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Background: This study aims to evaluate the relationship between volumetric measurements of residual tumor via magnetic resonance imaging (MRI) and pathologic complete response (pCR) in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (nCRT). Methods: Patients with locally advanced rectal cancer who had pelvic MRI for clinical staging and completed nCRT followed by radical resection were included. Two experienced radiologists measured tumor volume on MRI obtained before and after nCRT. We compared the pre- and post-CRT tumor volume and measured tumor volume reduction rates. Results: The median value of tumor volume reduction rate in all patients was 64.7% (min–max − 81.1–98.1%). When the relationship between tumor volume and tumor regression grade (TRG) after nCRT was assessed, it was found that 18 of 21 (86%) patients with a good response (TRG 1) had a post-CRT tumor volume of ≤ 8 cm3 (p = 0.001). While 9 of 10 patients with pCR after nCRT had a tumor volume of ≤ 8 cm3, one patient had pCR despite having a tumor volume greater than 8 cm3 (p = 0.015). Conclusion: The correlation between post-nCRT residual tumor volume and pCR underscores the potential of volumetric MRI as a predictive tool in tailoring rectal cancer treatment. For patients with residual tumor volumes greater than 8 cm3, extending neoadjuvant chemotherapy as part of TNT may enhance the likelihood of achieving pCR. This approach advocates for a more personalized treatment strategy, potentially optimizing outcomes for rectal cancer patients. [ABSTRACT FROM AUTHOR]

Immune checkpoint inhibitors (ICIs) can trigger immune-related adverse events (irAEs). The appearance pattern of irAEs, who is prone to them, and their mechanisms are still uncertain. In this study, we aimed to monitor patients initiated on ICIs for endocrinological aspects and to investigate the potential predictive markers in the development of endocrine-irAEs. The study prospectively included 43 patients with metastatic disease scheduled for anti-PD-1/ L1 therapy. Endocrinological follow-up was conducted at specified intervals as well as in response to any additional reported complaints. Serum concentrations of CXCL10, IL-1beta, and IL-17A were measured prior to ICI and during the endocrine-irAEs. A total of 39.5% of the patients experienced endocrine-irAEs, with a median onset time of 3 months. Among patients, 34.9% developed thyroid-related adverse events, and 4.6% experienced hypophysitis. Thyroid autoantibodies were associated with a higher incidence of thyroid-related irAEs (P = 0.004). In the irAE group, median pre-ICI CXCL10 and baseline thyroid stimulating hormone (TSH) levels were significantly higher, baseline total testosterone level in men was lower than in the non-irAE group (P < 0.05), whereas IL-1beta and IL-17A levels did not differ (P > 0.05). Serum CXCL10, IL-1beta, and IL-17A concentrations did not differ significantly pre-ICI and during adverse events (P > 0.05). Pre-ICI CXCL10 concentration was correlated positively with anti-TPO levels in patients with at least one thyroid autoantibody positivity (r = 0.706, P = 0.01) and negatively with baseline total testosterone level of men (r = 0.509, P = 0.002). Our results suggest that higher pre-ICI serum CXCL10 and TSH levels might have a predictive role in the development of endocrinopathies. Besides, baseline thyroid antibody measurements could be beneficial in predicting thyroid dysfunction. [ABSTRACT FROM AUTHOR]

