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Abiraterone experience in a patient with metastatic castration-resistant prostate cancer on hemodialysis
(Sage Publications Ltd, 2019) Eryilmaz, Melek Karakurt; Karaagac, Mustafa
Abiraterone is an oral inhibitor of cytochrome P450 (17alpha)-hydroxylase/17,20 lyase (CYP17) complex critical to androgen production. Abiraterone in combination with prednisone is currently FDA approved for use in men with metastatic castration-resistant prostate cancer, both in the pre- and post-chemotherapy settings. This article discusses the treatment with abiraterone in a patient with metastatic castration-resistant prostate cancer on hemodialysis.
Bevacuzimab May Be Less Effective in Obese Metastatic Colorectal Cancer Patients
(Springer, 2019) Artac, Mehmet; Korkmaz, Levent; Coskun, Hasan Senol; Dane, Faysal; Karabulut, Bulent; Karaagac, Mustafa; Cabuk, Devrim
PurposeThe purpose of this study was to investigate whether obesity affects survival in metastatic colorectal cancer (mCRC) patients treated with bevacizumab combined with chemotherapy.MethodsA total of 563 patients with mCRC who had received first-line chemotherapy in combination with bevacizumab were studied. Patients were grouped as obese (BMI levels >30) or non-obese (BMI levels <30). Progression-free survival (PFS) and overall survival (OS) were analyzed. Primary tumor location was also investigated in terms of PFS and OS.ResultsThe median age of the patients was 59years. The non-obese group had longer PFS than the obese group (P=0.030). The 2-year survival rate of the non-obese group was also significantly higher (P=0.036). The median PFS of non-obese patients was significantly longer in Kras wild-type patients (10.1 vs. 8.1months, P=0.010). Among patients with left-sided primary tumor location, median PFS and OS were significantly higher in the non-obese group (PFS non-obese, 11.5months; obese, 8.8months; P=0.002) (OS non-obese, 29.4months; obese, 21.4months; P=0.026).ConclusionsEfficacy of bevacizumab may be lower in obese patients. Among patients with Kras wild-type left-sided tumors treated with bevacizumab-based regimens, the prognosis could be worse for obese patients than that for non-obese patients. There is a need for prospectively designed studies of obese patients to prove the efficacy and dosages of bevacizumab in treatment of mCRC.
A case of severe vasculitis after FLOT chemotherapy in a patient with metastatic gastric cancer who received multiple line chemotherapy
(Sage Publications Ltd, 2022) Hendem, Engin; Korkmaz, Mustafa; Ukrakli, Muzaffer; Eryilmaz, Melek Karakurt; Karaagac, Mustafa; Araz, Murat; Artac, Mehmet
Introduction Leukocytoclastic vasculitis is a histopathological term describing vasculitis in which the inflammatory infiltrate in small vessels consists of neutrophils. Although FLOT is given perioperatively in locally advanced, resectable gastric or gastroesophageal junction adenocarcinoma, it has recently become a popular treatment option for metastatic cancers. In this case report, we present a case of FLOT-induced LCV. Case Report We present a 52-year-old patient with metastatic gastric adenocarcinoma treated with FLOT. The patient developed necrotizing vasculitis in the lower extremity after 5 cycles of FLOT. Management & Outcome After discontinuation of the FLOT regimen, the necrotizing morbid LCV gradually regressed with steroid therapy. Discussion To the best of our knowledge, our case is the first case of LCV that developed after FLOT chemotherapy. The clinical appearance of the patient, occurrence after chemotherapy, erythematous rash developing on bilateral lower extremities, and palpable purpuric vasculitis made us suspect. We found a potential relationship between FLOT and vasculitis according to the Naranjo scale (score 4 + ).
