Search

Background: Hepatitis B reactivation might occur in patients with hematological and solid organ malignancies due to immunosuppressive effect of chemotherapy. Methods: Fourteen patients were evaluated retrospectively from their files to discuss the clinical manifestations, management, and avoiding of Hepatitis B reactivation within patients who receive immunosuppressive treatment. Results: These 14 HbsAg positive patients were being followed up and treated via oncological immunosuppressive chemotherapy. The ages of the patients were between 25 and 72. Seven of the patients were male, and the average follow up period for the patients was between 10 and 74 months. TV 0, 5 mg was started for seven of the patients before the chemotherapy and TFV 245 mg to one of the patients. LAM 100 was started for three patients whose basal HBV DNA was low. It has been analyzed that HBV DNA was negative in further observations. In follow up controls, we noticed HBV reactivation at two patients, LAM was given one of them and TFV was given the other one. One patient was applied allogeneic transplantation whose basal liver tests were normal and Hbsag was negative. Hepatitis B reactivation was detected after the first week of therapy. Conclusions: We offer testing in all patients undergoing cancer therapy for hepatitis B, HBsAg, core antibody (anti-HBc total), and anti-HBs before to start cancer therapy. Patients with higher risk of HBV reactivation require antiviral prophylaxis.

Aim: This study aims to evaluate the prognostic and predictive value of plasma plasminogen activator inhibitor-1 (PAI-1) and endoglin in metastatic colorectal cancer (mCRC) patients receiving chemotherapy with bevacizumab. Materials and Methods: Between April 2012 and September 2013, 47 mCRC patients with a mean age of 58.5 ± 9.6 years were included in the study. Male-to-female ratio was 29/18. The baseline and posttreatment plasma PAI-1 and serum endoglin levels after 3 cycles of bevacizumab-containing chemotherapy were evaluated. The percent change between baseline and posttreatment levels after treatment was also recorded. Results: The median follow-up duration was 26.6 months (range 1.8–70.2 months). The clinical benefit rate was 70% (partial response [32%], stable disease [38%]). Overall survival was 20.8 ± 1.5 months. The patients with progressive disease had statistically significantly higher baseline PAI-1 level (57.9 pg/mL vs. 29.9 pg/mL, P = 0.036). The percent change of the plasma PAI-1 level after the third cycle of treatment was also statistically significantly lower in those with clinical benefit (P = 0.035). However, there was no statistically significant difference in endoglin level and its change after therapy with respect to the response to treatment (P = 0.771 and P = 0.776, respectively). Plasma PAI-1 level had no statistically significant effect on survival (P = 0.709). Conclusion: Baseline plasma PAI-1 level and its percent change with bevacizumab were shown to have statistically significant predictive value for the response to therapy whereas serum endoglin had no statistically significant predictive value for the response to therapy. However, neither PAI-1 nor endoglin had prognostic significance in mCRC.

Purpose: To investigate the effects of epidermal growth factor receptor (EGFR), cytokeratin 19 (CK19), cytokeratin 20 (CK20) and survinin gene expression on local control (LC) and overall survival (OS) in patients with locally advanced head and neck cancer (LAHNC) who were administered radiotherapy (RT). Materials and Methods: Twenty-six patients who were admitted to Uludag University Medical Faculty Department of Radiation Oncology with a diagnosis of LAHNC (GIII-GIV) were included in this study. Gene expression was evaluated in tumor tissues and peripheral blood. RNA isolation was performed on paraffinized tumor tissues and peripheral blood samples obtained before RT (BR). The densities of the obtained RNAs were analyzed at 260/280 nm. cDNA samples obtained from total RNA,EGFR, CK19, CK20 and survinin gene expression levels were assessed via the Sybr Green method and data were analyzed with the ${\Delta}{\Delta}Ct$ method. The same process was repeated for peripheral blood samples taken after RT (AR). Results: The female/male ratio was 3:23 and the mean age was 56.5 years (38-75years). After radiotherapy, CK19 and CK20 levels in the peripheral blood were found to be correlated according to Pearson correlation analysis(p=0.049). This result indicates a possibility of remaining positive for CK19 and CK20 in the peripheral blood even after RT in patients with CK19, CK20, and EGFR positive tumors before RT. There was a statistically significant correlation between survinin levels measured BR and AR (p=0.028). Conclusions: In this study, we found that patients with any EGFR, CK19, CK20 or survinin positivity in their peripheral blood obtain less benefit from radiotherapy. A wider patient population and advanced protein analyses are necessary in order to increase the reliability of our findings.

