The aim of the study is to compare the efficacy and safety of 3 chemotherapy regimens used as first-line treatments in the real-life management of metastatic pancreatic cancer.
A total of 218 ...patients were included in this multicenter study. Gemcitabine (Gem, n = 71), gemcitabine-cisplatin (Gem-Cis, n = 91), and FOLFIRINOX (a combination of leucovorin, 5-fluorouracil, irinotecan, and oxaliplatin FFX, n = 56) treatments were compared.
Overall response rate was significantly higher in the FFX group (50.0%) than in the Gem (28.2%) and Gem-Cis (27.5%) groups (P = 0.010). Median progression-free survival (8.4 vs 4.6 and 5.5 months, respectively, P < 0.001) and overall survival (16.4 vs 8.1 and 8.7 months, respectively, P = 0.002) were significantly longer in the FFX group than in the Gem and Gem-Cis groups. Toxicity of any grade was noted in 46 (64.8%), 56 (61.5%), and 49 (87.5%) patients in the Gem, Gem-Cis, and FFX groups, respectively (P = 0.003).
In our study, FFX regimen provides a significant advantage over the other treatment regimens in terms of response rates and survival. Treatment toxicity was more frequent but manageable with the FFX regimen.
Background: In this real-life practice study, we aimed to find whether elderly colorectal cancer (CRC) patients in our center were treated optimally and also if this has an effect on overall survival ...(OS) or not.
Methods: We have retrospectively screened 150 CRC patients older than 65 years, diagnosed in our institution between 2010 and 2018. As study variables, patient characteristics, tumor location, tumor, nodes, metastases stage, Eastern Cooperative Oncology Group performance status (ECOG PS), comorbidities, adjuvant or metastatic chemotherapy regimens, and treatment toxicity were recorded, and the OS rate of patients was assessed.
Results: The median age was 72 (range 65 - 89) years and 48 (32%) patients had metastatic disease at the time of diagnosis. The median OS (mOS) in the suboptimal adjuvant treatment group was 31.5 (range 20.7-42.3) months, whereas mOS was not reached during the median follow-up time in the optimal treatment group (P = 0.036). The addition of oxaliplatin to chemotherapy had no benefit on mOS (P = 0.318). In the metastatic setting, the mOS in the optimal and suboptimal treatment group was 27.2 (range 10.7-43.7) months and 13.4 (range 7.5-18.8) months respectively, and was statistically significant (P = 0.001).
Conclusion: Our study revealed that optimal treatment had a significant effect on the mOS of elderly CRC patients and it was well tolerated. Advanced age alone is not a sufficient parameter for precluding effective therapy in elderly patients with CRC.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Background and Design: This study aims to investigate the prognostic factors in BRAF wild-type metastatic cutaneous melanoma and the prognostic role of inflammation indices. Materials and Methods: ...Metastatic BRAF wild-type cutaneous melanoma patients who presented to our clinic between 2011 and 2021 were enrolled. To investigate their prognostic roles, age, gender, performance status, first immunotherapy regimen received by the patient, metastatic sites, and seven inflammation indices C-reactive protein (CRP)/albumin ratio (CAR), neutrophil lymphocyte ratio (NLR), prognostic nutritional index (PNI), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and advanced lung cancer inflammation index (ALI) and hemoglobin, albumin levels, lymphocyte and platelet counts (HALP) were studied. Results: Fourty-seven patients, consisting of 22 (46.8%) females and 25 (53.2%) males, were included in this study. Mean patient age was 54 (18-88) years. In our study, there were 16 (34%) patients with liver metastasis, 17 (36.2%) patients with lung metastasis, and 9 (19.1%) patients with brain metastasis. As immunotherapy, 34 (72.3%) patients had received Nivolumab, while 13 (27.7%) patients had received Ipilimumab therapy. When the relationships of the prognostic variables with overall survival were inspected in univariate and multivariate analyses, brain metastasis was found to be an independent prognostic factor (p=0.02). Lung metastasis approached the threshold of statistical significance in univariate analysis (p=0.09) and liver metastasis in multivariate analysis (p=0.07). The seven inflammation indices examined in the analyses CAR, NLR, PNI, PLR, SII ALI and HALP were found to have no prognostic role in both univariate and multivariate analyses. Conclusion: Our study determined that brain metastasis is an independent poor prognostic factor in BRAF wild-type metastatic melanoma. Prognostic roles of the CAR, NLR, PNI, PLR, SII ALI and HALP indices could not be demonstrated.
