The effect of sarcopenia on erlotinib therapy in patients with metastatic lung adenocarcinoma

Erlotinib, a tyrosine kinase inhibitor, has been shown to improve the survival of patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer. Sarcopenia is a status with increasing importance in lung cancer, and it may predict a poor prognosis. We aimed to evaluate the impact of sarcopenia on erlotinib therapy and prognosis in patients with EGFR-mutated (exon 19 or 21 L858R) metastatic lung adenocarcinoma. Sarcopenia was defined as skeletal muscle index ≤39 cm2/m2 for women and ≤55 cm2/m2 for men. The patient characteristics, inflammation parameters, clinical and survival outcomes of the erlotinib therapy were examined according to sarcopenia status. We also analyzed the erlotinib treatment-related toxicity. Seventy-two patients were included in our retrospective study, and the mean age of the patients was 63.7 years. A total of 39 (54.2%) patients were diagnosed with sarcopenia. Patients with sarcopenia had a poor prognosis and had a shorter median progression-free survival (PFS) than patients without sarcopenia (10.5 months vs. 21.8 months, p=0.002). Sarcopenia (HR 2.08) and C-reactive protein > 6.5 mg/L (HR 2.57) were determined as independent poor prognostic factors for PFS of erlotinib therapy. Treatment-related toxicity occurred in 34.7% of patients treated with erlotinib, and sarcopenia did not significantly affect treatment-related toxicity. We also found that sarcopenia significantly affected the response to erlotinib. The expected survival outcomes may be low when erlotinib therapy is used in patients with sarcopenia and metastatic lung adenocarcinoma. This study showed that survival and clinical outcomes could be better predicted by detecting sarcopenia in patients with lung cancer using erlotinib

Prevalence and co-incidence of geriatric syndromes according to the ECOG performance status in older cancer patients

BackgroundGeriatric syndromes may be more common in older cancer patients than in those without cancer. Geriatric syndromes can cause poor clinical outcomes. The Eastern Cooperative Oncology Group Performance Status (ECOG-PS) is often used as a clinically reported functional status score in oncology practice.MethodsOur study was designed as a cross-sectional study and included 218 older cancer patients. This study aimed to determine the prevalence and relationship of geriatric syndromes according to the ECOG-PS in older cancer patients.ResultsThe mean age of 218 participants was 73.0 ± 5.6 years, with 47.7% being women and 52.3% men in our study. ECOG-PS 0, 1, and 2 groups contained 51, 39, and 10% of the patients, respectively. The mean number of geriatric syndromes in the ECOG 0, 1, and 2 groups was 2.3 ± 2.2, 4.3 ± 2.4, and 5.7 ± 2.1, respectively (p < 0.001). After adjusting for age and sex, it was determined that dynapenia was 2.9 times, probable sarcopenia was 3.5 times, frailty was 4.2 times, depression was 2.6 times, malnutrition was 3.3 times, insomnia 2 was.2 times, falls was 2.5 times, and the risk of falling (TUG) was 2.4 times more likely in those with ECOG-PS 1 compared to those with ECOG-PS 0. In addition, it was found that dynapenia was 6 times, probable sarcopenia was 6.8 times, frailty was 10.8 times, depression was 3.3 times, malnutrition was 6.3 times, the risk of falling (Tinnetti Balance) was 28 times, and the risk of falling (TUG) was 13.6 times more likely in those with ECOG-PS 2 compared to those with ECOG-PS 0.ConclusionOur study found that the prevalence of geriatric syndromes increased as the ECOG-PS increased. Geriatric syndromes and their co-incidence were common in older cancer patients, even in normal performance status. Oncologists should incorporate geriatric syndromes into the decision-making process of cancer treatment to maximize the impact on clinical outcomes in older patients with cancer

Prognostic factors for regorafenib treatment in patients with refractory metastatic colorectal cancer: A real-life retrospective multi-center study

