Browsing by Author "Abali, Huseyin"

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Being A Medical Oncologist Near the War Area
(2014) Sumbul, Ahmet Taner; Sezer, Ahmet; Tonyali, Onder; Ozturk, Mehmet Akif; Abali, Huseyin; Ozyilkan, Ozgur; https://orcid.org/0000-0002-6445-1439; https://orcid.org/0000-0001-5596-0920; https://orcid.org/0000-0001-8825-4918; 24965429; AAD-2667-2020; D-7660-2016; AAD-2817-2021
Can Low Molecular Weight Heparins Circumvent the Problem of Coumadine and Chemotherapy Interaction in Cancer Patients with Prosthetic Heart Valves?
(2014) Sezer, Ahmet; Sumbul, Ahmet Taner; Abali, Gulcan; Sumbul, Zehra; Mualloglu, Sadik; Abali, Huseyin
Can Primary Tumor Localization Predict the Which Patient Will Have Benefit From Addition of Taxanes to Platin-5-FU Based Regimens in Metastatic Gastric Cancer. Multi Center Retrospective Analysis from Turkey, Society of Turkish Oncology Group Study
(2015) Kose, Fatih; Sedef, Ali Murat; Ozdemir, Nuriye; Gunaldi, Meral; Urun, Yuksel; Besen, Ali Ayberk; Sumbul, Ahmet Taner; Goksu, Sema Sezgin; Dogan, Ozlem; Mertsoylu, Huseyin; Tatli, Ali Murat; Erdem, Dilek; Demirci, Serkan; Gunduz, Seyda; Yildirim, Mustafa; Ozyilkan, Ozgur; Abali, Huseyin
Can serial monitoring of serum Vascular Endothelial Growth Factor (VEGF), Nitric Oxide (NO), and Angiotensin II (ANGII) levels have predictive role during Bevacizumab treatment?
(2014) Sumbul, Ahmet Taner; Disel, Umut; Sezgin, Nurzen; Sezer, Ahmet; Kose, Fatih; Besen, Ali Ayberk; Sumbul, Zehra; Abali, Huseyin; Ozyilkan, Ozgur
Background: Standard treatment of colorectal cancer includes both cytostatic chemotherapy and targeted therapies. Bevacizumab, targeting the VEGF receptor, is one of the primary targeted therapies that achieve better response rate and survival rate as compared to combination chemotherapy. To the best of our knowledge, there is no established single marker that can be used as a predictive marker in bevacizumab therapy. Material/Methods: We enrolled 24 patients with the diagnosis of metastatic colorectal cancer in our study. During the study, 2 blood samples were drawn from patients before the first cycle and after the sixth cycle of bevacizumab therapy. Serum levels of VEGF, ANG II, and NO were recorded. Results: While the change across VEGF levels was found to be a statistically significant decreasing trend (p=0.009), this decrease was not found to be correlated with treatment response and hypertension development. Additionally, no statistically significant difference was found in terms of NO and ANG II levels. Conclusions: This study showed a significant decrease in serum VEGF, but failed to show a significant change in NO and ANG II levels during bevacizumab treatment. Although no significant correlation was found between the presence of hypertension and markers, most patients (83%) had an increase in their blood pressure. Our results suggest that dynamic monitoring of NO and ANG II, along with VEGF, may not be useful as predictive markers for bevacizumab treatment in colorectal cancer.
Clinicohistopathological features and treatment outcomes of neuroendocrine tumors: a single center experience
(2018) Kose, Fatih; Sedef, Ali Murat; Sumbul, Ahmet Taner; Mertsoylu, Huseyin; Besen, Ali Ayberk; Sezer, Ahmet; Ozyilkan, Ozgur; Abali, Huseyin; D-4793-2014
Purpose: Tumor and patient characteristics of neuroendocrine tumors (NET) significantly change between geographical locations that probably induced by environmental and genetic factors throughout the world. Therefore, reporting single center experience may help clarifying epidemiological view and improving decision-making process. Materials and Methods: We performed retrospective analysis of 115 patients of NETs those who followed by Baskent University, department of Medical Oncology and department of General Surgery to record patients and tumors characteristics, treatment modalities, survival rates, and prognostic factors. Results: Median overall survival (OS) time for all group and localized NETs were 44 and 24 months, respectively. Most common primary site was found as gastrointestinal system and then pancreatic region. Curative surgical resection rate was 46% and 8.5% of patients presented with carcinoid syndrome. Liver metastasis was far the most common metastatic site compared to lung, bone, and lymph node metastasis. Over 70 percent of patients were treated with chemotherapy and somatostatin analogs. Conclusion: Patients with higher grade, male gender, and advanced age (>65 years old) had poor survival rate. However, relatively low number of patients and less usage of (<10%) of new treatment modalities created limitations for producing future directions from our study.
