6.A Phase II Trial of Nintedanib in Patients with Metastatic or Recurrent Head and Neck Squamous Cell Carcinoma: In-Depth Analysis of Nintedanib Arm from the KCSG HN 15-16 TRIUMPH Trial
Kyoo Hyun KIM ; Sun Min LIM ; Hee Kyung AHN ; Yun-Gyoo LEE ; Keun-Wook LEE ; Myung-Ju AHN ; Bhumsuk KEAM ; Hye Ryun KIM ; Hyun Woo LEE ; Ho Jung AN ; Jin-Soo KIM
Cancer Research and Treatment 2024;56(1):37-47
Purpose:
Precision oncology approach for recurrent and metastatic head and neck squamous cell carcinoma (HNSCC) is necessary due to its dismal prognosis. We performed a genomic profile-based umbrella trial of patients with platinum-refractory HNSCC (KCSG-TRIUMPH). Here, we present an in-depth report of the the nintedanib arm (arm 3) of the current trial.
Materials and Methods:
The TRIUMPH study was a multicenter, open-label, single-arm phase 2 trial, in which patients were assigned to treatment arms based on next-generation sequencing (NGS)–based, matching genomic profiles. Patients whose tumors harbor fibroblast growth factor receptor (FGFR) alteration were enrolled in the nintedanib arm (arm 3) as part of the TRIUMPH study. The primary endpoint was the overall response rate (ORR), and secondary endpoints included overall survival (OS), progression-free survival (PFS), safety, and biomarker analysis.
Results:
Between October 2017 and August 2020, 207 were enrolled in the TRIUMPH study, and eight were enrolled in the nintedanib arm. ORR and disease control rate were 42.9% and 57.1%, respectively. The median PFS was 5.6 months and the median duration of response was 9.1 months. Median OS was 11.1 months. One patient maintained the partial response for 36 months. Overall, the toxicity profiles were manageable.
Conclusion
Single-agent nintedanib has demonstrated significant efficacy in FGFR-mutated, recurrent or metastatic HNSCC patients, with tolerable toxicity profiles. The results from the study have provided the basis for routine NGS screening and FGFR-targeted therapy. Because of the small number of patients due to slow accrual in this study, further studies with a larger cohort are warranted for statistical power.
7.Applications of Bioinspired Platforms for Enhancing Immunomodulatory Function of Mesenchymal Stromal Cells
Ok-Hyeon KIM ; Tae Jin JEON ; Young In SO ; Yong Kyoo SHIN ; Hyun Jung LEE
International Journal of Stem Cells 2023;16(3):251-259
Mesenchymal stromal cells (MSCs) have attracted scientific and medical interest due to their self-renewing properties, pluripotency, and paracrine function. However, one of the main limitations to the clinical application of MSCs is their loss of efficacy after transplantation in vivo. Various bioengineering technologies to provide stem cell niche-like conditions have the potential to overcome this limitation. Here, focusing on the stem cell niche microenvironment, studies to maximize the immunomodulatory potential of MSCs by controlling biomechanical stimuli, including shear stress, hydrostatic pressure, stretch, and biophysical cues, such as extracellular matrix mimetic substrates, are discussed. The application of biomechanical forces or biophysical cues to the stem cell microenvironment will be beneficial for enhancing the immunomodulatory function of MSCs during cultivation and overcoming the current limitations of MSC therapy.
8.Impact of Coronavirus Disease 2019 on Gastric Cancer Diagnosis and Stage:A Single-Institute Study in South Korea
Moonki HONG ; Mingee CHOI ; JiHyun LEE ; Kyoo Hyun KIM ; Hyunwook KIM ; Choong-Kun LEE ; Hyo Song KIM ; Sun Young RHA ; Gyu Young PIH ; Yoon Jin CHOI ; Da Hyun JUNG ; Jun Chul PARK ; Sung Kwan SHIN ; Sang Kil LEE ; Yong Chan LEE ; Minah CHO ; Yoo Min KIM ; Hyoung-Il KIM ; Jae-Ho CHEONG ; Woo Jin HYUNG ; Jaeyong SHIN ; Minkyu JUNG
Journal of Gastric Cancer 2023;23(4):574-583
Purpose:
Gastric cancer (GC) is among the most prevalent and fatal cancers worldwide.National cancer screening programs in countries with high incidences of this disease provide medical aid beneficiaries with free-of-charge screening involving upper endoscopy to detect early-stage GC. However, the coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions to routine healthcare access. Thus, this study aimed to assess the impact of COVID-19 on the diagnosis, overall incidence, and stage distribution of GC.
