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Park SH, Lim DH, Sohn TS, Lee J, Zang DY, Kim ST, Kang JH, Oh SY, Hwang IG, Ji JH, Shin DB, Yu JI, Kim KM, An JY, Choi MG, Lee JH, Kim S, Hong JY, Park JO, Park YS, Lim HY, Bae JM, Kang WK. A randomized phase III trial comparing adjuvant single-agent S1, S-1 with oxaliplatin, and postoperative chemoradiation with S-1 and oxaliplatin in patients with node-positive gastric cancer after D2 resection: the ARTIST 2 trial ☆. Ann Oncol 2020; 32:368-374. [PMID: 33278599 DOI: 10.1016/j.annonc.2020.11.017] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/22/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Adjuvant chemotherapy and chemoradiotherapy are some of the standards of care for gastric cancer (GC). The Adjuvant chemoRadioTherapy In Stomach Tumors (ARTIST) 2 trial compares two adjuvant chemotherapy regimens and chemoradiotherapy in patients with D2-resected, stage II or III, node-positive GC. PATIENTS AND METHODS The ARTIST 2 compared, in a 1:1:1 ratio, three adjuvant regimens: oral S-1 (40-60 mg twice daily 4 weeks on/2 weeks off) for 1 year, S-1 (2 weeks on/1 week off) plus oxaliplatin 130 mg/m2 every 3 weeks (SOX) for 6 months, and SOX plus chemoradiotherapy 45 Gy (SOXRT). Randomization was stratified according to surgery type (total or subtotal gastrectomy), pathologic stage (II or III), and Lauren histologic classification (diffuse or intestinal/mixed). The primary endpoint was disease-free survival (DFS) at 3 years; a reduction of 33% in the hazard ratio (HR) for DFS with SOX or SOXRT, when compared with S-1, was considered clinically meaningful. The trial is registered at clinicaltrials.gov (NCT0176146). RESULTS A total of 546 patients were recruited between February 2013 and January 2018 with 182, 181, and 183 patients in the S-1, SOX, and SOXRT arms, respectively. Median follow-up period was 47 months, with 178 DFS events observed. Estimated 3-year DFS rates were 64.8%, 74.3%, and 72.8% in the S-1, SOX, and SOXRT arms, respectively. HR for DFS in the control arm (S-1) was shorter than that in the SOX and SOXRT arms: S-1 versus SOX, 0.692 (P = 0.042) and S-1 versus SOXRT, 0.724 (P = 0.074). No difference in DFS was found between SOX and SOXRT (HR 0.971; P = 0.879). Adverse events were as anticipated in each arm, and were generally well-tolerated and manageable. CONCLUSIONS In patients with curatively D2-resected, stage II/III, node-positive GC, adjuvant SOX or SOXRT was effective in prolonging DFS, when compared with S-1 monotherapy. The addition of radiotherapy to SOX did not significantly reduce the rate of recurrence after D2 gastrectomy.
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Affiliation(s)
- S H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D H Lim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - T S Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D Y Zang
- Division of Hematology-Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang-si, Gyeonggi-do, Korea
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J H Kang
- Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - S Y Oh
- Department of Hematology-Oncology, Dong-A University, Busan, Korea
| | - I G Hwang
- Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - J H Ji
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - D B Shin
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - J I Yu
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K-M Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Y An
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M G Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J H Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Y Hong
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J O Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y S Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Y Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J M Bae
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - W K Kang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Han M, Kim YD, Park HJ, Hwang IG, Choi J, Ha J, Heo JH, Nam HS. Brachial-ankle pulse wave velocity for predicting functional outcomes in patients with cryptogenic stroke. J Clin Neurosci 2019; 69:214-219. [DOI: 10.1016/j.jocn.2019.07.050] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 07/08/2019] [Indexed: 10/26/2022]
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Park H, Kim J, Ha J, Hwang IG, Song TJ, Yoo J, Ahn SH, Kim K, Kim BM, Kim DJ, Kim YD, Nam HS, Kwon I, Choi HJ, Sohn SI, Lee HS, Heo JH. Histological features of intracranial thrombi in stroke patients with cancer. Ann Neurol 2019; 86:143-149. [PMID: 31025392 DOI: 10.1002/ana.25495] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 04/22/2019] [Accepted: 04/25/2019] [Indexed: 12/21/2022]
Abstract
The histological features of thrombus in stroke patients with cancer are not well known. Using immunohistochemical staining of thrombi retrieved during mechanical thrombectomy in stroke patients, thrombus compositions were compared between 16 patients with active cancer, 16 patients with inactive cancer, and 16 patients without any history of cancer. The active cancer group showed higher platelet and lower erythrocyte fractions than the inactive cancer or the control group. Four patients with vegetation showed very high platelet and low erythrocyte fractions. Patients with cryptogenic etiology in the active cancer group showed a similar pattern to those with vegetation. These findings may aid the determination of treatment strategies in cancer-associated stroke. ANN NEUROL 2019.
