Introduction: The present study investigates the role of 68Ga-PSMA PET/CT-derived whole-body metabolic and volumetric parameters in the prediction of treatment response and prognosis among metastatic hormone-refractory prostate cancer patients undergoing second-generation androgen receptor axis-targeted therapy (abiraterone or enzalutamide). Materials and methods: This retrospective study included 44 metastatic hormone-refractory prostate cancer patients undergoing 68Ga-PSMA PET/CT, including 29 enzalutamide-treated and 15 abiraterone-treated patients. Results: Of the 44 patients included in the study, 29 received enzalutamide and 15 received abiraterone. During treatment, the changes in PET parameters were correlated with the PSA (biochemical) response. More specifically, a positive correlation was noted between PSA response and percent change in TLP (ΔTLP) response, and there was concordance between the results (r = 0.652, k = 0.42, P < 0.001). Baseline PSA (P =0.05), high MTVw (P = 0.005), the increase in ΔPSA (P = 0.036), ΔTLP (P = 0.039) and percent change in MTV (ΔMTV) (P = 0.049) values were identified as factors associated with mortality risk.Multivariate analysis showed that PSA1 [odds ratio (OR): 1.005, 95% confidence interval (CI) 1.002–1.008, P = 0.004], ΔPSA (OR: 14.7, 95% CI 1.50–143.7, P = 0.02) and MTVw1 (OR: 11.4, 95% CI 1.11–116, 6, P = 0.04) were independent prognostic factors associated with mortality risk. Conclusion: A statistically significant concordance and correlation was noted between 68Ga-PSMA PET/CT-derived whole-body metabolic parameters (ΔTLP and ΔMTV) and ΔPSA. In addition, the baseline PSA, ΔPSA, ΔTLP, ΔMTV and TMTV were identified as predictive factors for mortality risk.
Objectives: The clinicopathological characteristics, treatment modalities, and effects on the prognosis of pure squamous cell carcinoma (SqCC) and adenocarcinoma (AC) were evaluated. Materials and Methods: 86 patients with pure SqCC and AC bladder cancer were evaluated retrospectively. Results: Of the 86 patients, 51 had SqCC and 35 had AC. No differences in clinicopathological characteristics were observed between patients with AC and SqCC, except for the prevalence of T4 disease (28.6% vs. 51.0%, respectively). In multivariate analysis, older age, stage IV disease, and Eastern Cooperative Oncology Group (ECOG) performance status (> 2) were predictive of a poor overall survival (OS). The median OS was significantly longer for stage I-III patients (82.9 months) treated with surgery ± chemotherapy (CT) ± radiotherapy (RT) than for those treated with transurethral resection ± CT ± RT (24.3 months) (P = 0.007). The median OS of patients with SqCC and AC who were given platinum-based CT for metastasis was 7.7 and 30.3 months, respectively. Conclusions: Advanced age, stage IV disease, and poor ECOG performance status were factors associated with a poor prognosis. Surgery ± CT ± RT resulted in significantly better OS, except in stage IV disease. Patients with metastatic AC had better response rates with platinum-based CT.
Objective: The rates of and the factors influencing HER2 discordance in patients receiving neoadjuvant therapy for breast cancer are investigated. Methods: This study retrospectively examines the r... Plain language summary HER2 is an important and targetable molecule in breast cancer. In the early stages of breast cancer, a treatment modality called neoadjuvant therapy, which now includes anti-...
Rare tumours of the testis includes a wide variety of tumours. We aim to present clinical and histological characteristics of our patients with rare tumours of the testis. The medical records of 33 patients who were treated and followed-up for testicular rare tumours in our center between 2007 and 2020 were retrospectively reviewed. Of all the 243 testicular tumours, 222 cases (91.4%) were germ cell tumours and 21 cases (8.6%) were non-germ cell tumours. Thirty-three rare tumours of the testis including rare germ cell tumours and non-germ cell tumours were detected. The mean age of the patients at diagnosis was 34 years (range 18–68 years). The histological types of rare testicular tumours were as follows: teratoma 4.5% (n=11), sex-cord stromal tumours 4.5% (n=11), paratesticular tumours 3.2% (n=8), and the others [lymphoma 0.4% (n=1), mesothelioma 0.4% (n=1) and choriocarcinoma 0.4% (n=1)]. The median duration of follow-up was 32 months (range 1 to 256 months). None of the patients with non-metastatic disease stage developed recurrence after having received appropriate therapy. Metastatic disease was documented in 9 cases at the time of diagnosis (five patients with teratomas, two patients with Leydig cell tumour, one patient with choriocarcinoma and rhabdomyosarcoma). The most common subtypes of testicular rare tumours in our center was teratoma and sex-cord stromal tumours. Because of testicular rare tumours have different biological features and different clinical outcomes, the management of each tumour requires a different approach.
