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Purpose: This experimental study was planned to assess the efficiency of the acupressure in prevention of the chemotherapy-induced nausea and vomiting (CINV). Methods: This single-blinded randomized trial was performed at Istanbul University Institute of Oncology between October 2010 and January 2011. The patients, diagnosed with breast, gynecological, or lung cancer treated by doxorubicin-based- or cisplatin-based treatment were included in the study. Taking the consent of the patients, they were divided into experimental ( n = 67) and control groups ( n = 53) in line with the randomization list prepared before. The patient description form, Rhodes Index of Nausea, Vomiting, and Retching (INVR), and Functional Assessment of Cancer Therapy-General were used in data collection. Non-parametric tests were applied. Results: The patients in the experimental and control groups were identical in terms of sociodemographic features and their conditions. Most of the patients were married (84 %), and some were primary school graduates (41.7 %) and had mid-level income (54.2 %). In nausea-vomiting-retching, experiences of the patients before using a placebo and a real acupressure were identical and similar changes had been observed during 5 days after the treatment. It has been determined that there was no difference between the groups statistically. A similar result has been observed when the impact of acupressure on the subgroups of sociodemographic features and condition were examined, and it has been concluded that real acupressure application cannot increase the quality of life. Conclusion: It has been determined that CINV is directly related to the treatment, and acupressure wristband was not an effective approach in preventing CINV. [ABSTRACT FROM AUTHOR]

Our aim was to evaluate clinical and pathological features in prognosis of thymoma patients with particular emphasis on patients with myasthenia gravis (MG). From 1995 to 2010, 140 thymoma patients (women/men: 63/77) with a median age of 46 years (11-80 years) were admitted to our institution. According to World Health Organization (WHO), there were 23 (17%) type A, 12 (9%) type AB, 24 (17%) type B1, 42 (31%) type B2 and 36 (26%) type B3. The distribution of Masaoka stages I, II, III and IV was 24 (17%), 71 (51%), 18 (13%) and 27 (19%), respectively. MG coexisted in 61% of patients. After a mean follow-up of 34 months (1-158 months), 102 (73%) patients are alive and well while 14 (10%) are alive with disease. Twenty-three patients (16%) have died, only 9 died of thymoma. In univariate analyses, completeness of resection ( P < .001), WHO histology ( P = .008), Masaoka stage ( P < .001) and MG ( P = .002) were significant prognostic factors for progression-free survival (PFS). Young age ( P = .008); Masaoka stages 1 and 2 ( P = .039); WHO types A, AB and B1 ( P = .031); complete resection ( P = .024) and presence of MG ( P = .05) significantly correlated with overall survival (OS). In multivariate analysis, Masaoka stages 1 and 2 ( P = .038) and presence of MG ( P = .01) were significantly correlated with a longer PFS; MG ( P = .021) and WHO subtype ( P = .022) were found to be significant prognostic factors for OS. Adjuvant radiotherapy improved neither OS nor PFS in completely resected stage 2 thymoma. Masaoka staging, WHO and MG are major determinants of prognosis in Turkish thymoma patients. Additionally, radiotherapy did not provide survival advantage to stage 2 patients with complete resection. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The primary endpoint of this study was to determine predictors of taxane-related nail toxicity. The secondary endpoint was to evaluate the efficacy of the use of frozen gloves and socks in the prevention of taxane-related nail toxicity. Methods: This descriptive, interventional, cross-sectional study was conducted with 200 patients. The patients were assigned to the frozen gloves/socks intervention group or control group. Frozen gloves/socks were applied only in hourly taxane-based treatments. The Patients Record Forms of the clinic were used in data collection. Nail changes were graded using the NCI Common Toxicity Criteria for each patient and treatment. Logistic regression analysis was performed to predict the factors that affect nail changes. Results: The majority of the patients enrolled in the study were women diagnosed with breast cancer. The two groups were statistically similar for the cancer diagnosis, type and number of taxane cycles administered. Grade 1 nail toxicity was found in 34%, grade 2 in 11%, and grade 3 in 5.5% patients. Taxane-related nail toxicity was higher in patients who were female, had a history of diabetes, received capecitabine in conjunction with docetaxel and had breast or gynecological cancer diagnosis. Nail changes increased with an increase in the number of taxane cycles administered, BMI and severity of treatment-related neuropathy. Conclusions: The multivariate analysis demonstrated that BMI, breast or ovarian cancer diagnosis and the number of taxane cycles administered were the independent factors for this toxicity. No statistically significant difference in nail toxicity incidence and time to occurrence of nail changes was found between the intervention and the control groups. [Copyright &y& Elsevier]

