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Pancreatic Neoplasms: HELP
Articles by Kyu-Pyo Kim
Based on 22 articles published since 2010
(Why 22 articles?)
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Between 2010 and 2020, Kyu Pyo Kim wrote the following 22 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review What Is New in the 2017 World Health Organization Classification and 8th American Joint Committee on Cancer Staging System for Pancreatic Neuroendocrine Neoplasms? 2019

Choe, Jooae / Kim, Kyung Won / Kim, Hyoung Jung / Kim, Dong Wook / Kim, Kyu Pyo / Hong, Seung-Mo / Ryu, Jin-Sook / Tirumani, Sree Harsha / Krajewski, Katherine / Ramaiya, Nikhil. ·Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. · Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. · Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. · Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. · Department of Imaging, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. · Department of Imaging, UH Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA. ·Korean J Radiol · Pubmed #30627018.

ABSTRACT: The diagnosis and management of pancreatic neuroendocrine neoplasms (NENs) have evolved significantly in recent years. There are several diagnostic and therapeutic challenges and controversies regarding the management of these lesions. In this review, we focus on the recent significant changes and controversial issues regarding the diagnosis and management of NENs and discuss the role of imaging in the multidisciplinary team approach.

2 Clinical Trial Polymeric nanoparticle-docetaxel for the treatment of advanced solid tumors: phase I clinical trial and preclinical data from an orthotopic pancreatic cancer model. 2016

Song, Si Yeol / Kim, Kyu-Pyo / Jeong, Seong-Yun / Park, Jin / Park, Jaesook / Jung, Joohee / Chung, Hye Kyung / Lee, Sa-Won / Seo, Min Hyo / Lee, Jung-Shin / Jung, Kyung Hae / Choi, Eun Kyung. ·Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Institute for Innovative Cancer Research, Asan Medical Center, Seoul, Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · College of Pharmacy, Duksung Women's University, Seoul, Korea. · Korea Institute of Radiological and Medical Sciences, National Project to Establish Platform to Develop The New Concept Therapy, Seoul, Korea. · Department of Parenteral Delivery Program, Samyang Pharmaceuticals R&D, Daejeon, Korea. ·Oncotarget · Pubmed #27764799.

ABSTRACT: We assessed the efficacy of the polymeric nanoparticle containing docetaxel (PNP-DTX) in preclinical mouse models and determined the maximum tolerated dose (MTD) through clinical study. Subcutaneous and orthotopic mouse models were dedicated. Tumor growth delay in orthotopic model and quantification of in vivo imaging in orthotopic model were evaluated. Phase I clinical study was a single-center, prospective, open-label trial in advanced solid tumors. PNP-DTX was injected intravenously and the starting dose was 20 mg/m2 escalated to 35 mg/m2, 45 mg/m2, 60 mg/m2 and 75 mg/m2. Pharmacokinetics, tumor response, toxicities were evaluated. Preclinical result revealed the more potent cytotoxic effect of PNP-DTX than docetaxel (DTX). However, there was no difference between PNP-DTX and DTX in subcutaneous model. Tubulin polymerization assay showed that PNP-DTX preserved original mode of action of DTX. For phase I clinical trial, 18 patients were analyzed. The dose of 75 mg/m2 was tentatively determined as the MTD and the most common toxicity was grade 4 neutropenia not lasting over 7days. The Cmax of 60 mg/m2 PNP-DTX and AUClast of 45 mg/m2 PNP-DTX were measured to be comparable to those of 75 mg/m2 DTX. Partial remission (PR) was achieved in 4 (22%) patients. The potency of PNP-DTX was revealed especially in orthotopic mouse model. The MTD of PNP-DTX could not be confirmed, but 75 mg/m2 was tentatively determined. The PNP-DTX of 45 mg/m2 had the same pharmacokinetic profile with that of 75 mg/m2 DTX.

3 Article Clinical Outcomes of Second-Line Chemotherapy after Progression on Nab-Paclitaxel Plus Gemcitabine in Patients with Metastatic Pancreatic Adenocarcinoma. 2020

Lee, Kyoungmin / Bang, Kyunghye / Yoo, Changhoon / Hwang, Inhwan / Jeong, Jae Ho / Chang, Heung-Moon / Oh, Dongwook / Song, Tae Jun / Park, Do Hyun / Lee, Sang Soo / Lee, Sung Koo / Kim, Myung-Hwan / Park, Jin-Hong / Kim, Kyu-Pyo / Ryoo, Baek-Yeol. ·Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ·Cancer Res Treat · Pubmed #31291709.

ABSTRACT: PURPOSE: Since the introduction of nab-paclitaxel plus gemcitabine (nab-P+GEM) as first-line (1L) treatment for metastatic pancreatic adenocarcinoma (mPDAC), optimal second-line (2L) chemotherapy after progression is unclear. We assessed clinical outcomes of 2L chemotherapy for disease that progressed on 1L nab-P+GEM. Materials and Methods: Among the 203 patients previously treated with 1L nab-P+GEM for mPDAC at Asan Medical Center, between February and December 2016, records of 120 patients receiving 2L chemotherapy after progression on nab-P+GEM were retrospectively reviewed. The response rate and survival were evaluated along with analysis of prognostic factors. RESULTS: Fluoropyrimidine-oxaliplatin doublets (FOLFOX or XELOX) were used in 78 patients (65.0%), fluoropyrimidine monotherapy in 37 (30.8%), and liposomal irinotecan plus fluorouracil in two (1.7%). The median progression-free survival (PFS) and overall survival (OS) were 3.29 months and 7.33 months from the start of 2L therapy. Fluoropyrimidine-oxaliplatin regimens and fluoropyrimidine monotherapy did not yield significantly different median PFS (2.89 months vs. 3.81 months, p=0.40) or OS (7.04 months vs. 7.43 months, p=0.86). A high neutrophil-lymphocyte ratio (> 2.2) and a short time to progression with 1L nab-P+GEM (< 6.4 months) were independent prognostic factors of poor OS with 2L therapy. CONCLUSION: 2L fluoropyrimidine-oxaliplatin doublets and fluoropyrimidine monotherapy after failure of 1L nab-P+GEM had modest efficacy, with no differences in treatment outcomes between them. Further investigation is warranted for the optimal 2L chemo-regimens and sequencing of systemic chemotherapy for patients with mPDAC.

