1
|
Le X, Paz-Ares LG, Van Meerbeeck J, Viteri S, Galvez CC, Smit EF, Garassino M, Veillon R, Baz DV, Pradera JF, Sereno M, Kozuki T, Kim YC, Yoo SS, Han JY, Kang JH, Son CH, Choi YJ, Stroh C, Juraeva D, Vioix H, Bruns R, Otto G, Johne A, Paik PK. Tepotinib in patients with non-small cell lung cancer with high-level MET amplification detected by liquid biopsy: VISION Cohort B. Cell Rep Med 2023; 4:101280. [PMID: 37944528 PMCID: PMC10694660 DOI: 10.1016/j.xcrm.2023.101280] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 07/14/2023] [Accepted: 10/12/2023] [Indexed: 11/12/2023]
Abstract
High-level MET amplification (METamp) is a primary driver in ∼1%-2% of non-small cell lung cancers (NSCLCs). Cohort B of the phase 2 VISION trial evaluates tepotinib, an oral MET inhibitor, in patients with advanced NSCLC with high-level METamp who were enrolled by liquid biopsy. While the study was halted before the enrollment of the planned 60 patients, the results of 24 enrolled patients are presented here. The objective response rate (ORR) is 41.7% (95% confidence interval [CI], 22.1-63.4), and the median duration of response is 14.3 months (95% CI, 2.8-not estimable). In exploratory biomarker analyses, focal METamp, RB1 wild-type, MYC diploidy, low circulating tumor DNA (ctDNA) burden at baseline, and early molecular response are associated with better outcomes. Adverse events include edema (composite term; any grade: 58.3%; grade 3: 12.5%) and constipation (any grade: 41.7%; grade 3: 4.2%). Tepotinib provides antitumor activity in high-level METamp NSCLC (ClinicalTrials.gov: NCT02864992).
Collapse
Affiliation(s)
- Xiuning Le
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Luis G Paz-Ares
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Jan Van Meerbeeck
- Department of Thoracic Oncology, Antwerp University Hospital (UZA), 2650 Edegem, Belgium
| | - Santiago Viteri
- Instituto Oncologico Dr. Rosell, Hospital Universitari Dexeus, Grupo QuironSalud, 08028 Barcelona, Spain
| | - Carlos Cabrera Galvez
- Department of Medical Oncology, Hospital Universitari Sagrat Cor, 08029 Barcelona, Spain
| | - Egbert F Smit
- Department of Thoracic Oncology, Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands
| | - Marina Garassino
- Department of Medicine, Section of Hematology/Oncology, Knapp Center for Biomedical Discovery, The University of Chicago, Chicago, IL 1084250, USA
| | - Remi Veillon
- CHU Bordeaux, Service des Maladies Respiratoires, 33000 Bordeaux, France
| | - David Vicente Baz
- Department of Medical Oncology, Hospital Universitario Virgen Macarena, 41009 Seville, Spain
| | - Jose Fuentes Pradera
- Department of Medical Oncology, Hospital Universitario Nuestra Señora de Valme, 41014 Seville, Spain
| | - María Sereno
- Department of Medical Oncology, Hospital Universitario Infanta Sofia, San Sebastián de los Reyes, 28703 Madrid, Spain
| | - Toshiyuki Kozuki
- Department of Respiratory Medicine, NHO Shikoku Cancer Center, Matsuyama City 791-0280, Japan
| | - Young-Chul Kim
- Department of Internal Medicine, Chonnam National University Medical School and CNU Hwasun Hospital, Hwasun-Gun 58128, Rep. of Korea
| | - Seung Soo Yoo
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41566, Rep. of Korea
| | - Ji-Youn Han
- The Center for Lung Cancer, National Cancer Center, Goyang 10408, Rep. of Korea
| | - Jin-Hyoung Kang
- Division of Medical Oncology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul 06591, Rep. of Korea
| | - Choon-Hee Son
- Department of Internal Medicine, Dong-A University, 840 Hadan 2-dong, Saha-gu, Busan 604-714, Rep. of Korea
| | - Yoon Ji Choi
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University Anam Hospital, Seoul 02841, Rep. of Korea
| | - Christopher Stroh
- Clinical Biomarkers & Companion Diagnostics, the healthcare business of Merck KGaA, 64293 Darmstadt, Germany
| | - Dilafruz Juraeva
- Oncology Bioinformatics, the healthcare business of Merck KGaA, 64293 Darmstadt, Germany
