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23rd ESMO World Congress on Gastrointestinal Cance -- JUN 30-JUL 03, 2021 -- ELECTR NETWORK, [No Abstract Available], ESMO, Amgen Pharmaceuticals, This project was funded by Amgen Pharmaceuticals.

Cancer is one of the most common causes of death all over the World (Rahib et al. in Cancer Res 74(11):2913-2921, 2014; Silbermann et al. in Ann Oncol 23(Suppl 3):iii15-iii28, 2012). It is crucial to diagnose this disease early by effective screening methods and also it is very important to acknowledge the community on various aspects of this disease such as the treatment methods and palliative care. Not only the oncologists but every medical doctor should be educated well in dealing with cancer patients. Previous studies suggested various opinions on the level of oncology education in medical schools (Pavlidis et al. in Ann Oncol 16(5):840-841, 2005). In this study, the perspectives of medical students on cancer, its treatment, palliative care, and the oncologists were analyzed in relation to their educational status. A multicenter survey analysis was performed on a total of 4224 medical school students that accepted to enter this study in Turkey. After the questions about the demographical characteristics of the students, their perspectives on the definition, diagnosis, screening, and treatment methods of cancer and their way of understanding metastatic disease as well as palliative care were analyzed. The questionnaire includes questions with answers and a scoring system of Likert type 5 (absolutely disagree = 1, completely agree = 5). In the last part of the questionnaire, there were some words to detect what the words "cancer" and "oncologist" meant for the students. The participant students were analyzed in two study groups; "group 1" (n = 1.255) were phases I and II students that had never attended an oncology lesson, and "group 2" (n = 2.969) were phases III to VI students that had attended oncology lessons in the medical school. SPSS v17 was used for the database and statistical analyses. A value of p < 0.05 was noted as statistically significant. Group 1 defined cancer as a contagious disease (p = 0.00025), they believed that early diagnosis was never possible (p = 0.042), all people with a diagnosis of cancer would certainly die (p = 0.044), and chemotherapy was not successful in a metastatic disease (p = 0.003) as compared to group 2. The rate of the students that believed gastric cancer screening was a part of the national screening policy was significantly more in group 1 than in group 2 (p = 0.00014). Group 2 had a higher anxiety level for themselves or their family members to become a cancer patient. Most of the students in both groups defined medical oncologists as warriors (57% in group 1 and 40% in group 2; p = 0.097), and cancer was reminding them of "death" (54% in group 1 and 48% in group 2; p = 0.102). This study suggested that oncology education was useful for the students' understanding of cancer and related issues; however, the level of oncology education should be improved in medical schools in Turkey. This would be helpful for medical doctors to cope with many aspects of cancer as a major health care problem in this country. C1 [Oktay, Esin; Turan, Merve; Barutca, Sabri] Adnan Menderes Univ, Dept Med Oncol, Fac Med, Aydin, Turkey. [Levent, Mustafa] Sitki Kocman Univ, Dept Internal Med, Fac Med, Mugla, Turkey. [Gelincik, Hakan; Aktas, Gizem; Paydas, Semra] Cukurova Univ, Dept Med Oncol, Fac Med, Adana, Turkey. [Yumuk, Fulden] Marmara Univ, Dept Med Oncol, Fac Med, Istanbul, Turkey. [Koral, Lokman] Onsekiz Mart Univ, Dept Med Oncol, Fac Med, Canakkale, Turkey. [Arpaci, Erkan] Sakarya Univ, Dept Med Oncol, Fac Med, Sakarya, Turkey. [Keser, Murat; Yavuzsen, Tugba] Dokuz Eylul Univ, Dept Med Oncolog, Fac Med, Izmir, Turkey. [Alkan, Ali; Senler, Filiz Cay] Ankara Univ, Dept Med Oncol, Fac Med, Ankara, Turkey. [Karci, Ebru; Karadurmus, Nuri] Gulhane Mil Med Acad, Dept Med Oncol, Ankara, Turkey. [Degirmencioglu, Serkan; Yaren, Arzu] Pamukkale Univ, Dept Med Oncol, Fac Med, Denizli, Turkey. [Uyeturk, Ummugul] Abant Izzet Baysal Univ, Dept Med Oncol, Fac Med, Bolu, Turkey. [Cabuk, Devrim] Kocaeli Univ, Dept Med Oncol, Fac Med, Izmit, Turkey. [Avci, Nilufer] Balikesir Univ, Dept Med Oncol, Fac Med, Balikesir, Turkey. [Toprak, Omer] Balikesir Univ, Dept Internal Med, Fac Med, Balikesir, Turkey. [Ergen, Arzu; Sahinler, Ismet] Istanbul Univ, Cerrahpasa Fac Med, Dept Radiat Oncol, Istanbul, Turkey. [Urvay, Semiha] Cumhuriyet Univ, Dept Med Oncol, Fac Med, Sivas, Turkey. [Bayman, Evrim] Osmangazi Univ, Dept Radiat Oncol, Fac Med, Eskisehir, Turkey. [Petekkaya, Emine] Beykent Univ, Dept Anat, Fac Med, Istanbul, Turkey. [Nayir, Erdinc] Mersin Medicalpark Hosp, Dept Med Oncol, Mersin, Turkey. [Ozyilkan, Ozgur] Baskent Univ, Dept Med Oncol, Fac Med, Ankara, Turkey. [Tanriverdi, Ozgur] Mugla Sitki Kocman Univ, Fac Med, Dept Med Oncol, Mugla, Turkey.

