Karcinom prsu: od deeskalace lokální léčby po péči o kvalitu života v éře personalizované onkologieEditorial

prof. MUDr. Tomáš Büchler PhD.

Onkologie. 2026:20(4):199

Less visible forms of distress associated with health loss in cancer patients: implications for nursing careNursing Care

Olga Klepáčková, Milan Tomka

Onkologie. 2026:20(4):258-262 | DOI: 10.36290/xon.2026.046

The experience of health loss in oncology patients represents a complex, dynamic, and multidimensional process that significantly affects psychosocial adaptation and quality of life. In addition to the evident physical burden, patients also face less apparent, often not explicitly expressed forms of psychological, relational, and existential distress that may remain more difficult to recognize in clinical practice. The article focuses on selected aspects of experiencing health loss based on qualitative research conduc­ted using interpretative phenomenological analysis. Particular attention is devoted to the experience of health loss as a cumulative...

PD-L1 expression status in head and neck carcinomas - a topic review and the results of own studyCase report

Vladimír Bartoš, Katarína Janíková, Michal Urda, Anna Farkašová

Onkologie. 2026:20(4):253-257 | DOI: 10.36290/xon.2026.045

In head and neck cancers, PD-L1 protein expression in tumor tissue is a key predictive parameter that helps determine which patients will respond best to treatment with checkpoint inhibitors. PD-L1 status is standardly determined using the combined positive score (CPS). CPS ≥ 1 is a prerequisite for the use of pembrolizumab with chemotherapy in the first-line treatment of unresectable, recurrent and/or metastatic disease. In CPS ≥ 20, first-line treatment with pembrolizumab as a single agent may be considered. Previous studies on head and neck cancers have reported diverse conclusions regarding the prevalence of PD-L1-positive tumors and...

Kapivasertib in the treatment of metastatic HR+ breast cancer - real-world clinical experienceCase report

Věra Benešová

Onkologie. 2026:20(4):250-252

Breast cancer is among the most common oncological diseases in women in the world and in our country. The incidence in the Czech Republic from 2021 is 139.6 cases per 100,000 women. Thanks to an established screening programme, diseases are diagnosed at an early stage and so breast cancer mortality has been decreasing in recent years. However, despite the early detection of the disease and effective adjunctive treatment, metastatic disease develops.

Even a palliative dose of radiotherapy can bring long-term survival in HPV+ locoregionally advanced squamous cell carcinoma of the oropharynxCase report

Antonín Vrána, Tereza Drbohlavová, Miloslav Pála

Onkologie. 2026:20(4):246-249 | DOI: 10.36290/xon.2026.044

The treatment of HPV-positive, human papillomavirus-induced squamous cell carcinoma of the head and neck (HNSCC) is the daily bread of radiation oncologists worldwide. Due to the increasing incidence of infection with this virus, elderly or frail patients who are unable to undergo radical oncological treatment are also being treated. Therefore, radiation oncologists are forced to choose suboptimal treatment strategies where the probability of local control of the tumor and cure rate are significantly reduced. These strategies include for example palliative radiotherapy targeted on tumor foci without irradiation of elective lymph node areas and without...

Durvalumab in the treatment of limited-stage SCLC: experience from clinical practiceCase report

Juraj Kultan

Onkologie. 2026:20(4):241-245 | DOI: 10.36290/xon.2026.043

Consolidation therapy with durvalumab following chemoradiotherapy is the new standard of care for patients with limited-stage small-cell lung cancer (LS-SCLC) that is based on the results of the ADRIATIC study. We present a case report of a 75-year-old multimorbid patient with LS-SCLC and significant pulmonary dysfunction, in whom concomitant chemoradiotherapy was associated with severe toxicity, but nevertheless resulted in a marked therapeutic response, which made it possible to continue active anticancer therapy with durvalumab administered as consolidation therapy. To date, no immune-mediated adverse effects have developed during immunotherapy,...

Possibilities of predicting immune-related adverse events in patients treated with checkpoint inhibitors: the role of autoantibodiesInterdisciplinary overviews

Jiří Nevrlka, Lenka Zdražilová Dubská

Onkologie. 2026:20(4):235-240 | DOI: 10.36290/xon.2026.042

Immunotherapy with immune checkpoint inhibitors represents a significant advancement in cancer treatment. While this therapy restores the anti-tumour immune response, it can also trigger adverse immune reactions against healthy tissues and organs, known as immune-related adverse events (irAEs). Early prediction of irAEs would enable better management and potentially prevent premature discontinuation of anticancer treatment. This review focuses on autoantibodies, both pre-existing and those emerging after the initiation of immunotherapy. Current data suggest that organ-specific autoantibodies show the strongest correlation with corresponding irAEs:...

