1.The onco-bariatric paradigm: a tri-phasic metabolic obesity framework for synergizing glucagon-like peptide-1 receptor agonists and metabolic bariatric surgery
Dong Jin PARK ; Yoonhong KIM ; Dongjae JEON ; Young Suk PARK ; Kyung Won SEO ; Ki Hyun KIM
Kosin Medical Journal 2026;41(1):3-8
Obesity is a chronic, progressive neuroendocrine disease that warrants a shift toward an “onco-bariatric” treatment paradigm. This study introduces the tri-phasic metabolic obesity (TPMO) framework, which integrates glucagon-like peptide-1 receptor agonists (GLP-1 RAs) with metabolic bariatric surgery (MBS). Recent clinical and economic evidence—including findings from the Indiana multicenter study and the Highmark Health analysis—was reviewed to evaluate the effectiveness of the TPMO model in improving surgical and metabolic outcomes. The TPMO framework streamlines the patient journey through three synergistic phases. In the neoadjuvant phase, a 4–8-week course of GLP-1 RAs reduces liver volume and visceral fat, thereby improving surgical access, provided that treatment is discontinued 1 week before surgery to mitigate aspiration risk. During the core surgery phase, MBS provides a definitive metabolic reset and remains the most cost-effective treatment, yielding an average savings of $11,689 per patient over 2 years compared with medication alone. In the adjuvant phase, pharmacotherapy—used by 17.2% of post-bariatric patients—counteracts metabolic adaptation and supports sustained weight loss, while a high-protein intake (≥1.2 g/kg/day) is essential for preserving lean body mass. The TPMO framework represents a precision-based, synergistic standard of care designed to promote durable, cost-effective long-term metabolic health within the onco-bariatric paradigm.
2.Harnessing Institutionally Developed Clinical Targeted Sequencing to Improve Patient Survival in Breast Cancer: A Seven-Year Experience
Jiwon KOH ; Jinyong KIM ; Go-Un WOO ; Hanbaek YI ; So Yean KWON ; Jeongmin SEO ; Jeong Mo BAE ; Jung Ho KIM ; Jae Kyung WON ; Han Suk RYU ; Yoon Kyung JEON ; Dae-Won LEE ; Miso KIM ; Tae-Yong KIM ; Kyung-Hun LEE ; Tae-You KIM ; Jee-Soo LEE ; Moon-Woo SEONG ; Sheehyun KIM ; Sungyoung LEE ; Hongseok YUN ; Myung Geun SONG ; Jaeyong CHOI ; Jong-Il KIM ; Seock-Ah IM
Cancer Research and Treatment 2025;57(2):443-456
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.
3.Harnessing Institutionally Developed Clinical Targeted Sequencing to Improve Patient Survival in Breast Cancer: A Seven-Year Experience
Jiwon KOH ; Jinyong KIM ; Go-Un WOO ; Hanbaek YI ; So Yean KWON ; Jeongmin SEO ; Jeong Mo BAE ; Jung Ho KIM ; Jae Kyung WON ; Han Suk RYU ; Yoon Kyung JEON ; Dae-Won LEE ; Miso KIM ; Tae-Yong KIM ; Kyung-Hun LEE ; Tae-You KIM ; Jee-Soo LEE ; Moon-Woo SEONG ; Sheehyun KIM ; Sungyoung LEE ; Hongseok YUN ; Myung Geun SONG ; Jaeyong CHOI ; Jong-Il KIM ; Seock-Ah IM
Cancer Research and Treatment 2025;57(2):443-456
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.
4.Harnessing Institutionally Developed Clinical Targeted Sequencing to Improve Patient Survival in Breast Cancer: A Seven-Year Experience
Jiwon KOH ; Jinyong KIM ; Go-Un WOO ; Hanbaek YI ; So Yean KWON ; Jeongmin SEO ; Jeong Mo BAE ; Jung Ho KIM ; Jae Kyung WON ; Han Suk RYU ; Yoon Kyung JEON ; Dae-Won LEE ; Miso KIM ; Tae-Yong KIM ; Kyung-Hun LEE ; Tae-You KIM ; Jee-Soo LEE ; Moon-Woo SEONG ; Sheehyun KIM ; Sungyoung LEE ; Hongseok YUN ; Myung Geun SONG ; Jaeyong CHOI ; Jong-Il KIM ; Seock-Ah IM
Cancer Research and Treatment 2025;57(2):443-456
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.