Purpose: The purpose of this study was to determine whether primary tumor localization may be a risk factor for relapse and survival in seminomatous germ cell tumors (GCT) patients. Methods: In our study, 612 seminomatous GCT patients diagnosed in 22 centers between 01.01.1989 and 03.02.2019 were retrospectively evaluated. Patient interview information, patient files and electronic system data were used for the study. Results: The primary tumor was localized in the right testis in 305 (49.9%) patients and in 307 (50.1%) in the left testis. Mean age of the patients was 36 years (range 16-85±10.4). The median follow-up period was 47 months (1-298). Recurrence was observed in 78 (12.7%) patients and 29 (4.7%) died during the follow-up period. Four-year overall survival (OS) was 95.4% and 4-year progression-free survival (PFS) was 84.5%. The relationship between localization and relapse was significant in 197 patients with stage 2 and stage 3 (p=0.003). In this patient group, 41 (20.8%) relapses were observed. Thirty (73.2%) of the relapses were in the right testis and 11 (26.8%) in the left testis. Four-year OS was 92.1% in patients with right tumor; and 98.7% in patients with left tumor (p=0.007). When 612 patients were evaluated with a mean follow-up of 4 years, there was a 6.6% survival advantage in patients with left testicular tumor and this difference was significant (p=0.007). Conclusion: Survival rates of patients with primary right testicular localization were worse compared with left testicular localization, and relapse rates were higher in stage 2 and 3 patients with right testicular localization. © 2020 Zerbinis Publications. All rights reserved.

