Background: Metastatic gastric cancer (GC) and gastroesophageal junction (GEJ) cancer are associated with a poor prognosis. Recent advancements in treatment have incorporated trastuzumab, anti-PD-1 agents, and anti-claudin therapies alongside chemotherapy (ChT), significantly improving outcomes. Contemporary studies predominantly employ doublet ChT as the backbone for these regimens, although historically triplet ChT regimens have been favored, particularly in younger patients requiring rapid tumor shrinkage. Objective: The aim of this study was to compare the efficacy of mFOLFOX-6 and mDCF regimens in the treatment of advanced GC and GEJ adenocarcinoma. Design: This was a retrospective multicenter study. Methods: Patient data were obtained from the databases of 25 hospitals across Turkey. Demographic and clinicopathological characteristics were documented. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan–Meier method, and group discrepancies were assessed with log-rank test. Results: A total of 493 patients were included in the analysis, with similar baseline characteristics between the two groups. The objective response rate was 36.3% in the mDCF group and 38% in the mFOLFOX-6 group ( p = 0.7). The median PFS was 6 months for mDCF and 7 months for mFOLFOX-6 ( p = 0.2), while the median OS was 12 months for mDCF and 11 months for mFOLFOX-6 ( p = 0.4). Grade 3–4 neutropenia occurred in 27.6% of patients treated with mDCF versus 17.8% with mFOLFOX-6 ( p = 0.01). Likewise, grade 3–4 anemia was more frequent in the mDCF group (9.5%) compared to the mFOLFOX-6 group (4.8%; p = 0.04). Conclusion: Modified FOLFOX-6 demonstrated comparable efficacy to mDCF in the treatment of advanced GC and GEJ adenocarcinoma. Moreover, mFOLFOX-6 was associated with a lower incidence of hematological adverse effects.

Dihydropyrimidine dehydrogenase (DPD) is the key enzyme involved in fluoropyrimidine metabolism. Variants in the DPYD gene can lead to DPD deficiency, markedly increasing the risk of toxicity. The present report describes a case of a patient with rectal cancer treated with the CAPOX regimen (capecitabine and oxaliplatin) who developed grade 3 mucositis, fever, diarrhea and multi‑organ dysfunction, necessitating prolonged intensive care unit support. The patient was managed with aggressive intravenous fluid therapy, a broad spectrum of antibiotics, antivirals and antifungal agents, extended use of granulocyte colony‑stimulating factor and intensive anti‑diarrheal treatment. Full clinical recovery was achieved, and the patient was discharged. Genetic analysis revealed a heterozygous c.2845A>T DPYD variant, known to be associated with fluoropyrimidine‑related toxicity. The present case underscores the importance of early recognition of potential DPD deficiency and the essential role of prompt, intensive supportive care in managing severe fluoropyrimidine-related toxicities.

Amaç: Bu çalışmada, kronik hepatit B (KHB) enfeksiyonu veya KHB ilişkili kompanse karaciğer sirozu tanısı almış hastalarda, entekavir ve tenofovir tedavilerinin uzun süreli kullanımda virolojik baskılanma, serolojik dönüşüm ve biyokimyasal parametreler üzerindeki etkileri-nin karşılaştırmalı olarak incelenmesi amaçlanmıştır. Materyal ve Metot: Bu retrospektif kohort çalışmaya, Dicle Üniversitesi Tıp Fakültesi Hastanesi Gastroenteroloji Anabilim Dalı’nda tenofovir veya entekavir tedavisi alan kronik HBV enfeksiyonlu, yalnızca kompanse sirozu olan hastalar da dahil edilmiştir. Karaciğer nakli öyküsü, dekompanse siroz, immünsupresif tedavi, gebelik ve kontrolsüz diyabet dışlama kriterleri olarak belirlenmiştir. Klinik ve labora-tuvar veriler hasta dosyalarından retrospektif olarak toplanmıştır. HBV DNA, ALT ve AST düzeyleri düzenli aralıklarla izlenmiş; serolojik belirteçler (HBsAg, anti-HBs, HBeAg, anti-HBe) ilk yıl üçer aylık aralıklarla ve devamında altı aylık periyotlarla değerlendirilmiştir. Karaciğer biyopsileri, modifiye Knodell (İshak) skorlama sistemi ile analiz edilmiş, hepatik aktivite indeksi ve fibrozis evresi kaydedilmiştir. Bulgular: Toplam 400 hasta (234 tenofovir, 166 entekavir) çalışmaya dahil edilmiştir. Gruplar, başlangıç özellikleri açısından benzerdi. Virolojik baskılanma oranları genel olarak iki grupta benzer bulunmuştur. Ancak HBeAg pozitif hastalarda 2. yılda entekavir lehine anlamlı bir fark saptanmıştır (p=0.02). HBeAg pozitif hastalar arasında ALT normalleşmesi açısından entekavir tenofovire 6. ayda (p=0.02) ancak 5. yılda ise tenofovir entakavire göre (p=0.04) daha etkili bulunmuştur. HBeAg negatif hastalarda ise 5. yılda ALT normalleşme oranı entekavir grubunda anlamlı olarak daha yüksekti (p=0.007). Biyokimyasal yanıt açısından ise entekavir grubunda 6. Ayda (p=0.016) ve 60. ayda (p=0.045) ALT düzeylerinde daha belirgin normalleşme izlenmiştir. Serolojik yanıt oranları (HBeAg serokonversiyonu ve HBsAg kaybı) iki tedavi grubu arasında farklılık göstermemiştir. Sonuç: Tenofovir ve entekavir, KHB tedavisinde benzer virolojik ve serolojik etkinlik göstermektedir. Bununla birlikte, entekavir özellik-le bazı hasta alt gruplarında ve tedavinin belirli dönemlerinde biyokimyasal yanıt açısından üstünlük sağlayabilir.

