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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
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.
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.
The Concomitant Use Of Proton Pump Inhibitors And Pazopanib In Patients With Soft-Tissue Sarcoma: Is It Really To Be Avoided?
(2020) Kaplan, Muhammet Ali; Araz, Murat; Artaç, Mehmet; Sezgin, Yasin; Eryılmaz, Melek Karakurt; Karaağaç, Mustafa
Objectives: Pazopanib is an orally administered drug and has approval for the treatment of advanced Soft TissueSarcomas (aSTS). The absorption of pazopanib is pH-dependent. Acid-Reducing drugs such as proton pump inhibitors(PPI) may reduce the bioavailability of pazopanib. The primary purpose of this study was to assess whether the use ofconcomitant PPI and pazopanib had negative effects on survival outcomes.Methods: In this retrospective cross-sectional study, age ?18 years, having histologically proven STS, receiving pazopanibat least one day, and availability of information about the use of PPI during pazopanib treatment were the inclusioncriteria. Patients with adipocytic sarcoma were excluded.Results: A total of 46 eligible patients were assessed in this study. Thirty-one patients used concomitant PPI andpazopanib, 17 of them frequently used PPI, and the others occasionally. Fifteen patients never used concomitant PPI andpazopanib. The median progression-free survival (PFS) was 2.76 months, and the median overall survival (OS) was7.39?months for patients who never used concomitant PPI and pazopanib. Also, the median PFS was 5.22 months, and themedian OS was 14.52?months for patients who used concomitant PPI and pazopanib. In univariate analysis; usingconcomitant PPI (p=0.049) and primarily uterine located tumors (p=0.038) were significant parameters for PFS. Inmultivariate logistic regression analysis; both of using concomitant PPI (Wald=6.02; p=0.014) and primarily uterinelocated tumors (Wald=5.69; p=0.017) retained their association with longer PFS. No parameter was significant for OS.Conclusions: We showed that the use of concomitant PPI and pazopanib was associated with improved PFS. These resultsmay help guide clinicians and researchers for allowing patients co-administrating PPI and pazopanib, especially whentreating or investigating patients with dyspeptic symptoms.
ERKEN EVRE SEMİNOM HASTALARINDA PROGNOZU ETKİLEYEN FAKTÖRLER
(Ramazan AKDEMİR, 2020) Sezgin, Yasin; Ebinç, Senar; Urakçı, Zuhat
ÖzetGiriş: Cerrahi olarak orşiektomi yapılmış erken evre seminom hastalarında mükemmel bir prognoz gözlenir. Seminom hastaları metastatik evrede olsa bile yaklaşık olarak %50 kür şansı mevcuttur. Bu nedenle özellikle risk faktörü taşımayan erken evre seminom hastaları aktif izlem ile takip edilebilir. Aktif izlemdeki temel amaç; cerrahi orşiektomi sonrası hiçbir şekilde nüks etmeyecek olan %85 hastayı doğru olarak tespit etmek ve o hastaları gereksiz tedaviden ve kemoterapinin yan etkilerinden korumaktır. Biz bu çalışmamızda seminom hastalarında rekürrens riskini arttırabilecek faktörleri araştırdık. Materyal-Metod: Tek merkezli retrospektif olan bu çalışmaya erken evre seminom hastaları dahil edildi. Çalışmaya 18 yaş üstü olan çalışmaya dahil eilme kriterlerine uygun 70 hasta alındı. Çalışmadaki amacımız erken evre seminom hastalarında prognoz üzerinde etkili olan faktörler, nüksü gösteren bir prediktif değer olup olmadığının araştırılması olarak belirlendi. Hasta sayısının az olması nedeni ile ölüm ve nüks için regresyon modeli oluşturulamadı. Ancak hipotez testi olarak univariable Cox regresyon ve Logrank testi uygulandı.Bulgular:. Hastaların median yaşı 35,7 (27,24-38,09) yıl idi. Hastaların 61’i (%87,1) evre I ve 9’u (%12,9) evre II hastalığa sahip idi. Yapılan istatistiksel analizde hastalığın evresi ile rekürrens arasında anlamlı ilişki mevcut idi. Toplamda nüks eden 10 yastanın 4’ü (%40) evre II’de olup bu durum istatistiksel olarak anlamlı idi (p:0.019) (Şekil-I). Diğer parametreler ve rekürrens arasında anlamlı ilişki izlenmedi.Tartışma ve sonuç: Lenfovasküler invazyon, spermatik kord tutulumu, tunika albuginea tutulumu ve rete testis tutulumu gibi faktörlerin rekürrens riski ile ilişkisi izlenmezken, evrenin rekürrens riski üzerinde etkisi olduğunu gözledik (p=0,019).
