Hidden threat: sarcomatoid transformation of germ cell tumorCase report

Ondřej Lukáč

Onkologie. 2025:19(5):312-315 | DOI: 10.36290/xon.2025.056

Germline tumours are generally popular with oncologists as tumours with a very good prognosis, especially in the case of seminomas, even at advanced stages. Nevertheless, there are also high-risk groups where treatment can be difficult, and despite the use of toxic chemotherapy, we may not be able to save the patient. A separate issue is the so-called sarcomatoid transformation, which can develop in patients after previous cisplatin therapy. In my case report, I would like to present a patient who combined a number of these risk factors, which unfortunately led to the failure of our treatment.

Pemigatinib in the treatment of metastatic intrahepatic cholangiocellular carcinoma with FGFR2 alterationCase report

Martin Palkovský, Marián Liberko, Renata Soumarová

Onkologie. 2025:19(5):306-311 | DOI: 10.36290/xon.2025.055

Pemigatanib is a selective FGFR2 inhibitor for the treatment of adults with locally advanced or metastatic cholangiocarcinoma with fusion or rearrangement of fibroblast growth factor receptor 2 (fibroblast growth factor receptor 2, FGFR2) who have progressed after at least one prior line of systemic therapy. This case report documents the atypical behavior of cholangiocellular carcinoma diagnosed in 2013 at clinical stage II. After progression on first-line treatment (FOLFOX), treatment with pemigatinib was initiated in June 2024 and continues to date.

The role of T-lymphocyte subpopulations in the pathogenesis and treatment of B-cell non-Hodgkin lymphomasReview articles

Tereza Shokralla, Martin Špaček

Onkologie. 2025:19(5):299-304 | DOI: 10.36290/xon.2025.054

Research in the field of B-cell non-Hodgkin lymphomas (B-NHL) has in recent years shifted focus toward the significance of the tumor microenvironment (TME). The complex interactions between malignant lymphocytes, stromal cells (such as tumor-associated fibroblasts and macrophages), and T-lymphocytes represent key determinants of tumor biology and the clinical course of the disease. The T-lymphocyte compartment, an important and highly heterogeneous component of the lymphoma microenvironment, includes a variety of functionally and phenotypically distinct T-cell subpopulations. Their quantitative and qualitative representation, interactions, and dynamics...

Current landscape of precision medicine in oncologyReview articles

Alžběta Hlodáková, Martin Palkovský, Peter Priester, Jindřich Kopecký

Onkologie. 2025:19(5):294-298 | DOI: 10.36290/xon.2025.053

This review article summarizes the current state and trends in the field of precision medicine in oncology. Precision medicine utilizes advanced molecular profiling technologies, particularly genomics, transcriptomics, and proteomics, to individualize cancer treatment based on the biological characteristics of each tumor. The article clarifies the distinction between precision and personalized medicine and presents key molecular tools, such as next-generation sequencing (NGS), liquid biopsy, and molecular tumor boards. Established examples of targeted therapies and immunothe­rapies are discussed, including the use of driver mutations and predictive...

New trends in local and systemic treatment of uveal melanomaReview articles

Eva Skácelíková

Onkologie. 2025:19(5):288-293 | DOI: 10.36290/xon.2025.052

Uveal melanoma is the most common malignant tumor of the eye in adult patients. Although its incidence is relatively low, the disease is associated with a high risk of local recurrence and distant metastases, particularly to the liver. Traditional treatment strategies include enucleation, brachytherapy, or proton radiotherapy; in recent years, stereotactic radiotherapy (SRT) has become increasingly popular in clinical practice, offering precise application of high doses of radiation with a high degree of local control and preservation of the eyeball. Systemic treatment of metastatic disease is a completely separate issue. Until recently, there was...

