Berkay Yeşilyurt

1. Metastatic pancreatic ductal adenocarcinoma (mPDAC) stands amongst the most lethal malignant tumors worldwide [1,2]. Roughly 50–55% present with metastatic disease at diagnosis [1]. Therefore, o...

Objectives: Prognostic stratification remains challenging in patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors. The Lung Immune Prognostic Index (LIPI) may better reflect immunotherapy‐related outcomes in this setting. Methods: This retrospective study included 120 patients with mRCC who received second‐line nivolumab after progression on prior tyrosine kinase inhibitor therapy. LIPI was calculated using lactate dehydrogenase (LDH) and derived neutrophil‐to‐lymphocyte ratio (dNLR), and patients were categorized into good, intermediate, and poor risk groups. Overall survival (OS) was estimated using the Kaplan–Meier method and compared with the log‐rank test. Prognostic performance was assessed using log‐rank Chi‐squared statistics and the concordance index (C‐index). Cox regression analyses were performed to identify independent prognostic factors for OS. Results: Kaplan–Meier analyses demonstrated the most distinct survival separation for LIPI compared with MSKCC and IMDC risk models. Log‐rank Chi‐squared values were approximately 24 for LIPI, 16 for MSKCC, and 6.6 for IMDC. Concordance analysis confirmed superior prognostic discrimination with LIPI (C‐index 0.639) compared with MSKCC (0.618) and IMDC (0.555). In multivariate analysis, ECOG performance status 2 (HR 4.18, 95% CI 1.62–10.79; p = 0.003), absence of diabetes mellitus (HR 0.45, 95% CI 0.25–0.79; p = 0.005), absence of prior nephrectomy (HR 1.93, 95% CI 1.10–3.37; p = 0.021), and absence of brain metastases (HR 0.47, 95% CI 0.23–0.95; p = 0.036) were independently associated with OS. Conclusions: In mRCC patients treated with second‐line nivolumab, LIPI provided superior discrimination for OS compared with established risk models, supporting its clinical utility.

Background and Objectives: Neoadjuvant chemotherapy (NAC) followed by radical cystectomy is the standard of care for eligible patients with locally advanced bladder cancer (LABC). However, adjuvant chemotherapy (AC) remains widely used in real-world practice. Host-related inflammatory and nutritional biomarkers may also influence survival outcomes. This study aimed to compare survival outcomes between NAC and AC and to identify independent prognostic factors for overall survival (OS) and progression-free survival (PFS), with particular emphasis on the Prognostic Nutritional Index (PNI). Methods: This multicenter retrospective study included 262 patients with locally advanced bladder cancer. The median age was 66 years, and 84% of patients were male. Patients were treated with neoadjuvant chemotherapy followed by radical cystectomy or adjuvant chemotherapy after surgery between August 2021 and March 2025. The Prognostic Nutritional Index (PNI) was calculated using pretreatment laboratory values. ROC analysis was used to determine the optimal PNI cut-off for predicting mortality, and the derived threshold (49.97) was applied for stratification in all survival analyses. Survival outcomes were evaluated using the Kaplan–Meier method and compared using the log-rank test. Multivariate Cox proportional hazards regression was used to identify independent prognostic factors. Results: Among 262 patients, 138 (52.7%) received NAC, and 124 (47.3%) received AC. Median follow-up was 33.6 months (95% CI: 29.4–37.8). No statistically significant differences in OS (p = 0.388) or PFS (p = 0.499) were observed between treatment groups. In univariate analyses, nodal stage, pathological complete response (pCR), and PNI were significantly associated with both OS and PFS. In multivariate analysis, low PNI (≤49.97) remained an independent predictor of mortality (HR 1.78, 95% CI 1.04–3.38; p = 0.044), while N3 nodal stage independently predicted disease progression (HR 5.92, 95% CI 1.06–32.84; p = 0.042). Conclusions: In this multicenter real-world cohort, nodal stage and systemic inflammatory-nutritional status were key determinants of prognosis in patients with locally advanced bladder cancer receiving perioperative chemotherapy. PNI emerged as an independent predictor of overall survival, suggesting that host-related biomarkers may improve prognostic stratification beyond traditional clinicopathological factors.

Long-term Outcomes and Prognostic Factors in Chordoma: A 20-year Single-center Experience - Journal of Oncological Sciences

PURPOSE: Early-onset gastrointestinal cancers are concerning entities globally, yet early-onset biliary tract cancers (EOBTCs) are understudied. Early-stage disease is crucial for young patients' survival. METHODS: TOG/GI-SAFRADJU (ClinicalTrials.gov identifier: NCT06975917 ) is a multicenter, hospital-based, registry initiative of the Turkish Oncology Group, including patients with resected BTCs. Early-onset was defined as a diagnosis at age v 25.7%, P = .038). Adjuvant treatments did not differ between EOBTC and non-EOBTC. Among patients who received adjuvant chemotherapy, RFS (13.9 months [95% CI, 11.4 to 22.1] v 15.9 months [95% CI, 13.6 to 18.9], P = .947) and OS (35.6 months [95% CI, 28.0 to 81.4] v 31.3 months [95% CI, 27.8 to 44.3], P = .670) were similar between EOBTC and non-EOBTC groups. Among patients with EOBTC, R1-resection and high CA19-9 levels were associated with shorter RFS, and gallbladder localization and high CA19-9 were associated with shorter OS in adjusted analyses. Using these factors, risk scores early-stage EOBTC RFS score (EOB-RS) for RFS and early-stage EOBTC OS score (EOB-OS) for OS were formed, each including three ranks. Both scores significantly ordered the prognosis of patients with EOBTC (EOB-RS, [0 points]: 22.7 months, [1 or 2]: 10.3 months, [3]: 5.7 months, P < .001, EOB-OS: [0]: 110.9 months, [1 or 2]: 29.6 months, [3]: 10.1 months, P < .001). CONCLUSION: Resected EOBTC patients showed survival comparable to older counterparts receiving surgery/adjuvant therapy. This study suggests a potential risk scoring system for early-stage EOBTC, pending validation.

