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WOS:000612861200024 PubMed: 33380668 Background: The most common age at which gastric cancer is diagnosed is 70 years, and the majority of patients diagnosed are at the metastatic stage. However, although gastric cancer is a geriatric disease, there is no suggestion to discriminate treatment for the general geriatric patient population. Here, we evaluated patients receiving palliative chemotherapy for gastric cancer owing to advanced age. Patients and Methods: Multicenter data of geriatric patients receiving palliative chemotherapy because of metastatic gastric cancer were retrospectively reviewed. Results: In total, 262 geriatric patients with gastric cancer were included in the study. Of these, 167 patients, including 134 (51.8%) patients with metastasis at diagnosis and 33 patients with relapse after surgery, were evaluated for palliative therapy. Chemotherapy was started in 87 (52.1%) of 167 patients. The overall median survival of the patients receiving chemotherapy was 9.3 months. There was no difference in overall survival (OS) between patients aged >70 and 2. Conclusion: Advanced age chemotherapy receiving rates in patients with metastatic gastric cancer is decreasing. Survival is not associated with age, but pretreatment ECOG PS is important. Therefore, ECOG PS and comorbidities should be evaluated in detail, and combination therapies could contribute to patient survival.

In this study, the extract of Lavandula stoechas for production of silver and zinc oxide nanoparticle without use of any chemical agent was investigated. The silver (AgNPs) and zinc oxide nanoparticles (ZnONPs) showed strong antibacterial activity against both tested Escherichia coli 0157:H7 (Gram negative) and Staphylococcus aureus (Gram positive) bacteria. The antibacterial activity of bio-synthesized nanoparticles against two pathogens was assessed by minimal inhibitory concentration (MIC) assays. The MIC values ofAgNPs and ZnONPs of 10.63 mu g/mL and 12.5 mu g/mL for E.coli 0157:H7 AgNPs and Staphylococcus aureus against ZnONPs were at 3.32 mu g/mL and 6.25 mu g/mL respectively.

Glioblastoma multiforme (GBM) is the most common and aggressive malignant primary brain tumor in adults. The etiology of GBM is not known, and the prognosis is usually very poor. Despite new diagnostic techniques and treatment methods, the management of patients with GBM is difficult.Currently, the standard of care for the treatment of GBM is surgical resection, followed by concurrent RT with temozolomide, completed by adjuvant CT with temozolomide. Despite the survival benefit associated with these treatments, the majority of patients relapse following initial therapy. Unfortunately, optimal management for patients with recurrent or progressive GBM is unclear.In general, treatment for recurrent GBM may involve repeated resection, focal irradiation, and systemic therapies. When considering in terms of chemotherapy regimen, bevacizumab and irinotecan combination therapy for the progressive GBM may be used a suitable regimen. Also complete response in case of recurrent GBM is very rare.We present two cases with GBM who had complete response with bevacizumab plus irinotecan as second-line CT regimen, which rapidly progressed after surgery, chemoradiotherapy (CRT) and first-line temozolomide therapy.Signs of rapid proliferation in the pathologic specimen of both cases were recorded. During follow-up both cases developed recurrent tumor within a month after first three cycles first-line temozolomide CT.

Background: The primary objective of our study was to examine the clinical outcomes and prognosis of patients with metastatic renal cell carcinoma (mRCC) with brain metastases (BMs) receiving targeted therapy. Patients and methods: Fifty-eight patients from 16 oncology centers for whom complete clinical data were available were retrospectively reviewed. Results: The median age was 57 years (range 30-80). Most patients underwent a nephrectomy (n = 41; 70.7%), were male (n = 42; 72.4%) and had clear-cell (CC) RCC (n = 51; 87.9%). Patients were treated with first-line suni-tinib (n = 45; 77.6%) or pazopanib (n = 13; 22.4%). The median time from the initial RCC diagnosis to the diagnosis of BMs was 9 months. The median time from the first occurrence of metastasis to the development of BMs was 7 months. The median overall survival (OS) of mRCC patients with BMs was 13 months. Time from the initial diagnosis of systemic metastasis to the development of BMs (2; pConclusions: The time from the initial diagnosis of systemic metastasis to the development of BMs (2) were independent risk factors for a poor prognosis.

