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The aim of this study was to investigate the predictive value of PLR and NLR as an indicator of pathological complete response (pCR) in patients with breast cancer after NACT. One hundred thirty-nine patients with early or LABC and candidates to NACT were retrospectively analyzed. The prognostic significance of PLR and NLR was analyzed. In addition, predictive indicators of pCR to NACT were also evaluated. pCR was obtained in 48.9% of patients. Significant difference was detected between pCR and PLR, tumor grade, clinical lymph node status and molecular subgroup. The higher rate of pCR was significantly achieved for patients with PLRlow (181.7) (68.6% vs. 33.4%; P < 0.001). PLR, tumor grade and pCR to NACT for disease-free survival (DFS), and PLR, NLR, tumor grade and pCR to NACT for overall survival were detected to be prognostic factors by univariate analysis. On the other hand, a logistic regression analysis indicated that PLR and NLR were found to be an independent factors for predicting pCR to NACT (P < 0.001; OR, 0.07; 95% CI, 0.02-0.25 and P = 0.016; OR, 4.66; 95% CI, 1.33-16.2, respectively), as were molecular subtypes (P = 0.001; OR, 0.23; 95% CI, 0.09-0.56). Our results showed that PLRlow and NLRlow before NACT are readily feasible and simple and also inexpensive biomarkers predicting pCR to NACT for patients with LABC.

Atezolizumab is now the standard treatment for extensive-stage small cell lung cancer (ES-SCLC). Herein, we investigated the prognostic role of inflammatory markers in patients treated with atezolizumab plus chemotherapy and evaluated the efficacy and safety of adding atezolizumab to chemotherapy for patients with ES-SCLC and prognostic and predictive factors as a real-life experience. This retrospective study included 55 patients who received front-line atezolizumab with etoposide plus platin regimen for ES-SCLC. We analyzed the survival outcomes and factors that may predict response and survival. The objective response rate (ORR) was 81.8%. At a median follow-up of 23.5 months, the median progression-free survival (PFS) time was 10.8 months, and the median overall survival (OS) time was 15.2 months. In univariate analysis for PFS, limited-stage disease at the time of diagnosis, the presence of prophylactic cranial irradiation (PCI), the presence of liver metastasis, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were found to be prognostic factors (P = .041, P = .034, P = .031, P = .004, and P = 135.7. Similarly, median PFS was 14.9 months in patients with NLR ≤ 3.43, while it was 9.6 months in patients with > 3.43. Univariate analysis for OS revealed that limited stage at the time of diagnosis, NLR and PLR were significant prognostic indicators (P = .01, P = .006, and P = .007, respectively). Median OS time for patients with both NLR ≤ 3.43 and PLR ≤ 135.7 was significantly better than that of patients with NLR > 3.43 and PLR > 135.7 (16.9 vs 11.3 and 16.9 vs 11.5 months, respectively). Logistic regression analysis demonstrated that PLR was an independent significant predictive factor for the response to atezolizumab plus chemotherapy (OR: 0.07, P = .028). The patients with PLR ≤ 135.7 were significantly good responders to atezolizumab plus chemotherapy treatment. Real-life data demonstrated a significant correlation between survival and NLR and, PLR in ES-SCLC patients treated with atezolizumab. In addition, PLR was a significant predictive indicator of response to atezolizumab plus chemotherapy.

Background: Randomized clinical trials showed that maintenance chemotherapy plus biologics in patients with mCRC could increase the progression free survival (PFS) without any advantage for overall survival (OS). Our aim was to study the real-life experience (onco-colon registry Turkey) of maintenance chemotherapy with antiEGFR or antiVEGF mAbs after the standart firstline doublet chemotherapy backbone in RAS wild-type mCRC patients. Amgen