Circular analyses of dates on patients with gastric carcinoma
(Taylor & Francis Ltd, 2021) Karaibrahimoglu, Adnan; Ayhan, Seren; Karaagac, Mustafa; Artac, Mehmet
Dates have great importance in cancer diseases. However, the date variables themselves are not analyzed. This study aims to evaluate the descriptive statistics of diagnosis, operation, and last examination dates in gastric carcinoma patients by circular analysis methods. Totally 502 gastric carcinoma patients were enrolled in the study. The mean month of diagnosis date was found in nearly November (similar to 10.86) for females and May (similar to 5.17) for male patients. The mean month of operation date was found March (similar to 3.24) for females, and July & August (similar to 7.79) for males. The mean month of the last examination date was found as February & March (similar to 2.61) for females, and May (similar to 4.85) for males. Moreover, the mean day of the week for diagnosis date was found Thursday (similar to 5.50) for both female and male patients. The fitting of distributions of all variables was checked, also, according to von Mises, Rayleigh, and Kuiper's tests. When the days and months were analyzed by classical descriptive statistics, the results were obtained completely different from the circular analyses results. Therefore, the dates and times should be analyzed in certain diseases to give an idea for physicians.
Cisplatin plus paclitaxel and bevacizumab versus carboplatin plus paclitaxel and bevacizumab for the first-line treatment of metastatic or recurrent cervical cancer
(Bmj Publishing Group, 2022) Ilhan, Yusuf; Tatli, Ali Murat; Teker, Fatih; Onder, Arif Hakan; Kose, Fatih; Geredeli, Caglayan; Karaagac, Mustafa
Objective Cisplatin-paclitaxel and bevacizumab is a frequently used treatment regimen for metastatic or recurrent cervical cancer, and carboplatin-paclitaxel and bevacizumab are also among the recommended regimens. In this study we aimed to evaluate the efficacy of these two regimens for the treatment of metastatic or recurrent cervical cancer. Methods Patients with metastatic or recurrent cervical cancer treated with cisplatin-paclitaxel and bevacizumab or carboplatin-paclitaxel and bevacizumab were retrospectively evaluated in this study. The clinical and demographic characteristics of patients in each group were evaluated. Median overall survival, progression-free survival, and response rates between the two groups were compared. Results A total of 250 patients were included. Overall, the numbers of patients with recurrent disease and metastatic disease were 159 and 91, respectively. The most common histologic subtype was squamous cell carcinoma (83.2%). The median duration of follow-up was 13.6 (range 0.5-86) months. The median progression-free survival was 10.5 (95% CI 9.0 to 11.8) months in the cisplatin-paclitaxel and bevacizumab group (group 1), and 10.8 (95% CI 8.6 to 13.0) months in the carboplatin-paclitaxel and bevacizumab group (group 2) (HR 1.20; 95% CI 0.88 to 1.63; p=0.25). The median overall survival was 19.1 (95% CI 13.0 to 25.1) months in group 1 and 18.3 (95% CI 15.3 to 21.3) months in group 2 (HR 1.28; 95% CI 0.91 to 1.80; p=0.15). Conclusions There is no survival difference between cisplatin or carboplatin combined with paclitaxel and bevacizumab in metastatic or recurrent cervical cancer.
Comparison of palonosetron and granisetron in triplet antiemetic therapy in nonmetastatic breast cancer patients receiving high emetogenic chemotherapy: a multicenter, prospective, and observational study
(Springer, 2019) Araz, Murat; Karaagac, Mustafa; Korkmaz, Levent; Koral, Lokman; Inci, Fatih; Beypinar, Ismail; Uysal, Mukremin
PurposeWe aimed to investigate the efficacy of 0.25mg dose of palonosetron and granisetron in triplet antiemetic prophylaxis in breast cancer patients receiving HEC.MethodsPatients with nonmetastatic breast cancer who received HEC [doxorubicin or epirubicin plus cyclophosphamide (AC/EC)] were enrolled in the study. The prophylactic triplet antiemetic regimens were used according to the doctor's preference during the first cycle of HEC as intravenous dexamethasone and palonosetron 0.25mg or granisetron 3mg on day 1 as well as oral aprepitant (125mg on day 1 and 80mg on days 2 and 3).The primary endpoint was complete response rate (CR) on acute and delayed chemotherapy-induced nausea and vomiting (CINV), separately.ResultsA total of 118 female patients were included in the study. Patients received AC (83%), EC (3%), and dose-dense AC (14%) as adjuvant (88%) or neoadjuvant (12%). The majority of patients received palonosetron (59%) containing antiemetic treatment. The CR rate on acute and delayed vomiting was very high and not statistically different in both of the arms (acute 87% vs. 96%, p=0.089; delayed 90% vs. 92%, p=0.489), respectively. Nevertheless, the CR rate on either acute or delayed nausea was lower than vomiting (acute 51% vs. 51%; delayed 38% vs. 29%, p=0.203; respectively).ConclusionsThis is the second study that compared a 0.25mg dose of palonosetron with first-generation setron in triplet antiemetic prophylaxis in cancer patients receiving HEC. We could not find meaningful statistical differences between two arms, regarding CR rate on acute and delayed CINV.
