Journal of Yeungnam Medical Science

Review article

Oncology and Cancer Research
Immunotherapy in triple-negative breast cancer: mechanisms of resistance and emerging approaches: a narrative review: Sung Ae Koh; J Yeungnam Med Sci. 2026;43:17. Published online February 6, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.17

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Abstract PDF: Triple-negative breast cancer (TNBC) is characterized by less treatment responsiveness and poorer prognosis than other breast cancer subtypes. The introduction of anti-programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) immunotherapy has expanded the therapeutic options beyond conventional chemotherapy, leading to the adoption of pembrolizumab-based regimens in both adjuvant and first-line palliative settings. However, in contrast to other tumor types that respond robustly to immune checkpoint inhibitors, the efficacy of PD-1/PD-L1 blockade in TNBC remains modest. Multiple factors contribute to this limited response, including the heterogeneity of PD-L1 expression, presence of an immunosuppressive tumor microenvironment regulated by complex immunomodulatory pathways, differences in mutational burden and neoantigen presentation, quantity and functional exhaustion of tumor-infiltrating lymphocytes, and variable synergy with combination partners. Numerous combination strategies have been actively investigated to enhance immunotherapeutic efficacy. Among these, antibody drug conjugates (ADCs) have shown the most promising results. The phase III ASCENT-04/KEYNOTE-D19 trial demonstrated that the combination of sacituzumab govitecan and pembrolizumab significantly improved progression-free survival in patients with PD-L1–positive metastatic TNBC, establishing this regimen as a potential new first-line standard, pending guideline adoption. Although the overall survival data are still immature, the trend appears to be favorable. Other ADCs are being explored in early phase studies, and targeted therapies such as poly(ADP-ribose) polymerase and protein kinase B inhibitors have also shown preliminary activity in smaller trials. Further refinement of these strategies through biomarker-driven, large-scale studies is warranted to identify the most effective combinations and to improve outcomes in patients with TNBC.

Case reports

Dermatology
Ungual scabies mimicking periungual verruca in a patient with metastatic breast cancer treated with abemaciclib: a case report: Min Chong Kim, Joon-Goon Kim; J Yeungnam Med Sci. 2025;42:55. Published online September 13, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.55

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Abstract PDF: Ungual scabies is a rare manifestation of Sarcoptes scabiei infestation in nail units and may mimic other nail diseases, resulting in diagnostic delay. Herein, we report the case of a 58-year-old woman with metastatic breast cancer who received abemaciclib and presented with recalcitrant paronychia and verruca-like periungual hyperkeratosis, sparing the finger web area without pruritus. Skin biopsy confirmed multiple mites in the stratum corneum, resulting in the diagnosis of crusted scabies with nail involvement. Topical permethrin 5% cream and oral ivermectin were then administered. The prolonged unrecognized disease in our patient led to repeated visits to long-term care facilities and tertiary hospitals, thereby increasing the risk of nosocomial transmission. This case emphasizes that clinicians, including non-dermatologists, should consider scabies in patients with chronic periungual lesions, particularly in patients who are immunocompromised such as those using abemaciclib, to prevent hospital outbreaks and excessive healthcare costs.

Oncology and Cancer Research
Impressive effect of cisplatin monotherapy on a patient with heavily pretreated triple-negative breast cancer with poor performance: Dong Won Baek, Ji-Young Park, Soo Jung Lee, Yee Soo Chae; Yeungnam Univ J Med. 2020;37(3):230-235. Published online January 22, 2020; DOI: https://doi.org/10.12701/yujm.2019.00423

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Abstract PDF

Systemic therapy for metastatic triple-negative breast cancer (TNBC) still remains challenging because there are no targeted agents or endocrine therapies currently available. The present case report documents the successful use of cisplatin monotherapy to manage a heavily pretreated TNBC patient showing poor response to therapy. The patient was a 51-year-old woman who had already undergone several lines of systemic chemotherapy for widespread TNBC. Although the mutation analysis performed on DNA isolated from blood cells and progressed lesion samples confirmed the tumor to be germline BRCA wild-type, cisplatin monotherapy was administered based on the increasing evidence of safety and efficacy of platinum for breast cancer. After three cycles of cisplatin treatment, the patient’s metastatic lesions dramatically improved without any major toxicity, and she completed 17 cycles with good response. This case study indicates that patients with heavily pretreated TNBC can potentially achieve a good response to cisplatin monotherapy.

