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    ANTI-PROLIFERATIVE, ANTI-APOPTOTIC AND ANTI-ANGIOGENIC EFFECTS OF GOSSYPOL IN COMBINATION WITH ZOLEDRONIC ACID IN HUMAN OVARIAN CANCER CELL LINE OVCAR3
    (John Wiley & Sons Inc, 2009) Atmaca, Harika; Uzunoglu, Selim; Gorumlu, Gurbuz; Karaca, Burcak; Karabulut, Bulent; Sanli, Ulus Ali; Uslu, Ruchan
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    Anticancer Therapy for Breast Cancer Patients with Skin Metastases Refractory to Conventional Treatments
    (Asian Pacific Organization Cancer Prevention, 2014) Varol, Umut; Yildiz, Ibrahim; Alacacioglu, Ahmet; Uslu, Ruchan
    Skin metastases of breast cancer are usually late events in the course of tumor progression and signify a poor prognosis. They may remain as a therapeutic challenge especially after failure of standard treatments. Topical interventions, together with or without radiotherapy, may only palliate the symptoms temporarily. However, there may be alternative treatment modalities for unresectable breast cancer skin metastases resistant to chemotherapy and radiotherapy. There are various genetic alterations in tumors and therapeutic potential of expression patterns for factors like epidermal growth factor receptor may have important clinical implications in case of disease refractory to the conventional treatments. Here, we clarified the therapeutic options and genetic alterations in skin metastatic breast cancer patients refractory to standard chemotherapeutics.
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    Assessment of pain, fatigue, sleep and quality of life (QoL) in elderly hospitalized cancer patients
    (Elsevier Ireland Ltd, 2010) Eyigor, Sibel; Eyigor, Can; Uslu, Ruchan
    As the proportion of older adults in the population continues to grow, the number of patients with cancer is expected to increase proportionally. In the previously conducted studies, data on elderly cancer patients were generally compared with the QoL scores of elderly patient group and with the data of non-cancer individuals. The purpose of this study was to examine differences in reported pain, fatigue, sleep problems and QoL between middle-aged and elderly hospitalized patients with cancer. We included 53 middle-aged (between 18 and 50 years) hospitalized cancer patients and 47 elderly (>60 years) hospitalized cancer patients in this study. Pain (visual analog scale = VAS, verbal pain rating), fatigue (brief fatigue inventory = BFI), sleep problems, QoL (Short Form 36 = SF36), and European Organization for Research and Treatment of Cancer (EORTC)-QoL-C30 data were gathered using standardized measures. In the elderly group, no significant difference was detected in terms of VAS, verbal pain rating, fatigue, fatigue type, sleep problems and QoL scores (p > 0.05). When the two age groups were compared, BFI scores were found to be significantly high among the elderly patients (p < 0.05). A significant relationship was observed in both age groups between the scores of pain, fatigue and sleep problems, and QoL (p < 0.05). Elderly hospitalized cancer patients did not demonstrate a distinctive difference in terms of pain, sleep and QoL compared to the younger group. The relationship between pain, fatigue, sleep and QoL should be definitely kept in mind in clinical practice. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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    Association of age with breast cancer clinical and pathological factors: Analysis of Turkish National Breast Cancer Registry.
    (Amer Soc Clinical Oncology, 2015) Benekli, Mustafa; Altundag, Kadri; Dumanli, Esra; Isikdogan, Abdurrahman; Karaoglu, Aziz; Tekin, Salim Basol; Oksuzoglu, Berna; Kocer, Murat; Sevinc, Alper; Boruban, Melih Cem; Turna, Hande; Uslu, Ruchan; Ozyilkan, Ozgur; Yalcin, Bulent; Coskun, Ugur; Kilickap, Saadettin; Dogu, Gamze Gokoz; Ozturk, Banu; Gumus, Mahmut; Buyukberber, Suleyman; Uncu, Dogan; Kara, Oguz; Aliustaoglu, Mehmet; Ozkan, Metin; Cicin, Irfan; Elkiran, E. Tamer; Dane, Faysal; Avci, Nilufer; Ulas, Arife; Ozdemir, Feyyaz; Kaya, Ali Osman
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    Association of age with breast cancer clinical and pathological factors: Analysis of Turkish National Breast Cancer Registry.