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.
Factors influencing the prognosis in Braf wild-type metastatic malignant melanoma and the role of novel inflammation indices
(Galenos Publ House, 2023) Ebinc, Senar; Kalkan, Ziya; Oruc, Zeynep; Sezgin, Yasin; Urakci, Zuhat; Kucukoner, Mehmet; Kaplan, Muhammet Ali
Background and Design: This study aims to investigate the prognostic factors in BRAF wild-type metastatic cutaneous melanoma and the prognostic role of inflammation indices.Materials and Methods: Metastatic BRAF wild-type cutaneous melanoma patients who presented to our clinic between 2011 and 2021 were enrolled. To investigate their prognostic roles, age, gender, performance status, first immunotherapy regimen received by the patient, metastatic sites, and seven inflammation indices [C-reactive protein (CRP)/albumin ratio (CAR), neutrophil lymphocyte ratio (NLR), prognostic nutritional index (PNI), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and advanced lung cancer inflammation index (ALI) and hemoglobin, albumin levels, lymphocyte and platelet counts (HALP)] were studied.Results: Fourty-seven patients, consisting of 22 (46.8%) females and 25 (53.2%) males, were included in this study. Mean patient age was 54 (18-88) years. In our study, there were 16 (34%) patients with liver metastasis, 17 (36.2%) patients with lung metastasis, and 9 (19.1%) patients with brain metastasis. As immunotherapy, 34 (72.3%) patients had received Nivolumab, while 13 (27.7%) patients had received Ipilimumab therapy. When the relationships of the prognostic variables with overall survival were inspected in univariate and multivariate analyses, brain metastasis was found to be an independent prognostic factor (p=0.02). Lung metastasis approached the threshold of statistical significance in univariate analysis (p=0.09) and liver metastasis in multivariate analysis (p=0.07). The seven inflammation indices examined in the analyses [CAR, NLR, PNI, PLR, SII ALI and HALP] were found to have no prognostic role in both univariate and multivariate analyses.Conclusion: Our study determined that brain metastasis is an independent poor prognostic factor in BRAF wild-type metastatic melanoma. Prognostic roles of the CAR, NLR, PNI, PLR, SII ALI and HALP indices could not be demonstrated.
ICE Regimen in Adult Advanced/Relapsed Soft TissueSarcoma Patients; is it More Effective in Early Use?Retrospective Analysis of Single Center Study
(2021) Sezgin, Yasin; Ebinç, Senar; Işıkdoğan, Abdurrahman; Küçüköner, Mehmet; Kaplan, Muhammet Ali; Oruç, Idris; Urakci, Zuhat
Objectives: To analyze the efficacy and tolerability of the ICE regimen and prognostic factors for survival in patientswith advanced or relapsed soft tissue sarcomas treated with the ICE regimen (ifosfamide, carboplatin and etoposide). Methods: The records of 28 patients diagnosed with advanced or relapsed soft tissue sarcoma who were treated withthe ICE regimen at our center between 2008 and 2020, were evaluated retrospectively. Results: The most common histopathological subtype were pleomorphic sarcoma (9/32.1%). After a median follow-upduration of 8 months, the median PFS and OS were 6 months (95% confidence interval (CI), 3.6–8.3) and 9.3 months(95% CI, 4.7–13.9), respectively. A multivariate analysis for overall survival revealed the ICE treatment line (HR:4.8, 95%Cl 1.7–12.8, p: 0.002), tumor site (HR: 0.12, 95% Cl 0.03–0.4, p: 0.001) and response to ICE regimen (HR: 0.09, 95% Cl0.01–0.49, p: 0.005) to be independent prognostic factors. The group that received 1–2 chemotherapy regimens priorto the ICE regimen recorded better OS than the group received more than two chemotherapy regimens (22.8 monthsvs 5 months, p: 0.006). Conclusion: The ICE regimen may be particularly effective when used for early treatment after doxorubicin-basedtherapy in patients with advanced or relapsed soft tissue sarcomas.