Amaç: İlk-sıra tedavide oksaliplatin-temelli rejim alan metastatikkolorektal kanserli (mKRK) hastalarda ikinci-sıra tedavide modifiyeFOLFIRI-Bevacizumab (mFOLFIRI-B) rejiminin etkinlik ve tolerabilitesiaraştırıldı.Materyal ve Metot: Çalışmaya ilk-sıra tedavide oksaliplatin-temellirejim alan, ardından progresyon gözlenen ve ikinci-sıra tedavidemFOLFIRI-B rejimi alan mKRK’li hastalar alındı. Toksisite ve etkinlikile ilgili veriler retrospektif olarak değerlendirildi.IntroductionColorectal cancer is a widespread and fatal disease.While constituting approximately 10% of all cancers,it is the third commonest malignancy in both gendersand is the third leading cause of death. It is responsibleof 10% of deaths due to cancer1,2. The main method oftherapy in colorectal cancers is surgical therapy. A partof stage II patients and stage III patients are given adjuvantchemotherapy (CT) following surgical treatment.In stage IV patients, the main treatment approach issystemic CT2–4. In rectal cancer, adjuvant or neoadjuvantchemoradiotherapy (CRT) is added in additionto these approaches5.Metastatic colorectal cancer (mCRC) constitutes animportant part of all colorectal cancers6. Survival timeincreases and symptoms related to the disease are controlledwith use of CT7–9. Currently, survival time hasincreased to more then 2 years with new generationCT drugs including oxaliplatin and irinotecan andBulgular: Toplam 172 mKRK’li hasta ikinci-sıra tedavidemFOLFIRI-B rejimi almıştı. Hastaların %39,5’inde objektif cevap,9,0 aylık (7,6 ile 10,3 arası) median progresyonsuz yaşam, 19,0 aylık(15,1 ile 26,2 arası) median tüm yaşam saptandı. Grade 3/4 toksisite%33,7 oranında tespit edildi. Grade 3/4 hematolojik toksisite%31,9 oranında tespit edildi.Sonuç: Sonuç olarak mKRK’li hastalarda oksaliplatin-temelli rejimsonrası ikinci-sıra tedavide mFOLFIRI-B rejimi etkili ve güvenilir birtedavi rejimidir. Aim: We aimed to investigate the efficacy and tolerability of modifiedFOLFIRI-Bevacizumab (mFOLFIRI-B) regime in the secondlinetreatment of metastatic colorectal cancer (mCRC) patientswho received oxaliplatin-based regimen in the first-line treatment.Material and Method: The patients treated with mFOLFIRI-Bregimen in second-line therapy who had progressed after oxaliplatin-based chemotherapy were included in this study. The datas oftoxicity and efficacy of the regimen were retrospectively evaluated.Results: Total 172 mCRC patients had received mFOLFIRI-B regimein the second-line treatment. 39.5% objective response rate,9.0 months (7.6 to 10.3) median progression-free survival, 19.0months (15.1 to 26.2) median overall survival were found. Grade3/4 toxicity was observed in 33.7%. Grade 3/4 hematologic toxicitywas most frequently observed toxicity (31.9%).Conclusion: mFOLFIRI-B is an efficient and safe regimen for thesecond-line treatment of mCRC patients after the oxaliplatinbasedregimen.

