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    Antihormonal treatment associated musculoskeletal pain in women with breast cancer in the adjuvant setting
    (Dove Medical Press Ltd, 2016) Şeber, Erdoğan Selçuk; Solmaz, Dilek; Yetişyiğit, Tarkan
    Purpose: Antihormonal treatment is an effective therapy in the adjuvant setting. However, musculoskeletal pain is a common adverse effect encountered in patients receiving this treatment. We aimed to evaluate the risk factors for the development of antihormonal treatment-associated musculoskeletal pain (AHAMP) and its impact on the health-related quality of life (HRQOL). Patients and methods: A cross-sectional survey of 78 consecutive breast cancer patients receiving adjuvant antihormonal treatment for early-stage breast cancer in an academic medical oncology clinic was conducted. AHAMP was assessed by Health Assessment Questionnaire (HAQ) and 10 cm visual analog scale (VAS). HRQOL was assessed by self-administered short form 36 and Functional Assessment of Cancer Therapy-Breast subscale surveys. Results: AHAMP was found to be present in 37 (47.7%) patients. In multivariate regression analysis, having a normal body mass index (<30 kg/m(2)), cigarette smoking, and low serum vitamin D level (20 ng/mL) were found to be independent risk factors. In HRQOL assessment, physical and mental scores were found to be significantly lower in patients with joint arthralgia. Conclusion: AHAMP has an adverse effect on the quality of life of breast cancer patients receiving adjuvant antihormonal treatment, and assessment of predictive factors is important for identification of patient groups at risk of developing this condition.
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    Causes of Elevated Levels of Serum CA 19.9 in Patients without Prior Diagnosis of Malignant Disease
    (2019) Şeber, Erdoğan Selçuk; Güzel, Savaş; Yılmaz, Ahsen; Kara, Sonat Pınar; Yetişyiğit, Tarkan
    Objective: Serum CA 19.9 is commonly used as a tumor marker for diagnosis and followup of gastrointestinal malignancies. However, elevated levels can be found in various clinicalconditions.Methods: A total of 285 patients whose serum CA 19.9 level was ordered from variousoutpatient clinics other than oncology in a tertiary hospital setting and who had elevated CA19.9 (>34 U/mL) levels were included in the study group. Statistical analysis of marker levelsin relation to diagnosis of patients was performed.Results: Overall, 226 patients with benign disorders and 59 patients with malignant diseasehad elevated CA 19-9 levels. One hundred ten (39%) patients with increased CA 19-9 levelsdid not have any significant clinical condition associated with high CA 19-9 values. MedianCA 19-9 levels were significantly higher in patients with malignancies than in patients withbenign disorders (67.3 vs. 47.9; p<0.001). Receiver operating characteristic curve analysisidentified a cut-off value of 66.3 U/mL for discrimination of malignant from benign gastrointestinal diseases (sensitivity 58.3% and specificity 82.7%; p<0.001).Conclusion: Serum CA 19-9 levels are significantly higher in patients with malignant diseases. However, there are diverse etiologies associated with elevated serum levels. Duringchronic inflammatory states, elevated serum CA 19-9 levels can be a frequent finding.
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    Central nervous system metastatic epithelial ovarian cancer. Clinical parameters and prognostic factors: a multicenter study of Anatolian Society of Medical Oncology
    (Canada Inc, 2017) Şeber, Erdoğan Selçuk; Türkmen, E.; Harputoğlu, H.; Yeşil, H.; Arpacı, Erkan; Menekşe, S.; Yetişyiğit, Tarkan
    Central nervous system (CNS) metastasis is a rare event in the course of late stage epithelial ovarian cancer (EOC); however its incidence is increasing in parallel with prolonged survival of patients. Objective: The authors assessed the clinical parameters and potential prognostic features in patients with CNS metastatic disease. Materials and Methods: Clinical data of the 33 patients from the participating centers were retrospectively collected and analyzed. Median age at the time of CNS metastasis was 57 years. Median time from the diagnosis of primiuy EOC until CNS metastatic disease was 22 months. Nearly half (45.5%) of the patients had single CNS metastatic lesions and all patients in the study group except two received radiotherapy as palliative treatment. Median overall survival (OS) from the time of CNS metastasis was 15 months (0-66). At univariate analysis only number of brain metastatic lesions (p = 0.001) and presence of extracranial disease (p = 0.004) were strongly associated with OS whereas multimodal treatment, size of metastatic lesions, platinum sensitivity, age, grade, and disease stage at presentation were not. Development of CNS metastasis carries a poor prognosis, however patients with single metastatic lesions and only intracranial metastatic disease can have prolonged survival after appropriate palliative management of their disease.
