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전신적인 피부병변으로 발현한 모세포성 NK세포 림프종 1예
이근욱,윤탁,김동완,김태유,허대석,박영주,김노경 대한내과학회 2004 대한내과학회지 Vol.66 No.4
저자들은 다른 장기의 침범 없이 전신적인 피부 병변만으로 발현한 모세포성 NK세포 림프종 1예를 국내에서 처음으로 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다. Reports of blastic natural killer (NK)-cell lymphoma are rare. In previous reports, primary cutaneous blastic NK-cell lymphomas were even rarer. In asian patients, most CD56+ lymphomas are classified as nasal type extranodal NK/T-cell lymphoma and mostly associated with the presence of Epstein-Barr virus (EBV) and have an aggressive clinical course. Few cases of blastic NK-cell lymphoma were reported previously in Korea but there was report about blastic NK-cell lymphoma initially presented as disseminated skin lesions without any other organ involvement. We report such a young patient who was treated by systemic chemotherapy.
간 및 자궁에 전이된 췌장의 Somatostatinoma
김태유,박영이,임영혁,허대석,방영주,김노경,김선희,김철우 대한내과학회 1993 대한내과학회지 Vol.44 No.5
저자등은 췌장 부위의 종양과 간과 자궁으로의 전이가 있으면서, 일반적인 췌담관계의 악성 종양과는 다른 임상경과를 갖고, 면역 화학적 조직 검사와 혈장 somatostatin의 측정으로 입증된 somatostatinoma 1예를 경험하여 보고하는 바이다. Somatostatinoma, a rare endocrine tumor, is characterized by diarrhea, steatorrhea, diagetes, and cholelithiasis due to excessive production of somatostatin. We report a case of a 32-year-old woman with pancreatic somatostatinoma that methastasized to the liver and uterus. The patient first presented with jaundice and diarrhea, and subsequently ascites and vaginal bleeding. The diagnosis was made by the pathologic examination, immunohistochemistry, and elevated plasma level of somatostatin. The patient was transiently improved with recombinant γ-interferon therapy.
Bang, Yung-Jue,Cho, Jae Yong,Kim, Yeul Hong,Kim, Jin Won,Di Bartolomeo, Maria,Ajani, Jaffer A.,Yamaguchi, Kensei,Balogh, Agnes,Sanchez, Teresa,Moehler, Markus American Association for Cancer Research 2017 Clinical Cancer Research Vol.23 No.19
<P><B>Purpose:</B> Ipilimumab, a monoclonal antibody that blocks cytotoxic T-lymphocyte–associated protein-4 interactions, enhances T-cell activation and promotes tumor immunity. This phase II study evaluated the safety and efficacy of ipilimumab monotherapy versus best supportive care (BSC) among patients with advanced/metastatic gastric or gastroesophageal junction cancer who achieved at least stable disease with first-line chemotherapy.</P><P><B>Experimental Design:</B> Eligible patients were randomized to ipilimumab 10 mg/kg every 3 weeks for four doses, then 10 mg/kg every 12 weeks for up to 3 years, or BSC, which could include continuation of fluoropyrimidine until progression or toxicity. The primary endpoint was immune-related progression-free survival (irPFS); secondary endpoints included PFS by modified World Health Organization criteria and overall survival (OS).</P><P><B>Results:</B> Of 143 patients screened, 57 were randomized to each arm. irPFS with ipilimumab versus BSC was not improved [2.92 months, 95% confidence interval (CI), 1.61–5.16 vs. 4.90 months, 95% CI, 3.45–6.54, HR = 1.44; 80% CI, 1.09–1.91; <I>P</I> = 0.097], resulting in study cessation. At study closeout, which occurred 8 months after the interim analysis, the median OS durations were 12.7 months (95% CI, 10.5–18.9) and 12.1 months (95% CI, 9.3–not estimable), respectively. Grade 3/4 treatment-related adverse events occurred in 23% of ipilimumab-treated patients, in whom diarrhea (9%) and fatigue (5%) were most frequent, and in 9% of active BSC-treated patients.</P><P><B>Conclusions:</B> Although ipilimumab at 10 mg/kg was manageable, it did not improve irPFS versus BSC. However, comparable median OS of approximately 1 year and a favorable safety profile support the investigation of ipilimumab in combination with other therapies for advanced gastric cancer. <I>Clin Cancer Res; 23(19); 5671–8. ©2017 AACR</I>.</P>
Phase II study of sunitinib as second-line treatment for advanced gastric cancer
Bang, Yung-Jue,Kang, Yoon-Koo,Kang, Won K.,Boku, Narikazu,Chung, Hyun C.,Chen, Jen-Shi,Doi, Toshihiko,Sun, Yan,Shen, Lin,Qin, Shukui,Ng, Wai-Tong,Tursi, Jennifer M.,Lechuga, Maria J.,Lu, Dongrui Ray,R Springer US 2011 Investigational new drugs Vol.29 No.6
<P><B>Summary</B></P><P><I>Purpose.</I> This phase II, open-label, multicenter study assessed the oral, multitargeted, tyrosine kinase inhibitor sunitinib in patients with advanced gastric or gastroesophageal junction adenocarcinoma who had received prior chemotherapy. <I>Experimental design</I>. Patients received sunitinib 50 mg/day on Schedule 4/2 (4 weeks on treatment, followed by 2 weeks off treatment). The primary endpoint was objective response rate; secondary endpoints included clinical benefit rate, duration of response, progression-free survival (PFS), overall survival (OS), pharmacokinetics, pharmacodynamics, safety and tolerability, and quality of life. <I>Results</I>. Of 78 patients enrolled, most had gastric adenocarcinoma (93.6%) and metastatic disease (93.6%). All were evaluable for safety and efficacy. Two patients (2.6%) had partial responses and 25 patients (32.1%) had a best response of stable disease for ≥6 weeks. Median PFS was 2.3 months (95% confidence interval [CI], 1.6–2.6 months) and median OS was 6.8 months (95% CI, 4.4–9.6 months). Grade ≥3 thrombocytopenia and neutropenia were reported in 34.6% and 29.4% of patients, respectively, and the most common non-hematologic adverse events were fatigue, anorexia, nausea, diarrhea, and stomatitis. Pharmacokinetics of sunitinib and its active metabolite were consistent with previous reports. There were no marked associations between baseline soluble protein levels, or changes from baseline, and measures of clinical outcome. <I>Conclusions</I>. The progression-delaying effect and manageable toxicity observed with sunitinib in this study suggest that although single-agent sunitinib has insufficient clinical value as second-line treatment for advanced gastric cancer, its role in combination with chemotherapy merits further study.</P>