1
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Doğan Akagündüz D, Şahin H, Akagündüz B. Malnutrition and Related Factors in Older Patients With Gastrointestinal Cancer Receiving Chemotherapy. Cureus 2024; 16:e58252. [PMID: 38745807 PMCID: PMC11093618 DOI: 10.7759/cureus.58252] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2024] [Indexed: 05/16/2024] Open
Abstract
Objectives The incidence and mortality of gastrointestinal (GI) malignancies increase exponentially with age. Malnutrition is a documented poor prognostic factor in older patients with cancer. There is insufficient data about the prevalence of malnutrition and associated factors in older patients with GI cancer. Thus, we aimed to investigate the prevalence of malnutrition and related factors among older patients with GI cancer. Methods A total of 121 patients aged over 70 years diagnosed with various types of GI cancers applied to the medical oncology clinic included in this cross-sectional study. We evaluated the nutrition status with a mini-nutritional assessment (MNA) score. Results The prevalence of malnutrition was 76 (62.8%) in our study population. The mean age was 76.5 (range 70 to 90 years), and 71 (58.6%) were male. In the multivariate logistic regression model, lower BMI (OR: 3.379, 95% CI: 1.465-7.812, p = 0.005), having gastroesophageal cancer (OR: 5.797, 95% CI: 2.387-14.091, p<0.001), treating with palliative chemotherapy (OR: 4.597, 95% CI: 1.799-11.772, p = 0.002), and frailty according to G8 score (OR: 10.798, 95% CI: 4.495-25.924, p<0.001) were associated with malnutrition. Conclusions Our study revealed that palliative chemotherapy, low BMI, frailty, and gastroesophageal cancer are risk factors for malnutrition in older patients with GI cancer. Physicians need to be aware of patients who may be at risk for malnutrition. Patients at risk of malnutrition may benefit from interventions to enhance their nutrition. Further studies consisting of larger cohorts are needed to determine malnutrition and related factors in older patients with cancer.
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Affiliation(s)
- Diğdem Doğan Akagündüz
- Nutrition and Dietetics, Mengücek Gazi Training and Research Hospital, Erzincan Binali Yıldırım University, Erzincan, TUR
| | - Hilal Şahin
- Nutrition and Dietetics, Faculty of Health Science, Erzincan Binali Yıldırım University, Erzincan, TUR
| | - Baran Akagündüz
- Medical Oncology, Mengücek Gazi Training and Research Hospital, Erzincan Binali Yıldırım University, Erzincan, TUR
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2
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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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3
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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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4
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Ergun Y, Ucar G, Akagündüz B. Efficacy and safety of concomitant chemo-endocrine therapy in neoadjuvant treatment of hormone-positive HER2-negative breast cancer: a systemic review and meta-analysis. Expert Opin Drug Saf 2023; 22:313-322. [PMID: 37057733 DOI: 10.1080/14740338.2023.2203485] [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: 02/16/2023] [Accepted: 04/12/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND The rate of pathological complete response (pCR) with both chemotherapy alone (CT) and endocrine therapy (ET) in the neoadjuvant (Na) treatment of hormone receptor (HR)-positive/HER2-negative breast cancer (BC) is unsatisfactory. Limited data on neoadjuvant concomitant chemotherapy and endocrine therapy (NaCET) are available. RESEARCH DESIGN AND METHODS In this meta-analysis analyzed the efficacy and safety of randomized controlled trials (RCT) comparing the use of NaCET in HR-positive/HER2-negative BC. A comprehensive search was performed on PubMed, Cochrane Library and EMBASE databases, and congress paper lists for studies published/presented until 1 December 2022. RESULTS Five RCTs involving a total of 630 patients were included. A pooled analysis of the five studies demonstrated that the pCR ratio was numerically higher in the NaCET arm than in the NaCT arm, but the difference was not statistically significant (6.5% vs. 3.8%; OR:1.72, 95% CI 0.82-3.62). Nonetheless, the NaCET arm exhibited a significantly higher objective response rate (ORR) (82% vs. 72.7%; OR:1.77, 95% CI 1.20-2.62). There was no difference between the arms in terms of grade 3-5 adverse events. CONCLUSIONS In HR-positive/HER2-negative BC, NaCET significantly increases ORR without an increase in serious adverse events. Although the pCR rate increased numerically, it was not statistically significant.
