) alterations. Patients received pembrolizumab with chemotherapy every 3 weeks for 4 cycles, followed by pembrolizumab with or without maintenance chemotherapy up to 35 cycles. The primary endpoint was intracranial objective response rate (icORR). Secondary endpoints included intracranial progression free survival (icPFS), intracranial duration of response (icDoR), objective response rate (ORR), progression free survival (PFS), overall survival, and safety. RESULTS: Between February 2021 and June 2024, a total of 13 patients were enrolled. Due to challenges in recruiting patients, enrollment was discontinued after the 13 patients. The icORR was 46.2% (95% CI, 19.2-74.8), with 6 patients achieving partial response. The median icPFS was 9.8 months (95% CI, 5.2-21.5), and median icDoR was 9.3 months (95% CI, 4.0-20.3). Median PFS and overall survival was 7.2 months (95% CI, 2.4-12.3) and 10.7 months (95% CI, 7.2-21.5), respectively. Most treatment-related adverse events were grade 1-2." CONCLUSION: Pembrolizumab combined with chemotherapy demonstrated encouraging intracranial activity and manageable safety profile in NSCLC patients with untreated, asymptomatic brain metastases.
Conditional Relative Survival and Competing Mortality in Surgically Treated Patients with Localized and Regional Kidney Cancer in Korea: A Nationwide Cohort Study.
Shin HB, Shin DW, Cho IY … +4 more , Park J, Hyung JJ, Han K, Park J
Cancer Res Treat · 2026 Mar · PMID 41821141 · Publisher ↗
PURPOSE: To investigate the 5-year conditional relative survival and competing mortality in surgically treated patients with localized and regional kidney cancer. MATERIALS AND METHODS: Using a nationwide population-base...
PURPOSE: To investigate the 5-year conditional relative survival and competing mortality in surgically treated patients with localized and regional kidney cancer. MATERIALS AND METHODS: Using a nationwide population-based database, the Korea Clinical Data Utilization Network for Research Excellence, conditional relative survival conditioned on 1 to 3 years of survival after diagnosis was measured. These rates were stratified by age, sex, socioeconomic status, comorbidities, and treatment received. Cause of death and estimated cause-specific mortality were also described and considered with competing risks. RESULTS: This study included a total of 19,749 newly diagnosed patients with kidney cancer who underwent surgical treatment from 2013 to 2019. The baseline conditional relative survival rates for the entire cohort, patients with localized disease, and patients with regional disease were 97.2%, 99.4%, and 82.6%, respectively. After one year, these rates increased to 99.4%, 100.0%, and 95.3%, respectively. Patients who underwent surgery only had the highest baseline conditional relative survival rates (99.3%) compared with those who received surgery with radiotherapy (74.0%), with chemotherapy (38.9%), and with chemotherapy and radiotherapy (16.2%). Specifically, patients who underwent robotic surgery or partial nephrectomy showed higher baseline conditional relative survival rates (>100%) than others. Furthermore, kidney cancer was the leading cause of death (49.6%), followed by other types of cancer and cardiovascular disease. Over time, kidney cancer-specific mortality decreased. CONCLUSION: Conditional survival after surgery for localized or regional kidney cancer was high and improved over time. These findings indicate that long-term prognosis varies by stage and patient characteristics and should inform postoperative surveillance.
Non-Response to Durvalumab and Supraclavicular Nodal Involvement Predict Early Brain Metastasis After CCRT Followed by Durvalumab Consolidation in Stage III NSCLC.
Choi YK, Kim YS, Kwak YK … +5 more , Lee YH, Kim SH, Sung SY, Son SH, Choi KH
Cancer Res Treat · 2026 Feb · PMID 41748109 · Publisher ↗
PURPOSE: To identify predictors of brain metastasis in patients with unresectable stage III non-small cell lung cancer (NSCLC) treated with definitive concurrent chemoradiotherapy (CCRT) followed by durvalumab consolidat...
