Background/Objectives: Metastatic testicular germ cell tumor (mGCT) is a highly curable disease with first-line cisplatin-based combination chemotherapy. This study aims to evaluate the clinicopathological characteristics and survival outcomes of patients with metastatic testicular cancer in a nationwide multicenter cohort. Methods: This multicenter retrospective cohort study included 316 male patients diagnosed with mGCT who were treated with first-line cisplatin-based chemotherapy across 10 institutions in Turkey between 2011 and 2024. Clinical and pathological data, including International Germ Cell Cancer Collaborative Group (IGCCCG) risk classification, treatment details, and survival outcomes, were analyzed. Results: The median age of the cohort was 28 years, and 76.3% of patients were diagnosed with non-seminoma. According to IGCCCG risk stratification, 53.2% had good-risk, 25.3% intermediate-risk, and 21.5% poor-risk disease. Median follow-up was 38.4 months. Among patients with seminoma, the 5-year overall survival (OS) rate was 100% in the good-risk group and 87.5% in the intermediate-risk group. In patients with non-seminoma, 5-year OS rates were 96.6%, 86.9%, and 65.1% in the good-, intermediate-, and poor-risk groups, respectively. Among 125 patients who received salvage treatment, high-dose chemotherapy (HDCT) significantly improved survival in the International Prognostic Factors Study Group (IPFSG) very high-risk group (3-year OS: 55.0% vs. 16.3% with conventional-dose chemotherapy (CDCT), p = 0.007). Conclusions: This study provides the first large-scale nationwide dataset on mGCT outcomes in Turkey, demonstrating overall survival rates comparable to international cohorts. The findings emphasize the importance of a multidisciplinary approach, adherence to treatment guidelines, and optimal surgical interventions in improving patient outcomes.

Background and Objectives: Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers and remains a leading cause of cancer-related mortality worldwide. EGFR-targeted tyrosine kinase inhibitors (TKIs) have substantially improved outcomes in EGFR-mutant NSCLC; however, primary and acquired resistance continues to limit their long-term efficacy. HER3 (receptor tyrosine-protein kinase ErbB3), a member of the ErbB receptor family, has been implicated in TKI resistance through heterodimerization with EGFR and HER2, leading to downstream PI3K/AKT pathway activation. Despite its biological plausibility as a resistance mediator, the clinical significance of HER3 expression as a prognostic and predictive biomarker in EGFR-mutant NSCLC has not been thoroughly characterized in real-world cohorts. Materials and Methods: This retrospective, single-center study included 52 patients diagnosed with EGFR-mutant NSCLC who received TKI therapy at Afyonkarahisar Health Sciences University between January 2011 and September 2023. HER3 protein expression was evaluated by immunohistochemistry (IHC) on formalin-fixed, paraffin-embedded tumor tissue sections using the Huabio anti-HER3 antibody (clone PD00-44, 1:2000 dilution). Staining in more than 30% of tumor cells was considered HER3-positive; membranous staining intensity was scored on a 1–3 scale. Progression-free survival (PFS1, PFS2) and overall survival (OS) were analyzed using the Kaplan–Meier method and log-rank test. Statistical significance was set at p < 0.05. Results: Of 52 patients (55.8% female; mean age 64.5 years), 59.6% received chemotherapy and 40.4% received an EGFR TKI as first-line treatment; erlotinib constituted 71.2% of targeted therapies. In the first-line TKI group, HER3-negative patients had a numerically longer median PFS1 compared with HER3-positive patients (14.0 vs. 7.1 months; p = 0.285); however, this difference did not reach statistical significance and should be interpreted with caution given the small sample size. In contrast, among patients receiving first-line chemotherapy, HER3 staining status did not meaningfully affect PFS1 (4.1 vs. 2.5 months; p = 0.063). In second-line treatment, HER3-positive patients who received TKI after prior chemotherapy demonstrated a PFS2 comparable to or slightly exceeding that of HER3-negative patients (21.8 vs. 19.8 months; p = 0.49), suggesting that the sequencing of chemotherapy before TKI may attenuate the adverse effect of HER3 positivity. Median OS was 15.1 months in HER3-negative patients and 12.7 months in HER3-positive patients (p = 0.824); this numerical difference of approximately 3 months did not reach statistical significance and should therefore be interpreted cautiously. Among patients receiving TKI in the first line, HER3-positive patients had a shorter median OS than HER3-negative patients (9.6 vs. 14.2 months), whereas those receiving TKI in the second line showed a trend toward longer OS in HER3-positive patients (20.5 vs. 17.2 months). Conclusions: HER3 expression was associated with reduced first-line TKI efficacy in EGFR-mutant NSCLC, suggesting a possible role for HER3 in primary TKI resistance; however, these findings are exploratory and did not reach statistical significance. The observation that HER3-positive patients who received chemotherapy before TKI demonstrated outcomes comparable to HER3-negative patients raises the hypothesis that treatment sequencing may potentially influence the impact of HER3 positivity, though this requires prospective validation before any clinical conclusions can be drawn. These results suggest that HER3 expression may warrant further investigation as a candidate biomarker for treatment sequencing decisions and as a potential therapeutic target in EGFR-mutant NSCLC. Prospective studies evaluating chemotherapy–TKI sequencing and HER3-directed agents such as patritumab deruxtecan (HER3-DXd) in HER3-positive patients are needed to confirm these preliminary observations.

