Browsing by Author "Akar E."

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    Atezolizumab in Patients with Metastatic Urothelial Carcinoma Who Have Progressed After First-line Chemotherapy: Results of Real-life Experiences
    (Elsevier B.V., 2021) Tural D.; Ölmez Ö.F.; Sümbül A.T.; Artaç M.; Özhan N.; Akar E.; Çakar B.; Köstek O.; Ekenel M.; Erman M.; Coşkun H.Ş.; Selçukbiricik F.; Keskin Ö.; Türköz F.P.; Oruç K.; Bayram S.; Yılmaz U.; Bilgetekin İ.; Yıldız B.; Şendur M.A.N.; Paksoy N.; Dirican A.; Erdem D.; Selam M.; Tanrıverdi Ö.; Paydaş S.; Urakçı Z.; Atağ E.; Güncan S.; Ürün Y.; Alkan A.; Kaya A.O.; Özyükseler D.T.; Taşkaynatan H.; Yıldırım M.; Sönmez M.; Başoğlu T.; Gündüz Ş.; Kılıçkap S.
    Background: Atezolizumab (ATZ) has demonstrated antitumor activity and manageable safety in previous studies in patients with locally advanced or metastatic platinum-resistant urothelial carcinoma. Objective: To compare the real-life experience and data of clinical trials on ATZ treatment in metastatic urothelial carcinoma. Design, setting, and participants: Patients with urothelial cancer treated with ATZ after progression on first-line chemotherapy from an expanded access program were retrospectively studied. Data of patients were obtained from their files and hospital records. Safety was evaluated for patients treated with at least one cycle of ATZ. Outcome measurements and statistical analysis: The primary endpoint was objective response rate (ORR). The secondary endpoints are overall survival (OS), progression-free survival (PFS), duration of response, and safety profile of patients. Kaplan-Meier methods were used to calculate median follow-up and estimate PFS and OS. Results and limitations: Data of 115 enrolled patients were analyzed. Most of the patients (92.3%, n = 106) had received chemotherapy regimen only once prior to ATZ. The median follow-up duration was 23.5 mo. The complete response rate, partial response rate, and ORR were 8.7% (n = 10), 20.0% (n = 23), and 28.7% (n = 33), respectively. The median duration of response was 20.4 mo (95% confidence interval [CI], 6.47–28.8). Of the 33 patients who responded to treatment, 60% (n = 20) had an ongoing response at the time of the analysis. PFS and OS with ATZ were 3.8 mo (95% CI, 2.25–5.49) and 9.8 mo (95% CI, 6.7–12.9), respectively. All-cause and any-grade adverse events were observed in 113 (98%) patients. Of the patients, 64% experienced a treatment-related adverse event of any grade and 24 (21.2%) had a grade 3–4 treatment-related adverse event. Limitations of the study included its retrospective design, and determination of treatment response based on clinical notes and local radiographic studies. Conclusions: In these real-life data, ATZ was effective and well tolerated in patients with metastatic urothelial carcinoma who have progressed with platinum-based first-line chemotherapy. ATZ is an effective and tolerable treatment for patients with locally advanced or metastatic platinum-resistant urothelial carcinoma in our study, similar to previously reported trials. Patient summary: Atezolizumab is effective and well-tolerated in patients with metastatic urothelial cancer who progressed with first-line chemotherapy, consistent with the outcomes of the previous clinical trials in this setting. © 2020 European Association of Urology
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    Factors That Affect Methylphenidate Treatment Adherence in Attention Deficit Hyperactivity Disorder: A Retrospective Study; [Dikkat Eksikliği Hiperaktivite Bozukluğunda Metilfenidat Tedavisine Uyumu Etkileyen Faktörler: Retrospektif Bir Çalışma]
    (Galenos Publishing House, 2022) Kale M.K.; Yalın Sapmaz Ş.; Erten T.; Akar E.; Bilaç Ö.; Kandemir H.
    Objectives: In our research, we aimed to determine treatment adherence and examine socio-demographic and clinical factors that affect it in pediatric patients firstly given medical treatment for the diagnosis of attention deficit hyperactivity disorder (ADHD). Materials and Methods: Between 2018 and 2020, children and adolescents who were first diagnosed with ADHD were enrolled in our study and factors that affect treatment adherence were investigated. A data form including socio-demographic, ADHD and clinical data of patients was created. Those data were extracted by retrospective search of clinical records. Patients who continued the treatment for six or more months were accepted as adherent, those who did not continue were accepted as non-adherent. Factors affecting treatment adherence were evaluated. Results: Three hundred and thirty-eight patients were included in our research. At the end of the sixth month, adherence rate was 48.2%. The average age was higher in the non-adherent group. Between the adherent and non-adherent groups, age, psychiatric disorder and psychiatric treatment in family, time of the onset of side effects, presence of comorbid destructive behavior disorders, presence of multiple comorbid disorders, and change in academic achievement with treatment were statistically significant differences. As a result of the regression analysis, the relationship between the presence of psychiatric disorders in the family, change in the course success with treatment, time of the onset of side effects and treatment compliance remained significant in the model. Conclusion: After the diagnosis of ADHD, age, psychiatric disorder and treatment in family, time of the onset of side effects, change in course success with treatment, presence of comorbid destructive behavior disorders, and presence of multiple comorbid disorders could affect the treatment adherence. This situation should not be ignored when the treatment was started to patients. © Telif Hakkı 2022.