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    Aquaporin 1, Aquaporin 3 and Aquaporin 5 expression and EGFR mutation in malignant pleural mesotheliomas: an imunohistochemical and molecular study
    (Taylor & Francis Ltd, 2017) Alabalik, Ulas; Turkcu, Gul; Keles, Ayse Nur; Ibiloglu, Ibrahim; Urakci, Zuhat; Buyukbayram, Huseyin
    Malignant pleural mesothelioma is a rare and fatal malignancy. This disease is, unfortunately, at its advanced stage when it is diagnosed. Survival time is usually not more than a few months. The aim of this study was to analyse the expression of Aquaporin 1, Aquaporin 3 and Aquaporin 5 in malignant pleural mesotheliomas and to explore the relationship of these levels of expression with epidermal growth factor receptor (EGFR) gene mutation and prognostic parameters. In this study, 60 cases diagnosed as malignant pleural mesothelioma among the pleural biopsy materials in the archives of the Pathology Department of Medical Faculty of Dicle University in 2003-2013 were evaluated. The tissues were stained immunohistochemically with antibodies against Aquaporin 1, Aquaporin 3 and Aquaporin 5, and the existence of EGFR mutation was investigated in the tissues by real-time polymerase chain reaction (PCR). The obtained results showed expression of Aquaporin 1, Aquaporin 3 and Aquaporin 5 in varied amounts in malignant pleural mesotheliomas. However, no significant relation was obtained thus far between the expression levels of these aquaporins and the prognostic parameters. No mutations were detected in the EGFR gene exons 18-21 by using real-time PCR. It could be suggested that although Aquaporin 1, Aquaporin 3 and Aquaporin 5 are expressed in malignant pleural mesothelioma, they do not have any effect on the prognostic parameters. Mutations in different domains of EGFR gene, other than exons 18-21, should be sought to develop new targeted treatments.
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    Biased view against biopsy among cancer patients and its reasons
    (Drunpp-Sarajevo, 2012) Kucukoner, Mehmet; Inal, Ali; Kaplan, Muhammed Ali; Urakci, Zuhat; Isikdogan, Abdurrahman
    Objective: Because the belief that biopsy causes spread of the disease, is a widely accepted opinion among the people in our region. The aim of this study is to assess the view of patients diagnosed with cancer about biopsies and evaluate the factors influencing this. Material and Methods: Three hundred and twenty four patients who presented themselves to the Department of Medical Oncology between October 2009 and March 2010, were included in the study. Data were obtained from patient charts and evaluations of questionnaires. Results: Among those patients with low level of education, the number of people who are thinking that biopsy is harmful, was significantly high (p=0.001). The gender of patients thinking that biopsy was harmful was more female (p=0.065). However, significantly elderly patients (76.8%, n=99) aged over 40 years, considered biopsy as harmful compared to those aged less than 40 years (p=0.078). Significant differences were found in biopsy perception of patients based on their economic status (p=0.023). Conclusions: The education level of the patient should be taken into consideration in diagnosing cancer with biopsy and subsequent transition to treatment steps the consciousness level of the patient should be certainly increased as well.
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    Brain metastases in HER2-positive metastatic breast cancer patients who received chemotherapy with or without trastuzumab
    (Springer Japan Kk, 2015) Kaplan, Muhammet Ali; Ertugrul, Hamza; Firat, Ugur; Kucukoner, Mehmet; Inal, Ali; Urakci, Zuhat; Pekkolay, Zafer
    Objective The aim of this study was to assess whether trastuzumab usage is a risk factor for the development of brain metastasis (BM) in human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) and factors affecting survival after development of BM. Materials and methods One hundred thirty-two patients treated with (treatment group) or without trastuzumab (control group) with brain metastasis were retrospectively analyzed. Results Ninety of the 132 HER2-positive MBC patients were in the treatment group and 42 were in the control group. BM was significantly increased in patients who were treated with trastuzumab in two or more lines (58.5 vs 24.1 %, p < 0.001). Trastuzumab and lapatinib usage after BM and age were independent prognostic factors for overall survival in univariate and multivariate analysis. Conclusion The risk for BM was increased in patients who were treated with trastuzumab in two or more lines. Using trastuzumab and lapatinib after BM and age were independent prognostic factors for time to death from BM.
