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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 Real-world treatment outcomes from nationwide ONCO-colon Turkey registry in RAS wild-type patients treated with biologics first-line metastatic colorectal cancer(Lippincott Williams & Wilkins, 2021) Kefeli, Umut; Arslan, Çağatay; Yıldırım, Mahmut Emre; Işıkdoğan, Abdurrahman; Karadurmuş, Nuri; Karabulut, Bülent; Çubukçu, Erdem; Çiçin, İrfan; Yalçın, Şuayib; Türk, Hacı Mehmet; Bilir, Cemil; Karaca, Mustafa; Artaç, Mehmet; Şendur, Mehmet Nahit; Alacacıoğlu, Ahmet; Tanrıkulu Şimşek, Eda; Dane, Faysal; Bilici, Ahmet; Çevik, Duygu; Gümüş, MahmutBackground: Efficacy of anti-angiogenic and anti-EGFR agents has been demonstrated metastatic colorectal cancer (mCRC). Real-world evidence is especially important to detect the findings of patients outside of clinical trials. It complements together with clinical trials. However, there are a few studies that evaluated these treatments with biologics in the real-world setting. Recognizing the change that has occurred over the years will also shed light on future approaches. Therefore, we aimed to investigate the real-world data of patients with RAS-wild type mCRC. Methods: Medical records from 28 centers were collected for patients diagnosed with RAS wild-type mCRC between January 2016 and April 2019 and were included into the study. Histopathological, molecular and clinical characteristics of the patients were recorded. The treatment duration, response rate, progression-free survival and safety results were determined. Also, changes over the years were compared. Patients were compared according to the first-line biological treatments as anti-EGFR group (Group A and B) (panitumumab and cetuximab) and anti-VEGF group (group C).Öğe Surgical, pathological and clinical features of advanced collorectal cancers with metastasectomy. "Onco-Colon Turkey Registry" real-life data(Lippincott Williams & Wilkins, 2022) Karadurmuş, Nuri; Yıldırım, Emre; Yalçın, Şuayib; Gümüş, Mahmut; Bilir, Cemil; Çubukçu, Erdem; Tanrıkulu Şimşek, Eda; Arslan, Çağatay; Dane, Faysal; Çelik, Sinemiş; Bilici, Ahmet; Şendur, Mehmet Ali Nahit; Öven, Başak Bala; Işıkdoğan, Abdurrahman; Türk, Hacı Mehmet; Karaca, Mustafa; Karabulut, Bülent; Özçelik, Melike; Çevik, Duygu; Kefeli, UmutBackground: The contribution of metastasectomy to progression-free survival (PFS) and overall survival (OS) in patients (pts) with advanced stage colorectal cancer has been demonstrated in clinical trials. However, clinical trials may not represent the efficacy of treatment given to the whole population in daily practice, therefore evaluation of real-life data is needed. Methods: The demographic, pathological and clinical characteristics of 1064 RAS wild type pts were recorded in 28 centers in Turkey between January 2016 and March 2019 as part of the Onco-Colon Registry Program (NCT04757311). Metastasectomy was performed in 169 patients (15.9%). In this study, pts with and without metastasectomy were compared in terms of demographic, histopathological and clinical features and treatment results. Results: Median follow-up time was 24 months(mos) (1-74), median age was 59 years (30-81). 32.5% of the pts were women. The proportion of pts with primary right colon was determined to be 16.8%. Synchronous metastasis was detected in 76.3% of those who underwent metastasectomy. Isolated liver metastasectomy was performed in 85.8% of the pts. It has been shown that 21.1% of the pts have MSI-H and 23.3% have a mucinous component. Metastasectomy was performed after conversion therapy in 54.8% of pts. In the patient group who underwent metastasectomy after medical treatment, the median time between the beginning of treatment and metastasectomy was found to be 7 mos (2-34). When the patient characteristics were compared, no significant difference was found between the groups with and without metastasectomy (p > 0.05). The median PFS (mPFS) was 13.5 mos in the group that underwent metastasectomy and 9.9 mos in the group that was not performed (p < 0.0001; HR: 0.63 (95% CI: 0.51-0.77). The median OS (mOS) was 47.3 mos in the group that underwent metastasectomy and 24.3 mos in the group without metastasectomy (p < 0.0001; HR: 0.36 (95% CI: 0.27-0.48). Conclusions: The significant contribution of metastasectomy on mPFS and mOS was shown in this reallife data based trial, where no difference was found in terms of general participation characteristics. In daily practice, prolonged mPFS and mOS emerges as pts who are followed-up radiologically at regular intervals from the beginning and who are appropriate for surgery have the chance of metastasectomy.
