PIK3CA Mutation is Associated with Poor Response to HER2-Targeted Therapy in Breast Cancer Patients / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Mutations in the PIK3CA gene occur frequently in breast cancer patients. Activating PIK3CA mutations confer resistance to human epidermal growth factor receptor 2 (HER2)-targeted treatments. In this study, we investigated whether PIK3CA mutations were correlated with treatment response or duration in patients with HER2-positive (HER2+) breast cancer. @*Materials and Methods@#We retrospectively reviewed the clinical information of patients with HER2+ breast cancer who received HER2-targeted therapy for early-stage or metastatic cancers. The pathologic complete response (pCR), progression-free survival (PFS), and overall survival were compared between patients with wild-type PIK3CA (PIK3CAw) and those with mutated PIK3CA (PIK3CAm). Next-generation sequencing was combined with examination of PFS associated with anti-HER2 monoclonal antibody (mAb) treatment. @*Results@#Data from 90 patients with HER2+ breast cancer were analyzed. Overall, 34 (37.8%) patients had pathogenic PIK3CA mutations. The pCR rate of the PIK3CAm group was lower than that of the PIK3CAw group among patients who received neoadjuvant chemotherapy for early-stage cancer. In the metastatic setting, the PIK3CAm group showed a significantly shorter mean PFS (mPFS) with first-line anti-HER2 mAb. The mPFS of second-line T-DM1 was lower in the PIK3CAm group than that in the PIK3CAw group. Sequencing revealed differences in the mutational landscape between PIK3CAm and PIK3CAw tumors. @*Conclusion@#Patients with HER2+ breast cancer with activating PIK3CA mutations had lower pCR rates and shorter PFS with palliative HER2-targeted therapy than those with wild-type PIK3CA. Precise targeted-therapy is needed to improve survival of patients with HER2+/PIK3CAm breast cancer.

Efficacy of Lumbar Segmental Stabilization Exercises and Breathing Exercises on Segmental Stabilization in Lumbar Instability Patients

PURPOSE: The aim of this study was to determine the effectiveness of breathing exercises and lumbar segmental exercises on the segmental stability of patients with chronic back pain. METHODS: Fifty-nine patients, who suffered from chronic low back pain, were enrolled in this examination. They were divided randomly into three groups: experiment group 1 underwent breathing and segmental stabilization exercises (n=20), experiment group 2 experienced segmental stabilization exercises (n=20), and the control group was given the modality treatment (n=19). The measurements were assessed through an Oswestry disability questionnaire (ODQ), as well as a lumbar segmental instability test (LSIT). RESULTS: The ODQ results for experimental groups 1 and 2 were similar (p 0.05). The differences in segmental instability of each of the three groups were similar (p < 0.05), and also similar among the three groups (p < 0.05). CONCLUSION: These findings suggest that lumbar segmental stabilization exercises are efficient in increasing the segmental stability and alleviating pain in patients with chronic back pain. Additional studies on this subject will be needed to improve the clinical applications in the future.

The Effects of High Dose Rate Brachytherapy in Recurrent Obstructive Bronchogenic Cancer after External Irradiation Therapy / 결핵

BACKGROUND: Patients with centrally recurred bronchogenic carcinoma make a complaint of many symptoms like hemoptysis, cough & dyspnea. At these conditions, the goal of treatment is only to relieve their symptoms. High dose rate brachytherapy(HDR-BT) is the palliative treatment modality of centrally located endobronchial tumor regardless of previous external irradiation(XRT) on the same site in symptomatic patients. METHOD: We studied the effects of HDR-BT in 26 patients with symptomatic recurrent lung cancer. Patients(male: 24, mean age: 54yrs)were treated with HDR-BT underwent bronchoscopic placement of 192Ir HDR after loading unit(Gammamed(R), Germany) to deliver 500cGY intraluminal irradiation at a depth of 1cm every 1wk on 3 occasions. Evaluation at base line and 4wks after HDR brachytherapy included chest X-ray, bronchscopy, symptoms (Standadized Scale for dyspnea, cough, hemoptysis), and Karnofsky performance scale. RESULTS: Endobronchial obstruction was improved in 11/26 patients(37%). Atelectasis in chest X-ray was improved in 5/15 patients(33%). Hemoptysis, dyspnea & cough were improved in 5/10 patients (50%), 5/8 patients (62%) & 10/18 patients (56%) respectively. Karnofsky performance status was changed from 76.4 scores in pretreatment to 77.6 scores after treatment. During HDR-BT, massive hemoptysis (2 patients) and pneumothorax(1 patient) were occurred as complications. CONCLUSION: We concluded that HDR-BT gave additional benefits for the control of symptoms and general performance and endobronchial obstruction & atelectasis. And HDR-BT will be an additional treatment for the recurrent and endobronchial obstructive lung cancer.