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Hizal M, Bilgin B, Paksoy N, Açıkgöz Ö, Sezer A, Gürbüz M, Ak N, Yücel Ş, Ayhan M, Erol C, Demirkıran A, Mandel NM, Shbair A, Gökmen İ, Başoğlu T, Paydaş S, Demiray AG, İriağaç Y, Şakalar T, Zeynelgil E, Tatlı AM, Bahçeci A, Güven DC, Caner B, Can A, Gülmez A, Karakaş Y, Yalçın B, Demirkazık A, Bilici A, Aydıner A, Yumuk PF, Şendur MAN. The real-life efficacy and safety of osimertinib in pretreated advanced non-small cell lung cancer patients with T790M mutation: a Turkish Oncology Group Study. J Cancer Res Clin Oncol 2021; 148:1501-1508. [PMID: 34331582 DOI: 10.1007/s00432-021-03748-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/26/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Osimertinib, an irreversible third-generation EGFR-TKI, is the standard of care for second-line treatment of T790M-mutant advanced NSCLC patients whose disease progressed after first-line EGFR-TKI therapy. In this multicenter study, we aimed to determine the real-life efficacy and safety of Osimertinib in pretreated advanced NSCLC patients with T790M mutation. MATERIALS AND METHODS This retrospective trial included advanced T790M-mutant pretreated NSCLC patients who received Osimertinib from 24 different centers in Turkey. Primary endpoint was time-to-treatment discontinuation (TTD). Secondary endpoints were objective response rate (ORR), overall survival (OS), and safety. RESULTS Of 163 patients, 68.7% had EGFR exon 19 deletion and 22.7% had exon 21 L858R mutation. Osimertinib was given as second-line treatment in 96 patients (58.9%) and third-line in 48 patients (29.4%). After median of 13-month follow-up, median TTD was 21.6 months with an 82.2% ORR. Estimated median OS was 32.1 months. Grade 3-4 adverse events were seen in 11.7% of the patients. CONCLUSION Osimertinib is a highly effective option in second- or third-line treatment of NSCLC patients with T790M mutation, with a favorable safety profile.
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Affiliation(s)
- Mutlu Hizal
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey.
| | - Burak Bilgin
- Department of Medical Oncology, Atatürk Chest Disease and Chest Surgery Research and Education Hospital, Ankara, Turkey
| | - Nail Paksoy
- Department of Medical Oncology, İstanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey
| | - Özgür Açıkgöz
- Department of Medical Oncology, Medipol University, Faculty of Medicine, Istanbul, Turkey
| | - Ahmet Sezer
- Department of Medical Oncology, Başkent University, Faculty of Medicine, Adana, Turkey
| | - Mustafa Gürbüz
- Department of Medical Oncology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Naziye Ak
- Department of Medical Oncology, Yozgat City Hospital, Yozgat, Turkey
| | - Şebnem Yücel
- Department of Medical Oncology, Atatürk Chest Disease and Chest Surgery Research and Education Hospital, Ankara, Turkey
| | - Murat Ayhan
- Department of Medical Oncology, Kartal Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - Cihan Erol
- Department of Medical Oncology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Aykut Demirkıran
- Department of Medical Oncology, Meram Faculty of Medicine, Necmeddin Erbakan University, Konya, Turkey
| | | | - Abdallah Shbair
- Department of Medical Oncology, Bezmialem University Faculty of Medicine, Istanbul, Turkey
| | - İvo Gökmen
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Tuğba Başoğlu
- Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Semra Paydaş
- Department of Medical Oncology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Atike Gökçen Demiray
- Department of Medical Oncology, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Yakup İriağaç
- Department of Medical Oncology, Namık Kemal University Faculty of Medicine, Tekirdag, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Esra Zeynelgil
- Department of Medical Oncology, Dışkapı Education and Research Hospital, Ankara, Turkey
| | - Ali Murat Tatlı
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Aykut Bahçeci
- Department of Medical Oncology, Ersin Arslan Education and Research Hospital, Gaziantep, Turkey
| | - Deniz Can Güven
- Department of Medical Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burcu Caner
- Department of Medical Oncology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Alper Can
- Department of Medical Oncology, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Ahmet Gülmez
- Department of Medical Oncology, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Yusuf Karakaş
- Department of Medical Oncology, Bodrum Acıbadem Hospital, Mugla, Turkey
| | - Bülent Yalçın
- Department of Medical Oncology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Ahmet Demirkazık
- Department of Medical Oncology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Ahmet Bilici
- Department of Medical Oncology, Medipol University, Faculty of Medicine, Istanbul, Turkey
| | - Adnan Aydıner
- Department of Medical Oncology, İstanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey
