Browsing by Author "Sönmez M."

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    Health professionals' opinions and attitudes on induced abortus; [Saǧlik profesyonellerinin istemli düşükle ilgili görüş ve Tutumlar]
    (Ortadog u Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2016) Altan S.; Rahman S.; Sönmez M.; NazIk F.; Çame S.
    Objective: The induced abortions include ethical issues related to women, health professionals and society at different levels. The aim of this study was to determine the views and attitude of health personnel on induced abortion. Material and Methods: This study was carried out on the doctors and nurses who have been worked at the Bitlis State Hospital and Celal Bayar University Hafsa Sultan Hospital, in Manisa. A total of 309 health care providers who agree to fill out the questionnaire were included in the study. Results: Staff's 63.4% indicated that the induced abortions one of the ethical issues in reproductive health. The rate of people are considered that termination of life of the fetus is no different from terminated for any man's life was 63.8%. The rate of people are stated that abortions should not be used as a method of family planning was 72.8%. The rate of "No matter what the reason is that you should not apply abortion" was 10.4%. The rate of "The abortion was applied if the pregnancy occurs as a result of rape" was 56.0%. The 55.7% of staff considered that the abortion could applied if the sex workers becomes pregnant. The rate of people are considered that "If the anomalyis detected in the fetus during pregnancy, the abortion should be made" was 52.8%. 48.2% of respondents said that abortion should only be applied at state institutions. The percentage of those who thought that easy access to abortion facilities will increase risky sexual behavior and reduce the use of family planning methods is 50.2%. 47.2% of the health staff indicated that it was not required to participate in abortion as long as they did not want. 76.9% of the physicians, 56.2% of the nurses stated that the induced abortion is one of the ethical issues in reproductive health (p<0.05). 64.4% of women, 62.1% of men stated that the termination of the life of the fetus was not different from the termination of any human life (p<0.05). Conclusion: A large proportion of health care providers participating in the study stated that the implementation of induced abortions only should applied in case of medical necessity. The clarification of health staff especially about the ethical and legal perspective of induced abortion will be eligible. © Copyright 2016 by Türkiye Klinikleri.
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    Prognostic factors in patients with metastatic urothelial carcinoma who have treated with Atezolizumab
    (Springer Japan, 2021) Tural D.; Ölmez Ö.F.; Sümbül A.T.; Özhan N.; Çakar B.; Köstek O.; Ekenel M.; Erman M.; Coşkun H.Ş.; Selçukbiricik F.; Keskin Ö.; Türköz F.P.; Oruç K.; Bayram S.; 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.; Artaç M.
    Background: Atezolizumab (ATZ) has demonstrated antitumor activity and manageable safety in previous studies of patients with metastatic platinum-resistant urothelial carcinoma. However, the response rate of Atezolizumab was modest. In the current study, we evaluated the pretreatment prognostic factors for overall survival in patients with metastatic urothelial carcinoma who have progressed after first-line chemotherapy in the Expanded-Access Program of Atezolizumab. Patients and methods: In this study, we present a retrospective analysis of 113 patients with urothelial cancer treated with ATZ after progression on first-line chemotherapy. Data of the patients was obtained from patient files and hospital records. Eligible patients included metastatic urothelial carcinoma patients treated with at least one course of ATZ. Univariate analysis was used to identify clinical and laboratory factors that significantly impact OS. Variables were retained for multivariate analysis if they had a statistical relationship with OS (p < 0.1), and then included a final model of p < 0.05. Results: The median follow-up duration was 23.5 months. Of the patients, 98 (86.7%) were male and 13.3% were female. The median age was 65 years of age (37–86). In univariate analysis, primary tumor location in the upper tract, increasing absolute neutrophil count (ANC), increasing absolute lymphocyte count, neutrophil-to-lymphocyte ratio (NLR) > 3, liver metastases, baseline creatinine clearance less (GFR) than 60 ml/min, Eastern Cooperative Oncology Group (ECOG) performance status (1 ≥), and hemoglobin levels below 10 mg/dl were all the significantly associated with OS. Three of the five adverse prognostic factors according to the Bellmunt criteria were independent of short survival: liver metastases HR 3.105; 95% CI 1.673–5.761; p < (0.001), ECOG PS (1 ≥) HR 2.184; 95% CI 1.120–4.256; p = 0.022, and Hemoglobin level below 10 mg/dl HR 2.680; 95% CI 1.558–4.608; p < (0.001). In addition, NLR > 3 hazard ratio [HR] 2.092; 95% CI 1.031–4.243; p = 0.041 and GFR less than 60 ml/min HR 1.829; 95% CI 1.1–3.041; p = 0.02, maintained a significant association with OS in multivariate analysis. Conclusions: This model confirms the Bellmunt model with the addition of NLR > 3 and GFR less than 60 ml/min and can be associated with clinical trials that use immunotherapy in patients with bladder cancer. © 2021, Japan Society of Clinical Oncology.
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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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    Efficacy and safety of ruxolitinib in patients with myelofibrosis: A retrospective and multicenter experience in turkey
    (Turkiye Klinikleri, 2021) Soyer N.; Ali R.; Turgut M.; Haznedaroğlu İ.C.; Yilmaz F.; Aydoğdu İ.; Pir A.; Karakuş V.; Özgür G.; Kiş C.; Ceran F.; Ilhan G.; Özkan M.; Aslaner M.; Ince İ.; Yavaşoğlu İ.; Gediz F.; Sönmez M.; Güvenç B.; Özet G.; Kaya E.; Vural F.; Şahin F.; Töbü M.; Durusoy R.; Saydam G.
