• Title/Summary/Keyword: Metastatic cancer

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Local ablative radiotherapy for oligometastatic non-small cell lung cancer

  • Suh, Yang-Gun;Cho, Jaeho
    • Radiation Oncology Journal
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    • v.37 no.3
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    • pp.149-155
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    • 2019
  • In metastatic non-small cell lung cancer (NSCLC), the role of radiotherapy (RT) has been limited to palliation to alleviate the symptoms. However, with the development of advanced RT techniques, recent advances in immuno-oncology therapy targeting programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) and targeted agents for epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) translocation allowed new roles of RT in these patients. Within this metastatic population, there is a subset of patients with a limited number of sites of metastatic disease, termed as oligometastasis that can achieve long-term survival from aggressive local management. There is no consensus on the definition of oligometastasis; however, most clinical trials define oligometastasis as having 3 to 5 metastatic lesions. Recent phase II randomized clinical trials have shown that ablative RT, including stereotactic ablative body radiotherapy (SABR) and hypofractionated RT, to primary and metastatic sites improved progression-free survival (PFS) and overall survival (OS) in patients with oligometastatic NSCLC. The PEMBRO-RT study, a randomized phase II study comparing SABR prior to pembrolizumab therapy and pembrolizumab therapy alone, revealed that the addition of SABR improved the overall response, PFS, and OS in patients with advanced NSCLC. The efficacy of RT in oligometastatic lung cancer has only been studied in phase II studies; therefore, large-scale phase III studies are needed to confirm the benefit of local ablative RT in patients with oligometastatic NSCLC. Local intensified RT to primary and metastatic lesions is expected to become an important treatment paradigm in the near future in patients with metastatic lung cancer.

Phase Angle Using Bioelectrical Impedance Analysis for Predicting Survival in Patients with Metastatic Cancer (전이암 환자의 예후 판단 인자로서 생체전기 임피던스 분석을 이용한 위상각의 역할)

  • Yoon, Sung-soo;Yoon, Seong-woo;Ryu, Han-sung;Kim, Eun-hye;Lee, Jee-young
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.463-470
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    • 2018
  • Objectives: The aim of this study was to identify the validity of phase angle as a prognostic factor for survival in patients with metastatic cancer. Methods: Data of patients with metastatic cancer who visited the Korean medicine cancer center at Kyung Hee University Hospital in Gangdong from April 2016 to February 2018 were collected for this study. The values of phase angle (PhA) and blood hemoglobin (Hb), C-reactive protein (CRP), and serum albumin levels were also investigated by bioelectrical impedance analysis (BIA). Results: In total, 86 patients were analyzed. The cut-off value of the phase angle was determined as 5.0. Univariate and multivariate analysis revealed that phase angle (HR 3.15, 95% CI 1.79-5.54) and CRP (HR 2.15, 95% CI 1.24-3.73) predicted survival with statistical significance. The median overall survival of the low PhA group ($PhA{\leq}5.0$) was 1.8 months (95% CI 0.6-2.9 months) and 7.2 months (95% CI 5.2-9.2 months) in the high PhA group (PhA>5.0)(p<0.001). Conclusions: The phase angle could be an independent prognostic factor for patients with metastatic cancer. Further research is required to confirm these findings and their correlation with other indexes.

Pemetrexed in Treating Patients with Metastatic Bladder Cancer

  • Li, Qing;Li, Jian-Zhang;Xu, Wan-Hai;Gao, Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3839-3841
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    • 2015
  • Background: This pooled analysis was conducted to evaluate the efficacy and safety of pemetrexed based chemotherapy in treating patients with metastatic bladder cancer as salvage chemotherapy. Methods: Clinical studies evaluating the efficacy and safety of pemetrexed based regimens on response and safety for patients with bladder cancer were identified by using a predefined search strategy. Pooled response rate (RR) of treatment were calculated. Results: In pemetrexed based regimens, 3 clinical studies which including 105 patients with advanced transitional cell cancer of the urothelium were considered eligible for inclusion. Pooled analysis suggested that, in all patients, pooled RR was 26.7% (28/105) for pemetrexed based regimens. Major adverse effects were neutropenia, anorexia, fatigue, and anemia in pemetrexed based treatment. Two treatment related deaths occurred with pemetrexed based treatment. Conclusion: This pooled analysis suggests that pemetrexed based regimens are associated with mild activity and good tolerability in treating patients with metastatic bladder cancer.

