Karcinom prsu a chirurgická léčba v Čechách a na Moravě

Jiří Gatěk

Onkologie 2020: 14(Suppl.E): 103 | DOI: 10.36290/xon.2020.065  

Male breast cancer

Jiří Gatěk, Jiří Duben, Bohumil Dudešek, Martin Ratajský, Pavel Holík, Michaela Zábojníková, David Vrána

Onkologie 2020: 14(Suppl.E): 106-111 | DOI: 10.36290/xon.2020.066  

Male breast cancer is rare disease and it represents 1 % breast cancer. Invasive ductal cancer dominates in histology with 10 % portion in situ carcinoma. Other histology types are extraordinary. Female breast carcinoma has different diversion in molecular subtype than male carcinoma, which is predominant hormonal sensitive. Mastectomy is procedure of choice with sentinel node biopsy or axillary dissection in surgery. Radiotherapy is used after breast conservative procedure. Indication after mastectomy depends on stage of the carcinoma. Hormonal therapy is mainly applied in adjuvant therapy and mostly with Tamoxifen. Male carcinoma is very similar...

Paget disease of the breast and bladder cancer in man - rare synchronous multiple cancer

Martin Ratajský, Jiří Gatěk, Petr Vážan

Onkologie 2020: 14(Suppl.E): 112-115 | DOI: 10.36290/xon.2020.067  

This article refers mammary Paget's disease (MPD) in men. It summarizes clinical and pathological presentation, epidemiology, making of diagnosis, appropriate treatment and prognosis. It emphasises common and different findings in male and female patients. In additional case report we present patient with two concomitant malignancies - MPD and bladder cancer. We describe diagnosis procedure and disease management in real clinical setting, which implies in various problems with overlapping of their treatment.

A long-term survivor female patient with metastatic melanoma after treatment with pembrolizumab in the third line

Ilona Procházková

Onkologie 2020: 14(Suppl.E): 116-118 | DOI: 10.36290/xon.2020.068  

In recent years, there has been a significant increase in the survival of patients with metastatic malignant melanoma owing to modern immunotherapy using antibodies against immune checkpoints and the introduction of targeted therapy with BRAF and MEK inhibitors. The first antibody used was the anti-CTLA4 antibody ipilimumab which was followed by more effective anti-PD1 antibodies (nivolumab, pembrolizumab); most recently, anti-PD-L1 antibodies have been tested. An even better therapeutic response has been confirmed by the results of clinical trials investigating combinations of individual antibodies and combinations of antibodies with targeted therapy.

Case report of a young patient with a massively disseminated malignant melanoma treated with targeted therapy

Jiří Navrátil, Radek Lakomý, Alexandr Poprach, Jiří Vašina

Onkologie 2020: 14(Suppl.E): 119-121 | DOI: 10.36290/xon.2020.069  

Disseminated malignant melanoma is an aggressive disease and, despite the advancement in treatment modalities, it is still one of the diseases with an unfavorable prognosis. We present a case report of a patient with a rapidly-progressing disseminated skin melanoma treated with targeted therapy using dabrafenib and trametinib. The treatment was tolerated well and provided the patient with a very rapid symptom relief. Unfortunately, despite the initial rapid response, the disease progressed after less than five months. The case report demonstrates that targeted treatment is effective even in very advanced and symptomatic diseases, but it is necessary...

Autoimmune and non-autoimmune related complications of successful lung cancer treatment with pembrolizumab

Juraj Kultan

Onkologie 2020: 14(Suppl.E): 122-126 | DOI: 10.36290/xon.2020.070  

For several years, immunotherapy has been a well-established systemic treatment modality for metastatic or locally advanced stages of non-small cell lung cancer. Along with treatment benefits, there occurs an increased risk of adverse events (AEs), both those specifically associated with interference with the individual's immune environment, i. e. immune-related adverse events (irAEs), and those with no underlying autoimmune component which result from the general condition of the patient and/or their risk factors, such as age, comorbidities, comedications, nutritional, epidemiological and hygienic situation, or patient compliance. Recently, the role...

Early bone metastatic dissemination in patient with locally advanced rectal cancer after neoadjuvant chemoradiotherapy

Michal Eid, Jakub Foukal

Onkologie 2020: 14(Suppl.E): 127-130 | DOI: 10.36290/xon.2020.071  

Rectal cancer requires a multidisciplinary approach, especially in the early and locally advanced stages. The standard baseline staging is performed by pelvic MRI and CT scan of the chest, abdomen and pelvis. The incidence of bone metastases is very low in patients with colorectal cancer. The following case report presents a patient with locally advanced rectal cancer without evidence of distant metastases according to the baseline staging. After neoadjuvant chemoradiotherapy, PET/MRI of the trunk was performed and it revealed multiple skeletal lesions. Biopsy confirmed metastasis of the rectal cancer. This fact completely changed the treatment approach....

Good results of pembrolizumab treatment in a patient with double lung cancer

Jana Krejčí

Onkologie 2020: 14(Suppl.E): 131-134 | DOI: 10.36290/xon.2020.072  

Immunotherapy is a new and currently the most promising treatment strategy in oncology. It can significantly prolong the life of patients with bronchogenic carcinoma without impairing their quality of life. That has to do with the fact that adverse effects, in comparison with standard chemotherapy, are significantly lower and of a different spectrum. Among the drugs used is pembrolizumab which, in the Czech Republic, is indicated and reimbursed in patients with metastatic non-small cell lung cancer (NSCLC) in the first line of treatment. To meet the reimbursement requirements, the patient must be in a good general condition (ECOG PS 0-1), tumour cells...

Alectinib in the treatment of advanced ALK + NSCLC

Bohdan Kadlec

Onkologie 2020: 14(Suppl.E): 135-138 | DOI: 10.36290/xon.2020.073  

Alectinib - Alecenza® is a highly selective inhibitor of ALK tyrosine kinase, which has shown efficacy against mutated forms of ALK tumors, including mutations resistant to crizotinib. Its advantage is that it crosses the blood-brain barrier and is effective in the brain. It is approved as a first line monotherapy for patients with advanced ALK + NSCLC and as a treatment for patients with advanced ALK+ NSCLC progressing after previous treatment with crizotinib. The case study documents high efficacy in the treatment of patients with metastatic ALK + lung adenocarcinoma, including regression of brain metastases, without the need of cranial irradiation.