Background and Objectives: A high baseline neutrophil-to-lymphocyte ratio (NLR) is a poor prognostic factor in various cancers. However, its predictive role in metastatic bladder cancer (mBC) treated with immunotherapy is unclear. In this study, we aimed to investigate the relationship between the baseline and change in NLR and overall survival in mBC patients treated with immunotherapy, with the potential to significantly impact patient care. Materials and Methods: A retrospective analysis was conducted on 56 mBC patients who received second-line immunotherapy after progressing on platinum-based chemotherapy. Patients were classified into high and low NLR groups using a cutoff value of 3.3. A further division was made based on NLR changes after two cycles of immunotherapy: whether NLR increased (≥10%) or decreased (≥10%). The endpoint was to estimate the association between clinicopathological features and survival outcomes. Results: The study included 56 patients, with a median age of 66.6 years and a male-to-female ratio of 2.3:1. A low baseline NLR was associated with better OS than a high baseline NLR (p = 0.005). After two immunotherapy cycles, patients with a decreased NLR (≥10%) had significantly longer OS than those with an increased NLR (≥10%), regardless of the baseline NLR (p = 0.003). The overall median survival was 15 months, with 10 months for the NLR-increased group and not reached for the NLR-decreased group. Conclusions: Our study highlights the potential of baseline NLR and early changes in NLR as valuable prognostic markers for mBC patients receiving immunotherapy. Elevated neutrophils and lymphopenia negatively impact prognosis and treatment effectiveness, and NLR shows promise as a prognostic marker, inspiring further research and potential improvements in patient care.

Background and Objectives: The clinical value of HER2-low breast cancer (BC), defined by immunohistochemistry (IHC) scores of 1+ or 2+/ISH-negative without HER2 amplification, remains unclear in the neoadjuvant setting. This study aimed to determine whether HER2-low and HER2-zero tumors differ in pathological complete response (pCR) rates and disease-free survival (DFS) among early-stage breast cancer patients undergoing neoadjuvant chemotherapy (NAC). Materials and Methods: We retrospectively analyzed 134 early BC patients treated with NAC between 2017 and 2023. Patients were categorized as HER2-zero (IHC 0) or HER2-low (IHC 1+ or 2+/ISH–). The primary endpoint was total pCR (tpCR); secondary endpoints included breast (bpCR), nodal (npCR), and radiologic complete response (rCR), alongside DFS analysis stratified by hormone receptor (HR) status. Results: Of the cohort, 91 patients (67.9%) were HER2-zero and 43 (32.1%) were HER2-low. There was no statistically significant difference in tpCR (26.4% vs. 27.9%, p = 0.852), bpCR (28.6% vs. 30.2%, p = 0.843), npCR (37.4% vs. 32.6%, p = 0.588), and rCR (23.1% vs. 30.2%, p = 0.374) between HER2-zero and HER2-low groups. DFS did not significantly differ between HER2-zero and HER2-low groups overall (p = 0.714), nor within HR-positive (p = 0.540) or TNBC (p = 0.523) subgroups. Conclusions: HER2-low tumors demonstrated similar pathological responses and survival outcomes compared to HER2-zero tumors. While a HER2-low status does not appear to define a distinct biological subtype in early BC, it remains a relevant classification for emerging HER2-targeted therapies, needing further investigation in prospective studies.

