(1) Background: Metastatic L-type sarcomas (liposarcoma and leiomyosarcoma) are rare and have a poor prognosis. Trabectedin is an effective agent that can be used after anthracyclines. This study was designed to evaluate the real-life effectiveness and safety of trabectedin. (2) Methods: A retrospective multicenter study was conducted on patients who were treated with trabectedin for metastatic L-type sarcomas at ten tertiary oncology centers between 2015 and 2023. The objective response rate (ORR), disease control rate (DCR), time to treatment failure (TTF), and overall survival (OS) were evaluated in the cohort. Cox regression analysis was used to determine prognostic factors for survival. (3) Results: A total of 98 patients (52% liposarcoma and 48% leiomyosarcoma) were included in the study. The median treatment line was three (range: 1 to 6). Thirteen patients (13.3%) underwent local treatment due to oligoprogression, and dose reduction was required in seventeen patients (17.3%) due to toxicity. The ORR and DCR were 16% and 42%, respectively. The median TTF was 3 months, and the median OS was 10 months. In univariate analysis, a significantly longer median TTF was observed in patients who underwent local treatment (p = 0.008), obtained objective responses (p < 0.001), and underwent dose reduction (p = 0.002). No statistical differences were observed according to the histologic subtype and metastatic site. In the multivariate analysis for OS, it was found that obtaining an objective response was a good prognostic factor (p = 0.003), while the presence of liver metastases was associated with a poor prognosis (p = 0.016). (4) Conclusion: Trabectedin is a suitable option for L-type sarcoma after doxorubicin-based treatments. Survival was not worse in patients who underwent dose reduction. The use of local therapies simultaneously with trabectedin can be effective.

Background: The pan-immune-inflammation value (PIV) has been associated with survival outcomes across various cancer types. This study investigates the association between PIV and overall and progression-free survival in endometrial cancer patients receiving adjuvant chemotherapy. Materials and methods: A retrospective analysis was conducted on 138 endometrial cancer patients treated at our center between January 2014 and January 2024. Eligible patients received adjuvant chemotherapy following surgery and had preoperative blood tests available for PIV calculation. PIV was calculated as neutrophil count × platelet count × monocyte count/lymphocyte count. Survival outcomes were analyzed using Kaplan-Meier and Cox regression methods. Results: The median PIV was 352 [interquartile range (IQR): 199–600], with higher scores significantly associated with advanced International Federation of Gynecology and Obstetrics (FIGO) stage (p = 0.007) and extensive lymphovascular invasion (LVI) (p = 0.03). Multivariate analysis identified PIV [hazard ratio (HR): 1.001, p = 0.015], FIGO stage III–IV (HR: 5.957, p < 0.001), adjuvant radiotherapy (HR: 0.288, p = 0.002), and extensive LVI (HR: 2.295, p = 0.014) as independent prognostic factors for overall survival (OS). A PIV greater than 350 was linked to a 3.2-fold increase in mortality risk (p < 0.001). Additionally, radiotherapy in conjunction with adjuvant chemotherapy significantly improved OS in patients with a high PIV ( > 350), but not in those with a low PIV (≤ 350). Conclusion: The PIV score is a significant prognostic marker for survival in endometrial cancer patients receiving adjuvant chemotherapy. Patients with a high PIV score may benefit from the addition of radiotherapy to their treatment regimen. Further studies are needed to validate the PIV score as a predictive marker for adjuvant radiotherapy in this population. Keywords: pan-immune-inflammation value PIV endometrial cancer

Background: Poly(ADP-ribose) polymerase (PARP) inhibitors have been established as a first-line maintenance therapy in advanced epithelial ovarian cancer (EOC) following platinum-based chemotherapy. While phase III trials have demonstrated significant progression-free survival (PFS) benefits with olaparib and niraparib, real-world data remain limited. Methods: This retrospective, multicenter real-world study included 179 patients with newly diagnosed epithelial ovarian treated with first-line maintenance olaparib or niraparib across 33 centers in Türkiye between January 2014 and March 2025. Clinical, pathological, and molecular data—including BRCA (Breast Cancer Susceptibility Gene) mutation status, origin, and variant classification—was collected. The primary endpoint was PFS, and secondary endpoints included overall survival (OS) and safety. Survival outcomes were analyzed using Kaplan–Meier methods. Results: Of 179 patients, 110 received olaparib and 69 received niraparib. BRCA mutations were present in 88.3% of patients, while 11.7% had unknown HRD status. Median follow-up was 16.5 months, and median PFS was not reached. Estimated PFS rates for the overall cohort were 91.0% at 6 months, 83.0% at 12 months, and 64.0% at 24 months. In the olaparib cohort, BRCA-mutant patients demonstrated PFS rates of 89%, 78%, 73%, and 64% at 6, 12, 18, and 24 months, respectively. In the niraparib cohort, corresponding PFS rates among BRCA-mutant patients were 87% at 6 months and 75% at 12 months. Patients harboring pathogenic BRCA variants experienced longer PFS compared with those with likely pathogenic variants. Any-grade adverse events occurred in 73.7% of patients, and grade 3–4 events in 29.6%, with hematologic toxicities predominating. Dose interruptions were more frequent with niraparib, while treatment discontinuation rates were low in both groups. No cases of myelodysplastic syndrome or acute myeloid leukemia were observed. Conclusions: In this large multicenter real-world cohort, first-line maintenance therapy with olaparib and niraparib provided durable PFS benefit in patients with advanced EOC, particularly among those with pathogenic BRCA mutations, confirming their effectiveness and manageable safety profiles in routine clinical practice.

Aim: Muscle-invasive bladder cancer requires systemic treatment due to its high risk of metastasis. However, studies comparing neoadjuvant and adjuvant therapy regimens are currently limited. Our goal in this study was to compare the treatment efficacy of patients receiving neoadjuvant or adjuvant treatment in locally advanced bladder cancer. Material and Methods: We retrospectively included 107 bladder cancer patients from 6 centres who underwent radical cystectomy and received perioperative chemotherapy. Patients were divided into 2 categories: (i) neoadjuvant chemotherapy (n=54) and (ii) adjuvant chemotherapy (n=53). Results: Median follow-up was 31.6 months (95%CI 21.8-41.4). 30-month disease-free survival (DFS) was 58.9% in the whole group, 56.3% in neoadjuvant and 61.5% in adjuvant. 30-month DFS after neoadjuvant treatment was 70.1% in