Onkologicka klinika

Prague, Czech Republic

Onkologicka klinika

Prague, Czech Republic
SEARCH FILTERS
Time filter
Source Type

Kopeckova K.,Onkologicka klinika
Onkologie (Czech Republic) | Year: 2017

Despite the extensive possibilities of systemic treatment for advanced renal cell carcinoma have been still missing positive adjuvant trials. Several studies with immunotherapy based on interferon alfa or interleukin -2 failed. The adjuvant trials with TKI concluded with conflicting results. The ASSURE study compared sunitinib or sorafenib with placebo was not able to detect any difference in diseases free survival compared to placebo and was associated with high rate of toxicity and discontinuation of treatment. The adjuvant trial S-TRAC comparing sunitinib and placebo resulted in prolonged diseases free survival 6.8 years vs. 5.6 years. None of these trials incorporated a new validated genetic recurrence score to predict the risk of recurrence. The adjuvant systemic treatment for renal cell carcinoma is not recommended in the clinical daily practise today.


Buchler T.,Onkologicka klinika
Onkologie (Czech Republic) | Year: 2017

Renal cell carcinoma (RCC) has traditionally been considered an immunogenic malignancy. Despite this, the majority of existing immunotherapeutic strategies have brought only little benefit to patients with a generalized tumour. In some clinical settings, however, a novel generation of immunotherapeutic drugs, particularly those from the group of checkpoint inhibitors, has shown superiority over standard targeted therapy, while having relatively low toxicity.


Buchler T.,Onkologicka klinika
Onkologie (Czech Republic) | Year: 2016

Systemic treatment for bladder cancer is indicated in four clinical situations, including neoadjuvant therapy prior to radical cystectomy for muscle-invasive bladder cancer, adjuvant chemotherapy after cystectomy for muscle-invasive bladder cancer, as a part of bladder sparing protocols in concomitance with radiotherapy, and for treatment of advanced or metastatic disease. Chemotherapy regimens containing cisplatin are the basis of current systemic therapies for bladder cancer.


Zemanova M.,Onkologicka klinika
Klinicka Farmakologie a Farmacie | Year: 2015

Lung cancer is the leading worldwide cause of cancer death and the majority of patients present with metastatic stage IV disease. Palliative systemic therapy is the main choice in metastatic stage. Different treatment strategies exist according to squamous or non-squamous histology or molecularly defined markers in non-small-cell lung cancer. Molecular testing for at least epidermal growth factor receptor (EGFR) and ALK should be performed in all patients before therapy. Targeted therapy in sensitive mutations with TKI (gfitinib, erlotinib or afatinib) or crizotinib and ceritinib, respectively, can achieve response rate above 60 % and significantly prolong survival. Platinum doublet chemotherapy may be considered for all other patients. Bevacizumab can be considered for addition to the doublet in patients with nonsquamous cancers who have no contraindications. For patients initially treated with a platinum doublet, maintenance chemotherapy with pemetrexed, erlotinib, gemcitabine, or possibly docetaxel is an option with selection based on clinical features, histology, type of initial therapy, and response to first-line therapy. Treatment with docetaxel, pemetrexed or erlotinib can prolong survival in second line therapy. New antiangiogenic drugs nintedanib and ramucirumab were registred for second line treatment together with docetaxel in last year. Immunotherapy use (antiMUC-1, antiPDL-1) in clinical practice is approaching. © 2014, SOLEN s.r.o. All rights reserved.


Buchler T.,Onkologicka klinika | Cejkova J.,Onkologicka klinika
Klinicka Farmakologie a Farmacie | Year: 2015

Recognition of the importance of the HER2/neu receptor for the human epidermal growth factor has been a major progress in individualizing the treatment in patients with breast cancer. HER2 is a key regulator of tumour cell apoptosis. Overexpression of HER2 enables permanent activation of signalling pathways and acts as a factor stimulating tumour growth in breast cancer. Biological therapy that blocks the HER2 receptor results in improved treatment outcomes. Available agents blocking the HER2 receptor include trastuzumab, trastuzumab emtansine, lapatinib, and pertuzumab. © 2014, SOLEN s.r.o. All rights reserved.