    Background/aim: The aim of this study is to assess the efficacy and safety of ruxolitinib in patients with myelofibrosis. Materials and methods: From 15 centers, 176 patients (53.4% male, 46.6% female) were retrospectively evaluated. Results: The median age at ruxolitinib initiation was 62 (28–87) and 100 (56.8%) of all were diagnosed as PMF. Constitutional symptoms were observed in 84.7%. The median initiation dose of ruxolitinib was 30 mg (10–40). Dose change was made in 69 (39.2%) patients. Forty seven (35.6%) and 20 (15.2%) of 132 patients had hematological and nonhematological adverse events, respectively. The mean spleen sizes before and after ruxolitinib treatment were 219.67 ± 46.79 mm versus 199.49 ± 40.95 mm, respectively (p < 0.001). There was no correlation between baseline features and subsequent spleen response. Overall survival at 1-year was 89.5% and the median follow up was 10 (1–55) months. We could not show any relationship between survival and reduction in spleen size (p = 0.73). Conclusion: We found ruxolitinib to be safe, well tolerated, and effective in real-life clinical practice in Turkey. Ruxolitinib dose titration can provide better responses in terms of not only clinical benefit but also for long term of ruxolitinib treatment. © TÜBİTAK.
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    Efficacy and Safety of Ibrutinib Therapy in Patients with Chronic Lymphocytic Leukemia: Retrospective Analysis of Real-Life Data; [Kronik Lenfositik Lösemili Hastalarda İbrutinib Tedavisinin Etkililiği ve Güvenilirliği: Gerçek Hayat Verilerinin Retrospektif Analizi]
    (Turkish Society of Hematology, 2021) Tombak A.; Tanrıkulu F.P.; Durusoy S.S.; Dinçyürek H.D.; Kaya E.; Ümit E.G.; Yavaşoğlu İ.; Mehtap Ö.; Deveci B.; Özcan M.A.; Terzi H.; Okay M.; Sayınalp N.; Yılmaz M.; Okan V.; Kızıklı A.; Özcan Ö.; Çetin G.; Demircioğlu S.; Aydoğdu İ.; Saydam G.; Davulcu E.A.; İlhan G.; Uçar M.A.; Özet G.; Akpınar S.; Turgut B.; Berber İ.; Kurtoğlu E.; Sönmez M.; Batur D.S.; Yıldırım R.; Özkocamaz V.; Güneş A.K.; Sahip B.; Ertop Ş.; Akay O.M.; Baştürk A.; Doğu M.H.; Akdeniz A.; Ünal A.; Seyhanlı A.; Gürkan E.; Çekdemir D.; Ferhanoğlu B.
    Objective: This study aimed to retrospectively evaluate the efficacy, safety, and survival outcome of single-agent ibrutinib therapy in chronic lymphocytic leukemia patients. Materials and Methods: A total of 136 patients (mean age ± standard deviation: 64.6±10.3 years, 66.9% males) who had received at least one dose of ibrutinib were included in this retrospective multicenter, noninterventional hospital-registry study conducted at 33 centers across Turkey. Data on patient demographics, baseline characteristics, laboratory findings, and leukemia-cell cytogenetics were retrieved. Treatment response, survival outcome including overall survival (OS) and progression-free survival (PFS), and safety data were analyzed. Results: Overall, 36.7% of patients were categorized as Eastern Cooperative Oncology Group (ECOG) class 2-3, while 44.9% were in Rai stage 4. Fluorescence in situ hybridization revealed the presence of del(17p) in 39.8% of the patients. Patients received a median of 2.0 (range: 0-7) lines of pre-ibrutinib therapy. Median duration of therapy was 8.8 months (range: 0.4-58.0 months). The 1-year PFS and OS rates were 82.2% and 84.6%, respectively, while median PFS time was 30.0 (standard error, 95% confidence interval: 5.1, 20.0-40.0) months and median OS time was 37.9 (3.2, 31.5-44.2) months. Treatment response (complete or partial response), PFS time, and OS time were better with 0-2 lines versus 3-7 lines of prior therapy (p<0.001, p=0.001, and p<0.001, respectively), with ECOG class 0-1 versus class 2-3 (p=0.006, p=0.011, and p=0.001, respectively), and with Rai stage 0-2 versus 3-4 (p=0.002, p=0.001, and p=0.002, respectively). No significant difference was noted in treatment response rates or survival outcome with respect to the presence of comorbidity, bulky disease, or del(17p). While 176 adverse events (AEs) were reported in 74 (54.4%) patients, 46 of those 176 AEs were grade 3-4, including pneumonia (n=12), neutropenia (n=11), anemia (n=5), thrombocytopenia (n=5), and fever (n=5). Conclusion: This real-life analysis confirms the favorable efficacy and safety profile of long-term ibrutinib treatment while emphasizing the potential adverse impacts of poorer ECOG performance status, heavy treatment prior to ibrutinib, and advanced Rai stage on patient compliance, treatment response, and survival outcomes. © 2021 by Turkish Society of Hematology Turkish Journal of Hematology, Published by Galenos Publishing House.