We aimed to assess the prognostic and predictive significance of pretreatment Prognostic Nutritional Index (PNI) in extensive-stage small-cell lung cancer (ES-SCLC) patients treated with first-line ...chemotherapy. We designed this study to evaluate the prognostic role of PNI in 147 ES-SCLC patients treated with platinum-based combination regimen between 2011 and 2018. Kaplan-Meier survival analyses and Cox proportional hazard models were used to examine the effects of basal PNI on overall survival (OS). The median age of the patients was 61 (range 38-81). The cutoff value for PNI was determined for whole group and patients were dichotomized into high (≥49.17) and low (<49.17). Seventy-eight (53.1%) patients had low PNI score and 69 (46.9%) patients had high PNI score. Patients with the high PNI score had better OS than those with low PNI (13 versus 12 months, respectively, and P = 0.03). The relationship between PNI score and OS was more prominent in patients over 65 years of age (13 versus 10 months, respectively, and P = 0.03). Progression-free survival of patients with complete response to first-line treatment was statistically significantly better than the other patients (8 versus 7 months, respectively, and P = 0.02). Similarly, OS was statistically significantly better than the other patients (15 versus 8 months, respectively, and P = 0.001). The results of our study show that PNI score is useful in evaluating the OS of patients with ES-SCLC. PNI is a cost-effective prognostic marker and should therefore be included in routine clinical practice.
Introduction
Osimertinib, an irreversible third-generation EGFR-TKI, is the standard of care for second-line treatment of T790M-mutant advanced NSCLC patients whose disease progressed after ...first-line EGFR-TKI therapy. In this multicenter study, we aimed to determine the real-life efficacy and safety of Osimertinib in pretreated advanced NSCLC patients with T790M mutation.
Materials and methods
This retrospective trial included advanced T790M-mutant pretreated NSCLC patients who received Osimertinib from 24 different centers in Turkey. Primary endpoint was time-to-treatment discontinuation (TTD). Secondary endpoints were objective response rate (ORR), overall survival (OS), and safety.
Results
Of 163 patients, 68.7% had EGFR exon 19 deletion and 22.7% had exon 21 L858R mutation. Osimertinib was given as second-line treatment in 96 patients (58.9%) and third-line in 48 patients (29.4%). After median of 13-month follow-up, median TTD was 21.6 months with an 82.2% ORR. Estimated median OS was 32.1 months. Grade 3–4 adverse events were seen in 11.7% of the patients.
Conclusion
Osimertinib is a highly effective option in second- or third-line treatment of NSCLC patients with T790M mutation, with a favorable safety profile.
The aim of this study is to evaluate the efficacy and toxicity of trastuzumab emtansine (T-DM1) in cases with metastatic breast cancer (mBC) in different lines of treatment.
Retrospective analysis of ...T-DM1 results of human epidermal growth factor receptor 2 (Her2) positive 414 cases with mBC from 31 centers in Turkey.
Except 2, all of the cases were female with a median age of 47. T-DM1 had been used as second-line therapy in 37.7% of the cases and the median number of T-DM1 cycles was 9. Progression-free survival (PFS) and overall survival (OS) times were different according to the line of treatment. The median OS was found as 43, 41, 46, 23 and 17 months for 1st, 2nd, 3rd, 4th and 5th line, respectively (p = 0.032) while the median PFS was found as 37, 12, 8, 8 and 8 months, respectively (p = 0.0001). Treatment was well tolerated by the patients. The most common grade 3-4 adverse effects were thrombocytopenia (2.7%) and increased serum gamma-glutamyl transferase (2%).
The best of our knowledge this is the largest real-life experience about the safety and efficacy of T-DM1 use in cases with mBC after progression of Her2 targeted treatment. This study suggests and supports that T-DM1 is more effective in earlier lines of treatment and is a reliable option for mBC.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Myelomatous pleural effusion (MPE) is very rare and has a very poor prognosis. The effusion is thought to be a late manifestation of the disease and MPE is a sign of aggressive behavior of the ...disease.
A 57 year old male admitted with back pain, fatigue and weight loss and he diagnosed as multiple myeloma (MM). He had back pain due to T11-12 vertebral involvement. The patient was given zoledronic acid plus 3 cycles of VAD chemotherapy (vincristine, adriamycin and dexamethasone) and received palliative radiotherapy to T11-12 vertebrae.
Typically, bone metastasis causes osteolytic and osteoblastic lesions resulting from the interactions of tumor cells with osteoclasts and osteoblasts. In addition to these interactions, tumor tissues ...may grow inside bones and cause mass lesions. In the present study, we aimed to demonstrate the negative impact of a tumor mass in a large cohort of patients with bone metastatic cancer.