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    CRP/ albumin ratio can be a predictor of response to neoadjuvant chemoradiotherapy (CRT) in rectal cancer
    (Oxford Univ Press, 2018) Yetişyiğit, Tarkan; Şeber, Erdoğan Selçuk; Yolcu, Ahmet
    [No Abstract Available]
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    In vitro culture of tumor infiltrating lymphocytes for adoptive immunotherapy in breast cancer patients
    (Elsevier Sci Ltd, 2018) Şeber, Erdoğan Selçuk; Yetişyiğit, Tarkan; Turgut, Burhan; Buluş, Stephen; Gürdal, Sibel Özkan; Öznur, Meltem
    [No Abstract Available]
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    Investigation of the Effect of Low-positive HER-2 on Neoadjuvant Chemotherapy Response in Hormone-positive Breast Cancer Patients
    (2023) Karaboyun, Kubilay; Öznur, Meltem; Yolcu, Ahmet; İriağaç, Yakup; Şeber, Erdoğan Selçuk
    Objective: Recently, it has been suggested that low-positive human epidermal growth factor receptor-2 (HER-2) is a separate group of breast cancer. We examined the effect of low-positive HER-2 on neoadjuvant chemotherapy (NACT). Methods: This retrospective study included female patients aged >18 years who were diagnosed with histologically proven breast cancer between January 1, 2016, and January 1, 2020, and had breast surgery after NACT. Patients with triple-negative, estrogen receptor (<10%) weak positive, HER-2 immunohistochemical (IHC) scores 3+ or 2+/FISH-positive patients, and metastatic patients were excluded. Pathological complete response (pCR) was defined as the no invasive and in situ residue in the breast and lymph nodes in surgery after NACT. Results: One hundred twenty seven patients were included in this study. HER-2 IHC-score “0” patients were 55 (43.3%), “1+” patients were 52 (40.9%), and “2+” patients were 20 (15.7%). Nine (7.1%) patients showed a complete response to NACT. In the univariate analysis with clinicopathological variables of the patients to predict the complete response to NACT; estrogen receptor [odds ratio (OR): 0.97, 95% confidence interval (CI): 0.96-0.99, p=0.012], Ki-67 (OR: 1.12, 95% CI: 1.06-1.18, p<0.001), tumor grade (OR: 0.036, 95% CI: 1.13-30.36, p=0.036), and lymphovascular invasion (OR: 0.11, 95% CI: 0.01-0.93, p=0.043) showed the predictive features. In the multivariate analysis, Ki-67 (OR: 1.10, 95% CI: 0.04-1.17, p=0.001) was found to be an independent predictor of pCR. Conclusion: We determined that the low-positive-HER2 group has no effect on the treatment response in patients treated with NACT. We found that Ki-67 was an independent predictive for pCR.