Background
Positive effects of exercise in cancer patients have been reported.
Aim
To investigate whether intensity, duration, and timing of exercise affect disease relapse and mortality risk in ...patients with breast cancer (BC).
Methods
Patients with local or locally advanced stages of BC between January 2018 and January 2020 were recruited in the study. Sociodemographic and clinicopathological characteristics of patients were recorded. Exercise evaluation was performed by preparing a questionnaire and asking the patients face-to-face questions in the outpatient clinic.
Results
Risk of relapse was 58% lower in patients who exercised than inactive patients (
p
= 0.004). Patients who exercised for 2 to 5 days per week had a 63% lower relapse risk than inactive patients (
p
= 0.010). Risk of relapse was 66% lower in the patients who exercised for less than 1 h or 3 metabolic equivalent of task (MET)-hours per week when compared to inactive patients (
p
= 0.037). Similarly, relapse risk was 62% lower in patients who exercised between 1 to 3 h or 3 to 8.9 MET-hours per week than inactive patients (
p
= 0.026). Mortality risk was lower in patients who exercised than patients who did not (
p
= 0.027). A significantly decreased mortality risk was found in both groups that included patients who exercised for 1 to 5 days per week and patients who exercised for less than 3 h or 9 MET-hours per week when compared to inactive patients.
Conclusion
Exercise was associated with decreased relapse and mortality rates in patients with BC. Therefore, exercise should be recommended to BC patients as a significant component of the treatment.
In the present study, we analyzed serum vascular endothelial growth factor (VEGF) levels and its correlation with the other clinicopathological characteristics of patients with colorectal carcinoma ...(CRC).
Seventy-one patients (F/M, 29/42; Mean age +/- SD, 53.3 +/- 13.1 years) were included. The results of serum VEGF were analysed with respect to stage, gender, age, CEA, metastases and topographical tumour localization.
Patients with stage 3-4 disease had significantly higher values of VEGF (253.41 pg/mL +/- 302.24) than patients with stage 1-2 (49.99 pg/L +/- 100.30) (P < 0.003). Patients with the primary tumour localized in the colon had no significantly higher levels of serum VEGF than patients with the primary tumour localized in the rectum (225.97 +/- 324.88 pg/mL vs. 153.76 +/- 205.66 pg/ mL, respectively, P = 0.269). The VEGF expression significantly correlated with serum CEA level (P < 0.01) and clinical stages of colorectal cancer (P < 0.01). The VEGF expression was not correlated with patients' age (P = 0.955) and gender (P = 0.740).
The VEGF expression significantly correlated with advanced stage, and metastases but not age, gender, and tumour localization. VEGF may play an important role in the invasion and metastasis of CRC. Therefore, VEGF could be applied as prognostic markers in CRC.
We aimed to investigate the effectiveness of neoadjuvant therapy (NAT) and clinicopathological characteristics in locally advanced non-small cell lung cancer (NSCLC) (IIIA-IIIB), as well as the ...influence of the post-NAT treatment modalities on survival.
This study included patients who presented to the Dicle University Medical Oncology Clinic and received NAT for a diagnosis of locally advanced NSCLC between 2004 and 2020. Clinicopathological and radiological data of the 57 patients whose data could be retrieved from the hospital archive system were retrospectively reviewed. Patients' overall survival (OS) and failure-free survival (FFS) times and the factors influencing these times were evaluated.
