Klinika Onkologii Klinicznej i Doswiadczalnej

Centrum, Poland

Klinika Onkologii Klinicznej i Doswiadczalnej

Centrum, Poland
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Huszno J.,Klinika Onkologii Klinicznej i Doswiadczalnej | Nowara E.,Klinika Onkologii Klinicznej i Doswiadczalnej | Suwinski R.,II Klinika Radioterapii
Nowotwory | Year: 2011

Pharmacogenetics is a rapidly developing area of pharmacology aimed at therapeutic individualization i.e. the identification of patients who are most likely to benefit from a given treatment with minimal side effects. Pharmacogenetics investigates individual variability which results from the presence of genetic polymorphisms, mutations and varied gene expression. In this study we concentrated on the influence of polymorphisms on the function of proteins which participate in drug transport and metabolism and on the mechanisms of DNA repair. These processes influence drug activity, the efficacy of therapy therapeutic and the possible side effects. The paper presents the pharmacogenetics of drugs commonly used in oncology, including the mechanisms of drug transport and metabolism with special interest placed on the polymorphisms of genes encoding phase I and II proteins for enzymes and genes encoding transporting proteins.


Huszno J.,Klinika Onkologii Klinicznej i Doswiadczalnej | Nowara E.,Klinika Onkologii Klinicznej i Doswiadczalnej | Suwinski R.,II Klinika Radioterapii
Onkologia Polska | Year: 2012

Tyrosine kinase inhibitors (TKIs) therapy (tyrosine kinase inhibitors of the EGFR, kinase inhibitors of BCR-ABL, VEGFR and PDGFR kinases inhibitors) selectively inhibit transmission pathway of signals essential for proliferation, apoptosis, angiogenesis and formation of metastases. Due to the different toxicity profile and treatment response of the tumor new predictive factors are searching to select those patients who will most benefit from the treatment with lowest risk of side effects. This review discusses the results of pharmacogenetic studies that describes the influence of polymorphisms on toxicities and tumor response to treatment with application of tyrosine kinase inhibitors. In the future, some of these polymorphisms can become predictive markers applicable in clinical practice. Copyright © 2012 Cornetis.


Laprus I.,Klinika Onkologii Klinicznej i Doswiadczalnej | Adamek M.,Medical University of Silesia, Katowice | Kozielski J.,Medical University of Silesia, Katowice
Pneumonologia i Alergologia Polska | Year: 2011

Lung cancer is the most common cancer in Poland and in the world and the leading cause of cancer-related deaths. In the past 30 years lung cancer survival has not been improved. In the same period of time significant progress has been made in the results of treatment of many other cancers for example: breast, colorectal and prostate cancer. It may be connected with introduction of efficient screening tests. Lung cancer seems to be a disease for which screening could have great impact. In the 1970s trials evaluating chest roentgenograms and sputum cytology as screening modalities were conducted, but did not show reduction in lung cancer mortality. There have been several projects in which low-dose helical computed tomography was used. Many of them were non-randomized cohort studies and showed promising results with respect to sensitivity of computed tomography, but the real benefit, which is mortality reduction, must originate from randomized trials. The major breakthrough is the National Lung Screening Trial (NLST), randomized trial conducted in USA, that demonstrated 20% mortality reduction in low-dose computed tomography group comparing to radiography group. Several randomized trials are ongoing in Europe. Researchers continue to seek new methods of screening such as autofluorescence bronchoscopy, advanced techniques of sputum analysis and techniques of molecular biology. © 2011 Via Medica.


Venous thromboembolism is a one of the most common complications of cancer, which contributes to mortality in cancer patients. The prognosis of cancer patients with thrombosis is significantly worse. Venous thromboembolism can be the first manifestation of occult cancer. Incidence of subsequent cancer diagnosis after thrombotic event reaches 25% and is highest within the first 6 months. Risk of cancer diagnosis is significantly higher in patients with idiopathic thrombosis compared with those with secondary thrombosis. We present case of 67-year-old man with recurrent vein thromboembolism and pulmonary embolism, who was subsequently diagnosed with disseminated adenocarcinoma, most likely of the lung.


