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  • Küçük Resim
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    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, Mehmet
    Objective: 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.
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    The effect of the use of complex molecular profiling in advanced solid organ tumours on clinical decision: Turkey Molecular Profiling in Advanced Cancers Trial (TUMPACT)
    (Elsevier, 2020) Ölmez, Ömer Fatih; Bilici, Ahmet; Er, Özgür; Sevinç, Ali İbrahim; Akman, Tülay; Uslu, Rüçhan; Mandel, Nil Molinas; Yalçın, Şule; Teomete, Mehmet; Görümlü, Gürbüz; Demir, Ahmet Muzafer; Namal, Esat; Alıcı, Süleyman; Selçukbiricik, Fatih; Bavbek, Sevil; Paksoy, Fatma; Başaran, Gül; Özer, Leyla; Şener, Nazlı; Harputluoğlu, Hakan
    Background: Molecular genetic profiling (MGP) which has started to take an important part in cancer diagnosis and treatment in recent years, has entered the routineclinical practice much faster than expected. We aimed to evaluate the use of thistechnology in routine practice, the effect of changing the treatment decision.Methods: Two hundred and thirty-four patients who received treatment from 21different centers with OncoDeep MGP platform tests were included, which uses acombination of new generation sequencing (NGS), immunohistochemistry (IHC) andother specific tests (Package Plus).Results: Summary was given in the table. Physician waited for test results in 27%(n¼61) of patients for treatment decision. Prior to MGP analysis patients receivedmedian 2-lines of treatment. The median time between sending the sample abroadfor testing and reaching the result by the physician was 14 days (range:5-71). With thetest results, the physician changed the treatment decision in 51.8% of the patients(n¼118). The most frequent way of drug supply of patients whose treatment decisionwere 64.4% (n ¼ 67) from their own budget. When the treatment responses wereevaluated, the disease control rate was 31.1% and the drug discontinuation wasapplied due to toxicity in 4 patients (3.4%). 63.6% (n ¼ 75) of the patients were foundto be alive with a median follow-up of 18.0 months. (Table).
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    Value of intravoxel incoherent motion for hepatocellular carcinoma grading
    (Elsevier USA, 2019) Koyuncu Sökmen, Bedriye; Sabet, Soheil; Öz, Ayşegül; Server, Sadık; Namal, Esat; Dayangaç, Murat; Bülbül Do?usoy, Gülen; Tokat, Yaman; İnan, Nagihan
    Background: To evaluate the diagnostic accuracy of intravoxel incoherent motion (IVIM) parameters in estimation of hepatocellular carcinoma (HCC) grading. Materials and methods: Twenty-nine patients with histopathologically diagnosed as 42 HCC at explant were included in this retrospective study. All patients were examined by 1.5T magnetic resonance imaging with the use of 4-channel phased array body coil. In addition to routine pre- and postcontrast sequences, IVIM (16 different b factors varying from 0 to 1300 s/mm2) and conventional diffusion-weighted imaging (3 different b factors of 50, 400, 800 s/mm2) were obtained with single-shot echo planar spin echo sequence. Apparent diffusion coefficient (ADC) and IVIM parameters including mean D (true diffusion coefficient), D* (pseudo-diffusion coefficient associated with blood flow), and f (perfusion fraction) values were calculated. Histopathologically, HCC was classified as low (grade 1, 2) and high (grade 3, 4) grade in accordance with the Edmondson-Steiner score. Quantitatively, ADC, D, D*, and f values were compared between the low- and high-grade groups by Student t test. The relationship between the parameters and histologic grade was analyzed using the Spearman's correlation test. To evaluate the diagnostic performance of the parameters, receiver operating characteristic analysis was performed. Results: High-grade HCCs had significantly lower ADC and D values than low grade groups (P = .005 and P = .026, retrospectively); ADC and D values were inversely correlated with tumor grade (r = –0.519, P = .011, r = –0.510, P = .026, respectively). High-grade HCCs had significantly higher f values when compared with the low-grade group (P = .005). The f values were positively correlated with tumor grade (r = 0.548, P = .007). The best discriminative parameter was f value. Cut-off value of 32% of f values showed sensitivity of 75.6% and a specificity of 73.5%. Conclusion: ADC values and IVIM parameters such as f values appear to reflect the grade of HCCs.