Person: YUMUK, PERRAN FULDEN
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YUMUK
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PERRAN FULDEN
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Publication Metadata only QT interval prolongation related to afatinib treatment in a patient with metastatic non-small-cell lung cancer(MOSBY-ELSEVIER, 2020) KOCAKAYA, DERYA; Demircan, Nazim Can; Telli, Tugba Akin; Tuylu, Tugba Basoglu; Arikan, Rukiye; Kocakaya, Derya; Sahin, Ahmet Anil; Ercelep, Ozlem; Dane, Faysal; Yumuk, Perran FuldenAfatinib improves survival in metastatic non-small-cell lung cancer driven by activating epidermal growth factor receptor mutations. QT interval prolongation is a possible side effect of tar geted anticancer drugs, but this has not been reported before with afatinib. We report a case of metastatic pulmonary adenocarcinoma with epidermal growth factor receptor exon 19 deletion who was treated with first-line afatinib. The patient was started on afatinib with a total dose of 40 mg/day and experienced grade 3 (> 500 ms) QT interval prolongation in the seventh week. Dose was interrupted and then reduced to 30 mg/day after the event repeated. QT prolongation occurred only once with the reduced dose and radiologic oligoprogression was detected. Local therapy was performed and afatinib was continued as 30 mg/day. To the best of our knowledge, this case marks the first QT interval prolongation associated with afatinib. It is prudent to perform a baseline cardiologic evaluation and electrocardiogram monitoring in non-small cell lung cancer patients treated with this drug. (c) 2020 Elsevier Inc. All rights reserved.Publication Metadata only Enzalutamide versus Abiraterone Acetate as first-line treatment of castration resistant metastatic prostate cancer in geriatric (>= 75) patients(IMR PRESS, 2021) YUMUK, PERRAN FULDEN; Alkan, Ali; Guc, Zeynep Gulsum; Gurbuz, Mustafa; ozgun, Guliz; Degirmencioglu, Serkan; Dogan, Mutlu; Telli, Tugba Akin; Keskin, Ozge; Arslan, Cagatay; Bilgin, Burak; Goksu, Sema Sezgin; Demir, Hacer; Koksoy, Elif Berna; Kostek, Osman; Erturk, Ismail; Sakalar, Teoman; Yasar, Arzu; Turkkan, Gorkem; Kasim, Bu ra; Karaoglu, Aziz; oksuzoglu, Berna cakmak; Yumuk, Fulden; Sendur, Mehmet Ali; Coskun, Hasan Senol; cicin, Irfan; Karadurmu, Nuri; Tanriverdi, Ozgur; Akbulut, Hakan; Urun, YukselIntroduction: The efficacy and tolerability of Enzalutamide and Abiraterone Acetate have been reported in elderly patients with metastatic castration resistant prostate cancer (mCRPC). However, there is no randomized study directly comparing antitumor effects between these 2 agents in geriatric patients. We aimed to evaluate the efficacy of Enzalutamide (ENZA) and Abiraterone Acetate (AA) as a first-line treatment of mCRPC in elderly patients. Materials and methods: The geriatric patients (>= 75 years of age) with a diagnosis of mCRPC and treated with first-line ENZA or AA were included. The impacts of clinical parameters and treatment modalities on overall survival (mOS) were analyzed retrospectively and Cox regression analysis was performed. Results: One hundred thirty-four mCRPC patients (77 in AA, 57 in ENZA), with a median age of 81 (75-93) were analyzed. The patient and disease characteristics were similar between arms. While there were more grade 1-2 toxicities in AA arm (45.5% vs 17.5%, P = 0.001), the discontinuation due to toxicity was similar between groups (8.5% vs 5.9%, P = 0.81). The mOS was 18.0 months (95% CI, 15.2-20.7) in AA, and 20.0 months (95% CI, 4.4-35.5) in ENZA arm (P = 0.47). In multivariate analysis, high Gleason score (>= 8) (HR: 2.0 (95% CI, 1.1-3.4), P = 0.009) and high initial PSA values (>= 100 ng/mL) (HR: 2.6 (95% CI, 1.5-4.8), P = 0.001) were poor prognostic factors. The choice of AA vs ENZA was insignificant as a predictor of OS (HR: 0.87 (95% CI, 0.48-1.56), P = 0.65). Conclusion: In the first-line treatment of mCRPC in elderly (>= 75) patients, AA and ENZA showed similar results