1 November 2022 in Journal of the College of Physicians and Surgeons Pakistan
Objective: To investigate the status of thiol-disulphide homeostasis and ischemic-modified albumin and their association with clinicopathological parameters in breast cancer. Study Design: A cross-sectional descriptive study. Place and Duration of Study: Department of Internal Medicine and Department of Medical Oncology, Dicle University, Turkey, from April to September 2021. Methodology: Forty treatment- naive female patients diagnosed with breast cancer who presented to the Oncology Clinic of the hospital and 33 healthy women with no comorbidities were included. Serum levels of native thiol (NT), disulphide (Ds), total thiol (TT), IMA (ischemic modified albumin) at diagnosis and disulphide/native thiol (Ds/NT), disulphide/total thiol (Ds/TT), and the ratios of native thiol/total thiol (NT/TT) were analysed by the colorimetric method. Results: Median age at diagnosis was 44 (29-70) years. The majority of patients had stage II-III disease (77.5%). Mean serum levels of TT were significantly lower in breast cancer patients (462.45 +/- 100.2 mu mol/L) compared to healthy controls (507.28 +/- 75.72 mu mol/L) (p=0.038). Mean serum levels of Ds were significantly lower in breast cancer patients (20.25 +/- 5.94 mu mol/L) compared to healthy controls (22.99 +/- 3.56 mu mol/L) (p=0.018). Meanwhile, mean IMA levels were significantly higher in breast cancer patients (0.81 +/- 0.05 mu mol/L) compared to healthy controls (0.73 +/- 0.19 mu mol/L) (p=0.016). NT and TT levels showed a moderate correlation with the percentage of fat mass and body mass index (BMI), and a weak correlation with age (p<0.05). Univariate and multivariate analyses examining the association between thiol-disulphide levels and patient clinical characteristics demonstrated that NT and TT levels had a statistically significant relationship with body mass index and menopausal status (p<0.05), with lower levels of NT and TT in postmenopausal patients and patients with high BMI. Conclusion: Decreased TT and Ds levels and increased IMA levels were determined in patients diagnosed with breast cancer compared to the healthy control group. Thiol-disulphide levels were observed to be associated with clinical characteristics such as menopausal status and BMI.
1 January 2022 in The Eurasian Journal of Medicine
Objective: Regorafenib is a multikinase inhibitor, the effectiveness of which was demonstrated in metastatic colorectal cancer. This study aimed to investigate the factors that could predict the effectiveness of regorafenib. Materials and Methods: This study retrospectively reviewed the clinical characteristics, tumor characteristics, and previous therapies in 62 patients who presented to our center between 2016 and 2020 and used regorafenib for metastatic colorectal cancer. The effects of the investigated variables on the response obtained with regorafenib use were evaluated. Results: This study included a total of 62 patients diagnosed with metastatic colorectal cancer, of whom 30 (48.4%) were males and 32 (51.6%) were females. Patients' median age at diagnosis was 49 years (18- 68). Regorafenib therapy yielded a disease control rate of 64% [complete response=0, partial response= 14 (28%), and stable disease=18 (36%)]. Objective response was obtained in 28% of patients [complete response=0 and partial response=14 (28%)]. Progression-free survival was 4 months. The evaluation of the effects of patients' age, sex, performance status, previous treatments, metastatic sites, and RAS mutation status on the disease control rate and progression-free survival did not determine any positive or negative effects on progression-free survival. However, left-sided tumors had a positive effect on disease control rate (69.8% vs. 28.6%, P=.029). and previous use of cetuximab had a negative effect on disease control rate [76.5% vs. 37.5% (P=.007)]. Conclusion: In our study, tumor localization and previous cetuximab use were found to be correlated with the disease control rate in patients on regorafenib. However, the need for novel biomarkers that will predict the effectiveness of regorafenib in metastatic colorectal cancer treatment persists. Cite this article as: Ebinç S, Oruç Z, Urakçi Z, et al. Evaluation of factors predicting the effectiveness of regorafenib in the treatment of metastatic colorectal cancer. Eurasian J Med., 2022;54(3):229-234.