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    Blood-based biomarkers of frailty in older patients with cancer
    (2025) Akagunduz, Baran; Ergun, Yakup; Akagunduz, Digdem Dogan; Akbas, Nergis; Akagunduz, Dilara; Karaoglu, Aziz; Soysal, Pinar
    Purpose of reviewThis review aims to evaluate the current evidence on blood-based biomarkers for frailty detection in older cancer patients. It explores the potential of various biomarkers, including inflammatory markers and microRNAs (miRNAs), to serve as indicators of frailty and examines the limitations of existing studies. The review also highlights the need for further research to validate these biomarkers and improve their clinical applicability.Recent findingsRecent studies have examined blood biomarkers associated with frailty in older cancer patients. Findings suggest that elevated granulocyte levels and lower macrophage-derived stem cells and regulatory T cells are linked to frailty. Inflammatory biomarkers such as interleukin-6 and specific miRNAs, as well as higher neutrophil-to-lymphocyte ratios, have also been identified as potential indicators of frailty. While these biomarkers show promise, no single marker has proven sufficient, and combining them may improve frailty detection. Further research is needed to validate their clinical usefulness in this population.SummaryBlood-based biomarkers show potential for detecting frailty in older patients with cancer, but further research is needed, particularly beyond an inflammatory focus and with more robust study designs.
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    Öğe
    Efficacy of regorafenib in the second-and third-line setting for patients with advanced hepatocellular carcinoma: A real life data of multicenter study from Turkey
    (Imprimatur Publications, 2020) Hacioglu, Muhammet Bekir; Kostek, Osman; Karabulut, Senem; Tastekin, Didem; Goksu, Sema Sezgin; Alandag, Celal; Akagunduz, Baran
    Purpose: After failure of the first-line sorafenib treatment in advanced or metastatic stage hepatocellular carcinoma (HCC), regorafenib is one of the newly-approved targeted agents. We aimed to evaluate the efficacy of regorafenib in patients with advanced HCC treated in the secondor third-line setting. Methods: In this retrospective and multicenter study, advanced HCC patients not eligible for local therapies, who received a secondor third-line regorafenib therapy after progression on the first-line sorafenib or sequential therapy with chemotherapy (CT) followed by sorafenib, were included. Results: In the first-line setting, 28 (28.9%) patients received CT and 69 (71.1%) patients received sorafenib. There were 24 (24.7%) patients who were intolerant to sorafenib. Disease control rate (DCR) was 53.6% for all patients treated with regorafenib, 62.3% in patients who received regorafenib in the second-line, and 32.1% for those receiving regorafenib in the third-line (p=0.007). Median progression-free survival (PFS) and overall survival (OS) were 5.6 (range; 4.3-6.9) and 8.8 (range, 6.3-11.3) months for all patients treated with regorafenib vs. 7.1 months and 10.3 months for patients who received regorafenib in the second-line vs. 5.1 and 8.7 months for patients who received regorafenib in the third-line, respectively; however, there was no statistically significant difference (p(PFS)=0.22 and p(OS)=0.85). Conclusion: Although receiving CT as a first-line therapy in advanced HCC patients did not affect the survival rates of subsequent regorafenib therapy, it might diminish the DCR of regorafenib.