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Aktürk Esen S, Karabulut S, Buyukaksoy M, Kurt Cevik G, Ceylan F, Civelek B, Şendur MAN, Erdogan F, Uncu D. Is fibroblast growth factor 11 (FGF11) a predictive marker for breast cancer? Medicine (Baltimore) 2024; 103:e37656. [PMID: 38552037 PMCID: PMC10977561 DOI: 10.1097/md.0000000000037656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/28/2024] [Indexed: 04/02/2024] Open
Abstract
The prognostic role of fibroblast growth factor 11 (FGF11) has only been reported in cancers such as nasopharyngeal carcinoma and prostate cancer. The role of FGF11 in breast cancer is not fully known. It was aimed to compare FGF11 expression levels in de novo metastatic hormone receptor-positive, human epidermal reseptor-2-negative breast tumor tissue and healthy breast tissue and investigate the effect of the FGF11 expression on survival in breast cancer patients. To determine the FGF11 expression rate, breast tumor tissue of breast cancer patients diagnosed by breast biopsy and healthy breast tissue of healthy individuals who underwent breast biopsy due to benign lesions were used. The study population included 38 breast cancer patients and 24 healthy controls. The number of patients with a FGF11 expression level score of 1 (15.8% vs 12.5%), score of 2 (18.4% vs 12.5%), and score of 3 (31.6% vs 0%) was significantly higher in the patient group compared to the healthy control group. The median overall survival and progression-free survival were numerically better in the group with a FGF11 expression score of 0 to 1 than the group with a FGF11 expression score of 2 and 3, but this difference was not statistically significant. FGF11 may be a predictive marker for breast cancer formation. Additionally, with new FGF11-targeted treatment agents to be developed, endocrine resistance may be reduced, and better survival results may be achieved in hormone receptor-positive, human epidermal reseptor-2-negative breast cancer.
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Affiliation(s)
- Selin Aktürk Esen
- Medical Oncology Clinic, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Sefika Karabulut
- Medical Microbiology Department, Gulhane Health Sciences Institute, Ankara, Turkey
| | - Muge Buyukaksoy
- Internal Medicine Clinic, Ankara Bilkent City Hospital, Ankara, Turkey
| | | | - Furkan Ceylan
- Medical Oncology Clinic, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Burak Civelek
- Medical Oncology Clinic, Ankara Bilkent City Hospital, Ankara, Turkey
| | | | - Fazli Erdogan
- Pathology Clinic, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Doğan Uncu
- Medical Oncology Clinic, Ankara Bilkent City Hospital, Ankara, Turkey
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Esen İ, Arslan H, Aktürk Esen S, Gülşen M, Kültekin N, Özdemir O. Early prediction of gallstone disease with a machine learning-based method from bioimpedance and laboratory data. Medicine (Baltimore) 2024; 103:e37258. [PMID: 38394521 DOI: 10.1097/md.0000000000037258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
Gallstone disease (GD) is a common gastrointestinal disease. Although traditional diagnostic techniques, such as ultrasonography, CT, and MRI, detect gallstones, they have some limitations, including high cost and potential inaccuracies in certain populations. This study proposes a machine learning-based prediction model for gallstone disease using bioimpedance and laboratory data. A dataset of 319 samples, comprising161 gallstone patients and 158 healthy controls, was curated. The dataset comprised 38 attributes of the participants, including age, weight, height, blood test results, and bioimpedance data, and it contributed to the literature on gallstones as a new dataset. State-of-the-art machine learning techniques were performed on the dataset to detect gallstones. The experimental results showed that vitamin D, C-reactive protein (CRP) level, total body water, and lean mass are crucial features, and the gradient boosting technique achieved the highest accuracy (85.42%) in predicting gallstones. The proposed technique offers a viable alternative to conventional imaging techniques for early prediction of gallstone disease.
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Affiliation(s)
- İrfan Esen
- Yüksek İhtisas University, Faculty of Medicine Department of Internal Medicine, Ankara, Turkey
| | - Hilal Arslan
- Ankara Yildirim Beyazit University, Department of Software Engineering, Faculty of Engineering and Natural Sciences, Ankara, Turkey
| | | | - Mervenur Gülşen
- Keçiören VM Medicalpark Hospital, Department of Nutrition and Dietetics, Ankara, Turkey
| | - Nimet Kültekin
- Keçiören VM Medicalpark Hospital, Department of Nutrition and Dietetics, Ankara, Turkey
| | - Oğuzhan Özdemir
- Yüksek İhtisas University, Faculty of Medicine Department of Department of Radiology, Ankara, Turkey
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Gürler F, Aktürk Esen S, Kurt İnci B, Sütçüoğlu O, Uçar G, Akdoğan O, Uncu D, Turhan N, Akyürek N, Özdemir N, Özet A, Yazıcı O. Retrospective Analyses of PD-L1, LAG-3, TIM-3, OX40L Expressions and MSI Status in Gastroenteropancreatic Neuroendocrine Neoplasms. Cancer Invest 2024; 42:141-154. [PMID: 38486421 DOI: 10.1080/07357907.2024.2330102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
We investigated expressions of PD-L1, LAG-3, TIM-3, and OX40L as immune checkpoint proteins, and MSI (repetitive short-DNA-sequences due to defective DNA-repair system) status were analyzed with immunohistochemistry from tissue blocks. Of 83 patients, PD-L1 expression was observed in 18.1% (n = 15) of the patients. None of the patients exhibited LAG-3 expression. TIM-3 expression was 4.9% (n = 4), OX40L was 22.9% (n = 19), and 8.4% (n = 7) of the patients had MSI tumor. A low-to-intermediate positive correlation was observed between PD-L1 and TIM-3 expressions (rho: 0.333, p < 0.01). Although PD-L1 expression was higher in grade 3 NET/NEC, MSI status was prominent in grade 1/2 NET.
