Objective: Extragonadal germ cell tumours have a more unfavourable prognosis than gonadal germ cell tumours. We aimed to evaluate the survival analysis, response rates, and factors affecting responses to high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) in patients with relapsed/refractory extragonadal germ cell tumours. Methods: This study included patients diagnosed with extragonadal germ cell tumours who underwent HDCT + ASCT between November 2016 and January 2023 at Gülhane Training and Research Hospital. Clinical characteristics and follow-up data from patient records and the hospital’s electronic system were retrospectively analysed. Patients under 18 years of age and those without medical records were excluded. Patient characteristics, post-HDCT progression-free survival (PFS), overall survival (OS) data, and factors affecting survival were examined. The relationship between clinical factors and OS/PFS was analysed. Results: Twenty-five patients were included in this study. Complete response (CR) was observed in seven patients (28%), partial response (PR) was observed in nine patients (36%), stable disease (SD) was observed in one patient, and progressive disease (PD) was observed in eight patients (32%) after HDCT + ASCT. The median follow-up period was 25.4 months. The median PFS and OS after HDCT + ASCT were calculated as 6.1 months and 12.2 months, respectively. Conclusions: Salvage HDCT + ASCT is an option in the treatment of extragonadal germ cell tumours, offering the potential for prolonged survival and curing.

Background/Objectives: There is an unmet need to improve outcomes in patients with metastatic Ewing sarcoma (ES). This retrospective, multicenter study aimed to evaluate the efficacy and safety of the topotecan–cyclophosphamide (TC) regimen in adult patients with metastatic ES who had previously been treated with chemotherapy. Methods: This study enrolled 75 patients who were treated at five oncology centers in Turkey between 2011 and 2020. Patients were treated with the TC regimen, consisting of topotecan at 0.75 mg/m²/day and cyclophosphamide at 250 mg/m²/day, given daily for 5 days and repeated every 21 days. Results: The median progression-free survival was 3.06 months (95% CI, 2.91–3.22), and the median overall survival was 6.16 months (95% CI, 5.14–7.18). Patients who received the TC regimen in the second line demonstrated longer OS (7.55 months 95% CI, 5.37–14.17) compared to those who received it in the third line or later (5.70 months 95% CI, 4.07–6.60) (p = 0.005). When the TC regimen was used in the second line, the disease control rate was 50%, whereas in the third line or later, the DCR was 10.8%. In the entire group, the DCR was 30.7%. The most common toxicity was transient cytopenia. Conclusions: This study showed that the use of the TC regimen in the second line resulted in better efficacy and overall survival outcomes compared to its use in the third line or later. However, in the entire population, the TC regimen demonstrated only a modest effect on metastatic ES. TC can be considered one of the palliative treatment options for metastatic ES.

Background: c-MYC and enhancer of zeste homolog 2 (EZH2) are key regulators of cell proliferation and epigenetic reprogramming and have been implicated in the pathogenesis and progression of lung carcinoma. However, their clinicopathological and prognostic relevance in routine practice remains incompletely defined. This study aimed to evaluate the relationships between c-MYC and EZH2 immunohistochemical expression and survival in patients with small cell lung carcinoma (SCLC) and non-small cell lung carcinoma (NSCLC). Methods: This single-center retrospective study included 131 patients (98 NSCLC, 33 SCLC) followed at the outpatient clinic of medical oncology department with available archival formalin-fixed, paraffin-embedded tumor tissue. c-MYC and EZH2 expression was assessed immunohistochemically in tumor samples and evaluated by nuclear staining intensity and the percentage of stained tumor cells. For survival analyses, marker expression was dichotomized using a 30% cut-off of the percentage of stained tumor cells, and clinicopathological features were compared between groups. Overall survival (OS) was estimated using the Kaplan–Meier method and compared by the log-rank test. Prognostic factors for OS were examined using multivariate Cox proportional hazards models. Results: High c-MYC expression was associated with worse OS and an independent adverse prognostic factor in multivariate Cox regression [hazard ratio (HR) 1.86, 95% confidence interval (CI) 1.11–3.13; p = 0.019], together with poor performance status (ECOG ≥ 2; HR 2.91, 95% CI 1.73–4.89; p < 0.001). In contrast, EZH2 expression, although frequently positive and modestly correlated with c-MYC, was not significantly associated with OS. Conclusion: In this retrospective cohort of lung carcinoma patients, high c-MYC expression, but not EZH2 expression, was independently associated with poor OS after adjustment for clinical factors. c-MYC immunohistochemistry may provide additional prognostic information beyond conventional clinicopathological parameters. Larger prospective studies with standardized scoring systems are warranted to validate these findings and to clarify the clinical utility of c-MYC and EZH2 as potential prognostic and therapeutic biomarkers in lung cancer.

Background: Autologous stem cell transplantation (ASCT) is a standard treatment for relapsed or high-risk lymphoma. While disease-related factors are well-known, the impact of host-related factors like nutritional status remains less defined. We aimed to evaluate the prognostic value of the prognostic nutritional index (PNI) and other factors in lymphoma patients undergoing ASCT. Methods: We conducted a single-center retrospective cohort study including adult patients with Hodgkin and non-Hodgkin lymphoma who underwent ASCT between January 2015 and December 2023. Pre-transplant clinical, laboratory, and transplant-related variables were analyzed. The prognostic nutritional index (PNI) was calculated using serum albumin and absolute lymphocyte count and dichotomized according to the cohort median. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan–Meier and Cox regression analyses. We conducted a retrospective single-center cohort study including adult patients with Hodgkin and non-Hodgkin lymphoma who underwent ASCT between January 2015 and December 2023. Results: A total of 43 patients were included. Median age was 38 years, and 72.1% were male. Patients transplanted in complete remission (CR) had significantly longer PFS compared with those transplanted in partial remission (PR) (log-rank p = 0.022). Patients with higher pre-ASCT PNI demonstrated significantly improved PFS (median 45 vs. 7 months; log-rank p = 0.021). In multivariable Cox regression analysis, both higher PNI (HR 0.39; 95% CI 0.16–0.97; p = 0.043) and complete remission prior to ASCT (HR 0.41; 95% CI 0.17–0.98; p = 0.046) remained independently associated with improved PFS. Higher infused CD34⁺ (hematopoietic stem cell) dose was associated with shorter hospitalization but showed no statistically significant association with engraftment kinetics or survival. No variable was independently associated with OS, likely due to the limited number of death events. Conclusions: Pre-transplant prognostic nutritional index and disease response independently predict progression-free survival after ASCT in lymphoma. These findings highlight the complementary role of host-related and disease-related factors in transplant outcomes and suggest that PNI may serve as a practical tool for pre-transplant risk stratification and patient optimization. Given the small sample size and limited number of events, these findings should be interpreted with caution.