BACKGROUND:Enfortumab vedotin plus pembrolizumab (EV + P) is an established standard of care for metastatic urothelial carcinoma; however, real-world data remain limited. We evaluated clinical outcomes in patients treated in the frontline metastatic setting. PATIENTS AND METHODS:The primary endpoint was objective response rate (ORR); secondary endpoints included overall survival (OS), progression-free survival (PFS), duration of response, and safety. Median follow-up and survival outcomes were estimated using reverse and standard Kaplan-Meier methods and Cox regression analyses. RESULT:Overall, 160 patients were included, with 148 (92.5%) receiving EV + P in the 1L. The median follow-up was 14 months. In the 1L, the median PFS was 12 months (95% CI, 6.4-17.6). The CR rate was 14.9% and the PR rate was 54.1%, resulting in an ORR of 69.0%. SD and PD were observed in 16.9% and 14.1% of patients, respectively. Among patients achieving CR or PR, the median duration of response was 20 months (95% CI, 11.3-28.6). In univariate analyses for PFS, patients with upper urinary tract tumors had significantly shorter PFS compared with those with lower urinary tract tumors (5 vs. 20 months, P = .004). Patients with ECOG PS ≥ 2 had shorter PFS than those with ECOG PS ≤ 1 (3 vs. 16 months; P = .002). De novo metastatic disease was associated with worse PFS (6 vs. 23 months, P = .07). In the 1L EV + P cohort, 12- and 24-month OS rates were 73.8% and 57.7%, respectively. In the ≥ 2-line cohort (n = 12), the ORR was 66.7%, with PR in 58.4% and CR in 8.3%; SD and PD were observed in 8.3% and 25.0% of patients, respectively. Overall, 80.6% of patients experienced at ≥ 1 treatment-related adverse event (TRAEs) of any grade, and 19 patients (13.7%) developed grade 3 to 4 TRAEs. CONCLUSIONS:In this real-world cohort, EV + P demonstrated meaningful clinical activity and manageable safety as frontline therapy, consistent with EV-302.

Background/Aim:Advanced hepatocellular carcinoma has dismal prognosis. The choice of optimal therapy for each patient is not characterized well. There is a growing need to describe the relation of predictive and prognostic factors with survival. In this study, we aimed to examine the impact of clinical factors and inflammatory markers on the prognosis. Patients and Methods:A total of 125 patients who were diagnosed between January 2011-April 2018 were enrolled retrospectively. Patients' demographics, performance status, tumoral characteristics and inflammation-based prognostic scores (neutrophil/lymphocyte ratio (NLR), prognostic nutritional index (PNI), aspartate aminotransferase/platelet count ratio (APRI)) were recorded. Univariate and multivariate analyses were performed to determine the prognostic factors for survival. Results:Median age of patients was 64 (range=22-85) with male dominancy (n=105; 84%). Etiology was hepatitis B virus in 74 patients, and hepatitis C virus in 9 cases. Median overall survival (mOS) of the overall study population was 11.9 months (95% CI=7.1-16.9). Local treatment options yielded a median OS of 24.8 months (95% CI=12.8-36.8) in intermediate BCLC stage B patients. Patients who received sorafenib had an OS of 19.7 (95% CI=11.2-28.2 months). Initial ECOG performance status, Child Pugh Score, tumor size, presence of portal vein thrombosis was found to be significantly associated with worse OS in univariate analyses. Conclusion:Inflammation based scores, NLR and APRI were found to be associated with worse mOS. Larger tumor size, older age and ECOG PS were found to be independent prognostic factors.

