Oncology - Latest articles
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Enfortumab vedotin aneb začátek cesty k vyléčení pokročilého uroteliálního karcinomu?!Editorial
doc. MUDr. Hana Študentová, Ph.D.
Onkologie. 2024:18(Suppl.C):4-5 
Effect of treatment with enfortumab vedotin in a patient with generalized urothelial carcinoma pretreated with platinum and avelumabNaše první zkušenosti s léčbou přípravkem PADCEV
Šárka Stuhlová
Onkologie. 2024:18(Suppl.C):31-35 | DOI: 10.36290/xon.2024.048
Superficial bladder cancer is a disease with an excellent prognosis. By contrast, patients with a locally advanced or metastatic disease have a very low chance for long-term survival. For a number of years, platinum-based chemotherapy has been the gold standard of treatment, with an expected survival of less than two years. It was only with the introduction of immunotherapy with checkpoint inhibitors that long-term treatment responses were observed in a proportion of patients and, along with that, increased chances for longer-term survival. More recently, enfortumab vedotin (Padcev), which expands the armamentarium of treatment options for advanced...
Enfortumab vedotin in the treatment of urothelial bladder carcinomaNaše první zkušenosti s léčbou přípravkem PADCEV
Kateřina Pejřová, Anežka Zemánková
Onkologie. 2024:18(Suppl.C):25-30 | DOI: 10.36290/xon.2024.047
The case report describes the case of a 67-year-old woman with metastatic urothelial carcinoma. For the first-line chemotherapy carboplatin/gemcitabine regimen was chosen. Due to a partial response, the maintenance treatment with avelumab was subsequently continued, but the disease relapsed after 3 months of the therapy. According to the current standard of treatment of urothelial bladder carcinoma, the patient started the second-line treatment with enfortumab vedotin. A partial response was achieved after 3 months of the therapy with enfortumab vedotin and the patient benefited from the treatment for a total of 8 months.
Padcev (enfortumab vedotin): a new treatment option for urothelial carcinomaNaše první zkušenosti s léčbou přípravkem PADCEV
Lenka Ostřížková
Onkologie. 2024:18(Suppl.C):21-24 | DOI: 10.36290/xon.2024.046
The case report presents the initial clinical experience from routine practice with the Padcev (enfortumab vedotin) agent in treating metastatic urothelial carcinoma after failure of a platinum derivative and PD-1/PD-L1 inhibitor.
The early experiences with enfortumab vedotin in patients with metastatic bladder cancerNaše první zkušenosti s léčbou přípravkem PADCEV
Jindřich Kopecký
Onkologie. 2024:18(Suppl.C):13-20 | DOI: 10.36290/xon.2024.045
Enfortumab vedotin is an innovative targeted therapy for the treatment of metastatic urothelial carcinoma, demonstrating efficacy but also presenting certain toxicity risks. The following case report presents two distinct cases along with the adverse effects induced by this treatment. These two cases underscore the necessity for careful monitoring and management of these adverse effects. These experiences highlight the need to balance the effectiveness and safety of enfortumab vedotin treatment, where despite its high therapeutic potential, an individualized approach must be taken considering potential toxicity.
Enfortumab vedotin in the treatment of generalized urothelial carcinoma of the renal pelvis and ureterNaše první zkušenosti s léčbou přípravkem PADCEV
Eva Kindlová, Jan Dvořák
Onkologie. 2024:18(Suppl.C):6-12 | DOI: 10.36290/xon.2024.044
Antibody-drug conjugates are gradually being incorporated into recommended treatment protocols for various cancer diagnoses, primarily breast cancer and haematological malignancies. However, in patients with generalized urothelial carcinoma who have been pretreated with chemotherapy and immunotherapy, a drug of this type - enfortumab vedotin - is also indicated and now reimbursed in the Czech Republic. Our case report documents the potential benefit of this drug in the treatment of urothelial carcinoma of the renal pelvis and ureter.
