•Integrating targeted next generation sequencing (NGS) with traditional diagnostic tools can lead to more precise diagnosis, enhanced identification of molecular markers, and offers the potential of ...using targeted therapies for patients.•Our integrated analysis by applying NGS findings led to a change in patient management in which evidence-based targeted therapy was used for one of our patients with BRAF V600E mutation-positive astroblastoma.•Integrating findings from NGS and traditional diagnostic tools can thus have profound implications on patients with glioma.
Adult gliomas vary significantly in terms of their genetics, epigenetics, phenotypes as well as clinical outcomes 1. Optimal tumor classification that leads to more precise diagnoses, and which influences therapy selection is hence critically important. Targeted next-generation sequencing (NGS) is a highly reliable and efficient novel tool for the identification of biomarkers for the diagnosis of CNS tumors 2. In this study, we aimed to determine the implications of integrating NGS findings with the traditional diagnostic data on clinical diagnostics and patient management. All patients who were diagnosed with glioma at our institution between 2019 and 2020 and whose tumor biopsy materials were analyzed by both traditional histomorphological and immunohistochemical diagnostic techniques as well as NGS were included in our study. Patients’ information was retrieved from the electronic medical record. Data analyzed included the histopathologic diagnosis, tumor grade, ki67, and the mutation status of TP53 and /or IDH, as well as other genes such as BRAF and HER2 for some patients. The overall concordance between NGS and the traditional diagnostic tools for IDH and TP53 mutations was also evaluated. Further, we derived the overall survival of patients using the Kaplan–Meier estimate. We identified 9 patients with grade 3-4 gliomas whose biopsy materials were analyzed by NGS as well as traditional diagnostic tools. Our patients were 33.3 % females and had a median age of 43 years old at diagnosis. In terms of the identification of gene mutations by NGS in comparison to immunohistochemistry (IHC), it was found that the concordance for mutant identification was 77.8 % (7/9) for IDH mutations and 55.6 % (5/9) for TP53 mutations. NGS further led to a change in patient management in which evidence-based targeted therapy (dabrafenib plus trametinib) was used for one patient (11.1 %) with BRAF V600E mutated astroblastoma. Integrating NGS with traditional diagnostic tools for the diagnosis of gliomas can have significant implications on patients. Such integrated diagnosis can lead to more precise diagnosis, enhanced identification of molecular markers, and offers the potential of using targeted therapies for patients.
Pancreas cancer (PCa) is one of the mortal cancer types with ranking as fourth leading cancer death in both sexes together. FOLFIRINOX (FFX) and Gemcitabine plus nab-paclitaxel (GNP) are approved as ...first-line metastatic treatment in PCa. The aim of this study was to compare the clinical outcomes, treated with FFX and GNP as first-line metastatic PCa. Medical records of patients diagnosed with metastatic PCa, from January 2010 to December 2020 were analyzed. This study was a retrospective cohort, multi-institution analysis. The focus of the present study was to compare the efficiency of FFX and GNP chemotherapy combinations in the first-line treatment of PCa. Efficacy had been measured by progression-free survival (PFS) and overall survival (OS). 182 patients diagnosed with PCa receiving metastatic first-line treatment were retrospectively analyzed. Patients were divided into two groups one hundred and three (56.6%) patients treated with FFX and seventy-nine (43.4%) patients treated with GNP. Patients in the FFX group were younger and had a better ECOG performance status. Overall response rate (ORR) was 69.9% in FFX and 37.9% in GNP group (p: 0.000). Disease control rate (DCR) was 73.7% in patients treated with FFX and 39.2% in GNP group (p: 0.000). The median PFS was 8.3 months (FFX 9.1 vs. GNP 6.7, HR = 0.25, 95% CI: 0.16-0.38) the median OS was 12.2 months (FFX 14.1 vs. GNP 9.6, HR = 0.48, 95% CI: 0.31-0.72). Guidelines recommend both FFX and GNP regimens as a first-line treatment of metastatic PCa. In clinical routine, it is still unclear which regiment is more effective. The present study showed increased survival parameters with FFX versus GNP with similar toxicity profiles.
The treatment of gastroesophageal junction tumors remains controversial due to confusion on whether they should be considered as primary esophageal or as gastric tumors. The incidence of these tumors ...with poor prognosis has increased, thus creating scientific interest on gastroesophageal cancers. Esophagogastric cancers are classified according to their location by Siewert, and the treatment of each type varies. We evaluated the prognostic factors and differences in clinicopathologic factors of patients with gastroesophageal junction tumor, who have been treated and followed-up in our clinics.
We retrospectively analyzed 187 patients with gastroesophageal junction tumors who have been operated and treated in the Oncology Department between 2005 and 2014. The chi-square test was used to evaluate differences in clinicopathologic factors among Siewert groups I, II and III. Prognostic factors were analyzed by univariate and multivariate analysis.
