Serum endocan level and its prognostic significance in breast cancer patients

Background: Endocan, known as endothelial cell specific molecule (ESM), is a novel endothelial dysfunction marker. The aim of this study is to examine the plasma endocan level and its prognostic significance in newly diagnosed breast cancer patients. Methods: A total of 84 patients were enrolled the study. Plasma endocan level was measured by specific enzyme-linked immunosorbent assay (ELİSA) kit. Ethical approval and informed consent were attained. Results: At the time of diagnosis, 33 patients had stage 4 disease. The median plasma endocan level was 619.9 (min 259.9–2813.2) ng/L and its level was significantly higher in metastatic breast cancer group compared to non–metastatic breast cancer group. According to molecular sub-type of breast cancer, there is not statistical difference in plasma endocan level, but its level was higher in patients with Her-2 amplified and triple negative breast cancer (TNBC). Median follow-up time is 11 (1-30) months. Event free survival (EFS) was 15 months in patients with plasma endocan level lower than 620, while it was 4 months in patients with serum endocan level greater than 620 (p = 0.016). There was no difference between groups in terms of hypertension, age, Lymphovascular invasion (LVI), extra capsular extension (ECE), body mass index (BMI) and White blood cells (WBC), platelet count and plasma endocan level. Conclusion: Plasma endocan levels higher than non metastatic breast cancer. Patients with high plasma endocan levels are short EFS. Further studies would be useful to assess endocan level as a prognostic factor in breast cancer. Keywords: Endothelial cell specific molecule, Breast cancer, Prognosi

Retrospective Analysis Of Gestational Trophoblastic Neoplasia: Single Center Experience

This study aims to analyze the clinicopathologic characteristics and treatment outcomes of our patients with gestational trophoblastic neoplasia (GTN) and to present our real-life experience. A total of 32 patients with GTN diagnosed according to the FIGO 2002 criteria followed in Zekai Tahir Burak Women's Health Training and Research Hospital between 2011-2018 were included. Demographic features, treatment outcomes, and survival were analyzed retrospectively. The median follow up time was 32.1 (3.3-76.9) months. Of the 32 patients, 27 (84.4%) were defined as low-risk GTN (risk score = 7) according to the FIGO risk score. Seventeen (62.9%) patients with low-risk GTN achieved complete remission (CR) with single agent MTX. CR rate was 60% (12/20) in patients receiving weekly MTX and 71.4% (5/7) in MTX-FA eight-day regimen (p= 0.590). Of the 9 MTX resistant patients, 8 (88.8%) achieved CR with second-line Actinomycin D (ActD). Three (60%) out of the five high-risk GTN patients acquired CR with first-line EMA-CO (etoposide, MTX, plus ActD alternating with cyclophosphamide and vincristine). In the follow-up period one patient (3.1%) had recurrent disease. By the data cut off date, all of the patients were alive and CR could not be achieved in one (3.1%) patient. All patients with low-risk GM achieved CR with sequential therapies ultimately. Therefore, single agent MTX is a reasonable option in the initial treatment of low-risk GTN. Moreover, Actinomycin D is highly effective in patients with low-risk GTN who are resistant to MTX.WoSScopu

Prognostic Factors in Breast Cancer Patients with Hepatic Metastases: Impact of Molecular Subtype and Local Hepatic Treatment

Liver metastases usually develop in the terminal stage of breast cancer (BC), and often accompany with extrahepatic metastases. The prognosis of hepatic metastases (HM) in BC patient is poorer compared to bone and soft tissue metastases. In this study, we aimed to analyze some clinico-pathological prognostic factors in patients with HM. A total of 4300 follow-up records of breast cancer patients diagnosed and treated at Hacettepe University Cancer Institute between January 2000 and July 2015 were retrospectively analyzed. Total of 312 BC patients with HM were enrolled to study. Patients with HM at diagnosis and the patients who developed metastases during the follow-up were included. Total of 50 (16%) patients have HM as the first site of metastasis. While isolated HM were just seen in 36 (11%) patients, most of the patients had hepatic as well as bone metastases (n=148, 47%). Median interval from initial diagnosis to HM was 40.5 (5-262) months. Low grade (grade 1-2) tumors were associated with longer disease free interval to liver metastases by multivariate analysis. Overall survival after HM in whole group was 18 months. Multivariate analysis revealed statistically significant association between long survival and non-triple negative molecular subtype, lower stage disease at diagnosis and application of local hepatic treatment. Developments in systemic and targeted therapy, as well as local hepatic therapies may enhance outcomes of patient with hepatic metastases.WoSScopu

Real-world outcomes of pazopanib in metastatic soft tissue sarcoma: a retrospective Turkish oncology group (TOG) study

Aim: Description of patient characteristics, effectiveness and safety in Turkish patients treated with pazopanib for metastatic soft tissue sarcoma (STS). Patients and methods: This multicenter study is based on retrospective review of hospital medical records of patients (≥ 18 years) treated with pazopanib for non-adipocytic metastatic STS at 37 Oncology clinics across Turkey. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) were evaluated with further analysis of data on the three most common histological subtypes (leiomyosarcoma [LMS], undifferentiated pleomorphic sarcoma [UPS], synovial sarcoma [SS]) in the cohort. Results: Data of 552 adults (57.6% women, median age: 52 years) were analyzed. DCR and ORR were 43.1% and 30.8%, respectively. Median PFS was 6.7 months and OS was 13.8 months. For LMS, UPS and SS, median PFSs were 6.1, 5.9 and 7.53 months and median OSs were 15.03, 12.87 and 12.27 months, respectively. ECOG ≥ 2 was associated with poor PFS and OS. Liver metastasis was only a factor for progression. Second-line use of pazopanib (vs. front-line) was associated with better PFS, its use beyond third line predicted worse OS. Adverse events (AE) occurred in 82.7% of patients. Most common AEs were fatigue (58.3%) and anorexia (52.3%) which were graded as ≥ 3 in 8.2% and 7.4% of patients, respectively. Conclusion: Pazopanib is effective and well-tolerated in treatment of non-adipocytic metastatic STS. Its earlier use (at second-line), good performance status may result in better outcomes. Worldwide scientific collaborations are important to gain knowledge on rarer STS subtypes by conducting studies in larger patient populations

Treatment efficacy of ribociclib or palbociclib plus letrozole in hormone receptor-positive/HER2-negative metastatic breast cancer.

Background: Ribociclib, palbociclib and abemaciclib are currently approved CDK4/6 inhibitors along with aromatase inhibitors as the first-line standard-of-care for patients with hormone receptor-positive, HER2-negative metastatic breast cancer. Methods: The authors report retrospective real-life data for 600 patients with estrogen receptor- and/or progesterone receptor-positive and HER2-negative metastatic breast cancer who were treated with ribociclib and palbociclib in combination with letrozole. Results & conclusion: The results demonstrated that the combination of palbociclib or ribociclib with letrozole has similar progression-free survival and overall survival benefit in real life for the patient group with similar clinical features. Specifically, endocrine sensitivity may be a factor to be considered in the treatment preference