Objective: This study investigated effect of zaprinast and avanafil on vascular endothelial growth factor (VEGF), bone morphogenic protein (BMP) 4 and 7, and vitamin D₃ levels against the negative effect of dexamethazone. Method: Rats were randomly divided into four groups (n = 6). Control: Empty a syringe was immersed and removed subcutaneously. Dexamethasone (DEX): 120 µg/kg DEX was injected subcutaneously once a day for 28 days. DEX + zaprinast and DEX + avanafil groups: 10 mg/kg zaprinast and avanafil were administrated to rats in addition to the same procedure in the DEX, respectively. VitaminD₃, VEGF, BMP4 and 7 levels by enzyme linked immunosorbent assay (ELISA) and angiogenesis by histopathological/immunohistochemical were evaluated. Results: BMP4 values in the DEX were lower than the other groups (p < .05). DEX + zaprinast and DEX + avanafil exhibited an increase in all the parameters compared to the control and DEX (p < .05). However, these were not significant for the DEX + zaprinast (p > .05). Also, there was a significant increase in angiogenesis in the DEX + zaprinast and DEX + avanafil. Conclusion: Zaprinast and significantly avanafil induced vitamin D₃, BMP4 and 7 levels by increasing angiogenesis in renal.

Chemotherapy is the most important treatment option for patients diagnosed at an advanced stage. Chemotherapy both prolongs survival and increases the quality of life. Today, there is still no definite information about whether doublet or triplet chemotherapy should be chosen in empirical therapy. Therefore, we designed our study to evaluate first-line treatment options in metastatic gastric cancer.Our study is retrospective and involves five centers in Turkey. Inclusion criteria were the presen

Objective: CDK4/6 inhibitors constitute standard first-line therapy for hormone receptor (HR)-positive, HER2-negative metastatic breast cancer (MBC). We investigated real-world predictors of overall survival (OS), with particular focus on high ER expression (≥90%). Methods: In this multicenter, retrospective study, we analyzed 603 HR-positive/HER2-negative MBC patients treated with CDK4/6 inhibitors (ribociclib or palbociclib) between May 2020 and June 2024. We evaluated demographic, clinical, and pathological factors for their impact on OS using univariate and multivariate Cox regression analyses. Results: In univariate analysis, significantly longer OS was observed in endocrine therapy-naive patients (median OS: 51.0 vs. 33.3 months; p < 0.001), those without liver metastases (50.0 vs. 34.0 months; p = 0.019), bone-only metastases (57.7 vs. 40.5 months; p = 0.022), and PR-positive patients (50.0 vs. 36.0 months; p = 0.037). Patients with ER expression ≥90% showed a strong trend toward longer OS (49.0 vs. 41.0 months; p = 0.072). In multivariate analysis, endocrine therapy naivety (p = 0.045) and high ER expression (≥90%) (p = 0.031) emerged as independent predictors of superior OS. Conclusions: Our study identifies treatment naivety and exceptionally high ER expression (≥90%) as key independent predictors of prolonged OS in CDK4/6 inhibitor-treated MBC patients. These findings underscore the importance of early CDK4/6 inhibitor implementation and suggest that quantitative ER assessment may refine patient selection beyond conventional positivity thresholds.

Objective: Pancreatic cancer is a very fatal disease and is estimated to be the second leading cause of cancer deaths in the USA in 2030. Chemotherapy is usually the most important treatment option in metastatic pancreatic ductal adenocarcinoma and is applied for palliative purposes. FOLFIRINOX, which is a multi-drug regimen, is an important treatment option in patients with good performance in order to overcome chemoresistance in this desmoplastic cancer. Surgery is the most important way to eliminate chemoresistance in pancreatic cancer. FOLFIRINOX is preferred in adjuvant therapy because the disease reoccurs even in patients who can undergo surgery and it gives better survival results than gemcitabine. There is data suggesting that patients with pancreatic ductal adenocarcinoma who underwent surgery for the primary lesion and subsequently metastasized may have a better response with the FOLFIRINOX regimen than patients with metastatic presentation (de novo metastatic). This retrospective study was planned to investigate the response of previously operated patients who developed metastases (surgical group) and those with metastatic disease at the time of diagnosis (de novo metastatic group) to the FOLFIRINOX regimen. Materials and Methods: 35 patients followed between 2013 and 2017 were included in the study and their medical records were examined. Results: Progression free survival of surgery group was median 10 months. De novo metastatic group progression free survival was median 6 months (table 2). Surgery group progression free survival was statistically significant longer than de novo metastatic group (p:0.033). Surgery group overall survival was 20 months. De novo metastatic group overall survival was 7 months. Surgery group overall survival was statistically significant longer than de novo metastatic group (p:0.020). Conclusion: According to the results of our study, FOLFIRINOX treatment is more effective in patients with pancreatic ductal adenocarcinoma who underwent surgery for a primary pancreatic tumor and then developed metastasis. Therefore, regardless of performance, administration of FOLFIRINOX may be appropriate in patients who have undergone surgery. In addition, surgical treatments can be applied to metastatic patients to reduce the disease burden, since better results are obtained in patients who have been operated for palliative purposes. Randomized studies with larger patient populations are needed to validate our results.