4 Article Stereotactic body radiation therapy for locally advanced pancreatic cancer. 2019

Jung, Jinhong / Yoon, Sang Min / Park, Jin-Hong / Seo, Dong-Wan / Lee, Sang Soo / Kim, Myung-Hwan / Lee, Sung Koo / Park, Do Hyun / Song, Tae Jun / Ryoo, Baek-Yeol / Chang, Heung-Moon / Kim, Kyu-Pyo / Yoo, Changhoon / Jeong, Jae Ho / Kim, Song Cheol / Hwang, Dae Wook / Lee, Jae Hoon / Song, Ki Byung / Jo, Yoon Young / Park, Jongmoo / Kim, Jong Hoon. ·Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Radiation Oncology, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea. ·PLoS One · Pubmed #30978229.

ABSTRACT: PURPOSE: Stereotactic body radiation therapy (SBRT) is a promising treatment modality for locally advanced pancreatic cancer (LAPC). We evaluated the clinical outcomes of SBRT in patients with LAPC. PATIENTS AND METHODS: We retrospectively analyzed the medical records of patients with LAPC who underwent SBRT at our institution between April 2011 and July 2016. Fiducial markers were implanted using endoscopic ultrasound guidance one week prior to 4-dimensional computed tomography (CT) simulation and daily cone beam CT was used for image guidance. Patients received volumetric modulated arc therapy or intensity modulated radiotherapy using respiratory gating technique. A median dose of 28 Gy (range, 24-36 Gy) was given over four consecutive fractions delivered within one week. Survival outcomes including freedom from local disease progression (FFLP), progression-free survival (PFS), and overall survival (OS) were analyzed. Acute and late toxicities related to SBRT were assessed. RESULTS: A total of 95 patients with LAPC were analyzed, 52 of which (54.7%) had pancreatic head cancers. Most (94.7%) had received gemcitabine-based chemotherapy. The 1-year FFLP rate was 80.1%. Median OS and PFS were 16.7 months and 10.2 months, respectively; the 1-year OS and PFS rates were 67.4% and 42.9%, respectively. Among 79 patients who experienced failure, the sites of first failures were isolated local progressions in 12 patients (15.2%), distant metastasis in 55 patients (69.6%), and both in 12 patients (15.2%). Seven patients (7.4%) were able to undergo surgical resection after SBRT and four had margin-negative resections. Three patients (3.2%) had grade 3 nausea/vomiting during SBRT, and late grade 3 toxicity was observed in another three patients. CONCLUSIONS: LAPC patients who received chemotherapy and SBRT had favorable FFLP and OS with minimal treatment-related toxicity. The most common pattern of failure was distant metastasis, which warrants further studies on the optimal scheme of chemotherapy and SBRT.

5 Article Clinical Outcomes of Conversion Surgery after Neoadjuvant Chemotherapy in Patients with Borderline Resectable and Locally Advanced Unresectable Pancreatic Cancer: A Single-Center, Retrospective Analysis. 2019

Yoo, Changhoon / Shin, Sang Hyun / Kim, Kyu-Pyo / Jeong, Jae Ho / Chang, Heung-Moon / Kang, Jun Ho / Lee, Sang Soo / Park, Do Hyun / Song, Tae Jun / Seo, Dong Wan / Lee, Sung Koo / Kim, Myung-Hwan / Park, Jin-Hong / Hwang, Dae Wook / Song, Ki Byung / Lee, Jae Hoon / Ryoo, Baek-Yeol / Kim, Song Cheol. ·Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. cyoo.amc@gmail.com. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. surgeonssh@gmail.com. · Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea. surgeonssh@gmail.com. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. kkp1122@gmail.com. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. imdrho@gmail.com. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. changhm@amc.seoul.kr. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. bodle1125@naver.com. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. ssleedr@amc.seoul.kr. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. dhparkeus@gmail.com. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. medi01@naver.com. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. dwseoamc@amc.seoul.kr. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. sklee@amc.seoul.kr. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. mhkim@amc.seoul.kr. · Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. pjhynwie@hanmail.net. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. dwhwang@amc.seoul.kr. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. mtsong21c@naver.com. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. hbpsurgeon@gmail.com. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. ryooby@amc.seoul.kr. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. drksc@amc.seoul.kr. ·Cancers (Basel) · Pubmed #30813624.

ABSTRACT: The clinical benefit and potential risks of conversion surgery after neoadjuvant chemotherapy (NACT) have not been fully investigated in patients with borderline resectable pancreatic cancer (BRPC) and locally advanced unresectable pancreatic cancer (LAPC). Therefore, this has been evaluated in a retrospective, prospective cohort-based analysis. Between October 2005 and April 2017, 135 patients (65 with BRPC and 70 with LAPC) received conversion surgery after NACT. Exploratory analysis to assess clinical outcomes in comparison with patients who underwent upfront surgery in the same time period (

6 Article Prognostic factors in patients with metastatic or recurrent pancreatic cancer treated with first-line nab-paclitaxel plus gemcitabine: implication of inflammation-based scores. 2019

Hwang, Inhwan / Kang, Jihoon / Ip, Hei Nga Natalie / Jeong, Jae Ho / Kim, Kyu-Pyo / Chang, Heung-Moon / Yoo, Changhoon / Ryoo, Baek-Yeol. ·Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. · Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. yooc@amc.seoul.kr. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. ryooby@amc.seoul.kr. ·Invest New Drugs · Pubmed #30324344.

