509
ONKOLOGIE3418040010760120167227269329388409453
/8408040010731
Onkologie.9168040010761110147195214263313331375390
2025;19(2):80-821326804001074487128172185223260284327349364408452482528570
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www.onkologiecs.cz48658040010765133201214262311348396415464514532576617652669709748
801828020012657116
HLAVNÍ341200012670127198263336370
TÉMA733200012657114204274
Neoadjuvantní34136001063971111150190212253291328369401442460
terapie8173600106296297139174191223
karcinomů105536001063476111146163204245299340
močového141036001065292128167204236277318
měchýře174436001065183118159196232265
Neoadjuvantní3409200298166292430555696762900102611511289137415151579
terapie1967920029888213304428569633758
karcinomů277392002981312573464535186577939981136
močového340118002982063444515877098309701106
měchýře149511800298206332440580698790915
Tomáš3401580013760116211269317
Büchler6791580013767131180245275333376
Onkologická3401740013376137188247273333395420469519573
klinika936174001335279104164189240293
2.1253174001335679
LF13551740013352105
UK14831740013371131
a16371740013353
Fakultní17131740013354102153214239275335360
nemocnice20961740013361116208268318378403452505
v26251740013352
Motole,27011740013388149184243269324346
Praha3070174001335893146206259
Svalovinu340225001214995143167222269293348403
invadující770225001212379125173230285309332376399
karcinom1196225001214797129173196251307390
močového16132250012184139184238285334390445
měchýře20852250012184134180235280314363
(MIBC)24762250012128106131185243272
je2776225001212474
agresivní28772250012149105137187227249298354377
onemocnění32812250012155111161245300346401451507530
s3402390012140
vysokým4092390012149101141197246297383
rizikem821239001213357101125172222307
metastáz11582390012184136170220260294344389
a15762390012149
recidivy.1654239001213384130154211235285336353
Standardní2036239001215082132189246295328386442466
léčba2531239001212475122179229
zahrnuje2789239001214494151184241297321372
neoadjuvantní31912390012156107164214272296352401451507540596620
chemoterapii3402530012145100150234289322371404453509533556
na9212530012156104
bázi10502530012157105149172
cisplatiny1247253001214568107163187235268291346391
následovanou16642530012155103142165216273328375424479534589
radikální2278253001213382138161208257281336359
cystektomií,2662253001214594134168217264300354438461484504
avšak3192253001214894133182229
přibližně3446253001215790113170194217260315365
503402670012151102
%4542670012179
pacientů5562670012157106151174224279312366
do9452670012157112
tří108026700121336589
let1191267001212474108
po13222670012156112
operaci14572670012155112163196245290313
zaznamená1792267001214393136192240323374429477
relaps.2292267001213382106154211250272
Neoadjuvantní25872670012165116172221277301356404452508540595618
chemoterapie32282670012145100150234289322371404453509533583
zlepšuje340281001214265114170208261284333
celkové690281001214492115161213259307
přežití1014281001215688136178201233255
(OS)1286281001212893140167
a14702810012147
zvyšuje1534281001214292141179233256305
šanci1855281001213987141185207
na20792810012155101
patologickou21972810012156104135188211265321343387432484538
kompletní2752281001214699181236260309341395418
odpověď31862810012154110166220266314371
(pCR).3574281001212883141192219237
Nové3402950012166121168218
terapeutické577295001213383115164221272327360383428474523
přístupy1120295001215790113152186240297344
zahrnují1483295001214393148181236291315338
neoadjuvantní18412950012155106161210267290345394442497530585608
imunoterapii,24692950012123106161216271304353386435491515538559
kde30472950012147103153
klinické322029500121467194150173217264313
studie3552295001214074129185209259
fáze340309001213080124175
II544309001212449
s6223090012140
pembrolizumabem6913090012157110195252286342366390433490574623681733818
a15383090012149
atezolizumabem1616309001214982132176232257280324380465514571624709
prokázaly2354309001215791147195245289340364412
významné27953090012149101147203252337393444
zvýšení3268309001214496147187239295319
pCR.36163090012158118172195
Nově3403230012166122170219
publikovaná5883230012157113170195218265319367416471520
studie1136323001214074130187210261
fáze1426323001212978122173
III162732300121244973
NIAGARA1728323001216791152215277330394
prokázala,2151323001215790145193243286337360409430
že2610323001214393
perioperační27323230012157108142165221279330363412457513536
durvalumab32973230012157112145196245269324408457514
v3403370012148
kombinaci4133370012147101184241265320368413436
s8743370012140
chemoterapií9393370012145100150234289322371404452509533556
snižuje1520337001213994117160215239289
riziko183433700121335699123169223
progrese2082337001215790144201234284323373
o24813370012154
322561337001215199
%26733370012179