| | - Helene Vioix
- Global Evidence & Value Development, the healthcare business of Merck KGaA, 64293 Darmstadt, Germany
| | - Rolf Bruns
- Department of Biostatistics, the healthcare business of Merck KGaA, 64293 Darmstadt, Germany
| | - Gordon Otto
- Global Clinical Development, the healthcare business of Merck KGaA, 64293 Darmstadt, Germany
| | - Andreas Johne
- Global Clinical Development, the healthcare business of Merck KGaA, 64293 Darmstadt, Germany
| | - Paul K Paik
- Thoracic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA; Weill Cornell Medical College, New York 14853, NY, USA
| |
Collapse
|
2
|
Sivananthan AP, Hara J, Lynch C, Al-Hallaq HA, Wu T, Son CH, Hasan Y. Can Volume-Based MRI-Guided Planning for Interstitial Gynecologic Brachytherapy Overcome Clinicopathologic Risk Factors for Fistula Formation? Int J Radiat Oncol Biol Phys 2023; 117:e544. [PMID: 37785678 DOI: 10.1016/j.ijrobp.2023.06.1841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Tumor and patient factors requiring an interstitial (IS) approach for gynecologic tract brachytherapy (BT) may be associated with high morbidity despite the conformality maximizing effect of ISBT. We reviewed outcomes from a diverse, high-volume center to evaluate the association of clinical features and planning parameters with toxicity, with the hypothesis that MRI-guided volume-based planning mitigates clinicopathologic risk factors associated with treatment related fistula (TRF) after ISBT. MATERIALS/METHODS We retrospectively reviewed patients treated with Syed-based ISBT at a single institution from 2014-2019. Fisher's exact was used for group comparison with p<0.05. Kaplan-Meier method was used to estimate local control (LC), overall survival (OS), and fistula-free survival (FFS). Cox regression was used for univariate (UVA) and multivariate analysis (MVA) to estimate hazard ratios (HR). Collinearity was assessed using variable inflation factor and Pearson's correlation. RESULTS A total of 54 patients (median age 58 [IQR 46-67], 54% Caucasian, 39% African American, 15% Hispanic) treated with ISBT (89% MRI-guided) with median follow-up 32 months had initial (89%) or recurrent (11%) disease from cervical (70%), vaginal (15%), urethral (6%), and other cancers. At presentation 5.5% had clinically evident fistula. There was radiographic rectal and bladder involvement in 22.0% and 19.2%, respectively. 89% received concurrent chemotherapy and 98% received EBRT prior to ISBT with a cumulative median high-risk CTV (HRCTV) dose 80.8 Gy (IQR 76.8-84.3), bladder D2cc 84.3 Gy (IQR 75.8-89.0), and rectal D2cc 73.8 Gy (IQR 67.7-80.0 Gy). All 7 patients who developed a TRF (rectovaginal in 6/7 and vesicovaginal in 5/7) were former or current smokers, had primary cervical cancer, and received chemotherapy. Management included surgical intervention in 6 (85.7%). LC, OS, and FFS at 2-years was 89.3% (95% CI 75.9-95.4%), 87.8% (95% CI 66.9-89.8%), and 85.2% (95% CI 69.9-93.1%), respectively. On UVA, current smoking (HR 4.60, 95% CI 1.02-20.74), BT bladder D2cc (HR 1.63, 95% CI 1.07-2.47) and BT rectal Dmax (HR 1.30, 95% CI 1.07-1.58) predicted for increased risk of TRF. Most factors were non-significant including Charlson Comorbidity Index, age, BMI, surgical history, extent of vaginal involvement, race, HRCTV volume and number of needles used. No patients with radiographic bladder or rectal invasion developed TRF. On MVA, only smoking status (HR 14.05, 95% CI 1.48-133.1) remained significant. 0% of never (0/26), 20% of former (3/15) and 31% of current (4/13) smokers developed fistulas from toxicities (p<0.05). CONCLUSION In patients with locally advanced cancers of the gynecologic tract treated with MRI-guided volume-based ISBT, smoking was the only factor predictive of TRF formation, occurring primarily in cervical cancer patients. This highlights the importance of smoking cessation during treatment and appropriately counseling patients at high risk for this morbidity.
