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  • Küçük Resim
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    Efficacy of capecitabine and temozolomide regimen in neuroendocrine tumors: Data from the Turkish oncology group
    (Oxford University Press, 2023) Ünal, Çağlar; Azizy, Abdulmunir; Karabulut, Senem; Taştekin, Didem; Akyıldız, Arif; Yaşar, Serkan; Yalçın, Şuayib; Çoban, Eyüp; Evrensel, Türkkan; Kalkan, Ziya; Sağlam, Sezer
    Introduction: This study aims to report the efficacy and safety of capecitabine plus temozolomide (CAPTEM) across different lines of treatment in patients with metastatic neuroendocrine tumors (NETs).Methods: We conducted a multicenter retrospective study analyzing the data of 308 patients with metastatic NETs treated with CAPTEM between 2010 and 2022 in 34 different hospitals across various regions of Turkey.Results: The median follow-up time was 41.0 months (range: 1.7-212.1), and the median age was 53 years (range: 22-79). Our results across the entire patient cohort showed a median progression-free survival (PFS) of 10.6 months and a median overall survival (OS) of 60.4 months. First-line CAPTEM treatment appeared more effective, with a median PFS of 16.1 months and a median OS of 105.8 months (median PFS 16.1, 7.9, and 9.6 months in first-, second-and =third-line respectively, P = .01; with median OS values of 105.8, 47.2, and 24.1 months, respectively, P = .003) In terms of ORR, the first-line treatment again performed better, resulting in an ORR of 54.7% compared to 33.3% and 30.0% in the second and third or higher lines, respectively (P < .001). Grade 3-4 side effects occurred only in 22.5% of the patients, leading to a discontinuation rate of 9.5%. Despite the differences in outcomes based on treatment line, we did not observe a significant difference in terms of side effects between the first and subsequent lines of treatment.Conclusions and Relevance: The substantial superior outcomes in patients receiving first-line CAPTEM treatment highlight its potential as an effective treatment strategy for patients with metastatic NET.
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    Efficacy of regorafenib in the second-and third-line setting for patients with advanced hepatocellular carcinoma: A real life data of multicenter study from Turkey
    (Imprimatur Publication, 2020) Hacıoğlu, Muhammet Bekir; Köstek, Osman; Karabulut, Senem; Taştekin, Didem; Sezgin Göksu, Sema; Alandağ, Celal; Akagündüz, Baran; Bilgetekin, İrem; Caner, Burcu; Şahin, Ahmet Bilgehan; Yıldız, Birol; Köse, Fatih; Kaplan, Muhammet Ali; Gülmez, Ahmet; Doğan, Ender; Güven, Deniz Can; Gürbüz, Mustafa; Ergun, Yakup; Karaağaç, Mustafa; Demiray, Atike Gökçen; Türker, Sema; Sakalar, Teoman; Özkul, Özlem; Akın Telli, Tuğba; Şahin, Süleyman; Kılıçkap, Saadettin; Bilici, Ahmet; Erdoğan, Bülent; Çiçin, İrfan
    Purpose: After failure of the first-line sorafenib treatment in advanced or metastatic stage hepatocellular carcinoma (HCC), regorafenib is one of the newly-approved targeted agents. We aimed to evaluate the efficacy of regorafenib in patients with advanced HCC treated in the secondor third-line setting.Methods: In this retrospective and multicenter study, advanced HCC patients not eligible for local therapies, who received a secondor third-line regorafenib therapy after progression on the first-line sorafenib or sequential therapy with chemotherapy (CT) followed by sorafenib, were included.Results: In the first-line setting, 28 (28.9%) patients received CT and 69 (71.1%) patients received sorafenib. There were 24 (24.7%) patients who were intolerant to sorafenib. Disease control rate (DCR) was 53.6% for all patients treated with regorafenib, 62.3% in patients who received regorafenib in the second-line, and 32.1% for those receiving regorafenib in the third-line (p=0.007). Median progression-free survival (PFS) and overall survival (OS) were 5.6 (range; 4.3-6.9) and 8.8 (range, 6.3-11.3) months for all patients treated with regorafenib vs. 7.1 months and 10.3 months for patients who received regorafenib in the second-line vs. 5.1 and 8.7 months for patients who received regorafenib in the third-line, respectively; however, there was no statistically significant difference (p(PFS)=0.22 and p(OS)=0.85).Conclusion: Although receiving CT as a first-line therapy in advanced HCC patients did not affect the survival rates of subsequent regorafenib therapy, it might diminish the DCR of regorafenib.