Browsing by Author "Erdoğan A.P."
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Item A Rare Case Report of Skin Metastasis in Gastric Cancer(Springer, 2021) Şahin M.; Ekinci F.; Çelik C.; Temiz P.; Erdoğan A.P.; Göksel G.[No abstract available]Item Effect of mobile phone app-based training on the quality of life for women with breast cancer(Churchill Livingstone, 2021) Çınar D.; Karadakovan A.; Erdoğan A.P.Purpose: The study purpose was to determine the effects on quality of life (QoL) of a mobile phone app–based training for supportive care of women with breast cancer who were using adjuvant endocrine hormonal therapy. Methods: The study is based on a randomized pre-post test design. Participants were randomly assigned to either a control group that received routine care or an intervention group that received routine care plus access to the mobile phone app–based training support for 12 weeks. QoL and symptom distress were measured before intervention (T0), and after 12 weeks (T1) of intervention. This study is the application of two modality combinations: the mobile app-based patient education (1) and web-based management application (2). The mobile app-based training also provided basic information about breast cancer, symptom diary and lifestyle recommendations (adequate and balanced nutrition, regular physical activity, deal with stress effectively). Results: QoL of the treatment group after intervention increased and distress level was lower compared to the control group; these results were statistically significant. The majority of the patients reported that the mobile application was "informative and useful". Conclusions: This demonstrated that the mobile app is an effective intervention for supportive care in women with breast cancer. The mobile app–based training, which is an innovative intervention, is recommended as a supportive care initiative for women with breast cancer. © 2021 Elsevier LtdItem Can Albumin Bilirubin Ratio and Inflammatory Prognostic Index Be A New Marker Determining Survival in Metastatic Pancreatic Cancer?(NLM (Medline), 2021) Ekinci F.; Sarı D.; Çelik C.; Dirican A.; Erdoğan A.P.; Gökse G.OBJECTIVE: The main purpose of our study is to analyze the predictive and prognostic value of inflammatory prognostic index (IPI (using albumin, CRP, neutrophils and lymphocytes) and albumin / bilirubin ratio in metastatic pancreatic cancer patients in addition to other markers currently used. MATERIALS AND METHODS: Medical records of patients with pancreatic cancer treated in Celal Bayar University Medical Faculty Hospital Medical Oncology Clinic between February 2012 and April 2020 were retrospectively reviewed. Clinicopathologic variables such as age, gender, performance status (PS), treatments, histopathology type, localization of metastasis, comorbidity were recorded by an electronic medical record system. Patients performance status were recorded according to the Eastern Cooperative Oncology Group (ECOG). A total of 110 pancreatic cancer patients were reviewed. The IPI was calculated as C-reactive protein × NLR (neutrophil/lymphocyte ratio)/serum albumin. Univariate and multivariate analyses were performed to assess the prognostic value of relevant factors. RESULTS: Median OS of all patients was 6 months. The NLR cut off value we calculated was 3,47. The median OS of 47 (49,4%) patients was 8 months (95 % cl. 8,673- 15,383) with NLR < 3,47 and median OS of 48 (50,6%) patients was 4 months (95 % cl. 4,221-7,523) with NLR ≥ 3,47 (P: 0,001). The cut off value calculated for the IPI was 0,79. The median OS of 24 (25,8 %) patients was 8 months (95 % cl. 7,475-18,814) with IPI < 0,79 andmedian OS of 69 (74,2 %) patients was 5 months (95 % cl. 5,774-9,580) with IPI ≥ 0,79 (P: 0,047). The ABR cut off value we calculated was 5,23. The median OS of 45 (47,3 %) patients was 4 months (95 % cl. 8,879- 15,174) with ABR ≥ 5,23 and median OS of 50 (42,7 %) patients was 9 months (95 % cl. 4,015-7,585) with ABR < 5,23 (p< 0.001) (Figure 1). According to this analyses, presenting with jaundice, peritoneum metastasis, CA19.9 and LDH values higher than cut off, high NLR, high IPI and high ABR were also significantly associated with OS. In multivariate analyses, ABR was an independent prognostic factor in PC. Patients with high ABR (> 5,23) had increases in the risk of death compared with those with low ABR (< 5,23) (HR, 0,305; 95 % CI, 0,176-0,531; p: 0.000). Alongside ABR, CA-19.9 (HR, 2,300; 95 % CI, 1,111-4,764; p: 0,025) and LDH (HR, 3,348; 95 % CI, 1,792-6,253; p: 0.000) were an independent prognostic factor in PC. CONCLUSION: In this study, we demonstrated that both IPI and ABR, which were not evaluated in PC before, are non-invasive, cheap, accessible, and easily formulated parameters in determining the prognosis. Especially the fact that ABR is an independent prognostic indicator in multivariate analysis makes it stronger. Although we are aware that our study is retrospective, we hope that the reliability of these scores will increase if it is done with more patient series and if it is done multicenter.Item Are hormonal agents better than chemo in metastatic castration-resistant prostate cancer?