Purpose: To determine the characteristics and outcome of patients with refractory gestational trophoblastic neoplasia (GTN) after primary chemotherapy (CTx). Methods: The outcome of low- and high-risk patients with refractory GTN ( n = 14, 37%) was compared to those with non-refractory GTN ( n = 24, 63%). Methotrexate treatment was used for patients with low-risk disease and EMA/CO for patients with high-risk disease. Results: Median follow-up time was 53 months (range 1-173 months). All non-refractory patients and 11 refractory patients (79%) survived ( p = 0.015). Factors related to resistance to primary CTx was age ( p = 0.012), duration between causal pregnancy and initial treatment ( p = 0.003), surgery ( p = 0.014), hCG level before CTx ( p = 0.09) and half-life of hCG ( p = 0.061). Six out of 10 low-risk refractory patients treated with EMA/CO regimen in the second-line setting had been followed by no evidence of disease. Nine of 38 (24%) patients underwent surgery (TAH ± BSO) for GTN. All of the patients treated with surgery were in the non-refractory group, but none of refractory patients underwent surgery ( p = 0.014). Conclusions: Surgery and EMA/CO regimen are one of the main factors that play a role in the management of refractory low-risk GTN. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate efficacy and feasibility of a combination of weekly docetaxel and cisplatin administered concomitantly with radiotherapy followed by surgery in addition to consolidation chemotherapy with docetaxel and cisplatin administered every 3 weeks in stage III non-small cell lung cancer (NSCLC). Methods: A total of 31 histologically proven, locally advanced (stage IIIA-N2 = 9, stage IIIB-T4N0-2 = 22) NSCLC patients were investigated. After administration of 4-6 cycles of weekly docetaxel (20 mg/m) and weekly cisplatin (20 mg/m) concurrently with radiotherapy, patients underwent operation if their disease was appropriately downstaged. Combination chemotherapy with docetaxel 75 mg/m and cisplatin 75 mg/m every 3 weeks was administered as a consolidation regimen. The treatment response, toxicity, time to progression (TTP) and overall survival (OS) were evaluated. Results: After concomitant chemoradiotherapy, complete response and partial response occurred in 16.1 and 67.7% of patients, respectively. Thirteen percentage of patients progressed on treatment, and 3.2% had stable disease. Grade 3-4 hematologic and skin toxicities did not occur, whereas 17.9% of them experienced grade 3-4 oesophageal toxicity. Grade 3 pulmonary toxicity and grade 3-4 emesis developed in 9.7 and 6.4% of patients, respectively. Thirteen responsive patients (41.9%) underwent surgery. The toxicity of consolidation chemotherapy was tolerable. Median OS and TTP were 22 ± 5 (range 13-31) and 12 ± 3 (range 7-17) months, respectively. Median follow-up was 22 (range 2-57) months. Conclusions: Weekly administration of docetaxel and cisplatin concurrently with radiotherapy followed by consolidation chemotherapy is an effective treatment with acceptable toxicity for patients with locally advanced NSCLC especially in combination with surgery. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the psychometric validation of the Quality of Life and FAMCARE scales in Turkish family caregivers of cancer patients. Methods: This is a descriptive study involving 100 family caregivers of cancer patients. The validity and reliability study of the scales was performed in two phases. Phase I focused on the construction of the Turkish version of the instruments and pilot testing. Phase II was the psychometric assessment of the scales. Results: The caregivers stated that the two questionnaires were easy to read and to understand. However, the psychometric validation performed afterwards revealed that both the ordering of the factor loadings and content of the scales were influenced by prevailing characteristics of Turkish society. Caregivers were satisfied with the care their patients received, and family concerns were the most negatively affected quality-of-life (QOL) dimensions. Factors affecting the QOL and satisfaction with care were age, co-residence, relationship to patient, gender of the patients and caregivers, stage of the disease of the patient and marital status of the caregivers. Conclusion: Psychometric validation of the Quality of Life and FAMCARE scales demonstrates that these culturally adapted scales are valid and reliable tools to assess the QOL and satisfaction of Turkish family caregivers of cancer patients. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Although there are many non-pharmacological practices being recommended for symptom management, most patients prefer to use pharmacological interventions. This study assesses the non-pharmacological interventions used by cancer patients for symptom management during chemotherapy and the factors affecting its use. Method: This study was conducted at the Istanbul University Institute of Oncology, Turkey, with 202 patients. Personal characteristics, illness-related characteristics, symptom severity and non-pharmacological interventions used by the patients were assessed by using Patient Description Form, ECOG and Nightingale Symptom Assessment Scale. Results: Most of the patients in this study were living in Istanbul, 58.4% were women, 78.7% were married and their mean age was 48.82±1.44. Most of the patients experienced different symptoms related to chemotherapy, but only a small number of patients preferred to use and benefited from the non-pharmacological interventions in their symptom management. There were different factors affecting the well-being of the patients, but only being young was found to be an important variable in the use of psychological interventions (OR 3.06 [95% CI 1.17–7.96]). Conclusions: Physicians remain the central figure in the treatment of cancer patients, so oncologists and oncology nurses should be more proactive and innovative in their patient care, education, and counseling to maximize the use of non-pharmacological interventions that may be helpful in symptom management. Further research evaluating the use and effectiveness of non-pharmacological interventions on symptom management in cancer patients is needed. [Copyright &y& Elsevier]

Abstract: Purpose: Treatment-related side effects have an adverse impact on the health-related quality of life (HRQoL) of cancer patients undergoing chemotherapy. This study is a description of the validity and responsiveness demonstrated by a new cancer and cancer treatment-specific symptom scale – the Nightingale Symptom Assessment Scale (N-SAS) - which was developed and validated to address the QoL of Turkish cancer patients. Method: The comprehensiveness and clarity of the scale was assessed using 10 patients and pilot testing was carried out with 179 patients. A sample of 374 cancer patients who had received chemotherapy participated in the main study. Descriptive statistics were calculated and comparative tests and factor analysis were performed. Results: The internal reliability of N-SAS was examined and the validity of this scale was determined by correlation with FACT-G. The scale showed high internal reliability, Cronbach''s α for the subscales varied between 0.81 and 0.87 and was 0.93 for the tool. Longitudinal analyses showed that changes in N-SAS scores were strongly correlated with changes in FACT-G. Multivariate analysis revealed that having a metastatic cancer diagnosis, having a low level of income, receiving taxane-based therapy and being a woman were the most important predictive factors for the well-being of the cancer patients in this study. Conclusions: The high correlation with the FACT-G suggests that the new scale is a valid instrument that can be used to evaluate the effect of antineoplastic therapies on a cancer patient''s QoL and can help guide nursing care as well as track the improvement of patients'' HRQoL. [Copyright &y& Elsevier]

Abstract: The diagnosis of lung cancer in the advanced stage of illness, the poor prognosis associated with the disease, and the side effects of chemotherapy all have an impact on various dimensions of quality of life (QoL). The purpose of the research: The current study was designed to describe the QoL and symptom distress of lung cancer patients undergoing chemotherapy and to explore the relationships between demographic/treatment-related characteristics and QoL. Methods and sample: The sample consisted of 154 lung cancer patients undergoing chemotherapy. The symptom experiences and QoL of lung cancer patients undergoing chemotherapy were evaluated using the Memorial Symptom Assessment Scale and Quality of Life Index – Cancer Version. Results: The lung cancer patients had low QoL scores. The scores on the Health and Functioning subscale were the lowest (20.33±5.59), while those of the Family subscale were the highest (27.66±2.77). The most common physical symptoms experienced by lung cancer patients were lack of energy, coughing, pain, lack of appetite, and nausea, while the psychological symptoms were feeling nervous, difficulty sleeping, feeling sad, and worrying. There was a negative relationship between the symptom distress and quality of life scores (r=−0.45; p<0.000). Females and those with low income levels and performance status experienced greater symptom distress. Conclusions: Lung cancer patients receiving chemotherapy suffer many limitations due to the symptoms and disruptions to their QoL, arising from both the disease process and its treatment. Lung cancer patients need to be assessed regularly and supported. [Copyright &y& Elsevier]

