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Non-small cell lung cancer (NSCLC) is a leading cause of morbidity and mortality. Carboplatin and cisplatin based regimens are used in the treatment of NSCLC. The aim of the study was to find out whether there is a difference in white matter (WM) changes between two platinum-based chemotherapy agents using diffusion tensor imaging (DTI).

Introduction: One of the most intriguing situations for healthcare providers is cancer therapy. Drug-drug interactions (DDIs) account for 20–30% of all adverse effects. Cancer patients are more likely to have potential-DDIs since they are taking other drugs with anticancer treatments to prevent the side effects of chemotherapeutic agents. The purpose of this research is to compare various decision support software (CDSS) programs in terms of potential DDIs. Methods: A cross-sectional study was carried out. A clinical pharmacist assessed the treatment regimens of 231 cancer patients. pDDIs were evaluated using three sources: Lexicomp®, Medscape®, and Micromedex®. The ethical approval was given in November 2017 with decision number 21/286. Results: A total of 231 participants who were receiving therapy and had a median age of 61.5 ± 9.18 years were assessed. Almost half of the patients (49%) were female, and 155 had at least one comorbidity in addition to cancer. Medscape had a substantial pDDI ratio of 7.09%, Micromedex had a ratio of 11.15%, and Lexicomp had a ratio of 19.50%. The total number of pDDIs for major/X/contraindicated were 363–2716 (1.56–11.7 pDDI/patient) for Medscape®, 60–1723 (0.26–7.4 pDDI/patient) for Micromedex, and 145–984 (0.62–2.24 pDDI/patient) for Lexicomp®. One of the most common pDDI found was diclofenac and dexamethasone. Interactions between escitalopram and granisetron were also common, and different CDSSs made different recommendations. Conclusions: In this study, significant disparities in the quantity and severity of CDSS across distinct CDSS were discovered. One of the major finding of our study was suboptimal prescribing. To address this issue, regulatory organizations should establish and verify validation and reporting mechanisms. [ABSTRACT FROM AUTHOR]

Objectives: To compare the second-line treatments on survival after trastuzumab failure in HER2-positive metastatic gastric cancer. Methods: We retrospectively included 57 patients. Of whom, 32 (56%) received paclitaxel, whereas 25 (44%) received 5-fluorouracil, leucovorin, and irinotecan (FOLFIRI). We analyzed the patient characteristics, and survival outcomes of the second-line treatment. Results: The median PFS was 3.5 months in the paclitaxel-group and 4.8 months in the FOLFIRI-group (p=0.569). The median overall survival (OS) was 6.0 months in paclitaxel-group and 11.0 months in FOLFIRI-group (p=0.410). FOLFIRI provided a significant OS advantage over paclitaxel in patients with grade 3 tumors or who did not have an objective first-line treatment response. Conclusion: FOLFIRI may be recommended as a preferred option over paclitaxel in patients with these identified risk factors. [ABSTRACT FROM AUTHOR]

Purpose: Histopathological differentiation of primary lung cancer is clinically important. We aimed to investigate whether diffusion tensor imaging (DTI) parameters of metastatic brain lesions could predict the histopathological types of the primary lung cancer. Methods: In total, 53 patients with 98 solid metastatic brain lesions of lung cancer were included. Lung tumors were subgrouped as non-small cell carcinoma (NSCLC) (n = 34) and small cell carcinoma (SCLC) (n = 19). Apparent diffusion coefficient (ADC) and Fractional anisotropy (FA) values were calculated from solid enhanced part of the brain metastases. The association between FA and ADC values and histopathological subtype of the primary tumor was investigated. Results: The mean ADC and FA values obtained from the solid part of the brain metastases of SCLC were significantly lower than the NSCLC metastases (P < 0.001 and P = 0.003, respectively). ROC curve analysis showed diagnostic performance for mean ADC values (AUC=0.889, P = < 0.001) and FA values (AUC = 0.677, P = 0.002). Cut-off value of > 0.909 × 10-3 mm²/s for mean ADC (Sensitivity = 80.3, Specificity = 83.8, PPV = 89.1, NPV = 72.1) and > 0.139 for FA values (Sensitivity = 80.3, Specificity = 54.1, PPV = 74.2, NPV= 62.5) revealed in differentiating NSCLC from NSCLC. Conclusion: DTI parameters of brain metastasis can discriminate SCLC andNSCLC. ADC and FA values of metastatic brain lesions due to the lung cancer may be an important tool to differentiate histopathological subgroups. DTI may guide clinicians for the management of intracranial metastatic lesions of lung cancer. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is the most frequently diagnosed cancer in women worldwide. Ribociclib is now frequently used in the treatment of metastatic hormone-positive and human epidermal growth factor receptor 2 (HER 2)-negative breast cancer. Case Report: A 54-year-old woman with breast cancer presented at a clinic in November 2017 with multiple lung and bone metastases. After receiving multiple lines of treatment due to disease progression, ribociclib and fulvestrant were initiated. Grade 4 toxicity was observed due to ribociclib during follow-up, and ribociclib was discontinued permanently. Management & Outcome : Given that liver transaminases and bilirubin elevation persisted despite discontinuation of the treatment, other reasons for liver toxicity were investigated. Abdominal MRI showed no liver metastases, although there was acute hepatitis. A liver biopsy was performed to determine the etiology. The pathology result was compatible with drug-induced acute fulminant toxic hepatitis. After liver biopsy, prednisolone treatment was initiated, after which the laboratory findings normalized. Discussion: Although there are reported cases showing improvement in liver enzymes after ribociclib discontinuation, in our case, no recovery from hepatotoxicity was noticed. The treatment was changed to another hormonal pathway therapy option, exemestane. To the best of our knowledge, this is the first case in the literature reporting this rare side effect of ribociclib, which is a liver biopsy-proven fulminant hepatitis. [ABSTRACT FROM AUTHOR]