(Istanbul Tip Fakultesi, 2021) Yildirim S.; Erdoğan A.P.OBJECTIVE In this study, we aim to determine which treatment is more appropriate in castration-resistant chemo-therapy-naive patients. Therefore, docetaxel and agents active in the androgen pathway (abiraterone and enzalutamide) were compared retrospectively in patients progressing on androgen deprivation therapy. METHODS The study was designed as a retrospective and multicenter study. Patients from five centers in Turkey were included in the study. The primary endpoint of the study was overall survival (OS) and the second-ary endpoint was progression-free survival. RESULTS Median OS of the docetaxel group was 18.66 months, it was 16.26 months in the hormonal treatment group. There was no statistically significant difference between the groups (p=0.311). Median progression-free survival of the chemotherapy group was 5.6 months, while it was 9 months in the hormonal therapy group. There was statistically significant difference between the groups (p=0.024). CONCLUSION There was statistical difference in progression-free survival in favor of hormonal therapies in our study. The difference did not reflect on OS and there was no difference between hormonal therapies and docetaxel. Heterogeneity in the selection of patients is considered to lead to this result; however, larger randomized controlled studies are needed to determine the most appropriate treatment in these patients. © 2021, Turkish Society for Radiation Oncology.Item Level of COVID-19 fear in cancer patients(Springer Science and Business Media Deutschland GmbH, 2022) Erdoğan A.P.; Ekinci F.; Acar Ö.; Göksel G.Background: Cancer patients are in the high-risk group of getting COVID-19 infection and experiencing a severe course. Anxiety of cancer patients about how they pass this pandemic process and how changes in the health system would influence their treatment has increased together with the COVID-19 pandemic. Influence of COVID-19 on psychology of cancer patients is also a subject needed to be investigated as well as its course and prognosis. Thus, it is aimed to measure fear levels of cancer patients by a validated scale. Patients accepting to fill in the validated Fear of COVID-19 (FCV-19S) scale were included in our study. Higher scores obtained from the scale means high level of COVID-19 fear was experienced. Results: A total of 66.8% of 486 patients expressed that they are very afraid of coronavirus, and 66.3% expressed that they fear from losing their lives due to coronavirus. The level of fear in the patient group having adjuvant therapy has been found statistically to be significantly higher compared with groups having neoadjuvant and metastatic/palliative therapy (p: 0.004). Conclusions: Because the increase of level of fear may lead to vital outcomes such as weakening of immune system, disturbance of treatment compliance, and worsening of prognosis, a psychological approach to cancer patients is compulsory in order to prevent fear of COVID-19 infection. © 2022, The Author(s).Item Clinical outcomes of cyclin-dependent kinase 4–6 (CDK 4–6) inhibitors in patients with male breast cancer: A multicenter study(Churchill Livingstone, 2022) Yıldırım H.Ç.; Mutlu E.; Chalabiyev E.; Özen M.; Keskinkılıç M.; Ön S.; Çelebi A.; Dursun B.; Acar Ö.; Kahraman S.; Aykan M.B.; Kaman Ö.; Doğan A.; Erdoğan A.P.; Melisa Celayir Ö.; Günenç D.; Güven D.C.; Vedat Bayoğlu İ.; Yavuzşen T.; Hacıbekiroğlu İ.; İnanç M.; Kılıçkap S.; Yalçın Ş.; Aksoy S.Background: Since breast cancer is less common in men than in women, data on the use of new therapeutic agents, including cyclin-dependent kinase 4–6 (CDK 4–6) inhibitors, are limited in patients with metastatic hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) male breast cancer. Therefore; we aimed to investigate the treatment responses of metastatic HR+, HER2-male breast cancer patients treated with CDK 4–6 inhibitors in a multicenter real-life cohort. Methods: Male patients with a diagnosis of HR+ and HER2-metastatic breast cancer, treated with any CDK 4–6 inhibitor, were included in the study. Demographic