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    Comparison of the efficacy of mFOLFOX-6 and mDCF regimens in the treatment of metastatic gastric cancer: a multicenter retrospective study
    (SAGE Publications Inc., 2025) Karhan, O?ur Ur; İleri, Serdar; Urakçi, Zuhat; Sezgin, Yasin; Yıldırım, Umit; Ünlü, Beyza; Demir, Hacer
    Background: Metastatic gastric cancer (GC) and gastroesophageal junction (GEJ) cancer are associated with a poor prognosis. Recent advancements in treatment have incorporated trastuzumab, anti-PD-1 agents, and anti-claudin therapies alongside chemotherapy (ChT), significantly improving outcomes. Contemporary studies predominantly employ doublet ChT as the backbone for these regimens, although historically triplet ChT regimens have been favored, particularly in younger patients requiring rapid tumor shrinkage. Objective: The aim of this study was to compare the efficacy of mFOLFOX-6 and mDCF regimens in the treatment of advanced GC and GEJ adenocarcinoma. Design: This was a retrospective multicenter study. Methods: Patient data were obtained from the databases of 25 hospitals across Turkey. Demographic and clinicopathological characteristics were documented. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan–Meier method, and group discrepancies were assessed with log-rank test. Results: A total of 493 patients were included in the analysis, with similar baseline characteristics between the two groups. The objective response rate was 36.3% in the mDCF group and 38% in the mFOLFOX-6 group (p?=?0.7). The median PFS was 6?months for mDCF and 7?months for mFOLFOX-6 (p?=?0.2), while the median OS was 12?months for mDCF and 11?months for mFOLFOX-6 (p?=?0.4). Grade 3–4 neutropenia occurred in 27.6% of patients treated with mDCF versus 17.8% with mFOLFOX-6 (p?=?0.01). Likewise, grade 3–4 anemia was more frequent in the mDCF group (9.5%) compared to the mFOLFOX-6 group (4.8%; p?=?0.04). Conclusion: Modified FOLFOX-6 demonstrated comparable efficacy to mDCF in the treatment of advanced GC and GEJ adenocarcinoma. Moreover, mFOLFOX-6 was associated with a lower incidence of hematological adverse effects. © The Author(s), 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
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    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 Burak
    Purpose 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.
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    HIV NEGATİF BİR HASTADA LOKALİZE SKROTAL KAPOSİ SARKOMU OLGUSU
    (Afyonkarahisar Sağlık Bilimleri Üniversitesi, 2025) Demir, Hacer; Beypınar, İsmail; Öztürk, Düriye; Davarcı, Sena Ece; Baykara, Meltem
    Kaposi sarkomu (KS) endotel kaynaklı anjiyo-proliferatif bir hastalıktır. Dört ana KS türü vardır; klasik, endemik, iyatrojenik (transplantasyonla ilişkili KS) ve HIV ile ilişkili. Hastalık daha çok mukokutanöz bölgelerde ortaya çıksa da; yüz, gövde, alt ekstremitelerin derisi ve genital bölge sıklıkla tutulur. KS ürogenital sistemde en çok peniste görülse de skrotal hastalık nadirdir. 68 yaşında erkek hasta, skrotumda mavi-mor lezyonlarla dermatoloji kliniğine başvurdu. Doku biyopsisi sonucu 'Klasik Kaposi Sarkomu' olarak sonuçlanınca tıbbi onkoloji kliniğimize sevk edildi. Serolojik testi HIV negatifti ancak merkezimizde Human Herpes Virus (HHV) 8 testi yoktu. Hasta on gün boyunca günlük 300 cGy küratif radyoterapi aldı. Komplikasyon olarak tedavi alanında lokalize dermatit ve minimal lenfosel gelişti. Bu lezyonlar lokal semptomatik tedavi ile birkaç gün içinde düzeldi. Tedaviyi tamamladıktan üç ay sonra rezidü KS yoktu. Hastanın takibi nükssüz olarak devam etmektedir. Epidemik ve HIV ile ilişkili KS sıklıkla ürogenital yolu tutsa da, klasik KS nadiren görülür. KS en çok peniste görülürken skrotum yerleşimi çok nadirdir. Literatürde HIV pozitif ve negatif hastalardan oluşan toplam 9 hasta bildirilmiştir. Bildiğimiz kadarıyla bizim olgumuz HIV negatif bir hastada tanımlanan 4. skrotal KS hastasıdır.
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    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 Yazdan
    Aim: 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.
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    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, Murat
    Background 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.
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    The evaluation of vaccination status and the factors affecting vaccination in cancer patients
    (2022) Urun, Muslih; Beypinar, Ismail; Davarcı, Sena Ece; Demir, Hacer; Baykara, Meltem
    Aim: 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.
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    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, Furkan
    Background 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.