Background: Prognostic scores derived from the blood count have garnered significant interest as an indirect measure of the inflammatory pressure in cancer. The recently developed pan-immune-inflammation value (PIV), an equation including the neutrophil, platelet, monocyte, and lymphocyte levels, has been evaluated in several cohorts, although with variations in the tumor types, disease stages, cut-offs, and treatments. Therefore, we evaluated the association between survival and PIV in cancer, performing a systematic review and meta-analysis. Methods: We conducted a systematic review from the Pubmed, Medline, and Embase databases to filter the published studies until 17 May 2022. The meta-analyses were performed with the generic inverse-variance method with a random-effects model. Results: Fifteen studies encompassing 4942 patients were included. In the pooled analysis of fifteen studies, the patients with higher PIV levels had significantly increased risk of death than those with lower PIV levels (HR: 2.00, 95% CI: 1.51–2.64, p < 0.001) and increased risk of progression or death (HR: 1.80, 95% CI: 1.39–2.32, p < 0.001). Analyses were consistent across several clinical scenarios, including non-metastatic or metastatic disease, different cut-offs (500, 400, and 300), and treatment with targeted therapy or immunotherapy (p < 0.001 for each). Conclusion: The available evidence demonstrates that PIV could be a prognostic biomarker in cancer. However, further research is needed to explore the promise of PIV as a prognostic biomarker in patients with non-metastatic disease or patients treated without immunotherapy or targeted therapy.

The use of immune checkpoint inhibitors (ICIs) has revolutionized cancer care, particularly in immune-inflamed tumors and tumors with a high mutational burden, like microsatellite instable colorectal cancer (CRC). However, their effectiveness in microsatellite stable (MSS) CRC is limited. This systematic review aims to evaluate the efficacy of ICIs in MSS CRC and explore promising combination strategies. A comprehensive search from the Web of Science, Medline, and Embase databases, for studies published until 14 November 2022, identified 53 clinical trials included in the review. ICI monotherapy or ICI-ICI combinations demonstrated limited clinical activity for patients with MSS CRC, with overall response rates below (ORR) 10% in most studies. The ICI and tyrosine kinase inhibitor (TKI) garnered ORRs ranging from 10% to 40% and indicated a higher benefit for patients, particularly those without active liver metastases. The combination of ICIs with anti-VEGF agents showed modest ORRs, especially in the earlier treatment lines and in combination with chemotherapy. While these combinations could lead to modest improvements, well-defined biomarkers for long-term benefit are yet to be delineated. Combinations involving BRAF inhibitors with ICIs were studied, showing promising responses with combination approaches in molecularly defined subgroups. In conclusion, while ICI monotherapy has limited efficacy in MSS CRC, combination strategies hold promise to enhance survival outcomes. Further research is necessary to identify optimal combination approaches, predictive biomarkers for treatment response, as well as enrollment according to tumor molecular characteristics.

Background: In May 2022, the monkeypox virus outbreak in multiple countries on various continents marked a potential resurgence of the disease as a global health issue. Considering the crucial role of physicians in mitigating the monkeypox outbreak, we sought to evaluate physicians’ knowledge, attitude, concerns, and vaccine acceptance for monkeypox, in the shadow of the COVID-19 pandemic. Methods: A large-scale, cross-sectional survey was conducted among 283 physicians between 20 August–2 September 2022, in Turkey. The participants’ sociodemographic characteristics, knowledge, attitudes, concerns, and vaccine acceptance toward monkeypox infection were collected via a questionnaire. Results: Our study revealed that 32.5% of physicians achieved a good level of knowledge; similarly, 31.4% of the physicians planned to have the monkeypox vaccine. Multivariate binary logistic regression analysis showed that female physicians (p = 0.031) and older people (≥30 vs. <30) were more likely to be knowledgeable about monkeypox (p = 0.007). We found that participants from divisions of internal medicine (p = 0.033) who knew about the monkeypox disease during medical school or residency (p = 0.005) and were previously exposed to COVID-19 disease (p = 0.005) were more likely to have a good knowledge score of monkeypox. We also found that physicians with a good knowledge score were more worried about monkeypox compared to COVID-19 (AOR: 2.22; 95% CI:1.13–4.33; p = 0.019). Additionally, those who had information on monkeypox during medical education (AOR = 2.16, 95% CI = 1.10–4.21; p = 0.024) were more likely to receive the smallpox vaccine to prevent monkeypox viral infection when available. Conclusions: The present study pointed out that physicians in Turkey have unsatisfactory levels of knowledge about the emerging monkeypox. This study results can impede attempts to detect and manage cases of monkeypox and should be addressed through appropriate and timely awareness and educational programs, alerts, and seminars. These might serve as the basis for policymakers’ decisions about promoting national monkeypox vaccination strategies and addressing potential vaccine hesitancy and misinformation when needed.

