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.
Cancer was a common noncommunicable disease in Syria before the present conflict and is now a major disease burden among 3.6 million Syrian refugees in Turkey. Data to inform health care practice are ...needed.
To explore sociodemographic characteristics, clinical characteristics, and treatment outcomes of Syrian patients with cancer residing in the southern border provinces of Turkey hosting more than 50% of refugees.
This was a retrospective hospital-based cross-sectional study. The study sample consisted of all adult and children Syrian refugees diagnosed and/or treated for cancer between January 1, 2011, and December 31, 2020, in hematology-oncology departments of 8 university hospitals in the Southern province of Turkey. Data were analyzed from May 1, 2022, to September 30, 2022.
Demographic characteristics (date of birth, sex, and residence), date of first cancer-related symptom, date and place of diagnosis, disease status at first presentation, treatment modalities, date and status at last hospital visit, and date of death. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision and International Classification of Childhood Cancers, Third Edition, were used for the classification of cancer. The Surveillance, Epidemiology, and End Results system was applied for staging. The diagnostic interval was defined as the number of days from first symptoms until the diagnosis. Treatment abandonment was documented if the patient did not attend the clinic within 4 weeks of a prescribed appointment throughout the treatment.
A total of 1114 Syrian adult and 421 Syrian children with cancer were included. The median age at diagnosis was 48.2 (IQR, 34.2-59.4) years for adults and 5.7 (IQR, 3.1-10.7) years for children. The median diagnostic interval was 66 (IQR, 26.5-114.3) days for adults and 28 (IQR, 14.0-69.0) days for children. Breast cancer (154 13.8%), leukemia and multiple myeloma (147 13.2%), and lymphoma (141 12.7%) were common among adults, and leukemias (180 42.8%), lymphomas (66 15.7%), and central nervous system neoplasms (40 9.5%) were common among children. The median follow-up time was 37.5 (IQR, 32.6-42.3) months for adults and 25.4 (IQR, 20.9-29.9) months for children. The 5-year survival rate was 17.5% in adults and 29.7% in children.
Despite universal health coverage and investment in the health care system, low survival rates were reported in this study for both adults and children with cancer. These findings suggest that cancer care in refugees requires novel planning within national cancer control programs with global cooperation.
Rituximab maintenance therapy has emerged as an effective treatment for low-grade lymphomas. No major acute or cumulative toxicities were observed in patients receiving rituximab maintenance therapy ...compared with observation arms in clinical trials. However, B-cells are completely depleted throughout the maintenance period and even longer, which may render patients at high risk for infections. Several infections related to rituximab have been reported in the literature. Yet it is not clear whether rituximab maintenance therapy increases the infectious complications or not. To further investigate this topic, we have performed a systematic review and meta-analysis of randomised controlled trials (RCT). The meta-analysis of five RCTs showed that rituximab maintenance therapy significantly increased the relative risk of both infection and neutropenia in patients with lymphoma. On the basis of the available evidence, patients who received rituximab maintenance treatment have higher risk of neutropenia and infection than those who did not. Previously treated patients particularly with fludarabine containing regimens are more susceptible to infectious complications and require extended vigilance.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The aim of this study was to assess the use of 5-fluorouracil (5-FU), leucovorin and oxaliplatin (FOLFOX) regimens in clinical practice according to their efficacy and toxicity.
Patients who received ...oxaliplatin-containing regimens after curative resection for colorectal carcinoma from 10 different oncology centers between May 2004 and December 2009 were included in the study. All patients were treated with FOLFOX regimens. Patients with rectal carcinoma were also treated with chemoradiotherapy with 5-FU after 2 cycles of a FOLFOX regimen.
The median age of the patients was 56 years (range 17-78). Of the total 667 patients, 326 were given FOLFOX-4, 232 were given modified FOLFOX-4 and 109 were given FOLFOX-6. The distribution according to disease stage was 33 patients with stage IIIA colorectal cancer, 382 patients with stage IIIB and 252 patients with stage IIIC. The most common adverse events were neutropenia (54%), nausea (36.9%), neuropathy (38.2%) and anemia (33.1%) for all grades. The median follow-up time was 23 months (range 1-79). Three-year disease-free survival and overall survival were 65 and 85.7%, respectively.
The different oxaliplatin-containing 5-FU-based adjuvant chemotherapy regimens in patients with stage III colorectal cancer seemed to be at least equal in terms of efficacy regardless of the method of 5-FU administration or oxaliplatin dose.
