Background: Vandetanib and cabozantinib are the approved first-line antiangiogenic multikinase inhibitors (aaMKIs) for metastatic medullary thyroid carcinoma (MTC); however, real-world data on their comparative efficacy, optimal sequencing, and outcomes beyond the first-line setting remain limited. We report multicenter real-world outcomes from a large Turkish cohort. Methods: In this retrospective multicenter cohort study, we analyzed data from 24 oncology referral centers across Türkiye. Patients with histologically confirmed metastatic MTC who received systemic therapy between December 2011 and December 2024 were included. The primary endpoint was progression-free survival (PFS), assessed separately for first-line (PFS1) and second-line (PFS2) therapy. Overall survival (OS) and prognostic factors were evaluated using Kaplan-Meier and Cox proportional hazards analyses. Results: A total of 115 patients were included (median age 47.4 years; 63.5% male). In the first-line setting, vandetanib (47.8%) and cabozantinib (30.4%) were the most frequently used agents. Median PFS1 was 40.8 months with vandetanib and was not reached with cabozantinib; both were significantly superior to chemotherapy (median PFS1 4.9 months; log-rank p < 0.001). In the second-line setting, median PFS2 was not reached with cabozantinib and was 32.5 months with vandetanib. Sequential use of cabozantinib and vandetanib across the first two lines was associated with a median time to second progression of 114 months, compared with 39 months in patients receiving any other TKI combination (p = 0.003). Second-line use of cabozantinib or vandetanib was independently associated with improved OS (HR 0.40, 95% CI 0.16-0.98; p = 0.046). On multivariate analysis, younger age (HR 0.16, 95% CI 0.03-0.72; p = 0.017) and bone metastasis (HR 0.29, 95% CI 0.11-0.73; p = 0.009) were independent prognostic factors for OS. Conclusions: In this real-world cohort of patients with metastatic MTC, cabozantinib and vandetanib demonstrated durable efficacy across treatment lines, substantially outperforming alternative TKIs and chemotherapy. Sequential use of both approved aaMKIs was associated with prolonged disease control. These findings suggest a potential association between access to both agents and improved outcomes. They are consistent with their central role in treatment sequencing, particularly in settings with limited access to selective RET inhibitors. Given the retrospective design and small subgroup sizes, these results should be interpreted as exploratory and hypothesis-generating.

The purpose of this study is to investigate the effect of CD47 expression levels on survival function and to determine the relationship between the clinicopathological features of uterine carcinosarcoma (UCs). The expression of CD47 was analyzed by calculating immunoreactivity scoring (IRS) which takes into account both the category of staining intensity (0: no immunostaining; 1: weak staining; 2: moderate staining; and 3: strong staining) as well as the grade of percentage of positive cells five grades ( 0 for 0

ABSTRACT Background The role of carboplatin in neoadjuvant chemotherapy for triple‐negative breast cancer (TNBC) remains controversial, particularly in settings where access to immunotherapy is limited. This study evaluated the real‐world impact of adding carboplatin to neoadjuvant chemotherapy on pathological complete response (pCR) and survival outcomes in patients with TNBC. Methods This retrospective multicenter study included patients with nonmetastatic TNBC treated with neoadjuvant anthracycline‐ and taxane‐based chemotherapy between 2018 and 2023 at three oncology centers in Turkey. Patients were grouped according to receipt of platinum‐containing therapy. Survival outcomes were estimated using the Kaplan–Meier method and compared with the log‐rank test. Cox regression analyses were performed to evaluate factors associated with survival. Propensity score matching was also performed as a supportive analysis. Results A total of 142 patients were included, of whom 45 (32.2%) received platinum‐containing neoadjuvant chemotherapy. Overall, 80 patients (56.3%) achieved pCR. The pCR rate was significantly higher in the platinum group than in the non‐platinum group (68.9% vs. 50.5%, p = 0.031). After a median follow‐up of 57 months, 24 deaths and 33 DFS events were observed. Median OS and DFS were not reached. The 60‐month OS rate was 96.0% in the platinum group and 73.9% in the non‐platinum group (log‐rank p = 0.027), whereas the 60‐month DFS rates were 86.1% and 67.6%, respectively (log‐rank p = 0.139). Patients who achieved pCR had significantly better OS and DFS than those with residual disease. In the propensity score‐matched cohort, non‐platinum treatment remained associated with inferior OS and DFS. Conclusions In this multicenter real‐world cohort, carboplatin was associated with a higher pCR rate and numerically favorable survival outcomes. These findings may be clinically relevant where immunotherapy is not readily accessible but should be considered hypothesis‐generating and require prospective validation.