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    Lymphocyte Monocyte Ratio as a Prognostic Factor in Non-Small Cell Lung Cancer
    (Elsevier Science Inc, 2017) Yetişyiğit, Tarkan; Şeber, Erdoğan Selçuk
    [No Abstract Available]
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    METASTATİK KOLOREKTAL KANSERİNDE TİMİDİN KİNAZ AKTİVİTE DÜZEYLERİNİN PROGNOSTİK ÖNEMİ
    (Namık Kemal Üniversitesi, Tıp Fakültesi, 2016) Şeber, Erdoğan Selçuk
    Amaç: Serum timidin kinaz 1 (TK1) tümör hücre proliferasyonunun duyarlı bir belirtecidir. Bu çalışmada palyatif kemoterapi alan metastatik kolorektal kanserli (MKRK) hastalarda serum TK aktivite düzeylerinin prognostik öneminin araştırılması amaçlandı. Materyal ve Metot: Çalışmamızda hastanemiz medikal onkoloji polikliniklerine başvuran ardışık 46 metastatik MKRK’ li hastanın tedavi öncesi ve 2. Kür öncesi serum TK1 aktivite düzeyleri yüksek duyarlılığa sahip radyoaktif olmayan DiviTum kitleri kullanılarak ölçüldü. Kontrol grubu olarak 10 sağlıklı gönüllü alındı. Serum TK1 aktivite düzeyi, hastaların klinik ve biyokimyasal parametreleri, serum CEA ve CA 19.9 düzeyleri ile sağkalım süresi arasında ki ilişkileri incelendi. Bulgular: Çalışma grubu ile sağlıklı gönüllülerin serum TK1 aktivite düzeyleri karşılaştırıldığında hasta grubunun serum TK1 aktivite düzeyleri anlamlı olarak yüksek saptandı (sırasıyla 162.1± 27.8 vs 32.97±7.307; p<0.03). Çok değişkenli analizde serum TK1 düzeyleri, kemoterapi öncesi kilo kaybı; bağımsız prognostik risk faktörleri olarak saptandılar (sırası ile p=0.001 ve 0.018). TK1 aktivite düzeyi 65 Du/L’nin altında olan hasta grubunun PSK anlamlı olarak uzun saptandı (624 vs 231 gün; p <0.0001). TK1 aktivite düzeyi 230 Du/L'nin üzerinde olan hasta grubunun genel sağkalım süresi anlamlı olarak daha kısa idi (p<0.0001). Sonuç: Bu çalışmada kemoterapi öncesi yüksek TK1 aktivite düzeyinin MKRK’de sağkalımla anlamlı olarak ilişkili olduğu gösterilmiştir. Elde ettiğimiz sonuçlar serum TK1 aktivite tayininin metastatik solid tümörlerde prognozu tahmin eden bağımsız bir marker olma özelliğinin doğrulanması yolunda yeni bir adım olarak kabul edilebilir.
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    Neoadjuvan Kemoterapi Alan Meme Kanseri Hastalarında COVID-19 Pandemisinin Tanı ve Tedavi Sürecine Etkileri
    (2021) Şeber, Erdoğan Selçuk; Çavdar, Eyyüp; İriağaç, Yakup; Karaboyun, Kubilay; Avcı, Okan
    Amaç: Bu çalışmamızda neoadjuvan kemoterapi alan meme kanseri hastalarında pandeminin tanı-tedavi sürecine etkisini araştırdık.Gereç ve Yöntem: Koronavirüs hastalığı-2019 (COVID-19) pandemisi dönemindeki bir yıl ile pandemi öncesindeki 1 yılda neoadjuvan kemoterapialan hastaların klinikopatolojik özellikleri ile tanıdan operasyona kadar olan aşamaların süreleri karşılaştırıldı. Toplam 92 hasta retrospektif olarakanaliz edildi.Bulgular: Pandemi ve pandemi öncesi (prepandemik) dönemdeki hastaların klinikopatolojik özellikleri benzer bulundu. Pandemi dönemindeki hastasayısı 26 (%28,3) iken pandemi öncesi dönemde 66 (%71,7) idi. Tanı-tedavi sürelerinden patoloji raporlanma süresi, kemoterapi uygulanma süresi vepreoperatif hazırlık dönemi ve total süre iki dönem arasında benzerdi (sırasıyla; p=0,305, p=0,171, p=0,104, p=0,061). Manyetik rezonans raporlanmasüresi pandemi döneminde daha kısa saptandı (p=0,005).Sonuç: Neoadjuvan kemoterapi alan hastalarda meme kanserinin tanı ve tedavi süreleri pandemi döneminde, pandemi öncesi dönemle benzerdir.Yine de COVID-19 enfeksiyon riski düşünülerek hasta özelinde karar verilmelidir.