Continuous Distress in an Oncology Clinic in Turkey: Should We Make Use of The Distress Thermometer Mandatory As A Precautionary Measure For Physicians?
(2014) Sumbul, Ahmet Taner; Sezer, Sezer, Ahmet; Abali, Huseyin; Dicel, Umut; Gultepe, Ilhami; Besen, Ali Ayberk; Ozyilkan, Ozgur; https://orcid.org/0000-0002-6445-1439; https://orcid.org/0000-0001-5596-0920; https://orcid.org/0000-0002-7862-0192; https://orcid.org/0000-0001-8825-4918; 25261671; AAD-2667-2020; D-7660-2016; AAD-6910-2021; AAD-2817-2021
Cutaneous Melanoma in Turkey: Analysis of 1157 Patients in the Melanoma Turkish Study
(2015) Abali, Huseyin; Celik, Ismail; Karaca, Burcak; Turna, Hande; Saglam, Esra Kaytan; Akman, Tulay; Oztop, Ilhan; Coskun, Hasan Senol; Turhal, Nazim Serdar; Sezer, Ahmet; Nayir, Erdinc; Demir, Gokhan; Budakoglu, Burcin; Issikdogan, Abdurrahman; Engin, Huseyin; Kilickap, Saadettin; Coskun, Ugur; Oyan, Basak; Harputluoglu, Hakan; Er, Ozlem; Kavgaci, Halil; Elkiran, Tamer; 26416068
Purpose: To develop a large Turkish National Melanoma registry in order to define demographic and clinicopathologic characteristics of patients with melanoma. Methods: The data was collected from 1635 patients with melanoma through a web-based registry system in 22 centers. Herein we present the results of 1157 patients with cutaneous melanoma. Results: The patient median age was 56.4 years and 646 (55.8%) were males. The commonest subtype was superficial spreading type (357, 30.9%). The commonest primary site was the lower extremities (N=353, 30.5%). The most common Breslow thickness was 1-2 mm (361 patients, 43.5%). Only 104 (12.5%) patients had a thickness <1mm. Among 694 patients with available data, 136 (19.6%) presented with stage 4 disease while the most frequent stage was stage 3, encountered in 393 (56.6% patients). Conclusion: Our melanoma registry is the largest in our country providing a snapshot view of cutaneous melanoma and its care. Our patients presented with more advanced stages and they had worse prognosis compared to SEER database.
Docetaxel, Cisplatin, and Fluorouracil Combination in Neoadjuvant Setting in The Treatment of Locally Advanced Gastric Adenocarcinoma: Phase II NEOTAX Study
(2014) Ozdemir, Nuriye; Abali, Huseyin; Vural, Murat; Yalcin, Suayib; Oksuzoglu, Berna; Civelek, Burak; Oguz, Dilek; Bostanci, Birol; Yalcin, Bulent; Zengin, Nurullah; https://orcid.org/0000-0001-5596-0920; 25234436; D-7660-2016
This phase II trial aimed to evaluate the efficacy and safety of docetaxel, cisplatin, and fluorouracil (DCF) combination in neoadjuvant setting in patients with locally advanced gastric adenocarcinoma. Fifty-nine patients with resectable or unresectable locally advanced gastric and gastroesophageal cancer were recruited in this multicenter, single-arm, open-label, local clinical phase II study conducted at three centers from Turkey between June 2006 and March 2012. Patients had T3-4 or lymph node-positive disease. After staging with imaging and laparotomy or laparoscopy, they received three cycles of DCF with lenograstim. Imaging studies were repeated after the last two cycles. Patients who underwent surgery were followed up for at least 1 year after the surgery. Toxicity and response were evaluated in accordance with NCI-CTC version3.0 and RECIST 1.0. At baseline, 66.1 % of patients were considered resectable. In 47 patients evaluable, partial response in 16 (34.0 %), stable disease in 27 (57.5 %), and progressive disease in four (8.5 %) were observed. Forty-six patients underwent surgery. In 38 (64.4 %; 95 % confidence interval (CI) 52.2-76.6 %) out of 59 patients, complete resection (R0) was achieved. Median overall and disease-free survival were 19.1 months (95 % CI 13.5-24.7) and 11.6 months (95 % CI 5.9-17.4), respectively. The most frequent grade 3-4 adverse events were neutropenia (52.5 %), febrile neutropenia (11.9 %), leukopenia (39.0 %), and diarrhea (10.5 %). One patient died from an unknown cause. Classical DCF triplet with lenograstim showed a good clinical response with acceptable safety profile in the treatment of locally advanced gastric and gastroesophageal cancer with a significant R0 rate and manageable toxicity.
