Impact of systemic inflammatory markers in patients with ALK-positive non-small cell lung cancer treated with crizotinib.

OBJECTIVES: To evaluate the prognostic utility of inflammation-based prognostic scores in patients with ALK-positive metastatic or non-resectable non-small-cell lung cancer (NSCLC) treated with crizotinib. PATIENTS AND METHODS: A total of 82 patients with ALK-positive metastatic or non-resectable NSCLC who received ALK TKI crizotinib were included. Pre-treatment modified Glasgow prognostic score (mGPS), prognostic nutritional index (PNI), and systemic immune-inflammation index (SII) were calculated. Multivariable logistic regression and Cox proportional hazards models were used to assess the impact of pretreatment mGPS, PNI, and SII on overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). RESULTS: The ORR was 77.2%, while 1-year OS and PFS rates were 95.0% and 93.5%, respectively. The univariate analysis revealed significantly higher 1-year PFS (89.4 vs. 64.4%, p=0.043) and OS (92.0 vs. 83.3%, p=0.01) rates in patients with low (<934.7) vs. high (≥934.7) SII scores. Multivariate analysis revealed that PNI ≥0.09 was a significant determinant of poorer 1-year OS rates (hazard ratio [HR]: 2.46, 95% confidence interval [CI] 0.88-4.85, p=0.035). No significant difference was observed in survival rates according to gender, age, smoking status, prior lines of therapy, or mGPS scores, while higher mGPS scores (odds ratio [OR]: 0.1, 95%CI 0.16-1.04; p=0.009) and higher PNI scores (OR: 0.16, 95% CI 0.02-0.55; p=0.035) were associated with poorer ORR. CONCLUSION: Our findings indicate the prognostic significance of PNI and SII in terms of survival outcome and the impact of mGPS and PNI on treatment response in patients with ALK-positive NSCLC treated with crizotinib.

PAHs, PCBs and OCPs in olive oil during the fruit ripening period of olive fruits.

Because of their possible carcinogenic effects, it is crucial to determine levels of polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) in olive oils. However, there are a few studies about these pollutants' levels in olive oils and no other studies reported PAHs, PCBs and OCPs at the same time and during the ripening period of olives in olive oils. A modified clean-up technique was successfully applied for eliminating lipidic components. Additionally, this study does not just report the concentrations of these pollutants but also inspects the sources depending on the actual sampling site. Also, PCBs and OCPs carcinogenic risks in olive oil were reported for the first time in the literature. This study aims to present levels, carcinogenic risks, sources and concentration changes during the ripening period of these pollutants in olive oil. For this purpose, fruit samples for oil extraction were collected between the beginning of the fruit ripening and harvest period. Obtained olive oils from the fruits were extracted and cleaned up using the QuEChERS method. GC-MS and GC-ECD were used for the quantitative analysis of the targeted pollutants. The average concentrations for ∑16PAHs, ∑37PCBs and ∑10OCPs were 222.48 ± 133.76 µg/kg, 58.26 ± 21.64 µg/kg and 25.48 ± 19.55 µg/kg, respectively. During the harvest period, the concentrations were in a decreasing trend. Calculated carcinogenic risks were above acceptable limits for all groups and traffic, wood-coal burning, atmospheric transport and previous uses were the main sources. Results of the source determination indicated that some possible sources could be prevented with regulations and precautions.

The effect of different treatment modalities on survival in elderly patients with locally advanced non-small cell lung cancer.

