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Öğe A brief look at the evaluation of the development and effectiveness of cytotoxic chemotherapy in advanced non-small-cell lung cancer(Kare Publ, 2010) Uzunoglu, Sernaz; Karagol, Hakan; Tanriverdi, Ozgur; Cicin, Irfan; Caloglu, Murat; Kocak, ZaferSystemic chemotherapy for patients with advanced-stage non-small-cell lung cancer prolongs survival and palliates symptoms, when compared with the best supportive care alone. However, the results of standard cytotoxic regimens are not yet satisfactory. As the effectiveness in the treatment of refractory disease is low, it still remains critical to better understand and develop new treatment options for refractory disease. Within the second-line therapeutic approaches, there are new chemotherapeutic schemes as well as molecular-targeted treatment options that block the epidermal growth factor receptor or angiogenesis. Future research efforts should focus on identifying prognostic and predictive markers of benefit not only for the standard cytotoxic agents, but also for the new target-driven agents currently.Öğe A case of non-Hodgkin's lymphoma presenting as a large chest wall mass(Kare Publ, 2008) Uzunoglu, Sernaz; Tanriverdi, Ozgur; Karagol, Hakan; Cicin, Irfan; Caloglu, Vuslat; Tokatli, FusunMalignant lymphoma as a solitary chest wall mass is rare. Although surgical resection is the main treatment modality for malignant chest wall tumors, the treatment of primary chest wall lymphomas is controversial. A 65-year-old male patient with an enlarging mass on the left side of his chest wall, which had first appeared four months before, applied to our hospital. The patient was directed to our polyclinic with a diagnosis of large B-cell lymphoma after the biopsy. Following the clinical investigation, stage IIEB extranodal am-Hodgkin's lymphoma was determined, and after a palliative radiotherapy, eight cycles of chemotherapy were planned. However, shortly after the completion of the sixth cycle of chemotherapy, poor performance status developed secondary to chemotherapy and the patient was diagnosed with pulmonary embolus. Following the stop of chemotherapy after six cycles, a complete clinical remission and a nearly complete radiologic remission were achieved. The patient is still under follow-up and was free of disease at four months.Öğe The clinical and pathological features of 133 colorectal cancer patients with brain metastasis: a multicenter retrospective analysis of the Gastrointestinal Tumors Working Committee of the Turkish Oncology Group (TOG)(Humana Press Inc, 2014) Tanriverdi, Ozgur; Kaytan-Saglam, Esra; Ulger, Sukran; Bayoglu, Ibrahim Vedat; Turker, Ibrahim; Ozturk-Topcu, Turkan; Cokmert, SunaBrain metastasis in colorectal cancer is highly rare. In the present study, we aimed to determine the frequency of brain metastasis in colorectal cancer patients and to establish prognostic characteristics of colorectal cancer patients with brain metastasis. In this cross-sectional study, the medical files of colorectal cancer patients with brain metastases who were definitely diagnosed by histopathologically were retrospectively reviewed. Brain metastasis was detected in 2.7 % (n = 133) of 4,864 colorectal cancer patients. The majority of cases were male (53 %), older than 65 years (59 %), with rectum cancer (56 %), a poorly differentiated tumor (70 %); had adenocarcinoma histology (97 %), and metachronous metastasis (86 %); received chemotherapy at least once for metastatic disease before brain metastasis developed (72 %), had progression with lung metastasis before (51 %), and 26 % (n = 31) of patients with extracranial disease at time the diagnosis of brain metastasis had both lung and bone metastases. The mean follow-up duration was 51 months (range 5-92), and the mean survival was 25.8 months (95 % CI 20.4-29.3). Overall survival rates were 81 % in the first year, 42.3 % in the third year, and 15.7 % in the fifth year. In multiple variable analysis, the most important independent risk factor for overall survival was determined as the presence of lung metastasis (HR 1.43, 95 % CI 1.27-4.14; P = 0.012). Brain metastasis develops late in the period of colorectal cancer and prognosis in these patients is poor. However, early screening of brain metastases in patients with lung metastasis may improve survival outcomes with new treatment modalities.