Background/Objectives: Uveal melanoma (UM) is a subtype of melanoma that originates from the uveal layer of the eye (iris, ciliary body, choroid) and is biologically distinct from cutaneous melanoma. The real-world evidence on treatment patterns and survival outcomes, particularly from non-Western populations, remains limited. This study provides a comprehensive national overview of local and systemic management of UM across Türkiye. Methods: This multicenter retrospective cohort study, coordinated by the Turkish Oncology Group (TOG), included patients diagnosed with UM between 2012 and 2025 across 19 tertiary oncology centers. Clinical characteristics, treatment patterns, and outcomes were analyzed. Systemic therapies were subgrouped as immunotherapy or cytotoxic chemotherapy. Progression-free survival (PFS) and overall survival (OS) were assessed by the Kaplan–Meier method; prognostic factors for OS were analyzed by Cox regression. Results: A total of 113 patients were included; 89.4% presented with localized disease. During follow-up, 43.4% developed metastases, predominantly hepatic (93.5%). 47.4% of metastatic patients received liver-directed treatments; the most common treatment was radioembolization, and these treatments were associated with longer OS. Among 59 patients receiving systemic therapy, immunotherapy demonstrated higher ORR and DCR than chemotherapy across treatment lines, although small subgroup sizes limited statistical significance. Dual immune checkpoint blockade emerged as an independent favorable prognostic factor in multivariate analysis. Median OS for metastatic patients was 16 months (95% CI: 9.3–22.7). HLA-A*02:01 was positive in 29.4% of patients tested, and only three patients received tebentafusp. Conclusions: This large national cohort highlights substantial real-world heterogeneity in treatment patterns and confirms the limited efficacy of chemotherapy, the prognostic benefit of dual ICI therapy, and the potential survival advantage of liver-directed treatments in selected patients. Low HLA-A*02:01 positivity and limited access to tebentafusp remain major challenges in Türkiye. These findings provide an essential benchmark for improving treatment strategies in metastatic UM.

Background: In the challenging landscape of metastatic pancreatic ductal adenocarcinoma (mPDAC), clinicians urgently need accessible and reliable tools to predict outcomes and guide treatment. Immunonutritional indices like the Gustave Roussy Immune Score (GRIms) and the hemoglobin, albumin, lymphocyte, and platelet (HALP) index offer promise, but their full prognostic/predictive potential remained unclear. Methods: We retrospectively analysed 201 patients with mPDAC who received first-line chemotherapy between 2020 and 2024. GRIms and HALP scores were calculated at baseline and at interval using routine blood tests. We assessed their relationship with overall survival (OS) and progression-free survival (PFS) through univariate and multivariate Cox regression models. Results: Patients with high GRIms or low HALP at baseline had significantly shorter OS and PFS (all p < 0.05), with GRIms emerging as a stronger independent predictor (HR for OS: 2.3, p < 0.001). When combined, these two scores offered even greater prognostic precision, clearly identifying the highest-risk patient for mOS (HR: 2.5, p < 0.001). Dynamic changes also mattered; patients whose GRIms increased or HALP declined over time had notably worse survival (mOS: 7 vs 12 months; HR: 3.9, p < 0.001) with combined use suggest stronger prediction (HR: 5.9, p<0.001). A high combined score was also associated with early chemotherapy resistance and poor radiologic response. Conclusion: GRIms and HALP are inexpensive, non-invasive, and readily available markers that offer stronger prognosis in mPDAC. Their combined and longitudinal use may improve clinical decision-making, help flag patients at high risk, and ultimately support more personalized and proactive treatment approaches.

Objective: The aim of the study is to describe the clinical characteristics of Antineutrophil cytoplasmic antibodies-associated vasculitis and to analyze the parameters affecting the outcome. Materials and Methods: The study is a retrospective cohort study. Totally 130 patients with Antineutrophil cytoplasmic antibodies-associated vasculitis (18 years and over) who were followed up between October 2014 and October 2019 were analyzed. Demographic data, laboratory values, clinical course, thorax computed tomography findings and treatment approaches were noted from the charts of patients. Patients were divided into two groups as those with pulmonary involvement and non-pulmonary involvement. Results: We retrospectively reviewed the medical records of 130 patients with Antineutrophil cytoplasmic antibodies-associated vasculitis; 111 with granulomatosis with polyangiitis, 15 with microscopic polyangiitis, 1 with eosinophilic granulomatosis with polyangiitis, and 3 with other types of vasculitis. The ratio of having the abnormality in thoracic computed tomography was 72.2%. There were 84 cases with pulmonary involvement and 46 cases with non-pulmonary involvement. The frequency of microscopic polyangiitis was significantly higher (p=0.034) in non-pulmonary involvement cases. There were 67 cases with proteinase 3 Antineutrophil cytoplasmic antibodies and 39 cases with myeloperoxidase Antineutrophil cytoplasmic antibodies positivity. Most of the cases with proteinase 3 Antineutrophil cytoplasmic antibodies positivity were classified as granulomatosis with polyangiitis, this was statistically significant. Recovery was referenced for the outcome. Any of the variables were found statistically significant effective on outcome. Conclusions: Cases with pulmonary involvement were more than the cases without pulmonary involvement in our study. microscopic polyangiitis was significantly higher in non- pulmonary involvement cases. We studied on a large group, and these significant findings may have important implications for the investigation, pathogenesis, and treatment of Antineutrophil cytoplasmic antibodies-associated vasculitis.