Background: Trastuzumab deruxtecan (T-DXd) has transformed the treatment landscape of human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (mBC), with significant improvements in survival reported in clinical trials. However, limited data exist regarding its performance in real-world settings, particularly in lower-middle-income countries (LMICs). Objectives: To evaluate the real-world effectiveness and safety of T-DXd in patients with HER2+ mBC in Türkiye. Design: A multicenter retrospective cohort study. Methods: This multicenter, retrospective cohort study, conducted by the Turkish Oncology Group, evaluated the real-world outcomes and tolerability of T-DXd in patients with HER2+ mBC across 27 oncology centers in Türkiye. The primary endpoints were real-world progression-free survival (rwPFS) and overall survival (rwOS). Secondary endpoints included response rate, safety (with adverse events (AEs) graded according to CTCAE v5.0), and evaluation of the first post-T-DXd treatments. Results: A total of 269 patients were included. The median age was 49 years (interquartile range: 42–59), and the median follow-up was 12.9 months. The median rwPFS was 17.9 months (95% confidence interval: 13.3–22.5), and the median rwOS was 35.7 months (95% confidence interval: 27.8–43.6). The objective response rate was 71.4%, and the disease control rate was 95.2%. Patients receiving T-DXd in the second line experienced significantly longer rwPFS compared with those treated in later lines ( p < 0.001). Treatment-related AEs of any grade occurred in 68.4% of patients. Interstitial lung disease was reported in 21 patients (7.8%), with 4 cases being grade ⩾3. Conclusion: In this large national real-world cohort from an LMIC, T-DXd demonstrated robust antitumor activity and a manageable safety profile in patients with HER2+ mBC. These findings are consistent with prior clinical trial data and support the applicability of T-DXd in broader clinical settings.

Expanded RAS analysis is essential for guiding targeted therapy in metastatic colorectal cancer (mCRC), as RAS mutations predicts resistance to anti-EGFR agents. This study aimed to evaluate the plasma RAS mutation status using liquid biopsy at disease progression and to assess the prognostic significance of RAS mutation clearance. In this prospective study, 58 patients with mCRC harboring RAS mutations in baseline tumor tissue were enrolled. All patients experienced disease progression following first-line chemotherapy combined with bevacizumab. Plasma samples collected at progression were analyzed using the Idylla™ PCR-based system for detection of KRAS and NRAS mutations in circulating tumor DNA (ctDNA). Survival outcomes were estimated using the Kaplan–Meier method and compared with the log-rank test. The median age was 60 years (IQR 35–83), and 60.3

Approximately 50 to 67% of breast cancers (BCs), traditionally categorized as human epidermal growth factor receptor 2 (HER2)-negative, but demonstrating low HER2 expression, are now being defined as a new HER2-low subset or HER2-low category of BC. For metastatic BC (mBC), standard therapy options include targeted approaches, such as cyclin-dependent kinase 4/6 inhibitors, phosphoinositide 3-kinase inhibitors, poly (adenosine diphosphate-ribose) polymerase inhibitors, and anti-programmed death-ligand 1 agents, depending on tumor type and its molecular profile. Recent clinical trials reported significant clinical benefits from novel anti‑HER2 antibody‑drug conjugates, such as trastuzumab deruxtecan in HER2‑low mBC. Novel treatment options have increased the complexity of the clinical decision‑making process, particularly for treatment sequencing for each clinical setting. A regional expert committee meeting was held to discuss the challenges, overcome limitations, and present recommendations to enhance HER2 reporting as well as treatment of patients with HER2‑low mBC in the Middle East and Africa region.

Introduction: Therapeutic decisions in early breast cancer are based on clinico-pathological features which are subject to intra- and inter-observer variability. This single-center decision impact study aimed to evaluate the effects of the Prosigna assay on physicians’ adjuvant treatment choices. Methods: Between 09/2017 and 02/2018, formalin-fixed tumor samples from 52 newly diagnosed, postmenopausal, hormone receptor-positive, HER2-negative breast cancer (T1–T2; pN0-N1a) patients were analyzed. Pre-test clinical judgements and Prosigna test results were compared. Results: The mean age was 59 (42–77). Invasive ductal carcinoma (79.2%), grade 2 (52.8%) and T1c-N0 tumors (43.4%) were represented. There was 40.4% discordance between the pre- and post-test risk of recurrences. No significant change was observed in the clinical intermediate risk category, while there was a net reclassification of low-risk patients into a high Prosigna recurrence risk group. In addition, clinically determined intrinsic subtypes were 34.6% discordant with the Prosigna results, which is largely driven by the reclassification of the luminal A tumors into the Prosigna-assessed luminal B group. Before the Prosigna test, endocrine treatment was the primary choice in 20 patients (39.2%), and chemotherapy was recommended to 31 patients (60.8%). Overall, the Prosigna assay led to a change in treatment choice for one patient. Conclusions: Although conventional risk assessment methods are relatively inexpensive with shorter turnaround times, their accuracy and value for risk reduction are suboptimal. According to our results, the Prosigna assay was found to be a relevant tool for the clinical decision making process. Long-term follow-up of these patients will elucidate the potential benefits of using multigene molecular tests as biomarkers for treatment.

