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Bayoğlu İV, Hüseynov J, Topal A, Sever N, Majidova N, Çelebi A, Yaşar A, Arıkan R, Işık S, Hacıoğlu MB, Ercelep Ö, Sarı M, Erdoğan B, Hacıbekiroğlu İ, Topaloğlu S, Köstek O, Çiçin İ. PNI as a Potential Add-On Biomarker to Improve the IMDC Intermediate Prognostic Score. J Clin Med 2023; 12:6420. [PMID: 37835062 PMCID: PMC10573811 DOI: 10.3390/jcm12196420] [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: 07/30/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 10/15/2023] Open
Abstract
INTRODUCTION This study aimed to assess the role of the adjusted PNI-IMDC risk scoring system in stratifying the intermediate group of metastatic RCC patients who received TKIS in the first-line setting. METHODS A total of 185 patients were included. The adjusted PNI and IMDC model was used to divide the intermediate group into two groups: intermediate PNI-high and intermediate PNI-low groups. The statistical data were analyzed using Kaplan-Meier and Cox regression analysis. RESULTS The results showed that the adjusted PNI-IMDC risk score, classic IMDC, and PNI had similar prognostic values. Adjusted PNI-IMDC risk score might be used for a more homogeneous differentiation of the classic intermediate group. On the other hand, multivariate analysis revealed that the presence of nephrectomy, adjusted favorable/intermediate (PNI-high) group, ECOG performance score, and presence of bone metastasis were independent predictors of OS. CONCLUSIONS Pre-treatment PNI, as a valuable and potential add-on biomarker to the adjusted PNI-IMDC classification model, can be helpful for establishing an improved prognostic model for intermediate group mRCC patients treated with first-line TKISs. Further validation studies are needed to clarify these findings.
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Affiliation(s)
- İbrahim Vedat Bayoğlu
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Javid Hüseynov
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Alper Topal
- Department of Medical Oncology, School of Medicine, Trakya University, 22000 Edirne, Turkey; (A.T.)
| | - Nadiye Sever
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Nargiz Majidova
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Abdussamet Çelebi
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Alper Yaşar
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Rukiye Arıkan
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Selver Işık
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Muhammet Bekir Hacıoğlu
- Department of Medical Oncology, School of Medicine, Trakya University, 22000 Edirne, Turkey; (A.T.)
| | - Özlem Ercelep
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Murat Sarı
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Bülent Erdoğan
- Department of Medical Oncology, School of Medicine, Trakya University, 22000 Edirne, Turkey; (A.T.)
| | - İlhan Hacıbekiroğlu
- Department of Medical Oncology, School of Medicine, Sakarya University, 54290 Sakarya, Turkey
| | - Sernaz Topaloğlu
- Department of Medical Oncology, School of Medicine, Trakya University, 22000 Edirne, Turkey; (A.T.)
| | - Osman Köstek
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - İrfan Çiçin
- Department of Medical Oncology, School of Medicine, Trakya University, 22000 Edirne, Turkey; (A.T.)
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2
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Karacin C, Oksuzoglu B, Demirci A, Keskinkılıç M, Baytemür NK, Yılmaz F, Selvi O, Erdem D, Avşar E, Paksoy N, Demir N, Göksu SS, Türker S, Bayram E, Çelebi A, Yılmaz H, Kuzu ÖF, Kahraman S, Gökmen İ, Sakin A, Alkan A, Nayır E, Uğraklı M, Acar Ö, Ertürk İ, Demir H, Aslan F, Sönmez Ö, Korkmaz T, Celayir ÖM, Karadağ İ, Kayıkçıoğlu E, Şakalar T, Öktem İN, Eren T, Erul E, Mocan EE, Kalkan Z, Yıldırım N, Ergün Y, Akagündüz B, Karakaya S, Kut E, Teker F, Demirel BÇ, Karaboyun K, Almuradova E, Ünal OÜ, Oyman A, Işık D, Okutur K, Öztosun B, Gülbağcı BB, Kalender ME, Şahin E, Seyyar M, Özdemir Ö, Selçukbiricik F, Kanıtez M, Dede İ, Gümüş M, Gökmen E, Yaren A, Menekşe S, Ebinç S, Aksoy S, İmamoğlu Gİ, Altınbaş M, Çetin B, Uluç BO, Er Ö, Karadurmuş N, Erdoğan AP, Artaç M, Tanrıverdi Ö, Çiçin İ, Şendur MAN, Oktay E, Bayoğlu İV, Paydaş S, Aydıner A, Salim DK, Geredeli Ç, Yavuzşen T, Doğan M, Hacıbekiroğlu İ. Correction: Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy. BMC Cancer 2023; 23:192. [PMID: 36849943 PMCID: PMC9969671 DOI: 10.1186/s12885-023-10662-3] [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: 03/01/2023] Open
Affiliation(s)
- Cengiz Karacin
- Department of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Berna Oksuzoglu
- grid.413794.cDepartment of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Ayşe Demirci
- grid.49746.380000 0001 0682 3030Department of Medical Oncology, Sakarya University, Sakarya, Turkey
| | - Merve Keskinkılıç
- grid.21200.310000 0001 2183 9022Department of Medical Oncology, Dokuz Eylül University, İzmir, Turkey
| | | | - Funda Yılmaz
- grid.413794.cDepartment of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Oğuzhan Selvi
- Department of Medical Oncology, Okmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
| | - Dilek Erdem
- Department of Medical Oncology, VM Medical Park Hospital, Samsun, Turkey
| | - Esin Avşar
- grid.413819.60000 0004 0471 9397Department of Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Nail Paksoy
- grid.9601.e0000 0001 2166 6619Department of Medical Oncology, Istanbul University Instıtue of Oncology, Istanbul, Turkey
| | - Necla Demir
- grid.413290.d0000 0004 0643 2189Department of Medical Oncology, Acıbadem Hospital, Kayseri, Turkey
| | - Sema Sezgin Göksu
- grid.29906.34Department of Medical Oncology, Akdeniz University, Antalya, Turkey
| | - Sema Türker
- Department of Medical Oncology, Zonguldak Hospital, Zonguldak, Turkey
| | - Ertuğrul Bayram
- grid.98622.370000 0001 2271 3229Department of Medical Oncology, Çukurova University, Adana, Turkey
| | - Abdüssamet Çelebi
- grid.414850.c0000 0004 0642 8921Department of Medical Oncology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Hatice Yılmaz
- grid.34517.340000 0004 0595 4313Department of Medical Oncology, Adnan Menderes University, Aydın, Turkey
| | - Ömer Faruk Kuzu
- grid.512925.80000 0004 7592 6297Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Seda Kahraman
- grid.512925.80000 0004 7592 6297Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - İvo Gökmen
- grid.411693.80000 0001 2342 6459Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Abdullah Sakin
- grid.411781.a0000 0004 0471 9346Department of Medical Oncology, Istanbul Medipol University Bahçelievler Hospital, Istanbul, Turkey
| | - Ali Alkan
- grid.411861.b0000 0001 0703 3794Department of Medical Oncology, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Erdinç Nayır
- Mersin Medical Park Hospital, Department of Medical Oncology, Mersin, Turkey
| | - Muzafer Uğraklı
- grid.411124.30000 0004 1769 6008Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Ömer Acar
- grid.411688.20000 0004 0595 6052Department of Medical Oncology, Celal Bayar University, Manisa, Turkey
| | - İsmail Ertürk
- Department of Medical Oncology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Hacer Demir
- Department of Medical Oncology, Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Turkey
| | - Ferit Aslan
- Department of Medical Oncology, Ankara Medical Park Hospital, Ankara, Turkey
| | - Özlem Sönmez
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Taner Korkmaz
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Özde Melisa Celayir
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - İbrahim Karadağ
- grid.440466.40000 0004 0369 655XDepartment of Medical Oncology, Hitit University Hospital, Çorum, Turkey
| | - Erkan Kayıkçıoğlu
