Publications by authors named "David Kwon"

PIK-75 (F7) is a potent multikinase inhibitor that targets p110α, DNA-PK, and p38γ. PIK-75 has shown potential as a therapy in preclinical cancer models, but it has not been used in the clinic, at least in part, due to limited solubility. We therefore developed a nanoparticle to encapsulate PIK-75 and enable targeted cellular delivery.

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Objectives: In 2021, the opioid overdose crisis led to 1,441 fatalities in Chicago, the highest number ever recorded. Interdisciplinary post-overdose follow-up teams provide care at a critical window to mitigate opioid-related risk and associated fatalities. Our objective was to describe a pilot follow-up program in Chicago including eligible overdose incidents, provision of response team services, and program barriers and successes.

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Background & Aims: Liver cancer-related deaths are projected to exceed one million annually by 2030. Existing therapies have significant limitations, including severe side effects and inconsistent efficacy. Innovative therapeutic approaches to address primary liver cancer (PLC) have led to the ongoing development of tumor-derived organoids.

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Liver transplant (LT) for colorectal cancer liver metastases (CRLM) is increasingly popular, yet the ideal selection criteria remain unknown. Pretransplant positron emission tomography (PET) metabolic tumor volume (MTV) has been described as predicting recurrence, with a proposed cutoff of MTV ≥70 cm 3 . This approach has not been validated.

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Article Synopsis
  • The study compares liver vein deprivation (LVD) and portal vein embolization (PVE) in patients preparing for liver surgery to determine their safety and effectiveness.
  • Results showed that LVD resulted in a significantly greater increase in future liver remnant volume (FLRV) and degree of hypertrophy compared to PVE, with no adverse events reported.
  • The conclusion suggests that LVD may be a safer and more effective option than PVE for promoting liver growth before surgery.
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Introduction: Early detection of pancreatic cancer continues to be a challenge due to the difficulty in accurately identifying specific signs or symptoms that might correlate with the onset of pancreatic cancer. Unlike breast or colon or prostate cancer where screening tests are often useful in identifying cancerous development, there are no tests to diagnose pancreatic cancers. As a result, most pancreatic cancers are diagnosed at an advanced stage, where treatment options, whether systemic therapy, radiation, or surgical interventions, offer limited efficacy.

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Liver transplantation is known to generate significant inflammation in the entire organ based on the metabolic profile and the tissue's ability to recover from the ischemia-reperfusion injury (IRI). This cascade contributes to post-transplant complications, affecting both the synthetic liver function (immediate) and the scar development in the biliary tree. The new occurrence of biliary strictures, and the recurrence of malignant and benign liver diseases, such as cholangiocarcinoma (CCA) and primary sclerosing cholangitis (PSC), are direct consequences linked to this inflammation.

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Article Synopsis
  • - Primary liver cancers, particularly hepatocellular carcinoma and cholangiocarcinoma, pose significant health challenges and often have poor outcomes due to advanced disease at diagnosis.
  • - There's an urgent need for better diagnostic tools, treatments, and monitoring methods for these liver cancers, with liquid biopsy utilizing circulating tumor DNA (ctDNA) presenting a promising avenue for advancement.
  • - This review will explore the current research on ctDNA, its applications in liver malignancies, and potential future developments in this area.
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Secondary liver malignancies are a serious and challenging global health concern. Secondary metastasis to the liver is most commonly from colorectal cancer that has metastatically spread through splanchnic circulation. Metastatic diseases can portend poor prognosis due to the progressive nature typically found on detection.

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Article Synopsis
  • * Among the 2,596 patients analyzed, those receiving NAST had better results in terms of nodal harvest and lower rates of node positivity, but they did not experience improved overall survival (OS) after surgery compared to those who had immediate surgery.
  • * The findings suggest that while NAST may enhance the quality of oncologic resection, it does not provide a survival advantage, with node positivity and positive margins being significant risk factors for reduced OS.
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Background & Aims: Metabolic syndrome (MS) is a growing epidemic and a risk factor for the development of hepatocellular carcinoma (HCC). This study investigated the long-term outcomes of liver resection (LR) for HCC in patients with MS. Rates, timing, patterns, and treatment of recurrences were investigated, and cancer-specific survivals were assessed.