    (Amer Soc Clinical Oncology, 2015) Benekli, Mustafa; Altundag, Kadri; Dumanli, Esra; Isikdogan, Abdurrahman; Karaoglu, Aziz; Tekin, Salim Basol; Oksuzoglu, Berna; Kocer, Murat; Sevinc, Alper; Boruban, Melih Cem; Turna, Hande; Uslu, Ruchan; Ozyilkan, Ozgur; Yalcin, Bulent; Coskun, Ugur; Kilickap, Saadettin; Dogu, Gamze Gokoz; Ozturk, Banu; Gumus, Mahmut; Buyukberber, Suleyman; Uncu, Dogan; Kara, Oguz; Aliustaoglu, Mehmet; Ozkan, Metin; Cicin, Irfan; Elkiran, E. Tamer; Dane, Faysal; Avci, Nilufer; Ulas, Arife; Ozdemir, Feyyaz; Kaya, Ali Osman
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    Association of age with breast cancer clinical and pathological factors: Analysis of Turkish National Breast Cancer Registry.
    (Amer Soc Clinical Oncology, 2015) Benekli, Mustafa; Altundag, Kadri; Dumanli, Esra; Isikdogan, Abdurrahman; Karaoglu, Aziz; Tekin, Salim Basol; Oksuzoglu, Berna; Kocer, Murat; Sevinc, Alper; Boruban, Melih Cem; Turna, Hande; Uslu, Ruchan; Ozyilkan, Ozgur; Yalcin, Bulent; Coskun, Ugur; Kilickap, Saadettin; Dogu, Gamze Gokoz; Ozturk, Banu; Gumus, Mahmut; Buyukberber, Suleyman; Uncu, Dogan; Kara, Oguz; Aliustaoglu, Mehmet; Ozkan, Metin; Cicin, Irfan; Elkiran, E. Tamer; Dane, Faysal; Avci, Nilufer; Ulas, Arife; Ozdemir, Feyyaz; Kaya, Ali Osman
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    Association of Rac1 Expression with Trastuzumab Resistance In HER2-Positive Breast Cancer
    (Akad Doktorlar Yayinevi, 2013) Varol, Umut; Karaca, Burcak; Patir, Pusem; Sener, Alper; Zekioglu, Osman; Sanli, Ulus A.; Uslu, Ruchan
    Several molecular mechanisms are believed to take role in the development of trastuzumab resistance in breast cancer patients with overexpressing HER2. However, the sequence and the activity of these mechanisms are still unclear. In this study, Rac1 and neuregulin 1 (NRG1), two of ErbB pathway related proteins, were analyzed in HER2-positive breast cancer patients to investigate their roles in trastuzumab resistance. Trastuzumab resistance in metastatic breast cancer treatment was defined as a progression within six months of the treatment and in the adjuvant manner as an occurrence of local/distant recurrence before completion of treatment. Expression of Rac1 and NRG1 by immunohistochemistry (IHC) was studied in all 22 (n=12 adjuvant, n=10 metastatic) trastuzumab-resistant and 27 control tissue samples. The staining intensity of Rac1 was statistically significant in adjuvant treatment resistant group when compared with the controls (p=0.02). In addition, when all resistant groups were compared with the control groups, Rac1 staining intensity was denser (p=0.051). NRG1 staining intensity was in tendency to be denser as compared to control group, however it did not reach to a statistically significant level (p=0.09). In HER2-positive breast cancer, presence of Rac1 protein is significantly associated with early response failure to adjuvant trastuzumab therapy. However, further studies with larger groups are warranted to show the value of these molecules in predicting the response to trastuzumab-based therapies.