- grid.45978.37Department of Medical Oncology, Süleyman Demirel University Hospital, Isparta, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - İlker Nihat Öktem
- Department of Medical Oncology, Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Tülay Eren
- grid.413698.10000 0004 0419 0366Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Enes Erul
- grid.14442.370000 0001 2342 7339Department of Medical Oncology, Hacettepe University Instıtue of Oncology, Ankara, Turkey
| | - Eda Eylemer Mocan
- grid.7256.60000000109409118Department of Medical Oncology, Ankara University, Ankara, Turkey
| | - Ziya Kalkan
- grid.411690.b0000 0001 1456 5625Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Nilgün Yıldırım
- grid.411320.50000 0004 0574 1529Department of Medical Oncology, Fırat University, Elazığ, Turkey
| | - Yakup Ergün
- Batman Training and Research Hospital, Batman, Turkey
| | - Baran Akagündüz
- grid.412176.70000 0001 1498 7262Department of Medical Oncology, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Serdar Karakaya
- Department of Medical Oncology, Atatürk Pulmonary Diseases Hospital, Ankara, Turkey
| | - Engin Kut
- Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey
| | - Fatih Teker
- grid.411549.c0000000107049315Department of Medical Oncology, Gaziantep University, Gaziantep, Turkey
| | - Burçin Çakan Demirel
- grid.411742.50000 0001 1498 3798Department of Medical Oncology, Pamukkale University, Denizli, Turkey
| | - Kubilay Karaboyun
- grid.412006.10000 0004 0369 8053Department of Medical Oncology, Namık Kemal University, Tekirdağ, Turkey
| | - Elvina Almuradova
- grid.8302.90000 0001 1092 2592Department of Medical Oncology, Ege University, İzmir, Turkey
| | - Olçun Ümit Ünal
- grid.414882.30000 0004 0643 0132UHS İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Abdilkerim Oyman
- grid.417018.b0000 0004 0419 1887Department of Medical Oncology, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Deniz Işık
- Kocaeli Medical Park, Department of Medical Oncology, Kocaeli, Turkey
| | - Kerem Okutur
- grid.414854.8Department of Medical Oncology, Bahçelievler Memorial Hospital, Istanbul, Turkey
| | - Buğra Öztosun
- grid.411776.20000 0004 0454 921XDepartment of Medical Oncology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Burcu Belen Gülbağcı
- grid.49746.380000 0001 0682 3030Department of Medical Oncology, Sakarya University, Sakarya, Turkey
| | | | - Elif Şahin
- grid.411105.00000 0001 0691 9040Department of Medical Oncology, Kocaeli University, Kocaeli, Turkey
| | - Mustafa Seyyar
- grid.411105.00000 0001 0691 9040Department of Medical Oncology, Kocaeli University, Kocaeli, Turkey
| | - Özlem Özdemir
- grid.414879.70000 0004 0415 690Xİzmir Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Fatih Selçukbiricik
- grid.15876.3d0000000106887552Department of Medical Oncology, Koç University, Istanbul, Turkey
| | - Metin Kanıtez
- grid.413690.90000 0000 8653 4054Department of Medical Oncology, American Hospital, Istanbul, Turkey
| | - İsa Dede
- grid.14352.310000 0001 0680 7823Department of Medical Oncology, Mustafa Kemal University, Hatay, Turkey
| | - Mahmut Gümüş
- grid.411776.20000 0004 0454 921XDepartment of Medical Oncology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Erhan Gökmen
- grid.8302.90000 0001 1092 2592Department of Medical Oncology, Ege University, İzmir, Turkey
| | - Arzu Yaren
- grid.411742.50000 0001 1498 3798Department of Medical Oncology, Pamukkale University, Denizli, Turkey
| | - Serkan Menekşe
- Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey
| | - Senar Ebinç
- grid.411690.b0000 0001 1456 5625Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Sercan Aksoy
- grid.14442.370000 0001 2342 7339Department of Medical Oncology, Hacettepe University Instıtue of Oncology, Ankara, Turkey
| | - Gökşen İnanç İmamoğlu
- grid.413698.10000 0004 0419 0366Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mustafa Altınbaş
- grid.413698.10000 0004 0419 0366Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Bülent Çetin
- grid.45978.37Department of Medical Oncology, Süleyman Demirel University Hospital, Isparta, Turkey
| | - Başak Oyan Uluç
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Özlem Er
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Nuri Karadurmuş
- Department of Medical Oncology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Atike Pınar Erdoğan
- grid.411688.20000 0004 0595 6052Department of Medical Oncology, Celal Bayar University, Manisa, Turkey
| | - Mehmet Artaç
- grid.411124.30000 0004 1769 6008Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Özgür Tanrıverdi
- grid.411861.b0000 0001 0703 3794Department of Medical Oncology, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - İrfan Çiçin
- grid.411693.80000 0001 2342 6459Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Mehmet Ali Nahit Şendur
- grid.512925.80000 0004 7592 6297Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Esin Oktay
- grid.34517.340000 0004 0595 4313Department of Medical Oncology, Adnan Menderes University, Aydın, Turkey
| | - İbrahim Vedat Bayoğlu
- grid.414850.c0000 0004 0642 8921Department of Medical Oncology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Semra Paydaş
- grid.98622.370000 0001 2271 3229Department of Medical Oncology, Çukurova University, Adana, Turkey
| | - Adnan Aydıner
- grid.9601.e0000 0001 2166 6619Department of Medical Oncology, Istanbul University Instıtue of Oncology, Istanbul, Turkey
| | - Derya Kıvrak Salim
- grid.413819.60000 0004 0471 9397Department of Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Çağlayan Geredeli
- Department of Medical Oncology, Okmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
| | - Tuğba Yavuzşen
- grid.21200.310000 0001 2183 9022Department of Medical Oncology, Dokuz Eylül University, İzmir, Turkey
| | - Mutlu Doğan
- grid.413794.cDepartment of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - İlhan Hacıbekiroğlu
- grid.49746.380000 0001 0682 3030Department of Medical Oncology, Sakarya University, Sakarya, Turkey
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3
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Karacin C, Oksuzoglu B, Demirci A, Keskinkılıç M, Baytemür NK, Yılmaz F, Selvi O, Erdem D, Avşar E, Paksoy N, Demir N, Göksu SS, Türker S, Bayram E, Çelebi A, Yılmaz H, Kuzu ÖF, Kahraman S, Gökmen İ, Sakin A, Alkan A, Nayır E, Uğraklı M, Acar Ö, Ertürk İ, Demir H, Aslan F, Sönmez Ö, Korkmaz T, Celayir ÖM, Karadağ İ, Kayıkçıoğlu E, Şakalar T, Öktem İN, Eren T, Urul E, Mocan EE, Kalkan Z, Yıldırım N, Ergün Y, Akagündüz B, Karakaya S, Kut E, Teker F, Demirel BÇ, Karaboyun K, Almuradova E, Ünal OÜ, Oyman A, Işık D, Okutur K, Öztosun B, Gülbağcı BB, Kalender ME, Şahin E, Seyyar M, Özdemir Ö, Selçukbiricik F, Kanıtez M, Dede İ, Gümüş M, Gökmen E, Yaren A, Menekşe S, Ebinç S, Aksoy S, İmamoğlu Gİ, Altınbaş M, Çetin B, Uluç BO, Er Ö, Karadurmuş N, Erdoğan AP, Artaç M, Tanrıverdi Ö, Çiçin İ, Şendur MAN, Oktay E, Bayoğlu İV, Paydaş S, Aydıner A, Salim DK, Geredeli Ç, Yavuzşen T, Doğan M, Hacıbekiroğlu İ. Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy. BMC Cancer 2023; 23:136. [PMID: 36765293 PMCID: PMC9912535 DOI: 10.1186/s12885-023-10609-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/03/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). METHODS A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. RESULTS The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0-14.0) months in the ET arm of group A, and 5.3 (3.9-6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8-7.7) months in the ET arm of group B, and 5.7 (4.6-6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5-8.0) months in the ET arm of group C and 4.0 (3.5-4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. CONCLUSION Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET.