Collapse
Affiliation(s)
- A P Sivananthan
- Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL
| | - J Hara
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL
| | - C Lynch
- Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL
| | - H A Al-Hallaq
- University of Chicago, Department of Radiation and Cellular Oncology, Chicago, IL
| | - T Wu
- Department of Radiation and Cellular Oncology, The University of Chicago Medicine, Chicago, IL
| | - C H Son
- Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL
| | - Y Hasan
- Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL
| |
Collapse
|
3
|
Gutman M, Wu T, Son CH, Al-Hallaq HA, Hasan Y. Clinical Outcomes with Triple Tandem Brachytherapy for Medically Inoperable Endometrial Cancer in a Predominantly Black Patient Population. Int J Radiat Oncol Biol Phys 2023; 117:e22-e23. [PMID: 37784900 DOI: 10.1016/j.ijrobp.2023.06.697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation outcomes for Black patients with medically inoperable endometrial cancer (MIEC) is limited, despite this demographic comprising a higher proportion of the MIEC patient population. We report clinical outcomes and toxicities using triple tandem brachytherapy (TTB) with or without external beam radiation therapy (EBRT) for MIEC in predominantly Black patients. MATERIALS/METHODS An IRB approved retrospective review was performed of all MIEC patients treated definitively with TTB ± EBRT from 2014-2021 at a single institution. Patients were divided based on stage. Group 1 = FIGO stage 1A/1B and Group 2 = FIGO stage 2-4B. Patients with cervical involvement were treated with TTB + ovoids. The Kaplan-Meier estimates were generated to estimate overall survival (OS) and local failure-free survival (LFFS). Local control (LC) was evaluated clinically. Acute and late toxicities were evaluated. Planning parameters for target volume(s) and OARs (organs at risk) were per ABS guidelines. Statistics reported are median values and ranges. RESULTS Of 30 patients, 93.3% received TTB + EBRT. Mean age at diagnosis was 65.3 years (40.5-88.7 years). 70% of patients were Black. Median prescribed doses were 45 Gy (range: 21-50.4 Gy) for EBRT and 22.25 Gy (range: 16.5-49.1 Gy) for brachytherapy. Median BMI was 48.1 (27.8- 69) and Charlson Comorbidity Index was 4 (1-11). Patient stages were FIGO 1A/B (n = 19), 2 (n = 1), 3 (n = 1), 3b (n = 1), 3C1 (n = 3), 3C2 (n = 2), and 4B (n = 2) due to inguinal lymphadenopathy. 90% had endometrioid histology while 6.7% and 3.3% had clear cell and serous carcinoma, respectively. Median follow up was 32.1 months (1.7-93.6). Median OS for Group 1 was 50.9 months and 43.5 months for Group 2, while 1-/4-year OS was 84.2%/54.4% and 90.9%/17.5% for Group 1 and 2, respectively (p = 0.616). 53.3% of patients died of non-EC causes. The 1-/4-year LFFS was 100%/93.3% for Group 1 and 90%/70.5% for Group 2 (p = 0.113). Four patients (13.3%) developed recurrence (stage 1A/B, 2, 3C1, and 4B), but only 1 died of disease (Stage 2 with clear cell histology). After EBRT but pre-TTB, 50% (n = 15) and 16.6% (n = 5) had acute grade 2 gastrointestinal (GI) and genitourinary (GU) toxicities, respectively. After TTB treatment, 2 more patients developed acute grade 2 GU toxicity. Late toxicities were Grade 2: GU (n = 1) and GI (n = 1) and Grade 4 GI bleed (n = 1) treated with argon plasma coagulation. CONCLUSION TTB ± EBRT for MIEC in predominantly Black patients was associated with excellent LFFS and acceptable toxicity rates, especially in early-stage MIEC with endometrioid histology. Furthermore, even in patients at high risk of death from other causes, LC may help preserve quality of life. Additional studies are needed to evaluate and optimize outcomes for Black patients with MIEC.
Collapse
Affiliation(s)
- M Gutman
- University of Chicago, Chicago, IL, United States
| | - T Wu
- Department of Radiation and Cellular Oncology, The University of Chicago Medicine, Chicago, IL
| | - C H Son
- Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL
| | | | - Y Hasan
- Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL
| |
Collapse
|
4
|
Kim J, Kim T, Jang TW, Kang H, Kim MH, Yoon SH, Son CH, Lee HK, Kim HK, Lee SY, Shin KC, Han JY, Kang EJ. Clinical outcomes of hyperprogression based on volumetry in non-small cell lung cancer after immune checkpoint inhibitor treatment. Thorac Cancer 2022; 13:2170-2179. [PMID: 35785522 PMCID: PMC9346184 DOI: 10.1111/1759-7714.14539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Hyperprogressive disease (HPD) is a novel pattern of the treatment course after immune checkpoint inhibitor (ICI) therapy in patients with non-small cell lung cancer (NSCLC). This study aimed to investigate the clinical characteristics, outcomes, and associated factors of HPD using a semiautomatic volume measurement. METHODS This retrospective study enrolled patients with recurrent and/or metastatic NSCLC treated with ICIs between January 2015 and August 2019 at eight tertiary centers in Korea. HPD was defined according to the tumor growth kinetics and time to treatment failure. Tumor volume was measured using a semiautomatic software. RESULTS A total of 219 NSCLC patients with 35 HPD by volumetric measurement (HPDv) (15.9%) were enrolled. The median duration of overall survival (OS) and OS after ICI treatment (ICI-OS) were 34.5 and 18.4 months, respectively. HPDv patients had significantly worse progression-free survival (PFS) than progressive disease patients without HPDv (1.16 vs. 1.82 months, p-value <0.001). ICI-OS did not significantly differ between patients with HPDv and those without HPDv (2.66 vs. 5.4 months, p = 0.105). PD-L1 expression lower than 50%, more than three metastatic sites, neutrophil-to-lymphocyte ratio equal to or higher than 3.3, and hemoglobin level lower than 10 were found to be associated with HPDv. CONCLUSIONS There is no standardized definition of HPD. However, defining HPD in NSCLC patients treated with ICI using a semiautomatic volume measurement software is feasible.