Huszno J.,Klinika Onkologii Klinicznej i Doswiadczalnej | Starzyczny-Slota D.,Klinika Onkologii Klinicznej i Doswiadczalnej | Nowara E.,Klinika Onkologii Klinicznej i Doswiadczalnej
Onkologia Polska | Year: 2012

Introduction: Application of sunitinib - oral multitargeted tyrosine kinase inhibitor - to patients with metastatic renal-cell carcinoma (mRCC) assigned to the low and intermediate risk group has allowed for the extension of the overall survival and the improvement in the response and progression-free survival. Aim of the study was to present our own experience regarding the efficacy and safety of sunitinib in therapy of mRCC patients. Material and methods: This study was on 40 previously untreated mRCC patients who received sunitinib at the oral dose of 50 mg, given once daily for 4 weeks, followed by 2 weeks without treatment. The tumor response and adverse events were evaluated on the basis of clinical data. We analyzed the influence of factors such as: age, sex, hypertension, location of metastases, complications and survival with the use of a Cox regression model. Results: Among the 40 patients receiving sunitinib were 24 (65%) men and 14 women (35%). The age of the patients ranged from 39 to 76 years (median 60 years). Medians of OS and PFS were 20 and 9 months, respectively. Location of metastases in the liver (p=0.08), in lymph nodes (p=0.009) and the development of HA (p=0.08) were associated with a greater risk of death. The response rate was: partial regression in 8% patients and stagnation in 52% cases. Treatment side effects were observed in 16 (40%) patients. The most frequent clinical adverse events reported due to the use of sunitinib were neutropenia (22%), anemia (33%), oral mucosa inflammation (8%) and nausea (5%). Grades 3-4 adverse events were also observed with nausea (3%) and anemia (3%) respectively. Conclusions: Treatment with sunitinib in the first line of mRCC was burdened with a small percentage of side effects. Partial regression occurred in 8% of patients. The metastases localization in the liver and in lymph nodes as well as hypertension, which had developed before the treatment with sunitinib were associated with a higher risk of death. Copyright © 2012 Cornetis.


Huszno J.,Klinika Onkologii Klinicznej i Doswiadczalnej | Starzyczny-Solta D.,Klinika Onkologii Klinicznej i Doswiadczalnej | Nowara E.,Klinika Onkologii Klinicznej i Doswiadczalnej
Przeglad Dermatologiczny | Year: 2014

Introduction. Dermatofibrosarcoma protuberans (DFSP) is a rare sarcoma of the skin and subcutaneous tissue. The most common clinical problem is its local recurrence. The therapeutic procedure of choice is radical surgery. In the case of inoperable disease, targeted therapy with imatinib, a tyrosine kinase inhibitor, may cause significant reduction of tumor volume and even enable radical surgery. Objective. We present the effectiveness of imatinib for the treatment of unresectable DFSP localized in the area of the shoulder joint of a 62-year-old woman. Case report. The patient met the criteria for inclusion in treatment with imatinib. After 3 cycles of treatment, partial regression of the lesions (above 50%) was observed. Therapy was complicated by hepatological side effects during the sixth cycle. Treatment was continued with a reduced dose when transaminase levels normalized. In a physical examination and imaging studies, further regression was observed. The patient has regained considerable mobility of the shoulder joint. A decision to continue the treatment has been made. Conclusions. The use of imatinib allowed a clinical benefit to be gained in the form of significant regression of lesions. A very good treatment response and significant improvement in quality of life of the patient were achieved. The patient has been treated with imatinib for 30 months.


Drosik-Rutowicz K.,Klinika Onkologii Klinicznej I Doswiadczalnej | Nowara E.,Klinika Onkologii Klinicznej I Doswiadczalnej | Lesniak A.,Klinika Onkologii Klinicznej I Doswiadczalnej | Nieckula J.,Klinika Onkologii Klinicznej I Doswiadczalnej | Kozaczka M.,Klinika Onkologii Klinicznej I Doswiadczalnej
Onkologia Polska | Year: 2011

Introduction: Typically germ cell tumors are located in gonads. They can appear also in other locations, the most frequent ones are retroperitoneal space and mediastinum. There were described germ cell tumors located in pituitary gland. Primary mediastinal germ cell tumors are rare and constitute 1-6% of all mediastinal tumors. They concern mainly young males and prognosis is worse than in case of those located in gonads. The therapy of choice is chemotherapy with platin derivatives. BEP is the most frequently used combination. Material: The group of 11 patients was analysed retrospectively, average age was 26 years. Tumor was located in mediastinum in case of all patients. Four of them had seminoma and 7 had nonseminoma. Methods and results: Surgical resection was performed on 3 patients, but 2 of them experienced massive cancer progression. Chemotherapy containing cisplatin was given to all the patients. All patients with seminoma achieved partial or complete response. Average survival time/average follow-up period was 73 months. Among 7 patients with nonseminoma 6 had progression during I line chemotherapy. All of them received II line chemotherapy. High-dose chemotherapy was given to one patient. Median survival time was 13 months. Conclusions: Primary mediastinal germ cell tumors occur mainly in males. Prognosis is worse than when the tumor is located in gonads. Seminoma has better prognosis than nonseminoma. Surgical resection should be considered to remove chemotherapy residual tumors. Copyright © 2011 Cornetis.