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Affiliation(s)
- Yakup Ergun
- Department of Medical Oncology, Batman World Hospital, Batman, Turkey
| | - Gokhan Ucar
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Baran Akagündüz
- Department of Medical Oncology, Binali Yıldırım University Mengücek Gazi Training and Research Hospital, Erzincan, Turkey
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5
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Akagündüz B, Guven DC, Ozer M, Okten IN, Atag E, Unek İT, Tatli AM, Karaoglu A. Tailoring adjuvant chemotherapy by circulating tumor DNA (ctDNA) in older patients with stage II-III colon cancer. J Geriatr Oncol 2023; 14:101367. [PMID: 36038467 DOI: 10.1016/j.jgo.2022.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 10/15/2022]
Affiliation(s)
- Baran Akagündüz
- Department of Medical Oncology, Erzincan Binali Yıldrıım University Medical School, Erzincan, Turkey.
| | - Deniz Can Guven
- Department of Medical Oncology, Hacettepe University Medical School, Istanbul, Turkey
| | - Muhammet Ozer
- Department of Internal Medicine, Capital Health Regional Medical Center, Trenton, NJ, USA.
| | - Ilker Nihat Okten
- Department of Medical Oncology, Gaziantep Ersin Arslan State Hospital, Gaziantep, Turkey
| | - Elif Atag
- Department of Medical Oncology, Haydarpaşa Numune Research Hospital, Istanbul, Turkey
| | - İlkay Tugba Unek
- Department of Medical Oncology, Dokuzeylül University Medical School, 34000 Istanbul, Turkey
| | - Ali Murat Tatli
- Department of Medical Oncology, Akdeniz University Medical School, 07010 Antalya, Turkey
| | - Aziz Karaoglu
- Department of Medical Oncology, Dokuzeylül University Medical School, 34000 Istanbul, Turkey
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6
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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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7
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Ünek İT, Öztop İ, Başbınar Y, Ünek T, Leblebici A, Çakıroğlu E, Uysal T, Akagündüz B, Ellidokuz H, Astarcıoğlu İ. Association of Serum Hepatocyte Growth Factor Level with Systemic Inflammatory Biomarkers in Patients with Pancreatobiliary Cancer. Turk J Gastroenterol 2023; 34:568-575. [PMID: 36789987 DOI: 10.5152/tjg.2023.22124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND Hepatocyte growth factor is a cytokine secreted by the stromal cells in the tumor microenvironment. There is little information about the clinical significance of serum hepatocyte growth factor level in patients diagnosed with pancreatobiliary cancer. The objective of the current study was to investigate the relationship between serum hepatocyte growth factor level with inflammation markers and the clinical features of patients with pancreatobiliary cancer. METHODS A total of 62 patients with pancreatobiliary cancer were included in this study. Serum hepatocyte growth factor concentrations were evaluated utilizing the enzyme-linked immunosorbent assay method. RESULTS The median serum hepatocyte growth factor level was 329.1 ng/mL (1.4-1051.1). The patients were categorized into 2 groups as those below the median hepatocyte growth factor level (low hepatocyte growth factor) and those above the median hepatocyte growth factor level (high hepatocyte growth factor). While 40.9% of the patients without metastasis were observed to be in the high hepatocyte growth factor group, 72.2% of the metastatic patients were observed to be in the high hepatocyte growth factor group (P = .025). The median levels of monocyte, monocyte-to-lymphocyte ratio, C-reactive protein, and C-reactive protein-to-albumin ratio were found to be significantly higher in the high hepatocyte growth factor group as compared to the low hepatocyte growth factor group (P < .050). CONCLUSION The significant relationship between serum hepatocyte growth factor level and systemic inflammation markers in patients with pancreatobiliary cancer is shown for the first time in our study. This study, which showed a significant relationship between the presence of metastasis and serum hepatocyte growth factor level, suggests that serum hepatocyte growth factor level may be a prognostic biomarker in patients who are diagnosed with pancreatobiliary cancer.
