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    Efficacy of first-line CDK 4-6 inhibitors in premenopausal patients with metastatic breast cancer and the effect of dose reduction due to treatment-related neutropenia on efficacy: a Turkish Oncology Group (TOG) study
    (Taylor & Francis Ltd, 2024) Yildirim, Hasan Cagri; Kapar, Caner; Koksal, Baris; Seyyar, Mustafa; Sanci, Pervin Can; Guliyev, Murad; Perkin, Perihan
    The only phase 3 study on the effectiveness of CDK 4-6 inhibitors in first-line treatment in premenopausal patients with hormone receptor (HR) positive, HER2 negative metastatic breast cancer is the MONALEESA-7 study, and data on the effectiveness of palbociclib is limited. Data are also limited regarding the effectiveness of CDK 4-6 inhibitors in patients whose dose was reduced due to neutropenia, the most common side effect of CDK 4-6 inhibitors. In our study, we aimed to evaluate the effectiveness of palbociclib and ribociclib in first-line treatment in patients with premenopausal metastatic breast cancer and the effect of dose reduction due to neutropenia on progression-free survival. Our study is a multicenter, retrospective study, and factors affecting progression-free survival (PFS) were examined in patients diagnosed with metastatic premenopausal breast cancer from 29 different centers and receiving combination therapy containing palbociclib or ribociclib in the metastatic stage. 319 patients were included in the study. The mPFS for patients treated with palbociclib was 26.83 months, and for those receiving ribociclib, the mPFS was 29.86 months (p = 0.924). mPFS was 32.00 months in patients who received a reduced dose, and mPFS was 25.96 months in patients who could take the initial dose, and there was no statistical difference (p = 0.238). Liver metastasis, using a fulvestrant together with a CDK 4-6 inhibitor, ECOG PS 1 was found to be a negative prognostic factor. No new adverse events were observed. In our study, we found PFS over 27 months in patients diagnosed with premenopausal breast cancer with CDK 4-6 inhibitors used in first-line treatment, similar to post-menopausal patients. We did not detect any difference between the effectiveness of the two CDK 4-6 inhibitors, and we showed that there was no decrease in the effectiveness of the CDK 4-6 inhibitor in patients whose dose was reduced due to neutropenia.
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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.