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    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 Hakan
    BACKGROUND: 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.
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    Novel tumor marker index combining carcinoembryonic antigen and carbohydrate antigen 19-9: New prognostic factor for metastatic colorectal cancer
    (Baishideng Publishing Group Inc, 2025) Ilhan, Yusuf; Balcik, Onur Yazdan; Guzel, Halil Goksel; Onder, Arif Hakan; Demir, Bilgin; Baser, Mehmet Nuri; Karadag, Ibrahim
    BACKGROUND Metastatic colorectal cancer (mCRC) is a global health challenge with a poor prognosis. Prognostic markers are critical for survival prediction. AIM To evaluate a novel tumor marker index (TMI) combining carcinoembryonic antigen and carbohydrate antigen 19-9. METHODS This multicenter, retrospective study measured baseline carcinoembryonic antigen and carbohydrate antigen 19-9 levels to calculate a TMI as the geometric mean of values normalized to their upper limits of normal. Receiver operating characteristic curve analysis assessed TMI's prognostic accuracy, and patients were stratified into high-TMI (>= 1.39) and low-TMI (< 1.39) groups. The primary endpoint was overall survival (OS), with progression-free survival and treatment response as secondary endpoints. RESULTS The study included 305 mCRC patients with a median follow-up of 22.9 months. The median OS for high-TMI patients was 29.5 months, significantly lower than the 45.6 months observed in the low-TMI group (P = 0.02). The 2-year OS rates for the high- and low-TMI groups were 59.4% and 72.9%, respectively. Median progression-free survival was also shorter for the high-TMI group (14.0 vs 16.0 months, P = 0.84). High TMI is an independent prognostic factor for worse OS. CONCLUSION TMI is a simple, cost-effective prognostic tool for mCRC, with high TMI associated with poorer survival outcomes.
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    Prognostic Effect of Psoas Muscle Index, a Parameter of Sarcopenia, in Solid Cancer Patients Receiving Immunotherapy
    (2023) Onder, Arif Hakan; Beypınar, Ismail; Sozer, Yildiz Kılar
    Objectives: In this study, our objective was to evaluate the prognostic feature of sarcopenia and prognostic labora- tory markers, defined by using PMI measurement in patients with kidney cancer and malignant melanoma, receiving immunotherapy. Methods: Diagnosed with and followed up for kidney cancer (RCC) and malignant melanoma (MM) and received Nivolumab immunotherapy in the Oncology Clinic, were retrospectively analyzed. Laboratory examinations and CT images used for staging in the diagnosis were retrospectively used for psoas muscle measurements. Results: We investigated the effect of pretreatment PMI on survival and response to treatment. For this purpose, 93 patients with malignant melanoma (n=45) and kidney cancer (n=48) were included in the study. Among female pa- tients with and without sarcopenia at baseline, median progression-free survival was 30.2 and 50.1 months (p=0.769), respectively, while in men, conversely, 54.8 and 34.3 months (p=0.307), respectively. Median overall survival was 31.0 and 51.7 months (p=0.763) in female patients with and without sarcopenia, respectively, and 62.9 and 52.4 months in males with and without sarcopenia (p=0.906). Conclusion: This result may suggest that sarcopenia has a negative effect on the immune response. It should be con- sidered that sarcopenia may affect the clinical outcomes of immunotherapy. Further studies are needed.