Background: Parotid gland tumors pose diagnostic and surgical challenges due to their histological heterogeneity and proximity to the facial nerve. This study aimed to evaluate clinicopathological features and postoperative outcomes with a specific focus on facial nerve function in patients undergoing parotidectomy. Methods: This retrospective study included 314 patients who underwent parotidectomy between 2008 and 2024 at a tertiary center. Demographic data, tumor histology, and postoperative complications—particularly facial nerve paralysis within the first three months—were analyzed. Histopathological features including capsular, perineural, and lymphovascular invasion were also assessed. Results: Of all cases, 79% were benign, 14.6% malignant, and 6.4% non-neoplastic. Pleomorphic adenoma and Warthin tumor were the most common benign entities, while mucoepidermoid carcinoma was the most frequent malignancy. Malignant tumors were associated with higher rates of positive surgical margins (44.2% vs. 12.5%, p < 0.001), capsular invasion (25% vs. 7%, p < 0.001), and tumor necrosis (22% vs. <1%, p < 0.001). Facial paralysis occurred in 4.4% of patients, largely transient and significantly associated with malignant tumors (p < 0.001) and extensive lymph node dissection (p < 0.001). Capsular invasion and necrosis were rare in benign lesions but still observed, especially in pleomorphic adenoma. Conclusions: Histopathologic aggressiveness markers were associated with malignant disease and postoperative facial nerve dysfunction. These findings support a risk-stratified approach to follow-up: all patients undergo universal early assessment at two weeks and three months, after which surveillance intensity may be individualized according to histopathologic features—such as necrosis, perineural invasion, capsular invasion, or positive margins.

OBJECTIVE:Fine-needle aspiration cytology (FNAC) is routinely used in the preoperative evaluation of parotid gland tumors, yet its diagnostic performance varies across categories of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC). This study evaluated category-specific malignancy risk and the clinical impact of different diagnostic thresholds. METHODS:We retrospectively analyzed 277 patients who underwent parotidectomy with available preoperative FNAC. Cytologic diagnoses were classified according to the MSRSGC and correlated with final histopathology. Diagnostic performance was assessed using two thresholds: Milan V-VI and Milan III-VI. Trends in malignancy risk across Milan categories were examined, and false-negative and false-positive cases were reviewed by histopathological subtype. Overall discriminatory performance was evaluated using receiver operating characteristic analysis. RESULTS:Final histopathology revealed benign disease in 85.2% and malignancy in 14.8% of cases. Malignancy risk increased significantly across higher Milan categories (p = 0.006). Using Milan V-VI as the threshold yielded high specificity (97.0%) and negative predictive value (88.8%) but low sensitivity (29.3%). Expanding the threshold to Milan III-VI increased sensitivity (78.0%) but markedly reduced specificity (21.2%). Discriminatory performance was poor (AUC 0.622). False-negative results were mainly low-grade malignancies, particularly low-grade mucoepidermoid carcinoma, whereas false-positive results were largely benign oncocytic or hypercellular lesions. CONCLUSIONS:FNAC provides useful preoperative risk stratification for parotid gland tumors within the Milan framework, but its diagnostic value is highly threshold-dependent and limited by tumor biology.