e15562 Background: Varieties of systemic treatments in second-line treatment for metastatic colorectal cancer (mCRC) patients have showed an improvement on survival. In this context, most of mCRC patients are likely to progress and to change from first line to second line treatment when they develop resistance to first-line treatment options. Therefore, we aimed to investigate second-line treatment selection in patients with RAS-wild type mCRC. Methods: Medical records from 28 centers were collected for patients diagnosed with RAS wild-type and were included into the study. Histopathological, molecular and clinical characteristics of the patients were recorded. The treatment duration, response rate, progression-free survival and safety results were determined. Patients were compared according to the second-line biological treatments as anti-EGFR group (Group A and B; panitumumab and cetuximab) and anti-VEGF group (group C; bevacizumab or aflibercept). Results: A total of 1064 patients with documented RAS wild-type status were evaluated. Fifty-six percent of all first line patients were treated with regimen including biologics received second line treatment. Median age was 60 years. 34,7 percent of the patients were female. Nineteen percent of the patients had a right-sided colon tumor. 16,3 %, 22,5% and 61,2 % of all second-line patients were treated with regimen including panitumumab, cetuximab and anti-VEGF, respectively. Patients received median 5 (1-21) cycles of treatment. Also, responded patients received median 4 (1-23) cycles of treatment as maintenance treatment with biologics plus fluoropyrimidine. Overall response rate was 28,5 % for all patients. Disease control rate also was 70,6 %. The median OS was 15,7, 14,3, and 14,7 months in A, B and C group respectively (p = 0.764). The median PFS of the patients in second-line setting that received panitumumab, cetuximab and bevacizumab/ aflibercept were 7,8, 6,6 and 7,4 months respectively (p = 0.848). There was not found as independent prognostic factors in multivariate analysis. Conclusions: According to the results of our real-life data study, there is no significant difference in efficacy between the combinations of biological agent and chemotherapy used in the second-line treatments. Therefore, the results of the first-line treatment become important and the use of the most effective agent at this setting also increases survival.

Background: Molecular genetic profiling (MGP) which has started to take an important part in cancer diagnosis and treatment in recent years, has entered the routineclinical practice much faster than expected. We aimed to evaluate the use of thistechnology in routine practice, the effect of changing the treatment decision.Methods: Two hundred and thirty-four patients who received treatment from 21different centers with OncoDeep MGP platform tests were included, which uses acombination of new generation sequencing (NGS), immunohistochemistry (IHC) andother specific tests (Package Plus).Results: Summary was given in the table. Physician waited for test results in 27%(n¼61) of patients for treatment decision. Prior to MGP analysis patients receivedmedian 2-lines of treatment. The median time between sending the sample abroadfor testing and reaching the result by the physician was 14 days (range:5-71). With thetest results, the physician changed the treatment decision in 51.8% of the patients(n¼118). The most frequent way of drug supply of patients whose treatment decisionwere 64.4% (n ¼ 67) from their own budget. When the treatment responses wereevaluated, the disease control rate was 31.1% and the drug discontinuation wasapplied due to toxicity in 4 patients (3.4%). 63.6% (n ¼ 75) of the patients were foundto be alive with a median follow-up of 18.0 months. (Table). European Society for Medical Oncology

Background Studies investigated different side effects of TKIs such as hypertension, dermatologic side effects and hormonal changes. Thyroid hormoneschange is take an interest for last decade and phase 2 and 3 trial result had been analyzed retrospectively for this reason.Method A totally 246 metastatic renal cell carcinoma patients who were treated with TKI included in the study and they recruited from over 10different oncology clinics.Results In the study 246 mRCC patients included and mean age was 60 (±8), and 183 (74%) of them were male, 63 (24%) of them were female.Following TKI therapy 15 patients (6%) became as a hyperthyroidic, 83 patients (34%) became hypothyroidic and remaining 148 patientshad in normal range for TSH levels. When we subgroup the patients according to the TSH change, in 38 patients (15.4%) had THSdecreasing at least 50% from baseline and 128 patients (52%) has elevated THS levels as described previous range. In survival analyses,became hyperthyroidic patients had significantly longer OS than became hypothyrodic patients (25.4 vs 14 months, P=0.036) but nosignificantly differ than remained normothyroidic patients (25.4 vs 18 months, P=0.16).Conclusion patients who had decreasing TSH levels under the treatment of TKI should have significantly higher overall survival but, hypothyroid patientsdon’t.

Background/Aims: Adiponectin is secreted from adipose tissue and is characterized by hyperinsulinemia, which is related with obesity. Adiponectin levels are significantly lower in gastric cancer patients than in healthy controls. The aim of this study was to investigate the relationship between adiponectin levels in serum, tumor tissue and normal tissue with some other insulin resistance parameters.

Background/Aims: Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal neoplasms of the tubular gastrointestinal tract (GI). Here, we present a series of 32 patients diagnosed with a primary neoplasm in addition to GIST, from six different institutions in Turkey.