and clinical characteristics of the patients were recorded. We aimed to determine progression-free survival (PFS) time, response rates and drug related side effects. Results: A total 25 patients from 14 institutions were recruited. The mean age at diagnosis was 57 years. Median follow-up was 19.53 (95% CI: 14.04–25.02) months. The overall response rate was 60%. While the median PFS was 20.6 months in the whole cohort, it wasn't reached in those using CDK 4–6 inhibitors in first line and 10 months in the subsequent lines (p:0.009). No new adverse events were encountered. Conclusion: In our study, we found that CDK 4–6 inhibitors are effective and safe options in men with HR+ and HER2-metastatic breast cancer as in women. Our results support the use of CDK 4–6 inhibitor-based combinations in the first-line treatment of HR+ and HER2-metastatic male breast cancer. © 2022Item Atezolizumab combined with chemotherapy in the first-line treatment of extensive-stage small cell lung cancer: a real-life data of the Turkish Oncology Group(Springer Science and Business Media Deutschland GmbH, 2022) Gürbüz M.; Kutlu Y.; Akkuş E.; Köksoy E.B.; Köse N.; Öven B.B.; Uluç B.O.; Demiray A.G.; Erdem D.; Demir B.; Turhal N.S.; Üskent N.; Akbaş S.; Selçukbiricik F.; İnal A.; Bilici A.; Ölmez Ö.F.; Çabuk D.; Ünal Ç.; Hızal M.; Şendur M.A.N.; Korkmaz M.; Karadurmuş N.; Ertürk İ.; Göksu S.S.; Tatlı A.M.; Güven D.C.; Kılıçkap S.; Paksoy N.; Aydıner A.; Çınkır H.Y.; Özkul Ö.; Öztürk A.; Ballı S.; Kemal Y.; Erdoğan A.P.; Er Ö.; Yumuk P.F.; Demirkazık A.Purpose: Atezolizumab has been shown to be effective and safe in randomized trial in the first-line treatment of extensive-stage small cell lung cancer (SCLC). However, there are limited real-life data on atezolizumab. In this study, we aimed to determine the real-life efficacy and safety of atezolizumab combined with chemotherapy in the first-line treatment of extensive-stage SCLC. Methods: This trial is a retrospective multicenter study of the Turkish Oncology Group, which included extensive-stage SCLC patients who received atezolizumab combined with chemotherapy in a first-line treatment. The characteristics of the patients, treatment and response rates, and PFS and OS are presented. Factors associated with PFS and OS were analyzed by univariate and multivariate analysis. Results: A total of 213 patients at the 30 oncology centers were included. The median number of chemotherapy cycle was 5 (1–8) and atezolizumab cycle was 7 (1–32). After median 11.9 months of follow-up, median PFS and OS was 6.8 months (95%CI 5.7–7.8), and 11.9 months (95%CI 11–12.7), respectively. The ORR was 61.9%. ECOG-PS (p = 0.002) and number of metastatic sites (p = 0.001) were associated with PFS and pack-year of smoking (p = 0.05), while ECOG-PS (p = 0.03) and number of metastatic sites (p = 0.001) were associated with OS. Hematological side effects were common and toxicities were manageable. Conclusion: This real-life data confirm the efficacy and safety of atezolizumab in combination with chemotherapy in first-line treatment of extensive-stage SCLC. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Item The Effect of Palliative Invasive Interventions on Overall Survival in the Last 3 Months of Life in Metastatic Gastric Cancer(Springer, 2022) Ekinci F.; Erdoğan A.P.Purpose: Gastric cancer is one of the biologically aggressive and highly mortal cancers. In addition to limited treatment options, especially in advanced stages, palliative treatment methods are applied to increase patients’ quality of life with gastric cancer. This study aims to discuss the effects of paracentesis, thoracentesis, tube thoracostomy, double J catheter nephrostomy, percutaneous transhepatic cholangiography (PTC), and abscess drainage catheter placement procedures applied in the last 3 months for problems requiring palliation, in the light of literature. Method: The patient characteristics of the patients and, in addition, the history of any invasive intervention for palliative treatment in the last 3 months were questioned and recorded with the electronic medical record system. The effect of an invasive intervention on survival was examined. The data of patients with metastatic gastric cancer followed in the medical oncology clinic between February 2012 and May 2020 were reviewed retrospectively. Conclusions: In this study, in which the effect of palliative invasive intervention (PIG) stories on survival in the last 3 months of life of patients diagnosed with metastatic gastric cancer was examined, no significant difference was found between those who underwent PIG and those who did not, in terms