Background/Objectives: In the REGOMA trial, regorafenib demonstrated an overall survival advantage over lomustine, and it has become a recommended treatment for recurrent glioblastoma in guidelines. This study aimed to evaluate the effectiveness and safety of regorafenib as a third-line treatment for patients with recurrent glioblastoma who progressed while taking bevacizumab-based therapy. Methods: This retrospective, multicenter study in Turkey included 65 patients treated between 2021 and 2023 across 19 oncology centers. The main inclusion criteria were histologically confirmed isocitrate dehydrogenase (IDH)-wildtype glioblastoma, progression after second-line bevacizumab-based treatment, and an Eastern Cooperative Oncology Group (ECOG) performance status score of ≤2. Patients received regorafenib 160 mg once daily for the first 3 weeks of each 4-week cycle. Results: The median age of the patients was 53 years (18–67 years), with a median progression-free survival of 2.5 months (95% Confidence Interval: 2.23–2.75) and a median overall survival of 4.1 months (95% CI: 3.52–4.68). The median overall survival was improved in patients who received subsequent therapy after regorafenib treatment compared with those who did not (p = 0.022). Progression-free survival was longer in patients with ECOG 0–1 than in those with ECOG 2 (p = 0.042). The safety profile was consistent with that of the REGOMA trial, with no drug-related deaths observed. Conclusions: Regorafenib shows good efficacy and safety as a third-line treatment for recurrent glioblastoma after bevacizumab-based therapy. This study supports the use of regorafenib and emphasizes the need for further randomized studies to validate its role and optimize treatment strategies.

Background: Reliable biomarkers that capture tumor–host interactions and predict treatment resistance in extensive-stage small cell lung cancer (SCLC) remain limited. We evaluated the prognostic and predictive value of the pretreatment lactate dehydrogenase-to-albumin ratio (LAR), an integrative biomarker reflecting metabolic activity, systemic inflammation, and host nutritional status. Methods: This multicenter, retrospective cohort study included patients with extensive-stage SCLC treated at five tertiary centers between 2016 and 2024. Pretreatment LAR was calculated using baseline serum lactate dehydrogenase and albumin levels and dichotomized using a Youden index-derived cut-off at the 12-month overall survival (OS) horizon. Time-dependent receiver operating characteristic (ROC) analyses using inverse probability weighting were performed to assess discriminative performance. Survival outcomes were evaluated using Kaplan–Meier estimates and Cox proportional hazards models. Associations with platinum resistance and lack of objective treatment benefit (defined as progressive disease as best response) were examined using logistic regression models. Results: A total of 223 patients were included. Elevated LAR was associated with inferior OS (median, 15.8 vs. 25.2 months; log-rank p < 0.001) and progression-free survival (7.9 vs. 11.5 months; p < 0.001). In multivariable analysis, LAR remained independently associated with OS (HR, 1.43; 95% CI, 1.04–1.95; p = 0.028). LAR demonstrated modest but consistently superior discriminative performance compared with other inflammatory indices for both 12-month OS (area under the curve [AUC], 0.692) and 6-month progression-free survival (PFS) (AUC, 0.646), with statistically significant differences in DeLong comparisons. Higher LAR was independently associated with increased odds of platinum resistance (adjusted odds ratio [aOR], 2.31; 95% CI, 1.41–3.81; p = 0.001) and lack of objective treatment benefit (adjusted OR, 2.04; 95% CI, 1.33–3.14; p = 0.001). Conclusions: Pretreatment LAR is a clinically accessible and biologically integrative biomarker associated with survival and treatment resistance in extensive-stage SCLC. By capturing tumor–host interactions, LAR may support risk stratification and identify patients at increased risk of early treatment failure. Prospective validation is warranted to define its role in biomarker-driven clinical decision-making.

Background/Objectives: Delayed diagnosis in psoriatic arthritis (PsA) is associated with significant health consequences. We hypothesize that musculoskeletal (MSK) surgery rates may be higher during the diagnostic delay period. This study aimed to compare the frequency of MSK surgeries in PsA patients during the period of diagnostic delay with the frequency of MSK surgeries post-diagnosis. Methods: This retrospective cohort study included PsA patients who fulfilled CASPAR criteria and were followed up on in our outpatient clinic. The pre-diagnosis symptomatic period was considered as the period of diagnostic delay. Data on MSK surgeries were obtained from patient records. The annual number of surgeries was calculated separately for the diagnostic delay and post-diagnosis periods. Results: The study included 84 PsA patients. The mean diagnostic delay in PsA patients was 7.49 years. During this period, 27.4% of patients underwent at least one MSK surgery. The mean annual number of MSK surgeries was significantly higher during the diagnostic delay period compared to the post-diagnosis period (Z = −3.18, p = 0.001, r = 0.35). Conclusions: Following PsA diagnosis, a reduction in MSK surgery rates was observed compared to during the diagnostic delay period. This suggests that inflammatory symptoms in PsA patients, which could have been managed with medical therapy, may have led to avoidable MSK surgeries. These findings highlight the potential for early diagnosis to reduce the rate of musculoskeletal surgery and associated healthcare costs.