Gastric cancer is a major cause of cancer-related mortality. At the time of diagnosis, majority of the patients usually have unresectable or metastatic disease. The most common sites of metastases are the liver and the peritoneum, but in the advanced stages, there may be metastases to any region of the body. Bone marrow is an important metastatic site for solid tumors, and the prognosis in such cases is poor. In gastric cancer cases, bone marrow metastasis is usually observed in younger patients and in those with poorly differentiated tumors. Prognosis is worsened owing to the poor histomorphology as well as the occurrence of pancytopenia. The effect of standard chemotherapy is unknown, as survival is limited to a few weeks. This report aimed to evaluate 5 gastric cancer patients with bone marrow metastases to emphasize the importance of this condition.

Background: The development of brain metastases (BMs) was associated with poor prognosis in melanoma patients. Patients with BMs have a median survival of 4 mm) (p = 0.008), ulceration (p = 0.007), and pathologically N2 and N3 diseases (p = 0.001) were found to be significantly associated with the development of BMs. In univariate analysis, tumor thickness and performance status had a significant influence on post-BMs survival. In multivariate analysis, these clinicopathologic factors were not remained as significant predictive factors. Conclusions: Our results revealed the importance of primary tumor characteristics associated with the development of BMs. Ulceration, primary tumor thickness, anatomic site, and pathologic ≥N2 disease were found to be significant predictors of BMs development. © 2013 Springer-Verlag Berlin Heidelberg.

Introduction: Sunitinib is an oral inhibitor of tyrosine kinase that was used for the treatment of mRCC. The general side effects are fatigue, asthenia, diarrhea, mucositis, nausea, vomiting, skin changes, hypertension, hypothyroidism and hematologic side effects. In addition, sunitinib-induced hypoglycemia has also been reported. There are limited number of case reports related to sunitinib-induced hypoglycemia. Case presentation: In this case report, we have presented a patient with type 2 diabetes mellitus (DM) with emerging severe hypoglycemia after sunitinib treatment. It was shown that blood glucose levels were normalized two weeks after the interruption of sunitinib. Conclusion: Although the underlying mechanism of sunitinib-induced hypoglycemia is not completely understood, sunitinib can be regarded to have an antidiabetic effect. In the literature, there are some reports about sunitinib/other TKI induced hypoglycemia; however, life threatening hypoglycemia is rare. There is no case report of severe hypoglycemia due to imatinib; however, there are two case reports with severe hypoglycemia due to sunitinib treatment. Symptomatic hypoglycemic episodes due to sunitinib may lead to hospital admission. Diabetic patients may develop severe hypoglycaemia and it should be kept in mind that the discontinuation of antihyperglycemic treatment may be required. Therefore, blood glucose levels should be closely monitored in diabetic patients with mRCC during sunitinib therapy.

Bisphosphonates are the mainstay therapeutic options for prevention of skeletal-related events and generally used for up to 2 years in bone metastatic cancer patients. We aimed to evaluate the long-term outcomes of prolonged (> 2 years) bisphosphonate usage in bone metastatic breast cancer (BMBC) patients. Ninety-nine BMBC patients who had prolonged bisphosphonates were evaluated retrospectively for long-term outcomes and survival rates. Median duration of bisphosphonate therapy was 46.8 (24–198) months. Seven patients had bisphosphonate-related adverse events (osteonecrosis of the jaw (ONJ) (n = 6), ONJ and renal failure (n = 1)). Bisphosphonate was switched to another one because of bone metastasis progression in more than one-third of the patients (n = 36, 36.3%). The patients who had bisphosphonate switch therapy had statistically significant longer overall survival (p < 0.01). Neither duration nor type of bisphosphonates had effect on frequency of bisphosphonate-related adverse events. Bisphosphonates might be prolonged for more than 2 years in BMBC patients with an acceptable toxicity profile. In addition, bisphosphonates switch therapy should be preferred in those with progressive bone metastasis since it might contribute to better survival despite bisphosphonates could not have been shown to have survival benefit in previous studies.