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Affiliation(s)
- Hyungjong Park
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.,Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - Jayoung Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Jimin Ha
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - In Gun Hwang
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Tae-Jin Song
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Joonsang Yoo
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - Seong Hwan Ahn
- Department of Neurology, Chosun University School of Medicine, Gwanju, Korea
| | - Kyoungsub Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Byung Moon Kim
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Joon Kim
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Dae Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyo Suk Nam
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Il Kwon
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun-Jung Choi
- Severance Integrative Research Institute for Cerebral & Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Sung-Il Sohn
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei Universeity College of Medicine, Seoul, Korea
| | - Ji Hoe Heo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
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Park H, Kim JY, Hwang IG, Song TJ, Yoo J, Ahn SH, Kim BM, Kim DJ, Kim YD, Nam HS, Kwon I, Heo JH. Abstract WP281: Histologic Features of Thrombi Retrieved From Ischemic Stroke Patients With Cancer. Stroke 2019. [DOI: 10.1161/str.50.suppl_1.wp281] [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: 11/16/2022]
Abstract
Background:
Systemic cancer is a cause of stroke. However, histologic features of thrombus in stroke patients with cancer are not well-known. We investigated histologic features of intracranial thrombi in acute stroke patients with cancer.
Methods:
We prospectively collected thrombi that were retrieved during mechanical thrombectomy. This study included 32 consecutive patients with any history of systemic cancer (16 patients with active cancer and 16 patients with inactive cancer.) All patients underwent continuous electrocardiographic monitoring for at least 24 h. Echocardiography was performed in all but three patients. Immunohistochemical staining of thrombus was done using anti-CD42b antibody for platelets, anti-glycophorin antibody for erythrocytes, anti-fibrinogen antibody for fibrin, anti-myeloperoxidase antibody for leukocytes, and anti-Histone H3 antibody for neutrophil extracellular traps. After acquiring images of entire thrombus area using the stereo investigator imaging system, quantitative fraction (%) of different thrombus composition was semi-automatically assessed using ImageJ software. We compared the thrombus composition between the active cancer group and the inactive cancer group.
Results:
Comparing with the inactive cancer group, the active cancer group showed higher platelet fraction (median [interquartile range], 20.6 [7.3-27.6] vs 6.1 [2.5-9.9], p=0.002) and lower erythrocyte fraction (1.6 [0.8-11.1] vs 20.7 [13.3-23.7], p=0.001). Fractions for fibrin, leukocytes, and neutrophil extracellular traps were not different between the active and inactive cancer groups. Four patients had vegetation on echocardiography and showed very high platelet fraction (29.5 [26.1-33.9]) and very low erythrocyte fraction (0.8 [0.7-0.9]). Of the active cancer group, 6 patients with negative evaluation also showed high platelet fraction and low erythrocyte fraction, but the thrombus composition in 4 patients with determined etiology (3 atrial fibrillation, 1 >50% stenosis) was similar to that in inactive cancer.
Conclusion:
Thrombi in stroke patients with active cancer were platelet-rich and erythrocyte-poor. These findings may aid to determine the treatment strategy for stroke patients with cancer.