Treatment of pain during oncological diseaseInterdisciplinary overviews

Lenka Kocmichová

Onkologie. 2026:20(4):230-234 | DOI: 10.36290/xon.2026.041

A serious illness has a significant impact on the lives of both the patient and their family. Medicine does everything in its power to cure the patient, but it is not always successful. Patients therefore often have many fears and doubts. Above all, they do not want to suffer from pain, which is a very distressing symptom. Many effective medications can be used to relieve it. Their selection depends on the specific patient's condition, as well as on the treating physician's experience. Patients have the right not only to proper treatment, but also to pain relief (1).

BRAF-mutated tumorsReview articles

Marián Liberko

Onkologie. 2026:20(4):225-229 | DOI: 10.36290/xon.2026.040

BRAF gene mutations represent a key oncogenic alteration across a range of solid tumors and, at the same time, a significant therapeutic target in the era of precision oncology. This article aims to provide an overview of current options for targeted thera­py of BRAF-mutated tumors and key clinical data. Based on the results of melanoma studies demonstrating the high efficacy of combined BRAF and MEK inhibition, and subsequent basket studies confirming activity across various diagnoses, BRAF has established itself as a model example of a tumor-agnostic therapeutic approach. At the same time, differen­ces in treatment efficacy depending on the biological...

Treatment of Small Cell Lung Cancer (SCLC)Review articles

Martin Svatoň

Onkologie. 2026:20(4):219-224 | DOI: 10.36290/xon.2026.039

Small cell lung cancer (SCLC) continues to be a disease with a poor prognosis. Therefore, efforts are underway to develop new treatments that would change this characteristic. Immunotherapy in extensive stage (ES) SCLC (both in the form of checkpoint inhibitors and tarlatamab) has only brought a modest benefit for long-term survival. The addition of chemotherapy with lurbinectedin appears to have also modest effect. In limited stage (LS) SCLC, long-term data on the benefit of immunotherapy are not yet known, but medium-term data are promising. With the adding of immunotherapy to treatment schedule, it will also be necessary to reassess the effect of...

Treatment-induced hot flushes in breast and prostate cancer: a review of pathophysiology and management optionsMain topic

Tomáš Büchler, Eva Strecková, Michaela Klimeš Lipánová

Onkologie. 2026:20(4):213-218 | DOI: 10.36290/xon.2026.038

Hot flashes and night sweats are common and clinically significant adverse effects of adjuvant endocrine therapy for breast cancer and androgen deprivation therapy for prostate cancer. They affect the majority of patients treated with tamoxifen or aromatase inhibitors and up to 80 % of men receiving androgen-deprivation therapy (ADT), substantially impairing sleep, mood, cognitive and sexual function, and overall quality of life. Severe vasomotor symptoms are an important cause of non-adherence or premature discontinuation of endocrine therapy, which may adversely affect oncologic outcomes. Because hormone replacement therapy is generally contraindicated...

Breast cancer with brain metastases: clinical and therapeutic aspectsMain topic

Michaela Klimeš Lipánová, Eva Strecková, Tomáš Büchler

Onkologie. 2026:20(4):207-212 | DOI: 10.36290/xon.2026.036

Brain metastases from breast cancer represent a serious complication of advanced disease and significantly affect patient morbidity and mortality. The highest risk of their development is associated with HER2-positive and triple-negative subtypes, while the incidence is lower in hormone receptor-positive tumors. The pathogenesis involves a complex metastatic cascade with a key role of the blood-brain barrier. Clinical presentation is variable and depends on the location and extent of involvement, with the most common symptoms including headache, neurological deficits, and cognitive impairment. Diagnosis is primarily based on contrast-enhanced magnetic...

Axillary management in breast cancer: a review of current diagnostic and therapeutic approachesMain topic

Eva Strecková, Michaela Klimeš Lipánová, Tomáš Büchler

Onkologie. 2026:20(4):202-206 | DOI: 10.36290/xon.2026.037

Axillary management in breast cancer patients has undergone a significant transformation over the past decade, moving towards a de-escalation of surgical and radiotherapeutic therapy while maintaining oncological safety. This review article summarizes current approaches to the diagnosis and treatment of the axilla. It discusses in detail the indications for various treatment modalities, including modern systemic therapy and current trends in the de-escalation of surgical treatment and radiotherapy. Attention is also paid to post-treatment complications, particularly the prevention and treatment of lymphedema and rehabilitation.

Karcinom prostaty: integrace lokální, systémové a teranostické léčby v éře personalizované onkologieEditorial

doc. MUDr. Hana Študentová, Ph.D.