Mucosal melanoma (MM) is a rare type of cancer that differs significantly from cutaneous melanoma. In this study, we aimed to evaluate clinical and demographical characteristics, prognoses and factors influencing survival, treatment alternatives, and features of different subtypes of the patients. The patients were followed up with and treated in different centers due to their diagnoses of MM. We retrospectively analyzed data of 107 patients who were diagnosed with MM in 14 different institutions in Turkey. The mean age of the patients was 64.5 years. Of the patients, 47 % were female and 53 % were male. The median overall survival (OS) was 17 months, and the mean follow-up duration was 27 months. The 2-year survival rate was 42 %, and the 5-year survival rate was 23 %. The best survival rate appeared in those patients with MM in the head-neck region (median survival rate was 27 months, P = 0.034). The most common anatomical site was the head-neck region. In a univariate analysis, variables including age ≥65 years, the anatomical site of the primary lesion other than head and neck region, the metastatic stage of the disease, high levels of lactate dehydrogenase (LDH), and an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of ≥1 were found to be associated with poor survival (P < 0.05). However, in a multivariate analysis, only advanced stage disease (HR = 2.70; 95 % CI, 1.64–4.45; P = 0.000) and high LDH levels (HR = 2.31; 95 % CI, 1.40–3.80; P = 0.001) were determined to be adverse prognostic variables. Primary MM presents a more aggressive behavior and offers a poorer prognosis compared to cutaneous melanoma. Because the disease is rarely seen, is heterogeneous, and lacks randomized studies, issues concerning optimal treatment approaches and management and clinical characteristics of the disease have not been clarified yet. © 2016, International Society of Oncology and BioMarkers (ISOBM).

Medulloblastoma (MB) is rarely seen in adults. For adjuvant therapy in adults the same therapy protocols used in pediatric cases are used. The present study retrospectively evaluated the data of MB patients who were treated in different Oncology Centers in Turkey.The data of 60 adult patients with MB from 8 Oncology Centers diagnosed between 2005 and 2012 were retrospectively analyzed.The median patient age was 28.8 years (range 16-54). The administered chemotherapy included procarbazine+lomustin+vincristine (group A, N=31) and cyclophosphamide/ifosfamide+vincristine+cisplatin (group B, N=13). Median chemotherapy courses were 4 (range 1-8). Median progression free survival (PFS) was 76 months and median overall survival (OS) has not been reached in both groups. In young female patients and in those who received adjuvant chemotherapy, median PFS and OS were longer but without statistical significance. Mean PFS and OS were 65.9 months and 101.2 months in group A and 113.6 months and 141.6 months in group B, respectively.Improved survival results were obtained in women, in patients aged below 25 years, in those who underwent gross total excision (GTE) and in those who received adjuvant therapy with cyclophosphamide/ifosphamide.

Metaplastic breast carcinoma (MpBC) is a rare disease entity, accounting for less than 1% of all breast carcinomas. Furthermore, it is a heterogenous disease with different subgroups, including malignant epithelial (carcinoma) and stromal (sarcoma) features. Here we evaluated, retrospectively, 14 female MpBC patients admitted to Ankara Oncology Training and Research Hospital between 2005 and 2011. Median age was 45.5 (range:16.0-76.0) and tumor size 57.5 mm (range: 20.0-80.0 mm). Histopathological subtypes were as follows: 5 carcinosarcoma, 5 squamous and 4 adenosquamous carcinoma. All but one with upfront lung metastasis, had their primary breast tumor operated. Axillary lymph nodes were involved in 64.3%. The most common sites of metastasis were lungs and brain. Chemotherapy including antracycline, taxane and even platinium was planned for adjuvant, neoadjuvant and palliative purposes in 9, 3 and 1 patient, respectively. Median cycles of chemotherapy was 6 (range:4-8). Median follow-up of the patients was 52 months (95%CI 10.4-93.6 month). Median 3 year progression free survival (PFS) and overall survival (OS) in this patients cohort were 33% and 56%, respectively. In conclusion, MpBC is a rare and orphan disease without standardized treatment approaches and the prognosis is poor so that larger studies to investigate different treatment schedules are urgently needed.

e18218Background: Standard treatment for early stage breast cancer (ESBC) consists of optimal surgery followed by adjuvant chemotherapy and/or hormonotherapy and/or radiotherapy. Doxorubicin and cy...

