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Öğe Beyond traditional therapies: clinical significance of complex molecular profiling in patients with advanced solid tumours—results from a Turkish multi-centre study(2024) Ölmez, Ömer Fatih; Bilici, Ahmet; Er, Özlem; Bişgin, Atıl; Sevinç, Alper; Akman, Tülay; Uslu, Rüçhan; Molinas Mandel, Nil; Yalçın, Şuayib; Teomete, Mehmet; Görümlü, Gürbüz; Demir, Atakan; Namal, Esat; Alıcı, Süleyman; Selçukbiricik, Fatih; Bavbek, Sevil; Paksoy, Fatma; Başaran, Gül; Özer, Leyla; Şener, Nur; Harputluoğlu, Hakan; Kaya, Ali Osman; Yazar, Aziz; Afşar, Çiğdem Usul; Göker, Erdem; Şen, Fatma; Gököz Doğu, Gamze; Şeker, Mesut; Özkan, Metin; Türken, Orhan; Özveren, Ahmet; Orhan, Bülent; Yumuk, Fulden; Üskent, Necdet; Saip, Pınar; Şanlı, Ulus Ali; Dişel, Umut; Berk, Veli; Alakavuklar, MehmetObjective: The objective of this multi-centre, real-world study was to examine the potential influence of comprehensive molecular profiling on the development of treatment decisions or adjustments for patients with advanced solid malignancies. We then evaluated the impact of these informed choices on patient treatment outcomes. Methods: The study encompassed 234 adult patients (mean age: 52.7 ± 14.3 years, 54.7% women) who were diagnosed with solid tumours at 21 different medical centres in Turkey. Remarkably, 67.9% of the patients exhibited metastasis at the time of diagnosis. We utilized an OncoDNA (Gosselies, Belgium) platform (OncoDEEP) integrating next-generation sequencing with additional tests to harvest complex molecular profiling data. The results were analyzed in relation with two specific outcomes: (i) the impact on therapeutic decisions, including formulation or modifications, and (ii) associated treatment response. Results: Out of the 228 patients with final molecular profiling results, 118 (50.4%) had their treatment modified, whilst the remaining 110 (47.0%) did not. The response rates were comparable, with 3.9 versus 3.4% for complete response, 13.6 versus 29.3% for partial response, 66.9 versus 51.7% for progressive disease and 15.5 versus 15.5% for stable disease for treatments informed and not informed by complex molecular profiling, respectively (P = 0.16). Conclusion: Our real-world findings highlight the significant impact of complex molecular profiling on the treatment decisions made by oncologists for a substantial portion of patients with advanced solid tumours. Regrettably, no significant advantage was detected in terms of treatment response or disease control rates.Öğe Evaluation of prognostic factors and adjuvant chemotherapy in patients with small bowel adenocarcinoma who underwent curative resection(Cıg Media Group, LP, 2017) Aydın, Dinçer; Şendur, Mehmet Ali; Kefeli, Umut; Ünal, Ölçün Ümit; Taştekin, Didem; Akyol, Murat; Tanrıkulu, Eda; Çiltaş, Aydın; Ustaalioğlu, Başak Bala; Uysal, Mükremin; Esbağ, Onur; Yazılıtaş, Doğan; Tanrıverdi, Özgür; Bilici, Ahmet; Arpacı, Erkan; Berk, Veli; Yetişyiğit, Tarkan; Özdemir, Nuriye Yıldırım; Öztop, İlhan; Alacacıoğlu, Ahmet; Aydın, Özhan; Özçelik, Melike; Yıldırım, Emre; Dinç, Nur; Gümüş, MahmutThis is a multicenter study to assess the prognostic factors and adjuvant chemotherapy in patients with small bowel adenocarcinoma (SBA). A total of 78 patients with SBA diagnosed with completely resected SBA were involved in the study. Only status of surgical margin was determined to be an independent prognostic factor in patients with SBA who underwent curative resection. Neither disease-free survival nor overall survival was found to be significantly improved by the adjuvant chemotherapy Background: Small bowel adenocarcinoma (SBA) is a rare tumor of the gastrointestinal system with poor prognosis. Because these are rarely encountered tumors, the aim of this multicenter study was evaluation of prognostic factors and adjuvant chemotherapy in patients with curatively resected SBA. Materials and Methods: A total of 78 patients diagnosed with curatively resected SBA were involved in the retrospective study. Forty-eight patients received 1 of 3 different chemotherapy regimens, whereas 30 patients did not receive any adjuvant treatment. No adjuvant and adjuvant chemotherapy cohorts were matched (1: 1) by propensity scores based on the likelihood of receiving chemotherapy or the survival hazard from Cox modeling. Overall survival (OS) was compared with Kaplan-Meier estimates. Results: Median age of 78 patients with curatively resected SBA was 58, and 59% of these were men. According to TNM classification, 8 (10%) of the patients were at stage I, 26 (34%) were at stage II, and 44 (56%) were at stage III. Median follow-up duration was 29 months. Three-year median disease-free survival (DFS) and OS were 62.5% and 67.0%, respectively. In univariate analysis, presence of vascular invasion, perineural invasion, lymph node involvement, and presence of positive surgical margin were significant predictors of poor survival. Multivariate analysis showed that the only adverse prognostic factor independently related with OS was the presence of positive surgical margin (hazard ratio, 0.37; 95% confidence interval, 0.11-1.26; P = .01). Neither DFS nor OS was found to be significantly improved by the adjuvant chemotherapy in both matched and unmatched cohorts. Conclusions: Only status of surgical margin was determined to be an independent prognostic factor in patients with SBA who underwent curative resection.