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Guven DC, Aykan MB, Muglu H, Bayram E, Helvaci K, Dursun B, Celayir M, Chelebiyev E, Nayir E, Erman M, Sezer A, Urun Y, Demirci U, Er O, Disel U, Bilici A, Arslan C, Karadurmus N, Kilickap S. The efficacy of immunotherapy and chemoimmunotherapy in patients with advanced rare tumors: A Turkish oncology group (TOG) study. Cancer Med 2023; 13:e6869. [PMID: 38140782 PMCID: PMC10809296 DOI: 10.1002/cam4.6869] [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: 07/06/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION The advances in immune checkpoint inhibitors (ICIs) were relatively slow in rare tumors. Therefore, we conducted a multi-center study evaluating the efficacy of ICI monotherapy and the combination of ICIs with chemotherapy (CT) in patients with advanced rare tumors. METHODS In this retrospective cohort study, we included 93 patients treated with ICIs for NCI-defined rare tumors from the 12 cancer centers in Turkey. The primary endpoints were the overall response (ORR) and disease control rate (DCR). RESULTS The cohort's median age was 56, and 53.8% of the patients were male. The most frequent diagnosis was sarcoma (29%), and 81.7% of the patients were previously treated with at least one line of systemic therapy in the advanced stage. The ORR and DCR were 36.8% and 63.2%, respectively. The germ cell tumors had the lowest ORR (0%), while the Merkel cell carcinoma had the highest ORR to ICIs (57.1%). Patients treated with ICI + ICI or ICI plus chemotherapy combinations had higher ORR (55.2% vs. 27.6%, p = 0.012) and DCR (82.8% vs. 53.4%, p = 0.008). The median OS was 13.47 (95% CI: 7.79-19.15) months, and the six and 12-month survival rates were 71% and 52%. The median duration of response was 16.59 months, and the 12-month progression-free survival rate was 66% in responders. The median time-to-treatment failure was 5.06 months (95% CI: 3.42-6.71). Three patients had high-grade irAEs with ICIs (grade 3 colitis, grade 3 gastritis, and grade 3 encephalitis in one patient each). CONCLUSION We observed over 30% ORR and a 13-month median OS in patients with rare cancers treated with ICI monotherapy or ICI plus CT combinations. The response rates to ICIs or ICIs plus CT significantly varied across different tumor types. Responding patients had over 2 years of survival, highlighting a need for further trials with ICIs for patients with rare tumors.
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Affiliation(s)
- Deniz Can Guven
- Department of Medical OncologyHacettepe University Cancer InstituteAnkaraTurkey
| | - Musa Baris Aykan
- Department of Medical OncologyGulhane School of Medicine, University of Health SciencesAnkaraTurkey
| | - Harun Muglu
- Istanbul Medipol University Faculty of MedicineIstanbulTurkey
| | - Ertugrul Bayram
- Department of Medical OncologyCukurova UniversityAdanaTurkey
| | | | - Bengü Dursun
- Department of Medical OncologyAnkara UniversityAnkaraTurkey
| | - Melisa Celayir
- Department of Medical OncologyMAA Acıbadem UniversityİstanbulTurkey
| | - Elvin Chelebiyev
- Department of Medical OncologyHacettepe University Cancer InstituteAnkaraTurkey
| | - Erdinc Nayir
- Department of Medical OncologyMersin Medical Park HospitalMersinTurkey
| | - Mustafa Erman
- Department of Medical OncologyHacettepe University Cancer InstituteAnkaraTurkey
| | - Ahmet Sezer
- Baskent University Adana HospitalAdanaTurkey
| | - Yuksel Urun
- Department of Medical OncologyAnkara UniversityAnkaraTurkey
| | | | - Ozlem Er
- Department of Medical OncologyMAA Acıbadem UniversityİstanbulTurkey
| | - Umut Disel
- Department of Medical OncologyAcibadem Adana HospitalAdanaTurkey
| | - Ahmet Bilici
- Istanbul Medipol University Faculty of MedicineIstanbulTurkey
| | - Cagatay Arslan
- Department of Medical OncologySchool of Medicine, Medical Park Hospital, Izmir Economy UniversityIzmirTurkey
| | - Nuri Karadurmus
- Department of Medical OncologyGulhane School of Medicine, University of Health SciencesAnkaraTurkey
| | - Saadettin Kilickap
- Department of Medical OncologyIstinye University Faculty of MedicineIstanbulTurkey
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Almuradova E, Basoglu T, Nayir E, Bayram E, Paydas S, Gokmen I, Karakaya S, Oksuzoglu B, Erdem D, Sakin A, Atcı M, Belen Gulbagcı B, Hacibekiroglu I, Onder AH, Karaarslan S, Karakurt Eryılmaz M, Korkmaz M, Yazıcı O, Sutcuoglu O, Akagunduz B, Arak H, Sakalar T, Aydin D, Iriagac Y, Alan O, Midik M, Cetin D, Kip AD, Turhal S, Kacan T, Koseci T. Real-life experience of patients with sarcomatoid renal cell carcinoma: a multicenter retrospective study. Neoplasma 2023; 70:158-165. [PMID: 36620878 DOI: 10.4149/neo_2022_221004n984] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/01/2022] [Indexed: 01/10/2023]
Abstract
Sarcomatoid renal cell carcinoma (sRCC) is a rare variant of renal cell carcinoma (RCC) and is associated with a poor prognosis. We reviewed the outcomes of patients from oncology centers in Turkey. Our aim is to share our real-life experience and to contribute to the literature. The demographic and clinical features, treatment, and survival outcomes of 148 patients with sRCC were analyzed. The median age at the time of diagnosis was 58 years (range: 19-83 years). Most patients (62.8%) had clear-cell histology. Most patients were in the intermediate Memorial Sloan-Kettering Cancer Center (MSKCC) risk group (67.6%) and were stage 4 at the time of diagnosis (63.5%). The most common sites of metastasis were the lung (60.1%), lymph nodes (47.3%), and bone (35.8%). The patients received a median of two lines (range: 0-6) of treatment. The most common side effects were fatigue, hematological side effects, hypertension, and hypothyroidism. The median follow-up was 20.9 months (range: 1-162 months). The median overall survival (OS) was 30.8 months (95% confidence interval: 24.9-36.7 months). In multivariate analysis, high MSKCC scores, sarcomatoid differentiation rates >50%, having stage 4 disease, and having lung metastasis at the time of diagnosis were independent factors for poor prognosis affecting OS. No difference was observed between patients who received tyrosine kinase inhibitor (TKI) as the first or second-line treatments. Similarly, no difference between TKI and immunotherapy as the second-line treatment. In conclusion, sRCC is a rare variant of RCC with a poor prognosis and response to treatment. Larger-scale prospective studies are needed to define an optimal treatment approach for longer survival in this aggressive variant.
