Publications by authors named "Jin-Yuan Shih"

Leptomeningeal metastasis (LM) is a challenging complication of non-small cell lung cancer (NSCLC). Cerebrospinal fluid (CSF) cell-free DNA (cfDNA) analysis using next-generation sequencing (NGS) offers insights into resistance mechanisms and potential treatment strategies. We conducted a study from February 2022 to April 2023 involving patients from five hospitals in Taiwan who had recurrent or advanced NSCLC with LM.

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Background: PD-L1 is associated with poor efficacy of first- or second-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in untreated EGFR-mutant non-small-cell lung cancer (NSCLC). Whether PD-L1 is also predictive of osimertinib efficacy in pre-treated patients with an acquired EGFR T790 M mutation is unclear.

Patients And Methods: PD-L1 expression and tumor microenvironments were evaluated in tumors from EGFR-mutant T790 M + NSCLC patients treated with osimertinib.

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Introduction: EGFR tyrosine kinase inhibitors (TKIs) are the standard therapy for non-small-cell lung cancer (NSCLC) patients with EGFR-activating mutations in the first-line setting. Despite initial efficacy, resistance to EGFR-TKIs often develops, and platinum-based chemotherapy is the predominant subsequent treatment. For this study, we aimed to identify prognostic factors for overall survival (OS) and progression-free survival (PFS) among advanced EGFR-mutant NSCLC patients receiving platinum-pemetrexed after progression on EGFR-TKIs.

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Backgroundpurpose: Immunotherapy is a new treatment option for patients with Lung Cancer (LC). However, relatively limited research has explored about patients' perception of hope and its associated factors during the process. This study aimed to examine level of perceived hope and the factors related to hope, with a particular focus on treatment and physically related factors, in LC patients receiving immunotherapy.

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Osimertinib has demonstrated efficacy in patients with epidermal growth factor receptor (EGFR) T790M-positive non-small cell lung cancer (NSCLC) in clinical trials. However, real-world data on its effectiveness remain scarce. Taiwanese patients with T790M-positive locally advanced or metastatic NSCLC and progressive disease following treatment with at least one EGFR tyrosine kinase inhibitor (TKI) were enrolled from the osimertinib early access program.

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Background: Although electronic nose (eNose) has been intensively investigated for diagnosing lung cancer, cross-site validation remains a major obstacle to be overcome and no studies have yet been performed.

Methods: Patients with lung cancer, as well as healthy control and diseased control groups, were prospectively recruited from two referral centers between 2019 and 2022. Deep learning models for detecting lung cancer with eNose breathprint were developed using training cohort from one site and then tested on cohort from the other site.

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  • The study investigates the validity of epidermal growth factor receptor (EGFR) exon 20 insertion mutations (ex20ins) in lung cancer as reported by the cobas test, finding discrepancies when validated through Sanger sequencing.
  • Out of 123 cases tested, the cobas+/Sanger- group showed significant clinicopathological differences, with higher tumor content and increased EGFR gene amplification.
  • The findings highlight a concerning rate of EGFR amplification among patients with unreliable ex20ins reports, indicating the need for validation of cobas test results before clinical decision-making.
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Background: Afatinib, an irreversible ErbB family inhibitor, is widely used as first-line treatment in advanced lung adenocarcinoma patients harbouring mutant epidermal growth factor receptor (EGFR). With the advancements in next-generation sequencing (NGS), comprehensive research into the clinical impact of co-occurring genetic mutations and the molecular mechanisms of acquired resistance is required for afatinib users.

Materials: From January 2010 to December 2019, we enrolled patients with advanced lung adenocarcinoma with mutations using afatinib as first-line treatment, and we retrospectively collected pre- and post-afatinib treatment specimens from these patients for NGS testing.

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Purpose: To ascertain the performance of dual-energy CT (DECT) with iodine quantification in differentiating malignant mediastinal and hilar lymph nodes (LNs) from benign ones, focusing on patients with lung adenocarcinoma.

Materials And Methods: In this study, patients with suspected lung cancer received a preoperative contrast-enhanced DECT scan from Jun 2018 to Dec 2020. Quantitative DECT parameters and the size were compared between metastatic and benign LNs.

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Introduction: gene mutations are drivers of NSCLC. The RELAY double-blind, placebo (PBO)-controlled phase 3 study revealed superior progression-free survival (PFS) for ramucirumab plus erlotinib (RAM + ERL) versus PBO (PBO + ERL) in patients with untreated advanced NSCLC and an activating mutation. This exploratory analysis evaluated potential associations between exon 19 deletion (ex19del) variants and clinical outcomes.

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  • Lorlatinib is a third-generation ALK inhibitor used to treat patients with advanced non-small cell lung cancer who have not responded to prior ALK-targeted therapies, particularly in Taiwan.
  • A study involving 63 patients followed their treatment outcomes and safety after switching to lorlatinib, revealing that a high percentage had brain metastases and many had undergone multiple prior therapies.
  • Results showed that lorlatinib led to a median progression-free survival of 9.2 months, with an 80.4% disease control rate, indicating it is both effective and well-tolerated in heavily pretreated patients.
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Purpose: The Blood First Assay Screening Trial (BFAST) is a prospective study using next-generation sequencing (NGS) of circulating tumor DNA (ctDNA) in treatment-naïve advanced/metastatic non-small-cell lung cancer (NSCLC). We compared liquid biopsy to tissue testing and analyzed genomic alterations in Taiwanese patients with NSCLC using the BFAST database.

