Person: CANER, BURCU
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CANER
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BURCU
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Publication Retrospective comparison of the efficacy of therapeutic agents in metastatic soft-tissue sarcomas(Kare Yayınevi, 2023-03-02) Caner, Burcu; Ocak, Birol; Şahin, Ahmet Bilgehan; Salı, Seda; Çoban, Eyüp; Deligönul, Adem; Çubukçu, Erdem; Evrensel, Türkkan; CANER, BURCU; SALİ, SEDA; ÇOBAN, EYÜP; DELİGÖNÜL, ADEM; ÇUBUKÇU, ERDEM; EVRENSEL, TÜRKKAN; Tıp Fakültesi; Tıbbi Onkoloji Ana Bilim Dalı; 0000-0003-1591-3323 ; HJH-6371-2023; DPO-3759-2022; JIS-1916-2023; JHC-1731-2023; JGT-4101-2023; EXZ-0745-2022OBJECTIVEThere are few agents used in soft-tissue sarcoma treatment. We compared the efficacy of therapies, aiming to identify the best therapy sequence, and reveal the factors affecting the risk of progression or death.METHODSFifty-five patients were included in the study. Data such as age, gender, tumor primary site, histological type, tumor grade, the Ki67 percentage score, treatments, radiotherapy, and metastasectomy history, the dates of diagnosis, metastasis, progression, and death were retrospectively evaluated. Progression-free survival (PFS) and overall survival (OS) for therapies, and the risk factors for the progression or death were analyzed.RESULTSIn the first-line, gemcitabine-docetaxel provided longer PFS than the doxorubicin-ifosfamide combination (7.4 months vs. 4.8 months, p=0.035), although this did not result in OS difference. In the second line, the efficacy of trabectedin and pazopanib were similar, whereas trabectedin showed less activity in liposarcomas. In the third-line and beyond, trabectedin, pazopanib and eribulin showed similar PFS and OS. The only factor that affected the risk of death was metastasectomy (HR for death: 0.35, 95% CI: 0.18-0.66, p=0.001). CONCLUSIONWe found that agents used in soft-tissue sarcoma have similar efficacy, which is not affected by the previous therapies. However, it should be noted that soft-tissue sarcomas include many histological types, and to choose the optimal drug, the histological type must be one of the major factors considered. Furthermore, all patients should be evaluated for possible metastasectomy, which came out as the only factor reducing the risk of death in our study.Publication Platinum-induced neurotoxicity: A review of possible mechanisms(Baishideng Publishing Group Inc, 2017-08-10) Kanat, Özkan; Ertaş, Hülya; Caner, Burcu; CANER, BURCU; Tıp Fakültesi; OnkolojiAna Bilim Dalı; 0000-0002-5872-8825; HJH-6371-2023; AAE-8549-2022Patients treated with platinum-based chemotherapy frequently experience neurotoxic symptoms, which may lead to premature discontinuation of therapy. Despite discontinuation of platinum drugs, these symptoms can persist over a long period of time. Cisplatin and oxaliplatin, among all platinum drugs, have significant neurotoxic potential. A distal dose-dependent symmetrical sensory neuropathy is the most common presentation of platinum neurotoxicity. DNA damage-induced apoptosis of dorsal root ganglion (DRG) neurons seems to be the principal cause of neurological symptoms. However, DRG injury alone cannot explain some unique symptoms such as cold-aggravated burning pain affecting distal extremities that is observed with oxaliplatin administration. In this article, we briefly reviewed potential mechanisms for the development of platinum drugs-associated neurological manifestations.Publication 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, 2021-07-31) Caner, Burcu; CANER, BURCU; Tıp Fakültesi; Tıbbi Onkoloji Bilim Dalı; AAE-8549-2022Introduction 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 Platin-based chemotherapy does not improve survival in patients with non-metastatic resected typical carcinoid tumors(Spandidos Publ Ltd, 2022-10-01) Şahin, Ahmet Bilgehan; Melek, Hüseyin; Ocak, Birol; Oyucu Orhan, Sibel; Erkan, Buket; Caner, Burcu; Deligönül, Adem; Çubukcu, Erdem; Bayram, Ahmet Sami; Akyıldız, Elif Ülker; Evrensel, Türkkan; ŞAHİN, AHMET BİLGEHAN; MELEK, HÜSEYİN; OCAK, BİROL; OYUCU ORHAN, SİBEL; ERKAN ÖZMARASALI, BUKET; CANER, BURCU; DELİGÖNÜL, ADEM; ÇUBUKÇU, ERDEM; BAYRAM, AHMET SAMİ; AKYILDIZ, ELİF ÜLKER; EVRENSEL, TÜRKKAN; Tıp Fakültesi; Tıbbi Onkoloji Ana Bilim Dalı; 0000-0002-7846-0870; 0000-0003-0684-0900; 0000-0003-1822-8153; 0000-0001-8217-3471; 0000-0003-1591-3323; AAM-4927-2020; AAI-5039-2021; AEC-2238-2022; AAJ-8314-2021; CPN-8681-2022; HJH-6371-2023; ESM-4544-2022; ETP-1691-2022; ABB-7580-2020; ELN-4128-2022; EXZ-0745-2022Chemotherapy is controversial in non-metastatic typical carcinoid (TC) tumors. Therefore, it was aimed to evaluate the impact of platin-based chemotherapy on the survival of patients with lung TC. The medical records of patients who underwent surgical resection for non-metastatic TC from 2002 to 2020 at our institution