The aim of this study is to evaluate the efficacy and toxicity of trastuzumab emtansine (T-DM1) in cases with metastatic breast cancer (mBC) in different lines of treatment.Retrospective analysis o...

Background: In this study, we aimed to investigate the frequency, prognostic effect of codon, and amino acid specific KRAS mutations in patients with metastatic colorectal cancer (mCRC) and their predictive effect on irinotecan and oxaliplatin during first-line treatment. Methods: The data of 304 mCRC patients were retrospectively evaluated between 2010 and 2018. Patients were categorized according to the most prominent codon and amino acid mutation and their prognostic features were analyzed. Results: In total, 274 patients were included in the study and 128 patients (47%) revealed KRAS mutation. Median follow-up time was 19.8 months (range; 1.6–96). The median overall survival rates for patients with codons 12 and 13 mutations were 25.4 and 22.2 months, respectively (p = 0.4). Moreover, the median overall survival for the codon 12 mutant patients who received irinotecan-based chemotherapy in the first-line treatment was 42.7 months, whereas for the codon 13 mutant and KRAS wild-type patients, it was 18.3 and 23.9 months, respectively (codon 12 vs. codon 13; HR: 0.31, p = 0.03, codon 12 vs. wild-type; HR: 0.45, p = 0.03). Conclusion: The significant survival advantage was observed in patients with codon 12 mutations who received irinotecan-based chemotherapy as a first-line treatment.

Treatment options for metastatic renal cell carcinoma disease have been improved in recent years. However, there is still no optimal treatment sequence or combination for metastatic disease. We aimed to investigate whether patients differed in terms of disease outcomes regarding pre-nivolumab tyrosine kinase inhibitors (TKIs). The analysis of patients was performed after all cohorts were sub-grouped into two groups according to pre-nivolumab TKIs as following the sunitinib arm and the pazopanib arm. A total of 75 patients were included in this study. The median follow-up time was eight months for all cohorts. The objective response rate was statistically significantly higher in the pazopanib arm as compared to the sunitinib arm (56% vs 30%, p=0.02). Progression-free survival was significantly higher in pazopanib than sunitinib (10.3 months vs 5.3 months, p=0.02). Multivariate analysis revealed that pazopanib treatment was associated with better progression-free survival (HR: 0.44, 95 CI; 0.22-0.91, p=0.02). While the median overall survival for patients who had received sunitinib was 11.0 months, it has not been reached the median in the pazopanib arm (11.0 months vs NR, p=0.051). We demonstrated significantly better progression-free survival and a higher objective response rate with nivolumab treatment in patients who had received pazopanib as compared with patients who received sunitinib in the pre-nivolumab period.

Background and Objectives: Anorectal malignant melanoma (ARMM) is a rare and aggressive mucosal melanoma with a poor prognosis. Due to its rarity and nonspecific clinical presentation, diagnosis is often delayed, and prognostic data remain limited. Methods: In this retrospective study, 17 patients diagnosed with ARMM were identified from a cohort of 404 malignant melanoma cases treated at our center; however, only 14 patients with complete clinical and pathological data were included in the final analysis. Demographic, clinical, and histopathological data were collected. Disease stage, treatment modalities, and survival outcomes were analyzed. Event-free survival (EFS) and overall survival (OS) were calculated, and potential prognostic factors were evaluated using univariate and multivariate analyses. Results: The mean age at diagnosis was 58 ± 12 years, and six patients (42.9%) were female. The median follow-up duration was 13.3 months, and the median OS was 12.6 months. Six patients (42.9%) were initially misdiagnosed due to overlapping symptoms with benign anorectal conditions. At presentation, seven patients had localized disease, while six had distant metastases. Univariate analysis identified male sex and liver metastasis as adverse prognostic factors for OS; however, these associations were not statistically significant in multivariate analysis. Conclusions: ARMM is associated with poor survival outcomes, and liver metastasis and male sex may be linked to worse prognosis. Diagnostic delay is common due to nonspecific symptoms and frequent initial misdiagnosis, highlighting the need for increased clinical awareness. Further large-scale studies are warranted to better define prognostic markers and optimize management strategies.

Background/aim: Cancer of unknown primary (CUP) is a difficult clinical entity to manage. The aim of the study was to investigate the sociodemographic and pathological characteristics, treatment options, and factors affecting overall survival (OS) in CUP patients whose primary tumor was not detected during follow-up. Materials and methods: A total of 243 CUP patients whose primary tumors could not be detected during follow-up were included in the study. Their demographic characteristics, survival outcomes, and prognostic factors were investigated. Results: Of the 243 patients included in this study, 61.7% were male and 38.3% were female, and the median age was 61 (range: 19-90) years. The most common histological type was adenocarcinoma (79%). The median follow-up time of the patients was 30.3 months (95% CI: 11.4-49.3), the median OS time was 9.1 months (95% CI: 7.2-11.0), and 72.4% of the patients received at least 1 line of chemotherapy (CT). The difference in survival between the patients who did and did not receive CT was statistically significant (median OS: 10.1 vs. 4.2 months, p = 0.003). According to the multivariate analysis, the presence of cholestasis (HR: 0.48, 95% CI: 0.29-0.79, p = 0.004), lung metastasis (HR: 0.69, 95% CI: 0.51-0.95, p = 0.001), second-line chemotherapy (HR: 1.69, 95% CI: 1.14-2.49, p < 0.001), and Eastern Cooperative Oncology Group (ECOG) performance status (HR: 0.20, 95% CI: 0.10-0.40, p < 0.001) were independent prognostic factors influencing OS. Conclusion: CUP patients who receive multiple lines of chemotherapy tend to have longer survival. This is the first study to report cholestasis as a prognostic factor in CUP patients. In addition, the presence of lung metastases, not receiving second-line chemotherapy, and ECOG performance status (-2) were found to be independent poor prognostic factors.

Background/Objectives: Genomic profiling guides treatment in metastatic non-small-cell lung cancer (mNSCLC), yet country-level data from Türkiye remain limited. Methods: We retrospectively analyzed consecutive patients with mNSCLC diagnosed between January 2018 and March 2025 across tertiary centers in all seven regions. Variables included demographics, smoking, histology, testing modality (single-gene vs. next-generation sequencing [NGS]), targetable genomic alterations (TGAs) and co-mutations, and programmed death-ligand 1 (PD-L1) tumor proportion score. Results: Among 1023 patients (mean age 64 years; 76.4% male), tobacco exposure was frequent (mean 42.1 pack-years); 16.9% were never-smokers. NGS use increased over time, exceeding 90% by 2025. TGAs were detected in 28.3% (EGFR 16.0%, ALK 5.0%, KRAS G12C 2.6%, BRAF V600E 3.2%; ROS1, MET exon 14, HER2, NTRK ≤ 2.5%; no RET). EGFR alterations occurred in 19% of non-squamous carcinomas and 6% of squamous cell carcinomas (SCCs), suggesting an intermediate East–West pattern. Among NGS-tested samples, TP53 was the most frequent co-mutation (33.1%), followed by alterations in CDKN2A, PIK3CA, FGFR, STK11, and KEAP1. Conclusions: In this large, multicenter Turkish real-world cohort, the TGA spectrum broadly mirrors global patterns while revealing local nuances; EGFR mutations were more frequent than expected in SCC, and nationwide NGS adoption is accelerating. Limitations include retrospective design, non-centralized PD-L1 testing, and missing data. Prospective, standardized studies integrating outcomes and resistance mechanisms are warranted to refine regional precision oncology.