Cancer Res Treat [JOURNAL]
Sun
200 papers
Safety and Efficacy of Combining Metastasis-Directed Stereotactic Ablative Radiation Therapy with Tyrosine Kinase Inhibitors Versus Immune Checkpoint Inhibitors in Metastatic Hepatocellular Carcinoma.
Yang E, Yu JI, Park HC … +11 more , Goh MJ, Song BG, Kang W, Sinn DH, Gwak GY, Paik YH, Lee JH, Choi MS, Hong JY, Kwon M, Kim N
Cancer Res Treat · 2026 Feb · PMID 41643566 · Publisher ↗
PURPOSE: Immune checkpoint inhibitors (ICIs) have become a standard therapy for metastatic hepatocellular carcinoma (HCC), often as an alternative to tyrosine kinase inhibitors (TKIs). However, safety data combining ICIs...
PURPOSE: Immune checkpoint inhibitors (ICIs) have become a standard therapy for metastatic hepatocellular carcinoma (HCC), often as an alternative to tyrosine kinase inhibitors (TKIs). However, safety data combining ICIs with stereotactic ablative radiotherapy (SABR) remain limited. We compared the safety and efficacy of SABR combined with ICIs versus TKIs in patients with extrahepatic metastatic HCC. MATERIALS AND METHODS: This single-center retrospective study included patients with HCC who received SABR for extrahepatic metastases combined with either TKIs or ICIs within 30 days of SABR between January 2010 and June 2024. Adverse events (AEs; CTCAE v5.0) and oncologic outcomes were evaluated using logistic regression and Cox models. RESULTS: Among 103 patients with 128 SABR-treated lesions, 72 patients (90 lesions) received SABR+TKI and 31 patients (38 lesions) received SABR+ICI. Acute AEs occurred only in the SABR+TKI group (8.9%), predominantly grade 1. Grade 3 late AEs were rare, occurring in one case in each group, while late AEs of lower grades were more frequent with SABR+ICI (any-grade: 57.9% vs. 25.6%, p<0.001; grade ≥2: 23.7% vs. 8.9%, p=0.024). Multivariable analysis showed borderline increased risk of grade ≥2 late AEs with SABR+ICI (p=0.052). One-year local control, progression-free survival, and overall survival were 76.6%, 35.3%, and 72.3% respectively, with no significant differences between groups. CONCLUSION: Metastasis-directed SABR combined with either TKIs or ICIs was generally well tolerated in patients with extrahepatic metastatic HCC, with rare grade 3 late AEs; grade ≥2 late AEs were more frequent with SABR plus ICIs, warranting prospective evaluation.
Associations between Smoking, Opioid Analgesic Use, and Risk For Chemical Coping in Korean Patients with Advanced Cancer.
Jung EH, Kim YJ, Dev R … +8 more , Suh KJ, Kim JW, Kim SH, Kim JW, Lee KW, Kim JH, Lee JS, Bruera E
Cancer Res Treat · 2026 Feb · PMID 41643565 · Publisher ↗
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 METHO...
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 never-smokers. 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.
A Novel Classification of Esophageal Anastomotic Leaks and Its Impact on Healing Time After Esophagogastrostomy.
Ma Z, Zheng J, Wang H … +4 more , Chen C, Yue J, Duan X, Jiang H
Cancer Res Treat · 2026 Feb · PMID 41643564 · Publisher ↗
PURPOSE: Anastomotic leakage (AL) is a severe complication after esophagogastrostomy, yet the classifications of AL and their associated healing times are poorly understood. MATERIALS AND METHODS: This study retrospectiv...
