Browsing by Author "Majidova, N"

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    Regorafenib Treatment for Recurrent Glioblastoma Beyond Bevacizumab-Based Therapy: A Large, Multicenter, Real-Life Study
    Tünbekici, S; Yuksel, HC; Acar, C; Sahin, G; Orman, S; Majidova, N; Coskun, A; Seyyar, M; Dilek, MS; Kara, M; Disli, AK; Demir, T; Kolkiran, N; Sahbazlar, M; Demirciler, E; Kus, F; Aytac, A; Menekse, S; Yucel, H; Biter, S; Koseci, T; Unsal, A; Ozveren, A; Sevinc, A; Goker, E; Gürsoy, P
    Background/Objectives: In the REGOMA trial, regorafenib demonstrated an overall survival advantage over lomustine, and it has become a recommended treatment for recurrent glioblastoma in guidelines. This study aimed to evaluate the effectiveness and safety of regorafenib as a third-line treatment for patients with recurrent glioblastoma who progressed while taking bevacizumab-based therapy. Methods: This retrospective, multicenter study in Turkey included 65 patients treated between 2021 and 2023 across 19 oncology centers. The main inclusion criteria were histologically confirmed isocitrate dehydrogenase (IDH)-wildtype glioblastoma, progression after second-line bevacizumab-based treatment, and an Eastern Cooperative Oncology Group (ECOG) performance status score of <= 2. Patients received regorafenib 160 mg once daily for the first 3 weeks of each 4-week cycle. Results: The median age of the patients was 53 years (18-67 years), with a median progression-free survival of 2.5 months (95% Confidence Interval: 2.23-2.75) and a median overall survival of 4.1 months (95% CI: 3.52-4.68). The median overall survival was improved in patients who received subsequent therapy after regorafenib treatment compared with those who did not (p = 0.022). Progression-free survival was longer in patients with ECOG 0-1 than in those with ECOG 2 (p = 0.042). The safety profile was consistent with that of the REGOMA trial, with no drug-related deaths observed. Conclusions: Regorafenib shows good efficacy and safety as a third-line treatment for recurrent glioblastoma after bevacizumab-based therapy. This study supports the use of regorafenib and emphasizes the need for further randomized studies to validate its role and optimize treatment strategies.
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    Prognostic Factors in High Grade Osteosarcoma Patients Who Received Neoadjuvant Therapy and Subsequently Underwent Surgery: Data from the Turkish Oncology Group
    Sever, N; Simsek, F; Onur, ID; Arvas, H; Guliyev, T; Sakalar, T; Çiçek, CM; Orman, S; Çetin, EB; Kayas, K; Akbas, S; Agyol, Y; Güren, AK; Erel, P; Kocaaslan, E; Paçaci, B; Tunç, MA; Çelebi, A; Majidova, N; Durnali, A; Simsek, M; Sahbazlar, M; Isik, S; Arikan, R; Ercelep, Ö; Sari, M; Köstek, O; Bayogu, IV
    Background: Osteosarcoma is a rare but aggressive bone malignancy. Despite advances in multimodal therapy, survival remains suboptimal, highlighting the need for prognostic markers to guide treatment. Methods: This study included 162 osteosarcoma patients who received neoadjuvant chemotherapy followed by surgery between January 2009 and March 2024. Patients received either double (cisplatin + doxorubicin) or triple (MAP or PEI) chemotherapy. Survival analyses were conducted using Kaplan-Meier curves, log-rank tests, and Cox proportional hazards models. Results: The median age was 20 years (IQR: 18-29), and 53.1% were male. Patients who received triple chemotherapy regimens demonstrated significantly longer overall survival (OS) compared to those on doublet regimens. High tumor necrosis rates (>90%) and negative surgical margins were strongly associated with improved OS, while metastatic disease at diagnosis, elevated alkaline phosphatase (ALP), and male gender were linked to poorer survival. Multivariate analysis identified adjuvant therapy, age under 18, high necrosis rate, negative margins, and normal ALP as significant OS predictors. Conclusions: Triple-agent chemotherapy, necrosis rate >= 90 and negative surgical margins are strongly associated with prolonged survival in osteosarcoma. The key prognostic indicators such as ALP levels, surgical margins and age at diagnosis should guide personalized treatment strategies to improve outcomes in curable patients.
