Search

The optimal chemotherapy regimen for concurrent chemoradiation in locally advanced non-small cell lung cancer (NSCLC) remains unclear. Cisplatin-etoposide regimen related toxicity is high, weekly regimens have been investigating. We aimed to compare the efficacy and safety of different concurrent chemotherapy regimens in the context. A total of 225 patients with locally advanced, unresectable stage III NSCLC were included. Patients who were treated with weekly docetaxel-platin (DP), paclitaxel-platin (PP) and standard dose etoposide-platin (EP) chemotherapy regimens were selected and divided into groups for the comparison of toxicity, response rate, progression free survival (PFS), and overall survival (OS) times. There was a statistically significant difference between overall response rate of each treatment groups (DP: 96.1%, PP: 94% and EP: 76.7%, p

Introduction Soft tissue sarcomas are a heterogeneous and rare group of cancers with a short median overall survival despite the chemotherapy. Pazopanib has approval for the treatment of advanced soft tissue sarcoma. We aimed to investigate the clinical outcomes of Turkish patients with advanced soft tissue sarcoma who received pazopanib. Patients and methods This was a retrospective study. The inclusion criteria were: ≥18 years of age, having histologically proven advanced soft tissue sarcoma and receiving pazopanib at least one day. Results A total of 79 patients were assessed in this study. The median age was 49.6 years. The average dose intensity of pazopanib was 767 mg (400–800). The median duration of pazopanib treatment was 6.11 months. Fourteen patients (17.7%) used pazopanib at first line for advanced soft tissue sarcomas. The most common cause of discontinuation of pazopanib was the progression of the disease (89.6%). Pazopanib was well tolerated. The most common grade ≥3 side effect was anemia. The most common grade ≤2 side effects were anemia and hyperbilirubinemia. The median progression-free survival, overall survival, and follow-up were 3.97 months, 11.40 months, and 32.72 months, respectively. Female gender, good performance status, and the presence of pazopanib-induced hypothyroidism were associated with longer progression-free survival. Also, good performance status and being a responder to first-line treatment were associated with longer overall survival. Conclusions We showed that pazopanib was well tolerated and had clinical benefit in patients with advanced soft tissue sarcoma in a Turkish cohort. This is the first study that suggests pazopanib-induced hypothyroidism may act as a predictive marker for better outcomes in patients with advanced soft tissue sarcoma.

Objectives: Pazopanib is an orally administered drug and has approval for the treatment of advanced Soft Tissue Sarcomas (aSTS). The absorption of pazopanib is pH-dependent. Acid-Reducing drugs such as proton pump inhibitors (PPI) may reduce the bioavailability of pazopanib. The primary purpose of this study was to assess whether the use of concomitant PPI and pazopanib had negative effects on survival outcomes. Methods: In this retrospective cross-sectional study, age ≥18 years, having histologically proven STS, receiving pazopanib at least one day, and availability of information about the use of PPI during pazopanib treatment were the inclusion criteria. Patients with adipocytic sarcoma were excluded. Results: A total of 46 eligible patients were assessed in this study. Thirty-one patients used concomitant PPI and pazopanib, 17 of them frequently used PPI, and the others occasionally. Fifteen patients never used concomitant PPI and pazopanib. The median progression-free survival (PFS) was 2.76 months, and the median overall survival (OS) was 7.39 months for patients who never used concomitant PPI and pazopanib. Also, the median PFS was 5.22 months, and the median OS was 14.52 months for patients who used concomitant PPI and pazopanib. In univariate analysis; using concomitant PPI (p=0.049) and primarily uterine located tumors (p=0.038) were significant parameters for PFS. In multivariate logistic regression analysis; both of using concomitant PPI (Wald=6.02; p=0.014) and primarily uterine located tumors (Wald=5.69; p=0.017) retained their association with longer PFS. No parameter was significant for OS. Conclusions: We showed that the use of concomitant PPI and pazopanib was associated with improved PFS. These results may help guide clinicians and researchers for allowing patients co-administrating PPI and pazopanib, especially when treating or investigating patients with dyspeptic symptoms

