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Öğe Adjuvant Systemic Chemotherapy with or without Bevacizumab in Patients with Resected Liver Metastases from Colorectal Cancer(Karger, 2013) Turan, Nedim; Benekli, Mustafa; Koca, Dogan; Ustaalioglu, Basak Oven; Dane, Faysal; Ozdemir, Nuriye; Ulas, ArifeBackground: We aimed to investigate the impact of adjuvant systemic therapy with modern chemotherapy combinations on survival outcomes in patients with resected liver-confined metastases from colorectal carcinomas, and whether addition of bevacizumab (BEV) provides further benefit. Methods: A total of 229 consecutive patients who underwent resection for liver-confined colorectal liver metastases were retrospectively analyzed. Results: Of 229 patients, 204 who received chemotherapy with fluoropyrimidine-based (n = 27), irinotecan-based (n = 84) and oxaliplatin-based (n = 93) combinations were analyzed. Among these, 87 patients received BEV while 117 did not (NoBEV). With a median follow-up of 27 months after metastasectomy, the median recurrence-free survival (RFS) and overall survival OS) were 17 and 53 months, respectively. OS rates at 3 and 5 years were 71% and 40%, respectively. No significant differences were found in the median RFS (p = 0.744) and OS (p = 0.440) among different chemotherapy regimens. The median RFS (p = 0.375) and OS (p = 0.251) were similar in BEV and NoBEV arms. In multivariate analysis, having 4 liver metastases was the only negative independent factor on both RFS and OS, while positive surgical margin was another negative independent factor for RFS. Conclusion: Chemotherapy type and addition of BEV have no impact on both RFS and OS in the adjuvant setting following complete resection of colorectal liver metastases. Copyright (C) 2012 S. Karger AG, BaselÖğe Adjuvant systemic chemotherapy with or without bevacizumab in patients with resected pulmonary metastases from colorectal cancer(Wiley-Blackwell, 2014) Turan, Nedim; Benekli, Mustafa; Dane, Faysal; Unal, Olcun Umit; Kara, Hasan Volkan; Koca, Dogan; Balvan, OzlemIntroduction: We investigated the impact of modern chemotherapy regimens and bevacizumab following pulmonary metastasectomy (PM) from metastatic colorectal cancer (CRC). Methods: A total of 122 consecutive patients who were curatively resected for pulmonary metastases of CRC in twelve oncology centers were retrospectively analysed between January 2000 and April 2012. Results: Of 122 patients, 14 did not receive any treatment following PM. The remaining 108 patients received fluoropyrimidine-based (n = 12), irinotecan-based (n = 56) and oxaliplatin-based (n = 40) chemotherapy combinations. Among these, 52 patients received bevacizumab (BEV) while 56 did not (NoBEV). Median recurrence-free survival (RFS) was 17 months and median overall survival (OS) has not been reached at amedian follow-up of 25 months after PM. Three and five-year OS rates were 66% and 53%, respectively. RFS and OS were similar, irrespective of the chemotherapy regimen or BEVuse. Positive pulmonary margin, KRASmutation status, and previous liver metastasectomy were negative independent prognostic factors for RFS, while pathologically confirmed thoracic lymph node involvement was the only negative independent prognostic for OS in multivariate analysis. Conclusions: No significant RFS or OS difference was observed in respect to chemotherapy regimens with or without BEV in patients with pulmonary metastases of CRC following curative resection.Öğe Adjuvant systemic chemotherapy with or without bevacizumab in patients with resected pulmonary metastases from colorectal cancer.(Lippincott Williams & Wilkins, 2013) Turan, Nedim; Dane, Faysal; Unal, Olcun Umit; Benekli, Mustafa; Kara, Hasan Volkan; Koca, Dogan; Balvan, Ozlem[Abstract Not Available]Öğe Biological Subtypes and Survival Outcomes in Breast Cancer Patients with Brain Metastases (Study of the Anatolian Society of Medical Oncology)(Karger, 2012) Kaplan, Muhammet Ali; Isikdogan, Abdurrahman; Koca, Dogan; Kucukoner, Mehmet; Gumusay, Ozge; Yildiz, Ramazan; Dayan, AdemBackground: The aim of this study is to determine the relationship between the survival outcomes and biological subtype in breast cancer patients with brain metastases. Methods: We retrospectively evaluated clinical data from 422 breast cancer patients with brain metastases between 2001 and 2011 from referral centers in Turkey. The study population was divided into four biological subtypes according to their hormone receptor status and HER2 expression. Results: Systemic treatment prolonged median overall survival (OS) after brain metastases in the entire group (14 vs. 3.2 months, p < 0.001). It also prolonged median OS after brain metastases in the triple negative (7.5 vs. 1.6 months, p = 0.010) and luminal A (14.3 vs. 7.1 months, p = 0.003) subgroups. The median OS for untreated patients, chemotherapy and/or hormonal therapy receiving patients, and chemotherapy and/or hormonal therapy plus targeted therapy receivers was 2, 5.8, and 17.7 months, respectively (p < 0.001), in the HER2-overexpressing subgroup. In the luminal B subgroup, it was 3.7, 5.3, and 15.4 months, respectively (p = 0.003). Conclusions: The use of systemic therapy improves OS after brain metastases in all biological subgroups. Targeted therapies also improve OS after brain metastases in HER2-positive patients. The combined use of targeted therapies and lapatinib are superior to single use and trastuzumab, respectively, in these patients. Copyright (C) 2012 S. Karger AG, BaselÖğe