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Öğe Classical versus non-classical EGFR mutations: Erlotinib response and impact of renal insufficiency(Sage Publications Ltd, 2021) Celik, Emir; Samanci, Nilay Sengul; Karadag, Mehmet; Demirci, Nebi Serkan; Cikman, Duygu Ilke; Derin, Sumeyra; Bedir, SahinIntroduction Erlotinib is an effective treatment option for EGFR-mutant non-small cell lung cancer. It is important to predict patients who will respond better to erlotinib. We designed this study to investigate the effect of renal insufficiency (RI) on erlotinib treatment outcomes. Methods All patients receiving erlotinib were stratified into 3 groups. Group 1 consisted of non-RI subjects with classical epidermal growth factor receptor (EGFR) mutations, Group 2 consisted of those with RI (Estimated glomerular filtration rate <60 mL/min) and classical EGFR mutations, and Group 3 consisted of those with non-classical EGFR mutations. Results 82 patients were included in the study. Median progression-free survival (PFS) in patients with classical mutation was approximately 6 months shorter in those with RI, although not statistically significant. Median overall survival (OS) in Group 1, 2 and 3 was 34.1 months, 35.2 months, and 15 months, respectively and although not statistically significant, median OS was 20 months shorter in Group 3. Univariate and multivariate cox-regression analysis revealed shorter PFS and OS in males and those with ECOG >= 2 while PFS and OS were longer in those with recurrent lung tumors and generating rash during erlotinib treatment. There was no difference between RI and non-RI patients in terms of adverse events except for fatigue and appetite loss. Conclusions This research showed OS in patients with and without RI was comparable. Although not statistically significant, PFS in patients with classical mutation was approximately 6 months shorter in those with RI patients.Öğe Could Systemic Inflammation-Based Prognostic ScoresPredict the Clinical Outcome in Patients with Breast CancerTreated with Everolimus Plus Exemestane?(2021) Çelik, Emir; Samancı, Nilay Sengul; Karadağ, Mehmet; Demirci, Nebi Serkan; Demirelli, Fuat HulusiObjectives: No study to clarify which inflammation score could best reflect survival in a cohort of metastatic breastcancer (mBC) patients who received everolimus plus exemestane. Methods: The impact of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and prognostic nutritional index (PNI) on PFS and OS was evaluated. Results: A total of 80 mBC patients were included. Median PFS was 8.9 months and median overall survival (OS) was31.8 months. We found that there was no significant difference between NLR, PLR, SII, and PNI groups for median PFSand OS. Conclusion: Inflammation-based prognostic scores were not correlated with prognosis in patients with mBC who hadbeen treated with everolimus plus exemestane.Öğe Hospitalize Kanser Hastalarında Malnütrisyon Riski ve Yaşam Kalitesine Etkisi(2021) Çelik, Emir; Aslan, Muhammed Şamil; Samancı, Nilay Şengül; Karadağ, Mehmet; Suzan, Veysel; Çelik, Yasemin Çakan; Demirci, Nebi SerkanAmaç: Malnutrisyon kanser hastalarında en sık klinik sorunlardan biridir. Hospitalize kanser hastalarında sıklığı daha da artar. Bu çalışmada hospitalize edilmiş kanser hastalarında malnutrisyon sıklığı ve yaşam kalitesine (YK) etkisinin araştırılması amaçlandı.Gereç ve Yöntem: Kesitsel olarak dizayn edilen bu çalışmada medikal onkoloji servisine yatan kanser tanılı hastalar için Nutrisyon Risk Skorlaması-2002 (NRS-2002) ve “Avrupa Kanser Araştırma ve Tedavi Teşkilatı” (EORTC)-QLQ C30 ölçekleri dolduruldu. Klinik ve laboratuvar paramatreleri ile malnutrisyon riski ve YK arasındaki ilişki istatistik yöntemleri ile analiz edildi.Bulgular: Çalışmaya 113 hasta dahil edildi. NRS-2002 sonuçlarına göre %42,5 (n=48) hastada malnutrisyon riski tespit edildi. Cinsiyet ve yaş açısından gruplar arasında fark yoktu. EORTC-QLQ C30 ölçek puanları karşılaştırıldığında malnutrisyon riskinin genel sağlık skoru üzerine etkisi yoktu (p=0,679). Fiziksel fonksiyon