Effect of Port-Care Frequency on Venous Port Catheter-Related Complications in Cancer Patients
(2014) Odabas, Hatice; Ozdemir, Nuriye Yildirim; Ziraman, Ipek; Aksoy, Sercan; Abali, Huseyin; Oksuzoglu, Berna; Isik, Metin; Civelek, Burak; Dede, Dogan; Zengin, Nurullah; https://orcid.org/0000-0001-5596-0920; 23978939; D-7660-2016
Subcutaneous central venous port catheters (SCVPC) are of great importance in the treatment of patients with malignancies since they provide secure vascular access. Our aim was to assess the impact of long-term catheter care frequency on the frequency of port-related complications. Two hundred and seven patients who had not been on active chemotherapy through their SCVPC for at least 3 months were enrolled into the study. Those who received catheter care every 3 months or more frequently were assigned to the frequent care group, and the others to the infrequent care group. The patients were examined for port-related complications and thrombosis including port occlusion. Routinely in our clinic, catheter care was done by using 300 IU of heparin. According to the frequency of SCVPC care, 49 (23.7 %) patients were in the frequent care group and 158 (76.3 %) were in the infrequent care group. Median follow-up of all patients was 671 days (range 133-1712). Median frequency of port care in the frequent care group was 90 days (range 30-90), but 441.5 days in the infrequent care group (range 91-1630). None of the patients experienced port-related severe complications during the follow-up time. None of them presented with port occlusion. When the groups were analysed for thrombus (symptomatic and asymptomatic), there was no statistically significant difference (6.4 vs 13.8 %, p = 0.17). Those patients who had received more than first-line chemotherapy were found to have more thrombi than the patients who were treated with only one type of chemotherapy protocol (28.6 vs 10.2 %, p = 0.01), and the patients who had metastatic disease at the last control were found out to have thrombi more frequently than the non-metastatic patients (24.3 vs 9.3 %) (p = 0.01). In the present study, there was no difference in port-related severe complications between frequent and infrequent care groups during follow-up. However, the rate of thrombosis was slightly higher in the infrequent port care group.
Efficacy and Safety of First Line Vincristine with Doxorubicin, Bleomycin and Dacarbazine (ABOD) for Hodgkin's Lymphoma: a Single Institute Experience
(2014) Ozdemir, Nuriye; Dogan, Mutlu; Sendur, Mehmet Ali Nahit; Yazici, Ozan; Abali, Huseyin; Yazilitas, Dogan; Akinci, Muhammed Bulent; Aksoy, Sercan; Zengin, Nurullah; 25374196
Background: ABVD (doxorubicin, bleomycin, vinblastine (Vb) and dacarbazine) is the standard regimen in Hodgkin's lymphoma (HL). Vincristine (O) is a mitotic spindle agent like Vb. We aimed to evaluate the efficacy and safety of O as a part of ABOD in HL. Materials and Methods: Patients who had ABOD were enrolled. Stage I-II HL were evaluated for unfavorable risk factors according to NCCN. National Cancer Institute Common Toxicity Criteria was used for toxicity. Results: Seventy-nine HL patients in our center between 2003 and 2007 were evaluated retrospectively. Median follow-up was 54 months. Most of the patients were male in their third decade. Median ABOD cycles were 6 (2-8). Primary refractory disease rate was 17.7% whereas it was 5.1% for early relapse and 5.1% for late relapse disease. Response rates were as 82.3% for complete response, 11.4% for partial response, 5.1% for stable disease and 1.3% for progressive disease. Half of relapsed patients had autologous stem cell transplantation. Estimated 5-year failure-free survival was 71% and significantly longer in early stage patients without risk factors, bulky disease or radiotherapy (RT) (p=0.05, p<0.0001, p=0.02; respectively). Estimated 5-year overall survival was 74% and significantly longer in those who had no RT (p=0.001). Dose modification rate was 5.1% and chemotherapy delay rate was 19%. There were no toxicity-related deaths. Conclusions: ABOD seems to be effective with managable toxicity in HL, even in those with poor prognostic factors.