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Affiliation(s)
- Fatih Gürler
- Department of Medical Oncology, University of Health Sciences, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Selin Aktürk Esen
- Department of Medical Oncology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Bediz Kurt İnci
- Department of Medical Oncology, Aksaray Training & Research Hospital, Aksaray, Turkey
| | - Osman Sütçüoğlu
- Department of Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Gökhan Uçar
- Department of Medical Oncology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Orhun Akdoğan
- Department of Internal Medicine, Yenimahalle Training and Research Hospital, Ankara, Turkey
| | - Doğan Uncu
- Department of Medical Oncology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Nesrin Turhan
- Department of Pathology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Nalan Akyürek
- Department of Pathology, Gazi University School of Medicine, Ankara, Turkey
| | - Nuriye Özdemir
- Department of Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Ahmet Özet
- Department of Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Ozan Yazıcı
- Department of Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
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Taşçı EŞ, Oyan B, Sönmez Ö, Mutlu AU, Atcı MM, Sakin A, Öner İ, Çınkır HY, Eryılmaz MK, Çağlayan D, Balçık OY, Paksoy N, Karabulut S, Salim DK, Bilir C, Özen M, Özçelik M, Arıcan A, Akagündüz B, İnal A, Aydın D, Özer L, Gülmez A, Turhal NS, Esen SA, Algın E, Akbaş S, İriağaç Y, Şakalar T, Ünal Ç, Er Ö, Seçmeler Ş, Bozkurt M. Correction: Comparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer. BMC Cancer 2024; 24:114. [PMID: 38262962 PMCID: PMC10804792 DOI: 10.1186/s12885-024-11863-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Affiliation(s)
- Elif Şenocak Taşçı
- Department of Medical Oncology, Saglık Bilimleri University, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey.
| | - Başak Oyan
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Özlem Sönmez
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Arda Ulaş Mutlu
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Muhammed Mustafa Atcı
- Department of Medical Oncology, Haseki Education and Research Hospital, Istanbul, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, Medipol Bahçelievler Hospital, Istanbul, Turkey
| | - İrem Öner
- Department of Medical Oncology, Konya City Hospital, Konya, Turkey
| | - Havva Yeşil Çınkır
- Department of Medical Oncology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Melek Karakurt Eryılmaz
- Meram Faculty of Medicine, Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Dilek Çağlayan
- Meram Faculty of Medicine, Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Onur Yazdan Balçık
- Department of Medical Oncology, Mardin Education and Research Hospital, Mardin, Turkey
| | - Nail Paksoy
- Department of Medical Oncology, Tekirdağ Dr. İsmail Fehmi Cumalıoğlu City Hospital, Tekirdağ, Turkey
| | - Senem Karabulut
- Department of Medical Oncology, Şişli Kolan Hospital, Istanbul, Turkey
| | - Derya Kıvrak Salim
- Department of Medical Oncology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Cemil Bilir
- Department of Medical Oncology, Medical Park Hospital, Istanbul, Turkey
| | - Miraç Özen
- Department of Medical Oncology, Sakarya University Research and Education Hospital, Sakarya, Turkey
| | - Melike Özçelik
- Department of Medical Oncology, University of Health Sciences Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Ali Arıcan
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Baran Akagündüz
- Department of Medical Oncology, Binali Yıldırım University, Erzincan, Turkey
| | - Ali İnal
- Department of Medical Oncology, Mersin City Hospital, Mersin, Turkey
| | - Dinçer Aydın
- Department of Medical Oncology, Derince Education and Research Hospital, Kocaeli, Turkey
| | - Leyla Özer
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Ahmet Gülmez
- Department of Medical Oncology, Adana City Hospital, Adana, Turkey
| | | | - Selin Aktürk Esen
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Efnan Algın
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Sinem Akbaş
- Department of Medical Oncology, Koç University Hospital, Istanbul, Turkey
| | - Yakup İriağaç
- Department of Medical Oncology, Namık Kemal University, Tekirdağ, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Çağlar Ünal
- Department of Medical Oncology, Bilim University, Istanbul, Turkey
| | - Özlem Er
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Şaban Seçmeler
- Department of Medical Oncology, Medical Park Bahçelievler Hospital, Istanbul, Turkey
| | - Mustafa Bozkurt
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
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Taşçı EŞ, Oyan B, Sönmez Ö, Mutlu AU, Atcı MM, Sakin A, Öner İ, Çınkır HY, Eryılmaz MK, Çağlayan D, Balçık OY, Paksoy N, Karabulut S, Salim DK, Bilir C, Özen M, Özçelik M, Arıcan A, Akagündüz B, İnal A, Aydın D, Özer L, Gülmez A, Turhal NS, Esen SA, Algın E, Akbaş S, İriağaç Y, Şakalar T, Ünal Ç, Er Ö, Seçmeler Ş, Bozkurt M. Comparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer. BMC Cancer 2024; 24:16. [PMID: 38166764 PMCID: PMC10763265 DOI: 10.1186/s12885-023-11783-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The optimal treatment for metastatic colorectal cancer (mCRC) after the second line is still controversial. Regorafenib has been the standard of care in this setting as it improved overall survival (OS) compared to placebo. In real-world practice chemotherapy rechallenge is also a preferred option even though supporting evidence is not enough. We aim to compare the efficacy of regorafenib and 5-fluorouracil-based (5-FU) rechallenge treatment in the third line setting of mCRC. METHODS In this retrospective multi-institutional trial, mCRC patients from 21 oncology centers who progressed after 2 lines of chemotherapy were analyzed. Patients who were treated with regorafenib or rechallenge therapy in the third-line setting were eligible. Rechallenge chemotherapy was identified as the re-use of the 5-FU based regimen which was administered in one of the previous treatment lines. OS, disease control rate (DCR), progression free survival (PFS) and toxicity were analyzed. RESULTS Three hundred ninety-four mCRC patients were included in the study. 128 (32.5%) were in the rechallenge, and 266 (67.5%) were in the regorafenib group. Median PFS was 5.82 months in rechallenge and 4 months in regorafenib arms (hazard ratio:1.45,95% CI, p = 0.167). DCR was higher in the rechallenge group than regorafenib (77% vs 49.5%, respectively, p = < 0.001). Median OS after the third-line treatment was 11.99 (95% CI, 9.49-14.49) and 8.08 months (95% CI, 6.88-9.29) for rechallenge and regorafenib groups, respectively (hazard ratio:1.51, 95% CI, p < 0.001). More adverse effects and discontinuation were seen with regorafenib treatment. CONCLUSION Our study revealed that higher disease control and OS rates were achieved with rechallenge treatment compared to regorafenib, especially in patients who achieved disease control in one of the first two lines of therapy.
