Pancreatic cancer (PanCa) presents a catastrophic disease with poor overall survival at advanced stages, with immediate requirement of new and effective treatment options. Besides genetic mutations, epigenetic dysregulation of signaling pathway-associated enriched genes are considered as novel therapeutic target. Mechanisms beneath the deoxyribonucleic acid methylation and its utility in developing of epi-drugs in PanCa are under trails. Combinations of epigenetic medicines with conventional cytotoxic treatments or targeted therapy are promising options to improving the dismal response and survival rate of PanCa patients. Recent studies have identified potentially valid pathways that support the prediction that future PanCa clinical trials will include vigorous testing of epigenomic therapies. Epigenetics thus promises to generate a significant amount of new knowledge of biological and medical importance. Our review could identify various components of epigenetic mechanisms known to be involved in the initiation and development of pancreatic ductal adenocarcinoma and related precancerous lesions, and novel pharmacological strategies that target these components could potentially lead to breakthroughs. We aim to highlight the possibilities that exist and the potential therapeutic interventions.

This study investigates the prognostic significance of Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) score and Prognostic Nutritional Index (PNI) in metastatic head and neck cancers. Retrospective analysis was conducted on data obtained from January 2014 to June 2022 for 68 patients using rigorous statistical methods. HALP and PNI scores, derived from routine laboratory parameters, were categorized into low and high groups using respective median values. Prognostic significance was determined through Kaplan-Meier survival analyses and Cox proportional hazards regression using IBM SPSS Statistics. Of the 68 patients (80.9% male, median age 57), 39 (57.4%) had laryngeal cancer. When stratified by low and high HALP scores, the median overall survival (OS) was 5.9 and 16.4 months, respectively (P < 0.001), while the median progression-free survival (PFS) was 5.7 months and 8.2 months, respectively (P: 0.016). In the low and high PNI score groups, the median OS was 7 and 13.2 months (P < 0.001), with median PFS of 5.6 months and 8.2 months (P: 0.002), respectively. In the multivariate analysis, while the HALP score did not reach statistical significance in terms of PFS, the PNI score and age groups were found to be statistically significant. In terms of OS, higher HALP score and PNI scores were significantly associated with longer OS. In this study, the HALP score and PNI score were found to be a prognostic factor in patients with metastatic head and neck cancer.

Is sarcopenia effective on survival in patients with metastatic gastric cancer?

Background and Objectives: This study aimed to investigate the prognostic value of the hemoglobin–albumin–lymphocyte–platelet (HALP) score—a marker reflecting both inflammatory and nutritional status—in patients with metastatic non-small cell lung cancer (NSCLC) undergoing immunotherapy. We also sought to determine whether dynamic changes in the HALP score during treatment could predict therapeutic success and help distinguish between pseudoprogression and hyperprogression. Materials and Methods: A retrospective analysis was conducted on 160 patients diagnosed with metastatic NSCLC and treated with immunotherapy at the Ankara Atatürk Sanatorium Training and Research Hospital. Chemotherapy regimens, metastatic sites, baseline and third-month hemograms and biochemistry parameters, and survival data were recorded. Survival outcomes were analyzed using the Kaplan–Meier method with the log-rank test and the Cox proportional hazards regression model using IBM SPSS Statistics. Results: The median overall survival (OS) for the entire cohort was 15 months (95% CI: 11.88–18.12). HALP1 score (p = 0.048), HALP2 score (p = 0.026), and hyperprogression (p < 0.001) were statistically significant predictors of OS. Regarding progression-free survival (PFS), the HALP2 score (p = 0.031), line of immunotherapy (p = 0.046), and hyperprogression (p < 0.001) were found to be significant. When comparing patients with increasing versus decreasing HALP scores, those with increasing HALP scores demonstrated significantly better outcomes for both OS (p = 0.034) and PFS (p = 0.007). Conclusions: In patients with metastatic NSCLC undergoing immunotherapy, the HALP score and its dynamic alterations during treatment appear to be non-invasive, easily calculable biomarkers that may predict both OS and PFS.

Objectives: This study aims to investigate the relationship between postprandial C-peptide-to-glucose ratio (PCGR), β-cell function and successful glycemic glycemic control in type 2 diabetes mellitus (DM) and determine the efficacy and feasibility of the PCGR index in the individualization of diabetes treatment. Materials and methods: This prospective study included a total of 49 patients (17 males, 32 females; mean age: 56±10 years; range, 32 to 75 years) under follow-up in Istanbul Medeniyet University Göztepe Training and Research Hospital Department of Internal Medicine with the diagnosis of type 2 DM between June and December 2016. Patients receiving insulin or insulin secretagogues were excluded. Data including age, sex, weight, height, waist circumference, hip circumference, date of DM diagnosis, serum hemoglobin A1c (HbA1c), and creatinine levels were recorded. All patients underwent a mixed meal test and their fasting blood glucose, C-peptide, postprandial glucose, and C-peptide levels were measured and recorded. Patients with a serum HbA1c level of 7% or lower were considered to have good glycemic control while patients with a serum HbA1c level of higher than 7% were considered to have uncontrolled diabetes. The relationship between C-peptide index (CPI), PCGR index, and parameters related to glycemia and β cell function was investigated. Results: Mean diabetes duration was 6.6±6 years and mean serum HbA1c level was 7.9±1.8%. There was a weak correlation between CPI and Homeostasis Model Assessment-β (HOMA-β), a moderate correlation between fasting C-peptide, delta C-peptide, and HOMA-β, and a strong correlation between fasting C-peptide, postprandial C-peptide, PCGR, and HOMA-β (p<0.05, p<0.05, p<0.001, respectively). There was a moderate negative correlation between postprandial C-peptide, delta C-peptide, fasting C-peptide-to-glucose ratio (FCGR), and serum HbA1c level (p<0.05). There was no correlation between fasting C-peptide and serum HbA1c level while there was a strong negative correlation between PCGR and serum HbA1c level (p<0.001). Comparison of the patient groups with and without glycemic control revealed that mean PCGR was significantly higher in the former group than the latter (p<0.001). Conclusion: We conclude that PCGR is significantly associated with glycemic control and variability. Our data suggest that PCGR is a useful index indicating β-cell function, and it can be used in the individualization of DM treatment.

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