PURPOSE: Anastomotic leakage (AL) is a severe complication after esophagogastrostomy, yet the classifications of AL and their associated healing times are poorly understood. MATERIALS AND METHODS: This study retrospectively analyzed 117 cases of AL among 2,728 patients who underwent esophagectomy with circular stapled esophagogastric anastomosis at Tianjin Medical University Cancer Institute and Hospital from January 1, 2019, to March 31, 2024. AL cases were categorized into four types based on the direction of leakage (anterior, right, posterior, and left). The differences in healing times among these four types were analyzed using the log-rank test. A multivariable Cox model was used to identify factors associated with healing time. RESULTS: The incidence of AL was 4.3% (117/2728), with a median occurrence time of 9 days (Interquartile Range[IQR]: 5) and a median healing time of 56 days (IQR:64). Single cervical ALs accounted for 17.5%, with significantly shorter healing times compared to intrathoracic leaks (33 days vs. 61 days, p=0.018). Right-sided leaks were the most common (49.6%), while left-sided leaks healed faster than right- and posterior-sided leaks (42 days vs. 63 days vs. 70 days, p<0.05). Body Mass Index (BMI), diabetes, and neoadjuvant therapy did not influence healing time. In 117 AL patients, the occurrence of tracheoesophageal fistula (p=0.004) and the placement of trans-fistula reverse drainage tubes (p=0.002) were associated with healing time. CONCLUSION: These findings provide valuable insights for clinicians to better understand the mechanisms of AL development and predict the healing times.
Understanding the Unmet Needs in Diagnostics and Therapeutics of Chronic Lymphocytic Leukemia in Korea.
Yu ES, Kwon S, Byeon S … +4 more , Byun JM, Park SS, Eom KS, Choi CW
Cancer Res Treat · 2026 Jan · PMID 41612810 · Publisher ↗
PURPOSE: Since the FDA approval of ibrutinib in 2012, the treatment landscape for chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) has undergone a paradigm shift. Nevertheless, the disease remains...
PURPOSE: Since the FDA approval of ibrutinib in 2012, the treatment landscape for chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) has undergone a paradigm shift. Nevertheless, the disease remains incurable, posing ongoing clinical challenges. In Korea, these challenges are further compounded by unique characteristics of patients and national healthcare system. MATERIALS AND METHODS: The multicenter retrospective analysis included 519 patients diagnosed with CLL/SLL between 2006 and 2024 across three major Korean institutions. RESULTS: The median age at diagnosis was 62 years. Among 267 patients who received first-line therapy, 68.9% (184/267) were treated with immunochemotherapy, 19.4% (52/267) with cytotoxic chemotherapy, and 11.2% (30/267) with a Bruton tyrosine kinase (BTK) inhibitors. Since the Korean approval of ibrutinib in 2016, BTK inhibitor use has steadily increased. Subgroup analyses demonstrated that patients receiving BTK inhibitor-based therapy had more favorable outcomes compared to those treated with immunochemotherapy. CONCLUSION: This study provides the most comprehensive real-world reflection of current diagnostic and therapeutic practices in Korea. Through comparative analysis with international data, it offers valuable insights into the limitations of current CLL/SLL care and may inform future strategies to optimize management in the Korean context.
A Phase I/II Trial to Evaluate the Safety and Efficacy of Continuous Positive Airway Pressure in Volumetric Modulated Arc Therapy for Breast Cancer.
Park JB, Yu T, Son J … +5 more , Choi CW, Kwon S, Shin HW, Kim HJ, Chang JH
Cancer Res Treat · 2026 Jan · PMID 41612809 · Publisher ↗
PURPOSE: This phase I/II study aimed to evaluate the tolerability and the organ-sparing effects of continuous positive airway pressure (CPAP) in breast cancer radiotherapy (RT). MATERIALS AND METHODS: We conducted a pros...
PURPOSE: This phase I/II study aimed to evaluate the tolerability and the organ-sparing effects of continuous positive airway pressure (CPAP) in breast cancer radiotherapy (RT). MATERIALS AND METHODS: We conducted a prospective, single-institutional trial approved by the Ministry of Food and Drug Safety of South Korea. Patients with breast cancer who received postoperative RT underwent 4D-CT simulation and treatment planning under both free breathing (FB) and CPAP-assisted breathing (WC), with a target pressure of 20 cm H2O. Adverse events (AEs) were evaluated, and dosimetric parameters of organs at risk and heart position change were compared between the FB and WC arms. RESULTS: Among 20 enrolled patients, four withdrew due to discomfort during simulation. During the trial, no CPAP-related AEs greater than grade 2 were observed. Compared to FB, CPAP reduced the mean heart dose by 33.8% (p < 0.001), as well as V5-V30 for both the left ventricle and left anterior descending artery (all p < 0.05). It also led to significant reductions in V5-V40 and the mean ipsilateral lung dose, including a 4.4% reduction in V20 (all p < 0.001). The heart centroid shifted rightward (4.8 mm), ventrally (8.1 mm), and caudally (16.3 mm) with CPAP, displacing the heart away from the RT field. CONCLUSION: CPAP demonstrated both safety and efficacy for breast cancer RT, achieving significant reductions in cardiac and pulmonary radiation exposure. These findings support further investigation of CPAP as a novel respiratory motion management strategy. Future studies are warranted to identify optimal CPAP pressure levels to facilitate broader clinical implementation.