Purpose: Quality of life always has become an important concern in the health care of cancer patients. This descriptive study was planned to assess the validity and reliability of the Turkish version of Quality of Life Index – Cancer version in the assessment of the quality of life of lung cancer patients. Method: The validity and reliability of the scale was performed in two phases. Phase I focused on construction of the Turkish version of the instrument and pilot testing. The scale was translated using the back-translation technique. Five nursing experts reviewed the translation for inconsistencies with the original English form. The comprehensiveness and clarity of the scale was assessed with 20 patients. Phase II included factor analysis and psychometric assessment of the scale. The final version of the scale was pretested with 154 cancer patients. Results: According to the recommendations of the expert panel, some items were revised and modified, and the Turkish version of the scale was created. The content validity index (CVI) was 97%. Patients cited that this questionnaire was easy to read and understood. Differently from the original QLI scale, factor analysis was changed the domain of some items. Test–retest coefficients for items were between 0.63 and 0.95 (p < 0.05). The scale showed high internal reliability, Cronbach’s alpha values for domain varied between 0.63 and 0.85 and was 0.89 for the tool. Conclusion: The Turkish version of the QLI was sufficient and suitable tool in evaluating the quality of life of lung cancer patients in Turkey. [Copyright &y& Elsevier]

Background: Non-HIV related Kaposi sarcoma (NHKS) is a rare indolent neoplasm which is more common around Mediterranean origin. Data concerning factors that influence progression-free survival (PFS) for NHKS are insufficient. The purpose of present retrospective analysis was to distinguish the factors affecting PFS in patients with NHKS.Methods: A hundred and twenty-eight consecutive patients with NHKS who were treated or observed between 1997 and 2014 at Istanbul University Institute of Oncology were included into the study. Treatment response and progression definitions were determined according to different treatment modalities administered at first line.Results: Majority of patients were male (n = 97, 75.8%). Median age of the whole group was 66 years (28–85). Of the patients, 15 patients were immunosuppressant, whereas 113 patients had no disease that caused immunosuppression. Patients were treated with local excision (n = 57, 44.5%), chemotherapy (n = 32, 25.0%) and/or radiotherapy (n = 13, 10.2%) or observed without treatment (n = 26, 20.3%). At a median follow-up of 28 months, 71 (55.5%) patients had progression, while 3 patients (2.3%) died of NHKS. On univariate analysis, patients who had hypertension (HT) had poorer PFS compared with others (19 ± 12 versus 41 ± 22 months;p = 0.03), whereas plaque formation was associated with better outcome (25 ± 9 versus 54 ± 12 months;p = 0.03). In addition, heavy smoking (≥40 pack-years) had a borderline significance regarding better PFS time (23 ± 24 versus 45 ± 38 months,p = 0.06). On multivariate analysis, none of factors evaluated had any impact on PFS.Conclusions: HT was correlated with poorer outcome among NHKS patients. Patients with plaque formation and ≥40 pack-years of smoking had better PFS than others. [ABSTRACT FROM AUTHOR]

Abstract: Aim: The purpose of this study was to assess the relationships between quality of life and use of complementary and alternative medicine (CAM) among Turkish cancer patients. Methods: This cross-sectional study was conducted in Istanbul University Institute of Oncology, Turkey. Two-hundred patients were invited and informed consent was obtained, however 179 cancer patients completed the study. The Patient Characteristics form, The Nightingale Symptom Assessment Scale and The Functional Assessment of Cancer Therapy Scale were used in the evaluation of the patients’ characteristics and quality of life. Results: Some form of CAM had been used by 71.5% of the sample. Frequently used CAM methods appeared to be religious practices (68.2%) and only 37.4% of the patients used herbs. However, female patients, single patients, and individuals with metastatic disease and worse quality of life showed a tendency to use CAM more often. More than one-third of our patients began to use CAM immediately after being diagnosed with cancer and factors associated with CAM use varied according to the type of CAM. Although CAM use did not affect the patients’ quality of life, logistic regression analysis revealed that gender, type of cancer diagnosis and education level were important factors to be considered in different CAM therapies. Conclusion: CAM use is common in cancer patients in Turkey. More discussion about CAM use should take place between patients and health professionals to inform the patients’ decisions. [Copyright &y& Elsevier]

Abstract: Self-efficacy has a positive effect on health behaviors, symptom control, compliance with cancer treatment, and quality of life. This study aims to describe the quality of life and self-efficacy of Turkish breast cancer patients undergoing chemotherapy. The sample consisted of 141 patients. Data was gathered using a Patient Information Form, the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B), a scale about Strategies Used by Patients to Promote Health and the Rotterdam Symptom Checklist. All quality of life dimensions were negatively affected at a significant level. Following commencement of chemotherapy, there was an increase in the negative effect on physical well-being, emotional well-being and additional concerns subscales and total FACT-B and their self-efficacy was negatively affected to a moderate degree. However, a significant degree of change did not occur in the self-efficacy. During treatment the physical symptoms and psychological distress increased and the activity level was negatively affected. The quality of life and self-efficacy were influenced by personal and medical characteristics, showing consistency with similar studies. Because there are negative effects of cancer and chemotherapy on patients'' quality of life and self-efficacy, nurses need to focus on designing psychosocial interventions to improve their self-efficacy and quality of life. [Copyright &y& Elsevier]

Summary: Patients’ satisfaction with the care given by nursing students will have a say in the development of practical nursing student education and in improving the quality of clinical training. The purpose of this study was to test whether the Turkish version of “The Oncology Patients’ Perceptions of the Quality of Nursing Care Scale-Short Form (OPPQNCS-SF)” is appropriate for oncology patients done by studying the tool''s validity and reliability and to evaluate the effect of care given by nursing students on oncology patients’ satisfaction with the care they receive. The Turkish version of OPPQNCS-SF''s item-score correlation coefficients were r s=0.38–0.85 (p<0.05). The Cronbach values were 0.91 for the total scale, 0.66–0.87 for the subscales. The results show that the scale is a valid and reliable tool for Turkish patients. The mean scores for every subscale and item were high. The patients were most pleased about the respect they were shown, with the answered to their questions, with the sincere interest shown and with the knowledge of nursesabout their condition. The patients’ high level of satisfaction with the care nursing students gave is important to ensure that nurses, who will have primary responsibility for patient care in the future, receive a good clinical and theoretical education. [Copyright &y& Elsevier]

