1.Targeted Therapy for Pancreatic Cancer: Focus on KRAS
Journal of Digestive Cancer Research 2025;13(1):52-64
Pancreatic cancer is among the most aggressive malignancies, with a 5-year overall survival rate of approximately 10%. Despite the establishment of gemcitabine- and fluoropyrimidine-based combination chemotherapy as the standard of care, therapeutic outcomes remain poor due to inherent and acquired resistance to chemotherapy. In recent years, the development of targeted therapies has emerged as a promising treatment modality, driven by advances in molecular biology and genomic profiling. Notably, mutations in the KRAS gene—detected in nearly 90% of pancreatic cancer cases—are recognized as key oncogenic drivers, contributing significantly to tumor initiation, progression, and therapeutic resistance. As such, KRAS has become a focal point for therapeutic intervention. Strategies aimed at targeting KRAS include (1) direct inhibitors of specific KRAS mutations, (2) inhibitors of upstream regulators such as SOS1 and SHP2, and (3) inhibitors of downstream effectors within the RAS signaling cascade. Given the challenges posed by compensatory signaling mechanisms that reduce the efficacy of direct KRAS inhibitors, ongoing research is exploring alternative approaches such as pan-KRAS inhibitors, combination regimens that pair KRAS inhibitors with cytotoxic chemotherapy, and dualtarget strategies involving upstream and downstream signaling components. For the subset of patients (approximately 10%) with wild-type KRAS, the U.S. Food and Drug Administration has approved targeted therapies for tumors harboring specific rare genetic alterations, including NTRK, BRAF, NRG1, ALK, ROS1, RET, and those with mismatch repair deficiency or microsatellite instability-high status. Furthermore, poly(ADP-ribose) polymerase inhibitors have shown clinical benefit in patients with germline or somatic mutations in DNA damage repair genes such as BRCA1, BRCA2, and PALB2.
2.Targeted Therapy for Pancreatic Cancer: Focus on KRAS
Journal of Digestive Cancer Research 2025;13(1):52-64
Pancreatic cancer is among the most aggressive malignancies, with a 5-year overall survival rate of approximately 10%. Despite the establishment of gemcitabine- and fluoropyrimidine-based combination chemotherapy as the standard of care, therapeutic outcomes remain poor due to inherent and acquired resistance to chemotherapy. In recent years, the development of targeted therapies has emerged as a promising treatment modality, driven by advances in molecular biology and genomic profiling. Notably, mutations in the KRAS gene—detected in nearly 90% of pancreatic cancer cases—are recognized as key oncogenic drivers, contributing significantly to tumor initiation, progression, and therapeutic resistance. As such, KRAS has become a focal point for therapeutic intervention. Strategies aimed at targeting KRAS include (1) direct inhibitors of specific KRAS mutations, (2) inhibitors of upstream regulators such as SOS1 and SHP2, and (3) inhibitors of downstream effectors within the RAS signaling cascade. Given the challenges posed by compensatory signaling mechanisms that reduce the efficacy of direct KRAS inhibitors, ongoing research is exploring alternative approaches such as pan-KRAS inhibitors, combination regimens that pair KRAS inhibitors with cytotoxic chemotherapy, and dualtarget strategies involving upstream and downstream signaling components. For the subset of patients (approximately 10%) with wild-type KRAS, the U.S. Food and Drug Administration has approved targeted therapies for tumors harboring specific rare genetic alterations, including NTRK, BRAF, NRG1, ALK, ROS1, RET, and those with mismatch repair deficiency or microsatellite instability-high status. Furthermore, poly(ADP-ribose) polymerase inhibitors have shown clinical benefit in patients with germline or somatic mutations in DNA damage repair genes such as BRCA1, BRCA2, and PALB2.
3.Targeted Therapy for Pancreatic Cancer: Focus on KRAS
Journal of Digestive Cancer Research 2025;13(1):52-64
Pancreatic cancer is among the most aggressive malignancies, with a 5-year overall survival rate of approximately 10%. Despite the establishment of gemcitabine- and fluoropyrimidine-based combination chemotherapy as the standard of care, therapeutic outcomes remain poor due to inherent and acquired resistance to chemotherapy. In recent years, the development of targeted therapies has emerged as a promising treatment modality, driven by advances in molecular biology and genomic profiling. Notably, mutations in the KRAS gene—detected in nearly 90% of pancreatic cancer cases—are recognized as key oncogenic drivers, contributing significantly to tumor initiation, progression, and therapeutic resistance. As such, KRAS has become a focal point for therapeutic intervention. Strategies aimed at targeting KRAS include (1) direct inhibitors of specific KRAS mutations, (2) inhibitors of upstream regulators such as SOS1 and SHP2, and (3) inhibitors of downstream effectors within the RAS signaling cascade. Given the challenges posed by compensatory signaling mechanisms that reduce the efficacy of direct KRAS inhibitors, ongoing research is exploring alternative approaches such as pan-KRAS inhibitors, combination regimens that pair KRAS inhibitors with cytotoxic chemotherapy, and dualtarget strategies involving upstream and downstream signaling components. For the subset of patients (approximately 10%) with wild-type KRAS, the U.S. Food and Drug Administration has approved targeted therapies for tumors harboring specific rare genetic alterations, including NTRK, BRAF, NRG1, ALK, ROS1, RET, and those with mismatch repair deficiency or microsatellite instability-high status. Furthermore, poly(ADP-ribose) polymerase inhibitors have shown clinical benefit in patients with germline or somatic mutations in DNA damage repair genes such as BRCA1, BRCA2, and PALB2.