Öğe Impact of active smoking on survival of patients with metastatic lung adenocarcinoma harboring an epidermal growth factor receptor (EGFR) mutation(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2016) Erdogan, Bulent; Kodaz, Hilmi; Karabulut, Senem; Cinkaya, Ahmet; Tozkir, Hilmi; Tanriverdi, Ozgur; Cabuk, DevrimLung cancer in smokers and non-smokers demonstrates distinct genetic profiles, and cigarette smoking affects epidermal growth factor receptor (EGFR) function and causes secondary EGFR tyrosine kinase resistance. We evaluated the effect of active smoking in patients with metastatic lung adenocarcinoma. A total of 132 metastatic lung adenocarcinoma patients, diagnosed between 2008 and 2013, with known EGFR mutation status, were evaluated retrospectively. Among these patients, 40 had an activating EGFR mutation. Patients who continued smoking during the treatment were defined as active smokers. Former smokers and never smokers were together defined as non-smokers. The outcomes of the treatment in relation to the EGFR mutation and smoking status were evaluated. The median follow-up time was 10.5 months. The overall response rate for the first-line therapy was significantly higher among the EGFR-mutant patients (p = 0.01), however, smoking status had no impact on the response rate (p = 0.1). The EGFR-mutant active smokers progressed earlier than the non-smokers (p < 0.01). The overall survival (OS) of the non-smokers and patients treated with erlotinib was significantly longer (p = 0.02 and p = 0.01, respectively). Smoking status did not affect the OS in EGFR wild type tumors (p = 0.49) but EGFR-mutant non-smokers had a longer OS than the active smokers (p = 0.01). The active smokers treated with erlotinib had poorer survival than the non-smokers (p = 0.03). Multivariate analysis of EGFR-mutant patients showed that erlotinib treatment at any line and non-smoking were independent prognostic factors for the OS (p = 0.04 and p = 0.01, respectively). Smoking during treatment is a negative prognostic factor in metastatic lung adenocarcinoma with an EGFR mutation.Öğe Importance of Ki-67 in human epidermal growth factor receptor 2 positive breast cancer(Imprimatur Publications, 2015) Erdogan, Bulent; Turkmen, Esma; Yalta, Tulin Deniz; Usta, Ufuk; Kodaz, Hilmi; Hacibekiroglu, Ilhan; Tanriverdi, OzgurPurpose: The aim of this study was to evaluate the importance of Ki-67 in Human Epidermal Growth Factor Receptor 2 (Her-2) positive breast cancer patients. Methods: We reviewed the records of patients diagnosed with Her-2-positive non-metastatic breast cancer between 2005 and 2011. Paraffin-embedded tissue samples were stained with MIB-1 mouse monoclonal antibody to find Ki-67 levels. Patients were grouped as low Ki-67 <20% and high Ki-67 >= 20%. Demographic and clinical features were compared. Results: One hundred and six patients were included in the study. Median follow up time was 41 months (range 15-100). Median age was 49.5 years (range 29-79). Twenty-nine patients (27.4%) were in the Ki-67 low group. Demographic features were similar in both groups. Lymphovascular invasion was more frequent in the Ki-67 high group, and hormone receptor (HR) positivity was more frequent in the Ki-67 low group (p=0.03, p=0.03, respectively). Recurrence rate was not significantly different in both groups (p=0.36). T stage (p=0.02), stage (p<0.01), lymphovascular invasion (p=0.02), ER status (p=0.02), and HR status (p<0.01) were related with recurrence. In multivariate analysis, stage and HR negativity were independent factors for recurrence (p<0.01, p=0.01, respectively). Recurrence sites were also similar in both groups. Survival rates at the third year for Ki-67 low group and Ki-67 high group were 94% and 92%, respectively. Conclusion: Her-2 positive patients with low Ki-67 and high Ki-67 had similar demographic and pathologic features except lymphovascular invasion and HR status. HR status was an important factor for disease course. Clinical course was determined by HR status rather than Ki-67.