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Öğe After an Earthquake: The Comparison of Psychological Status of Resident and Earthquake Survivor Cancer Patients(Cambridge Univ Press, 2024) Beypinar, IsmailObjective: Natural disasters such as earthquakes can have a significant impact on cancer treatment and care. The objective of the study was to evaluate the psychological effect of the earthquake on survivor cancer patients compared to regular cancer patients. Methods: Cancer patients who were evacuated from earthquake sites and referred for the continuation of their treatment, as well as regular resident patients were included in the study. The resident cancer patients were compared with the study population as a control group. DASS-21 forms were filled based on patients' declarations. Results: Forty-six patients were earthquake survivors and 55 were resident cancer patients. Stress scores were significantly higher in earthquake survivors (P = 0.021). In contrast, there was no difference in stratified groups due to DASS-21 categorization in stress scores while depression and anxiety subgroups had significant differences (P = 0.012; P < 0.001). Also, women significantly had a worse outcome in the depression and anxiety categories (P = 0.028; P = 0.021) while no difference was observed in men. Conclusion: Recent earthquakes in Turkey had psychological negative effects on oncology patients. The increased stress, depression, and anxiety levels were observed in earthquake survivors who were evacuated from the disaster zone and compared to the control group.Öğe Are they all the same? Different effects of opioid types on survival in metastatic NSCLC receiving nivolumab(E-Century Publishing Corp, 2025) Balcik, Onur Yazdan; Beypinar, Ismail; Urvay, Semiha; Urun, Muslih; Ercek, Berrak; Yildiz, Canan; Araz, MuratThe aim of this study was to evaluate the effects of concurrent opioid analgesic (OA) use and types of OA on progression-free survival (PFS) and overall survival (OS) in non-small cell lung cancer (NSCLC) patients receiving nivolumab. This observational, retrospective study included patients with pathologically confirmed, driver mutations negative metastatic NSCLC at five different hospitals in Turkey between 2018 and 2024. A total of 209 patients were included in this study. Of these patients, 113 (54.1%) used OA. 86 (41.1%) patients were using tramadol, and 48 (23.4%) were using fentanyl. The median survival of the group without OA was significant in the univariate analysis compared to that of the group with OA PFS (7 vs. 4 months, P = 0.006) an OS (8 vs. 14 months, P = 0.003). The group with bone metastases had worse OS than the group without bone metastases [7 vs. 15 months, HR (95% CI) = 1.810 (1.064-3.079), (P = 0.029)]. In the group without bone metastases, patients on tramadol had worse PFS than patients not on tramadol [5 vs. 8 months, HR (95% CI) = 2.260 (1.097-4.655), (P = 0.027)]. In conclusion, OA use was associated with poor PFS and OS. Fentanyl use led to worse OS in the group with bone metastases, whereas tramadol use led to worse PFS in the group without bone metastases. The prognostic impact of OA may differ according to the site of metastasis; therefore, prospective studies that include the type of OA are needed.Öğe Assessing the prognostic value of IMDC risk score for nivolumab-treated patients with renal cancer and malignant melanoma(Ios Press, 2023) Beypinar, Ismail; Sozel, Yildiz; Onder, Arif HakanBACKGROUND: The response of Renal Cell Cancer (RCC) to tyrosine kinase inhibitors (TKI) has been well established. Although these stratifications have been established for TKI response and prognosis, these parameters have recently been used to predict immunotherapy response in RCC. We aimed to use a combination of clinical parameters of International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk groups and metastatic sites at the time of diagnosis to predict the effectiveness of immune checkpoint inhibitors in malignant melanoma (MM). METHOD: In this cross-sectional study, we retrospectively analyzed the demographic information, metastatic sites, and IMDC risk group data. The blood parameters were included in the first cycle of nivolumab treatment. RESULTS: The OS was statistically different between the RCC and MM groups in terms of the IMDC. In univariate analysis of stage at diagnosis, CRP levels and bone and bone marrow metastases were confirmed to be prognostic factors in the