INTRODUCTION: Advances in non-small lung cancer (NSCLC) treatment is limited. Disease progression is seen in most patients after first line chemotherapy and many patients receive second line chemotherapy. A prospective study is planned to compare the life quality of NSCLC patients who received second line chemotherapy and those without second line chemotherapy.METHODS: EORTC QLQ-C30 Version 3.0 (Turkish version) is used to evaluate the quality of life of the patients. The questionnaire is given to the patients at baseline and repeated two times with monthly intervals.RESULTS: Twenty-four of the total 40 patients entered the study received second line chemotherapy and 16 patients received only supportive care. The general health status, overall function, overal symptom, physical function, role function, emotional function, social function, fatigue symptoms and pain symptoms scores were significantly better in patients who received second line chemotherapy. Cognitive function and dyspnea symptom scores were significantly better after second month in the patients who received second line chemotherapy. There were no statistical difference for nausea, vomiting, anorexia, constipation, diarrhea symptom scores between groups during the first and second month. While insomnia and financial difficulty symptoms scores were significantly better at first month in patients who received second line chemotherapy; no difference is seen in second month.DISCUSSION AND CONCLUSION: Our findings shows that second line chemotherapy in advanced NSCLC patients significantly improve the general quality of life when compared to only supportive care., GİRİŞ ve AMAÇ: İleri evre küçük hücreli dışı akciğer kanser (KHDAK)'li hastalarda tedavilerdeki gelişmelere rağmen çoğunda ilk tedavi sonrası hastalık progresyon gelişmektedir. Çoğunlukla hastalar ikinci basamak kemoterapi tedavisi almaktadırlar. Çalışmamızda, birinci basamak kemoterapi tedavisi sonrası progresyon gelişen ileri evre KHDAK'li hastalarda, ikinci basamak kemoterapi alanlar ile sadece destek tedavisi alanlarda yaşam kalitesini karşılaştırılması amaçlanmıştır. YÖNTEM ve GEREÇLER: Yaşam kalitesi değerlendirilmesinde EORTC QLQ-C30 Version 3.0 Türkçe anket formu kullanıldı. Hastalara çalışmaya alındığı tarihte bazal olarak ilk anket yapıldıktan sonra, aynı anket ayda bir olmak üzere iki kez daha tekrarlandı.BULGULAR: İkinci basamak kemoterapi alan 24 ve sadece destek tedavisi alan 16 hasta olmak üzere toplam 40 hasta değerlendirildi. Genel sağlık durumu, toplam fonksiyon, toplam semptom, fiziksel fonksiyon, uğraş fonksiyon, duygusal fonksiyon, sosyal fonksiyon, yorgunluk semptom ve ağrı semptom skorları ikinci basamak kemoterapi alanlarda anlamlı şekilde daha iyi bulundu. Kavrama fonksiyon ve nefes darlığı semptom skorları ikinci aydan itibaren ikinci basamak kemoterapi alanlarda daha iyi saptandı. Bulantı-kusma, iştahsızlık, konstipasyon, diyare semptom skorları açısından birinci ve ikinci aylarda iki grup arasında anlamlı fark bulunmadı. Uykusuzluk ve mali zorluk semptom skorları birinci ayda, ikinci basamak kemoterapi alanlarda anlamlı olarak iyi bulunurken, ikinci ayda iki grup arasında anlamlı fark saptanmadı.TARTIŞMA ve SONUÇ: İleri evre KHDAK hastalarında, ikinci basamak kemoterapinin, sadece destek tedavisine göre yaşam kalitesinde genel olarak anlamlı iyileşme sağladığı gösterildi.

