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OncoReview
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2020
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vol. 10
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issue 1
27-30
EN
Colorectal cancer is the second leading cause of cancer-related death worldwide. Trifluridine/tipiracil is a novel orally administered antineoplasmatic thymidine-based nucleoside analog which represents an approved option for the treatment of advanced metastatic colorectal cancer in patients who are refractory, or are not considered candidates for, currently available therapies. In this report, we present a case of chemotherapy using trifluridine/tipiracil confirming the effectiveness of this drug primarily in the term of prolongation of progression free survival.
EN
Chemotherapy is the standard treatment for metastatic testicular cancers. The autologous hematopoietic stem cell transplantation is a salvage option for relapsed patients. The paper presents a case of a 20-year-old patient with stage IIIC non-seminoma treated with BEP chemotherapy and autologous transplantation of stem cells, which allowed to achieve durable remission.
EN
Taxanes, whose mechanism of action is based on blocking the cells’ division of cells, have been commonly used in the chemotherapy process for over two decades. The indications for the use of taxanes include ovarian cancer, breast cancer, lung cancer, prostate cancer, some of gastrointestinal malignant tumors or Kaposi sarcoma. Currently, chemotherapy based on taxanes, as well as every cytostatic medicine, allows to improve survival outcomes in many patients with diagnosed malignancies, although it also involves the occurrence of adverse effects. These adverse events may be life-threatening or at least they can decline the patient’s quality of life. The main aim of this paper is to feature possible ocular side effects during taxane based chemotherapy. Physicians taking care of patients during chemotherapy based on taxanes, as well as on every other cytostatic medicine, should be aware of these probable ocular complications. An early diagnosis of ophthalmic complications caused by chemotherapy makes it possible to avoid long-lasting adverse effects.
EN
Numerous studies of mitochondrial DNA (mtDNA) in cancer have shown differences between mtDNA sequences in tumor and normal tissue and at various stages of cancer treatment in the same patient. However, there is little data on acute lymphoblastic leukemia (ALL), the most common type of leukemia in children. In this study we compared mitochondrial sequence variation in the D-loop region and in 5 genes of mtDNA in bone marrow samples of 6 pediatric patients with ALL at various stages of therapy. We found several common polymorphisms and one variant at position 3688 whose level varied during leukemia treatment. Our results suggest that mitochondrial DNA mutations, whose levels change during patient treatment, could be potential biomarkers for monitoring treatment efficacy and disease progression.
OncoReview
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2021
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vol. 11
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issue 2
40-43
EN
Pancreatic cancer is one of the most common malignant neoplasms with a short survival time and a low cure rate. This neoplasm progresses quickly, it is often diagnosed in the advanced stage, which means that systemic treatment regimens are not sufficiently effective. A case of 65-year-old patient with metastatic pancreatic cancer who underwent sequential chemotherapy with the use of liposomal irinotecan was presented.
EN
The paper discusses two clinical cases of cancer patients undergoing chemotherapy, in whom fractured and displaced tips of portacath catheters were revealed based on plain chest imaging. In the first case, the portacath fragment migrated to the left pulmonary artery, with the missing catheter tip revealed during the procedure of port removal due to its occlusion, with no other prior clinical symptoms. In the second case, the catheter broke off at the level of its entry into the subclavian vein, and migrated into the right cardiac ventricle, which was accompanied by mild pain and oedema in the subclavicular region. Both patients underwent successful procedures of percutaneous foreign body retrieval with the use of endovascular snares. The procedures were performed via femoral vein access, with no complications.
OncoReview
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2017
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vol. 7
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issue 2
98-103
EN
Anaemia is one of the most frequently diagnosed complications in cancer patients and also occurs during the course of cancer treatment. The condition can be observed in as many as 60–70% of patients who receive chemotherapy or radiotherapy. As a cancer symptom, it is found in 30% of cases and is particularly severe when accompanied by kidney failure. In patients undergoing cancer therapy, anaemia is treated with PRBC transfusions and/or recombinant human erythropoietin. The article discusses 3 case studies of patients with late-stage cancer (pleural mesothelioma, urothelial kidney carcinoma, and lung carcinoma), who suffered from moderate to severe anaemia during aggressive treatment with chemo- and radiotherapy. All 3 patients were treated with erythropoietin, which made it possible for them to stay on chemotherapy and/or undergo radiotherapy. Thanks to erythropoietin, they did not require PRBC transfusions and their general condition and quality of life improved. They tolerated the treatment well and no complications were observed.
OncoReview
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2020
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vol. 10
|
issue 1
23-26
EN
Colorectal cancer is the most common gastrointestinal malignancy and the third most frequently diagnosed cancer worldwide. Trifluridine/tipiracil represents an approved option for the treatment of advanced metastatic colorectal cancer in patients who are refractory, or are not considered candidates for currently available therapies. We present a case of a young woman with refractory metastatic colorectal cancer treated with this agent as the IV line of chemotherapy in which remarkable prolongation of progression free survival time was observed.