Pegylated liposomal doxorubicin (PLD) is the only nonplatinum agent to significantly improve survival in patients with platinum-sensitive recurrent ovarian cancer. The present study was designed to assess the efficacy and safety of PLD plus cisplatin combination therapy in these patients. Twenty-two women (median age, 57 years) with ovarian cancer that recurred 6 months or more after standard carboplatin and paclitaxel therapy were eligible for enrollment. Cisplatin was administered intravenously as a 60-min infusion on day 1, at a single dose of 60 mg/m2, and PLD was given intravenously as a 1-h infusion on day 2, at a dose of 50 mg/m2. Treatment cycles were repeated on an outpatient basis every 28 days. Hematological toxicity was mainly leucopenia/neutropenia, and this was the principal dose-limiting toxicity. Severe (grade III–IV) leucopenia/neutropenia was observed in 7 (32%) and 9 (41%) patients, respectively. Only 2 (9%) patients were complicated by febrile neutropenia. Grade III–IV anemia occurred in only 4 (18%) patients. Severe thrombocytopenia was not noted; only 5 patients (23%) had grade I–II toxicity. NO toxicity in biochemical parameters was noted. Several severe nonhematological adverse effects were managed according to standard protocols and were transient, as well as being well-tolerated. Twenty-one patients were evaluated for response. The overall response rate was 62% (13 of 21; 95% confidence interval [CI], 38%–82%), with four (19%) complete and nine (43%) partial responses. At the time of last follow-up, all of the 22 patients were alive. The median follow-up period was 8.5 months (range, 2 to 22 months). PLD combined with cisplatin at the schedule and dosage used in this study is an active and safe second-line chemotherapy regimen with acceptable and easily manageable toxicities in women with platinum-sensitive recurrent ovarian cancer. [ABSTRACT FROM AUTHOR]

This study was conducted to investigate the distribution of metastatic lesions and their influence on survival, as well as other prognostic factors previously shown to have an impact on the outcome of patients with extensive small cell lung cancer (SCLC). Of the 207 patients were included and retrospectively analyzed; 124 patients had extended disease at initial presentation and the remaining 83 developed metastatic disease during follow-up. Patients who relapsed presented most frequently with distant metastases. The brain was the most frequent organ targeted for metastatic disease following the completion of chemotherapy (p<0.05). Serum LDH levels correlated significantly with the presence of liver metastasis (p<0.001). The site of involvement did not seem to have an impact on survival. Nevertheless, patients with multiple metastatic sites had a significantly poor survival rate (p=0.001). Weight loss, performance status, gender, clinical stage, serum LDH and albumin levels were all shown to correlate with survival (p<0.05). Response to chemotherapy was determined to be the most important prognostic factor. [ABSTRACT FROM AUTHOR]

Leptomeningeal metastases (LM) occurs in approximately 5% of individuals diagnosed with metastatic breast cancer (BC). Both systemic and intrathecal (IT) agents can be used for treatment. However, data to support the effectiveness of IT therapy are insufficient. The primary aim of this study was to assess the efficacy and safety of IT therapy in BC patients with LM. This was a retrospective observational study. SPSS version 27 was used for statistical analysis. Kaplan--Meier and Cox regression analyses were used for survival analysis. The study included 14 patients (median age, 52 years). The predominant histopathological t ypes were invasive ductal carcinoma (57%) and invasive lobular carcinoma (36%). In IT treatment, methotrexate was used in 64% of the patients and trastuzumab was used in 36%. Notably, 36% of patients had a partial response, 14% had a stable response, and 5 0% had disease progression. It was found that approximately 50% of patients with positive cerebrospinal fluid (CSF) cytology became negative after treatment. Furthermore, toxicity of grade 2 or higher was observed in 49% of patients. The median progression-free survival duration among patients who received methotrexate was 1.46 months (95% CI, 0.29-2.0) and among those who received trastuzumab was 5.1 months (95% CI, 0-13.1). The median overall survival duration among all patients was 3.8 months. LM is an indicator of poor prognosis among patients with breast cancer. However, IT therapy is one of the few treatment options. IT trastuzumab should be considered as a treatment if leptomeningeal metastases develop in HER2-positive breast cancer. [ABSTRACT FROM AUTHOR]

Objective: Thoracic wall recurrences following mastectomy are seen relatively rare in breast cancer. Local and regional recurrences are seen about %5-10 in breast cancer. Of those, 20% to 30% of recurrences are seen with regional recurrences. The aim of this study is to investigate the clinical, pathological features and long-term survival of patients with local recurrence after mastectomy. Materials and Methods: Between 1993 and 2015, 27 patients who were operated with a diagnosis of breast cancer at the Istanbul Medical Faculty Breast Surgery Clinic, developed recurrence in the thorax wall. Clinicopathologic and long-term survival data was obtained for 27 patients. Results: Median age was 47 (25-79) and 63% of patients (n=17) were premenopausal. The majority of patients were found to have stage III disease (30%), whereas 30% had stage 1, and %26 had stage 2 disease. Furthermore, the majority of patients were found to have invasive ductal carcinoma as histological tumor type. Hormone receptor positivity (estrogen and/or progesterone receptor positivity) was detected in 16 patients (67%, n=24), whereas 2 patients were found to have HER-2 positivity (15%, n=13). One patient (6.7%, n=15) with hormone receptor positivity upfront was turned to be hormone receptor negative (ER/PR negative) in recurrence. At a median follow-up of 87 month (12-261), 21 patients (78%) had isolated thoracic wall recurrence, whereas 6 patients (22%) had synchronous thoracic®ional recurrence. The median recurrence time was 44 months (6-260), and 37% (n=10) of recurrences were detected in the first 2 years, whereas 22% of them (n=6) were seen between 2 and 5 years, and 41% (n=11) of them developed after 5 years. Twenty patients (74%) underwent a surgical procedure as recurrent mass excision+/- axillary dissection, and 7 patients (26%) underwent systemic treatment after tissue biopsy (core / FNAB). Hormone-positive patients (median recurrence month=89.5) were less likely to be found a recurrence compared to the hormone receptor-negative patients (median recurrence month, 89.5 vs 14.5; p=0.002). Four patients (15%) developed distant metastasis after recurrence. There were 3 deaths due to breast cancer during the follow-up period and the overall 10-year survival rate was 86.8%. Conclusion: Our findings suggest that the majority of patients who developed local/regional relapse after mastectomy relapsed within the first five years, and HR-positive patients were less likely to recur than HR-negative patients. Therefore, triple negative patients may require more aggressive local and systemic therapies. [ABSTRACT FROM AUTHOR]