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Affiliation(s)
- Hyungjong Park
- Neurology, Dept of Neurology, Yonsei Univ College of Medicine, Seoul, Korea, Republic of
| | - Ja young Kim
- Neurology, Dept of Neurology, Yonsei Univ College of Medicine, Seoul, Korea, Republic of
| | - In Gun Hwang
- Neurology, Dept of Neurology, Yonsei Univ College of Medicine, Seoul, Korea, Republic of
| | - Tae-Jin Song
- Neurology, Dept of Neurology, Ewha Womans Univ Sch of Medicine, Seoul, Korea, Republic of
| | - Joonsang Yoo
- Neurology, Dept of Neurology, Keimyung Univ Sch of Medicine, Daegu, Korea, Republic of
| | - Sung Hwan Ahn
- Neurology, Dept of Neurology, Chosun Univ Sch of Medicine, Gwangju, Korea, Republic of
| | - Byung Moon Kim
- Radiology, Dept of Radiology, Yonsei Univ College of Medicine, Seoul, Korea, Republic of
| | - Dong Joon Kim
- Radiology, Dept of Radiology, Yonsei Univ College of Medicine, Seoul, Korea, Republic of
| | - Young Dae Kim
- Neurology, Dept of Neurology, Yonsei Univ College of Medicine, Seoul, Korea, Republic of
| | - Hyo Suk Nam
- Neurology, Dept of Neurology, Yonsei Univ College of Medicine, Seoul, Korea, Republic of
| | - Il Kwon
- Neurology, Dept of Neurology, Yonsei Univ College of Medicine, Seoul, Korea, Republic of
| | - Ji Hoe Heo
- Neurology, Dept of Neurology, Yonsei Univ College of Medicine, Seoul, Korea, Republic of
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Yoo J, Baek JH, Park H, Song D, Kim K, Hwang IG, Kim YD, Kim SH, Lee HS, Ahn SH, Cho HJ, Kim GS, Kim J, Lee KY, Song TJ, Choi HY, Nam HS, Heo JH. Thrombus Volume as a Predictor of Nonrecanalization After Intravenous Thrombolysis in Acute Stroke. Stroke 2018; 49:2108-2115. [DOI: 10.1161/strokeaha.118.021864] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Joonsang Yoo
- From the Department of Neurology (J.Y., J.-H.B., H.P., D.S., K.K., I.G.H., Y.D.K., K.-Y.L., H.S.N., J.H.H.)
- Yonsei University College of Medicine, Seoul, Korea; Department of Neurology, Keimyung University School of Medicine, Daegu, Korea (J.Y.)
| | - Jang-Hyun Baek
- From the Department of Neurology (J.Y., J.-H.B., H.P., D.S., K.K., I.G.H., Y.D.K., K.-Y.L., H.S.N., J.H.H.)
- Department of Neurology, National Medical Center, Seoul, Korea (J.-H.B.)
| | - Hyungjong Park
- From the Department of Neurology (J.Y., J.-H.B., H.P., D.S., K.K., I.G.H., Y.D.K., K.-Y.L., H.S.N., J.H.H.)
| | - Dongbeom Song
- From the Department of Neurology (J.Y., J.-H.B., H.P., D.S., K.K., I.G.H., Y.D.K., K.-Y.L., H.S.N., J.H.H.)
| | - Kyoungsub Kim
- From the Department of Neurology (J.Y., J.-H.B., H.P., D.S., K.K., I.G.H., Y.D.K., K.-Y.L., H.S.N., J.H.H.)
| | - In Gun Hwang
- From the Department of Neurology (J.Y., J.-H.B., H.P., D.S., K.K., I.G.H., Y.D.K., K.-Y.L., H.S.N., J.H.H.)
| | - Young Dae Kim
- From the Department of Neurology (J.Y., J.-H.B., H.P., D.S., K.K., I.G.H., Y.D.K., K.-Y.L., H.S.N., J.H.H.)
| | - Seo Hyun Kim
- Department of Neurology, Yonsei Wonju University College of Medicine, Korea (S.H.K.)
| | | | - Seong Hwan Ahn
- Department of Neurology, Chosun University College of Medicine, Kwangju, Korea (S.H.A.)
| | - Han-Jin Cho
- Department of Neurology, Pusan National University School of Medicine, Busan, Korea (H.-J.C.)
| | - Gyu Sik Kim
- Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Korea (G.S.K.)
| | - Jinkwon Kim
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (J.K.)
| | - Kyung-Yul Lee
- From the Department of Neurology (J.Y., J.-H.B., H.P., D.S., K.K., I.G.H., Y.D.K., K.-Y.L., H.S.N., J.H.H.)
| | - Tae-Jin Song
- Department of Neurology, Ewha Womans University College of Medicine, Seoul, Korea (T.-J.S.)
| | - Hye-Yeon Choi
- Department of Neurology, Kyung Hee University School of Medicine, Seoul, Korea (H.-Y.C.)
| | - Hyo Suk Nam
- From the Department of Neurology (J.Y., J.-H.B., H.P., D.S., K.K., I.G.H., Y.D.K., K.-Y.L., H.S.N., J.H.H.)
| | - Ji Hoe Heo
- From the Department of Neurology (J.Y., J.-H.B., H.P., D.S., K.K., I.G.H., Y.D.K., K.-Y.L., H.S.N., J.H.H.)