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    Avelumab versus docetaxel in patients with platinum-treated advanced non-small-cell lung cancer (JAVELIN Lung 200): an open-label, randomised, phase 3 study
    (Elsevier Science Inc, 2018) Barlesi, Fabrice; Vansteenkiste, Johan; Spigel, David; Ishii, Hidenobu; Garassino, Marina; de Marinis, Filippo; Ozguroglu, Mustafa; Szczesna, Aleksandra; Polychronis, Andreas; Uslu, Ruchan; Krzakowski, Maciej; Lee, Jong-Seok; Calabro, Luana; Frontera, Osvaldo Aren; Ellers-Lenz, Barbara; Bajars, Marcis; Ruisi, Mary; Park, Keunchil
    Background Antibodies targeting the immune checkpoint molecules PD-1 or PD-L1 have demonstrated clinical efficacy in patients with metastatic non-small-cell lung cancer (NSCLC). In this trial we investigated the efficacy and safety of avelumab, an anti-PD-L1 antibody, in patients with NSCLC who had already received platinum-based therapy. Methods JAVELIN Lung 200 was a multicentre, open-label, randomised, phase 3 trial at 173 hospitals and cancer treatment centres in 31 countries. Eligible patients were aged 18 years or older and had stage IIIB or IV or recurrent NSCLC and disease progression after treatment with a platinum-containing doublet, an Eastern Cooperative Oncology Group performance status score of 0 or 1, an estimated life expectancy of more than 12 weeks, and adequate haematological, renal, and hepatic function. Participants were randomly assigned (1:1), via an interactive voice-response system with a stratified permuted block method with variable block length, to receive either avelumab 10 mg/kg every 2 weeks or docetaxel 75 mg/m(2) every 3 weeks. Randomisation was stratified by PD-L1 expression (>= 1% vs < 1% of tumour cells), which was measured with the 73-10 assay, and histology (squamous vs non-squamous). The primary endpoint was overall survival, analysed when roughly 337 events (deaths) had occurred in the PD-L1-positive population. Efficacy was analysed in all PD-L1-positive patients (ie, PD-L1 expression in >= 1% of tumour cells) randomly assigned to study treatment (the primary analysis population) and then in all randomly assigned patients through a hierarchical testing procedure. Safety was analysed in all patients who received at least one dose of study treatment. This trial is registered with ClinicalTrials.gov, number NCT02395172. Enrolment is complete, but the trial is ongoing. Findings Between March 24, 2015, and Jan 23, 2017, 792 patients were enrolled and randomly assigned to receive avelumab (n=396) or docetaxel (n=396). 264 participants in the avelumab group and 265 in the docetaxel group had PD-L1-positive tumours. In patients with PD-L1-positive tumours, median overall survival did not differ significantly between the avelumab and docetaxel groups (11.4 months [95% CI 9.4-13.9] vs 10.3 months [8.5-13.0]; hazard ratio 0.90 [96% CI 0.72-1.12]; one-sided p=0.16). Treatment-related adverse events occurred in 251 (64%) of 393 avelumab-treated patients and 313 (86%) of 365 docetaxel-treated patients, including grade 3-5 events in 39 (10%) and 180 (49%) patients, respectively. The most common grade 3-5 treatment-related adverse events were infusion-related reaction (six patients [2%]) and increased lipase (four [1%]) in the avelumab group and neutropenia (51 [14%]), febrile neutropenia (37 [10%]), and decreased neutrophil counts (36 [10%]) in the docetaxel group. Serious treatment-related adverse events occurred in 34 (9%) patients in the avelumab group and 75 (21%) in the docetaxel group. Treatment-related deaths occurred in four (1%) participants in the avelumab group, two due to interstitial lung disease, one due to acute kidney injury, and one due to a combination of autoimmune myocarditis, acute cardiac failure, and respiratory failure. Treatment-related deaths occurred in 14 (4%) patients in the docetaxel group, three due to pneumonia, and one each due to febrile neutropenia, septic shock, febrile neutropenia with septic shock, acute respiratory failure, cardiovascular insufficiency, renal impairment, leucopenia with mucosal inflammation and pyrexia, infection, neutropenic infection, dehydration, and unknown causes. Interpretation Compared with docetaxel, avelumab did not improve overall survival in patients with platinum-treated PD-L1-positive NSCLC, but had a favourable safety profile. Copyright (C) 2018 Elsevier Ltd. All rights reserved.