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Affiliation(s)
- Cengiz Karacin
- Department of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Berna Oksuzoglu
- grid.413794.cDepartment of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Ayşe Demirci
- grid.49746.380000 0001 0682 3030Department of Medical Oncology, Sakarya University, Sakarya, Turkey
| | - Merve Keskinkılıç
- grid.21200.310000 0001 2183 9022Department of Medical Oncology, Dokuz Eylül University, İzmir, Turkey
| | | | - Funda Yılmaz
- grid.413794.cDepartment of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Oğuzhan Selvi
- Department of Medical Oncology, Okmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
| | - Dilek Erdem
- Department of Medical Oncology, VM Medical Park Hospital, Samsun, Turkey
| | - Esin Avşar
- grid.413819.60000 0004 0471 9397Department of Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Nail Paksoy
- grid.9601.e0000 0001 2166 6619Department of Medical Oncology, Istanbul University Instıtue of Oncology, Istanbul, Turkey
| | - Necla Demir
- grid.413290.d0000 0004 0643 2189Department of Medical Oncology, Acıbadem Hospital, Kayseri, Turkey
| | - Sema Sezgin Göksu
- grid.29906.34Department of Medical Oncology, Akdeniz University, Antalya, Turkey
| | - Sema Türker
- Department of Medical Oncology, Zonguldak Hospital, Zonguldak, Turkey
| | - Ertuğrul Bayram
- grid.98622.370000 0001 2271 3229Department of Medical Oncology, Çukurova University, Adana, Turkey
| | - Abdüssamet Çelebi
- grid.414850.c0000 0004 0642 8921Department of Medical Oncology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Hatice Yılmaz
- grid.34517.340000 0004 0595 4313Department of Medical Oncology, Adnan Menderes University, Aydın, Turkey
| | - Ömer Faruk Kuzu
- grid.512925.80000 0004 7592 6297Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Seda Kahraman
- grid.512925.80000 0004 7592 6297Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - İvo Gökmen
- grid.411693.80000 0001 2342 6459Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Abdullah Sakin
- grid.411781.a0000 0004 0471 9346Department of Medical Oncology, Istanbul Medipol University Bahçelievler Hospital, Istanbul, Turkey
| | - Ali Alkan
- grid.411861.b0000 0001 0703 3794Department of Medical Oncology, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Erdinç Nayır
- Mersin Medical Park Hospital, Department of Medical Oncology, Mersin, Turkey
| | - Muzaffer Uğraklı
- grid.411124.30000 0004 1769 6008Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Ömer Acar
- grid.411688.20000 0004 0595 6052Department of Medical Oncology, Celal Bayar University, Manisa, Turkey
| | - İsmail Ertürk
- Department of Medical Oncology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Hacer Demir
- Department of Medical Oncology, Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Turkey
| | - Ferit Aslan
- Department of Medical Oncology, Ankara Medical Park Hospital, Ankara, Turkey
| | - Özlem Sönmez
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Taner Korkmaz
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Özde Melisa Celayir
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - İbrahim Karadağ
- grid.440466.40000 0004 0369 655XDepartment of Medical Oncology, Hitit University Hospital, Çorum, Turkey
| | - Erkan Kayıkçıoğlu
- grid.45978.37Department of Medical Oncology, Süleyman Demirel University Hospital, Isparta, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - İlker Nihat Öktem
- Department of Medical Oncology, Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Tülay Eren
- grid.413698.10000 0004 0419 0366Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Enes Urul
- grid.14442.370000 0001 2342 7339Department of Medical Oncology, Hacettepe University Instıtue of Oncology, Ankara, Turkey
| | - Eda Eylemer Mocan
- grid.7256.60000000109409118Department of Medical Oncology, Ankara University, Ankara, Turkey
| | - Ziya Kalkan
- grid.411690.b0000 0001 1456 5625Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Nilgün Yıldırım
- grid.411320.50000 0004 0574 1529Department of Medical Oncology, Fırat University, Elazığ, Turkey
| | - Yakup Ergün
- Batman Training and Research Hospital, Batman, Turkey
| | - Baran Akagündüz
- grid.412176.70000 0001 1498 7262Department of Medical Oncology, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Serdar Karakaya
- Department of Medical Oncology, Atatürk Pulmonary Diseases Hospital, Ankara, Turkey
| | - Engin Kut
- Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey
| | - Fatih Teker
- grid.411549.c0000000107049315Department of Medical Oncology, Gaziantep University, Gaziantep, Turkey
| | - Burçin Çakan Demirel
- grid.411742.50000 0001 1498 3798Department of Medical Oncology, Pamukkale University, Denizli, Turkey
| | - Kubilay Karaboyun
- grid.412006.10000 0004 0369 8053Department of Medical Oncology, Namık Kemal University, Tekirdağ, Turkey
| | - Elvina Almuradova
- grid.8302.90000 0001 1092 2592Department of Medical Oncology, Ege University, İzmir, Turkey
| | - Olçun Ümit Ünal
- grid.414882.30000 0004 0643 0132UHS İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Abdilkerim Oyman
- grid.417018.b0000 0004 0419 1887Department of Medical Oncology, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Deniz Işık
- Kocaeli Medical Park, Department of Medical Oncology, Kocaeli, Turkey
| | - Kerem Okutur
- grid.414854.8Department of Medical Oncology, Bahçelievler Memorial Hospital, Istanbul, Turkey
| | - Buğra Öztosun
- grid.411776.20000 0004 0454 921XDepartment of Medical Oncology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Burcu Belen Gülbağcı
- grid.49746.380000 0001 0682 3030Department of Medical Oncology, Sakarya University, Sakarya, Turkey
| | | | - Elif Şahin
- grid.411105.00000 0001 0691 9040Department of Medical Oncology, Kocaeli University, Kocaeli, Turkey