Materials and Methods:
We identified patients in our hospital cancer registry who were diagnosed with GC between January 2018 and December 2021 and compared the cancer stage at diagnosis before and during the COVID-19 pandemic. Subgroup analyses were conducted according to age and sex. The years 2018 and 2019 were defined as the “before COVID” period, and the years 2020 and 2021 as the “during COVID” period.
Results:
Overall, 10,875 patients were evaluated; 6,535 and 4,340 patients were diagnosed before and during the COVID-19 period, respectively. The number of diagnoses was lower during the COVID-19 pandemic (189 patients/month vs. 264 patients/month) than before it.Notably, the proportion of patients with stages 3 or 4 GC in 2021 was higher among men and patients aged ≥40 years.
Conclusions
During the COVID-19 pandemic, the overall number of GC diagnoses decreased significantly in a single institute. Moreover, GCs were in more advanced stages at the time of diagnosis. Further studies are required to elucidate the relationship between the COVID-19 pandemic and the delay in the detection of GC worldwide.
9.Latanoprostene Bunod 0.024% w/v Treatment of Open-anlge Glaucoma: Short-term Effects, Safety, and Changes in Ocular Blood
Hyun Woo KIM ; Chong Eun LEE ; Sam SEO ; Kyoo Won LEE ; Chang Hoon LEE
Journal of the Korean Ophthalmological Society 2023;64(10):930-938
Purpose:
To study the short-term intraocular pressure (IOP)-lowering effect and optic nerve head (ONH) blood flow improvement after switching from latanoprost 0.005% w/v to latanoprostene bunod 0.024% w/v.
Methods:
This prospective study ran from May 2022 to December 2022 and included 40 patients with open-angle glaucoma who switched from latanoprost 0.005% w/v to latanoprostene bunod 0.024% w/v. The IOP, ONH blood flow, and conjunctival hyperemia, corneal erosion, and eyelid pigmentation status were measured 3 months after switching. We recorded all possible side effects.
Results:
The baseline IOP significantly dropped from 17.53 ± 6.49 to 16.00 ± 8.06 mmHg at 3 months (p = 0.032). The best-corrected visual acuity did not significantly change (0.24 ± 0.19 to 0.23 ± 0.16); neither did eyelid pigmentation (1.16 ± 0.78 to 1.16 ± 0.82) nor the corneal erosion score (0.58 ± 0.85 to 0.39 ± 0.76). Conjunctival hyperemia significantly decreased from 2.00 ± 0.69 to 1.67 ± 0.63 (p = 0.010). Neither the whole-image vessel density nor the peripapillary vessel density significantly changed. However, pruritus became significantly worse after the change (p = 0.008).
Conclusions
In the short term, latanoprostene bunod 0.024% w/v lowered the IOP more effectively than did latanoprost 0.005% w/v. However, there was no significant change in ONH blood flow after the switch.
10.Inhibition of DNMT3B and PI3K/AKT/mTOR and ERK Pathways as a Novel Mechanism of Volasertib on Hypomethylating Agent-Resistant Cells
Eun-Ji CHOI ; Bon-Kwan KOO ; Eun-Hye HUR ; Ju Hyun MOON ; Ji Yun KIM ; Han-Seung PARK ; Yunsuk CHOI ; Kyoo-Hyung LEE ; Jung-Hee LEE ; Eun Kyung CHOI ; Je-Hwan LEE
Biomolecules & Therapeutics 2023;31(3):319-329
Resistance to hypomethylating agents (HMAs) in myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) is a concerning problem. Polo-like kinase 1 (PLK1) is a key cell cycle modulator and is known to be associated with an activation of the PI3K pathway, which is related to the stabilization of DNA methyltransferase 1 (DNMT1), a target of HMAs. We investigated the effects of volasertib on HMA-resistant cell lines (MOLM/AZA-1 and MOLM/DEC-5) derived from MOLM-13, and bone marrow (BM) samples obtained from patients with MDS (BM blasts >5%) or AML evolved from MDS (MDS/AML). Volasertib effectively inhibited the proliferation of HMA-resistant cells with suppression of DNMTs and PI3K/AKT/mTOR and ERK pathways. Volasertib also showed significant inhibitory effects against primary BM cells from patients with MDS or MDS/AML, and the effects of volasertib inversely correlated with DNMT3B expression. The DNMT3B-overexpressed AML cells showed primary resistance to volasertib treatment. Our data suggest that volasertib has a potential role in overcoming HMA resistance in patients with MDS and MDS/ AML by suppressing the expression of DNMT3 enzymes and PI3K/AKT/mTOR and ERK pathways. We also found that DNMT3B overexpression might be associated with resistance to volasertib.

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