Mehmet Nuri Baser

Background: Neuroendocrine prostate cancer (NEPC) is a rare and aggressive malignancy with limited prognostic tools. The Lung Immune Prognostic Index (LIPI), derived from dNLR and lactate dehydrogenase, has demonstrated prognostic value in small-cell lung cancer but has not been evaluated in NEPC. This study assessed the prognostic role of LIPI in NEPC. Methods: This multicenter retrospective study included 34 patients with NEPC (21 secondary, 13 de novo) from four centers in Turkey. Laboratory data were collected at NEPC diagnosis (T3), initial prostate cancer diagnosis (T1), and castration-resistant prostate cancer diagnosis (T2). LIPI was scored using original fixed cut-offs. Survival analyses included Kaplan–Meier, Cox regression, and ROC methods. Results: At NEPC diagnosis, 18 patients (52.9%) had Good LIPI and 16 (47.1%) Intermediate + Poor LIPI. Intermediate + Poor LIPI was associated with significantly shorter overall survival (median 4 vs. 15 months; log-rank p = 0.001; HR 3.83, 95% CI 1.65–8.90). In multivariable analysis, albumin was an independent predictor (HR 0.37, p = 0.015), while LIPI showed a trend (HR 2.35, p = 0.091). LIPI demonstrated the highest discriminatory ability for 6-month overall survival (AUC 0.763, p = 0.009). LIPI at earlier disease stages did not predict time to transformation or castration resistance. Among secondary NEPC patients, worsening LIPI trajectory was associated with shorter survival (median 4 vs. 10 months; log-rank p = 0.031). Conclusions: LIPI at NEPC diagnosis was associated with overall survival and demonstrated the highest discriminatory ability among the inflammatory indices assessed. As a routine blood-based score, LIPI may support risk stratification at NEPC diagnosis. Prospective validation is warranted.

Antibody-drug Conjugates (ADCs) in Breast Cancer - Acta Haematologica Oncologica Turcica

This study aimed to evaluate the prognostic significance of hemoglobin, albumin, lymphocyte, and platelet (HALP) levels at diagnosis in patients with multiple myeloma (MM). We retrospectively analyzed 450 patients diagnosed with MM between 2008 and 2023. The HALP score was calculated using pretreatment laboratory values of hemoglobin, albumin, lymphocytes, and platelets. Patients were categorized into the high and low HALP groups. Survival outcomes were analyzed using the Kaplan–Meier and Cox regression methods. Patients with HALP ≤ 27.68 had a significantly lower overall survival (OS) (median 50 vs 79 months, P < .001). Patients with low HALP scores had significantly shorter median OS and progression-free survival than those with high HALP scores ( P < .001). In the multivariate analysis, HALP ≤ 27.68 was independently associated with increased mortality risk (hazard ratio: 1.74; 95% confidence interavl: 1.32–2.29). The HALP score remained an independent predictor of OS. The HALP score is a useful, accessible, and cost-effective prognostic marker for MM, and may aid in risk stratification.

Background/Objectives: Systemic inflammation and nutritional status influence cancer progression and prognosis. The C-reactive protein–albumin–lymphocyte (CALLY) index is a novel biomarker reflecting inflammation, immune response, and nutritional status; however, its prognostic value in metastatic hormone-sensitive prostate cancer (mHSPC) remains unclear. Methods: This retrospective multicenter cohort study included 159 patients with de novo mHSPC diagnosed between January 2018 and April 2025. Baseline CALLY, neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were calculated. Results: The optimal CALLY cut-off was 0.58. A low CALLY was associated with significantly shorter progression-free survival (PFS) and overall survival (OS). It correlated with higher tumor burden, higher Gleason grade, elevated prostate-specific antigen levels, and poorer performance status. In univariate analysis, a low CALLY predicted worse OS (HR 5.20; p = 0.021), although this effect was attenuated in multivariate analysis (HR 2.15; 95% CI 0.52–8.90; p = 0.290), and its absolute discriminatory performance in receiver operating characteristic analysis remained modest (AUC = 0.558). Complete response rates differed significantly (high-CALLY 41.7% vs. low-CALLY 5.9%, p < 0.001), suggesting a potential link between baseline CALLY and treatment response. Conclusions: Among the indices evaluated, CALLY demonstrated the highest, though still modest, discriminatory ability for overall survival (AUC 0.558), and was the only marker to reach statistical significance in survival analysis. Its prognostic effect was attenuated in multivariable analysis, suggesting that CALLY reflects, rather than independently drives, the systemic consequences of high-burden disease. These findings are exploratory, and prospective validation in larger cohorts is required to determine its potential clinical utility.

