Purpose: This subgroup analysis of the Korean subset of patients in the phase 3 LASER301 trial evaluated the efficacy and safety of lazertinib versus gefitinib as first-line therapy for epidermal growth factor receptor mutated (EGFRm) non–small cell lung cancer (NSCLC). Materials and Methods: Patients with locally advanced or metastatic EGFRm NSCLC were randomized 1:1 to lazertinib (240 mg/day) or gefitinib (250 mg/day). The primary endpoint was investigator-assessed progression-free survival (PFS). Results: In total, 172 Korean patients were enrolled (lazertinib, n=87; gefitinib, n=85). Baseline characteristics were balanced between the treatment groups. One-third of patients had brain metastases (BM) at baseline. Median PFS was 20.8 months (95% confidence interval [CI], 16.7 to 26.1) for lazertinib and 9.6 months (95% CI, 8.2 to 12.3) for gefitinib (hazard ratio [HR], 0.41; 95% CI, 0.28 to 0.60). This was supported by PFS analysis based on blinded independent central review. Significant PFS benefit with lazertinib was consistently observed across predefined subgroups, including patients with BM (HR, 0.28; 95% CI, 0.15 to 0.53) and those with L858R mutations (HR, 0.36; 95% CI, 0.20 to 0.63). Lazertinib safety data were consistent with its previously reported safety profile. Common adverse events (AEs) in both groups included rash, pruritus, and diarrhoea. Numerically fewer severe AEs and severe treatment–related AEs occurred with lazertinib than gefitinib. Conclusion Consistent with results for the overall LASER301 population, this analysis showed significant PFS benefit with lazertinib versus gefitinib with comparable safety in Korean patients with untreated EGFRm NSCLC, supporting lazertinib as a new potential treatment option for this patient population.

Cardio-oncology is a critical field due to the escalating significance of cardiovascular toxicity as a side effect of anti‑ cancer treatments. Cancer therapy-related cardiac dysfunction (CTRCD) is a prevalent condition associated with car‑ diovascular toxicity, necessitating effective strategies for prediction, monitoring, management, and tracking. This comprehensive review examines the definition and risk stratification of CTRCD, explores monitoring approaches during anticancer therapy, and highlights specific cardiovascular toxicities linked to various cancer treatments. These include anthracyclines, HER2-targeted agents, vascular endothelial growth factor inhibitors, immune checkpoint inhibitors, chimeric antigen receptor T-cell therapies, and tumor-infiltrating lymphocytes therapies. Incorporating the Korean data, this review offers insights into the regional nuances in managing CTRCD. Using systematic follow-up incorporating cardiovascular imaging and biomarkers, a better understanding and management of CTRCD can be achieved, optimizing the cardiovascular health of both cancer patients and survivors.

Purpose: To evaluate the technical feasibility and clinical efficacy of percutaneous transgastric stent placement after the failure of treatment attempt with the transoral approach in malignant gastroduodenal obstruction patients. Materials and Methods: From October 2008 to April 2016, nine patients (M:F = 4:5; mean age = 66 years) with malignant gastroduodenal obstruction underwent stent placement via a gastrostomy tract, which was attributed to the failure of the transoral approach. The primary etiologies of the obstruction were pancreatic (n = 5), gastric (n = 2), and metastatic (n = 2) cancers. Through percutaneous gastrostomy, dual stents (inner bare metal and outer polytetrafluoroethylene-covered) were deployed at the obstruction site. The technical and clinical success rates, as well as complications were evaluated during the follow-up period. Results: Stents were successfully inserted in eight patients (88%). We failed to insert stent in one patient due to the presence of a tight obstruction. After stent placement, symptoms improved in seven patients. Gastrostomy tube was removed 9 to 20 days (mean = 12 days) after the stent insertion. During the mean follow-up of 136 days (range, 3–387 days), one patient developed a recurrent symptom due to tumor overgrowth. However, there were no other major complications associated with the procedure. Conclusion Percutaneous transgastric stent placement appeared to be technically feasible and clinically effective in patients who underwent a failed transoral approach.

BACKGROUND/AIMS: Managing breakthrough pain (BTP) is important for many cancer patients because of the rapid onset and unpredictable nature of the pain episodes. Fentanyl buccal tablets (FBTs) are a rapid-onset opioid indicated for BTP management. However, FBT titration is needed to optimize BTP management. In this study, we aimed to evaluate the safety and efficacy of initiating 200 μg FBTs in Korean cancer patients. METHODS: A retrospective analysis of medical records was performed on all advanced cancer patients treated with FBTs for BTP between October 2014 and July 2015. Patients who received initial doses of 200 μg FBTs for at least 3 days and cases in which FBT was available at doses of 200, 400, and 800 μg were included. RESULTS: A total of 56 patients with a median age of 62 years (range, 32 to 80) were analyzed, 61% of whom were male. The median and mean values of morphine equivalent daily doses were 60 mg/day (range, 15 to 540) and 114.8 ± 124.8 mg/day, respectively. The most frequent effective doses of FBT were 200 μg (41 patients, 74%) and 400 μg (12 patients, 21%). Three patients (5%) could not tolerate 200 μg of FBT and discontinued treatment. Nausea, vomiting, somnolence, and dizziness were the most frequent treatment-related adverse events (AEs), and all AEs were grade 1 (mild) or 2 (moderate). CONCLUSIONS: FBT at the initial 200 μg dosage was well-tolerated and effective as a BTP management strategy in Korean cancer patients. Further prospective studies are needed to determine appropriate initiating doses of FBT in Korean patients with opioid tolerance.
Analgesics, Opioid ; Breakthrough Pain ; Dizziness ; Fentanyl* ; Humans ; Male ; Medical Records ; Morphine ; Nausea ; Prospective Studies ; Retrospective Studies* ; Tablets* ; Vomiting

