In the primary analysis of the randomized phase III KEYNOTE-811 trial (NCT03615326), pembrolizumab plus trastuzumab and chemotherapy improved progression-free survival and overall survival versus placebo plus trastuzumab and chemotherapy in participants with previously untreated human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer. Overall, 698 participants were randomly assigned (1 : 1) to pembrolizumab 200 mg or placebo every 3 weeks, both with trastuzumab and chemotherapy. We report prespecified exploratory patient-reported outcomes (PROs), including change from baseline, time to deterioration (TTD), and overall improvement/stability rate assessed in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) scales/items, EORTC Quality of Life Questionnaire-Stomach 22 pain scale, and EuroQoL 5-dimension 5-level questionnaire visual analog scale. The PRO population comprised 685 participants. At baseline, the rates of compliance and completion for all PRO questionnaires and for both treatment groups were >92%; at week 24, the rates were >80% and >55%, respectively. No between-group differences were observed from baseline to week 24 for the QLQ-C30 global health status/quality of life (GHS/QoL) scale [least squares mean (LSM) difference -1.16; 95% confidence interval (CI) -4.23 to 1.91] and EQ VAS (LSM difference, -0.69; 95% CI -3.06 to 1.68). Median TTD was not reached. A similar proportion of participants in each treatment group had improved and/or stable scores in the QLQ-C30 GHS/QoL scale (pembrolizumab group 71.9%; placebo group 71.5%). Findings were similar for all other prespecified scales/items. While improving clinical outcomes, the addition of pembrolizumab to trastuzumab and chemotherapy did not negatively impact health-related quality of life during treatment, supporting the use of pembrolizumab plus trastuzumab and chemotherapy for first-line treatment of HER2-positive advanced gastric cancer.

Background and Objectives: Despite developments in cervical cancer (CC) treatment, an advanced stage is a poor prognostic factor. Cervical cancer is an immunogenic tumor in which viruses, like HPV, play a role in carcinogenesis. Therefore, systemic inflammatory markers (SIMs) may have prognostic value. Most studies on SIMs focus on the early stage by evaluating pretreatment levels. This study aims to evaluate the prognostic and predictive values of both pretreatment and post-treatment parameters at the advanced stage, as well as treatment efficacy after progression with first-line treatment. Materials and Methods: A total of 133 advanced-stage CC patients with progression on first-line platin–paclitaxel and bevacizumab were evaluated retrospectively. Demographic and histopathological characteristics were recorded along with treatment details. Pre-treatment baseline blood parameters and post-treatment follow-up values were recorded to calculate SIMs as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI). Results: Median values for SIMs were accepted as cut-off values. Post-treatment values demonstrated stronger predictive power, with pre-treatment SIRI and NLR being significant only in univariate analysis, but not in multivariate analysis. High post-treatment SIRI (>2.1) was correlated with shorter overall survival (OS) and considered a poor prognostic factor. High post-treatment SIRI (>2.1), -SII (>746), and -PLR (>197) emerged as independent prognostic factors for progression-free survival (PFS). Their prognostic values were clearer in the whole population and the metachronous metastatic subgroup. Rechallenge of platinum-based chemotherapy was an option for those who had at least 6 months of PFS with first-line platinum-based chemotherapy. Bevacizumab addition to single-agent or combination regimens led to improved ORR as well. Conclusions: Post-treatment SIRI is a promising prognostic factor for OS, while post-treatment SIRI, SII, and PLR may serve as convenient SIMs for PFS. Platinum-based combination chemotherapy reinduction is a feasible second-line treatment strategy, especially with the addition of bevacizumab.

Background: Finding dependable prognostic biomarkers for metastatic colorectal cancer (mCRC) is crucial. The albumin-to-carcinoembryonic antigen (CEA) ratio (ACR), a measure of nutritional-inflammatory status and tumor load, has emerged as a promising prognostic indicator. This study assessed ACR’s prognostic value of ACR in patients with mCRC. Methods: This retrospective study included 125 patients with mCRC followed at our institution between July 2010 and March 2022. ROC curve analysis was used to determine the optimal cutoff values for ACR, prognostic nutritional index (PNI), lymphocyte-to-monocyte ratio (LMR), and CEA. Kaplan–Meier and Cox regression analyses were used to evaluate progression-free survival (PFS) and overall survival (OS). Results: PFS and OS were 13.3 and 26.0 months, respectively. Patients with an ACR ≥ 4.24 experienced significantly longer PFS (16.8 vs. 11.0 months; p = 0.001) and OS (32.0 vs. 22.3 months; p < 0.001) compared with those with ACR < 4.24. In univariable analyses, ACR was significantly associated with both PFS and OS, whereas PNI, LMR, and CEA were associated with OS only. In multivariable Cox regression models ACR showed a significant association with both PFS (HR 0.413; 95% CI: 0.265–0.643; p < 0.001) and OS (HR 0.341; 95% CI: 0.210–0.551; p < 0.001), while maintenance therapy was significantly associated with PFS only and ECOG performance status, LMR and PNI with OS only. Conclusions: ACR appears to be a cost-effective biomarker that is associated with PFS and OS in mCRC. These findings suggest that ACR may have potential value for prognostic assessment and risk stratification in patients with mCRC.