BACKGROUND:Germline pathogenic variants are increasingly recognized as critical determinants of pancreatic ductal adenocarcinoma (PDAC) susceptibility, prognosis, and response to targeted therapies such as PARP inhibitors. Recent guidelines recommend germline testing for all PDAC patients, regardless of family history, to identify hereditary cancer syndromes and guide treatment decisions. However, data from populations underrepresented in genomic studies, such as the Turkish population, remain limited. METHODS:We retrospectively analyzed 151 unselected PDAC patients who underwent germline testing using a next-generation sequencing (NGS) panel between January 2023 and April 2025. The panel covered established cancer susceptibility genes. Clinical parameters-including age, sex, tumor location and stage, diabetes status, and cancer family history-were reviewed. Variants were classified as pathogenic/likely pathogenic (P/LP), variants of uncertain significance (VUS), or benign. RESULTS:Among the 151 patients, 17 (11.3%) harbored P/LP variants, most frequently in ATM (n=3), BRCA1 (n=2), BRCA2 (n=2), and CDKN2A (n=2). An additional 33 patients (21.9%) carried VUS, again most commonly affecting ATM. No benign variants were reported. Notably, 70.6% of P/LP carriers had a first- or second-degree family history of cancer. Most tumors originated in the pancreatic head (72.8%), and 41.1% of patients had metastatic disease at diagnosis. CONCLUSIONS:Our findings confirm the relevance of multigene panel testing in PDAC and reveal a germline mutation spectrum consistent with global data. These results support universal germline screening and emphasize the need for continued VUS interpretation, particularly in genomically understudied populations.

Background The benefit of adding carboplatin to standard anthracycline–taxane neoadjuvant chemotherapy for triple-negative breast cancer (TNBC) remains debated, particularly in settings with limited access to immunotherapy. We evaluated the real-world impact of neoadjuvant carboplatin on pathological complete response (pCR) and survival outcomes.. Methods This retrospective, multicenter observational study included adult patients with nonmetastatic TNBC treated with neoadjuvant chemotherapy between January 2018 and December 2023 at three oncology centers in Turkey. Patients received anthracycline- and taxane-based regimens with or without carboplatin. The primary endpoint was pCR (ypT0/TisN0). Overall survival (OS) and disease-free survival (DFS) were estimated using Kaplan–Meier methods and compared with the log-rank test; Cox regression was used to identify independent prognostic factors. Results Among 142 patients, 45 (32.2%) received platinum-containing neoadjuvant therapy. Overall, pCR was achieved in 80 patients (56.3%). The pCR rate was higher with carboplatin than without (62.2% vs 42.1%, p = 0.031). With a median follow-up of 57 months, 60-month OS was 96% in the platinum group versus 73.9% in the nonplatinum group ( p = 0.027), while DFS differences were not statistically significant ( p = 0.139). Conclusion In this multicenter real-world cohort, adding carboplatin to neoadjuvant chemotherapy was associated with higher pCR rates and improved OS. Achieving pCR and receipt of platinum remained independently associated with better survival in multivariable analyses.

Background and Objective: The clinical success of novel antibody-drug conjugates has led to the identification of a new subgroup within traditionally HER2-negative breast cancers, termed 'HER2-low.' The aim of this study was to investigate the clinicopathological differences between HER2-low and HER2-negative groups in neoadjuvant-naive primary breast cancer patients, with a specific focus on stromal tumor-infiltrating lymphocyte (sTIL) density. Materials and Methods: The study included 731 neoadjuvant-naive invasive breast cancer patients. Tumors were classified as HER2-negative (IHC 0) and HER2-low (IHC 1+ or 2+/ISH-negative). sTIL levels were evaluated following the International TILs Working Group guidelines. Results: The HER2-low group (38.7%) demonstrated significantly higher histological grade (p = 0.033) and higher sTIL density (p = 0.006) compared to the HER2-negative group. A stepwise increase in sTIL rates was observed parallel to the HER2 immunohistochemical score (0 → 1+ → 2+) (p = 0.015). The HER2-low/hormone receptor (HR)-negative subgroup exhibited the highest sTIL density (median 35%). No statistically significant difference in overall or disease-free survival was found between the groups. Conclusions: HER2-low breast cancers were associated with a more immunogenic tumor microenvironment compared to HER2-negative tumors. This robust immune infiltration may offset the higher histological grade observed in the HER2-low cohort, potentially explaining the comparable survival outcomes. These findings provide a biological rationale for exploring the synergy between novel antibody-drug conjugates and immune checkpoint inhibitors, particularly in the highly immunogenic HER2-low/HR-negative subgroup.