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Ryang JH, Kim NH, Lee BS, Kim CT, Lee SH, Hwang IG, Rhee MS. Inactivation of Bacillus cereus spores in a tsuyu sauce using continuous ohmic heating with five sequential elbow-type electrodes. J Appl Microbiol 2015; 120:175-84. [PMID: 26497155 DOI: 10.1111/jam.12982] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 09/30/2015] [Accepted: 10/12/2015] [Indexed: 11/27/2022]
Abstract
AIMS The effect of ohmic heating (OH) in a pilot plant system which had a zig-zag shaped (elbow-type) ohmic heater with five sequential voltage electrodes was investigated on Bacillus cereus spores in a commercial tsuyu sauce. METHODS AND RESULTS The electrical field was fixed at 26·7 V cm(-1) with an alternating current frequency of 25 kHz. Raw tsuyu sauce (50 l) inoculated with B. cereus spores was submitted in a 4 × 3 factorial design to the OH system and heated at 95, 105, 115, and 125°C each for 30, 60, and 90 s. Survival of B. cereus spores and colour change in the commercial tsuyu sauce were both measured before and after treatment. As the treatment temperature and time increased, the number of surviving B. cereus spores decreased. The OH treatment in a bath-type process at 105°C for more than 30 s resulted in the total inactivation of the inoculated B. cereus spores (average 5·4 log reductions to undetectable levels after treatment). The OH protocol of heating at 105°C for 60 s which ensure complete eradication of the inoculated spores without compromising product quality was chosen and investigated for its suitability for commercial application on bulk quantities of samples (500 l). Reliable and reproducible reductions in B. cereus spore counts of 4·7-5·5 log CFU ml(-1) (mean ± standard deviation = 5·1 ± 0·3 CFU ml(-1) ) were achieved by the selected protocol of the continuous OH treatment (105°C for 60 s). CONCLUSION This study suggests that OH treatment with five sequential elbow-type electrodes has great potential as an industrial sterilizing method for liquid food contaminated with B. cereus spores. SIGNIFICANCE AND IMPACT OF THE STUDY This procedure will enhance the microbiological quality of liquid foods while minimizing quality deterioration.
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Affiliation(s)
- J H Ryang
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Korea.,Food Safety Research Institute, NONGSHIM Co., Ltd., Seoul, Korea
| | - N H Kim
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Korea
| | - B S Lee
- Food Safety Research Institute, NONGSHIM Co., Ltd., Seoul, Korea
| | - C T Kim
- Food Safety Research Institute, NONGSHIM Co., Ltd., Seoul, Korea
| | - S H Lee
- Nutrition Safety Policy Division, Ministry of Food and Drug Safety, Osong, North Chungcheong Province, Korea
| | - I G Hwang
- Food Safety Risk Assessment Division, National Institute of Food and Drug Safety Evaluation, Osong, North Chungcheong Province, Korea
| | - M S Rhee
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, Korea
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Kim SA, Jeon SH, Kim NH, Kim HW, Lee NY, Cho TJ, Jung YM, Lee SH, Hwang IG, Rhee MS. Changes in the Microbial Composition of Microbrewed Beer during the Process in the Actual Manufacturing Line. J Food Prot 2015; 78:2233-9. [PMID: 26613919 DOI: 10.4315/0362-028x.jfp-15-261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study investigated changes in the microbial composition of microbrewed beer during the manufacturing processes and identified potential microbial hazards, effective critical quality control points, and potential contamination routes. Comprehensive quantitative (aerobic plate count, lactic acid bacteria, fungi, acetic acid bacteria, coliforms, and Bacillus cereus) and qualitative (Escherichia coli and eight foodborne pathogens) microbiological analyses were performed using samples of raw materials (malt and manufacturing water), semiprocessed products (saccharified wort, boiled wort, and samples taken during the fermentation and maturation process), and the final product obtained from three plants. The initial aerobic plate count and lactic acid bacteria counts in malt were 5.2 and 4.3 log CFU/g, respectively. These counts were reduced to undetectable levels by boiling but were present at 2.9 and 0.9 log CFU/ml in the final product. Fungi were initially present at 3.6 log CFU/g, although again, the microbes were eliminated by boiling; however, the level in the final product was 4.6 log CFU/ml. No E. coli or foodborne pathogens (except B. cereus) were detected. B. cereus was detected at all stages, although it was not present in the water or boiled wort (total detection rate ¼ 16.4%). Results suggest that boiling of the wort is an effective microbial control measure, but careful management of raw materials and implementation of effective control measures after boiling are needed to prevent contamination of the product after the boiling step. The results of this study may constitute useful and comprehensive information regarding the microbiological quality of microbrewed beer.