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    Bevacizumab plus Capecitabine as Maintenance Therapy after Initial Bevacizumab plus XELOX Treatment in Previously Untreated Patients with Metastatic Colorectal Cancer: Phase Ill 'Stop and Go' Study Results - A Turkish Oncology Group Trial
    (Karger, 2013) Yalcin, Suayib; Uslu, Ruchan; Dane, Faysal; Yilmaz, Ugur; Zengin, Nurullah; Buyukunal, Evin; Buyukberber, Suleyman; Camci, Celalettin; Sencan, Orhan; Kilickap, Sadettin; Ozdener, Fatih; Cevik, Duygu
    Objective: It was the aim of this study to evaluate maintenance therapy with bevacizumab + capecitabine following induction with bevacizumab + capecitabine + oxaliplatin (XELOX) versus bevacizumab + XELOX until progression as first-line therapy in metastatic colorectal cancer (mCRC). Methods: Patients received either bevacizumab (7.5 mg/kg) + XELOX (capecitabine 1,000 mg/m(2) twice daily on days 1-14 + oxaliplatin 130 mg/m2 on day 1 every 3 weeks) until disease progression (arm A) or the same doses of bevacizumab + XELOX for 6 cycles followed by bevacizumab + capecitabine until disease progression (arm B). The primary endpoint was progression-free survival (PFS); secondary endpoints included overall survival (OS), objective response rate (ORR) and safety. Results: One hundred and twenty-three patients were randomized. Treatment compliance was similar in both groups. Median PFS was significantly longer for arm B than for arm A (11.0 vs. 8.3 months; p = 0.002). There was no significant difference between the two arms for ORR (66.7 vs. 59.0%; p = 0.861) or median OS (23.8 vs. 20.2 months; p = 0.100). Tolerability was acceptable in both treatment arms; the most frequent grade 3/4 treatment-related adverse events (arm B vs. arm A) were fatigue (6.6 vs. 16.1%), diarrhoea (3.3 vs. 11.3%), anorexia (3.3 vs. 11.3%), and neuropathy (1.6 vs. 8.1%). Conclusions: Maintenance therapy with bevacizumab + capecitabine can be considered an appropriate option following induction bevacizunnab + XELOX in patients with mCRC instead of continuation of bevacizumab + XELOX. (C) 2013 S. Karger AG, Basel
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    Bisphosphonate (Zoledronic Acid) Associated Adverse Events: Single Center Experience
    (Akad Doktorlar Yayinevi, 2010) Kucukzeybek, Yuksel; Gorumlu, Gurbuz; Cengiz, Ercument; Erten, Cigdem; Karaca, Burcak; Gul, M. Kemal; Karabulut, Bulent; Sanli, Ulus A.; Uslu, Ruchan
    Zoledronic acid is an efficacy-proven bisphosphonate used in the patients who develop bone metastasis. In our study, we planned to evaluate side effects occurring in the patients who receive zoledronic acid. The records of a total of 5.482 patients diagnosed with solid tumor who were admitted to oncology out-patients' clinic between January 2001 and January 2007 were scanned. It was found that 256 patients received zoledronic acid. Zoledronic acid is administered in 4 mg doses for a period of 15 minutes as intravenous infusion once in 21/28 days. Side effects such as hypocalcemia, symptomatic hypocalcemia, impairment in renal functions and osteonecrosis of the jaw, were evaluated retrospectively. Zoledronic acid was administered due to bone metastasis in 248 patients, malign hypercalcemia in 6 patients and ostoporosis in 2 patients. Four patients (1.5%) were diagnosed with jaw osteonecrosis, 22 patients (8.5%) were diagnosed with hypocalcemia, 19 patients (7.4%) were diagnosed with impairment in renal functions, and 2 patients were (0.7%) diagnosed with symptomatic hypocalcemia. Zoledronic acid is a bisphosphonate which has been proven to reduce complications which may develop depending on the bone metastasis, such as pathological fracture, spinal chord impression andhypercalcemia. On the other hand, side effects may occur in the patients receiving zoledronic acid. It will be appropriate to inform the patients who are planned to start administering zoledronic acid of the benefits to be obtained and the side effects to take place.