Data from 335 patients with bone metastases were retrospectively reviewed. For the analysis, all patients were divided into three subgroups with respect to the type of bone metastasis: osteolytic, osteoblastic, or mixed. The patients were subsequently categorized as having bone metastasis with or without a tumor mass, and statistically significant differences in median survival and 2-year overall survival were observed between these patients (the median survival and 2-year overall survival were respectively 3 months and 16% in patients with a tumor mass and 11 months and 26% in patients without a tumor mass; p<0.001).
According to multivariate analysis, the presence of bone metastasis with a tumor mass was found to be an independent prognostic factor (p=0.011, hazard ratio: 1.62, 95% confidence interval: 1.11–1.76). Bone metastasis with a tumor mass was more strongly associated with osteolytic lesions, other primary diseases (except for primary breast and prostate cancers), and spinal cord compression.
Bone metastasis with a tumor mass is a strong and independent negative prognostic factor for survival in cancer patients.
OBJECTIVE Small cell lung cancer (SCLC) is the most aggressive type of lung cancer. Platinum-etoposide chemotherapy combination is used as first line treatment. The aim of this trial is evaluate the ...effect of complete response rates and clinical features in patients with extensive stage (ES) SCLC. METHODS In this retrospective study, a total of 117 patients from four different oncology centers in Turkey between 2011 and 2017 were divided into 2 groups, namely, patients with complete response (group 1) and those with no complete response (group 2) after platin-etoposide combination therapy. RESULTS The median age of the patients was 61 (range 38-81) years.The median follow-up time was 12 months and 95 (81%) patients died. Progression-free survival (PFS) and overall survival (OS) were estimated, respectively, as 8 and 13 months. Overall survival of group 1 patients was statistically significantly better than the group 2 (16 versus 10 months respectively and p=0.00). The overall survival of patients who had late recurrent disease (>6 mo.) was statistically significantly better than the early ones (<6 mo) (19 versus 14 months respectively and p=0,008). CONCLUSION Complete response and recurrent free time were the prognostic factors for ES SCLC patients in our study
The prognostic value of UHRF-1 and p53 in gastric cancer Babacan, Nalan A; Egilmez, Hatice Reyhan; Yücel, Birsen ...
Saudi journal of gastroenterology,
2016 Jan-Feb, 2016-00-00, 20160101, 2016-01-01, Letnik:
22, Številka:
1
Journal Article
Recenzirano
Odprti dostop
This study aimed to examine whether UHRF-1 and p53 overexpression is a prognostic marker for gastric cancer.
Sixty-four patients with gastric cancer (study group) and 23 patients with gastritis ...(control group) were evaluated. Immunohistochemistry was used to examine expression of UHRF-1 and p53 in gastric cancers and a control group diagnosed with gastritis.
The median age was 63 years (18-83 years) in the study group. UHRF-1 was positive in 15 (23%) patients with gastric cancer and fi ve (21.7%) patients with gastritis (P = 0.559). UHRF1 expression level in gastric cancer is more powerful than in gastritis (P = 0.046). Thirty-seven (61%) patients with gastric cancer and only one patient with gastritis were p53 positive (P < 0.001). After a median follow-up of 12 months (1-110), the 2-year overall survival rates were 55% and 30% in negative and positive p53, respectively (P = 0.084). Also, the 2-year overall survival rates were 45% and 53% in negative and positive UHRF-1, respectively (P = 0.132).
According to this study, UHRF-1 and p53 were not prognostic factors for gastric cancer, whereas they may have a diagnostic value for differentiating between gastric cancer and gastritis.
Trastuzumab and pertuzumab are monoclonal antibodies used for the treatment of breast cancer. Until now, there have been no reports on the use of pertuzumab during pregnancy and on its potential ...effects on the fetus. Herein, we present a breast cancer patient who received trastuzumab and pertuzumab treatment during the first 20 weeks of pregnancy. This 22-year-old patient initially diagnosed with invasive ductal carcinoma of the breast was found to be negative for estrogen receptor and progesterone receptor and positive for human epidermal growth factor receptor in the immunohistochemical examination. At the time of diagnosis, she had metastatic lesions and a protocol of docetaxel, trastuzumab, pertuzumab, q21, and zolendronic acid 4 mg every month was started. Following six courses of therapy, she had near-complete response, and, after administration of the same course of treatment for two additional cycles, treatment with pertuzumab plus trastuzumab was continued. While she was being followed-up with remission, a 20-week pregnancy was detected. A fetal ultrasound examination showed oligohydramnios and right renal agenesis. Treatment was stopped, and the fetus was monitored. After 7 weeks of follow-up, fetal growth retardation and anhydramnios were detected. The pregnancy was terminated. Fetal autopsy showed no urinary system pathology, but macroscopic and microscopic hyperplasia of the right adrenal gland was identified. Concomitant use of pertuzumab and trastuzumab during pregnancy may be associated with an unresolved oligohydramnios and/or anhydramnios risk. Extreme caution should be used when these monoclonal antibodies are administered during pregnancy.
PDF
