1,721,357 research outputs found
What to expect from HER-2 directed therapies in advanced gastric cancer?
No full textGastric cancer is the second most common cause of cancerrelated death worldwide. Over 20% of the advanced gastriccancer are considered to be HER-2 positive. Studiesinvestigating the prognosis of HER-2 positive advancedgastric cancer revealed conflicting results. Trastuzumab, amonoclonal antibody against HER-2, has shown a significantclinical activity in HER-2 positive gastric cancer patients. Inthis review, I will briefly summarize the clinical studies ofanti-HER-2 therapies performed in HER-2 positive gastriccarcinoma.Keywords: Gastric cancer, HER-2/neu, Targeted therap
Impact of adherence to antiemetic guidelines on the incidence of chemotherapy-induced nausea and vomiting and quality of life
No full textBackground International guidelines are tools enabling physicians to incorporate the latest evidence based clinical information into practice. Objective This study aimed to evaluate the impact of antiemetic guidelines adherence on the incidence of chemotherapy-induced nausea and vomiting (CINV) and patient quality of life. Setting Marmara University Pendik Training and Research Hospital chemotherapy unit, Istanbul, Turkey. Method The study included 100 chemotherapy naive patients. Antiemetic prescribing patterns and their consistency with MASCC/ESMO 2014 guidelines were assessed. Patients recorded incidences of vomiting in a daily dairy and described their nausea using a 7-item Likert Scale. The incidence of CINV was recorded over five days. To assess the patient's quality of life, a modified Turkish version of the Functional Living Index-Emesis (FLIE) questionnaire was administered before and after receiving chemotherapy. A questionnaire on the existence and severity of side effects was developed and administered. Main outcome measures Incidence of side effects on CINV and quality of life according to the FLIE. Results The primary outcome revealed differences in complete control (no emetic episodes, rescue therapy or nausea), FLIE scores and side effects. Guidelines consistency was observed more with acute (A) than with delayed (D) prevention of CINV, with significant differences in complete control between the guideline adherent group (GAG) and the guideline nonadherent group (GNG). Significant differences in the FLIE score were noticed between GAG(D) and GNG(D), and GNG(D) had a higher incidence of diarrhoea, headache, swallowing difficulties and dark-coloured stool. Conclusion Consistency with guidelines resulted in significant reduction in the incidence of both cute and delayed CINV and other side effects, and with improvement of the patient quality of life
Analysis of Resected Gastric Cancer in Turkish Population
No full textBackground/Aims: Gastric cancer is still an important health issue in Eastern Europe and Middle East, including Turkey, although its prevalence is decreasing in the western world. Methodology: In order to define the profiles of the patients operated with a diagnosis of gastric cancer in Turkey, a multicenter retrospective study was conducted. Results: Six hundred and forty-eight of the 840 patients with complete data in all parameters were included in the analysis. The median follow-up time was 17.16 months (range, 6-143.63 months). Mean age was 57+/-11.7 (19-85). There was a recurrent disease in 42% of the tumors located at cardia, corpus or antrum, and 86% of diffuse tumors (p<0.0001). The ratio of patients with recurrent disease was greater in stage III and IV tumors (52%) than stage II (29%) and stage I (17%) tumors. There were also greater recurrence ratios in patients with node positive (pN1-3) patients than pN0 tumors, and pT3-4 tumors than pT1 or pT2 tumors. Any recurrence was found in 48% of the tumors with lymphovascular invasion, while in 39% without lymphovascular invasion (p=0.026). A statistically significant difference was found in the recurrence status of patients with positive/ dissected node ratio of <10% and >= 10% (p<0.0001). Conclusions: Gastric cancer cases in Turkey are seen at a younger age, and at a higher stage. Proximal gastric cancer is seen much less than the western series. Prognostic significance of lymphovascular invasion in both univariate, and multivariate analyses is noteworthy
Markers of bone turnover in patients with lung cancer
