Dermatological Side-Effects Developing in Patients Using Targeted Chemotherapy Drugs: A Review of the Literature

Objectives: Numerous dermatological side-effects are reported with the use of targeted therapies. These adverseevents derive from common signaling pathways implicated in malignant behavior and normal homeostatic activity ofboth the epidermis and dermis.Methods: Patients under follow-up at the Oncology Clinic 12 using bevacizumab, five cetuximab, four sunitinib, foursorafenib, three panitumumab, one pazopanib, one trastuzumab, and one using vemurafenib, were included in thestudy. Patients’ cutaneous drug side-effects were assessed at dermatological examinations before starting treatmentand at months 1, 3, and 6 during treatment.Results: The most common finding was xerosis, seen in 54% (17/31) of our patients receiving targeted treatment.Papulopustular eruption was observed in 63% (12/19) of patients using epidermal growth factor receptor inhibitors.The most common finding in the nails was brittleness-tenderness. Dry mouth was prominent among the mucositisfindings. The four patients with nosebleeds were using antiangiogenesis agents. Papulopustular eruptions emergedin the first month, xerosis in the second and third, dry mouth in the third, and pyogenic granuloma, nail findings, andnosebleeds in the fourth to sixth months.Conclusion: Dermatological side-effects can impact on the patient’s quality of life and cause significant morbidity.Dermatologists and oncologists should therefore collaborate closely to manage these side-effects

Malignant pleural mesothelioma with rarely seen metastases

Malignant mesothelioma, primarily located in the pleura, is a locally aggressive tumor. Distant metastases are rarely seen and mostly diagnosed postmortem. We present the third malignant pleural mesothelioma (MPM) case in the literature with bone marrow metastasis. A 36-year-old male patient presented with pain at the right mediastinal area and 5 × 6cm mass on the right side of his chest. 18-FDG positron emission tomography (PET) scan showed local uptake at the pleura, regional lymph nodes and 5th rib. The tru-cut biopsy reported as sarcomatoid type MPM. Cisplatin-pemetrexed therapy was planned. His medical condition deteriorated after 2 months and multiple metastases to brain, liver, adrenal glands and bone marrow were detected. The patient was lost 4 months after he was diagnosed. Brain and bone marrow metastasis of MPM are rarely seen. Physicians should be careful about the rapid progression and unexpected metastases of MPM

Presentation of Diffuse Large B-Cell Lymphoma Relapse as a Penile Mass

WOS: 000392282500022PubMed: 27095140

Investigation of Serum Seladin-1/DHCR24 Levels in Breast Cancer Patients

Objective: Seladin-1, an enzyme that catalyzes the cholesterol formation reactionfrom desmosterol, has been shown to be expressed at different levels in various typesof tumor. The purpose of this study was to investigate the relationship between serumseladin-1 levels and clinical characteristics of patients with non-metastatic breastcancer, and to examine the prognostic value of seladin-1 in breast cancer.Methods: Patients aged 18 and over diagnosed with breast cancer usinghistopathological methods at our medical oncology clinic, whose tumor tissue hadbeen surgically removed and who had not yet received any oncological treatment, andwith no distant organ metastasis or additional malignancy, and healthy womenvolunteers as a control group were included in the study. Demographic and laboratorydata were recorded. Serum seladin-1 levels were compared between the patient andcontrol groups.Results: Seventy-three women, 46 patients and 27 controls, were enrolled. Mean ageswere 56±12 years in the patient group and 62±12 in the control group (p=0.055)Seladin-1 levels were lower in the patient group than in the control group (p=0.038).No statistically significant relationship was observed between tumor size and seladin1 levels (p=0.138). No relationship was also determined between patient grades andstages and seladin-1 (p=0.720; p=0.092, respectively).Conclusions: Seladin-1 levels were lower in the serum of breast cancer patients thanin the control group. However, no statistically significant relationship was foundbetween breast cancer prognostic factors and seladin-1 levels. Further research isneeded to clarify the mechanisms underlying the low seladin-1 levels in breast cancerpatients.Amaç: Meme kanseri kadınlarda önemli bir morbidite ve mortalite nedenidir. Desmosterolden kolesterol oluşum reaksiyonunu katalizleyen enzim olan Seladin-1 daha önce çeşitli tümör türlerinde farklı düzeylerde exprese edildiği gözlenmiştir. Çalışmamızda; serum seladin-1 düzeyleri ile metastatik olmayan meme kanseri hastalarının klinik özellikleri arasındaki ilişkiyi ve seladin-1'in meme kanserinde prognostik değerini araştırmayı amaçladık. Gereç ve Yöntem: Tıbbi onkoloji kliniğimizde, 18 yaş üstü, histopatolojik olarak meme kanseri tanısı almış, cerrahi olarak tümör dokusu çıkarılmış, herhangi bir onkolojik tedavi henüz almamış, uzak organ metastazı ve ek malignitesi olmayan hastalar ile kontrol grubu olarak sağlıklı kadın gönüller çalışmaya dahil edildi. Demografik veriler ve laboratuvar verileri kaydedildi. Serum seladin-1 düzeyleri hasta ve kontrol grupları arasında karşılaştırıldı. Bulgular: 46 hasta ve 27 kontrol grubu olmak üzere toplam 73 kadın hasta çalışmaya dahil edildi. Hasta grubunun yaş ortalaması 56±12 yıl, kontrol grubunun 62±12 yıldı (p=0.055) Seladin-1 düzeyleri gruplar arasında karşılaştırıldığında; hasta grubunda kontrol grubuna göre daha düşük seviyede saptandı (p=0.038). Tümör boyutları ile Seladin-1 düzeyi arasında istatistiksel bir ilişki yoktu. (p=0.138). Bunun yanında, hastaların stage ve gradelerine göre seladin-1 düzeyi karşılaştırıldığında istatistiksel fark olmadığı görüldü (p=0,720; p=0,092, sırasıyla). Sonuç: Çalışmamızda meme kanseri hastalarının serumlarında seladin-1 düzeyi kontrol grubuna göre daha düşük saptandı. Ne var ki, meme kanserinin prognostik faktörleri ile seladin-1 düzeylerinin ilişkili olmadığı görülmüştür. Seladin-1’in meme kanserli hastalarında düşük olmasının altında yatan mekanizmaların aydınlatılabilmesi için daha ileri araştırmalar gerekmektedirWOS:00061311550001