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    Neoadjuvan Tedavi Alan Meme Kanserli Hastalarda Yeni Bir Enflamatuvar Belirteç Olan Serum Kalprotektin Düzeyinin Tedaviye Yanıtta Prediktif Değeri
    (2023) Baydar, Ece; Çelikkol, Aliye; Gürdal, Sibel Özkan; Şeber, Erdoğan Selçuk
    Amaç: Enflamasyon ile kanser arasındaki yakın ilişki vardır. Kalprotektin enflamasyon sırasında salınan bir proteindir. Bu çalışma ile neoadjuvan tedavi alan meme kanserli hastalarda kalprotektin seviyesi ile meme kanseri ilişkisi ve tedavi yanıtı için kalprotektinin prediktif rolünün araştırılması amaçlanmıştır. Gereç ve Yöntem: Prospektif bir araştırma olarak dizayn edilen çalışmamızda 69 meme kanseri tanılı hasta ile hasta grubu ve 20 hasta ile kontrol grubu oluşturuldu. Örneklemin tamamından alınan kan tetkiklerinden kalprotektin çalışıldı. Hasta verileri elektronik kayıt sisteminden elde edildi. Çalışmamızda istatistiksel değerlendirmeler IBM Statistical Package for the Social Sciences Statistics 24 adlı paket program kullanılarak yapıldı. Bulgular: Çalışmaya 89 hasta (69 kanser, 20 kontrol) dahil edildi. Meme kanseri hastalarının median yaşı 48 [minimum (min): 24-maksimum (maks): 73], kontrol grubunda 44,5 (min: 19-maks: 68) olarak saptandı ve iki grubun yaşları benzerdi (p=0,599). Meme kanseri hastalarında kalprotektin düzeylerinin ortalaması 28,63±30,5, median 16,5 (min: 6,7-maks: 160,7) saptandı. Kontrol grubunda ortalama 16,09±6,1 (min: 8,7-maks: 27,4) olarak görüldü ve 2 grup arasında istatistiksel fark yoktu (p=0,072). Ki67 sınıflarına göre kalprotektin değerleri açısından istatistiksel olarak anlamlı farklılık tespit edildi (Z=-20,043; p=0,041). Ki67 sınıfı >20 olanların kalprotektin değerleri, ?20 olanlara göre istatistiksel olarak anlamlı düzeyde daha yüksekti. Kemoterapi tam yanıtını ön görebilecek parametreler lojistik regresyon analizi ile değerlendirildi. Kalprotektin düzeyi ile tam yanıt arasında ilişki yoktu. Yaş artışı ile tam yanıt arasında pozitif bir ilişki vardı. Sonuç: Hasta ve kontrol grubunun serum kalprotektin düzeyleri arasında anlamlı fark saptanmadı fakat kalprotektin seviyesi Ki67 düzeyi ile ilişkili bulundu. Bu önemli ilişkisine rağmen kalprotektin ile kemoterapi yanıtı arasında ilişki yoktu. Daha büyük örneklem sayıları ile yapılacak çalışmalar anlamlı bir fark oluşturabilir.
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    Next generation sequencing analysis of BRCA1 and BRCA2 identifies novel variations in breast cancer
    (Elsevier Inc., 2020) Yıldız Tacar, Seher; Bozgeyik, Esra; Şeber, Erdoğan Selçuk; Yetişyiğit, Tarkan; Tozkır, Hilmi; Avcı, Okan; Arslan, Ahmet
    Mutations in two major breast cancer susceptibility genes, BRCA1 and BRCA2, have been identified to be the most important predisposing factors for the development of breast cancer. Thus, BRCA1/2 testing is a well-established method of choice for the assessment of developing breast cancer. Accordingly, here we aimed to report novel BRCA1/2 variations and distribution of previously known mutations and their association with the clinical course of breast cancer disease. A total of 287 breast cancer patients were enrolled from January 2017 through December 2019. Of these patients, 50 of them were identified to be positive for BRCA1/2. Next Generation Sequencing analysis was performed for the screening of exonic and intronic variations of BRCA1/BRCA2 genes. Notably, novel variations of 4448 G > A (Ser1843Asn) in BRCA1, and 982dupA (Thr328AspfsTer) and 7588C > T (Gln2530Ter) in BRCA2 gene were identified. The most common variations in BRCA1 gene were 5152 + 66G > A, 442-34C > T and 5266dupC. In BRCA2 gene, the most common variations were 9097dupA, 67 + 1G > A and 1114A > C. Novel variations of BRCA1 and BRCA2 genes were identified in breast cancer and might be useful predisposing factors in breast cancer diagnosis. © 2020 Elsevier Inc.