Citations

Citations to this article as recorded by

Mitochondrial Redox Vulnerabilities in Triple-Negative Breast Cancer: Integrative Perspectives and Emerging Therapeutic Strategies
Alfredo Cruz-Gregorio
Metabolites.2026; 16(1): 60. CrossRef
Synthesis, Structure, and Stability of Copper(II) Complexes Containing Imidazoline-Phthalazine Ligands with Potential Anticancer Activity
Łukasz Balewski, Iwona Inkielewicz-Stępniak, Maria Gdaniec, Katarzyna Turecka, Anna Hering, Anna Ordyszewska, Anita Kornicka
Pharmaceuticals.2025; 18(3): 375. CrossRef
Structure–activity insights and molecular modeling approaches of anti-TNBC agents: a comprehensive systematic review
Risqi Ayu Febriana, Dhania Novitasari, Nur Kusaira Khairul Ikram, Muchtaridi Muchtaridi
Future Science OA.2025;[Epub] CrossRef
Zeolitic Imidazole Framework/Silica Nanocomposite for Targeted Cancer Therapeutics: Comparative Study of Chemo-Drug Cisplatin (CPt) and Green Platinum (GPt) Efficacy
Hend Ghnaim Alotaibi, Eman Al-Abbad, Dana Almohazey, Vijaya Ravinayagam, Sultan Akhtar, Hatim Dafalla, B. Rabindran Jermy
International Journal of Molecular Sciences.2024; 25(6): 3157. CrossRef
Cisplatin Monotherapy as a Treatment Option for Patients with HER-2 Negative Breast Cancer Experiencing Hepatic Visceral Crisis or Impending Visceral Crisis
Mirosława Püsküllüoğlu, Małgorzata Pieniążek, Agnieszka Rudzińska, Agnieszka Pietruszka, Renata Pacholczak-Madej, Aleksandra Grela-Wojewoda, Marek Ziobro
Oncology and Therapy.2024; 12(3): 419. CrossRef
Hypoxia: syndicating triple negative breast cancer against various therapeutic regimens
Nityanand Srivastava, Salman Sadullah Usmani, Rajasekaran Subbarayan, Rashmi Saini, Pranav Kumar Pandey
Frontiers in Oncology.2023;[Epub] CrossRef
Inhibiting L1CAM Reverses Cisplatin Resistance of Triple Negative Breast Cancer Cells by Blocking AKT Signaling Pathway
Lu-Yao Zhang, Zhi-Xin Shen, Lu Guo
Cancer Investigation.2022; 40(4): 313. CrossRef
Curcumin as an Enhancer of Therapeutic Efficiency of Chemotherapy Drugs in Breast Cancer
Reyhaneh Farghadani, Rakesh Naidu
International Journal of Molecular Sciences.2022; 23(4): 2144. CrossRef
Atorvastatin improves cisplatin sensitivity through modulation of cholesteryl ester homeostasis in breast cancer cells
Diandra Zipinotti dos Santos, Isabella dos Santos Guimaraes, Mariam F. Hakeem-Sanni, Blake J. Cochran, Kerry-Anne Rye, Thomas Grewal, Andrew J. Hoy, Leticia B. A. Rangel
Discover Oncology.2022;[Epub] CrossRef
Targeting Hypoxia Sensitizes TNBC to Cisplatin and Promotes Inhibition of Both Bulk and Cancer Stem Cells
Andrew Sulaiman, Sarah McGarry, Jason Chambers, Emil Al-Kadi, Alexandra Phan, Li Li, Karan Mediratta, Jim Dimitroulakos, Christina Addison, Xuguang Li, Lisheng Wang
International Journal of Molecular Sciences.2020; 21(16): 5788. CrossRef
Antioxidant Supplementation in the Treatment of Neurotoxicity Induced by Platinum-Based Chemotherapeutics—A Review
Jelena S. Katanic Stankovic, Dragica Selakovic, Vladimir Mihailovic, Gvozden Rosic
International Journal of Molecular Sciences.2020; 21(20): 7753. CrossRef