Background/Aims:The treatment of hepatocellular carcinoma (HCC), which accounts for 90% of all liver cancers, is highly varied. The use of second-line treatments following progression on first-line atezolizumab and bevacizumab (Atez/Bev) for advanced HCC remains controversial. The aim of this study was to analyze the real-world clinical results of second-line treatments in progression after Atez/Bev and to determine the factors affecting prognosis. Materials and Methods:Fifty-eight patients treated with second-line sorafenib, regorafenib, and cabozantinib for progression after first-line Atez/Bev for advanced/metastatic HCC from 20 centers in Türkiye between October 2020 and June 2024 were retrospectively analyzed. Responses were evaluated by Response criteria, specifically Response Evaluation Criteria in Solid Tumors (RECIST v1.1) criteria. Median overall survival (OS) and progression-free survival (PFS) were computed with the Kaplan-Meier method. The Cox regression model was utilized to analyze multivariate analyses. Results:About 82.8% of the patients were male and the median age of the whole group was 62 (range, 18-78) years. All patients progressed after first-line Atez/Bev and were given second-line treatment. The most commonly used second-line treatment option was sorafenib (70.7%), followed by regorafenib (12.1%) and cabozantinib (10.3%). Both median PFS (4.1 months) and median OS (7.8 months) were longer in patients treated with sorafenib compared to other treatments. In univariate analyses, Child-Pugh score B, high alpha-fetoprotein (AFP) levels (>200 ng/mL), extrahepatic spread, and Prognostic Nutritional Index (PNI) < 47.6 substantially raised the risk of overall mortality. Multivariate analysis showed that extrahepatic spread (HR (Hazard ratio): 0.41, P = .012), PNI level (HR: 0.24, P = .005), and AFP level (HR:1.97, P = .049) were independent predictors of OS. Conclusion:Although second-line therapies after Atez/Bev show different degrees of efficacy, survival rates are consistent with the literature. Extrahepatic spread, AFP level, and PNI level are the main prognostic factors. In light of this information, personalized treatment strategies may improve outcomes for this challenging patient group.

Background and Objectives: Small-cell lung cancer (SCLC) is an exceedingly aggressive neoplasm distinguished by an unfavorable prognosis. Recent studies have confirmed chemo-immunotherapy as the conventional first treatment for extensive-stage small-cell lung cancer (ES-SCLC), but the impact of treatment duration remains unclear. The goal of this study was to find out how the length of treatment affected progression-free survival (PFS) and overall survival (OS) in patients with ES-SCLC who were receiving first-line atezolizumab plus chemotherapy. Materials and Methods: This retrospective multicenter study comprised 82 patients from six oncology centers in Turkey between 2017 and 2024. Patients were categorized into two categories according to the quantity of chemotherapy cycles they had undergone: standard treatment (≤4 cycles) and extended treatment (≥5 cycles). For the purpose of analyzing survival outcomes and related clinical determinants, as well as the demographic structures and features of the patients, both univariate and multivariate Cox regression models were utilized. Results: The median number of atezolizumab cycles was 8 (1–63). OS was 29.46 months after 15.8 months of follow-up, while PFS was 10.63 months. When comparing the two groups, we found no statistically significant differences in either PFS (p = 0.952) or OS (p = 0.374). Significant associations with OS were seen in the standard therapy group for both ECOG PS 1 (p = 0.028). Thoracic radiation considerably decreased progression risk (HR = 0.41, p = 0.031) in the extended group. Conclusions: While prolonging chemo-immunotherapy beyond four cycles did not significantly improve survival, the selected patient subgroups may benefit from personalized approaches. Thoracic radiotherapy emerged as a key modifier of outcome.

Background and Objectives: A recent clinical trial has demonstrated that breast cancer with low-HER2 expression levels responds to trastuzumab deruxtecan treatment. This has prompted a re-evaluation of HER2-targeted therapies in the HER2-negative group. Further research is required in the form of more detailed information about HER2-negative breast cancers with HER2-null, HER2-ultralow, and HER2-low subgroups. This study represents a novel approach to this field. Materials and Methods: HER2-negative breast cancer patients were classified into three groups as HER2-null, HER2-ultralow, and HER2-low. A comparison of clinicopathological features was analyzed retrospectively. Results: Of 722 patients, 22.3% were HER2-null, 23.7% were HER2-ultralow, 54.0% were HER2-low. While two-thirds of all the patients were evaluated as having T2 tumors, T4 tumors constituted 2.4%. Among HER2-negative cases, 11.8% were triple-negative and 88.2% were hormone-positive. The mean tumor diameter was 0.57 cm larger in the HER2-ultralow group than in the HER2-null group and 0.34 cm larger in the HER2-low group than in the HER2-null group. HER2-null tumors tend to be smaller. The HER2-low group was more likely to relapse than the HER2-null group. There were no significant differences in the distribution of hormone positivity or negativity (TNBC) among the groups; they accounted for 89.2% and 10.8% of all cases, respectively. Conclusions: HER2-negative breast cancer is a heterogeneous disease and deserves a detailed review in terms of diagnosis and treatment. HER2-ultralow tumors are larger in size and have a prognosis comparable to HER2-null tumors. HER2-low tumors tend to recur much more frequently and with poorer outcomes. In this field, new therapeutic approaches may result in better outcomes.