PubMed | Klinika Onkologii Klinicznej i Doswiadczalnej
Type: Journal Article | Journal: Pneumonologia i alergologia polska | Year: 2011

Lung cancer is the most common cancer in Poland and in the world and the leading cause of cancer-related deaths. In the past 30 years lung cancer survival has not been improved. In the same period of time significant progress has been made in the results of treatment of many other cancers for example: breast, colorectal and prostate cancer. It may be connected with introduction of efficient screening tests. Lung cancer seems to be a disease for which screening could have great impact. In the 1970s trials evaluating chest roentgenograms and sputum cytology as screening modalities were conducted, but did not show reduction in lung cancer mortality. There have been several projects in which low-dose helical computed tomography was used. Many of them were non-randomized cohort studies and showed promising results with respect to sensitivity of computed tomography, but the real benefit, which is mortality reduction, must originate from randomized trials. The major breakthrough is the National Lung Screening Trial (NLST), randomized trial conducted in USA, that demonstrated 20% mortality reduction in low-dose computed tomography group comparing to radiography group. Several randomized trials are ongoing in Europe. Researchers continue to seek new methods of screening such as autofluorescence bronchoscopy, advanced techniques of sputum analysis and techniques of molecular biology.


PubMed | Klinika Onkologii Klinicznej i Doswiadczalnej
Type: Case Reports | Journal: Wiadomosci lekarskie (Warsaw, Poland : 1960) | Year: 2012

Venous thromboembolism is a one of the most common complications of cancer, which contributes to mortality in cancer patients. The prognosis of cancer patients with thrombosis is significantly worse. Venous thromboembolism can be the first manifestation of occult cancer. Incidence of subsequent cancer diagnosis after thrombotic event reaches 25% and is highest within the first 6 months. Risk of cancer diagnosis is significantly higher in patients with idiopathic thrombosis compared with those with secondary thrombosis. We present case of 67-year-old man with recurrent vein thromboembolism and pulmonary embolism, who was subsequently diagnosed with disseminated adenocarcinoma, most likely of the lung.


PubMed | Klinika Onkologii Klinicznej i Doswiadczalnej
Type: Case Reports | Journal: Ginekologia polska | Year: 2013

Mutations of BRCA1 and BRCA2 genes account for the majority of hereditary breast and ovarian cancers. So far; risk-reducing salpingo-oophorectomy has been the most effective strategy for gynecological cancer prevention in susceptibility gene mutation carriers. It does not prevent, however from the occurrence of primary peritoneal cancer We present two clinical cases of patients with the BRCA1 gene mutation. Both patients had a family history of cancer and both were presenting with metachronic malignances. The first patient, whose mother suffered from breast and ovarian cancer, was diagnosed with left breast cancer in 2004. The patient was 44 years old at diagnosis. Genetic testing revealed the BRCA1 gene mutation. A breast conserving therapy (BCT) was conducted, followed by chemotherapy, radiotherapy and immunotherapy with trastuzumab due to HER2 overexpression. Due to BRCA1 mutation, in November 2005, prophylactic hysterectomy with appendages was performed. Histological examination revealed bilateral ovarian cancer (adenocarcinoma G3) with metastasis to the paraaortal lymph node. The patient received six cycles of chemotherapy: paclitaxel and carboplatin. Ovarian cancer relapsed 3 years later After that the patient received 5 lines of chemotherapy and finally died due to disease progression in September 2011. The second patient, a 49-year-old woman, was diagnosed with breast cancer in July 2003 and subsequently treated with neoadjuvant chemotherapy breast conserving surgery and radiotherapy Genetic testing was also performed and revealed the BRCA1 gene mutation. A year earlier the patient had undergone hysterectomy with appendages due to uterine myomas. Three of her five sisters suffered from breast and ovarian cancer The patients father died of colorectal cancer The patient remained under surveillance. Because of the increasing level of Ca-125 (since October 2004), PET-CT was performed and revealed a tumor lesion of the peritoneum. Histological examination from the biopsy confirmed primary peritoneal cancer (papillary serous adenocarcinoma--primary peritoneal carcinoma). Reexamination of the tissues from hysterectomy with appendages was also performed and revealed an adenocarcinoma in the right ovary Pathologic examination excluded metastasis of a breast cancer Pathomorphology of the ovarian lesion was also different than in the lesions of the peritoneum. Thus, three different tumor types (breast, ovarian and peritoneal cancer) coexisted independently The patient received chemotherapy: paclitaxel and cisplatin. Later on, due to disease progression she was treated with five consecutive chemotherapy regimens and hormonal therapy The patient died in January 2008. These case illustrate that genetic diagnosis may be critical for the overall treatment plan.

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