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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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    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.