Lung cancer ranks first in cancer mortality in Korea and cancer incidence in Korean men. More than half of Korean lung cancer patients undergo chemotherapy, including adjuvant therapy. Cytotoxic agents, targeted therapy, and immune checkpoint inhibitors are used in chemotherapy according to the biopsy and genetic test results. Among chemotherapy, the one that has developed rapidly is targeted therapy. The National Comprehensive Cancer Network (NCCN) guidelines have been updated recently for targeted therapy of multiple gene mutations, and targeted therapy is used not only for chemotherapy but also for adjuvant therapy. While previously targeted therapies have been developed for common genetic mutations, recently targeted therapies have been developed to overcome uncommon mutations or drug resistance that have occurred since previous targeted therapy. Therefore, this study describes recent, rapidly developing targeted therapies.
A significant proportion of patients with non-small cell lung cancer (NSCLC) is diagnosed in the early and resectable stage. Despite the use of platinum-based adjuvant chemotherapy, there was only a marginal increase in overall survival and a 15% decrease in relapse. With the advents of immunotherapy and epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), the landscape of adjuvant treatment in completely resectable NSCLC is changing. Postoperative radiotherapy can be beneficial to patients who underwent surgical resection in certain clinical settings. In addition, new biomarkers that predict efficacy of EGFR TKI and immunotherapy as adjuvant treatment are also necessary. In this review, recent updates in adjuvant treatment in resectable NSCLC were briefly explained.
Everyone is aware that air and environmental pollutants are harmful to health. Among them, indoor air quality directly affects physical health, such as respiratory rather than outdoor air. However, studies that have examined the correlation between environmental and health information have been conducted with public data targeting large cohorts, and studies with real-time data analysis are insufficient. Therefore, this research explores the research with an indoor air quality monitoring (AQM) system based on developing environmental detection sensors and the internet of things to collect, monitor, and analyze environmental and health data from various data sources in real-time. It explores the usage of wearable devices for health monitoring systems. In addition, the availability of big data and artificial intelligence analysis and prediction has increased, investigating algorithmic studies for accurate prediction of hazardous environments and health impacts. Regarding health effects, techniques to prevent respiratory and related diseases were reviewed.
Background: Umeclidinium/vilanterol (UMEC/VI; ANORO ELLIPTA, GSK) is a commonly used dual bronchodilator. This study evaluated the safety and effectiveness of UMEC/VI in Korean patients with chronic obstructive pulmonary disease (COPD) over a 6-year period.Methods: This was an open-label, multicentre, observational, post-marketing surveillance study. A total of 3,375 patients were enrolled consecutively in 52 hospitals, by 53 physicians, between July 2014 and July 2020. Patients who were administered UMEC/VI (fixed-dose 62.5 μg/25 μg) at least once and were monitored for safety and effectiveness were included in the analysis. Incidence and severity of adverse events (AEs) reported after administrating at least one dose of UMEC/VI were monitored, including unexpected adverse events (UAEs) and adverse drug reactions (ADRs). Effectiveness of UMEC/VI after 24 weeks of administration was also assessed using physician’s evaluation (effective, ineffective/no change, worsening, indeterminable) and lung function improvement.Results: Of 3,375 patients, 3,086 were included in the safety assessment group (mean age±standard deviation: 69.76±8.80 years; 85.9% male [n=2,652]; 73.1% aged ≥65 years [n=2,255]). The overall incidence of AEs was 28.8% (n=890), of which 2.2% (n=67) were ADRs. Serious AEs and UAEs were reported in 181 (5.9%) and 665 (21.6%) patients, respectively, and two patients (<0.1%) reported unexpected severe ADR. Of the 903/3,086 patients analysed for effectiveness, most (82.8%, n=748) showed overall disease improvement after UMEC/VI treatment.Conclusion: This study confirmed UMEC/VI administered to Korean patients according to the prescribing information was well-tolerated and can be considered an effective option for COPD treatment.
Background: There is a global increase in isolation of nontuberculous mycobacteria (NTM). The aim of the study was to analyze longitudinal trends of NTM identification and pattern of antimicrobial susceptibility testing.Methods: NTM recovery rates, distribution of NTM species identification, and antimicrobial susceptibility pattern of NTM at Pusan National University Yangsan Hospital between January 2016 and December 2020 were retrospectively analyzed.Results: A total of 52,456 specimens from 21,264 patients were submitted for mycobacterial culture, of which 2,521 from 1,410 patients were NTM positive over five years (January 2016 to December 2020). NTM isolation showed an increasing trend from 2016 to 2020 (p<0.001, test for trend) mainly caused by <i>Mycobacterium avium</i> complex. The vast majority of <i>M. avium</i> complex were susceptible to key agents clarithromycin and amikacin. For <i>Mycobacterium kansasii</i>, resistance to rifampin and clarithromycin is rare. Amikacin was the most effective drug against <i>Mycobacterium abscessus</i> subspecies <i>abscessus</i> and <i>Mycobacterium</i> subspecies <i>massiliense</i>. Most of <i>M.</i> subspecies <i>massiliense</i> were susceptible to clarithromycin, while the majority of <i>M. abscessus</i> subspecies abscessus were resistant to clarithromycin (p<0.001).Conclusion: There was an increasing trend of NTM isolation in our hospital. Resistance to key drugs was uncommon for most NTM species except for <i>M. abscessus</i> subspecies <i>abscessus</i> against clarithromycin.