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    Approach to Breast Cancer Treatment in Elderly Patients
    (Ortadogu Reklam Tanitim & Yayincilik, 2020) Seber, Selçuk; Çabuk, Devrim; Başaran, Gül
    Old age should be carefully evaluated before the treatment of all kinds of diseases, not only chronologically but also in functional terms. Regardless of the stage of breast cancer, it is known that older patients benefit from standard treatments as much as younger patients to the extent that they are represented in clinical trials, but we also know that toxicity is augmented in this age group. The elderly patient group is a very heterogeneous group within itself, and it is important to separate the healthier, more fit elderly group who will benefit from standard treatments from the group that can only receive standard treatment with some rehabilitation. In addition, it is one of the most important duties of the clinician to identify patients who cannot tolerate both standard and modified treatments before initiation of the cancer treatment. Today, although there are several Comprehensive Geriatric Evaluation tools which are developed for aiding the clinician for making treatment decisions, most of the elderly patients are not properly evaluated in the busy day to day clinical practice. As an alternative,parameters such as patients daily work, social enviorment, prescirbed medicines for other comorbidities, and the potential side effects of the recommended treatment should be carefully reviewed. The validity of the treatment decisions taken at the start of the treatment should be re-evaluated at each visit and if necessary, modifications should be made to maximize benefit with the least toxicity.
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    Review of the current role of targeted therapies as maintenance therapies in first and second line treatment of epithelial ovarian cancer; in the light of completed trials
    (Elsevier Science Inc, 2016) Korkmaz, Taner; Seber, Selçuk; Başaran, Gül
    Late and recurrent stage ovarian cancer has a high mortality and low response rate to therapy beyond first line treatment. Although first line platinum/taxane based regimens have a satisfactory response rate eventually in most cases disease recurrence is common and second-line treatments are not curative. Delaying progression or recurrence is the main goal of current ongoing clinical studies by means of establishing an effective maintenance regimen with acceptable toxicity profile. Clearly, the persistence of dormant and drug-resistant cells after front-line treatments results in the inability to cure the disease. Over the past several years, the idea of prolongation of therapy for ovarian cancer has garnered clinical attention and academic debate. As a result of a greater understanding of the molecular pathways involved in carcinogenesis and tumor growth, a large number of potential therapeutic targets have been identified and drugs to block receptors, ligands or pathways are being developed. Currently, numerous clinical trials with targeted agents have just been completed or are ongoing involving patients achieving a complete or durable response after first-line and beyond the first line chemotherapy in order to evaluate the efficacy of different therapeutic approaches in terms of progression-free survival and overall survival. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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    Turkish national consensus on breast cancer management during temporary state of emergency due to COVID-19 outbreak
    (Turkish Surgical Assoc, 2020) Sezer, Atakan; Çiçin, İrfan; Karadeniz Çakmak, Güldeniz; Gürbüz, Mehmet Sabri; Başaran, Gül; Oyan, Başak; Güllüoğlu, Bahadır; Gürdal, Sibel Özkan
    Objective: Cancer care is excessively influenced by the COVID-19 outbreak for various reasons. One of the major concerns is the tendency for delayed surgical treatment of breast cancer patients. The outbreak has urged clinicians to find alternative treatments until surgery is deemed to be feasible and safe. Here in this paper, we report the results of a consensus procedure which aimed to provide an expert opinion-led guideline for breast cancer management during the COVID-19 outbreak in Turkey. Material and Methods: We used the Delphi method with a 9-scale Likert scale on two rounds of voting from 51 experienced surgeons and medical oncologists who had the necessary skills and experience in breast cancer management. Voting was done electronically in which a questionnaire-formatted form was used. Results: Overall, 46 statements on 28 different case scenarios were voted. In the first round, 37 statements reached a consensus as either endorsement or rejection, nine were put into voting in the second round since they did not reach the necessary decision threshold. At the end of two rounds, for 14 cases scenarios, a statement was endorsed as a recommendation for each.Thirty-two statements for the remaining 14 were rejected. Conclusion:There was a general consensus for administering neoadjuvant systemic therapy in patients with node-negative, small-size triple negative, HER2-positive and luminal A-like tumors until conditions are improved for due surgical treatment. Panelists also reached a consensus to extend the systemic treatment for patients with HER2-positive and luminal B-like tumors who had clinical complete response after neoadjuvant systemic therapy.