of overall survival. However, since PIG was not included in the design of our study, the effect of PIG in terms of quality of life, mood, motivation of patient relatives, and the cost is unknown. Results: In the final analysis, it was noted that 143 (94.1%) of the 152 patients included in the study died and 9 (5.9%) were still alive. Overall survival of all patients was reported as 12.9 months (95% CI, 10.9-14.9). The mean overall survival of 36 patients who underwent palliative invasive intervention (PIG) in the last 3 months was 13.0 months (95% CI, 9.1-17.0), and a similar 13.0 months (95% CI, 10.6-15.3) of 116 patients who did not undergo PIG no significant difference was found (p: 0.887). © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.Item Factors affecting the serologic response to SARS-CoV-2 vaccination in patients with solid tumors: A prospective study(Elsevier B.V., 2022) Erdoğan A.P.; Ekinci F.; Akçalı S.; Göksel G.Objective: To evaluate the factors affecting seropositivity and antibody levels after SARS-CoV-2 vaccines in patients with cancer because they were excluded from clinical studies of SARS-CoV-2 vaccines. Methods: This prospective, observational, single-center study included 290 patients with solid tumors followed up in our medical oncology clinic between March 2021 and August 2021. SARS-CoV-2 antibody status was determined before the first dose of vaccine. Fifty-one patients with positive prevaccine baseline antibody tests were excluded from the study, regardless of whether they had previously confirmed SARS-CoV-2 PCR positivity. To determine the quantitative IgG antibody response of the vaccines, blood samples were collected at least 28 days after each dose of vaccine. Quantitative IgG levels against virus spike protein receptor binding domain (RBD) were measured using chemiluminescent enzyme immunoassay (CLIA). Demographic and clinical features affecting seropositivity were analyzed. Results: One hundred and fifty-one (69.3%) patients were vaccinated with two doses of CoronaVac followed by one dose of BNT162b2 (Biontech) (group 1). Sixty-seven (30.7%) patients were vaccinated with three doses of BNT162b2 (group 2). The proportion of patients who developed seropositivity was significantly higher in group 2 (78.6% vs. 54.9%, p < 0.012). Antibody response increased significantly after the second dose of vaccine in both groups. Female sex, being younger than 65 years, and chemotherapy status were significantly related to higher anti-SARS-CoV-2 S antibody levels (p = 0.033, p = 0.036, and p = 0.047, respectively). Antibody levels were significantly higher in patients who had previously received chemotherapy than in patients receiving active chemotherapy (p = 0.042). Conclusions: Our study is the first to evaluate basal SARS-CoV-2 IgG levels before the first dose of vaccine and after three doses in patients with solid tumors. The rate of development of seropositivity with two doses of mRNA vaccine was found to be higher than with two doses of inactivated SARS-CoV-2 vaccine. More attention should be paid to preventive measures in addition to vaccination in patients aged over 65 years and men with cancer diagnoses. © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious DiseasesItem Could the Inflammatory Prognostic Index Predict the Efficacy of Regorafenib in Patients with Metastatic Colorectal Cancer?(Springer, 2022) Erdoğan A.P.; Ekinci F.; Karabaş A.; Balçık O.Y.; Barutça S.; Dirican A.Purpose: To investigate the clinical importance of the inflammatory prognostic index (IPI) in patients with metastatic colorectal cancer treated with regorafenib. Methods: A retrospective analysis of 65 metastatic CRC patients treated with regorafenib between 2015 and 2020 was performed. The association between NLR, PNLR, IPI, and overall survival (OS) and progression-free survival (PFS) was evaluated. Results: According to the cut-off points, patients were divided into two groups. The patients in the high IPI group showed poorer OS compared to patients in the low IPI groups. The PFS was better in patients with low neutrophil-lymphocyte ratio (NLR) and platelet-neutrophil to lymphocyte ratio (PNLR), and the OS was better in patients with low IPI. Conclusion: Among the immune inflammation scores analyzed in mCRC patients receiving regorafenib, NLR and PNLR were the best predictor of recurrence, whereas IPI was the best predictor of long-term survival. After being confirmed by better designed controlled trials, IPI can be used to identify the group of patients who will benefit more from regorafenib treatment. © 2021, Springer Science+Business Media, LLC, part of Springer Nature.Item Metastatic Pancreatic Cancer Second-Line Treatment Options: Is the Difference Only in Cost?