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Emir Sokolović

Društvene mreže:

E. Sokolović, Amil Druzic, Una Stojanovic, Elma Kapisazovic, Emina Borovac-Gurda, Jasmina Redžepagić, Amina Aljic, Mattar Layan, Šejla Cerić et al.

Introduction. The aim of this article is to evaluate the efficacy and outcomes of FOLFIRINOX as a first-line treatment for initial metastatic pancreatic cancer patients at the Clinical Center University of Sarajevo. Methods. The research presents a retrospective analysis was conducted on 33 patients treated with FOLFIRINOX, between January 2021 and January 2023. Baseline characteristics, tumor markers (CEA, CA 19-9, CA 125), neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-platelet ratio (NPR) and initial metastatic site were evaluated using Cox regression analysis in order to identify predictive and prognostic factors for progression-free survival (PFS) and overall survival (OS). Results. The median age of patients was 64 (range 38-76). There were 18 males and 15 females. The median OS was 21.7 months (95% CI, 10.5-32.9) and the median PFS was 10.0 months (95% CI, 8.2-11.8). A statistically significant negative correlation was found between NLR and OS (r=-0.464, p=0.045). Patients with initial liver metastasis had a numerically worse median OS (16.3 months, 95% CI, 5.1-27.5), compared to those with non-liver metastasis (OS not reached, p=0.058). Tumor markers, NLR, NPR, and initial metastatic site were not independent predictors of PFS and OS. Conclusion. FOLFIRINOX demonstrates significant efficacy in treating metastatic pancreatic cancer in a real-world setting. Personalized approaches, including genetic profiling and microbiome analysis, along with AI integration, offer promising avenues to enhance treatment outcomes and quality of life for patients. Keywords: metastatic pancreatic cancer, enhanced outcomes, overall survival, progression-free survival.

Azra Rašić, E. Sokolović, Lejla Alidzanovic Nurkanovic, Inga Marijanovic, Alma Mekic-Abazovic, S. Bešlija

Hepatocellular carcinoma (HCC) is the sixth most common cancer globally and the third leading cause of cancer-related deaths. It remains especially lethal among patients with cirrhosis and chronic liver diseases like hepatitis B and C, alcohol abuse and non-alcoholic fatty liver disease. A retrospective, multicenter study was conducted across five oncology centers in the Federation of Bosnia and Herzegovina, with the aim of gaining a better insight into the current state of healthcare for patients with HCC in this region. The study reveals several regional disparities in the etiology, treatment, and outcomes of HCC, but it also indicates that the diagnostic approach varies significantly from one city to another. One of the highlights of the study is the late-stage diagnosis of most patients, due to the limited healthcare access, diagnostic delays and, especially, lack of screening programs. Implementation of targeted screening methods, regular monitoring of high-risk patients and enhanced use of biomarkers could lead to a significant improvement in the diagnostic accuracy. The limited use of innovative treatments recommended by the global guidelines was also identified as an issue, which directly leads to limited surgical and other treatment options. This study signals the need for a standardized patient pathway in the Federation of Bosnia and Herzegovina, implementation of national registry and targeted HCC database, which could reduce mortality, improve overall care and patient outcomes. Keywords: hepatocellular carcinoma, healthcare, standardized patient pathway.

L. Arecco, M. Bruzzone, R. Bas, H.J. Kim, A. di Meglio, R. Bernstein-Molho, F. Hilbers, K. Pogoda, E. Carrasco et al.

L. Arecco, E. Blondeaux, M. Bruzzone, M. M. Latocca, E. Mariamidze, S. Begijanashvili, E. Sokolović, G. Gentile, G. Scavone et al.

