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    Are Syrian refugee breast cancer patients diagnosed at advanced stage and do they have treatment delays?
    (Future Medicine Ltd, 2023) Karhan, Ogur; Secmeler, Saban; Sezgin, Yasin; Ileri, Serdar; Yerlikaya, Halis
    Aim: To compare the clinicopathological features and time to reach treatment of patients with breast cancer among Syrian refugees (SRs) and Turkish citizens (TCs). Methods: Retrospective data from 2014 to 2021 were extracted from the hospital database. Student's t-test, Mann-Whitney U test and chi 2 test were used to compare the two groups. Results: Data of 88 SR and 402 TC patients were analyzed. The mean age was 45 years for SRs and 50 years for TCs. Breast cancer subtypes were similar in both groups. The de novo metastatic ratio was 23% in SRs and 21.3% in TCs and the time to reach treatment was similar between the two groups. Conclusion: Provided the absence of any obstacle in the healthcare system, SRs are diagnosed and treated like the citizens of their host nation. Tweetable abstractPatients with breast cancer among Syrian refugees are younger but are not diagnosed and treated later than Turkish citizens. #Syrian #refugees #TreatmentDelay #BreastCancer
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    Comparison of three different chemotherapy regimens for concomitant chemoradiotherapy in locally advanced non-small cell lung cancer
    (Springer Japan Kk, 2020) Akdeniz, Nadiye; Kucukoner, Mehmet; Kaplan, Muhammet Ali; Urakci, Zuhat; Karhan, Ogur; Sezgin, Yasin; Bilen, Erkan
    Purpose The optimal chemotherapy regimen for concurrent chemoradiation in locally advanced non-small cell lung cancer (NSCLC) remains unclear. Cisplatin-etoposide regimen related toxicity is high, weekly regimens have been investigating. We aimed to compare the efficacy and safety of different concurrent chemotherapy regimens in the context. Methods A total of 225 patients with locally advanced, unresectable stage III NSCLC were included. Patients who were treated with weekly docetaxel-platin (DP), paclitaxel-platin (PP) and standard dose etoposide-platin (EP) chemotherapy regimens were selected and divided into groups for the comparison of toxicity, response rate, progression free survival (PFS), and overall survival (OS) times. Results There was a statistically significant difference between overall response rate of each treatment groups (DP: 96.1%, PP: 94% and EP: 76.7%,p < 0.001). The median PFS time of patients who were treated with DP, PP and EP was 16, 15 and 13.3 months, respectively (p = 0.435). The median OS time of patients treated with DP, PP and EP was 19.2, 29.7 and 28.3 months, respectively (p < 0.001). The rates of adverse events such as nausea, vomiting, neuropathy and anaphylaxis was similar. Grade 1-2 mucositis or esophagitis, anemia, pneumonitis were significantly higher in PP group than other groups. However, hematologic toxicities were higher in the EP group than other groups. Conclusions Compared to the weekly chemotherapy regimens with the standard dose, our study demonstrated similar PFS, but a prolonged OS with the EP regimen. The clinical response rate of weekly regimens was better than the full-dose regimen. Adverse events and toxicity rates were different and depended on the type of chemotherapy regimen used.
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    Concomitant Use of Proton Pump Inhibitors and CDK4/6 Inhibitors in Metastatic Hormone-Positive Breast Cancer: A Real-World Cohort Study
    (Karger, 2024) Karhan, Ogur; Ileri, Serdar; Urakci, Zuhat; Arvas, Hayati; Kilic, Delyadil Karakas; Sezgin, Yasin; Ercek, Berrak Merit
    Introduction: Conflicting evidence exists regarding the concurrent use of cyclin-dependent kinase (CDK) 4/6 inhibitors and proton pump inhibitors (PPIs) in the treatment of breast cancer. This study aimed to investigate whether PPI use interferes with the efficacy of CDK4/6 inhibitors. Methods: This retrospective, multicenter, real-world study included 205 patients with hormone receptor-positive, HER2-negative metastatic breast cancer. Patient data were collected from January 2020 to August 2023. Patients who received either ribociclib or palbociclib, with or without a PPI, were included. Median progression-free survival (mPFS) was estimated using the Kaplan-Meier method, and factors associated with mPFS were analyzed using Cox regression. Results: Among the patients, 100 received palbociclib and 105 received ribociclib. In the palbociclib group, 40 patients (40%) used a PPI, and 60 (60%) did not. The mPFS was 16.1 months for patients with a PPI versus 22.2 months for those without (p = 0.26). In the ribociclib group, 44 patients used a PPI and 61 did not use a PPI. The median PFS was comparable between patients receiving PPIs and those not receiving PPIs (19.3 months and 20.7 months, respectively). Poor PFS was associated with liver metastasis, brain metastasis, and high Ki-67. Conclusion: Concomitant use of PPIs with ribociclib or palbociclib did not affect the efficacy of either CDK4/6 inhibitor. PPIs can be administered alongside these medications when clinically indicated. (c) 2024 S. Karger AG, Basel.
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    Factors influencing HER2 discordance in nonmetastatic breast cancer and the role of neoadjuvant therapy
    (Future Medicine Ltd, 2022) Ebinc, Senar; Oruc, Zeynep; Sezgin, Yasin; Karhan, Ogur; Bilen, Erkan; Yerlikaya, Halis; Kalkan, Ziya
    Plain language summary HER2 is an important and targetable molecule in breast cancer. In the early stages of breast cancer, a treatment modality called neoadjuvant therapy, which now includes anti-HER2 therapies, is administered before surgery in order to achieve disease regression and make the patient suitable for a more minor operation. In breast cancer, HER2 status may be positive in the initial biopsy specimen and negative in the surgical specimen. HER2 status plays an important role in treatment decisions. In this study, we investigated the factors causing HER2 status to change in early-stage breast cancer. This study has a retrospective design and includes 400 female patients with early-stage breast cancer. The results of the study identified the factors causing HER2 status to change to negative as receipt of neoadjuvant therapy, small tumor size and younger age. Objective: The rates of and the factors influencing HER2 discordance in patients receiving neoadjuvant therapy for breast cancer are investigated. Methods: This study retrospectively examines the rates of HER2 and hormone receptor discordance between the biopsy and postoperative resection specimens of 400 female early-stage breast cancer patients. Results: One hundred and thirty-three (33.3%) patients had received neoadjuvant therapy. The rate of HER2 discordance between biopsy and resection specimens was 1.7% in the control group and 5.3% in the neoadjuvant therapy group (p = 0.018). The rate of HER2 discordance was higher in younger patients and in patients with T1 tumors in the neoadjuvant therapy group. Conclusion: Neoadjuvant therapy, age <40 years and smaller tumor size were independent risk factors for HER2 discordance.