Person: AKIN TELLİ, TUĞBA
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AKIN TELLİ
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TUĞBA
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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 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.