(Springer, 2022) Yıldırım S.; Erdoğan A.P.; Karateke M.; Yılmaz C.; Özveren A.; Bulut G.; Ekinci F.; Almuradova E.İntroduction: Although pancreatic cancer ranks seventh in cancer-related deaths, it is an extremely fatal disease, and more than 330,000 people die from this disease worldwide. Although there are many first-line treatment studies in the literature, there are almost no prospective studies regarding second-line therapy. Therefore, there is no standard approach in the second-line treatment of pancreatic cancer. We decided to conduct this study to investigate second-line treatments with problems such as cost, treatment efficacy, and toxicity. Methods: Patients older than 18 years old who applied to Ege University Hospital medical oncology department with a diagnosis of metastatic pancreatic cancer, who received first-line chemotherapy due to their illness, and who had progressed afterwards were included in the study. The files of the patients who applied between 2013 and 2017 were examined. Results: Our study’s primary endpoint was progression-free survival, and it was found that the median progression-free survival was 3.2 months in the Xelox patients, 3.7 months in the gemcitabine-nab paclitaxel patients, and 3.5 months in the other regimens. When the secondary endpoint was evaluated, overall survival, the median overall survival was 5.9 months in the Xelox patients, 5.3 months in the gemcitabine-nab paclitaxel patients, and 4.8 months in the other regimens. Conclusion: As a result, second-line treatments were compared, and no statistically significant difference was found between them. For this reason, the side effects of previously used drugs and the side effects of new drugs to be used, as well as their costs, should be evaluated when choosing a treatment. © 2021, Springer Science+Business Media, LLC, part of Springer Nature.Item Effects of Nutritional Support on the Quality of Life of Cancer Patients(Turkiye Klinikleri, 2022) Karadaş G.; Erdoğan A.P.; Ekinci F.; Çivi M.; Göksel G.Objective: In this study, we investigated the effects of nutritional support on the quality of life of cancer patients, determined nutritional deficiencies, eliminated it at the earliest, and established a built-in system to prolong patient survival. Material and Methods: We included 459 patients admitted to the medical oncology outpatient clinic, diagnosed with cancer and receiving chemotherapy; 59 of 459 patients were diagnosed with malnutrition in the study using the Nutritional Risk Screening (NRS) 2002 nutritional status scale. Appropriate enteral nutrition support was provided to the patients, and control evaluations were made four times at intervals of 28 days. In these controls, information on the height, weight, and the right and left middle arm circumference of the patients was recorded. Along with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-30) Quality of Life Scale, the Hospital Anxiety and Depression Scale was also used. Results: A statistically significant difference was found in the NRS 2002 scores of the patients regarding the adequacy of intake, protein and calorie requirement, functional status, and the symptom scale. The anxiety and depression scores of the patients decreased in all the controls, and the most noticeable decrease occurred at the end of the third control. Conclusion: Evaluating malnutrition and providing adequate nutritional support to cancer patients improves body composition and the quality of life by reducing anxiety and depression. © 2022 by Turkish Society of Medical Oncology.Item Palliative Biliary Drainage Has No Effect on Survival in Pancreatic Cancer: Medical Oncology Perspective(Springer, 2022) Erdoğan A.P.; Ekinci F.; Yıldırım S.; Özveren A.; Göksel G.Purpose: Removal of obstructive jaundice in metastatic pancreatic cancer is an important part of palliative therapy. However, it is not known whether invasive procedures reduce cancer-related mortality. In this study, the effect of palliative biliary drainage on survival outcomes in pancreatic cancer patients was evaluated. Methods: Patients diagnosed with pancreatic cancer and undergoing biliary drainage in two different centers between 2010 and 2019 were evaluated retrospectively. Results: Biliary drainage was applied to 73 patients, constituting 20.6% of 355 patients included in the study. The median progression-free survival (PFS) of patients with biliary stent was 5 months, while the median PFS of patients without stenting was 5.5 months and the median overall survival (OS) was 11.1 and 