Evaluation of Flare Phenomena in Advanced Colorectal Cancer After Bevacizumab Cessation in The Well-Responded Cases
(2016) Besen, Ali Ayberk; Kose, Fatih; Abali, Huseyin; Ozyilkan, Ozgur; Zengin, Nurullah; Yildirim, Nuriye; https://orcid.org/0000-0002-7862-0192; https://orcid.org/0000-0001-8825-4918; AAD-6910-2021; AAD-2817-2021
Flare Phenomenon in Advanced Colorectal Cancer: Cessation of evacizumab after Predefined Cycles of Therapy may not Affect Outcome
(2017) Besen, A.Ali; Kose, Fatih; Sumbul, Ahmet T:; Ozdemir, Nuriye; Ozyilkan, Ozgur; Zengin, Nurullah; Abali, Huseyin; 0000-0002-5573-906X; 0000-0002-0156-5973; 0000-0002-7862-0192; 0000-0001-8825-4918; D-4793-2014; G-4827-2016; AAD-6910-2021; AAD-2817-2021
Limited number of experimental and clinical studies showed rapid tumor regrowth after bevacizumab cessation in advanced colorectal cancer. We retrospectively evaluated rapid regrowth phenomenon in 105 patients those who were treated with the predefined number of chemotherapy cycles and grouped according to whether the chemotherapy regimen in the first line setting included bevacizumab (CT-Bev arm) or not (CT arm). Median age was 55 years old. Median overall and progression free survival times were 27 and 11 months, respectively. Rapid progression rates were 42% and 40% in CT arm and CT -Bev arm without no statistically significant difference (p= 0.84). In CT arm, significantly more patients with stable disease (SD) progressed rapidly compared to patients with complete (CR) or partial response (PR) (53% vs. 27%, p= 0.04). This result was also similar in CT-Bev arm (48% vs. 30%, p= 0.27) but could not reach to the significant p-value. Overall survival 2, the time from the end of last dose of chemotherapy +/- bevacizumab to death, was significantly shorter in both CT and CT -Bev arms for patients who showed SD compared to CR or PR (15 vs 38 months) (p< 0.001).Current study supports that withdrawal of bevacizumab after predefined treatment cycles may not have any adverse effect on patients' outcome of advanced CRC. This result is particularly acceptable for the patients who show CR or PR to the treatment.
Low Serum Levels of Vitamin D in Metastatic Cancer Patients: A Case-Control Study
(2014) Sumbul, Ahmet Taner; Sezer, Ahmet; Kavvasoglu, Gamze; Batmaci, Celal Yucel; Yengil, Erhan; Yagiz, Abdullah Erman; Gultepe, Ihami; Abali, Huseyin; Ustun, Ihsan; Gokce, Cumali; https://orcid.org/0000-0002-6445-1439; https://orcid.org/0000-0001-5596-0920; 24493144; AAD-2667-2020; D-7660-2016
Accompanying comorbidities observed during the cancer treatment usually affect the course and outcome of the therapy. Hypovitaminosis D, which is one of these conditions, is a resolvable problem, if recognized. In this study, we investigated whether the serum 25(OH) D levels of the patients who were presented to our outpatient clinic were different from the serum levels of the healthy population living in the same area. Our study included 90 patients who were presented to the Medical Oncology outpatient clinic and 90 age, gender, body mass index and ethnic origin matched controls without a known disease, who were presented to the outpatient clinics of the Departments of Internal Diseases and Family Medicine for routine controls. Blood count tests, detailed biochemistry tests (including serum levels of Cr, Ca and P), measurement of serum 25(OH) D levels and C-reactive protein were performed in serum samples of all of the patients and controls. Mean serum levels of 25(OH) D were 13.5 ng/ml (SD 5.1) in all cancer patients, 13.1 ng/ml (SD 4.2) in the patients who were presented for adjuvant therapy, 13.8 ng/ml (SD 5.5) in the patients who were presented at metastatic stage and 18.4 ng/ml (SD 12.5) in the controls. Mean serum CRP levels were 5.4 mg/dl (SD 1.2) in the control group, 8.4 mg/dl (SD 4.3) in the adjuvant therapy group and 20.3 (SD 16.8) in the patients with metastatic disease. Generally, all cancer patients (p 0.003) and the patients with metastatic cancer (p 0.004) had lower serum 25(OH) D levels compared to controls, and there was an inverse correlation between serum 25(OH) D and CRP levels in patients with metastatic cancer (p 0.036). In metastatic cancer patients, hypovitaminosis D may be a comorbidity and it is recommended to consider during initial evaluation and follow-up. Because it might improve these patients quality of life and chemotherapy adherence.
