Browsing by Author "Sahbazlar, M"
Now showing 1 - 9 of 9
Results Per Page
Sort Options
Item Clinical and pathological features of breast cancer patients in the geriatric populationAcar,Ö; Sahbazlar, MPurpose: A significant portion of patients diagnosed with breast cancer are over the age of 65. Elderly patients are often excluded from prospective clinical trials due to comorbidities. Clinicians have different treatment management options for elderly patients. Under-treatment or over-treatment may negatively affect treatment outcomes and prognosis. There are few data to guide treatment decisions. We present the clinical and pathological features of elderly breast cancer patients followed in our cancer center. Materials and Methods: A retrospective review of files about surgically treated patients with breast cancer was conducted. The prognostic impact on overall survival and progression-free survival was assessed. Results: The study encompassed a total of 101 patients. The median age was 67 (65-81) years. Approximately half of the patients were classified as TNM stage 2. The majority of them had undergone modified radical mastectomy. 15.8% received neoadjuvant chemotherapy. 84.2% had invasive ductal carcinoma histological subtype. progression-free survival was lower in patients receiving neoadjuvant chemotherapy with pathological N3 lymph nodes and in HER2-positive patients. The 5-year survival rate was 61.7% in patients with N3 pathological lymph nodes, 91% in those with N2 pathological lymph nodes, and 100% in patients with N1 or N0 pathological lymph nodes. Conclusion: The pathological stage was associated with survival. The presence of pathological N3 lymph nodes resulted in lower progression-free survival and lower overall survival. Regardless of age, patients with good performance, who are not frail, and who have no comorbidities should be encouraged to receive current therapy.Item Real-Life Efficacy of Palbociclib and Ribociclib in Advanced Breast CancerAvci, T; Sahbazlar, M; Ekinci, F; Erdogan, APBackground: Clinical trials in metastatic hormone receptor-positive (HR+) human epidermal growth factor receptor-2 (HER2)-negative patients have shown that cyclin-dependent kinase 4/6 (CDK 4/6) inhibitors both increase response rates and provide survival benefits. The efficacy of these therapies needs to be supported by real-life data. In this study, we aimed to evaluate treatment response, survival and affecting factors in patients with HR+/HER2- metastatic breast cancer (MBC) who were followed up with CDK 4/6 inhibitors in our center. Materials and methods: A retrospective analysis of 120 patients with HR+/HER2- MBC treated with ribociclib or palbociclib in combination with letrozole or fulvestrant was performed. Results: Median progression-free survival (mPFS) was 24 months in the general population, 27 months in the ribociclib arm and 20 months in the palbociclib arm, with no significant difference in progression-free survival (PFS) in both arms (p = 0.25). The mPFS was longer in the ribociclib + letrozole arm compared to palbociclib + letrozole (27 vs. 20 months, respectively). PFS was also longer in patients receiving ribociclib + fulvestrant compared to palbociclib + fulvestrant but not statistically significant (33 vs. 21 months, respectively). Median overall survival (mOS) was not reached, but 3-year overall survival (OS) was statistically significantly longer in the ribociclib arm (87% vs. 55.5%, respectively, p = 0.03). Conclusion: Palbociclib and ribociclib are first-line treatment options for metastatic HR+/HER2- disease and have similar efficacy. In our study, while the mPFS was not statistically significant in both arms, the 3-year OS rate was higher in the ribociclib arm and statistically significant. Our findings were confirmed in randomized studies comparing both agents head-to-head.Item Real-Life Data of Neoadjuvant Chemotherapy in Breast Cancer: Aegean Region ExperienceErdogan, AP; Ekinci, F; Özveren, A; Eniseler, EB; Demir, B; Sahbazlar, MObjective: The use of neoadjuvant chemotherapy (NACT) in breast cancer is increasing. However the management