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Affiliation(s)
- İlkay Tuğba Ünek
- Department of Medical Oncology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - İlhan Öztop
- Department of Medical Oncology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Yasemin Başbınar
- Department of Translational Oncology, Dokuz Eylül University, Institute of Oncology, İzmir, Turkey
| | - Tarkan Ünek
- Department of General Surgery, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Asım Leblebici
- Department of Translational Oncology, Dokuz Eylül University, Institute of Health Sciences, İzmir, Turkey
| | - Ece Çakıroğlu
- Department of Genomics and Molecular Biotechnology, Dokuz Eylül University, İzmir International Biomedicine and Genome Institute, İzmir, Turkey
| | - Tuğba Uysal
- Department of Molecular Biology and Genetics, Hitit University Faculty of Science and Art, Çorum, Turkey
| | - Baran Akagündüz
- Department of Medical Oncology, Erzincan Binali Yıldırım University Faculty of Medicine, Erzincan, Turkey
| | - Hülya Ellidokuz
- Department of Preventive Oncology, Dokuz Eylül University Institute of Oncology, İzmir, Turkey
| | - İbrahim Astarcıoğlu
- Department of General Surgery, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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8
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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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9
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Demircan NC, Atcı MM, Demir M, Işık S, Akagündüz B. Dynamic changes in systemic immune-inflammation index predict pathological tumor response and overall survival in patients with gastric or gastroesophageal junction cancer receiving neoadjuvant chemotherapy. Asia Pac J Clin Oncol 2023; 19:104-112. [PMID: 35538045 DOI: 10.1111/ajco.13784] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 10/13/2021] [Revised: 03/05/2022] [Accepted: 04/06/2022] [Indexed: 01/20/2023]
Abstract
AIM Systemic inflammation has been associated with chemoresistance and prognosis in solid tumors. Systemic immune-inflammation index (SII) is a novel marker derived from complete blood count. We investigated whether differences between SIIs measured before and after neoadjuvant chemotherapy (NACT) are associated with tumor regression grade (TRG) and survival in gastric and gastroesophageal junction (GEJ) cancer patients. METHODS Records of gastric and GEJ cancer patients treated with NACT in two centers were evaluated retrospectively. Patients were categorized according to difference between pre- and post-NACT SII values (ΔSII). Association between clinicopathological factors and TRG was analyzed using logistic regression method. Predictors of disease-free and overall survival (DFS and OS) were determined with Cox regression models. RESULTS The study included 140 patients. Patients with ΔSII<0 were more likely to achieve TRG 0/1 (45.2% vs. 19.1%, p = 0.003) and ΔSII<0 was an independent predictor of TRG 0/1 (OR = 6.05, p<0.001). DFS and OS of patients with ΔSII<0 were also significantly longer (p = 0.031 and p = 0.006, respectively). After adjustment for other variables, ΔSII≥0 was an independent prognostic factor for OS (Hazard ratio (HR) = 2.13, p = 0.008). CONCLUSIONS Changes in SII, which is a low-cost and easily accessible marker, may be used to estimate prognosis, individualize postoperative treatment and optimize surveillance in gastric and GEJ cancer patients treated with NACT.
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Affiliation(s)
- Nazım Can Demircan
- Department of Medical Oncology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Muhammed Mustafa Atcı
- Department of Medical Oncology, Prof. Dr. Cemil Taşçıoğlu State Hospital, Istanbul, Turkey
| | - Metin Demir
- Department of Medical Oncology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Selver Işık
- Department of Medical Oncology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Baran Akagündüz
- Department of Medical Oncology, Binali Yıldırım University School of Medicine, Erzincan, Turkey
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10
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Hizal M, Bilgin B, Paksoy N, Atcı MM, Kahraman S, Kılıçkap S, Güven DC, Keskinkılıç M, Ayhan M, Eren Ö, Mustafayev FNA, Yaman Ş, Bayram E, Ertürk İ, Özcan E, Korkmaz M, Akagündüz B, Erdem D, Telli TA, Aksoy A, Üskent N, Baytemür NK, Gülmez A, Aydın D, Şakalar T, Arak H, Tatlı AM, Ergün Y, Ak N, Ünal Ç, Özgün MA, Yalçın B, Öztop İ, Algın E, Sakin A, Aydıner A, Yumuk PF, Şendur MAN. The percentage of ALK-positive cells and the efficacy of first-line alectinib in advanced non-small cell lung cancer: is it a novel factor for stratification? (Turkish Oncology Group Study). J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04252-2. [PMID: 36048274 DOI: 10.1007/s00432-022-04252-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/02/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Alectinib