MM population in terms of OS. Brain metastasis was a prognostic factor for RCC, whereas sex, line of treatment, LDH, bone, and splenic metastasis remained significant in patients with MM in terms of OS. Brain metastasis was prognostic in both cancer types in multivariate analysis in terms of PFS. In addition to brain metastasis, LDH levels and lung, liver, and splenic metastases also affect PFS in patients with MM undergoing nivolumab treatment. CONCLUSION: In our study, the IMDC was confirmed to be a prognostic factor for MM. The IMDC groups were similar, except for the favorable RCC and MM groups. Different metastatic sites were prognostic, similar to the IMDC risk group in the MM group.Öğe BEFORE & AFTER: THE EVALUATION OF THE EFFECT OF THE COVID-19 PANDEMIC ON CANCER PATIENTS IN PALLIATIVE CARE CENTER(2024) Kaya, Zeynep İrmak; Beypinar, Ismail; Urun, MuslihOBJECTIVE: In addition to the high risk of death from COVID-19 infection in cancer patients, delays in cancer diagnosis may result in delayed treatment of cancer patients. The study aimed to evaluate the changes in the characteristics of cancer patients, such as diagnosis, stage and prognosis, between the pre-pandemic and post-pandemic one-year periods in Turkey. MATERIAL AND METHODS: The records of patients who received palliative treatment in the palliative service between March 11, 2019 and March 11, 2021 were reviewed retrospectively. Age, gender, diagnosis, type of diagnosis, type of treatment, place of arrival to the palliative service, and way of discharge were retrospectively scanned from patient files. The first hospitalizations were evaluated in patients with recurrent hospitalizations. Patients with inadequate patient records were excluded from the study. RESULTS: The proportion of patients diagnosed with cancer radiologically has increased. While radiological findings of cancer were detected in 9.1 percent of patients in the pre-pandemic period, this rate was 16.2 percent in the post-pandemic period. When the patients were evaluated in terms of the oncological treatment they received before inpatient palliative care, a significant difference was found (p=0.002). This difference was due to the increase in the proportion of patients who were not suitable for oncological treatment after the pandemic. CONCLUSIONS: We believe that the pandemic had great effects on newly diagnosed patients and patients in need of palliative care services. In the present study, we observed an increase in cancer patients who were radiologically diagnosed with cancer and treated in palliative care services in the post-pandemic period.Öğe Cabozantinib plus Nivolumab and Ipilimumab in Renal-Cell Carcinoma(Massachusetts Medical Soc, 2023) Beypinar, Ismail; Araz, Murat[Abstract Not Available]Öğe Cancer Care After the Earthquake? What Is Left to Us?(Lippincott Williams & Wilkins, 2024) Beypinar, IsmailCan you rely on national health records after an earthquake for cancer care? When nothing is left!Öğe Comparison of granisetron and palonosetron in triplet anti-emetic prophylaxis in non-small cell lung cancer patients receiving cisplatin-based highly emetogenic chemotherapy(Sage Publications Ltd, 2025) Araz, Murat; Beypinar, Ismail; Inci, Fatih; Koral, Lokman; Kocak, Mehmet Zahid; Korkmaz, Mustafa; Demirkiran, AykutIntroduction We compared the efficacy of first-generation granisetron and second-generation palonosetron in triplet anti-emetic prophylaxis in patients with non-small cell lung cancer (NSCLC) receiving cisplatin-based high emetogenic chemotherapy (HEC).Methods This prospective, multicenter, non-randomized, observational study was conducted between June 2018 and December 2021. Patients diagnosed with NSCLC who received triplet anti-emetic prophylactic treatment with aprepitant and dexamethasone plus granisetron or palonosetron before the first cycle of chemotherapy were included in the study. At the end of the first week after chemotherapy, the emesis scale was applied to the patients during the outpatient control. The primary endpoint was complete response (CR) and total control (TC).Results One hundred twenty-one patients were included in the study. Sixty-one patients were in the granisetron group and 60 patients were in the palonosetron group. CR was higher with granisetron in the acute phase (70.5% vs. 58.3%, p = 0.16; respectively) and higher with palonosetron in the delayed phase (61.7% vs. 55.7%, p = 0.5; respectively), although not statistically significant. The TC rates were also not significantly different between the groups (54.1% vs.57.6%, p = 0.69).Conclusions There was no significant difference between granisetron and palonosetron in both acute and delayed control of emesis in NSCLC patients receiving cisplatin-based HEC.