Background: Unplanned hospitalizations in patients with cancer are associated with adverse outcomes, including intensive care unit (ICU) transfer and in-hospital mortality. This study aimed to evaluate the predictive role of the prognostic nutritional index (PNI) and albumin-to-globulin ratio (AGR) for these outcomes in patients with unplanned hospitalization in a medical oncology ward. Methods: This retrospective, single-center study included patients aged ≥18 years with malignancy who had unplanned hospitalization between 1 January and 30 April 2025. PNI and AGR were calculated at admission. The primary outcome was ICU transfer or in-hospital mortality. Univariable and multivariable logistic regression analyses were performed, with AGR and PNI evaluated in separate models to avoid collinearity. Predictive performance was assessed using ROC analysis. Results: A total of 418 patients were included, with adverse clinical outcomes in 26.8%. Metastatic disease was present in 73.7%, and gastrointestinal (41.6%) and lung cancers (21.5%) were most common. In univariable analysis, metastatic disease (p < 0.001), Eastern Cooperative Oncology Group (ECOG) performance status (p < 0.001), cancer type (p = 0.030), reason for hospitalization (p = 0.001), AGR (p < 0.001), and PNI (p < 0.001) were significantly associated with adverse clinical outcomes. In multivariable analyses performed in separate models, ECOG ≥ 2 emerged as the strongest independent predictor of adverse clinical outcomes (AGR model: OR: 9.93; PNI model: OR: 11.14; both p < 0.001). Metastatic disease remained an independent risk factor, while higher AGR and PNI values were independently associated with a reduced risk (all p < 0.05). Among hospitalization reasons, only electrolyte imbalance/transfusion was associated with a lower risk, whereas most cancer type subgroups were not independently significant. Both indices showed moderate predictive performance, with PNI performing slightly better than AGR (AUC: 0.729 vs. 0.707). Conclusions: ECOG performance status, together with PNI and AGR, were identified as practical and accessible predictors of adverse clinical outcomes in patients with unplanned hospitalization in a medical oncology ward.

Aims: The CALLY index, integrating C-reactive protein (CRP), albumin, and lymphocyte count, has been identified as a promising prognostic biomarker in various cancers. The present study aims to evaluate its prognostic significance in De Novo metastatic colorectal cancer (mCRC). Methods: A retrospective analysis was conducted on 108 patients diagnosed with de novo mCRC at Ankara Etlik City Hospital (2021–2024). The CALLY index was calculated from baseline laboratory values and dichotomized at the median (0.2018). Progression-free survival (PFS) and overall survival (OS) were compared between low and high CALLY groups using the Kaplan–Meier method and log-rank test. The associations between the CALLY index and tumour location, as well as RAS/BRAF mutation status, were evaluated using the chi-square test. Cox regression analyses were also performed to determine independent prognostic factors. Results: Patients with elevated CALLY scores exhibited significantly prolonged median PFS (24.0 vs. 13.0 months; p

Background: Febrile neutropenia (FN) is a serious chemotherapy-related complication in patients with solid tumors. Identifying simple and accessible biomarkers that can predict prolonged hospitalization may support early risk stratification and clinical decision-making. Methods: This retrospective study included 169 adults hospitalized with FN between January 2023 and January 2025. Immunonutritional indices, including the Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score, the Prognostic Nutritional Index (PNI), and the C-reactive protein/albumin ratio (CAR), as well as the Clinical Index of Stable Febrile Neutropenia (CISNE) score were calculated. HALP and PNI were categorized using ROC-derived cut-offs based on the Youden Index. Prolonged hospital stay was defined as a binary variable based on the cohort median (>9 days). Spearman correlation, univariate and multivariate logistic regression were performed to identify predictors of prolonged hospitalization. Results: HALP showed a significant negative correlation with hospitalization duration (r = −0.469; p < 0.001), as did serum albumin (r = −0.184; p = 0.017) and PNI (r = −0.273; p < 0.001). CAR (p = 0.617) and neutrophil count (p = 0.955) demonstrated no correlation. In univariate logistic regression, low HALP (p < 0.001), low PNI (p = 0.001), intermediate CISNE (p = 0.002), high CISNE (p < 0.001), microbiological culture positivity (p < 0.001), and sex (p = 0.015) were significantly associated with prolonged hospitalization. Age, comorbidity status, metastatic stage, and CAR were not significant. In the multivariate model, low HALP (p < 0.001), intermediate CISNE (p = 0.007), high CISNE (p < 0.001), and culture positivity (p < 0.001) remained independent predictors. PNI (p = 0.400) and sex (p = 0.176) did not retain significance. Conclusions: A Low HALP score, higher CISNE risk categories, and microbiological culture positivity independently predicted prolonged hospitalization in FN. HALP, as a simple and inexpensive immunonutritional marker, may enhance early FN risk assessment when used alongside validated clinical tools such as CISNE or MASCC.

