Serap Hastürk

Two dose levels of ifosfamide in malignant mesothelioma

Thirty-one consecutive patients with histologically proven and symptomatic malignant mesothelioma were treated with two dose levels of ifosfamide. The first group of 15 patients were given 2.3 g/m2/day for 5 days (group A) and the following 16 patients were treated with 1.2 g/m2/day for 5 days of ifosfamide (group B). Treatment cycles were repeated every 3 weeks. While the partial response rate (PR) in group A was 38.5%, it was only 6.25% in group B (P > 0.05). The 95% confidence interval for the difference in PR rates was 3.3-61.2% > The overall survival (OAS) of groups A and B were similar (8 months and 9 months, respectively). Higher Grade 3-4 myelotoxicity was observed in group A when compared to group B (30.8% vs. 18.7%; P > 0.05). In conclusion, a favourable response rate could be achieved in malignant mesothelioma with high dose ifosfamide at the cost of increased toxicity.

Granulomatous reaction after chemotherapy for Hodgkin's disease

There are some reports that relate the coexistence of sar-coidosis and lymphoma. This coexistence has been calledthe sarcoidosis–lymphoma syndrome. Generally, sarcoido-sis precedes the lymphoma in these cases. On the other handthere are some other reports about sarcoidosis or sarcoid likereaction following the therapy of lymphoma. We report herea case with sarcoid like reaction developing after systemicchemotherapy for Hodgkin’s disease (HD) and discuss thepossible definitions.1. Case reportA 55-year-old man was admitted to our hospital withrelapsed HD. He had a history of lymphocyte rich-HD dia-gnosed in November 1999. He had cervical and abdomi-nal lymph nodes, right pleural effusion, splenomegaly andconstitutional symptoms. He had the history of six coursesof ABVD chemotherapy at another hospital. Cervical, tho-racic and abdominal CT scans were found to be normaland 2-microglobulin ( 2M) was within normal limits(2772ng/ml) after chemotherapy. Two months later he com-plained of constitutional symptoms and at that time, CTscans showed cervical, intraabdominal and retroperitoneallymph nodes, splenomegaly and mediastinal lymph nodes.Physical examination disclosed cervical and inguinallymph nodes. Laboratory results: Hb was 11.7g/dl, Hctwas 35.4%, WBC was 10 × 10

Alterations in p16 and p53 genes and chromosomal findings in patients with lung cancer: fluorescence in situ hybridization and cytogenetic studies.

BACKGROUND Chromosomal aberrations and instability of gene(s) are two factors related to the genetic instability of cancer cells. A loss of the tumor-suppressor function of the genes p16 and p53 is the most common event leading to the development of human cancers. Carcinoma of the lung is the leading cause of cancer deaths in the world. Chromosomal abnormalities in lung cancer may provide a valuable clue to the identification of target loci and culminate in a successful search for the major genes. The aim of this study was to investigate (i) alterations of the p16 and p53 genes and (ii) chromosomal aberrations in patients with small cell and non-small cell lung cancer by fluorescence in situ hybridization (FISH) and cytogenetic studies. We carried out cytogenetic analysis by Giemsa-banding in 18 cases. FISH probes for the p16 and p53 genes were also used on interphase nuclei to screen the alterations in these genes in lung cancer (LC). RESULTS We observed a high frequency of losses of the p16 - in 8/18 (44%) - and p53 - in 7/18 (39%) - genes in the cases with LC. A total of 18 patients showed predominantly numerical and structural aberrations. Among these two types, structural aberrations predominated and usually consisted of deletions, breaks, and fragilities in various chromosomes. Both structural and numerical changes were observed in almost all patients. Chromosomes 3 and 1 were found to be most frequently involved in structural abnormalities, followed by chromosomes 6, 9, and 8. Autosomal aneuploidies were also observed to be the most frequent (chromosomes 22, 19, 18, 20, 9, and 17), followed by those of the X and Y chromosomes. The expression of fragile sites was also found to be significantly higher in seven chromosomal regions: 3p14, 1q21, 1q12, 6q26, 9q13, 8q22, and 8q24. CONCLUSION Our data confirmed that DNA damage and genomic instability may be factors contributing to the mutation profile and development of lung cancer. The patients who developed lung cancer showed a high frequency of loss of both p16 and p53, in addition to chromosomal aberrations. Tobacco could be a major carcinogenic factor in lung-cancer progression. The loss of p16 and p53, and increased incidence of autosomal aneuploidy and chromatid breaks, along with other chromosomal alterations, can contribute to the progression of the disease.

There is no Significant Association Between Death Receptor 4 (DR4) Gene Polymorphisms and Lung Cancer in Turkish Population

Death receptor 4 (DR4) gene is a candidate tumor supressor gene that has a role in apoptotic pathway. It was reported in literature that polymorphisms in DR4 gene lead to susceptibility to many cancers. In accordance with this information, we aimed to investigate the association between G422A, C626G, A683C and A1322G polymorphisms in DR4 gene and lung cancer. We selected 60 patients with lung cancer (LC) and 30 healthy, sex and age matched volunteers randomly. Four polymorhisms, G422A, C626G, A683C and A1322G, in DR4 gene were analyzed with Polymerase Change Reaction (PCR) – Restriction Fragment Lenght Polymorphism (RFLP) and Amplification Refractory Mutation System (ARMS) techniques in both groups. Our results showed that there are no statistically significances between the patients and controls in terms of the G422A, C626G, A683C and A1322G polymorphisms in DR4 gene (p > 0,05). Our findings showed no role of DR4 gene polymorhisms in susceptibility to LC and provide a plausible explanation for DR4 genetic heterogeneity in LC susceptibility.