Malignant pleural mesothelioma: A single-center experience in Turkey
(2014) Sezer, Ahmet; Sumbul, Ahmet Taner; Abali, Huseyin; Mertsoylu, Huseyin; Ozyilkan, Ozgur
Background: Malignant pleural mesothelioma is a rare lethal malignancy caused by asbestos exposure. It is more frequently seen in certain regions in Turkey. In this retrospective study, we aimed to analyse demographic, clinical, and pathological data and treatment-related features in 54 patients. Material/ Methods: The study included 54 patients diagnosed with malignant mesothelioma that were followed and treated. Results: Of the 54 patients, 34 (55.6%) were male. The median age in men and women were 60.3 (38.2-77.2) and 65.8 (37.7-77.5) years, respectively. In 35 (64.8%), exposure to asbestosis was present. Epithelial type was found in 27 (50.0%), followed by mixed type in 7 (13.0%) patients, and in 20 (37.0%) patients the subtype could not be determined. The disease was staged as IV in 37 (68.5%) patients. In 28 patients (51.9%), it was right-sided and in 1 (1.9%) it was bilateral. The most frequent metastatic sites (in decreasing order) were lungs, mediastinum, diaphragm, liver, and thoracal wall. Of the 54 patients, 36 (66.6%) received 1st-line chemotherapy and 20 (37%) 2nd-line chemotherapy. Eighteen patients (33.3%) received radiotherapy; 11 (20.3%) with palliative intention and 7 (12.9%) with curative intention. Median overall survival (OS) was 12.03 months (95% CI 7.2-16.8). OS was not affected by sex (p=0.32), smoking history (p=0.51), alcohol consumption (p=0.36), family history (p=0.67), pleural effusion presence (p=0.80), operation (p=0.14), clinical stage (p=0.072), symptom at presentation (p=0.66), having mixed type histology (p=0.079), asbestos exposure (p= 0.06), and type of 1st-line chemotherapy (p=0.161). On the contrary, it may be positively affected by good ECOG PS (0-1) (p<0.01), age below 65 (p=0.03), left-sided disease (p=0.01), receiving chemotherapy (p<0.01), having unilateral pleural effusion (p=0.018), and type of 2nd-line chemotherapy (p=0.025). Conclusions: OS of our patients was better than that found in the literature, seeming to be positively affected by early stages, better ECOG PS, age below 65 years, left side involvement, and having second-line chemotherapy with cisplatin- gemcitabine or 3M. Overall treatment success seems to be comparable to what is currently expected.