Collapse
Affiliation(s)
- Jehun Kim
- Division of Pulmonology, Department of Internal Medicine, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, South Korea
| | - Taeyun Kim
- Department of Internal Medicine, The Armed Forces Goyang Hospital, Goyang-si, South Korea
| | - Tae Won Jang
- Division of Pulmonology, Department of Internal Medicine, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, South Korea
| | - Hee Kang
- Department of Radiology, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, South Korea
| | - Mi Hyun Kim
- Division of Pulmonology, Department of Internal Medicine, Pusan National University Hospital, Pusan, South Korea
| | - Seong Hoon Yoon
- Division of Pulmonology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Choon-Hee Son
- Division of Pulmonology, Department of Internal Medicine, Gwanghye General Hospital, Pusan, South Korea
| | - Hyun-Kyung Lee
- Division of Pulmonology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, South Korea
| | - Hyun-Kuk Kim
- Division of Pulmonology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, South Korea
| | - Shin Yup Lee
- Division of Pulmonology, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Kyeong Choel Shin
- Division of Pulmonology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, South Korea
| | - Ji-Yeon Han
- Department of Radiology, Inje University Busan Paik Hospital, Busan, South Korea
| | - Eun-Ju Kang
- Department of Radiology, Dong-A University College of Medicine, Busan, South Korea
| |
Collapse
|
5
|
Byers LA, Bentsion D, Gans S, Penkov K, Son C, Sibille A, Owonikoko TK, Groen HJM, Gay CM, Fujimoto J, de Groot P, Dunbar M, Kang K, He L, Sehgal V, Glasgow J, Bach BA, Ellis PM. Veliparib in Combination with Carboplatin and Etoposide in Patients with Treatment-Naïve Extensive-Stage Small Cell Lung Cancer: A Phase 2 Randomized Study. Clin Cancer Res 2021; 27:3884-3895. [PMID: 33947690 DOI: 10.1158/1078-0432.ccr-20-4259] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/24/2021] [Accepted: 04/26/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE This study investigated the efficacy and safety of oral PARP inhibitor veliparib, plus carboplatin and etoposide in patients with treatment-naïve, extensive-stage small cell lung cancer (ED-SCLC). PATIENTS AND METHODS Patients were randomized 1:1:1 to veliparib [240 mg twice daily (BID) for 14 days] plus chemotherapy followed by veliparib maintenance (400 mg BID; veliparib throughout), veliparib plus chemotherapy followed by placebo (veliparib combination only), or placebo plus chemotherapy followed by placebo (control). Patients received 4-6 cycles of combination therapy, then maintenance until unacceptable toxicity/progression. The primary endpoint was progression-free survival (PFS) with veliparib throughout versus control. RESULTS Overall (N = 181), PFS was improved with veliparib throughout versus control [hazard ratio (HR), 0.67; 80% confidence interval (CI), 0.50-0.88; P = 0.059]; median PFS was 5.8 and 5.6 months, respectively. There was a trend toward improved PFS with veliparib throughout versus control in SLFN11-positive patients (HR, 0.6; 80% CI, 0.36-0.97). Median overall survival (OS) was 10.1 versus 12.4 months in the veliparib throughout and control arms, respectively (HR, 1.43; 80% CI, 1.09-1.88). Grade 3/4 adverse events were experienced by 82%, 88%, and 68% of patients in the veliparib throughout, veliparib combination-only and control arms, most commonly hematologic. CONCLUSIONS Veliparib plus platinum chemotherapy followed by veliparib maintenance demonstrated improved PFS as first-line treatment for ED-SCLC with an acceptable safety profile, but there was no corresponding benefit in OS. Further investigation is warranted to define the role of biomarkers in this setting.