11.5 months, respectively (p: 0.424, p: 0.802). Conclusions: A positive effect of palliative biliary drainage on median PFS and OS could not be demonstrated in our study group. In pancreatic cancer, predictive markers are needed to select patients who can derive a survival benefit from biliary drainage. © 2021, Springer Science+Business Media, LLC, part of Springer Nature.Item Vinorelbine Induced Serpentine Supravenous Hyperpigmentation(Turkiye Klinikleri, 2022) Yetut A.D.; Taş S.; Ekinci F.; Çelik C.; Erdoğan A.P.; Dirican A.Serpentine supravenous hyperpigmentation (SSH) is a rare complexity arising from antineoplastic therapy. Vinorelbine, a chemotherapeutic drug that is frequently used for the treatment of breast and lung cancer, contributes to the etiology of SSH. A 54 years old male patient was being treated for lung adenocarcinoma. An intravenous (IV) infusion of vinorelbine was administered in the distal dorsal vein of the left forearm. Erythematous hyperpigmentation at the infusion area was observed a week after the administration of the chemotherapeutic drug. The initial symptoms of SSH usually appear between 1 to 15 days post IV administration of a cytotoxic drug, and it spontaneously be-comes hyperpigmented within 1-3 weeks. However, these local reactions can be prevented by applying IV infusion for a short period (15-30 min) along with adequate venous irrigation (75-124 mL) instead of bolus administration. The termination of the drug can also be considered. © 2022 by Turkish Society of Medical Oncology.Item Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy(BioMed Central Ltd, 2023) Karacin C.; Oksuzoglu B.; Demirci A.; Keskinkılıç M.; Baytemür N.K.; Yılmaz F.; Selvi O.; Erdem D.; Avşar E.; Paksoy N.; Demir N.; Göksu S.S.; Türker S.; Bayram E.; Çelebi A.; Yılmaz H.; Kuzu Ö.F.; Kahraman S.; Gökmen İ.; Sakin A.; Alkan A.; Nayır E.; Uğraklı M.; Acar Ö.; Ertürk İ.; Demir H.; Aslan F.; Sönmez Ö.; Korkmaz T.; Celayir Ö.M.; Karadağ İ.; Kayıkçıoğlu E.; Şakalar T.; Öktem İ.N.; Eren T.; Urul E.; Mocan E.E.; Kalkan Z.; Yıldırım N.; Ergün Y.; Akagündüz B.; Karakaya S.; Kut E.; Teker F.; Demirel B.Ç.; Karaboyun K.; Almuradova E.; Ünal O.Ü.; Oyman A.; Işık D.; Okutur K.; Öztosun B.; Gülbağcı B.B.; Kalender M.E.; Şahin E.; Seyyar M.; Özdemir Ö.; Selçukbiricik F.; Kanıtez M.; Dede İ.; Gümüş M.; Gökmen E.; Yaren A.; Menekşe S.; Ebinç S.; Aksoy S.; İmamoğlu G.İ.; Altınbaş M.; Çetin B.; Uluç B.O.; Er Ö.; Karadurmuş N.; Erdoğan A.P.; Artaç M.; Tanrıverdi Ö.; Çiçin İ.; Şendur M.A.N.; Oktay E.; Bayoğlu İ.V.; Paydaş S.; Aydıner A.; Salim D.K.; Geredeli Ç.; Yavuzşen T.; Doğan M.; Hacıbekiroğlu İ.Background: There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods: A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results: The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0–14.0) months in the ET arm of group A, and 5.3 (3.9–6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8–7.7) months in the ET arm of group B, and 5.7 (4.6–6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5–8.0) months in the ET arm of group C and 4.0 (3.5–4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion: Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET. © 2023, The Author(s).Item Correction: Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy (BMC Cancer, (2023), 23, 1, (136), 10.1186/s12885-023-10609-8)(BioMed Central Ltd, 2023) Karacin C.; Oksuzoglu B.; Demirci A.; Keskinkılıç M.; Baytemür N.K.; Yılmaz F.; Selvi O.; Erdem D.; Avşar E.; Paksoy N.; Demir N.; Göksu S.S.; Türker S.; Bayram E.; Çelebi A.; Yılmaz H.; Kuzu Ö.F.; Kahraman S.; Gökmen İ.; Sakin A.; Alkan A.; Nayır E.; Uğraklı M.; Acar Ö.; Ertürk İ.; Demir H.; Aslan F.; Sönmez Ö.; Korkmaz T.; Celayir Ö.M.; Karadağ İ.; Kayıkçıoğlu E.; Şakalar T.; Öktem İ.N.; Eren T.; Erul E.; Mocan E.E.; Kalkan Z.; Yıldırım N.; Ergün Y.; Akagündüz B.; Karakaya S.; Kut E.; Teker F.; Demirel B.Ç.; Karaboyun K.; Almuradova E.; Ünal O.Ü.; Oyman A.; Işık D.; Okutur K.; Öztosun B.; Gülbağcı B.B.; Kalender M.E.; Şahin E.; Seyyar M.; Özdemir Ö.; Selçukbiricik F.; Kanıtez M.; Dede İ.; Gümüş M.; Gökmen E.; Yaren A.; Menekşe S.; Ebinç S.; Aksoy S.; İmamoğlu G.İ.; Altınbaş M.; Çetin B.; Uluç B.O.; Er Ö.; Karadurmuş N.; Erdoğan A.P.; Artaç M.; Tanrıverdi Ö.; Çiçin İ.; Şendur M.A.N.; Oktay E.; Bayoğlu İ.V.; Paydaş S.; Aydıner A.; Salim D.K.; Geredeli Ç.; Yavuzşen T.; Doğan M.; Hacıbekiroğlu İ.Following publication of the original article [1], the authors reported an error in the author name of Enes Erul. Incorrect: Enes Urul Correct: Enes Erul, The original article [1] has been corrected. © 2023, The Author(s).Item Real-life comparison of afatinib and erlotinib in non-small cell lung cancer with rare EGFR exon 18 and exon 20 mutations: a Turkish Oncology Group (TOG) study(Springer Science and Business Media Deutschland GmbH, 2023) Gursoy P.; Tatli A.M.; Erdem D.; Goker E.; Celik E.; Demirci N.S.; Sakin A.; Atci M.M.; Bayram E.; Telli T.A.; Bilgin B.; Bilici A.; Akangunduz B.; Balli S.; Demirkazik A.; Selçukbiricik F.; Menekse S.; Cavdar E.; Ozturk A.; Bekmez E.T.; Turhal S.; Kilickap S.; Yildirim H.