PURPOSE: To identify predictors of brain metastasis in patients with unresectable stage III non-small cell lung cancer (NSCLC) treated with definitive concurrent chemoradiotherapy (CCRT) followed by durvalumab consolidation. MATERIALS AND METHODS: We retrospectively analyzed 138 patients with unresectable stage III NSCLC treated with definitive CCRT followed by durvalumab from 2018 to 2024. The primary endpoint was brain metastasis incidence. Univariate and multivariate logistic regression analyses identified factors associated with brain metastasis development. RESULTS: With a median follow-up of 18.7 months (range, 1.2-73.3), brain metastasis occurred in 18 of 138 patients (13.0%). In multivariate analysis, non-responders to durvalumab (OR 4.86, 95% CI 1.69-13.96, p=0.003) and initial supraclavicular nodal (SCN) involvement (OR 2.89, 95% CI 0.99-8.48, p=0.05) were independent predictors of brain metastasis. Non-responders demonstrated accelerated central nervous system (CNS) progression, with 63.6% developing brain metastases within 6 months versus 28.6% in responders. PD-L1 ≥50% was associated with improved OS but not with brain metastasis incidence. All patients who developed brain metastases were EGFR/ALK wild-type. CONCLUSION: Non-responders to durvalumab and supraclavicular nodal involvement were significant predictors of brain metastasis in NSCLC treated with CCRT followed by durvalumab. These findings support risk-adapted CNS surveillance strategies in high-risk patients.
Effect of Smoking Cessation Duration on Lung Cancer Incidence: A Nationwide Retrospective Cohort Study in Korea.
Choi MG, Kim MH, Kim HJ … +1 more , Chun EM
Cancer Res Treat · 2026 Feb · PMID 41748108 · Publisher ↗
PURPOSE: While smoking cessation is known to reduce lung cancer risk, the extent to which smoking cessation duration mitigates lung cancer risk remains unclear. This study aimed to analyze the association between smoking...
PURPOSE: While smoking cessation is known to reduce lung cancer risk, the extent to which smoking cessation duration mitigates lung cancer risk remains unclear. This study aimed to analyze the association between smoking cessation duration and the reduction in lung cancer incidence using large-scale health insurance data from Korea. MATERIALS AND METHODS: In this retrospective cohort study, we utilized the cohort from the Korea National Health Insurance Corporation. Approximately 50% of the adults aged ≥50 years who underwent health examinations in 2009-2013 were randomly sampled and followed using medical and health examination records. The participants were classified into three groups: never-smokers, former smokers, and current smokers, and the incidence rates of lung cancer were compared among these groups. RESULTS: We analyzed 165,512 individuals selected through propensity score matching (82,756 never-smokers, 41,378 former smokers, and 41,378 current smokers). Lung cancer risk significantly decreased after two years of smoking cessation (2-3 years after cessation: hazard ratio 0.760, p<0.001) but remained higher than that of never-smokers for up to 10 years. Subgroup analyses revealed similar tendencies among males, whereas no consistent patterns were observed among females. Moreover, a longer duration of smoking cessation was generally required for heavy smokers (≥20 pack-years) than for light smokers (<20 pack-years). CONCLUSION: This nationwide cohort study highlights the significant impact of smoking cessation duration on lung cancer risk, emphasizing the substantial benefits of even short-term cessation regardless of prior smoking history.
Korean Practical Guidelines for Geriatric Assessment and Management of Older Adults with Cancer: A Korean Cancer Association Guideline for Geriatric Oncology.
Kang M, Kang J, Song C … +24 more , Oh HK, Chung H, Lee I, Jung JH, Jeon JH, Jeong E, Koh JR, Kwon JH, Choi JY, Kim K, Kim K, Moon KH, Jung M, Hong SJ, Koh SJ, Cho S, Kim S, Lee YG, Choi M, Park DA, Han MA, Hwang IG, Kim JW, Kim JH
Cancer Res Treat · 2026 Feb · PMID 41713030 · Publisher ↗
The Korean Cancer Association's clinical practice guidelines for geriatric oncology provide an evidence-based, multidisciplinary framework to optimize cancer care for the growing population of older adults. Geriatric Ass...
The Korean Cancer Association's clinical practice guidelines for geriatric oncology provide an evidence-based, multidisciplinary framework to optimize cancer care for the growing population of older adults. Geriatric Assessment (GA) identifies multidimensional vulnerabilities often missed by standard performance measures, providing critical information to guide individualized treatment planning. This guideline recommends using validated geriatric screening tools, life expectancy prediction models, and toxicity risk calculators to support risk stratification and decision-making. By integrating GA-based multidisciplinary interventions and shared decision-making into clinical practice, clinicians can avoid both overtreatment and undertreatment, reduce treatment-related toxicity, and potentially enhance quality of life. Although the certainty of evidence for most recommendations ranged from very low to low, the panel reached a consensus to provide conditional recommendations. This decision reflects the judgment that the clinical benefits-specifically in reducing treatment-related toxicity and identifying vulnerabilities-outweigh the limitations of current evidence, addressing the urgent need for standardized geriatric care in Korea. Ultimately, these guidelines aim to support individualized, patient-centered care and serve as a practical foundation for clinical and educational applications within the Korean healthcare system.
