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Objectives: Denosumab reduces skeletal related events in castration-resistant metastatic prostate cancer (CRMPC)with bone metastases.It is recommended to give calcium and vitamin D to prevent hypocalcemia after denosumab.There is no recommendation to check vitamin D and the specific level of vitamin D that should not be given beforedenosumab. We aimed to show that the rate of hypocalcemia is high even in vitamin D deficiency alone in the absenceof other risk factors for hypocalcemia and can be reduced by checking vitamin D before the administration or by adjust ing the dose of denosumab according to the vitamin D, which are not included in denosumab product information (PI). Methods: We retrospectively analyzed 40 CRMPC patients who received subcutaneous injections of 120 mg denosumab. Results: 28 patients had vitamin D deficiency before treatment. Patients with vitamin D deficiency had a higher rate ofhypocalcemia (87.5% vs 16.6%). Hypocalcemia was significantly higher in patients with vitamin D deficiency (p:0.001).In patients with vitamin D deficiency, 87.5% grade1, 8.3% grade 2 and 4.1% grade 3 hypocalcemia developed. Conclusion: Vitamin D should be checked before treatment to prevent denosumab-related hypocalcemia. New studiesshould be planned for this recommendation to be in the denosumab PI.

PubMedID: 30377778 Purpose: In this study, we aimed to describe the real-life practice outcomes of pertuzumab–trastuzumab–taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients. Methods: This study was conducted by Turkish Oncology Group and included 317 patients’ data from 36 centers. Results: Median age was 51 (22–82). Median PFS was 28.5 months, while median OS was 40.3 months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8 m vs. 28.5 m; p = 0.002) and OS (26.7 m vs. 40.3 m; p = 0.009). Patients older than 65 years of age (n: 42, 13.2%) had significantly lower OS results (19.8 m vs. 40.3 m; p = 0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5–40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure. Conclusions: Our RLP trial included only visceral metastatic, trastuzumab-naïve BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab–trastuzumab–taxane therapy to date. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Bangladesh University of Health Sciences and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the committee of University of Health Sciences, Ankara Oncology Education and Research Hospital (TUEK meeting number: 40-15.5.2018).

Bu çalışmanın amacı; ileri evre küçük hücreli dışı akciğer kanserli hastalarda (KHDAK) beyinmetastazı için risk faktörlerini belirlemektir. Yüz altmış üç ileri evre KHDAK’li hastaların dosya kayıtlarıretrospektif olarak incelendi. İzlemleri sırasında beyin metastazı gelişen ve gelişmeyen olmak üzere 2gruba ayrıldı. Yaş, cinsiyet, performans durumu, kilo kaybı, histopatolojik tip, primer tümörünlokalizasyonu, sigara içme öyküsü, tedavi yanıtı ve tanı anındaki laboratuvar tetkiklerinden laktatdehidrogenaz (LDH), albumin, hemoglobin düzeyleri univaryant ve multivaryant analize alındı. Coxproportional hazard modeli ve Kaplan-Meier sağ kalım analizleri SPSS 11.0 kullanılarak yapıldı.İzlemleri sırasında hastaların 40’ında (%24.5) beyin metastazı gelişti. Beyin metastazını etkileyenfaktörler kilo kaybı, ekstrakraniyal metastaz varlığı, tedaviye yanıtın olmaması, primer tümörün üst lobyerleşimli olması, mediastinal lenf nodu tutulumu ve LDH yüksekliği olarak tespit edildi. Tüm gruptaortanca sağ kalım süresi 44 hafta, 1 yıllık sağ kalım oranı %38, beyin metastazı gelişinceye kadargeçen süre 32 hafta, beyin metastazı tanısından sonra ortanca sağ kalım süresi 28 hafta idi. Kilokaybı, ekstrakraniyal metastaz varlığı, tedaviye yanıtın olmaması, primer tümörün üst lob yerleşimliolması, mediastinal lenf nodu tutulumu ve LDH yüksekliği beyin metastazını belirleyen en önemlifaktörlerdir. Profilaktik kraniyal radyoterapi bu grup hastalarda beyin relapsını geciktirmek, yaşamkalitesini düzeltmek ve beyin metastazının mortalite ve morbiditesini azaltmak için düşünülebilir., We aimed to determine the risk factors for brain metastases among patients with advanced NSCLC. Aretrospective analysis was made for 163 advanced NSCLC patients. The patients were enrolled intotwo groups in terms of who developed brain metastases or not during follow-up. Age, gender,performance status, weight-loss, histopathologic type, localisation of the primary tumor, smokingstatus, response to treatment, and lactate dehydrogenase (LDH), albumin, heamoglobin levels at thetime of the diagnosis were analyzed by univariate and multivariate analysis. Cox proportional hazardmodel and Kaplan-Meier survival analysis.There were 40 (24.5%) patients who had brain metastasesat the follow-up. Risk factors for brain metastases were weight-loss, extracranial metastases, upperlocalisation of primary tumor, unresponsiveness of first-line chemotherapy regimen, mediastinal lymphnode involvement and high LDH level. Median survival was 44 weeks, overall survival rate at 1 yearwas 38%, median time to onset of brain metastases was 32 weeks and median survival from thediagnosis of brain metastases was 28 weeks. Weight-loss, extracranial metastases, upper localisationof primary tumor, unresponsiveness of first-line chemotherapy regimen, high LDH level andmediastinal lymph node involvement were the most important risk factors for the prediction of brainmetastases. Prophylactic cranial irradiation may be choise in those patients to delay brain relapse, toimprove quality of life and to decrease morbidity and mortality of brain metastases.