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Öğe The association between albumin-globulin ratio (AGR) and survival in patients treated with immune checkpoint inhibitors(IOS Press, 2022) Güven, Deniz Can; Aktepe, Oktay Halit; Aksun, Melek Seren; Şahin , Taha Koray; Kavgacı, Gözde; Üçgül, Enes; Çakır, İbrahim Yahya; Yıldırım, Hasan Çağrı; Güner, Gürkan; Akın, Serkan; Kertmen, Neyran; Dizdar, Ömer; Aksoy, Sercan; Erman, Mustafa; Suayib, Yalçın; Kılıçkap, SaadettinBACKGROUND: The albumin-globulin ratio (AGR) could be a prognostic biomarker in patients with cancer, although the data is limited in patients treated with immune-checkpoint inhibitors (ICIs). OBJECTIVES: We aimed to evaluate the association between AGR and survival in ICI-treated patients. METHODS: The data of 212 advanced-stage patients were retrospectively evaluated in this cohort study. The association between AGR with overall (OS) and progression-free survival (PFS) were evaluated with multivariate analyses. Additionally, receptor operating curve (ROC) analysis was conducted to assess the AGR’s predictive power in the very early progression (progression within two months) and long-term benefit (more than twelve months survival). RESULTS: The median AGR was calculated as 1.21, and patients were classified into AGR-low and high subgroups according to the median. In the multivariate analyses, patients with lower AGR (< 1.21) had decreased OS (HR: 1.530, 95% CI: 1.100–2.127, p= 0.011) and PFS (HR: 1.390, 95% CI: 1.020–1.895, p= 0.037). The area under curve of AGR to detect early progression and long-term benefit were 0.654 (95% CI: 0.562–0.747, p= 0.001) and 0.671 (95% CI: 0.598–0.744, p< 0.001), respectively. CONCLUSIONS: In our experience, survival with ICIs was impaired in patients with lower AGR. Additionally, the AGR values could detect the very early progression and long-term benefit ICIs.Öğe Association Between Body Mass Index and Survival in Patients with De Novo Metastatic Non-Small Cell Lung Cancer(International Scientific Information, Inc., 2024) Ürün, Müslih; Güner, Gürkan; Sezgin, Yasin; Sakin, Abdullah; Kılıçkap, SaadettinBackground: This retrospective study from a single center included 289 patients diagnosed with advanced non-small cell lung cancer (NSCLC) between 2010 to 2017 and aimed to evaluate the effects of body mass index (BMI) on overall survival. Material/Methods: This retrospective study involved 289 patients diagnosed with metastatic-stage NSCLC at a single institution between January 2010 and December 2017. Patients were categorized into 2 groups based on their BMI at diagnosis: those with a BMI <25 kg/m2 and those with a BMI 325 kg/m2. Univariate and multivariate Cox regression analyses were conducted to identify factors associated with overall survival. Results: A total of 289 patients (241 men, 48 women) were included in the study, with a mean age of 60.1±11.1 years. Among them, 175 patients (60.6%) had a BMI less than 25 kg/m2. Multivariate analysis revealed that BMI, pathological diagnosis, and complete response after first-line treatment were independently associated with survival in patients with lung cancer. Predicted survival time was significantly shorter in the BMI <25 group than in the BMI 325 group (9.3 months vs 13.0 months, P<0.05). Conclusions: The study demonstrated that a higher BMI at the time of diagnosis is associated with improved overall survival in patients with de novo metastatic NSCLC. BMI may serve as an important prognostic factor in this patient population. Future prospective, multi-center studies are necessary to further validate the role of BMI in predicting survival outcomes in NSCLC patients across different treatment modalities. © Med Sci Monit.Öğe Differences between hyperprogressive disease and progressive disease in patients receiving immunotherapy(Kare Publishing, 2022) Yıldırım, Hasan Çağrı; Güven, Deniz Can; Aktepe, Oktay Halit; Taban, Hakan; Yılmaz, Feride; Yaşar, Serkan; Aktaş, Burak Yasin; Güner, Gürkan; Dizdar, Ömer; Aksoy, Sercan; Erman, Mustafa; Yalçın, Suayib; Kılıçkap, SaadettinObjectives: Although immune checkpoint inhibitors (ICIs) became a vital part of cancer care, many patients do not respond to treatment. In this group, a few of the patients with a hyperprogressive disease (HPD) have shorter overall survival (OS) compared with those having a progressive disease (PD). Therefore, biomarkers are needed to differentiate HPD and PD. Methods: Ninety-five patients treated with ICIs with progression according to response evaluation criteria ın solid tumors criteria in the first control imaging were included. HPD was defined according to Russo's work. The PILE scoring system, which includes pan-immune-inflammation value, lactate dehydrogenase, and Eastern Cooperative Oncology Group PS, was followed. The relationship between PILE score and HPD was analyzed. Results: The median OS of all cohorts was 11.18 months. The patients in the HPD group had decreased OS (4.77 vs. 13.94 months, p<0.001) and progression-free survival (PFS) (1.89 vs. 3.16 months, p<0.001) compared with those in the PD group. The risk of HPD was higher than the risk of PD in patients with a high PILE score (p=0.001). Conclusion: In this study, we showed that patients treated with ICI with a higher PILE score are at greater risk for HPD. The PILE score may be a biomarker to differentiate HPD from PD. © 2022 by Eurasian Journal of Medicine and Oncology.Öğe Lower prognostic nutritional index is associated with poorer survival in patients receiving ımmune-checkpoint ınhibitors(Future Medicine, 2021) Güven, Deniz C.; Aktepe, Oktay H.; Taban, Hakan; Aktaş, Burak Y.; Güner, Gürkan; Yıldırım, Hasan C.; Kılıçkap, SaadettinAim: Blood-based biomarkers like prognostic nutritional index (PNI) are readily available biomarkers for immunotherapy efficacy, although the data are limited. So, we aimed to evaluate the association between PNI and overall survival (OS) in immunotherapy-treated patients. Materials & methods: For this retrospective cohort study, data of 150 immunotherapy-treated advanced cancer patients were evaluated. The association between clinical factors and OS was evaluated with multivariate Cox-regression analyses. Results: After a median follow-up of 8.5 months, 94 patients died. The median OS was 11.07 months. The low PNI (hazard ratio [HR]: 2.065; p = 0.001), high lactate dehydrogenase (HR: 2.515; p = 0.001) and poor Eastern Cooperative Oncology Group (ECOG) status (HR: 2.164; p = 0.009) was associated with poorer OS in multivariate analyses. Conclusion: In our experience, survival with immunotherapy was impaired in patients with lower PNI and higher lactate dehydrogenase levels and poorer ECOG status.