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Affiliation(s)
- Elif Şenocak Taşçı
- Department of Medical Oncology, Saglık Bilimleri University, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey.
| | - Başak Oyan
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Özlem Sönmez
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Arda Ulaş Mutlu
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Muhammed Mustafa Atcı
- Department of Medical Oncology, Haseki Education and Research Hospital, Istanbul, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, Medipol Bahçelievler Hospital, Istanbul, Turkey
| | - İrem Öner
- Department of Medical Oncology, Konya City Hospital, Konya, Turkey
| | - Havva Yeşil Çınkır
- Department of Medical Oncology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Melek Karakurt Eryılmaz
- Meram Faculty of Medicine, Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Dilek Çağlayan
- Meram Faculty of Medicine, Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Onur Yazdan Balçık
- Department of Medical Oncology, Mardin Education and Research Hospital, Mardin, Turkey
| | - Nail Paksoy
- Department of Medical Oncology, Tekirdağ Dr. İsmail Fehmi Cumalıoğlu City Hospital, Tekirdağ, Turkey
| | - Senem Karabulut
- Department of Medical Oncology, Şişli Kolan Hospital, Istanbul, Turkey
| | - Derya Kıvrak Salim
- Department of Medical Oncology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Cemil Bilir
- Department of Medical Oncology, Medical Park Hospital, Istanbul, Turkey
| | - Miraç Özen
- Department of Medical Oncology, Sakarya University Research and Education Hospital, Sakarya, Turkey
| | - Melike Özçelik
- Department of Medical Oncology, University of Health Sciences Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Ali Arıcan
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Baran Akagündüz
- Department of Medical Oncology, Binali Yıldırım University, Erzincan, Turkey
| | - Ali İnal
- Department of Medical Oncology, Mersin City Hospital, Mersin, Turkey
| | - Dinçer Aydın
- Department of Medical Oncology, Derince Education and Research Hospital, Kocaeli, Turkey
| | - Leyla Özer
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Ahmet Gülmez
- Department of Medical Oncology, Adana City Hospital, Adana, Turkey
| | | | - Selin Aktürk Esen
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Efnan Algın
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Sinem Akbaş
- Department of Medical Oncology, Koç University Hospital, Istanbul, Turkey
| | - Yakup İriağaç
- Department of Medical Oncology, Namık Kemal University, Tekirdağ, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Çağlar Ünal
- Department of Medical Oncology, Bilim University, Istanbul, Turkey
| | - Özlem Er
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Şaban Seçmeler
- Department of Medical Oncology, Medical Park Bahçelievler Hospital, Istanbul, Turkey
| | - Mustafa Bozkurt
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
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Oktar O, Korkmaz V, Tokalıoğlu A, Öztürk Ç, Erdoğan Ö, Uçar Y, Koca Yıldırım HE, Hanedan C, Kılıç F, Ersak B, Yalçın N, Özmen F, Kahraman A, Esen SA, Baş S, Özdaş ED, Selçuk İ, Uçar G, Koçak Ö, Çakır C, Koç S, Kılıç Ç, Cömert GK, Üreyen I, Toptaş T, Narin MA, Taşçı T, Taşkın S, Boran N, Sancı M, Köş FT, Tekin ÖM, Üstün YE, Ortaç F, Turan T. Prognostic factors of adult granulosa cell tumors of the ovary: a Turkish retrospective multicenter study. J Gynecol Oncol 2023; 35:35.e39. [PMID: 38156722 DOI: 10.3802/jgo.2024.35.e39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/08/2023] [Revised: 09/14/2023] [Accepted: 11/26/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE To define the clinical, histopathological features and the prognostic factors affecting survival in patients with adult granulosa cell tumors of the ovary (AGCT). METHODS A 322 patients whose final pathologic outcome was AGCT treated at nine tertiary oncology centers between 1988 and 2021 participated in the study. RESULTS The mean age of the patients was 51.3±11.8 years and ranged from 21 to 82 years. According to the International Federation of Gynecology and Obstetrics 2014, 250 (77.6%) patients were stage I, 24 (7.5%) patients were stage II, 20 (6.2%) patients were stage III, and 3 (7.8%) were stage IV. Lymphadenectomy was added to the surgical procedure in 210 (65.2%) patients. Lymph node involvement was noted in seven (3.3%) patients. Peritoneal cytology was positive in 19 (5.9%) patients, and 13 (4%) had metastases in the omentum. Of 285 patients who underwent hysterectomy, 19 (6.7%) had complex hyperplasia with atypia/endometrial intraepithelial neoplasia, and 8 (2.8%) had grade 1 endometrioid endometrial carcinoma. It was found that 93 (28.9%) patients in the study group received adjuvant treatment. Bleomycin, etoposide, cisplatin was the most commonly used chemotherapy protocol. The median follow-up time of the study group was 41 months (range, 1-276 months). It was noted that 34 (10.6%) patients relapsed during this period, and 9 (2.8%) patients died because of the disease. The entire cohort had a 5-year disease-free survival (DFS) of 86% and a 5-year disease-specific survival of 98%. Recurrences were observed only in the pelvis in 13 patients and the extra-abdominal region in 7 patients. The recurrence rate increased 6.168-fold in patients with positive peritoneal cytology (95% confidence interval [CI]=1.914-19.878; p=0.002), 3.755-fold in stage II-IV (95% CI=1.275-11.063; p=0.016), and 2.517-fold in postmenopausal women (95% CI=1.017-6.233; p=0.046) increased. CONCLUSION In this study, lymph node involvement was detected in 3.3% of patients with AGCT. Therefore, it was concluded that lymphadenectomy can be avoided in primary surgical treatment. Positive peritoneal cytology, stage, and menopausal status were independent prognostic predictors of DFS.