were retrospectively reviewed. Multivariate regression analysis was performed for chemotherapy and prognostic factors in disease-free survival (DFS) in 72 patients. The pathological stages of patients were as follows: 73.6% of the patients were in stage I, 15.3% in stage II and 11.1% in stage III. A total of 5 patients (6.9%) received platin-based chemotherapy and 6 patients (8.3%) had recurrences. The DFS rates at 12, 36 and 60 months were 98.5, 95.1 and 92.5%, respectively. Log-rank testing showed that patients who received chemotherapy and had stage III disease had shorter DFS (P=0.021 for chemotherapy and P<0.001 for stage). However, multivariate analysis revealed that the pathological stage was the only statistically significant factor affecting DFS (P=0.016). Platin-based chemotherapy did not improve DFS, and the eighth edition of TNM (tumor, nodes, metastases) staging did have prognostic value for patients with non-metastatic TC. Although resection has satisfying long-term outcomes, studies on new agents are needed to decrease the recurrence rate, particularly in patients with stage III disease.Publication Chemotherapy plus radiotherapy vs . radiotherapy alone in high-risk endometrioid endometrial carcinoma(Verduci Publisher, 2022-01-01) Ocak, B.; Şahin, Ahmet Bilgehan; ŞAHİN, AHMET BİLGEHAN; Abakay, Candan Demiröz; DEMİRÖZ ABAKAY, CANDAN; Çubukçu, Erdem; ÇUBUKÇU, ERDEM; Deligönül, Adem; DELİGÖNÜL, ADEM; Caner, Burcu; CANER, BURCU; Evrensel, Türkkan; EVRENSEL, TÜRKKAN; Özerkan, Kemal; ÖZERKAN, KEMAL; DAKİKİ KORUCU, BAHAR; İşlek, G.; Tıp Fakültesi; Onkoloji Ana Bilim Dalı; 0000-0002-7846-0870; 0000-0001-9255-2475; AAM-4927-2020; ABA-2897-2021OBJECTIVE: Adding chemo-therapy to radiotherapy in patients with high-risk endometrioid endometrial cancer (EEC) remains controversial, particularly in stages I-II. We aimed to investigate the effect of treat-ment modalities on survival in high-risk EEC patients. PATIENTS AND METHODS: Patients with high-risk EEC were evaluated retrospectively between 2010 and 2019. Patients who did not re-ceive adjuvant treatment were excluded. We in-cluded seventy patients and formed two groups: patients who received radiotherapy (RT) alone and those who received chemotherapy and ra-diotherapy (CT and RT). RESULTS: The median follow-up time was 60.3 months (8.0-143.5). 38.5% of the patients had relapsed. Recurrence-free survival (RFS) rates were 97. 1%, 68.3% , and 60.8% at 12-, 36-, and 60-month, respectively. Overall survival rates were 97.1%, 80.6%, and 72.6% at 12-, 36-, and 60-month, respectively. Hematological adverse events and neuropathy were more common in the CT and RT group than in the RT group. Multi-variate Cox regression analysis for RFS revealed that the FIGO stage and treatment modalities were statistically independent factors (p=0.031 and p=0.040, respectively). Stage stratified log-rank test revealed that adding chemotherapy im-proved RFS in patients with stage III (p=0.020) but not in stage I-II disease (p=0.725). The num-ber of chemotherapy cycles administered (<= 4 vs. > 4) did not affect survival in all patients and stage III disease (p=0.497, and p=0.436, respec-tively). CONCLUSIONS: Adding chemotherapy to radiotherapy may be considered in high-risk stage III EEC. Further studies are needed to determine the optimal duration of chemother-apy.Publication Hyperprogression and hypercalcemia after nivolumab treatment in three cases with renal cell carcinoma(Sage Publications Ltd, 2022-02-21) Ertaş, Hülya; Ocak, Birol; CANER, BURCU; Çubukçu, Erdem; ÇUBUKÇU, ERDEM; Tıp Fakültesi; Tıbbi Onkoloji Ana Bilim Dalı; 0000-0002-5872-8825; HJH-6371-2023Introduction Hyperprogression is a specific type of response seen with immunotherapy that is observed in all malignancies with a frequency of 9% - 29%, characterized by a rapid increase in tumor burden. Many possible related factors and possible markers have been evaluated but a clinical or laboratory parameter associated with hyperprogression has not yet been established. For renal cell carcinoma, hypercalcemia is known to be a poor prognostic factor but it has not been linked to hyperprogression. Case report We retrospectively evaluated 52 patients diagnosed with renal cell carcinoma who had nivolumab treatment in any line. 3 of 9 patients who had hyperprogression were noticed to have hypercalcemia preceding hyperprogression. Here we present those 3 cases who developed hypercalcemia after nivolumab and had hyperprogression at follow-up. Management and outcome All cases had less than 4 courses of nivolumab and showed hyperprogression in assessment. Nivolumab was discontinued. However, patients' survival was extremely poor, as expected. Discussion The development of hypercalcemia may help predict hyperprogression in patients with renal cell carcinoma who receive immunotherapy. In such cases, early evaluation of progression and cessation of nivolumab may be considered.