Collapse
Affiliation(s)
| | - Dmitry Bentsion
- Sverdlovsk Regional Oncology Center, Yekaterinburg, Russian Federation
| | - Steven Gans
- Respiratory Diseases, Hospital Saint Jansdal, Harderwijk, the Netherlands
| | - Konstantin Penkov
- Private Medical Institution Euromedservice, St. Petersburg, Russian Federation
| | - ChoonHee Son
- Department of Pulmonology, Dong-A University, Busan, Korea
| | | | - Taofeek K Owonikoko
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Harry J M Groen
- Department of Pulmonary Diseases, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands
| | - Carl M Gay
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Junya Fujimoto
- The University of Texas MD Anderson Cancer Center, Houston, Texas.,Nagasaki University, Nagasaki, Japan
| | | | | | | | - Lei He
- AbbVie Inc., North Chicago, Illinois
| | | | | | | | - Peter M Ellis
- Juravinski Cancer Center, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
6
|
Park MR, Nam YH, Lee SK, Kim KH, Roh MS, Lee HW, Jeong IH, Um SJ, Son CH. Uncertain areas in the diagnosis of allergic bronchopulmonary aspergillosis in patients with asthma. Allergol Immunopathol (Madr) 2014; 42:433-8. [PMID: 23827645 DOI: 10.1016/j.aller.2013.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 04/12/2013] [Accepted: 04/23/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVE The prevalence of allergic bronchopulmonary aspergillosis (ABPA) in patients with bronchial asthma remains unknown. We evaluated the roles of various laboratory tests in the diagnosis of ABPA, including, skin prick test (SPT) for Aspergillus fumigatus (Af), and serum Af specific IgE and IgG antibody measurement. METHODS A total of 50 asthma patients with more than 1000cell/μL of peripheral blood eosinophils were prospectively collected between January 2007 and September 2011. Evaluations using SPT for Af, serum total IgE and specific IgE antibody to Af by CAP system, IgG antibody to Af by enzyme immunoassay (EIA) or CAP system were performed according to the essential minimal criteria for the diagnosis of ABPA - asthma, immediate cutaneous reactivity to Af, elevated total IgE, and raised Af specific IgE and IgG. RESULTS Among 50 patients, three patients (6.0%) were diagnosed as ABPA, of whom each confirmed five items of the essential minimal diagnostic criteria for the diagnosis of ABPA. Six patients (12.0%) showed negative responses to Af in SPT, but positive responses in specific IgE by CAP system. Eight patients (16.0%) showed negative responses to IgG to Af by CAP system, but positive responses by enzyme immunoassay (EIA). CONCLUSIONS SPT and serum IgE to Af measurement by CAP system should be performed simultaneously. It is reasonable to set up cut-off values in Af specific IgE/IgG by CAP system for the differentiation of ABPA from Af sensitised asthma patients.
Collapse
Affiliation(s)
- M R Park
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea
| | - Y H Nam
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea
| | - S K Lee
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea.
| | - K H Kim
- Laboratory Medicine, College of Medicine, Dong-A University, Busan, South Korea
| | - M S Roh
- Anatomic Pathology, College of Medicine, Dong-A University, Busan, South Korea
| | - H W Lee
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea
| | - I H Jeong
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea
| | - S J Um
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea
| | - C H Son
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea
| |
Collapse
|
7
|
Nam YH, Jeong IH, Lee HW, Yoon NB, Um SJ, Son CH, Lee SK. Allergic diseases of the skin and drug allergies – 2028. Vitamin D insufficiency in dress syndrome. World Allergy Organ J 2013. [PMCID: PMC3643234 DOI: 10.1186/1939-4551-6-s1-p114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
8
|
Park MR, Nam YH, Jeong IH, Lee HW, Kim YJ, Park IC, Cho DS, Yoon NB, Um SJ, Son CH, Lee SK. Relationships between serum vitamin D levels and clinical characteristics of drug reaction with eosinophilia and systemic symptoms syndrome. Allergy Asthma Respir Dis 2013. [DOI: 10.4168/aard.2013.1.2.144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Mi-Ran Park
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Young-Hee Nam
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Il-Hwan Jeong
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Hye-Won Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Yong-Jun Kim
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - In-Chul Park
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Duk-Song Cho
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Neul-Bom Yoon
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Soo-Jung Um
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Choon-Hee Son
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Soo-Keol Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| |
Collapse
|
9
|
Nam YH, Kim JI, Um SJ, Lee SK, Son CH. Absence of hyper-responsiveness to methacholine after specific bronchial provocation tests in a worker with hydroxyapatite-induced occupational asthma. Allergy Asthma Immunol Res 2011; 3:135-7. [PMID: 21461255 PMCID: PMC3062794 DOI: 10.4168/aair.2011.3.2.135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 11/24/2010] [Indexed: 12/05/2022]
Abstract
Hydroxyapatite is commonly used as a filler to replace amputated bone or as a coating to promote bone ingrowth into prosthetic implants. Many modern implants, such as hip replacements and dental implants, are coated with hydroxyapatite. We report a patient with occupational asthma due to hydroxyapatite, proven by a specific inhalation challenge, who experienced an early asthmatic reaction after exposure to hydroxyapatite, without increased airway responsiveness to methacholine despite an increased eosinophil count in the peripheral blood. A 38-year-old male dental implant worker visited our allergy department for the evaluation of occupational asthma. He had treated dental implant titanium surfaces with hydroxyapatite for 1.5 years. One year after starting his employment, he noticed symptoms of rhinorrhea, paroxysmal cough, and chest tightness. His symptoms were aggravated during and shortly after work and subsided several hours after work. When he stopped working for 2 months because of his chest symptoms, he became asymptomatic. After restarting his work, his symptoms reappeared and were aggravated. A methacholine bronchial challenge test had a negative response. The following day, a specific bronchial provocation test with wheat powder was negative. On the third day, a specific bronchial provocation test with hydroxyapatite powder produced an early asthmatic response. On the fourth day, a methacholine bronchial challenge test was negative. Further studies are needed to evaluate the exact pathogenetic mechanism of hydroxyapatite-induced occupational asthma.
