Abstract Epidermal growth factor receptor (EGFR) is overexpressed in several solid human tumor types, such as colorectal, breast and lung cancers. There are strong evidences that EGFR inhibitors have an increased risk of dermatological side effects arise during the treatment of these agents. Lapatinib is an EGFR inhibitor approved for the treatment of patients with recurrent HER2-positive advanced or metastatic breast cancer. Herein, we report a 35 year old female patient, who had lung metastasis associated with breast cancer, with the presence of acneiform eruption in her face and metastatic lesions which did not progress for 17 months while she was having the lapatinib treatment for her metastatic lesions. As it is occur in all other EGFR inhibitors, the development of acneiform eruption during the lapatinib treatment might be an indicator of better and longer drug response.

Abstract Electronic cigarette (e-cigarette) is a device developed with an intent to enable smokers to quit smoking and avoid the unhealthful effects of cigarettes. The popularity of e-cigarette has increased rapidly in recent years. The increase in its use during the adolescence period is attention-grabbing. Despite the fact that e-cigarette has become popular in a dramatic way, there are certain differences of opinion regarding its long-term effects on health, in particular. While some people assert that it is less harmful than conventional cigarettes, some others assert the contrary. Although e-cigarette contains less toxic substances compared to conventional cigarette, it contains certain carcinogens existing in conventional cigarette such as formaldehyde and acetaldehyde. It also contains heavy metals (nickel, chrome) that conventional cigarette does not contain; and therefore, raises concerns about health. E-cigarette leads to upper and lower respiratory tract irritation as well as an increased airway resistance and an increased bacterial colonization in the respiratory tract. It may also cause tahcycardia and increase diastolic blood pressure. Although e-cigarette has been found to have certain benefits in terms of smoking cessation, most of the studies have shown unfavorable results. In this collected work, the effects of e-cigarette on health and its role in smoking cessation are discussed in detail.

Abstract Immuno-oncology is a very popular field of medical science right now and developments on melanoma therapy have been absolutely marvelous for medical oncologists. Following these recent improvements, I remembered Irvin Yalom's novel “Schopenhauer Cure”. Because the book was narrating a psychotherapist who died from malignant melanoma. I think after all current innovations including BRAF, MEK inhibitors, and check point inhibitors, the novels' ‘end’ would be change. It is really exciting to have scientific developments that may change the end of the story in the book even though it is published less than ten years.

Abstract Background The protease-activated receptor 1 (PAR1) is associated with increased invasiveness of breast cancer (BC) cell lines and its overexpression is significantly correlated with advanced stage and poor prognosis. The aim of this study was to determine the clinical significance of the serum PAR1 levels in BC patients. Methods We enrolled 96 female patients with pathologically diagnosed BC who did not receive chemotherapy (CT) or radiotherapy. Serum PAR1 levels were measured by ELISA method and compared with 30 healthy controls. Results The mean serum PAR1 level of BC patients was significantly higher than controls (3.07 vs 2.82 ng/ml, p = 0.011). The levels of PAR1 tended to be higher among CT responders ( p = 0.052) and grade I disease than others ( p = 0.055). However, there was no significant difference in PAR1 levels according to other clinic-pathological or laboratory parameters. Serum PAR1 level did not have a significant impact on overall survival in both univariate ( p = 0.73) and multivariate analysis ( p = 0.67). Conclusion Serum PAR1 level is elevated in BC patients and may have predictive role for CT response. However, it has no prognostic role on survival.