Simple Summary This study investigates the real-world efficacy and safety of combining pembrolizumab, a novel immunotherapy agent, with chemotherapy in early-stage triple-negative breast cancer treatment. We specifically aimed to validate clinical trial results in routine practice. A total of 108 Turkish patients receiving neoadjuvant therapy were examined. The combined regimen demonstrated high efficacy, with 64% of patients achieving pathological complete response, and exhibited generally favorable safety profiles with predominantly mild adverse events. These findings support the use of this combination as a standard treatment for this aggressive breast cancer subtype. However, the results underscore the need for further research to identify optimal patient selection criteria, which can inform oncologists' decision-making and potentially enhance outcomes for patients with triple-negative breast cancer.Abstract Background/Objectives: Following the results of the phase 3 KEYNOTE-522 trial, the U.S. Food and Drug Administration approved pembrolizumab, a humanized IgG4 kappa monoclonal antibody, in combination with neoadjuvant chemotherapy as a new standard of care for high-risk early-stage triple-negative breast cancer (TNBC). This retrospective, multicenter study in T & uuml;rkiye assessed the real-world efficacy and safety of neoadjuvant pembrolizumab combined with chemotherapy in early-stage TNBC. Methods: The study included 108 patients treated between 2021 and 2023 across 14 oncology centers. Three distinct neoadjuvant regimens incorporating pembrolizumab were administered at the discretion of the treating physicians. The primary outcomes were the pathological complete response (pCR) rate after neoadjuvant therapy and the 2-year event-free survival (EFS) and overall survival (OS) rates. Results: The observed pCR rate was 63.9%, closely mirroring the 64.8% reported in the KEYNOTE-522 trial. At the two-year mark, the EFS rate was 87.2% and the OS rate was 92.3%. Multivariable analysis identified pCR as the sole independent predictor of both EFS and OS. The safety profile was consistent with previous clinical trial data, with most adverse events being of grade 1-2 in severity. Conclusions: These findings provide valuable real-world confirmation of the efficacy and safety of neoadjuvant pembrolizumab-chemotherapy in early-stage TNBC, complementing evidence from randomized trials.

OBJECTIVE:Hereditary cancer syndromes constitute 5-10% of all cancers. The development of next-generation sequencing technologies has made it possible to examine many hereditary cancer syndrome-causing genes in a single panel. This study's goal was to describe the prevalence and the variant spectrum using NGS in individuals who were thought to have a hereditary predisposition for cancer.MATERIAL AND METHOD:Analysis was performed for 1254 who were thought to have a familial predisposition for cancer. We excluded 46 patients who were carrying BRCA1/2 variants in this study, for focusing on the rare gene mutations. Sequencing was performed using the Sophia Hereditary Cancer Solution v1.1 Panel and the Qiagen Large Hereditary Cancer Panel. The Illumina MiSeq system was used for the sequencing procedure. The software used for the data analyses was Sophia DDM and QIAGEN Clinical Insight (QCITM) Analyze. The resulting genomic changes were classified according to the current guidelines of ACMG/AMP.RESULTS:Pathogenic/likely pathogenic variants were detected in 172 (13.7%) of 1254 patients. After excluding the 46 BRCA1/2-positive patients, among the remaining 126 patients; there were 60 (4.8%) breast cancer, 33 (2.6%) colorectal cancer, 9 (0.7%) ovarian cancer, 5 (0.4%) endometrium cancer, 5 (0.4%) stomach cancer, 3 (0.2%) prostate cancer patients. The most altered genes were MUTYH in 27 (2.1%) patients, MMR genes (MLH1, MSH6, MSH, MSH2, PMS2 and EPCAM) in 26 (2%) patients, and ATM in 25 (2%) patients. We also examined the genotype-phenotype correlation in rare variants. Additionally, we identified 11 novel variations.CONCLUSION:This study provided significant information regarding rare variants observed in the Turkish population because it was carried out with a large patient group. Personalized treatment options and genetic counseling for the patients are therefore made facilitated.

