Colorectal cancer is one of the leading causes of mortality both globally and in our country. In Turkey, we conducted a multicenter investigation into the effectiveness of second-line treatments and ...real-life data for patients with RAS wild-type metastatic colorectal cancer (NCT04757311).
In this retrospective analysis, records from 28 centers were collected, and histopathological, molecular, and clinical characteristics were documented. Patients were categorized into groups based on their second-line biological treatments: anti-EGFR (Group A and Group B, panitumumab and cetuximab) and anti-VEGF (Group C, bevacizumab and aflibercept). They were then compared within these groups.
A total of 588 patients with documented RAS wild-type status were evaluated. The median OS was 15.7, 14.3 and 14.7 months in Group A, Group B and Group C, respectively (
= 0.764). The median PFS of the patients in second-line setting that received panitumumab, cetuximab and bevacizumab/aflibercept were 7.8, 6.6 and 7.4 months, respectively (
= 0.848).
According to the results of our real-life data study, there is no significant difference in efficiency between the combination of biological agent and chemotherapy used in the second-line treatments.
Neoadjuvant chemotherapy is the standard front-line treatment modality in locally advanced breast cancer. Achieving pathological complete response (pCR) is a significant prognostic factor for ...prolonged disease-free and overall survival. Insulin resistance is defined as a pathological condition in which insulin effect is impaired in peripheral target tissues such as the skeletal muscle, liver, and adipose tissue. The relationship between breast cancer and insulin resistance is controversial. In this study, our aim is to evaluate the role of insulin resistance, body mass index (BMI), metabolic syndrome, and inflammation markers to predict complete response in breast cancer patients who underwent neoadjuvant treatment.
Data from 55 locally advanced non-diabetic breast cancer patients, treated with neoadjuvant chemotherapy between 2015 and 2017, were retrospectively evaluated. Homeostatic model assessment, IR = insulin resistance (HOMA-IR) was calculated by using the obtained insulin and fasting blood glucose values before neoadjuvant chemotherapy (fasting insulin × fasting glucose/405). We considered a cut-off of 2.5 for insulin resistance. The systemic inflammatory index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were calculated.
Twenty-five patients had no insulin resistance. The most common pathologic subtype (56%) was hormone receptor (HR) positive and human epidermal growth factor receptor-2 (Her-2)-negative invasive ductal carcinoma. Sixteen (29%) patients had a pathological complete response (pCR). We found that the probability of pCR in patients with insulin resistance was 4.7 times lower than that in patients without insulin resistance OR: 4.7 (95%CI 1.7-17.2), p = 0.01.
Our results revealed that insulin resistance may have a negative effect on pathological complete response (pCR) following neoadjuvant therapy particularly with hormone-positive and Her-2-negative cases of non-diabetic breast cancer.
The purpose of this study was to determine whether primary tumor localization may be a risk factor for relapse and survival in seminomatous germ cell tumors (GCT) patients.
In our study, 612 ...seminomatous GCT patients diagnosed in 22 centers between 01.01.1989 and 03.02.2019 were retrospectively evaluated. Patient interview information, patient files and electronic system data were used for the study.
The primary tumor was localized in the right testis in 305 (49.9%) patients and in 307 (50.1%) in the left testis. Mean age of the patients was 36 years (range 16-85±10.4). The median follow-up period was 47 months (1-298). Recurrence was observed in 78 (12.7%) patients and 29 (4.7%) died during the follow-up period. Four-year overall survival (OS) was 95.4% and 4-year progression-free survival (PFS) was 84.5%. The relationship between localization and relapse was significant in 197 patients with stage 2 and stage 3 (p=0.003). In this patient group, 41 (20.8%) relapses were observed. Thirty (73.2%) of the relapses were in the right testis and 11 (26.8%) in the left testis. Four-year OS was 92.1% in patients with right tumor; and 98.7% in patients with left tumor (p=0.007). When 612 patients were evaluated with a mean follow-up of 4 years, there was a 6.6% survival advantage in patients with left testicular tumor and this difference was significant (p=0.007).
Survival rates of patients with primary right testicular localization were worse compared with left testicular localization, and relapse rates were higher in stage 2 and 3 patients with right testicular localization.
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Background: Although neoadjuvant treatment has been standart approach in gastric cancer with the positive results of randomized controlled studies in recent years, neoadjuvant ...treatment approach rates are far below the expectations in our country. We aimed to evaluate neoadjuvant treatment approaches and results of gastric cancer patients in this retrospective study. Methods: We evaluated characteristics and survival outcomes of 54 patients that were operated after neoadjuvant systemic treatment out of 1,143 gastric cancer patients recorded in our database. Results: The median follow-up was 12 months in this study. 38% of the patients was female and the median age was 61 (24-78). While 46 % of the tumors were located in gastro-esophagial junction and cardia, others were located distally. All of the patients treated with neoadjuvant treatment had positive lymph nodes. While lymphatic and perineural invasion were detected in 67% of the patients, vascular invasion was detected in 39 % of the patients after the operation. While 43 % of the patients had grade 3 tumors, others had grade 1-2 tumors. R0 resection was achieved in 91% of the patients and D2 dissection was done in 82% of the patients. FOLFOX/XELOX, DCF/DCX, EOX/ECF and FLOT were applied as neoadjuvant treatment regimes in 19%, 50%, 21% and 11% of the patients respectively. The median chemotherapy cycle number was 3 applied pre and postoperatively. The disease control rate (response or stable disease) was achieved in 75,9 % of the patients after the neoadjuvant chemotherapy. In 13 patients progressive disease was detected and these patients were not operated. We found the median disease free survival was 25 months and overall survival was 41 months in survival analysis. Three year DFS was 29 % and 3 year OS was 52 %. Conclusions: Neoadjuvant treatment approach is important both to facilitate operation procedure and to evaluate efficacy of systemic treatment. As the survival advantage was shown in a study last year, FLOT regime is expected to be used more commonly. The patients have to be evaluated and the treatment decisions should be made in a multidisiplinary tumor board including surgeon, radiologist, medical oncologist to provide optimal treatment benefit.
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