Primary lung cancer is the most common cancer worldwide and is an increasingly common problem. The primary endpoint of this study was; to investigate the effect of radiotherapy dose and ...neutrophil-lymphocyte ratio (NLR) on overall survival (OS) and progression-free survival (PFS). We retrospectively examined 99 patients who were stage III A and stage III B at the time of diagnosis, who did not receive surgical treatment, and who received definitive chemoradiotherapy. Data of patients such as sex, age, ECOG status, tumor location, pathological subtype, radiotherapy dose, type of chemotherapy, neutrophil/lymphocyte ratio (NLR), and some biochemical parameters and PFS and OS were included in the study by scanning the patient's files. The radiotherapy cut-off value was accepted as 60 Gray. OS was statistically better in patients who received radiotherapy at doses of 60 Gray and above. When the patients with radiotherapy dose less than 60 Gy and patients with more than 60 Gray were evaluated in two groups, the overall survival was 8,569 ± 1,404 / month and 14,326 ± 1,209 / month, respectively. (p <0.05). When we evaluate the patients based on NLR; It was observed that the overall survival of patients below NLR 4 at the time of diagnosis was statistically significantly better. The overall survival of patients with NLR <4.0 and NLR> 4 was 14.32 ± 1.30 / month and 10.54 ± 1.16 / month, respectively. (p <0.05)
Primer akciğer kanseri dünya çapında en sık görülen kanserdir ve giderek yaygınlaşan bir sorundur. Bu çalışmanın birincil sonlanım noktası; radyoterapi dozu ve nötrofil-lenfosit oranının (NLR) genel sağ kalım (OS) ve progresyonsuz sağ kalım (PFS) üzerindeki etkisini araştırmaktır. Tanı anında evre III A ve evre III B olan, cerrahi tedavi olmayan ve definitif kemoradyoterapi alan 99 hastayı retrospektif olarak inceledik. Hastalara ait cinsiyet, yaş, ECOG durumu, tümör yerleşimi, patolojik alt tip, radyoterapi dozu, kemoterapi tipi, nötrofil/lenfosit oranı (NLR), bazı biyokimyasal parametreler ve PFS ve OS gibi veriler hastaların detaylı dosya taraması yapılarak çalışmaya dahil edildi. Radyoterapi cut-off değeri 60 Gray olarak kabul edildi. OS, 60 Gray ve üzeri dozlarda radyoterapi alan hastalarda istatistiksel anlamlı olacak şekilde daha iyiydi. Radyoterapi dozu 60 Gy'nin altında olan hastalar ve 60 Gray'in üzerinde olan hastalar iki grupta değerlendirildiğinde genel sağ kalım sırasıyla 8.569 ± 1.404 / ay ve 14.326 ± 1.209 / ay idi. (p <0.05). Hastaları NLR'ye göre değerlendirdiğimizde; tanı anında NLR 4'ün altındaki hastaların genel sağ kalımının istatistiksel olarak anlamlı derecede daha iyi olduğu gözlendi. NLO <4.0 ve NLO> 4 olan hastaların genel sağ kalımları sırasıyla 14.32 ± 1.30/ay ve 10.54 ± 1.16/ay idi. (p <0.05)
Acute sunitinib neurotoxicity GULMEZ, Ahmet; DIKILITAS, Mustafa; ELKIRAN, Emin Tamer ...
Cancer treatment and research communications,
2021, 2021-00-00, 2021-01-01, Letnik:
27
Journal Article
Recenzirano
Odprti dostop
Sunitinib malate is a multitargeted oral tyrosine kinase inhibitor (TKI) which is used in treatment of metastatic renal cell carcinoma with side effects such as diarrhea, mucositis, asthenia and ...myelosuppression. Serious toxicity associated with sunitinib is a rare situation. However; there are few cases reported in the literature. As a result of the inhibition that is caused by sunitinib malate agent at the receptor level, vascular endothelial growth factor (VEGF) level increases. These increased VEGF levels are considered to having a positive contribution on neurological side effects. Neurotoxicity that is related with the usage of sunitinib malate for two weeks will be presented in this case report.
Objective
Hepatocellular cancer (HCC) is an aggressive tumor with an increasing incidence in recent years. Life expectancy is limited, especially due to limited effective treatments and tumor ...biology. In this study, we aimed to examine the effect of neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), prognostic nutritional index (PNI) parameters of treatment efficacy of patients using sorafenib in primary systemic therapy, progression-free survival (PFS), and overall survival (OS).
Materials and Methods
In this study, we retrospectively analyzed 78 patients who used sorafenib as a first-line systemic treatment. NLR, PLR, and PNI values were calculated with the existing formulas. Cut-off values for these markers were determined by performing ROC curve analysis. These values were determined respectively as 2.88, 111.05, and 38.25. Patients were divided into two groups according to this threshold value. OS and PFS values were calculated using a Cox proportional risk model. The effects of markers on OS and PFS were examined based on the cut-off value.