41st Annual Congress of the European-Society-for-Medical-Oncology (ESMO) -- OCT 07-11, 2016 -- Copenhagen, DENMARK, WOS: 000393912500656, …, European Soc Med Oncol

This study aimed to reveal the habits of using internet by cancer patients and their relatives to access health-related information and services in Turkey.An 18-item questionnaire survey was applied in cancer patients and their relatives.A total of 1106 patients (male, 37.3%, and female, 62.7%) and their relatives were included in the study. The responders had been using internet to obtain health information about oncological diseases, once a month (34.2%), 1-2 times a week (27.4%) or 2-3 times a month (21.9%). After diagnosis of cancer was made, participants more frequently (64.4%) investigated health-related issues, while 64.9% of them considered internet as an important search tool, and 16.7% of them had thought to give up cancer therapy under the influence of internet information. Some (33.1%) participants had used herbal medicine, and 16.7% of them had learnt these herbal products from internet. Still 12.7% of them had not questioned the accuracy of internet information, while 26.9% of them indicated that they had not shared the internet information about cancer with their physicians, and 13 % of them searched information in internet without asking their physicians.Cancer patients and their relatives showed a higher tendency to use health-related internet information which may mislead them, and can result in treatment incompliance. Health professionals should offer evidence-based information to the patients and their relatives through internet.

Background: To evaluate the factors that have an impact on the development of brain metastasis in patients with breast cancer. Materials and Methods: Among the patients who were followed-up and treated for breast cancer between January 2000 and January 2010, the ones with brain metastasis were included to the analysis. Metastatic breast cancer patients without brain metastasis, which had similar duration of follow-up and median age were included as the control group. Both group were compared for prognostic and predictive factors in terms of relationship between with or without brain metastasis and survival. Results: There were a total of 63 female patients with metastatic breast cancer who had brain metastasis and the researchers enrolled the same number of female patients as the control group. In the univariate analysis, as a significant finding, it was found that, the patients with breast cancer who had brain metastasis had vascular invasion positivity, human epidermal growth factor receptor-2 (HER-2) positivity, a rare detection of invasive lobular carcinoma component in the tumor, estrogen receptor negativity, and no bone and liver metastasis and they did not receive chemotherapy due to several reasons after the detection of metastasis in any organ. In the multivariate analysis, HER-2 positivity, no bone and liver metastasis and not receiving chemotherapy due to several reasons after the detection of metastasis in any organ were detected as significant findings. Conclusions: As the prognostic and predictive factors showing the development of brain metastasis in breast cancer patients may be identified, follow-up also including the brain is important in order to take preventive measures.

Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO) / Clinical Science Symposium on Predicting and Improving Adverse Outcomes in Older Adults with Cancer -- MAY 29-JUN 02, 2015 -- Chicago, IL, WOS: 000358036902751, …, Amer Soc Clin Oncol

Lapatinib is the first dual tyrosine kinase inhibitor of human epidermal growth factor receptor type 2 (HER2/neu) and epidermal growth factor receptor (EGFR). The present study evaluated the efficacy and tolerability of the combination of lapatinib and capecitabine in patients with metastatic breast cancer (MBC) who progressed after therapy with trastuzumab, a taxane and/or anthracycline. A total of 203 patients with a median age of 48 years (range: 25-82 years) were evaluated retrospectively in 11 centres between September 2007 and May 2011. All the patients had HER2-positive MBC progressing after trastuzumab and chemotherapy including an anthracycline and/or taxane. All patients were treated with the combination of lapatinib (1250 mg/day, continuously) and capecitabine (2000 mg/m(2) on days 1 through 14 of a 21-day cycle). Data on demographics, clinical outcome, and toxicity were collected for descriptive analyses. The median follow-up was 10.7 months (range: 1-40 months). An overall response rate (ORR) of 33.4% was achieved including 7 complete responses (CR, 3.4%), 61 partial responses (PR, 30.0%), and 44 stable disease (37.9%). Clinical benefit rate of 71.3% was achieved. Median progression-free survival (PFS) was 7 months (95% CI: 6-10 months), with a median overall survival (OS) of 15 months (95% CI: 12-18 months). The most common side effects were hand-foot syndrome (46.8%), nausea (42.3%), fatigue (42.2%), anorexia (38.5%), diarrhea (31.5%), and rash (29.6%). Grade 3-4 toxicities were identified as hand foot syndrome (7.9%), diarrhea (6.9%), fatigue (5.9%), and rash (5.4%). There were no symptomatic cardiac events. Lapatinib and capecitabine combination therapy is effective and well tolerated in patients with MBC who had progressive disease after trastuzumab, taxane, and/or anthracycline therapy, as evidenced by this retrospective evaluation. Toxicity was mild to moderate with low grade 3-4 toxicity.