e17509 Background: SOLO-2 trial results have proven the efficacy of Olaparib in BRCA-mutant platinum-sensitive relapsed ovarian cancer patients. LynTurk as an open label, multi-center study, designed to show the real world safety and efficacy results of Turkey Olaparib managed access program. Methods: Patients with BRCA mutated relapsed ovarian cancer who are in complete or partial response following platinum based chemotherapy were eligible for Olaparib maintenance in Turkish managed access program. The primary aim was safety. Progression free survival, overall survival were the secondary endpoints. Results: Between December 2014 and March 2021, 48 patients were accepted for program. Due to immaturity of data, in this report, a total of 26 patient results were analyzed. BRCA2 mutation was present in 5 patients, one patient have both BRCA1 and BRCA2 mutations; 20 cases were found to be BRCA1 mutated. The median age of patients was 51 (29-61) years. All patients have high grade serous adenocarcinoma of ovary or primary peritoneal carcinoma. The most common site of involvement are lymph nodes and peritoneal surfaces; in 11% of cases there are liver parenchyma metastasis. All of the patients received at least two lines of platinum-based chemotherapy; median 3 lines (2-4) of treatment were applied before Olaparib maintenance. Previous bevacizumab treatment was allowed in this program, 53.8% of cases were received at least 3 cycles, maintenance bevacizumab was given to 12 patients. Median treatment duration with Olaparib was 26,2 months (3-80m). In 30.7% of cases no adverse events were noted, at least one level dose reduction was needed for 50% of patients due to toxicity. Hematological adverse events were the mostly encountered followed by dyspepsia and fatigue. Anemia was the reason for permanent drug discontinuation in 2 patients (0.7%). No febrile neutropenia was reported. During the follow-up, no secondary malignancy and pneumonitis was noted. Median progression free survival from the end of last chemotherapy was 19.3 months. One-year PFS rate was 88.4% and 2-y PFS rate was 53.8%. One-year OS rate from the end of chemotherapy was 92.3% and 2-year was 61.5%. Conclusions: The real world data from Turkey managed access program has showed that Olaparib has a safety profile in paralel with clinical trials (SOLO). No new safety signals were reported. Although a heterogenous population including heavily pretreated patients, maintenance Olaparib was found effective. This report will be updated as the data of all intent to treat population will gather and will get mature.

ABS TRACT Objective: Pancreatic cancer is one of the leading causes of cancer-related death. Despite the introduction of new therapeutic agents, survival rates remain low. Furthermore, few trials have evaluated the options for second-line therapy and the prognostic variables. In this study, we aimed to determine the real-world efficacy and prognostic parameters of second-line treatment for advanced pancreatic cancer. Material and Methods: Patients with advanced pancreatic cancer from different centers who received second-line treatment were enrolled in the study. The patients’ demographic, clinical, and pathological characteristics were retrieved retrospectively. Results: A total of 161 pa- tients were enrolled in the study. The majority of the patients (50.3%) received oxaliplatin plus fluoropyrimidine as second-line treatment. The median progression-free survival and overall survival for the entire cohort were 2.5 months and 4.5 months, respectively. In univariate anal- yses, an Eastern Cooperative Oncology Group performance status ≥ 2, age ≥ 65 years, hypoalbuminemia, thrombocytosis, presence of metastatic peritoneal disease, elevated alkaline phosphatase and carcinoembryonic antigen levels, and a neutrophil-lymphocyte ratio (NLR) ≥ 3 were identified as poor prognostic factors. In multivariable analyses, low albumin level (p=0.031) and high NLR (p=0.05) were found to be independent prognostic factors for overall survival. Conclusion: Pancreatic cancer is a unique malignancy, and advanced disease has a dismal prog- nosis. In univariate analyses, we identified multiple factors that were poor prognostic variables. In particular, the albumin level and NLR were independent prognostic factors for overall survival, and these parameters might be useful in selecting the second-line treatment and pre- dicting the survival of these patients.

