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Öğe Advancing hepatocellular carcinoma treatment with hepatic arterial infusion chemotherapy(Baishideng Publishing Group Inc, 2024) Yildirim, Eda Caliskan; Ergun, YakupHepatocellular carcinoma (HCC) remains a major challenge in oncology, being a leading cause of cancer-related mortality worldwide. Early-stage HCC is typically treated with surgical resection, transplantation, or ablation, while advanced-stage HCC relies on systemic therapies like sorafenib and newer combinations such as atezolizumab-bevacizumab. Despite these advancements, there is still a need for effective treatments for unresectable HCC, especially in cases with macroscopic vascular invasion. Hepatic arterial infusion chemotherapy (HAIC) has demonstrated promising outcomes in Asia for the treatment of unresectable HCC, yet its application in Western countries has been relatively limited. This letter reviews the recent meta-analysis by Zhou et al published in the World Journal of Gastrointestinal Oncology, which demonstrates the efficacy and safety of HAIC vs sorafenib. The analysis includes 9 randomized controlled trials and 35 cohort studies, highlighting significant improvements in overall survival, progression-free survival, and objective response rates with HAIC and its combinations. The editorial explores the reasons behind the limited use of HAIC in Western countries. It underscores the potential of HAIC to enhance treatment outcomes for advanced HCC and calls for more research and broader adoption of HAIC in clinical practice globally.Öğe 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, PinarPurpose 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.Öğe The Comparison of FLOT and DCF Regimens as Perioperative Treatment for Gastric Cancer(Karger, 2024) Ucar, Gokhan; Sekmek, Serhat; Karahan, Irfan; Ergun, Yakup; Isak, ozlem Aydin; Tunc, Sezai; Dogan, MutluIntroduction: Locoregional gastric cancer is a still serious problem and perioperative treatments may improve the success of management. Different regimens were examined. The present study purposed to compare the efficacy of fl uorouracil-leucovorin-oxaliplatin-docetaxel (FLOT) and docetaxel-cisplatin-fluorouracil (DCF) regimens. Methods: A retrospective multicenter study assessed the patients with loco regional gastric cancer. There are 240 patients (137 DCF, 103 FLOT). Survival rates were compared. Results: Demographic features were similar between the two groups, but the time period was different. The FLOT group had 7.8% pathological complete response, while the DCF group did not. Disease-free survival was longer in the FLOT than in the DCF group (median not reached - 13.94 months, respectively). Median overall survival was similar (30.9 vs. 37.8 months), but median follow-up affected the analysis. Survival for 36 months was 63% for the FLOT group and 40% for the DCF group (log-rank; p = 0.015). Conclusion: FLOT regimen was superior to DCF regimen for response and survival rates. DCF is a historical approach. Long-term follow-up period is needed for FLOT treatment. (c) 2024 S. Karger AG, BaselÖğe The Efficacy and Safety of Treatment Regimens Used in the First-Line Setting in Metastatic Pancreatic Cancer Patients A Multicenter Real-Life Study(Lippincott Williams & Wilkins, 2022) Akdeniz, Nadiye; Kaplan, Muhammet Ali; Inanc, Mevlude; Uncu, Dogan; Ergun, Yakup; Kucukoner, Mehmet; Demirci, AyseObjectiveThe aim of the study is to compare the efficacy and safety of 3 chemotherapy regimens used as first-line treatments in the real-life management of metastatic pancreatic cancer.MethodsA total of 218 patients were included in this multicenter study. Gemcitabine (Gem, n = 71), gemcitabine-cisplatin (Gem-Cis, n = 91), and FOLFIRINOX (a combination of leucovorin, 5-fluorouracil, irinotecan, and oxaliplatin [FFX], n = 56) treatments were compared.ResultsOverall response rate was significantly higher in the FFX group (50.0%) than in the Gem (28.2%) and Gem-Cis (27.5%) groups (P = 0.010). Median progression-free survival (8.4 vs 4.6 and 5.5 months, respectively, P < 0.001) and overall survival (16.4 vs 8.1 and 8.7 months, respectively, P = 0.002) were significantly longer in the FFX group than in the Gem and Gem-Cis groups. Toxicity of any grade was noted in 46 (64.8%), 56 (61.5%), and 49 (87.5%) patients in the Gem, Gem-Cis, and FFX groups, respectively (P = 0.003).ConclusionsIn our study, FFX regimen provides a significant advantage over the other treatment regimens in terms of response rates and survival. Treatment toxicity was more frequent but manageable with the FFX regimen.Öğe Elevated neutrophil-to-lymphocyte ratio in the diagnosis of subacute thyroiditis(Mattioli 1885, 2018) Kilinc, Faruk; Ergun, Yakup; Pekkolay, Zafer; Tuzcu, Sadiye Altun; Gozel, Nevzat; Tuna, Mazhar Muslum; Tuzcu, Alpaslan KemalSubacute thyroiditis (SAT) is a self-limiting inflammatory condition of the thyroid gland in which multinucleated giant cells constitute a key histological finding. The neutrophil-lymphocyte ratio (NLR), determined from peripheral blood, is accepted as an available and practical indicator of the systemic inflammation. The purpose of this study was to determine the neutrophil-to-lymphocyte ratio (NLR), a novel marker of inflammation, in patients with SAT and to compare these values with those from healthy subjects. A total of 150 participants were included in the study, 75 SAT patients and 75 healthy volunteers. Retrospectively, demographic and laboratory data of the subjects were obtained from our institution's database. Patients with active infection, diabetes mellitus, malignancy, other chronic inflammatory diseases and hematologic disorders were excluded from the study. Values for complete blood count (CBC) and serum laboratory parameters of SAT patients were the baseline values obtained at the time of SAT diagnosis. Control subjects consisted of healthy volunteers who visited our institution for a routine check-up. A total of 75 subacute thyroiditis patients 54 (72%) were female and 21 (28%) were males and 50 (66.6%) were female and 25 (33.3%) were male and 75 were healthy adults were included. The mean age was 39.95 +/- 14.2, years for patients with SAT and 37.53 +/- 13.45 years for the control group. There was no significant difference between the age for groups (P = 0.13). NLR levels were found to be 3,56 +/- 2,64 in patients with SAT; NLR levels were found to be 1.41 +/- 0.9 in the control group. NLR levels were significantly higher in patients with SAT compared to the control group. Our study showed that increased NLR may be useful as an indicator of the presence of SAT, especially in complicated cases. The assessment of neutrophil-lymphocyte ratio in conjunction with radiological and clinical findings will assist in the achievement of an accurate diagnosis. Larger, prospective studies are required to determine its usefulness in assessing diagnostic potential and treatment outcomes in SAT patients.Öğe KRAS codon 12 and 13 mutations may guide the selection of irinotecan or oxaliplatin in first-line treatment of metastatic colorectal cancer(Taylor & Francis As, 2019) Ergun, Yakup; Acikgoz, Yusuf; Bal, Oznur; Ucar, Gokhan; Dirikoc, Merve; Yildirim, Eda Caliskan; Akdeniz, NadiyeBackground: In this study, we aimed to investigate the frequency, prognostic effect of codon, and amino acid-specific KRAS mutations in patients with metastatic colorectal cancer (mCRC) and their predictive effect on irinotecan and oxaliplatin during first-line treatment. Methods: The data of 304 mCRC patients were retrospectively evaluated between 2010 and 2018. Patients were categorized according to the most prominent codon and amino acid mutation and their prognostic features were analyzed. Results: In total, 274 patients were included in the study and 128 patients (47%) revealed KRAS mutation. Median follow-up time was 19.8 months (range; 1.6-96). The median overall