Oncology, 2024, issue 4
Editorial
Léčba nádorů žaludku
Marián Liberko
Onkologie. 2024:18(4):231
Main topic
Locoregionally advanced carcinoma of gastroesophageal junction and stomach: past, present, future
Marián Liberko, Renata Soumarová
Onkologie. 2024:18(4):237-243 | DOI: 10.36290/xon.2024.049
Given the high incidence of gastroesophageal junction (OGJ) and gastric tumours globally, they represent a major medical problem. The majority of these diseases are diagnosed at a locoregionally advanced and/or metastatic stage, which requires a comprehensive multidisciplinary approach. The mainstay of treatment of locoregionally advanced stages is systemic perioperative therapy, which has been shown to improve patient prognosis. With the aim of further improvement, standard perioperative chemotherapy is combined with immunotherapy. The aim of this review is to provide an overview of current recommendations and new treatment guidelines for locoregionally...
Her2 negative metastatic gastric cancer
Marián Liberko, Renata Soumarová
Onkologie. 2024:18(4):244-248 | DOI: 10.36290/xon.2024.050
In the vast majority of cases, gastric cancer is diagnosed at the metastatic stage. However, even patients who are diagnosed at earlier stages of the disease experience relapse in the form of systemic generalization. Treatment options for metastatic disease depend on a number of variables. At present, the unsurpassed minimum is testing for predictive markers (Her2, MMR, PD-L1 CPS). For Her2-negative tumors, chemotherapy alone has long been the standard of care. Advances in molecular biology, genetics, together with the development of immunotherapy have led to a change in therapeutic options for these patients. The aim of this article is to provide...
Her2 positive metastatic gastric cancer
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...
New targets in gastric cancer
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...
Trifluridine/tipiracil in the 4th line treatment of metastatic distal esophageal and cardia cancer
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.
Review articles
Use of contrast agent in planning CT scan in radiotherapy
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...
Case report
Efficacy of trifluridine/tipiracil plus bevacizumab in clinical practice
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...
Fanconi syndrome after ifosfamide administration in a patient with Ewing sarcoma
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...
Cemiplimab in the treatment of locoregionally metastasizing cutaneous squamous cell carcinoma
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.
Role of Fruquintinib in metastatic colorectal cancer
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.