Background: The Meet-URO score combines the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) criteria with neutrophil-to-lymphocyte ratio (NLR) and bone metastasis status. Although developed in immune checkpoint inhibitor (ICI) cohorts, its performance among patients receiving first-line tyrosine kinase inhibitor (TKI) monotherapy is uncertain. Methods: We performed a multicenter, retrospective cohort study of 301 adults with histologically confirmed metastatic renal cell carcinoma (mRCC) treated with first-line TKI monotherapy (sunitinib, pazopanib, or cabozantinib) between 2008 and 2025 across five tertiary centers in Turkey. The primary endpoint was overall survival (OS). Meet-URO was calculated at treatment start and analyzed as prespecified risk strata (0–4, 5–8, 9). Kaplan–Meier estimates, Cox models, and Harrell’s C-index assessed discrimination, with bootstrapped 95% CIs. Results: Median follow-up was 40 months; median OS (mOS) was 25 months (95% CI, 21–29) and median progression-free survival was 10 months (95% CI, 8–12). Meet-URO stratified OS: 41 months for scores 0–4, 21 months for 5–8, and 7 months for 9 (log-rank p < 0.001). In multivariable analysis, Meet-URO remained independently prognostic (HR 1.73 for 5–8 vs. 0–4; HR 3.57 for 9 vs. 0–4; both p < 0.001). Discrimination was modest (C-index 0.722) and slightly lower than IMDC (C-index 0.745). NLR ≥ 3.2 was associated with inferior OS (19 vs. 37 months; p < 0.001). Bone metastasis was not significantly associated with OS (p = 0.27). Conclusions: Meet-URO is a valid prognostic tool for mRCC patients treated with first-line TKIs and identifies an ultra-high-risk subgroup (score = 9) with poor survival. While not superior to IMDC, Meet-URO may offer complementary risk information to support clinical monitoring and trial referral, particularly in settings where ICI combinations are restricted.

Background/Objectives: Uveal melanoma (UM) is a subtype of melanoma that originates from the uveal layer of the eye (iris, ciliary body, choroid) and is biologically distinct from cutaneous melanoma. The real-world evidence on treatment patterns and survival outcomes, particularly from non-Western populations, remains limited. This study provides a comprehensive national overview of local and systemic management of UM across Türkiye. Methods: This multicenter retrospective cohort study, coordinated by the Turkish Oncology Group (TOG), included patients diagnosed with UM between 2012 and 2025 across 19 tertiary oncology centers. Clinical characteristics, treatment patterns, and outcomes were analyzed. Systemic therapies were subgrouped as immunotherapy or cytotoxic chemotherapy. Progression-free survival (PFS) and overall survival (OS) were assessed by the Kaplan–Meier method; prognostic factors for OS were analyzed by Cox regression. Results: A total of 113 patients were included; 89.4% presented with localized disease. During follow-up, 43.4% developed metastases, predominantly hepatic (93.5%). 47.4% of metastatic patients received liver-directed treatments; the most common treatment was radioembolization, and these treatments were associated with longer OS. Among 59 patients receiving systemic therapy, immunotherapy demonstrated higher ORR and DCR than chemotherapy across treatment lines, although small subgroup sizes limited statistical significance. Dual immune checkpoint blockade emerged as an independent favorable prognostic factor in multivariate analysis. Median OS for metastatic patients was 16 months (95% CI: 9.3–22.7). HLA-A*02:01 was positive in 29.4% of patients tested, and only three patients received tebentafusp. Conclusions: This large national cohort highlights substantial real-world heterogeneity in treatment patterns and confirms the limited efficacy of chemotherapy, the prognostic benefit of dual ICI therapy, and the potential survival advantage of liver-directed treatments in selected patients. Low HLA-A*02:01 positivity and limited access to tebentafusp remain major challenges in Türkiye. These findings provide an essential benchmark for improving treatment strategies in metastatic UM.

