Background There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0–14.0) months in the ET arm of group A, and 5.3 (3.9–6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8–7.7) months in the ET arm of group B, and 5.7 (4.6–6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5–8.0) months in the ET arm of group C and 4.0 (3.5–4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET.
Systemic inflammation and nutrition are associated with survival outcomes in metastatic colon cancer (mCC) patients. A new and strong prognostic marker named the Prognostic Immune Nutritional Index (PINI) was proposed as the best marker for outcomes in metastatic colon cancer patients. This study aimed to evaluate the prognostic significance of PINI in mCC patients. MethodsThe data of 190 patients who were admitted to our center and diagnosed with mCC between 2010 and 2020 abiding by our inclusion criteria were reviewed retrospectively. Receiver operating characteristic (ROC) analysis was used to identify the optimum cutoff value of PINI for overall survival (OS). ResultsThe mean age of the participants was 62.64±11.99 years. The median follow-up time was 25.81 months. According to PINI, the median OS in patients who had PINI<3 was 22.70 months (95% confidence interval (CI): 16.05-29.35), and the median OS in patients who had PINI≥3 was 38.83 months (95% CI: 26.98-37.01) (p<0.001). PINI score lower than 3 was an independent prognostic indicator in multivariate analysis. ConclusionsPINI was discovered to be an independent prognostic factor in metastatic colorectal cancer. We believe that PINI, which can be calculated using a simple formula, will provide clinicians with important clues when deciding on individual treatment.
Aim: To define the effect of clinicopathological characteristics of patients with malign mesothelioma (MM) on overall survival. Materials and Methods: Forty-one patients diagnosed with MM who were treated at the medical oncology clinics between 2008 to 2020 were assessed. Clinicopathological characteristics and overall survival (OS) of patients, and treatment modalities analyzed. Results: Forty-one patients were included in this study. The median age of patients was 63.5. At a median follow-up of 16.7 (range:0.5-172.6) months, 78%(32) of patients died. Median OS was 17.6 months. 65.9% (27) of patients had stage 3 and 29.3% (12) had stage 4 diseases when they were diagnosed. Most of the patients were diagnosed at the advanced stage (Stages 3-4) (95.2%). The median OS of patients diagnosed with epithelioid histopathologic subtype was 32.4 months, while the median OS of those with sarcomatoid was 5.23 months, while the median OS of biphasic was 4.33 months. This difference was statistically significant (p
Fonksiyonel gastrointestinal bozukluklar, herhangi bir yapısal ya da biyokimyasal patoloji olmaksızın, çeşitli kombinasyonlarda, kronik ve tekrarlayıcı gastrointestinal semptomları içeren bir sendromdur. Bugüne kadar, bu grup hastalıkların tanımlanması ve sınıflandırılmasında çeşitli kriterler geliştirilmiş ve bunlardan en sık kullanılanı Roma kriterleri olmuştur. ROMA III kriterlerine göre yaptığımız çalışmada, sorgulamaya aldığımız populasyon genç yaştaki sağlık çalışanları idi. Fonksiyonel gastroduodenal bozuklukların tümünün sıklığı populasyonumuzda % 26,2 idi ve bu oran erkek-kadın ya da doktor-yardımcı sağlık personeli arasında istatistiksel farklılık göstermiyordu. Fonksiyonel gastroduodenal bozuklukların büyük çoğunluğu fonksiyonel dispepsi, fonksiyonel dispepsinin de büyük çoğunluğu post-prandiyal distress(sıkıntı) sendromu idi. Epigastrik ağrı sendromu nadirdi. Bunu geğirme bozuklukları ile bulantı ve kusma bozuklukları izlemekteydi. Fonksiyonel dispepsi sıklığı bizim çalışmamızda,% 15,4 idi. Wang ve arkadaşları da Roma III kriterleri ile yaptıkları çalışmalarında sadece dispepsi oranını % 15,2, İBS overlapingi ile birlikte % 20,2 bulmuşlardı. Fonksiyonel barsak bozukluklarının sıklığı % 45,1 bulundu. Bu kadın-erkek, doktoryardımcı sağlık personeli arasında istatistiksel farklılık göstermiyordu. Bunun % 20,6’ sı spesifik olmayan barsak bozukluklarıydı. Fonksiyonel barsak bozukluklarının neredeyse yarısını oluşturan bu grubu daha iyi tanımlayıcı ya da ayırt edici kriterler düzenlenebilir. Bizim çalışmamızda İBS oranı % 10,1 idi. Wang’ ın çalışmasında da sadece İBS oranı % 10,9, dispepsi overlapingi ile birlikte % 15,9 hesaplanmıştır. Bu çalışma ülkemizde Roma III kriterleri kullanılarak tüm fonksiyonel gastrointestinal bozuklukların tarandığı ilk çalışmadır.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.