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Onkologie.40728040010760109147194214262312331375389
2025;19(1):29-324481804001074487128172185223261285324342356401444474514555
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ONKOLOGIE51598040010760120166227269329388409452
2956558020012657115
PŘEHLEDOVÉ4549200012660124182256312369444520587645
ČLÁNKY5216200012660115187259327395
Terapie25303600106306298139174191223
KRAS276936001063369111145
pozitivního292936001063374105123155173211252270311351
metastatického329636001065284117154187220256285302337373405446487
nemalobuněčného379936001063971125166197236272313355386421463494536576
plicního43913600106336482116158175216257
karcinomu466436001063375110145162203244298339
ve501836001063769
druhé510236001063873114155187
linii53053600106294788105122
léčby54433600106296196132168
Terapie3409200298132240330454596660785
KRAS11739200298147290450579
pozitivního1801920029814328139145754360873487493810811218
metastatického30679200298206332420546648735861947101211181248136915101646
nemalobuněčného3401180029814126547159766179893910781217134214501590171518551992
plicního238011800298144209273379519582726862
karcinomu3291118002981302563454525176567929971135
ve34014400298127248
druhé63714400298143232370509634
linii13191440029866130269332396
léčby17641440029866191299442562
Martin3401840013793152194236267331
Svatoň6931840013760115173213276341
Klinika340200001336087111172197247301
pneumologie6642000013363124179239330391417477539564619
a13062000013353
ftizeologie,138220000133327297143198259285345407432487508
FN19142000013353123
Plzeň2060200001335983130184245
Nemalobuněčný3402510012168120207257282339399456514566613671718
plicní1088251001215984108155212237
karcinom1355251001214899133179204261318405
(NSCLC)1790251001212996147207255313344
s21642510012141
mutací22282510012185142177228275299
KRAS25572510012156113178230
představuje2817251001215993145205245281331380438463515
nejčastější33622510012157110135182232273308359384425449
typ340265001213383141
plicního506265001215781104148204227284339
tumoru870265001213388171227260315
se1210265001214090
senzitivní1326265001213990145188212245268316372395
mutací.17462650012184139172221266288309
Zároveň20802650012156105137192239288344
je2449265001212474
mutace25482650012184139172221265314
KRAS28882650012154109172222
spojena3135265001214096152176226282330
se3490265001214090
špatnou36052650012140971451783402790012155111166
prognózou530279001215790144201257312353408463
pacientů.10172790012157106151174224280312367387
Vyhlídky14282790012156104160184207263310360
na18122790012155103
delší19402790012156106130169192
přežití2156279001215790140183206239262
pacientů24422790012157106151174224280312367
s28332790012140
metastatickým28942790012183134167216255289338370393438484535619
NSCLC35372790012166115172219274
s3402930012140
mutací4012930012183138171220265288
KRAS7082930012155109173223
proto950293001215790145178232
nebyly12012930012156106163210234281
dlouhou1502293001215680135190245300356
dobu18772930012157112169224
dobré.21212930012156111169202251271
Osud24122930012169109163220
těchto2651293001213382128183215269
nemocných29402930012156106190245290346391435490
se3450293001213990
však3559293001214888136183
v37632930012148
posledních3403070012157113152175226283338361406461
letech822307001212374107156202257
dramaticky1100307001215689137221269301324369415466
změnil.15863070012143127177233256279300
To1907307001214998
především2026307001215789139196247294333357440
díky2487307001215679128178
novým26863070012155110158208292
možnostem29993070012184139181236292331365414497
léčby3517307001212474120176223
–37613070012150
jednak340321001212475132187235282
imunoterapie6423210012124107162217272305354387436492516566
a12293210012148
rovněž1297321001213387135191241284
cílené160232100121456793143199249
léčby1872321001212374119176222
pomocí21153210012157112196251297320
tyrosinkinázových2455321001213383117171211233289335360416464507561609659703758
inhibitorů3234321001212378134157213237270324357412
pro3667321001215790144
bodovou3403350012157113170225272326382
mutaci7473350012183138171220265288
KRAS10613350012154109172222
G12C.13083350012165111155212234
Článek1568335001215881129184234282
představuje1875335001215790140197236270319365421444495
možnosti23953350012184139181236292331365388
cílené280833500121456893144199250
léčby3083335001212474120176223
pro3331335001215790145
druhou3501335001215789145200255310
linii340349001212346100122144