Onkologie. 2026:20(3):127

Myslíme u onkologických pacientů dostatečně na suplementaci magnéziem, kalciem a vitaminem D?Heard at a congress

MUDr. Zuzana Zafarová

Onkologie. 2026:20(3):192-194

Využíváme antiemetickou profylaxi v onkologii dostatečně?Heard at a congress

MUDr. Zuzana Zafarová

Onkologie. 2026:20(3):188-191

Naděje pro pacienty s pokročilým mCRC - fruchintinib jako účinná volba po více než roce klinických zkušenostíHeard at a congress

MUDr. Zuzana Zafarová

Onkologie. 2026:20(3):181-187

Malignant phyllodes tumor of the breast: clinical case and review of the literatureCase report

Zuzana Bielčiková, Barbora Englcová, David Erhart

Onkologie. 2026:20(3):176-180 | DOI: 10.36290/xon.2026.032

Malignant phyllodes tumor (MPT) of the breast is a rare entity, typically characterized by an aggressive clinical course with rapid tumor growth. Surgery remains the only treatment modality firmly established in current therapeutic recommendations; however, achieving adequate surgical margins may be challenging in many cases. Neither adjuvant radiotherapy nor chemotherapy has been shown to improve overall survival, and their use is largely based on retrospective data. This article presents several case reports and summarizes the current knowledge regarding malignant phyllodes tumors and their management.

Immunohistochemical expression of DNA repair proteins and its association with treatment outcomes in laryngeal carcinomaCase report

Zdeňka Pechačová, Radka Lohynská, Zuzana Špůrková, Vratislav Šedivec, Marián Švajdler, Tereza Drbohlavová, Petra Tesařová, Miloslav Pála

Onkologie. 2026:20(3):169-175 | DOI: 10.36290/xon.2026.031

Background: Radiotherapy represents a key treatment modality for laryngeal carcinoma. Proteins involved in DNA repair may influence tumour radiosensitivity as well as treatment outcomes and radiation-related toxicity. Patients and Methods: In 108 patients with laryngeal carcinoma treated with (chemo)radiotherapy, immunohistochemical expression of DNA repair proteins was assessed in pretreatment biopsy specimens and correlated with treatment outcomes. Results: Higher MRE11 expression was associated with early clinical stage (I-II) (p < 0.001), improved overall survival (p < 0.001), and longer progression-free survival (p = 0.025). Expression of...

Multidisciplinary collaboration in radioligand therapy of prostate cancerReview articles

Otakar Čapoun, Martin Matějů, Stanislav Hloušek, Vladimír Černý, Petr Hanuš, Iva Macová, Václav Ptáčník, Peter Papp, David Zogala

Onkologie. 2026:20(3):163-168 | DOI: 10.36290/xon.2026.030

Radioligand therapy (RLT) targeting the prostate-specific membrane antigen (PSMA) represents a significant advance in the treatment of metastatic castration-resistant prostate cancer. The implementation of this modality into clinical practice places high demands on appropriate patient selection, organizational support, and the safe delivery of treatment. This article summarizes the role of the multidisciplinary team (MDT) in PSMA-targeted RLT for prostate cancer and outlines the key responsibilities of individual specialists, including the clinical oncologist, urologist, nuclear medicine physician, radiologist, and specialized nurse. Particular attention...

Metastatic hormone-sensitive prostate cancer, new treatmentsMain topic

Jan Dvořák, Renata Soumarová, Martin Palkovský

Onkologie. 2026:20(3):155-162 | DOI: 10.36290/xon.2026.029

Prostate cancer is one of the most common malignancies in men. In recent years, it has significantly expanded to include biological, or targeted therapy. Biological treatment includes mainly drugs that interfere with androgen signaling, therapy focused on specific molecular pathways and features. The aim of this article is to present recent developments in metastatic hormone-sensitive prostate cancer and to indicate possible future directions of development.

From detection to destruction: a theranostic approach to prostate cancerMain topic

Veronika Ičová, Libuše Quinn, Lenka Henzlová, Milan Kamínek

Onkologie. 2026:20(3):150-154 | DOI: 10.36290/xon.2026.028

Theranostics represents a concept wherein the same or similar targeting molecules are used both for diagnostic imaging and targeted radionuclide therapy. In prostate cancer, it involves the prostate-specific membrane antigen (PSMA) whose expression correlates with how aggressive and advanced the disease is. The article summarizes the current diagnostic options using positron emission tomography with prostate-specific membrane antigen ligands (PSMA PET/CT) labelled with the radionuclides ⁶⁸Ga or ¹⁸F and radioligand therapy (RLT) using ¹⁷⁷Lu-PSMA-617 in patients with metastatic castration-resistant prostate cancer (mCRPC)....

