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Öğe Does primary tumor localization has prognostic importance in seminoma patients?: Turkish Oncology Group Study(Imprimatur Publications, 2020) Yıldız, Birol; Küçükarda, Ahmet; Gökyer, Ali; Demiray, Atike Gökçen; Paydaş, Semra; Aral, İpek Pınar; Gümüşay, Özge; Bilici, Ahmet; Akdeniz, Nadiye; Bahçeci, Aykut; Demir, Hacer; Esin, Ece; Üyetürk, Ümmügül; Ökten, İlker Nihat; Ertürk, İsmail; Türk, Hacı Mehmet; Topaloğlu, Ulaş Serkan; Başoğlu, Tuğba; Turhal, Nazım Serdar; Yeşil Çınkır, Havva; Menekşe, Serkan; Çakmak, Yağmur; Ürün, Yüksel; Acar, Ramazan; Kut, Engin; Dal, Pınar; Sakalar, Teoman; Aktepe, Oktay Halit; Karadurmuş, NuriPurpose: The purpose of this study was to determine whether primary tumor localization may be a risk factor for relapse and survival in seminomatous germ cell tumors (GCT) patients.Methods: In our study, 612 seminomatous GCT patients diagnosed in 22 centers between 01.01.1989 and 03.02.2019 were retrospectively evaluated. Patient interview information, patient files and electronic system data were used for the study.Results: The primary tumor was localized in the right testis in 305 (49.9%) patients and in 307 (50.1%) in the left testis. Mean age of the patients was 36 years (range 16-85 +/- 10.4).The median follow-up period was 47 months (1-298). Recurrence was observed in 78 (127%) patients and 29 (4.7%) died during the follow-up period. Four-year overall survival (OS) was 95.4% and 4-year progression-free survival (PFS) was 84.5%. The relationship between localization and relapse was significant in 197 patients with stage 2 and stage 3 (p=0.003). In this patient group, 41 (20.8%) relapses were observed. Thirty (73.2%) of the relapses were in the right testis and 11 (26.8%) in the left testis.Four-year OS was 92.1% in patients with right tumor; and 98.7% in patients with left tumor (p=0.007). When 612 patients were evaluated with a mean follow-up of 4 years, there was a 6.6% survival advantage in patients with left testicular tumor and this difference was significant (p=0.007).Conclusion: Survival rates of patients with primary right testicular localization were worse compared with left testicular localization, and relapse rates were higher in stage 2 and 3 patients with right testicular localization.Öğe Neoadjuvant pembrolizumab plus chemotherapy in early-stage triple-negative breast cancer: a nationwide retrospective Turkish oncology group study(2024) Karcı, Ebru; Bilici, Ahmet; Ölmez, Ömer Fatih; Sakin, Abdullah; Günaldı, Meral; Esin, Ece; Yıldız, ÖzcanBackground/Objectives: Following the results of the phase 3 KEYNOTE-522 trial, the U.S. Food and Drug Administration approved pembrolizumab, a humanized IgG4 kappa monoclonal antibody, in combination with neoadjuvant chemotherapy as a new standard of care for high-risk early-stage triple-negative breast cancer (TNBC). This retrospective, multicenter study in Türkiye assessed the real-world efficacy and safety of neoadjuvant pembrolizumab combined with chemotherapy in early-stage TNBC. Methods: The study included 108 patients treated between 2021 and 2023 across 14 oncology centers. Three distinct neoadjuvant regimens incorporating pembrolizumab were administered at the discretion of the treating physicians. The primary outcomes were the pathological complete response (pCR) rate after neoadjuvant therapy and the 2-year event-free survival (EFS) and overall survival (OS) rates. Results: The observed pCR rate was 63.9%, closely mirroring the 64.8% reported in the KEYNOTE-522 trial. At the two-year mark, the EFS rate was 87.2% and the OS rate was 92.3%. Multivariable analysis identified pCR as the sole independent predictor of both EFS and OS. The safety profile was consistent with previous clinical trial data, with most adverse events being of grade 1–2 in severity. Conclusions: These findings provide valuable real-world confirmation of the efficacy and safety of neoadjuvant pembrolizumab–chemotherapy in early-stage TNBC, complementing evidence from randomized trials.