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Affiliation(s)
- Elvina Almuradova
- Division of Medical Oncology, Ege University School of Medicine, Izmir, Turkey
| | - Tugba Basoglu
- Division of Medical Oncology, Nigde Omer Omer Halisdemir University Training and Research Hospital, Nigde, Turkey
| | - Erdinc Nayir
- Division of Medical Oncology, Medikal Park Hospital, Mersin, Turkey
| | - Ertugrul Bayram
- Division of Medical Oncology, Cukurova University School of Medicine, Adana, Turkey
| | - Semra Paydas
- Division of Medical Oncology, Cukurova University School of Medicine, Adana, Turkey
| | - Ivo Gokmen
- Division of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Serdar Karakaya
- Division of Medical Oncology, Abdurrahman Yurtaslan Hospital, Ankara, Turkey
| | - Berna Oksuzoglu
- Division of Medical Oncology, Abdurrahman Yurtaslan Hospital, Ankara, Turkey
| | - Dilek Erdem
- Division of Medical Oncology, VM Samsun Medikal Park Hospital, Samsun, Turkey
| | - Abdullah Sakin
- Division of Medical Oncology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Atcı
- Division of Medical Oncology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Burcu Belen Gulbagcı
- Division of Medical Oncology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Ilhan Hacibekiroglu
- Division of Medical Oncology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Arif Hakan Onder
- Division of Medical Oncology, Antalya Research and Training Hospital, Antalya, Turkey
| | - Serap Karaarslan
- Department of Pathology, Izmir Tinaztepe University Faculty of Medicine, Izmir, Turkey
| | - Melek Karakurt Eryılmaz
- Division of Medical Oncology, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Mustafa Korkmaz
- Division of Medical Oncology, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Ozan Yazıcı
- Division of Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Osman Sutcuoglu
- Division of Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Baran Akagunduz
- Division of Medical Oncology, Binali Yildirim University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey
| | - Haci Arak
- Division of Medical Oncology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Teoman Sakalar
- Division of Medical Oncology, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Dincer Aydin
- Division of Medical Oncology, Derince Research and Training Hospital, Kocaeli, Turkey
| | - Yakup Iriagac
- Division of Medical Oncology, Namik Kemal University School of Medicine, Tekirdag, Turkey
| | - Ozkan Alan
- Division of Medical Oncology, Tekirdag City Hospital, Tekirdag, Turkey
| | - Murat Midik
- Division of Medical Oncology, Ege University School of Medicine, Izmir, Turkey
| | - Denis Cetin
- Division of Medical Oncology, Ege University School of Medicine, Izmir, Turkey
| | - Asli-Dilara Kip
- Division of Medical Oncology, Ege University School of Medicine, Izmir, Turkey
| | - Serdar Turhal
- Division of Medical Oncology, Anadolu Health Group, Istanbul, Turkey
| | - Turgut Kacan
- Bursa High Specialized Research and Training Hospital, Bursa, Turkey
| | - Tolga Koseci
- Division of Medical Oncology, Cukurova University School of Medicine, Adana, Turkey
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Erol C, Sendur Mehmet AN, Bilgetekin I, Garbioglu DB, Hamdard J, Akbas S, Hizal M, Arslan C, Sevinc A, Kucukarda A, Erdem D, Kahraman S, Cakir E, Demirkiran A, On S, Dogan I, Erdogan AP, Koca S, Kubilay P, Eren OO, Cilbir E, Celik E, Araz M, Ozyukseler DT, Yildirim ME, Bahceci A, Taskaynatan H, Oyman A, Deniz GI, Menekse S, Kut E, Gulmez A, Sakin A, Nayir E, Acar R, Sen E, Inal A, Turhal S, Kaya AO, Paydas S, Tastekin D, Hacibekiroglu I, Cincin I, Bilici A, Mandel NM, Dede DS, Akinci MB, Oksuzoglu B, Uncu D, Yalcin B, Artac M. Efficacy and safety of folfiri plus aflibercept in second-line treatment of metastatic colorectal cancer: Real-life data from Turkish oncology group. J Cancer Res Ther 2022; 18:S347-S353. [PMID: 36510987 DOI: 10.4103/jcrt.jcrt_1104_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Aims The addition of aflibercept to the fluorouracil and irinotecan (FOLFIRI) regimen significantly improved clinical outcomes in patients with metastatic colorectal cancer (CRC) previously treated with oxaliplatin. We aimed to investigate the efficacy and safety of second-line FOLFIRI and aflibercept combination in patients with metastatic CRC in real-life experience. Materials and Methods Four hundred and thirty-three patients who treated with FOLFIRI and aflibercept in the second-line were included in the study. The clinical and pathological features of the patients were recorded retrospectively. Survival (overall and progression-free survival [PFS]), response rates, and safety data were analyzed. Results The median age was 61. Majority of patients (87.5%) received first-line bevacizumab and 10.1% of patients received anti-epidermal growth factor receptor agents. About 80% of patients had KRAS, 18.6% of patients had NRAS, and 6.4% of patients had BRAF mutations. The median OS was 11.6 months (95% confidence interval [CI], 10.6-12.6) and the median PFS was 6 months (95% CI, 5.5-6.5). About 4.6% of patients had complete response and 30.6% of patients had partial response as best tumor response. Grade 1-2 toxicities were seen in 33.4% of patients, while grade 3-4 toxicities were recorded in 27% of patients. Eight patients (2%) died due to treatment toxicity. Conclusions Overall and PFS were similar in routine clinical practice compared to phase III pivotal VELOUR trial. However, response rates were found to be higher. It was observed that there were fewer adverse events compared to the VELOUR trial.
