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Öğe The clinical and pathologic characteristics of 400 gastrointestinal stroinal tumor patients from Turkey: The final results of the Turkish Anatolian Society of Medical Oncology Multicenter Registery(Lippincott Williams & Wilkins, 2014) Sevinc, Alper; Seker, Mesut; Yildiz, Ramazan; Cihan, Sener; Kaplan, Mehmet Ali; Dane, Faysal; Karaca, Halit[Abstract Not Available]Öğe Efficacy and Safety of Erlotinib in Previously Treated Advanced Non-Small Cell Lung Cancer(Akad Doktorlar Yayinevi, 2013) Karaca, Halit; Geredeli, Caglayan; Kaplan, M. Ali; Demirci, Umut; Alici, Suleyman; Artac, Mehmet; Isikdogan, AbdurrahmanErlotinib is a potent inhibitor of the epidermal growth factor receptor (EGFR) tyrosine kinase, with single-agent antitumor activity which improves symptom control and quality of life compared with placebo in non-small-cell-lung cancer (NSCLC) patients. We aimed to determine the efficacy and safety of the second, third or fourth-line erlotinib in advanced NSCLC patients in Turkish population. Eighty patients (33 males and 47 females) were retrospectively evaluated. All patients had received a platinum-based regimen as the first-line metastatic therapy. Most of the patients (62.5%) had received erlotinib as the second-line treatment. None of the patients had EGFR mutation studied. One patient achieved a complete response, 10 patients partial response and 21 stable diseases. The overall response rate was 14% and disease control rate was 40%. The median progression-free survival (PFS) and overall survival (OS) were 12 months and 18 months, respectively. Although, there was no survival difference between male and female patients, the median PFS of females was significantly better than male patients (p=0.03). There was no significant difference in disease control rate in terms of age, smoking status, erlotinib line, performance status (PS), stage and skin rash. The most common adverse events were skin rash (56%), diarrhea (9%) and anorexia (8%). Sixteen patients (20%) developed grade 3 toxicities. Grade 4 toxicity or treatment related interstitial lung disease were not observed. Erlotinib showed an acceptable response rate, survival time and toxicity after disease progression with chemotherapy. It's an alternative therapy as a second or third-line therapy in patients with NSCLC. Prospective studies are needed to evaluate the efficiency of the treatment in Turkish population.Öğe Efficacy and safety of raltitrexed combinations with uracil-tegafur or Mitomycin C as salvage treatment in advanced colorectal cancer patients.(Amer Soc Clinical Oncology, 2014) Ozkan, Metin; Bozkurt, Oktay; Karaca, Halit; Ozaslan, Ersin; Daloglu, Osman Onur; Ciltas, Aydin; Kaplan, Mehmet Ali[Abstract Not Available]Öğe Efficacy and Safety of Raltitrexed Combinations with Uracil-Tegafur or Mitomycin C as Salvage Treatment in Advanced Colorectal Cancer Patients: A Multicenter Study of Anatolian Society of Medical Oncology (ASMO)(Asian Pacific Organization Cancer Prevention, 2014) Bozkurt, Oktay; Karaca, Halit; Ciltas, Aydin; Kaplan, M. Ali; Benekli, Mustafa; Sevinc, Alper; Demirci, UmutBackground: There is no standard treatment for patients with colorectal cancer (CRC) progressing after irinotecan and oxaliplatin treatment. Here we aimed to retrospectively evaluate the efficacy and tolerability of raltitrexed in combination with oral 5-fluoropyrimidine (uracil tegafur-UFT) or mitomycin C as salvage therapy in mCRC patients. Materials and Methods: A total of 62 patients who had received raltitrexed combined with UFT or mitomycin C were identified between December 2008 and June 2013. They were given raltitrexed 2.6 mg/m(2) (max 5 mg) i.v. on day 1 in combination with either oral UFT 500 mg/day on days 1-14 every 3 weeks (group A) or mitomycin C 6 mg/m(2) i.v. on day every 3 weeks (group B). Results: Forty-two patients (67.7%) were in group A and 20 (32.2%) in group B. In 15 patients (24%) grade 3/4 toxicity was observed, resulting in dose reduction, and in 13 patients (20.9%) dose delay was necessary. The median progression free survival (PFS) was 3 months (95% CI 2.65-3.34) and median overall survival (OS) was 6 months (95% CI 2.09-9.90) in the whole group. Median PFS was 3 months (95% CI 2.60-3.39) in group A vs 3 months (95% CI 1.64-4.35) in group B (p=0.90). Median OS was 6 months (95% CI 2.47-9.53) in group A vs 12 months (95% CI 2.83-21.1) in group B (p=0.46). Conclusions: The combination of raltitrexed with UFT or mitomycin C seem to be a salvage therapy option due to safety profile and moderate clinical activity in heavily-pretreated mCRC patients.