LANGUAGE= "English" Objectives: Enzalutamide(ENZ) is an effective hormonal treatment modality in mCRPC. It can be used before or after docetaxel(DTX) in this setting. Herein, we aimed to show the ...efficacy of ENZ before or after DTX use and the factors predicting the efficacy. Methods: We retrospectively collected the data of 320 patients from 12 centers who were treated with ENZ in mCRPC. The initial stage, age, line of treatment, serum prostate-specific antigen (PSA) levels before ENZ treatment and at nadir, site of metastasis, gleason score were evaluated. Results: Median age of 320 patients were 69. At a median follow-up of 56 months, 271/320 (84.7%) disease progression and 230/320(71.9%) death had been observed. Median PFS was 11(8.9-13)) and median OS was 25(22.1-27.8) months in all patients group. Median PFS was 10(7.4-12.5) months, 11(8-13.9) months in pre-DTX and post-DTX groups respective?ly. Median OS was higher in the post-DTX group than the pre-DTX group (28(25.7-30.2) vs 19(15.0-22.9-46.6) (p:0.000). Gleason score?8 (HR 0.59, 95%CI 0.46-0.77, p=0.00), presence of non-visceral metastasis (HR 0.72, 95%CI 0.53-0.97, p=0.031), initial PSA value<43(median) (HR 0.70, 95%CI 0.54-0.91, p=0.009), PSA at nadir <2 (HR 0.61, 95%CI 0.44-0.85, p=0.004), >50% decline in PSA (HR 0.27, 95%CI 0.19-0.36, p=0.000) significantly predicted ENZ response regarding rPFS. Conclusion: ENZ has shown equal efficacy before and after DTX treatment in mCRPC regarding rPFS. But OS rate was significantly better in the pre-DTX group. Therefore, we recommend starting with DTX in patients who can tolerate chemotherapy in mCRPC setting.
Purpose:
Taxane-containing combinations are recommended for the first-line therapy of advanced gastric cancer. It is not known which chemotherapy regimen is the best with trastuzumab for ...HER2-positive patients. The aim of this study was to compare taxane-containing intensified chemotherapy versus standard chemotherapy in combination with trastuzumab in the first-line treatment of HER2-positive advanced gastric adenocarcinoma.
Methods:
This study is a retrospective multicenter study of the Turkish Oncology Group. A total of 130 HER2-positive patients with inoperable locally advanced, recurrent, or metastatic gastric adenocarcinoma being given chemotherapy plus trastuzumab as the first-line treatment were included from 16 different oncology centers. Trastuzumab combination with intensified chemotherapy including taxane or standard chemotherapy was compared in terms of progression-free survival (PFS), overall survival (OS), and toxicity.
Results:
There were 108 patients in the standard and 22 patients in the intensified chemotherapy group. PFS of the standard and intensified group were 5.6 months (95% confidence interval CI 4.8–6.4) and 5.3 months (95% CI 2.6–8), respectively (p = 0.70). OS of the standard and intensified group were 11.1 months (95% CI 8.3–13.9) and 15.2 months (95% CI 12.7–17.7), respectively (p = 0.03). Repeated analysis excluding patients given any previous therapy revealed similar results. The intensified group had more fever and febrile neutropenia.
Conclusion:
Trastuzumab combination with intensified chemotherapy provides better OS in first-line treatment of HER2-positive advanced gastric cancer. Further large-scale studies should be performed in HER2-positive patients.
The objectives of this study were to compare progression-free survival (PFS) with somatostatin analog (SSA) versus chemotherapy (CTx) in first-line therapy and to determine the patient group in which ...these treatments were more effective in neuroendocrine tumors (NETs) with a Ki-67 index of 20% or less. Patients who received SSA or CTx and had unresectable locally advanced and metastatic NETs with a Ki-67 index of 20% or less were retrospectively selected from 13 centers in the Turkish database between 2000 and 2015. One hundred and sixty-five patients were enrolled. The median age was 56 years and the male-to-female ratio was 1.09. Seventy-four (45%) patients were of grade 1 NET and 91 (55%) were of grade 2. SSA was given to 104 patients, whereas 61 were treated with CTx. The objective response rate after SSA was 15.4%; another 73.1% had stable disease. The objective response rate after CTx was 36.1%, and 40.9% had stable disease (P=0.008). The median PFS in SSA patients was 21 months (95% confidence interval12.4–29.6), and 8 months for CTx (95% confidence interval5.5–10.6) (P<0.001). There was no significant difference between PFS of receiving SSA and CTx in pancreatic neuroendocrine tumor (PNET) patients; however, the PFS of receiving SSA was longer in non-PNET patients (P<0.001). SSA was better treatment in advanced NET patients with a Ki-67 index of less than 5%, having a primary resected and a performance status of 0 (P<0.05). SSA may be preferred over CTx in advanced NET patients with low-to-intermediate grade.
OBJECTIVE Brain metastasis is the most common type of brain tumor. The present study is an investigation of prognostic factors for survival in patients with brain metastasis. METHODS We ...retrospectively investigated patients with brain metastasis who were treated at the Cumhuriyet University center for radiation oncology between 2006 and 2014. RESULTS The data of 277 patients were analyzed. Age of the patient, performance status, length of time to metastasis, site of primary disease, and performance of metastasectomy were determined to be factors that affect prognosis. Independent prognostic factors were found to be: time to metastasis (hazard ratio HR: 0.72; 95% confidence interval CI: 0.52-0.99; p=0.0047), performance status (HR: 1.40; 95% CI: 1.07-1.85; p=0.015), and metastasectomy (HR: 0.54; 95% CI: 0.33-0.89; p=0.017). CONCLUSION Survival rate was better in patients with breast cancer, longer time before metastasis, good performance, and those who had undergone metastasectomy. Therapeutic approaches should be planned with consideration that patients exhibiting these characteristics might have more favorable therapeutic outcomes.
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