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Aim: The aim of this study is to evaluate the efficacy and toxicity of trastuzumab emtansine (T-DM1) in cases with metastatic breast cancer (mBC) in different lines of treatment. Method: Retrospective analysis of T-DM1 results of human epidermal growth factor receptor 2 (Her2) positive 414 cases with mBC from 31 centers in Turkey. Findings: Except 2, all of the cases were female with a median age of 47. T-DM1 had been used as second-line therapy in 37.7% of the cases and the median number of T-DM1 cycles was 9. Progression-free survival (PFS) and overall survival (OS) times were different according to the line of treatment. The median OS was found as 43, 41, 46, 23 and 17 months for 1st, 2nd, 3rd, 4th and 5th line, respectively (p = 0.032) while the median PFS was found as 37, 12, 8, 8 and 8 months, respectively (p = 0.0001). Treatment was well tolerated by the patients. The most common grade 3–4 adverse effects were thrombocytopenia (2.7%) and increased serum gamma-glutamyl transferase (2%). Discussion: The best of our knowledge this is the largest real-life experience about the safety and efficacy of T-DM1 use in cases with mBC after progression of Her2 targeted treatment. This study suggests and supports that T-DM1 is more effective in earlier lines of treatment and is a reliable option for mBC. © 2021 Taylor & Francis Group, LLC.

Introduction To investigate the level of psychological resilience and the impact of attachment styles on the degree of resilience to distress in patients with cancer receiving chemotherapy. Methods Patients with cancer receiving chemotherapy were included in the study. Participants were requested to complete the Relationship Scales Questionnaire (RSQ), Resilience Scale for Adults (RSA), and a personal information form during the data collection phase. One-way analysis of variance (ANOVA) was used to compare that parameter among the attachment styles. Logistic regression analysis was carried out to identify independent factors affecting resilience. Results A total of 384 individuals were included in this study (mean age 53.5 ± 12.1, 27.1 % male). The RSQ results showed that the attachment styles of 190 (49.5%) participants were secure, whereas 194 (50.5%) subjects had an insecure attachment. The median RSA score of participants with a secure attachment was significantly higher than that of patients with insecure attachment (133.15 ± 16.6 vs. 127.0 ± 20.0, p=0.001). Patients with the RSA score of >130 were more educated, were in better economic condition, had better perceived social support, and had a higher frequency of secure attachment than those defined as low resilient. Logistic regression analysis revealed that poor and medium perceived social support and insecure attachment style independently predicted low resilience (RSA≤130). Conclusion This study demonstrates that the secure attachment style in patients with cancer improves stress resilience as compared to the insecure attachment style. Our findings also show that insufficient perceived social support is likely a negative factor in resilience.

Background Cancer is considered a traumatic event that can lead to post-traumatic stress disorder. Significant changes are taking place in the life, body image, lifestyle and social life of the individual diagnosed with cancer. Therefore, they are faced with a psychological and physiological difficult process. In the researches, it was found that the attachment styles that individuals will experience in their lifelong relationships are one of the important predictors of psychological resilience. The aim of our study is to examine the relationship between psychological resilience and adult attachment styles among cancer patient individuals receiving chemotherapy. Methods A total of 391 volunteer patients receiving chemotherapy were included from Dr. A.Y. Ankara Oncology Research and Training Hospital and Ankara Guven Hospital in the study. The inventories used in the data collection phase of the study are Relationship Scales Questionnaire, Resilience Scale for Adults and a personal information form that is produced by researcher. Datasare analyzed with SPSS 23.00. Results In our results, 285 (73%) of the patients were female and the median age was 53 (20-83). The median endurance score was 130 (49-165). The patients were divided into median values to be less resistant and resistant. The age, gender, marital status, working status, educational status, economic status, who they experienced, who they grew up with, their social support, trust in chemotherapy and dominant attachment styles were compared with univariate analysis. there were four style of attachments; secure, avoidant, fearful, preoccupied. Secure attachment was at half of patients (n = 191,48.8%) while avoidant attachment was at 159 (40.6%) patients. The other attachment styles were seen significantly less. As a result of multivariate analysis, the patient’s social support is moderate or bad; lack of confidence in chemotherapy, the presence of avoidant or fearful attachment was found to be independent negative factors affecting the resilience of the patient. Conclusions Avoidant and fearful attachment have a significant negative impact on the resilience of the patients receiving chemotherapy. Legal entity responsible for the study Fatma Bugdayci Basal. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

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.