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Affiliation(s)
- S A Kim
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul 02841, Republic of Korea
| | - S H Jeon
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul 02841, Republic of Korea
| | - N H Kim
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul 02841, Republic of Korea
| | - H W Kim
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul 02841, Republic of Korea
| | - N Y Lee
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul 02841, Republic of Korea
| | - T J Cho
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul 02841, Republic of Korea
| | - Y M Jung
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul 02841, Republic of Korea
| | - S H Lee
- Nutrition Safety Policy Division, Ministry of Food and Drug Safety, 187 Osongsaengmyeong 2-ro, Osong-eup, Heungdeok-gu Cheongju-si, Chungcheongbuk-do 28159, Republic of Korea
| | - I G Hwang
- Food Safety Risk Assessment Division, National Institute of Food and Drug Safety Evaluation, 187 Osongsaengmyeong 2-ro, Osong-eup, Heungdeok-gu Cheongju-si, Chungcheongbuk-do 28159, Republic of Korea
| | - M S Rhee
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul 02841, Republic of Korea.
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Lim SH, Kim TW, Hong YS, Han SW, Lee KH, Kang HJ, Hwang IG, Lee JY, Kim HS, Kim ST, Lee J, Park JO, Park SH, Park YS, Lim HY, Jung SH, Kang WK. A randomised, double-blind, placebo-controlled multi-centre phase III trial of XELIRI/FOLFIRI plus simvastatin for patients with metastatic colorectal cancer. Br J Cancer 2015; 113:1421-6. [PMID: 26505681 PMCID: PMC4815882 DOI: 10.1038/bjc.2015.371] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/22/2015] [Accepted: 10/05/2015] [Indexed: 12/19/2022] Open
Abstract
Background: The purpose of this randomised phase III trial was to evaluate whether the addition of simvastatin, a synthetic 3-hydroxy-3methyglutaryl coenzyme A reductase inhibitor, to XELIRI/FOLFIRI chemotherapy regimens confers a clinical benefit to patients with previously treated metastatic colorectal cancer. Methods: We undertook a double-blind, placebo-controlled phase III trial of 269 patients previously treated for metastatic colorectal cancer and enrolled in 5 centres in South Korea. Patients were randomly assigned (1 : 1) to one of the following groups: FOLFIRI/XELIRI plus simvastatin (40 mg) or FOLFIRI/XELIRI plus placebo. The FOLFIRI regimen consisted of irinotecan at 180 mg m−2 as a 90-min infusion, leucovorin at 200 mg m−2 as a 2-h infusion, and a bolus injection of 5-FU 400 mg m−2 followed by a 46-h continuous infusion of 5-FU at 2400 mg m−2. The XELIRI regimen consisted of irinotecan at 250 mg m−2 as a 90-min infusion with capecitabine 1000 mg m−2 twice daily for 14 days. The primary end point was progression-free survival (PFS). Secondary end points included response rate, duration of response, overall survival (OS), time to progression, and toxicity. Results: Between April 2010 and July 2013, 269 patients were enrolled and assigned to treatment groups (134 simvastatin, 135 placebo). The median PFS was 5.9 months (95% CI, 4.5–7.3) in the XELIRI/FOLFIRI plus simvastatin group and 7.0 months (95% CI, 5.4–8.6) in the XELIRI/FOLFIRI plus placebo group (P=0.937). No significant difference was observed between the two groups with respect to OS (median, 15.9 months (simvastatin) vs 19.9 months (placebo), P=0.826). Grade ⩾3 nausea and anorexia were noted slightly more often in patients in the simvastatin arm compared with with the placebo arm (4.5% vs 0.7%, 3.0% vs 0%, respectively). Conclusions: The addition of 40 mg simvastatin to the XELIRI/FOLFIRI regimens did not improve PFS in patients with previously treated metastatic colorectal cancer nor did it increase toxicity.