Background/Aims: We aimed to investigate the efficacy and tolerability of a FOLFOX7 regimen in the first-line treatment of metastatic colorectal cancer (mCRC) patients. Materials and Methods: Patients were evaluated in two groups. Group A did not receive any treatment before, and group B had metastasectomy or metastasectomy plus primary tumor resection. Results: In total, 132 mCRC patients had received FOLFOX7 regimen. The A group consisted of 117 (88.6%) patients, and group B consisted of 15 (11.4%) patients. In the A group, 52.1% had an objective response, 9.4% complete response, 42.7% partial response, 24.8% stable response, and 23.1% progression, and there was a 54.5% rate of primary tumor resection, 22.2% rate of metastasectomy, 80.7% rate of R0 metastasectomy, 19.1% rate of R1 metastasectomy, 15 (10-19) months median progression-free survival, and 32 (22-41) months median overall survival. In the B group, 40 (4-70) months median disease-free survival and 58 (21-94) months median overall survival were found. When toxicities were evaluated, grade 3/4 toxicity was observed in 35.6%. Grade 3/4 hematologic toxicity was the most frequently observed toxicity (29.5%). Conclusion: FOLFOX7 regimen was found to be an efficient and safe regimen for the first-line treatment of mCRC patients.

This study examined the incidence rates of cancer cases (averages for 2006-2010) and relationships with environmental radioactivity levels. Soil and water samples were collected from provincial and district centers of Van city and the outdoor gamma doses were determined using a portable gamma scintillation detector. Gross alpha and beta, (226)Ra, (232)Th, and (40) K activities were measured in both tap water and soil samples. Although high rates of stomach and esophagus cancers have been reported previously in Van the underlying reasons have not hitherto been defined. Incidences of cancers were highest in the Gurpinar (326.0) and Ozalp (377.1) counties (p

Background: Cancer diagnosis affects all the relatives living with the patient; however, whether the behavior of family members changes or not is unknown. To end this we evaluated the relatives of lung cancer patients. Materials and Methods: Forty-one questions were used to collect data from the relatives of lung cancer patients who had been living with them for at least one year, to evaluate changes in their attitudes and behaviors related to cancer prevention. Results: The study included 246 lung cancer patients' relatives, of them 172 (69.9%) were women and 74 (30.1%) were men. The median age was 46 years (range: 20-83 years). Patients and their relatives had been living together for an average of 28 years (range: 1-68 years), and 88 (35.7%) of the patients' relatives were their children. We found changes in the attitudes and behaviors toward prevention and screening for cancer in 92 (37.4%) of the relatives. Fifty-two (21.1%) of them changed their smoking habits, 34 (13.8%) altered their eating habits, 25 (10.2%) changed their exercise habits, 13 (5.3%) visited a doctor due to a suspicion of having cancer, 12 (4.9%) changed their lifestyles, seven (2.8%) underwent cancer screening tests, three (1.2%) started using alternative medicines, and three (1.2%) started using vitamins for cancer prevention. Conclusions: Important changes occur in the attitudes and behaviors of patients' relatives toward cancer prevention and screening after the patients are diagnosed with lung cancer. Being aware of how patients' relatives react to a family member's cancer diagnosis may provide healthcare professionals with more incentive to address the relatives' special needs.