Objectives: The treatment of epithelial ovarian cancer has been revolutionized by the development of poly ADP-ribose polymerase (PARP) inhibitors which offer maintenance therapy options that extend progression-free survival (PFS). Methods: Patients from sixteen institutions in Turkey who had International Federation of Gynecology and Obstetrics stage III or IV epithelial ovarian cancer and complete or partial response to at least four cycles of platinum-based chemotherapy were included in this retrospective study regardless of BRCA status and recurrence disease. Results: A total of 67 patients were evaluated. The median age was 58. The median follow-up was 17.5 months. Median PFS was 8.3 months in BRCAwt and 10.9 months in BRCAmut group (p=0.033). There was no significant difference in mPFS between primary and recurrent patients (10.2 vs. 9.4 months, p=0.328). The most common grade 3/4 adverse events were anemia (32.8%), thrombocytopenia (16.4%), and neutropenia (16.4%). Conclusion: The Turkish EAP's real-world data supports the efficacy and tolerability of niraparib in routine clinical practice and complements findings from randomized phase III trials. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this research was to assess the prognostic value of Gustave-Roussy immune score (GRIm-Score) in stage II and III colon cancer patients receiving capecitabine and oxaliplatin (CAPEOX). Methods: Serum lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), and albumin levels were used to create the GRIm-Score. The GRIm-score was obtained with the sum of these three laboratory parameters, which were scored as 0 and 1 according to the cut-off values. A homogeneous patient group (high-risk stage II and stage III patients) was classified into two groups, one with a high GRIm-Score (score 2 and 3) and the other with a low GRIm-Score (score 0 and 1). Results: The 4-year recurrence-free survival (RFS) was 60% in the GRIm-Score high group and 94.4% in the GRIm-Score low group (p<0.001). The 4-year overall survival (OS) was 78.1% in the GRIm-Score high group and 93.8% in the GRIm- Score low group (p<0.001). Additionally, multivariable analyses revealed that GRIm-Score (HR: 4.226, 95% CI: 1.953-9.143, p <0.001) was an independent prognostic marker for OS. Conclusion: High GRIm-Score was significantly related to poor OS in stage II and III colon cancer patients who received CAPEOX. [ABSTRACT FROM AUTHOR]

Introduction: The efficacy of immune checkpoint inhibitors (ICIs) against malignant melanoma and numerously solid tumors has been demonstrated in several clinical studies. The incidence of immune-related adverse effects (irAEs) has increased after the rapidly expanding indications and clinical applications of ICIs. We present a case of nivolumab and ipilimumab-induced encephalitis with rapidly worsening consciousness and full recovery following ICIs suspension and high-dose steroid coupled with intravenous immunoglobulin (IVIG). Case Report: A 67-year-old woman was diagnosed with stage 4 BRAF wild malignant melanoma with metastasis to the axillary and mediastinal lymph nodes. Beyond progression with dacarbazine, ipilimumab and nivolumab combination were administered at the second-line treatment of metastatic setting. A week after the first cycle patient was reported to have a fever of more than 38°C. Subacute cognitive impairment including mild changes in behavior was reported on the third day of fever. She suddenly developed confusion, dysarthria, and motor dysfunction a few days later. Due to the altered mental status accompanied by fever, lumbar puncture was performed with a pre-diagnosis of encephalitis, meningitis, and leptomeningeal carcinomatosis. Management & Outcome: After excluding viral and autoimmune encephalitis, high-dose methylprednisolone was administered in addition to IVIG for 5 days with the diagnosis of immunotherapy-related encephalitis according to the recommendations for the management of irAEs. On the second day of the treatment patient's neurological status improved gradually. Discussion: Being aware of symptoms of serious neurological irAEs associated with ICIs can prevent complications and improve survival. [ABSTRACT FROM AUTHOR]

