Browsing by Author "Yildirim, HC"

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    Clinical outcomes of cyclin-dependent kinase 4-6 (CDK 4-6) inhibitors in patients with male breast cancer: A multicenter study
    Yildirim, HC; Mutlu, E; Chalabiyev, E; Özen, M; Keskinkiliç, M; Ön, S; Çelebi, A; Dursun, B; Acar, O; Kahraman, S; Aykan, MB; Kaman, O; Dogan, A; Erdogan, AP; Celayir, OM; Günenç, D; Güven, DC; Bayoglu, IV; Yavuzsen, T; Hacibekiroglu, I; Inanç, M; Kiliçkap, S; Yalçin, S; Aksoy, S
    Background: Since breast cancer is less common in men than in women, data on the use of new therapeutic agents, including cyclin-dependent kinase 4-6 (CDK 4-6) inhibitors, are limited in patients with metastatic hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) male breast cancer. Therefore; we aimed to investigate the treatment responses of metastatic HR+, HER2-male breast cancer patients treated with CDK 4-6 inhibitors in a multicenter real-life cohort. Methods: Male patients with a diagnosis of HR+ and HER2-metastatic breast cancer, treated with any CDK 4-6 inhibitor, were included in the study. Demographic and clinical characteristics of the patients were recorded. We aimed to determine progression-free survival (PFS) time, response rates and drug related side effects. Results: A total 25 patients from 14 institutions were recruited. The mean age at diagnosis was 57 years. Median follow-up was 19.53 (95% CI: 14.04-25.02) months. The overall response rate was 60%. While the median PFS was 20.6 months in the whole cohort, it wasn't reached in those using CDK 4-6 inhibitors in first line and 10 months in the subsequent lines (p:0.009). No new adverse events were encountered. Conclusion: In our study, we found that CDK 4-6 inhibitors are effective and safe options in men with HR+ and HER2-metastatic breast cancer as in women. Our results support the use of CDK 4-6 inhibitor-based combinations in the first-line treatment of HR+ and HER2-metastatic male breast cancer.
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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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    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
    Gursoy, P; Tatli, AM; Erdem, D; Goker, E; Celik, E; Demirci, NS; Sakin, A; Atci, MM; Bayram, E; Telli, TA; Bilgin, B; Bilici, A; Akangunduz, B; Balli, S; Demirkazik, A; Selçukbiricik, F; Menekse, S; Cavdar, E; Ozturk, A; Bekmez, ET; Turhal, S; Kilickap, S; Yildirim, HC; Oyan, B; Aksoy, A; Turkoz, FP; Kut, E; Katgi, N; Sakalar, T; Akyol, M; Ellez, HI; Topcu, A; Erdogan, AP; Pilanci, KN; Hedem, E; Arak, H; Akdeniz, N; Alan, Ö; Yapar, B; Nart, D; Yumuk, PF
    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.
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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.