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Affiliation(s)
- S H Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - T W Kim
- Division of Hematology-Oncology, Department of Medicine, Asan Medical Center, Seoul, South Korea
| | - Y S Hong
- Division of Hematology-Oncology, Department of Medicine, Asan Medical Center, Seoul, South Korea
| | - S-W Han
- Division of Hematology-Oncology, Department of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - K-H Lee
- Division of Hematology-Oncology, Department of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - H J Kang
- Division of Hematology-Oncology, Department of Medicine, Korea Cancer Center Hospital, Seoul, South Korea
| | - I G Hwang
- Division of Hematology-Oncology, Department of Medicine, Chungang University Hospital, Seoul, South Korea
| | - J Y Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - H S Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - J Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - J O Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - S H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Y S Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - H Y Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - S-H Jung
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.,Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - W K Kang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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9
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Kim SA, Kim NH, Lee SH, Hwang IG, Rhee MS. Survival of foodborne pathogenic bacteria (Bacillus cereus, Escherichia coli O157:H7, Salmonella enterica serovar Typhimurium, Staphylococcus aureus, and Listeria monocytogenes) and Bacillus cereus spores in fermented alcoholic beverages (beer and refined rice wine). J Food Prot 2014; 77:419-26. [PMID: 24674433 DOI: 10.4315/0362-028x.jfp-13-234] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Only limited information is available on the microbiological safety of fermented alcoholic beverages because it is still a common belief that such beverages do not provide a favorable environment for bacterial growth and survival. Thus, in this study, we examined the survival of major foodborne pathogens and spores in fermented alcoholic beverages. Foodborne pathogens (Bacillus cereus, Escherichia coli O157:H7, Listeria monocytogenes, Salmonella enterica serovar Typhimurium, and Staphylococcus aureus) and B. cereus spores (initial population, 3 to 4 log CFU/ml) were inoculated separately into three types of beer and refined rice wine, which were then stored at 5 and 22°C. Bacterial counts were assayed periodically for up to 28 days. Vegetative B. cereus counts decreased rapidly, whereas B. cereus spore counts remained constant (P > 0.05) for a long period of time in all beverages. Vegetative B. cereus cells formed spores in beer at 5 and 22°C, and the spores survived for long periods. Among vegetative cells, E. coli O157:H7 had the highest survival (only 1.49 to 1.56 log reduction during 28 days in beer at 5°C). Beer and refined rice wine supported microbial survival from several days to several weeks. Our results appear to contradict the common belief that pathogens cannot survive in alcoholic beverages. Long-term survival of pathogens (especially B. cereus and E. coli O157:H7) in beer and refined rice wine should be taken into consideration by the manufacturers of these beverages. This study provides basic information that should help further research into microbial survival in alcoholic beverages and increase the microbiological safety regulation of fermented alcoholic beverages.
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Affiliation(s)
- S A Kim
- Department of Food Bioscience and Technology, College of Life Sciences and Biotechnology, Korea University, Seoul 136-713, South Korea
| | - N H Kim
- Department of Food Bioscience and Technology, College of Life Sciences and Biotechnology, Korea University, Seoul 136-713, South Korea
| | - S H Lee
- Food Microbiology Division, Ministry of Food and Drug Safety, Cheongwon-gun, 363-951, South Korea
| | - I G Hwang
- Food Standardization Division, Ministry of Food and Drug Safety, Cheongwon-gun, 363-951, South Korea
| | - M S Rhee
- Department of Food Bioscience and Technology, College of Life Sciences and Biotechnology, Korea University, Seoul 136-713, South Korea.
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10
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Kim MJ, Kim SA, Kang YS, Hwang IG, Rhee MS. Microbial diversity and prevalence of foodborne pathogens in cheap and junk foods consumed by primary schoolchildren. Lett Appl Microbiol 2013; 57:47-53. [PMID: 23551123 DOI: 10.1111/lam.12075] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Revised: 03/08/2013] [Accepted: 03/15/2013] [Indexed: 11/29/2022]
Abstract
UNLABELLED Aerobic plate counts (APC), coliforms, Bacillus cereus, Escherichia coli and eight foodborne pathogens were tested in 1008 cheap and junk foods, including candies, dried cakes, chewing gum, chocolate, dried and seasoned seafood, ice cream, and sugary foods. APCs were positive for 342 samples (33·9%), and the majority of the counts were 2-3 log CFU g(-1) or ml(-1) (average: 1·10 log CFU g(-1) or ml(-1) ). Most samples (97·3%) contained no coliforms (average: 0·07 log CFU g(-1) or ml(-1) ). Bacillus cereus was detected in 68 samples (average: 0·14 log CFU g(-1) or ml(-1) ). Escherichia coli and Listeria monocytogenes were detected in 6 and 1 samples, respectively, whereas other foodborne pathogens were not isolated. The highest bacterial counts were associated with dried and seasoned seafood products and dried cakes, suggesting that appropriate regulations of these food types should be considered. Cheap and junk foods were produced mainly in developing countries, but there were no significant differences in the bacterial counts among different countries of origin. The presence of foodborne pathogens may pose a risk for children. These results suggest that there is cause for deeper concern about the safety of these foods and that effective countermeasures should be established to improve their microbiological safety. SIGNIFICANCE AND IMPACT OF THE STUDY Food safety is especially important for children, but only limited information is available about the microbiological quality of cheap and junk foods that are consumed frequently by primary schoolchildren (e.g. dried cakes, candies and chocolates). The present study investigated the microbial quality of cheap and junk foods, and our results indicate that these foods are a potential health risk for children, therefore, deeper concern about the safety of these foods and effective countermeasures should be established to improve their microbiological safety. The present study may contribute to the development of an appropriate child food safety management system.