Results
The mean PFS was 7.1 (range 1–46) months, and the mean OS was 14.1 (range 1.5–94) months. The pre-treatment decreased NLR (< 2.88) value was prognostic for higher PFS and OS rates. These values were determined respectively as 9.23 ± 1.79 and 3.45 ± 0.32 months for PFS and 21.17 ± 4.53 and 5.32 ± 0.53 months for OS. Pre-treatment decreased PLR (< 111.05) was found to be a positively significant prognostic value for both survival. These values were determined respectively as 7.37 ± 1.43 months and 3.16 ± 0.47 months for PFS and 21.12 ± 5.52 months and 6.16 ± 0.87 months for OS. And also, low PNI (< 38.25) value was prognostic for lower PFS and rates. These values were determined respectively as 7.47 ± 0.59 months and 3.25 ± 0.21 months for PFS and 16.36 ± 4.37 months and 5.15 ± 0.42 for OS. All three parameters were found to be statistically significant (
p
< 0.05) for both OS and PFS as independent prognostic markers.
Conclusion
Today, as the standard first-line treatment of HCC has shifted to combinations with immunotherapy (IO), IO transportation is not possible in most countries of the world. However, there are also patients who achieve great survival with only sorafenib. The important point is to identify the biomarkers that predict which patient will benefit better from which treatment. With the markers in our study and a scoring system that can be obtained with these markers, it can be evaluated which patient will be given IO combination and which patient will be given only TKI treatment. We think that such a scoring system can be used to identify suitable patients, especially in countries where, for financial reasons, not every patient can access Immunotherapy. The advantage of these tests is that they are inexpensive, easily calculable and standardized.
Trial Registration
Number and date of registration: 2021/2088, 01–06-2021, retrospectively registered.
To investigate the prevalence of arthralgia in breast cancer patients taking aromatase inhibitors (AIs) and perform a detailed rheumatologic assessment including autoimmune serology, musculoskeletal ...sonography, and electromyography (EMG) in these patients.
Postmenopausal patients with stage I to III breast cancer who were taking adjuvant AIs were enrolled (n = 92). Patients who were not receiving hormone treatment were included as a control group (n = 28). Musculoskeletal sonography and EMG were applied to the patients and the controls along with markers of autoimmunity.
Thirty patients (32.6%) reported to have AI-related new-onset or worsening arthralgia. The most commonly affected joints were knee (70%), wrist (70%), and small joints of the hand (63%). Patients taking AIs had increased tendon thicknesses compared with those who never received AIs (P < .001). Patients with AI-related arthralgia had higher rates of effusion in hand joints/tendons than those without arthralgia (P = .033). More patients with AI-related arthralgia had EMG findings consistent with carpal tunnel syndrome (CTS) than those without arthralgia (P = .024). No significant difference was observed in erythrocyte sedimentation rates, C-reactive protein, antinuclear antibody, antidouble stranded DNA antibody, rheumatoid factor, or anticyclic citrullinated peptide levels between patients and controls or between those with and without arthralgia.
Patients with AI-related arthralgia often show tenosynovial changes suggesting tenosynovitis, exerting local problems but lacking a systemic inflammatory component. Our finding of increased CTS frequency also supports this hypothesis.
Abstract Central nervous system (CNS) metastases are detected in up to one third of patients with advanced breast cancer, but their incidence and outcomes by breast cancer subtypes are not precisely ...documented. Herein, we retrospectively analyzed clinicopathologic data of 259 breast cancer patients with CNS metastases to evaluate the association between breast cancer subtypes and CNS metastasis. The patient groups were classified according to their hormone receptor status and HER-2 expression. Median follow-up time among the patients was 42 months and median survival after CNS metastasis detection was 7.8 months. In HER-2 overexpressing group, median time period between the diagnosis of breast cancer and the detection of CNS metastasis (15.9 months) was significantly shorter compared to the other groups ( p = 0.01). The triple negative group had the shortest median survival time after CNS metastasis (6.6 months), although statistically not significant ( p = 0.3). In multivariate Cox regression analyses, having solitary CNS metastasis (HR 0.4, 95% CI; 0.2–0.7, p = 0.004), and receiving chemotherapy after CNS metastasis (HR 0.4, 95% CI; 0.287–0.772, p = 0.003) were independent prognostic factors for increasing survival after CNS metastasis. In conclusion, new and effective treatment strategies are required for breast carcinoma patients with brain metastasis considering the positive effect of the treatment on survival.
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