Öğe Performance Status is an Important Prognostic Factor in Second Line Treatment of Pancreaticobiliary Adenocarcinoma(H G E Update Medical Publishing S A, 2013) Erdogan, Bulent; Turkmen, Esma; Uzunoglu, Sernaz; Tanriverdi, Ozgur; Cicin, IrfanBackground/Aims: To define the factors related with disease control and survival in patients with pancreaticobiliary adenocarcinoma treated with second-line therapy. Methodology: We retropectively reviewed the data of 39 pancreaticobiliary adenocarcinoma patients treated with second-line chemotherapy between 2000 and 2012. Age, gender, origin of tumor, location of tumor, stage at diagnosis, Eastern Cooperative Oncology Group (ECOG) performance status, progression site, progression free survival (PFS) for first-line therapy, disease control at first-line therapy and chemotherapy protocols are analyzed for disease control rate, PFS and overall survival (OS). Results: Disease control was recorded in 21 (53.8%) patients (20 stable disease, 1 partial response). Disease control rate was higher in patients with good performance status (p=0.03). Disease control at first-line therapy was not a predictor of disease control at second-line (p=0.6). Response to first-line therapy and other prognostic factors was not related with disease control. Progression free survival and OS was significantly longer in patients with good ECOG performance status (0-1) (p=0.01, p=0.006). Choice of chemotherapy (single agent or combination) and other factors did not have any impact on PFS and OS. In multivariate analysis; disease control was independent prognostic factor for both PFS and OS (p<0.001), (p<0.001). Conclusions: Disease control and performance status are two important prognostic factors. Chemotherapy regimen has no impact on disease control and survival. Salvage chemotherapy can be considered for patients with good performance status whether they are resistant to first-line therapy or not.Öğe A retrospective analysis on first-line bevacizumab, cetuximab, and panitumumab-containing regimens in patients with RAS-wild metastatic colorectal cancer: A Collaborative Study by Turkish Oncology Group (TOG)(Imprimatur Publications, 2019) Degirmencioglu, Serkan; Tanriverdi, Ozgur; Menekse, Serkan; Dogan, Mutlu; Hacioglu, Bekir; Oktay, Esin; Erdem, DilekPurpose: To compare the efficacy and adverse effect profiles of the first-line treatment of patients with KRAS wild type metastatic colorectal cancer (CRC) in Turkey who were treated based on regimens including bevacizumab, cetuximab and panitumumab. Methods: This retrospective multicenter observational study involved a total of 238 patients who received chemotherapy in combination with either bevacizumab or cetuximab or panitumumab as first-line therapy for KRAS wild-type metastatic colorectal cancer. Patients with full medical records having pathological diagnosis of CRC adenocarcinoma were included in the study. The demographic, laboratory, histopathological and clinical characteristics of the patients were determined, and three groups were compared based on the study variables. Results: The mean age of the entire sample (n=238) was 58 +/- 11 years, 64% of which were male. The most frequent tumor localization was the rectum (37%) and G2 was the most common tumor grade (59.7%). About 63% of the patients had metastatic disease at diagnosis, with the most common site of metastasis being lung (14.7%) and liver (52.5%). Overall survival (OS) was 63.9%, while 1-, 3- and 5-year survival rates were 91.7, 56.6 and 36.9%, respectively. The expected mean survival was 49.1 months (95% CI, 42.9-55.3). The 1-, 3- and 5-year progression-free survival (PFS) rates following first-line treatment were 65.3, 26.1 and 5.6%, respectively, while disease free survival (DFS) in patients without metastasis at diagnosis was 68.5%. An analysis carried out disregarding which treatment the patients received (FOLFOX or FOLFIRI) revealed that a panitumumab-containing combination resulted in poorer prognosis compared to bevacizumab or cetuximab-containing combination (p <0.001). With regard to the adverse effect profile, the most common adverse effects were neuropathy and neutropenia in patients receiving FOLFOX-bevacizumab; neutropenia and perforation in patients receiving FOLFIRI-bevacizumab; rash and pustular infection in patients receiving FOLFIRI-cetuximab; and diarrhea in patients who received FOLFIRI-panitumumab combination. Conclusion: is the first multicenter study performed in Turkey evaluating the response to treatment and adverse effects in patients with KRAS wild-type metastatic colorectal cancer.