Original Articles

Surgery
The Relationship Between the Expression of Estrogen Receptor beta and Recurrence in Breast Cancer.: Su Hwan Kang, Jung Eun Choi, Soo Jung Lee; Yeungnam Univ J Med. 2011;28(2):153-164. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.153

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Abstract PDF: BACKGROUND
It has been reported that estrogen receptor beta (ERbeta) mRNA expression was down-regulated during carcinogenesis and was inversely related to estrogen receptor alpha (ERalpha) expression in breast cancer. The association of ERbeta mRNA expression to tamoxifen resistance has also been reported. In this study, the expression of ERalpha and ERbeta via immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) was prompted, and an attempt was made to find out the relationship between ERbeta expression and recurrence in the hormonal therapy group, and between ERbeta expression and known prognostic factors. METHODS: Tumor specimens were obtained at surgery from 67 female breast cancer patients during the period of September 1995 to December 2000. All the specimens were frozen in liquid nitrogen and kept at -70degrees C until they were used. The medical records were analyzed retrospectively. The expressions of ER were analyzed using IHC and RT-PCR methods. RESULTS: The median follow-up was at 93.0 months (range: 14-157 months). The percentage of ERalpha+/ERbeta+, ERalpha+/ERbeta-, ERalpha-/ERbeta+, and ERalpha-/ERbeta group were 35.9% 9.4%, 47.2%, and 7.5%, respectively, in 53 patients with hormonal therapy. ERbeta was positive in 42 (82.3%) of 51 ER-positive patients. In the hormonal therapy group, the recurrence rates of each group was 15.8%, 0%, 40.0%, and 0%, respectively. In this group, the ERbeta expression tended to recur, but there was no clinical significance (p=0.084). CONCLUSION: The ERbeta expression may be a predictive marker of a poor response to endocrine therapy in breast cancer patients, although this needs to be confirmed in additional studies.

Oncology and Cancer Research
Radiologic Findings of Uncommon Breast Cancer.: Jae Woon Kim, Jae Hong An, Mi Soo Hwang, Jae Kyo Lee, Woo Mok Byun; Yeungnam Univ J Med. 1998;15(1):114-124. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.114

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Abstract PDF: We analyzed the mammographic (n=21) findings (location, margin, shape, cluster microcalcifications, size, multiplicity) and ultrasonographic (n=12) findings (shape, border, internal echo, boundary echo, posterior echo, lateral echo, width/depth ratio) to evaluate specific radiologic findings of histopathologically proved uncommon breast cancer. The mammographic findings (n=21) are as follow; 1) single; 16, multiple; 5 2) margin (smooth; 13, irregular; 4, spiculated; 4) 3) shape (round and ovoid; 9, lobulated; 8, irregular; 4) 4) cluster microcalcifications (abscent; 20, present; 1) 5) size (1-3cm; 18, 3-5cm; 2, 5cm> ; 1) 6) location (UOQ; 13, UIQ; 4, LIQ; 3, LOQ; 1). The ultrasonographic findings (n=12) are as follow; 1) shape (round to oval; 5, lobulated; 5, irregular; 2) 2) border (smooth even; 9, rough uneven; 3) 3) internal echo (fine homogeneous; 5, coarse heterogeneous; 7) 4) boundary echo (regular fine; 4, irregular thick; 8) 5) posterior echo (enhanced; 11, no change; 1) 6) lateral echo (marked; 7, nonexistent; 5) 7) width/depth ratio (1.5> 1, 1.0-1.5; 7, 1.0< ; 4). Uncommon breast cancer show benign nature on mammogram, but malignant nature on ultrasonogram (especially boundary echo, internal echo, width/depth ratio)

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