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Öğe Atezolizumab Lung Toxicity: Importance of Combination Treatment On The Edge of Life, A Case Report(Bentham Science Publ, 2023) Koc, Aysu Sinem; Can, Orcun; Kobak, SenolBackground: Lung cancer is one of the most common and mortal cancers worldwide. According to pathological and clinical groups, treatments vary, and a tailored approach is considered. Adjuvant therapies, such as chemotherapy, radiation, and immune checkpoint inhibitors (ICI), are recommended by recent guidelines for patients with locally advanced cancer. Objective: This study aimed to report the case of a patient with stage 2B squamous cell lung carcinoma who was managed for pulmonary toxicity after receiving adjuvant chemotherapy and atezolizumab treatment. Case Report: A 66-year-old male patient received chemotherapy and immunotherapy after surgery for squamous cell lung cancer. A diagnosis of atezolizumab-associated pneumonitis was made using laboratory tests and imaging due to the patient's worsening dyspnea after treatment. Due to the patient's rapid progression, pulse steroid and MMF therapy were administered concurrently. When Klebsiella pneumoniae growth was detected in the sputum culture during the follow-up, IVIg was used to supplement the medication. The patient showed significant clinical and radiological improvement. Conclusion: In this study, we present an atezolizumab-induced pneumonitis case of a squamous cell lung cancer patient. It may be life-saving not to avoid aggressive treatment approaches by combining the steps of guideline recommendations in patients with rapidly progressive pneumonitis.Öğe How reliable is the high-volume definition in prostate cancer patients: the potential game-changing role of PSMA(Lippincott Williams & Wilkins, 2023) Guven, Osman; Karyagar, Savas; Arici, Serdar; Ozulker, Tamer; Can, OrcunPurposeTo evaluate whether metabolic and volumetric data from Ga-68-PSMA PET/CT performed during staging of de-novo high-volume mCSPC patients who received docetaxel could be used to predict survival. MethodsForty-two de-novo high-volume mCSPC patients, who received ADT + Docetaxel and underwent Ga-68-PSMA PET/CT for staging, were included in the study. The association between patients' pathological data, all PSA measurements, treatments they received, the data obtained from Ga-68-PSMA PET/CT and progression-free and overall survival were examined. ResultsIn the multivariate analysis, PSMA-TV (primary) and PSMA-TV (WB) variables were shown to be independent negative predictors of overall survival. For the threshold value of 19.91 cm(3) obtained for PSMA-TV (primary), HR was calculated as 6.31, the 95% confidence interval (CI): 1.01-39.18, P = 0.048. For the threshold value of 1226.5 cm(3) obtained for PSMA-TV (WB) variable, HR was calculated as 58.62, the 95% CI: 2.55-1344.43, P = 0.011. In our study, SUVmax (WB) variable was found to be an independent and negative predictor of progression-free survival. For the determined threshold value of 17.74, HR was calculated as 16.24, 95% CI: 1.18-22.76, P = 0.037. ConclusionMetabolic and volumetric data obtained from Ga-68-PSMA PET/CT can be used to predict survival in de-novo high-volume mCSPC. Our results show that in ADT + Docetaxel receiving patients, a subgroup with higher PSMA-TV (WB) values have a significantly worse prognosis. This situation suggests that the high-volume disease definition in the literature may be insufficient for this group, and that Ga-68-PSMA PET/CT can play an essential role in demonstrating the heterogeneity within the group.Öğe SERUM FETUIN-A AND RANKL LEVELS IN PATIENTS WITH EARLY STAGE BREAST CANCER(Soc Medical Biochemists Serbia, 2023) Afsar, Cigdem Usul; Aral, Hale; Can, Orcun; Trabulus, Didem Can; Karacetin, Didem; Nazli, Mehmet Ali; Gursu, Riza UmarBackground: Breast cancer (BC) is the primary cause of mortality due to cancer in females around the world. Fetuin-A is known to increase metastases over signals and peroxisomes related with growing. Receptor activator of nuclear factor-KB ligand (RANKL) takes part in cell adhesi-on, and RANKL inhibition is used in the management of cancer. We aimed to examine the relationship between serum fetuin-A, RANKL levels, other laboratory parameters and clinical findings in women diagnosed with early stage BC, in our population.Methods: Women having early stage BC (n=117) met our study inclusion criteria as they had no any anti-cancer the-rapy before. Thirty-seven healthy women controls were also confirmed with breast examination and ultrasonography and/or mammography according to their ages. Serum samples were stored at-80 & DEG;C and analysed via ELISA.Results: Median age of the patients was 53 (range: 57-86) while it was 47 (range: 23-74) in the healthy group. Patients had lower high-density lipoprotein levels (p=0.002) and higher neutrophil counts (p=0.014). Fetuin-A and RANKL levels did not differ between the gro-ups (p=0.116 and p=0.439, respectively) but RANKL leves were found to be lower in the favorable histological subtypes (p=0.04). Conclusions: In this study, we found no correlation between serum fetuin-A levels and clinical findings in patients diag-nosed with early stage BC. However, RANKL levels are found to be lower in subgroups with favorable histopatho-logic subtypes such as tubular, papillary and mucinous BC and there was statistically significant difference.