Purpose: The purpose of this study was to determine whether primary tumor localization may be a risk factor for relapse and survival in seminomatous germ cell tumors (GCT) patients. Methods: In our study, 612 seminomatous GCT patients diagnosed in 22 centers between 01.01.1989 and 03.02.2019 were retrospectively evaluated. Patient interview information, patient files and electronic system data were used for the study. Results: The primary tumor was localized in the right testis in 305 (49.9%) patients and in 307 (50.1%) in the left testis. Mean age of the patients was 36 years (range 16-85 +/- 10.4). The median follow-up period was 47 months (1-298). Recurrence was observed in 78 (127%) patients and 29 (4.7%) died during the follow-up period. Four-year overall survival (OS) was 95.4% and 4-year progression-free survival (PFS) was 84.5%. The relationship between localization and relapse was significant in 197 patients with stage 2 and stage 3 (p=0.003). In this patient group, 41 (20.8%) relapses were observed. Thirty (73.2%) of the relapses were in the right testis and 11 (26.8%) in the left testis. Four-year OS was 92.1% in patients with right tumor; and 98.7% in patients with left tumor (p=0.007). When 612 patients were evaluated with a mean follow-up of 4 years, there was a 6.6% survival advantage in patients with left testicular tumor and this difference was significant (p=0.007). Conclusion: Survival rates of patients with primary right testicular localization were worse compared with left testicular localization, and relapse rates were higher in stage 2 and 3 patients with right testicular localization. C1 [Yildiz, Birol; Erturk, Ismail; Acar, Ramazan; Karadurmus, Nuri] Hlth Sci Univ, Gulhane Training & Res Hosp, Dept Med Oncol, Ankara, Turkey. [Kucukarda, Ahmet; Gokyer, Ali] Trakya Univ, Fac Med, Dept Med Oncol, Edirne, Turkey. [Demiray, Atike Gokcen] Pamukkale Univ, Fac Med, Dept Med Oncol, Denizli, Turkey. [Paydas, Semra] Cukurova Univ, Fac Med, Dept Med Oncol, Adana, Turkey. [Aral, Ipek Pinar] Nevsehir State Hosp, Dept Radiat Oncol, Nevsehir, Turkey. [Gumusay, Ozge] Gazi Osman Pasa Univ, Fac Med, Dept Med Oncol, Tokat, Turkey. [Bilici, Ahmet] Medipol Univ, Fac Med, Dept Med Oncol, Istanbul, Turkey. [Akdeniz, Nadiye] Dicle Univ, Fac Med, Dept Med Oncol, Diyarbakir, Turkey. [Bahceci, Aykut] Gaziantep Dr Ersin ARSLAN Training & Res Hosp, Dept Med Oncol, Gaziantep, Turkey. [Demir, Hacer] Afyon Kocatepe Univ, Fac Med, Dept Med Oncol, Afyon, Turkey. [Esin, Ece] Bayindir Hosp, Dept Med Oncol, Ankara, Turkey. [Uyeturk, Ummugul] Abant Izzet Baysal Univ, Fac Med, Dept Med Oncol, Bolu, Turkey. [Okten, Ilker Nihat] Istanbul Medeniyet Univ, Gortepe Training & Res Hosp, Dept Med Oncol, Istanbul, Turkey. [Turk, H. Mehmet] BezmiAlem Vakif Univ, Dept Med Oncol, Istanbul, Turkey. [Topaloglu, Ulas Serkan] Kayseri City Hosp, Dept Internal Med, Kayseri, Turkey. [Basoglu, Tugba] Marmara Univ, Fac Med, Dept Med Oncol, Istanbul, Turkey. [Turhal, Nazim Serdar] Anadolu Med Ctr, Dept Med Oncol, Kocaeli, Turkey. [Cinkir, Havva Yesil] Gaziantep Univ, Dept Med Oncol, Fac Med, Gaziantep, Turkey. [Menekse, Serkan; Kut, Engin] Manisa City Hosp, Dept Med Oncol, Manisa, Turkey. [Cakmak, Yagmur] Kocaeli Univ, Fac Med, Dept Med Oncol, Kocaeli, Turkey. [Urun, Yuksel] Ankara Univ, Fac Med, Dept Med Oncol, Ankara, Turkey. [Dal, Pinar] Eskisehir City Hosp, Dept Med Oncol, Eskisehir, Turkey. [Sakalar, Teoman] Kahramanmaras City Hosp, Dept Med Oncol, Kahramanmaras, Turkey. [Aktepe, Oktay Halit] Hacettepe Univ, Fac Med, Dept Med Oncol, Ankara, Turkey.

PubMed: 32507911 Classical Hodgkin lymphoma (cHL) is considered a curable disease; however, in approximately one-third of the responding patients, the disease relapses following completion of therapy. One of the drugs that have been approved for the treatment of relapsed/refractory cHL is nivolumab, an immune check point inhibitor that shows its effects by blocking the programmed death 1 (PD-1) receptor. In this study, we present a retrospective “real-life” analysis of the usage of nivolumab in patients with relapsed/refractory cHL that have joined the named patient program (NPP) for nivolumab, reflecting 4 years of experience in the treatment of relapsed/refractory cHL. We present a retrospective analysis of 87 patients (median age, 30) that participated in the NPP in 24 different centers, who had relapsed/refractory cHL and were consequently treated with nivolumab. The median follow-up was 29 months, and the median number of previous treatments was 5 (2–11). In this study, the best overall response rate was 70% (CR, 36%; PR, 34%). Twenty-eight of the responding patients underwent subsequent stem cell transplantation (SCT). Among 15 patients receiving allogeneic stem cell transplantation, 9 patients underwent transplantation with objective response, of which 8 of them are currently alive with ongoing response. At the time of analysis, 23 patients remained on nivolumab treatment and the rest discontinued therapy. The main reason for discontinuing nivolumab was disease progression (n = 23). The safety profile was acceptable, with only nine patients requiring cessation of nivolumab due to serious adverse events. The 24-month progression-free and overall survival rates were 58.5% (95% CI, 0.47–0.68) and 78.7% (95% CI, 0.68–0.86), respectively. Eighteen patients died during the follow-up and only one of these was regarded to be treatment-related. With its efficacy and its safety profile, PD-1 blockers became an important treatment option in the heavily pretreated cHL patients. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.

