No abstract

Although patupilone has not demonstrated superiority over pegylated liposomal doxorubicin in a large Phase III trial in relapsed or refractory ovarian cancer, its evaluation is continuing in a range of other malignancies, especially in primary or secondary tumors of the CNS.

No abstract

Oesophageal cancer is the eighth most common cancer diagnosed worldwide, with almost half a million new cases diagnosed each year. Despite improvements in surgical and radiotherapy techniques and refinements of chemotherapeutic regimens, long-term survival, even from localized oesophageal cancer, remains poor. Surgical resection alone remains the standard approach for very early stage disease (stage I), but whilst surgery remains fundamental to the treatment of stage II-III resectable adenocarcinoma, multimodality therapy with chemotherapy or chemoradiation (CRT) is internationally accepted as the standard of care. Data from two large, randomized phase III trials support the use of perioperative combination chemotherapy in lower oesophageal and oesophagogastric junction adenocarcinomas, but the contribution of the adjuvant therapy is uncertain. There are conflicting data from randomized studies of a purely neoadjuvant approach; however, recent meta-analyses have demonstrated that chemotherapy or CRT given prior to radical surgery improves survival in patients with adenocarcinoma of the oesophagus. Neoadjuvant CRT but not chemotherapy alone is also beneficial for patients with squamous cell carcinoma. Definitive CRT has emerged as a useful option for the treatment of resectable squamous cell carcinoma of the oesophagus, avoiding potential surgical morbidity and mortality for most patients, with salvage surgery reserved for those with persistent disease. In this review, we focus on the pharmacotherapy of resectable oesophageal and oesophagogastric junction cancers and how clinical trials and meta-analyses inform current clinical practice.

Even though the blood coagulation pathway may be activated in more aggressive disease related to an elevated CTC count, in this study, we did not find any association between CTCs and plasma concentrations of tPA.

ANXA2 stromal expression might play a key role in aggressive tumor phenotype associated with increased EMT CTCs release, however, other factors beyond ANXA2 are responsible for coagulation activation mediated by CTCs in breast cancer patients.

Východiska: Syndróm hornej dutej žily (superior vena cava obstruction-SVCO) je spôsobený obštrukciou prietoku v hornej dutej žile. V súčasnosti najčastejšou príčinou je karcinóm pľúc alebo iná malignita rastúca expanzívne v hornom mediastine. SVCO je jeden z urgentných stavov u onkologických pacientov a vyžaduje neodkladnú dia gnostiku a liečbu. Prípad 1: Sedemdesiat deváť ročného pacienta s nemalobunkovým karcinómom pľúc vpravo, IIIB štádium, po dvoch cykloch chemoterapie sme prijali k hospitalizácii pre klinické známky SVCO. U pacienta sme indikovali urgentnú rádioterapiu na oblasť tumoru. Pre progredujúci klinický stav počas rádioterapie sme pristúpili k implantácii samoexpanzibilného stentu do hornej dutej žily s rýchlym ústupom klinických ťažkostí. Prípad 2: V druhom prípade ide o 56ročnú pacientku s novodia gnostikovaným difúznym veľkobunkovým B lymfómom vo IV. štádiu s postihnutím mediastina. Pacientka bola s klinickými známkami SVCO privezená na našu chemoterapeutickú ambulanciu ešte pred zahájením onkologickej liečby. Pacientka udávala rozvoj opuchu viečok, tváre a úporného kašľa v priebehu dvoch dní. CT vyšetrenie ukázalo tumor mediastina s kompresiou vena cava superior. U pacientky bola indikovaná urgentná chemoterapia v schéme R-CHOP, ktorá viedla k rýchlemu vymiznutiu príznakov SVCO. Záver: Syndróm hornej dutej žily je urgentný stav u onkologických pacientov spôsobený externým útlakom hornej dutej žily najčastejšie pľúcnym karcinómom, lymfómom alebo, zriedkavejšie, trombózou centrálneho venózneho katétra. Stav vyžaduje promptnú liečbu a multidisciplinárnu spoluprácu medzi radiačnými a klinickými onkológmi a intervenčnými rádiológmi. Kľúčové slová syndróm hornej dutej žily-karcinóm pľúc nemalobunkový-lymfom B bunkový-rádioterapia-chemoterapia nádorov-stenty Summary Background: Superior vena cava syndrome (SVCO) is caused by compression of superior vena cava and restriction of blood flow to the heart. The most common underlying condition in cancer patients is lung cancer or other malignancy expanding in the upper mediastinum. SVCO belongs to oncological emergencies and requires a prompt dia gnostic work up and treatment. Case 1: A 79year old man with a history of right sided stage IIIB nonsmall cell lung cancer, after two cycles of chemotherapy, was admitted to hospital with clinical signs of SVCO. The initial radiotherapy brought no relief of symptoms and due to deterioration of patient's status during the treatment we proceeded to self expanding caval stent insertion. This was followed by immediate resolution of SVCO symptoms. Case 2: In the second case we describe a 56year old female with a newly dia gnosed diffuse large B cell lymphoma who presented with SVCO symptoms when referred to our outpatient chemotherapy department. She had no history of previous treatment and she complained of a rapid face and eyelid edema and intractable cough in the last two days. CT scan revealed mediastinal mass compressing the superior vena cava. Urgent antilymphoma chemotherapy (RCHOP schedule) was commenced and yiel...

Systemic oncological treatment may cause drug-induced liver injury (DILI). Therefore, there is a pressing need for an active drug able to accelerate liver regeneration. Silymarin mitigates oxidative stress, and inhibits pro-inflammatory and pro-apoptotic cytokines and the fibrotic transformation of liver tissue. Currently, there are a lack of data regarding the optimal dosage of silymarin and its efficacy. Thus, the present retrospective study aimed to determine the optimal dose of silymarin for use in oncological DILI treatment. For this purpose, 180 patients with solid malignancies treated with systemic oncological therapy and silymarin between January, 2015 and November, 2021 were enrolled in the study. Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (Bil) levels, as well as the dose of silymarin were assessed at the initiation of silymarin treatment, after 3-6 weeks and after 6-12 weeks. Pearson's correlation analysis was performed to evaluate the correlation between the initial dose of silymarin (IDoS), and the ALT, AST and Bil levels. The effects of four independent variables, namely IDoS, the initial dose reduction of systemic treatment, the systemic treatment dose reduction at first assessment (DR1M) and the elevation of the silymarin dose at first control on the ALT, AST and Bil levels were evaluated using regression analysis. The median IDoS was 450 mg. A decrease in or the stabilization of the ALT, AST and Bil levels after 6-12 weeks were observed in 68.63, 65.85 and 53.25% of patients, respectively. There was a weak correlation between IDoS and the decrease in ALT and AST levels after 6-12 weeks (correlation coefficient, R=0.361 and 0.277 respectively, P<0.001). No significant correlation between the IDoS and a decrease in Bil levels was observed. DR1M was a negative predictor for a decrease in Bil levels in patients with liver tumors. On the whole, the present study demonstrates that silymarin appears to be efficient in alleviating DILI at a dose of 300-450 mg. A further increase in the dose of silymarin may not lead to an adequate increase in its efficacy.