Collapse
Affiliation(s)
- Young-Hee Nam
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea
| | | | | | | | | |
Collapse
|
10
|
Abstract
A 26-year-old woman was referred to our department due to fever and skin rash after having taken medication for a common cold. Physical examination revealed erythematous skin changes on her body associated with mucosal involvement in her eyes and oral cavity. Peripheral blood examination revealed leukopenia and thrombocytopenia. Liver function test showed hyperbilirubinemia. She was managed with high dose intravenous immunoglobulin (IVIG) at 1.0 gm/kg of body weight infused for 5 consecutive days. Although the patient's skin lesion improved dramatically with IVIG therapy, her hyperbilirubinemia aggravated progressively. Eighteen months after her presentation, liver cirrhosis was diagnosed by ultrasonography, laboratory and liver biopsy findings.
Collapse
Affiliation(s)
- Young-Hee Nam
- Department of Internal Medicine, College of Medicine, Dong-A University, Republic of Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Kim CJ, Nam HS, Lee CY, Yum HK, Yang SH, Seo KH, Son CH, Kim DJ, Jang SH, Chung MP, Park YB, Lee JC, Ryu JS. Catamenial Hemoptysis: A Nationwide Analysis in Korea. Respiration 2010; 79:296-301. [DOI: 10.1159/000228831] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Accepted: 03/11/2009] [Indexed: 11/19/2022] Open
|
12
|
Lee SW, Yoon NB, Park SM, Lee SM, Um SJ, Lee SK, Son CH, Kim YH, Kim KH, Roh MS. Antituberculosis drug-induced drug rash with eosinophilia and systemic symptoms syndrome confirmed by patch testing. J Investig Allergol Clin Immunol 2010; 20:631-632. [PMID: 21314014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Affiliation(s)
- S W Lee
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Um SJ, Lee SK, Kim YH, Kim KH, Son CH, Roh MS, Lee MK. Clinical features of drug-induced hypersensitivity syndrome in 38 patients. J Investig Allergol Clin Immunol 2010; 20:556-562. [PMID: 21313995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND The clinical features of drug-induced hypersensitivity syndrome (DIHS) or drug rash with eosinophilia and systemic symptoms (DRESS) syndrome are complicated, and the incidence of this condition is very low. OBJECTIVE To evaluate the clinical course of DIHS/DRESS and identify effective treatment options. METHODS This study was a retrospective analysis of prospectively collected clinical data in 38 consecutive patients with DIHS/DRESS diagnosed between March 2004 and January 2009. We investigated the clinical features, response to treatment, and outcome of 38 patients. RESULTS The study patients consisted of 18 men (47.4%) and 20 women (52.6%). The most common causative drugs were anticonvulsants (47.4%) and antibiotics (18.4%), followed by nonsteroidal anti-inflammatory drugs (NSAIDs) (13.2%), allopurinol (5.3%), and undetermined agents (15.8%). The latency period ranged from 3 to 105 days, with a mean (SD) of 25.2 (21.5) days. Systemic corticosteroids were administered to 16 patients (42.1%). Twenty-two (57.9%) patients were treated with topical corticosteroids and antihistamines (no systemic corticosteroids). Complete recovery was noted in 36 patients (94.8%). Two of the patients treated with systemic corticosteroids had a poor outcome: one died due to an opportunistic infection secondary to long-term systemic corticosteroid treatment; the other showed progressive deterioration of liver damage, although the final outcome is not known. CONCLUSION The drugs associated with DIHS/DRESS were variable and most frequently included anticonvulsants, beta-lactam antibiotics, and NSAIDs. The syndrome was more common than generally recognized. Additional studies are needed to evaluate the clinical indications for systemic corticosteroids in patients with DIHS/DRESS.