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Affiliation(s)
- Cihan Erol
- Department of Medical Oncology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Ali Nahit Sendur Mehmet
- Department of Medical Oncology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Irem Bilgetekin
- Department of Medical Oncology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Duygu Bayir Garbioglu
- Department of Medical Oncology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Jamshid Hamdard
- Department of Medical Oncology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Sinem Akbas
- Department of Medical Oncology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Mutlu Hizal
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Cagatay Arslan
- Department of Medical Oncology, Izmir Medical Park Hospital, Izmir, Turkey
| | - Alper Sevinc
- Department of Medical Oncology, Gaziantep Medical Park Hospital, Edirne, Turkey
| | - Ahmet Kucukarda
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Dilek Erdem
- Department of Medical Oncology, Samsun Medical Park Hospital, Samsun, Turkey
| | - Seda Kahraman
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Emre Cakir
- Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Aykut Demirkiran
- Department of Medical Oncology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Sercan On
- Department of Medical Oncology, Istanbul University, Institute of Oncology, Istanbul, Turkey
| | - Izzet Dogan
- Department of Medical Oncology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Atike Pinar Erdogan
- Department of Medical Oncology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Sinan Koca
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Pinar Kubilay
- Department of Medical Oncology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Orhan Onder Eren
- Department of Medical Oncology, Diskapi Training and Research Hospital, Ankara, Turkey
| | - Ebru Cilbir
- Department of Medical Oncology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Emir Celik
- Department of Medical Oncology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Araz
- Department of Medical Oncology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Deniz Tataroglu Ozyukseler
- Department of Medical Oncology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mahmut Emre Yildirim
- Department of Medical Oncology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Aykut Bahceci
- Department of Medical Oncology, Dr. Ersin Arslan Education and Research Hospital, Gaziantep, Turkey
| | - Halil Taskaynatan
- Department of Medical Oncology, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Abdilkerim Oyman
- Department of Medical Oncology, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Gulhan Ipek Deniz
- Department of Medical Oncology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Serkan Menekse
- Department of Medical Oncology Manisa City Hospital, Manisa, Turkey
| | - Engin Kut
- Department of Medical Oncology Manisa City Hospital, Manisa, Turkey
| | - Ahmet Gulmez
- Department of Medical Oncology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Erdinc Nayir
- Department of Medical Oncology, Mersin Medical Park Hospital, Mersin, Turkey
| | - Ramazan Acar
- Department of Medical Oncology, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Erdem Sen
- Department of Medical Oncology, Mehmet Akif Ersoy Hospital, Canakkale, Turkey
| | - Ali Inal
- Department of Medical Oncology, Mersin City Hospital, Mersin, Turkey
| | - Serdar Turhal
- Department of Medical Oncology, Anadolu Medical Center, Kocaeli, Turkey
| | - Ali Osman Kaya
- Department of Medical Oncology, Faculty of Medicine, Biruni University, Istanbul, Turkey
| | - Semra Paydas
- Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Didem Tastekin
- Department of Medical Oncology, Istanbul University, Institute of Oncology, Istanbul, Turkey
| | - Ilhan Hacibekiroglu
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Irfan Cincin
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Ahmet Bilici
- Department of Medical Oncology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Nil Molinas Mandel
- Department of Medical Oncology, Istanbul American Hospital, Istanbul, Turkey
| | - Didem Sener Dede
- Department of Medical Oncology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Muhammed Bulent Akinci
- Department of Medical Oncology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Berna Oksuzoglu
- Department of Medical Oncology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, 5Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Dogan Uncu
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Bulent Yalcin
- Department of Medical Oncology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Mehmet Artac
- Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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Özdemir Ö, Zengel B, Yildiz Y, Uluç BO, Cabuk D, Ozden E, Salim DK, Paydas S, Demir A, Diker O, Pilanci KN, Sönmez ÖU, Vatansever S, Dogan I, Gulmez A, Cakar B, Gursoy P, Yildirim ME, Ayhan M, Karadurmus N, Aykan MB, Cevik GT, Sakalar T, Hacibekiroglu I, Gülbagci BB, Dincer M, Garbioglu DB, Kemal Y, Nayir E, Taskaynatan H, Yilmaz M, Avci O, Sari M, Coban E, Atci MM, Esen SA, Telli TA, Karatas F, Inal A, Demir H, Kalkan NO, Yilmaz C, Tasli F, Alacacioglu A. The effectiveness and safety of neoadjuvant pertuzumab and trastuzumab in women with locally advanced, inflammatory, or early-stage human epidermal growth factor receptor 2-positive breast cancer: Turkish Oncology Group study. Anticancer Drugs 2022; 33:663-670. [PMID: 35703239 DOI: 10.1097/cad.0000000000001310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In our study, we aimed to evaluate the pathological response rates and side effect profile of adding pertuzumab to the treatment of HER2+ locally advanced, inflammatory, or early-stage breast cancer. This study was conducted by the Turkish Oncology Group (TOG) with data collected from 32 centers. Our study was multicentric, and a total of 364 patients were included. The median age of the patients was 49 years (18-85 years). Two hundred fifteen (60%) of the cases were hormone receptor/HER2+ positive(ER+ or PR+, or both), and 149 (40%) of them were HER2-rich (ER and PR negative). The number of complete responses was 124 (54%) in the docetaxel+trastuzumab+pertuzumab arm and 102 (45%) in the paclitaxel+trastuzumab+pertuzumab arm, and there was no difference between the groups in terms of complete response. In 226 (62%) patients with complete response, a significant correlation was found with DCIS, tumor focality, removed lymph node, and ER status P < 0.05. Anemia, nausea, vomiting, myalgia, alopecia, and mucosal inflammation were significantly higher in the docetaxel arm, P < 0.05. In our study, no statistical difference was found between the before-after echocardiography values. DCIS positivity in biopsy before neoadjuvant chemotherapy, tumor focality; the number of lymph nodes removed and ER status were found to be associated with pCR. In conclusion, we think that studies evaluating pCR-related clinicopathological variables and radiological imaging features will play a critical role in the development of nonsurgical treatment approaches.