Classical Hodgkin lymphoma (cHL) is considered a curable disease; however, in approximately one-third of the responding patients, the disease relapses following completion of therapy. One of the drugs that have been approved for the treatment of relapsed/refractory cHL is nivolumab, an immune check point inhibitor that shows its effects by blocking the programmed death 1 (PD-1) receptor. In this study, we present a retrospective "real-life" analysis of the usage of nivolumab in patients with relapsed/refractory cHL that have joined the named patient program (NPP) for nivolumab, reflecting 4 years of experience in the treatment of relapsed/refractory cHL. We present a retrospective analysis of 87 patients (median age, 30) that participated in the NPP in 24 different centers, who had relapsed/refractory cHL and were consequently treated with nivolumab. The median follow-up was 29 months, and the median number of previous treatments was 5 (2-11). In this study, the best overall response rate was 70% (CR, 36%; PR, 34%). Twenty-eight of the responding patients underwent subsequent stem cell transplantation (SCT). Among 15 patients receiving allogeneic stem cell transplantation, 9 patients underwent transplantation with objective response, of which 8 of them are currently alive with ongoing response. At the time of analysis, 23 patients remained on nivolumab treatment and the rest discontinued therapy. The main reason for discontinuing nivolumab was disease progression (n = 23). The safety profile was acceptable, with only nine patients requiring cessation of nivolumab due to serious adverse events. The 24-month progression-free and overall survival rates were 58.5% (95% CI, 0.47-0.68) and 78.7% (95% CI, 0.68-0.86), respectively. Eighteen patients died during the follow-up and only one of these was regarded to be treatment-related. With its efficacy and its safety profile, PD-1 blockers became an important treatment option in the heavily pretreated cHL patients. C1 [Bekoz, Huseyin] Medipol Univ, Med Fac, Dept Internal Med, Div Hematol, Istanbul, Turkey. [Ozbalak, Murat] Istanbul Univ, Dept Internal Med, Div Hematol, Istanbul Med Fac, Istanbul, Turkey. [Karadurmus, Nuri] Gulhane Res & Training Hosp, Dept Internal Med, Div Med Oncol, Ankara, Turkey. [Paydas, Semra] Cukurova Univ, Dept Internal Med, Div Med Oncol, Adana, Turkey. [Turker, Alev; Barista, Ibrahim] Hacettepe Univ, Dept Internal Med, Div Med Oncol, Ankara, Turkey. [Toptas, Tayfur; Tuglular, Tulin Firatli] Marmara Univ, Dept Internal Med, Div Hematol, Istanbul, Turkey. [Altuntas, Fevzi; Cakar, Merih Kizil] Dr Abdurrahman Yurtaslan Ankara Oncol Res & Train, Div Hematol, Ankara, Turkey. [Sonmez, Mehmet] Karadeniz Tech Univ, Dept Internal Med, Div Hematol, Trabzon, Turkey. [Gulbas, Zafer] Anadolu Med Ctr, Div Hematol, Izmit, Turkey. [Demir, Nazli] Gazi Yasargil Res & Training Hosp, Dept Internal Med, Div Hematol, Diyarbakir, Turkey. [Kaynar, Leylagul] Erciyes Univ, Dept Internal Med, Div Hematol, Kayseri, Turkey. [Yildirim, Rahsan] Ataturk Univ, Div Hematol, Dept Internal Med, Erzurum, Turkey. [Karadogan, Ihsan] Medstar Antalya Hosp, Div Hematol, Antalya, Turkey. [Arat, Mutlu] Florence Nighthingale Hosp, Div Hematol, Istanbul, Turkey. [Kapucu, Irem] Koc Univ, Dept Internal Med, Sch Med, Istanbul, Turkey. [Aslan, Nevin Alayvaz] Dr Ersin Arslan Res & Training Ctr, Div Hematol, Gaziantep, Turkey. [Ozkocaman, Vildan] Uludag Univ, Dept Internal Med, Div Hematol, Bursa, Turkey. [Turgut, Mehmet] Ondokuz Mayas Univ, Dept Internal Med, Div Hematol, Samsun, Turkey. [Yuksel, Meltem Kurt; Ozcan, Muhit; Toprak, Selami K.] Ankara Univ, Dept Internal Med, Div Hematol, Ankara, Turkey. [Hacioglu, Sibel Kabukcu] Pamukkale Univ, Dept Internal Med, Div Hematol, Denizli, Turkey. [Demirkaya, Metin] Uludag Univ, Dept Pediat, Div Med Oncol, Bursa, Turkey.

