Janja Ocvirk | University of Ljubljana (original) (raw)
Papers by Janja Ocvirk
Onkologija, 2013
Melanom, če je odkrit dovolj zgodaj, je ozdravljiva bolezen, medtem ko v bolj napredovalih stadij... more Melanom, če je odkrit dovolj zgodaj, je ozdravljiva bolezen, medtem ko v bolj napredovalih stadijih ostaja neozdravljiv. Kirurgija je še vedno osnovni način zdravljenja za lokalno, regionalno in izolirano metastatsko bolezen. Tveganje bolnikov z melanomom, debelejšim od 4 mm, za ponovitev bolezni je 50 %, bolnikov z zajetimi bezgavkami pa 50 do 85 % in je odvisno od števila zajetih bezgavk. Za to, da bi zmanjšali število ponovitev bolezni pri bolnikih z melanomom z velikim tveganjem, jih adjuvantno zdravimo z interferonom α (IFN α). IFN α je učinkovit, če ga uporabimo v visokih odmerkih. Tako zdravljeni bolniki imajo manj ponovitev bolezni in izboljšano 5-letno celokupno preživetje za 24 %. Zdravljenje ima tudi neželene učinke, ki pa so obvladljivi. Ostala zdravila v adjuvantnem zdravljenju niso toliko učinkovita, da bi značilno vplivala na preživetje. Metastatski melanom je neozdravljiva bolezen, kljub zdravljenju je preživetje bolnikov kratko. Različne sheme s kombinacijo tako cit...
Onkologija, 2010
Veliko bolnikom s karcinomom želodca (KŽ) in gastroezofegealnega prehoda (GEP) se bolezen po rese... more Veliko bolnikom s karcinomom želodca (KŽ) in gastroezofegealnega prehoda (GEP) se bolezen po resekciji ponovi. Ponovitve so lokalne ali z oddaljenimi zasevki ali pa gre za kombinacijo obojega. Adjuvantna kemoterapija lahko pri nekaterih vrstah solidnih tumorjev celotno preživetje podaljša predvsem z zmanjšanjem ostanka mikrozasevkov. Vloga adjuvantne kemoterapije pri teh karcinomih ni tako jasna, adjuvantna radiokemoterapija pa značilno podaljša čas brez bolezni in celotno preživetje. Perioperativno zdravljenje s kemoterapijo ECF značilno podaljša preživetje brez bolezni in v celoti. Standardno zdravljenje za bolnike z napredovalim KŽ in GEP je kemoterapija ECF ali njene izpeljanke EOF, ECX in EOX. Učinkovito je tudi zdravljenje s taksani v kombinaciji s 5-FU in cisplatinom (TCF). Z novimi kombinacijami citostatikov in z uvajanjem novih citostatikov se srednje preživetje bolnikov s KŽ in GEP podaljšuje. V zdravljenje metastatskega KŽ in GEP pa prihajajo tudi tarčna zdravila. Določan...
Background. In most cases, metastatic colorectal cancer is incurable; however, the prognosis and ... more Background. In most cases, metastatic colorectal cancer is incurable; however, the prognosis and survival of these patients have significantly improved in the last 6 years. A few years back, the only efficient drug for colorectal carcinoma, 5-fluoruracil, yielded the mean survival of 10 months, whereas today, the survival rates of 20 months or more may be obtained by using new cytostatics. In the last six years, five new drugs were registered for the treatment of metastatic colorectal cancer. These are three cytostatics (capecitabine, irinotecan, oxaliplatin) and two target drugs (cetuximab and bevacizumab). Conclusions. A combined treatment assures a better quality of life, and longer remissions and overall survival. The combination of cytostatics and target drugs improves particularly the mean survival rate, which may be longer than 30 months. These combinations of drugs used together with surgical treatment of lung and liver metastases may result in complete remission. An important research achievement of this year is the determination of KRAS mutations. The KRAS gene is the first biomarker that predicts how well patients will respond to certain combination of treatment.
Background: Glioma cells not only secrete high levels of vascular endothelial growth factor (VEGF... more Background: Glioma cells not only secrete high levels of vascular endothelial growth factor (VEGF) but also express VEGF receptors (VEGFR), supporting the existence of an autocrine loop. The direct impact on glioma cells metabolism of drugs targeting the VEGF pathway, such as Bevacizumab (Bev) or VEGFR Tyrosine Kinase Inhibitor (TKI), is poorly known. Material and Methods: U87 cells were treated with Bev or SU1498, a selective VEGFR2 TKI. VEGFR expression was checked with FACS flow cytometry and Quantitative Real-Time PCR. VEGF secretion into the medium was assessed with an ELISA kit. Metabolomic studies on cells were performed using High Resolution Magic Angle Spinning Spectroscopy (HR-MAS). Results: U87 cells secreted VEGF and expressed low level of VEGFR2, but no detectable VEGFR1. Exposure to SU1498, but not Bev, significantly impacted cell proliferation and apoptosis. Metabolomic studies with HR MAS showed that Bev had no significant effect on cell metabolism, while SU1498 indu...