Neutrophil-to-lymphocyte Ratio Predicts PSA Response, but not Outcomes in Patients with Castration-Resistant Prostate Cancer Treated with Docetaxel
(2014) Sumbul, Ahmet Taner; Sezer, Ahmet; Abali, Huseyin; Kose, Fatih; Gultepe, Ilhami; Mertsoylu, Huseyin; Muallaoglu, Sadik; Ozyilkan, Ozgur; https://orcid.org/0000-0002-6445-1439; https://orcid.org/0000-0001-5596-0920; https://orcid.org/0000-0002-0156-5973; https://orcid.org/0000-0002-1932-9784; https://orcid.org/0000-0002-6242-2802; https://orcid.org/0000-0001-8825-4918; 24526335; AAD-2667-2020; D-7660-2016; G-4827-2016; M-9530-2014; IVU-7523-2023; AAD-2817-2021
The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammatory response and evidences for the relationship between NLR and the response to treatment gradually increases in cancer patients. In this study, we aimed to investigate the effect of the pretreatment NLR and other factors related to the patient on predicting the outcome of docetaxel + prednisone chemotherapy in prostate cancer patients who become castration resistant. Thirty-three metastatic castration-resistant prostate cancer patients those who were treated between 2009 and 2013 were included in our study. All data of the patients, including pathological, clinical, radiological, biochemical and hematological data, were assessed retrospectively using our database system. The median progression-free survival (PFS) was determined as 23.9 months (range 0.36-118.7) with androgen suppression therapy and 9.5 months (range 1.7-39.4) with docetaxel + prednisone therapy. NLR was found to be correlated with only posttreatment psa levels. In the NLR a parts per thousand currency sign3 group, the PSA levels were statistically significantly lower than the other group (r = 0.002). Furthermore, the relationships between the clinical response and PFS and the other pretreatment parameters of the patients were evaluated in order to predict which group would respond better to docetaxel + prednisone therapy after becoming androgen resistant. No relationship was found between any of the parameters and the response to therapy. Although NLR was found effective in predicting the PSA response in docetaxel + prednisone therapy, neither NLR nor any other clinical parameter was found effective in predicting the outcome and the role of NLR in the future of CRPC is questionable.
An old enemy not to be forgotten during PET CT scanning of cancer patients: tuberculosis
(2016) Sumbul, Ahmet Taner; Sezer, Ahmet; Abali, Huseyin; Gultepe, Bilge; Kocer, Emrah; Reyhan, Mehmet; Tonyali, Onder; Ozyilkan, Ozgur; 27358601
Aim of the study: Positron emission tomography-computed tomography (PET CT) scan is commonly used in current medical oncology practice as an imaging method. In this study we present data from cancer patients who were followed at our clinic and suspected of having tuberculosis during PET CT scanning. After the biopsy, they were diagnosed with concomitant tuberculosis. Material and methods: In this study, 14 patients who applied to our clinic and followed up due to cancer, and had PET CT scanning for the preliminary staging or further evaluation, were included. The patients were diagnosed with metastatic or recurrent disease, and their biopsy results revealed tuberculosis. Results: The mean age was 57.8 years with SD (standard deviation) 13.1 years and gender distribution of 78.6% (n = 11) females and 21.4% (n = 3) males. None of the patients had tuberculosis in their personal history (0%). Among the patients, 5 (35.7%) were diagnosed with tuberculosis during the preliminary staging, whereas 9 (64.3%) were diagnosed during the follow-up after the treatment. The median time to tuberculosis diagnosis was 11 months (min-max: 3-24 months) after the treatment. The most commonly involved lymph nodes during PET CT scanning were mediastinal in 8 (64.3%), axillary in 3 (21.4%) and para-aortic in 3 (21.4%) patients. The mean SUVmax (maximum standardised uptake value) of lymph node involved by PET CT scanning was defined as 8.5 (SD 2.6). Conclusions: Despite all improvements in modern medicine, tuberculosis is still a serious public health problem. It should always be considered in differential diagnosis while evaluating PET CT scanning results of cancer patients, because it may cause false positive results.
Patients with Distal Intestinal Gastric Cancer Have Superior Outcome with Addition of Taxanes to Combination Chemotherapy, While Proximal Intestinal and Diffuse Gastric Cancers do not: Does Biology and Location Predict Chemotherapy Benefit?