Circulating Tumor Cell-based Molecular Responses Stratify EGFR-TKI Efficacy in Patients with EGFR-Mutant Lung Cancer.
Lee S, Kim C, Kim CG … +9 more , Hong MH, Han M, Son W, Kim G, Woo HJ, Shin HY, Lee J, Kim MS, Kim HR
Cancer Res Treat · 2026 Jan · PMID 41612808 · Publisher ↗
PURPOSE: Circulating tumor cell (CTC) is a promising minimally invasive biomarker for EGFR-mutant non-small cell lung cancer (NSCLC). However, the rarity of CTCs and limitations in their isolation and molecular character...
PURPOSE: Circulating tumor cell (CTC) is a promising minimally invasive biomarker for 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 (CCM-CTCD) and compared with 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 EGFR-mutant 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.
Biomarker Testing Practices for Non-small Cell Lung Cancer: Survey Insights from South Korean Pathology Laboratories.
Kim S, Kim D, Kim L … +1 more , Kim WS
Cancer Res Treat · 2026 Jan · PMID 41612807 · Publisher ↗
PURPOSE: Molecular biomarker testing is essential for lung cancer management and precision medicine. This study evaluated biomarker testing practices for non-small cell lung cancer across pathology laboratories in South...
PURPOSE: Molecular biomarker testing is essential for lung cancer management and precision medicine. This study evaluated biomarker testing practices for non-small cell lung cancer across pathology laboratories in South Korea. MATERIALS AND METHODS: A nationwide survey of 30 pathology laboratories assessed testing policies, biomarker adoption, testing platforms, next-generation sequencing (NGS) implementation, reporting practices, turnaround times (TATs), and perceived challenges. RESULTS: All institutions routinely performed biomarker testing; 20 (66.7%) employed reflex testing at least in part. Tissue was the primary specimen type, and cytology and liquid biopsy specimens were accepted by 90.0% and 46.7% of institutions, respectively. For non-squamous NSCLC, all institutions tested EGFR, ALK, ROS1, and PD-L1, with additional testing for BRAF (86.7%) and KRAS (80.0%); other actionable targets were rarely tested outside NGS. In squamous NSCLC, PD-L1 was routinely assessed, whereas other drivers were tested less frequently. All institutions performed tissue-based NGS using companion diagnostic (CDx) and/or non-CDx platforms, and liquid biopsy-based NGS was available in 46.7% of institutions. Median TATs were 2-3, 5, 9, 19, and 15 days for immunohistochemistry, polymerase chain reaction, fluorescence in situ hybridization, tissue-based NGS, and liquid biopsy-based NGS, respectively. Reported barriers included limited sample availability, workforce shortages, prolonged TATs, regulatory restrictions, and lack of standardization. CONCLUSION: Biomarker testing is widely implemented in South Korea, with increasing integration of NGS. Despite alignment with international recommendations, systemic and policy reforms are needed to harmonize workflows, reduce variability, and optimize precision oncology.
Radiomics-Based Prediction of Lymphedema after Radiotherapy in Breast Cancer: Integrating Clinical and Dosimetric Features.
Kim JS, Jeon SH, Jang BS … +4 more , Kim JH, Chang JH, Kim D, Shin KH
Cancer Res Treat · 2026 Jan · PMID 41531151 · Publisher ↗
PURPOSE: Arm lymphedema is a common, debilitating complication in patients with breast cancer undergoing postoperative radiotherapy (PORT). Although clinical and dosimetric factors have been used for risk prediction, rad...