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    Breast cancer subtypes and the risk of distant relapse after breast conserving surgery or mastectomy: An Anatolian Society of Medical Oncology study.
    (Amer Soc Clinical Oncology, 2015) Kaplan, Muhammet Ali; Urakci, Zuhat; Uncu, Dogan; Dane, Faysal; Ozkan, Metin; Akman, Tulay; Harputluoglu, Hakan
    [Abstract Not Available]
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    BREAST CARCINOMA METASTASIS TO THE TAIL OF PANCREAS
    (Aves, 2009) Cil, Timucin; Altintas, Abdullah; Pasa, Semir; Urakci, Zuhat; Isikdogan, Abdurrahman
    The most common distant metastasis of breast cancer are detected in liver, lung, bone and brain. However, atypical organ metastasis is not uncommon. Isolated pancreas metastasis can be seen rarely as well. There have been only seven cases described in the literature. Here, we report extremely a rare case of breast cancer, which metastasizes to the pancreas tail. The patient has diagnosed as breast cancer four years ago, gradual increases in serum levels of CEA and Ca15-3 were detected (129 (0-4,3ng/ml) and 84 U/ml (0-25 U/ml) respectively) in routine follow-up. Although she had no symptoms, contrast-enhanced abdominal computerized tomography (CT) scan revealed a mass of 81mm x 79mm x 68mm, with a necrozis in the tail of the pancreas. No other metastatic sites were detected by gastric endoscopy, lung CT scan or bone scintigraphy. Percutan transabdominal biopsy from tail of pancreas was showed that metastasis of breast carcinoma. We propose that, when an increase is detected in tumor markers, such as CA15-3 or CEA, without any detectable metastasis in common metastatic organs, should be investigated other atypical metastatic areas such as pancreas.
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    Can aquaporins be used as diagnostic and prognostic markers for uterine smooth muscle tumours?
    (Taylor & Francis Ltd, 2017) Alabalik, Ulas; Turkcu, Gul; Keles, Ayse Nur; Ibiloglu, Ibrahim; Ozler, Ali; Urakci, Zuhat; Buyukbayram, Huseyin
    Generally, uterine leiomyosarcoma is easily diagnosed. However, uterine smooth muscle tumours which show atypical histological features and unusual growth patterns may mimic malignancy and may not be easily diagnosed. In this study, our aim is to show the expressions of Aquaporin3, Aquaporin7 and Aquaporin9 in uterine smooth muscle tumours, and to investigate if aquaglyceroporins can be used as diagnostic and prognostic markers to start rapidly an appropriate treatment for patients with these tumours in order to extend the survival time. We determined that there had been 74 patients diagnosed with uterine smooth muscle tumours. We divided patients into four groups based on the diagnosis: bizarre leiomyoma, smooth muscle tumour of uncertain malignant potential, leiomyosarcoma and leiomyoma. Aquaporin3, Aquaporin7 and Aquaporin9 were detected by using monoclonal anti-Aquaporin3, anti-Aquaporin7 and anti-Aquaporin9 antibodies, respectively. In leiomyosarcoma group, we observed a statistically significant relation of Aquaporin3 expression with survival time, grade, stage, mitotic index and Ki-67 score. A significant relation of both Aquaporin7 and Aquaporin9 expressions with survival time, grade, stage was not statistically detected in leiomyosarcoma group. The decrease of Aquaporin3 expression can be used as important diagnostic and prognostic marker. Aquaporin7 and Aquaporin9 expressions cannot be used as diagnostic and prognostic markers.