Background: Parotid gland tumors pose diagnostic and surgical challenges due to their histological heterogeneity and proximity to the facial nerve. This study aimed to evaluate clinicopathological features and postoperative outcomes in a large cohort undergoing parotidectomy. Methods: This retrospective study included 314 patients who underwent parotidectomy between 2008 and 2024 at a tertiary center. Demographic data, tumor histology, and postoperative complications—particularly facial nerve paralysis—were analyzed. Histopathological features such as capsular, perineural, and lymphovascular invasion were also assessed. Results: Of all cases, 79% were benign, 14.6% malignant, and 6.4% non-neoplastic. Pleomorphic adenoma and Warthin tumor were the most common benign entities, while mucoepidermoid carcinoma was the most frequent malignancy. Malignant tumors were associated with higher rates of positive surgical margins (44.2%), capsular invasion (25%), and tumor necrosis (22%). Facial paralysis occurred in 4.4% of patients, more frequently among those with malignant tumors and extensive lymph node dissection. Capsular invasion and necrosis were rare in benign lesions but still observed, especially in pleomorphic adenoma. No significant differences in pathology were found based on place of birth. Conclusion: Most parotid tumors are benign, but certain histopathological features—such as necrosis, capsular and perineural invasion—are strong indicators of malignancy and should guide surgical planning and postoperative surveillance. These findings highlight the need for individualized, risk-adapted management strategies in parotid surgery to balance oncological safety with preservation of function.

Aim: Hormone receptor (HR)-positive, human epidermal growth factor 2 (HER2)-negative breast cancer which represents the most common subgroup of metastatic breast cancer (MBC). Recently, further subclassification for HER2-negative tumors has emerged as HER2-low. There is limited knowledge regarding the effect of HER2-low expression on outcomes of patients with HR-positive and HER2-negative MBC treated with CDK 4/6 inhibitors plus hormonal therapy. Therefore, we evaluated survival parameters according to HER2-low status for this patient group in this study. Material and Methods: As the Turkish Oncology Group (TOG) Project, retrospectively collected data from 423 patients with HR-positive/HER2-negative MBC treated with ribociclib and palbociclib plus letrozole therapy was assessed. Included patients had metastatic first-line therapy and endocrine-sensitive disease. Survival outcomes were compared between HER2-negative and HER2-low patient groups. Conclusion: HER2-low status had no statistically significant impact on survival in patients treated with palbociclib or ribociclib plus letrozole.

BACKGROUND:Real-world (RW) data provide valuable information about the effectiveness and safety of treatment modalities in the general population that is not limited by selection criteria in clinical studies. The aim of this study was to evaluate the effectiveness of palbociclib or ribociclib plus fulvestrant in hormone receptor-positive and human epidermal factor 2-negative metastatic breast cancer (HR+/HER2-MBC). MATERIALS AND METHODS:We conducted a multicenter, retrospective cohort study that included 522 patients with HR+/HER2-MBC treated with ribociclib or palbociclib in combination with fulvestrant. RESULTS:Median real-world progression-free survival (mPFS) was 12.9 months (95% CI, 11.16-14.65) for the entire cohort, and no statistically significant difference was present between the palbociclib and ribociclib groups (P = .70). Real-world median overall survival (mOS) was estimated to be 43.3 months (95% CI, 20-66.6) for the palbociclib group and 48.5 months (95% CI, NA-NA) for the ribociclib group and similar between the 2 groups (P = .56). When evaluated for the entire group, there was a significant difference in mPFS between patients with primary and secondary endocrine resistance (8.6 and 13.5 months, P = .002), and this difference was more pronounced in the palbociclib arm (6.6 and 14.4 months, P = .006) than in the ribociclib arm (11.6 and 13.3 months, P = .064). CONCLUSION:Although the 3 CDK4/6 inhibitors did not seem to differ significantly from each other in terms of effectiveness in a real-world context, they may vary depending primarily on the specific characteristics of the patient population being treated.

