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    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, Murat
    The 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.
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    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, Muslih
    OBJECTIVE: 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.
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    Prognostic Effect of KELIM Score of Prostate-Specific Antigen in Hormone-Sensitive Prostate Cancer Patients Treated With Novel Androgen Receptor Inhibitors: Pioneering New Ways
    (Wiley, 2025) Ilhan, Yusuf; Araz, Murat; Gurbuz, Ali Fuat; Urvay, Semiha; Urun, Muslih; Ercek, Berrak Mermit; Ozilice, Ozden
    Background The prognostic value of the PSA ELIMination rate constant K (PRO-KELIM) score was investigated in patients with metastatic castration-sensitive prostate cancer (mCSPC) treated with novel androgen receptor inhibitors. Methods This multicenter retrospective study included 160 patients diagnosed with prostate adenocarcinoma between 2011 and 2024 who received enzalutamide or abiraterone during the mCSPC and had at least three PSA measurements within the first 100 days of treatment. The patients were categorized into favorable (PRO-KELIM >= 1.0) and unfavorable (PRO-KELIM < 1.0) groups. Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier survival analysis and Cox regression. Results Median PFS was significantly higher in the favorable group than in the unfavorable group (not reached vs. 40.0 months, p < 0.001). The estimated 2-year PFS rates in the favorable and unfavorable groups were 78% and 52%, respectively. In multivariate analyses, a high PRO-KELIM score (HR 2.99; 95% CI 1.35-6.66, p = 0.007) and good initial response to treatment (p = 0.001) were independent favorable prognostic factors for PFS. The median OS did not differ significantly between the groups (p = 0.27). PRO-KELIM score was not an independent prognostic factor for OS (p = 0.76). Conclusion These findings suggest that the PRO-KELIM score can be a valuable prognostic tool in the mCSPC to assess early treatment response and predict disease progression.
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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.