Introduction Treatment options for metastatic renal cell carcinoma disease have been improved in recent years. However, there is still no optimal treatment sequence or combination for metastatic disease. We aimed to investigate whether patients differed in terms of disease outcomes regarding pre-nivolumab tyrosine kinase inhibitors (TKIs). Material and methods The analysis of patients was performed after all cohorts were sub-grouped into two groups according to pre-nivolumab TKIs as following the sunitinib arm and the pazopanib arm. Result A total of 75 patients were included in this study. The median follow-up time was eight months for all cohorts. The objective response rate was statistically significantly higher in the pazopanib arm as compared to the sunitinib arm (56% vs 30%, p=0.02). Progression-free survival was significantly higher in pazopanib than sunitinib (10.3 months vs 5.3 months, p=0.02). Multivariate analysis revealed that pazopanib treatment was associated with better progression-free survival (HR: 0.44, 95 CI; 0.22-0.91, p=0.02). While the median overall survival for patients who had received sunitinib was 11.0 months, it has not been reached the median in the pazopanib arm (11.0 months vs NR, p=0.051).
Aim: It has been known for a long time that systemic inflammation is an important risk factor in cancer development.Colorectal cancer (CRC) is one of the most common causes of cancer-related morbidity and mortality in the world. In this study, we aimed to compare the inflammatory parameters tested in CRC patients at the time of diagnosis such as systemic immune-inflammation index (SII) and pan-immune inflammation value (PIV) with those of the healthy control group. Materials and Methods:The data of 162 patients diagnosed with CRC in the internal medicine clinic between 2012-2016 were analysed retrospectively and a total of 139 patients who met the inclusion criteria were included in the study. Hemogram values, histopathology and tumour stage according to TNM classification of all patients at the time of diagnosis were recorded. The patients' neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocytemonocyte ratio (LMR), SII and PIV were calculated using hemogram parameters such as neutrophils, monocytes, platelets and lymphocytes.Results: A total of 139 CRC patients and 139 healthy control subjects with similar age and sex distribution were included in the study. The mean age of all subjects included in the study was 61.7±11.8 years, and 170 subjects (61.2%) were male.In the CRC group, SII, PIV, NLR, and PLR levels were significantly higher, and LMR level was significantly lower than the control group (p<0.001, p<0.001, p<0.001, p<0.001, p=0.001, respectively). When the CRC group was divided according to the disease stage, it was found that SII and PIV levels of all stages were significantly higher than the control group (p= 0.029, p<0.001, p= 0.001, p= 0.002 for SII, p= 0.034, p<0.001, p= 0.002, p= 0.014 for PIV). Conclusion:In addition to colonoscopy screening in patients with CRC, whose early diagnosis is very important, SII and PIV values that do not require an additional cost and can be measured in routine hemogram tests can also be taken into consideration.
e15587 Background: Expanded RAS analysis is essential for the selection of biologic agents in mCRC. RAS mutations indicates anti-EGFR unresponsiveness. In this study, we aimed to investigate RAS and BRAF mutations by liquid biopsy at progression in patients with RAS mutant mCRC. Methods: Sixty patients with mCRC who harbored tissue RAS mutations were prospectively analyzed between July 2019 and April 2020. All the patients treated with chemotherapy plus bevacizumab combinations . The plasma samples of the patients were analyzed after progression of bevacizumab combinations. RAS mutation profile was evaluated in plasma using Idylla PCR-based molecular diagnostics method, which enables rapid detection of common mutations in RAS and BRAF genes in circulating tumor DNA (ctDNA). Kaplan-Meier method was used for survival analysis and log-rank test was performed for comparison of groups. Results: The median age of the patients was 60 years (IQR:35-83 years) and female was (n=23, 38.3%). Primary tumor was located in the left colon in 81.7% of all patients. There were 95.0% KRAS and 5% NRAS mutations in baseline tissue biopsy. As a result of liquid biopsy after progression, 55.0% of the patients had KRAS, 3.3% NRAS and 3.3% had BRAF mutations. The RAS mutation detected in 58.3% of the patients. While there was no significant difference in terms of clinicopathological features between wild type (RAS/BRAF) and mutant type (RAS/BRAF) determined by liquid biopsy, the overall survival (OS) of the wild type group was significantly longer than mutant group (43.8 vs. 20.4 months, p= 0.002). Conclusions: This study demonstrated that there may be changes in RAS/BRAF mutation from plasma analysis after progression in patients with mCRC. Since better survival in the patient group with wild type was detected compared to the RAS concordance group, the evaluation of RAS mutation status at the time of progression may be important in terms of disease prognosis and treatment options.