Actual possibilities of target therapy for Non-Small Cell Lung Cancer in Czech RepublicMain topic

Monika Bratová

Onkologie. 2025:19(5):283-287 | DOI: 10.36290/xon.2025.051

Target therapy od non-small cell lung cancer (NSCLC) has experienced further huge development in last years. There were new agents introduced into clinical practice (RET, KRAS, MET, ROS1, BRAF inhibitors, HER2 blocker). Also indication of this therapy spreads into the adjuvant use (osimertinib, alectinib) or into the combination with chemotherapy (osimertinib). An important change of clinical practise is caused by amivantamab, that proved effectivity in the treatment of NSCLC with sensitising mutations or in NSCLC with EGFR insertion in exon 20. This progress leads to the further precise personalization of the treatment of NSCLC with driving mutations....

Immunotherapy in the treatment of metastatic non-small cell lung cancerMain topic

Ondřej Bílek

Onkologie. 2025:19(5):275-282 | DOI: 10.36290/xon.2025.050

Immune checkpoint inhibition has become an integral component of standard treatment algorithms across all lines of therapy. PD-1 and PD-L1 inhibitors are indicated as monotherapy, as part of dual checkpoint blockade with CTLA-4 inhibitors, or in combination with other therapeutic modalities such as chemotherapy, anti-angiogenic agents, and radiotherapy. The use of immunotherapy has significantly improved survival outcomes even in advanced disease stages and enables durable clinical responses in a subset of patients.

Treatment of inoperable stage III non-small cell lung cancerMain topic

Milada Zemanová

Onkologie. 2025:19(5):268-274 | DOI: 10.36290/xon.2025.049

Antitumor immunotherapy using checkpoint inhibitors brings significant improvement in treatment outcomes for patients with stage III NSCLC. To determine the treatment strategy in stage III, multidisciplinary team decision-making is necessary with the most precise definition of operable vs. inoperable cases. In the case of inoperable stage III, consolidation treatment with immunotherapy is the standard with the condition of PD-L1 expression above 1 %. One-year treatment after concomitant chemoradiothe­rapy significantly increases the chance of long-term survival and has also been shown to significantly prolong the time to disease recurrence. In inoperable...

Treatment of SCLC (Small Cell Lung Cancer)Main topic

Marie Drösslerová

Onkologie. 2025:19(5):263-267 | DOI: 10.36290/xon.2025.048

Small cell lung cancer (SCLC) is a type of bronchogenic carcinoma characterized by rapid growth. Initially, it shows marked chemosensitivity and radiosensitivity. Current standard treatment approaches also include immunotherapy. Despite significant advances in SCLC treatment in recent years, the overall prognosis remains poor for most patients. This is due to the tumor's highly aggressive biological behavior, with a typically high relapse rate and subsequent resistance to further therapy. As a result, intensive research is underway into new therapeutic strategies, including targeted therapy and combination regimens.

Hypomagnezemie jako nejčastější nediagnostikovaná iontová nerovnováha v klinické praxi a jak ji řešitCompany information

MUDr. Jiří Havel, MSc.

Onkologie. 2025:19(4):250-254

Radioterapie dnes: mezi klinickou praxí a vědeckým pokrokemEditorial

MUDr. Miloslav Pála, Ph.D., MBA

Onkologie. 2025:19(4):179

Toxicity of combined immunotherapy with ipilimumab and nivolumab in advanced renal cell carcinomaCase report

Michaela Tkadlecová, Luboš Mastný

Onkologie. 2025:19(4):246-249 | DOI: 10.36290/xon.2025.046

Systemic Antitumor Immunotherapy (IT) is now the cornerstone of systemic treatment for advanced renal carcinoma. Despite the significant benefits of this therapy, its associated toxicity must not be overlooked. This case report discusses a 51-year-old patient with generalized clear cell renal carcinoma. The patient was indicated for immunotherapy in combination with a monoclonal antibody against the CTLA-4 antigen (ipilimumab at a dose of 1 mg/kg) and an antibody against the programmed cell death receptor PD-1 (nivolumab 3 mg/kg).Initially, the treatment was well tolerated, but after four cycles of the mentioned combination, the patient developed grade...