A 43 year-old man admitted with abdominal pain and hematemesis. He diagnosed with gastric cancer by endoscopic biopsy and total gastrectomy was carried out. On the sixth day of gastrectomy he complained about headache and diplopia. Magnetic resonance imaging of the brain showed leptomeningeal thickening and contrast enhancement of bilateral cerebellar hemisphere. First cerebrospinal fluid examination revealed no malignant cells, the second one was suspicious for malignant cells. Because of the radiological and clinical evaluation of the patient compatible with the Leptomeningeal Carcinomatosis, intrathecal chemotherapy was performed and his neurological symptoms were improved., 43 yaşında bir erkek karın ağrısı ve hematemez ile kabul edildi. Hasta Endoskopik biopsi ile Mide karsinomu tanısı aldı ve Total Gastrektomi yapıldı.Gastrektomi'nin 6.gününde, baş ağrısı ve çift görme yakınması oldu.Beyin MRI bilateral serebellar hemisferde kontrast artışı ve Leptomeningeal kalınlaşma gözlendi.Birinci Serebrospinal sıvı muayenesinde maliğn hücre gözlenmedi,İkinci inceleme maliğn hücre şüphesi içermekteydi.Hastanın Leptomeningeal Karsinomatosis ile uyumlu klinik ve Radyolojik değerlendirmelerinden dolayı, İntratekal Kemoterpi uygulandı ve Hastanın nörolojik semptomları düzeldi.

Patients with advanced non-small cell lung cancer (NSCLC) generally require second-line treatment although their prognosis is poor. In this multicenter study, we aimed to detect the characteristics related to patients and disease that can predict the response to second-line treatments in advanced NSCLC. Data of 904 patients who have progressed after receiving first-line platinum-based chemotherapy in 11 centers with the diagnosis of stage IIIB and IV NSCLC and who were evaluated for second-line treatment were retrospectively analyzed. The role of different factors in determining the benefit of second-line treatment was analyzed. Median age of patients was 57 years (range 19-86). Docetaxel was the most commonly used (20.9 %, n = 189) single agent, while gemcitabine-platinum was the most commonly used (6.7 %, n = 61) combination chemotherapy regimen in second-line setting. According to survival analysis, median progression-free survival after first-line treatment (PFS2) was 3.5 months (standard error (SE) 0.2; 95 % confidence interval (CI), 3.2-3.9), median overall survival (OS) was 6.7 months (SE 0.3; 95 % CI, 6.0-7.3). In multivariate analysis, independent factors affecting PFS2 were found to be hemoglobin (Hb) level over 12 g/dl and treatment-free interval (TFI) longer than 3 months (p = 0.006 and 0.003, respectively). Similarly, in OS analysis, Hb level over 12 g/dl and time elapsed after the first-line treatment that is longer than 3 months were found to be independent prognostic factors (p = 0.0001 and 0.045, respectively). In light of these findings, determining and using the parameters for which the treatment will be beneficial prior to second-line treatment can increase success rate.

Adding targeted therapies to chemotherapy in metastatic colorectal cancer (CRC) improves response rates and survival. KRAS is a predictive indicator for anti-epidermal growth factor receptor (EGFR) treatments. The most important reasons for KRAS discordance are intratumoral heterogeneity and incorrect mutation analysis. Evaluating the status of KRAS in primary and metastatic lesions becomes even more crucial to ensure efficient usage of anti-EGFR treatments.Patients with metastatic CRC, whose primary disease and liver and/or lung metastases were operated, were retrospectively evaluated, and KRAS assessment was performed on 31 patients who were suitable for DNA analysis. Pyrosequencing with polymerase chain reaction (PCR) was used for KRAS analysis.The median age of 31 patients diagnosed with rectal cancer (N=13) and colon cancer (N=18) was 63 years (range 33-73). Metastasectomy locations included the liver (N=27), lung (N=3), and both lung and liver (N=1). KRAS discordance was detected in 22% (7/31) of the patients. While 3 patients with detected discordance had mutated KRAS in the primary material, wild type KRAS was detected in their liver or lung lesions. On the other hand, while 4 patients had wild type KRAS in the primary material, mutated KRAS was determined in their liver or lung lesions. The McNemar test revealed no significant discordance between primary and metastatic disease (p=1.00). No progression free survival (PFS) difference was detected between patients with determined discordance and patients with undetermined discordance (10.6 vs 14.7 months, p=0.719).This is the first study to evaluate KRAS discordance between primary and metastasis in CRC patients, who underwent metastasectomy, together with survival data. In the literature and recent studies with large patient numbers in which modern KRAS tests were used, the KRAS discordance rate varies between 3-12%. In our study, a higher KRAS discordance (22%) was detected, and no survival difference was determined between patients with or without discordance. In recent years, the rising interest in borderline resectable disease may bring forward discussions related to which material the KRAS status should be analyzed.

