Kaposi sarcoma (KS) is a rare disease caused by human herpesvirus-8 (HHV-8) infection, that occurs in the elderly and more often in men. We aimed to compare the clinical and prognostic features of patients with classic and AIDS-related KS who have been followed in our clinic over the last 10 years and to present real-life data in first-line treatment. We retrospectively reviewed the medical records of 73 patients with KS, 57 with classic KS and 16 with acquired immunodeficiency syndrome (AIDS)-related KS, who were followed up at our clinic between January 2014 and December 2023. Information analyzed included demographic characteristics, clinical features, treatment modalities and prognosis of the patients. The median follow-up period was 44 months in the classic KS group and 20 months in the AIDS-related group. The median age at diagnosis of classic KS patients was 67 years and 82.5% of the patients were male. The median age at diagnosis of AIDS-related KS patients was 41 years and all patients were male. The majority of patients had an Eastern Cooperative Oncology Group performance status of 0 or 1, and comorbidities were more common in the classic KS group. The most common site of involvement in both groups was the lower extremity. 48% and 69% of patients with classic KS and AIDS-related KS, respectively, received first-line systemic chemotherapy. All patients with AIDS-related KS received antiretroviral therapy. Paclitaxel was the most preferred first-line agent in both groups. An optimal overall response rate of 78% was achieved in patients with both classic KS and AIDS-related KS. 5-year overall survival was 75% in patients with classic KS and 93% in patients with AIDS-related KS. This real-world, single-center experience provides insight into the management of patients with KS in a developing country and highlights the need to improve access to standard first-line treatment.

Many developing countries lack access to recommended first-line treatments for metastatic renal cell carcinoma (mRCC), such as immune checkpoint inhibitors (ICIs) or ICI-tyrosine kinase inhibitor (TKI) combinations. As a result, predictive markers are necessary to identify patients who may benefit from single-agent TKIs for long-term response. This study aims to identify such parameters. This was a multi-centre, retrospective study of patients with mRCC who were undergoing first-line treatment with sunitinib or pazopanib. Patients who had been diagnosed with mRCC and had not experienced disease progression for 36 months or more were deemed to have achieved a long-term response. Predictive clinical and pathological characteristics of patients who did not experience long-term disease progression were investigated. A total of 320 patients from four hospitals were included in the study. The median age of the patients was 60 years (range 20-89 years). According to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk classification, 109 patients were classified as having favourable risk and 211 were in the intermediate-poor risk group. The median progression-free survival (PFS) and overall survival (OS) for all patients were 12.5 months and 76.4 months, respectively. In the long-term responder’s group, the median PFS was 78.4 months. Among all patients, prior nephrectomy, the Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) <1, and the absence of brain metastasis were predictive factors for long-term response. For patients in the favourable risk group, the lack of brain metastasis was a predictor of long-term response. In the intermediate-poor risk group, prior nephrectomy and ECOG PS <1 were predictive factors for long-term response. Some individuals with mRCC may experience a durable response to TKIs. The likelihood of a long-term response can be determined by factors such as nephrectomy, ECOG PS < 1, and the absence of brain metastases.

Background and Objectives: Clinically meaningful drug–drug interactions may be overlooked in oncology. Proton pump inhibitors (PPIs) may modulate outcomes with immune checkpoint inhibitors (ICIs) by altering the gut microbiome, altering the immune milieu, and affecting transporter interactions. We evaluated whether concomitant PPI use affects survival among patients with metastatic non-small cell lung cancer (NSCLC) treated with nivolumab. Materials and Methods: We retrospectively included patients with metastatic NSCLC who received second-line nivolumab across five oncology centers (January 2020–June 2023). Patients were grouped as concomitant PPI users vs. non-users. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan–Meier method and compared with the log-rank test; multivariable Cox models assessed independent associations. Results: A total of 194 patients were screened, of whom 30 were excluded according to predefined criteria. The final analysis included 164 patients—85 PPI users and 79 non-users. Median OS was 26.1 months (95% CI 15.5–36.7) in PPI users and 29.3 months (22.2–36.4) in non-users; this difference was not statistically significant (p = 0.54). Median PFS was 6.2 months (3.7–8.6) in PPI users vs. 10.2 months (7.1–13.2) in non-users (p = 0.04). In multivariable analysis, absence of concomitant PPI use (No vs. Yes) was independently associated with longer PFS (HR = 0.52, 95% CI 0.24–0.89, p = 0.03), whereas PPI use was not associated with OS (HR = 0.96, 95% CI 0.67–1.61, p = 0.83). Conclusions: Concomitant PPI use during nivolumab therapy was associated with significantly shorter PFS and a numerical reduction in OS in real-world metastatic NSCLC. Where clinically feasible, the need for PPIs should be re-evaluated before and during ICI therapy.

Triple-negative breast cancer (TNBC) is an aggressive subtype with limited treatment options and poor prognosis. Effective prognostic tools are essential to guide risk-adapted strategies following neoadjuvant chemotherapy (NACT). In this multicenter retrospective study, we evaluated 690 patients with locally advanced TNBC treated between 2010 and 2023 across 25 oncology centers. Patients were stratified into CPS-EG risk groups: low (0–1), intermediate (2–3), and high (≥4). The CPS-EG score was strongly associated with pathological complete response (pCR), recurrence, disease-free survival (DFS), and overall survival (OS). Five-year DFS rates were 80.6%, 53.2%, and 31.5% in the low-, intermediate-, and high-risk groups, respectively, while OS rates were 76.7%, 53.2%, and 48.8% (p<0.001). Multivariate analysis confirmed CPS-EG as an independent predictor of both DFS and OS after adjusting for clinicopathological factors. These findings highlight the CPS-EG score as a simple, cost-effective, and widely applicable prognostic tool that may improve post-NACT risk stratification and support treatment decisions, especially in resource-limited oncology settings.

Ejmi Eurasian Journal of Medical Investigation

Aim: Metastatic renal cell carcinoma (mRCC) with lung metastases is associated with poor prognosis, and there is a growing interest in systemic inflammatory markers as potential prognostic indicators. This study evaluates the prognostic significance of the Systemic Immune-Inflammation Index (SII), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to- Lymphocyte Ratio (PLR), and Advanced Lung Cancer Inflammation Index (ALI) in patients with mRCC. Material and Methods: In our retrospective and multicenter study, we analyzed 76 mRCC patients with isolated lung metastases. Clinical data, including demographic characteristics, treatment details, and inflammatory markers, were collected. Patients were stratified according to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk classification. The association of clinical and laboratory parameters with progression-free survival (PFS) and overall survival (OS) was analyzed using Kaplan-Meier curves and Cox proportional hazards models. Results: The median age of the patients was 61 years (IQR: 29-84), with the majority being male (74%) and smokers (57%). High SII, NLR, and PLR were significantly associated with poor IMDC risk classification (p=0.001, p=0.003, and p=0.001, respectively). Multivariate analysis identified age >65 years (HR 3.09, 95% CI 1.3-6.9, p=0.006) and high PLR (HR 5.9, 95% CI 2.2-15.8, p=0.001) as independent predictors of worse OS. ALI was not significantly associated with survival outcomes. Conclusion: Systemic inflammatory markers, particularly SII, NLR and PLR are strongly associated with poor prognosis in mRCC patients with lung metastases. These markers could be integrated into existing prognostic models to improve risk stratification and guide clinical decision-making. Further research is warranted to validate these findings and explore the underlying mechanisms linking systemic inflammation to RCC progression.