is an effective second-generation ALK tyrosine kinase inhibitor (TKI) used in the first-line treatment of patients with advanced ALK-positive NSCLC. Recent studies demonstrated that the percentage of ALK-positive tumor cells in patient groups receiving crizotinib might affect outcomes. This study aimed to investigate whether the percentage of ALK-positive cells had a predictive effect in patients with advanced NSCLC who received first-line Alectinib as ALK-TKI. MATERIALS AND METHODS This retrospective study included patients with advanced-stage NSCLC who received alectinib as a first-line ALK-TKI and whose percentage of ALK-positive cells was determined by FISH at 27 different centers. Patients who received any ALK-TKI before alectinib were not included in the study. Patients were separated into two groups according to the median (40%) value of the percentage of ALK-positive cells (high-positive group ≥ 40% and low-positive group < 40%). The primary endpoint was PFS, and the secondary endpoints were OS, ORR, and PFS of the subgroups based on different threshold values for the percentage of ALK-positive cells. RESULTS 211 patients were enrolled (48.3% female, 51.7% male) to study. 37% (n = 78) of the patients had received chemotherapy previously. After a median of 19.4 months of follow-up, the median PFS was not reached in the high-positive group (n = 113), but it was 10.8 months in the low-positive group (n = 98) (HR 0.39; 95% CI 0.25-0.60, p < 0.001). The median OS in the high-positive group was not reached, whereas it was 22.8 months in the low-positive group (HR 0.37; 95% CI 0.22-0.63, p < 0.001). ORR was significantly higher in the high-positive group (87.2 vs. 68.5%; p = 0.002). According to the cut-off values of < 20%, 20-39%, 40-59%, and ≥ 60%, the median PFS was 4.5, 17.1, and 26 months, respectively, and could not be reached in the ≥ 60% group. CONCLUSION Our study demonstrated that the efficacy of alectinib varies significantly across patient subgroups with different percentages of ALK-positive cells. If these findings are prospectively validated, the percentage of ALK-positive cells may be used as a stratification factor in randomized trials comparing different ALK-TKIs.
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Affiliation(s)
- Mutlu Hizal
- Department of Medical Oncology, Ankara City Hospital, Bilkent Caddesi, No:1, 06800, Ankara, Turkey.
| | - Burak Bilgin
- Department of Medical Oncology, Atatürk Chest Disease and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Nail Paksoy
- Department of Medical Oncology, İstanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey
| | - Muhammed Mustafa Atcı
- Department of Medical Oncology, İstanbul Prof. Cemil Taşçıoglu City Hospital, Istanbul, Turkey
| | - Seda Kahraman
- Department of Medical Oncology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Saadettin Kılıçkap
- Department of Medical Oncology, Faculty of Medicine, Ankara Liv Hospital, İstinye University, Ankara, Turkey
| | - Deniz Can Güven
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Merve Keskinkılıç
- Department of Medical Oncology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Murat Ayhan
- Department of Medical Oncology, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - Önder Eren
- Department of Medical Oncology, Faculty of Medicine, Selçuk University, Konya, Turkey
| | - Fatma Nihan Akkoç Mustafayev
- Department of Medical Oncology, Sultan 2. Abdülhamid Han Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Şebnem Yaman
- Department of Medical Oncology, Atatürk Chest Disease and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Ertuğrul Bayram
- Department of Medical Oncology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - İsmail Ertürk
- Department of Medical Oncology, Ankara Gülhane Education and Research Hospital, Ankara, Turkey
| | - Erkan Özcan
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Mustafa Korkmaz
- Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Baran Akagündüz
- Department of Medical Oncology, Erzincan Mengücek Gazi Education and Research Hospital, Erzincan, Turkey
| | - Dilek Erdem
- Department of Medical Oncology, Samsun Medical Park Hospital, Samsun, Turkey
| | - Tuğba Akın Telli
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Asude Aksoy
- Department of Medical Oncology, Faculty of Medicine, Fırat University, Elazıg, Turkey
| | - Necdet Üskent
- Department of Medical Oncology, Anadolu Medical Center, Kocaeli, Turkey
| | | | - Ahmet Gülmez
- Department of Medical Oncology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Dinçer Aydın
- Department of Medical Oncology, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Necip Fazıl City Hospital, Kahramanmaras, Turkey
| | - Hacı Arak
- Department of Medical Oncology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ali Murat Tatlı