Öğe Gemcitabine Plus Paclitaxel as Second-line Chemotherapy in Patients with Advanced Non-Small Cell Lung Cancer(Asian Pacific Organization Cancer Prevention, 2012) Baykara, Meltem; Coskun, Ugur; Berk, Veli; Ozkan, Metin; Kaplan, Muhammet Ali; Benekli, Mustafa; Karaca, HalitPurpose: The aim of this retrospective study was to determine response rates, progression-free survival (PFS), overall survival (OS) and toxicity of gemcitabine and paclitaxel combinations with advanced or metastatic non-small cell lung cancer patients (NSCLC) who have progressive disease after platinum-based first-line chemotherapy. Methods: We retrospectively evaluated the file records of patients treated with gemcitabine plus paclitaxel in advanced or metastatic NSCLC cases in a second-line setting. The chemotherapy schedule was as follows: gemcitabine 1500 mg/m(2) and paclitaxel 150 mg/m(2) administered every two weeks. Results: Forty-eight patients (45 male, 3 female) were evaluated; stage IIIB/IV 6/42; PS0, 8.3%, PS1, 72.9%, PS2, 18.8%; median age, 56 years old (range 38-76). Six (12.5%) patients showed a partial response (PR), 13 (27.1%) stable disease (SD), and 27 (56.3%) progressive disease (PD). The median OS was 6.63 months (95% CI 4.0-9.2); the median PFS was 2.7 months (95% CI 1.8-3.6). Grade 3 and 4 hematologic toxicities, including neutropenia (n=4, 8.4%), and anemia (n=3, 6.3%) were encountered, but no grade 3 or 4 thrombocytopenia. One patient developed febrile neutropenia. There were no interruption for reasons of toxicity and no exitus related to therapy. Conclusion: The combination of two-weekly gemcitabine plus paclitaxel was an effective and well-tolerated second-line chemotherapy regimen for advanced or metastatic NSCLC patients previously treated with platinum-containing chemotherapy. Although the most common and dose limiting toxicities were neutropenia and neuropathy, this regimen was tolerated well by the patients.Öğe Is Late Recurrence a Predictive Clinical Marker for Better Sunitinib Response in Metastatic Renal Cell Carcinoma Patients?(Cig Media Group, Lp, 2015) Bozkurt, Oktay; Hacibekiroglu, Ilhan; Kaplan, Muhammet Ali; Duzkopru, Yakup; Uysal, Mukremin; Karaca, Halit; Berk, VeliAlthough there has been an increase in overall and progression-free survival with the use of novel targeted therapies in metastatic renal cell carcinoma (mRCC) in recent times, predictive markers to determine which patients would benefit from tyrosine kinase inhibitor therapies are needed. The late recurrence might be a predictive marker for response to sunitinib treatment in patients with mRCC. Background: We investigated the clinicopathological features in patients with recurrent renal cell carcinoma (RCC) within 5 years or more than 5 years after nephrectomy and determined predictors of overall survival (OS) and progression-free survival (PFS) after disease recurrence in the administration of first-line sunitinib in the treatment of metastatic RCC (mRCC). Patients and Methods: In this study we enrolled 86 Turkish patients with mRCC who received sunitinib. Univariate analyses were performed using the log rank test. Results: Fifty-six patients (65%) were diagnosed with disease recurrence within 5 years after radical nephrectomy (early recurrence) and 30 patients (35%) were diagnosed with recurrence more than 5 years after radical nephrectomy (late recurrence). Fuhrman grade was statistically significantly different between the 2 groups (P = .013). The late recurrence patients were