Berisa Hasanbegović, Belmina Sarić Medić, E. Sokolović, Nikolina Tomić, L. Pojskić

Introduction: Breast cancer (BC) is the most common malignancy in the female population globally. Obesity is associated with an increased risk of postmenopausal BC, BC recurrence, and mortality. Fat mass and obesity-associated (FTO) gene polymorphisms have attracted the most attention due to several single-nucleotide polymorphisms (SNPs) that may have an impact on obesity and different types of cancer. The primary goal of our work was to assess the association of the SNP rs17817449 FTO, physical status/metabolic changes, and dietary habits with the occurrence of BC. Methods: We conducted research as a population-genetic study including 93 women with a diagnosis of BC during their lifetime. Genomic DNA was extracted from the swabs of the buccal mucosa. Genotyping was achieved by polymerase chain reaction-restriction fragment length polymorphism. The IBM SPSS Statistics program v. 23.0 was used for statistical analysis. All values of p < 0.05 were considered statistically significant. Results: The risk genotype of the FTO gene (rs17817449) GG was detected in 16 subjects (17.2%), the heterozygous TG in 46 subjects (49.5%), while the normal genotype TT was recorded in 29 subjects (31.2%). We found no statistically significant difference in the body mass index values of the three genotype groups, p = 0.72, χ2 = 2.1 and no significant relationship between the allelic or genotypic frequencies of the rs17817449 FTO gene polymorphism and other variables examined in our study. Analysis of the distribution of hereditary diseases in the family according to the molecular subtype of BC showed statistically significant p-values, p = 0.02. Conclusion: While previous research has suggested a potential link between FTO gene polymorphism, obesity, and BC, our study did not find a statistically significant association between the aforementioned variables. Future studies with a larger number of subjects in different populations should confirm the role of the FTO genotype in the risk of BC.

L. Arecco, E. Blondeaux, E. Mariamidze, S. Begijanashvili, E. Sokolović, G. Scavone, S. Ottonello, I. Vaz-Luis, C. Saura et al.

Is it safe to have a pregnancy in women with prior history of hormone receptor-positive early breast cancer? Pregnancy following breast cancer treatments in young women with history of hormone receptor-positive disease is safe with no detrimental effect on patients’ prognosis. Breast cancer is the most common malignancy diagnosed in women of reproductive age. Both physicians and patients continue to have concerns about a potential detrimental effect of pregnancy after breast cancer, particularly in the setting of hormone receptor-positive disease. In recent years, several studies have demonstrated the safety of pregnancy after anticancer treatments in breast cancer survivors. A systematic literature search of Medline, Embase and Cochrane library with no language or date restriction up to January 1st, 2023, was performed following the PRISMA guidelines. We included retrospective or prospective case-control and cohort studies as well as prospective clinical trials comparing survival outcomes of premenopausal female patients with reported pregnancy or not after diagnosis and treatment for hormone receptor-positive breast cancer. Included patients were childbearing potential age women with a prior history of hormone receptor-positive early breast cancer. Outcomes of interest were disease-free survival and overall survival. Hazard ratios (HR) with 95% confidence intervals (CI) were extracted. Higgins I2 index was used to evaluate the degree of inconsistency in the results of the included studies. Pooled HRs were considered statistically significant with a P value of < 0.05 (two-sided). Eight studies were eligible to be included in the final analysis. A total of 3,805 patients with hormone receptor-positive breast cancer were included in these studies, of whom 1,285 had a pregnancy after treatments. Median follow-up of the included studies ranged from 3.81 years to 15.8 years. In three studies (n = 987 patients) reporting on disease-free survival outcomes, no difference was observed between patients with or without a subsequent pregnancy (HR 0.96, 95% CI 0.75 – 1.24, p = 0.781). Six studies (n = 3,504 patients) reported outcomes in terms of overall survival: patients with a pregnancy after breast cancer had better overall survival compared with those without a pregnancy (HR 0.46, 95% CI 0.27 – 0.77, p < 0.05). At the subgroup analysis on timing of pregnancy, no detrimental effect of pregnancy after breast cancer in terms of disease-free survival was observed for patients achieving a late pregnancy (defined as 2 or 5 years after diagnosis) as compared to patients without a subsequent pregnancy (HR 1.08, 95% CI 0.80 – 1.46, p = 0.611). Increased disease-free survival was observed in patients with an early pregnancy (HR 0.63, 95% CI 0.47 – 0.85, p < 0.05). This meta-analysis is based on abstracted data and most of the studies are retrospective cohort studies. Median follow-up in a large proportion of the studies was shorter than 10 years. Adjuvant hormone therapy before and after pregnancy was not available in many studies included. Our results strengthen the evidence that having a pregnancy in women with prior history of hormone receptor-positive breast cancer is safe. not applicable