Simple Summary: We investigated any possible associations between chemokine receptor expression and responses to chemotherapy along with survival outcomes in patients with triple-negative breast cancer with locally advanced disease. Expressions of chemokine receptors were examined after staining surgical specimens using specific antibodies for CCR5, CCR7, CXCR4, and CXCR5. Patients with high CCR5, CCR7, CXCR4, and CXCR5 expression on tumors and high CXCR4 expression on tumor-infiltrating lymphocytes were less likely to have a chemotherapy response compared to others. Patients with residual lymph node metastases after chemotherapy, CCR5, or CXCR4 expressions on tumors have shown a worse outcome compared to others. However, patients with CXCR5 expression on tumor-infiltrating lymphocytes had a better outcome compared to those without. High expression of CXCR4 or CCR5 on tumor was found to be associated with poor prognosis, and CXCR5 on tumor was associated with poor chemotherapy response in the present cohort with locally advanced triple-negative breast cancer. Our results suggest that patients with triple-negative breast cancer could benefit from a chemokine receptor inhibitor therapy. Background: We aim to investigate any possible associations between chemokine receptor expression and responses to neoadjuvant chemotherapy (NAC) along with outcomes in patients with triple-negative breast cancer (TNBC) with locally advanced disease. Method: Expressions of chemokine receptors were examined immunohistochemically after staining archival tissue of surgical specimens (n = 63) using specific antibodies for CCR5, CCR7, CXCR4, and CXCR5. Results: Patients with high CCR5, CCR7, CXCR4, and CXCR5 expression on tumors and high CXCR4 expression on tumor-infiltrating lymphocytes (TILs) were less likely to have a pathological complete response (pCR) or Class 0-I RCB-Index compared to others. Patients with residual lymph node metastases (ypN-positive), high CCR5TM(tumor), and high CXCR4TM expressions had an increased hazard ratio (HR) compared to others (DFS: HR = 2.655 [1.029–6.852]; DSS: HR = 2.763 [1.008–7.574]), (DFS: HR = 2.036 [0.805–5.148]; DSS: HR = 2.689 [1.020–7.090]), and (DFS: HR = 2.908 [1.080–7.829]; DSS: HR = 2.132 (0.778–5.846)), respectively. However, patients without CXCR5TIL expression had an increased HR compared to those with CXCR5TIL (DFS: 2.838 [1.266–6.362]; DSS: 4.211 [1.770–10.016]). Conclusions: High expression of CXCR4TM and CCR5TM was found to be associated with poor prognosis, and CXCR5TM was associated with poor chemotherapy response in the present cohort with locally advanced TNBC. Our results suggest that patients with TNBC could benefit from a chemokine receptor inhibitor therapy containing neoadjuvant chemotherapy protocols. [ABSTRACT FROM AUTHOR]

OBJECTIVE Breast cancer is the most diagnosed cancer in females. Cancer screening programs increase the detection of early-stage breast cancer. This study aimed to assess the long-term outcomes and the effect of adjuvant therapies for recurrence in stage I breast cancer patients. METHODS We recorded clinicopathological and treatment features of the stage I breast cancer patients and evaluated long-term outcomes retrospectively. Kaplan-Meier analysis and Cox regression analysis were used for recurrence and overall survival. RESULTS 308 patients with stage I breast cancer were involved in the study. The average age was 52 (range 21-81). The median follow-up was 99 (12-380) months. Forty-three (14%) patients were aged over 65, and 162 (52.7%) patients were postmenopausal. ER, PR, and HER2 receptor positivity were 78.9%, 60.8%, and 14.3%, respectively. Lumpectomy plus adjuvant radiotherapy was performed in 82.1% of the patients, and mastectomy in 10.7% of the patients for primary treatment. The patients received adjuvant chemotherapy (42.5%) and adjuvant hormonal therapy (79.9%). Recurrence (local-47.8%, metastatic-52.2%) occurred in 23 (7.5%) patients. In multivariate Cox regression analysis, we found that primary treatment (lumpectomy + adjuvant RT or mastectomy) (p=0.614), surgical margin status (p=0.495), adjuvant chemotherapy (p=0.259), and adjuvant hormonal therapy (p=0.289) were not statistically significant factors for recurrence. However, aged over 65 years (p=0.002) was statistically significant. CONCLUSION In this study, we showed long-term outcomes in stage I breast cancer patients. It was shown that the primary treatment type (lumpectomy + adjuvant RT or mastectomy) was not different in terms of recurrence. In addition, it was determined that adjuvant chemotherapy did not provide benefit for recurrence in stage I breast cancer patients in our results. For this reason, in patients with stage I cancer, more care should be taken in the decision of adjuvant therapy. [ABSTRACT FROM AUTHOR]

Aim: This study’s goal is to evaluate the safety and efficacy of bevacizumab (BEV )-based therapies in patients with metastatic cervical cancer (CC) using real-life data. Materials and Methods: This study constitutes a retrospective observational analysis. Patients diagnosed with metastatic CC who received BEV treatment in the Medical Oncology department between January 2012 and December 2022 were included in the study. Results: This study encompassed 40 patients, with a median age of 51 years (range: 21-78), and a median follow-up duration post-treatment of 16.6 months. Predominant metastatic sites included the lymph nodes 72.5% (n=29), peritoneum 55% ( n=22), lungs 35% (n=14), liver 22.5% (n=9) and bones 15%( n=6). Regarding treatment responses, 12.5% (n = 5) of patients achieved complete response, 45% (n = 18) achieved partial response, 17.5% (n = 7) had stable disaese, and 25% (n = 10) experienced disease progression. The median progression-free survival was found 8.5 months (95% CI: 6.838 – 10.295), and the median overall survival was 16.3 months (95% CI: 11.305 – 21.362). The presence of bone metastasis (p=0.024) and obesity (p=0.020) are statistically significant factors affecting survival outcomes. There were no statistically significant differences in survival outcomes due to several factors, including age, pathology classification, number of metastatic sites, tumor grade, initial staging, previous surgeries and radiotherapy before starting therapy, and the type of cytotoxic agents administered with BEV (p > 0.05). Conclusions: Metastatic CC has a challenging prognosis. Combinations of BEV with chemotherapy agents are effective and safe in the treatment of this patient group. [ABSTRACT FROM AUTHOR]