WOS: 000454014501235 Background: Increasing evidence leads to a ratiocination that genetic heterogeneity of the lung adenocarcinoma patients with sensitive EGFR mutations may impact clinical responses and outcomes to EGFR-TKIs. Method: We performed targeted NGS with a gene panel covering 416 cancer-related genes to profile genetic characteristics of 69 lung adenocarcinoma patients with activating EGFR mutations and assessed the contribution of targeted NGS to exploration of genetic heterogeneity of such cohort. Result: We detected total 200 actionable genetic alterations (mean 2.9 variations per patient, range: 1-7 variations) in tumor DNA and 140 actionable genetic alterations (mean 2.0 variations per patient, range: 0-5 variations) in matched plasma ctDNA, respectively. The concurrent genes with the highest mutation rate were TP53 (observed in 72.5% patients), other uncommon EGFR mutations (observed in 21.7% patients), EGFR amplification (observed in 20.3% patients), RB1 (observed in 10.1% patients), PIK3CA (observed in 7.2% patients), and MYC (observed in 5.8% patients). NGS provides EGFR mutation detection in plasma with a test sensitivity of 88.2% and specificity of 100.0%.

PurposeIn this study, we aimed to describe the real-life practice outcomes of pertuzumab-trastuzumab-taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients.MethodsThis study was conducted by Turkish Oncology Group and included 317 patients' data from 36 centers.ResultsMedian age was 51 (22-82). Median PFS was 28.5months, while median OS was 40.3months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8m vs. 28.5m; p=0.002) and OS (26.7m vs. 40.3m; p=0.009). Patients older than 65years of age (n: 42, 13.2%) had significantly lower OS results (19.8m vs. 40.3m; p=0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5-40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure.ConclusionsOur RLP trial included only visceral metastatic, trastuzumab-naive BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab-trastuzumab-taxane therapy to date. C1 [Esin, Ece; Oksuzoglu, B.; Erdur, E.; Demirci, U.] Univ Hlth Sci, Dept Med Oncol, Dr AY Ankara Oncol Educ & Res Hosp, Ankara, Turkey. [Bilici, A.] Medipol Univ, Int Hlth Ctr, Dept Med Oncol, Istanbul, Turkey. [Cicin, I.; Kostek, O.] Trakya Univ, Dept Med Oncol, Edirne, Turkey. [Kaplan, M. A.] Dicle Univ, Dept Med Oncol, Fac Med, Diyarbakir, Turkey. [Aksoy, S.; Aktas, B. Y.] Hacettepe Univ, Dept Med Oncol, Fac Med, Ankara, Turkey. [Ozdemir, O.; Alacacioglu, A.] Izmir KC Univ, Ataturk Educ & Res Hosp, Dept Med Oncol, Izmir, Turkey. [Cabuk, D.] Kocaeli Univ, Fac Med, Dept Med Oncol, Izmit, Turkey. [Sumbul, A. T.] Baskent Univ, Dept Med Oncol, Adana Hosp, Adana, Turkey. [Sakin, A.] Istanbul Okmeydani Educ & Res Hosp, Dept Med Oncol, Istanbul, Turkey. [Paydas, S.; Yetisir, E.] Cukurova Univ, Dept Med Oncol, Fac Med, Adana, Turkey. [Er, O.; Basaran, G.] Acibadem MAA Univ, Acibadem Maslak Hosp, Dept Med Oncol, Istanbul, Turkey. [Korkmaz, T.; Oyan, B.] Acibadem MAA Univ, Acibadem Altunizade Hosp, Dept Med Oncol, Istanbul, Turkey. [Yildirim, N.] Dr