1.Glucagon-Like Peptide-1 Receptor Agonists and Acute Pancreatitis: Current Evidence and Clinical Implications
Kwang Hyun CHUNG ; Jaihwan KIM
Korean Journal of Pancreas and Biliary Tract 2026;31(1):1-7
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated remarkable efficacy in the management of diabetes and obesity; however, their potential association with acute pancreatitis has been debated since their early clinical use. Numerous cases of suspected GLP-1 RA-related pancreatitis have been reported in the literature and pharmacovigilance databases, raising concerns about their safety. This review aims to examine the clinical and mechanistic evidence linking GLP-1 RA use to acute pancreatitis, including recent clinical studies, meta-analyses, and pathophysiological investigations. Based on the latest clinical evidence and practice guidelines, we propose strategies for the safe and appropriate use of GLP-1 RAs in clinical practice.
2.Small Cell Transformation in Pancreatic Metastasis from EGFR-Mutated Lung Adenocarcinoma Following TKI
Wootaek SEO, ; Hyeon-Gi KIM ; Hee-Eon LIM ; Kwangrok JUNG ; Jong-Chan LEE ; Jin-Hyeok HWANG ; Jaihwan KIM
Korean Journal of Pancreas and Biliary Tract 2025;30(2):76-80
Lazertinib is an oral, third-generation, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for the treatment of non-small cell lung cancer (NSCLC). This case report presents a rare instance of small cell carcinoma transformation in pancreatic metastasis in a patient with EGFR-mutated NSCLC undergoing treatment with lazertinib. Small cell carcinoma transformation indicates a mechanism of treatment resistance, and tissue biopsy is essential to confirm this. When isolated progression of a lesion is suspected during TKI therapy in EGFR-mutated NSCLC, histological evaluation is necessary to confirm the transformation for the treatment strategy.
3.Prognostic Value of the Metabolic Response on Serial18F-FDG PET/CT in Pancreatic Cancer
Jinwoo AHN ; Yoo Sung SONG ; Bomi KIM ; Soomin YANG ; Kwangrok JUNG ; Jong-Chan LEE ; Jaihwan KIM ; Jin-Hyeok HWANG
Gut and Liver 2025;19(3):462-472
Background/Aims:
The prognostic value of serial 18F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT) for patients with borderline resectable or locally advanced pancreatic cancer who undergo conversion surgery or continue chemotherapy without surgery has not been well-established.
Methods:
A retrospective analysis of patients with pancreatic ductal adenocarcinoma was conducted at Seoul National University Bundang Hospital between March 2013 and February 2022.Patients underwent PET/CT at baseline and subsequent radiologic evaluations following chemotherapy. Changes in the maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume, and total lesion glycolysis were analyzed.Based on their treatment regimens, patients were stratified into the conversion surgery group or nonconversion surgery group. Survival outcomes and various clinical factors were assessed.
Results:
Among 121 patients, 52 underwent conversion surgery, and 69 continued to receive chemotherapy without surgery. A significant reduction in the SUVmax was correlated with prolonged recurrence-free survival and overall survival in the conversion surgery group. Confirmation of a pathologic response indicated a significant association between reductions in the SUVmax and positive outcomes. Reductions in the metabolic tumor volume and total lesion glycolysis were associated with improved progression-free survival and overall survival in the nonconversion surgery group.
Conclusions
Serial PET/CT scans demonstrated prognostic value in pancreatic ductal adenocarcinoma patients, revealing distinct correlations in the conversion surgery group and nonconversion surgery group.
4.Small Cell Transformation in Pancreatic Metastasis from EGFR-Mutated Lung Adenocarcinoma Following TKI
Wootaek SEO, ; Hyeon-Gi KIM ; Hee-Eon LIM ; Kwangrok JUNG ; Jong-Chan LEE ; Jin-Hyeok HWANG ; Jaihwan KIM
Korean Journal of Pancreas and Biliary Tract 2025;30(2):76-80
Lazertinib is an oral, third-generation, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for the treatment of non-small cell lung cancer (NSCLC). This case report presents a rare instance of small cell carcinoma transformation in pancreatic metastasis in a patient with EGFR-mutated NSCLC undergoing treatment with lazertinib. Small cell carcinoma transformation indicates a mechanism of treatment resistance, and tissue biopsy is essential to confirm this. When isolated progression of a lesion is suspected during TKI therapy in EGFR-mutated NSCLC, histological evaluation is necessary to confirm the transformation for the treatment strategy.