in terms of mPFS and mOS. The clinical impacts of second-generation androgen receptor pathway inhibitors in the elderly population should be tested in prospective randomized studies.Publication Metadata only The real-life efficacy and safety of osimertinib in pretreated advanced non-small cell lung cancer patients with T790M mutation: a Turkish Oncology Group Study(SPRINGER) YUMUK, PERRAN FULDEN; Hizal, Mutlu; Bilgin, Burak; Paksoy, Nail; Acikgoz, Ozgur; Sezer, Ahmet; Gurbuz, Mustafa; Ak, Naziye; Yucel, Sebnem; Ayhan, Murat; Erol, Cihan; Demirkiran, Aykut; Mandel, Nil Molinas; Shbair, Abdallah; Gokmen, Ivo; Basoglu, Tugba; Paydas, Semra; Demiray, Atike Gokcen; Iriagac, Yakup; Sakalar, Teoman; Zeynelgil, Esra; Tatli, Ali Murat; Bahceci, Aykut; Guven, Deniz Can; Caner, Burcu; Can, Alper; Gulmez, Ahmet; Karakas, Yusuf; Yalcin, Bulent; Demirkazik, Ahmet; Bilici, Ahmet; Aydiner, Adnan; Yumuk, Perran Fulden; Sendur, Mehmet Ali NahitIntroduction Osimertinib, an irreversible third-generation EGFR-TKI, is the standard of care for second-line treatment of T790M-mutant advanced NSCLC patients whose disease progressed after first-line EGFR-TKI therapy. In this multicenter study, we aimed to determine the real-life efficacy and safety of Osimertinib in pretreated advanced NSCLC patients with T790M mutation. Materials and methods This retrospective trial included advanced T790M-mutant pretreated NSCLC patients who received Osimertinib from 24 different centers in Turkey. Primary endpoint was time-to-treatment discontinuation (TTD). Secondary endpoints were objective response rate (ORR), overall survival (OS), and safety. Results Of 163 patients, 68.7% had EGFR exon 19 deletion and 22.7% had exon 21 L858R mutation. Osimertinib was given as second-line treatment in 96 patients (58.9%) and third-line in 48 patients (29.4%). After median of 13-month follow-up, median TTD was 21.6 months with an 82.2% ORR. Estimated median OS was 32.1 months. Grade 3-4 adverse events were seen in 11.7% of the patients. Conclusion Osimertinib is a highly effective option in second- or third-line treatment of NSCLC patients with T790M mutation, with a favorable safety profile.Publication Metadata only Pertuzumab, trastuzumab and taxane-based treatment for visceral organ metastatic, trastuzumab-naive breast cancer: real-life practice outcomes(SPRINGER, 2019) KÖSTEK, OSMAN; Esin, Ece; Oksuzoglu, B.; Bilici, A.; Cicin, I.; Kostek, O.; Kaplan, M. A.; Aksoy, S.; Aktas, B. Y.; Ozdemir, O.; Alacacioglu, A.; Cabuk, D.; Sumbul, A. T.; Sakin, A.; Paydas, S.; Yetisir, E.; Er, O.; Korkmaz, T.; Yildirim, N.; Sakalar, T.; Demir, H.; Artac, M.; Karaagac, M.; Harputluoglu, H.; Bilen, E.; Erdur, E.; Degirmencioglu, S.; Aliyev, A.; Cil, T.; Olgun, P.; Basaran, G.; Gumusay, O.; Demir, A.; Tanrikulu, E.; Yumuk, P. F.; Imamoglu, Inanc; Oyan, B.; Cetin, B.; Haksoyler, V.; Karadurmus, N.; Erturk, I.; Evrensel, T.; Yilmaz, H.; Beypinar, I.; Kocer, M.; Pilanci, K. N.; Seker, M.; Urun, Y.; Yildirim, N.; Eren, T.; Demirci, U.PurposeIn this study, we aimed to describe the real-life practice outcomes of pertuzumab-trastuzumab-taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients.MethodsThis study was conducted by Turkish Oncology Group and included 317 patients' data from 36 centers.ResultsMedian age was 51 (22-82). Median PFS was 28.5months, while median OS was 40.3months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8m vs. 28.5m; p=0.002) and OS (26.7m vs. 40.3m; p=0.009). Patients older than 65years of age (n: 42, 13.2%) had significantly lower OS results (19.8m vs. 40.3m; p=0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5-40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure.ConclusionsOur RLP trial included only visceral metastatic, trastuzumab-naive BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab-trastuzumab-taxane therapy to date.Publication Metadata only Modified Glasgow Prognostic Score, Prognostic Nutritional Index and ECOG Performance Score Predicts