Background: The coronavirus disease 2019 (COVID-19) pandemic continues to wreak havoc on lives and ravage the world. Several vaccines have been approved for use against COVID-19; however, there may be hesitancy and negative perceptions towards vaccination, which may reduce the willingness to be vaccinated. Further, studies assessing the current perception toward COVID-19 vaccination are scarce. This study aimed to assess community knowledge, attitudes, and perceptions regarding COVID-19 vaccines among the general population of Turkey. Methods: A cross-sectional survey was carried out among 1009 adult participants from the 13–20 April 2021. Demographic data were collected, and attitudes and perceptions toward COVID-19 vaccines were evaluated. A multivariable regression analysis was performed to identify the factors predicting perception towards COVID-19 vaccinations. Results: Just over half of participants were male (52.6%) and the majority of respondents were aged between 30 and 39 years (33.8%). Our study revealed that 62.7% of participants had positive perceptions of COVID-19 vaccines. Logistic regression analysis results showed that older people (≥30 vs. <30) were less likely to have a positive perception towards COVID-19 vaccines (OR = 0.70, 95% CI = 0.51–0.94). We also found participants who had a previous history of influenza vaccines (OR = 2.01, 95% CI = 1.43–2.84), bachelor’s degrees or above (OR = 1.47, 95% CI = 1.12–1.91), and a personal history of COVID-19 (OR = 1.58, 95% CI = 1.10–2.26) were more likely to have a positive perception regarding COVID-19 vaccines. Conclusion: The proportion of the general population in Turkey who believe in COVID-19 vaccine effectiveness is not inferior to that of other countries. However, the low positive perception even among the population applying for vaccination indicates that understanding the perception of the general population and its influencing factors may contribute to developing a strategy for improving vaccination rates by addressing these factors.

Introduction: The use of artificial intelligence (AI) in oncology has increased rapidly, transforming various healthcare areas such as pathology, radiology, diagnostics, prognosis, genomics, treatment planning, and clinical trials. However, perspectives, comfort levels, and concerns about AI in cancer care remain largely unexplored. Materials and Methods: This prospective, descriptive cross-sectional survey study was conducted between May 20, 2024 and October 22, 2024, among 363 patients with cancer from two different hospitals affiliated with Ankara University, a tertiary care center in Türkiye. The survey included three distinct sections: (1) Perceptions: Patients’ general views on AI’s impact in oncology; (2) Attitudes: Comfort level with AI performing medical tasks; (3) Concerns: Specific fears related to AI implementation (eg, diagnostic errors, data privacy, healthcare costs). Survey responses were summarized descriptively, and differences by age, gender, and education were analyzed using chi-square tests. Results: A majority (50.7%) believed AI would somewhat (32%) or significantly (18.7%) improve healthcare. However, one-third of patients (33.1%) were very uncomfortable with AI diagnosing cancer, with higher discomfort among less-educated participants ( P < .005). Top patient concerns included AI making incorrect diagnoses (31.1%), increasing healthcare costs (27.5%), and not keeping data private (19.6%). Patients with higher education levels expressed less discomfort and fewer concerns. Conclusions: Patients’ perceptions and attitudes on AI varied significantly based on education, highlighting the need for targeted educational initiatives. While AI holds potential to revolutionize cancer care, addressing concerns about accuracy, security, and transparency is critical to enhance its acceptance and effectiveness in clinical practice.

Dynamic changes in the blood-based biomarkers could be used as a prognostic biomarker in patients treated with immune checkpoint inhibitors (ICIs), although the data are limited. We evaluated the association between the neutrophil–lymphocyte ratio (NLR) and early NLR changes with survival in ICI-treated patients. We retrospectively evaluated the data of 231 patients with advanced-stage cancer. We recorded baseline clinical characteristics, baseline NLR and fourth-week NLR changes, and survival data. A compound prognostic score, the NLR2-CEL score, was developed with the following parameters: baseline NLR (<5 vs. ≥5), ECOG status (0 vs. ≥1), Charlson Comorbidity Index (CCI, <9 vs. ≥9), LDH (N vs. ≥ULN), and fourth-week NLR change (10% or over NLR increase). In the multivariable analyses, higher NLR (HR: 1.743, p = 0.002), 10% or over NLR increase in the fourth week of treatment (HR: 1.807, p = 0.001), higher ECOG performance score (HR: 1.552, p = 0.006), higher LDH levels (HR: 1.454, p = 0.017), and higher CCI (HR: 1.400, p = 0.041) were associated with decreased OS. Compared to patients with the lowest scores, patients in the highest score group had significantly lower OS (HR: 7.967, 95% CI: 3.531–17.979, p < 0.001) and PFS. The composite score had moderate success for survival prediction, with an AUC of 0.702 (95% CI: 0.626–0.779, p < 0.001). We observed significantly lower survival in patients with higher baseline NLR values and increased NLR values under treatment.