ÖzAmaç: Çalışmamızda sağ kolon ile sol kolon yerleşimli tümörler arasındaki farkın iki bölge arasındaki inflamatuvar süreçle ilişkili olup olmadığını basit bir yöntem olan nötrofil lenfosit oranına bakarak karşılaştırmayı amaçladık.Gereç ve Yöntem: Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Tıbbi Onkoloji bölümüne Temmuz 2011-Haziran 2015 tarihleri arasında başvuran evre 1-3 kolorektal kanser tanısı almış 142 hastanın dosyalarını retrospektif olarak inceledik. Tümör lokalizasyonu ile nötrofil lenfosit oranı (NLO) ve hastalıksız sağ kalım arasında ilişki olup olmadığını araştırdık.Bulgular: Hastalar splenik fleksura baz alınarak sağ ve sol kolon şeklinde ikiye ayrıldı. Sağ kolon olarak tanımladığımız 35 (%24), sol kolon olarak tanımladığımız 107 (%76) hasta vardı. Hastaların 85'i (%60) erkek, 57'si (%40) kadındı. Tanı anındaki NLO karşılaştırıldı. Sağ ve sol kolonun NLO ortalama değerleri sırasıyla 4,43 ve 5,05 olarak hesaplandı. Sağ ve sol kolon arasında NLO açısından istatiksel olarak anlamlı farklılık saptanmadı (p=0.234). Hastalıksız sağ kalım oranları sağ kolon tümörlerinde sol kolona göre istatiksel anlamlılığa ulaşmasa da daha düşük olarak hesaplandı (20. ayda 0,88/0,84; 40. ve 60. ayda sırasıyla 0,80/0,77 ve 0,80/0,77; p =0,064). Sonuçlar:Yaptığımız çalışmada metastatik olmayan kolorektal kanserli hastalarda tanı anında bakılan NLO ile hastalığın lokalizasyonu arasında ilişki bulamadık. Hastalıksız sağ kalım oranlarını sağ kolon tümörlerinde sol kolona göre istatiksel anlamlılığa ulaşmasa da daha düşük olarak hesapladık.Anahtar Kelimeler: Sağ-sol kolon, kolorektal kanser, NLO 64 Abstract Aim: We aimed to compare the neutrophil lymphocyte ratio(NLR), which is a simple method, to determine whether the difference between the right colon and the left colon tumors in our study is related to the inflammatory process between the two regions. Material and Method:We retrospectively reviewed the files of 142 patients who were diagnosed with stage 1-3 colorectal cancer between July 2011 and June 2015 at Medical Oncology Department, Dışkapı Yıldırım Beyazıt Education and Research Hospital. We examined whether tumor localization correlates with neutrophil lymphocyte ratio (NLR) and disease-free survival. Results:The patients were divided into right and left colon based on splenic flexure. There were 35 patients (24%) defined as right colon and 107 (76%) patients defined as left colon. 85 (60%) of the patients were male and 57 (40%) were female. The ratio of neutrophil and lymphocytes at diagnosis was compared. The mean NLR values of the left and right colon were calculated as 4.43 and 5.05, respectively. No statistically significant difference was found between the right and left colon (p = 0.234). The disease-free survival rates were lower in the right colon tumors than in the left colon, but not statistically significant (0,88 / 0,84 40th and 60th at 20th month) 0.80 / 0.77 and0,80/0,77; p = 0.064) Conclusion:In our study, we could not find any relation between the NLR and the localization of the disease ...
Günümüzde kanser tedavisinde modern tıptaki gelişmelere rağmen tamamlayıcı ve alterntif tedavi (TAT) yöntemlerine olan ilgi devam etmektedir. Çalışmamızın amacı kemoterapi tedavisi alan hastalarda TAT kullanım oranlarını, çeşitlerini ve buna etki eden faktörlerin tespit edilmesidir YÖNTEM ve GEREÇLER: 1 Temmuz-1 Ağustos 2017 tarihleri arasında Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Tıbbi Onkoloji Kliniği ayaktan kemoterapi ünitesinde tedavi alan ve ankete katılmak isteyen gönüllü hastalara demografik, klinik özelliklerini, TAT kullanımını sorgulayan 26 sorudan oluşan anket uygulandı. Anket öncesi hastalardan onam formu alındı. BULGULAR: Çalışmaya katılmak isteyen 97 hastaya anket uygulandı. Medyan yaş 60 olarak bulundu (26-84). Hastaların 66%'sı kadın idi. Hastaların çoğunluğu ilk/orta okul mezunu (61.5%) ve düşük gelir düzeyinde idi (71.1%). En çok izlenen kanser türü meme kanseriydi (39.2%). Hastaların 51.5%'i evre 4 hastalığa sahipti. Hastaların büyük çoğunluğu palyatif amaçla tedavi almaktaydı (52.6%). TAT kullananma oranı 21.6% bulundu. Kullanılan TAT çeşitleri incelendiğinde en sık ısırgan otu (9.2%), zerdeçal (4.1%) ve zencefil (2.1%) kullanımı tespit edildi. Hastaların 57.2%' sinin kullandığı ürünlerden takip eden doktorunun bilgisi yoktu. Hastaların 80.9% 'u bu ürünleri hastalığın iyileşme sürecinde fayda göstereceğine inandığı için kullanıyordu. TAT kullanan hastaların 28.5'%'i klinik fayda gördüğünü düşünmekte idi. Düşük gelir düzeyi ile tamamlayıcı tedavi kullanımı arasında istatistiksel olarak anlamlı şekilde ilişki saptandı (p: 0,01). TARTIŞMA ve SONUÇ: Günümüzde tamamlayıcı tedaviler kanser hastaları tarafından sıklıkla kullanılan yöntemlerdir. Sağlık çalışanlarının TAT kullanımı açısından dikkatli olması ve hastalarla bu açıdan iletişim içinde olması olası toksisiteleri önlemek açısından oldukça önemlidir.
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