Regorafenib, an oral multikinase inhibitor, has improved survival in metastatic colorectal cancer (mCRC) patients who have progressed on standard therapies. Our study aimed to evaluate prognostic factors influencing regorafenib treatment and assess the optimal dosing regimen in a real-life setting. We retrospectively analysed 263 patients with mCRC from multiple medical oncology clinics in Turkey. Treatment responses and prognostic factors for survival were evaluated using univariate and multivariate analysis. Of the patients, 120 were male, and 143 were female; 28.9% of tumors were located in the rectum. RAS mutations were present in 3.0% of tumors, while BRAF, K-RAS, and N-RAS mutations were found in 3.0%, 29.7%, and 25.9% of tumor tissues, respectively. Dose escalation was preferred in 105 (39.9%) patients. The median treatment duration was 3.0 months, with an objective response rate (ORR) of 4.9%. Grade ≥ 3 treatment-related toxicity occurred in 133 patients, leading to discontinuation, interruption, and modification rates of 50.6%, 43.7%, and 79.0%, respectively. Median progression-free survival (PFS) and overall survival (OS) were 3.0 and 8.1 months, respectively. RAS/RAF mutation (hazard ratio [HR] 1.5, 95% confidence interval [CI] 1.1-2.3; P = 0.01), pretreatment carcinoembryonic antigen (CEA) levels (HR 1.6, 95% CI 1.1-2.3; P = 0.008), and toxicity-related treatment interruption or dose adjustment (HR 1.6, 95% CI 1.1-2.4; P = 0.01) were identified as independent prognostic factors for PFS. Dose escalation had no significant effect on PFS but was associated with improved OS (P < 0.001). Independent prognostic factors for OS were the initial TNM stage (HR 1.3, 95% CI 1.0-1.9; P = 0.04) and dose interruption/adjustment (HR 0.4, 95% CI 0.2-0.9; P = 0.03). Our findings demonstrate the efficacy and safety of regorafenib. Treatment line influences the response, with dose escalation being more favorable than adjustment or interruption, thus impacting survival

Gastric pneumatosis intestinalis associated with malignancy: An unusual case report

Pneumatosis intestinalis (PI) is an uncommon disease defined as gas-filled cysts that are found in the wall of the gastrointestinal (GI) tract. The exact causes of PI are still unclear, but it may associated with coexisting diseases, such as some GI disorders, connective tissue disease, some medication and drugs, and rarely malignancy. The most common localization is the small intestine. Gastric PI secondary to malignancy has been rarely documented. We report on a 94-year-old man with gastric PI associated with inoperable adenocarcinoma localized in the duodenum. Following the gastrojejunostomy and choledochojejunostomy bypass, his general condition improved and PI disappeared, but he died due to poor performance status and malignancy 6 mo later. We suggest that in patients presenting with PI, malignancy should be considered in the differential diagnosis

Classification of Mental Task EEG Records Using Hjorth Parameters

25th Signal Processing and Communications Applications Conference (SIU) -- MAY 15-18, 2017 -- Antalya, TURKEYWOS: 000413813100471The effects of mental activities on brain dynamics is the main field that studied for a long time, but the results of studies have not reached the desired level. The aim of present study was to classify the mental task EEG records by using Hjorth parameters. hi this study, EEG signals that recorded from 9 subjects were used. EEG signals were recorded by applying a experimental paradigm which contains five stimuli related to different mental task. These stimuli are defined as condition word mental subtraction spatial navigation right hand motor imagery and feet motor imagery Wavelet packet transform was used to obtain sub bands of EEC signals. Statistical parameters that consist of mobility, complexity and Mahalanobis distance were applied to sub-bands. Feature vectors were classified by using artificial neural network. When classification performances related to mental activities were examined, the best classification accuracy was obtained as nearly 80% for 'condition word - mental subtraction', ('spatial navigation feet motor imagery;' and 'spatial navigation - condition word'. The lowest classification accuracy was obtained for 'mental subtraction - right hand motor imagery,', 'condition word - right hand motor imagery' and 'spatial navigation right hand motor imagery'. The classification accuracies related to all stimuli that classifed among themselves were obtained as 77,61%.Turk Telekom, Arcelik A S, Aselsan, ARGENIT, HAVELSAN, NETAS, Adresgezgini, IEEE Turkey Sect, AVCR Informat Technologies, Cisco, i2i Syst, Integrated Syst & Syst Design, ENOVAS, FiGES Engn, MS Spektral, Istanbul Teknik Uni