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Affiliation(s)
- Okan Oktar
- Department of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Vakkas Korkmaz
- Department of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Alp Tokalıoğlu
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | | | - Özgür Erdoğan
- Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Izmir, Turkey
| | - Yeşim Uçar
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Hande Esra Koca Yıldırım
- Department of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Candost Hanedan
- Department of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Fatih Kılıç
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Burak Ersak
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Necim Yalçın
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Fatma Özmen
- Department of Gynecologic Oncology, Adana City Hospital, Faculty of Medicine, University of Health Sciences, Adana, Turkey
| | - Alper Kahraman
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Selin Aktürk Esen
- Department of Medical Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Sevda Baş
- Department of Gynecologic Oncology, Adana City Hospital, Faculty of Medicine, University of Health Sciences, Adana, Turkey
| | - Emel Doğan Özdaş
- Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Izmir, Turkey
| | - İlker Selçuk
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Gökhan Uçar
- Department of Medical Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Özgür Koçak
- Department of Gynecologic Oncology, Hitit University, Corum, Turkey
| | - Caner Çakır
- Department of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey.
| | - Sevgi Koç
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and
| | - Çiğdem Kılıç
- Department of Gynecologic Oncology, Hitit University, Corum, Turkey
| | - Günsu Kimyon Cömert
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Işın Üreyen
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Tayfun Toptaş
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Mehmet Ali Narin
- Department of Gynecologic Oncology, Adana City Hospital, Faculty of Medicine, University of Health Sciences, Adana, Turkey
| | - Tolga Taşçı
- Department of Gynecologic Oncology, Bahcesehir University, Istanbul, Turkey
| | - Salih Taşkın
- Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Nurettin Boran
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and
| | - Muzaffer Sancı
- Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Izmir, Turkey
| | - Fahriye Tuğba Köş
- Department of Medical Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Özlem Moraloğlu Tekin
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Yaprak Engin Üstün
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and
| | - Fırat Ortaç
- Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Taner Turan
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
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Bayram D, Aktürk Esen S, Uçar G, Köş FT. Toxic hepatitis in metastatic breast cancer patient using ribociclib and denosumab. J Oncol Pharm Pract 2023; 29:1494-1497. [PMID: 37170613 DOI: 10.1177/10781552231174593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
INTRODUCTION Hepatotoxicity is observed due to cyclin-dependent kinase (CDK4/6) inhibitors used to treat hormone receptor-positive metastatic breast cancer. However, it should not be ignored that denosumab may be hepatotoxic, although it is rare. CASE REPORT A 73-year-old female patient with breast cancer with axillary lymph node, adrenal gland and bone metastases was started on ribociclib letrozole and denosumab treatment. Ribociclib treatment was discontinued due to grade 4 hepatotoxicity during treatment, but liver function tests did not decrease. After discontinuation of denosumab treatment, alanine aminotransferase and aspartate aminotransferase values regressed to baseline values. MANAGEMENT AND OUTCOME Despite the discontinuation of ribociclib treatment, other causes of liver toxicity were investigated due to persistence of hepatic transaminases and elevation. Autoimmune hepatitis markers were negative. Hepatobiliary USG did not reveal any pathological findings except hepatosteatosis. Liver biopsy was performed to determine the etiology. Pathology result was compatible with acute hepatocellular damage (in favor of toxic hepatitis). A decrease in liver values was detected after discontinuation of denosumab treatment. DISCUSSION Although cases with improvement in liver enzymes have been reported after discontinuation of ribociclib, no improvement in hepatotoxicity was observed in our case. Since the liver biopsy was toxic hepatitis, it was thought that other drugs used by the patient might cause this toxicity, and a significant decrease was observed in liver values after discontinuation of denosumab. Denosumab-induced liver toxicity is very rare, and there are only a limited number of cases in the literature.
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Affiliation(s)
- Doğan Bayram
- Department of Medical Oncology, Ankara Cıty Hospital, Cankaya, Turkey
| | - Selin Aktürk Esen
- Department of Medical Oncology, Ankara Cıty Hospital, Cankaya, Turkey
| | - Gökhan Uçar
- Department of Medical Oncology, Ankara Cıty Hospital, Cankaya, Turkey
| | - Fahriye Tuğba Köş
- Department of Medical Oncology, Ankara Cıty Hospital, Cankaya, Turkey
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8
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Sütcüoğlu O, Doğan A, Yilmaz F, Şahin AB, Şahin TK, Esen SA, Erol C, Üner A, Özet A, Turan N, Eraslan E, Deligönül A, Odabaş H, Günel N, Uçar G, Dede DŞ, Dizdar Ö, Çubukçu E, Öksüzoğlu ÖB, Emre Yildirim M, Yazici O, Özdemir N. Retrospective Evaluation of the Efficacy of Gemcitabine-Based Therapies After FOLFIRINOX Failure in Advanced Pancreatic Cancer, Multi-Center Real-Life Data. Pancreas 2023; 52:e235-e240. [PMID: 37816170 DOI: 10.1097/mpa.0000000000002238] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
OBJECTIVE Combination therapies such as FOLFIRINOX or gemcitabine-nanoparticle albumin-bound paclitaxel (GnP) are recommended for the first-line treatment of patients with advanced pancreatic cancer. The purpose of this study was to evaluate the efficacy of gemcitabine-based second-line therapies in patients whose disease progressed on FOLFIRINOX. METHOD Patients diagnosed with advanced pancreatic cancer in 7 tertiary hospitals in Turkey were included. Patients were divided into 3 different groups according to their treatment regimens: GnP, gemcitabine doublet (gemcitabine-cisplatin or gemcitabine-capecitabine), and gemcitabine monotherapy. RESULTS A total of 144 patients were included in the study. In the second-line treatment, 65% of patients were given GnP, 20% were given gemcitabine doublet, and 15% were given gemcitabine monotherapy. The median exposure of the patients to gemcitabine-based therapy was 3 cycles, whereas the median progression-free survival was calculated as 3.4 months. The median overall survival for patients who received GnP was 4.6 months, 6.4 months for patients who received gemcitabine doublet therapy, and 3.7 months for patients who received gemcitabine monotherapy ( P = 0.248). CONCLUSION In conclusion, it has been shown that gemcitabine-based second-line treatments contribute to survival in patients with advanced pancreatic cancer. In addition, there was no difference in efficacy between gemcitabine monotherapy or combination treatments.