léčby501349001212473117173218
a7363490012148
poukazuje8013490012156111165210259301355378427
i12453490012123
na12853490012155102
srovnání1404349001213970124170225272326348
s17693490012139
dříve1828349001215687110157205
užívanou2050349001215597119167214268322376
chemoterapií.2443349001214498148230284316364396444499522544564
Rovněž30243490012153107153208258300
jsou3341349001212462116170
v35283490012147
textu3595349001213381127162216
zmíněny3403630012143127151207258314360
možnosti7283630012184140183239294334368392
vzniku1148363001214994150173221276
rezistence1453363001213383127151190224274330376425
na19073630012156104
cílenou204036300121456894145201257312
léčbu.2381363001212475121178234255
V26653630012156
neposlední27423630012156107165221261285335393449473
řadě3243363001213382139190
pak34623630012157106153
text3644363001213383131167
popisuje3403770012157113170194232287311361
i7213770012123
vyhlídky764377001214899155178201258304355
do11383770012157112
blízké1270377001215781104147194242
budoucnosti15323770012157113169224280325380435474508531
s20833770012140
rozšířením2144377001213387129170193228278334357440
možností26043770012183138181236291330364387
cílené301137700121456893144199250
léčby3281377001212374119176222
i35233770012123
mimo35663770012184107190245
bodovou3403910012157113170225272326382
mutaci7433910012183138171220265288
KRAS10523910012154109172222
G12C.12953910012165111155212234
Klíčová340407001246190118163220272325
slova:686407001244371129181234260
NSCLC,9674080012166115172219274297
KRAS,12854080012154109172222243
sotorasib,1549408001214095128182215263302325382401
adagrasib,19724080012148104152208241290329352408428
imunoterapie.24214080012123106161217272304354387435492515566586
Second-line3404350012454107153211270330363392420479532
therapy892435001243797150189241301353
for1265435001243492131
KRAS-positive14164350012461122189244279340398442470507535588640
metastatic20764350012486140177231275312366402431476
non-small25724350012459117176209253340393421448
cell3041435001244597126154
lung3215435001242786145204
cancer3439435001244599157203255294
Non-small3404530012166121177209249332380403427
cell789453001214493117140
lung951453001212479134190
cancer1163453001214593149194243276
(NSCLC)1460453001212993142200246302331
with1813453001217498131186
a20214530012148
KRAS20914530012154109172222
mutation23354530012183138171220253276331386
is2743453001212462
the2827453001213389139
most29884530012183139178212
common3222453001214498182265320376
type3620453001213383140192
of340467001215584
lung448467001212378133189
tumour661467001213388171227282314
with999467001217497130186
a12084670012148
sensitive1280467001214090146185208241264312361
mutation.16654670012183138171220253276331386407
At2096467001216193
the2212467001213389139
same2375467001213988171222
time,2621467001213356139190209
KRAS28544670012154109172222
mutation31004670012184138172220253276331387
is3510467001212462
associated3596467001214887127182340481001214568116148197255
with619481001217397130185
a8284810012148
poor9004810012157113169202
prognosis1126481001215790144201256311351374412
for1562481001213084117
patients.17034810012157106139162212267300340362
Therefore,20894810012149106156189239269324356406426
the2539481001213388139
outlook27024810012155110143166222277325
for3051481001212984117
longer3192481001212378134190241273
survival3489481001214094127178202250299322
of340495001215584
patients4434950012157105138161211267299340
with801495001217498131186
KRAS-mutated10064950012154109172222255339394427476508558615
metastatic16404950012183134167216255289338370393438
NSCLC20974950012165114172218274
has23904950012155103142
not25514950012155110143
been27134950012157108159215
good29464950012156111167224
for3189495001212984117
a33254950012148
long3392495001212378134190
time.3601495001213356139190210
However,3405090012165121194243291340373389
the754509001213388138
prognosis917509001215790145201257312351374413
of1355509001215584
these1464509001213388139178229
patients17185090012156105138161211267299339
has20825090012156104143
changed22505090012145100148203259310367
dramatically2642509001215689137220269301324369417441464511
in3178509001212479
recent3282509001213382128177233265
years.3572509001214797145177217239
The3405230012150108160
possibility5295230012158115155195219277301325349382433
of992523001215585
immunotherapy11065230012124109194250306363396453504538588646693
treatment1828523001213467118167201285337394427
as2284523001214989
well24025230012175126151174