Meme kanserli hastalarda Pet - BT ile tümör özellikleri arasındaki ilişki
(Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi, 2022) Sezgin, Yasin; Karhan, Oğur; İleri, Serdar; Ebinç, Senar; Bilen, Erkan; Ürün, Muslih; Yerlikaya, Halis
Amaç: Meme kanseri dünya çapında kadınlarda en sık görülen ve en sık ölüme yol açan kanserdir. Pozitron emisyon tomografisi (PET) - bilgisayarlı tomografinin (BT) onkolojide kullanımı giderek artan öneme sahip olmaktadır. Çalışmamızda tümörün bazı özelliklerine göre 18 F-floro-2-deoksi-D-glukoz ( 18 F-FDG) tutulum yoğunluğu arasındaki ilişkiyi araştırmayı planladık. Gereç ve Yöntem: Çalışmamızda onkoloji kliniğimize meme kanseri teşhisi ile başvuran ve PET-BT çekimi yapılan 414 hastanın dosyası retrospektif incelendi. Çalışmaya 18-90 yaş aralığında olan meme kanserli hastalar dahil edildi. İkincil malignitesi olan, akli dengesi yerinde olmayan, 18 yaşından küçük ve 90 yaşından büyük hastalar çalışma dışı bırakıldı. Moleküler alt tiplere, tümör boyutlarına, vücut kitle indeksine ve proliferasyon indekslerine göre FDG tutulumları araştırıldı. Bulgular: Çalışmaya dahil edilen 414 hastanın yaş ortalaması 48.8 yıldı. Hastaların büyük çoğunluğunun alt tipi; invaziv duktal karsinom idi. Tanı anında 86 hasta metastatik evrede iken, 327 hasta lokal veya lokal ileri evredeydi. Çalışmada Ki-67 artışı ile FDG tutulumunun artışı arasında korelasyon saptandı ve istatiksel olarak anlamlı bulundu. Sonuç: Çalışmada tümör boyutu büyük olanlarda daha fazla FDG tulumu mevcut idi. Aynı şekilde proliferasyon indeksi artışında ve invaziv duktal karsinomda daha yüksek FDG tutulumu mevcut idi. Tümör özellikleri ile FDG tutulumları arasındaki ilişki gelecekte bireyselleştirilmiş tedavi için prediktif bir belirteç olarak kullanılabilir.
Prognostic importance of primary tumor location in RAS mutant metastatic colorectal cancer
(Dicle Üniversitesi Tıp Fakültesi, 2019) Akdeniz, Nadiye; Kaplan, Muhammet Ali; Küçüköner, Mehmet; Urakçı, Zuhat; Sezgin, Yasin; Ebinç, Senar; Bilen, Erkan; Karhan, Oğur; Laçin, Şahin; Büyükbayram, Hüseyin; Işıkdoğan, Abdurrahman
Objective: The prognostic value of tumor location in patients with metastatic colorectal cancer (mCRC) was reported by recent analyses in RAS wild-type patients. However, there is no enough specific data regarding prognostic value of primary tumor location in RAS mutated mCRC patients. We aimed to find if there is any relation between tumor prognosis and primary tumor location in patients with RAS mutated mCRC. Method: This retrospective study included 57 patients with mCRC who were diagnosed and treated in our hospital between January 2011 and December 2017. Characteristics features of the patients were obtained from our institution patient medical records. Patients were included to the present study if KRAS or NRAS mutation was detected in tumor tissues.Results: Twenty-nine (50.9%) of patients were female and the median age of all patients was 52 (18-80) years. Forty (70.2%) of 57 patients were defined as left side (LS) and 17 (29.8%) of patients were located in the right side (RS). As first line systemic treatment, twenty-five (43.9%) patients had received oxaliplatin-based chemotherapy while 32 (56.1%) patients had received irinotecan-based chemotherapy. Tumor sidedness did not affect on progression-free survival (PFS) (mPFS, 10.9 months for LS vs 8.1 months for RS, p=0.400) and overall survival (OS) (mOS, 20.9 months for LS vs 20.8 months for RS, p=0.930).The patients who had oxaliplatin based chemotherapy regimens showed better OS rate than irinotecan based regimens (28.7months vs16.3 months, p=0.017, respectively). Conclusion: Our study results support the thought that claims the sidedness of primary CRC in metastatic setting does not have effect on PFS and OS in patients with RAS mutant mCRC. However, our findings also underline the necessity of studies with larger patient populations and subgroup analyzes to evaluate potential prognostic and molecular features to determine the standart approach to this specific subgroup of the disease.