Management diagnostiky a léčby akutní myeloidní leukemieSupplementum
doc. MUDr. Jan Novák, Ph.D., doc. MUDr. Peter Rohoň, PhD., Mgr. Daniela Klučková, PhD., MUDr. Barbora Žiaková, MUDr. Benjamín Víšek, MUDr. Eva Mikušková, PhD., MBA, MUDr. Ing. Silvia Cingelová, PhD., MUDr. Ivana Tresová, MUDr. Ivana Zubatá, Ph.D., MUDr. Jan Válka, Ph.D., MUDr. Ladislav Sopko, PhD., MPH, MUDr. Martin Ihnatko, MUDr. Petr Soukup, MHA, MUDr. Tomáš Guman, PhD., MBA, MUDr. Veronika Řivnáčová, MUDr. Ľudmila Ihnatková
Onkologie. 2024:18(Suppl.B)
Jak efektivně využít venetoklax v léčbě CLL?Supplementum
Michael Doubek, Martin Špaček, Heidi Móciková
Onkologie. 2024:18(Suppl.A)
Cesta k digitální medicíně: Rozhovor s MUDr. Katarínou Petrákovou, Ph.D. – Pohled onkologa na výhody i limity technologiíInformation
Mediately
Onkologie. 2024:18(5):339-340
Nové možnosti v diagnostice a terapii karcinomu ovariaEditorial
Josef Chovanec
Onkologie. 2024:18(5):287
Treatment of secondary immunodeficiency in hemato-oncological patientsCase report
Alexandra Jungová
Onkologie. 2024:18(5):334-338 | DOI: 10.36290/xon.2024.070
Secondary immunodeficiency (SID) is a very common complication of hematologic, oncologic, or other chronic diseases and is often underestimated and overlooked. SID arises both as a result of the underlying disease and as a consequence of the administered treatment, leading to increased morbidity and mortality. It most commonly involves a deficiency in humoral immunity and clinically manifests as an increased frequency of infections, the presence of unusual complications from common infections, and the occurrence of opportunistic infections. Immunoglobulin replacement therapy is indicated for these patients as it significantly reduces patient morbidity,...
Emicizumab in treating acquired haemophilia A: our initial experienceCase report
Eva Drbohlavová
Onkologie. 2024:18(5):330-333 | DOI: 10.36290/xon.2024.069
Acquired haemophilia A (AHA) is a rare bleeding disorder occurring particularly in the elderly. It is caused by the presence of autoantibodies against coagulation factor VIII (FVIII). It may be associated with an autoimmune disease, malignancy, occur after birth, or arise idiopathically. Early diagnosis and treatment are important, which involves treatment of bleeding and immunosuppressive therapy to induce disease remission or eradicate the inhibitor. We report a case of a female patient with rheumatoid arthritis with bleeding manifestations from the gastrointestinal tract (GIT), skin suffusions, and prolonged bleeding after tooth extraction. The...
Early ocular toxicity of targeted therapy in metastatic melanomaCase report
Miroslav Důra, Johana Glezgová, Ivana Krajsová
Onkologie. 2024:18(5):325-329 | DOI: 10.36290/xon.2024.068
The authors describe a clinical case of a patient with metastatic melanoma treated with the targeted therapy by encorafenib and binimetinib. In the very beginning of the treatment, the ocular toxicity in the form of the bilateral detachment of the outer retinal layers was detected. Subjective symptoms disappeared in 2 months and follow-up OCT confirmed the restoration of the detachment. The targeted therapy with dabrafenib and trametinib in the subsequent line of the treatment was not complicated by the symptoms of the ocular toxicity. The article discusses the ocular toxicity of the targeted therapy in melanoma, its types, grading, and management....