PURPOSE: Arm lymphedema is a common, debilitating complication in patients with breast cancer undergoing postoperative radiotherapy (PORT). Although clinical and dosimetric factors have been used for risk prediction, radiomics offers a novel approach for improving the predictive accuracy. MATERIALS AND METHODS: We designed a predictive model for lymphedema using clinical, dosimetric, and radiomic features. We included 532 patients (399 training and 133 testing) who underwent breast cancer surgery followed by PORT. Radiomic features were extracted from axillary levels I, II, III, and supraclavicular regions, which were automatically contoured on PORT-planning computed tomography scans. Least absolute shrinkage and selection operator regression was used for feature selection. Model performance was evaluated using the area under the curve (AUC), accuracy, sensitivity, and specificity. RESULTS: The Combined model integrating clinical, dosimetric, and radiomic features showed higher predictive performance (AUC: training 0.783, test 0.767, total 0.779) than the Clinical/Dosimetric (AUC: training 0.730, test 0.671, total 0.717) and Radiomics-only (AUC: training 0.721, test 0.668, total 0.708) models. The Combined model also achieved a higher accuracy (training 78.9%, test 78.2%, total 78.8%), sensitivity (training 74.6%, test 62.5%, total 72.0%), and specificity (training 79.7%, test 80.3%, total 79.9%) than the other models. DeLong's test confirmed that the Combined model significantly outperformed the Clinical/Dosimetric model (p=0.036 in training and p=0.010 in all datasets). CONCLUSION: Integrating radiomic features with clinical and dosimetric factors showed potential to enhance lymphedema prediction in patients with breast cancer receiving PORT. This model can potentially guide personalized treatment strategies and improve patient outcomes.
Pre-Treatment Ki67 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.
Tan Y, Jiang H, Ma F … +7 more , Lan B, Luo Y, Wang J, Zhang P, Xu B, Zhao W, Fan Y
Cancer Res Treat · 2026 Jan · PMID 41531150 · Publisher ↗
PURPOSE: The study aims to explore the predictive value of the Ki67 index for everolimus efficacy in patients with hormone receptor-positive and human epidermal growth factor receptor 2-negative (HR+/HER2-) advanced brea...
PURPOSE: The study aims to explore the predictive value of the Ki67 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 Ki67 index from 14% to 50%, only the Ki67 cut-off of 40% was found to be significantly correlated with progression-free survival (PFS) for patients in the training cohort. Multivariate Cox analyses further showed that Ki67 index of 40% (p=0.03) was significantly associated with PFS in patients treated with everolimus. Patients with Ki67 less than 40% had an improved PFS of 7.0 months, significantly better than 4.6 months for patients with Ki67 more than 40% (p=0.03, HR=0.67, 95CI%=0.46-0.97). In the validation cohort, patients with a Ki67 index of less than 40% had a significantly longer PFS of 4.3 months (2.1 months versus 4.3 months, p<0.001, HR=0.29, 95CI%=0.17-0.51). CONCLUSION: The Ki67 cut-off 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.
Salidroside-Loaded, TMTP1-Modified CSC-Exosomes Reprogram the PI3K/AKT/mTOR Axis to Overcome PD-1 Resistance in Breast Cancer.
Yin F, Jin X, Zhang L … +2 more , Xie Q, Qian J
Cancer Res Treat · 2026 Jan · PMID 41531149 · Publisher ↗
PURPOSE: To elucidate how Salidroside-loaded, oligopeptide-modified tumor exosomes (Salidroside@T-exo) rewire the PI3K/AKT/mTOR axis to remodel the immune microenvironment (IME) and reverse acquired PD-1 resistance in br...