| | - Mustafa Seyyar
- grid.411105.00000 0001 0691 9040Department of Medical Oncology, Kocaeli University, Kocaeli, Turkey
| | - Özlem Özdemir
- grid.414879.70000 0004 0415 690Xİzmir Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Fatih Selçukbiricik
- grid.15876.3d0000000106887552Department of Medical Oncology, Koç University, Istanbul, Turkey
| | - Metin Kanıtez
- grid.413690.90000 0000 8653 4054Department of Medical Oncology, American Hospital, Istanbul, Turkey
| | - İsa Dede
- grid.14352.310000 0001 0680 7823Department of Medical Oncology, Mustafa Kemal University, Hatay, Turkey
| | - Mahmut Gümüş
- grid.411776.20000 0004 0454 921XDepartment of Medical Oncology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Erhan Gökmen
- grid.8302.90000 0001 1092 2592Department of Medical Oncology, Ege University, İzmir, Turkey
| | - Arzu Yaren
- grid.411742.50000 0001 1498 3798Department of Medical Oncology, Pamukkale University, Denizli, Turkey
| | - Serkan Menekşe
- Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey
| | - Senar Ebinç
- grid.411690.b0000 0001 1456 5625Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Sercan Aksoy
- grid.14442.370000 0001 2342 7339Department of Medical Oncology, Hacettepe University Instıtue of Oncology, Ankara, Turkey
| | - Gökşen İnanç İmamoğlu
- grid.413698.10000 0004 0419 0366Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mustafa Altınbaş
- grid.413698.10000 0004 0419 0366Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Bülent Çetin
- grid.45978.37Department of Medical Oncology, Süleyman Demirel University Hospital, Isparta, Turkey
| | - Başak Oyan Uluç
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Özlem Er
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Nuri Karadurmuş
- Department of Medical Oncology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Atike Pınar Erdoğan
- grid.411688.20000 0004 0595 6052Department of Medical Oncology, Celal Bayar University, Manisa, Turkey
| | - Mehmet Artaç
- grid.411124.30000 0004 1769 6008Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Özgür Tanrıverdi
- grid.411861.b0000 0001 0703 3794Department of Medical Oncology, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - İrfan Çiçin
- grid.411693.80000 0001 2342 6459Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Mehmet Ali Nahit Şendur
- grid.512925.80000 0004 7592 6297Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Esin Oktay
- grid.34517.340000 0004 0595 4313Department of Medical Oncology, Adnan Menderes University, Aydın, Turkey
| | - İbrahim Vedat Bayoğlu
- grid.414850.c0000 0004 0642 8921Department of Medical Oncology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Semra Paydaş
- grid.98622.370000 0001 2271 3229Department of Medical Oncology, Çukurova University, Adana, Turkey
| | - Adnan Aydıner
- grid.9601.e0000 0001 2166 6619Department of Medical Oncology, Istanbul University Instıtue of Oncology, Istanbul, Turkey
| | - Derya Kıvrak Salim
- grid.413819.60000 0004 0471 9397Department of Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Çağlayan Geredeli
- Department of Medical Oncology, Okmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
| | - Tuğba Yavuzşen
- grid.21200.310000 0001 2183 9022Department of Medical Oncology, Dokuz Eylül University, İzmir, Turkey
| | - Mutlu Doğan
- grid.413794.cDepartment of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - İlhan Hacıbekiroğlu
- grid.49746.380000 0001 0682 3030Department of Medical Oncology, Sakarya University, Sakarya, Turkey
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4
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Yıldırım HÇ, Mutlu E, Chalabiyev E, Özen M, Keskinkılıç M, Ön S, Çelebi A, Dursun B, Acar Ö, Kahraman S, Aykan MB, Kaman Ö, Doğan A, Erdoğan AP, Melisa Celayir Ö, Günenç D, Güven DC, Vedat Bayoğlu İ, Yavuzşen T, Hacıbekiroğlu İ, İnanç M, Kılıçkap S, Yalçın Ş, Aksoy S. Clinical outcomes of cyclin-dependent kinase 4-6 (CDK 4-6) inhibitors in patients with male breast cancer: A multicenter study. Breast 2022; 66:85-88. [PMID: 36208540 PMCID: PMC9547301 DOI: 10.1016/j.breast.2022.09.009] [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] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Since breast cancer is less common in men than in women, data on the use of new therapeutic agents, including cyclin-dependent kinase 4-6 (CDK 4-6) inhibitors, are limited in patients with metastatic hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) male breast cancer. Therefore; we aimed to investigate the treatment responses of metastatic HR+, HER2-male breast cancer patients treated with CDK 4-6 inhibitors in a multicenter real-life cohort. METHODS Male patients with a diagnosis of HR+ and HER2-metastatic breast cancer, treated with any CDK 4-6 inhibitor, were included in the study. Demographic and clinical characteristics of the patients were recorded. We aimed to determine progression-free survival (PFS) time, response rates and drug related side effects. RESULTS A total 25 patients from 14 institutions were recruited. The mean age at diagnosis was 57 years. Median follow-up was 19.53 (95% CI: 14.04-25.02) months. The overall response rate was 60%. While the median PFS was 20.6 months in the whole cohort, it wasn't reached in those using CDK 4-6 inhibitors in first line and 10 months in the subsequent lines (p:0.009). No new adverse events were encountered. CONCLUSION In our study, we found that CDK 4-6 inhibitors are effective and safe options in men with HR+ and HER2-metastatic breast cancer as in women. Our results support the use of CDK 4-6 inhibitor-based combinations in the first-line treatment of HR+ and HER2-metastatic male breast cancer.
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Affiliation(s)
- Hasan Çağrı Yıldırım
- Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey.