Ersin Arslan Training & Res Hosp, Dept Med Oncol, Gaziantep, Turkey. [Sakalar, T.] Erciyes Univ, Dept Med Oncol, Fac Med, Kayseri, Turkey. [Demir, H.] Kayseri Educ & Res Hosp, Univ Hlth Sci, Dept Med Oncol, Kayseri, Turkey. [Artac, M.; Karaagac, M.] Necmettin Erbakan Univ, Meram Med Fac, Dept Med Oncol, Konya, Turkey. [Harputluoglu, H.; Bilen, E.] Inonu Univ, Dept Med Oncol, Turgut Ozal Med Ctr, Malatya, Turkey. [Degirmencioglu, S.] Pamukkale Univ, Dept Med Oncol, Fac Med, Denizli, Turkey. [Aliyev, A.] Bezmialem Univ, Dept Med Oncol, Fac Med, Istanbul, Turkey. [Cil, T.; Olgun, P.] Adana City Hosp, Univ Hlth Sci, Dept Med Oncol, Adana, Turkey. [Gumusay, O.] Gaziosmanpasa Univ, Dept Med Oncol, Fac Med, Tokat, Turkey. [Demir, A.] Univ Hlth Sci, Dept Med Oncol, Istanbul Okmeydani Educ & Res Hosp, Istanbul, Turkey. [Tanrikulu, E.; Yumuk, P. F.] Marmara Univ, Dept Med Oncol, Fac Med, Istanbul, Turkey. [Imamoglu, Inanc] Univ Hlth Sci, Ankara Diskapi Educ & Res Hosp, Dept Med Oncol, Ankara, Turkey. [Cetin, B.] RTE Univ, Dept Med Oncol, Fac Med, Rize, Turkey. [Haksoyler, V.] Univ Hlth Sci, Diyarbakir GY Educ & Res Hosp, Dept Med Oncol, Diyarbakir, Turkey. [Karadurmus, N.; Erturk, I.] Univ Hlth Sci, Gulhane Educ & Res Hosp, Dept Med Oncol, Ankara, Turkey. [Evrensel, T.; Yilmaz, H.] Uludag Univ, Dept Med Oncol, Fac Med, Bursa, Turkey. [Beypinar, I.] Afyon Kocatepe Univ, Dept Med Oncol, Fac Med, Afyon, Turkey. [Kocer, M.] Isparta SD Univ, Dept Med Oncol, Fac Med, Isparta, Turkey. [Pilanci, K. N.] Univ Hlth Sci, Dept Med Oncol, Haseki Educ & Res Hosp, Istanbul, Turkey. [Seker, M.; Urun, Y.] Ankara Bayindir Hosp, Dept Med Oncol, Ankara, Turkey. [Urun, Y.] Ankara Univ, Dept Med Oncol, Fac Med, Ankara, Turkey. [Yildirim, N.; Eren, T.] Univ Hlth Sci, Numune Educ & Res Hosp, Dept Med Oncol, Ankara, Turkey.

Purpose: In this study, we aimed to describe the real-life practice outcomes of pertuzumab–trastuzumab–taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients. Methods: This study was conducted by Turkish Oncology Group and included 317 patients’ data from 36 centers. Results: Median age was 51 (22–82). Median PFS was 28.5 months, while median OS was 40.3 months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8 m vs. 28.5 m; p = 0.002) and OS (26.7 m vs. 40.3 m; p = 0.009). Patients older than 65 years of age (n: 42, 13.2%) had significantly lower OS results (19.8 m vs. 40.3 m; p = 0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5–40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure. Conclusions: Our RLP trial included only visceral metastatic, trastuzumab-naïve BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab–trastuzumab–taxane therapy to date. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

22nd Congress of the European-Hematology-Association -- JUN 22-25, 2017 -- Madrid, SPAIN Arat, Mutlu/0000-0003-2039-8557; Yuksel, Meltem Kurt/0000-0003-0369-299X; Kaynar, Leylagul/0000-0002-2035-9462; Paydas, Semra/0000-0003-4642-3693; Toprak, Selami K/0000-0001-7717-5827; WOS: 000404127001176 … European Hematol Assoc