Genomic characterization of BRAF mutation in colorectal cancer (CRC) revolutionized it's management. Current knowledge regarding BRAF mutant CRC is based on the prevalent V600E mutation and mostly on Western population. However, CRC is known to be a complex and heterogenous disease. Thus, we aim to characterize the molecular, clinical and epidemiologic features of V600E as well as non-V600E BRAF mutated CRC in Turkish population. Demographic, histopathologic, molecular and clinical data of V600E and non-V600E BRAF mutant, metastatic and non-metastatic CRC cases were retrospectively collected from a tertiary Oncology hospital. Thirty cases of BRAF mutant colorectal carcinoma was identified. BRAF mutations were V600E (66.7%), V600A (10.0%), V600G (3.3%), V600K (3.3%), and L597V (16.7%). BRAF V600E cases had similar characteristics with Western population: frequent in females (45.0%), more proximal location (52.6%), aggressive histopathologic features (LVI 50.0%), and a worse prognosis (OS 13 vs 30 months, p= 0.068). Non-V600E BRAF mutant cases were diferred from V600E cases by being more frequent in males (50.0%), located more distally (60.0%), and carrying a better prognosis. This study demonstrates V600E mutation in CRC in Turkey is similar with Western population. In like manner, non-V600E BRAF mutation in CRC bears the potential to be a significant attribute for both prognostic and therapeutic implications as well.

e15587 Background: Expanded RAS analysis is essential for the selection of biologic agents in mCRC. RAS mutations indicates anti-EGFR unresponsiveness. In this study, we aimed to investigate RAS and BRAF mutations by liquid biopsy at progression in patients with RAS mutant mCRC. Methods: Sixty patients with mCRC who harbored tissue RAS mutations were prospectively analyzed between July 2019 and April 2020. All the patients treated with chemotherapy plus bevacizumab combinations . The plasma samples of the patients were analyzed after progression of bevacizumab combinations. RAS mutation profile was evaluated in plasma using Idylla PCR-based molecular diagnostics method, which enables rapid detection of common mutations in RAS and BRAF genes in circulating tumor DNA (ctDNA). Kaplan-Meier method was used for survival analysis and log-rank test was performed for comparison of groups. Results: The median age of the patients was 60 years (IQR:35-83 years) and female was (n=23, 38.3%). Primary tumor was located in the left colon in 81.7% of all patients. There were 95.0% KRAS and 5% NRAS mutations in baseline tissue biopsy. As a result of liquid biopsy after progression, 55.0% of the patients had KRAS, 3.3% NRAS and 3.3% had BRAF mutations. The RAS mutation detected in 58.3% of the patients. While there was no significant difference in terms of clinicopathological features between wild type (RAS/BRAF) and mutant type (RAS/BRAF) determined by liquid biopsy, the overall survival (OS) of the wild type group was significantly longer than mutant group (43.8 vs. 20.4 months, p= 0.002). Conclusions: This study demonstrated that there may be changes in RAS/BRAF mutation from plasma analysis after progression in patients with mCRC. Since better survival in the patient group with wild type was detected compared to the RAS concordance group, the evaluation of RAS mutation status at the time of progression may be important in terms of disease prognosis and treatment options.