Öğe Efficacy of everolimus plus hormonal treatment after cyclin-dependent kinase inhibitor; real-life experience, A TOG study(Springer, 2024) Beypinar, Ismail; Demir, Hacer; Yaslikaya, Sendag; Koseci, Tolga; Demir, Bilgin; Colak, Gokhan; Agaoglu, Ahmet BurakPurpose In advanced breast cancer, endocrine therapy is preferred in the absence of visceral crisis. Cyclin-dependent kinase inhibitors (CDKi) are the gold standards. The selection of subsequent treatments after CDKi treatment is still controversial, and the efficacy of everolimus (EVE) combinations is unknown. In this study, we aimed to investigate the efficacy of EVE after CDKi administration in real-life experiences. Method The study received data from 208 patients from 26 cancer centers. Demographic and histologic features, diagnosis, progression, last visit dates, and toxicities were recorded. This study was a retrospective case series. Results One hundred and seven patients received palbociclib, while 101 patients received ribociclib as a CDKi. The overall response and disease control rates of EVE combinations were 60% and 88%, respectively. In univariate analysis, the absence of liver metastasis, age > 40 years, better type of response, and immediate treatment after CDKi were related to increased progression-free survival. Liver metastasis and response type were significantly associated with overall survival. In the multivariate analysis, response remained significant in terms of progression-free survival, while response type, liver metastatic disease, and hematologic toxicity were prognostic in terms of overall survival. Conclusion This study provides evidence of the benefits of EVE combinations after CDKi treatment. EVE combinations may be more appropriate for patients with non-liver metastasis, and the first treatment response shows the benefit of treatment. In addition, immediate treatment after CDKi treatment is more beneficial than later lines of treatment.Öğe Inflammatory Biomarkers from Blood Counts as Prognostic Tools in Metastatic Esophageal Cancer(Int Scientific Information, Inc, 2025) Urun, Yonca Yilmaz; Beypinar, IsmailBackground: Globally, esophageal cancer ranks as the sixth leading cause of cancer-related mortality. This retrospective study from a single center in Turkey aimed to evaluate hematological inflammatory biomarkers in complete blood count (CBC) data and outcomes in 113 patients with advanced esophageal carcinomas. Material/Methods: We conducted a retrospective analysis of 113 patients with metastatic esophageal cancer composed of squamous (92), adenocarcinoma (18), and small cell (3) histology. We investigated neutrophil-to-lymphocyte ratio tory response index (SIRI), and aggregate index of systemic inflammation (AISI) in terms of prognosis. Results: The initial treatment for 25.7% of patients consisted of a carboplatin-paclitaxel combination. In response to the initial round of chemotherapy, 52.2% of patients showed improvement (15% complete, 37.2% partial), while 18.6% experienced disease progression. Neutropenia was observed as the most prevalent severe (grades 3-4) adverse reaction, affecting 19.8% of patients. Higher NLR, PLR, SII, NLPR, SIRI, and AISI values were associated with worse survival (P=0.016, P=0.008, P=0.011, P=0.028, P=0.014, P=0.001, respectively), whereas higher LMR was correlated with better survival (P=0.001). The NMR analysis showed no significant association (P=0.46). Multivariate analysis identified independent prognostic factors except histology, PLR, and NLPR. Conclusions: Research indicates that inflammatory indicators obtained from complete blood count analyses possess prognostic significance for individuals with metastatic esophageal cancer. These biomarkers demonstrate diverse capacities in forecasting the course of the disease. These simple and inexpensive markers need further confirmation to guide individualized treatment planning.