PURPOSE: The aim of this study is to investigate the effect of treatment modalities on survival among unoperat ed and locally-advanced non-small cell lung cancer (NSCLC) patients aged 70 years and older, representing real-life data. METHODS: From 2005 through 2017, medical records of 2259 patients with lung cancer from Okmeydani Training and Research Hospital-Istanbul/Turkey were reviewed retrospectively. Patients with locally advanced NSCLC ≥ 70 years of age who did not undergo surgery for lung cancer were reviewed. In total, 130 patients were eligible for the final analysis. Patients were stratified into four groups as: chemotherapy (CT), concurrent chemoradiotherapy (cCRT), sequential chemoradiotherapy (sCRT), and radiotherapy (RT) only. RESULTS: Of the 130 patients included in the analysis; CT, cCRT, sCRT, and RT only were applied to 25(19.2%), 30(23.1%), 31(23.8%), and 44(33.8%) patients, retrospectively. Twelve (9.2%) patients were female. Median age was 72 years (range, 70-88). Sixty (46.2%) patients had stage IIIA disease and 70(53.8%) patients had stage IIIB disease. Median progression-free survival(mPFS) in patients treated with CT, cCRT, sCRT, and RT were 8.0, 15, 10, and 9.0 months, respectively(p = 0.07). Corresponding median overall survival (mOS) were 10, 33, 20, and 15 months (p = 0.04). In multivariate analysis, stage IIIB disease [hazard ratio (HR), 2.8], ECOG-PS 2(HR, 2.10), and ECOG-PS 3-4(HR, 5.13) were found to be the negative factors affecting survival, while cCRT (HR, 0.45) and sCRT (HR, 0.50) were the independent factors associated with better survival. CONCLUSION: This study showed that the use of combined treatment modality was associated with better survival in elderly patients with locally advanced NSCLC, with the greatest survival observed in patients treated with cCRT. We therefore suggest that cCRT, when feasible, should be strongly considered in locally advanced NSCLC patients 70 years and over.

Levels of persistent organic pollutants in pine tree components and ambient air.

Pine needles are employed as alternative biomonitoring agents in atmospheric studies. In this study, pine (Pinus Pinea) components (needles and branches) and air samples were collected simultaneously to monitor polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs) and organochlorine pesticides (OCPs) from Gemlik, Turkey between January and December 2016. The relationship between ambient air and pine needles were examined to enlighten the usability of pine components as passive samplers for persistent organic pollutants (POPs) in the Marmara region. Average ∑14PAH concentrations for the ambient air, pine needles, and pine branches were 23.1 ±â€¯18.3 ng/m3, 626 ±â€¯306 ng/g DW and 548 ±â€¯261 ng/g DW respectively. PCB concentrations were 118 ±â€¯74 pg/m3, 7.5 ±â€¯2.1 ng/g DW and 6.8 ±â€¯2.9 ng/g DW and ∑10 OCP concentrations were 122 ±â€¯89 ng/m3,1.3 ±â€¯1.5 ng/g DW and 10.0 ±â€¯3.8 ng/g DW in the same order. Levels of PAHs and PCBs were higher in needles than branches. PAH, PCB and OCP concentrations in pine components tended to decrease with increasing temperatures in spring. PAH compounds with medium and light molecular weighted ones were found to be dominant. On the other hand, the predominant PCB components were the medium-weighted congeners while γ-HCH, Heptachlor endo. Epox. Iso A, endrin aldehyde, and methoxychlor were the dominant OCP species.

Pertuzumab, trastuzumab and taxane-based treatment for visceral organ metastatic, trastuzumab-naïve breast cancer: real-life practice outcomes.

PURPOSE: In this study, we aimed to describe the real-life practice outcomes of pertuzumab-trastuzumab-taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients. METHODS: This study was conducted by Turkish Oncology Group and included 317 patients' data from 36 centers. RESULTS: Median age was 51 (22-82). Median PFS was 28.5 months, while median OS was 40.3 months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8 m vs. 28.5 m; p = 0.002) and OS (26.7 m vs. 40.3 m; p = 0.009). Patients older than 65 years of age (n: 42, 13.2%) had significantly lower OS results (19.8 m vs. 40.3 m; p = 0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5-40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure. CONCLUSIONS: Our RLP trial included only visceral metastatic, trastuzumab-naïve BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab-trastuzumab-taxane therapy to date.