Browsing by Author "Turhal S."

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    The clinical and pathological features of 133 colorectal cancer patients with brain metastasis: a multicenter retrospective analysis of the Gastrointestinal Tumors Working Committee of the Turkish Oncology Group (TOG)
    (Humana Press Inc., 2014) Tanriverdi O.; Kaytan-Saglam E.; Ulger S.; Bayoglu I.V.; Turker I.; Ozturk-Topcu T.; Cokmert S.; Turhal S.; Oktay E.; Karabulut B.; Kilic D.; Kucukzeybek Y.; Oksuzoglu B.; Meydan N.; Kaya V.; Akman T.; Ibis K.; Saynak M.; Sen C.A.; Uysal-Sonmez O.; Pilancı K.N.; Demir G.; Saglam S.; Kocar M.; Menekse S.; Goksel G.; Yapar-Taskoylu B.; Yaren A.; Uyeturk U.; Avci N.; Denizli B.; Ilis-Temiz E.
    Brain metastasis in colorectal cancer is highly rare. In the present study, we aimed to determine the frequency of brain metastasis in colorectal cancer patients and to establish prognostic characteristics of colorectal cancer patients with brain metastasis. In this cross-sectional study, the medical files of colorectal cancer patients with brain metastases who were definitely diagnosed by histopathologically were retrospectively reviewed. Brain metastasis was detected in 2.7 % (n = 133) of 4,864 colorectal cancer patients. The majority of cases were male (53 %), older than 65 years (59 %), with rectum cancer (56 %), a poorly differentiated tumor (70 %); had adenocarcinoma histology (97 %), and metachronous metastasis (86 %); received chemotherapy at least once for metastatic disease before brain metastasis developed (72 %), had progression with lung metastasis before (51 %), and 26 % (n = 31) of patients with extracranial disease at time the diagnosis of brain metastasis had both lung and bone metastases. The mean follow-up duration was 51 months (range 5–92), and the mean survival was 25.8 months (95 % CI 20.4–29.3). Overall survival rates were 81 % in the first year, 42.3 % in the third year, and 15.7 % in the fifth year. In multiple variable analysis, the most important independent risk factor for overall survival was determined as the presence of lung metastasis (HR 1.43, 95 % CI 1.27–4.14; P = 0.012). Brain metastasis develops late in the period of colorectal cancer and prognosis in these patients is poor. However, early screening of brain metastases in patients with lung metastasis may improve survival outcomes with new treatment modalities. © 2014, Springer Science+Business Media New York.
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    A retrospective analysis on first-line bevacizumab, cetuximab, and panitumumab-containing regimens in patients with ras-wild metastatic colorectal cancer: A collaborative study by Turkish oncology group (tog)
    (Zerbinis Publications, 2019) Degirmencioglu S.; Tanriverdi O.; Menekse S.; Dogan M.; Hacioglu B.; Oktay E.; Erdem D.; Arpaci E.; Uluc B.O.; Turhal S.; Yilmaz M.; Pilanci K.N.; Sakin A.; Araz M.; Cokmert S.; Ozdemir O.; Sen E.; Nayir E.