Background: In this study, we aimed to investigate the benefits of 18F-deoxyglucose positron emission tomography/computed tomography (FGD-PET/CT) imaging for staging and radiotherapy planning in patients with head and neck cancer undergoing definitive radiotherapy. Materials and Methods: Thirty-seven head and neck cancer patients who had undergone definitive radiotherapy and PET/CT at the Uludag University Medical Faculty Department of Radiation Oncology were investigated in order to determine the role of PET/CT in staging and radiotherapy planning. Results: The median age of this patient group of 32 males and 5 females was 57 years (13-84years). The stage remained the same in 18 cases, decreased in 5 cases and increased in 14 cases with PET/CT imaging. Total gross tumor volume (GTV) determined by CT (GTVCT-Total) was increased in 32 cases (86.5%) when compared to total GTV determined by PET/CT (GTVPET/CT-Total). The GTV of the primary tumor determined by PET/CT (GTVPET/CT) was larger in 3 cases and smaller in 34 cases compared to that determined by CT (GTVCT). The GTV of lymph nodes determined by PET/CT (GTVLNPET/CT) was larger in 20 cases (54%) and smaller in 12 cases (32.5%) when compared to GTV values determined by CT (GTVLNCT). No pathological lymph nodes were observed in the remaining five cases with both CT and PET/ CT. Conclusions: We can conclude that PET/CT can significantly affect both pretreatment staging and assessed target tumor volume in patients with head and neck cancer. We therefore recommend examining such cases with PEC/CT before treatment.

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: 000358036903002, …, Amer Soc Clin Oncol

In advanced stage renal cell cancer (RCC), overall survival (OS) of patients has been prolonged due to targeted therapies. To date, there are several prognostic risk models that have been developed for metastatic RCC (mRCC). The purpose of this study was to evaluate the outcomes of the sequential therapy (IFN-α, tyrosine kinase inhibitors/TKIs, m-TOR inhibitor) and prognostic factors in patients with mRCC, especially those with bone metastasis.We retrospectively examined the data of 82 patients with pathologically proven mRCC who were followed-up and treated at the Medical Oncology Clinic of the Dr A.Y Oncology Hospital between 2005 and 2013.Median OS was 23 months in all patients with mRCC and 20 months in patients treated with TKIs. According to MSKCC and HENG risk classifications, median OS differed between the groups (p=0.02, p0.001, respectively). Median OS was lower in patients with isolated bone metastasis compared to those with lung metastasis (16 vs 24 months, p=0.25). Median OS improved with increasing number of sequential therapies (p=0.08).This study confirmed the correlation between MSKCC and HENG risk models and survival data. Additionally, it was shown that increase of the number of therapeutic lines in sequential therapy prolonged survival and that bone metastases were negative prognostic factors.

Background: The aim of this retrospective study was to evaluate the prognostic factors in patients operated for stage IIIC breast carcinoma who had > 10 positive axillary lymph nodes (pN3a). Patients and Methods: The medical records of 302 operated N3a breast cancer patients without distant metastasis followed up in 2 medical oncology clinics in Ankara between January 1998 and June 2013 were evaluated retrospectively. Results: The median age was 50 (21-83) years. The median follow-up time was 43 (5-191) months. The patients were divided into 4 subgroups according to hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. There were 151 (50.0%) patients in the HR+/HER2- group, 80 (26.5%) patients in the HR+/HER2+ group, 42 (13.9%) patients in the HR-/HER2+ group, and 29 (9.6%) patients in the triple negative (TN) group. At the time of analysis, 155 (51.3%) patients had recurrent disease and 117 (38.7%) patients had died. The median disease-free survival (DFS) and overall survival (OS) times were 46.0 and 78.0 months, respectively. Both the DFS and OS in the HR+/HER2- group were longer than in the other groups (log-rank p = 0.034 and p = 0.016, respectively). Menopausal status, progesterone receptor (PgR) status, and lymph node ratio (LNR; defined as the number of positive lymph nodes compared to the total number of removed lymph nodes) were found to be independent prognostic factors (p = 0.019, p = 0.001, and p = 0.012, respectively). Conclusion: Menopausal status, PgR status, and LNR were independent prognostic factors in operated N3a breast cancer patients, who are underrepresented in breast cancer trials.