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Affiliation(s)
- M J Kim
- Division of Food Bioscience and Technology, College of Life Sciences and Biotechnology, Korea University, Seoul, South Korea
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11
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Kim YW, Lee SH, Hwang IG, Yoon KS. Effect of temperature on growth of Vibrio parahaemolyticus [corrected] and Vibrio vulnificus in flounder, salmon sashimi and oyster meat. Int J Environ Res Public Health 2012; 9:4662-75. [PMID: 23330227 PMCID: PMC3546782 DOI: 10.3390/ijerph9124662] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 12/04/2012] [Accepted: 12/10/2012] [Indexed: 11/16/2022]
Abstract
Vibrio parahaemolyticus and Vibrio vulnificus are the major pathogenic Vibrio species which contaminate ready-to-eat seafood. The purpose of this study was to evaluate the risk of human illness resulting from consumption of ready-to-eat seafood such as sashimi and raw oyster meat due to the presence of V. parahaemolyticus and V. vulnificus. We compared the growth kinetics of V. parahaemolyticus and V. vulnificus strains in broth and ready-to-eat seafood, including flounder and salmon sashimi, as a function of temperature. The growth kinetics of naturally occurring V. vulnificus in raw oyster meat was also evaluated. The minimum growth temperatures of V. parahaemolyticus and V. vulnificus in broth were 13 °C and 11 °C, respectively. Overall, significant differences in lag time (LT) and specific growth rate (SGR) values between flounder and salmon sashimi were observed at temperatures ranging from 13 °C to 30 °C (p < 0.05). The growth of naturally occurring V. vulnificus reached stationary phase at ~4 log CFU/g in oysters, regardless of the storage temperature. This data indicates that the population of V. vulnificus in oysters did not reach the maximum population density as observed in the broth, where growth of V. vulnificus and V. parahaemolyticus isolated from oysters grew up to >8 log CFU/mL.
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Affiliation(s)
- Yoo Won Kim
- Department of Food and Nutrition, Hoeki-dong Dongdaemun-Ku, Kyung Hee University, Seoul 130-701, Korea; E-Mail:
| | - Soon Ho Lee
- Food Microbiology Division, National Institute of Food and Drug Safety Evaluation, Korea Food and Drug Administration, Chungcheongbuk-do 363-700, Korea; E-Mails: (S.H.L.); (I.G.H)
| | - In Gun Hwang
- Food Microbiology Division, National Institute of Food and Drug Safety Evaluation, Korea Food and Drug Administration, Chungcheongbuk-do 363-700, Korea; E-Mails: (S.H.L.); (I.G.H)
| | - Ki Sun Yoon
- Department of Food and Nutrition, Hoeki-dong Dongdaemun-Ku, Kyung Hee University, Seoul 130-701, Korea; E-Mail:
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12
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Kim SA, Lee YM, Hwang IG, Kang DH, Woo GJ, Rhee MS. Eight enrichment broths for the isolation of Campylobacter jejuni from inoculated suspensions and ground pork. Lett Appl Microbiol 2009; 49:620-6. [PMID: 19780965 DOI: 10.1111/j.1472-765x.2009.02714.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS The efficiency of eight enrichment broths for the selective isolation of Campylobacter jejuni was compared to identify an optimal enrichment broth. METHODS AND RESULTS Brucella-FBP, Preston, Doyle and Roman, modified CCD (mCCD), Park and Sanders, Bolton, Hunt and Radle and Hunt broths were compared for their recovery of (i) Camp. jejuni in suspension, (ii) Camp. jejuni from inoculated ground pork, (iii) heat-injured Camp. jejuni (55 degrees C for 20 min) in suspension and (iv) heat-injured Camp. jejuni from inoculated ground pork. Hunt broth and Bolton broth showed the highest and most rapid enrichment efficacy for the cell suspensions and ground pork, respectively. Preston, Park and Sanders and mCCD broths had relatively high enrichment efficiencies, while Brucella-FBP broth was significantly inferior to the other broths (P < 0.05). CONCLUSIONS Cell recovery from the eight enrichment broths was dependent on the sample type and the state of the cells. The use of the appropriate broth is important for the rapid and efficacious enrichment of Camp. jejuni. In particular, heat-injured Camp. jejuni require a longer cultivation time and a suitable enrichment broth. SIGNIFICANCE AND IMPACT OF THE STUDY The results from the present study provide information for selecting the most appropriate enrichment broth for Camp. jejuni and may contribute to improved detection methods for the organism.