Objective: The prognostic value of tumor location in patients with metastatic colorectal cancer (mCRC) was reported by recent analyses in RAS wild-type patients. However, there is no enough specific data regarding prognostic value of primary tumor location in RAS mutated mCRC patients. We aimed to find if there is any relation between tumor prognosis and primary tumor location in patients with RAS mutated mCRC. Method: This retrospective study included 57 patients with mCRC who were diagnosed and treated in our hospital between January 2011 and December 2017. Characteristics features of the patients were obtained from our institution patient medical records. Patients were included to the present study if KRAS or NRAS mutation was detected in tumor tissues.Results: Twenty-nine (50.9%) of patients were female and the median age of all patients was 52 (18-80) years. Forty (70.2%) of 57 patients were defined as left side (LS) and 17 (29.8%) of patients were located in the right side (RS). As first line systemic treatment, twenty-five (43.9%) patients had received oxaliplatin-based chemotherapy while 32 (56.1%) patients had received irinotecan-based chemotherapy. Tumor sidedness did not affect on progression-free survival (PFS) (mPFS, 10.9 months for LS vs 8.1 months for RS, p=0.400) and overall survival (OS) (mOS, 20.9 months for LS vs 20.8 months for RS, p=0.930).The patients who had oxaliplatin based chemotherapy regimens showed better OS rate than irinotecan based regimens (28.7months vs16.3 months, p=0.017, respectively). Conclusion: Our study results support the thought that claims the sidedness of primary CRC in metastatic setting does not have effect on PFS and OS in patients with RAS mutant mCRC. However, our findings also underline the necessity of studies with larger patient populations and subgroup analyzes to evaluate potential prognostic and molecular features to determine the standart approach to this specific subgroup of the disease. Amaç: RAS wild metastatik kolorektak kanser (KRK) tanılı hastalarda tümör lokalizasyonun prognostik önemi hakkında çok sayıda çalışma bildirilmiştir. Ancak RAS mutant hastalar ile ilgili yeterli sayıda çalışma bulunmamaktadır. Bu çalışmada RAS mutant metastatik KRK tanılı hastalarda tümör yerleşim yerinin prognostik önemini belirlemeyi amaçladık. Yöntemler: Bu retrospektif çalışmaya hastanemizde 2011 ve 2017 yılları arasında tanı alan RAS mutant metastatik KRK tanılı 57 hasta dahil edildi. Hasta özellikleri hastane kayıt sistemindeki verilerden elde edildi. KRAS veya NRAS mutasyonu saptanan hastalar dahil edildi. Bulgular: Hastalardan 29 ’u (%50,9) kadın olup ortanca yaş 52 (18-80) idi. Primer tümör, hastaların 40’ında (%70,2) sol kolon ve 17’sinde (%29,8) sağ kolonda yerleşim göstermekteydi. Yirmi beş (%43,9) hasta oxaliplatin temelli ve 32 (%56,1) hasta da irinotekan temelli kemoterapi almıştı. Primer tümör lokalizasyonuna göre progresyonsuz sağkalım (PSK) ve genel sağkalım (GSK) süreleri arasında istatiksel anlamlı fark saptanmadı (PSK sol kolonda 10.9 ay, sağ kolonda 8.1 ay, p=0.400 ve GSK sol kolonda 20.9 ay, sağ kolonda 20.8 ay, p=0.930). Oxaliplatin temelli tedavi alan hastaların irinotekan temelli tedavi alanlara göre GSK ’larının daha iyi olduğu görüldü (28.7 ay,16.3 ay, sırası ile p=0.017). Sonuç: Çalışmamızda metastatik KRK hastalarında primer tümör yerleşim yerine göre guruplar arasında PSK ve GSK açısından fark saptanmadı. Ancak, bulgularımız bu hasta alt gurubu için standart yaklaşımın belirlenmesi için daha büyük hasta popülasyonları ve alt grup analizleri ile potansiyel prognostik ve moleküler özelliklerin değerlendirildiği çalışmalara olan ihtiyacın altını çizmektedir.

Mild clinical signs of hyperandrogenism such as hirsutism may appear during the menopausal transition as part of the normal aging process, but the development of frank virilization suggests a specific source of androgen excess. We report a case of a 68-year-old woman with signs of virilization that had started 6 months before. Clinical analyses revealed high levels of serum testosterone for a postmenopausal woman. Pelvic MRI and abdomen CT showed no evidence of ovarian and adrenal tumor. Postmenopausal hyperandrogenism can be the result of numerous etiologies ranging from normal physiologic changes to ovarian or rarely adrenal tumors. Our patient was found to have iatrogenic hyperandrogenism. This condition is rarely reported cause of virilization.