PURPOSE: To elucidate how Salidroside-loaded, oligopeptide-modified tumor exosomes (Salidroside@T-exo) rewire the PI3K/AKT/mTOR axis to remodel the immune microenvironment (IME) and reverse acquired PD-1 resistance in breast cancer. MATERIALS AND METHODS: CSC-exosomes were surface-engineered with TMTP1 peptide and electroporated with Salidroside. PD-1-resistant MA782/5s-8101-R cells and an orthotopic mouse model were used. Multi-omics, flow cytometry, ELISA, immunofluorescence, in vivo imaging, and molecular assays examined immune and signaling outcomes. RESULTS: Salidroside@T-exo restored T-cell IFN-γ and GZMB secretion, suppressed CD8+ T-cell apoptosis, and inhibited p-PI3K/p-AKT/p-mTOR in T cells. CSC migration, invasion, and stemness (OCT4, NANOG, SOX2) were markedly reduced. Tumor growth, Ki-67 index, and CSC frequency dropped while TUNEL-positive cells rose. CONCLUSION: Salidroside@T-exo reverses PD-1 blockade resistance by simultaneously inhibiting PI3K/AKT/mTOR signaling in T cells and eradicating breast CSCs, offering a clinically translatable strategy for refractory breast cancer immunotherapy.
Trends in Incidence and Survival of Childhood and Adolescent Cancer in Korea, 2001-2020: Comparison with U.S. SEER Data.
Suh JK, Park EH, Park M … +3 more , Lee JA, Jung KW, Park HJ
Cancer Res Treat · 2026 Jan · PMID 41506851 · Publisher ↗
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...
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 US. 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 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.
Smoking, Alcohol, and Abdominal Obesity Increase Gastric Cancer Risk after Helicobacter pylori Eradication.
Lim JH, Shin CM, Han K … +5 more , Jung JH, Choi J, Jin EH, Kang SJ, Lee DH
Cancer Res Treat · 2026 Jan · PMID 41506850 · Publisher ↗
PURPOSE: Helicobacter pylori is the single most important risk factor for gastric cancer (GC). However, H. pylori eradication (HPE) does not eliminate risk of GC. To clarify the association of lifestyle factors with GC r...
PURPOSE: Helicobacter pylori is the single most important risk factor for gastric cancer (GC). However, H. pylori eradication (HPE) does not eliminate risk of GC. To clarify the association of lifestyle factors with GC risk after HPE. MATERIALS AND METHODS: Using the Korean National Health Insurance Services (NHIS) database, adult individuals who claimed HPE between 2010 and 2016 were analyzed. The adjusted hazard ratios (aHR) for GC were analyzed according to the lifestyle status including smoking (never; light [<10PY]; moderate [10-20PY]; heavy [≥20PY]), alcohol (none; mild [<30g/day]; heavy [30g/day]), and abdominal obesity by using Cox proportional hazard model. RESULTS: During a median follow-up period of 6.7 years, 9,754 individuals were newly diagnosed with GC among the total of 1,282,702 subjects. Compared with never smokers, moderate (aHR 1.12 [95%CI 1.04-1.20]) and heavy smokers (1.34 [1.27-1.42]) had greater risks of post-HPE GC with dose-response manner. Heavy drinkers had increased risk of GC (1.23 [1.15-1.32]) compared with non-drinkers, and those with abdominal obesity had slightly elevated GC risk compared with those without that (1.11 [1.06-1.15]). In subgroup analyses, those who had HPE at age ≥ 55 were shown to be more affected by the unhealthy lifestyles (smoking [p-for-interaction <0.01], alcohol [0.03], and abdominal obesity [0.03]). Also, male showed greater risk increase by smoking habit [p-for-interaction 0.02] than female. CONCLUSION: Unhealthy lifestyles like smoking, alcohol, and abdominal obesity were shown as risk factors for post-HPE GC. Those with late HPE were more likely to be affected by unhealthy lifestyles.
Unplanned Readmission among Patients with Advanced Cancer on Active Treatment: Multi-Center, Retrospective Study.
Lee SY, Kim HJ, Yoo SH … +13 more , Hwang IG, Kang B, Kim YJ, Kim D, Oh CR, Baek SK, Jung EH, Woo GU, Cho W, Hwang IY, Kim KH, Kim MS, Cho B
Cancer Res Treat · 2026 Jan · PMID 41506849 · Publisher ↗
PURPOSE: Unplanned readmissions of patients with cancer increase healthcare costs and disrupt care. Although well-studied in surgical oncology, data on patients receiving active treatment for advanced cancer remain limit...