Intensification of systemic therapy in a patient with de novo metastatic hormone-sensitive prostate cancerMain topic

Pavel Vlček

Onkologie. 2026:20(3):146-149 | DOI: 10.36290/xon.2026.027

The treatment landscape for metastatic hormone-sensitive prostate cancer has undergone significant shifts in recent years. The current standard of care has transitioned toward combination regimens integrating androgen deprivation therapy with androgen receptor signaling inhibitors, and potentially docetaxel-based chemotherapy. This intensified approach facilitates a delay in disease progression to the castration-resistant stage and significantly extends overall survival. The presented case report documents the clinical application of a "triplet therapy" (ADT, darolutamide, docetaxel) in a patient diagnosed with high-risk de novo metastatic prostate cancer.

Radiation therapy for advanced prostate cancerMain topic

Igor Richter, Josef Dvořák

Onkologie. 2026:20(3):141-145 | DOI: 10.36290/xon.2026.026

Radiotherapy is an important treatment modalities for prostate cancer. It is most often used as the primary treatment of localized disease. Actually is discussed the role of radiotherapy in the treatment of advanced disease. The aim may be local irradiation of the prostate in the case of de novo diagnosed metastatic prostate cancer or local irradiation of metastases. Especially with the development of modern diagnostic methods, oligometastatic disease is being diagnosed. In these patients, targeted irradiation of metastases with a higher dose using stereotactic radiotherapy methods can be considered.

Diagnosis and treatment of biochemical recurrence of prostate cancer after radical therapyMain topic

Otakar Čapoun

Onkologie. 2026:20(3):136-140 | DOI: 10.36290/xon.2026.025

Biochemical recurrence (BCR) of prostate cancer represents a common clinical scenario after radical prostatectomy (RP) or radiotherapy (RT), with heterogeneous biological behavior ranging from indolent disease to rapid metastatic progression. Appropriate interpretation of BCR requires a precise definition according to the type of primary treatment, assessment of prostate-specific antigen (PSA) kinetics, and risk stratification. Positron emission tomography targeting prostate-specific membrane antigen enables localization of recurrence even at low PSA levels and significantly influences the selection and targeting of salvage treatment. In patients with...

Individualization of systemic treatment for advanced prostate cancerMain topic

Jana Katolická

Onkologie. 2026:20(3):130-135 | DOI: 10.36290/xon.2026.024

Advanced prostate cancer represents a heterogeneous disease with diverse biological characteristics, clinical course, and treatment responses. In recent years, there has been a significant expansion of therapeutic options, which places increased demands on the individualization of treatment strategies. The aim of this article is to summarize the current options for systemic therapy of advanced prostate cancer and to emphasize the importance of a personalized approach based on clinical, laboratory, imaging, and molecular-genetic characteristics of both the patient and the tumor.

Když standardní léčba selhává: nová éra terapie PROCEditorial

doc. MUDr. Igor Sirák, Ph.D.

Onkologie. 2026:20(2):71

Skin toxicity in the treatment of metastatic malignant melanoma with combination immunotherapyCase report

Věra Benešová

Onkologie. 2026:20(2):120-122 | DOI: 10.36290/xon.2026.023

Malignant melanoma is an oncological disease whose incidence has continued to rise in recent years (24.6 cases per 100,000 inhabitants for the period 2018-2022). The disease ratio of both men and women is close to 1 : 1. Although the incidence of the disease is rising, mortality remains stable, mainly attributable to the early diagnosis of the disease (1). Even so, we see a finding of primarily metastatic melanoma, as well as a portion of patients despite early diagnosis and established treatment metastasizing. In my case report, I describe a case of treatment of primarily metastatic melanoma with combination immunotherapy, where significant skin toxicity...

Complete remission in a patient with locally advanced rectal cancer after total neoadjuvant therapy (TNT)Case report

Eva Skácelíková

Onkologie. 2026:20(2):117-119 | DOI: 10.36290/xon.2026.022

Total neoadjuvant therapy (TNT) for rectal cancer is a treatment procedure in which the patient undergoes complete oncological treatment, i.e., chemotherapy and radiotherapy, before surgery. The aim is to improve treatment outcomes in terms of longer overall survival (OS), prolong disease-free survival (DFS), and increase the number of patients who achieve complete remission (CR). In the case of low tumors, where the only possible surgical treatment would be rectal amputation and permanent stoma, a rectum-preserving procedure may also be chosen if CR is achieved.

Diabetes mellitus and neoplastic diseasesInterdisciplinary overviews

Andrea Křivanová

Onkologie. 2026:20(2):112-116 | DOI: 10.36290/xon.2026.021

Diabetes mellitus and cancer are considered to be the 4th, the 2nd respectively, cause of death in developed countries worldwide. The incidence and prevalence has increased in the last decade and continues to grow further, it is estimated that about 8-18 % of patients suffer from both - diabetes and cancer. Epidemiologic evidence suggests that people with diabetes 2nd type are at significantly higher risc for many forms of cancer. In the text we comment on an association between diabetes and the risk of cancer, possible biological background of this relationship and the influence of antidiabetic therapy to cancer and also anticancer therapy to the...