This study included a total of 57 patients consisting of five (8.8%) females and 52 (91.2%) males. The median patient age at diagnosis was 58 (30-75) years. All patients had received four courses of chemotherapy during the neoadjuvant period. When the factors influencing OS were evaluated, the post-NAT modality was found to have a statistically significant effect on survival. FFS times were 12, 13, and 16 months in the chemotherapy, chemoradiotherapy, and surgery arms, respectively (log-rank p=0.035). FFS was longer in those who underwent surgery (Hazard ratio (HR): 0.33, 95 % CI: 0.14-0.77, (p=0.01)). OS times were 20, 21, and 55 months in the chemotherapy, chemoradiotherapy, and surgery arms, respectively (log-rank p=0.05). OS was longer in the arm undergoing surgery compared to the other arms (HR: 0.36, 95% CI: 0.14-0.87, (p=0.02)). Five-year survival rates for the chemotherapy, chemoradiotherapy, and surgery arms were 14.3%, 21.4%, and 40%, respectively.
This study shows that achieving an operable status is the most important indicator of survival and that patients undergoing surgery have a marked advantage in OS and FFS compared with patients receiving chemoradiotherapy or palliative chemotherapy.
Aim
To compare survival outcomes, response rates, and adverse events (AEs) in proton pump inhibitor (PPI) user and non-user patients with metastatic colorectal cancer (mCRC) treated with regorafenib.
...Methods
We included 272 patients with mCRC treated with regorafenib in this study. Patients were divided into two categories according to their status of PPI use. The primary endpoint was overall survival (OS). The secondary endpoints were time to treatment failure (TTF), response rates, and safety. To exclude immortal time bias in survival analyses, we compared PPI non-user patients and all patients.
Results
There were 141 and 131 patients in the PPI non-user and user groups. Baseline characteristics were similar in each group. Pantoprazole was the most used PPI. At the median 35.2 (95% confidence interval (CI): 32.6–37.9) months follow-up, the median OS was similar in PPI non-user and all patients (6.9 months (95% CI: 5.3–8.5) and 7.7 months (95% CI:6.6–8.8),
p
= 0.913). TTF was also similar in PPI non-user and all patients (3.3 months (95% CI: 2.7–3.9) and 3.5 months (95% CI: 3.0–4.0),
p
= 0.661). In multivariable analysis, no statistically significant difference was observed between PPI user and non-user groups in OS and TTF (hazard ratio (HR), 0.99; 95% CI, 0.77–1.28;
p
= 0.963 for OS; HR, 0.93; 0.77–1.20,
p
= 0.598 for TTF). The objective response rates (ORR) were similar in the PPI non-user and user groups (19.8% and 16.8%,
p
= 0.455). The rates of any grade AEs were also similar in each group.
Conclusion
This study found no worse outcome in the combined use of PPI and regorafenib among patients with mCRC.
Purpose
Anaplastic lymphoma kinase (ALK) mutations occurs in approximately 3–5% of patients with non-small cell lung cancer (NSCLC). Pleural involvement/effusion is common in ALK-positive patients ...with NSCLC at baseline. The aim of the study was to evaluate the characteristics of ALK-positive patients who have Ple-I/E.
Methods
In this multicenter study, patients with ALK-positive NSCLC who have Ple-I/E were retrospectively analyzed. Clinical and demographic characteristics of the disease, response rates, median progression-free survival (PFS), and overall survival (OS) were evaluated in 362 ALK-positive patients with NSCLC.
Results
Of the patients, 198 (54.7%) were male. The median age at the time of diagnosis was 54 (range 21–85) years. All patients’ histology was adenocarcinoma (100%). At baseline, 57 (15.7%) patients had Ple-I/E. There was no association between Ple-I/E and gender, lung metastasis, or distant lymphadenopathy (LAP) metastasis. The frequencies of liver, brain, and bone metastases were significantly higher in ALK-positive patients without Ple-I/E compared to those with Ple-I/E (respectively 18.2% vs 4.8%, p = 0.008; 19.1% vs 4.8%, p = 0.001; 20.6% vs 8.9%, p = 0.002). The median PFS was longer in ALK-positive patients who had Ple-I/E (18.7 vs 10.6 months, p = 0.017). Similarly, the median OS was longer in ALK-positive patients who had Ple-I/E (44.6 vs 22.6 months, p = 0.051).
Conclusion
Brain, liver, and bone metastases were lower in ALK-positive patients with Ple-I/E. Patients presented with Ple-I/E were prone to have better PFS and OS.
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