The treatment of stage III non-small cell lung cancer (NSCLC) is complex. Here, we aimed to examine the prognostic utility of sarcopenia and metabolic muscle volumes and evaluate their relationship with oncological treatments in patients with locally advanced NSCLC. Patients with unresectable stage III NSCLC were evaluated retrospectively. Muscle fields were measured, and metabolic parameters of the psoas were obtained. The skeletal muscle index (SMI), sarcopenia, sarcopenic obesity, and body mass index (BMI)-associated sarcopenia were evaluated. Fifty-three (94.6%) patients were men, and three (5.4%) were women. Sarcopenia was identified in 36 (64.3%) patients. Pretreatment sarcopenia and BMI-associated sarcopenia negatively affected overall survival (p = 0.040 and 0.023, respectively). A high psoas SUVmean (Standardized Uptake Value mean) and low mean psoas HU (Hounsfield unit) were poor prognostic factors (p = 0.009 and 0.014, respectively). SMI and muscle mass decreased after oncological treatment. Advanced age, inability to complete treatment, administration of chemoradiotherapy after chemotherapy, presence of sarcopenia, and a low mean psoas HU decreased survival. In conclusion, sarcopenia and BMI-associated sarcopenia are poor prognostic factors in patients with lung cancer. Oncological treatments can adversely affect muscle mass. The metabolic parameters of the psoas muscle can predict patient prognosis.

OBJECTIVES: Black cumin is widely used as a spice and as a traditional treatment. The active ingredient in black cumin seeds is thymoquinone. Thymoquinone has shown anticancer effects in some cancers. We planned to investigate its anticancer effect on pancreatic cancer cell lines.METHODS: Thymoquinone chemical component in various doses was prepared and inoculated on pancreatic cancer cell culture, healthy mesenchymal stem cells, and peripheral blood mononuclear cell culture. IC50 values were calculated by absorbance data and measuring cell viability by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide staining of cells incubated with thymoquinone at 24, 48, and 72 h.RESULTS: There was dose-related cytotoxicity. Maximal cytotoxicity was observed at 24 h and 100 mu M thymoquinone concentrations in pancreatic cancer cell culture and mesenchymal stem cells. Any concentration of thymoquinone was not cytotoxic to peripheral blood mononuclear cell. Thymoquinone even caused proliferation at a concentration of 6.25 mu M.CONCLUSIONS: Since the cytotoxic concentration of thymoquinone on pancreatic cancer cell culture and mesenchymal stem cells is the same, it is not appropriate to use thymoquinone to achieve cytotoxicity in pancreatic cancer. However, since thymoquinone provides proliferation in peripheral blood mononuclear cell at a noncytotoxic dose, it may have an immune activator effect. Therefore, in vivo studies are needed to investigate the effect of thymoquinone on the immune system.

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 and Objectives: Our study aimed to investigate the effect of RAS and TP53 mutations, either alone or in combination, on survival in patients with metastatic colorectal carcinoma (mCRC). Materials and Methods: Patients diagnosed with mCRC and followed up at our center between January 2019 and November 2023, who underwent somatic mutation analysis via next-generation sequencing (NGS) testing, were retrospectively evaluated. A total of 155 patients were evaluated within the scope of the study. Patients were grouped as mutant type (m) or wild type (w) for RAS and TP53. Survival times between the groups were examined using the Kaplan–Meier method. Cox regression analysis was performed for factors with a prognostic effect on survival. Results: Among the patients, 35.4% exhibited an RASm/TP53w mutation profile, 30.9% had RASw/TP53w, 20% had RASw/TP53m, and 13.5% had RASm/TP53m. The lowest median progression-free survival (mPFS) and median overall survival (mOS) durations were observed in the RASm/TP53w group (7.3 months and 16.9 months, respectively). Median OS was significantly lower in the RASm/TP53w group compared to the RASw/TP53w group (16.9 months vs. 26.0 months, p = 0.003), whereas no significant difference was found between mPFS durations. No statistically significant difference was observed between the RASw/TP53m and RASm/TP53m groups and the RASw/TP53w group for mPFS and mOS. The RASm/TP53w mutation profile was identified as an independent prognostic factor for decreased OS in the multivariate Cox regression analysis. Conclusions: In mCRC cases with the RASm/TP53w mutation profile, the mOS was significantly lower. The RASm/TP53w mutation profile was identified as an independent prognostic factor for decreased OS. These findings are expected to contribute to the literature as real-world evidence regarding the prognostic value of different RAS and TP53 mutation combinations in mCRC.

