The relation of CD3, CD4, CD8 and PD-1 expression with tumor type and prognosis in epithelial ovarian cancers

Objectives: Ovarian cancer is a heterogeneous disease, where chronic inflammation plays a key role in carcinogenesis. In this study, it is aimed to analyze the relationship with prognosis and chemotherapy response to clinicopathologicalnvariables in epithelial ovarian cancers such as proliferation of PD-1 +, CD8 +, CD4 +, CD3 + T-lymphocytes infiltrating the tumor and tumor stroma.Material and methods: Seventy-six cases diagnosed with primary epithelial ovarian tumor from biopsy or surgical resection materials were included in the study. Immunreactivity of CD3, CD4, CD8, PD1 was evaluated immunohistochemically in lymphocytes in tumor infiltrating lymphocytes and stromal lymphocytes.Results: Seventeen (22.4%) of the cases were Type I, 59 (77.6%) of them were Type II ovarian carcinoma. PD-1 positivity was observed in stromal and intraepithelial lymphocytes in 22 (28.9%) of 76 cases. In the presence of PD-1 + T-lymphocytes that infiltrate tumor and stroma, disease-free survival are shorter (p = 0.037). The presence of stromal CD4 + and CD8 + T-lymphocytes was more common in late stage patients (p = 0.012, p = 0.036; respectively). The disease-free and overall survival rate was statistically significantly shorter in the presence of CD8 + T lymphocytes (p = 0.009, p = 0.003; respectively).Conclusions: CD3, CD4 and CD8 may contribute to PD-1 mediated tumor control. Anti PD-1 therapy may be an alternative to chemotherapy in PD-1 positive patients. Identifying patients who do not respond to chemotherapy through PD-1 expression prior to immunotherapy will help develop potential personalized immunotherapy

The relationship with quality of life and serum levels of adiponectin, resistin, leptin, ghrelin in advanced non-small cell lung cancer patients

Malignensilerin en sık etkilerinden biri olan kanser kaşeksisi, kansere bağlı ölümlerin %20 sinden fazlasından sorumlu olabilir ve kötü prognozla ilişkilidir. Kanser kaşeksisi, artmış iskelet kası ve yağ dokusu kaybına sekonder kilo kaybı ve anoreksiyi içeren kompleks, multifaktöryel metabolik bir durumdur. Birçok sitokinin ve akut faz proteinlerinin bu katabolizmada rolü olmasına rağmen, kanser kaşeksi patogenezi henüz tam anlamıyla açıklanmamıştır. Serum adipokin düzeyleri kanser kaşeksisi ve yaşam kalitesi ile ilişkilidir fakat rolleri henüz kanıtlanmamıştır. Çalışmamızın amacı ileri evre küçük hücreli dışı akciğer kanserli hastalarda kanser kaşeksisi, serum adiponektin, resistin, leptin, ghrelin düzeyi, beslenme durumu ve yaşam kalitesi arasındaki ilişkiyi değerlendirmektir. Altmış yedi hasta (62 erkek ve 5 kadın) ile 20 sağlıklı gönüllü (16 erkek ve 4 kadın) çalışmaya dahil edildi. İki grubta demografik, antropometrik,labaratuar verileri ve serum adipokin düzeyleri ölçüldü. Beslenme durumunu gösteren PG-SGA ve SF-36, EORTC-QLQ-C30, HAD yaşam kalitesi anketleri değerlendirildi. Hastaların kontrol grubuna göre anlamlı olarak yüksek serum resistin ve düşük serum leptin düzeyleri vardı. Kilo kaybı olan hastaların anlamlı olarak yüksek serum ghrelin ve düşük serum leptin düzeyleri vardı. Düşük serum ghrelin ve yüksek serum adiponektin düzeyleri yorgunluk ve ağrı ile ilişkiliydi. Yüksek serum resistin düzeylerine sahip olan hastaların yaşam kalitesi düşüktü. LDH, ferritin ve ghrelin yüksekliği progresyon ile ilişkiliydi. Leptin düşüklüğü sağkalım ile ilişkiliydi. Sonuç olarak adipokinlerin kanser kaşeksisinde ve yaşam kalitesindeki rolü gösterildi. Fakat adipokinlerin kanser kaşeksisindeki potansiyel rollerini ortaya koymak için birçok çalışmaya ihtiyaç vardır.Cancer cachexia is one of the most frequent effects of malignancy, is often associated with poor prognosis, and may account for up to 20% of cancer deaths. Cancer cachexia is a complex, multifactorial metabolic state, involving anorexia and decreasing body weight secondary to accelerated loss of skeletal muscle and adipose tissue. Pathogenesis of cancer cachexia is not clearly explained although several cytokines and acute phase proteins have some roles on this catabolism. Serum levels adipokines are strongly associated with cancer cachexia and the quality of life but their roles is not established yet. The aims of our study were to evaluate the relationship with cancer cachexia and serum levels of adiponectin, resistin, leptin, ghrelin and nutritional assesment and quality of life in advanced non-small cell lung cancer patients. Sixty seven patiens (62 male, 5 female) and twenty healhty (16 male, 4 female) volunteers were included in this study. Demographical, anthropometrical, laboratory data and serum levels of adipokines were mesured for two groups. PG-SGA for evaluation of nutrition and the questionnaire of quality of life like SF-36, EORTC QLQ-C30 and HAD were assessed. Patients presented significantly higher serum resistin (p=0.000) and lower serum leptin levels (p=0.025) than controls. Patients with weight loss presented significantly increased serum ghrelin (p=0.009) and decreased serum leptin levels (p=0.044) compared to patients without weight loss. Low serum ghrelin levels and high adiponectin serum levels were associated with fatigue and pain. Patients who had high serum resistin levels had low quality of life. High serum levels of LDH, ferritin and ghrelin were associated with disease progression. Low serum levels of leptin was associated with survival. In conclusion, the role of adipokines in cancer cachexia and quality of life is showed. But further studies are needed to determine its potential role in cancer cachexia