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Affiliation(s)
| | - Baha Zengel
- General Surgery, Bozyaka Training and Research Hospital
| | - Yaşar Yildiz
- Department Medical of Oncology, Katip Çelebi University, Atatürk Training and Research Hospital, Izmir
| | | | - Devrim Cabuk
- Department of Medical Oncology, Kocaeli University Faculty of Medicine Hospital, Kocaeli
| | - Ercan Ozden
- Department of Medical Oncology, Kocaeli University Faculty of Medicine Hospital, Kocaeli
| | - Derya Kivrak Salim
- Department of Medical Oncology, Health Sciences University Antalya Training and Research Hospital, Antalya
| | - Semra Paydas
- Department of Medical Oncology, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Atakan Demir
- Department of Medical Oncology, Acibadem Hospital, Istanbul
| | - Omer Diker
- Department of Medical Oncology, Near East University Hospital, Lefkosa, Cyprus
| | | | | | - Sezai Vatansever
- Department of Medical Oncology, Istanbul University Faculty of Medicine, Istanbul
| | - Izzet Dogan
- Department of Medical Oncology, Istanbul University Faculty of Medicine, Istanbul
| | - Ahmet Gulmez
- Department of Medical Oncology, Inonu University Faculty of Medicine, Malatya
| | - Burcu Cakar
- Department of Medical Oncology, Ege University Faculty of Medicine, Izmir
| | - Pinar Gursoy
- Department of Medical Oncology, Ege University Faculty of Medicine, Izmir
| | | | - Murat Ayhan
- Department of Medical Oncology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul
| | - Nuri Karadurmus
- Department of Medical Oncology, Health Sciences University Gulhane Training and Research Hospital, Ankara
| | - Musa Baris Aykan
- Department of Medical Oncology, Health Sciences University Gulhane Training and Research Hospital, Ankara
| | - Gökcen Tugba Cevik
- Department of Medical Oncology, Usak University Training and Research Hospital, Usak
| | - Teoman Sakalar
- Department of Medical Oncology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras
| | - Ilhan Hacibekiroglu
- Department of Medical Oncology, Sakarya University Training and Research Hospital, Sakarya
| | - Burcu Belen Gülbagci
- Department of Medical Oncology, Sakarya University Training and Research Hospital, Sakarya
| | - Murat Dincer
- Department of Medical Oncology, Osmangazi University Faculty of Medicine Hospital, Eskisehir
| | - Duygu Bayir Garbioglu
- Department of Medical Oncology, Osmangazi University Faculty of Medicine Hospital, Eskisehir
| | - Yasemin Kemal
- Department of Medical Oncology, Medical Park Hospital, Samsun
| | - Erdinc Nayir
- Department of Medical Oncology, Medical Park Hospital, Mersin
| | | | - Mesut Yilmaz
- Department of Medical Oncology, Bakirköy Dr. Sadi Konuk Training and Research Hospital, Istanbul
| | - Okan Avci
- Department of Medical Oncology, Namik Kemal University Hospital, Tekirdag
| | - Murat Sari
- Department of Medical Oncology, Haydarpaşa Numune Training and Research Hospital
| | - Ezgi Coban
- Department of Medical Oncology, Haydarpaşa Numune Training and Research Hospital
| | | | | | - Tugba Akin Telli
- Department of Medical Oncology, Marmara University Faculty of Medicine, Istanbul
| | - Fatih Karatas
- Department of Medical Oncology, Karabuk University Faculty of Medicine, Karabuk
| | - Ali Inal
- Department of Medical Oncology, Mersin City Training and Research Hospital, Mersin
| | - Hacer Demir
- Department of Medical Oncology, Afyonkarahisar Health Sciences University, Afyonkarahisar
| | - Nurhan Onal Kalkan
- Department of Medical Oncology, Van Yuzuncu Yil Faculty of Medicine, Van
| | | | - Funda Tasli
- Department of Pathology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Ahmet Alacacioglu
- Department Medical of Oncology, Katip Çelebi University, Atatürk Training and Research Hospital, Izmir
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Koseci T, Haksoyler V, Olgun P, Ata S, Nayir E, Duman BB, Cil T. Prognostic Importance of Inflammatory Indexes in Patients Treated by Pazopanib for Soft Tissue Sarcoma. Clin Lab 2022; 68. [PMID: 35142203 DOI: 10.7754/clin.lab.2021.210431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The goal of this study was to evaluate the predictive and prognostic importance of the lymphocyte to monocyte ratio (LMR), neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (DNLR), and systemic immune inflammation index (SSI) in STS cases treated with pazopanib. METHODS Thirty STS patients treated with pazopanib were included in this study. SSI, DNLR, LMR, and NLR values were calculated at baseline and in the first month. Median values of these predictors in these patients (SSI (944), DNLR (1.8), LMR (2.7), and NLR (3.0)) were taken as cutoff values. The associations between the survival time (both overall survival (OS) and progression-free survival (PFS)) and cutoff values were evaluated using Kaplan Meier curves and Cox regression models. RESULTS Patients with low SSI, NLR, and DNLR values at pretreatment and after the initial response had longer OS (for OS - p = 0.024, p = 0.015, and p = 0.041, respectively). Longer OS was also found in patients who showed increasing LMR and decreasing NLR after one month of therapy (for ΔLMR, p = 0.016; for ΔNLR, p = 0.016). Pa-tients with low SSI and NLR values at pretreatment and after the initial response had longer PFS (for PFS, p = 0.014, p = 0.04, p ˂ 0.001, respectively). In terms of initial responses to treatment, SSI, NLR, DNLR, and increased LMR were detected as independent risk factors in univariate analysis, but initial response was found to be the only independent risk factor for PFS in multivariate analysis. CONCLUSIONS Low values of SSI, NLR, and DNLR at pretreatment and at initial response may predict long-term survival rates. After one month of treatment with pazopanib, decreased NLR and increased LMR are predictive of favorable outcomes in these cases.
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Karadurmus N, Paydas S, Esin E, Surmeli ZG, Yildiz B, Erturk I, Nayir E, Dogan M, Sumbul AT, Barista I, Gurkan E, Ocal R, Ferhanoglu B, Ozgur G, Karakas Y, Lacin S, Ozaydin S, Petekkaya HI, Uskent N. Effectiveness of bendamustine in relapsed or refractory lymphoma cases: a Turkish Oncology Group study. Arch Med Sci 2021; 17:920-927. [PMID: 34336021 PMCID: PMC8314394 DOI: 10.5114/aoms.2019.83000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/07/2018] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION We aimed to investigate the efficacy and side effects of bendamustine in relapsed/refractory lymphoma patients in Turkey. MATERIAL AND METHODS In this retrospective study, we included relapsed/refractory Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) patients who underwent multiple lines of chemotherapy. The primary endpoint was to determine the objective response and toxicity. RESULTS Ninety-nine patients with a median age of 59.8 years were included in the study. Eighty-one patients had NHL (follicular lymphoma: 10, diffuse large B-cell lymphoma: 27, mantle-cell lymphoma: 18, marginal zone lymphoma: 9, small lymphocytic lymphoma/chronic lymphocytic leukemia: 17) and 18 patients had HL. The patients had previously received a median of three lines of chemotherapy (range: 2-8) except autologous stem cell transplantation (ASCT); 19 patients (HL: 11, NHL: 8) had undergone ASCT. The objective response rate (ORR) was 74.3%, the complete response rate was 57% (= 53), and the partial response rate was 16.6% ( = 19). The overall survival (OS) rate at 1 year was 74.6%. The progression-free survival (PFS) rate at 1 year was 62.5%. The most common side effects were lymphopenia, anemia and neutropenia. Side effects which were observed as grade 3 and higher levels were lymphopenia (14.1%), neutropenia (10.1%) and fatigue (7.1%). CONCLUSIONS Objective response rate of bendamustine was found to be 74.3% in relapsed/refractory HL and NHL patients. It appears to be an effective option as a salvage treatment for patients who have previously received multiple lines of therapy.