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    The case of gastric adenocarcinoma applying with malign Acanthosis Nigricans
    (Kare Publ, 2015) Oruc, Zeynep; Kaplan, Mehmet Ali; Urakci, Zuhat; Kucukoner, Mehmet; Avci, Yahya; Isikdogan, Abdurrahman
    Achantosis Nigricans (AN) is a skin disorder characterised with hyperpigmented hyperkeratotic lesions. It occurs mostly in association with insulin resistance while it may also arise as a symptom of visceral malignancies. In the occurrence of AN considered as associated with malignancy, a detailed examination may be necessary to identify underlying malignancy. 85% of malign AN cases abdominal adenocarcinomas, and especially 60% of those are gastric adenocarcinomas. A 44-year-old male patient applied to our clinic with hyperpigmentation and hyperkeratosis, widespread body pain and weight loss within 3-4 months. Skin symptoms were reviewed as acanthosis nigricans. He had no endocrinological diseases such as DM or obesity. Due to ocurrence of many skin symptoms in accordance with acanthosis nigricans in a rapid growth on our patient, no findings of other AN causes, systemic symptoms such as the age of patient and weight loss, it is considered as malign AN.
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    A Case of neuroleptic malignant syndrome accompanied to an atypical antipsychotic agent: Risperidone
    (Elsevier Science Bv, 2008) Pasa, Semir; Sayhan, Mustafa Burak; Boyraz, Taylan; Urakci, Zuhat; Altintas, Abdullah
    [Abstract Not Available]
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    A Case with Lipoid Proteinosis Intersected with Diabetes Mellitus
    (Galenos Yayincilik, 2009) Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Yildirm, Muzeyyen; Akdeniz, Sedat; Ozekinci, Selver; Urakci, Zuhat
    Lipoid proteinosis (LP) is a rare disorder inherited as an autosomal recessive trait. LP is characterized by deposition of hyaline-like material in the skin, mucous membranes, and other tissues. LP has been mapped to chromosome 1q21, the locus for the extracellular matrix protein 1 (ECM1) gene. In this case report, we aimed to present a case with LP accompanied by diabetes mellitus, and to discuss the possible mechanisms of diabetes in LP. A 16-year-old girl presented to the endocrinology department with hyperglycemia. She reported a history of progressive hoarseness of her voice since she was two years old. Our patient meets the clinical and histopathological criteria for the diagnosis of LP. Her fasting glucose was 310 mg/dl. Plasma insulin and C-peptide levels were 5.1 uU/ml and 1.57 ng/ml, respectively. Hemoglobin A1c was 12.3%. HOMA-IR (Homeostasis Model Assessment-Insulin Resistance) ratio was 3.1 (normal range <3.7). Serum islet cell antibodies, anti-GAD antibodies and anti-insulin antibodies were negative. Diabetes mellitus was diagnosed and insulin treatment was initiated. In conclusion, possible mechanism of diabetes mellitus may be result of the diffuse deposition of amorphous material into the capillary vessels or in pancreas. The other possible mechanism responsible for the association of diabetes mellitus and insulin resistance in LP patients may be sharing a mutation at 1q21 locus. Future studies which aimed screening of insulin resistance and diabetes mellitus in LP patients may be helpful to explain this association.