(2015) Sedef, Ali Murat; Kose, Fatih; Sumbul, Ahmet Taner; Dogan, Ozlem; Besen, Ali Ayberk; Tatli, Ali Murat; Mertsoylu, Huseyin; Sezer, Ahmet; Muallaoglu, Sadik; Ozyilkan, Ozgur; Abali, Huseyin; 0000-0002-6445-1439; 0000-0002-6242-2802; 0000-0002-1932-9784; 0000-0002-7862-0192; 0000-0002-5573-906X; 0000-0001-8825-4918; 0000-0002-0156-5973; 25572818; AAD-2667-2020; IVU-7523-2023; -9530-2014; AAD-6910-2021; D-4793-2014; D-7660-2016; AAD-2817-2021; G-4827-2016; GZH-1913-2022
Gastric cancer, with one million new cases observed annually, and its dismal prognosis, is one of the leading causes of cancer-related mortalities. Systemic chemotherapy is the main treatment modality in advanced gastric cancer patients. We aim to evaluate the predictive role of tumor localization and histopathology on choosing three or two-drug combination regimens. Consecutive 110 metastatic gastric adenocarcinoma patients who were admitted to the Baskent University Department of Medical Oncology and the Van Research and Training Hospital were included in the study. Data of patients were analyzed retrospectively. Median age of patients was 58 years (range 30-80). Proximal intestinal, distal intestinal, and diffuse gastric cancers were found in 35 (32 %), 64 (58 %), and 11 (10 %) patients, respectively. 5-fluoracil and platinum (PF) and PFtax were administered to 47 (43 %) and 63 (57 %) patients, respectively. Median progression-free survival (PFS) was 4.0 (95 % CI 2.5-5.6) and 7.4 months (95 % CI 6.0-8.7) for PF and PFtax groups, (p = 0.034). When we used tumor localization as strata in the PFS survival curve, PFtax produced significantly higher PFS rates only in distal intestinal-type gastric cancer, compared with PF (p = 0.03). Median overall survival (OS) was 9.0 (95 % CI 5.2-12.3) and 17.3 months (95 % CI 7.8-27) for PF and PFtax groups, (p = 0.010). When we used tumor localization as strata in the OS survival curve, PFtax produced significantly higher OS rates only in distal intestinal-type gastric cancer compared with PF (p = 0.015). Pathology and tumor location in gastric cancers may affect the outcome, the addition of taxanes as a third drug may significantly increase PFS and OS rate purely in distal intestinal-type gastric cancer but not in patients with proximal and diffuse-type gastric cancers.
A Phase II Study of the Combination of Oxaliplatin, Capecitabine, and Trastuzumab and Chemoradiotherapy in the Adjuvant Setting in Operated Patients With HER2-positive Gastric or Gastroesophageal Junction Cancer (TOXAG Study) A Turkish Oncology Group Study
(2021) Abali, Huseyin; Yalcin, Suayib; Onal, Huseyin C; Dane, Faysal; Oksuzoglu, Berna; Ozdemir, Nuriye; Mertsoylu, Huseyin; Artac, Mehmet; Camci, Celaletdin; Karabulut, Bulent; Basal, Fatma B.; Budakoglu, Burcin; Sendur, Mehmet A. N.; Goktas, Burce; Ozdener, Fatih; Baygul, Arzu; 33979100
Background: Trastuzumab prolonged the overall survival in patients with advanced gastric cancer with human epidermal growth factor receptor 2 (HER2) overexpression in combination with chemotherapy. In this phase II open-label prospective study, the tolerability and safety of trastuzumab with chemotherapy, and chemoradiotherapy for curatively resected patients with HER2-positive gastric carcinoma was investigated. Methods: The patients with HER2-positive gastric, or gastroesophageal junction adenocarcinoma, after gastrectomy plus D2 dissection, were included. They received 3 cycles of oxaliplatin (100 mg/m(2) intravenously day 1) plus capecitabine (850 mg/m(2) orally days 1 to 14), trastuzumab (8 mg/kg intravenously day 1 in cycle 1, 6 mg/kg thereafter) every 21 days, followed by chemoradiotherapy. Trastuzumab was given for 1 year. Results: Of the 212 patients screened, 35 were eligible, and 34 were treated. The median age was 56 years (minimum to maximum: 35 to 75 y), male patients constituted 73.5% (n=25), and 33 (97.1%) had gastric adenocarcinoma. R0 resection was performed in 30 (88.2%). The majority (26, 61.7%) were in stage III disease. Most of the adverse events were grade I/II, the most frequent grade III side effects were nausea (3, 8.8%), vomiting (3, 8.8%), diarrhea (2, 5.9%), and weight loss (n=2, 5.9%). Two patients died during the first 3 cycles of chemotherapy and chemoradiotherapy; 1 secondary to pulmonary thromboembolism, and the other due to cerebral ischemia. After excluding 2 with early progression and 1 consent withdrawal, of the remaining 31 patients, 28 (90.3%) were able to complete the chemotherapy and chemoradiotherapy part of the trial. After the 25 months follow-up period, 21 patients (61.8%) were alive. Overall survival at 12 and 24 months was 75.0% and 58.0%, while disease-free survival at 12 and 24 months was 65.7% and 55.0%, respectively. Conclusions: Trastuzumab in combination with capecitabine, oxaliplatin following chemoradiotherapy as the adjuvant therapy for gastric or gastroesophageal junction adenocarcinoma was considered as safe and tolerable. The frequency of HER2 overexpression in curatively resected patients is comparable to that in patients with metastatic disease