No full textINTRODUCTION: Bone metastases may change the primary treatment modality, especially if the bone is the only site of metastasis in patients considered to be in the early stage of lung cancer. It is usually diagnosed by imaging techniques. However, the diagnostic yields of imaging methods are limited. Some bone markers such as propeptides of type-1 collagen, pyridinoline cross-links and deoxypyridinoline (D-PYD) cross-links, serum osteocalcin, alkaline phosphatase are thought to be useful in the detection of bone metastasis in lung cancer. Thus, we aimed to determine the clinical usefulness of bone turnover markers in the assessment of bone metastases in patients with lung cancer. MATERIAL AND METHODS: Urinary D-PYD, calcium, and serum osteocalcin, calcium and total alkaline phosphatase (T-ALP) were measured in 60 lung cancer patients. Patients were evaluated by technetium 99 (99Tc) bone scintigraphy. The comparisons of measured values in patients with and without bone metastasis were done by using appropriate statistical methods. RESULTS: Fifty-four males and six females were included into study. Twenty-two patients had bone metastases, while 38 did not. Forty-two patients were nonsmall-cell lung cancer, whereas 18 were small-cell carcinoma. Urinary D-PYD level was the unique value that was statistically significantly higher in patients with bone metastases than that level in patients without bone metastasis (p < 0.05). CONCLUSION: Our study suggests that urinary measurement of D-PYD might be helpful in detecting bone metastasis in lung cancer. The high urinary D-PYD level may be an early sign of occult metastases in patients with no bone metastasis assessed by scintigraphic techniques
Prognostic factors for gemcitabine-refractory patients with advanced pancreatic cancer: a retrospective analysis of a multicentre study (Anatolian Society of Medical Oncology)
No full textAim of the study: Systemic chemotherapy for patients with pancreatic cancer has limited impact on overall survival (OS). Patients eligible for chemotherapy should be selected carefully. The aim of the study was to search for prognostic factors for survival in patients with gemcitabine (Gem)-refractory or with gemcitabine and cisplatin (GemCis)-refractory advanced pancreatic cancer. Material and methods: We retrospectively evaluated patients with Gem-or GemCis-refractory advanced pancreatic cancer. Sixteen potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. Univariate and multivariate statistical methods were used to determine prognostic factors. Results: Multivariate analysis included the four prognostic significance factors in univariate analysis. Multivariate analysis showed that liver metastasis and second-line chemotherapy were considered independent prognostic factors for survival. Conclusions: Liver metastasis and second-line chemotherapy were identified as important prognostic factors in advanced pancreatic cancer patients refractory to treatment with Gem or GemCis. This prognostic factors may also facilitate pretreatment prediction of survival and can be used for selecting patients for treatment
Neoadjuvant chemotherapy for locally advanced breast cancer: a single center experience
No full textNeoadjuvant chemotherapy (NAC) is one of the treatment options for patients with locally advanced breast cancer (LABC). Preoperative chemotherapy potentially may reduce the extent of the surgery and offers the opportunity to assess the chemosensitivity of the tumor in vivo. Herein, we evaluated the results of NAC in Turkish LABC patients. We retrospectively analyzed 73 LABC patients. Anthracycline/taxane-based chemotherapy regimens were administered. Patients were stratified according to age, menopausal status, type of surgery, response to the treatment, histopathological properties, and survival. After 3-6 cycles of chemotherapy, patients were re-staged radiologically and surgery was performed in operable patients. Adjuvant chemotherapy was administered as needed. The median age was 45 (29-93) at the time of diagnosis. Sixteen percentage of patients were younger than 35 years of age and 45.2% were premenopausal. Median follow-up time was 20.2 months. Sixty-seven out of 73 patients responded to therapy (89%). Breast conserving surgery was possible in the 15% of the patients. In histopathological analysis, lymph node invasion was detected in 85%. The estrogen (ER) and progesterone (PR) receptor were positive in 78.1% and c-erb-B2 was positive in 17.5% of patients. The median disease-free survival (DFS) was 44 months (SE: 9; %95 CI: 27.1-60.8), overall survival (OS) was not reached at the time of analysis. Three-year DFS and OS were 58% and 91.9%, respectively. In a multivariate Cox regression analyses; no demographic or pathologic prognostic parameter predicted overall survival. In recent years, NAC in breast cancer has become a viable treatment option for patients with LABC. NAC is not commonly applied in Turkey. The response rate to NAC in Turkish breast cancer patients is encouragingly high. Broader efforts should be made to evaluate breast cancer patients preoperatively at tumor boards for proper treatment sequence
Factors that affect the suitability of cancer patients for clinical drug trials in Turkey: Final analysis of a multicenter study.