Dragan Miletić, Marija Kraljević, E. Sokolović, M. Soče, M. Milović-Kovačević, Simonida Bobic, T. Cerić, S. Pleština, S. Bešlija et al.

Background Therapeutic options for human epidermal growth factor 2 (HER2)-positive metastatic breast cancer (mBC) are developing rapidly. This study aimed to determine the differences in the survival outcomes of patients with HER2-positive mBC in relation to access to anti-HER therapy at 3 oncology centers in upper-middle-income countries (UMICs) and 1 oncology center in a high-income country (HIC). Material/Methods We retrospectively identified 42 patients from Croatia (HIC), 71 patients from Serbia (UMIC), and 57 from Bosnia and Herzegovina (UMIC) diagnosed with HER2-positive mBC who were treated between January 2015 and December 2020. The pathohistological features of the tumors were obtained from the pathological findings, which were made according to standard procedures for each center. Patients were treated depending on the availability of therapy, which differed for centers in different countries. We evaluated disease-free survival, progression-free survival, and overall survival (OS) based on the availability of first- and second-line anti-HER2 therapy in UMICs vs HIC. Results OS in first-line therapy was better in patients treated with dual HER2 blockade than in patients treated without dual HER2 blockade, P<0.001. OS in second-line therapy was significantly better in patients treated with trastuzumab emtansine than in patients treated with other reported regimens, P=0.004. Conclusions Results of our study showed superior survival among patients who were treated with dual first-line HER2 therapy as well as second-line trastuzumab emtansine therapy than in those patients in other centers where these drugs were not available. Raising awareness about this could help improve the situation.

L. Arecco, E. Blondeaux, M. Bruzzone, M. M. Latocca, E. Mariamidze, S. Begijanashvili, E. Sokolović, G. Scavone, S. Ottonello et al.

A. Zumarraga, B. L. D. S. Vicente, C. F. Bejarano, J. Legaspi, J. R. B. Galíndez, Sande Sardina, M. Lopez, M. T. P. Hoyos, M. A. S. Gonzalez et al.

Dejan Djokanovic, Bojana Lazic, Z. Gojković, Željka Cvijetić, E. Sokolović, T. Cerić, S. Jungić

Introduction/Objective. The purpose of this study was to assess the effectiveness of different approaches in the treatment of metastatic melanoma in daily clinical practice in a situation with limited and late availability of new drugs in a resource-limited country and to compare these parameters with those reported in clinical studies and from other real-world data. Methods. Main methods included assessment of overall survival (OS) and progression-free survival (PFS). Patients were included in the study if they were treated with first or second-line systemic therapy for radiologically/pathologically confirmed metastatic melanoma. Patients were divided into four groups based on the type of therapy they received: chemotherapy (dacarbazin), BRAF inhibitor (vemurafenib), BRAF/MEK inhibitors (vemurafenib/cobimetinib and trametinib/dabrafenib) and anti PD-1 therapy with pembrolizumab. Results. Regardless of the line of therapy, the calculated median OS in chemotherapy and vemurafenib group was nine months. The median OS in the BRAF/MEK inhibitor group was 14 months and 15 months in the pembrolizumab group. Median PFS in the chemotherapy group was four months, seven months for vemurafenib, in the BRAF/MEK inhibitor group nine months and in the pembrolizumab group six months. There was a statistically significant difference in survival between first and second-line therapy in the pembrolizumab group. Conclusion. Our results showed lower median OS and PFS in comparison to reported data from clinical trials. Compared to other real-world data from countries with similar problems related to the late reimbursement of new drugs, our research has shown similar results.

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