Yunus Emre

Department of Medical Oncology, Health Science University, Kartal Dr. Lütfi Kirdar City Hospital, Istanbul 34865, Turkey

Scientific Reports , Article number: Cite this article Abstract

Background: The treatment and escape for metastatic renal cell carcinoma (RCC) has rapidly evolved, particularly with the integration of immune therapies into first-line regimens. However, optimal strategies following progression in first-line immunotherapy remain uncertain. This study aims to evaluate the efficacy and safety of axitinib and cabozantinib as third-line therapies after progression on nivolumab following first-line VEGF-TKI therapy. Methods: Patients with metastatic RCC who progressed on prior nivolumab treatment after receiving first-line VEGF-TKI therapy were included. Data on patient characteristics, treatment regimens, response rates, progression-free survival (PFS), and overall survival (OS) were collected. Statistical analyses were conducted to assess the prognostic factors and treatment outcomes. Results: A total of 46 patients were included who were predominantly male (83%) with clear-cell histology (89%). The median PFS on first-line TKI therapy was 10.2 months. All the patients received nivolumab as a second-line therapy, with a median of 12 cycles. The median second-line PFS was seven months. Third-line therapies included axitinib (24 patients) and cabozantinib (20 patients). The median PFS for axitinib and cabozantinib was six months, with comparable survival outcomes. The IMDC risk group and treatment tolerability were significant predictors of survival in multivariate analysis. Adverse events were manageable, with hypertension, fatigue, and diarrhea being the most common. Conclusion: Axitinib and cabozantinib show promise as third-line therapies post-nivolumab progression in metastatic RCC, though prospective validation is warranted. This study underscores the need for further research to establish treatment standards in this evolving landscape.

Abstract Triple negative breast cancer (TNBC) subtype is characterized with higher EMT/stemness properties and immune suppressive tumor

Abstract Open surgery for developmental dysplasia of the hip (DDH) may cause severe pain due to tenotomies and pelvic–femoral osteotomies.

Abstract Background Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome is a recurrent fever syndrome.

Today, various systems are used to reduce vibrations in civil engineering structures. Among these systems, tuned liquid dampers are the preferred passive systems due to their ability to be designed in different geometries, their low cost, their ease of installation, and their low maintenance costs. This study examines the effectiveness of tuned liquid dampers (TLD) and tuned liquid column dampers (TLCD) under identical geometric conditions and harmonic ground motion to assess which is more efficient in controlling the behavior of a three-storey steel shear frame model equipped with these systems. A small-scale, three-storey shear frame model placed on a uniaxial shaking table was subjected to harmonic motion with a 5 mm amplitude, 1.4 Hz frequency, and 10 cycles. The chosen frequency aligns with the resonance frequency of the undamped building model's first mode. Both TLD and TLCD tanks, positioned atop the structure, share a geometry of 30 cm in length and 10 cm in width, with variable liquid heights of 5, 10, 15, and 20 cm. Mounting TLD and TLCD models with four different liquid heights on the undamped model resulted in nine distinct setups. In this designed scenario, the TLDs and TLCDs on the undamped shear frame were compared according to liquid heights at rest. To identify the best-performing system based on liquid height, response displacement–frequency graphs were generated for all models within a frequency range of 0.5–2.5 Hz, and damping ratios were calculated using the half-power bandwidth method. Additionally, harmonic ground motion experiments at the resonance frequency compared both acceleration and displacement values over time for damped and undamped models. Peak acceleration and displacement values on each floor were also analyzed. The results highlight which system proves more effective based on damping ratio, acceleration, and displacement values under equivalent conditions.

Department of Medical Oncology, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul 34865, Türkiye

Background and Objectives: Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy with a poor prognosis. Identifying reliable prognostic factors is crucial for risk stratification and optimizing treatment strategies. This study aimed to evaluate the impact of clinicopathologic factors and systemic inflammatory markers on survival outcomes in patients with MPM. Materials and Methods: This retrospective, multicenter study included 217 patients diagnosed with MPM between January 2009 and March 2024. Data on age, gender, histology, disease stage, treatment modalities, and inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein/albumin ratio (CAR) were collected. Survival outcomes were analyzed using Kaplan–Meier methods, and prognostic factors were evaluated using Cox regression analysis. Results: CAR was identified as an independent prognostic factor for both overall survival (OS) and progression-free survival (PFS). Patients with CAR < 0.98 had significantly longer OS (87.0 months vs. 14.0 months, p < 0.001) and PFS (17.61 months vs. 8.96 months, p = 0.010). While NLR was significant in univariate analysis (OS: 25.0 months for NLR < 2.58 vs. 21.0 months for NLR ≥ 2.58, p = 0.040), it did not retain significance in the multivariate model (p = 0.180). Epithelioid histology and early-stage disease were strongly associated with improved survival outcomes (OS: 32.0 vs. 11.0 months for epithelioid vs. non-epithelioid histology, p < 0.001; 32.0 vs. 12.0 months for early-stage vs. metastatic disease, p < 0.001). Conclusions: CAR is a strong independent prognostic factor in MPM, reflecting systemic inflammation and nutritional status. Epithelioid histology and early-stage disease are associated with significantly longer survival, underscoring the critical role of early detection in improving patient outcomes.

Department of Medical Informatics, Gulhane Faculty of Medicine, University of Health Sciences, Ankara 06018, Türkiye