Basaloid large cell lung carcinoma presenting concurrently with metastatic uveal tumor

A 51-year-old man complaining of cough, hemoptysis, and decreased visual acuity was admitted to our hospital. Chest radiography revealed a left hilar mass and pleural effusion in the left hemithorax. In his ophtalmological examination, there was total retinal detachment in the left eye. Ultrasonographic examination and orbital magnetic resonance imaging (MRI) were reported as choroidal metastasis. A computed tomography (CT) confirmed the mass in the left hilum and multiple mass lesions consistent with metastasis in the liver and in the body of 12th thoracic vertebra. Bronchoscopic biopsies revealed large cell carcinoma with basaloid features. He died after 4 months with rapid progression of the disease in spite of combined chemotherapy. Although primary lung cancer with concurrent eye metastasis is an uncommon entity, it should always be kept in mind for patients with ocular symptoms.

Combination of chemotherapy and recombinant interferon-alpha in advanced non-small cell lung cancer

Some studies have shown that the combination of chemotherapy and interferon in non-small cell lung cancer (NSCLC) and other solid tumors is feasible and possesses antitumor activity. Our study was aimed at verifying whether the addition of recombinant human interferon alpha (rh-IFN alpha) to combined chemotherapy would be able to increase the response rate and survival of patients with NSCLC. Thirty-eight patients with previously untreated advanced NSCLC were evaluated in this study. Median age of patients was 57 years; performance status according to ECOG 0 and 1, 37 pts (97%); stage IIIB, 27 pts (71%); stage IV, 11 pts (29%). Histology was squamous cell carcinoma in 53%, adenocarcinoma 44% and large cell carcinoma 3%. Our schedule consisted of 80 mg/m2 cisplatin I.V., 100 mg/m2 etoposide I.V., 10 million U rh-IFN alpha IM and 10 million U rh-IFN alpha I.V. on first day of treatment, every 3 weeks. None of the patients had complete response. Partial response rate was 34%. Median response duration was 7 months (range 3-19 months), median survival time was 11 months (range 4-41 months). Twenty-nine percent of patients had grade 3 nausea and vomiting, 24% had grade 2 leucopenia, 5% had grade 2 cardiotoxicity, 2.6% had flu-like syndrome. According to these results, in advanced NSCLC, the addition of rh-IFN alpha did not increase the cisplatin-etoposide combined chemotherapy induced response rate and survival time.

Gemcitabine, Vinorelbine, and Cisplatin in the Treatment of Advanced Nonsmall Cell Lung Cancer

Objectives:Currently, cisplatin-based doublet combinations are accepted to be the first-line chemotherapy for advanced nonsmall cell lung cancer (NSCLC). Although triplet chemotherapeutics have been shown to be more effective and active than doublets, their toxicity was higher as expected. Therefore, we conducted this phase II trial using the combination of gemcitabine-cisplatin-vinorelbine with lower than usual but acceptable doses of gemcitabine and cisplatin to obtain higher response rate than doublet but less toxicity than triplet combinations. Methods:In this trial, stage IIIB and IV chemotherapy naive NSCLC patients with measurable disease and performance status of 0 to 2 were included. Gemcitabine and vinorelbine at the doses of 900 mg/m2 and 25 mg/m2, respectively were administered on days 1 and 8, and cisplatin at a dose of 50 mg/m2 on day 1, every 21 days. Results:Three of the 39 patients included in the trial were complete responders (7.7%). The overall response rate was 56.4%, median time to the progression was 6 months, median overall survival time was 12 months, and 1-year survival rate was 49.6%. Grade II to III neutropenia and thrombocytopenia occurred in 24% and 30% of the patients, respectively. Febrile neutropenia was observed in 13.5% of the patients and only these patients received G-CSF. Platelet and erythrocyte transfusions were required in 12 (32.4%) patients. No toxic or early death was observed. Conclusions:This combination of gemcitabine-cisplatin-vinorelbine with lower doses of cisplatin and gemcitabine was effective and active in advanced NSCLC. The overall response rate, 1-year survival and median survival time were nearly similar to previous trials in which higher doses of these 3 drugs were used. The toxicities were more acceptable and manageable than the regimes with higher doses; therefore, we may suggest a treatment option for advanced stage NSCLC.

P-97 No change the relationship of lung cancer and smoking behavior for Turkey: Based on the hospital population in the South of Turkey

were individuals without cancer diagnosis and matched 3:i with cases (97.5% match) on age, gender, healthcare coverage, region, and follow-up period. Utilization of healthcare services and costs were standardized to monthly means. Comparison between lung cancer cases designated non-small cell (NSCLC, cases treated with paclitaxel) and small cell (SCLC, cases treated with etoposide) lung cancer subgroups was performed. Results: 77% of cases were diagnosed with early-mid stage disease. Median age for cases and controls was 68 and 69 years, respectively with approximately 60% being men. Mean duration of follow-up was 9.4 and 9.3 months, respectively. Mean monthly use of major healthcare services such as office or hospital visits, and associated costs of cases were significantly higher than controls (table, p<O.OOOi). Mean monthly inpatient costs were

Membranoproliferative glomerulonephritis associated pulmonary sarcoidosis.

3,232 for cases and

P1.04-017 The Survival of Our Patients Diagnosed with Lung Cancer in 2013: Topic: Pulmonology

87 for controls. SCLC patients had significantly more physician office visits (20.2 vs. 16.8) but less outpatient radiology services (3.7 vs. 4.9) than NSCLC patients (p<O.O5), however total costs were not significantly different.