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Golnik, Slovenia

Cufer T.,University Clinic Golnik | Ovcaricek T.,University of Maribor | O'Brien M.E.R.,Royal Marsden Hospital
European Journal of Cancer | Year: 2013

The standard palliative treatment for advanced stage NSCLC remains a platinum doublet but by tailoring chemotherapy according to tumour histology the results can be improved through using pemetrexed-containing schemas in non-squamous-cell disease. In addition, maintenance chemotherapy appears to be effective in patients achieving clinical benefit by induction therapy. Targeted therapy based on the presence of activating epidermal growth factor receptor (EGFR) activating mutations or EML4-ALK gene rearrangement is becoming standard practice with high median survival rates, up to 30 months. There are still numerous other molecular targeted drugs in development. This review presents the most recent relevant progress in systemic anti-cancer therapy of advanced NSCLC in the past 5 years and delineates today's new treatment options. © 2012 Elsevier Ltd. All rights reserved. Source

Sersa G.,Institute of Oncology Ljubljana | Cufer T.,University Clinic Golnik | Paulin S.M.,Institute of Oncology Ljubljana | Cemazar M.,Institute of Oncology Ljubljana | Snoj M.,Institute of Oncology Ljubljana
Cancer Treatment Reviews | Year: 2012

Chest wall breast cancer recurrence after mastectomy is a disease difficult to treat. Its incidence varies between 5% and 30% in different subset of patients. When possible, radical surgical therapy represents the main treatment approach, however when the disease progresses and/or treatments are not successful, ulceration, bleeding, lymphedema and psychological distress of progressive disease significantly decrease the quality of the remaining life of a patient. When surgical excision of chest wall recurrence is not possible, other local treatments such as radiotherapy, radiotherapy with hyperthermia, topical chemotherapy and electrochemotherapy might be taken into account. Electrochemotherapy provides safe, efficient and non-invasive locoregional treatment approach for chest wall breast cancer recurrence. Several clinical studies have demonstrated high efficacy and a good safety profile of electrochemotherapy applied in single or multiple consecutive sessions, till clinical response was reached. Electrochemotherapy can be performed either with cisplatin injected intratumorally or with bleomycin given intratumorally or intravenously. Furthermore, it can be effectively used in heavily pre-treated areas, after surgery, radiotherapy or systemic chemotherapy. These are the advantages that might demand its use especially in patients with pre-treated extensive disease and in frail elderly patients. With development of the technology electrochemotherapy could even be suggested as a primary local therapy in patients not suitable for surgical removal of the primary tumor. © 2011 Elsevier Ltd. Source

McDonagh T.A.,Kings College | Gardner R.S.,Golden Jubilee National Hospital | Lainscak M.,University Clinic Golnik | Nielsen O.W.,Copenhagen University | And 3 more authors.
European Journal of Heart Failure | Year: 2014

It is well established that organized care of heart failure patients, including specialist management by cardiologists, improves patient outcomes. In response to this, other national training bodies (the UK and the USA) have developed heart failure subspecialty curricula within their Cardiology Training Curricula. In addition, European Society of Cardiology (ESC) subspecialty curricula exist for Interventional Cardiology and Heart Rhythm Management. The purpose of this heart failure curriculum is to provide a framework which can be used as a blueprint for training across Europe. This blueprint mirrors other ESC curricula. Each section has three components: the knowledge required, the skills which are necessary, and the professionalism (attitudes and behaviours) which should be attained. The programme is designed to last 2years. The first year is devoted to the specialist heart failure module. The second year allows completion of the optional modules of advanced imaging, device therapy for implanters, cardiac transplantation, and mechanical circulatory support. The second year can also be devoted to continuation of specialist heart failure training and/or research for those not wishing to continue with the advanced modules. © 2014 European Society of Cardiology. Source

Koren A.,University Clinic Golnik | Motaln H.,Slovenian National Institute of Biology | Cufer T.,University Clinic Golnik
Cellular Oncology | Year: 2013