Öğe Is The COVID-19 Pandemic Reason, Shortage Result? A Survey Study on Drug Shortages in Turkish Oncology Clinics(2024) Beypinar, Ismail; Demir, Hacer; Balçık, Onur YazdanAim: The rapid development of the drug industry led to a great spectrum of medical treatment, especially in oncology practice. The prescribed drug alternations increased three times in the United States. Also, the increased drug numbers led to drug shortages, which doubled during this period in the oncology era. In this study, we try to evaluate the oncology clinics' drug supply last year in the eyes of oncology practitioners Methods: We conducted an online questionnaire via Google Forms on the drug shortages which are faced last year by oncologists in Turkey. Our study is a cross-sectional study.The SPSS 25 software was used for statistical analysis Results: Eighty-nine percent of the participants declared they had a drug shortage last year. The most affected drug groups were chemotherapeutics (61,4%), biologic agents (anti-VEGF, anti-EGFR agents, etc.) (56,8%), immunologic drugs (available anti-PD1 drugs) (54,5%), and supportive medicines (Folinic acid, GCSF, etc.) (42%). 61 percent of the oncologists referred their patients to other clinics to get over the drug shortage. The most common reasons were supply problems (70%), drug companyrelated concerns due to exchange rates (68%), hospital budget problems (48%), and bureaucratic procedures (47%). There was a significant difference between drug shortage and participants' hospitals. Also, the shortage has significantly lasted longer in university hospitals. Conclusion: Our study showed an extensive drug shortage in oncology clinics last year independent of drug types. University hospitals had reported worse results compared with other organizations. There is an urgent need for further evaluation of drug shortages and the availability of oncologic drugs and the prognostic effect of this phenomenon.Öğe Prognostic value of IMDC score in non-small cell lung cancer receiving immunotherapy: old dog, new tricks?(Springer Heidelberg, 2025) Beypinar, Ismail; Urvay, Semiha; Urun, Muslih; Ercek, Berrak; Demir, Hacer; Yildiz, Canan; Araz, MuratBackground Although there are multiple treatment options, oncologists lack appropriate biomarkers for determining the efficacy and toxicity of immunotherapy. In this study, we aimed to use a combination of the clinical parameters of IMDC risk groups at the time of diagnosis to predict the effectiveness of immunotherapy. Methods This multicenter cross-sectional study retrospectively analyzed non-small cell lung cancer (NSCLC) patients receiving nivolumab for the prognostic effects of clinical factors, including the IMDC score. Results Two hundred and five patients were enrolled in this study. There was no favorable group because the TTI was less than 1 year in the entire study group in the IMDC. The IMDC score and IMDC groups showed significant differences in PFS (p < 0.001; p < 0.001, respectively). Intermediate and poor-risk groups had PFS of 8 and 3 months PFS, respectively. The IMDC group showed a significant effect on OS (p = 0.002). The intermediate- and poor-risk groups had 12- and 4-month OS, respectively. The TTI risk factor excluded patient numbers in the favorable, intermediate, and poor risk groups were 47, 129, and 29, respectively, in the revised IMDC group (rIMDC). The prognostic effect of the rIMDC score and groups remained significant (p < 0.001 and p < 0.001, respectively). The classical IMDC had a significant effect on PFS in the multivariate analysis (p = 0.016). Also, rIMDC score in multivariate analysis resulted with significant effect on OS (p = 0.035). Conclusion To date, this is the first study to prove that the IMDC may be a valuable option for predicting both prognosis and treatment efficacy in NSCLC patients receiving especially second or further lines nivolumab treatment.Öğe The correlation between pre-treatment CEA levels and the EGFR mutation status in advanced lung adenocarcinoma(Wolters Kluwer Medknow Publications, 2024) Uysal, Mukremin; Beypinar, Ismail; Araz, MuratBackground: The discovery of the epidermal growth factor receptor (EGFR) mutation, especially in adenocarcinoma, has led to a major change in the treatment of non-small-cell lung cancer (NSCLC). This study investigated the relationship between the EGFR mutation status and the carcinoembryonic antigen (CEA) levels at the time of diagnosis. Materials and Methods: A total of 102 patients with EGFR mutation and tested CEA levels were recruited for this study. Of the patients, 24 were EGFR mutants (23.5%), while 78 patients (76.5%) did not harbor any EGFR mutations. Results: The CEA levels did not differ across groups. Additionally, the CEA levels were analyzed