Introduction: Approximately 20–33% of all cancer patients are treated with acid-reducing agents (ARAs), most commonly proton pump inhibitors (PPIs), to reduce gastroesophageal reflux disease symptoms. Palbociclib and ribociclib are weak bases so their solubility depends on different pH. The solubility of palbociclib dramatically decreases to < 0.5 mg/ml when pH is above 4,5 but ribociclibs’ solubility decreases when pH increases above 6,5. In the current study, we aimed to investigate the effects of concurrent PPIs on palbociclib and ribociclib efficacy in terms of progression-free survival in metastatic breast cancer (mBC) patients. Patients and methods: We enrolled hormone receptor-positive, HER2-negative mBC patients treated with endocrine treatment (letrozole or fulvestrant) combined palbociclib or ribociclib alone or with PPI accompanying our observational study. During palbociclib/ribociclib therapy, patients should be treated with "concurrent PPIs" defined as all or more than half of treatment with palbociclib/ribociclib, If no PPI was applied, it was defined as ‘no concurrent PPI’, those who used PPI but less than half were excluded from the study. All data was collected from real-life retrospectively. Results: Our study included 217 patients, 105 of whom received palbociclib and 112 received ribociclib treatment. In the study population CDK inhibitor treatment was added to fulvestrant 102 patients ( 47%), to letrozole 115 patients (53%). In the Palbociclib arm fulvestrant/letrozole ratio was 53.3/46.7%, in the ribociclib arm it was 41.07/58.93%. Of 105 patients who received palbociclib, 65 were on concomitant PPI therapy, 40 were not. Of the 112 patients who received ribociclib, 61 were on concomitant PPI therapy, 51 were not. In the palbociclib group, the PFS of the patients using PPIs was shorter than the PFS of the patients not using (13.04 months vs. unreachable, p < 0.001). It was determined that taking PPIs was an independent predictor of shortening PFS (p < 0.001) in the multivariate analysis, In the ribociclib group, the PFS of the patients using PPIs was shorter than the PFS of the patients not using (12.64 months vs. unreachable, p = 0.003). It was determined that taking PPIs was single statistically independent predictor of shortening PFS (p = 0.003, univariate analysis). Conclusions: Our study demonstrated that concomitant usage of PPIs was associated with shorter PFS in mBC treated with both ribociclib and especially palbociclib. If it needs to be used, PPI selection should be made carefully and low-strength PPI or other ARAs (eg H2 antagonists, antacids) should be preferred.

BACKGROUND: The response of Renal Cell Cancer (RCC) to tyrosine kinase inhibitors (TKI) has been well established. Although these stratifications have been established for TKI response and prognosis, these parameters have recently been used to predict immunotherapy response in RCC. We aimed to use a combination of clinical parameters of International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk groups and metastatic sites at the time of diagnosis to predict the effectiveness of immune checkpoint inhibitors in malignant melanoma (MM). METHOD: In this cross-sectional study, we retrospectively analyzed the demographic information, metastatic sites, and IMDC risk group data. The blood parameters were included in the first cycle of nivolumab treatment. RESULTS: The OS was statistically different between the RCC and MM groups in terms of the IMDC. In univariate analysis of stage at diagnosis, CRP levels and bone and bone marrow metastases were confirmed to be prognostic factors in the MM population in terms of OS. Brain metastasis was a prognostic factor for RCC, whereas sex, line of treatment, LDH, bone, and splenic metastasis remained significant in patients with MM in terms of OS. Brain metastasis was prognostic in both cancer types in multivariate analysis in terms of PFS. In addition to brain metastasis, LDH levels and lung, liver, and splenic metastases also affect PFS in patients with MM undergoing nivolumab treatment. CONCLUSION: In our study, the IMDC was confirmed to be a prognostic factor for MM. The IMDC groups were similar, except for the favorable RCC and MM groups. Different metastatic sites were prognostic, similar to the IMDC risk group in the MM group.

Introduction: The monoclonal anti-vascular endothelial growth factor antibody bevacizumab is increasingly being used in the treatment of malignant tumors. It is the first molecular-targeted agent used in the treatment of several ovarian cancers. The typical side effects of this drug are hypertension and proteinuria. Bevacizumab-related acute pancreatitis (AP) has not been described before, but AP associated with other chemotherapeutic agents has been reported. Research has shown that patients can develop AP when taking sorafenib, a multiple tyrosine kinase inhibitor that inhibits VEGF. Case presentation: We explored the case of a 48-year-old woman who presented with undefined upper abdominal pain after receiving a cisplatin-gemcitabine-bevacizumab combination treatment as second-line therapy for metastatic ovarian cancer. Our patient was hospitalized because of AP after two cycles of this treatment. The patient started experiencing abdominal pain after the first course of chemotherapy. The severity and duration of this pain increased after the second cycle of chemotherapy. Her abdominal pain and elevated serum amylase disappeared when treated by chemotherapy without bevacizumab; this also improved her clinical pancreatitis. Conclusions: AP without other etiological factors can occur in patients treated by chemotherapy. Furthermore, bevacizumab might induce the side effects of AP.

Introduction and Aim: Cancer affects people psychologically and organically. The emotional state of cancer patients is fragile and can be affected by many factors. We aimed to evaluate the effect of the COVID-19 pandemic on the mood and behavioral changes of cancer patients with solid cancer who are in follow-up and treatment. Material and Method: A face-to-face questionnaire was filled in solid cancer patients without known psychological disorders who applied to the Medical Oncology outpatient clinic between 1-30 September 2021. The Hospital Anxiety and Depression Scale (HADS) and the scale examining the perspectives on COVID-19 were applied to the patients whose consent was obtained. Results: A total of 235 people, participated in the survey. In the review of 202 completed surveys, 139 women and 63 men and the median age was 55 (23-83 years). In the study in which seventeen different solid cancer patients were evaluated, breast (52.5%), colon (19.3%) and lung (10.8%) cancers were most common. Most of the people who were more afraid of COVID-19 compared to cancer were patients who were on active cancer treatment. In the multivariate regression analysis, being on active treatment was found to be the only risk factor for 'being more afraid of COVID-19' compared to cancer. During COVID-19 pandemic, it was observed that 18 (8.9%) patients delayed their treatment/follow-up due to fear of COVID-19 infection. A high HADS anxiety score was observed in 58 (28.7%) patients, and a high HADS depression score was observed in 39 patients (19.3%). Conclusion: Cancer patients are seriously worried about the progression of their cancer due to changes in follow-up or treatment due to COVID-19 pandemic. However, despite the associated risks, they were found to want to continue their treatment as planned.