Background and Objectives: Despite advances in immunotherapy, predicting survival outcomes in patients with non-small-cell lung cancer (NSCLC) remains challenging. Inflammatory and nutritional indices such as the Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Inflammatory Burden Index (IBI) have emerged as promising prognostic markers associated with overall survival (OS) in NSCLC patients. Materials and Methods: We retrospectively analyzed a total of 196 NSCLC patients treated with second-line nivolumab across multiple centers in Turkey. Of these, 101 patients aged ≥ 65 years were included in the elderly subgroup analysis. PNI, GNRI (in patients aged ≥ 65), and inflammation-based indices were calculated using pre-treatment laboratory values. ROC analysis determined optimal cut-off values. The Kaplan–Meier method and Cox proportional hazards models were used for survival analysis. Results: Median overall survival (OS) was 12.9 months in the full cohort and 12.1 months in patients aged ≥ 65. In univariate analysis, ECOG performance status (0–1), lower NLR (<3.3), lower PLR (<196.8), higher PNI (≥45.2), and higher GNRI (≥98.0) were significantly associated with longer OS. However, in the multivariate analysis adjusted for ECOG PS, NLR, PLR, and GNRI, only PNI remained an independent prognostic factor for OS in both the overall cohort [HR: 0.49, 95% CI: 0.26–0.92; p = 0.02] and elderly patients [HR: 0.45, 95% CI: 0.24–0.84; p = 0.01]. PNI is an independent prognostic biomarker for OS in NSCLC patients treated with immune checkpoint inhibitors. Conclusions: These findings support incorporating simple, cost-effective nutritional indices into clinical decision-making, particularly in elderly patients with NSCLC.

We aimed to evaluate the efficacy and safety of a combination of nab-paclitaxel and gemcitabine as a second-line treatment, after first-line treatment with FOLFIRINOX regimen, for metastatic or locally advanced unresectable pancreatic cancer. This national multicenter retrospective study included patients with metastatic or unresectable locally advanced pancreatic cancer treated with FOLFIRINOX in the first-line setting. After progression with first-line treatment, all patients were treated with nab-paclitaxel and gemcitabine as second-line treatment. This study included 180 patients across 15 centers with a median age of 60 years. The median overall survival (OS) of all patients was 17.9 months. The median progression-free survival (PFS) following first-line chemotherapy was 8.4 months, whereas the median PFS achieved with nab-paclitaxel plus gemcitabine treatment was 5.5 months. Regarding treatment-related adverse events (TRAEs), all grades of non-hematologic adverse events (AEs) occurred at expected rates. However, the incidence of hematologic TRAEs was lower than anticipated. Grade 5 TRAEs were not observed. Patients who responded well to first-line FOLFIRINOX demonstrated a trend toward better outcomes with NG, although this did not reach statistical significance. The combination of nab-paclitaxel and gemcitabine is safe and effective as second-line treatment for locally advanced unresectable or metastatic pancreatic cancer after FOLFIRINOX.

Background and Objectives: Perioperative fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) is the standard of care for resectable gastric and gastroesophageal junction adenocarcinoma; however, up to 50% of patients develop metastatic recurrence. These patients have prior exposure to platinum and taxane agents, and optimal first-line treatment in the metastatic setting remains undefined. This study aimed to characterize real-world treatment patterns and outcomes in patients progressing after perioperative FLOT, focusing on relapse timing and HER2 status. Materials and Methods: This retrospective, multicenter cohort study included 296 patients from 31 centers across Türkiye, stratified into early relapse (≤6 months, n = 114) and late relapse (>6 months, n = 182) groups. Survival analyses were performed using the Kaplan-Meier method and Cox proportional hazards regression. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Results: Median PFS and OS for the entire cohort were 6 and 9 months, respectively. Early relapsers had significantly shorter median PFS (4 vs. 6 months, p = 0.029) and OS (8 vs. 12 months, p = 0.047); however, early relapse timing did not retain independent prognostic significance on multivariable analysis. No significant difference in PFS or OS was observed between cytotoxic chemotherapy regimens in either relapse group. HER2 positivity was the only independent predictor of improved PFS on multivariable Cox analysis (HR 0.48, 95% CI 0.29–0.81; p = 0.006). In the late relapse group, trastuzumab-based chemotherapy achieved a median PFS of 14 months and OS of 18 months, significantly superior to all cytotoxic regimens (PFS p = 0.007; OS p = 0.029). Conclusions: In patients progressing after perioperative FLOT, cytotoxic chemotherapy regimen selection did not demonstrate a statistically significant survival difference in this retrospective cohort, regardless of relapse timing. HER2 positivity is the dominant predictive biomarker, and trastuzumab-based therapy suggests a potential survival benefit that warrants prospective validation. Comprehensive biomarker profiling at metastatic diagnosis and prospective trials designed for this post-FLOT population are needed to establish evidence-based treatment standards.

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.

UYARI Bu üründe yer alan bilgiler sadece lisanslı tıbbi çalışanlar için kaynak olarak sunulmuştur. Herhangi bir konuda profesyonel tıbbi danışmanlık veya tıbbi tanı amacıyla kullanılmamalıdır. Akademisyen Kitabevi ve alıcı arasında herhangi bir şekilde doktor-hasta, terapist-hasta ve/veya başka bir sağlık sunum hizmeti ilişkisi oluşturmaz. Bu ürün profesyonel tıbbi kararların eşleniği veya yedeği değildir. Akademisyen Kitabevi ve bağlı şirketleri, yazarları, katılımcıları, partnerleri ve sponsorları ürün bilgilerine dayalı olarak yapılan bütün uygulamalardan doğan, insanlarda ve cihazlarda yaralanma ve/veya hasarlardan sorumlu değildir. İlaçların veya başka kimyasalların reçete edildiği durumlarda, tavsiye edilen dozunu, ilacın uygulanacak süresi, yöntemi ve kontraendikasyonlarını belirlemek için, okuyucuya üretici tarafından her ilaca dair sunulan güncel ürün bilgisini kontrol etmesi tavsiye edilmektedir. Dozun ve hasta için en uygun tedavinin belirlenmesi, tedavi eden hekimin hastaya dair bilgi ve tecrübelerine dayanak oluşturması, hekimin kendi sorumluluğundadır. Akademisyen Kitabevi, üçüncü bir taraf tarafından yapılan ürüne dair değişiklikler, tekrar paketlemeler ve özelleştirmelerden sorumlu değildir.