Person: YUMUK, PERRAN FULDEN
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YUMUK
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PERRAN FULDEN
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Publication Open 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.Publication Metadata only Multicenter real life clinical outcomes of pdl-1 tested patients with non small cell lung cancer (NSCLC) in Turkey(2022-09-01) YUMUK, PERRAN FULDEN; Yazici O., Gurler F., Acar R., Gurbuz M., Guven D. C. , Tuylu T. B. , Araz M., Kilickap S., Erturk I., Senler F. C. , et al.Publication Open 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.Publication Open 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.Publication Open 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.Publication Metadata only Real-world assessment of quality-of-life in patients with breast cancer treated with adjuvant endocrine therapy(2022-07-01) ARIKAN, RUKİYE; BAŞOĞLU TÜYLÜ, TUĞBA; DANE, FAYSAL; YUMUK, PERRAN FULDEN; KÖSTEK, OSMAN; AKIN TELLİ T., ÖZTÜRK M. S., Alan O., Hasanov R., KÖSTEK O., Arikan R., BAŞOĞLU TÜYLÜ T., Kaya S., Ercelep O., Babacan N. A., et al.Objective: The aim of this study was to investigate quality-of-life (QoL) in breast cancer (BC) patients treated with adjuvant endocrine therapy (AET). Methods: We designed a cross-sectional study of 233 BC patients treated with AET and used the Functional Assessment of Cancer Therapy - Breast questionnaire. Results: No significant difference was observed between endocrine agents. Duration of AET did not affect QoL. In the entire cohort, multivariate analysis determined age (p = 0.034) and switching treatment from tamoxifen to aromatase inhibitors (p = 0.049) as significant positive coefficients of QoL, while comorbidity (p = 0.072) tended to be associated with lower scores. Education level (p = 0.001) and chemotherapy (p = 0.04) were significant predictors of QoL in the tamoxifen group, while comorbidity (p = 0.04), surgery type (p = 0.02), radiotherapy (p = 0.006) and stage (p = 0.009) had a significant impact on QoL in aromatase inhibitors group. Conclusion: Evaluating the well-being of BC patients by QoL questionnaires is of great importance to identify particular subgroups that may require supportive care.Publication Metadata only Kanser tanisi alan hastalarda poli̇kli̇ni̇k şartlarinda üç farkli test İle nütri̇syonel durum değerlendi̇rmesi̇(2012-04-19) ATASOY, BESTE MELEK; ÖZGEN, ZERRİN; DANE, FAYSAL; YUMUK, PERRAN FULDEN; Atasoy B. M., Aygör H. A., Günaydın D., Özlen T., İbrahimov R., Özgen Z., Dane F., Yumuk P. F.Publication Metadata only Treatment outcomes of breast cancer patients older than 65 years old received local radiotherapy(2014-09-30) ATASOY, BESTE MELEK; ÖZGEN, ZERRİN; YUMUK, PERRAN FULDEN; UĞURLU, MUSTAFA ÜMİT; KAYA, HANDAN; GÜLLÜOĞLU, MAHMUT BAHADIR; Atasoy B. M., Kefeli A., Özgen Z., Rzayev R., Yumuk P. F., Uğurlu M. Ü., Kaya H., Arıbal M. E., Güllüoğlu M. B.Publication Open 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 pembroPublication Metadata only Rektum kanseri̇ni̇n adjuvan tedavi̇si̇nde oral floropi̇ri̇mi̇di̇n foli̇ni̇k asi̇tle eş zamanli radyoterapi̇ uygulamasinin