Trifluridin/tipiracil and bevacizumab as a treatment after rapid progression of rectal carcinoma after total neoadjuvant therapy and first line of systemic therapyCase report

Aleš Langer

Onkologie. 2025:19(4):243-245 | DOI: 10.36290/xon.2025.045

This case report describes 63-year-old women with rectal adenocarcinoma. She was treated with initial curative goal with total neoadjuvant approach. She received short course of radiotherapy followed by mFOLFOX6 chemotherapy. This was followed radical surgery. We found an early local relapse and our patient underwent an amputation of the rectum. Eight months later we observed metastatic stage and we began the first line of systemic therapy cetuximab + FOLFIRI. The effect was short-lived and the disease progressed after six cycles of therapy. Our patient then started combined therapy trifluridin/tipiracil and bevacizumab with an ongoing effect after...

Stereotactic radiotherapy with the CyberKnife System: An Effective and safe modality in the treatment of recurrent squamous cell carcinoma of the head and neckReview articles

Tomáš Blažek, Jana Jackaninová, Zuzana Čermáková, Lukáš Knybel, Jan Štembírek, Jakub Cvek

Onkologie. 2025:19(4):237-242 | DOI: 10.36290/xon.2025.044

Treatment of locoregional recurrences of squamous cell carcinoma of the head and neck represents a challenge in clinical practice requiring advanced therapeutic approaches and multidisciplinary collaboration. The optimal treatment strategy has a significant impact on the prognosis of patient survival. Choosing the appropriate local treatment modality can lead to excellent results with curative effect. However, careful patient selection and evaluation of key factors such as size and location of recurrence, primary treatment characteristics and time to recurrence are important. Modern external beam radiotherapy techniques, such as stereotactic radiotherapy...

Biliary tract cancerReview articles

Marián Liberko, Renata Soumarová

Onkologie. 2025:19(4):230-236 | DOI: 10.36290/xon.2025.043

Biliary tract tumors represent a serious medical problem due to the high mortality rate. In the case of early stages, after potentially curative surgery, patients are indicated for postoperative therapy to reduce the risk of recurrence and prolong survival. Most patients with biliary tract cancer are diagnosed at locoregionally advanced and/or metastatic stages. The standard of care for these patients is systemic therapy, now combined with immunotherapy. Increasing knowledge of the molecular biology of this disease allows tailored treatment to be selected in a proportion of patients according to the presence of a specific targetable alteration. This...

Brachytherapy for prostate cancer in 2025: Present landscape, key challenges, and perspectives for the futureReview articles

Miroslav Hodek, Denisa Pohanková, Petr Paluska, Linda Kašaová, Jakub Grepl, Jiří Petera, Igor Sirák

Onkologie. 2025:19(4):223-229 | DOI: 10.36290/xon.2025.042

Introduction: Brachytherapy is one of the key curative modalities in the treatment of localized prostate cancer, enabling the delivery of high-dose ionizing radiation directly into the prostate tissue while relatively sparing surrounding organs. Over the past three decades, significant technological and clinical advances have reshaped its indications, technical implementation, and outcomes. Nevertheless, the utilization of brachytherapy remains uneven across countries and institutions, and the method still faces multiple challenges, both technical and organizational. Objective: The aim of this review article is to provide a comprehensive and up-to-date...

Treatment of patients with myelofibrosis and anemiaReview articles

Natália Podstavková

Onkologie. 2025:19(4):219-222 | DOI: 10.36290/xon.2025.041

Myelofibrosis has the highest symptom burden and frequency of hepatosplenomegaly from all myeloproliferative neoplasms. In addition patients with MF often develop anemia with varying degrees of severity, which can be related to myelofibrosis pathogenesis or develop as a result of therapy with JAK2 inhibitors. Although symptoms can be similar between the two anemia types, only anemia as a result of myelofibrosis itself is negative prognostic factor of reduced overall survival. JAK2 inhibitors differ in their effect on anemia from one another.

Durvalumab in the treatment of limited-stage SCLCReview articles

Juraj Kultan

Onkologie. 2025:19(4):214-218 | DOI: 10.36290/xon.2025.040

Despite general advances in the systemic treatment of solid malignant tumours in recent decades, limited-stage small cell lung cancer has remained one of the few in which novel types of anticancer therapy (immunotherapy or targeted therapy with tyrosine kinase inhibitors) had not been implemented into the therapeutic algorithm. This was logically associated with a limited progress in the parameters of overall survival, speci­fically the 5-year survival rates of patients. Currently, we are witnessing the introduction of adjuvant immunotherapy after chemoradiotherapy in real-world clinical practice for limited-stage small cell lung cancer. This option...

