Publications by authors named "Yen-Yang Chen"
Sonography-Guided Endovascular Retrieval of Fractured Angiocatheter in Brachial Artery: A Case Report.
Vasc Endovascular Surg
November 2024
Background: The insertion of an angiocatheter into a peripheral artery for continuous hemodynamic monitoring is a widely employed clinical practice. Fracture of a angiocatheter retained in an artery, though infrequent, presents a challenge in clinical management, particularly in critically ill patients. Surgical exploration for retrieval is generally required, as fluoroscopy-guided endovascular methods are precluded due to the radiolucency of catheters.
View Article and Find Full Text PDFSurvival of advanced/recurrent gastrointestinal stromal tumors treated with tyrosine kinase inhibitors in Taiwan: a nationwide registry study.
BMC Cancer
July 2024
Article Synopsis
- The study investigated the clinical outcomes of patients in Taiwan with advanced or recurrent gastrointestinal stromal tumors (GISTs) treated with tyrosine kinase inhibitors (TKIs) from 2010 to 2020.
- A total of 224 patients were analyzed, revealing significant survival rates: 50.5% progression-free survival (PFS) and 79.5% overall survival (OS) at 48 months for those treated with imatinib; other treatments like sunitinib and regorafenib showed shorter PFS.
- The research highlighted specific genetic mutations (c-KIT and PDGFRA) as critical prognostic factors affecting patient outcomes, indicating that certain mutations
Background/objectives: Liposomal irinotecan plus 5-fluorouracil and leucovorin (nal-IRI + 5-FU/LV) provides survival benefits for metastatic pancreatic adenocarcinoma (mPDAC) refractory to gemcitabine-based treatment, mainly gemcitabine plus nab-paclitaxel (GA), in current practice. Gemcitabine plus S-1 (GS) is another commonly administered first-line regimen before nab-paclitaxel reimbursement; however, the efficacy and safety of nal-IRI + 5-FU/LV for mPDAC after failed GS treatment has not been reported and was therefore explored in this study.
Methods: In total, 177 patients with mPDAC received first-line GS or GA treatment, followed by second-line nal-IRI + 5-FU/LV treatment (identified from a multicenter retrospective cohort in Taiwan from 2018 to 2020); 85 and 92 patients were allocated to the GS and GA groups, respectively.
Pancreatic cancer is a highly aggressive malignancy with a poor prognosis. Over the past decade, significant therapeutic advancements have improved the survival rates of patients with pancreatic cancer. One of the primary factors contributing to these positive outcomes is the evolution of chemotherapy, from monotherapy to doublet or triplet regimens, and the integration of multimodal approaches.
View Article and Find Full Text PDFArticle Synopsis
- This study aimed to create a predictive score (ANS) for patients with biliary tract cancer using serum albumin concentrations and neutrophil-to-lymphocyte ratios (NLR) before surgery.
- The research involved analyzing data from 268 patients who underwent complete tumor resections and categorized them into three groups based on their ANS score.
- Results showed that a higher ANS score was associated with lower five-year survival rates and could serve as an independent predictor for overall and recurrence-free survival after surgery.
Background: Nivolumab and pembrolizumab have not been directly compared in clinical trials, and the aim of this study is to investigate the efficacy and safety of nivolumab versus pembrolizumab in patients with advanced hepatocellular carcinoma (HCC) in real-world practice.
Methods: We retrospectively reviewed patients with HCC who received intravenous nivolumab or pembrolizumab alone as second-line and later therapy. The objective response was determined according to the Response Evaluation Criteria in Solid Tumors criteria version 1.
Background/aim: Ramucirumab has been approved for the management of hepatocellular carcinoma (HCC) after progression on sorafenib; however, the data on ramucirumab in heavily pretreated HCC are limited. This study aimed to investigate the real-world efficacy and safety of ramucirumab in patients with heavily pretreated advanced HCC.
Patients And Methods: Patients with advanced HCC who received intravenous ramucirumab as second-line and later therapy were retrospectively reviewed.
Background/aim: This study aimed to assess the clinical impact of lenvatinib after disease progression on atezolizumab plus bevacizumab in patients with advanced hepatocellular carcinoma (HCC).