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    Biweekly cetuximab in combination with platinum and 5-fluorouracil in metastatic head and neck carcinoma
    (Wolters Kluwer Medknow Publications, 2019) Surmeli, Zeki G.; Ozveren, Ahmet; Arslan, Cagatay; Degirmenci, Mustafa; Karaca, Burcak; Uslu, Ruchan
    BACKGROUND AND AIM: The combination of cetuximab with platinum and 5-fluorouracil (5-FU) chemotherapy prolongs survival in patients with metastatic or recurrent squamous-cell carcinoma of the head and neck (SCCHN). Biweekly (once in 2 weeks) administration of cetuximab requires fewer hospital visits and decreases treatment costs; therefore, it is more convenient both for the patients and for the healthcare providers. Here, we assessed the efficacy, safety, and tolerability of an alternative biweekly regimen of cetuximab in combination with platinum and 5-FU chemotherapy as a first-line treatment for these patients. METHODS AND MATERIALS: Medical records of patients with metastatic or recurrent non-nasopharyngeal SCCHN who were treated with a biweekly regimen of cetuximab (500 mg/m(2) on day 1), cisplatin (40 mg/m(2) on day 1) or carboplatin (target area under the curve 3.5 mg/ml x min on day 1), folinic acid (400 mg/m(2) on day 1), and 5-FU (400 mg/m(2) bolus on day 1 followed by continuous infusion of 2,400 mg/m(2) 5-FU over 46 h) were retrospectively reviewed. Survival estimates were calculated with the Kaplan-Meier method. RESULTS: In total, 60 patients were included. The median age of the patients was 60.5. The objective response rate was 53.3% (95% confidence interval [CI] = 40.7-65.9). The median progression-free survival duration was 6.8 months (95% CI = 5.5-8.1) and the median overall survival duration was 13.3 months (95% CI = 8.4-18.2). The most common grade 3 or 4 adverse events were neutropenia (28.3%) and leucopenia (13.3%). Grade 3 or 4 rash was observed in 3.3% of the patients. CONCLUSION: Biweekly administration of cetuximab, cisplatin, and 5-FU is an effective regimen with a favorable toxicity profile for the first-line treatment of metastatic or recurrent SCCHN. These results warrant further evaluation of this regimen in prospective trials.
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    Can gossypol be a hope for transsexual patients (male to female) before sex reassignment surgery? Just for adjusting the body to mind
    (Churchill Livingstone, 2009) Yurekli, Banu; Karaca, Burcak; Cetinkalp, Sevki; Saygili, Fusun; Uslu, Ruchan
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    Can gossypol be a hope for transsexual patients (male to female) before sex reassignment surgery? Just for adjusting the body to mind
    (Churchill Livingstone, 2009) Yurekli, Banu; Karaca, Burcak; Cetinkalp, Sevki; Saygili, Fusun; Uslu, Ruchan
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    Can yoga have any effect on shoulder and arm pain and quality of life in patients with breast cancer? A randomized, controlled, single-blind trial
    (Elsevier Sci Ltd, 2018) Eyigor, Sibel; Uslu, Ruchan; Apaydin, Sebnem; Caramat, Ismail; Yesil, Hilal
    Objective: To examine the effects of yoga on shoulder and arm pain, quality of life (QOL), depression, and physical performance in patients with breast cancer. Methods: This prospective, randomized study included 42 patients. The patients in Group 1 underwent a 10-week Hatha yoga exercise program. The patients in Group 2 were included in a 10-week follow-up program. Our primary endpoint was arm and shoulder pain intensity. Results: The group receiving yoga showed a significant improvement in their pain severity from baseline to post-treatment, and these benefits were maintained at 2.5 months post-treatment. When compared to the control group, there were no statistically significant differences between the 2 groups with respect to the parameters assessed at the end of week 10. Conclusion: Yoga was an effective and safe exercise for alleviating shoulder and arm pain, which is a complication with a high prevalence in patients with breast cancer.