Introduction The efficacy of chemotherapy plus bevacizumab has been shown in patients with metastatic colorectal cancer (mCRC) compared with chemotherapy alone. The aim of the present study was to evaluate the efficacy and safety of FOLFIRI or XELIRI regimens in combination with bevacizumab for mCRC patients in the first-line setting. Methods Totally 132 patients with previously untreated and histologically confirmed mCRC were included. They were treated with either the FOLFIRI-Bevacizumab (Bev) or the XELIRI-Bev according to physician preference. The efficacy and safety of both regimens were compared. Results Between 2006 and 2010, 68 patients were treated with XELIRI-Bev regimen, while the remaining 64 patients received FOLFIRI-Bev regimen. The median age was 58.5 years (53.6 years in the FOLFIRI-Bev and 59.7 years in the XELIRI-Bev arm, p=0.01). Objective response rate was 51.6% for FOLFIRI-Bev versus 41.2% for XELIRI-Bev arm (p=0.38). At the median follow-up of 24.5 months, the median progression-free survival (PFS) was not different between two groups (14.2 months in FOLFIRI-Bev vs. not reached in the XELIRI-Bev, p=0.30). Moreover, median overall survival time for the FOLFIRI-Bev arm was better than that for patients treated with the XELIRI-Bev arm, but these differences was not statistically significant (37.8 months vs. 28.7 months, respectively, p=0.58). Most commonly reported grade 3-4 toxicities (FOLFIRI-Bev vs XELIRI-Bev) were nausea/vomiting (7.8% vs. 14.7%, p=0.27), diarrhea (10.9% vs 22.1%, p=0.10), hand-foot syndrome (0% vs 8.8%, p=0.02) and neutropenia (18.7% vs 27.9%, p=0.22). Conclusion Our results showed that FOLFIRI-Bev and XELIRI-Bev regimens were similarly effective treatments as a first-line setting for patients with untreated mCRC, with manageable adverse event profiles.

WOS: 000370365102437 …

Tanker tipi gemiler için yükleme tahliye operasyonları en kritik operasyonlardır. (1) Gemi limanda iken çevre kirliliği, yangın ve patlama riski ile kaza sonucunda doğabilecek zararların büyük ölçeklerde olma olasılığı yükleme-tahliye operasyonlarını kritik hale getirmektedir. (2). Bu kazaların oluşmasındaki nedenlerin başında personelin üzerine düşen ağır iş yükü neticesinde oluşan aşırı yorgunluk gelmektedir.(3) Bu çalışmada, insan hatasını ve doğabilecek operasyonel riskleri en aza indirgemek için yükleme ve tahliye operasyonunun operatör tarafından belirlenecek kriterlere göre çalışan bir otomasyon sisteminin oluşturulması hedeflenmiştir. Bu sistemin oluşturulması için gemi stabilite formüllerinden yararlanılarak oluşturulacak bilgisayar programları kullanılacaktır. Oluşturulan bilgisayar yazılımı sayesinde geminin kargo ve balast tanklarında bulunan mevcut değerler belirli aralıklarla ölçülüp operatör tarafından belirlenen trim, meyil, kargo akış miktarı, basınç ve geminin intakt stabilite kriterleri hiçbir safhada aşılmadan operasyon gerçekleştirilebilecektir. Sistem, otomasyon sistemine bağlı olan kargo ve balast tanklarının valflerini belirlenen kriterlere bağlı kalarak ayarlamaktadır. Tüm bunları yaparken girilen kargo akış miktarı ve basınç değerlerine bağlı olarak kargo pompasının cinsine bağlı olarak devir sayısını ayarlayabilmektedir. Otomasyon sistemi emniyet açısından beklenmedik durumlarda alarm vererek operatörü uyarmaktadır. Alarm sistemi meyil, basınç, intakt stabilite, akış miktarı ve trim değerleri için farklı olarak ayarlanmakla beraber operatörün belirleyeceği periyotlarda susturulmaması neticesinde genel alarm devreye girecek şekilde tasarlanmıştır. Ayrıca geminin fribord ve draft değerleri arasındaki fark hesaplanarak geminin ne kadar yükseldiği ve alçaldığı hesaplanmaktadır. Yapılan bu hesap neticesinde bağlı olan gemi halatlarına yük binebileceği ya da tutma kuvvetinin azalabileceği gösterilebilmekte ve bu sayede halatların kesmesi(kopması) önlenmiş olmaktadır. Sistemin alarm seviyeleri ve tasarım detayları bu yazıda detaylandırılmıştır. Sistem istenilen aşama esnasında kapatılıp manuel yükleme tahliye operasyonuna başlanabilmektedir. Yapılan bu otomasyon sistemi sayesinde operatör tüm tanklardaki değerleri her seferinde kontrol edip tank valflerini ayarlamak için zaman kaybetmemekte, bu zamanı meyil, trim, intakt stabilite, kargo miktarı değerlerini takip etmede ve ilk hedefteki kargo-balast değerlerine ulaşım safhalarını takip etmekte kullanacaktır. Bu sistem sayesinde operatörün aşırı yoğunluğu önlenmiş olmakta, dolayısıyla yorgunluğun önüne geçilmesi sayesinde insan kaynaklı hataların minimize edilmesi sağlanmış olacaktır. Alarm sistemleri sayesinde oluşabilecek beklenmedik kazaların önlenmesi hususunda erken müdahale yöntemi geliştirilmiş olacaktır (4). Bu sunumda, tasarlanan otomasyon sisteminin kullanıcı gereksinimleri, teknik isterler, proje ilk tasarımı için blok diyagramlar, projenin hayata geçirilmesi için belirlenen yol haritası (5) ve izlenecek spiral proje yönetimi (6) doğrultusunda proje tasarımı anlatılacaktır.