Identifying Kirsten rat sarcoma (KRAS) mutation status is important for metastatic colorectal cancer treatment. Validating KRAS mutation profile on neuroimaging without histopathologic analysis would be beneficial. We aimed to differentiate Kirsten rat sarcoma (KRAS) gene mutation profile according to diffusion tensor imaging (DTI) metrics obtained from colorectal brain metastases (CRBM). Total of 8 patients with 17 CRBM included with known KRAS gene mutation status. All patients were categorized into two groups according to the KRAS mutation status as positive (+) (n: 5, 11 lesions) and negative (-) (wild type) (n: 3, 6 lesions). DTI values of the BMs were evaluated by consensus of two radiologists. Apparent diffusion coefficient (ADC), normalized apparent diffusion coefficient (nADC) and fractional anisotropy (FA) values of the two groups were compared. For comparison the Mann-Whitney U test was used. KRAS mutation (+) group showed significantly lower ADC and nADC values on CRBM rather than the wild-type. Comparison of the FA values of the two groups did not reveal any statistical significance. In conclusion, decreased ADC and nADC values of CRBM are correlated with presence of KRAS mutation. Lower ADC and nADC values obtained from CRBM can be utilized to insight KRAS mutation profile. [ABSTRACT FROM AUTHOR]

Objective: We aimed to study whether long-term kidney function would be affected by different chemotherapy regimens in patients with malignancy. Methods: In this study, 500 cancer patients between the ages of 18 and 85 years were included. Estimated glomerular filtration rate (eGFR) calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula was used to evaluate renal function. Patients with eGFR less than 60 mL/min/1.73 m² before chemotherapy were excluded. Demographic and clinical data were recorded. Patients were divided into 4 groups according to the chemotherapy protocols: cisplatin-containing regimens, carboplatin-containing regimens, oxaliplatin-containing regimens, and platinum-free regimens. eGFR, urea, and creatinine values of 0th, 7th, 30th,and 180th days were recorded. Results: In 180 days of treatment, eGFR decreased in 69 (13.8%) patients, whereas it increased in 46 (9.2%) patients (P = .001) and remained unchanged in 385 patients (77%). The cisplatin group had lower eGFR at the 180th day compared to the carboplatin (P = .033), oxaliplatin (P = .007), and platinum-free groups (P < .001). The median eGFR at the 180th day was lower in the cisplatin group compared to baseline (P < .001), while eGFR levels were not changed in the carboplatin and oxaliplatin groups and were significantly increased in the platinum-free group (P = .004). Conclusion: Cisplatin-based treatment protocols were shown to worsen renal function during long-term follow-up. It is important to monitor kidney function closely for early intervention. [ABSTRACT FROM AUTHOR]

We aimed to investigate whether there is a difference between intrahepatic cholangiocarcinoma (IHCC) and liver metastases of gastrointestinal system (GIS) adenocarcinoma in terms of apparent diffusion coefficient (ADC) values.

A 71-year-old male patient with solitary pulmonary nodule underwent fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) showing slightly increased FDG uptake in this nodule. In addition, PET/CT detected hypermetabolic sclerotic bone lesions in the right second rib and 7th thoracic vertebrae, which were interpreted as possible metastases, and mildly increased FDG uptake in the prostate gland highly suspicious of malignancy. The patient's prostate-specific antigen (PSA) level was with in normal range (3.8 ng/dL). The histopathological examination of the lung nodule and right second rib lesion proved metastases from prostate cancer, then the prostate biopsy-confirmed prostate adenocarcinoma. The unique feature of this case is to emphasize the importance of performing PET/CT for solitary pulmonary nodule in detecting PSA-negative metastatic prostate cancer. This case indicated that it should be kept in mind that, even if the PSA is negative, a lung metastasis of prostate cancer may be an underlying cause in patients evaluated for solitary pulmonary nodule by FDG PET/CT. [ABSTRACT FROM AUTHOR]

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.