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    Bevacuzimab May Be Less Effective in Obese Metastatic Colorectal Cancer Patients
    (Springer, 2019) Artac, Mehmet; Korkmaz, Levent; Coskun, Hasan Senol; Dane, Faysal; Karabulut, Bulent; Karaagac, Mustafa; Cabuk, Devrim; Karabulut, Senem; Aykan, Nuri Faruk; Doruk, Hatice; Avci, Nilufer; Turhal, Nazim Serdar
    PurposeThe purpose of this study was to investigate whether obesity affects survival in metastatic colorectal cancer (mCRC) patients treated with bevacizumab combined with chemotherapy.MethodsA total of 563 patients with mCRC who had received first-line chemotherapy in combination with bevacizumab were studied. Patients were grouped as obese (BMI levels >30) or non-obese (BMI levels <30). Progression-free survival (PFS) and overall survival (OS) were analyzed. Primary tumor location was also investigated in terms of PFS and OS.ResultsThe median age of the patients was 59years. The non-obese group had longer PFS than the obese group (P=0.030). The 2-year survival rate of the non-obese group was also significantly higher (P=0.036). The median PFS of non-obese patients was significantly longer in Kras wild-type patients (10.1 vs. 8.1months, P=0.010). Among patients with left-sided primary tumor location, median PFS and OS were significantly higher in the non-obese group (PFS non-obese, 11.5months; obese, 8.8months; P=0.002) (OS non-obese, 29.4months; obese, 21.4months; P=0.026).ConclusionsEfficacy of bevacizumab may be lower in obese patients. Among patients with Kras wild-type left-sided tumors treated with bevacizumab-based regimens, the prognosis could be worse for obese patients than that for non-obese patients. There is a need for prospectively designed studies of obese patients to prove the efficacy and dosages of bevacizumab in treatment of mCRC.
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    Efficacy of Capecitabine and Temozolomide Regimen in Neuroendocrine Tumors: Data From the Turkish Oncology Group
    (Oxford Univ Press, 2023) Ünal, Çağlar; Azizy, Abdulmunir; Karabulut, Senem; Tastekin, Didem; Akyıldız, Arif; Yaşar, Serkan; Yalçın, Şuayib
    Introduction: This study aims to report the efficacy and safety of capecitabine plus temozolomide (CAPTEM) across different lines of treatment in patients with metastatic neuroendocrine tumors (NETs).Methods: We conducted a multicenter retrospective study analyzing the data of 308 patients with metastatic NETs treated with CAPTEM between 2010 and 2022 in 34 different hospitals across various regions of Turkey.Results: The median follow-up time was 41.0 months (range: 1.7-212.1), and the median age was 53 years (range: 22-79). Our results across the entire patient cohort showed a median progression-free survival (PFS) of 10.6 months and a median overall survival (OS) of 60.4 months. First-line CAPTEM treatment appeared more effective, with a median PFS of 16.1 months and a median OS of 105.8 months (median PFS 16.1, 7.9, and 9.6 months in first-, second-and =third-line respectively, P = .01; with median OS values of 105.8, 47.2, and 24.1 months, respectively, P = .003) In terms of ORR, the first-line treatment again performed better, resulting in an ORR of 54.7% compared to 33.3% and 30.0% in the second and third or higher lines, respectively (P < .001). Grade 3-4 side effects occurred only in 22.5% of the patients, leading to a discontinuation rate of 9.5%. Despite the differences in outcomes based on treatment line, we did not observe a significant difference in terms of side effects between the first and subsequent lines of treatment.Conclusions and Relevance: The substantial superior outcomes in patients receiving first-line CAPTEM treatment highlight its potential as an effective treatment strategy for patients with metastatic NET.
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    Kras-mutation influences outcomes for palliative primary tumor resection in advanced colorectal cancer-a Turkish Oncology Group study
    (Elsevier Sci Ltd, 2018) Korkmaz, Levent; Coskun, Hasan Senol; Dane, Faysal; Karabulut, Bulent; Karaagac, Mustafa; Cabuk, Devrim; Karabulut, Senem; Aykan, Nuri Faruk; Doruk, Hatice; Avci, Nilufer; Turhal, Nazim Serdar; Artac, Mehmet
    Purpose: We aimed to investigate the prognostic effect of primary tumor resection (PTR) prior to bevacizumab-based treatments in unresectable metastatic colorectal cancer (mCRC). Methods: We retrospectively collected 341 mCRC cases with unresectable metastases at diagnosis. PTR was performed in 210 cases (the surgery group) and the other patients (n = 131) were followed without PTR (the no-surgery group). All the patients were treated with bevacizumab combined chemotherapy regimens. Results: The median progression free survival (PFS) of the surgery group was 10.4 months (95% CI: 8.9-11.9), which was significantly better than that of the no-surgery group (7.6 months, 95% CI: 6.4-8.8, P = 0.000). The median overall survival (OS) of the surgery group was longer than that of the no-surgery group (27.4 months vs. 18.3 months, respectively, P = 0.000). The median PFS and OS of the surgery group were 10.4 months and 28.2 months, which were significantly longer than that of the no-surgery group in Kras-mutant patients (7.8 months and 18.3 months; P = 0.004, P = 0 .028, respectively). There was no difference in terms of PFS and OS between the surgery and the no-surgery groups in Kras-wild type patients. Conclusion: Palliative PTR may improve the survival outcomes for unresectable mCRC patients. PTR may be preferred, particularly in Kras-mutant patients.