PICC-port: a novel type of long-term venous access device for cancer patientsReview articles
Viktor Maňásek
Onkologie. 2024:18(5):322-324 | DOI: 10.36290/xon.2024.067
The PICC-port is a novel type of long-term venous access device that is increasingly indicated for use because of the reduced risk of complications during insertion and excellent aesthetic effect when compared with a chest port. It is the next generation of ports that has replaced the previously inserted arm or brachial ports in which inappropriate implantation hindered their widespread use due to high rates of complications. When modern recommendations are followed, the PICC-port can become the first-choice venous access in specific clinical situations.
Innovations and developments in chronic lymphocytic leukemia therapyReview articles
Martin Šimkovič
Onkologie. 2024:18(5):318-321 | DOI: 10.36290/xon.2024.066
New findings in the biology of chronic lymphocytic leukemia (CLL) have major implications for the treatment of this disease. CLL cells exhibit a dependence on increased expression of BCL-2, an autonomous BCR signaling pathway, and are characterized by overexpression of the p110 PI3K delta kinase isoform and BTK kinase, which promotes tumor cell survival. Targeted therapies such as the monoclonal antibodies rituximab and obinutuzumab, along with small molecules such as ibrutinib, idelalisib, and venetoclax, have dramatically expanded therapeutic options, resulting in improved overall patient survival. In this context, it is noteworthy that patients...
Current status of immunotherapy for the pacients with advanced, metastatic and recurent cervical cancerMain topic
Helena Kolářová, Monika Náležinská, Josef Chovanec
Onkologie. 2024:18(5):315-317 | DOI: 10.36290/xon.2024.065
Despite the identified etiopathogenesis, primary prevention and national screening program, advanced and metastatic cervical cancer remains a significant clinical problem with limited treatment options. Immunotherapeutics - checkpoint inhibitors enter the treatment portfolio in patients with inoperable locally advanced stages and bring the necessary hope in patients with progressive, metastatic and recurrent cervical cancer in the cohort of fragile, difficult-to-treat patients. The inclusion of immunotherapy in combination with chemotherapy with or without bevacizumab in first-line systemic therapy and in second-line therapy monotherapy following platinum-based...
HIPEC - ovarian cancer case reportMain topic
Gabriel Jelenek, Libor Němec, Magdalena Plch, Jana Kalvodová
Onkologie. 2024:18(5):311-314 | DOI: 10.36290/xon.2024.064
Hyperthermic intraperitoneal chemotherapy (HIPEC), as a possible part of a radical cytoreductive surgery for ovarial cancer with responce or stable state after neoadjuvant chemotherapy, from 2018 due to results of game changing study is getting more focus. As a part of management of patients with ovarial cancer with the possibility to ad HIPEC to cytoreductive surgery with R0 resection.
Current status of PARP inhibition in advanced, metastatic and recurent endometrial cancerMain topic
Monika Náležinská, Josef Chovanec
Onkologie. 2024:18(5):305-310 | DOI: 10.36290/xon.2024.063
Knowledge of molecular subtypes of endometrial cancer (EC) has led to major changes in the classification system, prognostic groups and, as a result, in therapeutic procedures in patients with advanced, metastatic and recurrent endometrial cancer (EC) in the last few years. The most significant shift in the difficult-to-treat cohort of patients with advanced, metastatic and recurrent EC since conventional chemotherapy is clearly the combination of the checkpoint inhibitor pembrolizumab with the antiangiogenic agent lenvatinib, independent of the presence of microsatellite instability (MSI) of tumor cells. In the MSI-high group of carcinomas, the administration...
Incidental finding of cervical adenocarcinoma after complication of caesarean sectionMain topic
František Velčický, Monika Náležinská, Jiří Nagy, Josef Chovanec
Onkologie. 2024:18(5):300-304 | DOI: 10.36290/xon.2024.062
Carcinoma of the uterine cervix is the most frequent malignant disease diagnosed in pregnant women. Most cases are early carcinomas due to cervical screening methods (PAPP smear, HPV DNA testation and colposcopy). However sometimes the results of the examination are unclear due to the physiological pregnancy associated changes of the cervical epithelium (squamous of the vaginal portion and columnar of the cervical canal). Cervical cancer complicating pregnancy is a specific clinical situation, that requires individual approach, multidisciplinary experienced team of specialists in gynaecological oncology and in obstetrics, respecting the opinion of...
