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    Genetic testing and counseling challenges in personalized breast cancer care: review article with insights from Türkiye
    (Future Medicine Ltd, 2024) Cicin, Irfan; Karadurmus, Nuri; Bilici, Ahmet; Bahsi, Taha; Sendur, Mehmet Ali; Demirci, Umut; Goksu, Sema Sezgin
    According to current evidence, testing for germline BRCA pathogenic variants in newly diagnosed breast cancer (BC) patients has the potential to reduce the burden of the disease through targeted therapies and secondary prevention. A personalized approach to testing can lead to improved individual outcomes for patients. Despite the proven clinical utility and therapeutic impact of BRCA1/2 tests in shaping therapy for metastatic BC, awareness and access to these tests are limited in many developing countries, including Turkiye. This limitation impacts the healthcare economy as delayed or missed interventions can lead to increased long-term costs. The limited access is mainly due to fear of stigmatization among patients, country-specific legislation and costs, a lack of awareness, vagueness surrounding the tests and access restrictions. This review offers a perspective for policymakers and healthcare providers in Turkiye to establish pathways that integrate the patient experience into comprehensive care pathways and national cancer control plans.
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    Safety of lorlatinib in ALK-positive non-small-cell lung cancer and management of central nervous system adverse events
    (Future Medicine Ltd, 2023) Kilickap, Saadettin; Ak, Sertac; Dursun, Oldac U.; Sendur, Mehmet A. N.; Karadurmus, Nuri; Demirci, Umut
    The use of tyrosine kinase inhibitors has made a breakthrough in the treatment of non-small-cell lung cancer (NSCLC). Recently, lorlatinib, a third-generation tyrosine kinase inhibitor, has demonstrated significant systemic and intracranial activity in both first-line and subsequent-line therapy in ALK-positive NSCLC patients. In this review, general characteristics of lorlatinib, its efficacy in the treatment of ALK-positive NSCLC patients and the safety of lorlatinib, particularly addressing CNS adverse events, are discussed. Management of CNS adverse events, which seem to be specific to lorlatinib therapy, is outlined. Plain language summary - Safety of lorlatinib in ALK-positive non-small-cell lung cancer and management of central nervous system adverse eventsLung cancer is a common disease and affects patients badly. Lorlatinib is a new and useful drug for this disease. But this drug has also some undesirable effects for the brain. These effects are generally mild and can be treated. This article discusses the undesirable effects of this drug on the brain and how to cope with these effects.