4.Guideline for Minimizing Radiation Exposure of Interventionalists during Fluoroscopy-guided Interventional Procedures
Il Sang SHIN ; Yun Nah LEE ; Jun Kyu LEE ; Joo Seong KIM ; Sung Bum KIM ; Jiyoung KEUM ; Chang Hoon OH ; Kang Won LEE ; Joowon CHUNG ; Lyo Min KWON ; Nam Hee KIM ; Sang Soo LEE ; Byoung Kwan SON ; Miyoung CHOI
The Korean Journal of Gastroenterology 2024;84(6):251-264
As fluoroscopy-guided interventional procedures gain popularity, the associated health threats from radiation exposure to interventionalists during these procedures are increasing. Therefore, an understanding of the potential risks of radiation and careful consideration on minimizing exposure to radiation during the procedures are of paramount importance. The Korean Pancreatobiliary Association has developed a clinical practice guideline to minimize radiation exposure during fluoroscopy-guided interventional procedures. This guideline provides recommendations to deal with the risk of radiation exposure to interventionalists who perform fluoroscopy-guided procedures, and emphasizes the importance of proper and practical approaches to avoid unnecessary radiation exposure.
5.Guideline for Minimizing Radiation Exposure of Interventionalists during Fluoroscopy-guided Interventional Procedures
Il Sang SHIN ; Yun Nah LEE ; Jun Kyu LEE ; Joo Seong KIM ; Sung Bum KIM ; Jiyoung KEUM ; Chang Hoon OH ; Kang Won LEE ; Joowon CHUNG ; Lyo Min KWON ; Nam Hee KIM ; Sang Soo LEE ; Byoung Kwan SON ; Miyoung CHOI
The Korean Journal of Gastroenterology 2024;84(6):251-264
As fluoroscopy-guided interventional procedures gain popularity, the associated health threats from radiation exposure to interventionalists during these procedures are increasing. Therefore, an understanding of the potential risks of radiation and careful consideration on minimizing exposure to radiation during the procedures are of paramount importance. The Korean Pancreatobiliary Association has developed a clinical practice guideline to minimize radiation exposure during fluoroscopy-guided interventional procedures. This guideline provides recommendations to deal with the risk of radiation exposure to interventionalists who perform fluoroscopy-guided procedures, and emphasizes the importance of proper and practical approaches to avoid unnecessary radiation exposure.
6.Guideline for Minimizing Radiation Exposure of Interventionalists during Fluoroscopy-guided Interventional Procedures
Il Sang SHIN ; Yun Nah LEE ; Jun Kyu LEE ; Joo Seong KIM ; Sung Bum KIM ; Jiyoung KEUM ; Chang Hoon OH ; Kang Won LEE ; Joowon CHUNG ; Lyo Min KWON ; Nam Hee KIM ; Sang Soo LEE ; Byoung Kwan SON ; Miyoung CHOI
The Korean Journal of Gastroenterology 2024;84(6):251-264
As fluoroscopy-guided interventional procedures gain popularity, the associated health threats from radiation exposure to interventionalists during these procedures are increasing. Therefore, an understanding of the potential risks of radiation and careful consideration on minimizing exposure to radiation during the procedures are of paramount importance. The Korean Pancreatobiliary Association has developed a clinical practice guideline to minimize radiation exposure during fluoroscopy-guided interventional procedures. This guideline provides recommendations to deal with the risk of radiation exposure to interventionalists who perform fluoroscopy-guided procedures, and emphasizes the importance of proper and practical approaches to avoid unnecessary radiation exposure.