| | - Emel Mutlu
- Erciyes University Faculty of Medicine, Department of Medical Oncology, Kayseri, Turkey
| | - Elvin Chalabiyev
- Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
| | - Miraç Özen
- Sakarya University Faculty of Medicine, Department of Medical Oncology, Sakarya, Turkey
| | - Merve Keskinkılıç
- 9 Eylül University Faculty of Medicine, Department of Medical Oncology, İzmir, Turkey
| | - Sercan Ön
- Ege University Faculty of Medicine, Department of Medical Oncology, İzmir, Turkey
| | - Abdussamet Çelebi
- Marmara University Faculty of Medicine, Department of Medical Oncology, İstanbul, Turkey
| | - Bengü Dursun
- Ankara University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
| | - Ömer Acar
- Manisa Celal Bayar University Faculty of Medicine, Department of Medical Oncology, Manisa, Turkey
| | - Seda Kahraman
- Ankara Yıldırım Beyazıt University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
| | - Musa Barış Aykan
- Gulhane Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey
| | - Ömür Kaman
- Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey
| | - Akif Doğan
- Kartal Dr. Lütfi Kirdar City Hospital, Department of Medical Oncology, İstanbul, Turkey
| | - Atike Pınar Erdoğan
- Manisa Celal Bayar University Faculty of Medicine, Department of Medical Oncology, Manisa, Turkey
| | | | - Damla Günenç
- Ege University Faculty of Medicine, Department of Medical Oncology, İzmir, Turkey
| | - Deniz Can Güven
- Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
| | - İbrahim Vedat Bayoğlu
- Marmara University Faculty of Medicine, Department of Medical Oncology, İstanbul, Turkey
| | - Tuğba Yavuzşen
- 9 Eylül University Faculty of Medicine, Department of Medical Oncology, İzmir, Turkey
| | - İlhan Hacıbekiroğlu
- Sakarya University Faculty of Medicine, Department of Medical Oncology, Sakarya, Turkey
| | - Mevlüde İnanç
- Erciyes University Faculty of Medicine, Department of Medical Oncology, Kayseri, Turkey
| | - Saadettin Kılıçkap
- İstinye University Liv Hospital, Department of Medical Oncology, Ankara, Turkey
| | - Şuayib Yalçın
- Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
| | - Sercan Aksoy
- Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
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5
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Erol C, Sakin A, Başoğlu T, Özden E, Çabuk D, Doğan M, Öksüzoğlu B, Yıldırım HÇ, Öner İ, Eryılmaz MK, Dülgar Ö, Aydın D, Doğan N, Özen M, Hacıbekiroğlu İ, Özdemir N, Gürler F, Paksoy N, Karabulut S, Aksoy A, Hızal M, Kahraman S, Şen E, Paydaş S, Çılbır E, Fırat F, Akdeniz N, Özçelik M, Oyman A, Baytemür NK, Acar R, Almuradova E, Karabulut B, Şakalar T, Arak H, Değerli E, Türker S, Alan Ö, Er Ö, Taşçı EŞ, Demir N, Çavdar E, Turhal S, Dede DŞ, Akıncı MB, Yalçın B, Yumuk F, Yalçın Ş, Şendur MAN. Prognostic factors of perioperative FLOT regimen in operable gastric and gastroesophageal junction tumors: real-life data (Turkish Oncology Group). Turk J Med Sci 2022; 52:1022-1032. [PMID: 36326360 PMCID: PMC10387859 DOI: 10.55730/1300-0144.5404] [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: 02/07/2022] [Accepted: 05/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Perioperative FLOT regimen is a standard of care in locally advanced operable gastric and GEJ adenocarcinoma. We aimed to determine the efficacy, prognostic factors of perioperative FLOT chemotherapy in real-life gastric and GEJ tumors. METHODS The data of patients who were treated with perioperative FLOT chemotherapy were retrospectively analyzed from 34 different oncology centers in Turkey. Baseline clinical and demographic characteristics, pretreatment laboratory values, histological and molecular characteristics were recorded. RESULTS A total of 441 patients were included in the study. The median of age our study population was 60 years. The majority of patients with radiological staging were cT3-4N(+) (89.9%, n = 338). After median 13.5 months (IQR: 8.5-20.5) follow-up, the median overall survival was NR (95% CI, NR to NR), and median disease free survival was 22.9 (95% CI, 18.6 to 27.3) months. The estimated overall survival at 24 months was 62%. Complete pathological response (pCR) and near pCR was achieved in 23.8% of all patients. Patients with lower NLR or PLR have significantly longer median OS (p = 0.007 and p = 0.033, respectively), and patients with lower NLR have significantly longer median DFS (p = 0.039), but PLR level did not affect DFS (p = 0.062). The OS and DFS of patients with better ECOG performance scores and those who could receive FLOT as adjuvant chemotherapy instead of other regimens were found to be better. NLR was found to be independent prognostic factor for OS in the multivariant analysis. At least one adverse event reported in 57.6% of the patients and grade 3-4 toxicity was seen in 23.6% patients. DISCUSSION Real-life perioperative FLOT regimen in operable gastric and GEJ tumors showed similar oncologic outcomes compared to clinical trials. Better performance status, receiving adjuvant chemotherapy as same regimen, low grade and low NLR and PLR improved outcomes in real-life. However, in multivariate analysis, only NLR affected OS.
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Affiliation(s)
- Cihan Erol
- Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey
| | - Tuğba Başoğlu
- Department of Medical Oncology, School of Medicine, Marmara University, İstanbul, Turkey
| | - Ercan Özden
- Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Devrim Çabuk
- Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Mutlu Doğan
- Department of Medical Oncology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Berna Öksüzoğlu
- Department of Medical Oncology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Hasan Çağrı Yıldırım
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - İrem Öner
- Department of Medical Oncology, Konya Meram State Hospital, Konya, Turkey
| | - Melek Karakurt Eryılmaz
- Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Özgecan Dülgar
- Department of Medical Oncology, Göztepe Training and Research Hospital, İstanbul Medeniyet University, İstanbul, Turkey
| | - Dinçer Aydın
- Department of Medical Oncology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Neslihan Doğan
- Department of Medical Oncology, Prof. Dr. A. İlhan Özdemir Education and Research Hospital, Giresun University, Giresun, Turkey
| | - Miraç Özen
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - İlhan Hacıbekiroğlu
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Nuriye Özdemir
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Fatih Gürler
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nail Paksoy
- Department of Medical Oncology, Institute of Oncology, İstanbul University, İstanbul, Turkey
| | - Senem Karabulut
- Department of Medical Oncology, Institute of Oncology, İstanbul University, İstanbul, Turkey
| | - Asude Aksoy
- Department of Medical Oncology, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - Mutlu Hızal
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Seda Kahraman
- Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Erdem Şen
- Department of Medical Oncology, Çanakkale Mehmet Akif Ersoy State Hospital, Çanakkale, Turkey
| | - Semra Paydaş
- Department of Medical Oncology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Ebru Çılbır
- Department of Medical Oncology, Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Feyza Fırat
- Department of Medical Oncology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Nadiye Akdeniz
- Department of Medical Oncology, Adıyaman Training and Research Hospital, Adıyaman, Turkey
| | - Melike Özçelik
- Department of Medical Oncology, Ümraniye Education and Research Hospital, İstanbul, Turkey
| | - Abdilkerim Oyman
- Department of Medical Oncology, Ümraniye Education and Research Hospital, İstanbul, Turkey
| | | | - Ramazan Acar
- Department of Medical Oncology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Elvina Almuradova
- Department of Medical Oncology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Bülent Karabulut
- Department of Medical Oncology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Hacı Arak
- Department of Medical Oncology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ezgi Değerli
- Department of Medical Oncology, Cerrahpaşa School of Medicine, İstanbul University, İstanbul, Turkey
| | - Sema Türker
- Department of Medical Oncology, Zonguldak Atatürk State Hospital, Zonguldak, Turkey
| | - Özkan Alan
- Department of Medical Oncology, Tekirdağ State Hospital, Tekirdağ, Turkey
| | - Özlem Er
- Department of Medical Oncology, Acıbadem Maslak Hospital, İstanbul, Turkey
| | - Elif Şenocak Taşçı
- Department of Medical Oncology, Acıbadem Maslak Hospital, İstanbul, Turkey