Collapse
Affiliation(s)
- S J Um
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea
| | | | | | | | | | | | | |
Collapse
|
14
|
Son CH, Um SJ, Jung MH. FEASIBILITY OF IMMUNOTHERAPY WITH AUTOLOGOUS DENDRITIC CELL VACCINE FOR NON-SMALL CELL LUNG CANCER PATIENTS. Chest 2009. [DOI: 10.1378/chest.136.4_meetingabstracts.21s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
15
|
Son CH, Lee CU, Roh MS, Lee SK, Kim KH, Yang DK. Acute generalized exanthematous pustulosis as a manifestation of carbamazepine hypersensitivity syndrome. J Investig Allergol Clin Immunol 2008; 18:461-464. [PMID: 19123438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Anticonvulsant hypersensitivity syndrome (AHS) is a multisystemic disorder involving cutaneous changes and typical blood abnormalities that can be triggered by aromatic anticonvulsant drugs.The syndrome is commonly associated with a macular or papular rash or erythroderma. Acute generalized exanthematous pustulosis is a very rare cutaneous manifestation of AHS. A 41-year-old man was referred to our hospital for evaluation of a 3-day history of fever, leukocytosis, and generalized skin eruption. The patient had been taking carbamazepine for 1 month to treat hand tremor following surgery for intracerebral hemorrhage. Physical examination revealed facial edema and a large number of variable-sized pustules covering the body. Initial laboratory testing showed peripheral blood eosinophilia and abnormal liver function.A biopsy of pustular lesions revealed intraepidermal pustules, with perivascular lymphocytic infiltration. The skin lesions and laboratory results improved after withdrawal of carbamazepine and treatment with oral corticosteroids.
Collapse
Affiliation(s)
- C H Son
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | | | | | | | | | | |
Collapse
|
16
|
Son CH, Kim HI, Kim KN, Lee KN, Lee CU, Roh MS, Kim KH, Yang DK, Lee SK. Moxifloxacin-associated drug hypersensitivity syndrome with drug-induced hypersensitivity pneumonitis. J Investig Allergol Clin Immunol 2008; 18:72-73. [PMID: 18361108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- C H Son
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Ryu JS, Lee CY, Yum HK, Yang SH, Seo KH, Kim DJ, Son CH, Kim CJ, Jeong SH, Lee JC, Jang SH, Park YB, Kim HJ, Chung MP, Jang TW. CLINICAL CHARACTERISTICS OF TWENTY-ONE PATIENTS WITH CATAMENIAL HEMOPTYSIS. Chest 2007. [DOI: 10.1378/chest.132.4_meetingabstracts.617c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
18
|
Kim SH, Son CH, Nah SY, Jo SK, Jang JS, Shin DH. Modification of radiation response in mice by Panax ginseng and diethyldithiocarbamate. In Vivo 2001; 15:407-11. [PMID: 11695238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
The aim of this study was to determine the effect of Panax ginseng and its fractions on jejunal crypt survival, endogenous spleen colony formation and apoptosis in jejunal crypt cells of mice irradiated with high- and low-dose of gamma-irradiation. The radioprotective effect of ginseng was compared with the effect of diethyldithiocarbamate (DDC). Ginseng administration before irradiation protected the jejunal crypts (p < 0.005), increased the formation of endogenous spleen colony (p < 0.005) and reduced the frequency of radiation-induced apoptosis (p < 0.05). The radioprotective effect on jejunal crypts and apoptosis in the DDC-treated group appeared similar to that in the ginseng--treated groups. Treatment with DDC showed no significant modifying effects on the formation of endogenous spleen colony. In the experiment on the effect of fractions of ginseng, the result indicated that the lipophilic non-polar compounds (Fraction 1), lipophilic-acidic compounds (Fraction 2), free sugars (Fraction 7) and saponin compounds (Fraction 8) might have a major radioprotective effect. Although the mechanisms of this inhibitory effect remain to be elucidated, these results indicated that ginseng might be a useful radioprotector, especially since it is a relatively nontoxic natural product. Further studies are needed to fully characterize the protective nature of ginseng extract and its components.
Collapse
Affiliation(s)
- S H Kim
- Department of Anatomy, College of Veterinary Medicine, Chonnam National University, 300 Yongbong-dong, Puk-ku, Kwangju 500-757, South Korea
| | | | | | | | | | | |
Collapse
|
19
|
Son CH, Jeong KA, Kim JH, Park IC, Kim SH, Lee CS. Establishment of the prediction table of parturition day with ultrasonography in small pet dogs. J Vet Med Sci 2001; 63:715-21. [PMID: 11503898 DOI: 10.1292/jvms.63.715] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To establish a prediction table of parturition day the real-time B-mode ultrasonographic examinations were performed in the 8 pregnant Malteses and 10 Yorkshire terriers (total pups, 25 and 38 pups, respectively) from 18 days of gestation until the parturition. Ovulation was designated the first day of gestation (day 0). Extra fetal and fetal structures were measured from all conceptues. The parameters that exhibited the best correlation to parturition were used to compile a prediction table of parturition day. To testify the precision of the prediction table of parturition day, the 15 pregnant Malteses (48 pups) and 13 pregnant Yorkshire terriers (42 pups) with unknown mating time were examined using ultrasonography. Inner chorionic cavity diameter on days 18 to 37 and fetal head diameter on day 38 to parturition that showed the best correlation to gestational age were the most pertinent to the estimation of gestational age and the prediction of parturition day. The two parameters were used to compile a prediction table of parturition with averaged regression equations. In verificational examinations, with the exception of I Yorkshire terrier (3.6%) having 1 fetus, 18 of 28 bitches (64.3%) delivered exactly on the date predicted and 9 of 28 bitches (32.1%) delivered within I day of the date predicted. Therefore, the prediction table of parturition day seems to be a useful tool of the prediction of parturition day in practice.