Many studies have been published on the association between IFN-λ3 and IFN-λ4 polymorphisms and treatment related or spontaneous clearance of chronic hepatitis C. To date there is little known about the impact of IFN-λ4 polymorphisms on the natural history of chronic hepatitis B(CHB). This study aimed to investigate the role of IFN-λ4 polymorphisms on the course of CHB and to influence the presence of spontaneous clearance (SC) in CHB patients. One hundred and twenty-two patients who had CHB, and 81 subjects who had spontaneous resolution of HBV were analyzed regarding IFN-λ4 rs12979860 and rs11322783 single‑nucleotide polymorphisms. We couldn’t found any significant difference between CHB groups and SC groups in terms of IFN-λ4 rs12979860 polymorphisms and, the CC, C/T and TT genotypes represented 49%, 45% and 5% of CHB patients and, %46, 43% and 11% of SC group respectively (p=0.65). On the other hand, in IFN-λ4 rs11322783 polymorphisms analysis, recessive G/G allele was more common in SC group compared to CHB group (5% vs 16%, p=0.04; OR: 3,55). Moreover, non-G/G genotypes had significantly higher in CHB patients compared to SC group (95% vs 84%, p=0.013; OR:3.55). Our results suggest that IFN-λ4 rs11322783 polymorphism may be a predictor of spontaneous clearance in HBV infected patients. The role of IFN-λ4 polymorphisms needs to be investigated in the natural history of HBV.

This study aims to evaluate the effectiveness and real-world applicability of total neoadjuvant therapy (TNT) in patients with locally advanced rectal cancer (LARC), focusing on pathological complete response (pCR) and disease-free survival (DFS) across different chemotherapy regimens. In this multicenter retrospective study, patients treated between January 2019 and January 2023, 437 patients with locally advanced rectal cancer who underwent total neoadjuvant therapy followed by surgery were analyzed. Standard fluoropyrimidine-based chemotherapy regimens (CAPOX, FOLFOX, or FOLFIRINOX) were used according to institutional practice, and long-course chemoradiotherapy constituted the predominant radiotherapy approach. Patients were grouped based on chemotherapy sequencing as induction, consolidation, or sandwich regimens. Outcomes were evaluated using multivariable logistic regression for pathological complete response and Kaplan–Meier analysis with Cox proportional-hazards modeling for disease-free survival. The median follow-up duration was 66 months. The overall pCR rate was 26.3% (n = 115). pCR rates did not differ significantly between induction, sandwich, and consolidation chemotherapy regimens. A longer interval (> 8 weeks) between radiotherapy and surgery was associated with a higher likelihood of achieving pCR. In contrast, cT4 disease and baseline CEA levels > 3 ng/mL were associated with lower pCR rates.The estimated 3-year disease-free survival (DFS) rate was 83.8%. Recurrence rates within 3 years were numerically higher in patients receiving induction and sandwich regimens compared with consolidation chemotherapy, although these differences did not reach statistical significance. In multivariable analysis, poor tumor regression grade, ypT4 stage, ypN + disease, and post-TNT CEA ≥ 3 ng/mL were independently associated with an increased risk of recurrence. TNT is effective and feasible in real-world settings, achieving pCR and DFS outcomes comparable to clinical trials. No statistically significant differences were observed in pCR or recurrence rates between induction, consolidation, and sandwich chemotherapy regimens. Prospective phase III trials are needed to compare DFS and OS outcomes across these treatment strategies. The online version contains supplementary material available at 10.1007/s12672-026-04842-3.

Background and Objectives: Palliative care awareness among family caregivers plays a critical role in the timely utilization of supportive care services. However, awareness levels and associated factors among caregivers of cancer patients remain insufficiently explored in Türkiye. This study aimed to evaluate palliative care awareness and identify factors associated with awareness among caregivers of cancer patients. Materials and Methods: This cross-sectional study included 550 caregivers of cancer patients receiving treatment at oncology clinics. Sociodemographic characteristics, caregiving-related factors, and palliative care awareness levels were assessed using a structured questionnaire. Associations between awareness and explanatory variables were evaluated using chi-square tests. Independent predictors of awareness were determined by multivariable logistic regression analysis. Results: Among the 550 caregivers included in the study, 277 (50.4%) reported no knowledge of palliative care, 141 (25.6%) reported sufficient knowledge, and 131 (23.8%) reported limited knowledge. Higher educational level, active employment, older age, closer relationship to the patient, advanced disease stage, and previous exposure to palliative care services were significantly associated with greater awareness. In multivariable logistic regression analysis, education level (OR = 2.05, 95% CI: 1.35–3.15, p < 0.001), employment status (OR = 1.79, 95% CI: 1.23–2.61, p = 0.003), age (OR = 1.04, 95% CI: 1.01–1.07, p = 0.004), disease stage (OR = 1.34, 95% CI: 1.05–1.72, p = 0.016), caregiver relationship (OR = 1.94, 95% CI: 1.18–3.17, p = 0.008), and having a relative who had previously received palliative care (OR = 2.34, 95% CI: 1.42–3.84, p < 0.001) were identified as independent predictors of awareness. Conclusions: Palliative care awareness among caregivers of cancer patients remains limited. Educational level, caregiving experience, and exposure to palliative care services significantly influence awareness. Strategies aimed at improving caregiver education and increasing public awareness may facilitate earlier integration of palliative care into oncology practice.