Background: Reed-Sternberg cells of classical Hodgkin's lymphoma (cHL) are characterized by genetic alterations at the 9p24.1 locus, leading to over-expression of programmed death-ligand 1 and 2. In a phase 1b study, nivolumab, a PD-1-blocking antibody, produced a high response in patients with relapsed or refractory cHL, with an acceptable safety profile. Patients and methods: We present a retrospective analysis of 82 patients (median age: 30 years; range: 18-75) with relapsed/refractory HL treated with nivolumab in a named patient program from 24 centers throughout Turkey. The median follow-up was 7 months, and the patients had a median of 5 (2-11) previous lines of therapy. Fifty-seven (70%) and 63 (77%) had been treated by stem-cell transplantation and brentuximab vedotin, respectively. Results: Among 75 patients evaluated after 12 weeks of nivolumab treatment, the objective response rate was 64%, with 16 complete responses (CR; 22%); after 16 weeks, it was 60%, with 16 (26%) patients achieving CR. Twenty patients underwent subsequent transplantation. Among 11 patients receiving allogeneic stem-cell transplantation, 5 had CR at the time of transplantation and are currently alive with ongoing response. At the time of analysis, 41 patients remained on nivolumab treatment. Among the patients who discontinued nivolumab, the main reason was disease progression (n = 19). The safety profile was acceptable, with only four patients requiring cessation of nivolumab due to serious adverse events (autoimmune encephalitis, pulmonary adverse event, and two cases of graft-versus-host disease aggravation). The 6-month overall and progression-free survival rates were 91.2% (95% confidence interval: 0.83-0.96) and 77.3% (0.66-0.85), respectively. Ten patients died during the follow-up; one of these was judged to be treatment-related. Conclusions: Nivolumab represents a novel option for patients with cHL refractory to brentuximab vedotin, and may serve as a bridge to transplantation; however, it may be associated with increased toxicity.

Although the coexistence of hairy cell leukemia with sarcoidosis has been reported in a few cases in the literature, in our case the patient had been diagnosed and followed about 10 years with sarcoidosis and massive splenomegaly. It has been demonstrated that T helper 1 cells exist in organs influenced by sarcoidosis. These cells produce IL-2 and IFN-γ and induce a nonspecific inflammatory response and granuloma formation. Also these cytokines may play a role in the development of hairy cell leukemia.Key words: hairy cell leukemia - sarcoidosis - massive splenomegaly.

Alkaptonuria (ochronosis) is a rare autosomal recessive disorder featuring a genetic error in the amino acid metabolism. A defect in the tyrosine metabolism results in the accumulation and deposition of homogentisic acid in connective tissue, causing a blue-black discolouration. Degenerative arthropathy of the spine, knee, and hip are common signs of ochronosis in older age. An association between ochronosis and depression has not previously been discussed in the literature. This case report describes a 69 year-old woman with diabetes mellitus, ochronosis, depression and chronic pain. (Pol J Endocrinol 2010; 61 (6): 710-713)

WOS: 000280620800022 …

PubMed: 21104643 Introduction: Serum transforming growth factor beta (TGF-?) level is increased in type-2 diabetes mellitus (T2DM) and certain diabetic complications are mediated by this cytokine. Impaired glucose tolerance (IGT) is a prediabetic condition, and confers a risk for the development of certain diabetes-specific complications. However, no data is available regarding the alteration of TGF-? in IGT subjects. Therefore, we aimed to investigate TGF-? levels in otherwise healthy subjects with IGT. Material and methods: Thirty IGT subjects and 30 subjects relatively matched for age, sex and body mass index with normal glucose tolerance were enrolled. Subjects with overt diabetes, cardiovascular, renal or inflammatory disease, or on any medication were excluded. Relevant laboratory examinations were performed by routine methods. Assessment of TGF-? was made by a commercially available enzyme-linked immunosorbent assay kit. IGT and control subjects were compared for their clinical and laboratory parameters. Results: Serum TGF-? levels were found to be similar in IGT and normal glucose tolerance subjects (p < 0.05). No statistically significant correlation was found between TGF-? and other laboratory parameters, either in IGT subjects or in the whole study population. Conclusions: Serum TGF-? is not elevated in otherwise healthy subjects with IGT. The results of our study imply that the presence of IGT alone is not sufficient to induce TGF-? elevation; and for the alteration of TGF-?, worsening of metabolic risk factors may be required.