5.Small Cell Transformation in Pancreatic Metastasis from EGFR-Mutated Lung Adenocarcinoma Following TKI
Wootaek SEO, ; Hyeon-Gi KIM ; Hee-Eon LIM ; Kwangrok JUNG ; Jong-Chan LEE ; Jin-Hyeok HWANG ; Jaihwan KIM
Korean Journal of Pancreas and Biliary Tract 2025;30(2):76-80
Lazertinib is an oral, third-generation, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for the treatment of non-small cell lung cancer (NSCLC). This case report presents a rare instance of small cell carcinoma transformation in pancreatic metastasis in a patient with EGFR-mutated NSCLC undergoing treatment with lazertinib. Small cell carcinoma transformation indicates a mechanism of treatment resistance, and tissue biopsy is essential to confirm this. When isolated progression of a lesion is suspected during TKI therapy in EGFR-mutated NSCLC, histological evaluation is necessary to confirm the transformation for the treatment strategy.
6.Prognostic Value of the Metabolic Response on Serial18F-FDG PET/CT in Pancreatic Cancer
Jinwoo AHN ; Yoo Sung SONG ; Bomi KIM ; Soomin YANG ; Kwangrok JUNG ; Jong-Chan LEE ; Jaihwan KIM ; Jin-Hyeok HWANG
Gut and Liver 2025;19(3):462-472
Background/Aims:
The prognostic value of serial 18F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT) for patients with borderline resectable or locally advanced pancreatic cancer who undergo conversion surgery or continue chemotherapy without surgery has not been well-established.
Methods:
A retrospective analysis of patients with pancreatic ductal adenocarcinoma was conducted at Seoul National University Bundang Hospital between March 2013 and February 2022.Patients underwent PET/CT at baseline and subsequent radiologic evaluations following chemotherapy. Changes in the maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume, and total lesion glycolysis were analyzed.Based on their treatment regimens, patients were stratified into the conversion surgery group or nonconversion surgery group. Survival outcomes and various clinical factors were assessed.
Results:
Among 121 patients, 52 underwent conversion surgery, and 69 continued to receive chemotherapy without surgery. A significant reduction in the SUVmax was correlated with prolonged recurrence-free survival and overall survival in the conversion surgery group. Confirmation of a pathologic response indicated a significant association between reductions in the SUVmax and positive outcomes. Reductions in the metabolic tumor volume and total lesion glycolysis were associated with improved progression-free survival and overall survival in the nonconversion surgery group.
Conclusions
Serial PET/CT scans demonstrated prognostic value in pancreatic ductal adenocarcinoma patients, revealing distinct correlations in the conversion surgery group and nonconversion surgery group.
7.Small Cell Transformation in Pancreatic Metastasis from EGFR-Mutated Lung Adenocarcinoma Following TKI
Wootaek SEO, ; Hyeon-Gi KIM ; Hee-Eon LIM ; Kwangrok JUNG ; Jong-Chan LEE ; Jin-Hyeok HWANG ; Jaihwan KIM
Korean Journal of Pancreas and Biliary Tract 2025;30(2):76-80
Lazertinib is an oral, third-generation, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for the treatment of non-small cell lung cancer (NSCLC). This case report presents a rare instance of small cell carcinoma transformation in pancreatic metastasis in a patient with EGFR-mutated NSCLC undergoing treatment with lazertinib. Small cell carcinoma transformation indicates a mechanism of treatment resistance, and tissue biopsy is essential to confirm this. When isolated progression of a lesion is suspected during TKI therapy in EGFR-mutated NSCLC, histological evaluation is necessary to confirm the transformation for the treatment strategy.