Background and Objectives: Axillary lymph node metastasis and the number of metastatic lymph nodes are important prognostic factors which are directly related to overall survival in women with breast cancer. Several factors have been identified to predict the likelihood of axillary lymph node metastasis in early-stage breast cancer. High PR expression is often more prevalent in the luminal A subgroup, which is associated with a better prognosis. The aim of this study was to determine the relationship between the percentage of PR expression and the likelihood of axillary metastasis in Her-2-negative, clinical T1-T2N0 luminal type breast cancer. Materials and Methods: A hundred and ninety-nine cases with luminal type, Her-2-negative, clinically and radiologically axilla-negative T1-T2 breast cancer who received radiotherapy were evaluated retrospectively. The pathological specimens were assessed by an experienced pathologist. Results: The statistical evaluation showed that tumor diameter greater than 2 cm, (p = 0.003), presence of lymphovascular invasion (p = 0.001), and PR expression level below 80% (p = 0.037) were identified as significant predictors of lymph node positivity in breast cancer patients. Conclusions: Percentage of progesterone receptor expression along with other molecular biological markers and clinicopathological parameters should be evaluated altogether when predicting axillary metastasis risk before surgery.

ATM plays a crucial role in repairing DNA damage and maintaining genomic stability. Mutations in ATM are associated with increased breast cancer risk and the development of various neuroendocrine carcinomas, including small-cell lung carcinoma and neuroendocrine tumors of the gastrointestinal tract. Here, we present a case with a heterozygous ATM variant [NM_000051.4.7174C>T(p.Arg2392Trp)], which is classified as a variant of uncertain significance (VUS) in the ClinVar database. This patient, who was initially treated for breast cancer, was later diagnosed with a rare vaginal neuroendocrine carcinoma at month 31 post-breast cancer diagnosis. In contrast to most cases, the patient tested negative for human papillomavirus (HPV)-DNA. Based on the rare presentation of neuroendocrine carcinoma and the negative HPV-DNA status, we proposed that VUS of ATM may be associated with cancer development and has pathogenic roles.

Alveolar soft part sarcoma (ASPS) is an ultra-rare, highly angiogenic sarcoma with limited responsiveness to chemotherapy. Tyrosine kinase inhibitors (TKIs) such as sunitinib and pazopanib have shown promising activity, but comparative real-world data remain scarce. This multicenter, retrospective study included 51 patients with metastatic ASPS treated with sunitinib and/or pazopanib between January 2013 and March 2025. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier methods, and prognostic factors were assessed via Cox regression. First-line TKI therapy achieved significantly longer median PFS compared with chemotherapy (24.9 vs. 5.8 months; p < 0.001), without a significant OS difference. In first-line comparisons, pazopanib demonstrated a trend toward longer PFS (27.2 vs. 15.2 months; p = 0.052) and significantly prolonged OS (45.0 vs. 21.0 months; p = 0.021) versus sunitinib. Across all lines, median PFS and OS were 24.9 and 38.3 months for pazopanib, and 17.7 and 21.0 months for sunitinib, respectively. Multivariate analysis identified prior chemotherapy and liver metastases as independent predictors of shorter PFS. Both agents were well tolerated, with mostly Grade 1-2 toxicities. In one of the largest real-world ASPS cohorts, frontline TKIs provided substantial disease control and prolonged survival compared with chemotherapy, with manageable toxicity. These findings reinforce the role of anti-angiogenic therapy as a preferred first-line approach in advanced ASPS. Prospective studies are warranted to optimize treatment sequencing in this ultra-rare sarcoma.