as2606523001214988
targeted2724523001213383117173225259310368
treatment3121523001213467118167201285337394427
using3577523001215696120176234
tyrosine340537001213383116171210233288339
kinase698537001214772127175214265
inhibitors982537001212479134157214238271325358398
for1400537001212984117
the1536537001213388139
KRAS16945370012155109173223
G12C19365370012165111155211
point21675370012157113136191224
mutation24105370012184139172221253276331387
has28165370012156104143
increased2978537001212479124156206254293344401
prognosis3399537001215790144201256311351373412
of340551001215584
this445551001213388111150
patients.6165510012157105138161211267299340361
The9985510012149106156
article1175551001214881117140184208258
presents1454551001215790139179229285317358
these1833551001213388138178228
option20825510012155112145168223279
of2382551001215584
targeted2487551001213382114170220254303360
therapy2868551001213388139172220277323
for3212551001212984117
the3350551001213388139
second3509551001214091136190246302
line340565001212447102152
of514565001215584
treatment620565001213366115164196279330385418
and10605650012148103160
also1242565001214871110165
points14295650012157113136192224265
out17155650012155111144
a18815650012148
comparison1951565001214598182239287320343382437493
with2466565001217497130186
previously2673565001215790140188212267322361384432
used3126565001215695145202
chemotherapy.33505650012145100150234289322377428340579001213381138184201
The5595790012149106156
possibility7335790012157113152191214271295318341374424
of1175579001215584
developing12775790012156106154203227282339363418474
resistance1769579001213383122145184218267322367416
to2203579001213387
targeted2308579001213382115170221254303361
treatment2687579001213365115163195279329385417
is3122579001212462
also3202579001214972111166
discussed.3386579001215680118163218257296347404425
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but5345930012156112145
not7035930012156111143
least,870593001212474122161195216
the1110593001213388139
text1273593001213382129165
also1462593001214872111166
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the2070593001213389139
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for2670593001212984117
the2811593001213388138
near29735930012156106154187
future3184593001212985118173205255
with3463593001217397130185
the3672593001213388139
expansion340607001215097155203259297320375431
of792607001215584
targeted897607001213382115170221254303361
treatment1279607001213366115163196279330385418
options17186070012155112145168223279318
beyond20576070012157108155209264321
the2399607001213388139
KRAS25596070012154109172222
G12C28036070012164110154211
point30356070012157113136191224
mutation.32806070012183138171220253276331386408
Key3406230012461113164
words:5256230012476133171231275301
NSCLC,8476240012166115172219274297
KRAS,11656240012154109172222243
sotorasib,1429624001214095128182215263302325382401
adagrasib,18526240012148104152208241290329352408428
immunotherapy.23016240012123106190244300355388443493526575631678694
Úvod3406750014780142208279
Nemalobuněčný4806920010959104179222243292343392442487527576617
plicní112069200109527393133182202
karcinom1346692001094286115154174224273347
(NSCLC)1717692001092683127179220269295
s3407060010936
mutací3937060010974123152195235255
genu662706001095095144192
KRAS868706001094998154198
(Kirsten108070600109267394123158188231281
rat1375706001092972101
sarcoma1490706001093579107146194268311
virus)181570600109436492141176198
je340720001092165
v4177200010943
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populaci849720001095098147195214256294313
nejčastěji1175720001094992112150192225254296316335
zastoupeným1523720001093880114142189237285329377416490
typem340734001092972122166239
plicního59273400109507190128176195245293
adenokarcinomu898734001094291135183230271313341379398446494567614
s15257340010935
řídící157673400109294997117155174
mutací17637340010974121150192230250
s3407480010936
výskytem393748001094388123165209241285360
v7717480010943
cca832748001094079122
30972748001094691
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případů1162748001095180101151195245294
adenokarcinomů14747480010943941381882372793233513914114605093407620010975124
(1).47876200109266785101
V5947620010950
asijské66176200109437898119153194238
populaci9137620010951101152201222264304324
jsou1251762001092257106155
KRAS1420762001094998154199
mutované16337620010975124153201243286335380