The compliance with antiemetic guidelines of Turkish medical oncologists. A survey study of Turkish Oncology Group
(Mosby-Elsevier, 2019) Araz, Murat; Karaagac, Mustafa; Korkmaz, Levent; Beypinar, Ismail; Uysal, Mukremin
Purpose: We aimed to investigate the compliance of Turkish Medical Oncologists to antiemetic guidelines for treatment of acute and delayed chemotherapy-induced nausea and vomiting (CINV) in patients receiving high (HEC), moderate (MEC), and low (LEC) emetogenic chemotherapy. Method: A covering electronic mail letter with an online questionnaire link was sent to e-mail and mobile application groups including all 599 members of the Turkish Society of Medical Oncology in January 2018. The online survey has consisted of twelve questions. Results: Questionnaire form was responded by 146 of Turkish Medical Oncologists. The most of the participants were following up more than one antiemetic guideline (53%). While compliance with the antiemetic guidelines was higher in acute CINV prophylaxis for HEC and MEC, it was significantly lower in the delayed CINV treatment of HEC and LEC. The highest and lowest compliance rate was found in the prophylaxis of acute and delayed CINV of HEC (92% and 15%, respectively). The incidence of noncompliance for delayed CINV in HEC was statistically significantly higher in those who worked for <= five years in an oncology department, under 39 years of age, and non-academicians (p = 0.004, p = 0.042, p = 0.005, respectively). Conclusions: Noncompliance with the antiemetic guidelines is continue to be a big problem in Turkish Medical Oncologists. The use of standardized antiemetic protocols in chemotherapy order forms or a computerized decision-support system is now seen as a better tool to enhance compliance with the guidelines. (C) 2018 Elsevier Inc. All rights reserved.
Development of second primary multiple myeloma five years after treatment for limited-stage small cell lung cancer: a rare case report
(Via Medica, 2021) Eryilmaz, Melek Karakurt; Aykut, Talat; Korkmaz, Mustafa; Karaagac, Mustafa; Araz, Murat; Artac, Mehmet
Introduction. The development of a second primary malignancy (SPM) following small cell lung cancer (SCLC) has been previously reported in the literature. Especially smoking-related malignancy coupling is well known. The development of multiple myeloma (MM) in long-term survivors after treatment for SCLC is unknown. Here, we report the first case in the literature who developed MM 5 years after treatment for limited-stage SCLC. Case report. A 67-year-old male patient was diagnosed with limited-stage SCLC. After he received chemotherapy and radiotherapy, he was followed up without medication. He was admitted to the hospital with back pain and dyspnea 5 years after the diagnosis of small cell lung cancer. MRI revealed osteolytic lesions in the vertebrae. Laboratory testing revealed a markedly elevated serum IgA and an elevated serum beta-2 microglobulin level. Serum immunofixation revealed IgA lambda-type M-protein. Lambda excretion in urine immunofixation electrophoresis was observed. Bone marrow aspiration revealed the frequency of plasma cells to be 80% of all nucleated cells. Hence, the final diagnosis revealed IgA lambda free light chain MM. Treatment was given for multiple myeloma. In the follow-up, the patient experienced increased dyspnea and developed bilateral pleural effusion. The cytology sent from thoracentesis sampling was reported as plasmocyte-rich material. The patient fell into a coma and died in an intensive care unit. Conclusion. We presented the development of MM 5 years after treatment in a patient with SCLC who were treated for one year and then followed up with stable findings. It should be kept in mind that a patient with SCLC who is a long-term survivor and presents with back pain may have developed a primary malignancy originating from bone marrow rather than a bone metastasis. Patients should be advised smoking cessation after the treatment and diagnosis of SCLC. Also, the patients with SCLC who are long-term survivors should be closely monitored for the development of SPM.