Testicular tumors are a prevalent solid cancer among young men. The burnedout testicular seminoma phenomenon has been documented in several cases in the literature. Typically, these cases are diagnosed after metastasis, with both the metastatic lesions and the primary tumor exhibiting spontaneous regression. We present the case of a 39-year-old male patient who was previously diagnosed with a malignant teratoma in the left supraclavicular region 11 years ago. The patient was admitted to our clinic with inguinal pain, and further investigations revealed masses in the retroperitoneal and left testicular regions. Surgical resection confirmed these masses as spontaneously regressing teratomas and teratoma metastases. The patient did not receive systemic chemotherapy and remained asymptomatic during the follow-up period. This rare phenomenon, for which the underlying pathophysiology remains uncertain, is believed to be associated with the patient's immune response. Further studies are warranted to investigate and understand this unique phenomenon in greater detail. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the relationship between sarcopenia, myosteatosis, and systemic inflammatory response biomarkers and their prognostic role in stage 2 and 3 gastric cancer patients. This study included 84 patients with stage 2 or 3 gastric cancer who underwent a gastrectomy. Computed tomography scans were used to determine the skeletal muscle index (SMI) at the third lumbar vertebra level for sarcopenia and myosteatosis. Based on the Asian Working Group of Sarcopenia (AWGS2019) criteria, the sarcopenia incidence was 36.9% and that of myosteatosis 46.4%. Univariate analysis showed that sarcopenia (48 vs. 14 mo, p < 0.001), myosteatosis (45 vs. 16 mo, p = 0.016), a low prognostic nutritional index (60 vs. 15 mo, p = 0.003), stage 3 (104 vs. 21 mo, p = 0.013), and old age (45 vs. 16 mo, p = 0.015) were poor prognostic markers. Multivariate analysis revealed that sarcopenia (AWGS2019), age, and stage significantly affected overall survival (hazard ratio: 3.31, 95% CI: 1.85–5.1; 1.96, 95% CI: 1.06–6.63; 2.5, 95% CI: 1.2–5.1, respectively). We showed that sarcopenia directly affects overall gastric cancer survival. [ABSTRACT FROM AUTHOR]

Silymarin (Silybum marianum) has some protective effects against drug toxicity (cisplatin, acetaminophen, adriamycin, gentamicin etc.). Colistin is a strong antimicrobial, which is frequently used in the treatment of resistant gram-negative bacterial infections in recent years although it has nephrotoxic potential. This study was aimed to determine the role of silymarin against colistin-induced acute nephrotoxicity (CIN). Rats were randomly divided into four groups. The control group was treated with tap water whereas groups 2 and 3 received silymarin (orally, 100 mg/kg/day) and colistin (intraperitoneally, 750.000 IU/kg/day) for seven days, respectively. Group 4 received both 750,000 IU/kg/day colistin and 100 mg/kg/day silymarin for seven days. After euthanasia, histopathological and biochemical examinations were completed for the kidney tissue specimens and blood samples. All parameters of the control and silymarin groups were similar. Severe weight loss was seen in the groups receiving colistin (groups 3 and 4). Silymarin significantly increased glutathione peroxidase and superoxide dismutase levels when administered with colistin in group 4 only. Acute tubular injury, tubular necrosis, meduller congestion, interstitial inflammation and apoptotic indices of colistin group were significantly higher than the control group. The administration of colistin with silymarin (group 4) was able to make some improvements in tubular necrosis and significant increase in antioxidant capacity. Silymarin increased antioxidant enzyme activity only when used in combination with colistin. The effects of silymarin may become more pronounced when used at higher doses or with a longer duration of treatment and may prevent nephrotoxicity. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to assess the habits and knowledge of cancer patients regarding the use of herbal medicines and dietary supplements in cancer patients receiving immune checkpoint inhibitors (ICI)., Methods: The data of 181 cancer patients who were over 18 years old and received ICIs were collected. The usage patterns, anticipated benefits and harms, and sources of supply were evaluated by filling researcher-prepared forms., Results: Most patients did not use any kind of herbal medicine (91.2%) or dietary supplements (75.9%) during their immunotherapy. Boosting the immune system is the primary motivation for use among users. Multivitamins are the most frequently used supplements. Family members and TV advertisements were the main sources of information, in addition to limited advice from healthcare professionals. A minority of participants reported gastrointestinal side effects. Herbal medicine and dietary supplement use were more prevalent among patients with stage IV cancer and renal cell carcinoma (RCC)., Discussion: This study revealed that the limited uptake of herbal medicines and dietary supplements alongside ICI treatment among cancer patients. The lack of adequate information from healthcare professionals poses potential risks to patients. Improved communication with patients, education regarding herbal medicine and dietary supplement use, potential interactions, and associated risks during ICI treatment are essential. Further research is needed to identify the specific needs of patients, anticipated benefits, and potential harms of herbal medicine and dietary supplement use, together with ICIs., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.