| | - Nazan Demir
- Department of Medical Oncology, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Eyyüp Çavdar
- Department of Medical Oncology, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Serdar Turhal
- Department of Medical Oncology, Anadolu Medical Center, Kocaeli, Turkey
| | - Didem Şener Dede
- Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turke
| | - Muhammed Bülent Akıncı
- Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turke
| | - Bülent Yalçın
- Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turke
| | - Fulden Yumuk
- Department of Medical Oncology, School of Medicine, Marmara University, İstanbul, Turkey
| | - Şuayib Yalçın
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mehmet Ali Nahit Şendur
- Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turke
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6
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Başoğlu T, Sakin A, Erol C, Özden E, Çabuk D, Çılbır E, Tataroğlu Özyükseler D, Ayhan M, Şendur MA, Dogan M, Öksüzoğlu B, Eryılmaz MK, Er Ö, Taşçı EŞ, Özyurt N, Dülgar Ö, Özen M, Hacıbekiroğlu İ, Öner İ, Bekmez ET, Çağrı Yıldırım H, Yalçın Ş, Paydaş S, Yekedüz E, Aksoy A, Özçelik M, Oyman A, Almuradova E, Karabulut B, Demir N, Dinçer M, Özdemir N, Erdem D, Ak N, İnal A, Salim DK, Deniz Gİ, Şakalar T, Gülmez A, Kaçan T, Özdemir Ö, Alan Ö, Ünal Ç, Karakaş Y, Turhal S, Yumuk PF. Real life experience of patients with locally advanced gastric and gastroesophageal junction adenocarcinoma treated with neoadjuvant chemotherapy: a Turkish oncology group study. J Chemother 2022; 35:142-149. [PMID: 35579894 DOI: 10.1080/1120009x.2022.2073159] [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] [Indexed: 10/18/2022]
Abstract
Neoadjuvant chemotherapy (NACT) in gastroesophageal junction (GEJ) and gastric cancer (GC) was shown to improve survival in recent studies. We aimed to share our real-life experience of patients who received NACT to compare the efficacy and toxicity profile of different chemotherapy regimens in our country. This retrospective multicentre study included locally advanced GC and GEJ cancer patients who received NACT between 2007 and 2021. Relation between CT regimens and pathological evaluation were analysed. A total of 794 patients from 45 oncology centers in Turkey were included. Median age at the time of diagnosis was 60 (range: 18-86). Most frequent NACT regimens used were FLOT (65.4%), DCF (17.4%) and ECF (8.1%), respectively. In the total study group, pathological complete remission (pCR) rate was 7.2%, R0 resection rate 86.4%, and D2 dissection rate was 66.8%. Rate of pCR and near-CR (24%), and R0 resection (84%) were numerically higher in FLOT arm (p > 0.05). Patients who received FLOT had also higher chemotherapy-related toxicity rate compared to patients who received other regimens (p > 0.05). Median follow-up time was 16 months (range: 1-154 months). Estimated median overall survival (OS) was 58.4months (95% CI: 35.2-85.7) and disease-free survival (DFS) was 50.7 months (95% CI: 25.4-75.9). The highest 3-year estimated OS rate was also shown in FLOT arm (68%). We still do not know which NACT regimen is the best choice for daily practice. Clinicians should tailor treatment regimens according to patients' multifactorial status and comorbidities for to obtain best outcomes. Longer follow-up period needs to validate our results.
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Affiliation(s)
- Tuğba Başoğlu
- Medical Oncology, Marmara University School of Medicine, İstanbul, Turkey
| | - Abdullah Sakin
- Medical Oncology, Van Yuzuncu Yil University Faculty of Medicine, Van, Turkey
| | - Cihan Erol
- Medical Oncology, Ankara Yildirim Beyazit Universtiy, Ankara, Turkey
| | - Ercan Özden
- Medical Oncology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Devrim Çabuk
- Medical Oncology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Ebru Çılbır
- Medical Oncology, Dışkapı Training and Research Hospital, Ankara, Turkey
| | | | - Murat Ayhan
- Medical Oncology, Kartal Dr.LütfiKırdar Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Ali Şendur
- Medical Oncology, Ankara Yildirim Beyazit Universtiy, Ankara, Turkey
| | - Mutlu Dogan
- Medical Oncology, Ankara Dr.Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Berna Öksüzoğlu
- Medical Oncology, Ankara Dr.Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | | | - Özlem Er
- Medical Oncology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Elif Şenocak Taşçı
- Medical Oncology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Neslihan Özyurt
- Medical Oncology, Giresun Education and Research Hospital, Giresun, Turkey
| | - Özgecan Dülgar
- Medical Oncology, İstanbul Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Miraç Özen
- Medical Oncology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | | | - İrem Öner
- Medical Oncology, Konya City Hospital, Konya, Turkey
| | | | | | - Şuayib Yalçın
- Medical Oncology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Semra Paydaş
- Medical Oncology, Cukurova University School of Medicine, Adana, Turkey
| | - Emre Yekedüz
- Medical Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Asude Aksoy
- Medical Oncology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Melike Özçelik
- Medical Oncology, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Abdilkerim Oyman
- Medical Oncology, Umraniye Training and Research Hospital, İstanbul, Turkey
| | | | - Bülent Karabulut
- Medical Oncology, Ege University School of Medicine, İzmir, Turkey
| | - Nazan Demir
- Medical Oncology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Murat Dinçer
- Medical Oncology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Nuriye Özdemir
- Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Dilek Erdem
- Medical Oncology, VM Medical Park Samsun Hospital, Samsun, Turkey
| | - Naziye Ak
- Medical Oncology, İstanbul University, İstanbul, Turkey
| | - Ali İnal
- Medical Oncology, Mersin City Hospital, Mersin, Turkey
| | - Derya Kıvrak Salim
- Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Gülhan İpek Deniz
- Medical Oncology, Sisli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Teoman Şakalar
- Medical Oncology, Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Ahmet Gülmez
- Medical Oncology, İnönü University, Elazığ, Turkey
| | - Turgut Kaçan
- Medical Oncology, Bursa High Specialized Education and Research Hospital, Bursa, Turkey
| | - Özlem Özdemir
- Medical Oncology, İzmir Bozyaka Research and Training Hospital, İzmir, Turkey
| | - Özkan Alan
- Medical Oncology, Tekirdağ State Hospital, Tekirdağ, Turkey
| | - Çağlar Ünal
- Medical Oncology, Florance Nightingale Hospital, İstanbul, Turkey
| | - Yusuf Karakaş
- Medical Oncology, Bodrum Acıbadem Hospital, Muğla, Turkey
| | - Serdar Turhal
- Medical Oncology, Anadolu SağlıkMerkezi Anadolu Health Center, İstanbul, Turkey
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7
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Demirci A, Bilir C, Gülbağcı B, Hacıbekiroğlu İ, Bayoğlu İV, Bilgetekin İ, Koca S, Çınkır HY, Akdeniz N, Gül D, Varım C, Demirci U, Öksüzoğlu B. Comparison of real-life data of abiraterone acetate and enzalutamide in metastatic castration-resistant prostate cancer. Sci Rep 2021; 11:14131. [PMID: 34239026 PMCID: PMC8266820 DOI: 10.1038/s41598-021-93659-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/28/2021] [Indexed: 12/19/2022] Open
Abstract
To compare enzalutamide (E) and abiraterone acetate (AA) in terms of efficacy, survival and to characterize prognostic factors affecting survival in metastatic castration-resistant prostate cancer (mCRPC) patients. A total of 250 patients treated with E or AA in 5 centers were included. The number of patients with no prostate specific antigen (PSA) decline was higher in the AA group than that in the E group, and the proportion of patients with a PSA decline of ≥ 50% was higher in the E group (p = 0.020). Radiological progression free survival (rPFS) and overall survival (OS) were significantly longer in the E group when compared to that in the AA group (p < 0.001 and p = 0.027, respectively). In the E group, rPFS was significantly longer than that in the AA group in both pre- and post-docetaxel settings (p = 0.010 and p = 0.003, respectively). OS was similar in the pre-docetaxel setting; but in the post-docetaxel setting, E group had a significantly longer OS than the AA group (p = 0.021). In the multivariate analysis performed in the whole patient group, we found that good prognostic factors for rPFS were E treatment, being ≥ 75 years and a PSA decline of ≥ 50% while there was no factor affecting OS. With longer OS and PFS, E seems to be more suitable for mCRPC patients in the post-docetaxel setting than AA.