Multicenter Evaluation of Patients with Cutaneous Malignant Melanoma in Turkey: MELAS Study

WOS: 000319980200095PubMed: 23534790Background: Malignant melanoma is a cancer that demonstrates rapid progression and atypical clinically features with a poor prognosis. Aim: This study was performed to determine the clinical characteristics and treatment outcomes of patients with malignant melanoma in Turkey. Methods: The medical records of 98 patients between 2007-2012 at our centers were retrieved from the patient registry. Overall survival (OS) was calculated using the Kaplan-Meier method. Results: In our study, with the median follow-up of all patients with cutaneous MM of 46.3 months, the median OS rate of all cases was 43.6 months and 5-year OS was 48.6%. However, five-year OS rates of patients with localized disease (stage I-II) and node involvement (stage III) were 60.3% and 39.6%, respectively. The median OS of stage IV patients was 8.7 months and 1-year OS rate was 26.2%. We showed that advanced stage, male gender, and advanced age in all patients with MM were significant prognostic factors of OS. Conclusions: Compared with the results of current studies from Western countries, we found similar findings concerning demographical features, histological variables and survival analyses for our patients with cutaneous MM in Turkey

Germline landscape of BRCAs by 7-site collaborations as a BRCA consortium in Turkey

BRCA1/2 mutations play a significant role in cancer pathogenesis and predisposition particularly in breast, ovarian and prostate cancers. Thus, germline analysis of BRCA1 and BRCA2 is essential for clinical management strategies aiming at the identification of recurrent and novel mutations that could be used as a first screening approach. We analyzed germline variants of BRCA1/2 genes for 2168 individuals who had cancer diagnosis or high risk assessment due to BRCAs related cancers, referred to 10 health care centers distributed across 7 regions covering the Turkish landscape. Overall, 68 and 157 distinct mutations were identified in BRCA1 and BRCA2, respectively. Twenty-two novel variants were reported from both genes while BRCA2 showed higher mutational heterogeneity. We herein report the collective data as BRCA Turkish consortium that confirm the molecular heterogeneity in BRCAs among Turkish population, and also as the first study presenting the both geographical, demographical and gene based landscape of all recurrent and novel mutations which some might be a founder effect in comparison to global databases. This wider perspective leads to the most accurate variant interpretations which pave the way for the more precise and efficient management affecting the clinical and molecular aspects

PROPSEA, safety evaluation of palbociclib and ribociclib in older patients with breast cancer: A prospective real-world TOG study

Introduction: In this study, the toxicities and management of palbociclib and ribociclib in older patients (≥65 years) with metastatic breast cancer patients were investigated. Materials and Methods: Among older patients receiving palbociclib and ribociclib, Geriatric 8 (G8) and Groningen Frailty Index were used to evaluate frailty status. Dose modifications, drug withdrawal and other serious adverse events (SAEs) were recorded and analyzed according to baseline patient characteristics. Results: A total of 160 patients from 28 centers in Turkey were included (palbociclib = 76, ribociclib = 84). Forty-three patients were ≥ 75 years of age. The most common cause of first dose modification was neutropenia for both drugs (97% palbociclib, 69% ribociclib). Liver function tests elevation (10%) and renal function impairment (6%) were also causes for ribociclib dose modification. Drug withdrawal rate was 3.9% for palbociclib and 6% for ribociclib. SAEs were seen in 11.8% of those taking palbociclib and 15.5% of those on riboclib. An ECOG performance status of ≥2 and being older than 75 years were associated with dose reductions. Severe neutropenia was more common in patients with non-bone-only metastatic disease, those receiving treatment third-line therapy or higher, coexistance of non-neutropenic hematological side effects (for ribociclib). Neutropenia was less common among patients with obesity. Discussion: Our results show that it can be reasonable to start palbociclib and ribociclib at reduced dose in patients aged ≥75 years and/or with an ECOG performance status ≥2