Aim: In this study, we aimed to investigate the factors that may have the potential to predict pathological complete response (pCR) with platinum-based neoadjuvant chemotherapy (NAC) in non-metastatic muscle-invasive bladder cancer (MIBC).Methods: Our study included 46 patients diagnosed with non-metastatic MIBC, who applied to Dicle University Medical Oncology Clinic between 2016-2019 years and received NAC. Age, gender, ECOG performance score, tumor grade, pathological tumor (pT) stage, clinical lymph node (cN) status, localization of the primary tumor in the bladder, presence of comorbid diseases, renal failure status, hydronephrosis, and NAC regimens were analyzed.Results: Of the total 46 patients included in the study, 42 (81.3%) were male and 4 (8.7%) were female. The median age at diagnosis was 61.5 (34-77) years. In the group of patients aged

Myocarditis attributable to immune checkpoint inhibitors is regarded as among the most serious complications of immunotherapeutic treatment. We report a case of gastric cancer who developed myocarditis, and subsequent late complications following treatment with nivolumab and ipilimumab. The patient was managed with corticosteroids, mycophenolate mofetil (MMF), and intravenous immunoglobulin G (IVIG), but later developed supraventricular tachycardia and deep vein thrombosis. This report emphasizes the need to enhance recognition of immune-related toxicities within non-oncology specialties to support prompt interdisciplinary collaboration and appropriate patient management. Additionally, patients can develop myocarditis-related complications even when clinically stable or near the end of treatment, underscoring the need for close and ongoing monitoring.

Aim: Testicular cancer is the most common cancer in men aged 15-35 years and accounts for 1% of all lifetime male cancers. There are two histologic subtypes: seminoma and nonseminoma. In our study, we aimed to investigate the factors predicting recurrence in early-stage testicular cancer. Materials and Methods: Our study is a retrospective study of early stage testicular cancer admitted to the medical oncololi clinic of our hospital between 2006-2018. During the study, 344 patient files were reviewed and 130 patients who met the study criteria were included in the study. Our primary aim in this study was to investigate the factors predictive of recurrence in early stage testicular cancer. Results: When evaluating PFS in patients with nonseminoma with and without lymphovascular invasion, no median PFS value was reached in either group. However, PFS was worse in patients with LVI (p=0.037). When comparing stage 1 with stage 2 seminoma patients, no median PFS values could be reached, but there was a statistical difference between the two groups in terms of recurrence (p=0.019). Conclusions: In our study, we found no association between tumor size, embryonal carcinoma predominance, tunica albuginea invasion, spermatic cord involvement and tumor marker values and recurrence in nonseminoma germ cell testicular tumors. PFS was shorter in patients with LVI compared to those without LVI. Lymphovascular invasion, spermatic cord involvement, tunica albuginea involvement, and rete testis involvement were not associated with disease recurrence in seminoma patients, whereas higher disease stage predicted the risk of recurrence.