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Affiliation(s)
- Ayşe Demirci
- Department of Medical Oncology, Sakarya University Training and Research Hospital, Adnan Menderes caddesi, Sağlık Sokak, No: 195-54000, Adapazarı/Sakarya, Turkey.
| | - Cemil Bilir
- Department of Medical Oncology, Sakarya University Training and Research Hospital, Adnan Menderes caddesi, Sağlık Sokak, No: 195-54000, Adapazarı/Sakarya, Turkey
| | - Burcu Gülbağcı
- Department of Medical Oncology, Sakarya University Training and Research Hospital, Adnan Menderes caddesi, Sağlık Sokak, No: 195-54000, Adapazarı/Sakarya, Turkey
| | - İlhan Hacıbekiroğlu
- Department of Medical Oncology, Sakarya University Training and Research Hospital, Adnan Menderes caddesi, Sağlık Sokak, No: 195-54000, Adapazarı/Sakarya, Turkey
| | - İbrahim V Bayoğlu
- Department of Medical Oncology, Sakarya University Training and Research Hospital, Adnan Menderes caddesi, Sağlık Sokak, No: 195-54000, Adapazarı/Sakarya, Turkey
| | - İrem Bilgetekin
- Department of Medical Oncology, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Sinan Koca
- Department of Medical Oncology, Istanbul Medeniyet University Göztepe Training and Research Hospital, Istanbul, Turkey
| | - Havva Y Çınkır
- Department of Medical Oncology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Nadiye Akdeniz
- Department of Medical Oncology, Adıyaman Training and Research Hospital, Adiyaman, Turkey
| | - Deniz Gül
- Department of Urology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Ceyhun Varım
- Department of Internal Medicine, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Umut Demirci
- Department of Medical Oncology, Memorial Ankara Hospital, University of Usküdar, Ankara, Turkey
| | - Berna Öksüzoğlu
- Department of Medical Oncology, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
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8
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Varım C, Demirci T, Cengiz H, Hacıbekiroğlu İ, Tuncer FB, Çokluk E, Toptan H, Karabay O, Yıldırım İ. Relationship between serum osteopontin levels and the severity of COVID-19 infection. Wien Klin Wochenschr 2020; 133:298-302. [PMID: 33369698 PMCID: PMC7768087 DOI: 10.1007/s00508-020-01789-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Received: 10/05/2020] [Accepted: 11/26/2020] [Indexed: 12/23/2022]
Abstract
Background Coronavirus disease 2019 (COVID-19) is an acute inflammatory respiratory disease. Osteopontin (OPN) is a glycoprotein expressed in various cell types, such as bone, immune, smooth muscle, epithelial and endothelial cells. It also acts as a regulator of immune response. The aim of the present study was to reveal the place of serum osteopontin levels in predicting severity among patients with COVID-19. Methods This study included 84 patients, 43 female and 45 male. Patients were divided into 2 groups, group 1 non-severe group (n: 48), group 2 severe (n: 40). Demographic data, neutrophil, lymphocyte, platelet, white blood cell counts, albumin, procalcitonin, C‑reactive protein (CRP) and OPN levels were recorded. The OPN levels and these inflammatory parameters of the two groups were compared. Results There were no significant differences in terms of gender (female/male 25/23 vs. 18/22) and platelet count (178 K/μL vs. 191 K/μL) between the groups (p > 0.05). Ages (57.7 ± 17.0 years vs. 71.4 ± 12.8 years), procalcitonin (0.07 vs. 0.24 ng/mL), CRP (17 vs 158 mg/l), neutrophil count (3.7 vs 5.64 K/μL), WBC counts (5.38 vs 7.85 K/μL) and number of deaths (0 vs 26) (p < 0.001). The OPN levels (98.5 vs 13.75 ng/mL, p = 0.002) were found to be statistically higher, in group 2 than group 1. Conclusion The present study showed that OPN can be used to predict the severity in patients with COVID-19.
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Affiliation(s)
- Ceyhun Varım
- Department of Internal Medicine, Sakarya University Medicine Faculty, Sakarya, Turkey.
