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    A New Mortality Prediction Model in Advanced Stage Cancer Patients Requiring Hospitalisation while Receiving Active Systemic Therapy
    (Coll Physicians & Surgeons Pakistan, 2023) Karaboyun, Kubilay; Iriagac, Yakup; Cavdar, Eyyup; Avci, Okan; Seber, Erdogan Selcuk
    Objective: To predict short and long-term mortality in patients who were admitted to the emergency department and then hospitalised unplanned in medical oncology-ward.Study Design: An observational study.Place and Duration of the Study: Department of Medical Oncology, Tekirdag Namik Kemal University Hospital, Tekirdag, Turkiye, from May 2021 to May 2022.Methodology: Consecutive patients admitted to the emergency department with unplanned hospitalisation in the oncology ward, were included. Patients receiving treatment with the curative intent, patients hospitalised for febrile neutropenia, and terminally ill patients requiring intensive care unit follow-up at admission were excluded from the study. Univariate and multivariate logistic regression analyses were used to identify predictive factors for short and long-term mortality-dependent variables.Results: This study included 253 advanced cancer patients. The number of patients who died in the ward within 10 days (short-term mortality) was 28 (11.1%). Ninety patients (35.6%) died afterwards anytime in the ward during the study (long-term mortality). In the multi-variate analysis established for short-term mortality, higher ALT (OR = 6.75, 95% CI: 2.09 -21.85, p=0.001), rapid deterioration in perfor-mance status (OR = 5.49, 95% CI: 1.81-16.67, p=0.003), higher CRP (OR = 5.86, 95% CI: 1.20-28.53, p=0.029), higher procalcitonin (OR = 7.94, 95% CI: 0.99 -63.82, p=0.051), and higher lactate (OR = 2.47, 95% CI: 0.94-6.51, p=0.067) showed significant predictive features.Conclusion: The decision of whether to continue treatment or not is challenging in cancer patients who require unplanned hospitalisation while receiving palliative systemic therapy. New mortality estimation models can be used in making the transition from life-long to pallia-tive treatments.
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    Efficacy of Neoadjuvant Chemotherapy in Lobular and Rare Subtypes of Breast Cancer
    (Coll Physicians & Surgeons Pakistan, 2024) Seber, Erdogan Selcuk; Iriagac, Yakup; Cavdar, Eyyup; Karaboyun, Kubilay; Avci, Okan; Yolcu, Ahmet; Gurdal, Sibel Ozkan
    Objective: To determine the predictive factors for the pathological complete response (pCR) in patients with non-ductal invasive breast cancer (ND-BC) receiving neoadjuvant chemotherapy.Study Design: Observational study.Place and Duration of the Study: Departments of Medical Oncology, Tekirdag Namik Kemal University, Sirnak State Hospital, Aydin Adnan Menderes University, Marmara University, Bakirkoy Sadi Konuk Hospital, Basaksehir Cam and Sakura Hospital, Sakarya University, Balikesir Ataturk Hospital, Turkiye, from April 2016 to December 2022.Methodology: A total of 222 non-metastatic breast cancer patients who received neoadjuvant chemotherapy were included in this retrospective multicentric study. The clinicopathologic data were obtained from the hospitals' electronic-record-system. The logistic regression models were used to identify predictive factors for pCR.Results: One hundred and twenty-six patients (56.8%) had invasive lobular carcinoma and 28 patients (12.6%) had signet ring cell/mucinous carcinoma. A total of 45 patients (20.3%) achieved pCR. The pCR rate was 14.3% for lobular carcinoma and 17.9% for signet ring cell/mucinous carcinoma. The univariate analysis showed that estrogen receptor-negative tumours (p = 0.017), high Ki-67 (p = 0.008), high histologic grade (p<0.001), HER2+ expression (p<0.001), and non-lobular histologic type (p = 0.012) were predictive factors for pCR. The multivariate model revealed that HER2 expression (p<0.001) and Ki-67 (p = 0.005) were independent predictors.Conclusion: Neoadjuvant chemotherapy demonstrated effectiveness in ND-BC patients, leading to favourable pCR rates and enabling breast-conserving surgery. Predictive markers for pCR varied depending on histologic types, with HER2 expression, ER status, Ki-67, and histologic grade showing significance in non-ductal subtypes, while HER2 status alone was predictive in lobular carcinoma.
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    The Role of Interleukin-20 in Paclitaxel-Associated Peripheral Neuropathy in Non-Metastatic Breast Cancer Patients Receiving Chemotherapy
    (Galenos Publ House, 2023) Karaboyun, Kubilay; Cavdar, Eyyup; Iriagac, Yakup; Yilmaz, Ahsen; Celikkol, Aliye; Avci, Okan; Seber, Erdogan Selcuk
    Introduction: This study investigated the relationship between serum interleukin-20 (IL-20) levels and paclitaxel-associated neuropathy in patients with non-metastatic breast cancer. Paclitaxel-induced peripheral neuropathy (PIPN) is a significant side effect of paclitaxel chemotherapy, and the exact mechanism underlying PIPN is not fully understood. Methods: This prospective observational study was conducted with non-metastatic breast cancer patients between January 2022 and November 2022. Neuropathy symptoms were evaluated using the QLQ-CIPN20 questionnaire, and serum IL-20 levels were measured at three time points: before chemotherapy, on the 7(th) day after the first paclitaxel treatment, and after the last treatment. Univariate and multivariate logistic regression analyses were performed to identify factors predicting PIPN. Results: This study was completed with 59 female patients. During the study, 47 patients (79.6%) reported any degree of neuropathy, whereas 12 patients (20.4%) had no neuropathy. Univariate analysis to predict neuropathy measured on day 7 after first paclitaxel administration demonstrated that age, body mass index, 7(th)-day serum IL-20 level, and last cycle serum IL-20 level were predictive for PIPN. Conclusion: This study demonstrated the relationship between serum IL-20 levels and paclitaxel-related neuropathy in breast cancer patients. Further research targeting the function of IL-20 is needed to investigate potential strategies to prevent and treat PIPN.