39th ESMO Congress (ESMO) -- SEP 26-30, 2014 -- Madrid, SPAIN, WOS: 000346901000167, …, ESMO

Gastric cancer is often diagnosed in advanced stage. Palliative chemotherapy or best supportive care is recommended for patients with metastatic gastric patients. In several clinical trials, palliative chemotherapy improved overall survival (OS) and progression-free survival (PFS), but the survival benefit of second-line chemotherapy was demonstrated in small cohort studies. The main aim of our study was to compare retrospectively the efficacy of second-line modified EOX (epirubicin, oxaliplatin and capecitabine) [mEOX] and irinotecan, 5-fluorouracil, and leucovorin (FOLFIRI) regimens in metastatic gastric cancer patients that progressed on first-line modified docetaxel-cisplatin-fluorouracil (DCF) regimen. Metastatic gastric cancer patients who progressed on modified DCF regimens were included. A total 105 patients were included to this study; 55 and 50 patients were treated with mEOX and FOLFIRI regimens, respectively. The clinicopathological and demographic characteristics of all patients were collected from the medical charts. Kaplan-Meier survival analysis was carried out for PFS and OS. The median follow-up of our study was 16 (4-85) months. In both groups, all of the patients were treated with first-line mDCF. Median cycle of second-line chemotherapy was 3 (1-8) and 3.5 (1-6) in EOX and FOLFIRI groups, respectively (P = 0.44). Overall response rate was observed in 34.6 % and 42.0 % of patients second-line chemotherapy in mEOX and FOLFIRI arms, respectively (P = 0.17). Median PFS was 5.5 and 6.3 months in mEOX and FOLFIRI arms, respectively (P = 0.98). Median OS was 6.9 and 7.0 months in mEOX and FOLFIRI arms, respectively, from the time of beginning second-line chemotherapy protocol (P = 0.89). As compared with FOLFIRI regimen, mEOX regimen was associated with less neutropenia, thrombocytopenia and anemia. Dose reduction and dose delay were significantly higher in FOLFIRI group compared to mEOX group (P < 0.001). In our trial, triplet regimens mEOX and FOLFIRI regimens have similar efficacy as second-line treatment for patients with metastatic gastric cancer. FOLFIRI regimen was associated with more hematological toxicity.

e20051 Background: Mucosal melanoma is a rare disease that is clearly distinct from cutaneous melanoma in clinical course and prognosis. We aim to evaluate patients with mucosal melanoma of differe...

e17542 Background: The aim in this study was determining the factors that affects the appropriateness of cancer patients (pts) for clinical drug trials in Turkey. Methods: 1316 pts were recruited f...

Aim: Optimal adjuvant treatment in gastric cancer (GC) patients (pts) with D2 lymph node dissection (D2LND) is still undefined. The aim of this retrospective study was to evaluate the efficacy and tolerability of two different adjuvant chemoradiotherapy (ACRT) regimens in operable node-positive GC pts with D2LND. Methods: 138 curatively resected GC pts who underwent D2LND and had node-positive disease were included in this study. They received ACRT between January 2006 and March 2013 in Ankara Oncology Hospital. Pts treated with Intergroup 0116 ACRT protocol were named as arm A (54.3%, n = 75). Pts received biweekly cisplatin (50 mg/m2 on day 1) plus infusional 5-fluorouracil/folinic acid (CFF) and radiation therapy concurrent with bolus 5-FU were included in arm B (45.7%, n = 63). Also, the study population was divided into two different subgroups: Pts who completed all planned ACRT (75.4%, n = 104), and pts who did not complete the planned ACRT in spite of dose reduction and/or delaying and best supportive care (24.6%, n = 34 ). Results: Median follow-up was 30 ( range:6-120) months(mts). Completion rate of ACRT: 80% for arm A and 70% for arm B (p = .23). Grade 3-4 toxicity rate was greater in group B than group A (32.4% vs 67.6%, p Conclusions: Adjuvant CFF plus CRT are not able to change the prognosis of pts who had lymph node-positive GC with D2LND even if receiving for N3 disease and diffuse histology, but toxicity is increased by the treatment . Completion of ACRT is the more important predictor for survival in curatively resected GC. Disclosure: All authors have declared no conflicts of interest.

