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Despite progress in primary treatment of patients with advanced ovarian cancer, the majority develop recurrence of the disease. A platinum salt treatment, either as monotherapy or in combination with another cytostatic agent, is indicated for patients who have relapsed 6 or more months after primary treatment and thus have platinum-sensitive relapse. Because repeated use of paclitaxel treatment may lead to substantial neurotoxicity, the combination of gemcitabine with carboplatin represents a suitable treatment option, which is widely used in common clinical practice in the Czech Republic and Slovakia.This non-interventional, prospective study observed the effectiveness and tolerability of second-line treatment with gemcitabine and carboplatin in patients with platinum-sensitive relapse of ovarian cancer in routine clinical practice. The primary endpoint was to evaluate the survival and secondary endpoints were to evaluate time to disease progression, objective tumor response rate, and treatment toxicity.Patients were enrolled to planned second-line treatment with gemcitabine and carboplatin (gemcitabine 1000 mg/m 2 and carboplatin AUC 5 on Day 1, and gemcitabine 1000 mg/m 2 on Day 8 of a 21-day cycle) for platinum-sensitive relapse of ovarian cancer as a part of routine clinical practice and followed for 12 months. The events (death, tumor progression), tumor response, and maximal grades of toxicity were recorded according to common clinical practice. Survival time (using Kaplan-Meier analysis) and objective tumor response rate were calculated using data forms, and a subgroup analysis was performed using log rank tests for time-to-event endpoints; p-values were also calculated. Response rates were calculated for the whole population; for the subgroups, the Fisher's exact test was performed and only p-values were calculated.Between January 2004 and June 2005, 53 patients were enrolled in the study. The median age was 57 years and 96% of patients had an Eastern Cooperative Oncology Group Performance Status (ECOG-PS) of 0 and 1 at baseline. Approximately 91% of patients were originally diagnosed with stage III or IV; 60% of patients had disease free intervals (DFIs) of 12 or more months from previous therapy, and the additional 40% less than 12 months. The 1-year survival rate was 83%. Median survival time was not determined within the 12-month period following the start of the treatment study due to the limited duration of follow-up. Objective tumour response rate was 67.3%. Most common reasons for discontinuation of therapy were "Planned treatment completed" (53%) and "Tumor progression" (11%). Most common toxicities were leukopenia, anaemia, neutropenia, and thrombocytopenia; grades 3 and 4 of these toxicity types did not exceed 30%. Febrile neutropenia was recorded in two patients. Most common non-haematological toxicities were nausea and vomiting, fatigue, and neuropathy; grades 3 and 4 of these were below 6%. Results on time to disease progression are not published due to inconsistent statistical analysis of...

Background: Natriuretic factors are peptidic substances produced by atrial and ventricular myocardium. Primary stimulus to the synthesis of these factors is intramural pressure of atriums by the increase of venous return during intravascular hypervolemia. They may serve as useful cardiac markers in clinical practice. The elevation of N-terminal fragment of atrial natriuretic peptide is characteristic for cardiac failure. Troponin T is a basic component of muscle and is specific for myocardial cell. It is a marker of myocardial damage, specifically of myocardial infarction. Purpose: This paper aims to summarize the current knowledge on levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and their associations with cancer. At present, it is well known that natriuretic peptides may be produced by cancer cells without cardiac failure. While small cell lung cancer is a known producer of natriuretic factor, all oncologic diseases may have a potential to produce these substances. ProBNP synthesis may be stimulated by several pro-inflammatory cytokines, including tumour necrosis factor alpha and some interleukins. The production of pro-inflammatory cytokines has been proven in cancer. The influence of natriuretic factors to proto-oncogenes and cancer cells is considered and cross-reacting antibodies increasing NT-proBNP in paraproteinemias were described. Works discussing extreme elevations of NT-proBNP in terminal cancer patients without symptoms of cardiac failure were previously published. NT-proBNP and troponin T are also markers of myocardial damage during cardiotoxic chemotherapy with anthracyclines. Conclusion: NT-proBNP and troponin T can be valuable markers of the prognosis of oncologic diseases regarding not only cardiac damage during chemotherapy but also prognosis and extension of cancer patient lives.