Trifluridine-tipiracil + bevacizumab in the treatment of metastatic colorectal cancer - from the SUNLIGHT trial to routine clinical practiceReview articles

Marián Liberko, Renata Soumarová

Onkologie. 2025:19(4):208-213 | DOI: 10.36290/xon.2025.039

The aim of this article is to provide an overview of the data with regard to the combination trifluridine-tipiracil + bevacizumab in the third line treatment of metastatic disease. The main results of the SUNLIGHT registration study, the current meta-analysis and a subgroup analysis of the SUNLIGHT study are presented. At the same time, data from real-world clinical practice are discussed, including results from our own cohort of patients treated with this combination.

Pitfalls in larynx-preservation for laryngeal and hypopharyngeal cancerMain topic

Miloslav Pála

Onkologie. 2025:19(4):204-207 | DOI: 10.36290/xon.2025.038

A larynx preservation protocol is recommended for locally advanced laryngeal and hypopharyngeal carcinomas as an evidence-based treatment option. However, a re-evaluation of the current literature raises questions about whether there is indeed reliable evidence to support larynx preservation for locally advanced T4 tumors. According to both the results of retrospective studies and our cohort study, we can recommend a larynx preservation strategy in patients with limited tumor volume and minimal cartilage infiltration. Patients with T4 tumors who reject total laryngectomy should be informed that opting for larynx preservation with primary conservative...

Head and Neck carcinoma reirradiation. Does it make sense? - Experience and results of the treatment between years 2003 and 2023 from Radiation oncology dep., Universty Hospital Bulovka, PragueMain topic

Antonín Vrána, Tereza Drbohlavová, Jana Vránová, Miloslav Pála

Onkologie. 2025:19(4):198-203 | DOI: 10.36290/xon.2025.037

Head and neck cancer reirradiation represents difficult chapter in treatment of these malignancies. The biggest challenge is to reach narrow therapeutic window and to help our patients and not to harm them. But often it is the only therapeutic modality which we can use to achieve long term control of oncological disease. Especially in cases where we cannot use salvage surgical resection. Patients with reccurent head and neck cancer in very good performance status can be also treated by systemic therapy (chemoptherapy and in reasonable cases by immunotherapy). In certain cases where the volume and localization of reccurrence allow Stereotactic body...

Radiotherapy for soft tissue sarcomas of the head and neckMain topic

Tereza Drbohlavová

Onkologie. 2025:19(4):194-197 | DOI: 10.36290/xon.2025.036

Head and neck soft tissue sarcomas (HNSTS) represent a rare group of mesenchymal tumors. Their histological heterogeneity, distinct biological behavior, and the anatomical complexity of the region make their management particularly challenging. Surgical resection remains the cornerstone of curative treatment; however, due to the frequent difficulty in achieving negative margins, radiotherapy (RT) is an essential component of multimodal therapy. Adjuvant RT improves local control (LC), especially in cases with positive or close margins. The neoadjuvant approach may offer advantages in terms of lower dose, smaller irradiated volumes, and reduced late...

Impact of selected nutritional factors on patients with esophageal and gastroesophageal junction cancersMain topic

Karolína Votavová, Zdeňka Pechačová, Radka Lohynská, Tereza Drbohlavová, Miloslav Pála

Onkologie. 2025:19(4):189-193 | DOI: 10.36290/xon.2025.035

Malignant tumors of the esophagus and gastroesophageal junction are among the cancers with a poor prognosis. A long-term increase in incidence has been observed, particularly in adenocarcinomas, while mortality has remained relatively stable. The five-year survival rate, regardless of diseases stage, is only around 20 % (1). Between 2009 and 2018, a total of 138 patients with malignant tumors of the esophagus or gastroesophageal junction were treated at the Department of Radiation Oncology, Bulovka University Hospital. In these patients, the influence of individual factors on survival was retrospectively analyzed. Sarcopenia and hypoalbuminemia were...