Background/Aims: Gastric neuroendocrine tumors (G-NETs) are rare tumors, but their incidence is gradually increasing. Despite the existence of many classification systems, determining prognosis and planning treatment in patients with G-NETs remains a clinical challenge. In this study, the prognostic value of the World Health Organization (WHO) 2017 grading system and the effect of surgery on survival in low grade neuroendocrine tumors were investigated. Materials and Methods: G-NETs who were diagnosed between January 2000 and May 2017 were included in the study. Patients' demographic characteristics, treatment details, and survival data were obtained from medical charts. Pathological samples were re-classified according to the WHO 2017 grading system. Results: Of the total 94 evaluated patients, 50 (53.2%) were classified with G1 NETs, 37(39.4%) with G2 NETs, 4(4.2%) with well-differentiated G3 NETs, and the remaining 3 patients with poorly differentiated G3 neuroendocrine carcinoma (NEC). The median follow-up time was 83.2 months. There was a statistically significant difference in 5-year progression free survival (PFS) between G1 tumors (100%) and G2 tumors (76%) (p<0.001). However, there was no statistically significant deference in 5-year overall survival rate (OS) for G1 (97%) and G2 (82%) tumors (p=0.141). When G2 and G1 NETs were compared according to their surgical approach, radical surgery was more frequently performed in patients with G2 tumors (p<0.001). However, radical surgery did not improve PFS in G1 and G2 NETs. Conclusion: The WHO 2017 NET classification system may have low prognostic value for determining the prognosis of patients with G1 and G2 tumors. Radical surgery for G1 and G2 NETs did not improve PFS in our study.

ÖZETGİRİŞ ve AMAÇ: Over kanseri kadınlarda görülen beşinci en sık kanser olmakla birlikte jinekolojik kanserlere bağlı ölüm nedenleri arasında ilk sırada yer almaktadır.Çalışmamızda merkezimizde over kanseri nedeniyle tedavi verilen hastaların nüks durumunun, sağkalım sonuçlarının ve tedaviye bağlı gözlenen

Purpose: Testicular cancer is the most commonly diagnosed solid organ malignancy in 15 to 35 year-old men with 1% incidence among all malignancies. Sixty percent of patients with mild and poor-risk factors need additional treatments. Starting in 1980s, high dose chemotherapy regimens (HDCT) that were not applicable before due to hematological toxicity have been brought into use, and survival and cure possibility have increased. To date, no randomized trial has been conducted to demonstrate superiority of high-dose chemotherapy protocols used for autologous stem cell transplantation (ASCT). Our study aims to compare two commonly used HDCT regimens for a long period, with real-life data. Methods: Approval for thiss retrospective study was obtained from the ethics committee of Gulhane Training and Research Hospital. Fifty refractory testicular cancer patients above 18 years were treated with HDCT and ASCT at Gulhane Training and Research Hospital (January 2011-July 2018). Results: Fifty metastatic, refractory testicular carcinoma patients with a median age of 34 were included in the study. Ninety per cent of the cases had stage III disease at diagnosis. Except for 8 patients (16%) at mild risk group, all the other patients were at high risk. CE was used as salvage treatment for half of the patients and ICE was used for the other half. Four patients responded completely and 30 responded partially to ASCT. Post transplantation median progression free survival (PFS) was 22 months. Median overall survival (OS) in the general population was 223.4 months (76.1-370.7). Although there was a difference in OS between chemotherapy groups, the difference was not statistically significant. The mean duration of engraftment in patients treated with CE was 11.2 +/- 2.3 days, while in patients receiving ICE it was 15.5 +/- 2.1 days. This difference between chemotherapy groups was statistically significant (p<0.001). Conclusion: For patients with relapsed/refractory germ cell tumor high dose carboplatin/etoposide and high dose ifosfamide/carboplatinletoposide regimens were both safe and effective treatments.

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.

