Pokroky v léčbě uroteliálního karcinomu: Nové horizonty a výzvy

MUDr. Jindřich Kopecký, Ph.D.

Onkologie. 2025:19(2):67

Current options for adjuvant treatment of urothelial carcinomas

Jindřich Kopecký, Alexandr Poprach

Onkologie. 2025:19(2):69-75 | DOI: 10.36290/xon.2025.015

Urothelial carcinoma (UC) represents a significant oncological challenge with high mortality, particularly in advanced stages. Adjuvant therapy, whether chemotherapy or immunotherapy, plays a crucial role in reducing the risk of relapse and improving survival after radical surgery. This review summarises current knowledge on the use of adjuvant treatment in UC and upper tract urothelial carcinoma (UTUC), including its histological variants. The most established modality remains cisplatin-based chemotherapy, which has demonstrated benefits, particularly in patients at high risk of relapse (pT3-4, N+) without prior neoadjuvant chemotherapy. A major breakthrough...

Immunotherapy in the treatment of metastatic urothelial carcinoma

Martina Spisarová, Andrea Kopová

Onkologie. 2025:19(2):76-79 | DOI: 10.36290/xon.2025.016

Urothelial carcinoma is one of the most common cancers in its early stages. Oncologists, however, more frequently encounter patients with advanced disease. Unresec­table or metastatic urothelial carcinoma remains a significant therapeutic challenge. Traditional treatment has long relied on platinum-based chemotherapy. In recent years, this approach has evolved with the introduction of checkpoint inhibitors. A breakthrough came with combination immunotherapy regimens involving antibody-drug conjugates. The combination of pembrolizumab and enfortumab vedotin has redefined first-line treatment recommendations for urothelial carcinoma. Combination therapy...

Neoadjuvant therapy of bladder cancers

Tomáš Büchler

Onkologie. 2025:19(2):80-82 | DOI: 10.36290/xon.2025.017

Muscle-invasive bladder cancer (MIBC) is an aggressive malignancy with a high risk of metastases and recurrence. The standard treatment involves neoadjuvant cisplatin-based chemotherapy followed by radical cystectomy, yet approximately 50 % of patients relapse within three years. Neoadjuvant chemotherapy improves overall survival (OS) and pathological complete response (pCR). Emerging treatment strategies include neoadjuvant immunotherapy, with phase II trials demonstrating increased pCR rates with pembrolizumab and atezolizumab. The recently published NIAGARA trial established that perioperative durvalumab combined with chemotherapy reduces disease...

Radiotherapy as an organ-preserving approach in treating muscle-invasive bladder cancer

Martin Palkovský, Renata Soumarová

Onkologie. 2025:19(2):84-90 | DOI: 10.36290/xon.2025.018

Muscle-invasive bladder cancer (MIBC) has traditionally been treated with neoadjuvant chemotherapy (NAC) and radical cystectomy (RACE). Although trimodal therapy (TMT), involving maximal transurethral resection (TUR) and chemoradiotherapy (CRT), yields comparable results, it is not yet considered standard treatment. This paper analyses the results of recent studies and recommendations concerning TMT in the treatment of MIBC. Retrospective analyses suggest that TMT achieves metastasis-free survival (MFS) and disease-free survival (DFS) rates similar to those obtained by NAC with RACE. However, the lack of direct comparison of TMT and NAC plus RACE limits...

Venous access in oncology - the choice between PICC and port

Viktor Maňásek

Onkologie. 2025:19(2):91-99 | DOI: 10.36290/xon.2025.019

The choice of an adequate venous access in oncology is essential for an optimally mana­ged anticancer treatment, if parenteral administration is necessary. The treatment is usually longterm with the need to prefer to introduce such a venous access that offers the maximum benefits for the patient. It is not only a matter of safe introduction, taking into account the type and duration of the treatment, the patient's general condition, including comorbidities, and the quality of the venous system, but also a strategy for the care of the venous access device during its use. Education of the patient and his preferences are very important. In practice, we...

Patient with primary metastasizing anorectal mucosal melanoma

Linda Řandová, Ivana Krajsová, Miroslav Důra

Onkologie. 2025:19(2):100-103 | DOI: 10.36290/xon.2025.020

The presented case report describes the case of a patient with mucosal primary metastasizing malignant melanoma of the anorectum. Due to the synchronous generalization to the lymph nodes and lungs and therefore the impossibility of a curative surgical or radiotherapy solution, the patient was treated with several lines of systemic treatment. In accordance with guidelines and for BRAF negativity, combined immunotherapy with ipilimumab and nivolumab was indicated in the 1st line of treatment. Subsequently, due to repeated progression of the disease, the patient completed two more lines of conventional chemotherapy and then, regarding metastatic spread...

Complete remission of metastatic squamous esophageal carcinoma

Marián Liberko, Renata Soumarová

Onkologie. 2025:19(2):104-107 | DOI: 10.36290/xon.2025.021

Metastatic esophageal cancer is a disease with an infaust prognosis, with a median survival of approximately 12 months. New treatment options using chemotherapy in combination with immunotherapy may lead to long-term disease control and, in a small percentage of patients, complete remission. This case report describes a patient with primary metastatic disease, where chemoimmunotherapy led to rapid resolution of clinical symptoms, improvement of clinical status and ultimately to induction of a durable complete remission of the disease.

Management of epitheloid inflammatory myofibroblastic sarcoma of pulmonary origin

Simona Laštíková, Michal Urda, Robert Vyšehradský, Tomáš Šišmiš

Onkologie. 2025:19(2):108-110 | DOI: 10.36290/xon.2025.022

Epitheloid inflammatory myofibroblastic sarcoma (EIMS) is a rare variant of the inflammatory myofibroblastic tumour (IMT). Unlike the classic IMT, EIMS typically occurs intra-abdominally and is characterized by an adverse prognosis due to its aggressive nature, high rate of recurrence, and metastatic potential. Histologically, it exhibits epitheloid morphology and a unique immunohistochemical profile, which allows to distinguish EIMS from other mesenchymal tumours, thus significantly contributing to diagnostic accuracy. Immunohistochemically, ALK (anaplastic lymphoma kinase) protein positivity is characteristic with perinuclear or membrane staining...