Terahertz Pulse Imaging of Micro-metastatic Lymph Nodes in Early-stage Cervical Cancer Patients

  • Jung, Eun-A;Lim, Mee-Hyun;Moon, Ki-Won;Do, Young-Woong;Lee, Soon-Sung;Han, Hae-Wook;Choi, Hyuck-Jae;Cho, Kyoung-Sik;Kim, Kyu-Rae
    • Journal of the Optical Society of Korea
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    • v.15 no.2
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    • pp.155-160
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    • 2011
  • Lymph node metastasis is an important prognostic factor in cervical cancer patients. We report THz imaging for detecting micro-metastatic foci in the lymph nodes of early-stage uterine cervical cancer patients. Five paraffin-embedded metastatic lymph nodes from two cervical cancer patients were imaged using a THz time-domain spectroscopy system in the reflection mode. The size and shape of the tumor regions were compared with those from histopathologic examinations. The metastatic portions of lymph nodes as small as 3 mm were well delineated by THz imaging. The reflected peak amplitudes were lower in metastatic portions than in the normal portions of lymph nodes, and the difference in their peak-to-peak amplitudes was ~5%.

Dose Intensity of Oxaliplatin in 5-Fluorouracil and Leucovorin Regimens in Pretreated Metastatic Colorectal Cancer (5-Fluorouracil, Leucovorin과 병용 투여된 Oxaliplatin의 Dose Intensity가 재발된 전이성 대장암 치료에 미치는 영향)

  • Jeong, Kyong-Ju;Choi, Seung-Ki;Oh, Jung-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.14 no.1
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    • pp.1-10
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    • 2004
  • Studies of oxaliplatin, 5-fluorouracil and leucovorin in pretreated metastatic colorectal cancer showed that oxaliplatin dose intensity is important prognostic factor for objective response rates and progression-free-survival (PFS). To evaluate response rates, PFS and toxicity according to oxaliplatin dose intensity, we retrospectively analyzed data from patients with metastatic colorectal cancer received oxaliplatin,5-fluorouracil, leucovorin regimens. Sixty-three patients were reviewed in this study, 42 patients received low dose intensity oxaliplatin (LDI: $\leq85\;mg/m^2/2wks$) and 21 patients high dose intensity oxaliplatin (HDI: $>85\;mg/m^2/2wks$). Objective responses occurred in 10 $(47.7\%)$ HDI patients and 9 $(21.4\%)$ LDI patients (p = 0.014). Median PFS was 24.7 weeks in HDI group, with $45.1\%$ of HDI patients progression free at 6 months, and 20.5 weeks in LDI group, with $33.5\%$ of LDI patients progression free at 6 months (p = 0.344). Increased oxaliplatin dose intensity was not associated with neutropenia, thrombocytopenia, neuropathy, nausea and vomiting. This study showed that oxaliplatin dose intensification significantly improves objective response rate in pretreated metastatic colorectal cancer without increasing severe toxicity.

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A Case of Metastatic Brain Tumor Originated from Lung Cancer treated by Oriental Medicine (폐암(肺癌)에서 전이(轉移)된 뇌종양환자(腦腫瘍患者)의 한방(韓方) 치험(治驗) 1례(例))

  • Lee, Won-Chul;Shin, Kwang-Sik
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.5 no.1
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    • pp.151-158
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    • 1999
  • We have experienced a case of metastatic brain tumor originated from lung cancer treated by oriental medicine (Herbal medication, Acupuncture therapy, Moxa therapy) and We have a good result from that case to report it. According to the therapentic effects, it could be suggeted that Younggyaechulgamtanggagambang extracts and oriental medical symptomatic treatment were significant in improvement of the patient.

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Metastasis prognostic factors and cancer stem cell-related transcription factors associated with metastasis induction in canine metastatic mammary gland tumors

  • Kim, Saetbyul;Bok, Eunyeong;Lee, Sangyeob;Lee, Hyeon-Jeong;Choe, Yongho;Kim, Na-Hyun;Lee, Won-Jae;Rho, Gyu-Jin;Lee, Sung-Lim
    • Journal of Veterinary Science
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    • v.22 no.5
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    • pp.62.1-62.13
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    • 2021
  • Background: Canine mammary gland tumor (MGT) is the most common cancer in aged female dogs. Although it's important to identify reliable metastasis or prognostic factors by evaluating related to cell division, adhesion, and cancer stem cell-related transcription factor (TF) in metastasis-induced canine MGT, but there are limited studies. Objectives: We aimed to identify metastasis prognostic factors and cancer stem cell-TFs in canine MGTs. Methods: Age-matched female dogs diagnosed with MGT only were classified into metastatic and non-metastatic groups by histopathological staining of MGT tissues. The mRNA levels of cancer prognostic metastasis molecular factors (E-cadherin, ICAM-1, PRR14, VEGF, HPRT1, RPL4 and hnRNP H) and cancer stem cell-related TFs (Oct4, Sox2, and Nanog) were compared between metastatic and non-metastatic canine MGT tissues using qRT-PCR analysis. Results: The mRNA levels of ICAM-1, PRR14, VEGF, hnRNP H, Oct4, Sox2, and Nanog in metastatic MGT group were significantly higher than those in non-metastatic MGT group. However, mRNA level of RPL4 was significantly lower in metastatic MGT group. Loss of E-cadherin and HPRT1 was observed in the metastatic MGT group but it was not significant. Conclusions: Consistent expression patterns of all metastasis-related factors showing elevation in ICAM-1, PRR14, VEGF, hnRNP H, Oct4, Sox2, and Nanog, but decreases in RPL4 levels occurred in canine MGT tissues, which was associated with metastasis. Thus, these cancer prognostic metastasis factors and TFs of cancer stem cells, except for E-cadherin and HPRT1, can be used as reliable metastasis factors for canine MGT and therapeutic strategy.