OncoReview
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2016
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vol. 6
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issue 4
A193-198
EN
Purpose: To determine the toxicity and efficacy profile of non-pegylated doxorubicin in combination with capecitabine administered according to LipAX regimen. Materials and methods: The analysis included 5 female patients undergoing first-line treatment for metastatic breast cancer. Patients received non-pegylated doxorubicin intravenously and oral capecitabine at usual doses used for monotherapy, until disease progression or unacceptable toxicity. Results: Patients received a total of 26 complete treatment cycles according to LipAX regimen. During treatment, 15 toxicities occurred, including 7 adverse events with grade 3 severity. Only two haematological toxicities were observed, and the other 13 were of a non-haematological nature. Only one patient experienced no adverse events. Apart from symptomatic treatment, the capecitabine dose was reduced twice and the non-pegylated doxorubicin once. Positive clinical outcomes were observed in 4 patients, and disease progression was reported in the case of 1 patient in the course of the treatment. The median time to disease progression was 10.4 months, and the median overall survival was 34.2 months. During the 54-month follow-up, 4 of the patients died. The surviving patient continues treatment. Conclusions: Therapy according to the LipAX regimen was relatively well tolerated, however, since the majority of patients discontinued treatment due to adverse events, and not disease progression, an adequate reduction in the cytostatic doses should be considered. The use of the LipAX regimen may contribute to the achievement of long-term remission in some patients, a fact that encourages further studies on this form of therapy.
EN
Vindoline and its analogues are important constituents of the Madagascan periwinkle Catharanthus roseus, and some of them are valuable chemotherapy drugs used in treatment for some types of cancer, including leukaemia, lymphoma, breast and lung cancer. The search for semi-synthetic congeners of natural substances is still an important task for organic chemistry. In this communication we report the synthesis of five new vindoline derivatives, 15-(2-methoxyphenyl)vindoline 11, 15-(3-methoxyphenyl)vindoline 12, 15-(2-nitrophenyl)vindoline 13, 15-(3-cyanophenyl)vindoline 15, and 15-(4-cyanophenyl)vindoline 16 using the Suzuki-Miyaura reaction as the key step. X-Ray analysis of compound 16 is also reported.
OncoReview
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2021
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vol. 11
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issue 3
77-79
EN
Pancreatic cancer is one of the malignant neoplasms with the worst prognosis. It is most often diagnosed at an advanced stage, which relates to unsatisfactory results of the therapy. Only about 15–20% of patients with pancreatic cancer qualify for surgery. The remaining patients are diagnosed with locally advanced disease or much more frequently in the generalized stage. Systemic treatment (chemotherapy) remains the mainstay of therapy in these patients, but both the response rate and progression-free time are unsatisfactory [1, 2]. This paper presents a case of a patient with metastatic pancreatic cancer, in whom three lines of systemic treatment were applied sequentially, which allowed to extend the survival time and improve the quality of life.
EN
Introduction: The most common form of cardiotoxicity in cancer treatment is anthracycline-related cardiomyopathy. Objective: To study the factors affecting response to heart failure (HF) therapy in patients with anthracycline- related cardiomyopathy (ARC). Methods: Patients with ARC were included in the study. ARC was defined as left ventricular ejection fraction (LVEF) < 50% in patients who had received anthracycline based chemotherapy. 2Decho was done at baseline and every 3 months after starting anti-heart failure treatment. The primary endpoint of the study was response to anti-heart failure treatment. The patients were considered as responders when LVEF increased at least 10 absolute points. The secondary endpoint was overall survival. Results: 177 patients with ARC were included in the study. The median cumulative dose of doxorubicin was 275 mg/m2. Median clinical follow up duration was 19 months (range 3–73 months). 55% were responders. 25 cumulative doxorubicin dose of more than 200 mg/m2 increased the likelihood of non-response (p = 0.008), by a factor of 3.07 (95% CI: 1.34–7.05). 25 patients expired. There was a significant difference in overall survival among responders as compared to non-responders (p value: 0.002, log rank test). Conclusions: In patients with ARC cumulative doxorubicin dose of more than 200 mg/m2 increased the likelihood of non-response to anti-heart failure treatment. Responders have a better overall survival compared to non-responders in patients with ARC.
EN
We present 2 cases of acute coronary syndrome in patients with concomitant neoplastic disease during chemotherapy. In both patients, we found unusual angiographic image which showed that despite the presence of very large thrombi, there were no or hardly any atherosclerotic lesions in the vessel occlusion site. Aspiration thrombectomy was successfully performed in both cases to restore coronary flow and in the second patient, two bare metal stents were also implanted. After the patients were discharged from hospital, we decided to add enoxaparin to the routine dual antiplatelet therapy of both of them. So far, no guidelines have been developed on how to manage patients with acute coronary syndrome and concomitant neoplastic diseases while on chemotherapy.
14
88%
EN
Folates - one carbon carriers - take part in the metabolism of purine, thymidylate and some amino acids. Internalization of these compounds employs several mechanisms of transport systems. Reduced folate carriers and folate receptors play the most important role in this process. The physiological role of these molecules in normal and neoplastic cells is described regarding changes in transport activity and connection of transport systems with resistance to antifolates and cancer development.
