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    Comparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer
    (Bmc, 2024) Tasci, Elif Senocak; Oyan, Basak; Soenmez, Oezlem; Mutlu, Arda Ulas; Atci, Muhammed Mustafa; Sakin, Abdullah; Oener, Irem
    Background The optimal treatment for metastatic colorectal cancer (mCRC) after the second line is still controversial. Regorafenib has been the standard of care in this setting as it improved overall survival (OS) compared to placebo. In real-world practice chemotherapy rechallenge is also a preferred option even though supporting evidence is not enough. We aim to compare the efficacy of regorafenib and 5-fluorouracil-based (5-FU) rechallenge treatment in the third line setting of mCRC.Methods In this retrospective multi-institutional trial, mCRC patients from 21 oncology centers who progressed after 2 lines of chemotherapy were analyzed. Patients who were treated with regorafenib or rechallenge therapy in the third-line setting were eligible. Rechallenge chemotherapy was identified as the re-use of the 5-FU based regimen which was administered in one of the previous treatment lines. OS, disease control rate (DCR), progression free survival (PFS) and toxicity were analyzed.Results Three hundred ninety-four mCRC patients were included in the study. 128 (32.5%) were in the rechallenge, and 266 (67.5%) were in the regorafenib group. Median PFS was 5.82 months in rechallenge and 4 months in regorafenib arms (hazard ratio:1.45,95% CI, p = 0.167). DCR was higher in the rechallenge group than regorafenib (77% vs 49.5%, respectively, p = < 0.001). Median OS after the third-line treatment was 11.99 (95% CI, 9.49-14.49) and 8.08 months (95% CI, 6.88-9.29) for rechallenge and regorafenib groups, respectively (hazard ratio:1.51, 95% CI, p < 0.001). More adverse effects and discontinuation were seen with regorafenib treatment.Conclusion Our study revealed that higher disease control and OS rates were achieved with rechallenge treatment compared to regorafenib, especially in patients who achieved disease control in one of the first two lines of therapy.
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    Comparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer (vol 24, 16, 2024)
    (Bmc, 2024) Tasci, Elif Senocak; Oyan, Basak; Sonmez, Ozlem; Mutlu, Arda Ulas; Atci, Muhammed Mustafa; Sakin, Abdullah; Oner, Irem
    [Abstract Not Available]
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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.