Introduction: Lung cancer is the most lethal form of cancer in the world and despite significant therapeutic improvements that have been made, its survival rate still remains low. The latter is mainly due to the acquisition of resistance to systemic treatment regimens which, in turn, may be due to the presence of cancer stem cells (CSCs) within the primary tumors. CSCs constitute a subpopulation of cells that are highly tumorigenic and that exhibit biological properties similar to those of normal tissue stem cells, including an unlimited self-renewal capacity, an extensive proliferative capacity and a capacity to generate differentiated progeny. A better understanding of the signaling pathways that regulate lung CSC maintenance, proliferation, and tumorigenicity could thus lead to the design of improved approaches to lung cancer treatment. Aim: In this review we will discuss the current knowledge on lung CSCs, their biological properties and their putative clinical relevance. By employing currently available data, we will evaluate the prognostic value of several lung CSC markers. In addition, we will discuss the release of CSCs from tumor tissue into the blood circulation via epithelial-mesenchymal transition (EMT) as an important step towards acquiring a metastatic phenotype. Finally, we will provide an outlook into novel CSC-targeting approaches for achieving less invasive diagnostic procedures and improving long-term therapeutic options. Conclusion: Lung CSC research has gained considerable momentum to both basic and clinical applications, both aiming to identify a reliable panel of markers for lung CSCs and to clarify their function, with the final goal to develop a CSC-targeted therapy that will result in the complete elimination of CSCs for achieving significantly better long-time survival of lung cancer patients. © 2013 International Society for Cellular Oncology. Source

Borstnar S.,Institute of Oncology | Sadikov A.,Institute of Oncology | Mozina B.,University of Ljubljana | Cufer T.,University Clinic Golnik
Breast Cancer Research and Treatment | Year: 2010

Urokinase-type plasminogen activator (uPA) and its main inhibitor (PAI-1) were shown with level 1 evidence to be prognostic factors for primary breast cancer. Our preliminary retrospective study on a cohort of 1,220 consecutive patients hinted that uPA and PAI-1 could also serve as predictive factors for systemic therapy, namely that patients with high levels of the two markers benefit much more from anthracycline-based chemotherapy than patients with low levels of the two markers. The latter could equally well be treated with less toxic CMF-based chemotherapy (cyclophosphamide, methotrexate, and fluorouracil). The retrospective study, however, suffered from severely uneven patient and tumor characteristics as the patients were treated per institutional guidelines valid at the time and were not randomized between the anthracycline and CMF arms. In the present paper, we attempted to remedy this shortcoming and recheck our previous observations on more balanced data. To this end we employed a custom-made computer algorithm that selected 180 patients out of a total of 1,220 patients such that we obtained very well balanced anthracycline and CMF arms according to patient and tumor characteristics. Moreover, the low and high uPA/PAI-1 subgroups within both arms were also completely balanced. The algorithm in a way created a similar setting to that of a randomized study at the expense of greatly reducing the number of patients included into the study. In this setting, we observed the 3-year disease-free survival (DFS) in all four subgroups (according to treatment and levels of markers: both uPA and PAI-1 low versus one or both high). We report that the 3-year DFS in the CMF arm differed significantly: 87.1% for patients with low levels of markers versus 77.0% for patients with high levels of markers (P = 0.044, HR = 2.81, 95% CI = 0.98-8.04). On the other hand, the 3-year DFS in the anthracycline arm did not differ much between the two marker level subgroups: 85.2% for patients with low levels of markers versus 81.8% for patients with high levels of markers. Our observation points out that worse prognosis correlated to high uPA and PAI-1 levels can be reversed by treatment efficacy achieved through anthracycline-based chemotherapy. Based on this observation, we hypothesize that uPA/PAI-1 combination could be predictive for response to systemic therapy. © Springer Science+Business Media, LLC. 2009. Source

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