Background/Objectives: Genomic profiling guides treatment in metastatic non-small-cell lung cancer (mNSCLC), yet country-level data from Türkiye remain limited. Methods: We retrospectively analyzed consecutive patients with mNSCLC diagnosed between January 2018 and March 2025 across tertiary centers in all seven regions. Variables included demographics, smoking, histology, testing modality (single-gene vs. next-generation sequencing [NGS]), targetable genomic alterations (TGAs) and co-mutations, and programmed death-ligand 1 (PD-L1) tumor proportion score. Results: Among 1023 patients (mean age 64 years; 76.4% male), tobacco exposure was frequent (mean 42.1 pack-years); 16.9% were never-smokers. NGS use increased over time, exceeding 90% by 2025. TGAs were detected in 28.3% (EGFR 16.0%, ALK 5.0%, KRAS G12C 2.6%, BRAF V600E 3.2%; ROS1, MET exon 14, HER2, NTRK ≤ 2.5%; no RET). EGFR alterations occurred in 19% of non-squamous carcinomas and 6% of squamous cell carcinomas (SCCs), suggesting an intermediate East–West pattern. Among NGS-tested samples, TP53 was the most frequent co-mutation (33.1%), followed by alterations in CDKN2A, PIK3CA, FGFR, STK11, and KEAP1. Conclusions: In this large, multicenter Turkish real-world cohort, the TGA spectrum broadly mirrors global patterns while revealing local nuances; EGFR mutations were more frequent than expected in SCC, and nationwide NGS adoption is accelerating. Limitations include retrospective design, non-centralized PD-L1 testing, and missing data. Prospective, standardized studies integrating outcomes and resistance mechanisms are warranted to refine regional precision oncology.

Background: This retrospective cohort study evaluated the role of the PILE score as a prognostic biomarker for overall survival (OS) and progression-free survival (PFS) in patients with locally advanced esophageal squamous cell carcinoma (ESCC) who were treated with neoadjuvant chemoradiotherapy (nCRT). Methods: This study included 108 patients with ESCC treated with weekly paclitaxel-carboplatin and concurrent radiotherapy at Erzurum Atatürk University Faculty of Medicine Hospital between January 2018 and April 2024. Patients were categorized into low- (PILE score 0–1) and high-risk (PILE score 2–3) groups. Kaplan–Meier analysis and Cox regression models were used to evaluate the association between the PILE score and survival outcomes. Results: The results showed that the high-risk PILE group had significantly shorter median OS (18.6 months vs. not reached; p < 0.001) and PFS (12.4 months vs. not reached; p < 0.001) than the low-risk group. Multivariate analysis showed that the PILE risk classification [hazard ratio (HR) = 2.527; 95% confidence interval (CI): 1.380–4.629; p = 0.003] and surgical resection (HR = 0.249; 95% CI: 0.090–0.683; p = 0.007) were independent prognostic factors for OS, whereas the PILE risk classification (HR = 2.932; 95% CI: 1.525–5.639; p = 0.001) and surgical resection (HR = 0.131; 95% CI: 0.044–0.394; p < 0.001) were independent prognostic factors for PFS. Conclusions: The study concludes that the PILE score is a robust prognostic tool for OS and PFS in patients with ESCC undergoing nCRT, highlighting its potential for risk stratification and personalized treatment planning.

Background: Gastric cancer remains a leading cause of cancer mortality, and additional prognostic tools reflecting host inflammation and nutritional status are needed, particularly in patients receiving neoadjuvant regimens such as fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT). This study aimed to evaluate the prognostic significance of the Gustave Roussy Immune (GRIm) score in patients with locally advanced gastric cancer treated with neoadjuvant FLOT. Methods: This retrospective single-center study included 128 patients with locally advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma treated with neoadjuvant FLOT between 2018 and 2022. The GRIm score, based on albumin, lactate dehydrogenase (LDH), and neutrophil-to-lymphocyte ratio (NLR), was used to stratify patients into low- and high-risk groups. Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan–Meier and Cox proportional hazards regression models. Results: Among 128 patients (mean age, 61.5 years; 63.3% male), 69.5% underwent surgical resection, and 24.7% achieved a pathological complete response. During a median follow-up of 36.9 months, 57.0% of patients experienced disease progression and 48.4% died. The median OS and PFS were 49.9 and 25.5 months, respectively. The GRIm score demonstrated moderate discriminative ability for mortality (area under the curve [AUC]: 0.704) and was significantly associated with survival. The median OS was shorter in the high-risk group than in the low-risk group (35.2 vs. 69.6 months, p < 0.001), and the median PFS was also shorter in the high-risk group (17.2 months vs. not reached, p < 0.001). In the multivariate analysis, high GRIm risk remained independently associated with worse OS (hazard ratio [HR]: 1.832, p = 0.030) and PFS (HR: 2.491, p < 0.001), along with age, clinical stage, and surgical resection status. Conclusions: In this single-center retrospective cohort study, the GRIm score was associated with survival outcomes in patients with locally advanced gastric or GEJ adenocarcinoma receiving neoadjuvant FLOT. These findings suggest that the GRIm score may provide additional risk stratification when interpreted in conjunction with established clinical factors. However, external validation in larger prospective cohorts is required before it can be applied in routine clinical practice.