e14533 Background: To determine impact of modern chemotherapy regimens after pulmonary metastasectomy from colorectal cancer (CRC). Methods: A total of 122 consecutive patients who curatively resected for pulmonary metastases of CRC in eleven oncology centers were retrospectively analysed between January 2000 and April 2012. Results: Of 122 patients, 108 who received chemotherapy with fluoropyrimidine-based (n = 12), irinotecan-based (n = 56) and oxaliplatin-based (n = 40) combinations were analyzed. Among these, 52 patients received bevacizumab (BEV) while 56 did not (NoBEV). With a median follow-up of 14 months after metastasectomy, median recurrence-free survival (RFS) was 17 months, overall survival (OS) was not reached. Three and 5-years OS rates were 66% and 53%, respectively. There was no significant difference among cytotoxic regimens in respect to RFS and OS. Similarly, no significant difference was seen between BEV and NoBEV arms in respect to OS and RFS. In univariate analysis prior liver metastasectomy (p = 0.045), positive pulmonary margin (p = 0.028), disease-free interval < 12 months (p = 0.013), and KRAS mutation (0.009) were negative significant prognostic for RFS. Thoracic pathological lymphatic involvement (p = 0.006) and higher prethoracotomy carcinoembryonic antigen (p = 0.038) were negative significant prognostic for OS. In multivariate analysis, positive pulmonary margin was the only negative independent prognostic for RFS, while thoracic lymphatic involvement was the only negative independent prognostic for OS. Conclusions: Chemotherapy type and addition of bevacizumab have no impact on both RFS and OS in the adjuvant setting following complete resection of colorectal pulmonary metastases.

Background: To investigate epidermal growth factor receptor (EGFR) gene mutations in patients with non-small cell lung cancer (NSCLC) and to analyze any relationship with clinicopathological features and prognosis. Materials and Methods: EGFR gene exons 18-21 in 48 specimens of paraffin-embedded tumor tissue from NSCLC patients were amplified by PCR, followed by direct sequencing and analysis of links to clinicopathological features and prognosis. Results: EGFR mutations were detected in 18 of 48 (42.6%) patients with NSCLC. There were 9 cases of mutations in exon 20, 7 in exon 19 and 2 in exon 21. Mutations were more frequently observed in women (5/7 pts, 71.4%) than in men (13/41 pts, 31.7%) (p=0.086) and in non-smokers (5/5 pts, 100%) than smokers (13/43 pts, 30.2%). There was negative correlation of EGFR mutations with smoking status (p=0.005). EGFR mutations were more frequently observed with adenocarcinoma histology (13/32 pts, 40.6%) than in other types (5/16 pts, 31.3%) (p=0.527). The patients with EGFR mutations had better survival than those with wild-type EGFR (p=0.08). There was no association of EGFR mutations with metastatic spread. Conclusions: EGFR mutations in NSCLC were here demonstrated more frequently in females, non-smokers and adenocarcinoma histology in the western region of Turkey. Patients with EGFR mutations have a better prognosis.

Background: Changes in the attitudes and behavior of relatives of breast cancer patients concerning cancer prevention and screening after diagnosis in a loved one were evaluated. Materials and Methods: Forty-three questions were used to collect data from the relatives of the breast cancer patients who had been living with their relatives for at least one year. Results: The study group was composed of 171 female relatives (median age: 43, range: 17-82 yr). After the patients were diagnosed with breast cancer, changes in the attitudes and behavior of their relatives toward the prevention and screening of cancer were evident in 78 (45.6%) of the study participants (e.g. eating habits, quit or reduced smoking , exercise habits). In addition, it was noted that some characteristics of the relatives had different effects on different attitudes and behavior. Conclusions: Awareness on breast cancer among the relatives of breast cancer patients is useful for the management of health and social problems that can be seen in these individuals. At the same time, this information could help countries determine whether their actual level of healthcare for early cancer diagnosis, prevention, and screening are adequate.