OBJECTIVE This study assessed the efficacy of chemotherapeutic agents used in combination with bevacizumab in patients with metastatic ovarian cancer who could not receive platinum. METHODS The study is a retrospective observational study. Kaplan-Meier and Cox regression methods were used for statistical analysis. RESULTS The most common metastatic sites among the 60 patients were the peritoneum (91.7%), liver (51.7%), and lung (20%). As a single agent combined with bevacizumab, 29 (48.3%) patients received paclitaxel, 16 (26.7%) received liposomal doxorubicin, and 15 (25%) received gemcitabine. The median progression- free survival was 7.5 months (95% CI, 3.4-11.4), and the median overall survival was 14.4 months (95% CI, 9.3-19.4). Among the factors that affected overall survival, the number of metastasis sites (p=0.01) was statistically significant. The type of chemotherapy used with bevacizumab (p=0.55), age (p=0.057), liver metastasis (p=0.28), lung metastasis (p=0.19), bone metastasis (p=0.13), and brain metastasis (p=0.12) were not statistically significant. CONCLUSION Single-agent chemotherapy drugs used with bevacizumab demonstrated similar efficacy against ovarian cancer. Patients' performance scores, previous treatment regimens, and side effect profiles should be considered before administering any specific chemotherapy agent in combination with bevacizumab. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of hormonal therapy (HT) in patients with recurrent adult ovary granulosa cell tumors. Methods: The clinical and treatments features of the patients who received HT were studied retrospectively. The efficacy and safety of HT were evaluated. The Kaplan-Meier technique was used to conduct survival analysis. Results: The research involved a total of thirteen patients. The median age of the participants was 49 years (range: 34-61). Since diagnosis, the median number of surgeries has been three (range: 2-8). At least one chemotherapy regimen has been administered to 12 (92.3%) patients. Ten of the patients (76.9%) had at least two metastatic areas. Lung metastases were found in two (15.4%) of the patients. Inhibin B levels were elevated in 81.2% of patients before hormone treatment. The patients received different HTs (Leuprolide acetate + anastrozole-three patients, leuprolide acetate + tamoxifen-six patients, only anastrozole-three patients, only tamoxifen-one patients). The median progression-free survival was found 17.7 months (95 % CI: 14.7-20.6). In four (33.4%) patients, an overall response (complete or partial) was identified. A stable response was observed in eight (66.7%) patients. Conclusions: HT is effective in pretreated individuals with recurrent ovarian granulosa cell tumors, according to this research. Despite the limited number of patients and treatment variability, disease control was achieved in all patients. Also, we found that Inhibin B levels were associated with treatment response. [ABSTRACT FROM AUTHOR]

Background: The goal of this research is to investigate the clinical characteristics and prognosis of men with metastatic breast cancer (mMBC). Methods: A retrospective analysis of the data of 28 patients was conducted. Kaplan-Meier and Cox regression analyses were used to assess overall survival (OS) and prognostic variables. Results: At the time of diagnosis, the median age was 57 years (range 26-86). The most prevalent pathological subtype was invasive ductal carcinoma (92.6%). HER2 positivity was 21.6% in patients, with estrogen and progesterone receptor positivity at 96.4% and 71.4%, respectively. Bone-75%, lung-39.3%, brain-21.4%, and adrenal gland-10.7% were the most prevalent metastatic sites. Trastuzumab-based chemotherapy was given to six patients. During the study period, 14 patients (or half) died. All patients had a median OS of 42.6 months (range: 21.6-63.7). The OS rates after 1, 3, and 5 years were 95.7%, 54.2%, and 36.6%, respectively. The number of metastatic locations (P = 0.045), brain metastasis (P = 0.033), and a history of regular alcohol intake (P = 0.008) were all shown to be statistically significant factors affecting OS in univariate analysis. However, multivariate analysis did not support the findings. In addition, we discovered that trastuzumab-based therapy and de-novo metastatic disease had no effect on OS for mMBC. Conclusions: The data on mMBC is restricted because of its rarity. The prognosis of mMBC was shown to be poor in this investigation. Despite the small number of patients, we discovered that in univariate analysis, having brain metastases, the number of metastatic locations, and a history of alcohol intake may be prognostic factors. [ABSTRACT FROM AUTHOR]

Background: We evaluated the outcomes, and risk factors for recurrence in patients with early stage node-negative breast cancer in this study. Method: Retrospective data analysis was done on patient treatment records from 1988 to 2018. The patient's demographic, clinical, pathological, and therapeutic characteristics were noted. To evaluate survival analysis and predictors of recurrence, we employed Kaplan–Meier analysis with the log-rank test. Results: A total of 357 patients in all were enrolled in the research. At the time of diagnosis, the median age was 50 (with a range of 18–81). A total of 85.5% of patients had undergone a lumpectomy, while 14.5% had a mastectomy. 78.7% of patients had sentinel lymph node biopsy, and 21.3% had axillary lymph node dissection. In addition, the patients received adjuvant radiotherapy (88.7%), adjuvant endocrine therapy (82.1%), and adjuvant chemotherapy (48.5%). Recurrence of the tumor occurred in 31 (8.7%) patients (local recurrence 45.2% and metastatic disease 54.8%). Ten- and twenty-year recurrence-free survival rates were 92% and 77%. 19 (5.3%) patients had also developed contralateral breast cancer. Ten-year survival rates were 91.6%, and 20-year survival rates were 76.6%, respectively. Aged over 65 years (p = 0.004), necrosis (p = 0.002), mitosis (p = 0.003), and nuclear pleomorphism (p = 0.049) were found as statistically significant factors for recurrence in univariate analysis. In the ROC analysis, the largest size of the tumor (over 1.45 cm, p = 0.07) remained outside the statistical significance limit in terms of recurrence. Conclusions: Thirty-year outcomes in individuals with early stage, node-negative breast cancer were shown in this study. We found that the recurrence ratios between 10 and 20 years were more frequent than the first 10 years during the follow-up. Despite the small number of patients who experienced a recurrence, we demonstrated that, in univariate analysis, being older than 65 and having some pathological characteristics (nuclear pleomorphism, mitosis, and necrosis) were statistically significant factors for disease recurrence. [ABSTRACT FROM AUTHOR]