ABSTRACT: Background Nab-paclitaxel plus gemcitabine (AG) is standard first-line chemotherapy for patients with metastatic pancreatic cancer (mPC). However, prognostic factors for patients with mPC treated with AG, are largely unknown. We retrospectively identified prognostic factors, including inflammation-based prognostic scores, in patients with mPC, and recurrent pancreatic cancer treated with AG as first-line treatment. Method A total of 203 patients with histologically-confirmed recurrent or metastatic pancreatic cancer who were treated with first-line AG in Asan Medical Center, Seoul, Korea, between February 2016 and December 2016 were included in this analysis. As inflammation-based scores, baseline neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and modified Glasgow prognostic scores (mGPS) were tested. Result Median age was 62 years and 116 patients (57%) were male. With median follow-up duration of 21.5 months, median progression-free survival (PFS) was 7.1 (95% CI 6.2-7.9) months, and overall survival (OS) was 15.1 (95% CI 12.6-17.6) months. In the multivariate analysis, PFS was significantly associated with liver metastasis (HR 1.43), distant lymph node metastasis (HR 1.48), and elevated CA19-9 (HR 1.56). In multivariate analysis for OS, elevated CA19-9 (HR 1.75), liver metastasis (HR 1.76), distant lymph node metastasis (HR 1.41), and high mGPS (mGPS ≥1 vs.0: HR 1.64) were independent prognostic factors. NLR and PLR were not significantly associated with PFS and OS. Conclusion Among the inflammation based prognostic scores, mGPS was a reliable prognostic indicator that could stratify survival outcomes in patients with recurrent or mPC who received AG as first-line chemotherapy.

7 Article High-grade precursor lesions can be used as surrogate markers to identify the epicenter of periampullary carcinomas. 2019

Jeong, Byung-Kwan / Sung, You Na / Kim, Sung Joo / An, Soyeon / Park, Hosub / Hwang, Hee Sang / Kang, Hyo Jeong / Lee, Jae Hoon / Song, Ki Byung / Kim, Kyu-Pyo / Hwang, Dae Wook / Lee, Sang Soo / Kim, Song Cheol / Hong, Seung-Mo. ·Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea. · Department of Pathology, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, 21431, Republic of Korea. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea. · Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea. Electronic address: smhong28@gmail.com. ·Hum Pathol · Pubmed #30261192.

ABSTRACT: Identifying the accurate origin of periampullary cancers is important because different origins may trigger different clinicopathological behaviors. The presence of intraepithelial precursor lesions, including high-grade pancreatic intraepithelial neoplasias (PanINs) and/or high-grade biliary intraepithelial neoplasias (BilINs), may be suggestive of the origin of the periampullary carcinoma in challenging cases. To prove the usefulness of high-grade intraepithelial precursor lesions in identifying the origin of ambiguous periampullary cancers, the status and grades of PanINs and BilINs were evaluated in 256 periampullary carcinomas with a well-defined cancer origin as a test set, including 114 pancreatic cancers, 82 distal bile duct cancers, 54 ampullary cancers, and 6 duodenal cancers. One hundred twelve periampullary carcinomas with clinically equivocal epicenter either by radiologic imaging or by endoscopic finding used as a validation set. High-grade PanINs were found more commonly in pancreatic cancers than in distal bile duct, ampullary, and duodenal cancers both in test (P = .002) and validation sets (P < .001). Similarly, high-grade BilINs were identified more frequently in distal bile duct cancers than in ampullary, pancreatic, and duodenal cancers both in test (P < .001) and validation sets (P = .039). High-grade PanINs were found most commonly in pancreatic cancers, whereas high-grade BilINs were seen most frequently in distal bile duct cancers. In addition, both high-grade PanINs and high-grade BilINs are uncommonly noted in ampullary or duodenal cancers. The recognition of high-grade intraepithelial lesions can help identify the primary origin of periampullary cancers, especially when the epicenter of the periampullary cancer is ambiguous.

8 Article Nab-paclitaxel plus gemcitabine versus FOLFIRINOX as the first-line chemotherapy for patients with metastatic pancreatic cancer: retrospective analysis. 2018

Kang, Jihoon / Hwang, Inhwan / Yoo, Changhoon / Kim, Kyu-Pyo / Jeong, Jae Ho / Chang, Heung-Moon / Lee, Sang Soo / Park, Do Hyun / Song, Tae Jun / Seo, Dong Wan / Lee, Sung Koo / Kim, Myung-Hwan / Hong, Seung-Mo / Shin, Sang Hyun / Hwang, Dae Wook / Song, Ki Byung / Lee, Jae Hoon / Kim, Song Cheol / Ryoo, Baek-Yeol. ·Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. · Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. yooc@amc.seoul.kr. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. kkp1122@amc.seoul.kr. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. · Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. ·Invest New Drugs · Pubmed #29616439.

ABSTRACT: Purpose nab-paclitaxel plus gemcitabine (AG) and FOLFIRINOX have been established as standard first-line treatment in metastatic pancreatic cancer (mPC). We performed retrospective analysis comparing the efficacies of AG and FOLFIRINOX in daily practice setting. Materials and Methods We analyzed 308 patients who presented initially as mPC and received AG (n = 149) or FOLFIRINOX (n = 159) as first-line treatment between 2013 and 2016. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Result There were no significant differences between the two groups in terms of baseline characteristics, except older age and higher Charlson Comorbidity Index (CCI) score in AG group. The response rates (34% vs 34%) and median PFS (6.8 vs 5.1 months) were comparable between two groups (p = 0.88 and p = 0.19, respectively), while median OS was significantly better with AG than FOLFIRINOX (11.4 vs 9.6 months; p = 0.002). Elevated baseline CA19-9 level and liver metastasis were independent adverse prognostic factors for PFS and OS. In subgroup analyses, PFS with AG was better in patients with age ≥ 65 years, peritoneal metastasis, and higher CCI than that with FOLFIRINOX. Conclusion Both AG and FOLFIRINOX showed comparable efficacy outcomes in daily practice setting. AG might be preferentially considered in patients with peritoneal metastasis, comorbid medical conditions or old age.

9 Article Prognosis of Pancreatic Cancer Patients with Synchronous or Metachronous Malignancies from Other Organs Is Better than Those with Pancreatic Cancer Only. 2018

Shin, Su-Jin / Park, Hosub / Sung, You-Na / Yoo, Changhoon / Hwang, Dae Wook / Park, Jin-Hong / Kim, Kyu-Pyo / Lee, Sang Soo / Ryoo, Baek-Yeol / Seo, Dong-Wan / Kim, Song Cheol / Hong, Seung-Mo. ·Department of Pathology, Hanyang University College of Medicine, Seoul, Korea. · Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ·Cancer Res Treat · Pubmed #29268568.

