Oncology, 2021, issue 4

Editorial

Melanom a jeho léčba

MUDr. Miroslav Důra

Onkologie. 2021:15(4):155

Main topic

Adjuvant therapy of malignant melanoma: general and practical experience

MUDr. Jindřich Kopecký, Ph.D., MUDr. Ondřej Kubeček, MUDr. Peter Priester

Onkologie. 2021:15(4):158-163 | DOI: 10.36290/xon.2021.031

Over the last decade, we have witnessed remarkable progress in the treatment of malignant melanoma. Success in treating this disease is inextricably linked to understanding the molecular processes involved in its pathogenesis and the identification of critical structures controlling the immune response. Based on the results from clinical adjuvant studies, immunotherapy represented by checkpoint inhibitors (ipilimumab, pembrolizumab, and nivolumab) and targeted therapy (dabrafenib plus trametinib) in patients with a proven BRAF gene mutation were gradually included in the treatment algorithms.

Advances in the systemic treatment of brain metastases in malignant melanoma

Radek Lakomý, Alexandr Poprach, Tomáš Kazda

Onkologie. 2021:15(4):164-168 | DOI: 10.36290/xon.2021.032

Brain metastases are a significant negative prognostic factor, not only in malignant melanoma. With the development and availability of imaging methods, with progress in the field of neurosurgery, radiotherapy and especially with the advent of modern systemic treatment, the survival of these patients is significantly improving. The treatment of brain metastases requires a multidisciplinary approach. In a limited number of metastases, the treatment is based on neurosurgery and/or radiosurgery. We often combine the local method with modern systemic treatment based on immunotherapy with checkpoint inhibitors or targeted therapy with BRAF and MEK inhibitors....

Skin toxicity of BRAF and MEK inhibitors

Miroslav Důra

Onkologie. 2021:15(4):169-173 | DOI: 10.36290/xon.2021.033

Inhibitors of mutated BRAF kinase together with inhibitors of MEK kinase serve as one of alternative ways in modern systemic treatment of metastatic melanoma. BRAF and MEK inhibitors also demonstrated effect in adjuvant setting. Nevertheless, these drugs reveal a specific range of adverse reactions, skin toxicity being one of the most frequent and highly specific for certain drug combinations. The article summarizes different types of skin toxicity focused on etiopathogenetic mechanisms, grading and management.

Sequential treatment of metastatic BRAF V600 mutant melanoma. Still open questions without clear answers

Eugen Kubala

Onkologie. 2021:15(4):174-178 | DOI: 10.36290/xon.2021.034

Melanoma treatment has made significant progress over the last 10 years. For BRAF mutant melanoma, we even have two treatments for immunotherapy and biologic therapy. Both methods show similar results in 1 treatment line. However, a direct assessment of both treatments is lacking. Indirect analyzes of randomized studies and results from real practice do not confirm each other. So far, we follow the clinical experience we have from previous randomized studies when choosing treatment. In the overview, we will try to show the current knowledge about the prediction of treatment. We will compare the results of a meta-analysis of randomized studies and the...

Case report of a patient with metastatic melanoma treated with several lines of systemic treatment

Miroslav Důra, Ivana Krajsová

Onkologie. 2021:15(4):179-181 | DOI: 10.36290/xon.2021.035

This case report of a patient with metastatic, BRAF V600 mutated melanoma represents an example of the sequential therapy. The patient was treated with immunotherapy (with pembrolizumab and ipilimumab) in combination with intralesional therapy, afterwards with combinational chemotherapy and subsequently with two combinations of targeted drugs (dabrafenib plus trametinib, encorafenib plus binimetinib). A review of clinical trials showing high efficacy of the administered drugs is discussed. Current options of systemic anticancer therapy allow to conduct sequential therapy of metastatic melanoma with significant prolongation of progression free survival...

Review articles

ONIVYDE - New treatment option for better survival in patients with metastatic pancreatic adenocarcinoma

Marián Liberko, Renata Soumarová

Onkologie. 2021:15(4):182-186 | DOI: 10.36290/xon.2021.036

Pancreatic carcinoma is a disease with the worst outcomes across all malignancies. Nevertheless, in the last few years, there is progress in survival due to new effective combined regimens in first line setting. After progression on first line, the treatment options are limited and moreover, there are studies showing us contradictory results. Study, which showed an improvement in survival in patients progressing on first line with gemcitabine, or gemcitabine-based therapy is a NAPOLI-1 study. This article summarizes main findings from this study. There are also presented data from other studies, confirming benefit of this new treatment in long term...

Mogamulizumab: new treatment option for advanced stages cutaneous T-cell lymphomas -mycosis fungoides and Sezary syndrome

Jindřich Polívka

Onkologie. 2021:15(4):187-193 | DOI: 10.36290/xon.2021.037

Cutaneous T-cell lymphomas are a rare group of non-Hodgkin lymphomas. Mycosis fungoides and Sézary syndrome are the most common subtypes of cutaneous T-cell lymphomas. Primary cutaneous T-cell lymphomas is generally an incurable disease with substantial morbidity and mortality with limited treatment options for advanced stages. Mogamulizumab represents a new treatment option for patients with advanced stage mycosis fungoides and Sezary syndrome. The aim of the review article is to introduce the reader to the field of cutaneous T-cell lymphomas and new treatment options.

Case report

Endoscopic ultrasound-guided gastro-enteric anastomosis as a treatment of malignant gastric outlet obstruction

Hana Ptáčková, Jiří Stehlík

Onkologie. 2021:15(4):194-196 | DOI: 10.36290/xon.2021.038

Malignant gastric outlet obstruction (MGOO) is a clinical condition caused by advanced malignant disease, most frequent pancreas and stomach malignancy. These conditions are clinicly manifested by qualm, nauzea, vomiting, restriction of oral intake, emaciation, severe malnutrition and dehydration. Within a palliative care MGOO is currently mostly treated by surgical gastrojejunostomy or endoscopic enteral metal stenting. Tendency for miniinvazive approach and the improvement in endoscopy gives new possibility which is endoscopic ultrasound-guided gastro-enteric anastomosis (EUS-GEA). In this article all three methods are compared and the case report...

For nurses

FMEA used for the risk control in healthcare

Iva Brabcová, Radka Prokešová, Valérie Tóthová, Hana Hajduchová, Ivana Chloubová, Jan Neugebauer, Květoslava Slabáková, Dana Velimská, Edita Klavíková, Hana Kubešová

Onkologie. 2021:15(4):197-203 | DOI: 10.36290/xon.2021.039

The goal of the study was to identify and assess the risks in the process of medicament administration by nurses. Methodology: The empiric study was designed as a quantitative method using focus groups. 22 managers from 4 hospitals in South Bohemia took part in the focus groups. The process of medicament administration by nurses was analyzed using the FMEA method. Results: In the process of drug administration, 28 possible failure modes with 12 identifiable causes were identified. The mean value of the Risk Priority Number (RPN) was 97, the RPN was higher than 125 in six failure modes. They included the risk of medication errors, missed out drug administration,...