Person: SARI, MURAT
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SARI
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MURAT
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Publication Open Access The effect of low HER2 expression on treatment outcomes in metastatic hormone receptor positive breast cancer patients treated with a combination of a CDK4/6 inhibitor and endocrine therapy: A multicentric retrospective study(2023-08-01) SARI, MURAT; ÇALIŞKAN YILDIRIM E., ATAĞ E., Coban E., Umit Unal O., Celebi A., Keser M., UZUN M., KESKİNKILIÇ M., Tanrikulu Simsek E., Sari M., et al.Background: CDK4/6 inhibitors combined with endocrine therapy have significantly improved treatment outcomes for metastatic hormone receptor-positive (HR+) breast cancer patients. However, the impact of low HER2 expression on treatment response and progression-free survival (PFS) remains unclear. Methods: This multicenter retrospective study included 204 HR+ breast cancer patients treated with a combination of CDK4/6 inhibitor and endocrine therapy. HER2-zero disease was detected in 138 (68%) and HER2-low disease in 66 (32%) patients. Treatment-related characteristics and clinical outcomes were analyzed, with a median follow-up of 22 months. Results: The objective response rate (ORR) was 72.7% in the HER2 low group and 66.6% in the HER2 zero group (p = 0.54). Median PFS was not significantly different between the HER2-low and HER2 zero groups (19 months vs.18 months, p = 0.89), although there was a trend toward longer PFS in the HER2-low group for first-line treatment (24 months progression-free survival rate 63% vs 49%). In recurrent disease, the median PFS was 25 months in the HER2-low group and 12 months in the HER2-zero group (p = 0.08), while in de novo metastatic disease, the median PFS was 18 months in the HER2-low group and 27 months in the HER2-zero group (p = 0.16). The order of CDK4/6 inhibitor use and the presence of visceral metastasis were identified as independent variables affecting PFS. Conclusion: Low HER2 expression did not significantly impact treatment response or PFS in HR+ breast cancer patients treated with a CDK4/6 inhibitor and endocrine therapy. Because of the conflicting results in the literature, further prospective studies are needed to evaluate the clinical significance of HER2 expression in HR+ breast cancer.Publication Open Access PNI as a potential add-on biomarker to improve the IMDC intermediate prognostic score(2023-10-01) BAYOĞLU, İBRAHİM VEDAT; SEVER, NADİYE; YAŞAR, ALPER; ARIKAN, RUKİYE; SARI, MURAT; KÖSTEK, OSMAN; BAYOĞLU İ. V., Hüseynov J., Topal A., Sever N., Majidova N., Çelebi A., Yaşar A., ARIKAN R., Işık S., Hacıoğlu M. B., et al.Introduction: This study aimed to assess the role of the adjusted PNI-IMDC risk scoring system in stratifying the intermediate group of metastatic RCC patients who received TKIS in the first-line setting. Methods: A total of 185 patients were included. The adjusted PNI and IMDC model was used to divide the intermediate group into two groups: intermediate PNI-high and intermediate PNI-low groups. The statistical data were analyzed using Kaplan–Meier and Cox regression analysis. Results: The results showed that the adjusted PNI-IMDC risk score, classic IMDC, and PNI had similar prognostic values. Adjusted PNI-IMDC risk score might be used for a more homogeneous differentiation of the classic intermediate group. On the other hand, multivariate analysis revealed that the presence of nephrectomy, adjusted favorable/intermediate (PNI-high) group, ECOG performance score, and presence of bone metastasis were independent predictors of OS. Conclusions: Pre-treatment PNI, as a valuable and potential add-on biomarker to the adjusted PNI-IMDC classification model, can be helpful for establishing an improved prognostic model for intermediate group mRCC patients treated with first-line TKISs. Further validation studies are needed to clarify these findings.Publication Open Access Prognostic significance of mucinous histology in metastatic colorectal cancer patients treated with regorafenib(2023-01-01) ARIKAN, RUKİYE; DEMİRCAN, NAZIM