Do high-risk features support the use of adjuvant chemotherapy in stage II colon cancer? A Turkish Oncology Group study
(Sage Publications Ltd, 2014) Artac, Mehmet; Turha, Nazim Serdar; Kocer, Murat; Karabulut, Bulent; Bozcuk, Hakan; Yalcin, Suayip; Karaagac, Mustafa
Background. A high-risk group of patients with stage II colon cancer has been identified by the results of studies in Western populations. The aim of this study was to investigate the prognostic factors of adjuvant chemotherapy in Turkish patients with stage II colon cancer. Methods. A total of 554 stage II colon cancer patients were retrospectively enrolled in the study. Three hundred fifty-three patients had received adjuvant chemotherapy (5-FU-LV, FOLFOX or FLOX) and 201 had received no adjuvant chemotherapy. T4 tumor stage, lymphovascular invasion, perineural invasion, bowel obstruction and/or perforation, <12 harvested lymph nodes, and poor differentiation were defined as high-risk factors. Results. The median age of the patients was 62 years (range 26-88). The median disease-free survival (DFS) was 58.1 months (95% CI, 47.6 months to 68.5 months) in the non-treatment group and has not been reached in the treatment group (P <0.01). In univariate analysis, patient age >60 years and T4 tumor stage were statistically significant factors that affected DFS as poor prognostic factors. Adjuvant chemotherapy reduced the risk of recurrence with statistical significance (P <0.01). In multivariate analysis, patient age >60 years and T4 tumor stage were independent risk factors affecting DFS. In addition, adjuvant chemotherapy was an independent favorable prognostic factor for DFS (P <0.01). Conclusions. Clinical and pathological risk factors in patients with stage II colon cancer may be different in the Turkish population compared to other populations. Further prospective studies in colon cancer are needed to understand the differences in biology and risk factors between races.
DOES PRIMARY TUMOR RESECTION AFFECT SURVIVAL IN ELDERLY PATIENTS WITH METASTATIC GASTRIC CANCER?
(Gunes Kitabevi Ltd Sti, 2016) Yalcin Musri, Fatma; Mutlu, Hasan; Karaagac, Mustafa; Gunduz, Seyda; Karakurt Eryilmaz, Melek; Kivrak Salim, Derya; Tazegul, Gokhan
Introduction: In this study, the effect of primary tumor resection (PTR) on the survival of patients with metastatic gastric carcinoma (mCG) aged over 65 years was aimed to be searched. Materials and Method: In total, 98 patients with mCG from the Akdeniz University, Necmettin Erbakan University, and Antalya Training and Research Hospital databases who were aged over 65 years were retrospectively evaluated. The patients were divided into two groups based on PTR: PTR (+) and PTR (-). Results: The median progression-free survival in the PTR (+) group was 10.2 months (95% confidence interval [CI] 6.6-13.7) and in the PTR (-) group was 5.9 months (95% CI 2.6-9.3) (p=0.054). When we evaluated the overall survival (OS) of the groups, the median OS was significantly higher in the PTR (+) group (11.5 months, 95% CI 8.4-14.6) than in the PTR (-) group (7.2 months, 95% CI 4.3-10.0) (p=0.001). In the final multivariate analysis, none of the parameters studied were independent prognostic factors. Conclusion: PTR may be beneficial for the survival of patients with mGC aged over 65 years.