ABSTRACT: PURPOSE: Pancreatic cancer associated double primary tumors are rare and their clinicopathologic characteristics are not well elucidated. Materials and Methods: Clinicopathologic factors of 1,352 primary pancreatic cancers with or without associated double primary tumors were evaluated. RESULTS: Of resected primary pancreatic cancers, 113 (8.4%) had associated double primary tumors, including 26 stomach, 25 colorectal, 18 lung, and 13 thyroid cancers. The median interval between the diagnoses of pancreatic cancer and associated double primary tumors was 0.5 months. Overall survival (OS) of pancreatic cancer patients with associated double primary tumors was longer than those with pancreatic cancer only (median, 23.1 months vs. 17.0 months, p=0.002). Patients whose pancreatic cancers were resected before the diagnosis of metachronous tumors had a better OS than patients whose pancreatic cancer resected after the diagnosis of metachronous tumors (48.9 months and 13.5 months, p=0.001) or those whose pancreatic cancers were resected synchronously with non-pancreas tumors (19.1 months, p=0.043). The OS of pancreatic cancer patients with stomach (33.9 months, p=0.032) and thyroid (117.8 months, p=0.049) cancers was significantly better than those with pancreas cancer only (17.0 months). CONCLUSION: About 8% of resected pancreatic cancers had associated double primary tumors, and those from the colorectum, stomach, lung, and thyroid were common. Patients whose pancreatic cancer was resected before the diagnosis of metachronous tumors had better OS than those resected after the diagnosis of metachronous tumors or those resected synchronously.

10 Article Germline BRCA mutations in Asian patients with pancreatic adenocarcinoma: a prospective study evaluating risk category for genetic testing. 2018

Lee, Kyoungmin / Yoo, Changhoon / Kim, Kyu-Pyo / Park, Kyoung-Jin / Chang, Heung-Moon / Kim, Tae Won / Lee, Jae-Lyun / Lee, Woochang / Lee, Sang Soo / Park, Do Hyun / Song, Tae Jun / Seo, Dong Wan / Lee, Sung Koo / Kim, Myung-Hwan / Shin, Sang Hyun / Hwang, Dae Wook / Song, Ki Byung / Lee, Jae Hoon / Kim, Song Cheol / Ryoo, Baek-Yeol. ·Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. yooc@amc.seoul.kr. · Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. ryooby@amc.seoul.kr. ·Invest New Drugs · Pubmed #28782087.

ABSTRACT: Introduction Germline BRCA mutations may have therapeutic implications as surrogate markers of DNA-damage repair status in pancreatic ductal adenocarcinoma (PDAC). We performed a prospective study to evaluate the efficiency of risk criteria based on personal or family history of breast and ovarian cancer for determining germline BRCA mutations in PDAC patients with Asian ethnicity. Methods Between November 2015 and May 2016, we screened consecutive PDAC patients with locally advanced unresectable or metastatic disease who were referred for systemic chemotherapy. Analyses for germline BRCA mutations were performed if patients had one or more first-degree or second-degree relatives with breast or ovarian cancers or had a personal medical history of these diseases. DNA was extracted from whole blood, and all coding exons and their flanking intron regions of BRCA1 and BRCA2 were sequenced. Results A total of 175 patients were screened for personal and family history and 10 (5.7%) met the inclusion criteria for genetic sequencing. Pathogenic germline BRCA2 mutation [c.7480C>T (p.Arg2494*)] was identified in one male patient, resulting in a frequency of 10% for the risk-stratified patients and 0.6% for the unselected PDAC population. Two patients had germline BRCA2 variants of uncertain significance [c.1744A>C (p.Thr582Pro) and c.68-7T>A]. Conclusion Personal or family history of breast or ovarian cancers is a feasible, cost-effective risk categorization for screening germline BRCA mutations in Asian PDAC patients as 10% of this population had the pathogenic mutation herein. Future validation from a large, prospective cohort is needed.

11 Article Efficacy and safety of neoadjuvant FOLFIRINOX for borderline resectable pancreatic adenocarcinoma: improved efficacy compared with gemcitabine-based regimen. 2017

Yoo, Changhoon / Kang, Jihoon / Kim, Kyu-Pyo / Lee, Jae-Lyun / Ryoo, Baek-Yeol / Chang, Heung-Moon / Lee, Sang Soo / Park, Do Hyun / Song, Tae Jun / Seo, Dong Wan / Lee, Sung Koo / Kim, Myung-Hwan / Park, Jin-Hong / Hwang, Dae Wook / Song, Ki Byung / Lee, Jae Hoon / Kim, Song Cheol. ·Departments of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ·Oncotarget · Pubmed #28564637.

ABSTRACT: Borderline resectable pancreatic cancer (BRPC) is a potentially resectable disease but is associated with poorer survival compared to primary resectable disease. There has been no prospective trial that compare the efficacy of FOLFIRNOX and gemcitabine-based regimen for BRPC. Between February 2013 and December 2014, 18 patients with BRPC receiving FOLFIRINOX were reviewed retrospectively. For comparative analysis, data for all BRPC patients (n=18) in our previous phase 2 study of neoadjuvant fixed-dose rate-gemcitabine plus capecitabine were pooled. Patients received a median 6 cycles (range, 3-13) of FOLFIRINOX. Surgical resection was performed in 12 patients (67%) and R0 resection in 9 patients. Median progression-free survival (PFS) and overall survival (OS) were 16.8 (95% confidence interval [CI], 9.4-24.2) and 21.2 (95% CI, 14.2-28.2) months, respectively. Patients who underwent surgical resection showed significantly better PFS (p=0.01) and OS (p=0.003) than those unresected. In the exploratory analysis, patients receiving FOLFIRINOX showed significantly longer PFS compared to those receiving fixed-dose rate-gemcitabine plus capecitabine (median 16.8 months [95% CI, 9.4-24.2] vs. 6.5 months [1.6-11.3]; p = 0.04). There was a trend toward improved OS in patients who received FOLFIRINOX (median 21.2 months [95% CI, 14.2-28.2]) compared to those who received fixed-dose rate-gemcitabine plus capecitabine (13.6 months [11.8-15.4]; p=0.12). FOLFIRINOX was feasible and effective as neoadjuvant chemotherapy for patients with BRPC and may have improved efficacy compared to a gemcitabine-based regimen.