of locally advanced breast cancer differs due to the approach of the center to which the patient applied and the approach of the following physician. From this point of view, we aimed to evaluate the real life data of our region. Methods: The study included 106 patients treated with NACT in the medical oncology clinic of two different university hospitals. Association between clinicopathological features and pathological complete response (pCR) were analyzed. Results: The pCR rate was higher in patients with negative hormone receptors and this difference was statistically significant (p:0.000). The rate of obtaining pCR increased as the NACT duration increased, and this increase was statistically significant. The mean NACT duration applied to the patients with pCR was 5.48 +/- 0.22 months, and the mean NACT duration for those who could not obtain pCR was 5.01 +/- 0.1 months (p:0.041). The recurrence rate of patients with pCR was 11.1%, while the recurrence rate of patients who could not obtain pCR was 31.6% (p:0.04). Conclusion: Pathological response to chemotherapy is an important factor in determining prognosis. There appears to be a need for new biomarkers that allow the prediction of pCR and long-term outcomes.Item Investigating the Correlation Between Long-Term Response in Patients with Metastatic HER2+Breast Cancer and the Activity of Regulatory T Cells: A Retrospective StudyDegirmenci, M; Diniz, G; Kahraman, DS; Sahbazlar, M; Koral, L; Varol, U; Uslu, RBackground: Trastuzumab is commonly utilized in the management of metastatic HER2-positive breast cancer. Our main goal was to examine the clinical outcomes and immune markers of patients who received trastuzumab and chemotherapy treatment. Methods: Between 1995 and 2012, a total of 98 patients diagnosed with metastatic HER2-positive breast cancer were retrospectively analyzed at Ege University Hospital and Tepecik Training and Research Hospital. The clinicopathological characteristics and clinical outcomes of the patients were assessed, and the associations between response rates, survival and the immune profiles of tumor infiltrating lymphocytes were statistically evaluated. Results: The average age of patients at the time of diagnosis was 50.1 +/- 10.3 (ranging from 30 to 79) years. The mean follow-up period for all patients was 97.9 +/- 53.8 months. Among the patients, complete response was observed in 24.5%, partial response in 61.2%, and stable disease in 8.2% of cases. The average progression-free survival was 50.3 +/- 26.9 months (ranging from 1 to 163 months), and the average overall survival was 88.8 +/- 59.4 months (ranging from 12 to 272 months). After analyzing all cases, it was found that patients who were younger (p=0.006), exhibited higher CD3-positivity (p=0.041), presented with higher FOXP3-positivity (p=0.025), showed complete or at least partial response to treatment (p=0.008), and experienced a long-term response to trastuzumab (and chemotherapy) treatment had longer survival (p=0.001). Conclusion: Patients with HER2-positive breast cancer, who initially respond positively to palliative trastuzumab and chemotherapy treatment, can achieve long-term tumor remission lasting for several years.Item Regorafenib Treatment for Recurrent Glioblastoma Beyond Bevacizumab-Based Therapy: A Large, Multicenter, Real-Life StudyTünbekici, 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, PBackground/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.Item Prognostic Factors in High Grade Osteosarcoma Patients Who Received Neoadjuvant Therapy and Subsequently Underwent Surgery: Data from the Turkish Oncology GroupSever, 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, IVBackground: 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.Item Efficacy of everolimus plus hormonal treatment after cyclin-dependent kinase inhibitor; real-life experience, A TOG studyBeypinar, I; Demir, H; Yaslikaya, S; Köseci, T; Demir, B; Çolak, G; Agaoglu, AB; Sahbazlar, M; Sanci, PC; Cabuk, D; Isik, U; Sahin, E; Coskun, A; Caner, B; Aykut, T; Artac, M; Duygulu, ME; Sever, N; Öksüz, S; Turan, N; Aykan, MB; Tüzün, EK; Uysal, M; Ugurlu, I; Sakin, A; Acar, C; Özaskin, D; Sakalar, T; Keskinkilic, M; Yavuzsen, T; Köse, N; Ertürk, I; Yildirim, N; Balçik, OY; Alkan, A; Selvi, O; Ercin, E; Ünal, OU; Karaçin, CPurpose