Erlotinib Response in a Non-Small Cell Lung Cancer Patient with EGFR Exon 20 Mutation
(Akad Doktorlar Yayinevi, 2016) Korkmaz, Levent; Artac, Mehmet; Karaagac, Mustafa; Er, Zehra; Boruban, Melih C.; Poyraz, Necdet; Kaya, Bugra
[Abstract Not Availabe]
First renal metastasis report from tongue cancer
(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2022) Korkmaz, Mustafa; Eryilmaz, Melek Karakurt; Karaagac, Mustafa; Artac, Mehmet
[Abstract Not Availabe]
The goal of primary therapy in non-metastatic nasopharyngeal cancer should be radiological complete response
(Springer, 2022) Korkmaz, Mustafa; Eryilmaz, Melek Karakurt; Kocak, Mehmet Zahid; Demirkiran, Aykut; Karaagac, Mustafa; Artac, Mehmet
Background: We aimed to investigate the effect of radiological complete response on survival outcomes in patients with non-metastatic nasopharyngeal cancer. This study is conducted as a retrospective cohort. Of the 185 patients screened, 60 were metastatic, 25 patients' data was not available, and as a result, 92 patients were included in the study. Among the complete response (CR) and incomplete response (IR) groups, overall survival (OS), distant metastasis-free survival (DMFS), and locoregional failure-free survival (LRFFS) were evaluated. Results: Of the 92 patients, 54 (58.6%) were CR and 38 (41.4%) were IR patients. Of the whole study group, the 5-year OS, DMFS, and LRFFS rates were 75%, 78%, and 95%, respectively. A significant difference was found between the 5-year OS (90% vs. 60%, p= 0.001) and DMFS (87% vs. 65%, p= 0.02) rates. However, there was no significant difference in the 5-year LRFFS rate (97% vs. 92%, p= 0.16). Complete response were determined as an independent predictor for OS (HR: 0.13, 95% CI: 0.045-0.36, p <0.001) and DMFS (HR: 0.26, 95% CI: 0.095-0.744, p= 0.012). Conclusion: As a result, the survival benefit in patients with CR after primary treatment is evident as shown in the above studies. Therefore, the aim of primary treatment should be to increase the CR rates. It is important to evaluate early tumor response to determine poor tumor regression.
The goal of primary therapy in non-metastatic nasopharyngeal cancer should be radiological complete response
(Springer, 2022) Korkmaz, Mustafa; Eryilmaz, Melek Karakurt; Kocak, Mehmet Zahid; Demirkiran, Aykut; Karaagac, Mustafa; Artac, Mehmet
Background: We aimed to investigate the effect of radiological complete response on survival outcomes in patients with non-metastatic nasopharyngeal cancer. This study is conducted as a retrospective cohort. Of the 185 patients screened, 60 were metastatic, 25 patients' data was not available, and as a result, 92 patients were included in the study. Among the complete response (CR) and incomplete response (IR) groups, overall survival (OS), distant metastasis-free survival (DMFS), and locoregional failure-free survival (LRFFS) were evaluated. Results: Of the 92 patients, 54 (58.6%) were CR and 38 (41.4%) were IR patients. Of the whole study group, the 5-year OS, DMFS, and LRFFS rates were 75%, 78%, and 95%, respectively. A significant difference was found between the 5-year OS (90% vs. 60%, p= 0.001) and DMFS (87% vs. 65%, p= 0.02) rates. However, there was no significant difference in the 5-year LRFFS rate (97% vs. 92%, p= 0.16). Complete response were determined as an independent predictor for OS (HR: 0.13, 95% CI: 0.045-0.36, p <0.001) and DMFS (HR: 0.26, 95% CI: 0.095-0.744, p= 0.012). Conclusion: As a result, the survival benefit in patients with CR after primary treatment is evident as shown in the above studies. Therefore, the aim of primary treatment should be to increase the CR rates. It is important to evaluate early tumor response to determine poor tumor regression.
Ibrutinib and panitumumab used in combination safely in a patient with metachronous colorectal cancer and chronic lymphocytic leukemia
(Lippincott Williams & Wilkins, 2022) Korkmaz, Mustafa; Eryilmaz, Melek Karakurt; Karaagac, Mustafa; Araz, Murat; Ceneli, Ozcan; Artac, Mehmet
Ibrutinib is a Bruton tyrosine kinase inhibitor used in the treatment of chronic lymphocytic leukemia (CLL). Panitumumab, an mAb for epidermal growth factor receptor, is used in the treatment of metastatic colorectal cancer (CRC). We wanted to present our case where we used ibrutinib and panitumumab in combination in a patient with metachronous CLL and CRC. A 58-year-old male patient with a diagnosis of CLL was receiving ibrutinib treatment and primary rectal cancer was detected. FOLFOX + panitumumab were started when metastasis was detected in the lung after neoadjuvant chemoradiotherapy for rectal cancer. The patients used ibrutinib and panitumumab in combination. There was no cumulative or unexpected toxicity due to the combination of both antineoplastic agents. The most important point to be considered in the use of combined drugs is the evaluation of drug-drug interactions. Toxic effects of the combination of ibrutinib and cetuximab have been reported in a patient with metastatic CRC. We used ibrutinib together with panitumumab in our case and we did not encounter any cumulative or unexpected side effects during the treatment.