Background: The goal of the study was to evaluate the efficacy of tyrosine kinase inhibitors in patients with epidermal growth factor receptor (EGFR)-mutant metastatic non-small cell cancer and to determine the factors that predict objective response. Materials and Methods: In the study, data from metastatic non-small cell lung cancer patients with EGFR mutations treated with tyrosine kinase inhibitors were retrospectively reviewed. Factors predicting objective response were evaluated with logistic regression analysis. Results: The study evaluated the data of 105 patients. The most common EGFR mutations detected in patients were exon 19 (56.2%) and exon 21 (23.8%). The median progression-free survival (PFS) associated with EGFR tyrosine kinase inhibitors was 20.1 (95% confidence interval [CI], 13.4–26.7) months. The median overall survival (OS) in the post-metastasis period was found to be 30.8 (95% CI, 20.2–41.4) months. Five- and seven-year OS was determined as 28.7% and 22.9%, respectively. Factors predicting the objective response were analyzed. Presence of drug-related toxicity (P = 0.02), histopathologic type (P = 0.01), metastasis burden (P = 0.03), and EGFR mutation type (P = 0.04) were found to be statistically significant in multivariate analysis. Conclusions: In our study, we found that EGFR tyrosine kinase inhibitors are effective and safe. Better response to EGFR inhibitors was observed in the presence of drug-induced toxicity, adenocarcinoma histology, low metastasis burden, and exon 19 mutation. [ABSTRACT FROM AUTHOR]

Background: The goal of this study was to assess the clinicopathologic characteristics and prognostic variables in men with breast cancer (BC). Methods: Clinical features, pathological characteristics, stage at diagnosis, and therapy data were noted. Survival analysis was performed using the log-rank technique and Cox regression model. Results: Eighty patients were included in the study. In 31% of the individuals, BRCA (BReast CAncer genes 1 and 2) mutations were identified. The estrogen receptor (ER) positivity ratio was 93.6%, whereas the progesterone receptor (PR) positivity ratio was 74.4%. In 16.9% of the cases, HER2 overexpression was found. The median survival time was 120.9 months (70.3–171.5), and the five-year overall survival (OS) ratio was 74.9%. In univariate analysis, BRCA mutation status had no effect on OS (P = 0.50). CA15-3 levels (P = 0.03) at diagnosis and history of smoking (P = 0.03) were significantly linked with OS. However, the multivariate analysis could not confirm these results. Conclusions: We found that BRCA mutation, body mass index, a history of smoking, and alcohol consumption did not affect the OS in this research. [ABSTRACT FROM AUTHOR]

The purpose of the study was to assess the prognosis of HER2-positive metastatic breast cancer patients who received trastuzumab beyond progression and investigate the predictors of complete response. HER2-positive metastatic breast cancer patients who received long-term trastuzumab were included in the study. Predictors of complete response were analyzed with binary regression analysis. The prognosis of patients who had their trastuzumab-based treatment terminated was assessed. Eighty patients were involved in the study. The patients were received with trastuzumab for a median of 62 months (12–191). A complete response was observed in 60 (75%) patients. The median duration to development of complete response was found as 14.8 months (2.4–55). In logistic regression analysis: using endocrine therapy with trastuzumab (p = 0.04), menopausal status (p = 0.03), and the number of metastatic sites (p = 0.01) were found to be statistically significant factors for a complete response. Trastuzumab-based therapy of fifteen patients was terminated, six (40%) patients continued to receive an aromatase inhibitor, and nine (60%) patients were followed up without treatment. After termination of trastuzumab, at a median follow-up of 32 months (11–66), recurrence was detected in two (13.3%) patients. We detected that menopausal status, the number of metastatic sites, and using endocrine therapy with trastuzumab were predictors of complete response in HER2-positive metastatic breast cancer patients who received long-term trastuzumab-based therapy. We observed that HER2-positive metastatic breast cancer patients may be completely cured with trastuzumab-based therapy. There are no defined criteria for termination of trastuzumab treatment in this selected patient group. It is necessary to confirm our data with multicenter studies involving a large number of patients. [ABSTRACT FROM AUTHOR]

Introduction: Patients with HER2-positive metastatic breast cancer are at risk for developing brain metastases. Different anti-HER2 treatments can be used in the management of the disease. In this study, we aimed to evaluate the prognosis and the factors affecting the prognosis in brain metastatic patients with HER2-positive breast cancer. Methods: Clinical and pathological features of HER2-positive metastatic breast cancer patients and magnetic resonance imaging features at the onset of brain metastasis were recorded. Survival analyses were performed using Kaplan-Meier and Cox regression methods. Results: Analyses of the study were performed by including 83 patients. The median age was 49 (25–76). All patients had HER2 receptor-positive tumors. Thirty-five (42.2%) patients had a hormone-positive disease. Thirty-two (38.6%) patients had de novo metastatic disease. Brain metastasis sites were found to be bilateral – 49.4%, right brain – 21.7%, left brain – 12%, and unknown – 16.9%, respectively. The median brain metastasis largest size was 16 mm (range 5–63). The median follow-up time from the post-metastasis period was 36 months. Median overall survival (OS) was found as 34.9 months (95% CI, 24.6–45.2). In multivariate analysis for factors affecting OS, estrogen receptor status (p = 0.025), number of chemotherapy agents used with trastuzumab (p = 0.010), number of HER2-based therapy (p = 0.010), and the largest size of brain metastasis (p = 0.012) were found to be statistically significant. Conclusions: In this study, we demonstrated the prognosis in brain metastatic patients with HER2-positive breast cancer. When the factors affecting the prognosis were evaluated, we determined that the largest size of brain metastasis, estrogen receptor positivity, and the use of TDM-1 and lapatinib plus capecitabine consecutively during the treatment process affected the prognosis of the disease. [ABSTRACT FROM AUTHOR]

