Browsing by Author "Turhal N.S."

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    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.
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    Treatment efficacy of ribociclib or palbociclib plus letrozole in hormone receptor-positive/HER2-negative metastatic breast cancer
    (Newlands Press Ltd, 2023) Kahraman S.; Erul E.; Seyyar M.; Gumusay O.; Bayram E.; Demirel B.C.; Acar O.; Aksoy S.; Baytemur N.K.; Sahin E.; Cabuk D.; Basaran G.; Paydas S.; Yaren A.; Guven D.C.; Erdogan A.P.; Demirci U.; Yasar A.; Bayoglu İ.V.; Hizal M.; Gulbagci B.; Paksoy N.; Davarci S.E.; Yilmaz F.; Dogan O.; Orhan S.O.; Kayikcioglu E.; Aytac A.; Keskinkilic M.; Mocan E.E.; Unal O.U.; Aydin E.; Yucel H.; Isik D.; Eren O.; Uluc B.O.; Ozcelik M.; Hacibekiroglu I.; Aydiner A.; Demir H.; Oksuzoglu B.; Cilbir E.; Cubukcu E.; Cetin B.; Oktay E.; Erol C.; Okutur S.K.; Yildirim N.; Alkan A.; Selcukbiricik F.; Aksoy A.; Karakas Y.; Ozkanli G.; Duman B.B.; Aydin D.; Dulgar O.; Er M.M.; Teker F.; Yavuzsen T.; Aykan M.B.; Inal A.; Iriagac Y.; Kalkan N.O.; Keser M.; Sakalar T.; Menekse S.; Kut E.; Bilgin B.; Karaoglanoglu M.; Sunar V.; Ozdemir O.; Turhal N.S.; Karadurmus N.; Yalcin B.; Nahit Sendur M.A.
    Background: Ribociclib, palbociclib and abemaciclib are currently approved CDK4/6 inhibitors along with aromatase inhibitors as the first-line standard-of-care for patients with hormone receptor-positive, HER2-negative metastatic breast cancer. Methods: The authors report retrospective real-life data for 600 patients with estrogen receptor- and/or progesterone receptor-positive and HER2-negative metastatic breast cancer who were treated with ribociclib and palbociclib in combination with letrozole. Results & conclusion: The results demonstrated that the combination of palbociclib or ribociclib with letrozole has similar progression-free survival and overall survival benefit in real life for the patient group with similar clinical features. Specifically, endocrine sensitivity may be a factor to be considered in the treatment preference. © 2023 Future Medicine Ltd.
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    Can Cytoreductive Nephrectomy Improve Outcomes of Nivolumab Treatment in Patients with Metastatic Clear-Cell Renal Carcinoma?
    (Multidisciplinary Digital Publishing Institute (MDPI), 2024) Ocak B.; Sahin A.B.; Ertürk I.; Korkmaz M.; Erdem D.; Cakıroglu U.; Karaca M.; Dirican A.; Olmez O.F.; Goktas Aydın S.; Gökyer A.; Kücükarda A.; Gülmez A.; Yumuk P.F.; Demircan N.C.; Oyman A.; Sakalar T.; Karatas F.; Demir H.; Yasin A.I.; Deligonul A.; Dakiki B.; Goktug M.R.; Avcı O.; Tacar S.Y.; Turhal N.S.; Deniz G.I.; Kacan T.; Cubukcu E.; Evrensel T.
    Background: This study aimed to investigate the effect of cytoreductive nephrectomy (CN) on the survival outcomes of nivolumab used as a subsequent therapy after the failure of at least one anti-vascular endothelial growth factor (VEGF) agent in patients with metastatic clear-cell renal-cell carcinoma (ccRCC). Methods: We included 106 de novo metastatic ccRCC patients who received nivolumab after progression on at least one anti-VEGF agent. Multivariate Cox regression analysis was performed to investigate the factors affecting survival in patients receiving nivolumab. Results: Of the 106 de novo metastatic ccRCC patients, 83 (78.3%) underwent CN. There were no statistical differences between the two groups in terms of age, gender, Eastern Cooperative Oncology Group (ECOG) score, tumor size, International Metastatic RCC Database Consortium (IMDC) risk group, number of previous treatment lines, first-line anti-VEGF therapy, or metastasis sites (p = 0.137, p = 0.608, p = 0.100, p = 0.376, p = 0.185, p = 0.776, p = 0.350, and p = 0.608, respectively). The patients who received nivolumab with CN had a longer time to treatment discontinuation (TTD) [14.5 months, 95% confidence interval (CI): 8.6–20.3] than did those without CN 6.7 months (95% CI: 3.9–9.5) (p = 0.001). The median overall survival (OS) was 22.7 months (95% CI: 16.1–29.4). The patients with CN had a median OS of 22.9 months (95% CI: 16.3–29.4), while those without CN had a median OS of 8.1 months (95% CI: 5.6–10.5) (p = 0.104). In the multivariate analysis, CN [hazard ratio (HR): 0.521; 95% CI: 0.297–0.916; p = 0.024] and the IMDC risk score (p = 0.011) were statistically significant factors affecting TTD; however, the IMDC risk score (p = 0.006) was the only significant factor for overall survival. Conclusions: Our study showed that the TTD of nivolumab was longer in metastatic ccRCC patients who underwent cytoreductive nephrectomy. © 2024 by the authors.