- Department of Medical Oncology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Yakup Ergün
- Department of Medical Oncology, Batman Education and Research Hospital, Batman, Turkey
| | - Naziye Ak
- Department of Medical Oncology, Yozgat City Hospital, Yozgat, Turkey
| | - Çağlar Ünal
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Mehmet Alpaslan Özgün
- Department of Medical Oncology, Sultan 2. Abdülhamid Han Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Bülent Yalçın
- Department of Medical Oncology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - İlhan Öztop
- Department of Medical Oncology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Efnan Algın
- Department of Medical Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, İstanbul Prof. Cemil Taşçıoglu City Hospital, Istanbul, Turkey
| | - Adnan Aydıner
- Department of Medical Oncology, İstanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey
| | - Perran Fulden Yumuk
- Department of Medical Oncology, Faculty of Medicine, Koç University, Istanbul, Turkey.,Department of Medical Oncology, American Hospital, Istanbul, Turkey
| | - Mehmet Ali Nahit Şendur
- Department of Medical Oncology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
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11
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Hizal M, Bilgin B, Paksoy N, Kılıçkap S, Atcı MM, Kahraman S, Keskinkılıç M, Bilgetekin İ, Ayhan M, Tural D, Eren Ö, Akkoç Mustafayev FN, Yaman Ş, Tatlı AM, Bayram E, Kutlu Y, Ertürk İ, Özcan E, Gülmez A, Korkmaz M, Akagündüz B, Erdem D, Telli TA, Aksoy A, Üskent N, İriağaç Y, Baytemür NK, Aydın D, Şakalar T, Arak H, Selçukbiricik F, Ergün Y, Korkmaz T, Ak N, Ünal Ç, Akdeniz N, Özgün MA, Öksüzoğlu B, Yalçın B, Öztop İ, Algın E, Sakin A, Aydıner A, Yumuk PF, Nahit Şendur MA. Real-world data on efficacy and safety of first-line alectinib treatment in advanced-stage, ALK-positive non-small-cell lung cancer patients: a Turkish Oncology Group study. Future Oncol 2022; 18:2573-2582. [PMID: 35734870 DOI: 10.2217/fon-2022-0083] [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: 11/21/2022] Open
Abstract
Aims: In this multicenter study, the authors aimed to determine the real-life efficacy and safety of first-line alectinib. Materials & methods: This retrospective trial included advanced-stage, ALK-positive non-small-cell lung cancer patients who were treated with first-line alectinib in terms of ALK-tyrosine kinase inhibitors, regardless of previous chemotherapy. The co-primary end points were progression-free survival both for all patients and for the treatment-naive population. The secondary end points were overall response rate, overall survival, rate of CNS progression and safety. Results & conclusion: A total of 274 patients (n = 177 for treatment-naive patients) were enrolled in the study. The median progression-free survival was 26 and 28.8 months for all patients and the treatment-naive group, respectively. The overall response rate, CNS progression rate and 1-year overall survival ratio were 77.9, 12.4 and 77%. Alectinib is a highly effective therapy with a favorable safety profile.
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Affiliation(s)
- Mutlu Hizal
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Burak Bilgin
- Atatürk Chest Disease & Chest Surgery Education & Research Hospital, Department of Medical Oncology, Ankara, Turkey
| | - Nail Paksoy
- Department of Medical Oncology, İstanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey
| | - Saadettin Kılıçkap
- Department of Medical Oncology, İstinye University Faculty of Medicine, Ankara Liv Hospital, Ankara, Turkey
| | - Muhammed Mustafa Atcı
- Department of Medical Oncology, İstanbul Prof. Cemil Taşçıoglu City Hospital, Istanbul, Turkey
| | - Seda Kahraman
- Department of Medical Oncology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Merve Keskinkılıç
- Department of Medical Oncology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - İrem Bilgetekin
- Department of Medical Oncology, Abdurrahman Yurtaslan Ankara Onkoloji Education & Research Hospital, Ankara, Turkey
| | - Murat Ayhan
- Department of Medical Oncology, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - Deniz Tural
- Department of Medical Oncology, Bakırköy Dr. Sadi Konuk Education & Research Hospital, Istanbul, Turkey
| | - Önder Eren
- Department of Medical Oncology, Selçuk University Faculty of Medicine, Konya, Turkey
| | - Fatma Nihan Akkoç Mustafayev
- Department of Medical Oncology, University of Health Sciences, Sultan 2. Abdülhamid Han Education & Research Hospital, Istanbul, Turkey
| | - Şebnem Yaman
- Atatürk Chest Disease & Chest Surgery Education & Research Hospital, Department of Medical Oncology, Ankara, Turkey
| | - Ali Murat Tatlı
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Ertuğrul Bayram
- Department of Medical Oncology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Yasin Kutlu