BACKGROUND: The purpose of this study was to identify the effects of Tai Chi exercise program on physical symptoms (pain, stiffness) and physical function (difficulty with physical function) related to joint, stress, depression, and sleep disturbance in middle aged women with osteoarthritis. METHODS: The study was conducted with a nonequivalent control group pretest-posttest design. Forty participants were assigned to either the experimental group (20) or control group (20). Tai Chi exercise program was administered twice a week for 12 weeks to participants in experimental group. Data were collected from October 4 to December 24, 2011 and analyzed using chi2-test and t-test. RESULTS: There were significant differences between groups in joint pain score (z=-2.029, P=0.047) of Korean-Western Ontario and McMaster University Osteoarthritis (K-WOMAC) index and depression score (z=-2.566, P=0.010). However, there were no significant differences in stiffness score and physical function score of K-WOMAC index, stress score and sleep disturbance score. CONCLUSIONS: Findings from this study indicate that Tai Chi exercise program are effective in reducing joint pain and depression in osteoarthritis women. It could be regarded as positive program for health promotion of self-care skills in middle-aged women with osteoarthritis.
Arthralgia ; Depression ; Female ; Health Promotion* ; Humans ; Joints ; Middle Aged* ; Ontario ; Osteoarthritis* ; Self Care ; Tai Ji*

BACKGROUND: The purpose of this study was to identify the effects of Tai Chi exercise program on physical symptoms (pain, stiffness) and physical function (difficulty with physical function) related to joint, stress, depression, and sleep disturbance in middle aged women with osteoarthritis. METHODS: The study was conducted with a nonequivalent control group pretest-posttest design. Forty participants were assigned to either the experimental group (20) or control group (20). Tai Chi exercise program was administered twice a week for 12 weeks to participants in experimental group. Data were collected from October 4 to December 24, 2011 and analyzed using chi2-test and t-test. RESULTS: There were significant differences between groups in joint pain score (z=-2.029, P=0.047) of Korean-Western Ontario and McMaster University Osteoarthritis (K-WOMAC) index and depression score (z=-2.566, P=0.010). However, there were no significant differences in stiffness score and physical function score of K-WOMAC index, stress score and sleep disturbance score. CONCLUSIONS: Findings from this study indicate that Tai Chi exercise program are effective in reducing joint pain and depression in osteoarthritis women. It could be regarded as positive program for health promotion of self-care skills in middle-aged women with osteoarthritis.
Arthralgia ; Depression ; Female ; Health Promotion* ; Humans ; Joints ; Middle Aged* ; Ontario ; Osteoarthritis* ; Self Care ; Tai Ji*

BACKGROUND: The purpose of this study was to identify the effects of Tai Chi exercise program on physical symptoms (pain, stiffness) and physical function (difficulty with physical function) related to joint, stress, depression, and sleep disturbance in middle aged women with osteoarthritis. METHODS: The study was conducted with a nonequivalent control group pretest-posttest design. Forty participants were assigned to either the experimental group (20) or control group (20). Tai Chi exercise program was administered twice a week for 12 weeks to participants in experimental group. Data were collected from October 4 to December 24, 2011 and analyzed using chi2-test and t-test. RESULTS: There were significant differences between groups in joint pain score (z=-2.029, P=0.047) of Korean-Western Ontario and McMaster University Osteoarthritis (K-WOMAC) index and depression score (z=-2.566, P=0.010). However, there were no significant differences in stiffness score and physical function score of K-WOMAC index, stress score and sleep disturbance score. CONCLUSIONS: Findings from this study indicate that Tai Chi exercise program are effective in reducing joint pain and depression in osteoarthritis women. It could be regarded as positive program for health promotion of self-care skills in middle-aged women with osteoarthritis.
Arthralgia ; Depression ; Female ; Health Promotion ; Humans ; Joints ; Middle Aged ; Ontario ; Osteoarthritis ; Self Care ; Tai Ji

