Background: Hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer frequently involves liver metastases, which are linked to poor outcomes. The optimal first-line treatment strategy in this subgroup remains unclear. Methods: This multicenter, retrospective study evaluated 121 patients with HR-positive, HER2-negative breast cancer and liver metastasis who had not received prior systemic chemotherapy or cyclin-dependent kinase (CDK) 4/6 inhibitors (e.g., palbociclib, ribociclib). Patients were classified based on their initial treatment during the liver metastatic phase (CDK4/6 inhibitors or chemotherapy). Clinical characteristics, treatment patterns, and survival outcomes were assessed. Cox regression analysis identified independent prognostic factors. Results: The median age was 53 years; 62% were postmenopausal. Chemotherapy was administered to 36.4%, and CDK4/6 inhibitors to 63.6% of patients. Most cases (59.5%) were recurrent disease. Baseline characteristics were comparable, except for the use of local liver-directed therapies. Progression-free survival favored CDK4/6 inhibitors (10.9 vs. 4.8 months; p < 0.01), while overall survival favored chemotherapy (42.2 vs. 25.9 months; p = 0.042). In multivariate analysis, initial treatment modality, local liver-directed therapy, hormonal status, and the size of the largest liver lesion were independent predictors of survival. Conclusions: In patients with HR-positive, HER2-negative breast cancer and liver metastasis, first-line chemotherapy was associated with improved overall survival compared to CDK4/6 inhibitors. Local liver-directed therapies contributed to longer survival, while larger liver lesions and endocrine-resistant disease correlated with worse outcomes. These findings support considering chemotherapy as first-line treatment in selected patients with aggressive liver metastatic disease.

Although microtubule inhibitors are generally used in advanced stages, they provide the opportunity to prolong survival as an alternative when medical oncologists have difficulty finding options in their patients, who typically have a poor prognosis and most of whom are unresponsive to treatment. For this reason, we wanted to investigate the effect of ixabepilone treatment on survival in earlier metastatic lines. Our study also examined the frequency of side effects and survival differences in patients whose dose was reduced or whose treatment was discontinued. Our study includes patients diagnosed with metastatic breast cancer who received ixabepilone treatment between January 2011 and January 2021. Median overall survival (OS) in the group receiving ixabepilone on the 5th line and before was 22.0 months (95% CI: 21.0–22.9), in the group receiving ixabepilone after the 5th line was calculated as 10.0 months (95% CI: 8.9–11.0) (P < .001). Median OS (months) in the group receiving ixabepilone on the 4th line and before was 26.0 (95% CI: 23.6–28.3), in the group receiving ixabepilone after the 4th line was determined as 12.0 (95% CI: 10.5–13.4) (P < .001). Dose reduction or discontinuation of ixabepilone treatment in patients due to side effects did not affect OS and progression-free survival with ixabepilone statistically significantly. Ixabepilone treatment has side effects, similar to all other treatments used in metastatic breast cancer, however, these side effects are manageable. Additionally, since ixabepilone treatment is preferred in patients who have previously received many different chemotherapeutics and experienced cumulative toxicity, the side effects of ixabepilone may seem to be greater than they are. In our study, we showed that ixabepilone treatment has a statistically significant positive effect on survival if preferred in earlier metastatic lines. As similar studies increase in centers where ixabepilone treatment is generally given in advanced metastatic lines, treatment approaches may change in the coming years.

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.

Introduction: High recurrence rates and the emergence of resistance mechanisms in ovarian cancer necessitate exploring alternative therapeutic strategies except platinum-based chemotherapies. This has led to the development of bevacizumab, a recombinant humanized monoclonal antibody targeting VEGF. Nevertheless, the continuation of bevacizumab treatment initiated alongside chemotherapy, especially after disease progression, remains a topic of debate. Materials and Methods: Our study involved a single-center retrospective analysis of the medical records of patients diagnosed with stage 3 and 4 epithelial ovarian cancer between June 2011 and January 2023. All patients in our study were platinum-sensitive. Results: Patients with residual disease > 1 cm following initial surgery had significantly worse median OS (p = 0.002). Post-progression, patients were divided into two groups based on whether bevacizumab was continued. More than half of the patients who continued treatment with bevacizumab and chemotherapy achieved a 5-year OS, which was statistically superior (p < 0.001). When comparing PFS between patients who did and did not receive bevacizumab in the second line following recurrence/progression, those treated with bevacizumab demonstrated a median PFS of 12.0 months (95% CI: 10.5– 13.4), which was significantly better (p < 0.001). The hazard ratio for mortality in patients continuing bevacizumab treatment beyond progression was 0.11 (95% CI: 0.05– 0.22) (p < 0.001). Conclusion: Many studies have shown the effectiveness and survival benefit of bevacizumab in epithelial ovarian cancer. In contrast, the literature offers limited studies addressing the survival benefits of continuing bevacizumab beyond disease progression. However, our study indicates that continuing bevacizumab beyond progression significantly contributes to both OS (p < 0.001) and PFS (p < 0.001). As larger studies with similar results to ours are conducted in the future, current guidelines may improve, and the decision to continue bevacizumab treatment after progression may become more evidence-based.