Person: ŞEKER, MESUT
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Publication Metadata only Real-life analysis of treatment approaches and the role of inflammatory markers on survival in patients with advanced biliary tract cancer(2022-01-01) Goktas Aydin S.; Cakan Demirel B.; Bilici A.; TOPÇU A.; Aykan M. B.; KAHRAMAN S.; AKBIYIK I.; Atci M. M.; Olmez O. F.; Yaren A.; et al.; TOPÇU, ATAKAN; ŞEKER, MESUT© 2022 Informa UK Limited, trading as Taylor & Francis Group.Objectives: Advanced-stage biliary tract cancers (BTC) are rare malignancies with poor prognosis. There are few prospective trials, but several retrospective studies regarding treatment options. In this study, we aimed to investigate the role of systemic inflammatory parameters (SIP) and other possible independent factors that may affect survival and treatment approaches and to determine the benefit of later-line treatments in these patients. Methods: A total of 284 patients, initially diagnosed with advanced stage or progressed after curative treatment of BTC, from different oncology centers in Turkey were included in this retrospective study. The prognostic significance of clinicopathological factors, SIPs and treatment options was analyzed. Results: At a median follow-up of 13 months, the median progression-free survival (PFS) was 6.1 months (95% CI:5.51–6.82), and the median overall survival (OS) time was 16.8 months (95% CI: 13.9–19.6). Treatment choice (p <.001 HR:0.70 CI95% 0.55–0.9), performance status (p <.001 HR:2.74 CI 95% 2.12–3.54) and neutrophil-to-lymphocyte ratio (NLR) (p =.02 HR:1.38 CI 95% 1.03–1.84) were independent prognostic factors for PFS. For OS, the independent prognostic indicators were determined as The Eastern Cooperative Oncology Group Performance Status (ECOG PS) (p <.001 HR:1.78 CI 95% 1.5–2.3), Systemic Immune-inflammation Index (SII) (p <.001 HR:0.51 CI95% 0.36–0.73) and stage at diagnosis (p =.002 HR:1.79 CI 95% 1.24–2.59). Furthermore, second and third line treatments significantly prolonged OS in advanced BTC (p <.001 HR:0.55 CI 95% 0.38–0.79; p =.007 HR:0.51 CI95% 0.31–0.83, respectively). Conclusion: SII and NLR are useful prognostic factors and may be helpful in making treatment decisions. Additionally, second and later-line treatments in advanced BTC have a significant impact on survival under real-life conditions.Publication Metadata only The Impact of Hybrid Capture-Based Comprehensive Genomic Profiling on Treatment Strategies in Patients with Solid Tumors(2022-01-01) Dişel U.; Köse F.; Bilici A.; ÖZGÜROĞLU M.; Sağlam S.; ŞEKER M.; AKSOY S.; Tek İ.; Mandel N. M.; Demir G.; et al.; ŞEKER, MESUT© 2022 by Turkish Society of Medical Oncology.Objective: The development of bioinformatics and comprehensive genomic profiling (CGP) has provided insights into the ap-plicability and functionality of the genomic alterations (GA). In this study, we evaluated the impact of CGP on the treatment plan and outcomes in a significant number of patients. Material and Methods: We carried out a retrospective case-control study on 164 adult patients with advanced solid tumors from 15 oncology centers in Türkiye. Results: In all cases, CGP was performed within 23.8 [standard deviation (SD)±32.1] months of initial diagnosis. Non-small cell lung carcinoma, breast cancer, unknown primary carcinoma, colorectal carcinoma, and sarcoma were among the most common tumor types, accounting for 61.5% of all cases. CGP was performed immediately after the diagnosis of advanced cancer in 13 patients (7.9%). In 158 patients (96.4%), at least one GA was found as per the CGP report. Also, in the reports, the average tumor mutational burden (TMB) and GAs were 7.3 (SD±8.7) mut/Mb and 3.5 (SD±2.0), respectively. According to CGP reports, 58 patients had 79 evidence-based drug suggestions for their particular tumor type, whereas 97 patients had 153 evidence-based drug suggestions for another tumor type. After the primary oncologist interpreted the CGP reports, significant changes were made to the treatment of 35 (21.3%) patients. Conclusion: We strongly believe that in the future, high-TMB or other tumor-agnostic biomarkers will become much more afford-able, and CGP will serve as one of the major decision-making tools for the treatment of patients along with pathological, radiological or lab-oratory tests.