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    Cisplatin-Based Therapy for the Treatment of Elderly Patients with Non-Small-Cell Lung Cancer: a Retrospective Analysis of a Single Institution
    (Asian Pacific Organization Cancer Prevention, 2012) Inal, Ali; Kaplan, M. Ali; Kucukoner, Mehmet; Urakci, Zuhat; Karakus, Abdullah; Isikdogan, Abdurrahman
    Background: In spite of the fact that platinum-based doublets are considered the standard therapy for patients with advanced non-small-cell lung cancer (NSCLC), no elderly-specific platinum based prospective phase III regimen has been explored. The aim of this retrospective singlecenter study was to evaluate the efficacy and side effects of cisplatin-based therapy specifically for the elderly. Methods: Patients receiving platinum-based treatment were divided into three groups. In the first group (GC), Gemcitabine was administrated at 1000 mg/m(2) on days 1, 8 and cisplatin was added at 75 mg/m(2) on day 1. In the second group (DC), 75 mg/m(2) docetaxel and cisplatin were administered on day 1. The third group (PC) received 175 mg of paclitaxel and 75 mg of cisplatin on day 1. These treatments were repeated every three weeks. Result: GC arm had 36, the DC arm 42 and the PC arm 29 patients. Grade III-IV thrombocytopenia was higher in the GC arm (21.2% received GC, 2.8% received DC, and 3.8% received PC), while sensory neuropathy was lower in patients with GC arm (3.0%, 22.2%, and 23.1% received GC, DC and PC, respectively). There were no statistically significant difference in the response rates among the three groups (p>0.05). The median Progression-free survival (PFS) was 5.0 months and the median Overall survival (OS) in each group was 7.1, 7.4 and 7.1 months, respectively (p>0.05). Conclusion: The response rate, median PFS and OS were similar among the three treatment arms. Grade III-IV thrombocytopenia was higher in the GC arm, while the GC regimen was more favorable than the other cisplatin-based treatmetns with regard to sensory neuropathy.
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    The Clinical and Demographic Characteristics of Our Cases with Primary Bone Tumors and Soft Tissue Tumors
    (Akad Doktorlar Yayinevi, 2016) Oruc, Zeynep; Kaplan, Muhammet A.; Yerlikaya, Halis; Celik, M. Ali; Oruc, Idris; Urakci, Zuhat; Kucukoner, Mehmet
    The current study aimed to investigate the clinical and demographic characteristics of the patients with sarcoma who were treated and followed-up in Dicle University Medical Oncology Department. We retrospectively investigated the medical records of 547 patients who were diagnosed with sarcoma in the Dicle University School of Medicine, Department of Medical Oncology, between 2007 and 2015. When we considered the total number of patients (total 23,264) admitted to our center between 2007 and 2015, the rate of our patients with sarcoma was found to be 2.3% of this total number. Primary bone tumor and soft tissue sarcoma were determined in 32% (n=172) and 68% (n=375) of the patients, respectively. The most frequent histological type was osteosarcoma. The age, location of the primary tumor, adjuvant chemotherapy, location of relapse (local, metastatic), history of smoking, and comorbid diseases showed statistically significant differences between two groups. The overall survival and progression-free survival also did not differ significantly between the primary bone tumors and soft tissue tumors (p=0.65). The rate of our patients with sarcoma was 2.3% of the total number of patients (total 23,264) admitted to our center. This rate is higher than that in the literature. It is hard to interpret the results of the study, however it has been confirmed that the soft tissue sarcomas and primary bone tumors differ with regard to the age at diagnosis, location of tumor, location of relapse, prevalence of adjuvant chemotherapy and risk factors.