Serous tubal intraepithelial carcinoma and management after its incidental findingMain topic
Magdalena Plch, Gabriel Jelenek, Richard Feranec, Josef Chovanec
Onkologie. 2024:18(5):296-298 | DOI: 10.36290/xon.2024.061
Serous tubal intraepithelial carcinoma (STIC) is considered as a precursor of high-grade serous carcinoma of the pelvis (HGSC), which includes ovarian, tubal and peritoneal carcinomas. STIC is an early morphologically recognizable lesion in the pathogenesis of HGSC and is found predominantly in the distal part of the fallopian tube. Despite a great progress in elucidating the pathogenesis of ovarian carcinomas and the introduction of new pathological procedures for the diagnosis of precursor lesions of HGSC, there remain many unanswered questions.
The hyperthermic intraperitoneal chemotherapy in the treatment of advanced ovarian cancer - new trend, or a dead end?Main topic
Richard Feranec, Josef Chovanec, Gabriel Jelenek, Magdalena Plch, Jana Kalvodová, Lucie Mouková
Onkologie. 2024:18(5):291-295 | DOI: 10.36290/xon.2024.060
Ovarian cancer is the most common cause of death in gynaecological malignancies. The disease is diagnosed in advanced stage with peritoneal carcinomatosis in two-thirds of cases. The treatment is based on primary cytoreductive surgery with the aim of microscopic residual disease, followed by chemotherapy. In cases where optimal cytoreduction cannot be achieved, the administration of neoadjuvant chemotherapy followed by surgery is an alternative. Currently, the increasing interest in evaluation of potential benefit of radical cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC) especially in frontline ovarian cancer treatment...
Léčba nádorů žaludkuEditorial
Marián Liberko
Onkologie. 2024:18(4):231
Role of Fruquintinib in metastatic colorectal cancerCase report
Stanislav Batko
Onkologie. 2024:18(4):279-282 | DOI: 10.36290/xon.2024.058
The systemic treatment for metastatic colorectal cancer (mCRC) includes the use of cytostatics, targeted therapy, and immunotherapy. Neoangiogenesis blockade has been a part of mCRC treatment for two decades. Fruquintinib, a novel tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor (VEGFR) 1-3 blockade, significantly improved overall survival compared to a placebo in a heavily pretreated patient population. It also comes with a favourable, well-managed side-effect profile and is now the new standard of care for fourth line therapy for mCRC.
Cemiplimab in the treatment of locoregionally metastasizing cutaneous squamous cell carcinomaCase report
Linda Řandová
Onkologie. 2024:18(4):275-278 | DOI: 10.36290/xon.2024.057
The presented case report describes the case of a patient with repeatedly recurring locoregionally metastasizing squamous cell skin carcinoma of the left auricle, who was treated with cemiplimab immunotherapy after exhausting the possibilities of surgical treatment and actinotherapy. After completing 10 doses, complete remission was achieved, and therapy was discontinued at the patient's request. Complete clinical and radiological remission of the disease lasts 3 months after stopping treatment.
Fanconi syndrome after ifosfamide administration in a patient with Ewing sarcomaCase report
Ondřej Lukáč
Onkologie. 2024:18(4):271-274 | DOI: 10.36290/xon.2024.056
Ifosfamide is an anticancer drug from the group of alkylating cytostatics that disrupts the replication of nucleotide chains by incorporating an alkyl group into the DNA chain. Although it is a historical drug dating back to the 1970s, it is still commonly encountered in cancer treatment, e. g. in bone tumours, sarcomas and recurrent non-Hodgkin's lymphomas or CNS lymphomas. This therapy is burdened with a number of adverse effects, of the classic acute side effects include reversible encephalopathy and hemorrhagic cystitis. In this case report, I would like to focus on the renal toxicity of ifosfamide or damage to the proximal tubule, which may result...