No full textBevacizumab plus Capecitabine as Maintenance Therapy after Initial Bevacizumab plus XELOX Treatment in Previously Untreated Patients with Metastatic Colorectal Cancer: Phase Ill 'Stop and Go' Study Results - A Turkish Oncology Group Trial
No full textObjective: It was the aim of this study to evaluate maintenance therapy with bevacizumab + capecitabine following induction with bevacizumab + capecitabine + oxaliplatin (XELOX) versus bevacizumab + XELOX until progression as first-line therapy in metastatic colorectal cancer (mCRC). Methods: Patients received either bevacizumab (7.5 mg/kg) + XELOX (capecitabine 1,000 mg/m(2) twice daily on days 1-14 + oxaliplatin 130 mg/m2 on day 1 every 3 weeks) until disease progression (arm A) or the same doses of bevacizumab + XELOX for 6 cycles followed by bevacizumab + capecitabine until disease progression (arm B). The primary endpoint was progression-free survival (PFS); secondary endpoints included overall survival (OS), objective response rate (ORR) and safety. Results: One hundred and twenty-three patients were randomized. Treatment compliance was similar in both groups. Median PFS was significantly longer for arm B than for arm A (11.0 vs. 8.3 months; p = 0.002). There was no significant difference between the two arms for ORR (66.7 vs. 59.0%; p = 0.861) or median OS (23.8 vs. 20.2 months; p = 0.100). Tolerability was acceptable in both treatment arms; the most frequent grade 3/4 treatment-related adverse events (arm B vs. arm A) were fatigue (6.6 vs. 16.1%), diarrhoea (3.3 vs. 11.3%), anorexia (3.3 vs. 11.3%), and neuropathy (1.6 vs. 8.1%). Conclusions: Maintenance therapy with bevacizumab + capecitabine can be considered an appropriate option following induction bevacizunnab + XELOX in patients with mCRC instead of continuation of bevacizumab + XELOX. (C) 2013 S. Karger AG, Base
Clinicopathologic features of the nine patients with primary diffuse large B cell lymphoma of the breast
No full textNon-Hodgkin lymphomas of the breast are uncommon cancers that occur as either primary extranodal diseases or secondary localizations of a systemic disease. The term primary breast lymphoma (PBL) is used to define malignant lymphomas primarily occurring in the breast in the absence of previously detected lymphoma localizations. In this report, we analyzed nine patients with primary diffuse large B cell lymphoma (DLBCL) of breast. Patients with newly diagnosed PBLs treated between 1997 and 2009 in five institutions were retrospectively evaluated. The median age of the patients with PBL was 49 years (range 30-82 years), and four patients had left-sided and five had right-sided disease. All of the nine patients were classified as DLBCL. Five patients with DLBCL received chemotherapy followed by involved-field or elective-field radiotherapy and four received chemotherapy alone. Complete remission (CR) following primary treatment for all patients with PBL except for two cases was obtained. In two patients, recurrence occurred. At the median follow-up of 24.2 months, the 5-year OS rate was 76.2%. Univariate analysis indicated that age, ECOG PS, clinical stage, international prognostic index score, lactate dehydrogenase levels and the presence of B symptoms were not important prognostic factors in our study. Our series contained a small sample size, but it is interesting because it included only DLBCL cases. However, definitive conclusions about treatment and follow-up options of patients cannot be made in such a small series of patients. There are very few reports of patients with PBL treated with R-CHOP rather than CHOP alone. The followup is probably still too short and sample size very few to know how R-CHOP compares with CHOP-treated patients in other series, but this is definitely worth looking at in more detail when reasonable median follow-up has been achieved and sample size are sufficient
Lapatinib plus Capecitabine for HER2-Positive Advanced-Stage Breast Cancer in Elderly Women: Review of the Anatolian Society of Medical Oncology (ASMO) Experience
No full textBackground: The efficacy and safety of the lapatinib and capecitabine combination remain elusive in elderly patients with metastatic breast cancer (MBC), who progress after trastuzumab-based therapy. Patients and Methods: A total of 26 patients with HER2-positive MBC were included in this retrospective multicenter study. Median age was 69 years (range 65-82 years). All patients were treated with the combination of lapatinib (1,250 mg/day, continuously) and capecitabine (2,000 mg/m(2) on days 1-14 of a 21-day cycle). Data on demographics, clinical outcome, and toxicity were collected for descriptive analyses. Results: The median follow-up was 10 months (range 2-31 months). An overall response rate of 33.4% was achieved, including 1 complete response (3.8%), and 8 partial responses (30.8%). Median progression-free survival was 7 months (95% confidence interval (CI) 5-8), and the median overall survival was 15 months (95% CI 11-19). Most common side effects were fatigue (53.8%), diarrhea (46%), vomiting (36.3%), hand-foot syndrome (34.5%), and anorexia (34.6%). Grade 3-4 toxicities were identified as hand-foot syndrome (3.8%), diarrhea (7.6%), and fatigue (11.5%). There were no symptomatic cardiac events. Conclusion: Lapatinib and capecitabine combination therapy was effective and well tolerated in elderly patients with MBC, who had progressive disease after trastuzunnab-based therapy
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