Abstract Aim This study retrospectively assessed the efficacy and tolerability of combination chemotherapy with cisplatin, infusional 5-fluorouracil and folinic acid given every two weeks and subsequent chemoradiotherapy with continuous infusions of 5-fluorouracil, in gastric cancer following curative resection. Methods Between August 2007 and January 2014, 58 patients received adjuvant cisplatin 50 mg/m2, leucovorin 400 mg/m2, 5-fluorouracil 400 mg/m2 IV bolus and 5-fluorouracil 2400 mg/m2 as 48-h continuous infusion, every 14 days for gastric adenocarcinoma. After the first 2 cycles of chemotherapy, adjuvant radiation therapy was administered concurrently with the continuous infusion of 5-fluorouracil. Following the completion of radiation therapy, patients received another 4 cycles of combination chemotherapy. Results A total of 58 patients were included in this study and out of these, 41 patients were male and the median age was 53.5 years. 81% of the patients (n = 47) could complete 6 courses of planned chemotherapy. The median follow-up time was 31.4 (9.33–88.77) months, the median disease free survival (DFS) was 26.43 (95% CI: 49.38–69.95) months. The median overall survival (OS) was 28.53 (95% CI: 49.46–69.55) months. The estimated 3-year DFS and OS rates were 58.75% and 64.04% respectively. Common grade 3 and 4 side effects were weakness (18.9%), nausea and vomiting (12%), diarrhea (10.3%) and neutropenia (10.3%). Conclusion The addition of combination chemotherapy with cisplatin, infusional 5-fluorouracil and folinic acid before and after chemoradiotherapy was found to be safe and effective in patients with operated gastric cancer.

Abstract Background Endometrial cancer is the most common gynecological cancer in developed countries. Autoimmune thrombocytopenia is a rare cause of thrombocytopenia in solid tumors and to the best of our knowledge, this is the first case reported associated with clear cell endometrial cancer. Case report A 52-year-old woman patient diagnosed with endometrial carcinoma and total abdominal hysterectomy and bilateral salpingo-oophorectomy has been performed. After three cycles of chemotherapy, patient developed grade IV thrombocytopenia, which lasted for one month despite chemotherapy interruption. Bone marrow biopsy and some other tests were performed and she was diagnosed to have autoimmune thrombocytopenia. Conclusion Autoimmune thrombocytopenia is a diagnosis of exclusion. Immune-mediated paraneoplastic syndrome include autoimmune thrombocytopenia is well known in hematological cancers, but it is rare in solid tumors. New developments in the treatment of primary cancer by clarification of paraneoplastic syndromes immunology should be considered.

Abstract Spontaneous tumor regression is defined as spontaneous remission or disappearance of a tumor in the absence of any treatment. Activation of immune system has been found important in its pathogenesis. Further, spontaneous tumor regression appears to be associated with apoptosis, tumor microenvironment, and DNA oncogenic suppression. It can be observed in all types of tumors, most frequently in renal cell cancer, germ cell tumors, malignant melanoma, and neuroblastoma. It is crucial to understand this phenomenon in order to improve the immune treatments which are effective in neoplastic diseases.

Abstract: Background Hyponatremia is one of the most common electrolyte abnormalities seen in hospitalized patients. In cancer patients, it's generally related to syndrome of inappropriate ADH secretion (SIADH). Case Report Here, we report a breast cancer patient with hyponatremia related to high dose trimethoprim-sulfamethoxazole use for pneumonitis cariini pneumonia. Conclusion It is important to be aware that all hyponatremias are not related to SIADH in cancer patients. For proper treatment strategies, a proper differential diagnosis is needed.

Summary Aim The aim of this study is to be informed about demographic features, the reasons for preferring medical oncology, career plans, and the educational problems of the residents training in the subspecialty of medical oncology. Method The responses to questionnaire forms sent by e-mail to subspecialty residents who are continuing their training in different educational institutions of our country were recorded and analyzed. Results Seventynine of 129 residents (61.2%) responded the survey forms. Median age of the participants was 33 years. Thirty six (45.5%) were female, and 43 (54.5%) were male. The responders stated different reasons for their preference of medical oncology but most of them (n:64, 81%) thought that medical oncology has a bright future. Of them, 38 (48.1%) the responders intended to refrain from their medical conscription was their most important concern. Fiftytwo (65.8%) of them were not satisfied much with their present education and academic activities. Sixtynine (87.3%) of the participants indicated that they had been suffering from the symptoms of burnout syndrome. Conclusion Recognition of the subspecialty residents who are the future of medical oncology, and determination of their needs, and problems will contribute to the development of recommendations for their solution. In our country their main problems are medical conscription, inadequate education, and burnout.