Proteomic and genomic approach to lung cancer

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Akciğer kanseri dünyada, erkeklerde en sık rastlanılan, kadınlarda ise görülme oranı hızla artan ve en sık ölüme neden olan kanser türüdür. Sıklıkla ileri evrede tanı konulması nedeniyle hastaların yaşam oranları düşüktür. Evre I’de bile küratif tedavilere rağmen yaşam süresinin kısa olması, araştırmacıları daha farklı belirleyiciler araştırmaya yöneltmiştir. Bu derlemede gen ekspresyonunu saptama yöntemleri ve bu konuda yapılan çalışmalar irdelenmektedir.Worlwide lung cancer is the most common cause of death, it is seen frequently in men but also rapidly increasing in women. Survival rate of the patients is low due to usual diagnosis of disease in the late stages. These low survival rates even in stage I disease, after curative treatments has guided investigators to search different biomarkers in lung cancer. In this review, methods of gene expression profiling and sudies done in this field are discussed

Does Increased Body Mass Index Effect the Gains of Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease Patients?

Objective: We aimed to compare the gain of pulmonary rehabilitation (PR) in obese, pre-obese, and normal-weight patients with chronic obstructive pulmonary disease (COPD) who underwent a PR program. Methods: COPD patients (n=137) underwent pulmonary and cardiac system examination and pulmonary function tests (PFTs) before PR. Chest X-rays, arterial blood gases, body mass index, quality of life (QOL) questionnaires, anxiety and depression scores, and Modified Medical Research Council dyspnea scale (MMRC) scores were evaluated in all patients. A 6-min walk test was performed to determine the exercise capacity of the patients. All patients underwent an 8-week outpatient PR program. The patients were reevaluated at the end of 8th week in terms of all parameters. Results: The study group consisted of 44 normal-weight, 52 pre-obese, and 41 obese COPD patients. Before PR, there was no significant difference in terms of 6-min walk distance (6MWD), PFT, MMRC, or QOL scores between the groups (p>0.05 for all). After PR, partial arterial oxygen pressure and arterial saturation, MMRC, and QOL scores improved significantly in all three groups (p<0.05 for all). 6MWD and walkwork significantly increased after PR in all three groups (p<0.001 for all), but the gain in 6MWD was significantly lower in obese patients compared to pre-obese and normal-weight patients (p=0.049). Conclusion: Pre-obese and obese patients benefit from PR similarly to the normal-weight patients in terms of gas exchange, dyspnea perception, and QOL. But it seems to be that exercise capacity improves less in obese COPD patients compared to pre-obese and normal- weight patients

The impact of chemotherapy on the EORTC QLQ-C30 and LC-13 quality of life scales in patients with lung cancer

Objective: The concept of quality of life (QoL) in lung cancer includes many physical, psychological and social components. We aimed to assess the effect of chemotherapy (CT) on QoL of lung cancer patients using QoL scales. Methods: Fifty inoperable lung cancer patients who were newly diagnosed and taken into a CT plan were included. Patients were followed in terms of responsiveness and toxicity. Turkish versions of the EORTC QLQ-C30 and LC13 scales were used before every cycles. Results: The average age was 60.1 years. There was no difference between QoL and age/income levels. The assessment of physical, social and occupational functions and overall health status of the male patients was better than female. Overall health status without comorbidity was better in the first cycle CT. Chemotherapy led to deterioration in social functions and economic status together with increase in neuropathy, constipation and hair loss. Patients with complete or partial response to treatment were observed to have better physical, occupational, emotional, cognitive and social functions, economic status and overall health; less fatigue, pain, shortness of breath, neuropathy and better appetite. Toxicities were found to affect the QLQ C30 and LC13 scales adversely. Conclusion: Presence of comorbidity, low education levels, socioeconomic status and CT induced hematologic/ gastrointestinal toxicities are the major parameters affect QOL in lung cancer. Chemotherapy leads to deterioration in social functions, increase in adverse events as well as worsening in economic status. Radiologic complete or partial response and small cell carcinoma are states in which parameters of QoL are affected positively by chemotherapy

Iterative surgical resections in non-small cell lung cancer

Introduction: We reviewed our surgical preferences and the prognosis for recurrent and second primary tumors in patients who underwent surgical treatment for non-small cell lung carcinoma (NSCLC). Aim: We report our experience with patients undergoing iterative pulmonary resection for lung cancer. Material and methods: Among patients who underwent anatomical resection for primary NSCLC, those who underwent a second surgical resection between 2010 and 2020 due to recurrent or second primary tumor were included in the study. Operative mortality, survival, and prognostic factors were investigated. Results: In total, 77 cases were included: 31 (40.3%) underwent the second resection for the recurrent disease and 46 (59.7%) underwent the second resection for the second primary tumor. Postoperative mortality occurred in 8 (10.4%) patients. All patients with postoperative mortality were in the group that underwent thoracotomy in both surgical procedures. The 5-year survival rate was 46.5%. The 5-year survival of those operated on for recurrent or second primary tumor was 32.8% and 51.1%, respectively (p = 0.81). The 5-year survival rate was 68.8% in patients under the age of 60 years, while it was 27.5% in patients aged 60 years and above (p = 0.004). The 5-year survival was 21.8% in patients with an interval of 36 months or less between two operations and 72.2% in those with a longer interval (p = 0.028). Conclusions: Our study shows that survival results similar to or better than primary NSCLC surgery can be obtained with lower mortality if more limited resections are performed via video-assisted thoracic surgery, especially in young patients. In addition, the prognosis is better in patients with an interval of more than 36 months between two operations

Clinical Effects of T790M Mutation in EGFR Tyrosine Kinase Inhibitor Resistant NSCLC Patients

INTRODUCTION: To compare patient characteristics between the T790M-positive and T790M-negative populations, and to analyze the post-progression survival (PPS) after initial tyrosine kinase inhibitor (TKI) failure in order to investigate the prognosis in patients undergoing rebiopsy. METHODS: We investigated the patient characteristics, including the initial EGFR-TKI response and T790M status at the time of rebiopsy or liquid biopsy, subsequent treatment after resistance to the initial EGFR-TKI (the presence of EGFR-TKI re-challenge), treatment just before biopsy and/or rebiopsy (EGFR-TKIs or chemotherapy), the timing of the rebiopsy (just after the initial EGFR-TKI failure or others). RESULTS: No difference was found between the two groups with T790M mutation positive and negative in terms of age, gender, and metastasis location. Only patients with positive T790M mutation had higher progression after TKI use compared to negative ones (p: 0.000). The progression-free median survival in patients using TKI was 19.33 months in the group with T790M mutation and 22.25 months in the negative group. Overall survival was found to be 75 months and 27.5 months in the T790M positive and negative group, respectively, and this was statistically significant. (p: 0.009). DISCUSSION AND CONCLUSION: Overall survival was significantly longer in the T790M positive group than in the T790M negative group. In addition, liquid biopsy can be performed several times for patients with progression after EGFR-TKI use and who do not want to undergo tissue biops