- Department of Medical Oncology, İstanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - İsmail Ertürk
- Department of Medical Oncology, Ankara Gülhane Education & Research Hospital, Ankara, Turkey
| | - Erkan Özcan
- Department of Medical Oncology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Ahmet Gülmez
- Department of Medical Oncology, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Mustafa Korkmaz
- Department of Medical Oncology, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Baran Akagündüz
- Department of Medical Oncology, Erzincan Mengücek Gazi Education & Research Hospital, Erzincan, Turkey
| | - Dilek Erdem
- Department of Medical Oncology, Samsun Medical Park Hospital, Samsun, Turkey
| | - Tuğba Akın Telli
- Department of Medical Oncology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Asude Aksoy
- Department of Medical Oncology, Fırat University Faculty of Medicine, Elazıg, Turkey
| | - Necdet Üskent
- Department of Medical Oncology, Anadolu Medical Center, Kocaeli, Turkey
| | - Yakup İriağaç
- Department of Medical Oncology, Tekirdağ Namık Kemal University Faculty of Medicine, Tekirdag, Turkey
| | | | - Dinçer Aydın
- Department of Medical Oncology, Kocaeli Derince Education & Research Hospital, Kocaeli, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Necip Fazıl City Hospital, Kahramanmaras, Turkey
| | - Hacı Arak
- Gaziantep University Faculty of Medicine, Department of Medical Oncology, Gaziantep, Turkey
| | - Fatih Selçukbiricik
- Department of Medical Oncology, Koç University Faculty of Medicine, Istanbul, Turkey
| | - Yakup Ergün
- Department of Medical Oncology, Batman Education & Research Hospital, Batman, Turkey
| | - Taner Korkmaz
- Department of Medical Oncology, Acıbadem Maslak Hospital, Istanbul, Turkey
| | - Naziye Ak
- Department of Medical Oncology, Yozgat City Hospital, Yozgat, Turkey
| | - Çağlar Ünal
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Nadiye Akdeniz
- Department of Medical Oncology, Adıyaman University, Education & Research Hospital, Adıyaman, Turkey
| | - Mehmet Alpaslan Özgün
- Department of Medical Oncology, University of Health Sciences, Sultan 2. Abdülhamid Han Education & Research Hospital, Istanbul, Turkey
| | - Berna Öksüzoğlu
- Department of Medical Oncology, Abdurrahman Yurtaslan Ankara Onkoloji Education & Research Hospital, Ankara, Turkey
| | - Bülent Yalçın
- Department of Medical Oncology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - İlhan Öztop
- Department of Medical Oncology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Efnan Algın
- Department of Medical Oncology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, İstanbul Prof. Cemil Taşçıoglu City Hospital, Istanbul, Turkey
| | - Adnan Aydıner
- Department of Medical Oncology, İstanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey
| | - Perran Fulden Yumuk
- Department of Medical Oncology, Koç University Faculty of Medicine, Istanbul, Turkey.,Department of Medical Oncology, American Hospital, Istanbul, Turkey
| | - Mehmet Ali Nahit Şendur
- Department of Medical Oncology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
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12
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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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13
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Sakin A, Atci MM, Aldemir MN, Akagündüz B, Şahin S, Arıcı S, Secmeler S, Cihan S. The Prognostic Value of Postoperative Lymph Node Ratio in Gastric Adenocarcinoma Patients Treated With Neoadjuvant Chemotherapy. Cureus 2021; 13:e14639. [PMID: 34046274 PMCID: PMC8140955 DOI: 10.7759/cureus.14639] [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: 02/07/2023] Open
Abstract
Objective In this study, we aimed to investigate the prognostic value of postoperative lymph node ratio (LNR)in locally advanced gastric cancer (GC) patients receiving neoadjuvant chemotherapy (NACT). Methods LNR was calculated as the ratio of positive LNs to the total LNs removed. The receiver operating characteristic (ROC) curve was plotted to estimate the cut-off value of LNR for recurrence. The area under the curve of LNR was 0.714 (95% CI: 0.604-0.825, p<0.001) with 60% sensitivity and >0.255 with 76% specificity. Patients were grouped as group I (≤0.255) and group II (>0.255). Results In this study, 157 GC patients were included (39.5% female and 60.5% male). Of the patients, 97 (61.8%) were in group I and 60 (38.2%) were in group II. Disease‑free survival (DFS) was not reached in group I, and it was 16 months in group II (p<0.001). Overall survival (OS) was 58 months in group I and 28 months in group II (p>0.001). In multivariate analysis, lymphovascular invasion, neoadjuvant response, adjuvant treatment, and LNR were found to be the factors associated with DFS and OS (p<0.05). Conclusion In our study, it was observed that LNR can predict survival rates better than LN staging.
