Publications by authors named "Keun Seok Lee"

Introduction: Infertility resulting from cancer treatment is known to be a major factor that reduces the quality of life of young cancer survivors. However, discussions and decision-making about fertility preservation before cancer treatment have been insufficient owing to barriers in the clinical field. In addition, selecting a fertility preservation option requires a complex decision-making process that considers not only medical information but also the patient's values and preferences.

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Triple-negative breast cancer (TNBC) is an aggressive subtype with poor prognosis, especially in patients with residual disease post-neoadjuvant chemotherapy. This phase II MIRINAE trial (KCSG-BR18-21) evaluates the efficacy and safety of atezolizumab combined with capecitabine versus capecitabine monotherapy as adjuvant treatment in TNBC patients with residual invasive cancer. The primary endpoint is the 5-year invasive disease-free survival (IDFS) rate.

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Background: Neoadjuvant chemotherapy (NAC) leads to a nodal pathologic complete response (pCR) in approximately 70% of breast cancer patients, especially in human epidermal growth factor receptor 2 (HER2)-positive and triple-negative subtypes. However, sentinel lymph node (SLN)-mapping after NAC remains challenging due to lower identification and higher false-negative rates compared with early-stage breast cancer. This study aimed to evaluate the efficacy of a multimodal SLN-mapping approach after NAC.

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Background: The phase 2 randomised Young-PEARL study demonstrated that palbociclib plus exemestane with ovarian function suppression significantly prolonged progression-free survival compared with capecitabine in premenopausal women with hormone receptor-positive, HER2-negative metastatic breast cancer. Here, we report results of the protocol-specified secondary endpoint of overall survival.

Methods: Young-PEARL was a multicentre, randomised, open-label, phase 2 study conducted at 14 institutions in South Korea.

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Article Synopsis
  • A phase II trial was conducted to evaluate the effectiveness of combining letrozole (an endocrine therapy) with traditional chemotherapy in women with untreated stage II or III HR-positive, HER2-negative breast cancer.
  • Out of 53 patients, only 2 (4%) achieved a pathologic complete response (pCR), which was below the necessary threshold to continue the trial, though the overall response rate was high at 83%.
  • The treatment was deemed safe, with a 3-year disease-free survival rate of 87% and no deaths during treatment, but it did not significantly improve pCR rates, indicating the need for further research on neoadjuvant therapies for this cancer type.
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  • The DESTINY-Breast04 study found that trastuzumab deruxtecan (T-DXd) significantly improved progression-free survival (PFS) and overall survival (OS) compared to the treatment of physician's choice (TPC) in patients with HER2-low metastatic breast cancer who had undergone prior chemotherapy.
  • In a subgroup analysis involving 213 Asian patients, T-DXd showed a median PFS of 10.9 months compared to 5.3 months for TPC, with higher objective response rates and longer treatment durations.
  • The safety profile of T-DXd was manageable, with common side effects being neutropenia, anemia, and leukopenia, while serious lung issues were relatively
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Background: After neoadjuvant chemotherapy (NAC), the SLN identification rate is lower and has a higher false-negative rate than that at upfront surgery. This clinical trial aimed to confirm the effectiveness of sentinel lymph node (SLN) surgery by determining the lymph node identification rate using multimodal SLN marker methods in patients with advanced breast cancer undergoing NAC.

Patients And Methods: This clinical study is a prospective single-center randomized controlled trial involving patients with breast cancer receiving NAC.

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  • The effectiveness of pembrolizumab, a cancer treatment, increases with higher levels of PD-L1 expression in patients with previously treated metastatic triple-negative breast cancer (mTNBC), as shown in the KEYNOTE-119 study.
  • An exploratory analysis evaluated different scoring methods for PD-L1 expression, including combined positive score (CPS), tumor proportion score (TPS), and calculated immune cell density (CID), to see how well they predict clinical outcomes with pembrolizumab.
  • Results indicate that CPS, which includes both immune and tumor cell PD-L1 expression, is a reliable method for predicting treatment response and could enhance treatment decision-making for mTNBC and potentially other cancer types.
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Purpose: The OlympiA randomized phase III trial compared 1 year of olaparib (OL) or placebo (PL) as adjuvant therapy in patients with germline , high-risk human epidermal growth factor receptor 2-negative early breast cancer after completing (neo)adjuvant chemotherapy ([N]ACT), surgery, and radiotherapy. The patient-reported outcome primary hypothesis was that OL-treated patients may experience greater fatigue during treatment.

Methods: Data were collected before random assignment, and at 6, 12, 18, and 24 months.

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Purpose: This study aimed to investigate clinical practices and factors related to the outcomes of T-DM1 use in patients with HER2-positive metastatic breast cancer (mBC).

Methods: We included patients with HER2-positive mBC who received T-DM1 as a palliative therapy between August 2017 and December 2018. The safety and outcomes of T-DM1, including overall response rate (ORR), progression-free survival (PFS), and overall survival (OS), were evaluated.

