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.
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.
OBJECTIVEThis study was designed to compare the 18-Fluorodeoxyglucose positron emission tomography/computed tomography (F)FDG PET/CT and 1,4,7,10-tetraazacyclododecane-NI,NII,NIII,NIIII-tetraacetic ...acid (D)-Phe1-thy3-octreotate (Ga)DOTATATE PET/CT) findings in patients with pulmonary carcinoid (PC) tumors.
MATERIALS AND METHODSA total of 20 patients mean (SD) age52.2 (12.9) years, 60% women with PC tumors and available records on digital images of (F)FDG PET/CT and (Ga)DOTATATE PET/CT and histopathological analysis were included in this retrospective single-center study. Patient characteristics, structural and functional imaging, and final histopathology were recorded in all patients. Typical and atypical PC tumors were compared in terms of patient age, tumor site, tumor size, and SUV max values obtained by (F)FDG PET/CT and (Ga)DOTATATE PET/CT imaging.
RESULTSOverall, median (minimum−maximum) SUVmax values were 3.2 (1.2–11.2) in (F)FDG PET/CT and 17.2 (2.5–89.0) in (Ga)DOTATATE PET/CT. Atypical PC tumor was associated with significantly higher mean±SD age (64.6±5.4 vs. 45.5±10.5 years, P=0.036) and median (minimum−maximum) (F)FDG PET/CT SUVmax values 7.3 (4.8–11.2) vs. 2.4 (1.2–3.9), P=0.003, but with significantly lower median (minimum−maximum) (Ga)DOTATATE PET/CT SUVmax values 6.4 (2.5–10.6) vs. 23.7 (14.2–89), P<0.001, compared with typical PC tumor. (F)FDG PET/CT and (Ga)DOTATATE PET/CT SUVmax values were negatively correlated (r=−0.429, P=0.011).
CONCLUSIONOur findings in patients with histologically proven PC tumors showed higher SUV max values for (F)FDG PET/CT in atypical PC tumors and for (Ga)DOTATATE PET/CT in typical PC tumors. Our findings indicate the likelihood of higher detection rates particularly for typical PC tumors by (Ga)DOTATATE PET/CT imaging and the potential utility of the SUVmax ratio in predicting the histological subtype of PC tumors.
AbstractUterine smooth muscle tumors are common neoplasms of smooth muscle in the uterus. They range from benign leiomyomas and their variants to malignant leiomyosarcomas. Although there are many ...subtypes of leiomyoma, mitotically active leiomyoma and leiomyoma with bizarre nuclei are sometimes difficult to differentiate from leiomyosarcoma. Our aim in this study was to investigate whether EBP50 and Merlin expression can be used in the differential diagnosis of uterine smooth muscle tumors and to determine their prognostic significance. Our study analyzed 80 cases diagnosed with uterine smooth muscle tumors from the Pathology Department archive of Dicle University Faculty of Medicine between 2012 and 2023. Primary antibodies EBP50 and Merlin were used in the immunohistochemical study. Information regarding patient age, treatment, and clinical follow-up was obtained from Dicle University Department of Obstetrics and Gynecology and Dicle University Department of Medical Oncology. Our study revealed that EBP50 expression was significantly higher in the leiomyosarcoma and STUMP groups, while Merlin expression was significantly higher in only the leiomyosarcoma group. Prognostic parameters were not found to be associated with EBP50 and Merlin expression levels. EBP50 and Merlin expression levels have not been previously studied in uterine smooth muscle tumors. Our study suggests that high expression of EBP50 in STUMP and leiomyosarcoma, as well as Merlin in leiomyosarcoma, may be helpful in the differential diagnosis of uterine smooth muscle tumors.
Background
Atezolizumab (ATZ) has demonstrated antitumor activity and manageable safety in previous studies of patients with metastatic platinum-resistant urothelial carcinoma. However, the response ...rate of Atezolizumab was modest. In the current study, we evaluated the pretreatment prognostic factors for overall survival in patients with metastatic urothelial carcinoma who have progressed after first-line chemotherapy in the Expanded-Access Program of Atezolizumab.
Patients and methods
In this study, we present a retrospective analysis of 113 patients with urothelial cancer treated with ATZ after progression on first-line chemotherapy. Data of the patients was obtained from patient files and hospital records. Eligible patients included metastatic urothelial carcinoma patients treated with at least one course of ATZ. Univariate analysis was used to identify clinical and laboratory factors that significantly impact OS. Variables were retained for multivariate analysis if they had a statistical relationship with OS (
p
< 0.1), and then included a final model of
p
< 0.05.