Materials And Methods: A total of 269 patients underwent FoundationOne Liquid Companion Diagnostic (F1LCDx) assay at the National Taiwan University Hospital, of whom 264 underwent tissue-based genetic testing also.

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  • * The study found reduced miR-204 levels in osimertinib-resistant lung cancer cells, while higher levels were present in treatment-naive cases, suggesting miR-204 enhances sensitivity to osimertinib and inhibits cancer cell spread.
  • * Increasing miR-204 in resistant cells reversed resistance by upregulating BIM, activating apoptosis, and inhibiting cancer stemness and epithelial-to-mesenchymal transition through the CD44 signaling pathway. *
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Aims: Although epidermal growth factor receptor (EGFR)-mutant lung cancers respond well to osimertinib, acquired resistance to osimertinib eventually develops through EGFR-dependent and EGFR-independent resistance mechanisms. CD44 splicing variants are widely expressed in lung cancer tissues. However, it remains unclear whether specific splicing variants are involved in acquired resistance to osimertinib.

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  • In Taiwan, a study called TALENT is examining the effectiveness of low-dose CT (LDCT) screening for lung cancer in never-smokers who have other risk factors, as nearly 60% of such patients are diagnosed at advanced stages.
  • The study involved 17 medical centers and included individuals aged 55-75 who met specific eligibility criteria, like having never smoked or having a very limited smoking history, and certain risk factors for lung cancer.
  • Preliminary results from a 1-year follow-up after the initial LDCT screenings were analyzed, focusing on the detection rates of lung cancer and using various statistical methods to evaluate the outcomes.
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  • Most patients with non-small cell lung cancer (NSCLC) receiving immunochemotherapy are given short-term corticosteroids after immune checkpoint inhibitor (ICI) infusion to prevent side effects, but their impact on immune-related adverse events (irAEs) is unclear.
  • A study examined 252 NSCLC patients, comparing those who received early corticosteroids with those who did not, focusing on the rate of irAEs and treatment discontinuation.
  • Results showed that those in the corticosteroid group had a lower likelihood of permanently discontinuing their ICI treatment due to irAEs, suggesting that early corticosteroids may help in reducing serious side effects.
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Background: Metastasis is a multistep process involving the migration and invasion of cancer cells and is a hallmark of cancer malignancy. Long non-coding RNAs (lncRNAs) play critical roles in the regulation of metastasis. This study aims to elucidate the role of the lncRNA solute carrier organic anion transporter family member 4A1-antisense 1 (SLCO4A1-AS1) in metastasis and its underlying regulatory mechanisms.

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  • Next-generation sequencing (NGS) of plasma cell-free DNA can detect driver mutations in advanced non-small cell lung cancer (NSCLC) and might enhance standard molecular evaluations, though its initial utility remains unclear.
  • A randomised study on 180 patients with suspected advanced NSCLC compared two groups: one receiving NGS results after tissue genotyping and the other receiving them sooner; results showed earlier NGS led to a shorter wait for treatment (20 days vs. 28 days).
  • The study found high agreement between liquid NGS and tissue testing, identifying mutations in nearly 43% of cases where tissue tests were negative.
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  • Lung cancer is the leading cause of cancer deaths globally, and Taiwan has implemented several health policies since 1997, such as anti-smoking campaigns and low-dose CT screenings, to improve lung cancer survival rates.
  • Research analyzed national cancer data from 1994 to 2020 and clinical characteristics of over 17,000 patients from 2006 to 2019, revealing a decrease in lung cancer mortality rates and significant improvements in 5-year survival rates.
  • The findings indicate that early detection through LDCT screening has led to a shift towards diagnosing lung cancer at earlier, more treatable stages, thereby enhancing patient survival rates.
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  • A study analyzed early-stage non-small cell lung cancer (NSCLC) patients in Taiwan, comparing the effects of adjuvant oral uracil-tegafur (UFT) with intravenous chemotherapy following surgery between January 2011 and December 2017.* -
  • Results showed that before adjusting for confounding factors, patients using UFT had better overall and relapse-free survival rates than those receiving intravenous chemotherapy, but after matching the groups, their survival rates were similar.* -
  • The findings suggest that both UFT and intravenous chemotherapy are similarly effective in treating early-stage NSCLC post-surgery, while UFT showed some benefits in specific subgroups like non-drinkers and stage IB patients.*
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Purpose: Despite the importance of radial endobronchial ultrasound (rEBUS) in transbronchial biopsy, researchers have yet to apply artificial intelligence to the analysis of rEBUS images.

Materials And Methods: This study developed a convolutional neural network (CNN) to differentiate between malignant and benign tumours in rEBUS images. This study retrospectively collected rEBUS images from medical centres in Taiwan, including 769 from National Taiwan University Hospital Hsin-Chu Branch, Hsinchu Hospital for model training (615 images) and internal validation (154 images) as well as 300 from National Taiwan University Hospital (NTUH-TPE) and 92 images were obtained from National Taiwan University Hospital Hsin-Chu Branch, Biomedical Park Hospital (NTUH-BIO) for external validation.

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