| | - Perran Fulden Yumuk
- Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Mehmet Ali Nahit Şendur
- Department of Medical Oncology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
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Bahçeci A, Paydaş S, Ak N, Ferhatoğlu F, Saip PM, Seydaoğlu G, Bilici M, Şimşek M, Tekin SB, Çalikuşu Z, Yavuz S, Şahin AB, Çubukçu E, Evrensel T, Değirmencioğlu S, Demiray AG, Yumuk PF, Alan Ö, Çikman Dİ, Demirelli FH, Köstek O, Gökyer A, Doğan M, Bal Ö, Çakar B, Gökmen E, Yamaç D, Korkmaz T, Aliyev A, Keskin Ö, Urvay S, Büyükşimşek M, Karadeniz C, Yildiz B, Çinkir HY, Demir H, Beypinar İ, Karaçin C, Eser K, Baykara M, Kiliçkap S, Okutur K, Bulut G, Alkan A, Arpaci E, Pilanci KN, Demir A, Işik D, Yildirim N. Efficacy and Safety of Trastuzumab Emtansine in Her2 Positive Metastatic Breast Cancer: Real-World Experience. Cancer Invest 2021; 39:473-481. [PMID: 34014777 DOI: 10.1080/07357907.2021.1933011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM The aim of this study is to evaluate the efficacy and toxicity of trastuzumab emtansine (T-DM1) in cases with metastatic breast cancer (mBC) in different lines of treatment. METHOD Retrospective analysis of T-DM1 results of human epidermal growth factor receptor 2 (Her2) positive 414 cases with mBC from 31 centers in Turkey. FINDINGS Except 2, all of the cases were female with a median age of 47. T-DM1 had been used as second-line therapy in 37.7% of the cases and the median number of T-DM1 cycles was 9. Progression-free survival (PFS) and overall survival (OS) times were different according to the line of treatment. The median OS was found as 43, 41, 46, 23 and 17 months for 1st, 2nd, 3rd, 4th and 5th line, respectively (p = 0.032) while the median PFS was found as 37, 12, 8, 8 and 8 months, respectively (p = 0.0001). Treatment was well tolerated by the patients. The most common grade 3-4 adverse effects were thrombocytopenia (2.7%) and increased serum gamma-glutamyl transferase (2%). DISCUSSION The best of our knowledge this is the largest real-life experience about the safety and efficacy of T-DM1 use in cases with mBC after progression of Her2 targeted treatment. This study suggests and supports that T-DM1 is more effective in earlier lines of treatment and is a reliable option for mBC.
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Affiliation(s)
- Aykut Bahçeci
- Department of Medical Oncology, Dr. Ersin Arslan Education and Research Hospital, Gaziantep, Turkey
| | - Semra Paydaş
- Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Naziye Ak
- Department of Medical Oncology, Institute of Oncology, İstanbul University, İstanbul, Turkey
| | - Ferhat Ferhatoğlu
- Department of Medical Oncology, Institute of Oncology, İstanbul University, İstanbul, Turkey
| | - Pınar Mualla Saip
- Department of Medical Oncology, Institute of Oncology, İstanbul University, İstanbul, Turkey
| | - Gülşah Seydaoğlu
- Department of Biostatistics, University of Cukurova, Adana, Turkey
| | - Mehmet Bilici
- Department of Medical Oncology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Melih Şimşek
- Department of Medical Oncology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Salim Başol Tekin
- Department of Medical Oncology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Züleyha Çalikuşu
- Department of Medical Oncology, Acibadem Adana Hospital, Acibadem MAA University, Adana, Turkey
| | - Sinan Yavuz
- Department of Medical Oncology, Acibadem Adana Hospital, Acibadem MAA University, Adana, Turkey
| | - Ahmet Bilgehan Şahin
- Department of Medical Oncology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Erdem Çubukçu
- Department of Medical Oncology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Türkkan Evrensel
- Department of Medical Oncology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Serkan Değirmencioğlu
- Department of Medical Oncology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Atike Gökçen Demiray
- Department of Medical Oncology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Perran Fulden Yumuk
- Division of Medical Oncology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Özkan Alan
- Division of Medical Oncology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Duygu İlke Çikman
- Department of Medical Oncology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Fuat Hulusi Demirelli
- Department of Medical Oncology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Osman Köstek
- Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Ali Gökyer
- Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Mutlu Doğan
- Department of Medical Oncology, Numune Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Öznur Bal
- Department of Medical Oncology, Numune Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Burcu Çakar
- Department of Medical Oncology, Ege University, Izmir, Turkey
| | - Erhan Gökmen
- Department of Medical Oncology, Ege University, Izmir, Turkey
| | - Deniz Yamaç
- Department of Medical Oncology, Ankara Güven Hospital, Ankara, Turkey