(HR2777337001212892147
=29493370012159
0,68)3033337001215271123176202
a32603370012148
riziko3333337001213357100123169223
úmrtí35813370012155139171207230
o3403510012155
254153510012151102
%5293510012180
(HR629351001212892146
=7953510012160
0,75).875351001215171121169195214
Perioperační11093510012153101134158213270321354403447502525
imunoterapie16543510012124107162217272305354387436492516566
se2240351001214090
tak2350351001213382128
stává2498351001214074123169218
novým27363510012155110157208292
standardem3048351001214074122178234282315371421505
léčby.3573351001212374119176222238
Probíhají340365001215385139197220278326349372
další7313650012156104128166190
studie939365001214074128185208258
kombinující12163650012147101184241265320375398422466489
ADCs17243650012161127186226
a19693650012148
ICIs2036365001212482105144
a21993650012148
využívající2265365001214899155198221270318342365410432
ctDNA2716365001214580146212273
pro3008365001215689144
lepší3171365001212374131170193
stratifikaci3383365001213973105154187210239265312361406429
pacientů.3403790012157106150173224279312366387
Tyto752379001215091127181
pokroky9583790012157113160194249296347
směřují13303790012139122173204260284307
k16623790012147
personalizované17343790012157108141181236292340364386429484531580635685
onkologické24443790012155111158212236291347371415462511
léčbě2980379001212374119176227
a32323790012148
optimalizaci33053790012155112146169252300323346389439484507
neoadjuvantní3403930012155106162210267291345394442498530585608
terapie.970393001213382115163220244294314
Klíčová340409001246190118163220272325
slova:687409001244472130182235260
neoadjuvantní9714100012156106162210267291345394442498530585608
terapie,1602410001213383116164221244295314
karcinom1939410001214797129173196251306390
močového23524100012184139184238285334390445
měchýře,28204100012183134179234280313363383
imunoterapie,32264100012123106161217272304354387435492515566585
cirkulující340424001214568100147203226281305328372395
nádorová7564240012156104161216249303350399
DNA,11764240012167133193216
perioperační14134240012157108141165220277328361410454509532
léčba.1967424001212374119176224246
Neoadjuvant3404510012469123181235295323382435488547584
therapy944451001243796149188241301352
of1316451001245893
bladder1429451001246088141201261315354
cancers1803451001244598157203255294338
Muscle-invasive3404690012180136175220243293326351406452501540563611660
bladder1026469001215681129185242292325
cancer1376469001214594149194243276
(MIBC)16774690012128107131185243273
is1975469001212362
an20624690012149104
aggressive21914690012148104161193243282322344393442
malignancy26584690012184132155178234289337393438487
with3170469001217498131186
a33814690012148
high3455469001215578134189
risk367046900121325695141
of340483001215584
metastases4474830012184134168217256290338377428467
and9384830012148103160
recurrence.1121483001213383128183216249299354399448468
The16134830012149106156
standard1793483001213973122177234282314370
treatment2187483001213365115163196279329385417
involves2628483001212378125179203251300340
neoadjuvant29914830012155106162210267291345394442498530
cisplatin-based3544483001214568107163187235340497001213356111144202250289340397
chemotherapy7604970012145100150234289322377428461509566612
followed1395497001212984108131187260309366
by17844970012157104
radical1911497001213281138161205254277
cystectomy,2212497001214494133167216262297351435481497
yet2732497001214796130
approximately28854970012148105162195249295318401450482531555603
5035114970012151101
%36254970012179
of3727497001215584
patients3405110012158107140164215272305346
relapse715511001213384108157215255306
within1050511001217599133189213269
three1348511001213389123173225
years.1602511001214898147180221243
Neoadjuvant18745110012167118175225282307362412461517550
chemotherapy24535110012146102153238294328384435469518576623
improves31055110012124108166199255303353393
overall35275110012156104154187237261284
survival340525001214094127178202250298322
(OS)683525001212895143171
and8755250012148103160
pathological10565250012157106138193249273328384408452501524
complete1602525001214498182238262313346396
response2019525001213282122178234290329379
(pCR).2419525001212985144197225243
Emerging3405390012149132182215271294349405
treatment774539001213365115163196279329385417
strategies1220539001213973106154187236293316366406
include1654539001212379124147201258308
neoadjuvant19915390012155106161210267290345393442497530
immunotherapy,25495390012123106190244300355388443493526575631678694
with3271539001217497130186
phase34855390012157113161200250
II3763539001212448
trials34055300121336791139163203
demonstrating5725530012157108193249305345379412462495518575632
increased1232553001212480126159210259298350408
pCR16695530012157117171
rates1869553001213382115165206