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Objective: Describe the utility of circulating tumor DNA in the postoperative surveillance of hepatocellular carcinoma (HCC).

Background: Current biomarkers for HCC like alpha-fetoprotein (AFP) are lacking. Circulating tumor DNA (ctDNA) has shown promise in colorectal and lung cancers, but its utility in HCC remains relatively unknown.

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We describe a novel pre-liver transplant (LT) approach in colorectal liver metastasis, allowing for improved monitoring of tumor biology and reduction of disease burden before committing a patient to transplantation. Patients undergoing LT for colorectal liver metastasis at Cleveland Clinic were included. The described protocol involves intensive locoregional therapy with systemic chemotherapy, aiming to reach minimal disease burden revealed by positron emission tomography scan and carcinoembryonic Ag.

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The long-term follow-up findings of the phase I trial evaluating the efficacy of oncolytic adenovirus-mediated cytotoxic and interleukin-12 gene therapy in metastatic pancreatic cancer (mPC) seem very promising. The study employed a replication-competent Adenovector in combination with chemotherapy in a dose-escalation format. The trial demonstrated a clinically meaningful median overall survival (OS) benefit, with patients in the highest dose cohort exhibiting an impressive median OS of 18.

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Article Synopsis
  • The study aimed to evaluate the costs and complications associated with liver transplantation (LT) utilizing normothermic machine perfusion (NMP) compared to static cold storage (SCS).
  • A total of 803 liver transplant recipients were analyzed, showing that NMP reduced complications like the need for relaparotomy and renal therapy, especially in donations after circulatory death (DCD).
  • Although NMP increased organ acquisition costs, it led to lower 90-day pretransplant costs due to shorter waiting times, resulting in comparable overall costs between NMP and SCS cohorts.
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Introduction: Circulating tumor DNA (ctDNA) is emerging as a promising, non-invasive diagnostic and surveillance biomarker in solid organ malignancy. However, its utility before and after liver transplant (LT) for patients with primary and secondary liver cancers is still underexplored.

Methods: Patients undergoing LT for hepatocellular carcinoma (HCC), cholangiocarcinoma (CCA), and colorectal liver metastases (CRLM) with ctDNA testing were included.

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Extraction of a residual root tip and implant placement can be challenging because of the complexity and invasiveness of the procedure. Improvised application of a guided implant surgery may avoid such challenges. This clinical report presents an innovative technique combining a 3-dimensionally printed surgical guide with conventional instrumentation for a residual root tip extraction in a minimally invasive and predictable way.

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  • Colorectal cancer liver metastasis (CRLM) is common and significantly impacts patient outcomes, with liver resection being the preferred treatment for resectable cases; the safety of intraoperative autotransfusion during this procedure is debated.
  • This study analyzed data from 316 patients who underwent liver surgery for CRLM between 1999 and 2016, focusing on demographics, surgical variables, and survival rates, using propensity score matching to mitigate potential biases.
  • Results indicated that while the overall survival rates were similar regardless of autotransfusion, patients receiving autotransfusion experienced a significant reduction in recurrence-free survival, leading to concerns about its use in surgical treatment for CRLM.
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Colorectal cancer is the second most common cause of cancer-related death worldwide, and half of patients present with colorectal liver metastasis (CRLM). Liver transplant (LT) has emerged as a treatment modality for otherwise unresectable CRLM. Since the publication of the Lebeck-Lee systematic review in 2022, additional evidence has come to light supporting LT for CRLM in highly selected patients.

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Ca2+/calmodulin-dependent protein kinase II γ (CAMKIIγ) has been identified as a potential target for treating cancer. Based on our previous study of berbamine (BBM) as a CAMKIIγ inhibitor, we have synthesized a new BBM derivative termed PA4. Compared with BBM, PA4 showed improved potency and specificity and was more cytotoxic against lymphoma and leukemia than against other types of cancer.

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