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Affiliation(s)
- Nuri Karadurmus
- Department of Medical Oncology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Semra Paydas
- Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ece Esin
- Department of Medical Oncology, Health Sciences University, Dr. Abdurrahman Yurtaslan Training and Research Hospital, Ankara, Turkey
| | | | - Birol Yildiz
- Department of Medical Oncology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Ismail Erturk
- Department of Medical Oncology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Erdinc Nayir
- Department of Medical Oncology, Medicalpark Hospital, Ankara, Turkey
| | - Mutlu Dogan
- Department of Medical Oncology, Health Sciences University, Numune Training and Research Hospital, Ankara, Turkey
| | - Ahmet Taner Sumbul
- Department of Medical Oncology, Faculty of Medicine, Baskent University, Adana, Turkey
| | - Ibrahim Barista
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Emel Gurkan
- Department of Haematology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ramazan Ocal
- Department of Haematology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Burhan Ferhanoglu
- Department of Haematology, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Gokhan Ozgur
- Department of Haematology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Yusuf Karakas
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sahin Lacin
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sukru Ozaydin
- Department of Medical Oncology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | | | - Necdet Uskent
- Department of Medical Oncology, Anatolian Health Center, Istanbul, Turkey
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Murat Sedef A, Taner Sumbul FKA, Ayberk Besen A, Hacioglu B, Gunaldi M, Nayir E, Tanriverdi O, Arpaci E, Abali H, Ozyilkan O. Addition of taxanes to combination chemotherapy in distal intestinal gastric cancer is more beneficial than proximal ones: A multicenter retrospective study of Turkish Oncology Group. J BUON 2019; 24:650-655. [PMID: 31128019] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Advanced gastric cancer has a dismal prognosis. Platin/5-fluorouracil (PF) combination chemotherapy is the main treatment modality for metastatic gastric cancer patients. Third drug addition to PF is a controversial issue. The aim of this study was to evaluate the predictive role of tumor localization and histopathology on choosing three- or two-drug combination regimens. METHODS This study was designed as a hospital-based retrospective observational case-series study. A total of 516 patients with advanced gastric cancer has been treated at eight different oncology centers in Turkey between 2006 and 2016. Laboratory results and demographic data were collected and analyzed. RESULTS The median patient age was 59 years (range 25-85). Proximal intestinal and distal intestinal cancers were found in 357 (69.2 %) and 159 (30.8 %) patients, respectively. 5-fluorouracil (5FU) and cisplatin (PF) and cisplatin+5FU+docetaxel (PFtax, also known as DCF) were administered to 240 (46.5%) and 276 (53.5%) patients, respectively. Median progression free survival (PFS) was 5.0 (95% CI 4.21-5.29) and 8 months (95% CI 7.22-8.77) for PF and PFtax groups, respectively (p=0.000). When tumor localization was used as stratum in PFS survival, PFtax produced significantly higher PFS rates only in distal intestinal type gastric cancer compared to PF (p=0.000). Median overall survival (OS) was 12 (95% CI 9.8-14.2) and 16 months (95% CI 13.6-18.4) for the PF and PFtax groups, respectively (p=0.01). When tumor localization was used as stratum in OS, PFtax showed significantly higher OS rates only in the distal intestinal type gastric cancer compared to PF (p=0.01) Conclusion: Pathology and tumor location in gastric cancer may affect the outcome. Addition of taxanes as a third drug may significantly increase PFS and OS rates only in distal intestinal type gastric cancer but not in patients with proximal type gastric cancer.
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Affiliation(s)
- Ali Murat Sedef
- Department of Medical Oncology, Medical Faculty, Baskent University, Adana, Turkey
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Degirmencioglu S, Tanriverdi O, Menekse S, Dogan M, Hacıoglu B, Oktay E, Erdem D, Arpaci E, Uluc BO, Turhal S, Yilmaz M, Pilanci KN, Sakin A, Araz M, Cokmert S, Ozdemir O, Sen E, Nayir E. A retrospective analysis on first-line bevacizumab, cetuximab, and panitimumab-containing regimens in patients with RAS-wild metastatic colorectal cancer: A Collaborative Study by Turkish Oncology Group (TOG). J BUON 2019; 24:136-142. [PMID: 30941962] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE To compare the efficacy and adverse effect profiles of the first-line treatment of patients with KRAS wild type metastatic colorectal cancer (CRC) in Turkey who were treated based on regimens including bevacizumab, cetuximab and panitumumab. METHODS This retrospective multicenter observational study involved a total of 238 patients who received chemotherapy in combination with either bevacizumab or cetuximab or panitumumab as first-line therapy for KRAS wild-type metastatic colorectal cancer. Patients with full medical records having pathological diagnosis of CRC adenocarcinoma were included in the study. The demographic, laboratory, histopathological and clinical characteristics of the patients were determined, and three groups were compared based on the study variables. RESULTS The mean age of the entire sample (n=238) was 58±11 years, 64% of which were male. The most frequent tumor localization was the rectum (37%) and G2 was the most common tumor grade (59.7%). About 63% of the patients had metastatic disease at diagnosis, with the most common site of metastasis being lung (14.7%) and liver (52.5%). Overall survival (OS) was 63.9%, while 1-, 3- and 5-year survival rates were 91.7, 56.6 and 36.9%, respectively. The expected mean survival was 49.1 months (95% CI, 42.9-55.3). The 1-, 3- and 5-year progression-free survival (PFS) rates following first-line treatment were 65.3, 26.1 and 5.6%, respectively, while disease free survival (DFS) in patients without metastasis at diagnosis was 68.5%. An analysis carried out disregarding which treatment the patients received (FOLFOX or FOLFIRI) revealed that a panitumumab-containing combination resulted in poorer prognosis compared to bevacizumab or cetuximab-containing combination (p<0.001). With regard to the adverse effect profile, the most common adverse effects were neuropathy and neutropenia in patients receiving FOLFOX-bevacizumab; neutropenia and perforation in patients receiving FOLFIRI-bevacizumab; rash and pustular infection in patients receiving FOLFIRI-cetuximab; and diarrhea in patients who received FOLFIRI-panitumumab combination. CONCLUSION This is the first multicenter study performed in Turkey evaluating the response to treatment and adverse effects in patients with KRAS wild-type metastatic colorectal cancer.