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Affiliation(s)
- Osman Sütcüoğlu
- From the Department of Medical Oncology, Gazi University, Ankara
| | - Akif Doğan
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, İstanbul
| | - Funda Yilmaz
- Department of Medical Oncology, Dr. Abdurrahman Yurtarslan Oncology Training and Research Hospital, Ankara
| | | | | | | | - Cihan Erol
- Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Aytuğ Üner
- From the Department of Medical Oncology, Gazi University, Ankara
| | - Ahmet Özet
- From the Department of Medical Oncology, Gazi University, Ankara
| | - Nedim Turan
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, İstanbul
| | - Emrah Eraslan
- Department of Medical Oncology, Dr. Abdurrahman Yurtarslan Oncology Training and Research Hospital, Ankara
| | - Adem Deligönül
- Department of Medical Oncology, Uludağ University, Bursa
| | - Hatice Odabaş
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, İstanbul
| | - Nazan Günel
- From the Department of Medical Oncology, Gazi University, Ankara
| | - Gökhan Uçar
- Department of Medical Oncology, Ankara City Hospital
| | - Didem Şener Dede
- Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Ömer Dizdar
- Department of Medical Oncology, Hacettepe University
| | - Erdem Çubukçu
- Department of Medical Oncology, Uludağ University, Bursa
| | - Ömür Berna Öksüzoğlu
- Department of Medical Oncology, Dr. Abdurrahman Yurtarslan Oncology Training and Research Hospital, Ankara
| | | | - Ozan Yazici
- From the Department of Medical Oncology, Gazi University, Ankara
| | - Nuriye Özdemir
- From the Department of Medical Oncology, Gazi University, Ankara
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9
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Özdemir Ö, Zengel B, Yildiz Y, Uluç BO, Cabuk D, Ozden E, Salim DK, Paydas S, Demir A, Diker O, Pilanci KN, Sönmez ÖU, Vatansever S, Dogan I, Gulmez A, Cakar B, Gursoy P, Yildirim ME, Ayhan M, Karadurmus N, Aykan MB, Cevik GT, Sakalar T, Hacibekiroglu I, Gülbagci BB, Dincer M, Garbioglu DB, Kemal Y, Nayir E, Taskaynatan H, Yilmaz M, Avci O, Sari M, Coban E, Atci MM, Esen SA, Telli TA, Karatas F, Inal A, Demir H, Kalkan NO, Yilmaz C, Tasli F, Alacacioglu A. The effectiveness and safety of neoadjuvant pertuzumab and trastuzumab in women with locally advanced, inflammatory, or early-stage human epidermal growth factor receptor 2-positive breast cancer: Turkish Oncology Group study. Anticancer Drugs 2022; 33:663-670. [PMID: 35703239 DOI: 10.1097/cad.0000000000001310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In our study, we aimed to evaluate the pathological response rates and side effect profile of adding pertuzumab to the treatment of HER2+ locally advanced, inflammatory, or early-stage breast cancer. This study was conducted by the Turkish Oncology Group (TOG) with data collected from 32 centers. Our study was multicentric, and a total of 364 patients were included. The median age of the patients was 49 years (18-85 years). Two hundred fifteen (60%) of the cases were hormone receptor/HER2+ positive(ER+ or PR+, or both), and 149 (40%) of them were HER2-rich (ER and PR negative). The number of complete responses was 124 (54%) in the docetaxel+trastuzumab+pertuzumab arm and 102 (45%) in the paclitaxel+trastuzumab+pertuzumab arm, and there was no difference between the groups in terms of complete response. In 226 (62%) patients with complete response, a significant correlation was found with DCIS, tumor focality, removed lymph node, and ER status P < 0.05. Anemia, nausea, vomiting, myalgia, alopecia, and mucosal inflammation were significantly higher in the docetaxel arm, P < 0.05. In our study, no statistical difference was found between the before-after echocardiography values. DCIS positivity in biopsy before neoadjuvant chemotherapy, tumor focality; the number of lymph nodes removed and ER status were found to be associated with pCR. In conclusion, we think that studies evaluating pCR-related clinicopathological variables and radiological imaging features will play a critical role in the development of nonsurgical treatment approaches.
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Affiliation(s)
| | - Baha Zengel
- General Surgery, Bozyaka Training and Research Hospital
| | - Yaşar Yildiz
- Department Medical of Oncology, Katip Çelebi University, Atatürk Training and Research Hospital, Izmir
| | | | - Devrim Cabuk
- Department of Medical Oncology, Kocaeli University Faculty of Medicine Hospital, Kocaeli
| | - Ercan Ozden
- Department of Medical Oncology, Kocaeli University Faculty of Medicine Hospital, Kocaeli
| | - Derya Kivrak Salim
- Department of Medical Oncology, Health Sciences University Antalya Training and Research Hospital, Antalya
| | - Semra Paydas
- Department of Medical Oncology, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Atakan Demir
- Department of Medical Oncology, Acibadem Hospital, Istanbul
| | - Omer Diker
- Department of Medical Oncology, Near East University Hospital, Lefkosa, Cyprus
| | | | | | - Sezai Vatansever
- Department of Medical Oncology, Istanbul University Faculty of Medicine, Istanbul
| | - Izzet Dogan
- Department of Medical Oncology, Istanbul University Faculty of Medicine, Istanbul
| | - Ahmet Gulmez
- Department of Medical Oncology, Inonu University Faculty of Medicine, Malatya
| | - Burcu Cakar
- Department of Medical Oncology, Ege University Faculty of Medicine, Izmir
| | - Pinar Gursoy
- Department of Medical Oncology, Ege University Faculty of Medicine, Izmir
| | | | - Murat Ayhan
- Department of Medical Oncology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul
| | - Nuri Karadurmus
- Department of Medical Oncology, Health Sciences University Gulhane Training and Research Hospital, Ankara
| | - Musa Baris Aykan
- Department of Medical Oncology, Health Sciences University Gulhane Training and Research Hospital, Ankara
| | - Gökcen Tugba Cevik
- Department of Medical Oncology, Usak University Training and Research Hospital, Usak
| | - Teoman Sakalar
- Department of Medical Oncology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras
| | - Ilhan Hacibekiroglu
- Department of Medical Oncology, Sakarya University Training and Research Hospital, Sakarya
| | - Burcu Belen Gülbagci
- Department of Medical Oncology, Sakarya University Training and Research Hospital, Sakarya
| | - Murat Dincer
- Department of Medical Oncology, Osmangazi University Faculty of Medicine Hospital, Eskisehir
| | - Duygu Bayir Garbioglu
- Department of Medical Oncology, Osmangazi University Faculty of Medicine Hospital, Eskisehir