Background and Objectives: The prognostic significance of dynamic changes in glomerular filtration rate (GFR) during targeted therapies in metastatic renal cell carcinoma (mRCC) is not well understood. Thus, we aimed to investigate the prognostic significance of GFR value at 6 months in patients with mRCC receiving first-line targeted therapy. Materials and Methods: This retrospective cohort study included 260 mRCC patients at two tertiary centers in Turkey between 2015 and 2025. Patients were stratified into three groups according to GFR at 6 months: ≥60, 30–60, and <30 mL/min/1.73 m². Kaplan–Meier curves were used to estimate progression-free survival (PFS) and overall survival (OS) in prognostic subgroups. Cox proportional hazard models assessed associations between clinicopathologic variables, including GFR categories, and PFS and OS. Results: The median PFS for the cohort was 11.1 months (95% confidence interval [CI]: 9.3–12.9), and the median OS was 40.0 months (95% CI: 30.3–49.7). In multivariate analysis, GFR < 30 mL/min/1.73 m² was independently associated with shorter PFS (hazard ratio [HR]: 1.54, 95% CI: 1.01–2.33, p = 0.040) and OS (HR: 3.80, 95% CI: 2.06–7.01, p < 0.001), while GFR 30–60 mL/min/1.73 m² was linked to reduced OS (HR: 2.07, 95% CI: 1.08–3.98, p = 0.028). Additional independent predictors of worsened PFS were intermediate (p = 0.028) and poor IMDC risk (p < 0.001. For OS, liver metastases (p = 0.017), bone metastases (p = 0.014), brain metastases (p = 0.002), and intermediate (p = 0.014) or poor IMDC risk (p < 0.001) were also significant. Conclusions: In patients with mRCC treated with targeted therapy, the GFR at 6 months is an independent factor in predicting survival outcomes, indicating the clinical significance of serial kidney function monitoring.

Leptospirosis is the most common bacterial zoonosis globally, especially in tropical and temperate regions with heavy rainfall. Infection into humans occurs in direct contact with the urine of the sick animals’ contact with the environment contaminated with urine. The clinical spectrum of leptospirosis is quite broad. It is subclinical in 90% of cases. Multiple organ failure, especially kidney, liver, and lung, can be seen in 5-10% of cases [1-2]. Weil’s disease is the most severe form of leptospirosis. It progresses with liver dysfunction, acute renal failure, thrombocytopenia, and fever; If left untreated, it can be fatal at 1-5% [3]. In our case, a 60-year-old patient with fever, hyperbilirubinemia, acute renal failure, and thrombocytopenia will be discussed. Keywords: Liver dysfunction, acute renal failure, thrombocytopenia, fever

Background: Human epidermal growth factor receptor 2 (HER2) alterations have been implicated as mechanisms of resistance to anti-epidermal growth factor receptor (anti-EGFR) therapy in metastatic colorectal cancer (mCRC). We aimed to evaluate the predictive and prognostic significance of HER2 expression in patients with RAS wild-type mCRC in a real-world setting. Methods: We conducted a multicenter retrospective cohort study across ten oncology centers in Turkey, including patients with RAS wild-type mCRC treated between 2015 and 2022. Clinical outcomes, including progression-free survival (PFS) and overall survival (OS), were compared between HER2-positive and HER2-negative groups. Multivariable Cox proportional hazards models were used to identify independent predictors of survival outcomes. Results: Among 204 patients, 28 (13.7%) were HER2-positive. Baseline characteristics were generally comparable; however, HER2-positive patients showed a trend toward higher-grade tumors and were significantly less likely to receive anti-EGFR therapy. HER2-positive patients had significantly shorter PFS compared to HER2-negative patients (median 10 vs. 13 months; p = 0.006). In multivariable analysis, HER2 positivity remained an independent predictor of shorter PFS (HR 1.76, 95% CI 1.01–3.07; p = 0.045). In the subgroup of 144 patients receiving anti-EGFR therapy, HER2-positive patients also demonstrated significantly shorter PFS (median 9.0 vs. 14.0 months; p = 0.023). No significant differences in OS were observed between groups. Conclusions: HER2 positivity is associated with reduced response to anti-EGFR therapy and independently predicts shorter PFS in patients with RAS wild-type mCRC. These findings further support the role of HER2 as a clinically relevant biomarker in RAS wild-type mCRC, particularly in predicting response to anti-EGFR therapy, while highlighting the need for optimized patient selection strategies in the era of HER2-targeted treatments.

1. Gastric cancer ranks among the top five malignancies globally in terms of incidence and remains a leading cause of cancer-related mortality. Current global statistical data indicate that while g...