Background: Reliable biomarkers that capture tumor–host interactions and predict treatment resistance in extensive-stage small cell lung cancer (SCLC) remain limited. We evaluated the prognostic and predictive value of the pretreatment lactate dehydrogenase-to-albumin ratio (LAR), an integrative biomarker reflecting metabolic activity, systemic inflammation, and host nutritional status. Methods: This multicenter, retrospective cohort study included patients with extensive-stage SCLC treated at five tertiary centers between 2016 and 2024. Pretreatment LAR was calculated using baseline serum lactate dehydrogenase and albumin levels and dichotomized using a Youden index-derived cut-off at the 12-month overall survival (OS) horizon. Time-dependent receiver operating characteristic (ROC) analyses using inverse probability weighting were performed to assess discriminative performance. Survival outcomes were evaluated using Kaplan–Meier estimates and Cox proportional hazards models. Associations with platinum resistance and lack of objective treatment benefit (defined as progressive disease as best response) were examined using logistic regression models. Results: A total of 223 patients were included. Elevated LAR was associated with inferior OS (median, 15.8 vs. 25.2 months; log-rank p < 0.001) and progression-free survival (7.9 vs. 11.5 months; p < 0.001). In multivariable analysis, LAR remained independently associated with OS (HR, 1.43; 95% CI, 1.04–1.95; p = 0.028). LAR demonstrated modest but consistently superior discriminative performance compared with other inflammatory indices for both 12-month OS (area under the curve [AUC], 0.692) and 6-month progression-free survival (PFS) (AUC, 0.646), with statistically significant differences in DeLong comparisons. Higher LAR was independently associated with increased odds of platinum resistance (adjusted odds ratio [aOR], 2.31; 95% CI, 1.41–3.81; p = 0.001) and lack of objective treatment benefit (adjusted OR, 2.04; 95% CI, 1.33–3.14; p = 0.001). Conclusions: Pretreatment LAR is a clinically accessible and biologically integrative biomarker associated with survival and treatment resistance in extensive-stage SCLC. By capturing tumor–host interactions, LAR may support risk stratification and identify patients at increased risk of early treatment failure. Prospective validation is warranted to define its role in biomarker-driven clinical decision-making.

Background/Objectives: Metastatic pancreatic cancer is a highly lethal disease, and clinically useful biomarkers for outcome stratification are limited. Uric acid reflects systemic metabolic stress and inflammatory signaling, suggesting potential relevance as a tumor–host biomarker. However, the clinical significance of uric acid-based composite biomarkers in pancreatic cancer remains unclear. Methods: In this multicenter retrospective cohort study, 110 patients with metastatic pancreatic adenocarcinoma treated between 2015 and 2024 were analyzed. Sex-adjusted uric acid-based biomarkers were calculated using uric acid z-scores normalized by sex and integrated with markers of nutritional and immune status, including the uric acid z-score-to-albumin ratio (UAzAR) and uric acid z-score-to-lymphocyte ratio (UAzLR). Associations with overall survival (OS), progression-free survival (PFS), and chemotherapy response were evaluated using Kaplan–Meier analysis, Cox proportional hazards models, receiver operating characteristic (ROC) analyses, and multivariate logistic regression. Results: The median OS and PFS for the entire cohort were 12.6 months (95% CI 11.3–13.9) and 7.5 months (95% CI 6.6–8.4), respectively. Patients with high UAzAR had significantly shorter OS than those with low UAzAR (7.3 vs. 16.4 months; log-rank p < 0.001), and similar findings were observed for UAzLR (7.4 vs. 16.4 months; p < 0.001). In multivariate Cox models, elevated UAzAR independently predicted inferior OS (HR] 3.10, 95% CI 1.58–6.09; p = 0.001) and PFS (HR 2.35, 95% CI 1.22–4.52; p = 0.010), while elevated UAzLR was similarly associated with reduced OS (HR 3.28, 95% CI 1.68–6.39; p < 0.001) and PFS (HR 2.47, 95% CI 1.30–4.70; p = 0.006). High UAzAR and UAzLR were also independently associated with chemotherapy failure (adjusted odds ratio [OR] 5.52, 95% CI 2.16–14.06 and OR 6.42, 95% CI 2.49–16.55; both p < 0.001). In ROC analyses, UAzAR and UAzLR demonstrated moderate discrimination for 12-month OS (AUC 0.659 and 0.658) and stronger discrimination for 6-month PFS (AUC 0.705 and 0.692). Conclusions: Sex-adjusted uric acid-derived composite biomarkers independently predict survival and chemotherapy response in metastatic pancreatic cancer and may identify a high-risk metabolic phenotype relevant for clinical risk stratification.