e12610 Background: Studies in HER2+ locally-advanced breast cancer (LABC) patients with neoadjuvant dual HER2 blockage therapy demonstrated high rates of pathologic complete response (pCR). This study evaluates neoadjuvant chemotherapy (NCT) plus trastuzumab (H) with or without pertuzumab (P) therapy with a nation-wide real world setting. Methods: In this study, 1528 female HER2+ LABC patients’ data received NCT plus H with or without P were collected retrospectively from 21 centers. Ethics committee approved the study (NCT04765124). Primary end point was pCR rate (ypT0/Tis ypN0 in the current AJCC staging system). Results: Of the 1528, 951 (62.2%) were received NCT-H, 577 (37.8%) were received NCT-HP, follow-up durations were 30 months and 15 months, median ages were similar between 2 groups (47 years, range: 20-81 and 47 years, range 22-88, respectively). According to the menopausal and hormone receptor status 60% and 53.7% of patients were classified as premenopausal, 56% and 57.8% as estrogen receptor positive and 46.2% and 47.2% as progesterone receptor positive respectively at NCT-HP and NCT-H groups. Despite the patients at NCT-HP group mostly received docetaxel (75%), NCT-H group received weekly paclitaxel (59.4%) as taxane (p

WOS: 000404154000013, PubMed ID: 27812752, Background Currently, it is accepted that risk assessment of clinical stage I (CS I) nonseminomatous germ cell tumors (NSGCT) patient is mainly dependent on the presence of lymphovascular invasion (LVI). Initial active surveillance, adjuvant chemotherapy and retroperitoneal lymph node dissection (RPLND) are acceptable treatment options for these patients, but there is no uniform consensus. The purpose of this study was to compare outcomes of active surveillance with adjuvant chemotherapy. Methods A total of 201 patients with CS I NSGCT after orchiectomy were included. Outcomes of active surveillance and adjuvant chemotherapy were retrospectively analyzed. The prognostic significance of risk factors for survival and relapse was evaluated. Results Of the 201 patients, 110 (54.7%) received adjuvant chemotherapy, while the remaining 91 patients (45.3%) underwent surveillance. Relapses were significantly higher for patients underwent surveillance compared to adjuvant chemotherapy group (18.3 vs. 1.2%, p < 0.001). The 5-year relapse-free survival (RFS) rate for patients who were treated with adjuvant chemotherapy was significantly better than those of patients underwent surveillance (97.6 vs. 80.8%, respectively; p < 0.001). Univariate analysis showed that the presence of LVI (p = 0.01) and treatment option (p < 0.001) were prognostic factors for RFS and pT stage (p = 0.004) and invasion of rete testis (p = 0.004) and the presence of relapse (p < 0.001) were significant prognostic factors for OS. Multivariate analysis revealed that the treatment strategy was an independent prognostic factor for RFS (p < 0.001, HR 0.54). A logistic regression analysis demonstrated that treatment options (p = 0.031), embryonal carcinoma (EC) > 50% (p = 0.013) and tumor diameter (p = 0.016) were found to be independent factors for predicting relapse. Conclusion Our results indicate that adjuvant chemotherapy is associated with improved RFS compared with surveillance for CS I NSGCT patients. Moreover, the treatment strategy is an important prognostic indicator for RFS and a predictive factor for relapse. Although adjuvant chemotherapy seems to be a suitable treatment for patients with risk factors for relapse, surveillance is still preferred management option.