with2104553001217498132188
pembrolizumab23215530012157109194252286341366389433488573622680
and30295530012149105163
atezolizumab.3221553001214882132176231256279323379463512570590
The3405670012150108159
recently528567001213384131181237270294343
published9005670012157114172196220259316367425
NIAGARA1354567001216792153216279333398
trial178156700121336691139163
established1973567001215192126176234258282321378429487
that2489567001213490139172
perioperative26905670012158110144168224282334368417450474523573
durvalumab32925670012158113147199248272328412462519
combined340581001214598182239263318368426
with790581001217498131186
chemotherapy10015810012145100150234289322377427460509565612
reduces1638581001213282139194239288328
disease1991581001215679118168216255306
progression2322581001215790144201234283323362385440496
risk284258100121335795142
by30095810012157103
3231375810012151100
%32495810012179
(HR3353581001212993147
=35255810012159
0.68)3609581001215272124176202
and3405950012148103160
mortality5265950012183139172207256280303336386
risk93759500121335795142
by11055950012157103
2512345950012151102
%13495950012179
(HR1454595001212892146
=16265950012160
0.75).1712595001215171122170196215
This19535950012149106129167
supports2146595001214094151208264297333374
perioperative25455950012157109141165220277328361410442465513563
immunotherapy31335950012124107190245300355388443494527575632678
as340609001214887
the448609001213489139
new6086090012156106180
standard809609001213973122177234282314370
of1201609001215584
care.1306609001214593126175196
Ongoing3406230012169125181236260315371
studies734623001214074129185208259298
focus1055623001213084130185224
on13026230012155111
combining1436623001214598182239262318341396452
ADCs19116230012161128186227
and21616230012148103160
ICIs2344623001212482105145
and25126230012148103160
leveraging2695623001212474122171204252308331387443
ctDNA3161623001214580146212273
to3457623001213387
refine3567623001213383112139194244
patient3406370012157106139162213268301
selection.669637001214091115166212247270326382403
These11006370012150107158197248
advancements13776370012148105153202258303352436487543576616
drive2022637001215689113161211
personalized22616370012157109142182238294342366389432482540
oncology28296370012155111156210235290347395
and32536370012148103160
optimize34426370012155112146169252276319369
neoadjuvant3406510012155106162210267291345394442498530
therapy.891651001213388139172220277323340
Key3406670012461112164
words:5216670012476132171231274300
neoadjuvant8396680012155106161210266290344392441496528
therapy,1385668001213388138171219275322337
bladder1740668001215781129185242292324
cancer,2082668001214593148193242275291
immunotherapy,23906680012124107190244299354387442492525573629676692
circulating3099668001214568100144199222270302325380436
tumor3553668001213387170225258
DNA,3406820012167133193216
perioperative5776820012157109141165220277328361410442465514563
treatment.1161682001213365115163196279330385418439
Úvod3407310014780142208279
Svalovinu480748001094486130151201244266316365
invadující862748001092171113157208258279301341362
karcinom1240748001094387117157178228278354
močového16107480010975125166215257302353403
měchýře3407620010977124167219261293340
(MIBC)7067620010927100123174228256
představuje989762001095283130184220252298342394417464
agresivní1480762001094497127174211233279331353
malignitu1860762001097712234077600109224496149171202254
s6217760010936
vysokým684776001094592130181226273352
rizikem106377600109305393116159206284
metastáz.13747760010977124156202239271317358379
Léčba1780776001094491134187233
obvykle21407340010949100143188231254299
zahrnuje2455734001093883132161212261282327
radikální2798734001092973124145187231252301322
cystektomii,3136734001094084120151195237269318393414435453
avšak3605734001094385120164206
neoadjuvantní2140748001094993142185234255303345388436464513533
terapie,2687748001092972101143193214257275
zejména2976748001093781102175219268310
chemoterapie3300748001094088132206254283326354397447467511
a21407620010943
imunoterapie,2206762001092196146196246276320350394446467513531
hrají2759762001095080124146167
klíčovou294876200109426586127175218267317
roli3287762001093079101122
ve3432762001094387
zlepšení35427620010938601061571932392140776001095072
prognózy2237776001095282132184234285323369
pacientů.2631776001095296137159204255285335354
Cílem301177600109527396142219
neoadjuvantní3255776001095097147192244266316360404455484535556
DECLARATIONS:4068227008648871301662142563043393604124625014570227008514
Declaration406824100874987120141179206244271291333375
of445724100874066
originality:45372410087406888130150192230251271298337356
The406825200853473109
manuscript418825200855891130168195227249266306329
is452825200851744
original45832520085386178117133172205222