Survival Better than Sarcopenia, Cachexia and Some Inflammatory Indices in Metastatic Gastric Cancer(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2021) DANE, FAYSAL; Demirelli, Bulent; Babacan, Nalan Akgul; Ercelep, Ozlem; Ozturk, Mehmet Akif; Kaya, Serap; Tanrikulu, Eda; Khalil, Suleyman; Hasanov, Rahib; Alan, Ozkan; Telli, Tugba Akin; Koca, Sinan; Aribal, Mustafa Erkin; Kuzan, Beyza; Dane, Faysal; Yumuk, Perran FuldenBackground: Gastric carcinoma (GC) patients usually present with locally advanced or metastatic disease; therefore treatment aim is mainly palliation. In this study our purpose is to analyze the prognostic values of the sarcopenia index (SI), cachexia index (CIn) and other inflammatory indexes (advanced lung cancer inflammation index [ALI], modified Glasgow Prognostic Score [mGPS], prognostic index [PI], prognostic nutritional index [PNI] and neutrophil-to-lymphocyte ratio [NLR]) in metastatic GC patients. Methods: Data from the files of metastatic GC patients, who applied to Medical Oncology outpatient clinic in Marmara University Pendik Education and Research Hospital between January 2011 and June 2016, were retrospectively reviewed. Five hundred seventy patients with gastric cancer were detected. Exclusion criteria were the inability to reach the patient surveys for prognostic index calculations, the presence of additional comorbidities to affect the laboratory parameters, and the absence of metastatic disease. Finally, 87 of these patients were included in this study. For SI calculation L3 level muscle area was measured from patients' computed tomography (CT) by a radiologist. SI reference value was obtained from western-EGWSOP (The European Working Group on Sarcopenia in Older People) and eastern (Harada Y, et al.) sources separately, as Turkey doesn't have a reference value for SI. NLR cutoff value was accepted as the median value of patients' NLR measurements. Statistical analysis was conducted using SPSS. Kaplan-Meier and Cox regression models were used to assess independent prognostic factors. The area under the curve was used to compare the prognostic value of indexes. Results: The median length of follow-up of 87 patients was nine months (1-64 mo,/s), and 78 patients died during follow-up. Fifty-nine patients were male (63%), and the median age was 62 (range, 23-88). According to univariate analysis high mGPS and PI score, PNI level <45, NLR level >= 3.41, ALI level <18, CI level under 35, SI (Harada Y, et al) <= 44.5 for males and <= 36.5 for females, ECOG score >= 2, weight loss more than 10% during last 6 mo, BMI under 24 were poor prognostic factors. Age, gender, having multiple organ metastasis, history of gastric surgery, positivity C-erb-B2, SI (EGWSOP) <= 52.4 for males, and <= 38.4 for females did not have any impact on survival. According to multivariate analysis, high mGPS (score 2) (HR 2,494, 95% CI 1.25-4 .94, p = 0.02), PNI (score 1) (HR 4.2, 95% CI 1.73-10.1, p < 0.001) and ECOG score (>= 2) (HR 1.541, 95% CI 1,089-4,214, p = 0.004) have been found to be independent prognostic factors which are determining the survival. mGPS was found to be more valuable than other indexes for predicting mortality by measuring the AUC with ROC analysis. Conclusions: In our study, mGPS, PNI and ECOG score were independent indicators for shorter survival in metastatic gastric cancer patients. mGPS and PNI, which can be done by using only serum CRP, albumin level and complete blood count, might be inexpensive, practical and beneficial to use in routine clinical practice to determine survival.Publication Metadata only How long should we continue crizotinib in ALK translocation-positive inflammatory myofibroblastic tumors? Long-term complete response with crizotinib and review of the literature(SAGE PUBLICATIONS LTD, 2020) FİLİNTE, DENİZ; Alan, Ozkan; Kuzhan, Okan; Koca, Sinan; Telli, Tugba Akin; Tuylu, Tugba Basoglu; Ercelep, Ozlem; Filinte, Deniz; Sengul, Yildiz; Arikan, Huseyin; Kaya, Serap; Babacan, Nalan