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    Clinical characteristics, treatment and survival outcomes in malignant pleural mesothelioma: An institutional experience in Turkey
    (Imprimatur Publications, 2014) Kucukoner, Mehmet; Kaplan, Mehmet Ali; Inal, Ali; Urakci, Zuhat; Abakay, Ozlem; Tanrikulu, Abdullah Cetin; Abakay, Abdurrahman
    Purpose: To compare treatment modalities and investigate potential prognostic factors for survival in patients with malignant pleural mesothelioma (MPM). Methods: The present study has investigated the data of 150 patients with MPM who were examined and treated in our center from 2005 to 2012. Results: The study included 87 male (58%) and 63 female (42%) patients. Surgical resection (pleurectomy/decortications (P/D), and extrapleural pneumonectomy (EPP)) was performed in 32 (36.7%) patients; 87 patients (58%) received chemotherapy alone and 16 (10.7%) had surgery, chemotherapy and radiotherapy (trimodal treatment). The median progression free and overall survival (PFS and OS) for all patients were 10.6 and 14.8 months, respectively. No statistically significant difference was observed between the patients who received pemetrexed/cisplatin (N=54) and gemcitabine/cisplatin (N=28) in terms of PFS and OS (p=0.145, p=0.244, respectively). Also, no statistically significant difference was registered between operated and non operated patients (PFS and OS, p=0.416, p=0.095, respectively). There was no difference in both PFS and OS rates between patients who had P/D or EPP (p=0.87, p=0.652, respectively). Log rank analysis: Eastern Cooperative Oncology Group performance status (ECOG PS)(p=0.018), histology (p < 0.001), stage (p < 0.001) and leukocytosis (p=0.005) were found to be significant prognostic factors of OS. At multivariate analysis, ECOG PS (p=0.016) and stage (p < 0.001) were independent prognostic factors for OS. Conclusion: Median OS was approximately 1 year. ECOG PS, histological type, stage and presence of leukocytosis were prognostic factors that affected both PFS and OS. EPP or P/D surgical options did not provide difference in terms of survival. Survival rates in patients who received a combination of platinum analogues with pemetrexed or gemcitabine as front-line chemotherapy were similar.
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    Clinical characteristics, treatment, and survival outcomes in malignant pleural mesothelioma: A institution experience in Turkey
    (Lippincott Williams & Wilkins, 2013) Kucukoner, Mehmet; Kaplan, Muhammed Ali; Inal, Ali; Urakci, Zuhat; Abakay, Ozlem; Tanrikulu, Abdullah; Abakay, Abdurrahman
    [Abstract Not Available]
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    Clinicopathologic characteristics, treatment outcomes, and prognostic factors of primary thoracic soft tissue sarcoma: A multicenter study of the Anatolian Society of Medical Oncology (ASMO)
    (Wiley, 2015) Unal, Olcun Umit; Oztop, Ilhan; Yasar, Nurgul; Urakci, Zuhat; Ozatli, Tahsin; Bozkurt, Oktay; Sevinc, Alper
    BackgroundSoft tissue sarcomas (STSs) are rare malignant tumors of embryogenic mesoderm origin. Primary thoracic STSs account for a small percentage of all STSs and limited published information is available. This study aimed to identify the prognostic factors for thoracic STSs and evaluate the disease's clinical outcomes. MethodsThe medical records of 109 patients with thoracic STSs who were treated between 2003 and 2013 were retrospectively reviewed. Patients' survival rates were analyzed and potential prognostic factors evaluated. ResultsThe median follow-up period was 29 months (range: 1-121 months). STSs were most frequently localized on the chest wall (n = 42; 38.5%) and lungs (n = 42; 38.5%). The most common histological types were malignant fibrous histiocytoma (n = 23; 21.1%), liposarcoma (n = 17; 15.6%), and leiomyosarcoma (n = 16; 14.7%). The median survival time of all patients was 40.3 months (95% confidence interval, 14.22-66.37 months), with one and five-year survival rates of 93.4% and 63.5%, respectively. Univariate analysis of all groups revealed that metastatic stage, unresectability, tumor diameter of >10cm, tumor location other than the chest wall, and grade 3 diseases were predictable of poor survival. However, only grade 3 diseases and tumor location other than the chest wall were confirmed by multivariate analysis as poor prognostic factors. ConclusionsPrimary thoracic STSs are rarely seen malignant tumors. Our results indicated that patients with low-grade tumors and those localized on the chest wall often experienced better survival outcomes.