CAN; YAŞAR, ALPER; SEVER, NADİYE; ÇELİKEL, ÇİĞDEM; SARI, MURAT; KÖSTEK, OSMAN; BAYOĞLU, İBRAHİM VEDAT; ARIKAN R., Üstün H. S., Demircan N. C., Işik S., Telli T. A., Yaşar A., Çelebi A., Majidova N., Sever N., ÇELİKEL Ç., et al.Objective: Prognostic factors for regorafenib therapy have not been fully defined. Mucinous adenocarcinoma (MAC) is a dis-tinct subtype of colorectal cancer (CRC). We investigated the significance of mucinous histology in patients treated with regorafenib for metastatic CRC (mCRC). Material and Methods: In this retrospective study, patients were stratified according to the presence of mucinous histology; >1% extracellular mucin was defined as mucinous component adenocarcinoma (MCAC), and containing no mucin was defined as non-MAC. The prognostic significance of mucinous histology for progression-free survival (PFS) and overall survival (OS) was evaluated by univariate and multivariate analyses. Results: A total of 103 patients were included, including 20 (19.4%) patients with MCAC and 83 (80.6%) patients with non-MAC. The median follow-up time was 8.6 months (range 1.8-31.6 months). The median PFS was lower in cases with MCAC than those with non-MAC (3.2 months vs. 3.6 months, respectively, p=0.01). Median OS was lower in MCAC patients than in non-MAC patients (4.3 months vs. 9.6 months, respectively, p=0.008). In multivariate analyses, mucinous histology was an independent risk factor [haz-ard ratio (HR): 2.2, p=0.003] for PFS and Eastern Cooperative Oncology Group-Performance Status (HR: 2.2, p=0.01), cancer antigen 19-9 (HR: 1.7, p=0.03), and mucinous histology (HR: 1.9, p=0.02) were independent risk factors for OS. Conclusion: This study revealed the prognostic value of mucinous histology in mCRC patients treated with regorafenib. Consideration of histologic features may be helpful in se-lecting patients for regorafenib therapy.Publication Metadata only Prognostic Factors Associated with Resected Osteosarcoma: Efficacy of Adjuvant Setting, Real-World Experience(2024-01-01) ŞİMŞEK, FATİH; SEVER, NADİYE; KOCAASLAN, ERKAM; EREL, PINAR; ARIKAN, RUKİYE; SARI, MURAT; BAYOĞLU, İBRAHİM VEDAT; KÖSTEK, OSMAN; Majidova N., ŞİMŞEK F., Biter S., YASLIKAYA Ş., Seyyar M., DUYGULU M. E., Arcagok M., Kircali M. F., Sever N., KOCAASLAN E., et al.Osteosarcoma is a curable tumor. Surgery is performed after neoadjuvant chemotherapy as the primary standard treatment, followed by adjuvant therapy again. However, it is seen in patients who have undergone surgery without neoadjuvant chemotherapy. Adjuvant treatment is always given in this group. However, it is controversial how many cycles of adjuvant treatment should be given. In our study, 42 patients with osteosarcoma who received only adjuvant treatment without neoadjuvant treatment were analyzed for the effects of epidemiologic factors, treatment regimens on overall survival and disease-free survival. Retrospectively, 42 osteosarcoma patients (5 centers) with a current age of 18years and older who were followed up between 2001-2022 were examined. Twenty-five (60.0%) were below 8 cm, and 16 (38.0%) were 8 cm and above. The median number of cycles of adjuvant chemotherapy was 4 (range; 1-6). The 4-year DFS rate was 50.2%. In patients with primary tumors smaller and larger than 8cm, the 4-year DFS rates were 66.1% and 22.2%, respectively. The 4-year DFS rates for patients with 4 or less and more than 4 cycles of adjuvant chemotherapy were 27.1% and 69.2%, respectively. The 4-year OS rate was 78.5% in patients with primary tumors smaller than 8 cm and 18.8% in patients with tumors larger than 8 cm. The 4-year OS rate was 24.3% in patients who received 4 or less adjuvant cycles and 79.5% in patients who received more than 4 cycles. We have demonstrated that the number of adjuvant therapy courses above 4 and the presence of primary tumors smaller than 8 cm are influential over overall and disease-free survival in the patients who did not receive neoadjuvant therapy. The number of postoperative adjuvant treatment cycles should be forced as much as possible in these patients who haven’t had neoadjuvant therapy.