Akgul; Dane, Faysal; Yumuk, Perran FuldenIntroduction: Inflammatory myofibroblastic tumor is a rare disease which is typically seen in children and young adults. Approximately half of the inflammatory myofibroblastic tumors contain translocations that result in over-expression of anaplastic lymphoma kinase gene. Herein, we present two anaplastic lymphoma kinase-positive cases with long-term remission with crizotinib. We do not know how long these therapies need to be continued. Case reports: We present two cases of inflammatory myofibroblastic tumor treated with anaplastic lymphoma kinase inhibitor therapies: an 8-year-old Turkish boy and a 21-year-old Caucasian man. Management and outcome: Two cases, both with good tumor control under crizotinib, but one who progressed on drug holiday, responded again to the same drug, and had a very short period of response after restarting crizotinib. Conclusion: A molecular-targeted drug (anaplastic lymphoma kinase inhibitor) was found to be extremely effective as selective therapy for inflammatory myofibroblastic tumor with anaplastic lymphoma kinase translocation. Here, we want to emphasize the continuation of this treatment after achieving a good response until progression or a major side effect.Publication Metadata only Translation, validity, and reliability of NUTRISCORE: the nutrition risk assessment screening test for Turkish cancer patients(WILEY) ATASOY, BESTE MELEK; Ak, Elif; Demirel, Birsen; Atasoy, Beste M.; Yumuk, Perran FuldenPurpose The aim was to determine the validity and the reliability of the Turkish version of the screening test named NUTRISCORE in cancer patients. Methods The language validity of the Turkish form of the study scale was provided by the translationback-translation method. NUTRISCORE and nutritional risk screening (NRS)-2002, malnutrition screening tool (MST), and European Diagnostic Criteria (EDC) were administered to 240 volunteers in oncology clinics, and receiver operating characteristic curves (ROC) were calculated for the validity and reliability analysis. Cohen's kappa coefficient was used to determine the fit between the screening tests. Results Thirteen experts were consulted for scale content validity, and the content validity index was found to be 0.94. The scale was administered to 67 patients with 4-week intervals for test-retest reliability, and a positive, high-level and statistically significant relationship was found between the two measurements (r = 0.971, P < 0.01). Compared with the reference test NRS-2002, the specificity values of NUTRISCORE, MST, and EDC screening tests were found to be 100%, 83%, and 91%, whereas the sensitivity values of same screening tests were calculated as 85%, 91% and 81%, respectively. According to Cohen's kappa statistics, the kappa agreement between NRS-2002 and NUTRISCORE was 0.88, the kappa agreement between NRS-2002 and MST was 0.34, and it was found to be 0.73 for NRS-2002 and EDC. Conclusion The nutrition screening test named NUTRISCORE showed adequate validity and reliability in Turkish and can detect malnutrition risk of cancer patients treated in oncology clinics as a screening tool.Publication Unknown Prognostic value of modified Glasgow prognostic score in recurrent high-grade glial tumors treated with systemic treatment(ELSEVIER, 2020) ATASOY, BESTE MELEK; Alan, Ozkan; Telli, Tugba Akin; Basoglu, Tugba; Arikan, Rukiye; Demircan, Nazim Can; Ercelep, Ozlem; Bozkurt, Suheyla; Atasoy, Beste Melek; Dane, Faysal; Yumuk, Perran FuldenObjectives: Malignant high-grade gliomas are the most common and aggressive type of primary brain tumor. We aimed to evaluate the prognostic value of modified Glasgow Prognostic Score (mGPS), which is combination of C-reactive protein (CRP) and albumin, in recurrent high-grade glioma patients treated with systemic treatment. Patients and Methods: Data of 85 patients with recurrent high-grade glioma who received systemic treatment and followed in our clinic between 2012 and 2018 was retrospectively collected and analyzed. Patients were grouped according to mGPS criteria: mGPS-0: CRP 10 mg/L and albumin 3.5 g/dL or CRP 10 mg/L and albumin > 3.5 g/dL; and mGPS-2: CRP > 10 mg/L and albumin < 3.5 mg/L. We investigated the prognostic role of mGPS groups, mutations and survival outcomes. Results: There were 42 (49.4 %), 25 (29.6 %), and 18 (21 %) patients in mGPS-0, mGPS-1, and mGPS-2 groups, respectively. Median follow-up duration was 10 months (1-70 months). Median OS was 8.1 months. According to mGPS-0,-1 and-2; median OS was 13.8 months, 7.3 months and 3.6 months respectively (p = 0.003). mGPS, ATRX and IDH-1 mutation status, and ECOG PS were found to be independent prognostic factors for OS. Conclusion: In our study, mGPS was found to be an independent prognostic factor in patients with recurrent high-grade gliomas. If validated, mGPS can be used as an objective, easily calculated, cheap, and readily available prognostic model in routine practice.Publication Unknown Comparison of second-line treatment outcomes between sensitive and refractory small cell lung cancer patients: a retrospective analysis(SPRINGER INTERNATIONAL PUBLISHING AG, 2013) YUMUK, PERRAN FULDEN; Korkmaz, T.; Seber, S.; Kefeli, U.; Sari, E.; Canhoroz, M.; Oven, B.; Yildirim, E.; Yasar, N.; Aydin, D.; Balvan, O.; Sener, N.; Yuksel, S.; Mert, A.; Polat, O.; Yumuk, F.; Kanat, O.; Gumus, M.; Turhal, N. S.Small cell lung cancer (SCLC) has a high relapse rate despite being very chemosensitive. The efficacy of second-line treatment is dismal. Our aim was to evaluate the outcome of second-line treatment. We retrospectively assessed data of 120 SCLC patients who failed first-line treatment and received second-line treatment at three medical oncology centers. Median age of group was 58. 82 % had an ECOG PS of 0-1 at the time of relapse. 39 % were at limited stage (LS) at the time of diagnosis. Patients who progressed more than 3 months after first-line therapy were categorized as having platinum-sensitive disease (PSD) (64 %). The number of patients who received platin-based combination treatment was 33 (27 %). The median OS time starting from the initiation of second-line treatment was 7 months. Multivariate analysis identified PS (p = 0.006), extent of disease at diagnosis (0.014) and PSD (0.001) as the independent prognostic factors for survival. Subgroup analyses of the patients with PSD indicated platin rechallenge yields higher progression-free survival, overall survival and overall response rate. Patients with good ECOG PS,who have PSD or initially presenting with LS, have a good prognosis and in patients with PSD, platinum-based therapy would be more appropriate.Publication Metadata only Outcome of rectal and sigmoid carcinoma patients receiving adjuvant chemoradiotherapy in marmara university hospital(TAYLOR & FRANCIS LTD, 2003) YUMUK, PERRAN FULDEN; Yumuk, PF; Abacioglu, U; Caglar, H; Gumus, M; Sengoz, M; Turhal, NSAdjuvant chemoradiotherapy is the standard treatment in resected stage II/III rectosigmoid carcinoma. We report a retrospective analysis of 33 patients who received adjuvant chemoradiotherapy. Patients received 5-fluorouracil (375mg/m(2)/day x 5days) and calcium leucovorin (20mg/m(2)/day x 5days), q4weeks, two courses before and two courses after radiotherapy. The 5-fluorouracil dose was reduced to 225mg/m(2)/day given continuously as protracted short-term infusion on the first and last 3 days during radiotherapy. Radiotherapy was started at 7th week and 45-50.4 Gy was given to pelvic region. Median age was 63 years. Median follow-up was 38 months starting from the operation date. Four-year local and distant control rates were 78% and 69%, respectively. Four-year disease-free survival and overall survival were 60% and 62%, respectively. Protracted short-term infusion of 5-fluorouracil during pelvic irradiation is a safe treatment modality. Further studies are needed to improve the local control of high-risk rectal and sigmoid carcinomas.