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vol. 21(3)
237-250
EN
The aim of the study was a comparison of two groups of women who suffered from breast cancer in the past, selected on the basis of the time elapsed since treatment completion (<7 and >7 years). The specific areas of interest were the quality of life, sense of control, and level of depression. Results from 37 women were analysed. The average age in the research sample was 57. The study was conducted with the use of EORTC QLQ-C30, MHLC, and Depression Assessment Questionnaire. Women in whose case the time elapsed since the completion of anticancer treatment is no more than 7 years have a more negative assessment of the quality of life aspects, that is physical and social functioning, in comparison to persons in whose case the adaptation time to changes, following cancer and treatment, is longer (more than 7 years). The studied persons with a shorter period elapsed since the completion of anticancer therapy hold stronger beliefs concerning their own influence on their health in comparison to women who have not undergone oncological treatment for at least 7 years. The author’s own research highlights the trend pertaining to the differences in the intensity of experiencing guilt and anxiety between the groups. However, it requires further research involving a larger group of studied patients. Despite the progress in the diagnostics and treatment of breast cancer, patients with this type of cancer still experience long-term subjective difficulties in areas making up their physical, mental, and social well-being. The research proves the differences in functioning of women depending on the time that has elapsed since the completion of anticancer treatment.
EN
The paper presents a clinical case of a patient with a long-term response to IV line chemotherapy with trifluridine/tipiracil. The treatment allowed to maintain a good quality of life with acceptable side effects.
OncoReview
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2020
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vol. 10
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issue 2
41-47
EN
Coexistence of cardiovascular diseases and cancer is more and more common in everyday practice. This is due to the aging of the population and the fact that most of the classic cardiovascular risk factors also predispose to cancer. During anti-cancer treatment, cardiovascular components may be damaged and eventually lead to acute coronary syndrome. The first part of the review article presents the pathophysiology, clinical presentation and key elements of the diagnostic process of this life-threatening condition in cancer patients.
EN
Diffuse large B-cell lymphomas are the most common group among all lymphomas. Despite the effectiveness of the I line therapy in 10–40% of patients, the possibility of relapse should be taken into account. The anthracycline antibiotics used in the II line therapy carry a high risk of cardiac complications. In patients with refractory or recurrent disease, emergency treatment is used, aiming for the transplantation of hematopoietic cells. If the II line therapy fails, the prognosis is bad. A new chance for patients with refractory or recurrent B-cell lymphoma is pixantrone dimaleate, a drug structurally related to anthracyclines with a significantly lower cardiotoxic potential. The paper presents a case of a 65-year-old patient with relapsing DLBCL lymphoma, after two treatment lines: R-CHOP and R-DHAP, and after autologous transplantation of stem cells, in which the use of pixantrone in the treatment of recurrence allowed to achieve remission and prepare the patient for the allo-HSCT procedure.
EN
The overall survival (OS) of patients suffering From various tumour entities was correlated with the results of in vitro-chemosensitivity assay (CSA) of the in vivo applied drugs. Material and methods. Tumour specimen (n=611) were dissected in 514 patients and incubated for primary tumour cell culture. The histocytological regression assay was performed 5 days after adding chemotherapeutic substances to the cell cultures. n=329 patients undergoing chemotherapy were included in the in vitro/in vivo associations. OS was assessed and in vitro response groups compared using survival analysis. Furthermore Cox-regression analysis was performed on OS including CSA, age, TNM classification and treatment course. Results. The growth rate of the primary was 73-96% depending on tumour entity. The in-vitro response rate varied with histology and drugs (e.g. 8-18% for methotrexate and 33-83% for epirubicine). OS was significantly prolonged for patients treated with in vitro effective drugs compared to empiric therapy (log-rank-test, p=0.0435). Cox-regression revealed that application of in vitro effective drugs, residual tumour and postoperative radiotherapy determined the death risk independently. Conclusions. When patients were treated with drugs effective in our CSA, OS was significantly prolonged compared to empiric therapy. CSA guided chemotherapy should be compared to empiric treatment by a prospective randomized trial.
OncoReview
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2020
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vol. 10
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issue 2
52-56
EN
Chronic lymphocytic leukemia is the most commonly recognized type of leukemia in adults. The appearance of systemic symptoms such as weight loss, fever, or local symptoms in the form of rapidly growing organomegaly, lymphadenopathy in a patient with CLL raises the suspicion of transformation into a high-grade lymphoma – defined as Richter syndrome which is usually associated with very poor prognosis. The described case concerns a 71-year-old patient with this diagnosis, in whom due to the confirmed resistance to subsequent lines of immuno- and chemotherapy, an „emergency” treatment with a modern chemotherapy drug from the aza-anthracendion group – pixantrone was used. Treatment with pixantrone was associated with a relatively good response, translating into partial remission (also in the area of infiltrative changes in the head and neck structures), stabilization of the course of the disease and, consequently, allowed to extend the patient’s life.
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