Investigation of the effects of antidepressant treatment on hippocampus and hypothalamus endoplasmic reticulum stress in chronic mild stress induced depression in rats
(Klinik Psikiyatri Dergisi, 2023) Karaagac, Mustafa; Ak, Mehmet; Kurar, Ercan; Uguz, Faruk; Kutlu, Selim
Objective: This study aimed to examine the role of endoplasmic reticulum (ER) stress in the pathophysiology of depression in female rats exposed to the chronic mild stress model.Method: Chronic mild stress model was constituted in 48 female adult rats were and divided into 4 groups as control, depression, depression+1 mg/kg sertraline, and depression+10 mg/kg sertraline. Subcutaneous drug infusions were performed for 14 days using osmotic minipumps. Expression levels of genes in ER stress pathway were evalulated in hypothalamus and hippocampus tissues of rats. Results: It was found that ATF4 gene expression increased in depression in the hippocampus and decreased with treatment. Hippocampal GRP78 gene expression was downregulated after treatment. Hypothalamic and hippocampal CALR gene expression decreased with treatment, hypothalamic HSP47 gene expression decreased in both treatment groups. Hypothalamic and hippocampal XPB1 gene expression decreased with treatment, hippocampal XPB1 gene expression was further downregulated in the depression +10 mg/kg sertraline group compared to the depression+1 mg/kg sertraline group.Discussion: These findings show that the ER stress mechanism may have a role in the pathophysiology of depression and that this mechanism can be reversed with treatment. The results of our study have been encouraging for human studies and open the way for new projects to understand and accelerate the antidepressant effect.
Irinotecan and Ifosfamide Combination is an Effective and Safe Option in Patients with Refractory Small Cell Lung Cancer: A Retrospective Cross-Sectional Study
(Kare Publ, 2020) Karaagac, Mustafa; Artac, Mehmet; Goksu, Sema Sezgin; Eryilmaz, Melek Karakurt; Coskun, Hasan Senol; Bozcuk, Hakan
Objectives: Recurrent and progressive small cell lung cancer (SCLC) has a very poor prognosis, and treatment options are limited. Combination of irinotecan with ifosfamide ( I-I regimen) in SCLC has limited preliminary data. In this study, we aimed to evaluate the efficacy and toxicity of I-I regimen in patients with previously treated SCLC. Methods: A total of 25 patients were retrospectively reviewed. Ifosfamide dose was 1500 mg/m2/ per day, days 1-3, irinotecan 80 mg/m2 per day days 1.8 and 15 every four weeks. Results: Median age of patients was 55 years (range 42-80). Median chemotherapy cycles were 3 (range 1-7). The frequency of the second, third and fourth line treatments were 68%, 24%, and 8% respectively. Partial remission was obtained in 15 patients (60%) and complete remission in one patient (4%). Median progression free survival (PFS) and overall survival (OS) figures were 7.8 and 11.1 months, respectively. Granulocyte colony stimulating factor (G-CSF) was used in 40% of patients. Grade 3-4 anemia, leukopenia, and thrombocytopenia were seen in 20%, 36% and 12% of these cases, respectively. Conclusion: Ifosfamide and irinotecan combination is an effective and a tolerable treatment option for patients with platinum refractory SCLC.