Patients And Methods: A total of 14 patients who received lenvatinib after failure of atezolizumab plus bevacizumab and all patients were classified as having a Barcelona Clinic Liver Cancer stage C. Six patients had macrovascular invasion, and a liver occupation rate of >50% was reported in seven patients.
Background/aim: This retrospective study was designed to investigate the efficacy and safety of concurrent lenvatinib and proton beam therapy (PBT) in advanced hepatocellular carcinoma (HCC) patients.
Patients And Methods: Twenty HCC patients were identified, including Child-Pugh classification A in 16 patients and B (7) in four patients. Sixteen patients had macrovascular invasion, including four with main portal vein thrombosis (Vp4).
Background: The nomogram derived from the pivotal phase III NAPOLI-1 study demonstrated a significant ability to predict median overall survival (OS) in gemcitabine-refractory metastatic pancreatic ductal adenocarcinoma (PDAC) treated with liposomal irinotecan plus fluorouracil and leucovorin (nal-IRI+5-FU/LV). However, the NAPOLI-1 nomogram has not been validated in a real-world setting and therefore the applicability of the NAPOLI-1 nomogram in daily practice remains unknown. This study aims to evaluate the NAPOLI-1 nomogram in a multicenter real-world cohort.
View Article and Find Full Text PDFValidation of Pharyngeal Acid Reflux Episodes Using Hypopharyngeal Multichannel Intraluminal Impedance-pH.
J Neurogastroenterol Motil
January 2023
Background/aims: Hypopharyngeal multichannel intraluminal impedance-pH (HMII-pH) technology incorporating 2 trans-upper esophageal sphincter impedance channels has been developed to detect pharyngeal reflux. We used the HMII-pH technique to validate the candidate pharyngeal acid reflux (PAR) episodes based on the dual-pH tracings and determined the interobserver reproducibility.
Methods: We conducted a cross-sectional study in tertiary centers in Taiwan.
The impact of starting dose with or without subsequent dose escalation of liposomal irinotecan on treatment outcomes in patients with metastatic pancreatic ductal adenocarcinoma.
Am J Cancer Res
November 2022
Article Synopsis
- Liposomal irinotecan (nal-IRI) combined with 5-fluorouracil and leucovorin shows improved survival for pancreatic ductal adenocarcinoma (PDAC) patients after they progress from gemcitabine therapy.
- A study of 667 patients analyzed the effects of starting doses and escalation of nal-IRI on survival and toxicity, categorizing them into standard and reduced doses with or without escalation.
- Results indicated that patients with reduced doses followed by escalation had the longest treatment cycles and better overall survival compared to those on standard doses or reduced doses without escalation, although standard doses resulted in higher rates of severe side effects.
Article Synopsis
- This study explores the effectiveness and safety of low-dose nivolumab (20 or 100 mg) in treating hepatocellular carcinoma (HCC), with the aim of reducing costs for patients, as there is no clear dose-response relationship for the drug.
- Researchers reviewed data from 78 patients, primarily those infected with hepatitis B or C, and found that low-dose nivolumab was associated with better progression-free survival (PFS), while safety assessments showed that adverse events were generally mild (grade 1-2).
- The findings suggest that low-dose nivolumab could be a viable treatment option for advanced HCC patients, providing clinical benefits while also decreasing financial burden associated with standard high
Predictive value of albumin combined with neutrophil-to-lymphocyte ratio for efficacy and safety profiles in patients with pancreatic ductal adenocarcinoma receiving liposomal irinotecan plus 5-fluorouracil and leucovorin.
Am J Cancer Res
September 2022
Article Synopsis
- Liposomal irinotecan combined with 5-fluorouracil and leucovorin shows survival benefits in pancreatic ductal adenocarcinoma (PDAC) but also presents side effects, especially in patients resistant to gemcitabine.
- The study examined the albumin and neutrophil-to-lymphocyte ratio score (ANS) as a tool to predict survival and safety in 434 PDAC patients treated with nal-IRI + 5-FU/LV.
- Results indicated that higher ANS scores correlated with worse survival rates and increased treatment-related adverse events, confirming ANS as a significant predictor of outcomes in these patients.
Zone 0 thoracic endovascular aortic repair in high risk patients: A retrospective case series.