Ç.; Oyan B.; Aksoy A.; Turkoz F.P.; Kut E.; Katgi N.; Sakalar T.; Akyol M.; Ellez H.İ.; Topcu A.; Erdoğan A.P.; Pilanci K.N.; Hedem E.; Arak H.; Akdeniz N.; Alan Ö.; Yapar B.; Nart D.; Yumuk P.F.Objectives: To compare the survival of first- and second-generation tyrosine kinase inhibitors (TKIs) in patients with rare EGFR exon 18 and exon 20 mutation-positive non-small cell lung cancer (NSCLC). Materials and methods: We retrospectively evaluated survival characteristics of 125 patients with EGFR exon 18 and exon 20 mutated NSCLC who received erlotinib or afatinib as first line treatment between 2012 and 2021 from 34 oncology centres. Since exon 20 insertion is associated with TKI resistance, these 18 patients were excluded from the study. Results: EGFR exon 18 mutations were seen in 60%, exon 20 mutations in 16%, and complex mutations in 24% of the patients with NSCLC who were evaluated for the study. There were 75 patients in erlotinib treated arm and 50 patients in afatinib arm. Patients treated with erlotinib had progression-free survival time (PFS) of 8.0 months and PFS was 7.0 months in the afatinib arm (p = 0.869), while overall survival time (OS) was 20.0 vs 24.8 months, respectively (p = 0.190). PFS of exon 18 mutated arm was 7.0 months, exon 20 mutated arm was 4.3 months, and complex mutation positive group was 17.3 months, and this was statistically significant (p = 0.036). The longest OS was 32.5 months, seen in the complex mutations group, which was not statistically different than exon 18 and in exon 20 mutated groups (21.0 and 21.2 months, respectively) (p = 0.323). Conclusion: In this patient group, especially patients with complex mutations are as sensitive to EGFR TKI treatment similar to classical mutations, and in patients with rare exon 18 and exon 20 EGFR mutation both first- and second-generation EGFR-TKIs should be considered, especially as first- and second-line options. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Item The Confusion Caused by the Fear of COVID 19 in the Future of Cancer Patients(Ibn Sina Trust, 2023) Ekinci F.; Ateş G.A.; Erdoğan A.P.; Çelik C.; Dirican A.; Göksel G.Objective: The “centrality of events scale” (CES) was formed to determine to what extent this localisation of a traumatic memory is formed. The CES was used in this study to determine how overshadowed the cancer disease was by fear of COVID-19 in cancer patients or how centralised the cognitive trauma was in this patient group.Materials and Methods: In the first paragraph of the short 7-item CES, it was written, “Please think about the most stressful or traumatic event in your life”, then 3 options were given. These alternatives were: A) I am currently being treated here for my disease., B) I am likely to catch COVID-19 and C) Other. After marking one of these options, the subjects were instructed to mark their level of agreement with the 7 items as stated by Berntsen and Rubin, and thus this section was the same as the original questionnaire. To be able to evaluate the questionnaire results taking the disease characteristics into account, a record was made of age, gender, treatment history (chemotherapy and radiotherapy), current treatment (chemotherapy, hoemone therapy, immunotherapy, monoclonal antibodies, tyrosine kinase inhibitors) treatment aim (adjuvant, neoadjuvant, palliative), disease status on presentation (no spread, local, metastatic).The questionnaires were administered to all the cancer patients who presented at the oncology clinic between 1 April and 1 October 2020. Results:This study was conducted to seek an answer to this question, and it was seen that of a total of 523 patients diagnosed with cancer, the vast majority (n:368, 70.4%) saw the most traumatic and stressful event of their life as cancer, with the response to option A on the questionnaire. The possibility of contracting COVID-19 was selected by 83 (15.9%) patients as the most stressful or traumatic event in their life. The option of C was marked by 72 (13.8%) patients. This showed that neither cancer nor fear of coronavirus infection was strong enough to replace the traumatic event experienced and centred in the identity of these 72 patients. These