Klinická onkologie : casopis Ceské a Slovenské onkologické spolecnosti
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Review
[Immunotherapy of Urothelial Carcinoma of the Bladder - from BCG Vaccines to Targeted Therapy].
Bladder cancer has high prevalence in men and women. Bladder cancer usually originates from urothelium. More than 75% of cases are classified as nonmuscle invasive bladder cancer. ⋯ While local chemoprophylaxis is sufficient in low and middle risk patients, intravesical instillation of Mycobacterium bovis bacillus CalmetteGuerin (BCG) is preferred in high risk bladder cancer. Chemotherapy alone or in combination with locoregional treatment is used in advanced bladder cancer. New immunotherapy modalities have proven their efficacy in several clinical studies in advanced bladder cancer.
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Chimeric antigen receptors are synthetic, genetically modified receptors of T-cells. The introduction of chimeric antigen receptors into autologous patient T-cells can redirect the lymphocytes to specific antigen targets on the surface of malignant cells. ⋯ The individual variables are currently being tested in numerous clinical trials. In this review, I will briefly describe the principle, basic structure and construction of chimeric antigen receptor T-lymphocytes.
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Based on the results of phase III trial, vinflunine was approved by European Medicines Agency in 2010 as second line treatment of advanced urothelial cancer in patients with good performance status (ECOG 0- 1). The objective of this prospective observational study was to assess vinflunine treatment of advanced urothelial cancer patients in terms of progression free survival and overall survival, and to evaluate vinflunine toxicity. ⋯ This study summarizes the first Slovak experience with vinflunine therapy. Our data confirmed the efficacy of vinflunine and its acceptable toxicity in the treatment of patients with advanced urothelial cancer previously treated with a platinum-based regimen.Key words: advanced urothelial cancer - vinflunine - progression-free survival - overall survival - side effects.
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Rectal adenocarcinoma, in contrast to colorectal carcinoma, is typical of its high local reccurence rate. Radiotherapy is proved to reduce the incidence of recurrences. Neoadjuvant chemoradiotherapy demonstrated better treatment results than adjuvant chemoradiotherapy. ⋯ Epidermal growth factor receptor (EGFR) is supposed to play an important role in cell- cycle regulation, proliferation, differentiation, and surviving of normal epithelial tissues. EGFR overexpression in patients with rectal adenocarcinoma is associated with radioresistance of malignant tissues, lower rates of patological complete response after neoadjuvant chemoradiation and generally poor survival. There are many clinical studies describing combination of neoadjuvant chemoradiotherapy with EGFR inhibitors, however, this regimen has not gained an acceptance as a standard of treatmentment.
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Germ cell testicular cancer (TC) patients have an increased risk of developing a contralateral TC. This paper presents a retrospective analysis of patients with bilateral TC from a database of a single center and aims to highlight the need for an individual approach. ⋯ All patients with unilateral TC have an increased risk of developing a contralateral TC, years and even decades after the initial diagnosis. Management of subsequent TC should be individualized for each patient according to the histology and clinical stage of the primary tumor, as well as the therapeutic strategy applied initially. The further management should involve a long-term follow-up and life-long testosterone substitution.