PURPOSE: Unplanned readmissions of patients with cancer increase healthcare costs and disrupt care. Although well-studied in surgical oncology, data on patients receiving active treatment for advanced cancer remain limited. This study examined the causes, clinical characteristics, and outcomes of unplanned readmissions. MATERIALS AND METHODS: This retrospective, multicenter study included patients with advanced solid tumors from six South Korean university hospitals who had unplanned readmissions within 1 month of prior hospitalization in 2019. Patients with terminal cancer who did not receive active treatment were excluded. Readmissions were categorized as Cancer Progression (e.g., worsening symptoms), treatment-related (e.g., therapy complications), or other (e.g., non-cancer conditions). Additional unplanned hospital use within 1 month post-discharge was analyzed in survivors with 6-month follow-up data. RESULTS: Among the 542 patients, readmissions were classified as cancer progression (42.6%), treatment-related (37.3%), or other (20.1%). The cancer progression group had the longest hospital stay (median, 12 days) and the highest mortality (23.4%). The Treatment-Related group had shorter stays (8 days) and lower mortality (8.4%). Among the 445 survivors, 24.9% had unplanned hospital visits within 1 month post-discharge. Home discharge increased the likelihood of these events (adjusted odds ratio: 4.82 for readmissions, 2.65 for emergency department visits). CONCLUSION: Cancer progression was the leading cause of readmission and was associated with prolonged hospital stays and high mortality rates. Home discharge is a key predictor of early additional unplanned hospital visits, indicating the need for careful post-discharge monitoring in this population.
A Prospective Study of Non‑Treating Medical Institution Use for Supportive Care During Adjuvant Chemotherapy After Curative Surgery (PRO-SUCCESS).
Oh SY, Park K, Oh SB … +1 more , Kim JJ
Cancer Res Treat · 2026 Jan · PMID 41506848 · Publisher ↗
PURPOSE: Patients undergoing adjuvant chemotherapy often utilize non‑treating medical institutions (NTMIs) for supportive care. We investigated utilization patterns and associated clinical factors. MATERIALS AND METHODS:...
PURPOSE: Patients undergoing adjuvant chemotherapy often utilize non‑treating medical institutions (NTMIs) for supportive care. We investigated utilization patterns and associated clinical factors. MATERIALS AND METHODS: In this prospective observational study, patients with solid tumors receiving adjuvant chemotherapy after curative resection were surveyed using SCNS-SF34, FACT-G, MDASI-K, and HADS at multiple timepoints. Associations between facility usage and survey scores were analyzed. RESULTS: Forty-four percent of participants used non-treating medical institutions during adjuvant chemotherapy. Patients with breast cancer and those with an ECOG performance status of 0 were more likely to use NTMIs. Higher SCNS-SF34 scores in the Physical & Daily Living domain were significantly associated with the number of NTMI use days. FACT-G, MDASI, and HADS-anxiety scores also showed associations, while dose intensity and emergency room visits did not. CONCLUSION: Patients receiving adjuvant chemotherapy frequently use NTMIs for unmet physical or emotional needs. Systematic approaches to symptom control and patient education within oncology settings may reduce unnecessary healthcare utilization.
Diagnostic Challenges and Clinical Implications of Microsatellite Instability/Mismatch Repair Deficiency in Solid Tumors.
Kwak Y, Bae JM, Lee HS
Cancer Res Treat · 2026 Jan · PMID 41472355 · Full text
The mismatch repair (MMR) system plays a crucial role in correcting replication errors; when the MMR system is deficient (dMMR), replication errors (particularly within microsatellites) accumulate throughout the genome,...
The mismatch repair (MMR) system plays a crucial role in correcting replication errors; when the MMR system is deficient (dMMR), replication errors (particularly within microsatellites) accumulate throughout the genome, leading to microsatellite instability (MSI). The key MMR genes include MLH1, MSH2, MSH6, and PMS2. Germline mutations in these genes are associated with Lynch syndrome, whereas in sporadic solid tumors, dMMR is often caused by hypermethylation of the MLH1 promoter. As the clinical use of dMMR/MSI expands, the importance of reliable testing for dMMR or MSI in companion diagnostics continues to increase. dMMR/MSI is diagnosed using immunohistochemistry (IHC) for MMR proteins, polymerase chain reaction with fragmentation analysis, or next-generation sequencing. Although IHC has technical limitations, it requires less tissue, has a short processing time, and is cost-effective. Experienced or specialized pathologists and educational efforts are helpful for reliable diagnosis, in addition to the technical aspects. Solid tumors with dMMR/MSI exhibit distinct clinicopathological features, including prognostic significance and a predictive role in adjuvant cytotoxic chemotherapy. Solid tumors with dMMR/MSI are also characterized by a higher tumor mutational burden and abundant immune cell infiltration, making them promising candidates for immune checkpoint inhibitor therapy. However, the oncogenic processes and immune microenvironment are not identical across the organs of origin, between patients, and even within the same patient, which should be considered in future studies. This review provides an overview of the practical aspects of dMMR/MSI testing, along with the molecular mechanisms and immune microenvironments associated with dMMR/MSI solid tumors.