| | - Taner Korkmaz
- Acıbadem MAA University School of Medicine, Medical Oncology Division, Acibadem Research Institiute of Senology (Maslak Hospital)
| | - Altay Aliyev
- Department of Medical Oncology, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
| | - Özge Keskin
- Department of Medical Oncology, Selçuk University, Konya, Turkey
| | - Semiha Urvay
- Department of Medical Oncology, Acibadem Kayseri Hospital, Acibadem MAA University, Kayseri, Turkey
| | - Mahmut Büyükşimşek
- Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Cemile Karadeniz
- Department of Medical Oncology, Hatay Antakya State Hospital, Hatay, Turkey
| | - Birol Yildiz
- Department of Medical Oncology, Gulhane Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | | | - Hacer Demir
- Department of Medical Oncology, Kayseri Education and Research Hospital
| | - İsmail Beypinar
- Department of Medical Oncology, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Cengiz Karaçin
- Department of Medical Oncology, Ankara Diskapi Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Kadir Eser
- Department of Medical Oncology, Mersin University, Mersin, Turkey
| | - Meltem Baykara
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Saadettin Kiliçkap
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Kerem Okutur
- Department of Medical Oncology, Istanbul Memorial Bahcelievler Hospital, Istanbul, Turkey
| | - Gülcan Bulut
- Department of Medical Oncology, Antakya Defne Hospital, Hatay, Turkey
| | - Ali Alkan
- Department of Medical Oncology, Mugla Sıtkı Kocman University, Mugla, Turkey
| | - Erkan Arpaci
- Department of Medical Oncology, Kocaeli Gebze Medicalpark Hospital, Kocaeli, Turkey
| | - Kezban Nur Pilanci
- Department of Medical Oncology, Istanbul Aydın University, Istanbul, Turkey
| | - Atakan Demir
- Department of Medical Oncology, Ankara Güven Hospital, Ankara, Turkey
| | - Deniz Işik
- Department of Medical Oncology, Dr. Ersin Arslan Education and Research Hospital, Gaziantep, Turkey
| | - Nilgün Yildirim
- Department of Medical Oncology, Dr. Ersin Arslan Education and Research Hospital, Gaziantep, Turkey
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Babacan NA, Eğilmez HR, Yücel B, Parlak I, Şeker MM, Kaçan T, Bahçeci A, Cihan S, Akinci B, Eriten B, Kılıçkap S. The prognostic value of UHRF-1 and p53 in gastric cancer. Saudi J Gastroenterol 2016; 22:25-9. [PMID: 26831603 PMCID: PMC4763524 DOI: 10.4103/1319-3767.173755] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND/AIMS This study aimed to examine whether UHRF-1 and p53 overexpression is a prognostic marker for gastric cancer. PATIENTS AND METHODS Sixty-four patients with gastric cancer (study group) and 23 patients with gastritis (control group) were evaluated. Immunohistochemistry was used to examine expression of UHRF-1 and p53 in gastric cancers and a control group diagnosed with gastritis. RESULTS The median age was 63 years (18-83 years) in the study group. UHRF-1 was positive in 15 (23%) patients with gastric cancer and fi ve (21.7%) patients with gastritis (P = 0.559). UHRF1 expression level in gastric cancer is more powerful than in gastritis (P = 0.046). Thirty-seven (61%) patients with gastric cancer and only one patient with gastritis were p53 positive (P < 0.001). After a median follow-up of 12 months (1-110), the 2-year overall survival rates were 55% and 30% in negative and positive p53, respectively (P = 0.084). Also, the 2-year overall survival rates were 45% and 53% in negative and positive UHRF-1, respectively (P = 0.132). CONCLUSION According to this study, UHRF-1 and p53 were not prognostic factors for gastric cancer, whereas they may have a diagnostic value for differentiating between gastric cancer and gastritis.
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Affiliation(s)
- Nalan A. Babacan
- Department of Medical Oncology, Cumhuriyet University School of Medicine, Sivas, Turkey,Address for correspondence: Dr. Nalan A. Babacan, University of Marmara - Istanbul, PO Box TR-58140, Istanbul, Turkey. E-mail:
| | | | - Birsen Yücel
- Department of Radiation Oncology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ilknur Parlak
- Department of Internal Medicine, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Mehmet Metin Şeker
- Department of Medical Oncology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Turgut Kaçan
- Department of Medical Oncology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Aykut Bahçeci
- Department of Medical Oncology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Sener Cihan
- Department of Medical Oncology, Okmeydanı Education and Research Hospital, İstanbul, Turkey
| | - Bülent Akinci
- Department of Medical Oncology, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - Berna Eriten
- Department of Pathology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Saadettin Kılıçkap
- Department of Medical Oncology, Hacettepe University School of Medicine, Ankara, Turkey
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