12 Article Postoperative Radiotherapy for Pancreatic Cancer with Microscopically-positive Resection Margin. 2017

Park, Sunmin / Kim, Song Cheol / Hong, Seung-Mo / Lee, Young-Joo / Park, Kwang-Min / Hwang, Dae Wook / Lee, Jae Hoon / Song, Ki-Byung / Ryoo, Baek-Yeol / Jang, Heung-Moon / Kim, Kyu-Pyo / Yu, Changhoon / Choi, Eun Kyung / DO Ahn, Seung / Lee, Sang-Wook / Yoon, Sang Min / Park, Jin-Hong / Kim, Jong Hoon. ·Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Medical Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea jpark@amc.seoul.kr. ·Anticancer Res · Pubmed #28179327.

ABSTRACT: AIM: To analyze the outcomes in pancreatic cancer (PC) cases with a microscopically-positive resection margin (R1 resection) treated with postoperative radiotherapy (PORT). PATIENTS AND METHODS: We retrospectively analyzed the outcomes in 62 patients who received PORT for PC with R1 resection between 2001 and 2012. All patients received three-dimensional conformal radiotherapy. Concurrent chemotherapy was administered to 58 patients. RESULTS: The median follow-up was 20.1 months. The median survival was 22.0 months and the 3-year overall survival rate was 25%. The 3-year disease-free survival and local recurrence-free survival rates were 12% and 54%, respectively. Local recurrence occurred in 23 patients (44%), distant failure in 45 (87%), and both in 16 (31%). By multivariate analysis, the postoperative cancer antigen 19-9 (CA19-9) level and adjuvant chemotherapy were independent prognostic factors for survival. CONCLUSION: PORT is associated with a relatively favorable survival outcome in PC with R1 resection. Chemotherapy and postoperative CA19-9 level were significant prognostic factors for survival.

13 Article Efficacy and safety of everolimus and sunitinib in patients with gastroenteropancreatic neuroendocrine tumor. 2017

Yoo, Changhoon / Cho, Hyungwoo / Song, Min Jeong / Hong, Seung-Mo / Kim, Kyu-Pyo / Chang, Heung-Moon / Chae, Heejung / Kim, Tae Won / Hong, Yong Sang / Ryu, Min-Hee / Kang, Yoon-Koo / Kim, Song Cheol / Ryoo, Baek-Yeol. ·Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea. · Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea. ryooby@amc.seoul.kr. ·Cancer Chemother Pharmacol · Pubmed #27942928.

ABSTRACT: PURPOSE: Efficacy of targeted agents, such as everolimus and sunitinib, has been demonstrated in prospective trials on patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Considering the heterogeneous clinicopathological characteristics of neuroendocrine tumors (NETs), evaluation of treatment outcomes in a real-world setting is necessary. METHODS: Clinical records of 44 patients with GEP-NET who were treated with everolimus or sunitinib between March 2007 and October 2014 were retrospectively reviewed. Considering the distinct characteristics of pancreatic NETs (pNETs) and non-pancreatic gastrointestinal NETs (GI-NETs), efficacy analysis was performed separately. RESULTS: Pancreas was the most common primary site (n = 28, 64%), followed by rectum (n = 10, 23%) and stomach (n = 3, 7%). Sunitinib and everolimus were administered in 27 (61%) and 17 (39%) patients, respectively. In patients with pNET, median progression-free survival (PFS) with everolimus and sunitinib was 16.6 months (95% CI 8.0-25.1) and 8.0 months (95% CI 0.0-17.4), respectively (p = 0.51). Among non-pancreatic GI-NET patients, median PFS with everolimus and sunitinib was 14.7 months (95% CI 2.4-27.0) and 1.7 months (95% CI 0.5-3.0), respectively (p = 0.001). Compared to patients treated with everolimus, tumor grade 3 (30 vs. 0%) and history of prior cytotoxic chemotherapy (70 vs. 50%) were more common in patients treated with sunitinib. CONCLUSIONS: Both everolimus and sunitinib were effective in GEP-NET patients. Outcomes of everolimus therapy in GEP-NETs were consistent with those reported elsewhere. Poor efficacy of sunitinib in non-pancreatic GI-NETs may be attributable to the baseline characteristics associated with poor clinical outcomes.

14 Article Efficacy of Chemotherapy in Patients with Unresectable or Metastatic Pancreatic Acinar Cell Carcinoma: Potentially Improved Efficacy with Oxaliplatin-Containing Regimen. 2017

Yoo, Changhoon / Kim, Bum Jun / Kim, Kyu-Pyo / Lee, Jae-Lyun / Kim, Tae Won / Ryoo, Baek-Yeol / Chang, Heung-Moon. ·Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea. ·Cancer Res Treat · Pubmed #27857025.

ABSTRACT: PURPOSE: Pancreatic acinar cell carcinoma (ACC) is a rare cancer of the exocrine pancreas. Because of its rare incidence, the efficacy of chemotherapy in this patient population has been largely unknown. Therefore, we retrospectively analyzed the outcomes of patients with advanced pancreatic ACC who received chemotherapy. MATERIALS AND METHODS: Between January 1997 and March 2015, 15 patients with unresectable or metastatic pancreatic ACC who received systemic chemotherapy were identified in Asan Medical Center, Korea. RESULTS: The median age was 58 years. Eleven and four patients had recurrent/metastatic and locally advanced unresectable disease. The median overall survival in all patients was 20.9 months (95% confidence interval [CI], 15.7 to 26.1). As first-line therapy, intravenous 5-fluorouracil were administered in four patients (27%), gemcitabine in five (33%), gemcitabine plus capecitabine in two (13%), oxaliplatin plus 5-fluorouracil/leucovorin (FOLFOX) in two (13%), and concurrent chemoradiotherapy followed by capecitabine maintenance therapy in two (13%). The objective response rate (ORR) to chemotherapy alone was 23% and the median progression-free survival (PFS) was 5.6 months (95% CI, 2.8 to 8.4). After progression, second-line chemotherapy was administered in eight patients, while four patients received FOLFOX and the other four patients received gemcitabine. The ORR was 38%, and patients administered FOLFOX had significantly better PFS than those administered gemcitabine (median, 6.5 months vs. 1.4 months; p=0.007). The ratio of time to tumor progression (TTP) during first-line chemotherapy to TTP at second-line chemotherapy was significantly higher in patients administered FOLFOX (4.07; range, 0.87 to 8.30) than in those administered gemcitabine (0.12; range, 0.08 to 0.25; p=0.029). CONCLUSION: Our results suggest that oxaliplatin-containing regimens may have improved activity against pancreatic ACC.