Influence of selected factors on the development of radiotherapy toxicity in patients with laryngeal cancerMain topic

Zdeňka Pechačová, Tomáš Kořínek, Radka Lohynská, Tereza Drbohlavová, Miloslav Pála

Onkologie. 2025:19(4):182-188 | DOI: 10.36290/xon.2025.034

Background: Radiotherapy is one of the most effective modalities of cancer treatment, but its application is burdened by the risk of toxicity. The risk of adverse effects can be modelled using radiobiological analyses. Patients and methods: In a cohort of 189 patients treated with (chemo)radiotherapy for laryngeal cancer at the Institute of Radiation Oncology, First Faculty of Medicine, Charles University in Prague and Bulovka University Hospital between 2009-2018, data were analysed using radiobiological tools based on the Lyman-Kutcher-Burman model with the use of artificial intelligence. Results: Significant influence of patient-side characteristics,...

Zaznělo na kongreseHeard at a congress

MUDr. David Salát

Onkologie. 2025:19(3):169-174

Paliativní medicína jako součást moderní onkologieEditorial

MUDr. Miroslav Žiaran

Onkologie. 2025:19(3):115

Compensation for interruption of radiotherapy in a patient with oropharyngeal cancerCase report

Zdeňka Pechačová, Radka Lohynská, Tereza Drbohlavová

Onkologie. 2025:19(3):165-168 | DOI: 10.36290/xon.2025.032

In squamous cell carcinomas, radiotherapy is often the primary treatment modality and prolonging the overall radiotherapy treatment time may lead to inferior treatment outcomes. Therefore, to achieve maximum benefit for patients, it is essential to apply recommended practices to compensate for interruptions in the radiation series. This case report describes the management of a prolonged pause in treatment in a patient with advanced oropharyngeal cancer and complications from multiple comorbidities.

Cutaneous metastases of carcinomas originating from visceral organs - a contribution to the issue and description of particular casesCase report

Vladimír Bartoš, Michal Urda

Onkologie. 2025:19(3):160-164 | DOI: 10.36290/xon.2025.030

Skin metastases of malignant neoplasms originating from visceral organs represent a very complex issue. Most of them are diagnosed in patients with a known primary origin, but more rarely they are the first manifestation of a previously unknown oncological disease. Such cases cause a dilemma in clinical-pathological practice, because determining the origin is often problematic and sometimes it can't even be defined. Herein, we describe the case of a 78-year-old woman with biopsy-confirmed cutaneous metastasis of recurrent ductal breast carcinoma and the case of a 58-year-old man who was diagnosed to have a cutaneous metastasis of previously unknown...

Hypersensitivity drug reactions and desensitization in oncologyInterdisciplinary overviews

Tomáš Balner, Jaromír Bystroň

Onkologie. 2025:19(3):156-159 | DOI: 10.36290/xon.2025.029

Hypersensitivity drug reactions represent an unexpected complication of oncological treatment. They impair the patient's quality of life and may pose a life-threatening risk. Another negative consequence is the necessity to interrupt the administration of first-line oncological therapy, which, in the best-case scenario, can be replaced with an equally effective alternative. However, when no equally effective alternative exists, the only option to maintain the patient on their primary treatment is desensitization. For successful and safe desensitization, risk stratification based on knowledge of the phenotype, endotype, and biomarkers of the prior hypersensitivity...

The growing challenge of malignant melanoma: Strategies for improving careReview articles

Júlia Bartková, Soňa Hrižová, Sandra Harásková, Dušana Selecká, Gabriela Bakšová

Onkologie. 2025:19(3):152-155 | DOI: 10.36290/xon.2025.028

Malignant melanoma is one of the most severe forms of skin cancer, characterized by a high risk of metastasis and significant mortality. Although it accounts for only a small proportion of skin tumors, it is responsible for the majority of skin cancer-related deaths. This article focuses on the diagnosis and treatment of melanoma, covering the role of healthcare professionals from primary care physicians to dermatovenero­logists and plastic surgeons, while emphasizing the importance of early detection and a comprehensive approach to patient care. The article also highlights the significance of prevention through UV protection and raising awareness...