Catheter Cardiovasc Interv
November 2022
To report our experience applying endovascular stent graft repair to treat ascending aortic diseases in high-risk patients and to evaluate the safety and feasibility of this approach. Patients with comorbid conditions or older age are not suitable for open procedures but may be considered suitable for ascending endovascular repair. Eleven high-risk patients received zone 0 thoracic endovascular aortic repair from September 2014 to May 2020.
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- The study analyzed the effectiveness of sorafenib in treating hepatocellular carcinoma (HCC) patients infected with hepatitis B virus (HBV) or hepatitis C virus (HCV), suggesting that viremia status impacts patient outcomes more than the type of infection.
- Among 256 HCC patients treated with sorafenib, those with well-controlled viremia had better overall survival rates, with a significant lengthening of survival for patients with controlled infections compared to those with uncontrolled viremia.
- The research concluded that whether patients had HBV or HCV infection didn't significantly affect their prognosis, but maintaining well-controlled viremia is crucial for improving survival chances in HCC patients during sor
Article Synopsis
- This study investigates the effectiveness of a specific chemotherapy regimen (GSL) in elderly patients (age ≥70) with advanced pancreatic adenocarcinoma (APC), as this group previously faced challenges in receiving treatment and had lower survival rates.
- Of 49 enrolled patients, those who underwent GSL treatment showed a median progression-free survival of 6.6 months and an overall survival of 12.5 months, with 26.5% achieving an overall response to treatment.
- The treatment was relatively well tolerated, with some notable side effects like anemia and neutropenia, and resulted in improved emotional and health status for the patients, paving the way for further studies on the
Article Synopsis
- A multicenter study was conducted to assess how the cumulative dose and dosing patterns of liposomal irinotecan plus fluorouracil/leucovorin (nal-IRI+5-FU/LV) affect survival in patients with gemcitabine-refractory metastatic pancreatic ductal adenocarcinoma (mPDAC).
- The study reviewed medical records of 473 patients, finding that higher cumulative doses of the treatment led to significantly longer median overall survival (mOS), with those receiving >80% of the dose surviving the longest.
- The findings indicate that starting treatment with a lower dose followed by potential dose increases can achieve survival rates similar to a standard dose approach, highlighting the effectiveness of nal-IRI+5-F
Nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil and leucovorin (NalFL) comprises the current standard for gemcitabine-failed metastatic pancreatic ductal adenocarcinoma (PDAC). As liposomes generally accumulate in the spleen, we evaluated the impact of spleen volume on prognosis. We enrolled patients with metastatic PDAC who failed gemcitabine-based therapy and were initiated on NalFL between August 2018 and November 2020.
View Article and Find Full Text PDFEffect of previous conventional irinotecan treatment in patients with pancreatic cancer being treated with liposomal irinotecan plus 5-fluorouracil and leucovorin.
J Hepatobiliary Pancreat Sci
June 2022
Background: Recent studies have suggested the suboptimal efficacy of liposomal irinotecan plus 5-fluorouracil/leucovorin (nal-IRI+5-FU/LV) in metastatic pancreatic ductal adenocarcinoma (mPDAC) patients previously treated with conventional irinotecan. This study investigated the effect of conventional irinotecan treatment in mPDAC patients receiving nal-IRI+5-FU/LV by analyzing a population-based dataset.
Methods: We reviewed 667 consecutive mPDAC patients treated with nal-IRI+5-FU/LV between August 2018 and November 2020 at Taiwanese medical centers.
Atezolizumab plus bevacizumab has been approved as the first-line systemic treatment for patients with unresectable hepatocellular carcinoma (uHCC). This study was designed to assess the clinical impact of atezolizumab plus bevacizumab in uHCC patients. A total of 48 uHCC patients receiving atezolizumab plus bevacizumab were identified, including first-line, second-line, third-line, and later-line settings.
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- The KEYNOTE-063 study compared the effectiveness of pembrolizumab and paclitaxel as second-line treatments for Asian patients with advanced PD-L1-positive gastric or gastroesophageal junction cancer.
- Conducted across 36 medical centers in multiple Asian countries, it aimed to measure overall survival (OS) and progression-free survival (PFS) among participants who were randomly assigned to receive either medication.
- Results showed similar median OS (8 months) for both treatments, but paclitaxel had a better PFS (4 months) compared to pembrolizumab (2 months), while adverse events were less severe in the pembrolizumab group, suggesting it was better tolerated despite limited efficacy conclusions.