PURPOSE: Surgical therapy is the primary treatment for oral cancer, but it can cause facial distortion. Therefore, if anticancer drugs are effective against oral cancer, they may be used preferentially. However, oral squamous carcinoma cells (OSCCs) are resistant to these drugs, so finding a way to enhance the sensitivity of these cells to anticancer drugs is important. The bacterial protein azurin is known to selectively enter cancer cells and induce apoptosis. In this study, we show the anticancer effect of azurin in OSCC. MATERIALS AND METHODS: OSCC cell line (YD-9) was subjected to azurin treatment. Cell viability, morphology and protein expression levels were monitored after treatment of azurin. Cells were also subjected to combination treatment of azurin with either 5-fluorouracil or etopside. RESULTS: Azurin-treated cells showed decreased cell viability accompanied by apoptotic phenotypes including morphological change, DNA breakage, and increases in p53 and cyclin B1 protein levels. Combination treatment of azurin with other anti-tumor agents caused an increase in sensitivity to anticancer drugs in azurin-treated YD-9 cells. CONCLUSION: Azurin has a strong synergistic anticancer effect on oral cancer cells when it is used along with anticancer drugs.
Antineoplastic Agents/*administration & dosage ; Apoptosis/drug effects ; Azurin/*administration & dosage/genetics ; Carcinoma, Squamous Cell/*drug therapy/metabolism/pathology ; Cell Line, Tumor ; Cyclin B1/metabolism ; Drug Synergism ; Etoposide/administration & dosage ; Fluorouracil/administration & dosage ; Humans ; Mouth Neoplasms/*drug therapy/metabolism/pathology ; Tumor Suppressor Protein p53/metabolism

PURPOSE: The prognosis for patients with liver metastases (LM) from colorectal cancer is significantly influenced by the clinician's decision. Recently, there have been remarkable advances in treatment of LM, so there can be some changes in therapeutic modalities. We performed a comparative study between operated and non-operated groups of patients with LM to analyze the clinical outcome. METHODS: From Feb. 2001 to Feb. 2006, 27 patients with LM underwent a hepatectomy, and 113 patients received non-surgical therapy. thirteen hepatectomized cases among the 27 patients had multiple LM. The outcomes of those 13 patients (Group A) were retrospectively compared to those of the non-operated group (Group B, n=21), which had had potentially resectable LM at the initial diagnosis or after chemotherapy, but didn't undergo hepatic resection. RESULTS: After a median follow-up duration of 31.3 months, the estimated 3-years overall survival (OS) rates were 76.9% and 14.3% in group A and B, respectively (P=0.0001). In the stepwise Cox multivariate regression analysis, factors such as the absence of hepatic resection and a greater diameter of the liver mass independently influenced the poor survival (P=0.005 and P=0.012 respectively). Additionally, two radiologists evaluated the intraoperative ultrasonographic (IOUS) results. IOUS detected new metastatic lesions in 4/13 (30%) patients. There were sub-centimeter metastatic lesions (5~7 mm) and had not been detected in SPIO-enhanced MRI. CONCLUSIONS: Our results compared to palliative chemotherapy suggest that aggressive surgical resection should be performed to increase the survival rate in patients with LM. Additionally, the treatment plan for LM patients should be discussed with the gastroenterololgist, the radiologist, the oncologist, and the surgeon.
Colorectal Neoplasms* ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Prognosis ; Retrospective Studies ; Survival Rate

BACKGROUND: This study was desined to determine the efficacy and clincial usefulness of alfentanil and a combined use of alfentanil and esmolol for blunting hemodynamic responses after tracheal intubation in hypertensive patients who needed a rapid sequence induction. METHODS: Group 1 received alfentanil 15microgram/kg and group 2 received alfentanil 15microgram/kg and esmolol 1 mg/kg intravenously. Thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg were used for the induction of anesthesia. Changes in blood pressure and herat rate were measured during intubation and induction of anesthesia with enflurane-N2O-O2 and vecuronium. Rate pressure products (RPP) was calculated and the frequencies of hypertension, hypotension, tachycardia, bradycardia were measured. RESULTS: In group 1, systolic blood pressure increased significantly at 1, 2 minute and decreased significantly at 4, 5, 10, 15 minute compared to base, and diastolic blood pressure increased significantly at 1 minute and decreased significantly at 4, 5, 10 minute. Heart rate increased significantly at 1, 2 minute. In group 2, systolic blood pressure decrease significantly at 3, 4, 5 minute after tracheal intubation compared to base, and diastolic blood pressure increased at 1 minute and decreased at 4, 5, 10, 15 minute. HR did not change significantly (P < 0.05). CONCLUSION: In treated hypertensive patients, the use of a combination of alfentanil 15/kg and esmolol 1 mg/kg is a useful method to attenuate hemodynamic responses after endotracheal intubation and especially for rapid sequence induction.
Alfentanil* ; Anesthesia ; Blood Pressure ; Bradycardia ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Hypotension ; Intubation ; Intubation, Intratracheal* ; Succinylcholine ; Tachycardia ; Thiopental ; Vecuronium Bromide