Assessing Radiation Pneumonitis Through Functional Lung Imaging: A Single Photon Emission Computed Tomography (SPECT)-Based Approach in Lung Cancer.
Chung JH, Lee SJ, Kim JY … +1 more , Park HJ
Cancer Res Treat · 2026 Feb · PMID 41713029 · Publisher ↗
PURPOSE: To develop models to assess the risk of symptomatic radiation pneumonitis (SRP) (Common Terminology Criteria for Adverse Events 4.03 grade ≥ 2) in lung cancer patients by utilizing single-photon emission compute...
PURPOSE: To develop models to assess the risk of symptomatic radiation pneumonitis (SRP) (Common Terminology Criteria for Adverse Events 4.03 grade ≥ 2) in lung cancer patients by utilizing single-photon emission computed tomography (SPECT) for functional lung volume identification and dosimetric analysis. MATERIALS AND METHODS: This retrospective study included 71 lung cancer patients who underwent SPECT before radiotherapy from 2018 to 2024. Perfusion and ventilation SPECT images were co-registered with planning CT to define functional and anatomical lung volumes. Functional lung was defined as voxels with ≥ 20% of the maximum intensity on SPECT. Models to assess the risk of SRP were constructed using Cox regression and evaluated using corrected Akaike Information Criterion (AICc) and time-dependent receiver operating characteristic analysis. RESULTS: At a median follow-up of 16.8 months, 19 of 71 patients (26.8%) developed SRP. Factors significantly associated with SRP risk included planning target volume ≥ 150 mL, percentage of total perfusion-defined functional lung receiving ≥ 10 Gy (pVf10) exceeding that of total anatomical lung receiving ≥ 10 Gy (V10), percentage of total ventilation-defined lung receiving ≥ 10 Gy (vVf10) ≥ 45%, and ipsilateral vVf10 ≥ 60% (p=0.004, 0.004, 0.024, and 0.007, respectively). Among the three models, the model incorporating additional ventilation-based parameters demonstrated the best performance (AICc = 85.81, area under the curve = 0.819). CONCLUSION: SPECT-based dosimetric parameters derived from perfusion and ventilation are significantly associated with the risk of SRP. Incorporating SPECT may improve risk stratification and enable lung-sparing strategies.
Postoperative Radiotherapy May Improve Survival in Certain Patients with pN2 Non-Small Cell Lung Cancer Who Do Not Have Extranodal Extension.
Jeon SH, Song C, Jeon JH … +7 more , Chung JH, Cho S, Kim K, Jheon S, Kim SH, Kim YJ, Kim JS
Cancer Res Treat · 2026 Feb · PMID 41643567 · Publisher ↗
PURPOSE: The aim of this study was to identify subgroups of patients with pathologic N2 (pN2) non-small cell lung cancer (NSCLC) who may benefit from postoperative radiotherapy (PORT). Particular attention was given to e...
PURPOSE: The aim of this study was to identify subgroups of patients with pathologic N2 (pN2) non-small cell lung cancer (NSCLC) who may benefit from postoperative radiotherapy (PORT). Particular attention was given to evaluating whether extranodal extension (ENE) influences the therapeutic efficacy of PORT. MATERIALS AND METHODS: A total of 231 patients with pN2 NSCLC who underwent surgical resection followed by adjuvant chemotherapy at a single institution were analyzed retrospectively. Propensity score matching was performed to compare treatment outcomes according to the receipt of PORT. RESULTS: Propensity score matching yielded 99 matched pairs of patients with no significant differences in clinical parameters. There were no significant differences in the overall survival (OS; p=0.11) and disease-free survival (DFS; p=0.29) between the PORT and no PORT groups. However, PORT significantly improved the locoregional recurrence (LRR)-free rate (p=0.011), whereas the distant metastasis-free rate was comparable between groups (p=0.64). In subgroup analyses, PORT was associated with improved OS in patients with 1-3 positive N2 lymph nodes (p=0.013) and with significantly improved DFS among patients without ENE (p=0.046) or lymphatic invasion (p=0.032). CONCLUSION: Although PORT did not improve OS or DFS in the matched overall cohort, it significantly reduced LRR. Subgroup analyses suggested potential benefits in patients with limited nodal burden and in those without ENE or lymphatic invasion. These findings, however, should be interpreted cautiously given small subgroup sizes and inherent limitations of retrospective design.
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