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Affiliation(s)
- Serkan Degirmencioglu
- Pamukkale University School of Medicine, Medical Oncology Department, Denizli, Turkey
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Nayir E, Cor S, Altintas ZM, Buyukafsar K, Tiftik RN, Ata A, Arican A. Comparative investigation of antitumoral effectiveness of Rho-kinase inhibitor Y-27632, pravastatin and atorvastatin in anaplastic thyroid cancer cell culture. Journal of Oncological Sciences 2017. [DOI: 10.1016/j.jons.2017.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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10
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Karadurmus N, Paydas S, Ocal R, Yildiz B, Nayir E, Dogan M, Sumbul AT, Surmeli Z, Barısta I, Ferhanoglu B, Ozgur G, Erturk I, Ozaydin S, Petekkaya HI, Uskent N. Effectiveness of bendamustine in relapse or refractory lymphoma cases: A report from Turkey—The Turkish Oncology Group (TOG) study. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e19027] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19027 Background: Bendamustine is an old conventional agent which is used in the treatment of hodgkin's lymphoma (HL), non-hodgkin's lymphoma (NHL), and chronic lymphocytic leukemia (CLL) patients despite they are relapsed or refractory cases. In our study we wanted to reveal retrospectively the efficacy and side effects of bendamustine in relapse/refractory patients from Turkey. Methods: We included in the study relapse/refractory HL and NHL patients who underwent multiple line chemotherapy. Bendamustine was administered at 90 mg/m² on days 1 and 2, every 3 weeks by 60 minutes infusion. The primary endpoint of the study was to determine the objective response and toxicity. Results: Seventy-five patients (31 female) with a median age of 62.8 years (range 16-89 years) were included in the study. 58 of the patients were NHL (follicular lymphoma:8, diffuse large B-cell lymphoma: 17, mantle cell lymphoma: 11, marginal zone lymphoma: 4, Small lymphocytic lymphoma:11, Others:7) and 17 of them were HL patients. The patients were underwent median three lines chemotherapy (range 1-8) accept autologous stem cell transplantation, 20 patients (HL: 12, NHL:8) were underwent autologous stem cell transplantation. Bendamustine was performed an average of 6 cycles (range 1-38). The objective response rate was 73.3%, complete response rate was 44% (n = 33), partial response rate was 29.3% (n = 22), respectively. The response rate was 65% (11/17) in HL cases, 79% (30/38) in indolent NHL cases and 70% (14/20) in aggressive NHL cases. For median follow-up of 20.7 months, the median overall survival (OS) was 64.9 months, OS rate was 75.5% for 1 year, 67.6% for 2 years and 63.1% for 3 years. The most common side effects associated with treatment were lymphopenia, neutropenia, thrombocytopenia, abdominal pain, fatigue and diarrhea. Side effects which were seen as grade 3 and higher levels: 9.6% lymphopenia, thrombocytopenia 8% and 12% fatigue. Conclusions: Objective response rate of bendamustine with tolerable side effect profile was found to be 73.3% in relapsed / refractory HL and NHL patients as a rescue agent. It appears to be an ideal agent for rescue treatment which had previously received intensive treatment.
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Affiliation(s)
- Nuri Karadurmus
- Gulhane Education and Training Hospital, Medical Oncology Clinic, Ankara, Turkey
| | - Semra Paydas
- Cukurova University Faculty of Medicine, Medical Oncology Clinic, Adana, Turkey
| | - Ramazan Ocal
- Gazi University Faculty of Medicine, Medical Oncology Clinic, Ankara, Turkey
| | - Birol Yildiz
- Gulhane Education and Training Hospital, Medical Oncology Clinic, Ankara, Turkey
| | - Erdinc Nayir
- Mersin University Faculty of Medicine, Medical Oncology Clinic, Mersin, Turkey
| | - Mutlu Dogan
- Numune Education and Training Hospital, Medical Oncology Clinic, Ankara, Turkey
| | | | - Zeki Surmeli
- Gulhane Education and Training Hospital, Medical Oncology Clinic, Ankara, Turkey
| | - Ibrahim Barısta
- Hacettepe University Faculty of Medicine, Medical Oncology Clinic, Ankara, Turkey
| | - Burhan Ferhanoglu
- Koc University Faculty of Medicine, Hematology Clinic, Istanbul, Turkey
| | - Gokhan Ozgur
- Gulhane Education and Training Hospital, Hematology Clinic, Ankara, Turkey
| | - Ismail Erturk
- Gulhane Education and Training Hospital, Medical Oncology Clinic, Ankara, Turkey
| | - Sukru Ozaydin
- Gulhane Education and Training Hospital, Medical Oncology Clinic, Ankara, Turkey
| | | | - Necdet Uskent
- Anatolian Health Center, Medical Oncology Clinic, Istanbul, Turkey
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Tanriverdi O, Barista I, Paydas S, Nayir E, Karakas Y. Oncologists’ Perspectives on Consolidation Radiation Treatment after Chemotherapy for Lymphomas: A Survey Study by the Lymphoma Working Committee of the Turkish Oncology Group (TOG). Asian Pac J Cancer Prev 2017; 18:3149-3155. [PMID: 29172293 PMCID: PMC5773805 DOI: 10.22034/apjcp.2017.18.11.3149] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
In this study, we aimed to determine the perspectives of medical and radiation oncologists regarding consolidation radiotherapy in patients with a complete response after chemotherapy for Hodgkin’s and non-Hodgkin’s lymphomas. The survey was designed to identify demographic and occupational features of medical and radiation oncologists and their views on application of consolidation radiotherapy in their clinical practices, as based on a five-point Likert scale (never, rarely, sometimes, often, and always). The study covered 263, out of 935, physicians working in the oncology field as either medical or radiation oncologists; the rate of return on the invitations to participate was 28%. The majority of the participants were male radiation oncologists, with a duration of between 5 and 10 years of work as a university hospital official, and the mean age was 38 ± 14 (years). Although the most commonly followed international guidelines were NCCN, among the physicians, the majority of the respondents suggested that the guidelines were unclear regarding recommendations for consolidative radiotherapy. The administered dose for consolidative radiotherapy in lymphoma patients was indicated as 40 Gy by 49% of all the physicians and the most common cause of hesitancy concerning consolidative radiation treatment was the risk of secondary malignancies as a long-term adverse effect (54%). In conclusion, we suggest that medical oncologists could be most active in the treatment of lymphoma through a continuous training program about lymphomas and current national guidelines.
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Affiliation(s)
- Ozgur Tanriverdi
- Mugla Sitki Kocman University Faculty of Medicine, Department of Medical Oncology, Mugla, Turkey,For Correspondence:
| | - Ibrahim Barista
- Hacettepe University Oncology Institute, Department of Medical Oncology, Ankara, Turkey
| | - Semra Paydas
- Cukurova University Faculty of Medicine, Department of Medical Oncology, Adana, Turkey
| | - Erdinc Nayir
- Necip Fazil City Hospital, Medical Oncology Clinic, Kahramanmaras, Turkey
| | - Yusuf Karakas
- Hacettepe University Oncology Institute, Department of Medical Oncology, Ankara, Turkey
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Nayir E, Bakir Koyuncu M, Esin E, Turker I, Tanriverdi O, Uysal M, Er O, Demir A, Tuzel Akman T, Nur Pilanci K, Paydas S, Kocar M, Saip P, Kilickap S, Turhal S, Kacan T. Attitudes of cancer patients after diagnosis: How cancer affects social life? A Turkish Oncology Group study. J BUON 2017; 22:208-213. [PMID: 28365956] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE Each year, 12.7 million people learn that they have cancer and 8.2 million people die of cancer worldwide. Cancer is a major public health issue which causes fundamental changes in the lives of patients and their families. The purpose of this study was to evaluate the lives of patients after diagnosis and determine the changes in their lifestyles. METHODS Between September 2013 to December 2013, a questionnaire consisting of 22 questions was administered during a face to face interview to patients at 13 different Oncology Units in Turkey. Each patient was queried during the administration of his/her chemotherapy. Eight of the questions featured independent choices, and 14 had dependent (multiple) choices. RESULTS A total of 1300 patients were included in the study. Of patients 9.5% were 71 years of age and older which was the oldest age group. The mean patient age was 54.6±13.8 years. Of the whole group of patients 58.5% were female and 41.5% male. After diagnosis, 64% of the patients reported that they were complying with guidelines for a healthy lifestyle and 80% said that they were eating healthier food. At the time they filled in the questionnaire, more than half of the patients (57.3%) felt optimistic about their disease. CONCLUSIONS Diagnosis of cancer may change the patients' dietary and reading habits, social relationships, activities and more importantly, their point of life view.