Current and New Molecularly Targeted Agents for Metastatic Gastric Cancer

  • Sung Chul Park
    • Journal of Digestive Cancer Research
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    • v.3 no.1
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    • pp.11-16
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    • 2015
  • The discovery of HER2, a biomarker in advanced gastric cancer, and successful clinical trial using trastuzumab that targets this biomarker signaled a revolutionary turning point in treatment of metastatic gastric cancer. Many studies about targeted agents for gastric cancer have been attempted. Among them, ramicirumab, a monoclonal antibody that targets vascular endothelial growth factor receptor-2 (VEGFR-2), and apatinib, a tyrosine kinase inhibitor (TKI) that targets VEGFR2, have shown to improve the survival rates in advanced gastric cancer patients, for whom previous therapies had failed; hence, they are expected to be accepted as one of the standard therapies for advanced gastric cancer.

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Prognostic Value of a Single Center Nutrition Screening Tool in Patients with Metastatic Cancer (전이암 환자에서 단일기관 영양검색 도구의 예후 가치)

  • Yoon, Sung Soo;Kim, Min Jin;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.24 no.2
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    • pp.1-11
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    • 2019
  • Objectives : We investigated whether a single center nutrition screening tool (Kyunghee Neo Nutrition Risk Screening, KNNRS) can predict survival in patients with metastatic cancer. Methods : We retrospectively reviewed data of inpatients with metastatic cancer from April 2016 to August 2019. Data on demographic and clinical parameters were collected from electronic medical records, and overall survival was estimated using the Kaplan-Meier method. Stepwise Cox regression analysis was used to determine factors associated with survival. Patients with a KNNRS score of 0 to 3 were classified as "no-risk", 4 to 10 as "low-risk", and 11 to 20 as "high-risk". Results : Total 105 patients were included in the study. According to nutritional screening at baseline, 25 patients (23.8%, median age 57.0) were classified as ""no risk"" group; 80 patients (76.2%, median age 68.5) as "low risk" group; No patients as "high risk" group. Predictors of survival were Eastern Cooperative Oncology Group Performance Status score of 3 or 4 (hazard ratio [HR] = 1.93; 95% confidence interval [CI] = 1.21-3.10), hemoglobin less than 10 g/dL (HR = 1.97; 95% CI = 1.25-3.10) and C-reactive protein more than 1.0 mg/dL (HR = 1.95; 95% CI = 1.21-3.13). Kaplan-Meier survival analysis showed significant differences in the survival between KNNRS groups: ""no risk"" group: 6.1 ± 1.4 months (95% CI = 3.37-8.83); ""low risk"" group: 3.4 ± 0.9 months (95% CI = 1.5-5.37). Conclusions : Nutritional status according to KNNRS wasn't significant predictor of survival for patients with metastatic cancer. Improvement of KNNRS score thresholds is needed.

Anti-cancer and Immune Promoting Effects of Cultivated Wild Ginseng Herbal Acupuncture on Hepatic Metastatic Model Using Colon26-L5 Carcinoma Cells (산삼약침이 Colon26-L5 암세포주를 이용한 간전이 모델의 항암 및 면역증진에 미치는 영향)

  • Lim, Se-Young;Lee, Soo-Jin;Kwon, Ki-Rok
    • Journal of Acupuncture Research
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    • v.23 no.1
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    • pp.121-134
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    • 2006
  • Objectives : This experiment was conducted to evaluate inhibitory effects against hepatic metastasis and promotion of immunocytes by cultivated wild ginseng Herbal Acupuncture. Methods : Colon26-L5 carcinoma cells were injected through hepatic portal vein to induce hepatic metastatic cancer. Changes in weight, morphology of the cancer, histological impressions were evaluated and cytokine level was analyzed to yield immunological changes. Colon26-L5 carcinoma cells were injected through hepatic portal vein to induce hepatic metastatic cancer. Changes in weight, morphology of the cancer, histological impressions were evaluated and cytokine level was analyzed to yield immunological changes. Results : 1. Mice treated with cultivated wild ginseng Herbal Acupuncture reduced metastatic size compared to the control group. 2. No distinctive differences were witnessed between the cancer cells of control and experimental group in histological observation, but experimental group was closer to the normal tissue condition. 3. Observing immunocytes from the spleen of experimental group, T-lymphocytes were significantly increased. 4. Measuring the level of cytokine IL-4 which stimulates Th 2 were significantly increased. These findings strong1y indicate cultivated wild ginseng Herbal Acupuncture enhances immunity to inhibit the growth of cancer and metastasis.

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