Background: Prostate-specific antigen (PSA) is widely used in the diagnosis and monitoring of prostate cancer. The prognostic relevance of very low PSA levels has not been clearly established in metastatic castration-sensitive prostate cancer (mCSPC). More sensitive PSA assays may provide more accurate estimates of clinical outcomes. Objectives: To evaluate the relationship between achieving very deep PSA levels (⩽0.02 ng/mL) within 6 months of treatment and radiologic progression-free survival (rPFS) in patients with mCSPC. Design: A retrospective, unicenter observational study conducted at a tertiary oncology center. Methods: A total of 203 patients with mCSPC who received first-line treatment with luteinizing hormone-releasing hormone analogs, androgen receptor pathway inhibitors, or docetaxel were included. Patients were stratified into four groups based on their PSA nadir levels: ⩽0.02, 0.02–0.2, 0.2–4, and >4 ng/mL. Kaplan–Meier and Cox regression analyses were used to assess the association between PSA nadir and rPFS. Results: Patients achieving PSA ⩽ 0.02 ng/mL had significantly longer rPFS (median: 59.2 months) compared to other PSA groups. Multivariable analysis confirmed PSA ⩽ 0.02 ng/mL as an independent predictor of rPFS (HR: 2.02, p < 0.001). The overall log-rank p -value for group comparison was < 0.001. Conclusion: A very deep PSA response (⩽0.02 ng/mL) is associated with longer rPFS and may serve as a prognostic marker in mCSPC. This threshold could be considered in future clinical trial design and treatment stratification.

Background/Objectives: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been investigated as an immunonutritional biomarker in several solid tumors; however, data in metastatic renal cell carcinoma (mRCC) remain limited. This study aimed to evaluate the prognostic significance of the pretreatment HALP score in patients with mRCC receiving first-line tyrosine kinase inhibitor (TKI) therapy. Methods: A multicenter retrospective cohort study was conducted using data from the Turkish Oncology Group Kidney Cancer Consortium (TKCC) Database. HALP was calculated as hemoglobin (g/dL) × albumin (g/dL) × lymphocyte count (×10⁹/L)/platelet count (×10⁹/L). Patients were categorized into HALP-low and HALP-high groups according to the cohort median HALP value. Results: A total of 1001 patients were enrolled. The median time to treatment failure (TTF) was significantly shorter in the HALP-low group than in the HALP-high group (7.43 months [95% CI 6.4–8.5] vs. 14.26 months [95% CI 12.1–16.4], p < 0.001). The median overall survival (OS) was also significantly shorter in the HALP-low group (30.19 months [95% CI 25.2–35.1] vs. 46.06 months [95% CI 38.2–53.9], p < 0.001). In multivariable analysis, a high HALP score remained independently associated with longer TTF (HR 0.73, 95% CI 0.62–0.86; p < 0.001) and OS (HR 0.69, 95% CI 0.57–0.85; p < 0.001). Conclusions: The pretreatment HALP score was independently associated with TTF and OS in patients with mRCC treated with first-line TKI therapy. These findings support the prognostic relevance of HALP in this treatment setting and warrant further evaluation of its potential role alongside established clinical risk models.

Background: Obesity has been associated with adverse outcomes in several malignancies; however, the prognostic significance of body mass index (BMI) in metastatic cervical cancer remains unclear because of limited and conflicting evidence. This study aimed to evaluate the impact of BMI on progression-free survival (PFS) and overall survival (OS) in women with metastatic cervical cancer. Methods: A retrospective analysis was conducted on 60 women diagnosed with metastatic cervical cancer between February 2014 and January 2024. Patients were stratified into high (≥ 25 kg/m²) and low (< 25 kg/m²) BMI groups; underweight patients were included in the low-BMI group because of their small number. Survival outcomes were evaluated using Kaplan–Meier analysis and Cox proportional hazards models. Multivariate models were adjusted for age, histology, ECOG performance status, and metastatic burden. Results: Among the cohort, 70% of patients had a BMI ≥ 25. There were no significant differences between BMI groups in baseline characteristics such as age, histological subtype, or metastatic site. However, patients with a BMI < 25 demonstrated significantly better OS (2- and 5-year OS: 55.0% and44.0%) compared to those with a BMI ≥ 25 (22.2% and 17.8%, p = 0.024). A similar trend was observed for PFS (p = 0.037). In multivariable analysis, high BMI remained independently associated with worse OS (HR=2.55, 95% CI=1.18– 5.50, p=0.017) and PFS (HR=1.87, 95% CI=1.01– 3.66, p=0.045). Conclusion: Higher BMI is associated with poorer overall survival in patients with metastatic cervical cancer. These findings highlight the importance of nutritional assessment and suggest that BMI may serve as a prognostic marker associated with survival outcomes in this population.