Breast cancer is the most common type of cancer in women, and predicting disease progression through CPS and EG scoring is important for treatment and prognosis, especially after neoadjuvant chemotherapy. The present study aimed to evaluate the association between the clinical and pathological stage (CPS) + estrogen receptor status and histologic grade (EG) score and disease-free survival (DFS) and overall survival (OS) in patients with breast cancer undergoing neoadjuvant chemotherapy. Data from 148 patients with breast cancer who were treated with neoadjuvant chemotherapy in the Medical Oncology Clinic of Izmir Tepecik Training and Research Hospital between 2013-2018 were analyzed. The following variables were assessed: Demographic characteristics, tumor size, clinical staging, estrogen receptor status, tumor nuclear grade in biopsy material and postoperative pathological staging. CPS + EG scores were calculated using simultaneous estrogen receptor status and tumor nuclear grade parameters, which were developed using the Neoadjuvant Therapy Outcomes Calculator Software of the MD Anderson Cancer Center. The 5-year OS and DFS rates were evaluated, and the 5-year follow-up of the patients was analyzed. The median follow-up period was 76.5 months, and the median survival time was 104.1 months. The pathological complete response (pCR) rate was 23.6%. Patients with a pCR were revealed to have a significantly higher DFS rate compared with the non-pCR group (P=0.038). A significant decline in DFS was also demonstrated with increasing CPS + EG scores (P<0.001). Moreover, a CPS score of 3-4 (P<0.001) and a CPS + EG score of 3-4-5 (P<0.001) were significantly associated with a worse OS. In conclusion, the relationship between the CPS + EG score and survival is apparent in the real-world data in the present study. As the score increases, both the probability of recovery and OS decrease. Furthermore, the CPS + EG scoring system is an easy, free and accessible method to estimate prognosis.

Background/Objectives: Epithelial ovarian cancer (EOC) has one of the highest mortality rates among cancers affecting women. Herein we aimed to describe how to estimate the prognosis for EOC with clinicopathological features. Methods: This study included 86 patients with stage III and IV epithelial ovarian cancer who received neoadjuvant chemotherapy and who had been followed up at least one year. Prognostic factors and their impact on survival were evaluated. FIGO staging of the disease, body mass index (BMI), histological subtype, menopause status, ECOG performance status, genetic testing with variations, residual disease, ascites, serum Ca125 levels, platelets, MPV, neutrophils, lymphocytes, monocytes, lymphocyte/monocyte ratio, CRP, protein, LDH levels, albumin, CRP/albumin ratio, modified Glasgow prognostic score (mGPS), prognostic nutritional index (PNI), systemic inflammatory response index (SIRI), systemic inflammation index (SII), pan-immune inflammation value (PIV), relapse status, type and number of neoadjuvant chemotherapy were evaluated. Results: The median age of the patients was 60.0 years. Median overall survival (OS) was 55.1±8.7 months and median disease-free survival (DFS) was 36,8±5,0 months. No significant differences in survival were observed based on age, BMI, or menopausal status. However, patients with an ECOG score of 0 had significantly longer OS compared to those with an ECOG score of 1 (p

Aim: Approximately 5-10% of breast cancer (BC) cases are hereditary, most frequently associated with germline variants in homologous recombination repair (HRR) genes such as BRCA1/2. However, non-BRCA HRR gene alterations, including ATM gene and CHEK2, may also influence tumor biology and clinical outcomes. This study aimed to evaluate the clinical relevance of germline homologous recombination deficiency (HRD)-related variants in BC and to compare the clinicopathological features and survival outcomes between BRCA and non-BRCA carriers. Methods: A retrospective cohort of 148 BC patients with germline HRD-related variants identified by next-generation sequencing between 2018 and 2022 was analyzed. Variants were classified according to the American College of Medical Genetics and Genomics/Association for Molecular Pathology 2015 criteria. Clinical, pathological, and survival data were assessed using descriptive statistics and Kaplan-Meier survival analysis with the Log-Rank test. Results: Of 148 patients (mean age 45.2±10.1 years), 80 (54%) carried BRCA variants and 68 (46%) non-BRCA variants, most frequently ATM and CHEK2. Pathogenic or likely pathogenic variants were more frequent in BRCA carriers (77.5% vs. 58.8%, p=0.014). Disease-free survival (DFS) did not differ significantly between BRCA and non-BRCA groups (p=0.42). Prophylactic mastectomy and oophorectomy were performed significantly more often in BRCA carriers (p<0.05). Conclusions: Although DFS was comparable between BRCA and non-BRCA carriers, relapse was more frequent in BRCA1 and pathogenic variant carriers. These results emphasize the clinical importance of integrating germline HRR gene analysis into personalized surveillance and management strategies in BC.