significantly associated with the Memorial Sloan Kettering Cancer Center favorable risk group compared with patients with early recurrence (p = .001). There was a statistically significant correlation between recurrence time and the rate of objective remission (ORR) (the late recurrence group vs. the early recurrence group: 43.3% vs. 14.3%, respectively; P = .004). From the time of disease recurrence, the median OS was 42.0 (95% confidence interval [CI], 24.4-59.5) months in the late recurrence group, and 16 (95% CI, 11.5-20.4) months in the early recurrence group (P = .001). Median PFS was 8(95% CI, 4.05-11.9) months in the early recurrence group, and 20 (95% CI, 14.8-25.1) months in the late recurrence group (P <= .001). Conclusion: The study demonstrated a potential prognostic value of late recurrence in terms of PFS, OS, and ORR. (C) 2015 Elsevier Inc. All rights reserved.Öğe Is sunitinib-induced hypothyroidism a predictive clinical marker for better response in metastatic renal cell carcinoma patients?(Taylor & Francis Ltd, 2016) Bozkurt, Oktay; Karaca, Halit; Hacibekiroglu, Ilhan; Kaplan, Muhammed Ali; Duzkopru, Yakup; Uysal, Mukremin; Berk, VeliBackground: The main goal of this study was to examine whether the occurrence of hypothyroidism during sunitinib therapy in patients with metastatic renal cell carcinoma (mRCC) is associated with a better outcome. Methods: The study enrolled 81 patients with pathologically proven mRCC who were treated with sunitinib between March 2008 and June 2013. Thyroid function evaluation comprised (free-thyroxine) FT4 and thyroid-stimulating hormone (TSH) before treatment and at day 1 of each 6-week cycle. Survival analysis was performed using the Kaplan-Meier method, and the differences among the groups were determined using the log-rank test. Results: Hypothyroidism occurred in 30 (37%) of 81 patients within a median 3 months (range 1-18) of treatment initiation. There was a statistically significant correlation between the occurrence of hypothyroidism during treatment and the rate of objective remission (ORR) (hypothyroid patients vs euthyroid patients: 46.7 vs 13.7%, respectively; P = 0.001). Median progression-free survival (PFS) was 10 (95% CI 6.13-13.8) months in the euthyroid patients, and 17 (95% CI 9.33-24.6) months in the hypothyroid patients (P = 0.001). The median overall survival (OS) was 39 (95% CI 25.4-52.5) months in the hypothyroid patients and 20 (95% CI 14.7-25.2) months in the euthyroid patients (P = 0.019). Conclusions: The occurrence of hypothyroidism during treatment in patients was significantly associated with longer PFS, OS and better ORR in the current study.Öğe Is sunitinib-induced hypothyroidism a predictive clinical marker for better response in metastatic renal cell carcinoma patients?(Amer Soc Clinical Oncology, 2015) Ozkan, Metin; Bozkurt, Oktay; Hacibekiroglu, Ilhan; Kaplan, Muhammet Ali; Duzkopru, Yakup; Uysal, Mukremin; Karaca, Halit[Abstract Not Available]Öğe Lack of Prognostic Value of Mean Corpuscular Volume with Capecitabine Therapy in Metastatic Breast Cancer(Asian Pacific Organization Cancer Prevention, 2014) Bozkurt, Oktay; Berk, Veli; Kaplan, Muhammed Ali; Cetin, Bulent; Ozaslan, Ersin; Karaca, Halit; Inanc, MevludeCapecitabine is an oral fluoropyrimidine derivative which is frequently used alone or in combination regimens for the treatment of metastatic breast cancer. Although overall and progression free survivals have increased in recent years with the use of new generation drugs, predictive factors that would further improve the outcomes are needed. Previous studies have demonstrated the relation between post-treatment increase in mean corpuscular volume (MCV) and predicting therapy response as well as survival. The present study investigated the clinical impact of MCV elevation in metastatic breast cancer patients treated with capecitabine. Materials and Methods: The data of a total of 82 patients from three centers followed between June 2005 and June 2013 were retrospectively analyzed. The demographic data and hormone receptor status