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    Comparison of (18F)FDG PET/CT and (68Ga)DOTATATE PET/CT imaging methods in terms of detection of histological subtype and related SUVmax values in patients with pulmonary carcinoid tumors
    (Lippincott Williams & Wilkins, 2019) Komek, Halil; Can, Canan; Urakci, Zuhat; Kepenek, Ferat
    Objective This study was designed to compare the 18-Fluorodeoxyglucose positron emission tomography/computed tomography [(F-18)FDG PET/CT] and 1,4,7,10-tetraazacyclododecane-NI,NII,NIII,NIIII-tetraacetic acid (D)-Phe1-thy3-octreotate [(Ga-68)DOTATATE PET/CT) findings in patients with pulmonary carcinoid (PC) tumors. Materials and methods A total of 20 patients [mean (SD) age: 52.2 (12.9) years, 60% women] with PC tumors and available records on digital images of (F-18)FDG PET/CT and (Ga-68)DOTATATE PET/CT and histopathological analysis were included in this retrospective single-center study. Patient characteristics, structural and functional imaging, and final histopathology were recorded in all patients. Typical and atypical PC tumors were compared in terms of patient age, tumor site, tumor size, and SUV max values obtained by (F-18)FDG PET/CT and (Ga-68)DOTATATE PET/CT imaging. Results Overall, median (minimum-maximum) SUVmax values were 3.2 (1.2-11.2) in (F-18)FDG PET/CT and 17.2 (2.5-89.0) in (Ga-68)DOTATATE PET/CT. Atypical PC tumor was associated with significantly higher mean +/- SD age (64.6 +/- 5.4 vs. 45.5 +/- 10.5 years, P=0.036) and median (minimum-maximum) (F-18)FDG PET/CT SUVmax values [7.3 (4.8-11.2) vs. 2.4 (1.2-3.9), P=0.003], but with significantly lower median (minimum-maximum) (Ga-68)DOTATATE PET/CT SUVmax values [6.4 (2.5-10.6) vs. 23.7 (14.2-89), P<0.001], compared with typical PC tumor. (F-18)FDG PET/CT and (Ga-68)DOTATATE PET/CT SUVmax values were negatively correlated (r=-0.429, P=0.011). Conclusion Our findings in patients with histologically proven PC tumors showed higher SUV max values for (F-18)FDG PET/CT in atypical PC tumors and for (Ga-68)DOTATATE PET/CT in typical PC tumors. Our findings indicate the likelihood of higher detection rates particularly for typical PC tumors by (Ga-68)DOTATATE PET/CT imaging and the potential utility of the SUVmax ratio in predicting the histological subtype of PC tumors.
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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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    Comparison of Two Chemotherapy Regimens After First-Line Treatment for HER2-Negative Metastatic Gastric Cancer
    (Springernature, 2023) Urakci, Zuhat; Ebinc, Senar; Tunc, Sezai; Kalkan, Ziya; Oruc, Zeynep; Kucukoner, Mehmet; Kaplan, Muhammet Ali
    Aim: Metastatic stage gastric cancer is a disease with a poor prognosis and the likelihood of achieving a cure in these patients is low. Treatment response to subsequent-line treatments is poor. We aimed to investigate the effectiveness of the folinic acid, fluorouracil and irinotecan (FOLFIRI) and paclitaxel+carboplatin regimens, which are used in subsequent lines of therapy in advanced-stage gastric cancer.Materials and methods: This study included 40 patients who have metastatic stage gastric cancer and received FOLFIRI or paclitaxel+carboplatin therapy in subsequent lines of therapy between 2017 and 2022. The data of the patients were analyzed retrospectively.Results: At diagnosis median age was 51 (23-88) years. The tumor was localized in the gastroesophageal junction in eight (20%) patients and in other gastric locations in 32 (80%) patients. At diagnosis, 75% (n=30) of the patients presented with the disease in the metastatic stage, while 25% (n=10) presented with stage II -III disease. Regarding the treatments received in the second and further lines of therapy, 18 (45%) patients received paclitaxel+carboplatin and 22 (55%) patients received a FOLFIRI regimen. Of these treatments, 67.5% (n=27) were given as the second line and 32.5% (n=13) were given as third-line therapy. The objective response rate (ORR) was 45.5% in the FOLFIRI arm compared to 16.7% in the paclitaxel+carboplatin arm (p=0.05). Both treatment arms had a median progression-free survival (PFS) of three months (p=0.82). The median overall survival (OS) time was seven months in the FOLFIRI arm compared to eight months in the paclitaxel+carboplatin arm (p=0.71). Side effects were similar between both treatment arms.Conclusion: This study determined that FOLFIRI and paclitaxel+carboplatin treatments have similar OS, PFS, and side effect profiles in subsequent line treatment of gastric cancer. The FOLFIRI treatment regimen yielded a higher ORR.