Prognostıc Factors In Testıcular Cancer
(2024) Sezgin, Yasin; Karhan, Oğur; Biçer, Abdurrahman; İleri, Serdy; Yerlikaya, Halis; Tunç, Sezai; Aydın, İbrahim
Aim: Testicular cancer is the most common cancer in men aged 15-35 years and accounts for 1% of all lifetime male cancers. There are two histologic subtypes: seminoma and nonseminoma. In our study, we aimed to investigate the factors predicting recurrence in early-stage testicular cancer. Materials and Methods: Our study is a retrospective study of early stage testicular cancer admitted to the medical oncololi clinic of our hospital between 2006-2018. During the study, 344 patient files were reviewed and 130 patients who met the study criteria were included in the study. Our primary aim in this study was to investigate the factors predictive of recurrence in early stage testicular cancer. Results: When evaluating PFS in patients with nonseminoma with and without lymphovascular invasion, no median PFS value was reached in either group. However, PFS was worse in patients with LVI (p=0.037). When comparing stage 1 with stage 2 seminoma patients, no median PFS values could be reached, but there was a statistical difference between the two groups in terms of recurrence (p=0.019). Conclusions: In our study, we found no association between tumor size, embryonal carcinoma predominance, tunica albuginea invasion, spermatic cord involvement and tumor marker values and recurrence in nonseminoma germ cell testicular tumors. PFS was shorter in patients with LVI compared to those without LVI. Lymphovascular invasion, spermatic cord involvement, tunica albuginea involvement, and rete testis involvement were not associated with disease recurrence in seminoma patients, whereas higher disease stage predicted the risk of recurrence.
Rare Breast Cancer Types: A Study About Characteristics, Outcomes, and Peculiarities
(2020) Kaplan, Muhammet Ali; Karhan, Oğur; Urakçı, Zuhat; Ebınc, Senar; Akdeniz, Nadiye; Sezgin, Yasin; Nacir, Mustafa
Objective: We aimed to explore different features of rarely seen breast cancer (BC) subtypes, including their stage, molecularsubtypes, treatment choices, and prognosis. Material and Methods: We retrospectively screened patients who were diagnosed with BC inour hospital between July 2010 and June 2018. A total of 97 patients who had micropapillary, cribriform, mucinous, papillary, tubular, apocrine, metaplastic, medullary, and myoepithelial subtypes of BC were finally included in the current study.Results: Ninety-four (96.9%) patients were females. Patients with cribriform and mucinous subtypes were in the younger median age of 41 and 45 years, respectively, whereaspapillary cases were reported in the oldest median age (64.5 years). Lymph node and TNM stages showed a statistical difference between thesubtypes (p=0.029 and p=0.008, respectively). Most of the cribriform (60%), metaplastic (66.7%), and papillary (70%) cases were diagnosedwithout lymph node involvement. Apocrine (79%) and micropapillary (75%) tumors mostly presented with nodal involvement. Whilemedullary (75%), tubular (66.7%), and cribriform (66.7%) carcinomas were more likely to be diagnosed at stage II, micropapillary (70.8%),and apocrine (62.5%) carcinomas were mostly diagnosed at stage III. Mucinous, tubular, and cribriform tumors were noticed in the luminalgroup. Medullary, metaplastic, apocrine, and papillary tumors included triple-negative subgroups. HER2-enriched tumors included apocrine(62.5%), medullary (50%), and micropapillary (25%) subtypes. Disease-free survival and overall survival of the patients showed marginal statistical significance according to tumor subtypes (p=0.086, p=0.085, respectively). Conclusion: In this study, we investigated important features, clinical behavior, management, and outcomes of several rare BC subtypes. We opine that the current study may prove instrumental andinformative for both daily clinical practice and future studies.
Real-life data of pazopanib usage inm soft tissue sarcoma
(2023) İleri, Serdar; Yerlikaya, Halis; Ürün, Muslih; Sezgin, Yasin; Karhan, Oğur
Abstract: Objective: Soft tissue sarcomas are heterogeneous group of malignancies consisting of more than 50 subtypes. Although it is rare, it is usually resistant to chemotherapy and has a poor prognosis. In this study, we planned to investigate the efficacy, tolerability and side-effect profile of pazopanib in metastatic soft tissue sarcomas. Method-Material: Our study was a single-center retrospective study and included metastatic patients over the age of 18 who were treated with pazopanib. Data of 37 patients were obtained in retrospective medical records. In patients using pazopanib; Tumor location, histological subtype, tumor grade, disease stage, the line at which pazopanib was used, efficacy, tolerability, and side-effect profile of pazopanib were examined. Findings: The mean age of the patients at diagnosis was 49. Pleomorphic sarcoma was the most common subtype. The progression-free survival (PFS) of patients after first-line therapy was 18 weeks. The median overall survival (OS) of the patients was 20 months. The median PFS with pazopanip was 18 weeks. Conclusion: In the study we conducted research in terms of effectiveness and side effects; the use of pazopanib in soft tissue sarcoma was found to be effective in terms of both PFS and OS. Side effects were tolerable and treatable. In our study, a PFS of 32 weeks was obtained in patients with hypothyroidism and at 16 weeks in patients who did not. In this respect, development of hypothyroidism may be a predictive parameter for response.