survival rates for patients with codons 12 and 13 mutations were 25.4 and 22.2 months, respectively (p = 0.4). Moreover, the median overall survival for the codon 12 mutant patients who received irinotecan-based chemotherapy in the first-line treatment was 42.7 months, whereas for the codon 13 mutant and KRAS wild-type patients, it was 18.3 and 23.9 months, respectively (codon 12 vs. codon 13; HR: 0.31, p = 0.03, codon 12 vs. wild-type; HR: 0.45, p = 0.03). Conclusion: The significant survival advantage was observed in patients with codon 12 mutations who received irinotecan-based chemotherapy as a first-line treatment.Öğe Predictive and prognostic effect of ABO blood group on immune checkpoint inhibitors(Ios Press, 2022) Ergun, Yakup; Esen, Selin Akturk; Bardakci, Murat; Ucar, Gokhan; Kalkan, Ziya; Urakci, Zuhat; Seyran, ErdoganBACKGROUND: The relationship of the ABO blood group system with the immune response is known, but its relationship with immune checkpoint inhibitors (ICIs) has not been clearly investigated until now. OBJECTIVE: In this study, the relationship between different blood groups and nivolumab treatment response in patients with advanced malignant melanoma was investigated. METHODS: The data of patients who used nivolumab for advanced malignant melanoma between April 2018 and April 2021 were retrospectively reviewed. RESULTS: A total of 73 patients were included in the study. In the progression-free survival (PFS) analysis according to blood groups, it was 3.9 months, 16.1 months, 20.0 months and 3.0 months for A, B, AB and O, respectively ( p = 0.1). Overall survival (OS) analysis according to blood groups was 5.1 months, 25.0 months, 20.0 months and 9.3 months for A, B, AB and O, respectively (p = 0.1). The B antigen group (B or AB) had significantly longer PFS and OS than the non-B antigen group (A or O) (16.1 vs. 3.5 months for PFS, respectively, p = 0.03; 20.0 vs. 7.4 months for OS, respectively, p = 0.02). CONCLUSIONS: The presence of B antigen provides a significant advantage in terms of survival in patients using ICIs for advanced melanoma.Öğe Sunitinib or pazopanib: Is there any difference between tyrosine kinase inhibitors in the pre-nivolumab setting in metastatic renal cell carcinoma?(Cureus Inc., 2020) Uçar, Gökhan; Açıkgöz, Yusuf; Ergun, Yakup; Bal, Öznur; Yılmaz, Mesut; Karakaya, Serdar; Akdeniz, Nadiye; Köstek, Osman; Isak, Özlem Aydın; Şener, Görkem Yazıcı; Dirikoç, Merve; Esen, Selin Aktürk; Doğan, Mutlu; Uncu, DoğanIntroduction Treatment options for metastatic renal cell carcinoma disease have been improved in recent years. However, there is still no optimal treatment sequence or combination for metastatic disease. We aimed to investigate whether patients differed in terms of disease outcomes regarding pre-nivolumab tyrosine kinase inhibitors (TKIs). Material and methods The analysis of patients was performed after all cohorts were sub-grouped into two groups according to pre-nivolumab TKIs as following the sunitinib arm and the pazopanib arm. Result A total of 75 patients were included in this study. The median follow-up time was eight months for all cohorts. The objective response rate was statistically significantly higher in the pazopanib arm as compared to the sunitinib arm (56% vs 30%, p=0.02). Progression-free survival was significantly higher in pazopanib than sunitinib (10.3 months vs 5.3 months, p=0.02). Multivariate analysis revealed that pazopanib treatment was associated with better progression-free survival (HR: 0.44, 95 CI; 0.22-0.91, p=0.02). While the median overall survival for patients who had received sunitinib was 11.0 months, it has not been reached the median in the pazopanib arm (11.0 months vs NR, p=0.051). Discussion We demonstrated significantly better progression-free survival and a higher objective response rate with nivolumab treatment in patients who had received pazopanib as compared with patients who received sunitinib in the pre-nivolumab period.