Öğe Pertuzumab, trastuzumab and taxane combination for visceral organ metastatic patients: Real life practice results(Oxford University Press, 2018) Esin, Ece; Çakmak Öksüzoğlu, Ömür Berna; Bilici, Ahmet; Çiçin, İrfan; Aksoy, Sercan; Alacacıoğlu, Ahmet; Kaplan, Mehmet Ali; Çabuk, Devrim; Sümbül, Ahmet Taner; Paydaş, Semra; Sakin, Ayşegül; Korkmaz, Tuba; Özdemir Yıldırım, Nuriye; Artaç, Mehmet; Harputluoğlu, Hakan; Yumuk, Perran Fulden; Atalay Başaran, Gül; Oyan Uluç, Başak; Demirci, Umut[Abstract Not Available]Öğe Pertuzumab, trastuzumab and taxane-based treatment for visceral organ metastatic, trastuzumab-naive breast cancer: Real-life practice outcomes(Springer, 2019) Esin, Ece; Çakmak Öksüzo?lu, Berna; Bilici, Ahmet Erkan; Çiçin, İrfan; Köstek, Osman; Kaplan, Mehmet Ali; Aksoy, Sercan; Aktaş, Burak Yasin; Özdemir, Özlem; Alacacıoğlu, Ahmet; Çabuk, Devrim; Sümbül, Ahmet Taner; Sakin, Abdullah; Paydaş, Semra; Yetişir, Ersin; Er, Özlem; Korkmaz, Taner; Yıldırım, Nilgün; Şakalar, Teoman; Demir, Hacer; Artaç¸, Mehmet; Karaa?aç, Mustafa; Harputluo?lu, Hakan; Bilen, Ebru; Erdur, Erkan; De?irmencio?lu, Serkan; Aliyev, Altay; Çil, Timuçin; Olgun, Polat; Başaran, Gül Atalay; Gümüşay, Özge; Demir, Atakan; Tanrıkulu, Eda; Yumuk, Perran Fulden; İmamoğlu, İnanç; Oyan, Başak; Çetin, Bülent Eren; Haksöyler, Veysel; Karadurmuş, Nuri; Ertürk, İsmail; Evrensel, Türkkan; Yılmaz, Hasan; Beypınar, İsmail; Koçer, Murat; Pilancı, Kezban Nur; Şeker, Mesut Metin; Ürün, Yüksel; Yıldırım, Nuriye O.; Eren, Tülay; Demirci, UmutPurposeIn this study, we aimed to describe the real-life practice outcomes of pertuzumab-trastuzumab-taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients.MethodsThis study was conducted by Turkish Oncology Group and included 317 patients' data from 36 centers.ResultsMedian age was 51 (22-82). Median PFS was 28.5months, while median OS was 40.3months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8m vs. 28.5m; p=0.002) and OS (26.7m vs. 40.3m; p=0.009). Patients older than 65years of age (n: 42, 13.2%) had significantly lower OS results (19.8m vs. 40.3m; p=0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5-40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure.ConclusionsOur RLP trial included only visceral metastatic, trastuzumab-naive BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab-trastuzumab-taxane therapy to date.Öğe The real-life efficacy of the second line treatment strategy in advanced pancreas cancer(Turkiye Klinikleri, 2022) Hızal, Mutlu; Şendur, Mehmet Ali Nahit; Bilgin, Burak; Karcı Güner, Ebru; Akıncı, Muhammed Bülent; Ergün, Yakup; Esin, Ece; Köksoy, Elif Berna; Sezer, Ahmet; Özdemir, Nuriye; Öksüzoğlu, Berna; Yalçın, Bülent; Utkan, Güngör; Ürün, YükselABS TRACT Objective: Pancreatic cancer is one of the leading causes of cancer-related death. Despite the introduction of new therapeutic agents, survival rates remain low. Furthermore, few trials have evaluated the options for second-line therapy and the prognostic variables. In this study, we aimed to determine the real-world efficacy and prognostic parameters of second-line treatment for advanced pancreatic cancer. Material and Methods: Patients with advanced pancreatic cancer from different centers who received second-line treatment were enrolled in the study. The patients’ demographic, clinical, and pathological characteristics were retrieved retrospectively. Results: A total of 161 patients were enrolled in the study. The majority of the patients (50.3%) received oxaliplatin plus fluoropyrimidine as second-line treatment. The median progression-free survival and overall survival for the entire cohort were 2.5 months and 4.5 months, respectively. In univariate anal-yses, an Eastern Cooperative Oncology Group performance status ?2, age ?65 years, hypoalbuminemia, thrombocytosis, presence of metastatic peritoneal disease, elevated alkaline phosphatase and carcinoembryonic antigen levels, and a neutrophil-lymphocyte ratio (NLR) ?3 were identified as poor prognostic factors. In multivariable analyses, low albumin level (p=0.031) and high NLR (p=0.05) were found to be independent prognostic factors for overall survival. Conclusion: Pancreatic cancer is a unique malignancy, and advanced disease has a dismal prog-nosis. In univariate analyses, we identified multiple factors that were poor prognostic variables. In particular, the albumin level and NLR were independent prognostic factors for overall survival, and these parameters might be useful in selecting the second-line treatment and pre-dicting the survival of these patients.