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  • Metastatic breast cancer patients who don't respond to standard treatments need better therapies, so a phase II trial tested pemetrexed combined with vinorelbine against vinorelbine alone.
  • The trial involved 125 patients across 17 centers in Korea, and results showed that the combination significantly extended progression-free survival (PFS) compared to vinorelbine alone (5.7 months vs. 1.5 months).
  • While the combination therapy improved disease control, it did lead to a higher occurrence of anemia, although severe neutropenia rates were similar in both treatment groups.
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Background: In KEYNOTE-119 (ClinicalTrials.gov, NCT02555657), overall survival (primary end-point) was similar between pembrolizumab and chemotherapy in patients with previously treated metastatic triple-negative breast cancer (TNBC), although the pembrolizumab treatment effect increased with tumour PD-L1 expression. We report results of prespecified health-related quality of life (HRQoL) analyses from KEYNOTE-119.

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Oncotype DX (ODX), a 21-gene assay, predicts the recurrence risk in early breast cancer; however, it has high costs and long testing times. We aimed to identify clinicopathological factors that can predict the ODX risk group and serve as alternatives to the ODX test. This retrospective study included 547 estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and lymph node-negative breast cancer patients who underwent ODX testing.

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PF-06804103 is an anti-HER2 antibody-drug conjugate with auristatin payload. We evaluated its safety, tolerability, and antitumor activity in patients with advanced/unresectable or metastatic breast and gastric cancers. This multicenter, open-label, first-in-human, phase 1 study (NCT03284723) comprised dose escalation (P1) and dose expansion (P2).

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Improving the prognosis for patients with metastatic HR+/HER2- breast cancer remains an unmet need. Patients with tumors that have progressed on endocrine therapy and/or are not eligible for endocrine therapy had limited treatment options beyond chemotherapy. Antibody-drug conjugates are a novel and promising treatment class in this setting.

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Purpose: This study aimed to determine the risk factors for palbociclib-induced grade 4 or grade 3 neutropenia (NP) requiring dose reduction or delayed treatment in patients with HR+/HER2-metastatic breast cancer in the first 3 cycles (early grade 3/4 NP) and whether the early developing grade 3/4 NP affects progression-free survival.

Methods: A retrospective study using electronic medical records was conducted on patients who received palbociclib for metastatic breast cancer between January 2018 and August 2022. The early grade 3/4 NP risk factors were evaluated with univariate and multivariable logistic regression analyses.

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Purpose: Patient-derived tumor cells can be a powerful resource for studying pathophysiological mechanisms and developing robust strategies for precision medicine. However, establishing organoids from patient-derived cells is challenging because of limited access to tissue specimens. Therefore, we aimed to establish organoids from malignant ascites and pleural effusions.

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Background: We have reported that serum progranulin (PGRN) levels are clinically significant in predicting recurrence in patients with HR-positive breast cancer. The aim of the present study was to examine whether PGRN levels might be associated with breast cancer mortality.

Methods: This was a cohort study of 695 newly diagnosed breast cancer patients who underwent curative surgery between 2001 and 2004.

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Purpose: Several previous studies and case reports have reported ethanol-induced symptoms in patients receiving anticancer drugs containing ethanol. Most docetaxel formulations contain ethanol as a solvent. However, there are insufficient data on ethanol-induced symptoms when docetaxel-containing ethanol is administered.

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Purpose: We investigated the consistent efficacy and safety of eflapegrastim, a novel long-acting granulocyte-colony stimulating factor (G-CSF), in Koreans and Asians compared with the pooled population of two global phase 3 trials.

Materials And Methods: Two phase 3 trials (ADVANCE and RECOVER) evaluated the efficacy and safety of fixed-dose eflapegrastim (13.2 mg/0.

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Purpose: This single-arm phase II trial investigate the efficacy and safety of S-1 plus oxaliplatin (SOX) in patients with metastatic breast cancer.

Materials And Methods: Patients with metastatic breast cancer previously treated with anthracyclines and taxanes were enrolled. Patients received S-1 (40-60 mg depending on patient's body surface area, twice a day, day 1-14) and oxaliplatin (130 mg/m2, day 1) in 3 weeks cycle until disease progression or unacceptable toxicity.

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Purpose: This study investigated pathological complete response (pCR) according to androgen receptor (AR) in breast cancer patients undergoing neoadjuvant chemotherapy and estimated the relationship between AR expression and clinicopathological factors.

Materials And Methods: We identified 624 breast cancer patients who underwent surgery after neoadjuvant chemotherapy at the National Cancer Center in Goyang, Korea from April 2016 to October 2019. We retrospectively collected the clinicopathologic information and AR expression results and analyzed the data according to cancer stage, hormonal receptor (HR) status, human epidermal growth factor receptor 2 (HER2) status, tumor subtype, and pCR.

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