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Affiliation(s)
- Abdullah Sakin
- Medical Oncology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, TUR
| | - Muhammed M Atci
- Medical Oncology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, TUR
| | | | - Baran Akagündüz
- Medical Oncology, Erzincan Binali Yıldırım Üniversitesi Mengücek Gazi Hastanesi, Erzincan, TUR
| | - Suleyman Şahin
- Medical Oncology, Van Research and Training Hospital, Van, TUR
| | - Serdar Arıcı
- Medical Oncology, Şişli Etfal Research Hospital, Istanbul, TUR
| | - Saban Secmeler
- Medical Oncology, Şanlıurfa Research Hospital, Şanlıurfa, TUR
| | - Sener Cihan
- Medical Oncology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, TUR
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14
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Akagündüz B, Akin Telli T, Sezgin Goksu S, Yildirim HC, Ozer M, Göktaş Aydin S, Ozyurt N, Karacin C, Paydas S, Dogan M. Assessment of Prognostic Factors and Adjuvant Treatment Modalities in Adult Head and Neck Soft Tissue Sarcoma Patients Treated With Upfront Surgery. Cureus 2021; 13:e13324. [PMID: 33738167 PMCID: PMC7958307 DOI: 10.7759/cureus.13324] [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: 11/23/2022] Open
Abstract
Objectives Head and neck soft tissue sarcomas (HNSTSs) are a heterogeneous group of rare tumors. Surgical resection with negative margins remains the standard primary treatment for patients with HNSTS. The role of chemotherapy (CT) and radiotherapy (RT) remains controversial. In this multicenter study, we aimed to demonstrate the real-world assessing prognostic factors and the effect of adjuvant treatment modalities in adult patients with HNSTS treated with upfront surgery. Methods We included a total of 47 patients who underwent curative-intent resection of a primary HNSTS between 2000 and 2019. Results The median follow-up was 29 months. The median age of patients was 51 years, and 66% of patients were male. The median relapse-free survival (RFS) of the study population was 31 months (range: 1.0-61.1 months), and the median overall survival (OS) was 115 months (range: 60.8-169.2 months). The univariable analysis revealed that treatment modalities showed a significant impact on RFS (p = 0.021); however, no difference was found in its impact on OS (p = 0.137). R0 resection did not showed impact on RFS (p = 0.130), but a significant association was found with OS (p = 0.004). In multivariable analysis, T stage of the tumor (hazard ratio [HR]: 3.834; 95% CI: 1.631-9.008; p = 0.002) and treatment with surgery and sequential RT and CT (HR: 0.115; 95% CI: 0.035-0.371; p < 0.001) were independent factors associated with RFS. R0 resection was independently associated with OS (HR: 4.902; 95% CI: 1.301-18.465; p = 0.019). Conclusion Our study revealed that R0 resection improved OS, and T3-4 stage of tumor was a negative independent factor for RFS in surgically resected HNSTS patients. The use of sequential CT and RT after resection was associated with a better RFS, which emphasizes the importance of multidisciplinary evaluation of the treatment of HNSTS. Randomized prospective studies are needed
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Affiliation(s)
- Baran Akagündüz
- Medical Oncology, Erzincan Binali Yıldırım Üniversitesi Mengücek Gazi Hastanesi, Erzincan, TUR
| | - Tugba Akin Telli
- Medical Oncology, Marmara University Medical School, Istanbul, TUR
| | | | | | - Muhammet Ozer
- Internal Medicine, Capital Health Regional Medical Center, Trenton, USA
| | | | | | - Cengiz Karacin
- Oncology, Recep Tayyip Erdoğan University Medical School, Rize, TUR
| | - Semra Paydas
- Medical Oncology, Cukurova University Faculty of Medicine, Adana, TUR
| | - Mutlu Dogan
- Medical Oncology, Ankara Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, TUR
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