15 Article SAHA, an HDAC inhibitor, overcomes erlotinib resistance in human pancreatic cancer cells by modulating E-cadherin. 2016

Park, Seong Joon / Kim, Seung-Mi / Moon, Jai-Hee / Kim, Jeong Hee / Shin, Jae-Sik / Hong, Seung-Woo / Shin, Yu Jin / Lee, Dae-Hee / Lee, Eun Young / Hwang, Ih-Yeon / Kim, Jeong Eun / Kim, Kyu-Pyo / Hong, Yong Sang / Lee, Won-Keun / Choi, Eun Kyung / Lee, Jung Shin / Jin, Dong-Hoon / Kim, Tae Won. ·Innovative Cancer Research, ASAN Institute for Life Science, Asan Medical Center, Seoul, Republic of Korea. · Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. · Department of Biosciences and Bioinformatics, Myongji University, 116 Myongji-ro, Cheoin-gu, Yongin-si, Gyeonggi-do, 449-728, Republic of Korea. · Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. · Innovative Cancer Research, ASAN Institute for Life Science, Asan Medical Center, Seoul, Republic of Korea. inno183@amc.seoul.kr. · Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. inno183@amc.seoul.kr. · Department of Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. inno183@amc.seoul.kr. · Innovative Cancer Research, ASAN Institute for Life Science, Asan Medical Center, Seoul, Republic of Korea. twkimmd@amc.seoul.kr. · Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. twkimmd@amc.seoul.kr. ·Tumour Biol · Pubmed #26493999.

ABSTRACT: Pancreatic cancer is one of the most lethal cancers and remains a major unsolved health problem. Less than 20 % of patients are surgical candidates, and the median survival for non-resected patients is approximately 3 to 4 months. Despite the existence of many conventional cancer therapies, few targeted therapies have been developed for pancreatic cancer. Combination therapy using erlotinib and gemcitabine is an approved standard chemotherapy for advanced pancreatic cancer, but it has marginal therapeutic benefit. To try to improve the therapeutic outlook, we studied the efficacy of another combination treatment and the relevance to E-cadherin in human pancreatic cancer cells. We treated two human pancreatic cancer cell lines with the histone deacetylase inhibitor (HDACi) SAHA. Interestingly, in these Panc-1 and Capan1 cells, we observed that the expression levels of E-cadherin and phosphorylated EGFR were gradually upregulated after treatment with SAHA. Furthermore, these cells underwent induced cell death after exposure to the combination treatment of SAHA and erlotinib. In Panc-1 cells, overexpression of E-cadherin activated the phosphorylation of EGFR and increased the cell sensitivity to erlotinib. In Capan1 cells, knocking down E-cadherin decreased the expression of phosphorylated EGFR, and these cells did not respond to erlotinib. Therefore, we demonstrated the efficacy of the combined treatment with SAHA and erlotinib in human pancreatic cancer cells, and we determined that the increased efficacy was due, at least in part, to the effects of SAHA on the expression of E-cadherin. Our studies suggest that E-cadherin may be a potent biomarker for pancreatic cancer.

16 Article 1-Pamitoyl-2-Linoleoyl-3-Acetyl-rac-Glycerol May Reduce Incidence of Gemcitabine-Induced Neutropenia: A Pilot Case-Controlled Study. 2015

Oh, Dongwook / Kim, Myung-Hwan / Song, Tae Jun / Cho, Charles J / Nam, Kwangwoo / Cho, Min Keun / Chun, Joo Hyun / Jung, Kyoungwon / Kim, Kyu-Pyo / Kim, Jae Wha. ·Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. · Division of Oncology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. · Biomedical Translational Research Center, Korea Research Institute of Bioscience and Biotechnology, Deajeon, Korea. ·World J Oncol · Pubmed #28983339.

ABSTRACT: BACKGROUND: Chemotherapy-induced neutropenia (CIN) may compromise planned chemotherapy, resulting in severe infection, dose reduction or delayed treatment. Orally administered 1-pamitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG) is a synthetic monoacetyldiglyceride, a product found in the antlers of sika deer. The aim of this study was to evaluate the effectiveness of PLAG for the prevention of CIN. METHODS: A total of 48 patients with unresectable pancreatic cancer received gemcitabine-based palliative chemotherapy. Among those patients, 16 patients received PLAG (500 mg) twice daily from the start of chemotherapy to the completion. RESULTS: The PLAG group showed a significantly lower incidence of neutropenia (absolute neutrophil count < 1,500 cells/mm CONCLUSIONS: PLAG was shown to be clinically effective and safe in reducing the incidence of CIN in pancreatic cancer patients receiving gemcitabine-based chemotherapy.