Collapse
Affiliation(s)
- C H Son
- College of Veterinary Medicine, Chonnam National University, Kwangju, Republic of Korea
| | | | | | | | | | | |
Collapse
|
20
|
Oh H, Lee SE, Yang JA, Chung CY, Ryu SY, Huh MD, Jo SK, Son CH, Kim SH. Establishment of a biological indicator for the radiation and safety of diagnostic ultrasound using apoptosis. In Vivo 2000; 14:345-9. [PMID: 10836208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
We have studied, by a nonisotopic in situ end-labeling (ISEL) technique, the frequency of apoptosis in the intestinal crypt cell of adult mice and in the external granular layer(EGL) of the cerebellum of fetuses by gamma-ray irradiation from 60Co or diagnostic ultrasound exposure. The extent of changes following 200 cGy(1090 cGy/min) was studied at 2, 4, 6, 8, 12, or 24 hours after exposure. The maximal frequency was found 4-8 hours after exposure. The mice that received 18, 36, 54, 108, 198, 396 cGy of gamma-rays or diagnostic ultrasound (7.5 MHz, 4.2 mW, ISPTA = 7.9 mW/cm2, IsppA = 114.3 W/cm2) for 10 or 30 minutes were examined 6 hours after irradiation. Measurements performed after gamma-ray irradiation showed a dose-related increase in apoptotic cells in each of the mice studied. The dose-response curves were analyzed with alpha linear-quadratic model: the frequency (number per crypt) of apoptotic cells in the intestinal crypt of adult mice was y = (0.0386 +/- 0.004204)D + (-0.0000535 +/- 0.00001120)D2 + 0.15475(r2 = 0.952, y = apoptotic cell per crypt cell, D = dose in cGy), and the frequency (percentage of apoptotic cell in the EGL) of apoptotic cell in the EGL of fetus was y = (0.1349 +/- 1.175)D + (-0.001522 +/- 0.334)D2 + 0.0477(r2 = 0.981, y = % of apoptotic cell in the EGL, D = dose in cGy). In the experiment of ultrasound exposure, the frequencies of apoptosis were 0.181 +/- 0.055(10 minutes exposure) and 0.325 +/- 0.294 (30 minutes exposure) in the crypt cells and 0.106 +/- 0.130% (10 minutes exposure) and 0.167 +/- 0.220%(30 minutes exposure) in the EGL. We estimated the relative dose of the yield from the experiment with ultrasound by substituting the yield from ultrasound exposure into the curue from the gamma-irradiation. The relative doses of ultrasound exposure compared with gamma-irradiation were 0.692 cGy(10 minutes exposure) and 1.334 cGy(30 minutes exposure) in the experiment for crypt cells and 0.432 cGy(10 minutes exposure) and 0.885 cGy(30 minutes exposure) in the experiment for EGL. Although there is presently no evidence to indicate that diagnostic ultrasound involves a significant risk, it is not wise to use diagnostic ultrasound indiscriminately.
Collapse
Affiliation(s)
- H Oh
- College of Veterinary Medicine, Chonnam National University, Puk-Ku, Kwangju, South Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Kim SH, Chung CY, Son CH. Cell death by apoptosis in the neonatal mouse cerebellum following gamma-irradiation. Anticancer Res 1998; 18:1629-32. [PMID: 9673381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We have studied, by a nonisotopic in situ DNA end-labeling (ISEL) technique, the frequency of apoptosis in the external granular layer (EGL) of the cerebellum after whole-body irradiation of newborn mice by gamma-rays from 60Co. The total number of normal cells and cells showing morphological features of apoptosis were counted. The frequency of apoptotic cells was expressed as a percentage of the total number of cells in EGL. The extent of changes following 2 Gy (10.9 Gy/min) was studied at 2, 4, 6, 8, 12, or 24 hours after exposure. The maximal frequency was found 6-8 hours after exposure. Newborn mice that received 0.18, 0.36, 0.54, 1.08, 1.98, or 3.96 Gy were examined 6 hours after irradiation. Measurements performed after irradiation showed a dose-related increase in apoptotic cells in each of the mice studied. The dose-response curves were analyzed by a linear- quadratic model; frequency was (13.49 +/- 1.175) D + (-1.52 +/- 0.334) D2 +/- 0.048 (r2 = 0.981, D = dose in Gy). It provides the basis required for a better understanding of results which will be obtained in any further studies for biological responses of radiation using newborn orfetal mice.
Collapse
Affiliation(s)
- S H Kim
- Department of Veterinary Anatomy, College of Veterinary Medicine, Chonnam National University, Kwangju, Korea
| | | | | |
Collapse
|