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Affiliation(s)
- Erdinc Nayir
- Department of Medical Oncology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, Turkey
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Unlu A, Nayir E, Kirca O, Ay H, Ozdogan M. Ginseng and cancer. J BUON 2016; 21:1383-1387. [PMID: 28039696] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Derived from the Greek word Panacea that means 'cure for all', Ginseng (Panax) has had an important place in Chinese Medicine for many of years. As the name suggests, it is believed to be a miraculous plant effective in the treatment of many health problems. It is claimed to have many effects such as sedative, hypnotic, aphrodisiac, antidepressant, diuretic, and stimulating effects, and to be effective in the treatment of certain health problems such as diabetes, Alzheimer's disease, erectile dysfunction and infections. In addition, its effects on the prevention and treatment of cancer as well as on the reduction of cancer-related symptoms have been prioritized in recent years. However, the studies that have been done so far do not confirm these effects. Although certain favorable results have been obtained in some studies intended for investigating its effects on acute nasopharyngitis, diabetes, Alzheimer's disease, and erectile dysfunction, it is early to say anything conclusive. And in cancer patients, it has been shown to be effective in reducing weakness due to cancer and its treatment. On the other hand, ginseng may cause important drug interactions, although it is described as a relatively safe product. For now, it seems to be reasonable to use ginseng only for cancer-related weakness in cancer patients at this point. But this should definitely be done within the knowledge and under the control of oncologists.
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Affiliation(s)
- Ahmet Unlu
- Akdeniz University Faculty of Medicine, Antalya, Turkey
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Ata A, Küçük A, Nayir E, Eskici Ş. Comparison of combined chemoradiotherapy regimens; Paclitaxel plus carboplatin and cisplatin plus etoposide for locally advanced non-small-cell lung cancer: A randomized phase III trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw382.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Unlu A, Nayir E, Kirca O, Ozdogan M. Ganoderma Lucidum (Reishi Mushroom) and cancer. J BUON 2016; 21:792-798. [PMID: 27685898] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Having a long historical past in traditional Chinese medicine, Ganoderma Lucidum (G. Lucidum) is a type of mushroom believed to extend life and promote health. Due to the increasing consumption pattern, it has been cultivated and marketed intensively since the 1970s. It is claimed to be effective in the prevention and treatment of many diseases, and in addition, it exerts anticancer properties. Almost all the data on the benefits of G. Lucidum are based on laboratory and preclinical studies. The few clinical studies conducted are questionable. Nevertheless, when the findings obtained from laboratory studies are considered, it turns that G. Lucidum is likely to have some benefits for cancer patients. What is important at this point is to determine the components that will provide these benefits, and use them in drug development, after testing their reliability. In conclusion, it would be the right approach to abstain from using and incentivizing this product, until its benefits and harms are set out clearly, by considering its potential side effects.
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Affiliation(s)
- Ahmet Unlu
- Akdeniz University Faculty of Medicine, Antalya, Turkey
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Nayir E, Tanriverdi O, Karakas Y, Kilickap S, Serdar Turhal N, Avci N, Okutur K, Koca D, Erdem D, Abali H, Yamac D, Bilir C, Kacan T. Tendency of cancer patients and their relatives to use internet for health-related searches: Turkish Oncology Group (TOG) Study. J BUON 2016; 21:714-719. [PMID: 27569068] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE This study aimed to reveal the habits of using internet by cancer patients and their relatives to access health-related information and services in Turkey. METHODS An 18-item questionnaire survey was applied in cancer patients and their relatives. RESULTS A total of 1106 patients (male, 37.3%, and female, 62.7%) and their relatives were included in the study. The responders had been using internet to obtain health information about oncological diseases, once a month (34.2%), 1-2 times a week (27.4%) or 2-3 times a month (21.9%). After diagnosis of cancer was made, participants more frequently (64.4%) investigated health-related issues, while 64.9% of them considered internet as an important search tool, and 16.7% of them had thought to give up cancer therapy under the influence of internet information. Some (33.1%) participants had used herbal medicine, and 16.7% of them had learnt these herbal products from internet. Still 12.7% of them had not questioned the accuracy of internet information, while 26.9% of them indicated that they had not shared the internet information about cancer with their physicians, and 13 % of them searched information in internet without asking their physicians. CONCLUSION Cancer patients and their relatives showed a higher tendency to use health-related internet information which may mislead them, and can result in treatment incompliance. Health professionals should offer evidence-based information to the patients and their relatives through internet.
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Affiliation(s)
- Erdinc Nayir
- Department of Medical Oncology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, Turkey
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Nayir E, Ata A, Erdogdu S, Salman T, Sungur MA, Abalı H, Arican A. A snapshot of residents in medical oncology in Turkey: A Nationwide survey on profile and key problems. Journal of Oncological Science 2016. [DOI: 10.1016/j.jons.2016.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Unlu A, Nayir E, Dogukan Kalenderoglu M, Kirca O, Ozdogan M. Curcumin (Turmeric) and cancer. J BUON 2016; 21:1050-1060. [PMID: 27837604] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Curcumin is a substance obtained from the root of the turmeric plant, which has the feature of being a yellow or orange pigment. It is also the main component of curry powder commonly used in Asian cuisine. Curcumin, a substance that has had an important place in traditional Indian and Chinese medicines for thousands of years, has been the center of interest for scientific studies especially in the field of cancer treatment for several years. Laboratory studies have presented some favorable results in terms of curcumin's antioxidant, antiinflammatory and anticancer properties in particular. However, since such findings have yet to be confirmed in clinical studies, its effect on humans is not clearly known. Therefore, when its advantages in terms of toxicity, cost and availability as well as the favorable results achieved in laboratory studies are considered, it would not be wrong to say that curcumin is a substance worth being studied. However, for now the most correct approach is to abstain from its use for medical purposes due to lack of adequate reliable evidence obtained from clinical studies, and because of its potential to interfere with other drugs.