e14526 Background: The aims of this study were to evaluate the tolerability and toxicity with adjuvant chemoradiotherapy (CRT) and prognostic analysis of patients with operable gastric cancer. Methods: The retrospective analysis included 723 patients with operable gastric cancer, stage IB-IV (M0), received adjuvant CRT from 8 Medical Centers in Turkey between 2003 and 2010. Patients’ age, sex, tumor localization, Lauren classification, grade, stage, type of dissection, toxicity and tolerability status were analyzed. Results: 73.9% of the patients were with stage III- IVM0. 61.0% of the patients were in the intestinal type, 51.1% of the patients were with the distal type of gastric cancer and 61.4% of the patients had undergone D2 dissection. 545 (75.4%) of patients completed the entire of adjuvant CRT. The median follow-up period was 20.8 months. Overall Survival (OS) rates were 80% and 52% while relapse free survival (RFS) rates were 75% and 48%, at 1, 3 years, respectively. In univariate analysis of groups, according to the group under the age of 65 and above (p=0.16 / p=0.003), Lauren classification (p=0.004 / p

Background: Malignant gliomas are aggressive primary brain tumours, which include anaplastic gliomas & glioblastoma (GBM). The majority of patients relapse following initial therapy & treatment options are limited. We reviewed patients with recurrent glioma treated with single agent bevacizumab at our centre from May 2009 to Dec 2010. Materials and Methods: Patients were identified from the pharmacy database & their records reviewed. Results: 15 patients were identified; data was available for 12. There were 9 men and 3 women with mean age at diagnosis of 47 (16– 62). Histology at original presentation was GBM in 7 patients, anaplastic astrocytoma in 4 and oligoastrocytoma in 1. All had at least subtotal debulking, with subsequent radiation. In 9 (75%), radiation was concurrent with temozolomide − 8 proceeded to temozolomide alone, 1 patient had progressive disease. 2 (17%) patients had radiation followed by procarbazine, lomustine, vincristine (P.C.V.) − chemotherapy was stopped early in both, due to toxicity in one and progressive disease in the other, this patient then received temozolomide. The 1 patient who originally had an oligoastrocytoma subsequently transformed to GBM, he had radiation followed by temozolomide at that point. Upon progression of disease, 5 patients had further debulking, with insertion of carmustine wafers in 2. Patients started on bevacizumab a median of 16 months from initial diagnosis (5−92), 9 had 10mg/kg 2 weekly, 3 received 7.5mg/kg secondary to performance status concerns. There was a median of 11 cycles administered (1−22). 4 patients are alive, 1 continues on bevacizumab at 4 months, 3 are off treatment due to decreased performance status, at a median 6 months (6−10) from commencing therapy. The other 8 patients died a median of 6 months from starting bevacizumab (1−12). 1 bled into their tumour, 1 had a saddle pulmonary embolism, the remainder died of progressive disease. All patients were on steroid therapy, 7 (58%) had a reduction in steroid dose on bevacizumab. 3 (25%) patients had an improved scan on treatment. The median overall survival was 6 months from commencement of bevacizumab. Conclusion: The management of patients with recurrent malignant glioma is challenging. Despite a median overall survival of 6 months in an unselected cohort, in addition to the ability to reduce steroid dose − which compares reasonably to historical controls -outcome for this group is still disappointing overall. We continue to seek novel therapeutic options for this aggressive disease.

e11002 Background: The effectiveness of CTC determination on progression free survival (PFS) and overall survival (OS) in early and advanced breast cancer as an adjunct to standard care of treatment was evaluated. Methods: Between November 2008 and March 2009, 22 metastatic and 12 early stage breast carcinoma patients, admitted to Ankara Oncology Training and Research Hospital and gave informed consent to participate, were included in this prospective trial. Patients’ characteristics, treatment schedules and survival data were evaluated. Physical examination and routine radiological assessment were done regularly for the evaluation of response. CTC was detected by CellSearch method before and 9 to 12 weeks after the initiation of chemotherapy. Results: All patients were female. Median age was 48.0 (range: 29-65) and 52.5 (range: 35-66) in early stage and metastatic groups, respectively. CTC was positive (≥5) in 3 (13.6%) patients before chemotherapy and 6 (27.3%) patients at anytime during chemotherapy in...