Platinum and 5-FU Salvage Therapy for Severe Liver Crisis in Metastatic Breast Cancer: Efficacy and Analysis of Prognostic Factors.
Ho IW, Lai JI, Liu CY … +4 more , Lin WC, Yang MH, Tseng LM, Chao TC
Cancer Res Treat · 2025 Dec · PMID 41472354 · Publisher ↗
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 e...
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 (5FU), 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 AUC analysis was used to determine the optimal cutoff for liver function assessment model, 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 ORR was 22.7%, and the DCR was 29.5%. A 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.
Identification of Tumor Doubling Time-Related Subtypes and Construction of Risk Models to Predict Prognosis and Immunological Features in Breast Cancer.
Xu Y, Li H, Yang L … +1 more , Wang R
Cancer Res Treat · 2025 Dec · PMID 41472353 · Publisher ↗
PURPOSE: Breast cancer (BRCA)'s molecular heterogeneity complicates prognosis and treatment. Tumor Doubling Time (TDT), a critical growth rate metric with clinical and prognostic significance, offers untapped potential a...
PURPOSE: Breast cancer (BRCA)'s molecular heterogeneity complicates prognosis and treatment. Tumor Doubling Time (TDT), a critical growth rate metric with clinical and prognostic significance, offers untapped potential as a biomarker to decode heterogeneity and improve therapeutic strategies. MATERIALS AND METHODS: Based on transcriptomic and clinical data from TCGA and GEO, this study analyzed BRCA. Through differential expression and survival analyses, differentially expressed tumor doubling time-related genes (TDTRGs) with prognostic significance were identified. Consensus clustering using these genes defined two molecular subtypes. A prognostic risk model was constructed and validated through LASSO and multivariate Cox regression. Comprehensive evaluation was performed on these molecular subtypes and risk groups, encompassing immune infiltration (ssGSEA, CIBERSORT, ESTIMATE), mutational burden, response to immunotherapy (IMvigor210), and drug sensitivity (CellMiner, pRRophetic). RESULTS: This study constructed and validated an 8 gene prognostic risk model demonstrating robust predictive performance in both training (AUCs: 1-year=0.703, 3-year=0.693, 5-year=0.671) and validation cohorts. The low-risk group showed significantly enhanced immune cell infiltration, elevated immune checkpoint expression, and improved response to immunotherapy. Conversely, the high-risk group displayed increased tumor purity, metabolic reprogramming (e.g., respiratory electron transport), genomic instability, higher tumor mutational burden, and differential drug sensitivity (e.g., resistance to Gemcitabine/Tamoxifen). CONCLUSION: This study establishes a novel TDTRGs framework for BRCA molecular classification and validated prognostic stratification. It reveals key disparities in immune microenvironment and genomic stability, enhancing understanding and guiding personalized therapeutic strategies.
Immunosuppressive Tumor Microenvironment in Colorectal Cancer Lung Metastases: Implications for Recurrence After Metastasectomy.
Kwon M, Shin MK, An M … +9 more , Jeon YJ, Hong TH, Shin JK, Lim SH, Park Y, Cho YB, Kim ST, Choi YS, Lee J
Cancer Res Treat · 2025 Dec · PMID 41414807 · Publisher ↗
PURPOSE: Colorectal cancer (CRC) lung metastases exhibit high recurrence rates after resection, underscoring the need for improved therapeutic strategies. This study aimed to characterize the tumor microenvironment (TME)...