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    nvestigation of Serum Folate-Receptor-1 in Patients with Non- Small Cell Lung Cancer
    (2022) Şeber, Erdoğan Selçuk; Yetişyiğit, Tarkan; Yolcu, Ahmet; Çelikkol, Aliye; Güzel, Savaş; Yılmaz, Ahsen
    Objective: Histopathological overexpression of folate receptor-1(FOLR1) involved in folate transport in cell growth has been reported in various cancers. Increased serum FOLR1 (sFOLR1) has also been reported in epithelial ovarian cancer. The aim was to investigate sFOLR1 levels in non-small cell lung cancer(NSCLC) patients and the response prediction of the standard chemotherapy targeting folic acid metabolism. Methods: In this prospective study, sFOLR1 levels were investigated in 30 healthy individuals and 60 patients with stage4 malign metastatic NSCLC before and after standard chemotherapy. The commercial immunoassay(ELISA) kit was used for the analysis of sFOLR1. Serum carcinoembryonic antigen(CEA), vitamin B12, and folate levels were also investigated. Results: In NSCLC patients sFOLR1 levels were significantly higher(p<0.001) than the healthy individuals. After 3 months of standard treatment, sFOLR1 was significantly lower than pre-treatment values in NSCLC patients(p<0.001). Diagnostic accuracy was strong in the differentiation of NSCLC patients from healthy individuals(AUC= 0.966). with the cut-off point of 82.45 pg/ml, the sFOLR1 level was performed with 95% sensitivity and 99% specificity. Pretreatment sFOLR1 levels were significantly lower in patients with-response to standard chemotherapy(p<0.01). The best predictive value was determined as 393.80 pg/ml. At the end of the 401 days, a significant difference was found in patients with high sFOLR1 predictive value. The median overall survival(OS) duration was 288 days for all patients (95% GA 198.13-377.87). Median progression-free survival(PFS) was 321 days(95% GA 211.90-430.10). Conclusions: For monitoring standard chemotherapy with drugs targeting folic acid metabolism, sFOLR-1 levels may be an important biomark
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    Piperlongumine increases the apoptotic effect of doxorubicin and paclitaxel in a cervical cancer cell line
    (Wolters Kluwer Medknow Publications, 2020) Şeber, Erdoğan Selçuk; Şirin, Duygu Yaşar; Yetişyiğit, Tarkan; Bilgen, Türker
    Objective: Piperlongumine (PL) is an alkaloid derived from the edible pepper (Piper longum L) and it has been described to have various biologic activities including anticancer effects. Our aim in this study was to assess the cytotoxic role of PL on a cervical cancer cell line (HeLa) and to evaluate the effects of PL/doxorubicin and PL/paclitaxel combination therapies on apoptotic cancer cell death. Material and Methods: The cytotoxicity, IC50 doses by MTT assay confirmed by fluorescent imaging, and apoptotic cell rates by Annexin V staining using flow cytometry were determined for PL, doxorubicin, paclitaxel, and for their combinations. Results: It was shown that the PL by itself induced the apoptosis in HeLa cells. PL in combination with doxorubicin and paclitaxel increased apoptotic cell death compared to either chemotherapeutic agent alone. Conclusion: We conclude that the PL inhibits cancer cell growth by inducing apoptosis and has a potential anticancer activity in cervical cancer, especially when combined with doxorubicin and paclitaxel. © 2020 Wolters Kluwer Medknow Publications. All rights reserved.