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    COMPLEMENTARY AND ALTERNATIVE MEDICINE USAGE IN CANCER PATIENTS IN SOUTHEAST OF TURKEY
    (African Networks Ethnomedicines, 2013) Kucukoner, Mehmet; Bilge, Zulfikar; Isikdogan, Abdurrahman; Kaplan, M. Ali; Inal, Ali; Urakci, Zuhat
    The aim of this study was to investigate the frequency of complementary and alternative medicine (CAM) methods and clinical characteristics in cancer patients in southeast of Turkey. A total of 324 patients (173 female) were enrolled to this study. Questionnaire was applied to all patients individually for approximately 15 minutes by a doctor. At least one CAM method was used by 62% (n=201) of the patients. 82.5% (n=166) of patients treated with CAM were using at least one herbal species. Likewise, 40.9% (68/166) of these patients were using herbal mixtures and 39.8% (66/166) of them were using single herbal as nettle (Urtica dioica) or its seed, 19.3 % (32/166) of them were using other herbals. CAM methods were preferred more frequently by the patients with metastatic stage (p=0.005), receiving palliative treatment (p<0.001), chemotherapy (p=0.020), in between 40-60 ages patient groups (p=0.002), and when duration of disease was lengthened (p=0.002). CAM use among cancer patients is quite common. Presence of metastatic cancer at diagnosis, receiving chemotherapy and palliative treatment and long disease duration were found as main associated factors for CAM usage.
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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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    Cranial Magnetic Resonance Imaging in the Staging of HER2-positive Breast Cancer Patients
    (Karger, 2013) Kaplan, Muhammet A.; Inal, Ali; Kucukoner, Mehmet; Urakci, Zuhat; Ekici, Faysal; Firat, Ugur; Zincircioglu, Seyit B.
    Aim: The aim of the current study was to evaluate whether early detection of brain metastases (BMs) could improve survival outcomes in human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients. Material and Methods: HER2-positive breast cancer patients without BMs who had no neurological symptoms within 12 months from diagnosis or relapse time of the disease were included in the study. The patients were distributed into 2 groups: Group 1 comprised patients without metastases; group 2 comprised patients with metastases. The symptomatic historic control group with BMs was defined retrospectively for survival comparisons. Results: 55 (57.3%) and 41(42.7%) patients were in groups 1 and 2, respectively. 11 of the 96 patients (11.5%) had occult BMs, and 9 of them were in group 2 whereas only 2 patients were in group 1 (22% vs. 3.6%, respectively; p = 0.008). While the median survival times from the first metastasis (28.7 vs. 22.5 months, respectively; p = 0.561) and BM (6.8 vs. 6.1 months, respectively; p = 0.511) were similar, cerebral death was numerically different (16.7% vs. 46.3%; p = 0.221) between asymptomatic (n = 9) and symptomatic patients (n = 53). Conclusions: BMs were detected very rarely in asymptomatic, non-metastatic HER2-positive breast cancer patients compared with asymptomatic, metastatic patients. Furthermore, although early detection of BMs decreases the cerebral death rate, it does not prolong the survival rate in metastatic patients.