    Purpose: To compare the efficacy and adverse effect profiles of the first-line treatment of patients with KRAS wild type metastatic colorectal cancer (CRC) in Turkey who were treated based on regimens including bevacizumab, cetuximab and panitumumab. Methods: This retrospective multicenter observational study involved a total of 238 patients who received chemotherapy in combination with either bevacizumab or cetuximab or panitumumab as first-line therapy for KRAS wild-type metastatic colorectal cancer. Patients with full medical records having pathological diagnosis of CRC adenocarcinoma were included in the study. The demographic, laboratory, histopathological and clinical characteristics of the patients were determined, and three groups were compared based on the study variables. Results: The mean age of the entire sample (n=238) was 58±11 years, 64% of which were male. The most frequent tumor localization was the rectum (37%) and G2 was the most common tumor grade (59.7%). About 63% of the patients had metastatic disease at diagnosis, with the most common site of metastasis being lung (14.7%) and liver (52.5%). Overall survival (OS) was 63.9%, while 1-, 3- And 5-year survival rates were 91.7, 56.6 and 36.9%, respectively. The expected mean survival was 49.1 months (95% CI, 42.9-55.3). The 1-, 3- And 5-year progression-free survival (PFS) rates following first-line treatment were 65.3, 26.1 and 5.6%, respectively, while disease free survival (DFS) in patients without metastasis at diagnosis was 68.5%. An analysis carried out disregarding which treatment the patients received (FOLFOX or FOLFIRI) revealed that a panitumumab-containing combination resulted in poorer prognosis compared to bevacizumab or cetuximab-containing combination (p<0.001). With regard to the adverse effect profile, the most common adverse effects were neuropathy and neutropenia in patients receiving FOLFOX-bevacizumab; neutropenia and perforation in patients receiving FOLFIRI-bevacizumab; rash and pustular infection in patients receiving FOLFIRI-cetuximab; and diarrhea in patients who received FOLFIRI-panitumumab combination. Conclusion: is the first multicenter study performed in Turkey evaluating the response to treatment and adverse effects in patients with KRAS wild-type metastatic colorectal cancer. © 2019 Zerbinis Publications. All Rights Reserved.
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    Efficacy and safety of folfiri plus aflibercept in second-line treatment of metastatic colorectal cancer: Real-life data from Turkish oncology group
    (Wolters Kluwer Medknow Publications, 2022) Erol C.; Sendur M.A.N.; Bilgetekin I.; Garbioglu D.B.; Hamdard J.; Akbas S.; Hizal M.; Arslan C.; Sevinc A.; Kucukarda A.; Erdem D.; Kahraman S.; Cakir E.; Demirkiran A.; On S.; Dogan I.; Erdogan A.P.; Koca S.; Kubilay P.; Eren O.O.; Cilbir E.; Celik E.; Araz M.; Ozyukseler D.T.; Yildirim M.E.; Bahceci A.; Taskaynatan H.; Oyman A.; Deniz G.I.; Menekse S.; Kut E.; Gulmez A.; Sakin A.; Nayir E.; Acar R.; Sen E.; Inal A.; Turhal S.; Kaya A.O.; Paydas S.; Tastekin D.; Hacibekiroglu I.; Cincin I.; Bilici A.; Mandel N.M.; Dede D.S.; Akinci M.B.; Oksuzoglu B.; Uncu D.; Yalcin B.; Artac1 M.
    Aims: The addition of aflibercept to the fluorouracil and irinotecan (FOLFIRI) regimen significantly improved clinical outcomes in patients with metastatic colorectal cancer (CRC) previously treated with oxaliplatin. We aimed to investigate the efficacy and safety of second-line FOLFIRI and aflibercept combination in patients with metastatic CRC in real-life experience. Materials and Methods: Four hundred and thirty-three patients who treated with FOLFIRI and aflibercept in the second-line were included in the study. The clinical and pathological features of the patients were recorded retrospectively. Survival (overall and progression-free survival [PFS]), response rates, and safety data were analyzed. Results: The median age was 61. Majority of patients (87.5%) received first-line bevacizumab and 10.1% of patients received anti-epidermal growth factor receptor agents. About 80% of patients had KRAS, 18.6% of patients had NRAS, and 6.4% of patients had BRAF mutations. The median OS was 11.6 months (95% confidence interval [CI], 10.6-12.6) and the median PFS was 6 months (95% CI, 5.5-6.5). About 4.6% of patients had complete response and 30.6% of patients had partial response as best tumor response. Grade 1-2 toxicities were seen in 33.4% of patients, while grade 3-4 toxicities were recorded in 27% of patients. Eight patients (2%) died due to treatment toxicity. Conclusions: Overall and PFS were similar in routine clinical practice compared to phase III pivotal VELOUR trial. However, response rates were found to be higher. It was observed that there were fewer adverse events compared to the VELOUR trial. © 2022 Authors. All rights reserved.