Childhood, Adolescents, and Young Adults (?25 y) Colorectal Cancer: Study of Anatolian Society of Medical Oncology(Lippincott Williams & Wilkins, 2013) Kaplan, Muhammet A.; Isikdogan, Abdurrahman; Gumus, Mahmut; Arslan, Ulku Y.; Geredeli, Caglayan; Ozdemir, Nuriye; Koca, DoganPurpose: To evaluate the clinicopathologic characteristics and treatment outcomes of young patients with colorectal cancer (CRC). Methods: Between May 2003 and June 2010, 76 patients were found eligible for this retrospective study. Age, sex, presenting symptoms, patients with acute presentation, family history, presence of polyps, histologic features, localization and stage of the tumor, treatment outcomes, time and site of recurrence, sites of metastasis, and survival outcomes were recorded from the patient files. Results: Seventy-six patients (55.3% male) with a median age of 23 years were evaluated. Patients were evaluated in 2 groups as follows: child-adolescent (0 to 19 y, n=20) and young adult (20 to 25 y, n=56). Sex and symptoms (abdominal pain and rectal bleeding) were significantly differed between the groups and acute presentation was close to statistical significance. Overall survival significantly increased in patients undergoing curative surgery (P<0.001). Other parameters affecting the survival was stage of disease (P=0.004). Response to palliative chemotherapy in metastatic patients (P=0.042) and postoperative adjuvant chemotherapy had a statistically significant survival advantage (P=0.028). Conclusions: Diagnosis of CRC should not be excluded solely on the basis of age. CRC features in young-adult patients are more similar to adults compared with that of child-adolescent patients according to the symptoms and presentation. In patients with CRC in this age group, curative surgery, adjuvant chemotherapy, and palliative chemotherapy provide survival advantage.Öğe Clinical outcomes in patients who received lapatinib plus capecitabine combination therapy for HER2-positive breast cancer with brain metastasis and a comparison of survival with those who received trastuzumab-based therapy: a study by the Anatolian Society of Medical Oncology(Springer Japan Kk, 2014) Kaplan, Muhammet Ali; Isikdogan, Abdurrahman; Koca, Dogan; Kucukoner, Mehmet; Gumusay, Ozge; Yildiz, Ramazan; Dayan, AdemIn this study, we investigated the effect of lapatinib plus capecitabine treatment in HER2-positive breast cancer patients with brain metastasis. Of 405 metastatic breast cancer patients with brain metastases at referral centers in Turkey, 46 were treated with lapatinib plus capecitabine only after the development of brain metastasis. Patients who only received trastuzumab-based therapy after the development of brain metastases were accepted as the historic control group for survival analyses (n = 65). Patients who received both drugs consecutively or sequentially were excluded from the analyses (n = 34). Median age among 46 patients who received lapatinib plus capecitabine therapy was 45 years (27-76), and median time for development of brain metastases was 11.9 months (0-69 months). Twenty-six out of 38 patients who received lapatinib plus capecitabine and had extracranial metastasis showed partial response or stable diseases (68.4 %). Grade 3-4 toxicity was observed in eight patients (17.3 %). Median overall survival (OS) in patients treated with lapatinib plus capecitabine was significantly increased compared to that in patients treated with trastuzumab-based therapy (19.1 vs. 12 months, respectively, p = 0.039). The incidence of cerebral death was slightly decreased in patients who received lapatinib plus capecitabine compared to those who received trastuzumab-based therapy (32 vs. 43.4 %, p = 0.332). In the multivariate analysis, lapatinib plus capecitabine therapy remained an independent positive predictor for survival [odds ratio (OR), 0.57; p = 0.02]. Although this retrospective multicenter study had several limitations, the results suggest that undergoing lapatinib plus capecitabine therapy after the diagnosis of brain metastasis may further improve survival compared to undergoing only trastuzumab-based therapy.Öğe The efficacy and safety of first-line and salvage therapies with bevacizumab combination chemotherapy regimens in metastatic colorectal cancer: A retrospective ASMO experience.(Lippincott Williams & Wilkins, 2013) Yildiz, Ramazan; Buyukberber, Suleyman; Koca, Dogan; Korai, Lokman; Ciltas, Aydin; Unal, Olcun Umit; Gumus, Mahmut[Abstract Not Available]Öğe Efficacy of trastuzumab-based therapy after disease progression on lapatinib based therapy in heavily pretreated HER2-positive metastatic breast cancer patients.(Lippincott Williams & Wilkins, 2014) Uncu, Dogan; Bayoglu, Ibrahim Vedat; Arslan, Ulku Yalcintas; Kucukoner, Mehmet; Artac, Mehmet; Koca, Dogan; Oguz, Arzu[Abstract Not Available]Öğe Lapatinib or trastuzumab? Which anti-HER2 treatment is more effective in the treatment of patients with HER2-positive breast cancer with brain metastases? An Anatolian Society of Medical Oncology Study(Amer Soc Clinical Oncology, 2012) Kaplan, Muhammet Ali; Isikdogan, Abdurrahman; Koca, Dogan; Kucukoner, Mehmet; Gumusay, Ozge; Yildiz, Ramazan; Oztop, Ilhan[Abstract Not Available]Öğe What are the differences between young (25 years) and adults (>25 years) colorectal cancer (CRC)? An Anatolian Society of Medical Oncology Study.(Amer Soc Clinical Oncology, 2015) Kaplan, Muhammet Ali; Urakci, Zuhat; Gumus, Mahmut; Arslan, Ulku Yalcintas; Geredeli, Caglayan; Ozdemir, Nuriye; Koca, Dogan[Abstract Not Available]