between female and male patients separately due to EGFR mutations; no difference was observed. When the CEA levels were categorized as positive or negative based on different cut-off values, such as 5 and 10 ng/ml, no statistical difference was found between groups. Conclusion: In this study, no relationship between EGFR mutation and pre-treatment CEA levels was observed. Despite positive trials having shown a predictive value of CEA levels for EGFR mutation, more clinical trials are needed to elucidate the racial, clinical, and pathological differences of the study populations. Most studies have been located in the Far East, but new trials in Caucasian, African, and Hispanic populations are still lacking.Öğe The evaluation of vaccination status and the factors affecting vaccination in cancer patients(2022) Urun, Muslih; Beypinar, Ismail; Davarcı, Sena Ece; Demir, Hacer; Baykara, MeltemAim: Coronavirus disease 2019 (COVID-19) pandemic increased the mortality of cancer patients by causing direct infection or collateral damage to the healthcare system. After the development of effective vaccines against COVID-19 infection, mortality rates declined. In this study, we try to investigate the vaccination among cancer patients.Methods: A survey was applied to patients with cancer in order to investigate the attitudes towards vaccination and the factors effecting vaccination in two medical oncology centers in Turkey.Results: 271 patients were included in the study. No difference was observed in the attitudes of patients towards vaccination according to cancer type. 83% of the patients were vaccinated against COVID-19. In 75% of the study population, vaccine was administered in the earliest available time. Receiving chemotherapy was the most significant reason to avoid vaccination among the study group (p=0,002). There was no significant difference in terms of treatment type for COVID-19 between patients with or without adequate vaccination. The most negative factor affecting vaccination was active chemotherapy treatment. Social relations and traditional media were the most positive factors for vaccination.Discussion: Vaccination is of vital importance for patients who are treated or on remission. Even if patients are to receive chemotherapy, they should be informed about vaccination and should be encouraged for vaccination.Öğe The Utility of the Cachexia Index and the Modified Glasgow Score in Young Patients With Breast Cancer(Springernature, 2024) Beypinar, Ismail; Demir, Hacer; Culha, Yasar; Kaya, FurkanBackground Breast cancer is the most common cancer in women. Body composition and inflammatory markers are increasingly important for predicting cancer prognosis. The Cancer Cachexia Index (CXI) and the modified Glasgow Prognostic Score (GPS) are two new markers evaluating prognosis in cancer. In this study, we evaluated the utility of the CXI and the modified GPS in young patients with breast cancer. Methods Eighty patients diagnosed between 2012 and 2023 were included in the study. The following information was recorded: patient features, pathological subtype, estrogen receptor and human epidermal growth factor receptor -2 (HER -2) status, disease stage, therapies, disease recurrence, and last control or death date. The CXI and the modified GPS were calculated using clinical data, including skeletal muscle index, albumin, Creactive protein, and neutrophil-to-lymphocyte ratio. Results There were no differences in overall survival with respect to the CXI in the study population (p=0.96). Only stage 4 patients showed statistically significant survival differences according to the CXI (p=0.046). Although the median survival time was not reached for the modified GPS groups, there was a statistical overall survival difference favoring the negative group (p=0.017). No significant differences were observed in disease -free survival due to the CXI (p=0.128). In multivariate analysis, no factors, including the modified GPS and the CXI, influenced overall survival. There was a significant effect of the modified GPS and body mass index on recurrence (p=0.037; p=0.034). The CXI had a non -significant marginal p -value (p=0.074). Conclusion Our study showed that the modified GPS may be related to disease -free survival and overall survival, whereas the CXI has a more prominent prognostic effect on overall survival in advanced -stage breast cancers. In early -stage and young patients, optimization of risk scores is lacking.