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    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.
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    The Effectiveness of Adjuvant PD-1 Inhibitors in Patients with Surgically Resected Stage III/IV Acral Melanoma
    (Lippincott Williams and Wilkins, 2024) Arak H.; Erkiliç S.; Yaslikaya Ş.; Eylemer Mocan E.; Aktaş G.; Özdemir M.; Semiz H.S.; Kiliçkap S.; Özalp F.R.; Sever Ö.N.; Akdaǧ G.; Aǧaoǧlu A.B.; Özçelik M.; Sari M.; Arcagök M.; Anik H.; Yayla Ş.B.; Sever N.; Açar F.P.; Bayrakçi İ.; Turhal S.; Ayhan M.; Kuş T.
    Our aim was to assess the efficacy of adjuvant programmed cell death protein-1 (PD-1) inhibitors and compare the other adjuvant treatments in patients with surgically resected stage III or IV acral melanoma. This study is a multicenter, retrospective analysis. We included 114 patients with stage III or IV acral malignant melanoma who underwent surgery within the past 10 years. We analyzed the effect of adjuvant programmed cell death protein-1 inhibitors on disease-free survival (DFS). The mean follow-up was 40 months, during which 69 (59.5%) patients experienced recurrence. Among the participants, 64 (56.1%) received systemic adjuvant therapy. Specifically, 48.4% received anti-PD-1 therapy, 29.7% received interferon, 14.1% received tezozolomide, and 7.8% received B-Raf proto-oncogene/mitogen-activated protein kinase inhibitors. Patients who received adjuvant therapy had a median DFS of 24 (10.9-37.2) months, whereas those who did not receive adjuvant therapy had a median DFS of 15 (9.8-20.2) months. Multivariate analysis for DFS revealed that the receipt of adjuvant therapy and lymph node metastasis stage were independent significant parameters (P = 0.021, P = 0.018, respectively). No statistically significant difference was observed for DFS between programmed cell death protein-1 inhibitor treatment and other adjuvant treatments. Regarding overall survival (OS), patients who received adjuvant treatment had a median OS of 71 (30.4-111.7) months, whereas those who did not receive adjuvant treatment had a median OS of 38 (16.7-59.3; P = 0.023) months. In addition, there were no significant differences in OS observed between various adjuvant treatment agents (P = 0.122). In our study, we have shown that adjuvant therapy had a positive effect on both DFS and OS in patients with stages III-IV acral melanoma who underwent curative intent surgery. Notably, we found no significant differences between anti-PD-1 therapy and other adjuvant therapies. © 2024 Lippincott Williams and Wilkins. All rights reserved.
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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
    (Taylor and Francis Ltd., 2025) Yildirim H.C.; Kapar C.; Koksal B.; Seyyar M.; Sanci P.C.; Guliyev M.; Perkin P.; Buyukkor M.; Yaslikaya S.; Majidova N.; Keskinkilic M.; Ozaskin D.; Avci T.; Gunes T.K.; Arcagok M.; Topal A.; Keskin G.S.Y.; Kavgaci G.; Yildirim N.; Celayir O.M.; Avci N.; Aslan F.; Alkan A.; Erciyestepe M.; Cengiz M.; Pehlivan M.; Gulmez A.; Beypinar I.; Basoglu Tuylu T.; Kayikcioglu E.; Chalabiyev E.; Turhal S.; Guzel H.G.; Ayas E.; Sahbazlar M.; Dulgar O.; Demir H.; Yavuzsen T.; Bayoglu V.; Kivrak Salim D.; Ozturk B.; Ozdemir F.; Kara O.; Oksuzoglu B.; Bal O.; Demirci N.S.; 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. © 2024 Edizioni Scientifiche per l'Informazione su Farmaci e Terapia (Italian Society of Chemotherapy).