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Öğe Investigation of the Effect of Low-positive HER-2 on Neoadjuvant Chemotherapy Response in Hormone-positive Breast Cancer Patients(Galenos Publ House, 2023) Karaboyun, Kubilay; Oznur, Meltem; Yolcu, Ahmet; Iriagac, Yakup; Seber, SelcukObjective: 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.Öğe Predictive Value of Serum Calprotectin Level in Response to Treatment, a New Inflammatory Marker in Patients with Breast Cancer Requesting Neoadjuvant Treatment(Galenos Publ House, 2023) Baydar, Ece; Celikkol, Aliye; Gurdal, Sibel Ozkan; Seber, SelcukAim: There is a close relationship between inflammation and cancer. Calprotectin is a protein released during inflammation. The aim of this study is to investigate the relationship between breast cancer and calprotectin levels in breast cancer patients receiving neoadjuvant therapy the predictive role of calprotectin in response to treatment. Materials and Methods: In our prospective study, a patient group with 69 breast cancer patients and a control group with 20 patients were formed. Calprotectin was studied from the blood tests taken from the whole sample. Patient data were obtained from the electronic record system. In our study, statistical evaluations were made using a package program called IBM Statistical Package for the Social Sciences Statistics 24. Results: Eighty-nine patients (69 cancer, 20 controls) were included in the study. The median age of breast cancer patients was 48 [minimum (min): 24-maximum (max): 73], the control group was 44.5 (min: 19-max: 68) and the ages of the two groups were similar (p=0.599). Mean calprotectin levels in breast cancer patients were 28.63 +/- 30.5, median 16.5 (min: 6.7-max: 160.7). The mean in the control group was 16.09 +/- 6.1 (min: 8.7-max: 27.4) and there was no statistical difference between the 2 groups (p=0.072). A statistically significant difference was found in terms of calprotectin values according to Ki67 classes (Z=-20.043; p=0.041). Calprotectin values of those with Ki67 class >20 were statistically significantly higher than those with <= 20. Parameters that could predict complete chemotherapy response were evaluated with logistic regression analysis. There was no correlation between calprotectin level and complete response. There was a positive correlation between age increase and complete response. Conclusion: There was no significant difference between serum calprotectin levels of the patient and control groups, but calprotectin level was found to be associated with Ki67 level. There was no relationship between calprotectin and chemotherapy response. Studies with larger sample numbers may make a significant difference.Öğe Recommendations for cyclin-dependent kinase 4/6 inhibitor treatments in the context of co-morbidity and drug interactions (Review)(Spandidos Publ Ltd, 2024) Teomete, Mehmet; Cabuk, Devrim; Korkmaz, Taner; Seber, Selcuk; Ozturk, Ozge Fulya; Aver, Birkan; Karaalp, AtilaBreast cancer is most frequently diagnosed among women aged 65-74 years and the prevalence of comorbidities in elderly patients with breast cancer is 32.2%. In addition, polypharmacy is quite common in these patients. Understanding the interaction between breast cancer treatment modalities and comorbidities is important, particularly in elderly patients, as comorbidities affect the choice of appropriate treatment and are independent risk factors for survival. A total of three oral cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i), palbociclib, ribociclib and abemaciclib, notably prolonged progression-free survival when combined with endocrine therapy (ET), compared with ET alone in patients with advanced breast cancer (ABC). The present review article therefore addressed the safety, tolerability and toxicity of CDK4/6i treatment in ABC management, compiled real-world data on how multiple clinical and pharmacological features may affect the choice of these drugs and provided practical recommendations for clinical approaches. Before starting treatment with CDK4/6i drugs, all ongoing medical conditions should be inventorized and re-graded, and examination should be performed for any additional disease that the patient may not be aware of. It is also important to obtain a detailed history of concomitant drugs, including prescription and over-the-counter drugs, vitamins, supplements and herbal products. In addition, patients should be advised to consult their oncologist before starting any new medication.Öğe 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 Ireland Ltd, 2016) Korkmaz, Taner; Seber, Selcuk; Basaran, GulLate 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. © 2015 Elsevier Ireland Ltd.
