Purpose: Considering the high disease burden and unique features of Asian patients with breast cancer (BC), it is essential to have a comprehensive view of genetic characteristics in this population. An institutional targeted sequencing platform was developed through the Korea Research-Driven Hospitals project and was incorporated into clinical practice. This study explores the use of targeted next-generation sequencing (NGS) and its outcomes in patients with advanced/metastatic BC in the real world. Materials and Methods: We reviewed the results of NGS tests administered to BC patients using a customized sequencing platform—FiRST Cancer Panel (FCP)—over 7 years. We systematically described clinical translation of FCP for precise diagnostics, personalized therapeutic strategies, and unraveling disease pathogenesis. Results: NGS tests were conducted on 548 samples from 522 patients with BC. Ninety-seven point six percentage of tested samples harbored at least one pathogenic alteration. The common alterations included mutations in TP53 (56.2%), PIK3CA (31.2%), GATA3 (13.8%), BRCA2 (10.2%), and amplifications of CCND1 (10.8%), FGF19 (10.0%), and ERBB2 (9.5%). NGS analysis of ERBB2 amplification correlated well with human epidermal growth factor receptor 2 immunohistochemistry and in situ hybridization. RNA panel analyses found potentially actionable and prognostic fusion genes. FCP effectively screened for potentially germline pathogenic/likely pathogenic mutation. Ten point three percent of BC patients received matched therapy guided by NGS, resulting in a significant overall survival advantage (p=0.022), especially for metastatic BCs. Conclusion Clinical NGS provided multifaceted benefits, deepening our understanding of the disease, improving diagnostic precision, and paving the way for targeted therapies. The concrete advantages of FCP highlight the importance of multi-gene testing for BC, especially for metastatic conditions.

Purpose: Considering the high disease burden and unique features of Asian patients with breast cancer (BC), it is essential to have a comprehensive view of genetic characteristics in this population. An institutional targeted sequencing platform was developed through the Korea Research-Driven Hospitals project and was incorporated into clinical practice. This study explores the use of targeted next-generation sequencing (NGS) and its outcomes in patients with advanced/metastatic BC in the real world. Materials and Methods: We reviewed the results of NGS tests administered to BC patients using a customized sequencing platform—FiRST Cancer Panel (FCP)—over 7 years. We systematically described clinical translation of FCP for precise diagnostics, personalized therapeutic strategies, and unraveling disease pathogenesis. Results: NGS tests were conducted on 548 samples from 522 patients with BC. Ninety-seven point six percentage of tested samples harbored at least one pathogenic alteration. The common alterations included mutations in TP53 (56.2%), PIK3CA (31.2%), GATA3 (13.8%), BRCA2 (10.2%), and amplifications of CCND1 (10.8%), FGF19 (10.0%), and ERBB2 (9.5%). NGS analysis of ERBB2 amplification correlated well with human epidermal growth factor receptor 2 immunohistochemistry and in situ hybridization. RNA panel analyses found potentially actionable and prognostic fusion genes. FCP effectively screened for potentially germline pathogenic/likely pathogenic mutation. Ten point three percent of BC patients received matched therapy guided by NGS, resulting in a significant overall survival advantage (p=0.022), especially for metastatic BCs. Conclusion Clinical NGS provided multifaceted benefits, deepening our understanding of the disease, improving diagnostic precision, and paving the way for targeted therapies. The concrete advantages of FCP highlight the importance of multi-gene testing for BC, especially for metastatic conditions.

Purpose: Considering the high disease burden and unique features of Asian patients with breast cancer (BC), it is essential to have a comprehensive view of genetic characteristics in this population. An institutional targeted sequencing platform was developed through the Korea Research-Driven Hospitals project and was incorporated into clinical practice. This study explores the use of targeted next-generation sequencing (NGS) and its outcomes in patients with advanced/metastatic BC in the real world. Materials and Methods: We reviewed the results of NGS tests administered to BC patients using a customized sequencing platform—FiRST Cancer Panel (FCP)—over 7 years. We systematically described clinical translation of FCP for precise diagnostics, personalized therapeutic strategies, and unraveling disease pathogenesis. Results: NGS tests were conducted on 548 samples from 522 patients with BC. Ninety-seven point six percentage of tested samples harbored at least one pathogenic alteration. The common alterations included mutations in TP53 (56.2%), PIK3CA (31.2%), GATA3 (13.8%), BRCA2 (10.2%), and amplifications of CCND1 (10.8%), FGF19 (10.0%), and ERBB2 (9.5%). NGS analysis of ERBB2 amplification correlated well with human epidermal growth factor receptor 2 immunohistochemistry and in situ hybridization. RNA panel analyses found potentially actionable and prognostic fusion genes. FCP effectively screened for potentially germline pathogenic/likely pathogenic mutation. Ten point three percent of BC patients received matched therapy guided by NGS, resulting in a significant overall survival advantage (p=0.022), especially for metastatic BCs. Conclusion Clinical NGS provided multifaceted benefits, deepening our understanding of the disease, improving diagnostic precision, and paving the way for targeted therapies. The concrete advantages of FCP highlight the importance of multi-gene testing for BC, especially for metastatic conditions.

Background: Tacrolimus is a key immunosuppressant after liver transplantation.Although guideline-recommended trough levels are 4–10 ng/mL, concerns about nephrotoxicity, metabolic complications, and malignancies have led to interest in minimizing tacrolimus use. However, the effects of lower tacrolimus levels on graft rejection and hepatocellular carcinoma (HCC) recurrence remain unclear. Methods: We conducted a single-center, retrospective study of adult patients (≥19 years) who underwent living donor liver transplantation between January 2000 and December 2021. Patients were divided into low tacrolimus (FK) (<6 ng/mL) and high FK (≥6 ng/mL) groups based on tacrolimus levels measured 1–2 years post-transplantation. We analyzed overall survival, biopsy-proven rejection-free survival, and HCC recurrence-free survival in relevant subgroups. Cox proportional hazards regression identified predictors of mortality, rejection, and HCC recurrence. Results: Among 1,117 recipients, 941 were in the low FK group and 176 in the high FK group. Landmark analysis showed significantly better 10-year overall survival in the low FK group (82.8% vs. 68.8%, p=0.016), while rejection-free survival did not differ significantly beyond 2 years (p=0.098), despite early separation favoring the low FK group (p<0.001). Higher tacrolimus levels independently predicted increased mortality (hazard ratio [HR]=1.98, 95% confidence interval [CI] 1.35–2.89; p<0.001) and rejection (HR=2.20, 95% CI 1.48–3.27; p<0.001). Among 614 HCC patients, landmark analysis revealed no significant difference in recurrence-free survival (77.7% vs. 81.2%, p=0.288) or overall survival (77.3% vs. 65.8%, p=0.215), and FK levels were not independently associated with either outcome. Conclusion Maintaining tacrolimus levels below 6 ng/mL was associated with better survival and rejection outcomes without increasing HCC recurrence, suggesting dose minimization may be feasible in selected patients.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.