| | - Yasemin Kemal
- Department of Medical Oncology, Medical Park Hospital, Samsun
| | - Erdinc Nayir
- Department of Medical Oncology, Medical Park Hospital, Mersin
| | | | - Mesut Yilmaz
- Department of Medical Oncology, Bakirköy Dr. Sadi Konuk Training and Research Hospital, Istanbul
| | - Okan Avci
- Department of Medical Oncology, Namik Kemal University Hospital, Tekirdag
| | - Murat Sari
- Department of Medical Oncology, Haydarpaşa Numune Training and Research Hospital
| | - Ezgi Coban
- Department of Medical Oncology, Haydarpaşa Numune Training and Research Hospital
| | | | | | - Tugba Akin Telli
- Department of Medical Oncology, Marmara University Faculty of Medicine, Istanbul
| | - Fatih Karatas
- Department of Medical Oncology, Karabuk University Faculty of Medicine, Karabuk
| | - Ali Inal
- Department of Medical Oncology, Mersin City Training and Research Hospital, Mersin
| | - Hacer Demir
- Department of Medical Oncology, Afyonkarahisar Health Sciences University, Afyonkarahisar
| | - Nurhan Onal Kalkan
- Department of Medical Oncology, Van Yuzuncu Yil Faculty of Medicine, Van
| | | | - Funda Tasli
- Department of Pathology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Ahmet Alacacioglu
- Department Medical of Oncology, Katip Çelebi University, Atatürk Training and Research Hospital, Izmir
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10
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Esen SA, Ergun Y, Erol C, Arikan R, Er MM, Atci MM, Topçu A, Uçar G, Akagündüz B, Aykan MB, Özen M, Baytemur NK, Özçelik M, Şahin E, Güven D, Menekşe S, Ak N, Teker F, Kut E, Şakalar T, Alan Ö, Kaçan T, Turhal NS, Kiliçkap S, Türker S, Şendur MAN, Köstek O, Karaağaç M, Sakin A, Türk HM, Çağlayan D, Cihan Ş, Açikgöz Y, Uncu D. First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal carcinoma. Bosn J Basic Med Sci 2022; 22:818-825. [PMID: 35460397 PMCID: PMC9519153 DOI: 10.17305/bjbms.2021.7069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/04/2022] [Indexed: 11/16/2022] Open
Abstract
Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of human epidermal growth factor receptor 2 (HER2)-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (p = 0.495). About 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (p = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, p = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, p = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens.
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Affiliation(s)
- Selin Aktürk Esen
- Department of Medical Oncology, Ankara City Hospital, Ankara, Türkiye
- Corresponding author: Selin Aktürk Esen, Department of Medical Oncology, Ankara City Hospital, Universities 1604. Street Number: 9, 06800 Çankaya, Ankara, Türkiye. E-mail:
| | - Yakup Ergun
- Department of Medical Oncology, Batman Training and Research Hospital, Batman, Türkiye
| | - Cihan Erol
- Department of Medical Oncology, Ankara City Hospital, Ankara, Türkiye
| | - Rukiye Arikan
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Türkiye
| | - Muhammed Muhiddin Er
- Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye
| | - Muhammed Mustafa Atci
- Department of Medical Oncology, Prof. Dr. Cemil Taşcioğlu City Hospital, Istanbul, Türkiye
| | - Atakan Topçu
- Department of Medical Oncology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Türkiye
| | - Gökhan Uçar
- Department of Medical Oncology, Ankara City Hospital, Ankara, Türkiye
| | - Baran Akagündüz
- Department of Medical Oncology, Erzincan Binali Yildirim University, Erzincan, Türkiye
| | - Musa Bariş Aykan
- Department of Medical Oncology, Gulhane Medical Faculty, Health Sciences University, Ankara, Türkiye
| | - Miraç Özen
- Department of Medical Oncology, Faculty of Medicine, Sakarya University Sakarya, Türkiye
| | | | - Melike Özçelik
- Department of Medical Oncology, Ümraniye Training and Research Hospital, İstanbul, Türkiye
| | - Elif Şahin
- Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye
| | - Denizcan Güven
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Serkan Menekşe
- Department of Medical Oncology, Manisa City Hospital, Manisa, Türkiye
| | - Naziye Ak
- Department of Medical Oncology, Yozgat City Hospital, Yozgat, Türkiye
| | - Fatih Teker
- Department of Medical Oncology, Faculty of Medicine, Gaziantep University, Gaziantep, Türkiye
| | - Engin Kut
- Department of Medical Oncology, Manisa City Hospital, Manisa, Türkiye
| | - Teoman Şakalar
- Department of Medical Oncology, Kahramanmaraş Necip Fazil City Hospital, Kahramanmaraş, Türkiye
| | - Özkan Alan
- Department of Medical Oncology, Tekirdağ İsmail Fehmi Cumalioğlu City Hospital, Tekirdağ, Türkiye
| | - Turgut Kaçan
- Department of Medical Oncology, Yüksek İhtisas Training and Research Hospital, Health Sciences University Bursa, Bursa, Türkiye
| | | | - Saadettin Kiliçkap
- Department of Medical Oncology, Liv Hospital Ankara, Faculty of Medicine, İstinye University, Ankara, Türkiye
| | - Sema Türker
- Department of Internal Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Türkiye
| | | | - Osman Köstek
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Türkiye
| | - Mustafa Karaağaç
- Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye
| | - Abdullah Sakin
- Department of Medical Oncology, Prof. Dr. Cemil Taşcioğlu City Hospital, Istanbul, Türkiye
| | - Haci Mehmet Türk
- Department of Medical Oncology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Türkiye
| | - Dilek Çağlayan
- Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye
| | - Şener Cihan
- Department of Medical Oncology, Prof. Dr. Cemil Taşcioğlu City Hospital, Istanbul, Türkiye
| | - Yusuf Açikgöz
- Department of Medical Oncology, Ankara City Hospital, Ankara, Türkiye
| | - Doğan Uncu
- Department of Medical Oncology, Ankara City Hospital, Ankara, Türkiye
