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REAL-WORLD OUTCOMES OF BRAF-MUTANT METASTATIC COLORECTAL CANCER TREATED WITH TARGETED THERAPY
No full textREAL-WORLD OUTCOMES OF BRAF-MUTANTMETASTATIC COLORECTAL CANCER TREATEDWITH TARGETED THERAPYMustafa Ersoy, Selin Meşeli, Ismet ÇulcuoğluKütahya Sağlık Bilimleri Üniversitesi Tıp Fakültesi, İç Hastalıkları AnaBilim Dalı, KütahyaBackground: BRAF mutations are detected in approximately8–12% of metastatic colorectal cancer (mCRC) cases and areassociated with aggressive tumor biology and poor prognosis.Although chemotherapy remains the initial treatment in mostcases, targeted combinations involving BRAF, MEK, and EGFRinhibitors have emerged as effective options following diseaseprogression. However, data from real-world clinical settings remain limited.Methods: Between 2023 and 2025, five patients with BRAFmutant mCRC who had progressed after first-line chemotherapy(FOLFOX or FOLFIRI ± bevacizumab) were treated at our centerwith combination targeted therapy. All patients received a BRAFinhibitor (dabrafenib) plus an EGFR inhibitor (cetuximab), andthree also received a MEK inhibitor (trametinib). Radiological responses were assessed every 8–12 weeks according to RECISTv1.1. Clinical data, including age, metastatic sites, prior treatments, response rate, and progression-free survival (PFS), wereretrospectively analyzed.Results: The median age was 56 years (range 45–68). Allpatients had metastatic disease involving the liver and/or lung atbaseline. Following initiation of targeted therapy, three patients(60%) achieved partial response and two (40%) achieved stable disease, yielding a disease control rate of 100%. The median PFS was 7.8 months, and median overall survival had notbeen reached at the time of data cutoff. Treatment was generallywell tolerated. The most common adverse events were manageable skin rash (n=2), fatigue (n=2), and mild diarrhea (n=1).No grade >=3 toxicity or treatment-related discontinuationoccurred.Conclusion: This small real-world series demonstrates thatcombination BRAF-targeted therapy with EGFR ± MEK inhibition provides meaningful clinical benefit in patients withBRAF-mutant mCRC who have progressed after chemotherapy.Despite the historically poor prognosis of this subgroup, targeted therapy achieved encouraging response rates and acceptabletoxicity, supporting its role as an effective and tolerable option indaily practice. Further multicenter studies with larger cohorts arewarranted to validate these findings.Keywords: BRAF mutation, Metastatic colorectal cancer, Targetedtherapy</p
Hemşirelerin Nütrisyonel Bakıma İlişkin Tutumlarının ve Bilgi DüzeylerininDeğerlendirilmesi
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Correlation of Implant Location to Marginal Bone Level Changes in Single-Unit Restorations: A Retrospective Study
No full textIntroduction: The objective of the present study was to determine the emergence angle (EA) values and emergence profiles (EP) for single-unit fixed prosthetic restorations at the bone level, placed in different locations, and to evaluate their effect on radiographic marginal bone loss. Methods: The study included 226 patients (mean age 63.61 ± 14.9 years), and 500 single-unit dental implants were analyzed in three implant localizations: molar, premolar, and anterior. Patient-related factors, implant length and diameter, implant brand, abutment retention type, implant placement time, prosthetic delivery loading type, prosthetic suprastructure type, and duration of prosthetic delivery time—from implant placement to long-term prosthetic functional loading—were recorded. Radiographically, EA, EP, marginal bone level changes (ΔMBL) at mesial and distal aspects were calculated. Receiver operating characteristic (ROC) curve analysis was employed to determine the cut-off point for all implant locations. Binary logistic regression analysis was utilized to identify confounding factors affecting MBL. Results: The cut-off value of mesial EA was determined for molar, premolar, and anterior regions as 36.422°, 29.703°, and 25.12°, respectively. An increase in the duration of prosthetic delivery time, by every 1 month, the probability of MBL risk was 1.072 times higher. (OR: 1.072; CI: 1.009–1.139; p = 0.025) For the premolar localization variable, the OR value was determined as 2.381, and this indicated that the probability of bone loss in premolar implants is 2.381 times higher than in molar implants. Finally, the OR value of the anterior localization variable was obtained as 3.655, and this value indicated that the probability of bone loss in anterior implants is 3.655 times higher than in molar implants. Conclusions: The findings of this study indicate that ΔMBL can be evaluated over a range of EA values. It can be stated that as the duration of prosthetic delivery time increases following the surgical placement of dental implants, the risk of marginal bone loss also increases