17 Article A novel small-molecule IAP antagonist, AZD5582, draws Mcl-1 down-regulation for induction of apoptosis through targeting of cIAP1 and XIAP in human pancreatic cancer. 2015

Moon, Jai-Hee / Shin, Jae-Sik / Hong, Seung-Woo / Jung, Soo-A / Hwang, Ih-Yeon / Kim, Jeong Hee / Choi, Eun Kyoung / Ha, Seung-Hee / Kim, Jin-Sun / Kim, Kyoung-Mok / Hong, Dae-Won / Kim, Daejin / Kim, Yeong Seok / Kim, Jeong Eun / Kim, Kyu-Pyo / Hong, Yong Sang / Choi, Eun Kyung / Lee, Jung Shin / Hattersley, Maureen / Jin, Dong-Hoon / Kim, Tae Won. ·Innovative Cancer Research, Asan Institute for Life Science, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Republic of Korea. · Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Republic of Korea. · Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Republic of Korea. · University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Anatomy, Inje University College of Medicine, Busanjin-ku, Busan, Republic of Korea. · Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Republic of Korea. · Oncology iMed, Innovative Medicines & Early Development, AstraZeneca R&D Boston, Waltham, Massachusetts, USA. · Department of Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Republic of Korea. ·Oncotarget · Pubmed #26314849.

ABSTRACT: Inhibitor of apoptosis proteins (IAPs) plays an important role in controlling cancer cell survival. IAPs have therefore attracted considerable attention as potential targets in anticancer therapy. In this study, we investigated the anti-tumor effect of AZD5582, a novel small-molecule IAP inhibitor, in human pancreatic cancer cells. Treating human pancreatic cancer cells with AZD5582 differentially induced apoptosis, dependent on the expression of p-Akt and p-XIAP. Moreover, the knockdown of endogenous Akt or XIAP via RNA interference in pancreatic cancer cells, which are resistant to AZD5582, resulted in increased sensitivity to AZD5582, whereas ectopically expressing Akt or XIAP led to resistance to AZD5582. Additionally, AZD5582 targeted cIAP1 to induce TNF-α-induced apoptosis. More importantly, AZD5582 induced a decrease of Mcl-1 protein, a member of the Bcl-2 family, but not that of Bcl-2 and Bcl-xL. Interestingly, ectopically expressing XIAP and cIAP1 inhibited the AZD5582-induced decrease of Mcl-1 protein, which suggests that AZD5582 elicits Mcl-1 decrease for apoptosis induction by targeting of XIAP and cIAP1. Taken together, these results indicate that sensitivity to AZD5582 is determined by p-Akt-inducible XIAP phosphorylation and by targeting cIAP1. Furthermore, Mcl-1 in pancreatic cancer may act as a potent marker to analyze the therapeutic effects of AZD5582.

18 Article Initial human experience of endoscopic ultrasound-guided photodynamic therapy with a novel photosensitizer and a flexible laser-light catheter. 2015

Choi, Jun-Ho / Oh, Dongwook / Lee, Jae Hoon / Park, Jin-Hong / Kim, Kyu-Pyo / Lee, Seung Soo / Lee, Young-Joo / Lim, Young-Suk / Song, Tae Jun / Lee, Sang Soo / Seo, Dong-Wan / Lee, Sung Koo / Kim, Myung-Hwan / Park, Do Hyun. ·Division of Gastroenterology, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, South Korea. · Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Department of Hepato-biliary and Pancreatic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. ·Endoscopy · Pubmed #26070006.

ABSTRACT: BACKGROUND AND STUDY AIMS: New methods for the endoscopic selective ablation of locally advanced pancreaticobiliary malignancies as a minimally invasive approach are needed. Our aim was to examine the feasibility and safety of endoscopic ultrasonography (EUS)-guided photodynamic therapy (PDT) for local tumor control in patients with locally advanced pancreaticobiliary malignancies. PATIENTS AND METHODS: A chlorin e6 derivative and a flexible laser-light catheter were used to perform EUS-guided PDT in four patients with locally advanced pancreaticobiliary malignancies. RESULTS: EUS-guided PDT was technically feasible in all four patients with locally advanced pancreaticobiliary malignancies (two in the caudate lobe of the liver, one in the far distal bile duct, and one in the tail of the pancreas). No treatment-related complications occurred. The median volume of necrosis produced by PDT was 4.0 cm(3) (range 0.7 - 11.3). Disease remained stable in all four patients during a median follow-up of 5 months (range 3 - 7). CONCLUSION: These preliminary data suggest that EUS-guided PDT with a second-generation photosensitizer and a flexible laser probe is feasible and safe.

19 Article Clinicopathologic and prognostic significance of multiple hormone expression in pancreatic neuroendocrine tumors. 2015

Kim, Joo Young / Kim, Min-Sun / Kim, Ki-Suk / Song, Ki-Byung / Lee, Seung Hun / Hwang, Dae Wook / Kim, Kyu-Pyo / Kim, Hyoung Jung / Yu, Eunsil / Kim, Song Cheol / Jang, Hyeung-Jin / Hong, Seung-Mo. ·Departments of *Pathology **Radiology Divisions of ∥Hepatobiliary and Pancreas Surgery ¶Endocrinology and Metabolism #Oncology, Asan Medical Center, University of Ulsan College of Medicine ‡Asan Institute for Life Science, Asan Medical Center †Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine §Department of Biochemistry, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea. ·Am J Surg Pathol · Pubmed #25602797.

ABSTRACT: Pancreatic neuroendocrine tumors (PanNETs) produce variable peptide hormones. The expression status of some hormones has been linked to the biological and clinical behaviors of PanNETs. A total of 226 surgically resected PanNETs were selected. Immunolabeling for peptide hormones was compared with various clinicopathologic factors, including patient survival. Expression of insulin, glucagon-like peptide 1, glucagon, gastrin, somatostatin, and serotonin were observed in 56 (24.8%), 41 (18.1%), 25 (11.1%), 5 (2.2%), 5 (2.2%), and 4 (1.8%) cases, respectively. Expression of 1, 2, and 3 hormones was noted in 70 (31.0%), 28 (12.4%), and 3 (1.3%) cases, respectively; 125 cases (55.3%) were negative for all hormones. PanNETs with insulin and glucagon-like peptide 1 expression were associated with a lower grade, smaller size, lower pT and pN classifications, absence of lymphovascular invasion, and lymph node metastasis and had better survival by univariate analysis, whereas PanNETs with gastrin expression were associated with a higher grade, larger size, higher pT and pN classifications, presence of lymphovascular invasion, and lymph node metastasis and had worse survival. Gastrin expression, increased age, and tumor grade were negative prognostic factors in multivariate analysis. As the number of hormones expressed increased, the survival rate of PanNET patients increased. In summary, PanNET patients showing insulin or glucagon-like peptide 1 expression and increased numbers of expressed hormones had a better survival outcome by univariate analysis, whereas gastrin expression was a negative prognostic indicator in surgically resected PanNET patients.

