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YUMUK, PERRAN FULDEN

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PERRAN FULDEN

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Now showing 1 - 9 of 9
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    PublicationOpen Access
    Role of baseline Ga-68-PSMA PET/CT-derived whole-body volumetric parameters in predicting survival outcomes of metastatic castration-resistant prostate cancer patients receiving first-line treatment
    (2022-08-01) AKIN TELLİ, TUĞBA; ÖZGÜVEN, SALİH; FİLİZOĞLU, NUH; ÖZTÜRK, MEHMET SAADEDDİN; ARIKAN, RUKİYE; DEMİRCAN, NAZIM CAN; BAŞOĞLU TÜYLÜ, TUĞBA; ALSAN ÇETİN, İLKNUR; ÖNEŞ, TUNÇ; DANE, FAYSAL; YUMUK, PERRAN FULDEN; AKIN TELLİ T., ÖZGÜVEN S., Alan O., Filizoglu N., ÖZTÜRK M. S. , Sariyar N., Isik S., Arikan R., DEMİRCAN N. C. , BAŞOĞLU TÜYLÜ T., et al.
    Objective We aimed to evaluate whether baseline Ga-68-PSMA PET/CT-derived whole-body volumetric parameters could be used as predictive biomarkers for survival in metastatic castration-resistant prostate cancer (mCRPC) patients receiving first-line treatment. Materials and methods This retrospective study included 54 mCRPC patients, who underwent baseline Ga-68-PSMA PET/CT imaging within 1 month before starting first-line treatment. Pre-treatment prostate-specific antigen (PSA) levels and treatments were recorded. SUVmax, SUVmean, whole-body PSMA-derived tumor volume (wbPSMA-TV), and whole-body total lesion PSMA (wbTL-PSMA) were calculated for all patients. PSA response was defined as a decline of >= 50% from pre-treatment value at 12 weeks. Overall survival (OS) was measured from the start of the first-line treatment for mCRPC. Results Docetaxel and abiraterone/enzalutamide were administered to 32 and 22 patients in the first-line setting, respectively. wbPSMA-TV (rho = 0.582, p = 0.004) and wbTL-PSMA (rho = 0.564, p = 0.007) showed moderate positive correlations with PSA levels. Older age (p = 0.02), higher wbPSMA-TV (p = 0.007), higher PSA (p = 0.01), higher number of bone metastases (p = 0.02), and lack of PSA response (p = 0.03) were significantly associated with an increased risk of mortality. Multivariate analysis determined wbPSMA-TV (HR: 1.003, 95% CI 1.001-1.004, p = 0.001) and PSA response (HR: 2.241, 95% CI 1.189-4.222, p = 0.01) as independent predictors of OS. Conclusion The wbPSMA-TV may be a useful tool to reflect tumor burden and predict survival outcomes in patients with mCRPC.
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    PublicationOpen Access
    Prognostic factors of perioperative FLOT regimen in operable gastric and gastroesophageal junction tumors: real-life data (Turkish Oncology Group)
    (2022-01-01) YUMUK, PERRAN FULDEN; Erol C., Sakin A., Başoglu T., Özden E., ÇABUK D., Doğan M., Öksüzoğlu B., YILDIRIM H. Ç. , Öner İ., Karakurt Eryilmaz M., et al.
    © TÜBİTAK.Background/aim: Perioperative FLOT regimen is a standard of care in locally advanced operable gastric and GEJ adenocarcinoma. We aimed to determine the efficacy, prognostic factors of perioperative FLOT chemotherapy in real-life gastric and GEJ tumors. Materials and methods: The data of patients who were treated with perioperative FLOT chemotherapy were retrospectively analyzed from 34 different oncology centers in Turkey. Baseline clinical and demographic characteristics, pretreatment laboratory values, histological and molecular characteristics were recorded. Results: A total of 441 patients were included in the study. The median of age our study population was 60 years. The majority of patients with radiological staging were cT3-4N(+) (89.9%, n = 338). After median 13.5 months (IQR: 8.5–20.5) follow-up, the median overall survival was NR (95% CI, NR to NR), and median disease free survival was 22.9 (95% CI, 18.6 to 27.3) months. The estimated overall survival at 24 months was 62%. Complete pathological response (pCR) and near pCR was achieved in 23.8% of all patients. Patients with lower NLR or PLR have significantly longer median OS (p = 0.007 and p = 0.033, respectively), and patients with lower NLR have significantly longer median DFS (p = 0.039), but PLR level did not affect DFS (p = 0.062). The OS and DFS of patients with better ECOG performance scores and those who could receive FLOT as adjuvant chemotherapy instead of other regimens were found to be better. NLR was found to be independent prognostic factor for OS in the multivariant analysis. At least one adverse event reported in 57.6% of the patients and grade 3–4 toxicity was seen in 23.6% patients. Conclusion: Real-life perioperative FLOT regimen in operable gastric and GEJ tumors showed similar oncologic outcomes compared to clinical trials. Better performance status, receiving adjuvant chemotherapy as same regimen, low grade and low NLR and PLR improved outcomes in real-life. However, in multivariate analysis, only NLR affected OS.
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    PublicationOpen Access
    Real life experience of patients with locally advanced gastric and gastroesophageal junction adenocarcinoma treated with neoadjuvant chemotherapy: A Turkish oncology group study
    (2023-01-01) BAŞOĞLU TÜYLÜ, TUĞBA; YUMUK, PERRAN FULDEN; BAŞOĞLU TÜYLÜ T., Sakin A., Erol C., Ozden E., ÇABUK D., Cilbir E., Tataroglu ozyukseler D., Ayhan M., Sendur M. A., Dogan M., et al.
    Neoadjuvant chemotherapy (NACT) in gastroesophageal junction (GEJ) and gastric cancer (GC) was shown to improve survival in recent studies. We aimed to share our real-life experience of patients who received NACT to compare the efficacy and toxicity profile of different chemotherapy regimens in our country. This retrospective multicentre study included locally advanced GC and GEJ cancer patients who received NACT between 2007 and 2021. Relation between CT regimens and pathological evaluation were analysed. A total of 794 patients from 45 oncology centers in Turkey were included. Median age at the time of diagnosis was 60 (range: 18-86). Most frequent NACT regimens used were FLOT (65.4%), DCF (17.4%) and ECF (8.1%), respectively. In the total study group, pathological complete remission (pCR) rate was 7.2%, R0 resection rate 86.4%, and D2 dissection rate was 66.8%. Rate of pCR and near-CR (24%), and R0 resection (84%) were numerically higher in FLOT arm (p > 0.05). Patients who received FLOT had also higher chemotherapy-related toxicity rate compared to patients who received other regimens (p > 0.05). Median follow-up time was 16 months (range: 1-154 months). Estimated median overall survival (OS) was 58.4months (95% CI: 35.2-85.7) and disease-free survival (DFS) was 50.7 months (95% CI: 25.4-75.9). The highest 3-year estimated OS rate was also shown in FLOT arm (68%). We still do not know which NACT regimen is the best choice for daily practice. Clinicians should tailor treatment regimens according to patients\" multifactorial status and comorbidities for to obtain best outcomes. Longer follow-up period needs to validate our results.
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    PublicationOpen Access
    Practicality and potential restrictions of unresectable hepatocellular carcinoma prognostic index
    (2022-09-01) DEMİRTAŞ, COŞKUN ÖZER; ÖZDOĞAN, OSMAN CAVİT; BALTACIOĞLU, FEYYAZ; ÖNEŞ, TUNÇ; YUMUK, PERRAN FULDEN; DULUNDU, ENDER; GÜNDÜZ, FEYZA; DEMİRTAŞ C. Ö. , Ricco G., ÖZDOĞAN O. C. , BALTACIOĞLU F., ÖNEŞ T., YUMUK P. F. , DULUNDU E., Uzun S., Colombatto P., Oliveri F., et al.
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    PublicationOpen Access
    Pembrolizumab plus ipilimumab or placebo in previously untreated metastatic NSCLC with PD-L1 tumor proportion score >= 50%: KEYNOTE-598 3-year follow-up
    (2022-04-01) YUMUK, PERRAN FULDEN; Abreu D. R., Reck M., Sendur N., Park K., Lee D. H., Cicin I., Yumuk P. F., Orlandi F. J., Leal T. A., Soparattanapaisarn N., et al.
    Background: At protocol-specified interim analysis 1 (IA1; data cutoff Sep 1, 2020) of the phase 3 KEYNOTE-598 study (NCT03302234), adding ipilimumab (ipi) to pembrolizumab (pembro) did not improve OS (HR, 1.08) or PFS (HR, 1.06) vs placebo (pbo) + pembro in patients (pts) with previously untreated stage IV NSCLC with PD-L1 tumor proportion score (TPS) 50%. Per external DMC recommendation at IA1, ipi and pbo were discontinued and pembro monotherapy continued in both arms. We report 13 additional mo follow-up from IA1 and outcomes of pts who completed 35 cycles of pembro and pts who started second-course pembro. Methods: Eligible pts were randomized 1:1 to ipi 1 mg/kg or pbo Q6W for up to 18 doses (stratified by ECOG PS [0 vs 1], region [East Asia vs non-East Asia], and histology [squamous vs nonsquamous]). All pts received pembro 200 mg Q3W for up to 35 cycles. Dual primary endpoints were OS and PFS per RECIST v1.1 by BICR. Results: 568 pts were randomized to pembro + ipi vs pembro + pbo (n ¼ 284 each). Median time from randomization to data cutoff (Oct 1, 2021) was 33.6 (range, 25.4- 44.6) mo. After discontinuing ipi/pbo for all pts, median OS and PFS remained similar between groups (Table). Grade 3-5 treatment-related AEs occurred in 99/282 (35.1%) vs 57/281 (20.3%) pts in the pembro + ipi vs pembro + pbo arms, respectively. Among 52 pts vs 71 pts initially treated with pembro + ipi vs pembro + pbo who completed 35 cycles of pembro, ORR was 88.5% vs 87.3%, respectively; OS and PFS rates 1 y from completing pembro were 86.3% vs 87.6% and 72.8% vs 83.5%, respectively. 11 pts started second-course pembro
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    PublicationOpen Access
    A multicenter, retrospective archive study of radiological and clinical features of ALK-positive non-small cell lung cancer patients and crizotinib efficacy
    (2024-05-24) YUMUK, PERRAN FULDEN; Kilickap S., Ozturk A., Karadurmus N., KORKMAZ T., YUMUK P. F., ÇİÇİN İ., PAYDAŞ S., Cilbir E., Sakalar T., Uysal M., et al.
    To evaluate radiological and clinical features in metastatic anaplastic lymphoma kinase+ non-small cell lung cancer patients and crizotinib efficacy in different lines. This national, non-interventional, multicenter, retrospective archive screening study evaluated demographic, clinical, and radiological imaging features, and treatment approaches in patients treated between 2013-2017. Totally 367 patients (54.8% males, median age at diagnosis 54 years) were included. Of them, 45.4% were smokers, and 8.7% had a family history of lung cancer. On radiological findings, 55.9% of the tumors were located peripherally, 7.7% of the patients had cavitary lesions, and 42.9% presented with pleural effusion. Pleural effusion was higher in nonsmokers than in smokers (37.3% vs. 25.3%, P = .018). About 47.4% of cases developed distant metastases during treatment, most frequently to the brain (26.2%). Chemotherapy was the first line treatment in 55.0%. Objective response rate was 61.9% (complete response: 7.6%; partial response: 54.2%). The highest complete and partial response rates were observed in patients who received crizotinib as the 2nd line treatment. The median progression-free survival was 14 months (standard error: 1.4, 95% confidence interval: 11.2-16.8 months). Crizotinib treatment lines yielded similar progression-free survival (P = .078). The most frequent treatment-related adverse event was fatigue (14.7%). Adrenal gland metastasis was significantly higher in males and smokers, and pleural involvement and effusion were significantly higher in nonsmokers - a novel finding that has not been reported previously. The radiological and histological characteristics were consistent with the literature data, but several differences in clinical characteristics might be related to population characteristics.
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    PublicationOpen Access
    Impact of skeletal muscle measurements by chest computed tomography on survival and postoperative complications in patients with soft tissue sarcoma
    (2022-01-01) ARIKAN, RUKİYE; EROL, BÜLENT; KÖSTEK, OSMAN; BAYOĞLU, İBRAHİM VEDAT; DANE, FAYSAL; YUMUK, PERRAN FULDEN; ÖZGEN, ZERRİN; BUĞDAYCI, ONUR; AKIN TELLİ T., BUĞDAYCI O., Alan O., Sariyar N., Isik S., Arikan R., Yasar A., Majidova N., Celebi A., EROL B., et al.
    © 2022 Taylor & Francis Group, LLC.This study aims to evaluate whether sarcopenia, measured by chest computed tomography (CT), affects survival outcomes and postoperative complications in soft tissue sarcoma (STS) patients undergoing surgery. In this retrospective study, CT scans of 79 patients were reviewed to measure pectoralis and T12 vertebra muscle area. Both were then adjusted for height (cm2/m2) as pectoralis muscle index (PMI) and T12 vertebra muscle index (TMI). Analyses were performed by dichotomizing muscle indices at gender-specific 50th percentile; PMI and TMI < 50th percentile were defined as low, and ≥50th percentile as high. Overall postsurgical complication rate (PCR) was 16%. Median length of hospital stay (LOHS) was 10 days (3–90). PMI and TMI were significantly lower in women (p = 0.02, p = 0.04). Median body mass index was significantly higher in high PMI and TMI groups (p = 0.01 for both). PCR and LOHS were similar between low and high PMI and TMI groups. Median follow-up was 29 months, 37 patients had recurrence and 23 died. No significant difference was noted between low and high PMI and TMI groups, in terms of disease-free or overall survival. PMI and TMI as measured by chest CT had no impact on survival outcomes or postoperative complications in localized STS.
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    PublicationOpen Access
    Association of Pre-treatment Sarcopenia with Side Effects and Prognosis in Non-small Cell Lung Cancer Patients Receiving Erlotinib
    (2022-08-01) DEMİRCAN, NAZIM CAN; ENGÜR, CEREN ÖZGE; AKIN TELLİ, TUĞBA; BAŞOĞLU TÜYLÜ, TUĞBA; ARIKAN, RUKİYE; ÖZGÜVEN, SALİH; DANE, FAYSAL; KAYA, HANDAN; ÖNEŞ, TUNÇ; YUMUK, PERRAN FULDEN; DEMİRCAN N. C. , ENGÜR C. Ö. , AKIN TELLİ T., BAŞOĞLU TÜYLÜ T., Arikan R., Yasar A., Celebi A., Alan O., Isik S., ÖZGÜVEN S., et al.
    OBJECTIVE We investigated the relationship of baseline sarcopenia with toxicities, treatment response, and survival in patients who had non-small cell lung cancer (NSCLC) harboring an epidermal growth factor receptor (EGFR) mutation and received erlotinib.METHODS Computed tomography images from PET/CT scans before erlotinib treatment were retrospectively assessed. Skeletal muscle index, calculated as skeletal muscle area at third lumbar vertebra level/square of height, was used to define sarcopenia with < 52.4 cm2/m2 for males and < 38.5 cm2/m2 for females. Cox hazard models were conducted to determine predictors of survival.RESULTS The study included 30 patients, and 11 (36.7%) were sarcopenic. All-grade and Grade 3 toxicities were more frequent in sarcopenic group, although it was statistically insignificant (81.8% vs. 63.2%, p=0.282 for all-grade, and 18.2% vs. 10.5%, p=0.552 for grade 3). Response rates were 63.6% in sarcopenic and 68.4% in non-sarcopenic patients (p=0.789). Median progression-free survival was 7.9 and 9.2 months in sarcopenic and non-sarcopenic cases, respectively (p=0.561). However, median overall survival (OS) of sarcopenic patients was significantly shorter than non-sarcopenic ones (11.8 vs. 30.2 months, p=0.023), and sarcopenia predicted OS independently in multivariate analysis (Hazard ratio=2.63, p=0.029).CONCLUSION Early recognition, treatment, and prevention of sarcopenia may improve long-term survival in EGFRmutant NSCLC patients treated with first-line erlotinib.
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    PublicationOpen Access
    Evaluation of the efficacy and safety of nivolumab in the second- or later-line treatment of patients with locally advanced/metastatic non-small cell lung cancer in Türkiye: a retrospective multicenter non-interventional registry study
    (2024-01-01) YUMUK, PERRAN FULDEN; Karadurmus N., Kaplan M. A., Sendur M. A. N., ÜRÜN Y., Demirci U., Karaca S. B., Goktas Aydin S., Aykan M. B., Bilici A., Sezer A., et al.
    Objective: To evaluate the efficacy and safety of nivolumab in the second-line (2L) or later-line (LL) treatment of patients with locally advanced/metastatic non-small cell lung cancer (NSCLC) in real-life setting in Türkiye. Methods: This study was designed as a national, multi-center, retrospective study. The study population was evaluated in two groups for the line of nivolumab therapy: those receiving nivolumab in the 2L (Group 2L) and third-line (3L) or LL (Group 3L/LL). Efficacy was evaluated based on one-year overall survival (OS) and progression-free survival (PFS). Safety was evaluated based on treatment-related adverse events (AEs) and nivolumab discontinuation rate. Results: Of 244 patients, 52.9% were in Group 2L and 47.1% were in Group 3L/LL. Demographic and clinical characteristics did not differ between the groups. In Group 2L and Group 3L/LL, one-year OS and PFS rates were 60.8% and 61.4% (p = 0.592) and 31.2% and 21.3% (p = 0.078), respectively. The objective response rate (ORR) was 34.7% in Group 2L and 27.3% in Group 3L/LL (p = 0.262). The percentage of patients reporting at least one AE in Groups 2L and 3L/LL was 34.9% and 43.5%, respectively (p = 0.169). Fatigue was the most common (16.4%) treatment-related AE in each group. The groups were comparable regarding the AE frequency. Nivolumab was discontinued in 61 patients in Group 2L and 53 patients in Group 3L/LL, with the most common reason being disease progression (57.4% and 66.0%, respectively). Conclusion: Nivolumab is safe and effective in the 2L or 3L/LL treatment of locally advanced/metastatic NSCLC and associated with acceptable AEs in real-life setting.