ve rol fonksiyon skorları malnutrisyon riski olanlarda anlamlı olarak daha düşüktü (daha kötü YK). Diğer fonksiyonel skalalar açısından gruplar arasında anlamlı istatistiksel fark yoktu. Daha iyi genel sağlık skoruna etki eden faktörlere tek değişkenli lojistik regresyon (LR) uygulandığında sadece hemoglobin düzeyi anlamlı faktör olarak bulundu. Bu yüzden çok değişkenli LR yapılmadı.Sonuç: Malnutrisyon risk değerlendirmesi hastaneye yatan her kanser hastasına mutlaka yapılmalıdır. Malnutrisyon riski olan hastalarda EORTC-QLQ C30 ölçeğine göre daha kötü YK olduğu görüldü. Risk saptanan hastalara erken dönemde nutrisyon desteği verilmelidir.Öğe The relationship between eGFR and capecitabine efficacy/toxicity in metastatic breast cancer(Humana Press Inc, 2021) Celik, Emir; Samanci, Nilay Sengul; Karadag, Mehmet; Demirci, Nebi Serkan; Demirelli, Fuat Hulusi; Ozguroglu, MustafaThe objective of this study was to evaluate the efficacy and toxicity of capecitabine in metastatic breast cancer (mBC) according to the estimated glomerular filtration rate (eGFR). A total of 135 patients included in the final analysis were stratified into 3 categories according to baseline eGFR, i.e., eGFR <60 mL/min/1.73 m(2) (Group 1), eGFR 60-90 mL/min/1.73 m(2) (Group 2) and eGFR >90 mL/min/1.73 m(2) (Group 3). If a patient developed a level of toxicity that would lead to capecitabine dose reduction, this was recognized as dose-limiting toxicity (DLT). The dose was reduced due to toxicity in 95 cycles. A total of 95 DLTs were seen in 76 (56.2%) of the 135 patients. When 76 patients with DLT were evaluated according to eGFR, DLT was observed in 93.3% of those in Group 1, 72.5% of those in Group 2 and 41.3% of those in Group 3 (p < 0.001). The median time to progression (TTP) of all patients was 7.4 months. No significant difference in TTP was observed in patients stratified into 3 groups according to eGFR. When the patients were divided into two groups as DLT and without DLT, the median TTP was 8.68 months (95% CI, 7.53-9.81 months) in those with toxicity and 6.23 months (95% CI, 4.04-8.43 months) in those without toxicity (log-rank p = 0.004). We found a significant relationship between low eGFR and increased risk of DLT. Having a DLT was associated with a longer TTP. It indicates the need for more data/larger study investigating these discrepancies.Öğe The Relationship Between Symptom Severity and Caregiver Burden in Cancer Patients Under Palliative Care: A Cross-Sectional Study(Sage Publications Inc, 2022) Celik, Emir; Aslan, Muhammed Samil; Samanci, Nilay Sengul; Karadag, Mehmet; Saglam, Tarik; Celik, Yasemin Cakan; Demirci, Nebi SerkanIntroduction Hospitalization is a stressful experience both for primary caregivers (PCs) and cancer patients alike. Although there is significant evidence that PCs of cancer patients can experience significant caregiver burden (CB), less is known about the relationships between PCs and patient symptom severity that influence CB. Methods: In this cross-sectional study, measures of the symptom severity were obtained from cancer patients. The PCs were assessed for CB. Associations between patients' symptoms and demographic characteristics and CB were investigated using multivariate analyses. Results: A total of 98 participants (patient-caregiver dyads) filled the questionnaires. According to the Zarit Burden Interview results, 65.3% of PCs had a high CB. Pain, tiredness, nausea, depression, drowsiness, well-being, and dyspnea had significantly higher mean values in those with high CB (p < .05). Financial difficulties, first-degree relationships with the patient, higher anxiety levels, and more pronounced tiredness appear to be the variables most predictive with high CB. Conclusion: In conclusion, the present study showed CB of PCs among a group of hospitalized incurable cancer patients. PCs of more symptomatic cancer patients had a higher CB, according to our findings. This emphasized the significance of palliative care. Appropriate guidance should be provided for the psychostress caused by the CB.