yaşam kali̇tesi̇ne etki̇si̇(2012-04-19) ÖZGEN, ZERRİN; DANE, FAYSAL; ATASOY, BESTE MELEK; YUMUK, PERRAN FULDEN; Özgen Z., Dane F., Özden S., Akgün Z., Atasoy B. M., Yumuk P. F., Mayadağlı A., Turhal S., Abacıoğlu U.Amaç: Bu çalışmada rektum kanserinin adjuvan tedavisinde oral fl oropirimidin-folinik asitle eş zamanlı radyoterapi uygulamasının yaşam kalitesine etkisinin araştırılması amaçlandı. Gereç-Yöntem: Prospektif planlanan bu faz II çalışmada Ekim 2003-Aralık 2005 tarihleri arasında WHO performans skoru 0-1, evresi pT3-T4pN+, histopatolojisi adenokanser olan ve yazılı onamı alınmış yaşam kalitesi formlarını dolduran 25 hasta analize dahil edildi. Protokole göre pelvik radyoterapi (RT) konvansiyonel fraksiyon şemasıyla kemoterapi (KT) oral fl oroprimidin-UFT 300 mg/m2/ gün, folik asit 30 mg/m2/gün eş zamanlı olarak toplam 50.4 Gy/28 fraksiyon/5 haftada uygulandı. Çalışmada Avrupa Kanser Araştırma ve Tedavisi Organizasyonu (EORTC) yaşam kalitesi grubunun izni alınarak EORTC-QLQC30 genel sağlık ve EORTC QLQCR38 kolorektal kanser yaşam kalitesi formlarının Türkçe sürümleri kullanıldı. Formlar kemoradyoterapinin (KRT) başında (KRT1) ve tedavi bitiminde (KRT2) birer kez uygulandı. Yaşam kalitesi skorları 0-100 arasında hesaplandı ve ortalama değerleriyle (±standart sapma) verildi. Yüksek skor, fonksiyonel skalada sağlık durumunun iyiliğini semptom skalasında semptomun fazlalığını göstermekteydi. Zamana bağlı değişkenlerin ortalamalarının karşılaştırılmasında ilişkili örneklemler için t testi (paired-sample t test) kullanıldı. Anlamlılık için p değeri <0.05 seçildi. KRT sırasında görülen yan etkilerin değerlendirilmesi genel toksisite kriterleri (CTC) v2.0’a göre yapıldı. Bulgular: Tüm hastalar RT’yi planlandığı şekilde tamamlandı. Eş zamanlı KT uygulaması %84 hastada kesintisiz gerçekleşti. Yan etkilerden derece 2 diyare %25, derece 2 dizüri %10, derece 3 dizüri %10 oranında izlendi. Hastaların tamamı KRT başında yaşam kalitesi formalarını doldurmuşken KRT sonu tamamlama oranı %96 idi. Formlarda yer alan sorulardan genel sağlık durumunu, fiziksel fonksiyonları ve semptomları sorgulayan sorulara hastaların tamamı cevap verdi. Buna karşılık seksüel fonksiyon sorularına erkek hastalar %76 oranında cevap verirken kadınların hiçbirisi sorulara cevap vermedi. KRT başı ve sonu ortalama skorlardan anlamlı fark görülenler şu şekildeydi: diyare (KRT1:18.66±32.03; KRT2:43.99±35.64, p=0.01), idrar problemleri (KRT1: 34.66±24.49; KRT2:51.55±30.41, p=0.006), kemoterapiye bağlı yan etkiler (KRT1: 21.33±15.35; KRT2: 29.33±24.40, p=0.05). Bu parametreler dışında yer alan global sağlık durumu skoru, fonksiyonel durum parametreleri ve semptom skorları arasında KRT1-KRT2 karşılaştırmasında anlamlı fark bulunmadı. Semptom skalasında emosyonel ve insomnia skorları KRT başında kadınlarda kötü iken, fiziksel skorlar erkeklerde daha kötüydü. KRT sonu bu farkların kaybolduğu izlendi. Sonuç: Çalışmamızda rektum kanseril tanısı alan hastalarda oral fl oropirimidin ile eş zamanlı KRT uygulamasının diyare ve idrar probleri dışında yaşam kalitesine olumsuz etkisinin olmadığı görülmüştür. Çalışmamız yüksek hasta sayılı ve uzun takipli çalışmalarla desteklenmelidir.