PURPOSE: Colorectal cancer (CRC) lung metastases exhibit high recurrence rates after resection, underscoring the need for improved therapeutic strategies. This study aimed to characterize the tumor microenvironment (TME) of CRC lung metastases and identify the factors associated with recurrence. MATERIALS AND METHODS: Fifteen CRC patients who underwent lung metastasectomy were enrolled. Multiplex immunohistochemistry (IHC), whole exome sequencing, transcriptome profiling, and single-cell RNA sequencing (scRNA-seq) were conducted on matched tumor, adjacent and distant normal lung tissues. Immune cell populations and gene expression profiles were analyzed and correlated with clinical recurrence outcomes. RESULTS: Exome and transcriptome analyses revealed frequent TP53, KRAS, and APC mutations. Most tumors corresponded to consensus molecular subtypes 2 and 4, characterized by immune-depleted and fibrotic features. Tumors showed downregulation of effector T and NK cell signatures. IHC revealed reduced density and increased distance of CD8+ T cells and macrophages from the epithelial cells. scRNA-seq demonstrated increased regulatory T cells and decreased NK and effector T cells in tumor. Tumor-associated macrophages (TAMs), particularly SPP1 (osteopontin)-expressing subsets, were markedly enriched in tumor and correlated with suppressed effector T cella activity. High SPP1 expression was associated with early recurrence and poor overall survival. Patients with recurrence had higher proportion of PD-1+ CD8+ T cells in adjacent normal tissues. CONCLUSION: Immunosuppressive features including enrichment of SPP1+ TAMs and depletion of effector T and NK cells contribute to recurrence after CRC lung metastasectomy. Therapeutic strategies targeting both TAMs and T cells may enhance clinical outcomes in this patient population.
Redefining HER2 in Breast Cancer: From Conventional Positivity to Low and Ultralow in the New Era of Antibody-Drug Conjugates.
Koh J, Im SA
Cancer Res Treat · 2026 Jan · PMID 41414806 · Full text
Human epidermal growth factor receptor 2 (HER2) has evolved from a poor prognostic factor to one of the most impactful predictive biomarkers in oncology. The introduction of trastuzumab established HER2 as a binary deter...
Human epidermal growth factor receptor 2 (HER2) has evolved from a poor prognostic factor to one of the most impactful predictive biomarkers in oncology. The introduction of trastuzumab established HER2 as a binary determinant of therapy, with HER2 immunohistochemistry (IHC) becoming the treatment-guiding diagnostic assay. However, the emergence of antibody-drug conjugates (ADCs), particularly trastuzumab deruxtecan, has challenged this paradigm by demonstrating activity in tumors with low and even ultralow HER2 expression. This review outlines the evolution of HER2 testing, from its historical discovery and early assay variability to the ADC era, where categories such as HER2-low and HER2-ultralow have emerged. We highlight key challenges: poor reproducibility at the lower end of IHC scoring, instability of HER2 status across timepoints and between primary and metastatic tumors, and no consistent biological distinction between low, ultralow, and null. Efforts to improve reliability-including structured training, high-sensitivity assays, RNA-based methods, and artificial intelligence-assisted pathology-are summarized. Finally, we reconsider the therapeutic implications of ADCs, with the question of whether the benefit parallels HER2 expression or extends into HER2-null disease. HER2 exemplifies how biomarker interpretation evolves with drug development. As new ADCs target additional antigens, pathologists must balance trial-driven categories with biologic reproducibility to ensure diagnostics remain aligned with therapeutic advances.
Utilization, Reimbursement, and Barriers to Accessing Sequencing Tests for Cancer Care in the Asia-Pacific Region: KSMO Initiatives to Address Cancer Care Inequity.
Pitiyarachchi O, Tan AC, Thambamroong T … +11 more , Velasco R, Uehara Y, Lee D, Kao HF, Agarwala V, Lim YN, Priantono D, Ahani AR, Win KZ, Kim YS, Yoo C
Cancer Res Treat · 2025 Dec · PMID 41414805 · Publisher ↗
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 se...
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 deoxyribonucleic acid (ctDNA)-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 (79%), and then by policy or regulatory restrictions (50%). On a similar note, insurance coverage (93%) and patient income (86%) 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.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe