Background/Aims: The World Health Organization (WHO) aims to eliminate hepatitis C virus (HCV) by 2030; therefore, widespread HCV screening is required. The WHO recommends HCV self-testing (HCVST) as a new approach. We aimed to evaluate disease burden reduction using the HCVST screening strategy and identify the most cost-effective approach. Methods: We developed a dynamic open-cohort Markov model to assess the long-term effects and costeffectiveness of HCVST in the Republic of Korea from 2024 to 2030. Strategies for comparison included universal, birth cohort, high-risk group screening, and no screening, focusing on the following: (1) incremental costeffectiveness ratio (ICER) per disability-adjusted life-year (DALY) saved; (2) severe liver disease cases; and (3) liverrelated death reduction. Results: Universal HCVST screening is the most effective strategy for achieving the WHO goal by 2030, substantially lowering the incidence of severe liver disease by 71% and preventing liver-related deaths by 69%, thereby averting 267,942 DALYs. Moreover, with an ICER of US$8,078 per DALY and high cost-effectiveness, the sensitivity results prove that cost-effectiveness is robust. Although high-risk group screening offers the lowest cost compared with other strategies, its effectiveness in preventing severe liver disease is minimal, falling short of the current WHO goal. Conclusions Our study confirms that universal HCVST screening is a cost-effective strategy aligned with the WHO goal to eliminate HCV by 2030. Despite its higher costs compared to risk-based screening, the disease burden can be significantly reduced by providing effective HCVST access to individuals who might otherwise not be tested.

Background/Aims: The World Health Organization (WHO) aims to eliminate hepatitis C virus (HCV) by 2030; therefore, widespread HCV screening is required. The WHO recommends HCV self-testing (HCVST) as a new approach. We aimed to evaluate disease burden reduction using the HCVST screening strategy and identify the most cost-effective approach. Methods: We developed a dynamic open-cohort Markov model to assess the long-term effects and costeffectiveness of HCVST in the Republic of Korea from 2024 to 2030. Strategies for comparison included universal, birth cohort, high-risk group screening, and no screening, focusing on the following: (1) incremental costeffectiveness ratio (ICER) per disability-adjusted life-year (DALY) saved; (2) severe liver disease cases; and (3) liverrelated death reduction. Results: Universal HCVST screening is the most effective strategy for achieving the WHO goal by 2030, substantially lowering the incidence of severe liver disease by 71% and preventing liver-related deaths by 69%, thereby averting 267,942 DALYs. Moreover, with an ICER of US$8,078 per DALY and high cost-effectiveness, the sensitivity results prove that cost-effectiveness is robust. Although high-risk group screening offers the lowest cost compared with other strategies, its effectiveness in preventing severe liver disease is minimal, falling short of the current WHO goal. Conclusions Our study confirms that universal HCVST screening is a cost-effective strategy aligned with the WHO goal to eliminate HCV by 2030. Despite its higher costs compared to risk-based screening, the disease burden can be significantly reduced by providing effective HCVST access to individuals who might otherwise not be tested.

Background/Aims: The World Health Organization (WHO) aims to eliminate hepatitis C virus (HCV) by 2030; therefore, widespread HCV screening is required. The WHO recommends HCV self-testing (HCVST) as a new approach. We aimed to evaluate disease burden reduction using the HCVST screening strategy and identify the most cost-effective approach. Methods: We developed a dynamic open-cohort Markov model to assess the long-term effects and costeffectiveness of HCVST in the Republic of Korea from 2024 to 2030. Strategies for comparison included universal, birth cohort, high-risk group screening, and no screening, focusing on the following: (1) incremental costeffectiveness ratio (ICER) per disability-adjusted life-year (DALY) saved; (2) severe liver disease cases; and (3) liverrelated death reduction. Results: Universal HCVST screening is the most effective strategy for achieving the WHO goal by 2030, substantially lowering the incidence of severe liver disease by 71% and preventing liver-related deaths by 69%, thereby averting 267,942 DALYs. Moreover, with an ICER of US$8,078 per DALY and high cost-effectiveness, the sensitivity results prove that cost-effectiveness is robust. Although high-risk group screening offers the lowest cost compared with other strategies, its effectiveness in preventing severe liver disease is minimal, falling short of the current WHO goal. Conclusions Our study confirms that universal HCVST screening is a cost-effective strategy aligned with the WHO goal to eliminate HCV by 2030. Despite its higher costs compared to risk-based screening, the disease burden can be significantly reduced by providing effective HCVST access to individuals who might otherwise not be tested.

Imatinib mesylate (also known as Gleevec) is a selective tyrosine kinase inhibitor, primarily used for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors. Despite its effectiveness, the use of imatinib has been associated with various adverse skin reactions such as maculopapular rash, edema, and lichenoid or psoriasiform lesions. We report the case of a 71-year-old female presented with follicular hyperkeratotic papular eruption that affected her entire body. The lesions had developed 2 weeks ago. The patient had been diagnosed with a malignant gastrointestinal stromal tumor and had been receiving imatinib mesylate since 2013. Three weeks before the onset of the skin eruptions, the imatinib dosage was increased to 800 mg/d. Skin biopsies were performed on the chin and forearms. Based on the clinical and histopathological results, the patient was diagnosed with imatinib-induced keratosis pilaris. Following the discontinuation of imatinib and retinoid therapy, her skin condition markedly improved, and the lesions resolved within a few weeks. Herein, we report a case that highlights the association between imatinib mesylate and keratosis of the pilaris.

Imatinib mesylate (also known as Gleevec) is a selective tyrosine kinase inhibitor, primarily used for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors. Despite its effectiveness, the use of imatinib has been associated with various adverse skin reactions such as maculopapular rash, edema, and lichenoid or psoriasiform lesions. We report the case of a 71-year-old female presented with follicular hyperkeratotic papular eruption that affected her entire body. The lesions had developed 2 weeks ago. The patient had been diagnosed with a malignant gastrointestinal stromal tumor and had been receiving imatinib mesylate since 2013. Three weeks before the onset of the skin eruptions, the imatinib dosage was increased to 800 mg/d. Skin biopsies were performed on the chin and forearms. Based on the clinical and histopathological results, the patient was diagnosed with imatinib-induced keratosis pilaris. Following the discontinuation of imatinib and retinoid therapy, her skin condition markedly improved, and the lesions resolved within a few weeks. Herein, we report a case that highlights the association between imatinib mesylate and keratosis of the pilaris.

Imatinib mesylate (also known as Gleevec) is a selective tyrosine kinase inhibitor, primarily used for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors. Despite its effectiveness, the use of imatinib has been associated with various adverse skin reactions such as maculopapular rash, edema, and lichenoid or psoriasiform lesions. We report the case of a 71-year-old female presented with follicular hyperkeratotic papular eruption that affected her entire body. The lesions had developed 2 weeks ago. The patient had been diagnosed with a malignant gastrointestinal stromal tumor and had been receiving imatinib mesylate since 2013. Three weeks before the onset of the skin eruptions, the imatinib dosage was increased to 800 mg/d. Skin biopsies were performed on the chin and forearms. Based on the clinical and histopathological results, the patient was diagnosed with imatinib-induced keratosis pilaris. Following the discontinuation of imatinib and retinoid therapy, her skin condition markedly improved, and the lesions resolved within a few weeks. Herein, we report a case that highlights the association between imatinib mesylate and keratosis of the pilaris.

Novel clinical trial designs are conducted in the precision medicine era. This study aimed to evaluate biomarker-driven, adaptive phase II trials in precision oncology, focusing on infrastructure, efficacy, and safety. We systematically reviewed and analyzed the target studies. EMBASE and PubMed searches from 2015 to 2023 generated 29 eligible trials. Data extraction included infrastructure, biomarker screening methodologies, efficacy, and safety profiles. Government agencies, cancer hospitals, and academic societies with accumulated experiences led investigator-initiated precision oncology clinical trials (IIPOCTs), which later guided sponsor-initiated precision oncology clinical trials (SIPOCTs). Most SIPOCTs were international studies with basket design. IIPOCTs primarily used the central laboratory for biomarker screening, but SIPOCTs used both central and local laboratories. Most of the studies adapted next-generation sequencing and/or immunohistochemistry for biomarker screening. Fifteen studies included an independent central review committee for outcome investigation. Efficacy assessments predominantly featured objective response rate as the primary endpoint, with varying results. Nine eligible studies contributed to the United States Food and Drug Administration’s marketing authorization. Safety monitoring was rigorous, but reporting formats lacked uniformity. Health-related quality of life and patient-reported outcomes were described in some protocols but rarely reported. Our results reveal that precision oncology trials with adaptive design rapidly and efficiently evaluate anticancer drugs’ efficacy and safety, particularly in specified biomarker-driven cohorts. The evolution from IIPOCT to SIPOCT has facilitated fast regulatory approval, providing valuable insights into the precision oncology landscape.