20 Article Survival effect of tumor size and extrapancreatic extension in surgically resected pancreatic cancer: proposal for improved T classification. 2014

Park, Hosub / An, Soyeon / Eo, Soo-Heang / Song, Ki-Byung / Park, Jin-hong / Kim, Kyu-pyo / Lee, Sang Soo / Cho, HyungJun / Seo, Dong-Wan / Kim, Song Cheol / Yu, Eunsil / Hong, Seung-Mo. ·Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea. · Department of Statistics, Korea University, Seoul, 136-701, Republic of Korea. · Department of Hepatobiliary and Pancreatic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea. · Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea. · Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea. Electronic address: smhong28@gmail.com. ·Hum Pathol · Pubmed #25248573.

ABSTRACT: The T classification for pancreatic cancer of the American Joint Committee on Cancer may be inaccurate owing to lack of consideration of tumor size in cases of extension beyond the pancreas. To examine the accuracy of American Joint Committee on Cancer staging and to determine the prognostic implication of combined tumor size and extrapancreatic extension, 6145 cases of pancreatic ductal adenocarcinomas from the Surveillance, Epidemiology, and End Results database were categorized according to tumor size and extension as follows: group 1 (G1, ≤2 cm and limited to the pancreas), G2 (>2 cm and limited to the pancreas), G3 (≤2 cm with extrapancreatic extension), and G4 (>2 cm with extrapancreatic extension). The median survival of G1, G2, G3, and G4 were 23, 15, 19, and 14 months, respectively (P < .001), and the survival time in G3 was closer to that of G2 than G4. To test the classification system for accuracy of prognosis, G3 was merged with G2. The survival discrimination of this new grouping was greater (overall comparison, P < .001; G1 versus G2 + G3, P < .001; G2 + G3 versus G4, P < .001; χ(2) = 92.043) than that of the current T-classification scheme (overall comparison, P < .001; G1 versus G2, P < .001; G2 versus G3 + G4, P = .048; χ(2) = 60.424). To better discriminate survival, patients with a tumor less than or equal to 2 cm extending beyond the pancreas should be downstaged from the current class T3 to class T2.

21 Article Primary mesenchymal tumors of the pancreas: single-center experience over 16 years. 2014

Kim, Joo Young / Song, Joon Seon / Park, Hosub / Byun, Jae Ho / Song, Ki-Byung / Kim, Kyu-Pyo / Kim, Song Cheol / Hong, Seung-Mo. ·From the Departments of *Pathology, †Radiology, ‡Hepatobiliary and Pancreas Surgery, and §Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ·Pancreas · Pubmed #24743377.

ABSTRACT: OBJECTIVE: Primary mesenchymal tumors of the pancreas are extremely rare and no comprehensive study of this class of tumors has been previously performed. METHODS: Twenty cases of the primary mesenchymal tumors of the pancreas were selected and compared clinicopathologic variables with consecutively resected 500 pancreatic ductal adenocarcinomas. RESULTS: Finally, 20 (0.3%) cases were confirmed as primary mesenchymal tumors. The 14 (70%) cases of benign/borderline tumors included 4 cases of fibromatoses, 2 cases of cavernous hemangiomas, 2 cases of schwannomas, 2 cases of solid and cystic hamartomas, 2 cases of solitary fibrous tumors, 1 case of inflammatory myofibroblastic tumor, and 1 case of angiomyolipoma. The 6 (30%) cases of sarcomas comprised 3 cases of undifferentiated/unclassified sarcomas, 1 case of leiomyosarcoma, 1 case of Ewing sarcoma/primitive neuroectodermal tumor, and 1 case of atypical lipomatous tumor/well-differentiated liposarcoma. When compared with the 500 ductal adenocarcinomas, the 3 surgically resected sarcomas were larger (mean, 5.8 cm vs 3.6 cm; P = 0.02); however, no difference in median survival time was observed between patients with sarcoma (23 months) and patients with ductal adenocarcinoma (16 months). CONCLUSIONS: First, primary mesenchymal tumors of the pancreas are extremely rare. Second, several primary mesenchymal tumor types can be observed in the pancreas. Understanding these rare disease entities will help ensure their correct diagnosis.

22 Article The survivin suppressant YM155 potentiates chemosensitivity to gemcitabine in the human pancreatic cancer cell line MiaPaCa-2. 2012

Yoon, Dok Hyun / Shin, Jae-Sik / Jin, Dong-Hoon / Hong, Seung-Woo / Jung, Kyung A / Kim, Seung-Mi / Hong, Yong Sang / Kim, Kyu-Pyo / Lee, Jae-Lyun / Suh, Cheolwon / Lee, Jung Shin / Kim, Tae Won. ·Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ·Anticancer Res · Pubmed #22593446.

ABSTRACT: BACKGROUND: Survivin is a negative regulator of apoptosis. We evaluated the efficacy of YM155, a selective suppressant of survivin, in combination with gemcitabine in the pancreatic cancer cell line MiaPaCa-2. MATERIALS AND METHODS: Expression of survivin was demonstrated by immunoblotting. Cell cycle progression was determined by flow cytometric analysis. Cell viability was assayed using the trypan blue exclusion assay. RESULTS: Gemcitabine up-regulated survivin expression, whereas treatment with YM155 suppressed the expression of survivin. Concomitant treatment with YM155 enhanced chemosensitivity to gemcitabine, which was accompanied by a decrease in the expression of survivin. Knockdown of endogenous survivin via RNA interference also enhanced the sensitivity to gemcitabine. In addition, YM155 potentiated the antitumor effect of gemcitabine in xenograft tumors of MiaPaCa-2. CONCLUSION: YM155 potentiates chemosensitivity to gemcitabine in pancreatic cancer cells by suppressing the induction of survivin. Combination treatment with gemcitabine and YM155 may be a potential therapeutic strategy for the treatment of pancreatic cancer that warrants further clinical investigation.