| | - Taner Demirci
- Department of Internal Medicine, Division of Endocrinology, Sakarya University Medicine Faculty, Sakarya, Turkey
| | - Hasret Cengiz
- Department of Endocrinology, Sakarya University Medicine Faculty, Sakarya, Turkey
| | - İlhan Hacıbekiroğlu
- Department of Medical Oncology, Sakarya University Medicine Faculty, Sakarya, Turkey
| | - Fatima Betul Tuncer
- Department of Clinical Microbiology, Sakarya University Medicine Faculty, Sakarya, Turkey
| | - Erdem Çokluk
- Department of Medical Biochemistry, Sakarya University Medicine Faculty, Sakarya, Turkey
| | - Hande Toptan
- Department of Clinical Microbiology, Sakarya University Medicine Faculty, Sakarya, Turkey
| | - Oguz Karabay
- Department of İnfection Diseases and Clinical Microbiology, Sakarya University Medicine Faculty, Sakarya, Turkey
| | - İlhan Yıldırım
- Department of Internal Medicine, Sakarya University Medicine Faculty, Sakarya, Turkey
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9
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Kodaz H, Taştekin E, Erdoğan B, Hacıbekiroğlu İ, Tozkır H, Gürkan H, Türkmen E, Demirkan B, Uzunoğlu S, Çiçin İ. KRAS Mutation in Small Cell Lung Carcinoma and Extrapulmonary Small Cell Cancer. Balkan Med J 2016; 33:407-10. [PMID: 27606136 DOI: 10.5152/balkanmedj.2016.150610] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 05/15/2015] [Accepted: 11/21/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Lung cancer is one of the most lethal cancers. It is mainly classified into 2 groups: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Extrapulmonary small cell carcinomas (EPSCC) are very rare. The Ras oncogene controls most of the cellular functions in the cell. Overall, 21.6% of human cancers contain a Kirsten Ras (KRAS) mutation. SCLC and EPSCC have several similar features but their clinical course is different. AIMS We investigated the KRAS mutation status in SCLC and EPSCC. STUDY DESIGN Mutation research. METHODS Thirty-seven SCLC and 15 EPSCC patients were included in the study. The pathological diagnoses were confirmed by a second pathologist. KRAS analysis was performed in our medical genetic department. DNA isolation was performed with primary tumor tissue using the QIAamp DNA FFPE Tissue kit (Qiagen; Hilden, Germany) in all patients. The therascreen KRAS Pyro Kit 24 V1 (Qiagen; Hilden, Germany) was used for KRAS analyses. RESULTS Thirty-four (91.9%) of the SCLC patients were male, while 11 (73.3%) of the EPSCC l patients were female. SCLC was more common in males, and EPSCC in females (p=0.001). A KRAS mutation was found in 6 (16.2%) if SCLC patients. The most common mutation was Q61R (CAA>CGA). Among the 15 EPSCC patients, 2 had a KRAS mutation (13.3%). When KRAS mutant and wild type patients were compared in the SCLC group, no difference was found for overall survival (p=0.6). CONCLUSION In previous studies, the incidence of KRAS mutation in SCLC was 1-3%; however, it was 16.2% in our study. Therefore, there may be ethnic and geographical differences in the KRAS mutations of SCLC. As a result, KRAS mutation should not be excluded in SCLC.
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Affiliation(s)
- Hilmi Kodaz
- Department of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Ebru Taştekin
- Department of Medical Pathology, Trakya University School of Medicine, Edirne, Turkey
| | - Bülent Erdoğan
- Department of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - İlhan Hacıbekiroğlu
- Department of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Hilmi Tozkır
- Department of Medical Genetics, Trakya University School of Medicine, Edirne, Turkey
| | - Hakan Gürkan
- Department of Medical Genetics, Trakya University School of Medicine, Edirne, Turkey
| | - Esma Türkmen
- Department of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Bora Demirkan
- Department of Medical Genetics, Trakya University School of Medicine, Edirne, Turkey
| | - Sernaz Uzunoğlu
- Department of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - İrfan Çiçin
- Department of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
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10
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Yazıcı O, Özdemir N, Duran AO, Menekşe S, Şendur MA, Karaca H, Göksel G, Arpacı E, Hacıbekiroğlu İ, Bilgetekin İ, Kaçan T, Özkan M, Aksoy S, Aksoy A, Çokmert S, Uysal M, Elkıran ET, Çiçin İ, Büyükberber S, Zengin N. The effect of the gastrectomy on survival in patients with metastatic gastric cancer: a study of ASMO. Future Oncol 2016; 12:343-54. [PMID: 26775722 DOI: 10.2217/fon.15.304] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
AIM To investigate the role of surgical resection of primary tumor on overall survival (OS) in advanced gastric cancer patients at the time of diagnosis. PATIENTS & METHODS The survival rates of metastatic gastric cancer patients whose gastric primary tumor was resected at time of diagnosis were compared with metastatic gastric cancer patients whose primary tumor was nonresected. RESULTS The median progression-free survival and OS in operated and nonoperated group were 10 versus 6, 14 versus 9 months, respectively (p < 0.001). In multivariate analysis, gastric resection of primary tumor, Eastern Cooperative Oncology Group performance status, second-line chemotherapy had a significant effect on OS (hazard ratio [HR]: 0.52 [95% CI: 0.38-0.71], HR: 0.57 [95% CI: 0.42-0.78], HR: 1.48 [1.09-2.01]; p ≤ 0.001, p = 0.001 and p = 0.012, respectively). CONCLUSION Subpopulations of patients with metastatic gastric cancer might benefit from surgical removal of primary tumor.
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Affiliation(s)
- Ozan Yazıcı
- Ankara Numune Education & Research Hospital, Department of Medical Oncology, Sihhiye 06410, Ankara, Turkey
| | - Nuriye Özdemir
- Yıldırım Beyazıt University Faculty of Medicine, Department of Medical Oncology, Bilkent Avenue 06800, Ankara, Turkey
| | - Ayşe Ocak Duran
- Erciyes University Faculty of Medicine, Department of Medical Oncology, Kayseri, Talas/Melikgazi 38030, Turkey
| | - Serkan Menekşe
- Celal Bayar University Faculty of Medicine, Department of Medical Oncology, Uncubozköy 45030 Manisa, Turkey
| | - Mehmet Ali Şendur
- Yıldırım Beyazıt University Faculty of Medicine, Department of Medical Oncology, Bilkent Avenue 06800, Ankara, Turkey
| | - Halit Karaca
- Erciyes University Faculty of Medicine, Department of Medical Oncology, Kayseri, Talas/Melikgazi 38030, Turkey
| | - Gamze Göksel
- Celal Bayar University Faculty of Medicine, Department of Medical Oncology, Uncubozköy 45030 Manisa, Turkey
| | - Erkan Arpacı
- Sakarya University Education & Research Hospital, Department of Medical Oncology, Şirinevler 54100, Sakarya, Turkey
| | - İlhan Hacıbekiroğlu
- Trakya University Faculty of Medicine, Department of Medical Oncology, Karaağaç 22050, Edirne, Turkey
| | - İrem Bilgetekin
- Gazi University Faculty of Medicine, Department of Medical Oncology, Emniyet 06560, Ankara, Turkey
| | - Turgut Kaçan
- Cumhuriyet University Faculty of Medicine, Department of Medical Oncology, Sivas, Imaret 58140, Turkey
| | - Metin Özkan
- Erciyes University Faculty of Medicine, Department of Medical Oncology, Kayseri, Talas/Melikgazi 38030, Turkey
| | - Sercan Aksoy
- Ankara Numune Education & Research Hospital, Department of Medical Oncology, Sihhiye 06410, Ankara, Turkey
| | - Asude Aksoy
- İnönü University Faculty of Medicine, Department of Medical Oncology, Malatya, Centre 44000, Turkey
| | - Suna Çokmert
- Izmir Kent Hospital, Department of Medical Oncology, Izmir, Turkey
| | - Mükremin Uysal
- Afyon Kocatepe University Faculty of Medicine, Afyonkarahisar, Turkey
| | - Emin Tamer Elkıran
- İnönü University Faculty of Medicine, Department of Medical Oncology, Malatya, Centre 44000, Turkey
| | - İrfan Çiçin
- Trakya University Faculty of Medicine, Department of Medical Oncology, Karaağaç 22050, Edirne, Turkey
| | - Süleyman Büyükberber
- Gazi University Faculty of Medicine, Department of Medical Oncology, Emniyet 06560, Ankara, Turkey
| | - Nurullah Zengin
- Ankara Numune Education & Research Hospital, Department of Medical Oncology, Sihhiye 06410, Ankara, Turkey
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