of the patients, as well as initial examination before and after treatment and data concerning progression were recorded. MCV >= 100 fl was considered as macrocytosis. Capecitabine was given at a dose of 2500 mg/m(2) daily for 14 days every three weeks. Pre-treatment and post-treatment MCV and other parameters of complete blood count were recorded. Post-treatment initial evaluation was performed after 2 cycles of therapy. Results: The median age of the patients was 46.5 years (range 26-72 years) and 54% were premenopausal. Performance status was ECOG 0 and 1 in 81 (99%) patients. The median number of cycles for capecitabine therapy was 5 (min-max: 2-18). The median Delta MCV level (post-treatment values at sixth week - baseline) was 6.4. Whilst Delta MCV was >= 6.4 in 42 patients, it was <6.4 in 40 patients. Clinical benefit (complete response+partial response+stable disease) was observed in 37 (88%) of 42 patients with a median Delta MCV >= 6.4 and in 30 (75%) of 40 patients with Delta MCV <6.4 with no statistically significant difference (p=0.158). No significant difference was determined between the group with Delta MCV >= 6.4 and the group with Delta MCV <6.4 in terms of progression-free survival (11 vs 12 months) (p=0.55) and overall survival (20 months vs. 24 months) (p=0.11). Conclusions: The identification of new predictive markers in metastatic breast cancer is very important. In some recent studies, increase in MCV has been suggested as a marker in tumor response. In the present study, however, no significant difference was determined between tumor response and increase in MCV. Further studies including higher numbers of patients are needed to determine whether increase in MCV is a predictive marker or not.Öğe A retrospective evaluation of locally advanced thymoma and thymic carcinoma: Factors influencing the prognosis after local treatment modalities.(Lippincott Williams & Wilkins, 2013) Arslan, Ulku Yalcintas; Geredeli, Caglayan; Ozdemir, Nuriye; Ciltas, Aydin; Sonmez, Ozlem; Kucukoner, Mehmet; Karaca, Halit[Abstract Not Available]Öğe Weekly Topotecan for Recurrent Small Cell Lung Cancer - a Retrospective Anatolian Medical Oncology Group Study(Asian Pacific Organization Cancer Prevention, 2012) Altinbas, Mustafa; Kalender, Mehmet Emin; Oven, Basak; Sevinc, Alper; Karaca, Halit; Kaplan, M. Ali; Alici, SuleymanAim: To evaluate efficacy and tolerability of topotecan treatment for recurrent small cell lung carcinoma. Patients and Methods: A total of 62 patients were evaluated retrospectively. Statistical analysis was performed using GraphPad Instat (version 3.05). Results: DFifty five of patients (89%) were male and 7 (11%) were female. Median age was 56.7 +/- 9.3 (34-75). Forty eight of patients (80%) were extensive stage (ES) at the time of diagnosis. Fifty of the patients (80.6 Medical Oncology Clinic) were given median 5.36 cycles of cisplatin-etoposide (2-8 cycles). Time to recurrence was 15.6 +/- 6.13 weeks in patients with limited stage (LS) and 6.3 +/- 3.82 weeks in extensive stage (ES) (p<0.0001). Overall survival was 14.0 +/- 6.08 months in ES and 17.9 +/- 6.88 months in LS. The difference between two groups was statistically meaningful (p=0.0447). The overall survival of the patients was 14.8 +/- 6.43 months (4.5-40 months). In terms of survival, there was no difference between males and females (p=0.1171). In 17 (27%) patients who were refractory to topotecan or in whom progression occurred other chemotherapies were used. Conclusion: Small cell lung cancer is chemosensitive, but recurrences occur in short time. Other chemotherapy regimens are used in progression. Topotecan is one of them. Patients who were young and in whom recurrences occur late had given better response to topotecan. Because of the retrospective nature of the study, we couldn't reach the records exactly and consequently, rate and duration of response couldn't be calculated. In recurrent SCLC topotecan is one of the treatment choices. But both hematological and non hematological side effects should be taken into consideration.