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Affiliation(s)
- S A Kim
- Division of Food Bioscience and Technology, College of Life Sciences and Biotechnology, Korea University, Seoul 136-713, Korea
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13
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Hong YS, Lee HR, Park S, Lee SC, Hwang IG, Park BB, Lee J, Ahn JS, Ahn MJ, Lim HY, Park K. Three-week schedule of irinotecan plus cisplatin in patients with previously untreated extensive-stage small-cell lung cancer. Br J Cancer 2006; 95:1648-52. [PMID: 17133266 PMCID: PMC2360764 DOI: 10.1038/sj.bjc.6603500] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Irinotecan and cisplatin demonstrated promising outcomes in extensive-stage small-cell lung cancer. According to the dosage and schedule of irinotecan, efficacy and toxicity profiles showed subtle differences. This study was designed to evaluate efficacy and toxicity of 3-week schedule of irinotecan/cisplatin in patients with previously untreated extensive-stage small-cell lung cancer. The primary objective was to evaluate response rate and secondary objectives were overall survival and progression-free survival. Patients with previously untreated extensive-stage small-cell lung cancer were enrolled. Irinotecan 65 mg m-2 was administered on days 1 and 8 and cisplatin 60 mg m-2 on day 1. Treatment was repeated every 3 weeks. Seven out of 54 patients (13.0%) had complete response, and partial response was observed in 33 (61.1%). The overall response rate was 74.1% (95% CI; 62.0-82.2%). Stable disease was observed in eight (14.8%) and no progressive disease was observed. After a median follow-up duration of 28.7 months, the median overall survival and progressive-free survival were 13.6 and 6.5 months, respectively. Major grade 3/4 toxicities were neutropenia (50.0%), anorexia (42.6%), diarrhoea (29.6%), fatigue (29.6%) and vomiting (13.0%). There was one treatment-related death owing to pneumonia. Three-week schedule of irinotecan/cisplatin showed effective antitumour activity and moderate toxicities in patients with previously untreated extensive-stage small-cell lung cancer.
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Affiliation(s)
- Y S Hong
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H R Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S C Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - I G Hwang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - B-B Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J S Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M-J Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Y Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul 135-710 Korea. E-mail:
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14
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Kim HG, Lee GW, Lee DH, Hwang IG, Shim KS, Lee WS, Lee JD, Jang JS, Hwang YS, Lee JS. Combination Chemotherapy with Mitomycin C, Vinorelbine, and Cisplatin (MVrP) in Patients with Advanced Non-Small Cell Lung Cancer. Cancer Res Treat 2001; 33:377-84. [PMID: 26680811 DOI: 10.4143/crt.2001.33.5.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PURPOSE A phase II study was conducted in patients with advanced non-small cell lung cancer (NSCLC) in order to evaluate the efficacy and toxicity of the combination chemotherapy regimen of mitomycin C, vinorelbine, and cisplatin (MVrP). MATERIALS AND METHODS Between June 1996 and December 2000, fifty-nine patients with unresectable stage IIIB to IV, pathologically documented NSCLC were enrolled in this study. One cycle consisted of mitomycin C 10 mg/m2 i.v. day 1, vinorelbine 30 mg/m2 i.v. days 1 & 15, and cisplatin 80 mg/m2 i.v day 1 and the next cycle consisted of vinorelbine 30 mg/m2 i.v. days 29 & 43, and cisplatin 80 mg/m2 i.v day 29. Each cycle was alternated and treatments were repeated every 8 weeks. RESULTS We were able to evaluate fifty-three of 59 patients. Objective responses were seen in 22 (41.5%) patients (CR 0%, PR 41.5%). The median duration of response was 13.7 weeks and the median time to progression was 17.7 weeks. The median overall survival was 45.6 weeks. There was a significantly longer survival seen in responders (p=0.041). The toxicities of this regimen were acceptable without treatment related toxic death. CONCLUSION This study suggests that a combination regimen of mitomycin C, vinorelbine, and cisplatin is relatively effective and well tolerated for the treatment of advanced NSCLC.
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