Background: Immune checkpoint inhibitors (ICIs) targeting the PD-1 axis represent standard second-line therapy for metastatic non-small cell lung cancer (NSCLC). Emerging data suggest that SARS-CoV-2 mRNA vaccines may enhance antitumor immunity through innate immune activation and type I interferon signaling, potentially sensitizing tumors to PD-1 blockade. The clinical impact of patients initiating second-line nivolumab remains unclear. Methods: In this retrospective single-center cohort study, 88 patients with recurrent stage IV NSCLC who received second-line nivolumab between 1 January 2023 and 1 January 2026 were analyzed. Vaccination exposure was defined using a 6-month pre-treatment window prior to nivolumab initiation (T0). Patients were stratified according to receipt of ≥2 versus 0–1 mRNA COVID-19 vaccine doses within the 6 months preceding T0 (n = 45 and n = 43, respectively). The primary endpoint was progression-free survival from nivolumab initiation (PFS2). Survival outcomes were estimated using the Kaplan–Meier method and evaluated using Cox regression models. Results: With a median follow-up of 22.4 months, median PFS2 for the overall cohort was 11.1 months (95% CI, 9.4–15.1). Patients receiving ≥2 mRNA doses had significantly longer PFS2 than those receiving 0–1 dose (14.0 vs. 9.6 months; p = 0.04). In multivariable analysis, ≥2 doses were independently associated with reduced risk of progression or death (aHR 0.52, 95% CI 0.31–0.88; p = 0.01). Non-adenocarcinoma histology and baseline brain metastasis were independently associated with shorter PFS2. Conclusions: Receipt of ≥2 mRNA vaccine doses within 6 months before nivolumab initiation was independently associated with prolonged PFS2 in metastatic NSCLC. Prospective multicenter validation is warranted.

Aims: Early identification of clinical deterioration and intensive care unit (ICU) needs in patients with solid tumors is crucial for improving outcomes. This study aimed to evaluate the predictive role of the HALP score and the modified Glasgow prognostic score (mGPS) in forecasting ICU admissions. Methods: A retrospective analysis was conducted on 302 patients with solid tumors who were hospitalized between May and July 2024. HALP and mGPS scores were calculated using laboratory values obtained at admission. Patients were divided into two groups based on the median HALP score. ICU transfer status was compared between groups along with clinical and laboratory parameters. Results: ICU transfer was required in 26.5% of the patients. ICU need was significantly more common in patients with low HALP scores and high mGPS values (p=0.01 and p<0.01, respectively). Metastatic patients had a significantly higher ICU transfer rate compared to non-metastatic patients (p=0.01). There was no significant association between ICU requirement and comorbidity status (p=0.59) or tumor type (p=0.10). Conclusion: HALP and mGPS are simple, accessible prognostic tools reflecting systemic inflammation and nutritional status. These scores may contribute to the early identification of high-risk patients during hospitalization and support timely clinical decision-making regarding ICU admission in cancer patients.