8.Prognostic Value of the Metabolic Response on Serial18F-FDG PET/CT in Pancreatic Cancer
Jinwoo AHN ; Yoo Sung SONG ; Bomi KIM ; Soomin YANG ; Kwangrok JUNG ; Jong-Chan LEE ; Jaihwan KIM ; Jin-Hyeok HWANG
Gut and Liver 2025;19(3):462-472
Background/Aims:
The prognostic value of serial 18F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT) for patients with borderline resectable or locally advanced pancreatic cancer who undergo conversion surgery or continue chemotherapy without surgery has not been well-established.
Methods:
A retrospective analysis of patients with pancreatic ductal adenocarcinoma was conducted at Seoul National University Bundang Hospital between March 2013 and February 2022.Patients underwent PET/CT at baseline and subsequent radiologic evaluations following chemotherapy. Changes in the maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume, and total lesion glycolysis were analyzed.Based on their treatment regimens, patients were stratified into the conversion surgery group or nonconversion surgery group. Survival outcomes and various clinical factors were assessed.
Results:
Among 121 patients, 52 underwent conversion surgery, and 69 continued to receive chemotherapy without surgery. A significant reduction in the SUVmax was correlated with prolonged recurrence-free survival and overall survival in the conversion surgery group. Confirmation of a pathologic response indicated a significant association between reductions in the SUVmax and positive outcomes. Reductions in the metabolic tumor volume and total lesion glycolysis were associated with improved progression-free survival and overall survival in the nonconversion surgery group.
Conclusions
Serial PET/CT scans demonstrated prognostic value in pancreatic ductal adenocarcinoma patients, revealing distinct correlations in the conversion surgery group and nonconversion surgery group.
9.Prognostic Value of the Metabolic Response on Serial18F-FDG PET/CT in Pancreatic Cancer
Jinwoo AHN ; Yoo Sung SONG ; Bomi KIM ; Soomin YANG ; Kwangrok JUNG ; Jong-Chan LEE ; Jaihwan KIM ; Jin-Hyeok HWANG
Gut and Liver 2025;19(3):462-472
Background/Aims:
The prognostic value of serial 18F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT) for patients with borderline resectable or locally advanced pancreatic cancer who undergo conversion surgery or continue chemotherapy without surgery has not been well-established.
Methods:
A retrospective analysis of patients with pancreatic ductal adenocarcinoma was conducted at Seoul National University Bundang Hospital between March 2013 and February 2022.Patients underwent PET/CT at baseline and subsequent radiologic evaluations following chemotherapy. Changes in the maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume, and total lesion glycolysis were analyzed.Based on their treatment regimens, patients were stratified into the conversion surgery group or nonconversion surgery group. Survival outcomes and various clinical factors were assessed.
Results:
Among 121 patients, 52 underwent conversion surgery, and 69 continued to receive chemotherapy without surgery. A significant reduction in the SUVmax was correlated with prolonged recurrence-free survival and overall survival in the conversion surgery group. Confirmation of a pathologic response indicated a significant association between reductions in the SUVmax and positive outcomes. Reductions in the metabolic tumor volume and total lesion glycolysis were associated with improved progression-free survival and overall survival in the nonconversion surgery group.
Conclusions
Serial PET/CT scans demonstrated prognostic value in pancreatic ductal adenocarcinoma patients, revealing distinct correlations in the conversion surgery group and nonconversion surgery group.
10.Small Cell Transformation in Pancreatic Metastasis from EGFR-Mutated Lung Adenocarcinoma Following TKI
Wootaek SEO, ; Hyeon-Gi KIM ; Hee-Eon LIM ; Kwangrok JUNG ; Jong-Chan LEE ; Jin-Hyeok HWANG ; Jaihwan KIM
Korean Journal of Pancreas and Biliary Tract 2025;30(2):76-80
Lazertinib is an oral, third-generation, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for the treatment of non-small cell lung cancer (NSCLC). This case report presents a rare instance of small cell carcinoma transformation in pancreatic metastasis in a patient with EGFR-mutated NSCLC undergoing treatment with lazertinib. Small cell carcinoma transformation indicates a mechanism of treatment resistance, and tissue biopsy is essential to confirm this. When isolated progression of a lesion is suspected during TKI therapy in EGFR-mutated NSCLC, histological evaluation is necessary to confirm the transformation for the treatment strategy.

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