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 and Objectives: Small-cell lung cancer (SCLC) is an exceedingly aggressive neoplasm distinguished by an unfavorable prognosis. Recent studies have confirmed chemo-immunotherapy as the conventional first treatment for extensive-stage small-cell lung cancer (ES-SCLC), but the impact of treatment duration remains unclear. The goal of this study was to find out how the length of treatment affected progression-free survival (PFS) and overall survival (OS) in patients with ES-SCLC who were receiving first-line atezolizumab plus chemotherapy. Materials and Methods: This retrospective multicenter study comprised 82 patients from six oncology centers in Turkey between 2017 and 2024. Patients were categorized into two categories according to the quantity of chemotherapy cycles they had undergone: standard treatment (≤4 cycles) and extended treatment (≥5 cycles). For the purpose of analyzing survival outcomes and related clinical determinants, as well as the demographic structures and features of the patients, both univariate and multivariate Cox regression models were utilized. Results: The median number of atezolizumab cycles was 8 (1–63). OS was 29.46 months after 15.8 months of follow-up, while PFS was 10.63 months. When comparing the two groups, we found no statistically significant differences in either PFS (p = 0.952) or OS (p = 0.374). Significant associations with OS were seen in the standard therapy group for both ECOG PS 1 (p = 0.028). Thoracic radiation considerably decreased progression risk (HR = 0.41, p = 0.031) in the extended group. Conclusions: While prolonging chemo-immunotherapy beyond four cycles did not significantly improve survival, the selected patient subgroups may benefit from personalized approaches. Thoracic radiotherapy emerged as a key modifier of outcome.

Purpose: The present study evaluates the levels of oxidative stress and DNA damage in patients diagnosed with acute myeloid leukemia (AML; newly diagnosed patients and patients in remission) compared to healthy controls. Materials and methods: A total of 96 participants were enrolled into this study in three groups: 32 newly diagnosed AML patients, 32 patients in remission, and 32 age- and sex-matched healthy individuals. Various laboratory analyses were conducted to measure biochemical parameters, total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and DNA damage using the comet assay. Results: We showed that while TOS levels did not differ significantly between the groups, both the newly diagnosed and remission groups exhibited higher OSI levels compared to controls. TAS levels were notably lower in the remission group, suggesting decreased antioxidant capacity. The comet assay demonstrated significantly elevated DNA damage in the newly diagnosed AML group, followed by the remission group, relative to healthy controls. These findings highlight an increased oxidative stress burden and genotoxicity in AML patients, which may contribute to disease pathophysiology. Furthermore, the results suggest that the oxidative stress and DNA damage are more pronounced in newly diagnosed patients compared to those in remission. Conclusion: The study showed that the oxidative stress and DNA damage observed in AML patients, particularly at diagnosis, could play a role in the progression and recurrence of the disease, suggesting potential prognostic value for oxidative stress markers in AML management.

Purpose: Chronic lymphocytic leukemia (CLL) is the most seen type of leukemia in adults. There are few biomarkes that are used for better understanding how oxidative stress is involved in the pathophysiology of hematologic malignency.We aimed to oxidative stress, DNA damage and erythrocyte membrane lipid profile in CLL patients in this study. The study is included 38 CLL patients and 38 age-sex matched controls. Materials and method: Total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), DNA damage examination with Comet assay, serum 8-OHdG measurement and gas chromatographic analysis were performed between the case and control groups. Results: It was observed that TOS and OSI values were higher in the case group than in the control group (p=0.014 and p=0.022, respectively). DNA damage measured by Comet method was found to be increased in the case group (p0.05). Conclusion: It has been shown that CLL patients had higher oxidant capasity as consequence. Oxidative stress and DNA damage are increased in CLL patients in this study. It is early to evaulate on erythrocyte membrane lipid profile in CLL patients. However, the study can be ligthed the way future studies on the subject.