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    Comparison of the efficacy of sunitinib and pazopanib in patients with advanced non-clear renal cell carcinoma
    (Taylor & Francis Ltd, 2024) Yildirim, Hasan Cagri; Bayram, Ertugrul; Chalabiyev, Elvin; Majidova, Nargiz; Avci, Tugay; Guzel, Halil Goksel; Kapar, Caner
    Non-clear cell renal cell carcinoma (non-ccRCC) is a highly heterogeneous disease group, accounting for approximately 25% of all RCC cases. Due to its rarity and especially heterogeneity, phase III trial data is limited and treatment options generally follow those of clear cell RCC. In the literature, there exists a number of studies with sunitinib, cabozantinib, and everolimus, but data on the efficacy of pazopanib are limited. Our aim in this study was to compare the efficacy of pazopanib and sunitinib, in a multicenter retrospective cohort of non-ccRCC patients. Our study included patients diagnosed with non-ccRCC who received pazopanib or sunitinib treatment as first-line therapy from 22 tertiary hospitals. We compared the progression-free survival (PFS), overall survival (OS), and response rates of pazopanib and sunitinib treatments. Additionally, we investigated prognostic factors in non-ccRCC. PFS and response rates of sunitinib and pazopanib were found to be similar, while a numerical difference was observed in OS. Being 65 years and older, being in the intermediate or poor risk group according to the International Metastatic Renal Cell Carcinoma Database Consortium, having liver metastases, presence of a sarcomatoid component, and having de novo metastatic disease were found to be significantly associated with shorter PFS. Pazopanib treatment appears to have similar efficacy in the treatment of non-ccRCC compared to sunitinib. Though randomized controlled trials are lacking and will probably be never be available, we suggest that pazopanib could be a preferred agent like sunitinib and cabozantinib. Pazopanib and sunitinib treatments show similar progression free survival, overall survival and objective response rate.IMDC risk group, liver metastasis, sarcomatoid component and de novo metastatic disease were determined as prognostic factors
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    Prognostic Factors Associated with Resected Osteosarcoma: Efficacy of Adjuvant Setting, Real-World Experience
    (Akad Doktorlar Yayinevi, 2024) Majidova, Nargiz; Simsek, Fatih; Biter, Sedat; Yaslikaya, Sendag; Seyyar, Mustafa; Duygulu, Mustafa Emre; Arcagok, Murat
    Osteosarcoma is a curable tumor. Surgery is performed after neoadjuvant chemotherapy as the primary standard treatment, followed by adjuvant therapy again. However, it is seen in patients who have undergone surgery without neoadjuvant chemotherapy. Adjuvant treatment is always given in this group. However, it is controversial how many cycles of adjuvant treatment should be given. In our study, 42 patients with osteosarcoma who received only adjuvant treatment without neoadjuvant treatment were analyzed for the effects of epidemiologic factors, treatment regimens on overall survival and disease -free survival. Retrospectively, 42 osteosarcoma patients (5 centers) with a current age of 18years and older who were followed up between 2001-2022 were examined. Twenty-five (60.0%) were below 8 cm, and 16 (38.0%) were 8 cm and above. The median number of cycles of adjuvant chemotherapy was 4 (range; 1-6). The 4 -year DFS rate was 50.2%. In patients with primary tumors smaller and larger than 8cm, the 4 -year DFS rates were 66.1% and 22.2%, respectively. The 4 -year DFS rates for patients with 4 or less and more than 4 cycles of adjuvant chemotherapy were 27.1% and 69.2%, respectively. The 4 -year OS rate was 78.5% in patients with primary tumors smaller than 8 cm and 18.8% in patients with tumors larger than 8 cm. The 4 -year OS rate was 24.3% in patients who received 4 or less adjuvant cycles and 79.5% in patients who received more than 4 cycles. We have demonstrated that the number of adjuvant therapy courses above 4 and the presence of primary tumors smaller than 8 cm are influential over overall and disease -free survival in the patients who did not receive neoadjuvant therapy. The number of postoperative adjuvant treatment cycles should be forced as much as possible in these patients who haven't had neoadjuvant therapy.
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    Regorafenib Treatment for Recurrent Glioblastoma Beyond Bevacizumab-Based Therapy: A Large, Multicenter, Real-Life Study
    (Mdpi, 2025) Tunbekici, Salih; Yuksel, Haydar cagatay; Acar, Caner; Sahin, Goekhan; Orman, Seval; Majidova, Nargiz; Coskun, Alper
    Background/Objectives: In the REGOMA trial, regorafenib demonstrated an overall survival advantage over lomustine, and it has become a recommended treatment for recurrent glioblastoma in guidelines. This study aimed to evaluate the effectiveness and safety of regorafenib as a third-line treatment for patients with recurrent glioblastoma who progressed while taking bevacizumab-based therapy. Methods: This retrospective, multicenter study in Turkey included 65 patients treated between 2021 and 2023 across 19 oncology centers. The main inclusion criteria were histologically confirmed isocitrate dehydrogenase (IDH)-wildtype glioblastoma, progression after second-line bevacizumab-based treatment, and an Eastern Cooperative Oncology Group (ECOG) performance status score of <= 2. Patients received regorafenib 160 mg once daily for the first 3 weeks of each 4-week cycle. Results: The median age of the patients was 53 years (18-67 years), with a median progression-free survival of 2.5 months (95% Confidence Interval: 2.23-2.75) and a median overall survival of 4.1 months (95% CI: 3.52-4.68). The median overall survival was improved in patients who received subsequent therapy after regorafenib treatment compared with those who did not (p = 0.022). Progression-free survival was longer in patients with ECOG 0-1 than in those with ECOG 2 (p = 0.042). The safety profile was consistent with that of the REGOMA trial, with no drug-related deaths observed. Conclusions: Regorafenib shows good efficacy and safety as a third-line treatment for recurrent glioblastoma after bevacizumab-based therapy. This study supports the use of regorafenib and emphasizes the need for further randomized studies to validate its role and optimize treatment strategies.