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    Predictive Factors of Complete Tumor Response to First Line Chemotherapy in Patients with Extensive-stage Small Cell Lung Cancer
    (2022) Çavdar, Eyyüp; İriağaç, Yakup; Şeber, Erdoğan Selçuk; Sakin, Abdullah
    Objective: We aimed to investigate the factors affecting the complete response (CR) rate and the effect of treatment response on survival in patients with extensive stage-small cell lung cancer (ES-SCLC) who received a combination of cisplatin and etoposide as first-line therapy. Method: This retrospective analysis included 140 ES-SCLC patients, who were followed in an oncology clinic. Patients were divided into two groups as CR and non-CR according to radiological evaluation after first line chemotherapy. Clinical and demographic characteristics and pretreatment hemogram parameters were obtained from electronic medical record system. Results: While CR was seen in 34 (24.3%) of all patients after the first line chemotherapy, 106 (75.7%) patients were in the non-CR group. On univariate analysis, predictors for CR to treatment were the absence of brain metastasis, receiving 6 chemotherapy cycles and good performance status (p<0.001; p=0.020; p=0.001, respectively). In multivariate analysis, the absence of brain metastasis and good performance status were independent predictive factors for CR (p=0.033; p=0.019, respectively). Better treatment response rate to first-line chemotherapy was found to be associated with improved disease-free survival, and overall survival (log-rank p<0.001; log-rank p<0.001, respectively). Conclusion: Good performance status and the absence of brain metastases were identified as independent predictive factors for CR in ES-SCLC patients at the time of diagnosis. Patients who achieved CR had a significantly longer survival rate than patients with lower treatment response.
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    Predictors of Outcome in Patients with Advanced Nonseminomatous Germ Cell Testicular Tumors
    (Asian Pacific Organization Cancer Prevention, 2014) Yetişyiğit, Tarkan; Babacan, Nalan; Ürün, Yüksel; Şeber, Erdoğan Selçuk; Cihan, Sener; Arpacı, Erkan; Alkış, Necati; Yalçın, Banu Çiçek
    Background: Predictor factors determining complete response to treatment are still not clearly defined. We aimed to evaluate clinicopathological features, risk factors, treatment responses, and survival analysis of patient with advanced nonseminomatous GCTs (NSGCTs). Materials and Methods: Between November 1999 and September 2011, 140 patients with stage II and III NSGCTs were referred to our institutions and 125 patients with complete clinical data were included in this retrospective study. Four cycles of BEP regimen were applied as a first-line treatment. Salvage chemotherapy and/or high-dose chemotherapy (HDCT) with autologous stem cell transplantation were given in patients who progressed after BEP chemotherapy. Post-chemotherapy surgery was performed in selected patients with incomplete radiographic response and normal tumor markers. Results: The median age was 28 years. For the good, intermediate and poor risk groups, compete response rates (CRR) were, 84.6%, 67.9% and 59.4%, respectively. Extragonadal tumors, stage 3 disease, intermediate and poor risk factors, rete testis invasion were associated with worse outcomes. There were 32 patients (25.6%) with non-CR who were treated with salvage treatment. Thirty-one patients died from GCTs and 94% of them had stage III disease. Conclusions: Even though response rates are high, some patients with GCTs still need salvage treatment and cure cannot be achieved. Non-complete response to platinium-based first-line treatment is a negative prognostic factor. Our study confirmed the need for a prognostic and predictive model and more effective salvage approaches.