Simple Summary: Despite advances in treatment generated by clinical trials in metastatic breast cancer (MBC), their impact on routine daily practice and the reflection of the outcome within the community remains unclear. This study evaluates time-related differences in treatment patterns and outcome in a real-world patient population with MBC over a ten-year timeframe. Except for the HER2+ subgroup, which showed a significant survival benefit with the incorporation of novel agents, we failed to identify significant variations in outcomes for the remaining subgroups. A consistent feature we observed was the challenge in treating TNBC, which had the worst prognosis in both time-related cohorts. Elucidation of biologic characteristics to identify novel treatment options remains an unmet need to improve outcomes in TNBC. The favorable survival attained with routine endocrine agents in the luminal A subgroup suggests that barriers in access to CDK inhibitors may not have a negative impact on the outcome in subgroups of hormone receptor-positive patients, constituting an appealing strategy for communities with limited resources. This multicenter registry study aims to analyze time-related changes in the treatment patterns and outcome of patients with metastatic breast cancer (MBC) over a ten-year period. Correlations between demographic, prognostic variables and survival outcomes were carried out in database aggregates consisting of cohorts based on disease presentation (recurrent vs. de novo) and the diagnosis date of MBC (Cohort I: patient diagnosed between January 2010 and December 2014; and Cohort II: between January 2015 and December 2019). Out of 1382 patients analyzed, 52.3% patients had recurrent disease, with an increased frequency over time (47.9% in Cohort I vs. 56.1% in Cohort II, p < 0.001). In recurrent patients, 38.4% (n = 277) relapsed within two years from initial diagnosis, among which triple-negative BC (TNBC) was the most frequent (51.7%). Median overall survival (OS) was 51.0 (48.0–55.0) months for all patients, which was similar across both cohorts. HER2+ subtype had the highest OS among subgroups (HER2+ vs. HR+ vs. TNBC; 57 vs. 52 vs. 27 months, p < 0.001), and the dnMBC group showed a better outcome than recMBC (53 vs. 47 months, p = 0.013). Despite the lack of CDK inhibitors, luminal A patients receiving endocrine therapy had a favorable outcome (70 months), constituting an appealing approach with limited resources. The only survival improvement during the timeframe was observed in HER2+ dnMBC patients (3-year OS Cohort I: 62% vs. Cohort II: 84.7%, p = 0.009). The incorporation of targeted agents within standard treatment has improved the outcome in HER2+ MBC patients over time. Nevertheless, despite advances in early diagnosis and treatment, the prognosis of patients with TNBC remains poor, highlighting the need for more effective treatment options. [ABSTRACT FROM AUTHOR]

OBJECTIVE ROS1 positivity is seen in 1-2% of patients with metastatic lung cancer. Targeted drugs such as crizotinib, lorlatinib, and entrectinib are used in the treatment. We aimed to evaluate the efficacy of crizotinib and the prognosis of patients with ROS1 fusion-positive metastatic non-small cell lung cancer (NSCLC) in this study. METHODS We analyzed data of the advanced NSCLC patients with ROS1 mutation retrospectively. We determined the clinicopathological features of the patients. We evaluated the parameters affecting the prognosis with survival analyzes. RESULTS The research enlisted the participation of 21 patients. Median progression-free survival with crizotinib treatment was found 26.1 (95% Confidence interval [CI], 8.1-44.1) months. Median overall survival was 35.2 (95% CI, 13.5-56.9) months. Treatment-related Grade 1-2 adverse effects were observed in 9 (42.9%) patients and Grade 3-4 adverse effects were detected in 1 (4.8%) patient. Clinicopathological parameters affecting survival were evaluated; age (p=0.02) and liver metastasis (p=0.03) were defined as prognostic parameters. ROS1 positivity rate (p=0.08) was not found to be a prognostic factor. CONCLUSION In patients with ROS1 fusion-positive metastatic NSCLC, crizotinib was shown to be both efficacious and safe. We also found that in this patient group, age and the existence of liver metastases are prognostic factors. [ABSTRACT FROM AUTHOR]

The study's goal is to evaluate the effectiveness of erlotinib in patients with EGFR mutant metastatic non-small cell lung cancer (mNSCLC). The patient's medical data were analyzed retrospectively. Erlotinib's effectiveness was assessed by the radiological response. Survival analyzes were done for prognostic factors. Eighty-five patients were included in the study. 49 (57.6%) of the patients were female, and the average age was 60 (range, 33-85). Exon 19, exon, 21, and other mutations were detected in 62.4%, 24.7%, and 12.9%, respectively. Brain metastases were present in 25.9% and liver metastases in 17.6% of patients. Before erlotinib treatment, 25.9% of the patients received chemotherapy, and 43.5% received radiotherapy. With erlotinib treatment, complete response was found in 15.3%, partial response in 51.8%, and stable response in 10.6% of patients. Median PFS was 22.3 (95% CI, 11.0-33.5) months. Grade 1-2 side effects were observed in 29.1% of the patients, and grade 3-4 side effects in 7.1%. The median OS was found as 37.5 (95% CI, 22.6-52.4) months. The 5- years overall survival rate was found to be 32.2%. In this study, we showed outcomes of erlotinib therapy in patients with EGFR mutant mNSCLC. Erlotinib has been well-tolerated and effective in disease control. Age, number of metastases, and EGFR mutation type predict treatment-related prognosis. [ABSTRACT FROM AUTHOR]

The goal of this study was to evaluate the efficacy of crizotinib in patients with ALK-positive metastatic lung cancer. The patients' data were analyzed retrospectively. Cox regression and Kaplan-Meier methods were used to perform survival analyses. A total of 25 patients were involved in the study. Thirteen (52%) patients were male, and the average age was 55 (range, 30-80). 23 (92%) of the patients were de-novo metastatic. Brain metastases were present in 32% and liver metastases in 20% of the patients. Before crizotinib treatment, 64% of the patients had received chemotherapy, and 20% had received palliative radiotherapy. Progression-free survival was found as 16.8 (CI 95%, 5.7-27.9) months. Grade 1-2 side effects were detected in 36% of the patients, and grade 3-4 side effects were observed in 12%. After progression, 13 (52%) patients received 2nd series ALK inhibitors (alectinib, ceritinib, and lorlatinib) or chemotherapy. The median overall survival (OS) was found as 44.2 (95% CI, 28.5-59.9) months. The four-year OS rate was 37.4%. In the multivariate analysis, the ALK positivity ratio (p=0.02) was determined as a statistically significant factor affecting OS. We showed efficacy data of crizotinib in patients with ALK mutant metastatic non-small cell lung cancer. Crizotinib is an effective and safe therapy for patients with ALK mutant metastatic non-small cell lung cancer. Also, we found that the ALK positivity ratio was prognostic for OS. [ABSTRACT FROM AUTHOR]