Pazopanib in metastatic soft tissue sarcoma (STS): Results of a multi-institutional observational study

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Combination of trastuzumab and taxane-containing intensified chemotherapy in first-line treatment of HER2-positive advanced gastric cancer

Purpose: Taxane-containing combinations are recommended for the first-line therapy of advanced gastric cancer. It is not known which chemotherapy regimen is the best with trastuzumab for HER2-positive patients. The aim of this study was to compare taxane-containing intensified chemotherapy versus standard chemotherapy in combination with trastuzumab in the first-line treatment of HER2-positive advanced gastric adenocarcinoma. Methods: This study is a retrospective multicenter study of the Turkish Oncology Group. A total of 130 HER2-positive patients with inoperable locally advanced, recurrent, or metastatic gastric adenocarcinoma being given chemotherapy plus trastuzumab as the first-line treatment were included from 16 different oncology centers. Trastuzumab combination with intensified chemotherapy including taxane or standard chemotherapy was compared in terms of progression-free survival (PFS), overall survival (OS), and toxicity. Results: There were 108 patients in the standard and 22 patients in the intensified chemotherapy group. PFS of the standard and intensified group were 5.6 months (95% confidence interval [CI] 4.8–6.4) and 5.3 months (95% CI 2.6–8), respectively (p = 0.70). OS of the standard and intensified group were 11.1 months (95% CI 8.3–13.9) and 15.2 months (95% CI 12.7–17.7), respectively (p = 0.03). Repeated analysis excluding patients given any previous therapy revealed similar results. The intensified group had more fever and febrile neutropenia. Conclusion: Trastuzumab combination with intensified chemotherapy provides better OS in first-line treatment of HER2-positive advanced gastric cancer. Further large-scale studies should be performed in HER2-positive patients. © Fondazione IRCCS Istituto Nazionale dei Tumori 2020

Does primary tumor localization has prognostic importance in seminoma patients?: Turkish oncology Group study

Purpose: The purpose of this study was to determine whether primary tumor localization may be a risk factor for relapse and survival in seminomatous germ cell tumors (GCT) patients. Methods: In our study, 612 seminomatous GCT patients diagnosed in 22 centers between 01.01.1989 and 03.02.2019 were retrospectively evaluated. Patient interview information, patient files and electronic system data were used for the study. Results: The primary tumor was localized in the right testis in 305 (49.9%) patients and in 307 (50.1%) in the left testis. Mean age of the patients was 36 years (range 16-85±10.4). The median follow-up period was 47 months (1-298). Recurrence was observed in 78 (12.7%) patients and 29 (4.7%) died during the follow-up period. Four-year overall survival (OS) was 95.4% and 4-year progression-free survival (PFS) was 84.5%. The relationship between localization and relapse was significant in 197 patients with stage 2 and stage 3 (p=0.003). In this patient group, 41 (20.8%) relapses were observed. Thirty (73.2%) of the relapses were in the right testis and 11 (26.8%) in the left testis. Four-year OS was 92.1% in patients with right tumor; and 98.7% in patients with left tumor (p=0.007). When 612 patients were evaluated with a mean follow-up of 4 years, there was a 6.6% survival advantage in patients with left testicular tumor and this difference was significant (p=0.007). Conclusion: Survival rates of patients with primary right testicular localization were worse compared with left testicular localization, and relapse rates were higher in stage 2 and 3 patients with right testicular localization. © 2020 Zerbinis Publications. All rights reserved

Merkel cell carcinoma in Turkey: A multicentric study

Background: Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine carcinoma of the skin. In this study, we aimed to evaluate the clinicopathologic characteristics, treatment outcomes, and survival of MCC cases in Turkey. Materials and methods: The patients diagnosed with MCC between 1999 and 2018 at twenty different centers in Turkey were included in the study. Patient and tumor characteristics and adjuvant and metastatis treatment outcomes were analyzed retrospectively. Results: The median age of totally 89 patients was 70 (26-93). The most common primary location was lower limbs (n = 29, 32.5%). Immunohistochemically, CK20 positivity was present in 59 patients (66.3%). Only two patients had secondary malignancy. The majority of the patients (n = 76, 85.4%) were diagnosed at the localized stage. Surgery was performed for all patients in the early stage, and adjuvant radiotherapy or/and chemotherapy was applied to 52.6% (n = 40) of nonmetastatic patients. The median follow-up was 29 months. Recurrence developed in 21 (27.6%) of the 76 patients who presented with local or regional disease. Two-year disease-free survival (DFS) was 68.1% and 5-year DFS was 62.0% for localized stage. The 5-year DFS was similar for patients receiving adjuvant treatment (chemotherapy, radiotherapy, or sequential chemoradiotherapy) and without adjuvant therapy (P > 0.05). Two-year overall survival in patients who presented with localized disease was 71.3% and 18.5% in metastatic patients (P < 0.001). In the metastatic stage, platinum/etoposide combination was the most preferred combination regimen. Median progression-free survival (PFS) in first-line chemotherapy was 7 months (95% confidence interval: 3.5-10.5 months; standart error: 1.78). Conclusions: Although MCC is rare in Turkey, the incidence is increasing. Gender, CK20 status, tumor size, lymph node involvement, and adjuvant treatment were not associated with recurrence