Browsing by Author "Guven, Deniz Can"

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Activity of Cdk4/6 Inhibitors and Parameters Affecting Survival in Elderly Patients in Age-Subgroups: Turkish Oncology Group (Tog) Retrospective Study
(Bmc, 2024) Kahraman, Seda; Hizal, Mutlu; Demirel, Burcin Cakan; Guven, Deniz Can; Gumusay, Ozge; Uluc, Basak Oyan; Sendur, Mehmet Ali Nahit
Highly selective inhibitors of cyclin-dependent kinase 4 and 6 (CDK4/6is) have emerged as a standart of care for first- and second-line therapies in combination with endocrine therapy (ET) for HR+/HER2- metastatic breast cancer (MBC) patients. It has been reported that combination therapy is more effective than ET alone and is safe in elderly patients as well as young patients. Nevertheless, elderly and very old patients with HR+/HER2-MBC treated with CDK4/6 inhibitor (CDK4/6i) combinations are relatively underrepresented in randomized controlled trials. To contribute to the literature, we investigated the real-world efficacy, factors associated with survival and the rates of adverse events (AEs) of the treatment with palbociclib or ribociclib plus ET in the HR+/HER2- MBC patient cohort over the age of 65 for age subgroups. In this retrospective study, 348 patients were divided into subgroups: 65-69 years old, 70-79 years old and 80 years and older. Median PFS (mPFS) for whole group was 18.3 (95% CI,14.3-22.3) months. There was no significant difference in mPFS between age groups (p = 0.75). The estimated median OS (mOS) was 39.5 (95% CI, 24.9-54.1) months and there was no significant difference between age groups (p = 0.15). There was a meaningfull numerical difference that did not reach statistical significance in patients who received CDK4/6i treatment as the first line for MBC. Grade 3-4 AEs were reported in 42.7% for the entire group, and neutropenia was the most common (37.3%). It can be concluded that combination therapy with palbociclib or ribociclib with an ET partner has similar efficacy and is safe among subgroups of older patients diagnosed with HR+/HER2-MBC.
Health-Related Quality of Life and Psychosocial Outcomes in Long-Term Survivors Treated with Immune Checkpoint Inhibitors: A Nationwide Multicenter Study
(Frontiers Media SA, 2025) Sahin, Taha Koray; Atalah, Fatih; Koylu, Bahadir; Oruc, Ahmet; Acarbay, Aydin; Karakok, Akgun; Guven, Deniz Can
Background The increasing use of immune checkpoint inhibitors (ICIs) has resulted in a growing population of long-term survivors (LTS). However, the long-term psychosocial and quality of life (QoL) outcomes in these patients remain underexplored. This study aimed to evaluate QoL, psychological morbidity, fear of cancer progression (FoP), and functional outcomes in cancer patients treated with ICIs for at least six months without disease progression.Methods This cross-sectional, multicenter study included 346 adult cancer patients from 17 tertiary oncology centers in T & uuml;rkiye. Participants had received ICIs for >= 6 months in (neo)adjuvant or metastatic settings. Standardized questionnaires assessed QoL, psychological distress, FoP, immune-related adverse events (irAEs), and work status.Results The median age of the cohort was 62 years (IQR: 53-69). Average survivor QoL was comparable to the Turkish general population; but 119 (34.5%) survivors had poor QoL. Clinically relevant symptoms of depression and anxiety were present in 24.3% and 20.8% of patients, respectively, while 48% reported FoP. The overall return-to-work rate among patients initially employed was 50.9%, with 72.7% returning within the first year. Depression, anxiety, and FoP were negatively correlated with all QoL domains. All grade irAEs were common (53.8%) but not significantly associated with worse QoL (p=0.149).Conclusions This study represents one of the largest cohorts to date evaluating survivorship issues among LTS treated with ICIs. Among patients receiving ICIs for at least six months, nearly one-third experienced impaired QoL, primarily driven by psychological distress and FoP. Further research is needed to address survivorship care in this population.
Real-World Treatment Efficacy of Ribociclib or Palbociclib Plus Fulvestrant in Hormone Receptor-Positive/HER2-Negative Metastatic Breast Cancer: Turkish Oncology Group (TOG) Study
(Cig Media Group, Lp, 2025) Kahraman, Seda; Erul, Enes; Gumusay, Ozge; Guven, Deniz Can; Aksoy, Sercan; Basaran, Gul; Sendur, Mehmet Ali Nahit
We conducted a multicenter, retrospective cohort study that included 522 patients with HR+/HER2-MBC treated with ribociclib or palbociclib in combination with fulvestrant. Although the three 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: 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.