7.Guideline for Minimizing Radiation Exposure of Interventionalists during Fluoroscopy-guided Interventional Procedures
Il Sang SHIN ; Yun Nah LEE ; Jun Kyu LEE ; Joo Seong KIM ; Sung Bum KIM ; Jiyoung KEUM ; Chang Hoon OH ; Kang Won LEE ; Joowon CHUNG ; Lyo Min KWON ; Nam Hee KIM ; Sang Soo LEE ; Byoung Kwan SON ; Miyoung CHOI
The Korean Journal of Gastroenterology 2024;84(6):251-264
As fluoroscopy-guided interventional procedures gain popularity, the associated health threats from radiation exposure to interventionalists during these procedures are increasing. Therefore, an understanding of the potential risks of radiation and careful consideration on minimizing exposure to radiation during the procedures are of paramount importance. The Korean Pancreatobiliary Association has developed a clinical practice guideline to minimize radiation exposure during fluoroscopy-guided interventional procedures. This guideline provides recommendations to deal with the risk of radiation exposure to interventionalists who perform fluoroscopy-guided procedures, and emphasizes the importance of proper and practical approaches to avoid unnecessary radiation exposure.
8.Guideline for Minimizing Radiation Exposure of Interventionalists during Fluoroscopy-guided Interventional Procedures
Il Sang SHIN ; Yun Nah LEE ; Jun Kyu LEE ; Joo Seong KIM ; Sung Bum KIM ; Jiyoung KEUM ; Chang Hoon OH ; Kang Won LEE ; Joowon CHUNG ; Lyo Min KWON ; Nam Hee KIM ; Sang Soo LEE ; Byoung Kwan SON ; Miyoung CHOI
The Korean Journal of Gastroenterology 2024;84(6):251-264
As fluoroscopy-guided interventional procedures gain popularity, the associated health threats from radiation exposure to interventionalists during these procedures are increasing. Therefore, an understanding of the potential risks of radiation and careful consideration on minimizing exposure to radiation during the procedures are of paramount importance. The Korean Pancreatobiliary Association has developed a clinical practice guideline to minimize radiation exposure during fluoroscopy-guided interventional procedures. This guideline provides recommendations to deal with the risk of radiation exposure to interventionalists who perform fluoroscopy-guided procedures, and emphasizes the importance of proper and practical approaches to avoid unnecessary radiation exposure.
9.C3 glomerulonephritis with genetically confirmed C3 deficiency in a pediatric patient: a case report
Hae Min KIM ; Jae Il SHIN ; Ji Hong KIM ; Jiyoung OH ; Ji-Man KANG ; Hee Gyung KANG ; Seong Heon KIM ; Byoung Soo CHO ; Keum Hwa LEE
Childhood Kidney Diseases 2024;28(3):124-130
Complement component 3 glomerulonephritis (C3GN) is a rare kidney disease characterized by complement dysregulation that results in prominent complement component 3 (C3) deposition in the kidneys. The clinical course of C3GN varies from mild hematuria to progressive chronic kidney disease. In most patients, C3GN is driven by acquired factors, namely, autoantibodies that target C3 or C5 convertases. Genetic variations in complement-related genes are less frequent. We report the case of a 9-yearold Korean boy who presented with microscopic hematuria and a persistently low C3 level and had biopsy findings of C3GN, with the presence of a C3 gene mutation: a frameshift mutation associated with C3 deficiency. However, the patient did not exhibit any other symptoms of complement deficiency. Direct DNA sequencing of his family members revealed the same genetic mutation in his father and older brother. This case report is significant because there are very few such reports worldwide concerning gene mutations related to C3 deficiency to be discovered in patients with C3GN. Explaining C3GN pathogenesis is challenging; therefore, additional research is required in the future.
10.Guideline for Minimizing Radiation Exposure of Interventionalists during Fluoroscopy-Guided Interventional Procedures
Il Sang SHIN ; Yun Nah LEE ; Jun Kyu LEE ; Joo Seong KIM ; Sung Bum KIM ; Jiyoung KEUM ; Chang Hoon OH ; Kang Won LEE ; Joowon CHUNG ; Lyo Min KWON ; Nam Hee KIM ; Sang Soo LEE ; Byoung Kwan SON ; Miyoung CHOI
Korean Journal of Pancreas and Biliary Tract 2024;29(3):69-84
As fluoroscopy-guided interventional procedures gain popularity, the associated health threats from radiation exposure to interventionalists during these procedures are increasing. Therefore, an understanding of the potential risks of radiation and careful consideration on minimizing exposure to radiation during the procedures are of paramount importance. The Korean Pancreatobiliary Association has developed a clinical practice guideline to minimize radiation exposure during fluoroscopy-guided interventional procedures. This guideline provides recommendations to deal with the risk of radiation exposure to interventionalists who perform fluoroscopy-guided procedures, and emphasizes the importance of proper and practical approaches to avoid unnecessary radiation exposure.

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