Irinotecan and Ifosfamide Combination is an Effective and Safe Option in Patients with Refractory Small Cell Lung Cancer: A Retrospective Cross-Sectional Study
(Kare Publ, 2020) Karaagac, Mustafa; Artac, Mehmet; Goksu, Sema Sezgin; Eryilmaz, Melek Karakurt; Coskun, Hasan Senol; Bozcuk, Hakan
Objectives: Recurrent and progressive small cell lung cancer (SCLC) has a very poor prognosis, and treatment options are limited. Combination of irinotecan with ifosfamide ( I-I regimen) in SCLC has limited preliminary data. In this study, we aimed to evaluate the efficacy and toxicity of I-I regimen in patients with previously treated SCLC. Methods: A total of 25 patients were retrospectively reviewed. Ifosfamide dose was 1500 mg/m2/ per day, days 1-3, irinotecan 80 mg/m2 per day days 1.8 and 15 every four weeks. Results: Median age of patients was 55 years (range 42-80). Median chemotherapy cycles were 3 (range 1-7). The frequency of the second, third and fourth line treatments were 68%, 24%, and 8% respectively. Partial remission was obtained in 15 patients (60%) and complete remission in one patient (4%). Median progression free survival (PFS) and overall survival (OS) figures were 7.8 and 11.1 months, respectively. Granulocyte colony stimulating factor (G-CSF) was used in 40% of patients. Grade 3-4 anemia, leukopenia, and thrombocytopenia were seen in 20%, 36% and 12% of these cases, respectively. Conclusion: Ifosfamide and irinotecan combination is an effective and a tolerable treatment option for patients with platinum refractory SCLC.
Is pancreatic giant cell tumor resistant to standard chemotherapy?
(Lippincott Williams & Wilkins, 2022) Caglayan, Dilek; Eryilmaz, Melek Karakurt; Korkmaz, Mustafa; Karaagac, Mustafa; Hendem, Engin; Artac, Mehmet
Pancreatic giant cell tumors (PGCTs), undifferentiated pancreatic carcinoma are rare tumors of the pancreas. PGCTs consist of osteoclastic, pleomorphic and mixed variants. PGCT is usually diagnosed at an advanced stage. PGCT has a worse prognosis than pancreatic ductal adenocarcinoma. Although surgery can be curative, there is no standard treatment approach for advanced PGCT. We present a case of PGCT that is resistant to standard therapy and progresses in a short time.
Is the Prognostic Nutritional Index a Prognostic Marker for the Survival of Patients with Lymph-Node Positive Stage II-III Gastric Cancer Who Receive Adjuvant Chemotherapy?
(Springer, 2023) Korkmaz, Mustafa; Eryilmaz, Melek Karakurt; Er, Muhammed Muhiddin; Kocak, Mehmet Zahid; Demirkiran, Aykut; Karaagac, Mustafa; Araz, Murat
Purpose The prognostic nutritional index (PNI), like other systemic inflammatory markers, has been shown to be a prognostic factor in various cancer patients. In this study, we aimed to show whether PNI calculated before adjuvant chemotherapy is a prognostic factor for overall survival (OS) and disease-free survival (DFS) in patients with lymph node-positive stage II-III gastric cancer.Methods The PNI was calculated using the albumin and lymphocyte count. The PNI cut-off value was found to be 39.5. They were divided into two groups as being = 39.5 (PNI low group) and > 39.5 (PNI high group).Results Our study included 168 patients with lymph node-positive stage II-III gastric cancer who received adjuvant chemotherapy. Of the patients, 116 (69.0%) were 65 years or younger, and 52 (31.0%) were over 65 years old. Of the patients, 117 (69.6%) were pT3, 51 (30.4%) were pT4. Seventy-three (43.4%) patients had pN1-2 disease and 95 (56.6%) patients had pN3 disease. The number of stage II patients was 73 (43.5%) and the number of stage III patients was 95 (56.5%). There were 73 patients with PNI = 39.5 and 95 patients with PNI > 39.5. The mOS of the patients with low PNI group was 39.5 months, while the OS of the patients with high PNI group was 96.8 months (p = 0.002). In the group of patients with PNI low group, mDFS 24.4 months was significantly higher than those with PNI high group was 50.7 months (p = 0.021). The PNI score was statistically significant in univariate and multivariate analyzes for both DFS and OS.Conclusion PNI can be used as an independent prognostic factor for both OS and DFS in patients lymph node-positive, stage II-III gastric cancer who will receive adjuvant chemotherapy.

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