Objective To evaluate prognostic factors associated with the use of ipilimumab in patients with mucosal and uveal melanoma. Methods In this multicenter, retrospective study, 31 patients with uveal and mucosal melanoma diagnosed between 2010 and 2017 were enrolled. Patients' characteristics, metastatic disease sites, treatment before ipilimumab therapy, performance status, hemoglobin, lactate dehydrogenase levels, B-RAF and c-kit mutation status, toxicity, and survival data were assessed for patients with mucosal and uveal melanoma. SPSS version 17 was used for statistical analysis. Kaplan-Meier method was used for survival analysis. The log-rank test was used for univariate analyses. The Cox regression analysis was used to test the association between multivariate variables and survival. The p-value of less than 0.05 was considered statistically significant. Results Twenty patients had uveal and eleven patients had mucosal melanoma. The median overall survival was seven months (95% confidence interval: 1.1-12.7). In univariate analysis, while bone metastasis, anemia, high lactate dehydrogenase level, and more metastatic sites were associated with lower overall survival, better treatment response and administration of ipilimumab in first or second lines were associated with favorable overall survival. In multivariate analysis, only treatment response status and administration of ipilimumab in first or second lines were found to be significant as independent prognostic factors for survival. Conclusion Ipilimumab therapy may be associated with increased survival, but this retrospective small N study makes that hard to definitely conclude.

ABSTRACT  Objective: To evaluate the efficacy and safety of enzalutamide in metastatic castration-resistant prostate cancer (mCRPC) in docetaxel-naive and docetaxel-pretreated patients.STUDY DESIGNObservational study.PLACE AND DURATION OF STUDYHSU Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, Turkey, from March 2017 to July 2019.METHODOLOGYA total of 67 patients with mCRPC were retrospectively evaluated. Castration-naive patients and non-metastatic patients were excluded from the study. Comorbid diseases, ECOG performance status, PSA response, and the radiological response of the patients were recorded. Kaplan-Meier method was used for survival analysis, and a Cox regression model was formed.RESULTSThe overall survival (OS) was significantly longer in patients with eastern cooperative oncology group performance status (ECOG PS) 0 (26.0 vs. 14.0 months, p=0.031), PSA response (26.0 vs. 7.0 months, p=0.002), radiological response (26.0 vs. 10.0 months, p=0.006) and duration of enzalutamide ≥9 months (26.0 vs. 7.0 months, p<0.001) compared to ECOG PS 1. According to Cox regression analysis, patients with PSA response had 0.35 fold (CI.95% 0.13-0.94) reduced the risk of death and 0.36-fold (CI.95%0.16-0.85) reduced the risk of progression compared to those without PSA response. Moreover, longer enzalutamide treatment (≥9 months) was noted to decrease the risk of death.CONCLUSIONPSA response, radiological response and duration of enzalutamide treatment may predict the improvement of survival in patients with mCRPC treated with enzalutamide.   Key Words: Enzalutamide, Docetaxel, Castration-resistant prostate cancer, Overall survival, Progression-free survival.

Objective: Unlike left testicular vein, right testicular vein drains into inferior vena cava. Consequently, the systemic spread of testicular cancers in each side is expected to differ based on the vascular structures of the right and left testis. In this study, we investigated the effect of tumour localization on survival of nonseminomatous testicular cancer patients. Materials and Methods: We included three hundred and twenty-one (321) non-seminomatous testicular cancer patients who were followed-up at Gulhane Training and Research Hospital between January 1981 and December 2015. Results: The primary tumour found in the left testis in 152 (47.2%) patients, while 170 (52.8%) patients had the primary tumour in the right testis. The lungs (n=62, 42.5%) was the most common site of metastasis. During follow-up and primary treatment, 74 (23.1%) patients had recurrence, which was common in retroperitoneal lymph nodes (10.3%) and lung (5%). Median follow-up period was 88.3 (range: 1-386) months, while median survival was 337 months in all cases. Median 10 year survival rate was 74.1%, while median 20 year survival rate was 70.7%. We found that survival of patients with the primary tumour was significantly different between the left and right testis (337.6 months vs denotes not reached, p=0.001). The recurrence rate was significantly higher (84.7% vs 68.2%; p=0.002) in patients with right testicular tumour when compared to patients with left testicular tumour. Conclusion: The survival of the patients with tumour localized in the right testis was higher than patients with tumour localized in the left testis.