and481625200853472112
has49392520085387299
not50502520085387699
been516125200853975110149
published532225200853977117134150177216251291
or406826300853862
submitted414526300852867108167184208234269310
elsewhere.44702630085355381117169209245269305320
Ethical406827700873764107127160198218
principles43002770087427090132165185228249287319
compliance:463327700873173134177197218256298330368387
The406828800853678116
authors420528800853475100142183208238
attest44642880085356087124153179
that466428800852465101126
their481128800852465103121146
study49782880085295595138173
was517328800855389118
approved531228800853577120145186221258301
by406829900854073
the41582990085236399
local42742990085175689124141
Ethical44322990085345898115147182199
Committee464829900854179139198215239265300337
and500229900853373113
is513229900851745
in519429900851656
compliance526729900853169129169187204239278311346
with40683100085537298140
human423631000854081143180221
studies44863100085285596139157195226
and474031000853577119
animal48883100085347695156193212
welfare512831000855391110133170196234
regulations53903100085236110414516420140683210085234080120148
of423532100853960
the43153210085236399
authors’44343210085347397136176200229244
institutions46983210085165684109126150189213231270310338
as505632100853462
well513832100855187104122
as527932100853462
with53613210085526993133
the55143210085236299
World406833200856099124142184
Medical427333200855795137155188224242
Association453533200854474104144178196231256273314355
Declaration491133200854785119136172196232257274315356
of528833200853961
Helsinki537033200854684102131149189224243
on406834300853878
Ethical41653430085355898115147182199
Principles43833430085376178117150167207225261290
for46923430085205983
Medical479434300855693134151183218235
Research504834300853874102139173197229268
Involving53353430085175690128146181198238278
Human406835400854685145179219
Subjects430735400853474114132168201227256
adopted458335400853474114155179215256
by485835400854074
the49523540085236399
18th507135400853669514135400501437
WMA5198354008559116160
General537835400854582122158182217235
Assembly406836500854475105143204247266302
in439336500851758
Helsinki,447436500854785104134152193228248264
Finland,47613650085355394113149190232249
in503336500851758
June511536500852667109147
1964,528536500853771110150166
with54743650085537297139
subsequent406837600852867107136172213252288328352
amendments,443737600853493130169210269305345369398414
as486837600853462
well494837600855287105122
as508837600853362
with51673760085526993133
the53183760085236298
ICMJE543437600851759116143179
Recommendations406838700853977112153216278317359402439465483525568598
for46973870085226389
the481838700852466104
Conduct,495438700854283125168210245272290
Reporting,527538700853978121163189217236278321338
Editing,40683980085347491115132172212227
and430839800853373113
Publication443439800853776117134151183218242259298338
of478539800853859
Scholarly485739800853467106146163198221239273
Work514239800856097121155
in531039800851656
Medical537839800855693134151183218235
Journals,406840900852666105129169204221249265
updated435340900853980121155179215256
in462940900851656
December470540900854683116151211252289313
2018,503740900853673107140156
including52134090085165689106145186203243283
patient55164090085407540684200085234076116140
consent422242000853270110138174214238
where447542000855191127151187
appropriate.467742000853474115139178219243260295318354369
Conflict406843400874282124149171191223251
of433443400874065
interest44134340087196288126154192224251
and467843400873779122
financial48144340087244587125167200220258279
disclosures:51074340087416293126147188220261289327359378
None.406844500854686126162177
Funding/Support:406845800873777119162183225267291329371414457499526554574
None.406847000854686126162177
Cit.4068714008541588297
zkr:41807140085306489105
Onkologie.429971400864991127167186227268287324342
2025;19(2):80-82465571400863876113151167203238260297317334373412437477514
https://doi.org/10.36290/xon.2025.017406872500853962881291571721982194284725008641811004385725008514547811714345287250086387390130169206244283307342382423441481519556594611650686719
Článek40687360085415892132168202
přijat4285736008539638198132156
redakcí:445673600852359100134168199216231
16.47017360085367085
2.480173600853652
2025486873600853672107143
Článek40687470085415892132168202
přijat4285747008539638198132156
k4456747008533
tisku:45047470085234068101141156
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prof.406876600874270111137154
MUDr.4236766008760108159187203
Tomáš445376600873875136175206
Büchler,467376600874384117159180218246262
Ph.D.494976600874182102153171
tomas.buchler@ftn.cz406877800852362121156184200241281313353370406430482504531570586618650