adenokarcinomy340776001094393137186234276319347386406454503577617
naopak971776001094991140190233274
vzácnější1259776001094382126165213258278312332
s16057760010935
výskytem1657776001094387122163207238282356
5–122140678001094691130169
%23176780010971
(1).240167800109266684100
Nejčastěji25156780010958102123162204238267310330350
se2879678001093579
KRAS2972678001094896151195
mutace31806780010975122151194233276
nacházejí3469678001094991130178220258302322342
na2140692001095093
kodónu2255692001094290141190240288
12,2565692001094786104
z26916920010938
čehož2747692001094083133182220
je2989692001092266
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v34486920010943
celé3509692001094084105149
populaci3681692001095110121407060010951100120163202222
zastoupena2376706001093983117147195244294339388431
bodová28217060010951100151200242284
mutace31207060010974123152195235278
KRAS3412706001094997153197
G12C3624706001095898137187
(1).214072000109266785102
Její226572000109337899119
výskyt2407720001094489124165210242
u26727200010950
adenokarcinomů2745720001094393138188237279323351391411460509584632
je3400720001092267
v34907200010943
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udáván2140734001094998140180223271
na2424734001094991
9–182528734001094692131171
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(1).27927340010925658399
Zastoupení2904734001094992126155202250299344392412
mutace33297340010974122150193232274
KRAS3617734001094895151194
G12C2140748001095898136186
není2339748001095094142162
vázáno2515748001094385123166214263
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ale3198748001094363107
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mezi21407620010975120159179
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dominuje34537620010951100174195244293314358
bodová21407760010951101152201243286
mutace24437760010975124154197237280
KRAS2741776001094897153198
G12D)2956776001095899139197220
(2).319477600109256992108
DECLARATIONS:4068255008648871301662142563043393604124625014570255008514
Declaration406826900874987120141179206244271291333375
of445726900874066
originality:45372690087406888130150192230251271298337356
The406828300853473109
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or406829400853862
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elsewhere.44702940085355381117169209245269305320
Ethical406830800873764107127160198218
principles43003080087427090132165185228249287319
compliance:463330800873173134177197218256298330368387
The406831900853678116
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attest44643190085356087124153179
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by406833000854073
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Helsinki537036300854684102131149189224243
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Ethical41653740085355898115147182199
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for46923740085205983
Medical479437400855693134151183218235
Research504837400853874102139173197229268
Involving53353740085175690128146181198238278
Human406838500854685145179219
Subjects430738500853474114132168201227256
adopted458338500853474114155179215256
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WMA5198385008559116160
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for46974180085226389
the481841800852466104
Conduct,495441800854283125168210245272290
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Work514242900856097121155
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2018,503744000853673107140156
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patient55164400085407540684510085234076116140
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disclosures:51074640087416293126147188220261289327359378
None.406847600854686126162177
Funding/Support:406848900873777119162183225267291329371414457499526554574
Podpořeno406850000853878120162204229266307348
projektem443750000854166107125163198225262323
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FNPI,430651100853480118135151
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Cit.4068714008541588297
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Onkologie.429971400864991127167186227268287324342
2025;19(1):29-32465571400863876113151167203238260295313329368406430467504
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Svatoň,466576600873874112139180222242
Ph.D.492176600874182102153171
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