5.Analysis of Visual and Anatomical Outcomes with Biosimilar Intravitreal Injections for Neovascular Age-related Macular Degeneration: A Retrospective Cohort Study
Jehwi JEON ; Kyung Joo MAENG ; Suk Ho BYEON ; Sung Soo KIM ; Christopher Seungkyu LEE
Journal of Retina 2025;10(2):201-206
Purpose:
To evaluate the anatomical and visual effects of biosimilars in the treatment of wet age-related macular degeneration (AMD).
Methods:
We retrospectively reviewed patients with wet AMD treated with originator or biosimilar ranibizumab (CKD-701) or aflibercept (SB15) between June 2024 and February 2025 at Severance Eye Hospital. Clinical outcomes were assessed over six months using best corrected visual acuity (BCVA) and central macular thickness (CMT) measurements.
Results:
Among 272 patients, 91 received ranibizumab (54.9% originator, 45.1% biosimilar) and 181 received aflibercept (66.9% originator, 33.1% biosimilar). In the ranibizumab group, BCVA and CMT improvements were comparable between originator and biosimilar formulations, with no significant differences in injection number. In the aflibercept group, the biosimilar cohort received significantly fewer injections (3.63 [originator] vs. 3.11 [biosimilar], p = 0.006) and showed slightly inferior visual and anatomical outcomes, likely influenced by a smaller proportion of treatment-naïve patients and limited insurance coverage. No serious adverse events were observed in any group.
Conclusions
Biosimilars demonstrated acceptable efficacy and safety over six months. Broader use could improve accessibility, though further long-term data are needed.
6.The Awareness of Sports Physicians about Relative Energy Deficiency in Sport
Soo Hyun PARK ; Eon Sook LEE ; Jieun KWON ; Lina KIM ; Yeonsoo KIM ; Tae Kyung KIM ; Nayoung AHN ; Young Kill YUN ; Sun Joo LEE ; Young Sun LEE ; Hyo Jeong LEE ; Suk Ha JEON ; Tae Im YI
The Korean Journal of Sports Medicine 2024;42(4):247-2533
Purpose:
Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians.
Methods:
We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine.
Results:
A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%).
Conclusion
This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.
7.The Awareness of Sports Physicians about Relative Energy Deficiency in Sport
Soo Hyun PARK ; Eon Sook LEE ; Jieun KWON ; Lina KIM ; Yeonsoo KIM ; Tae Kyung KIM ; Nayoung AHN ; Young Kill YUN ; Sun Joo LEE ; Young Sun LEE ; Hyo Jeong LEE ; Suk Ha JEON ; Tae Im YI
The Korean Journal of Sports Medicine 2024;42(4):247-2533
Purpose:
Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians.
Methods:
We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine.
Results:
A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%).
Conclusion
This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.
8.The Awareness of Sports Physicians about Relative Energy Deficiency in Sport
Soo Hyun PARK ; Eon Sook LEE ; Jieun KWON ; Lina KIM ; Yeonsoo KIM ; Tae Kyung KIM ; Nayoung AHN ; Young Kill YUN ; Sun Joo LEE ; Young Sun LEE ; Hyo Jeong LEE ; Suk Ha JEON ; Tae Im YI
The Korean Journal of Sports Medicine 2024;42(4):247-2533
Purpose:
Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians.
Methods:
We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine.
Results:
A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%).
Conclusion
This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.
9.The Awareness of Sports Physicians about Relative Energy Deficiency in Sport
Soo Hyun PARK ; Eon Sook LEE ; Jieun KWON ; Lina KIM ; Yeonsoo KIM ; Tae Kyung KIM ; Nayoung AHN ; Young Kill YUN ; Sun Joo LEE ; Young Sun LEE ; Hyo Jeong LEE ; Suk Ha JEON ; Tae Im YI
The Korean Journal of Sports Medicine 2024;42(4):247-2533
Purpose:
Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians.
Methods:
We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine.
Results:
A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%).
Conclusion
This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.
10.The Awareness of Sports Physicians about Relative Energy Deficiency in Sport
Soo Hyun PARK ; Eon Sook LEE ; Jieun KWON ; Lina KIM ; Yeonsoo KIM ; Tae Kyung KIM ; Nayoung AHN ; Young Kill YUN ; Sun Joo LEE ; Young Sun LEE ; Hyo Jeong LEE ; Suk Ha JEON ; Tae Im YI
The Korean Journal of Sports Medicine 2024;42(4):247-2533
Purpose:
Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians.
Methods:
We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine.
Results:
A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%).
Conclusion
This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.

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