Targeted therapy is indicated for many types of solid malignancies, either in monotherapy or in combination with chemotherapy, hormonal therapy, or radiotherapy. The incorporation of targeted drugs into clinical algorithms has improved the prognosis of many cancers but also increased the risk of some less common adverse effects. Targeted therapy may increase haematological toxicity of chemotherapy and cause disruption of protective barriers or directly inhibit the function of immune cells. Routine prophylactic anti-infective therapy in patients treated with current targeted therapies for solid tumors is not recommended. Some targeted drugs, however, may predispose to specific infectious complications.


Petruzelka L.,Onkologicka Klinika
Vnitrni Lekarstvi | Year: 2011

Clinical use of targeted biological treatment was initiated in 1970s following a discovery of hormonal receptors and targeted clinical use of tamoxifen. Deeper understanding of molecular principles of the process of metastasizing and cell communication and signalling have contributed to the development of targeted molecular biological treatments based on direct impact on the key target structures of a tumour cell. Clinical effectiveness of targeted biological treatment has been shown in phase III clinical studies in advanced and metastasising solid tumours and importantly expanded our armamentarium of pharmacotherapeutic treatment options in breast cancer, colorectal cancer, non-small cell lung cancer, kidney cancer, hepatocellular carcinoma and gastrointestinal stromal tumour. Full implementation of targeted therapy is precluded by a lack of reliable predictors of efficacy of a number of targeted drugs. Therefore, full identification of such predictors is a subject to intensive clinical research. At present, selection of biological treatment is based on morphological, immunohistochemical and partly also molecular profile of a tumour. The future of biological treatment lies in a selection that is based on full molecular characterization of the primary tumour as well as metastasis.


Tesarova P.,Onkologicka Klinika
Aktuality v Nefrologii | Year: 2015

The therapy of overlapping problems of anemia in chronic renal failure and anemia of chronic disease associated with malignancies is one of a series of border issues between the oncology and nephrology, which may be included in the issue onconephrology (acute and chronic renal failure in patients with malignant tumor, nephrotoxicity of anticancer therapy, paraneoplastic syndromes with a the kidney injury, the patients after nephrectomy for kidney cancer, antitumor treatment and replacement of kidney function, kidney transplant in patients in remission of malignancy, systemic treatment of cancer patiens after kidney transplantation, treatment of pain in patients with malignancy and chronic renal insufficiency). New recommendations for the optimal therapeutic approach in these situations should most likely be based on the results of recent clinical studies in onconephrology A meta-analysis of clinical and preclinical trials with ESA in cancer patiens not confirmed the negative impact of the ESA on the progression of a malignant tumor, but some of the individual trials have demonstrated a link between the administration of the ESA and the progression of the disease. For the safe and a sufficient effect of the treatment, it is necessary to adhere to the principles of the administration of ESA based on the recommendations of the ASCO/ASH, ESMO, EORTC rules.


Buchler T.,Onkologicka Klinika
Klinicka Onkologie | Year: 2015

Background: Renal cell carcinoma is characterised by chemo- and radioresistance. Although drugs targeting angiogenesis and intracellular signaling have become the mainstay of systemic therapy for renal cell carcinoma in the last decade, latest immunotherapeutic approaches have achieved promising results. Aim: To review the development of immunotherapy for renal cell carcinoma, especially the results of published studies using novel immunotherapeutic agents including checkpoint inhibitors. Results: It has long been known that nonspecific immunotherapy may result in long term complete remission in a small number of patients. Advances in immunology have led to the renewal of interest in the use of anticancer immunotherapy for metastatic renal cell carcinoma. Promising results in phase I and II studies have been achieved using monoclonal antibodies against PD-1 receptor and its ligand. Studies comparing immunotherapy to standard targeted therapies are ongoing.


In recent years, thanks to new advances in tumor immunology, immunotherapy became a part of intensive research as a novel strategy in cancer treatment. Sipuleucel-T is the first and only medicinal product approved by the regulatory agencies in the USA and Europe for the treatment of asymptomatic or minimal symptomatic castrate-refractory prostate cancer. It represents the first product of autologous cell therapy. This article gives a brief overview of new approaches in cancer immunotherapy in clinical development.

Loading Onkologicka klinika collaborators
Loading Onkologicka klinika collaborators