The median age of our patients was 62 years, and approximately 70% was male. Nineteen patients (10.2%) had Siewert I tumors, 40 (21.4%) II, and the remaining 128 (64.4%) had Siewert III tumors. Siewert III tumors were at more advanced pathologic and T stages. Preoperative chemoradiotherapy was mostly applied to Siewert group I patients. There was no difference between the 3 groups in terms of recurrence. While the median overall survival and 2-year overall survival rate were 26.6 months and 39.6%, the median disease free survival and disease free survival rates were 16.5 months and 30.1%, respectively. The N stage, pathologic stage, vascular invasion, lymphatic invasion, perineural invasion, surgical margin, and grade were associated with both overall survival and disease free survival, while pathologic stage and presence of recurrence were significant factors for overall survival. The median disease free survival for Siewert III tumors was 20 months, 11.3 month for Siewert I tumors, and 14 months for Siewert II tumors, but the finding was not statistically significant (p=0.08).
Although gastroesophageal junction tumors were grouped according to their location and they exerted different clinicopathologic properties, their prognosis was similar.
Triple-negative-breast-cancer (TNBC) has a poor prognosis if pathologic complete response (pCR) cannot be achieved following neoadjuvant chemotherapy (NAC). The group of patients that benefit most ...from adjuvant capecitabine remains unclear.
We analyzed data of 160 consecutive patients with residual TNBC from eight cancer-center. Pathologic response was defined into two groups as having good-pathologic-response (MillerPayneGrading (MPG) IV-III) or poor-pathologic-response (MPG I-II). The characteristics of patients were compared regarding adjuvant capecitabine usage.
Univariate-analysis revealed that age, histology, clinical-stage, tumor-size, lymph-nodes number, menopausal status, and pathological-stage were significantly different between two groups. In multivariate-analysis, menopausal status (p = 0.043) and residual tumor-size (p < 0.001) were found to be independent prognostic factors for pathological response. The hazard-ratio for disease recurrence and death in the poor-response group with adjuvant capecitabine was 2.94 (95% confidence-interval (CI), 1.21 to 7.10; p = 0.016) and 4.080 (95% CI, 1.22 to 13.64; p = 0.022), respectively. DFS (p = 0.58) and OS (p = 0.89) improvements with adjuvant capecitabine were not demonstrated in good-response groups.
This multicenter-study suggested that only the poor-response group to NAC achieved benefit from adjuvant capecitabine. Postmenopausal status and residual tumor-size were related to poor prognosis.
Chronic infections with hepatitis C virus (HCV) are frequently pronounced in the etiology of malignancies especially in hepatocellular carcinoma. The association between HCV and risk of renal cell ...carcinoma (RCC) development has been stated recently. The authors retrospectively evaluated hepatitis serology for HCV and HBV in patients who had RCC diagnosis between 2005 and 2010 in six oncology centers. Control group was also included from the three different published studies that hepatitis serology studied in healthy people that has been living in the same geographic regions. Histologically confirmed 903 RCC cases and 5,267 healthy subjects were included the study. Median age at diagnosis of RCC was 58 (range: 26–89). There was no increase in HCV positivity in RCC patients compared to healthy control group (1.7 vs. 1.5%;
P
= 0.77). Frequency of HBsAg positivity was 4.4 and 4.1% in RCC and control groups, respectively (
P
= 0.65). There is no increase in frequency of HCV and HBsAg positivity in RCC patients. HCV positivity in RCC patients were not different from the healthy people.
Amaç: Akciğer kanserinde cinsiyet, tümör tipi ve diğer klinik özelliklerin sıklık ve mortalitedeki artışa sebep olduğu belirtilmiştir. Çalışmamızda, akciğer kanserli hastalarda klinik ve patolojik ...özelliklerin sağkalım üzerine etkilerini araştırdık. Hastalar ve Yöntem: Merkezimizde 2005-2012 yılları arasında akciğer kanseri tanısı almış 1031 olgunun dosyaları geriye dönük olarak incelendi. Bulgular: Kadınlarda en sık rastlanan akciğer kanseri tipi adenokarsinom (%42,2), erkeklerde en sık rastlanan tip skuamöz hücreli karsinom (% 41,5) olarak bulundu. Akciğer kanserinin sigara ile ilişkisinde, tiplendirilemeyen küçük hücreli dışı akciğer kanseri hariç, diğer akciğer kanseri hücreleri analiz edildiğinde,sigara içenlerde en sık skuamöz hücreli tip (%40,7) ve sigara içmeyenlerde ise en sık histopatolojik tanı adenokarsinom (% 39,8) olarak bulundu ve istatiksel olarak anlamlı bir ilişki saptandı. Tüm grup için medyan sağkalım süresi 12,09 ay olarak saptandı. Tek değişkenli analizlerde 60 yaşın altında olma, Doğu Kooperatif Onkoloji Grubu Performans Skoru (The Eastern Cooperative Oncology Group Performance Score- (ECOG PS))’na göre iyi performans durumu (0-1), % 5’den az kilo kaybı, primer tümörün büyüklüğü, metastaz olmaması ve erken evre hastalık faktörlerinin sağkalımı olumlu etkilediği saptandı. Çok değişkenli analizlerde sağkalımı olumlu etkileyen faktörler iyi performans durumu ve % 5’den az kilo kaybı olarak bulundu. Sonuç: Çalışmamız sonucunda, akciğer kanserinde cinsiyetler arasında histopatoloji tipinin farklılık gösterdiği saptandı. Sigara da histopatoloji tipini etkilemektedir. Ancak, cinsiyet, tümörün histopatoloji tipi ve sigara ile sağkalım arasında istatistiksel bir ilişkisi gösterilememiştir.
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