Results
The median follow-up duration was 23.5 months. Of the patients, 98 (86.7%) were male and 13.3% were female. The median age was 65 years of age (37–86). In univariate analysis, primary tumor location in the upper tract, increasing absolute neutrophil count (ANC), increasing absolute lymphocyte count, neutrophil-to-lymphocyte ratio (NLR) > 3, liver metastases, baseline creatinine clearance less (GFR) than 60 ml/min, Eastern Cooperative Oncology Group (ECOG) performance status (1 ≥), and hemoglobin levels below 10 mg/dl were all the significantly associated with OS. Three of the five adverse prognostic factors according to the Bellmunt criteria were independent of short survival: liver metastases HR 3.105; 95% CI 1.673–5.761;
p
< (0.001), ECOG PS (1 ≥) HR 2.184; 95% CI 1.120–4.256;
p
= 0.022, and Hemoglobin level below 10 mg/dl HR 2.680; 95% CI 1.558–4.608;
p
< (0.001). In addition, NLR > 3 hazard ratio HR 2.092; 95% CI 1.031–4.243;
p
= 0.041 and GFR less than 60 ml/min HR 1.829; 95% CI 1.1–3.041;
p
= 0.02, maintained a significant association with OS in multivariate analysis.
Conclusions
This model confirms the Bellmunt model with the addition of NLR > 3 and GFR less than 60 ml/min and can be associated with clinical trials that use immunotherapy in patients with bladder cancer.
Purpose
In this study, we investigated the effect of lapatinib plus capecitabine treatment in HER2-positive breast cancer patients with brain metastasis.
Methods
Of 405 metastatic breast cancer ...patients with brain metastases at referral centers in Turkey, 46 were treated with lapatinib plus capecitabine only after the development of brain metastasis. Patients who only received trastuzumab-based therapy after the development of brain metastases were accepted as the historic control group for survival analyses (
n
= 65). Patients who received both drugs consecutively or sequentially were excluded from the analyses (
n
= 34).
Results
Median age among 46 patients who received lapatinib plus capecitabine therapy was 45 years (27–76), and median time for development of brain metastases was 11.9 months (0–69 months). Twenty-six out of 38 patients who received lapatinib plus capecitabine and had extracranial metastasis showed partial response or stable diseases (68.4 %). Grade 3-4 toxicity was observed in eight patients (17.3 %). Median overall survival (OS) in patients treated with lapatinib plus capecitabine was significantly increased compared to that in patients treated with trastuzumab-based therapy (19.1 vs. 12 months, respectively,
p
= 0.039). The incidence of cerebral death was slightly decreased in patients who received lapatinib plus capecitabine compared to those who received trastuzumab-based therapy (32 vs. 43.4 %,
p
= 0.332). In the multivariate analysis, lapatinib plus capecitabine therapy remained an independent positive predictor for survival odds ratio (OR), 0.57;
p
= 0.02.
Discussion
Although this retrospective multicenter study had several limitations, the results suggest that undergoing lapatinib plus capecitabine therapy after the diagnosis of brain metastasis may further improve survival compared to undergoing only trastuzumab-based therapy.
To investigate the clinical features, prognostic factors and survival times of cervical cancer patients with brain metastasis.
We retrospectively reviewed the medical records of 820 patients with ...cervical cancer. Data were analyzed using SPSS version 12.0 statistical software (SPSS, Chicago, IL, USA). Overall survival, time interval from diagnosis of cervical cancer to identification of brain metastasis, and median survival time after diagnosis of brain metastasis were calculated using Kaplan-Meier curve analysis. The log-rank test was used to compare differences in survival. Differences were assumed statistically significant when p-values were < 0.05.
The incidence of brain metastases from cervical cancer in our institution was 1.82% (15/820) over a ten-year period. The median time interval from diagnosis of cervical cancer to detection of brain metastasis was 12.5 months (range: 2.9-91.9 months). Stage and tumor diameter were found to be significant relating to the interval from diagnosis of cervical cancer to detection of brain metastasis (p=0.001 for both).
This study provides much information about the prognosis of patients with brain metastases from cervical cancer and highlights the importance of initial stage and tumor diameter when determining the time interval until development of brain metastasis.
In this study, we aimed to investigate the causes of liver test abnormalities in newly diagnosed patients naive to anti-tumoral therapy.
This study included a total of 490 patients with ALT levels > ...5X ULN on liver function tests at the initial presentation to our clinic. Data from 247 (50.4%) patients diagnosed with cancer (cohort A) and 243 (49.6%) patients without cancer (cohort B) were compared with regard to the etiology of liver test abnormalities and the risk factors.
The most common etiological factor in cohort A was presence of liver metastasis (31.2%,
= 77). In the comparison of the two groups with regard to etiological factors; the rates of liver metastasis 31.2% vs 0%, (
< 0.001), drug-induced liver toxicity 30/4% vs 19.8%, (
= 0.007), pancreaticobiliary pathology 21.5% vs 14%, (
= 0.03) and chronic viral hepatitis 14.2% vs 7.4%, (
= 0.02) were higher in the cohort A. The rate of NAFLD was higher in the cohort B 6.9% vs 42.2% (
< 0.001).
In our study, the most common cause of liver test abnormalities was the presence of liver metastasis in cohort A and NAFLD in cohort B.
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