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    Predictors of Outcome in Patients with Advanced Nonseminomatous Germ Cell Testicular Tumors (Meeting Abstract)
    (Lippincott Williams & Wilkins, 2014) Yetişyiğit, Tarkan; Babacan, Nalan; Ürün, Yüksel; Şeber, Erdoğan Selçuk; Arpacı, Erkan; Cihan, Şaner; Alkış, Necati
    [No Abstract Available]
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    Prognostic Role of Lymphovascular Invasion and Perineural Invasion in Breast Cancer Treated with Neoadjuvant Chemotherapy
    (Akad Doktorlar Yayinevi, 2022) Çavdar, Eyyüp; İriağaç, Yakup; Karaboyun, Kubilay; Avcı, Okan; Öznur, Meltem; Şeber, Erdoğan Selçuk
    In our study, we investigated the predictive properties of LVI (lymphovascular invasion) and PNI (perineural invasion) on survival times from pathology specimens obtained from surgical operation after neoadjuvant chemotherapy (NAC) with breast cancer patients. Two hundered eleven female patients were included in this study. We evaluated the relationship between potential prognostic factors and mean recurrence-free survival (RFS) and overall survival (OS) times using Kaplan-Meier methodology and Cox proportional hazard modelling.The mean follow-up time was 27.3 months.PNI positive patients had shorter RFS and OS times than PNI negatives (p< 0.001, p= 0.002, respectively), and LVI positive patients had shorter RFS and OS times than LVI negatives (p< 0.001, p< 0.001, re-spectively). In the multivariate analysis performed, the presence of pN stage and PNI were found to be predictive for RFS (p= 0.047, p< 0.001, respectively), while pT stage and PNI positivity were found to be predictive for OS (p= 0.035, p= 0.017, respectively). LVI did not show the property of being an independent predictive marker for survival. PNI caused significant survival differences in all subtypes for both RFS (log-rank p< 0.001, p= 0.003, p= 0.001, respectively) and OS(log-rank p= 0.035, p= 0.006, p= 0.020 respectively) in HR+/Her2-, Her2+ and Triple negative breast cancer subtyping. LVI, on the other hand, caused survival distribution difference for RFS (p= 0.021) in the HR+/Her2-subtype and for both RFS and OS in the Triple-negative subtype (p< 0.001, p= 0.025, respectively). PNI is strongly and significantly associated with RFS and OS. We suggest that it can be used in identifying high-risk patients for recurrence of PNI and in new staging systems.
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    Prognostic Values of the De Ritis Ratio and Other Inflammatory Markers in Patients with Extensive-Stage Small Cell Lung Cancer
    (2021) Avcı, Okan; Özcan Ümit, Çağla; Yolcu, Ahmet Faruk; Şeber, Erdoğan Selçuk
    Objectives: We aimed to evaluate the prognostic significances of the aspartate aminotransferase-to-alanine aminotransferase ratio (the De Ritis ratio) and other some inflammatory markers on survival in extensive-stage small cell lungcancer (ES-SCLC).Methods: A total of 135 patients diagnosed with ES-SCLC in between 2017 and 2020 were included. The pre-treatment values of the De Ritis ratio, the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), and thepre-treatment levels of gamma-glutamyl transferase (GGT) and lactate dehydrogenase (LDH) were analyzed for theirrelationship with overall survival (OS). Optimal cutoff values were determined through receiver operating characteristic curves and survival probabilities were analyzed through the Kaplan–Meier method. Multivariate analyses wereperformed to investigate the prognostic significance of these parameters for ES-SCLC.Results: The median age of the patients at diagnosis was 62.2 (min: 42.5–max: 86.6). The median follow-up time was8.94±8.02 months. The most common sites of metastasis at admission were bones (33%), followed by the liver (27%),the brain (23%), and the adrenal glands (17%). Median OS was 7.52 months (min: 0.2–max: 50.6). The De Ritis ratio andother inflammatory markers (NLR, PLR, and GGT) were not statistically significantly related with OS (p=0.40; 0.06; 0.29;and 0.49, respectively). Multivariate analyses indicated that only LDH (HR=1.001; p=0.012) was an independent prognostic factor.Conclusion: The De Ritis ratio and other systemic inflammatory markers are not predictive for prognosis in ES-SCLCpatients. There is a need for larger prospective studies to investigate the roles of potential biomarker candidates inpredicting prognosis in ES-SCLC.