Background Uterine leiomyosarcoma is a rare and aggressive malignancy with limited responsiveness to standard therapies. We conducted a real-world, multicenter study to compare the clinical efficacy and safety of two commonly used first-line chemotherapy regimens—doxorubicin–ifosfamide and gemcitabine–docetaxel—in patients with metastatic uterine leiomyosarcoma. Methods This retrospective cohort included 271 patients with advanced or metastatic uterine leiomyosarcoma treated between 2010 and 2023 across 30 centers in Turkey. Patients received either doxorubicin–ifosfamide (n = 142) or gemcitabine–docetaxel (n = 129) as first-line therapy. The primary endpoint was overall survival; secondary endpoints included progression-free survival, objective response rate, disease control rate, and safety. Adverse events were graded according to the Common Terminology Criteria for Adverse Events version 5.0, while survival outcomes were estimated using the Kaplan–Meier method and further analyzed with Cox proportional hazards models. Results Median overall survival was 19.7 months with doxorubicin–ifosfamide and 20.2 months with gemcitabine–docetaxel (P = .26). Median progression-free survival was 5.5 months with doxorubicin–ifosfamide and 7.0 months with gemcitabine–docetaxel (P = .62). The objective response rate was numerically higher with gemcitabine–docetaxel (35% vs. 26%), although not statistically significant (P = .11). Grade 3–4 neutropenia (16% vs. 12%) and febrile neutropenia (7% vs. 6%) were more frequent with doxorubicin–ifosfamide. Conclusions In this largest-to-date real-world cohort of metastatic uterine leiomyosarcoma, doxorubicin–ifosfamide and gemcitabine–docetaxel demonstrated comparable survival outcomes. Gemcitabine–docetaxel, however, was associated with a more favorable hematologic safety profile. These findings support the clinical utility of both regimens while underscoring the need for prospective, biomarker-driven studies to refine treatment selection and improve personalization in this rare malignancy.

Adjuvant nivolumab is standard for locally advanced esophageal cancer patients without pathological complete response after neoadjuvant chemoradiotherapy, and this study evaluated its efficacy and the predictive value of the Glasgow Prognostic Score on survival. We retrospectively analyzed 33 patients diagnosed with stage II-III esophageal squamous cell carcinoma (ESCC) who were followed at our center between January 2020 and January 2025. These patients had undergone neoadjuvant chemoradiotherapy followed by R0 resection yet exhibited residual disease (ypT1-4 or ypN+). The relationship between disease-free survival (DFS) and overall survival (OS) and GPS (0,1,2) was analyzed. Our study shows that adjuvant nivolumab is effective in ESCC, with superior responses in patients with low Glasgow Prognostic Score and markedly reduced benefit in those with high GPS. Mean DFS was 43.2 months in GPS 0 patients (median not reached), compared with median DFS of 12 and 5 months in the GPS 1 and GPS 2 groups, respectively. Mean OS in the GPS 0 group was 49.5 months (median not reached), while median OS decreased to 27 months in GPS 1 and 10 months in GPS 2 patients. Adjuvant nivolumab improves survival in locally advanced ESCC with residual disease. Lower Glasgow Prognostic Score is associated with improved DFS and OS, underscoring the role of systemic inflammation in immunotherapy response. GPS may be a simple and cost-effective predictive biomarker for adjuvant immunotherapy.

Background/Objectives: Delayed diagnosis in psoriatic arthritis (PsA) is associated with significant health consequences. We hypothesize that musculoskeletal (MSK) surgery rates may be higher during the diagnostic delay period. This study aimed to compare the frequency of MSK surgeries in PsA patients during the period of diagnostic delay with the frequency of MSK surgeries post-diagnosis. Methods: This retrospective cohort study included PsA patients who fulfilled CASPAR criteria and were followed up in our outpatient clinic. PsA patients fulfilling the CASPAR criteria and followed in our outpa-tient clinic were included. The pre-diagnosis symptomatic period was considered as the period of diagnostic delay. Data on MSK surgeries were obtained from patient records. The annual number of surgeries was calculated separately for the diagnostic delay and post-diagnosis periods. Results: The study included 84 PsA patients. The mean diagnos-tic delay in PsA patients was 7.49 years. During this period, 27.4% of patients under-went at least one MSK surgery. The mean annual number of MSK surgeries was signifi-cantly higher during the diagnostic delay period compared to the post-diagnosis period (P = 0.001). Conclusion: Following PsA diagnosis, a reduction in MSK surgery rates was observed compared to the diagnostic delay period. This suggests that inflammatory symptoms in PsA patients, which could have been managed with medical therapy, may have led to avoidable MSK surgeries. Our findings highlight the need for early diagnosis to prevent unnecessary surgical interventions.