traumas of the patients were analyzed with the mean CES points. The highest points were obtained by those who marked option A, at 3.71, which was statistically significantly higher than the 3.29 points for B and 3.29 points for C (p:0.004).Conclusion:A trauma left in the past actually lives on in the cognitive memory and may even be established at the centre of the self and personal identity. Thus, by modifying the short 7-item CES, developed by Berntsen and Rubin to be an objective, measurable format, the results of this study demonstratated both the extent to which the possibility of contracting COVID-19 has started to be established in cancer patients and the unshakable but declining centrality of cancer in the traumatic past. © 2023, Ibn Sina Trust. All rights reserved.Item The efficacy of palbociclib and ribociclib in the first-line treatment of metastatic hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer in male patients: a Turkish oncology group (TOG) study(Springer, 2024) Yıldırım H.Ç.; Kutlu Y.; Mutlu E.; Aykan M.B.; Korkmaz M.; Yalçın S.; Şakalar T.; Celayir Ö.M.; Kayıkçıoğlu E.; Aslan F.; Hafızoğlu E.; Altıntaş Y.E.; Keskinkılıç M.; Chalabiyev E.; Çelebi A.; Dursun B.; Kapar C.; Özen M.; Acar Ö.; Dülgar Ö.; Kut E.; Biter S.; Kus F.; Almuradova E.; Erdoğan A.P.; Saray S.; Güven D.C.; Şimşek E.T.; Üskent N.; Kemal Y.; Çakar B.; Açıkgöz Ö.; Kılıçkap S.; Aksoy S.Introduction: Male breast cancer, comprising approximately 1% of all breast cancer cases, often leads to the exclusion of male patients as a criterion in clinical trials. While the efficacy of Cyclin-dependent kinases 4 and 6 (CDK 4/6) inhibitors has been established in metastatic hormone receptor-positive (HR +) and human epidermal growth factor receptor 2-negative (HER2 −) breast cancer in women, limited data exist on their effectiveness in male patients. We aimed to evaluate the efficacy and safety of palbociclib or ribociclib in male patients with breast cancer. Methods: This study is a multicenter, retrospective study. We included male patients with HR + and HER2-metastatic breast cancer who received palbociclib or ribociclib as first-line treatment. Our primary endpoints were progression-free survival (PFS), overall response rates (ORR), and drug-related adverse effects. Results: A total of 46 male patients from 27 institutions were enrolled. The median age at initiation of CDK 4/6 inhibitors was 63.64 ± 13.69 years, with a median follow-up of 21.33 (95% CI 14.92–27.74) months. The ORR were 84% for palbociclib and 76.2% for ribociclib. The mPFS for the entire cohort was 28.06 months (95% CI 18.70–37.42). No significant difference in PFS was observed between palbociclib and ribociclib (mPFS: 24.46 months (95% CI 11.51–37.42) vs 28.33 months (95% CI 14.77–41.88), respectively, p = 0.211). No new adverse events were reported. Discussion: This study demonstrates that palbociclib and ribociclib are effective and safe options for first-line treatment in male patients with HR + /HER2 − metastatic breast cancer. However, further prospective studies are warranted to establish their efficacy in this population. © The Author(s) under exclusive licence to Japan Society of Clinical Oncology 2024.Item Biases and Reluctances Causing Cancer Patients in Dilemma for COVID-19 Vaccination(Ibn Sina Trust, 2024) Ekinci F.; Erdoğan A.P.; Göksel G.Background We have planned this study to determine opinions of this patient group, who are affected negatively both in physical aspect during the treatment process of cancer and who are fragile and sensitive for psycho-social aspects, their opposition level and misimpressions related to vaccine and for eliminating these reluctances if possible. Methods Between February 2021 and 15 April 2021, all cancer patients applying to our oncology clinic have been first asked to fill in the questionnaire, which includes three articles where suggestions expressing their attitude towards vaccination were asked and subsequently nine articles expressing suggestions about vaccine opposition Results According to responses to a decision for vaccination, we have learned that 446 (79,6%) patients thought to have the Covid-19 vaccine, 62 (11.1%) were hesitant, and 52 (9.3%) did not think to have a vaccine. Conclusions The most critical data obtained from this study is that there were severe biases related to adverse effects due to vaccines, although patients have a positive attitude about vaccination. The most important task of health authorities should be to eliminate reluctance without waiting for patients to take a more negative attitude on this subject. © 2024, Ibn Sina Trust. All rights reserved.