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    Prospective comparison of the value of CARG, G8, and VES-13 toxicity tools in predicting chemotherapy-related toxicity in older Turkish patients with cancer
    (Elsevier, 2022) Çavdar, Eyyüp; İriağaç, Yakup; Karaboyun, Kubilay; Avcı, Okan; Şeber, Erdoğan Selçuk
    Background: In older patients with cancer, it is very important to choose the appropriate treatment because they are at high risk for chemotherapy toxicity. Our study investigated characteristics of Cancer and Aging Research Group (CARG), Geriatric 8 (G8), and Vulnerable Elders Survey (VES-13) screening tools for predicting chemotherapy-related toxicity (CRT) prospectively.Materials and methods: 208 patients aged >= 65 years old for whom chemotherapy was planned to treat non -haematological cancer between February 2021-September 2021 were included in the study. The CARG, G8, and VES-13 toxicity tools were completed by the oncologist through face-to-face interviews before starting the first chemotherapy treatment. CRTs during chemotherapy were evaluated according to the National Cancer Insti-tute's Common Terminology Criteria for Adverse Events v4.03. Logistic regression models, the area under the re-ceiver operating characteristic curve (ROC-AUC), and correlation analyses were used for comparing questionnaires.Results: Median age was 70.4 (range 65-86) years. Of the participants, 103 (49.5%) participants experienced grade 3-5 CRT (32.2% haematological, 28.4% non-haematological) during chemotherapy. ROC-AUC value of CARG was determined as 0.827 (95% CI [confidence interval]: 0.77-0.88, p < 0.001), it was determined as 0.744 (95% CI: 0.68-0.81, p < 0.001) for G8 and 0.726 (95% CI: 0.66-0.80, p < 0.001) for VES-13. In the univariate regression analysis, CARG (OR [odds ratio] = 13.57, 95% CI: 6.0-30.72, p < 0.001), G8 (OR = 3.19, 95% CI: 1.62-6.29, p = 0.001), and VES-13 (OR = 9.5, 95% CI: 5.01-17.89, p < 0.001) were found to be predictive for CRT. The multivariate analysis (included stage, Eastern Cooperative Oncology Group [ECOG] performance status, presence of comorbid disease, platinum-based treatment regimen, taxane-based treatment regimen, CARG, VES-13, G8) showed that CARG (OR =12.08, 95% CI: 5.11-28.56, p < 0.001), VES-13 (OR =10.06, 95% CI: 4.92-22.98, p < 0.001), and G8 (OR = 2.20, 95% CI: 1.04-4.69, p = 0.040) screening tools were strong predictors for CRT. The CARG and VES-13 questionnaires were predictive for reducing the initial treatment dose (p = 0.004, p = 0.004, respectively), interruption of treatment (p < 0.001, p < 0.001, respectively), discontinuing treatment (p = 0.002, p = 0.002, respectively), and unexpected hospitalisation (p = 0.012, p = 0.003, respectively).Conclusions: We showed that all three CARG, G8, and VES-13 questionnaires are helpful tools in the decision -making process for ideal chemotherapy to predict severe CRT; however, CARG and VES-13 questionnaires appear more useful in daily oncology practice than the G8 questionnaire. (c) 2022 Elsevier Ltd. All rights reserved.
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    Recurrent squamous cell carcinoma of the skin treated successfully with single agent cetuximab therapy
    (Dove Medical Press Ltd, 2016) Şeber, Erdoğan Selçuk; Gönültaş, Aylin; Öztürk, Özlem; Yetişyiğit, Tarkan
    Recurrent squamous cell carcinoma of the skin is a rare but difficult to treat condition. Frequently, the disease presents itself in elderly patients with poor performance status and bearing many comorbidities, thus the decision to administer systemic chemotherapy becomes difficult to make. In addition, current chemotherapeutic protocols response rates are far from satisfactory. Recently cetuximab, a chimeric antibody against epidermal growth factor receptor, is increasingly being reported as an alternative treatment. We therefore report this case of a recurrent squamous cell carcinoma of the skin in an elderly woman with poor performance status and who had an excellent clinical response to single agent cetuximab therapy with complete resolution of the disease and minimal toxicity during the course of the treatment to provide evidence for future prospective clinical trials.