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    The real-world outcomes of Lutetium-177 PSMA-617 radioligand therapy in metastatic castration-resistant prostate cancer: Turkish Oncology Group multicenter study
    (John Wiley and Sons Inc, 2024) Almuradova E.; Seyyar M.; Arak H.; Tamer F.; Kefeli U.; Koca S.; Sen E.; Telli T.A.; Karatas F.; Gokmen I.; Turhal N.S.; Sakalar T.; Ayhan M.; Ekinci F.; Hafizoglu E.; Kahraman S.; Kesen O.; Unal C.; Alan O.; Celik S.; Yekeduz E.; Omur O.; Gokmen E.
    Metastatic castration-resistant prostate cancer (mCRPC) remains a challenging condition to treat despite recent advancements. This retrospective study aimed to assess the activity and tolerability of Lutetium-177 (Lu-177) PSMA-617 radioligand therapy (RLT) in mCRPC patients across multiple cancer centers in Turkey. The study included 165 patients who received at least one cycle of Lu-177 PSMA-617 RLT, with the majority having bone metastases and undergone prior treatments. Prostate-specific antigen (PSA) levels were assessed before each treatment cycle, and the biochemical response was evaluated in accordance with the Prostate Cancer Work Group 3 Criteria. The PSA decline of ≥50% was classified as a response, while an increase of ≥25% in PSA levels was indicative of progressive disease. Neither response nor progression was considered as stable disease. The Lu-177 PSMA-617 RLT led to a significant PSA response, with 50.6% of patients achieving a >50% decrease in PSA levels. Median overall survival (OS) and progression-free survival were 13.5 and 8.2 months, respectively. Patients receiving Lu-177 PSMA-617 RLT in combination with androgen receptor pathway inhibitors (ARPIs) had a higher OS compared to those receiving Lu-177 PSMA-617 RLT alone (18.2 vs 12.3 months, P =.265). The treatment was generally well-tolerated, with manageable side effects such as anemia and thrombocytopenia. This study provides real-world evidence supporting the effectiveness and safety of Lu-177 PSMA-617 RLT in mCRPC patients, particularly when used in combination with ARPIs. These findings contribute to the growing body of evidence on the potential benefits of PSMA-targeted therapies in advanced prostate cancer. © 2023 UICC.
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    Activity of CDK4/6 inhibitors and parameters affecting survival in elderly patients in age-subgroups: Turkish Oncology Group (TOG) retrospective study
    (BioMed Central Ltd, 2024) Kahraman S.; Hizal M.; Demirel B.C.; Guven D.C.; Gumusay O.; Uluc B.O.; Bayram E.; Gulbagci B.; Yasar A.; Davarci S.E.; Mocan E.E.; Acar O.; Isik D.; Aydin E.; Karakas Y.; Ozcelik M.; Keser M.; Okutur S.K.; Eren O.; Menekse S.; Aydin D.; Yilmaz F.; Dogan O.; Ozkanli G.; Yucel H.; Sunar V.; Aykan M.B.; Ozdemir O.; Duman B.B.; Keskinkilic M.; Sakalar T.; Inal A.; Karaoglanoglu M.; Aksoy A.; Er M.M.; Turhal N.S.; Kalkan N.O.; Sendur M.A.N.
    Highly selective inhibitors of cyclin-dependent kinase 4 and 6 (CDK4/6is) have emerged as a standart of care for first- and second-line therapies in combination with endocrine therapy (ET) for HR+/HER2- metastatic breast cancer (MBC) patients. It has been reported that combination therapy is more effective than ET alone and is safe in elderly patients as well as young patients. Nevertheless, elderly and very old patients with HR+/HER2-MBC treated with CDK4/6 inhibitor (CDK4/6i) combinations are relatively underrepresented in randomized controlled trials. To contribute to the literature, we investigated the real-world efficacy, factors associated with survival and the rates of adverse events (AEs) of the treatment with palbociclib or ribociclib plus ET in the HR+/HER2- MBC patient cohort over the age of 65 for age subgroups. In this retrospective study, 348 patients were divided into subgroups: 65–69 years old, 70–79 years old and 80 years and older. Median PFS (mPFS) for whole group was 18.3 (95% CI,14.3–22.3) months. There was no significant difference in mPFS between age groups (p = 0.75). The estimated median OS (mOS) was 39.5 (95% CI, 24.9–54.1) months and there was no significant difference between age groups (p = 0.15). There was a meaningfull numerical difference that did not reach statistical significance in patients who received CDK4/6i treatment as the first line for MBC. Grade 3–4 AEs were reported in 42.7% for the entire group, and neutropenia was the most common (37.3%). It can be concluded that combination therapy with palbociclib or ribociclib with an ET partner has similar efficacy and is safe among subgroups of older patients diagnosed with HR+/HER2-MBC. © The Author(s) 2024.