Prognostic factors for survival in patients with metastatic malign melanoma treated with ipilimumab: Turkish Oncology Group study
(2019) Urun, Yuksel; Yasar, H. Arzu; Turna, Hande; Esin, Ece; Sedef, A. Murat; Alkan, Ali; Oksuzoglu, Berna; Ozdemir, Nuriye; Sendur, M. A. Nahit; Sezer, Ahmet; Kilickap, Saadettin; Utkan, Gungor; Akman, Tulay; Akbulut, Hakan; Celik, Ismail; Abali, Huseyin; 30400750
Purpose Studies in the last decade show survival improvement with checkpoint blocker therapy in patients with metastatic malign melanoma. Our purpose was to define the efficacy of ipilimumab according to the patient's baseline characteristics including absolute lymphocytes count. Methods We collected the data of 97 patients with advanced malign melanoma treated with ipilimumab (3 mg/kg, q3w) retrospectively. Log-rank test was used to analyze the univariate effects of patient's characteristics (age, gender, metastatic sites, ECOG PS, type of melanoma, lactic dehydrogenase levels, anemia, lymphocytes (L), neutrophils (N), N/L ratio), c-kit and BRAF status. Survival analyses were estimated with Kaplan-Meier method. Cox regression analysis was used to assess the possible factors identified with log-rank test. Results The median age was 58, and 58% were male and 90% of patients had at least one prior systemic therapy. The median survival was 9.7 months for all patients; and the 12- and 24-month survival rates were 43% and 19%, respectively. Absolute lymphocytes count, lactic dehydrogenase level, bone metastasis, the number of metastatic sites, and RECIST response were significantly related to survival. After Cox regression analysis, RECIST response (complete or partial response), absolute lymphocytes count (more than 1500/mm(3)) and the number of metastatic sites (less than three sites) remained as significant independent prognostic factors for longer survival. Conclusion Ipilimumab improved survival of patients with metastatic malign melanoma. However, patients with fewer metastatic sites and higher absolute lymphocytes count have a significantly better benefit. To determine if these markers could be used to direct patient therapy, further validation analysis is needed.
Prognostic factors for survival in patients with mucosal and ocular melanoma treated with ipilimumab: Turkish Oncology Group study
(2020) Yasar, H. Arzu; Turna, Hande; Esin, Ece; Sedef, A. Murat; Alkan, Ali; Oksuzoglu, Berna; Ozdemir, Nuriye; Sendur, M. A. Nahit; Sezer, Ahmet; Kilickap, Saadettin; Utkan, Gungor; Akbulut, Hakan; Celik, Ismail; Abali, Huseyin; Urun, Yuksel; 0000-0002-6445-1439; 30924738; AAD-2667-2020
Objective To evaluate prognostic factors associated with the use of ipilimumab in patients with mucosal and uveal melanoma. Methods In this multicenter, retrospective study, 31 patients with uveal and mucosal melanoma diagnosed between 2010 and 2017 were enrolled. Patients' characteristics, metastatic disease sites, treatment before ipilimumab therapy, performance status, hemoglobin, lactate dehydrogenase levels, B-RAF and c-kit mutation status, toxicity, and survival data were assessed for patients with mucosal and uveal melanoma. SPSS version 17 was used for statistical analysis. Kaplan-Meier method was used for survival analysis. The log-rank test was used for univariate analyses. The Cox regression analysis was used to test the association between multivariate variables and survival. The p-value of less than 0.05 was considered statistically significant. Results Twenty patients had uveal and eleven patients had mucosal melanoma. The median overall survival was seven months (95% confidence interval: 1.1-12.7). In univariate analysis, while bone metastasis, anemia, high lactate dehydrogenase level, and more metastatic sites were associated with lower overall survival, better treatment response and administration of ipilimumab in first or second lines were associated with favorable overall survival. In multivariate analysis, only treatment response status and administration of ipilimumab in first or second lines were found to be significant as independent prognostic factors for survival. Conclusion Ipilimumab therapy may be associated with increased survival, but this retrospective small N study makes that hard to definitely conclude.