The real-life outcome of pazopanib in patients with advanced soft tissue sarcoma: A retrospective cross-sectional study of a Turkish cohort
(Sage Publications Ltd, 2020) Karaagac, Mustafa; Sezgin, Yasin; Eryilmaz, Melek Karakurt; Araz, Murat; Kaplan, Muhammet Ali; Artac, Mehmet
Introduction Soft tissue sarcomas are a heterogeneous and rare group of cancers with a short median overall survival despite the chemotherapy. Pazopanib has approval for the treatment of advanced soft tissue sarcoma. We aimed to investigate the clinical outcomes of Turkish patients with advanced soft tissue sarcoma who received pazopanib. Patients and methods This was a retrospective study. The inclusion criteria were: >= 18 years of age, having histologically proven advanced soft tissue sarcoma and receiving pazopanib at least one day. Results A total of 79 patients were assessed in this study. The median age was 49.6 years. The average dose intensity of pazopanib was 767 mg (400-800). The median duration of pazopanib treatment was 6.11 months. Fourteen patients (17.7%) used pazopanib at first line for advanced soft tissue sarcomas. The most common cause of discontinuation of pazopanib was the progression of the disease (89.6%). Pazopanib was well tolerated. The most common grade >= 3 side effect was anemia. The most common grade <= 2 side effects were anemia and hyperbilirubinemia. The median progression-free survival, overall survival, and follow-up were 3.97months, 11.40months, and 32.72 months, respectively. Female gender, good performance status, and the presence of pazopanib-induced hypothyroidism were associated with longer progression-free survival. Also, good performance status and being a responder to first-line treatment were associated with longer overall survival. Conclusions We showed that pazopanib was well tolerated and had clinical benefit in patients with advanced soft tissue sarcoma in a Turkish cohort. This is the first study that suggests pazopanib-induced hypothyroidism may act as a predictive marker for better outcomes in patients with advanced soft tissue sarcoma.
Survival impact of optimal treatment for elderly patients with colorectal cancer: A real world study
(Wolters Kluwer Medknow Publications, 2021) Akdeniz, Nadiye; Küçüköner, Mehmet; Kaplan, Muhammet A.; Urakçı, Zuhat; Sezgin, Yasin; Karhan, Oğur; Işıkdoğan, Abdurrahman
Background: In this real-life practice study, we aimed to find whether elderly colorectal cancer (CRC) patients in our center were treated optimally and also if this has an effect on overall survival (OS) or not. Methods: We have retrospectively screened 150 CRC patients older than 65 years, diagnosed in our institution between 2010 and 2018. As study variables, patient characteristics, tumor location, tumor, nodes, metastases stage, Eastern Cooperative Oncology Group performance status (ECOG PS), comorbidities, adjuvant or metastatic chemotherapy regimens, and treatment toxicity were recorded, and the OS rate of patients was assessed. Results: The median age was 72 (range 65 - 89) years and 48 (32%) patients had metastatic disease at the time of diagnosis. The median OS (mOS) in the suboptimal adjuvant treatment group was 31.5 (range 20.7-42.3) months, whereas mOS was not reached during the median follow-up time in the optimal treatment group (P = 0.036). The addition of oxaliplatin to chemotherapy had no benefit on mOS (P = 0.318). In the metastatic setting, the mOS in the optimal and suboptimal treatment group was 27.2 (range 10.7-43.7) months and 13.4 (range 7.5-18.8) months respectively, and was statistically significant (P = 0.001). Conclusion: Our study revealed that optimal treatment had a significant effect on the mOS of elderly CRC patients and it was well tolerated. Advanced age alone is not a sufficient parameter for precluding effective therapy in elderly patients with CRC.

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