In advanced breast cancer, endocrine therapy is preferred in the absence of visceral crisis. Cyclin-dependent kinase inhibitors (CDKi) are the gold standards. The selection of subsequent treatments after CDKi treatment is still controversial, and the efficacy of everolimus (EVE) combinations is unknown. In this study, we aimed to investigate the efficacy of EVE after CDKi administration in real-life experiences. Method The study received data from 208 patients from 26 cancer centers. Demographic and histologic features, diagnosis, progression, last visit dates, and toxicities were recorded. This study was a retrospective case series. Results One hundred and seven patients received palbociclib, while 101 patients received ribociclib as a CDKi. The overall response and disease control rates of EVE combinations were 60% and 88%, respectively. In univariate analysis, the absence of liver metastasis, age > 40 years, better type of response, and immediate treatment after CDKi were related to increased progression-free survival. Liver metastasis and response type were significantly associated with overall survival. In the multivariate analysis, response remained significant in terms of progression-free survival, while response type, liver metastatic disease, and hematologic toxicity were prognostic in terms of overall survival. Conclusion This study provides evidence of the benefits of EVE combinations after CDKi treatment. EVE combinations may be more appropriate for patients with non-liver metastasis, and the first treatment response shows the benefit of treatment. In addition, immediate treatment after CDKi treatment is more beneficial than later lines of treatment.Item The prognostic impact of Her2 status in early triple negative breast cancer: a Turkish Oncology Group (TOG) studyÖzyurt, N; Alkan, A; Gülbagci, B; Seyyar, M; Aydin, E; Sahbazlar, M; Türker, M; Kinikoglu, O; Yerlikaya, T; Dinç, G; Aytaç, A; Kalkan, Z; Ebinç, S; Gültürk, I; Keskinkiliç, M; Isleyen, ZS; Çaglayan, D; Türkel, A; Aydin, E; Sakalar, T; Sekmek, S; Yildirim, N; Koçak, S; Okutur, K; Özveren, A; Dursun, B; Kitapli, S; Eren, OÖ; Beypinar, I; Hacibekiroglu, I; Çabuk, D; Karaman, E; Acar, Ö; Paydas, S; Eryilmaz, MK; Demir, B; Oruç, Z; Yilmaz, M; Biricik, FS; Salim, DK; Tanriverdi, Ö; Dogan, MThe studies evaluating the impact of Her2 levels in neoadjuvant setting have conflicting data. The aim of the study was to evaluate the prognostic impact of Her2 status in early triple negative breast cancer(TNBC). In the study TNBC patients who were treated with neoadjuvant chemotherapy (NAC) and surgery were analyzed retrospectively. The primary aim of the study was to analyze the impact of Her2 status(Her2-0 and Her2-low) on pathological complete response (pCR). The secondary objectives were disease free survival (DFS) and overall survival (OS). 620 female triple negative breast cancer patients were evaluated. 427 patients (68.9%) had Her2-0 and 193(31.1%) had her2-low pathology. The pCR rates were similar between Her2-0 and Her2-low patients (33.0% vs. 27.5%, p = 0.098). Although Her2-0 group has better DFS (106 vs. 50 months, p = 0.002), in multivariate analysis it had a HR of 0.74 (p = 0.06). In addition, OS was similar (131 vs. 105 months, p = 0.13) with a HR of 0.88 (p = 0.61). In multivariate analysis; presence of LVI (HR:2.2 (95% CI 1.1-3.5) p = 0.001), Clinical stage T1/T2 (HR:0.39 (95% CI 0.2-0.6) p < 0.001) and lymph node negativity (HR:0.35 (95% CI 0.1-0.9) p = 0.03) were independent factors for OS. Although there were pathological and clinical differences, the pCR, DFS and OS were similar between Her2-0 and Her2-low TNBC patients. The importance of Her2 status of TNBC in neoadjuvant setting should be further studied.Item 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) studyYildirim, 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, SThe 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.