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    Cancer patients' satisfaction with doctors and preferences about death in a university hospital in Turkey
    (Elsevier Ireland Ltd, 2011) Durusoy, Raika; Karaca, Burcak; Junushova, Bermeth; Uslu, Ruchan
    Objective: To determine the expectations and satisfaction levels of Turkish cancer patients regarding their doctors, their wishes about the place and process of dying and to elucidate factors affecting them. Methods: For this cross-sectional study, a self-administered questionnaire was given to 150 cancer patients in 2009. Results: Among respondents, 63% stated that they would like to know all the details about their disease and they generally preferred a sudden, painless death, without any intervention at the last moment, but in a hospital. Almost all wanted a religious ceremony after their death. The question with the highest reported level of satisfaction was whether patients had complete trust in their doctors, whereas the least satisfaction was reported for doctors' explanations during visits. Gender, tumour type and level of education had statistically significant effects on patient satisfaction. Conclusion: The majority of our cancer patients trusted doctors and wanted to learn more about the progress of their cancer, in contrast to the general tendency of their families to hide the diagnosis. The hospital is still the most preferred place for dying. Practice implications: Alterations in communication may lead to disparities in patient outcomes; therefore, communication skill training should guide clinicians to recognise these tendencies. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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    Capecitabine maintenance therapy after docetaxel/capecitabine combination chemotherapy in patients with metastatic breast cancer
    (Amer Soc Clinical Oncology, 2013) Gursoy, Pinar; Surmeli, Zeki Gokhan; Cakar, Burcu; Arslan, Cagatay; Zengel, Baha; Karaca, Burcak; Sezgin, Canfeza; Karabulut, Bulent; Sanli, Ulus Ali; Uslu, Ruchan
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    Central Line-associated Pantoea spp. Bacteremia and Solid Organ Malignancy: A Report of Two Cases
    (Galenos Yayincilik, 2018) Ozsoy Kayaokay, Esra; Bulut, Gulcan; Aydemir, Sohret; Uslu, Ruchan; Sipahi, Oguz Resat
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    Characteristics of Turkish colorectal cancer patients and bevacizumab preference.
    (Amer Soc Clinical Oncology, 2017) Cicin, Irfan; Gumus, Mahmut; Uncu, Dogan; Ozkan, Metin; Kilickap, Saadettin; Elkiran, Tamer E.; Isikdogan, Abdurrahman; Karaoglu, Aziz; Oksuzoglu, Berna; Ozdemir, Feyyaz; Turna, Hande; Kara, Oguz; Ozyilkan, Ozgur; Guducu, Merve; Erdogan, Alper; Uslu, Ruchan
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    Clinical effectiveness of Everolimus and Exemestane in advanced breast cancer patients from Asia and Africa: First efficacy and updated safety results from the phase IIIb EVEREXES study.
    (Amer Soc Clinical Oncology, 2015) Im, Young-Hyuck; Uslu, Ruchan; Lee, Keun Seok; Nagarkar, Rajnish Vasant; Sohn, Joohyuk; Sevinc, Alper; Altundag, Kadri; Chang, Yuan-Ching; Abdel-Razeq, Hikmat; Im, Seock-Ah; Jeong, Joon; Park, Ho Yong; Arpornwirat, Wichit; Bastick, Patricia A.; Tuan Anh Le; Arikan, Ozlem Ocak; Xue, Hong-Ling; Canatar, Aycin; Valenti, Roberta; Kim, Sung-Bae