Efficacy of trifluridine/tipiracil plus bevacizumab in clinical practiceCase report
Stanislav Batko, Jiří Pudil
Onkologie. 2024:18(4):266-270 | DOI: 10.36290/xon.2024.055
The treatment of metastatic colorectal cancer involves a multimodal approach including systemic treatment with chemotherapy, targeted therapy or immunotherapy, and where possible surgical intervention or other local methods as well. In the third line and beyond, clinicians' expectations have tended to be modest, however advances in new treatment combinations have expanded our options and shown the possibility of persistent treatment responses. This case report demonstrates the case of a patient with a pre-treated disease where trifluridine/tipiracil with bevacizumab led to a durable response. Trifludine/tipiracil in third-line therapy represents an...
Use of contrast agent in planning CT scan in radiotherapyReview articles
Karolína Michaličková, Jakub Grepl
Onkologie. 2024:18(4):262-265 | DOI: 10.36290/xon.2024.054
The planning CT scan is an essential part of the radiotherapy planning process. However iodine contrast agent (ICA) for CT scans is well known in radiology, there is a lack of national guidelines for ICA use in radiation onkology. So, there is no standardization of how and when it is appropriate to use ICA in planning CT. In 2023, an anonymous questionnaire survey was sent to all regional radiation oncology centers in the Czech Republic. The survey results showed that ICA is used mainly for the head and neck region. It is less commonly used in the region of the thyroid gland, lungs, liver, pancreas, and esophagus. From the survey, it is evident that...
Trifluridine/tipiracil in the 4th line treatment of metastatic distal esophageal and cardia cancerMain topic
Marián Liberko, Renata Soumarová
Onkologie. 2024:18(4):259-261 | DOI: 10.36290/xon.2024.053
This case report describes a patient with metastatic distal esophageal and cardia cancer who was treated with several lines of systemic therapy with repeated response and disease control. In the fourth-line, trifluridine/tipiracil treatment, a treatment response significantly superior to that observed in the TAGS registration study was observed. At the same time, effective trifluridine/tipiracil treatment did not lead to deterioration in the patient's general condition and had minimal impact on quality of life.
New targets in gastric cancerMain topic
Marián Liberko, Renata Soumarová
Onkologie. 2024:18(4):254-258 | DOI: 10.36290/xon.2024.052
Gastric cancer is a heterogeneous disease, both in terms of the frequency of occurrence in individual regions and the frequency of specific molecular alterations that are potentially targetable. In addition to the standard accepted, classical predictive and prognostic biomarkers (Her2, MMR or MSI, PD-L1 CPS) that need to be known prior to therapy, new ones are emerging that have the potential to significantly impact our treatment algorithms and ultimately patient prognosis. The aim of this article is to provide an overview of new potential therapeutic targets (CLDN 18.2, FGFR2b) in the treatment of this disease that, based on the positive results of...
Her2 positive metastatic gastric cancerMain topic
Marián Liberko, Renata Soumarová
Onkologie. 2024:18(4):249-253 | DOI: 10.36290/xon.2024.051
Her2 positive metastatic gastric cancer is diagnosed in approximately 20% of patients. For more than a decade, palliative chemotherapy in combination with the anti-Her2 agent, trastuzumab, has been the standard of care for these patients. Numerous efforts to introduce additional anti-Her2 agents into the treatment algorithm for metastatic disease have been unsuccessful. It is only in recent years that a better understanding of tumour biology has led to a shift in this field, with rational combinations of agents and new molecules. The aim of this article is to provide an overview of pivotal studies on Her2-positive metastatic disease, including the...