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Acikgoz Y, Aktürk Esen S, Ucar G, Dirikoc M, Ergun Y, Bal O, Uncu D. The Comparison of mDCF and mFOLFOX-6 as First-Line Treatment in Metastatic Gastric Cancer. Cureus 2021; 13:e14882. [PMID: 34104608 PMCID: PMC8179973 DOI: 10.7759/cureus.14882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction: Fluoropyrimidine and platinum-based chemotherapy regimens are widely accepted for metastatic gastric cancer (GC). Because of drug toxicity, a combined two-drug cytotoxic drug regimen is recommended for first-line therapy, while three-drug cytotoxic regimens are recommended for patients with medically fit and better performance status. In this study, it was aimed to compare modified FOLFOX-6 (mFOLFOX-6) and modified DCF (mDCF) regimens in terms of survival and side effects in first-line treatment in metastatic GC. Methods: We retrospectively reviewed the clinical record of patients with metastatic gastric or gastro-esophageal junction cancer who had received mDCF or mFOLFOX-6 as the first-line treatment, and followed up in our center between February 2013 and December 2020. The data were collected from the patients' registration database of the hospital and oncologic follow-up files of our center. In the mDCF arm, docetaxel 60 mg/m2 and cisplatin 60 mg/m2 on day 1 intravenous (i.v.) infusion, and 600 mg/m2 5-fluorouracil (FU) as a continuous infusion for five days were administrated every three weeks for up to six cycles. In the mFOLFOX-6 arm, 85 mg/m2 oxaliplatin and 400 mg/m2 LV as an i.v. infusion over two hours and a 5-FU bolus of 400 mg/m2 as a 10-minute infusion, followed by 2.400 mg/m2 5-FU as a 46-hour continuous infusion were administrated every two weeks for up to six cycles. Univariate and multivariate analyses for overall survival (OS) were performed by Cox proportional hazards regression model. Survival analysis was performed by the Kaplan-Meier method with the Long-rank test. P-value <0.05 was considered statistically significant. Results: A total of 70 patients included into the study. Of those, 40 (57%) patients had received mDCF and 30 (43%) had received FOLFOX-6 regimens as first-line treatment. There were no complete responses in both groups. The partial response rate was 28% and 27% for mDCF and mFOLFOX-6, respectively. There was no statistically significant difference regarding treatment response for both groups (p=0.787). The median OS was 13.9 months (95% CI: 7.5-20.4) in the mDCF arm, and 10.4 months (95% CI: 6.4-14.4) in the mFOLFOX-6 arm (p=0.409). The median progression-free survival (PFS) was 5.2 months (95% CI: 3.6-6.9) in the mDCF arm, and 6.4 months (3.2-9.6) in the FOLFOX-6 arm (p=0.126). The ratio of dose reduction, treatment delay, and neutropenic fever were not statistically different between treatment arms. Conclusion: The present study demonstrated that proper patient selection for metastatic GC may give rise to comparable survival rates without increased toxicity. mFOLFOX-6 and mDCF had similar response rates, OS, PFS, and side effect profiles.
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Affiliation(s)
- Yusuf Acikgoz
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
| | - Selin Aktürk Esen
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
| | - Gokhan Ucar
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
| | - Merve Dirikoc
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
| | - Yakup Ergun
- Medical Oncology, Batman City Hospital, Batman, TUR
| | - Oznur Bal
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
| | - Dogan Uncu
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
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Ucar G, Acikgoz Y, Ergun Y, Eren T, Dirikoc M, Esen SA, Yazıcı O, Uncu D, Ozdemir NY. Prognostic and Predictive Value of NAR Score in Gastric Cancer. J Gastrointest Cancer 2020; 52:1054-1060. [PMID: 33064272 DOI: 10.1007/s12029-020-00537-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Neoadjuvant treatment is a widely accepted approach for locally advanced rectum cancer. Efforts to explore a surrogate endpoint for clinical trials revealed a new prognostic scoring system which is named as neoadjuvant rectal score (NAR) in patients who received neoadjuvant treatment for rectal cancer. MATERIAL AND METHODS 88 patients who met inclusion criteria were included in the study. The optimal cutoff value of the NAR score was 17.6 with 71% sensitivity and 63% specificity. Patients with NAR score > 17.6 (n: 48, 54%) were defined as the high-risk group and those with NAR score ≤ 17.6 (n: 40, 56%) as the low-risk group. RESULT Survival analysis according to the NAR score group (low-risk vs high-risk) revealed that there was a statistically significant difference between groups regarding OS and DFS. The median OS for high-risk patients was 27.3 months (95% CI, 15.0-39.6); it was 76.6 months (47.3-106.0) for low-risk patients (p < 0.0001). The median DFS was 15.1 months (11.8-18.4) for high-risk patients; it was 44.3 months (95% CI, 4.1-84.6) in the low-risk group (p = 0.002). DISCUSSION As a result, we interpreted our findings as supporting data about the utility of NAR score not only as a surrogate endpoint for the clinical trial of rectal cancer but also as a prognostic marker in patients with gastric cancer who received neoadjuvant treatment.
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Affiliation(s)
- Gokhan Ucar
- Medical Oncology, Ankara City Hospital, Ankara, Turkey.
| | - Yusuf Acikgoz
- Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Yakup Ergun
- Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Tulay Eren
- Medical Oncology, Yıldırım Beyazıt Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Merve Dirikoc
- Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | | | - Ozan Yazıcı
- Medical Oncology, Medicine Faculty of Gazi University, Ankara, Turkey
| | - Dogan Uncu
- Medical Oncology, Ankara City Hospital, Ankara, Turkey
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Abstract
Aim The aim of this study was to investigate the relationship between health literacy (HL) and quality of life (QoL) in type 1 diabetes mellitus (DM) patients. Method This study was conducted between February 2020 and May 2020 at the University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, in Turkey. A total of 155 patients with type 1 DM between the ages of 18-65 were included in the study. QoL was evaluated with the Audit of Diabetes Dependent QoL questionnaire and HL was evaluated with the Newest Vital Sign (NVS) questionnaire and obtained results were compared. Results The weighted impact score for the overall QoL scale was higher for patients who did not have complications than those with complications (p=0.004). Retinopathy and nephropathy were higher in the group with low HL (p=<0.001; p=0.032; p=0.012, respectively). The weighted impact score for the overall QoL scale was lower in married individuals (p=0.040) and it was higher for high school and above education levels than those with lower education levels (p=0.004). The sex life weighted impact score was higher in the group with DM less than 10 years (p=0.045). Conclusion Patients with high HL status are more adaptable to their physician's recommendations, less frequent complications will occur in these patients and the QoL of the patients will be better in the absence of complications.
