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    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.
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    Immunotherapy era in the treatment of small cell lung cancer
    (Humana Press Inc, 2021) Araz, Murat; Karakurt Eryilmaz, Melek
    Small cell lung cancer (SCLC) is differentiated from non-small cell lung cancers with its histological and morphological features, rapid response to chemotherapy, and recurrence in a short time after treatment is discontinued. Platinum plus etoposide chemotherapy combination has been used as a standard treatment, and no new drug has been found for more than 30 years in this disease. In research, the targeted pathways that may affect survival have not been identified yet. During the second half of the second decade of the 2000s, with immunotherapies that inhibit immune checkpoints, improvements in survival were achieved for the first time in treating SCLC after many years. Then a rapid increase was observed in chemotherapy plus immunotherapy combination studies in this field. Updated analyses of these studies were represented at international oncology meetings in 2020. Here, we reviewed immunotherapy studies conducted in patients with SCLC and the reflections on the daily practice.
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    Pneumonitis associated with Trastuzumab emtansine in a patient with metastatic breast cancer
    (Sage Publications Ltd, 2022) Ugrakli, Muzaffer; Araz, Murat; Demirkiran, Aykut; celik, Ahmet Faruk; Karakurt Eryilmaz, Melek; Karaagac, Mustafa; Artac, Mehmet
    Introduction Trastuzumab emtansine (TDM-1) is an antibody-drug conjugate effective in human epidermal growth factor receptor-2 - expressing advanced breast cancer. Pulmonary complications of TDM-1 are rarely reported. TDM-1-associated interstitial lung disease is referred to as pneumonitis. Case report A 47-year-old female patient who underwent modified radical mastectomy and axillary lymph node dissection operations due to a palpable mass in the right breast and axillary region. The patient who had received multiple chemotherapy was last receiving TDM-1 treatment. Fatigue, dyspnea, and tachypnea were detected for the first time on 20 days after the 6(th) treatment. Menagement and outcome In our case, we first considered metastasis, pneumonia and fungal infection based on radiological findings, but the lack of response to the treatments and the results of the investigations suggested drug-induced pneumonia and steroid treatment was started. Our case had a complete radiological recovery and complete response to sterod therapy. In such cases, it is important to first exclude infections and metastasis. In cases of drug-induced pneumonia, the first treatment option is systemic corticosteroids and generally responded well. Discussion Unlike other cases of interstitial pneumonia, lung imaging of our case was resembling a metastasis, pneumonia and fungal infection. With increasing use of TDM-1, we will have more experience in both efficacy and complications of TDM-1. Although TDM-1 is a well-tolerated drug, clinicians should be aware of rare pulmonary complications and prepared to respond appropriately.