Öğe Evaluation of prognostic factors and treatment in advanced small bowel adenocarcinoma: report of a multi-institutional experience of anatolian Society of medical oncology (ASMO)(Imprimatur Publications, 2016) Aydın, Dinçer; Şendur, Mehmet Ali; Kefeli, Umut; Ünal, Olçun Umut; Taştekin, Didem; Akyol, Murat; Tanrıkulu, Eda; Çiltaş, Aydin; Ustaalioğlu Bala, Başak; Dede Şener, Didem; Esbağ, Onur; İnal, Ali; Bilir, Cemil; Bilici, Ahmet; Harputlu, Hakan; Berk, Veli; Sevinç, Alper; Özdemir Yıldırım, Nuriye; Yıldırım, Emre; Sonkaya, Alper; Ustaoğlu, Mehmet Ali; Gümüş, MahmutPurpose: Small bowel adenocarcinoma (SBA) is a rare tumor of the gastrointestinal system with poor prognosis. Since these are rarely encountered tumors, there are limited numbers of studies investigating systemic treatment in advanced SBA. The purpose of this study was to evaluate the prognostic factors and systemic treatments in patients with advance SBA. Methods: Seventy-one patients from 18 Centers with advanced SBA were included in the study. Fifty-six patients received one of the four different chemotherapy regimens as first-line therapy and 15 patients were treated with best supportive care (BSC). Results: Of the 71 patients, 42 (59%) were male and 29 (41%) female with a median age of 56 years. Median follow-up duration was 14.3 months. The median progression free survival (PFS) and overall survival (OS) were 7 and 13 months, respectively (N=71). In patients treated with FOLFOX (N=18), FOLFIRI (N=11), cisplatin-5-fluoroura-cil/5-FU (N=17) and gemcitabine alone (N=10), median PFS was 7, 8, 8 and 5 months, respectively, while median OS was 15, 16, 15 and 11 months, respectively. No significant differences between chemotherapy groups were noticed in terms of PFS and OS. Univariate analysis revealed that chemotherapy administration, de novo metastatic disease, ECOG PS 0 and 1, and overall response to therapy were significantly related to improved outcome. Only overall response to treatment was found to be significantly prognostic in multivariate analysis (p = 0.001). Conclusions: In this study, overall response to chemotherapy emerged as the single significant prognostic factor for advanced SBAs. Platin and irinotecan based regimens achieved similar survival outcomes in advanced SBA patients.Öğe Is change in hemoglobin level a predictive biomarker of tyrosine kinase efficacy in metastatic renal cell carcinoma? A Turkish oncology group study(Taylor & Francis Inc., 2017) Bilir, Cemil; Yıldız, İbrahim; Bilici, Ahmet; Uçar, Mahmut; Berk, Veli; Yıldız, Yaşar; Yazıcı, Ozan; İnanç İmamoğlu, Gökşen; Karadurmuş, Nuri; Pilancı, Kezban Nur; Arpacı, Erkan; Tanrıverdi, Özgür; Karcı, Ebru; Temiz, Süleyman; Nayır, Erdinç; Oktay, Esin; Dal, Pınar; Petekkaya, İbrahim; Varım, Ceyhun; Cinemre, HakanBackground: There are insufficient predictive markers for renal cell carcinoma (RCC). Methods: A total of 308 metastatic RCC patients were analyzed retrospectively. Results: The increased hemoglobin (Hb) group had significantly higher progression-free survival and overall survival (OS) compared with the decreased Hb group at 11.5 versus 6.35months (p < .001) and 21.0 versus 11.36months (p < .001) respectively. The 1- and 3-year OS rates were higher in the Hb increased group, i.e., 84% versus 64% and 52% versus 35% respectively. Conclusions: The present study showed that increased Hb levels after tyrosine kinase inhibitor therapy could be a predictive marker of RCC.Öğe Prognostic factors for lymph node negative stage I and IIA non-small cell lung cancer: Multicenter experiences(Asian Pacific Organization for Cancer Prevention, 2013) Ustaalioğlu Öven, Başak Bala; Ünal, Olçun Ümit; Turan, Nedim; Bilici, Ahmet Erkan; Kaya, Serap; Eren, Tülay; Ulaş, Arife; İnal, Ali; Berk, Veli; Demirci, Umut; Alıcı, Süleyman; Bal, Öznur; Benekli, Mustafa; Gümüş, MahmutSurgery is the only curative treatment for operable non-small lung cancer (NSCLC) and the importance of adjuvant chemotherapy for stage IB patients is unclear. Herein, we evaluated prognostic factors for survival and factors related with adjuvant treatment decisions for stage I and IIA NSCLC patients without lymph node metastasis. Materials and Methods: We retrospectively analyzed 302 patients who had undergone curative surgery for prognostic factors regarding survival and clinicopathological factors related to adjuvant chemotherapy. Results: Nearly 90% of the patients underwent lobectomy or pneumonectomy with mediastinal lymph node resection. For the others, wedge resection were performed. The patients were diagnosed as stage IA in 35%, IB in 49% and IIA in 17%. Histopathological type (p=0.02), tumor diameter (p=0.01) and stage (p<0.001) were found to be related to adjuvant chemotherapy decisions, while operation type, lypmhovascular invasion (LVI), grade and the presence of recurrence were important factors in predicting overall survival (OS), and operation type, tumor size greater than 4 cm, T stage, LVI, and visceral pleural invasion were related with disease free survival (DFS). Multivariate analysis showed operation type (p<0.001, hazard ratio (HR):1.91) and the presence of recurrence (p<0.001, HR:0.007) were independent prognostic factors for OS, as well visceral pleural invasion (p=0.01, HR:0.57) and LVI (p=0.004, HR:0.57) for DFS. Conclusions: Although adjuvant chemotherapy is standard for early stage lymph node positive NSCLC, it has less clear importance in stage I and IIA patients without lymph node metastasis.