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Affiliation(s)
- İrfan Esen
- Internal Medicine, Yildirim Beyazit University Yenimahalle Research and Training Hospital, Ankara, TUR
| | - Selin Aktürk Esen
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
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14
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Abstract
Colorectal cancer (CRC) is the third most common cancer in the world and is the second leading cause of cancer-related deaths. Several mutations are involved in the development of CRC. The prognostic significance of the KRAS mutation has been discussed in many studies. We aimed to investigate the prognostic significance of the number of KRAS mutations in metastatic CRC (mCRC).Patients with mutations in the KRAS gene were included in the study. They were divided into 2 groups as single mutation and multiple mutations in the KRAS gene.For the study, 425 CRC patients were screened. KRAS mutation was positive in 191 patients (45%). One hundred ninety-one patients were included in the study, 171 patients (90%) had single mutations and 20 patients (10%) had multiple mutations. Median progression-free survival was 12.8 months in patients with multiple mutations, while it was 8.8 months in patients with single mutations (P: .05). The median overall survival of patients with multiple mutations was 40.7 months, while it was 22.7 months for patients with single mutations (P = .01)We found that the presence of multiple mutations in KRAS mutant patients was associated with better overall survival and progression-free survival than a single mutation.
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Affiliation(s)
- Gokhan Ucar
- Department of Medical Oncology, Ankara City Hospital, Ankara
| | - Yakup Ergun
- Department of Medical Oncology, Ankara City Hospital, Ankara
| | | | - Yusuf Acikgoz
- Department of Medical Oncology, Ankara City Hospital, Ankara
| | - Merve Dirikoc
- Department of Medical Oncology, Ankara City Hospital, Ankara
| | - İrfan Esen
- Department of Internal Medicine, Yenimahalle Training and Education Hospital, Ankara, Turkey
| | - Öznur Bal
- Department of Medical Oncology, Ankara City Hospital, Ankara
| | - Doğan Uncu
- Department of Medical Oncology, Ankara City Hospital, Ankara
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15
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Ucar G, Acikgoz Y, Ergun Y, Bal O, Yilmaz M, Karakaya S, Akdeniz N, Kostek O, Aydin Isak O, Yazici Sener G, Dirikoc M, Aktürk Esen S, Dogan M, Uncu D. Sunitinib or Pazopanib: Is There Any Difference Between Tyrosine Kinase Inhibitors in the Pre-Nivolumab Setting in Metastatic Renal Cell Carcinoma? Cureus 2020; 12:e10525. [PMID: 33094066 PMCID: PMC7574822 DOI: 10.7759/cureus.10525] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction Treatment options for metastatic renal cell carcinoma disease have been improved in recent years. However, there is still no optimal treatment sequence or combination for metastatic disease. We aimed to investigate whether patients differed in terms of disease outcomes regarding pre-nivolumab tyrosine kinase inhibitors (TKIs). Material and methods The analysis of patients was performed after all cohorts were sub-grouped into two groups according to pre-nivolumab TKIs as following the sunitinib arm and the pazopanib arm. Result A total of 75 patients were included in this study. The median follow-up time was eight months for all cohorts. The objective response rate was statistically significantly higher in the pazopanib arm as compared to the sunitinib arm (56% vs 30%, p=0.02). Progression-free survival was significantly higher in pazopanib than sunitinib (10.3 months vs 5.3 months, p=0.02). Multivariate analysis revealed that pazopanib treatment was associated with better progression-free survival (HR: 0.44, 95 CI; 0.22-0.91, p=0.02). While the median overall survival for patients who had received sunitinib was 11.0 months, it has not been reached the median in the pazopanib arm (11.0 months vs NR, p=0.051). Discussion We demonstrated significantly better progression-free survival and a higher objective response rate with nivolumab treatment in patients who had received pazopanib as compared with patients who received sunitinib in the pre-nivolumab period.
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Affiliation(s)
- Gokhan Ucar
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
| | - Yusuf Acikgoz
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
| | - Yakup Ergun
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
| | - Oznur Bal
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
| | - Mesut Yilmaz
- Medical Oncology, Bakırkoy Sadi Konuk Training and Research Hospital, Istanbul, TUR
| | - Serdar Karakaya
- Medical Oncology, Health of Science Abdurrahman Yurtaslan Training and Research Hospital, Ankara, TUR
| | - Nadiye Akdeniz
- Medical Oncology, Dicle University Medical Faculty, Diyarbakır, TUR
| | - Osman Kostek
- Medical Oncology, Trakya University Medical Faculty, Edirne, TUR
| | - Ozlem Aydin Isak
- Medical Oncology, Health of Science Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, TUR
| | | | - Merve Dirikoc
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
| | - Selin Aktürk Esen
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
| | - Mutlu Dogan
- Medical Oncology, Health of Science Abdurrahman Yurtaslan Training and Research Hospital, Ankara, TUR
| | - Dogan Uncu
- Medical Oncology, Health of Science Ankara City Hospital, Ankara, TUR
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16
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Kahvecioğlu S, Gül CB, Aktürk Esen S. SP522 RELATİONSHİP BETWEEN PERİTONEAL DİALYSİS AND BODY MASS İNDEX. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx151.sp522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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17
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Kahvecioğlu S, Gül CB, Aktürk Esen S. MP552EVALUATION OF ANXIETY, DEPRESSION IN PERITONEAL DIALYSIS PATIENTS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx176.mp552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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