Background: Malignant bowel obstruction (MBO) is a condition secondary to intra-abdominal metastatic spread of advanced stage tumors. In this study, we aimed to evaluate the results of in the patients who were diagnosed with complete MBO and underwent palliative surgery treatment and to bring them to the attention of physicians. Methods: The patients who were treated for cancer and who were consulted from the surgery clinic due to MBO symptoms between January 2022 and December 2023 were identified and recorded. The age of the patients included in the study, computed tomography findings, oral food intake at the time of diagnosis and after treatment, nasogastric tube removal, symptom relief, hospital readmissions, total length of hospital stay, development of complications, hospital stay, and survival rates of the patients were compared. Results: The average age of the 24 patients in the study (13 females and 11 males) were 64.2 ± 10.07 years (range: 45–80). All patients underwent surgical treatment. In terms of the primary diagnosis of the patients, 12 patients (50%) had colorectal, 4 patients (16.6%) gastric, 3 patients (12.5%) ovarian, and 2 patients (8.3%) bladder cancers, while 2 patients (8.3%) had intra-abdominal spread of lung tumor and 1 patient (4.1%) had cancer of small intestine origin. In the evaluation of the level of obstruction in patients, it was observed that 11 patients (45.8%) had small intestine, 7 patients (29.1%) had colon obstruction while 6 patients (25%) developed colon and small intestine obstruction together. The length of stay in the hospital was 8.8 ± 5.5 days, recovery from nasogastric tube was 100%, the rate of restoring the oral food intake was 79%, and the rate of readmission to the hospital with the same complaints was 25%. Conclusion: The aim of palliative treatment is to increase the quality of life by eliminating the symptoms that impair the patient’s quality of life. According to our results, palliative surgery treatment in appropriate patients had positive effects on the patient’s quality of life. Further studies are needed to develop a common algorithm that would facilitate physicians’ decision-making in the selection of medical or palliative surgical treatment.

Germline BRCA1/2-mutated (gBRCAm) hormone receptor-positive/HER2-negative (HR+/HER2-) metastatic breast cancer (MBC) is a biologically distinct subset in which the efficacy of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors remains incompletely characterized. We evaluated real-world outcomes and prognostic factors in a multicenter retrospective Turkish cohort treated with a CDK4/6 inhibitor plus endocrine therapy (June 2020–September 2025). Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan–Meier and Cox methods. Among 121 patients, 30 (24.8%) had BRCA1, 88 (72.7%) had BRCA2, and three (2.5%) had dual mutations; 66.9% received first-line therapy, with ribociclib in 69.4% and palbociclib in 29.8%. Objective response rate was 69.4% and the clinical benefit rate was 82.6%. Median PFS was 17.0 months and OS 47.0 months. PFS was numerically longer in BRCA1 than in BRCA2 carriers (25.0 vs. 14.0 months), although the difference was not statistically significant in the pairwise comparison (HR 1.50, 95% CI 0.88–2.56; log-rank p = 0.135); the dual BRCA1/2 subgroup (n = 3) had the poorest outcomes and was assessed descriptively. OS did not differ significantly between BRCA1 and BRCA2 carriers (57.0 vs. 49.0 months; log-rank p = 0.520). PFS did not differ between ribociclib and palbociclib (p = 0.192); OS favored ribociclib at borderline significance (p = 0.050), but this was not confirmed in Cox regression. In multivariable analysis, ECOG ≥ 1 (HR 1.85; p = 0.010) and fulvestrant-based therapy (HR 1.74; p = 0.041) predicted shorter PFS; fulvestrant also predicted worse OS (HR 2.39; p = 0.008). CDK4/6 inhibitor-based therapy shows meaningful activity in gBRCAm HR+/HER2- MBC; the numerically poorer outcomes observed in BRCA2 carriers are hypothesis-generating and warrant validation in larger cohorts.