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    Comparison of the efficacy of sunitinib and pazopanib in patients with advanced non-clear renal cell carcinoma
    Yildirim, HC; Bayram, E; Chalabiyev, E; Majidova, N; Avci, T; Güzel, HG; Kapar, C; Uzun, M; Perkin, P; Akgül, F; Yildirim, SS; Sali, S; Yildiz, A; Kazaz, SN; Hendem, E; Arcagok, M; Tufan, G; Yildirim, U; Akgul, OF; Arslan, C; Taban, H; Sahin, E; Caglayan, M; Esen, R; Öksüzoglu, B; Guven, DC; Kaplan, MA; Araz, M; Basaran, M; Cubukcu, E; Gokmen, E; Cicin, I; Algin, E; Semiz, HS; Tural, D; Ozturk, B; Erdogan, AP; Sari, M; Kara, O; Erman, M
    Non-clear cell renal cell carcinoma (non-ccRCC) is a highly heterogeneous disease group, accounting for approximately 25% of all RCC cases. Due to its rarity and especially heterogeneity, phase III trial data is limited and treatment options generally follow those of clear cell RCC. In the literature, there exists a number of studies with sunitinib, cabozantinib, and everolimus, but data on the efficacy of pazopanib are limited. Our aim in this study was to compare the efficacy of pazopanib and sunitinib, in a multicenter retrospective cohort of non-ccRCC patients. Our study included patients diagnosed with non-ccRCC who received pazopanib or sunitinib treatment as first-line therapy from 22 tertiary hospitals. We compared the progression-free survival (PFS), overall survival (OS), and response rates of pazopanib and sunitinib treatments. Additionally, we investigated prognostic factors in non-ccRCC. PFS and response rates of sunitinib and pazopanib were found to be similar, while a numerical difference was observed in OS. Being 65 years and older, being in the intermediate or poor risk group according to the International Metastatic Renal Cell Carcinoma Database Consortium, having liver metastases, presence of a sarcomatoid component, and having de novo metastatic disease were found to be significantly associated with shorter PFS. Pazopanib treatment appears to have similar efficacy in the treatment of non-ccRCC compared to sunitinib. Though randomized controlled trials are lacking and will probably be never be available, we suggest that pazopanib could be a preferred agent like sunitinib and cabozantinib. Pazopanib and sunitinib treatments show similar progression free survival, overall survival and objective response rate.IMDC risk group, liver metastasis, sarcomatoid component and de novo metastatic disease were determined as prognostic factors
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    Efficacy of first-line CDK 4-6 inhibitors in premenopausal patients with metastatic breast cancer and the effect of dose reduction due to treatment-related neutropenia on efficacy: a Turkish Oncology Group (TOG) study
    Yildirim, HC; Kapar, C; Koksal, B; Seyyar, M; Sanci, PC; Guliyev, M; Perkin, P; Buyukkor, M; Yaslikaya, S; Majidova, N; Keskinkilic, M; Ozaskin, D; Avci, T; Gunes, TK; Arcagok, M; Topal, A; Keskin, GSY; Kavgaci, G; Yildirim, N; Celayir, OM; Avci, N; Aslan, F; Alkan, A; Erciyestepe, M; Cengiz, M; Pehlivan, M; Gulmez, A; Beypinar, I; Tuylu, TB; Kayikcioglu, E; Chalabiyev, E; Turhal, S; Guzel, HG; Ayas, E; Sahbazlar, M; Dulgar, O; Demir, H; Yavuzsen, T; Bayoglu, V; Salim, DK; Ozturk, B; Ozdemir, F; Kara, O; Oksuzoglu, B; Bal, O; Demirci, NS; Yilmaz, M; Cabuk, D; Aksoy, S
    The only phase 3 study on the effectiveness of CDK 4-6 inhibitors in first-line treatment in premenopausal patients with hormone receptor (HR) positive, HER2 negative metastatic breast cancer is the MONALEESA-7 study, and data on the effectiveness of palbociclib is limited. Data are also limited regarding the effectiveness of CDK 4-6 inhibitors in patients whose dose was reduced due to neutropenia, the most common side effect of CDK 4-6 inhibitors. In our study, we aimed to evaluate the effectiveness of palbociclib and ribociclib in first-line treatment in patients with premenopausal metastatic breast cancer and the effect of dose reduction due to neutropenia on progression-free survival. Our study is a multicenter, retrospective study, and factors affecting progression-free survival (PFS) were examined in patients diagnosed with metastatic premenopausal breast cancer from 29 different centers and receiving combination therapy containing palbociclib or ribociclib in the metastatic stage. 319 patients were included in the study. The mPFS for patients treated with palbociclib was 26.83 months, and for those receiving ribociclib, the mPFS was 29.86 months (p = 0.924). mPFS was 32.00 months in patients who received a reduced dose, and mPFS was 25.96 months in patients who could take the initial dose, and there was no statistical difference (p = 0.238). Liver metastasis, using a fulvestrant together with a CDK 4-6 inhibitor, ECOG PS 1 was found to be a negative prognostic factor. No new adverse events were observed. In our study, we found PFS over 27 months in patients diagnosed with premenopausal breast cancer with CDK 4-6 inhibitors used in first-line treatment, similar to post-menopausal patients. We did not detect any difference between the effectiveness of the two CDK 4-6 inhibitors, and we showed that there was no decrease in the effectiveness of the CDK 4-6 inhibitor in patients whose dose was reduced due to neutropenia.