Objective: The aim of this study was to assess the use of 5-fluorouracil (5-FU), leucovorin and oxaliplatin (FOLFOX) regimens in clinical practice according to their efficacy and toxicity. Methods: Patients who received oxaliplatin-containing regimens after curative resection for colorectal carcinoma from 10 different oncology centers between May 2004 and December 2009 were included in the study. All patients were treated with FOLFOX regimens. Patients with rectal carcinoma were also treated with chemoradiotherapy with 5-FU after 2 cycles of a FOLFOX regimen. Results: The median age of the patients was 56 years (range 17–78). Of the total 667 patients, 326 were given FOLFOX-4, 232 were given modified FOLFOX-4 and 109 were given FOLFOX-6. The distribution according to disease stage was 33 patients with stage IIIA colorectal cancer, 382 patients with stage IIIB and 252 patients with stage IIIC. The most common adverse events were neutropenia (54%), nausea (36.9%), neuropathy (38.2%) and anemia (33.1%) for all grades. The median follow-up time was 23 months (range 1–79). Three-year disease-free survival and overall survival were 65 and 85.7%, respectively. Conclusion: The different oxaliplatin-containing 5-FU-based adjuvant chemotherapy regimens in patients with stage III colorectal cancer seemed to be at least equal in terms of efficacy regardless of the method of 5-FU administration or oxaliplatin dose.

Introduction and Purpose: The frequency of bilateral breast cancer is 1.4-11.0% among all breast cancers. It can present as synchronous (SC) or metachronous (MC). Data regarding clinical course of bilateral breast cancer are scarce. In this study, we therefore evaluated demographic, pathological and clinical characteristics, treatments and responses in bilateral breast cancer cases; making distinctions between metachronous-synchronous and comparing with historic one-sided data for the same parameters. Materials and Methods: One hundred fifty bilateral breast cancer cases from ten different centers between 2000 and 2011 were retrospectively scanned. Age of the cases, family history, menopausal status, pathological features, pathological stages, neoadjuvant, surgery, adjuvant and palliative chemotherapy/radiotherapy were examined in the context of the first and second occurrence and discussed with reference to the literature. Results: Metachronous and synchronous groups showed similar age, menopausal status, tumor type, HER2/neu expression; the family history tumor grade, tumor stage, ER-negativity rate, local and distant metastases rates, surgery, adjuvant chemotherapy application rates were identified as significantly different. Palliative chemotherapy response rate was greater in the metachronous group but median PFS rates did not differ between the groups. Conclusion: Although bilateral breast cancer is not frequent, MC breast cancer is different from SC breast cancer by having more advanced grade, stage, less ER expression, more frequent rates of local relapse and distant metastasis and better response to chemotherapy in case of relapse/metastasis.

Background: Hepatocellular carcinoma (HCC), the main malignant tumor of the liver, is very common and highly lethal. The aim of this study was to determine its clinicopathologic characteristics and risk factors in Turkey. Materials and methods: In this study, patients who were diagnosed as suffering from HCC in the period between August 2004 and December 2011 were evaluated retrospectively. Results: A total of 98 patients were included, with a median age 61 (range: 16 to 82). Seventy nine (80.6%) were male 59 (60.2%) were infected with hepatitis B virus (HBV) and 15 (15.3%) with HCV, another 15 (15.3%) being alcohol abusers. Seventy two (73.5%) were at advanced stage and 54 (55.1%) had elevated serum alpha-fetoprotein (AFP). Surgery, chemoembolization, systemic chemotherapy and application of the tyrosine kinase inhibitor sorafenib were the major treatment options. Conclusions: According to our findings HCC is mostly diagnosed in advanced stage and age, being five times more common in males than females. Main risk factors of HCC are HBV infection, HCV infection and alcohol abuse. Elevation in AFP may facilitate early diagnosis of HCC in high risk groups.