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Affiliation(s)
- Ahmet Unlu
- Akdeniz University Faculty of Medicine, Antalya, Turkey
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Nayir E, Ata A, Arican A. Do medical oncologists and cancer patients care about treatment costs of systemic anticancer therapy? J BUON 2015; 20:1606-1611. [PMID: 26854459] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE The incidence, and thus the economic burden of cancer are increasing rapidly with prolongation of lifespan thanks to newly-developed anticancer drugs. Globally the number of newly diagnosed cases is expected to rise to 21.4 million by the year 2030. In this survey, our purpose was to investigate the level of awareness of oncologists and cancer patients concerning the treatment costs of systemic anticancer therapy. METHODS To this end questionnaire forms were sent via e-mails to 123 medical oncologists which were responded by 119 (96.7%) of them. RESULTS The responders (21%) stated that they had been attentive about the treatment costs or informed (9.5%) their patients about treatment costs. Half of the informed patients were desperately surprised when they heard the treatment costs. Half of the physicians thought that informing the patients had positive effects on patients compliance to the treatment. Most (83.5%) of the physicians prescribed drugs not paid back by reimbursement, and 79.3% of them indicated that overall survival was more important in the selection of expensive drugs. Still 30.2% of them indicated that they hadn't known to perform cost-effectiveness analyses. CONCLUSION Creating awareness about costs of different anticancer treatment modalities in the minds of oncologists and their patients will be beneficial regarding rational use of such treatment modalities. Countries with rapidly growing health expenditures, like ours, should possess and implement country-specific criteria of cost-effectiveness in daily practice which hopefull will lead to more proper use of our medical recources.
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Affiliation(s)
- Erdinc Nayir
- Department of Medical Oncology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, Turkey
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Abali H, Celik I, Karaca B, Turna H, Kaytan Saglam E, Akman T, Oztop I, Senol Coskun H, Serdar Turhal N, Sezer A, Nayir E, Arican A, Ozkan M, Sevinc A, Demir G, Budakoglu B, Issikdogan A, Engin H, Kilickap S, Coskun U, Oyan B, Harputluoglu H, Er O, Kavgaci H, Elk Ran T. Cutaneous melanoma in Turkey: analysis of 1157 patients in the Melanoma Turkish Study. J BUON 2015; 20:1137-41. [PMID: 26416068] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE To develop a large Turkish National Melanoma registry in order to define demographic and clinicopathologic characteristics of patients with melanoma. METHODS The data was collected from 1635 patients with melanoma through a web-based registry system in 22 centers. Herein we present the results of 1157 patients with cutaneous melanoma. RESULTS The patient median age was 56.4 years and 646 (55.8%) were males. The commonest subtype was superficial spreading type (357, 30.9%). The commonest primary site was the lower extremities (N=353, 30.5%). The most common Breslow thickness was 1-2 mm (361 patients, 43.5%). Only 104 (12.5%) patients had a thickness <1mm. Among 694 patients with available data, 136 (19.6%) presented with stage 4 disease while the most frequent stage was stage 3, encountered in 393 (56.6% patients). CONCLUSION Our melanoma registry is the largest in our country providing a snapshot view of cutaneous melanoma and its care. Our patients presented with more advanced stages and they had worse prognosis compared to SEER database.
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Affiliation(s)
- Huseyin Abali
- Acibadem University School of Medicine, Department of Medical Oncology, Istanbul, Turkey
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Altintas E, Altintas ZM, Sezgin O, Ucbilek E, Nayir E, Erdal ME, Polat A, Orekeci G. Polymorphisms in methylenetetrahydrofolate reductase gene: Their impact on liver steatosis and fibrosis of chronic hepatitis c patients. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojgas.2014.42013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
AIM We aimed to evaluate the metabolic parameters and diabetes complications which would probably affect the serum retinol-binding protein 4 (RBP4) levels in Type 2 diabetic individuals. In addition to serum RBP4 concentration, the levels of its ligands, serum retinol and transthyretin (TTR) were also considered in this evaluation. SUBJECTS AND METHODS Serum RBP4, retinol, and TTR levels were measured in 53 Type 2 diabetic subjects and 30 body mass index (BMI)- matched controls. The molar ratios of RBP4 to retinol and RBP4 to TTR were compared. RESULTS While the RBP4 values were similar to those in the control group in Type 2 diabetic patients, the molar ratio of RBP4 to TTR was found to be higher than that of the control group. The serum RBP4 levels in patients who had retinopathy and macrovascular disease were similar to those in patients who did not. However, the RBP4 levels, molar ratios of RBP4 to retinol and RBP4 to TTR in micro- macroalbuminuric patients were found to be significantly higher than in normoalbuminuric subjects and controls. There was no correlation between the RBP4 levels and the patients' age, BMI, duration of diabetes, LDL, triglyceride, serum creatinine, and glycated hemoglobin values. Micro-macroalbuminuria and estimated glomerular filtration rate were independent determinants for increased serum RBP4 levels. CONCLUSION According to the data obtained from this study, diabetic retinopathy and cardiovascular complications do not affect the serum RBP4 level in Type 2 diabetes. Renal functions rather than the metabolic factors of diabetes determine the RBP4 level and its relation with its ligands.
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Affiliation(s)
- E Akbay
- Department of Endocrinology and Metabolism, Mersin University Medical Faculty, Mersin, Turkey.
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Ceylan GB, Nayir E, Ozorak O, Yavuz L, Eroglu F. 516. Changes in Serum Electrolytes and Coagulation Tests in TUR-P Under Spinal Anesthesia: Is Procedure Duration an Important Factor? Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
STATEMENT OF PROBLEM Although the bond strengths of various resin composite luting materials have been reported in the literature, the evaluation of these systems with various cast alloys of different compositions has not been completely clarified. PURPOSE To evaluate the tensile bond strength of sandblasted high-noble, noble, and base metal alloys bonded to etched enamel by 2 different bonding agents of different chemical composition: Panavia-Ex (BIS-GMA) and Super-Bond (4-META acrylic). MATERIAL AND METHODS Flat enamel surfaces were prepared on buccal surfaces of 60 extracted noncarious human incisors. Teeth were divided into 3 groups of 20 each. Twenty circular disks of 5 mm diameter were prepared for casting for each group. Group I was cast with a high-noble, group II with a noble, and group III with a base metal alloy. The surfaces of the disks were sandblasted with 250 microm Al(2)O(3). Ten disks of each group were bonded to exposed enamel surfaces with Super-Bond and 10 disks with Panavia-Ex as recommended by the manufacturer. The tensile bond strength was measured with an Instron universal testing machine with a crosshead speed of 0.5 mm/min until failure occurred. RESULTS Two-way ANOVA was used to evaluate the results. The differences in bond strengths of Super-Bond and Panavia-Ex with different alloys were not significant. The highest bond strengths were obtained in base metal alloys, followed by noble and high-noble alloys. These results were significant. CONCLUSION Panavia-Ex and Super-Bond exhibited comparable tensile bond strengths. For both luting agents, the highest bond strengths were achieved with base metal alloys and the lowest with high-noble alloys.
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Affiliation(s)
- D Sen
- Department of Prosthodontics, Instanbul University, Instanbul, Turkey.
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