Cetuximab is a chimeric human-murine monoclonal antibody against the epidermal growth factor rece... more Cetuximab is a chimeric human-murine monoclonal antibody against the epidermal growth factor receptor (EGFR). It has shown activities against multiple malignancies in clinical trials. EGFR-inhibitors often cause skin toxicity, most frequently acneiform eruption. Xerosis, eczema, fissures, teleangiectasias, nail changes and paronychia can be seen in some cases, rarely hyperpigmentation. Management of the skin toxicity helps patients to overcome cetuximab-associated skin toxicity and is of great importance for patients’ compliance. It is generally manageable with standard topical or systemic antibiotics and anti-inflammatory agents. Education of patients prior to beginning the therapy and proactive intervention at the first signs of skin toxicity are keys to successful management
Incidenca melanoma v svetu in Sloveniji se vedno narasca, skupaj z njo pa žal tudi umrljivost. V ... more Incidenca melanoma v svetu in Sloveniji se vedno narasca, skupaj z njo pa žal tudi umrljivost. V zadnjem desetletju se je incidenca podvojila. Preživetje se je v zadnjih 20 letih izboljsalo, predvsem zaradi zgodnejsega odkrivanja melanoma in enotnih pristopov v primarnem zdravljenju. Približno 25 % melanomov vznikne v predobstojecem melanocitnem nevusu, vecina pa jih nastane de novo. Dejavnike tveganja za nastanek melanoma delimo na genetske in okoljske, pomembna pa je tudi njihova medsebojna interakcija. Med preventivne ukrepe za preprecevanje melanoma uvrscamo zascito kože pred UV-sevanjem, neuporabo solarijev in redno (samo)pregledovanje kože. Pri prepoznavanju melanoma nam je v pomoc metoda ABCDE: A (asimetrija, angl. asymmetry), B (rob, angl. border), C (barva, angl. colour), D (premer, angl. diameter), E (spreminjanje, angl. evolution). Na melanom posumimo, ko je pigmentna sprememba nesimetricna, z nepravilnimi robovi, sestavljena iz vec barv, v premeru vecja od 6 mm in se spr...
Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine skin cancer with a poor prognosi... more Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine skin cancer with a poor prognosis in advanced stage. The incidence is increasing with some deviations between different geographic regions. The risk factors are advanced age, immunosuppression, and ultraviolet light exposure. There are associations between MCC and polyomavirus infection, but the exact mechanism that leads to carcinogenesis is yet to be fully understood. For localized disease (when feasible), surgery is the recommended treatment, followed by adjuvant radiation or chemoradiation. In the metastatic setting, chemotherapy has been the standard treatment, but durable responses are rare. As tumour oncogenesis is linked to Merkel cell polyomavirus integration and ultraviolet-radiation-induced mutations, there is rationale for treatment with immunotherapy antibodies that target the PD-L1/PD-1 pathway. However, recently published trials with immune checkpoint inhibitors in the first- and second-line showed promi...
The majority of primary basal cell carcinomas (BCCs) are treated surgically or, in surface lesion... more The majority of primary basal cell carcinomas (BCCs) are treated surgically or, in surface lesions, using non surgical methods. The risk of recurrence increases with tumour size, poorly defined lesion margins, an aggressive histologic sub-type and previous recurrence. In some cases, the tumour can destroy the surrounding tissues (muscles, bones, cartilage etc.) due to long-term absence of treatment or aggressiveness of the tumour (locally advanced form of BCC - IaBCC). In extremely rare cases, BCC spreads also to distant tissues (metastatic BCC - mBCC). In multiple local recurrences or invasion of surrounding/distant structures (laBCC/mBCC), where surgery and/or radiation therapy are not appropriate, it is important to use a multidisciplinary approach in patient management. Abnormal activation of the Hedgehog signalling pathway is responsible for the occurrence of the disease in 90 % of BCCs. By selectively binding to the transmembrane protein SMO (Smoothened Transmembrane Protein),...
Colorectal cancer (CC) is the most common cancer in Slovenia. According to the Cancer Registry of... more Colorectal cancer (CC) is the most common cancer in Slovenia. According to the Cancer Registry of the Republic of Slovenia, a total of 1,450 people were diagnosed with colorectal cancer in Slovenia in 2008(1). The increasing incidence also means increasing morbidity, as in half of the patients, the disease is diagnosed when already at an advanced stage. Metastatic disease is incurable, but the prognosis and the survival of these patients have improved considerably, as in the last decade, with the use of new drugs, namely a combination of cytostatics (capecitabine, irinotecan, oxaliplatin) and target drugs (cetuximab, bevacizumab, panitumumab) we have achieved a median survival of more than 30 months(2). When combining systemic and surgical treatment in patients with liver metastases, in particular if these are solitary metastases, the 5-year survival can exceed 50%. In this paper, we present a case of a patient with primary metastatic rectal carcinoma with metastases in the liver. W...
Oesophageal cancer is a relatively rate tumor with high mortality. It is most frequent in men in ... more Oesophageal cancer is a relatively rate tumor with high mortality. It is most frequent in men in their sixties or seventies. In the past years, a constant increase in the incidence of adenocarcinoma of the distal esophagus and esophagogastric juncture (EGS) has been observed in the West. This can probably be attributed changing lifestyle with increases obesity incidence and gastroesophageal reflux disease. The latest, 7th review of the TNM Classification classifies both – cancer of the esophagus and cancer of the esophagogastric juncture – as oesophageal cancer. In a select group of patients this disease is curable, however the treatment is long, usually combined and with high morbidity that can significantly impact the patient’s quality of life. Due to the specific anatomy, cancer of the esophagus and cancer of the esophagogastric juncture develop metastasis early, and the prognosis is worse compared to other gastrointestinal cancers.
Radiology and Oncology, 2018
INTRODUCTION: Our study was performed to assess the metabolic effects of bevacizumab on the gliom... more INTRODUCTION: Our study was performed to assess the metabolic effects of bevacizumab on the glioma cells carrying the IDH1 mutation, a mutation associated with better prognosis and treatment outcome. Bevacizumab is known to inhibit tumour growth by neutralizing the biological activity of VEGF. However, the direct effects of bevacizumab on tumour cells metabolism remain poorly known. MATERIAL AND METHODS: The immunoassay and MTT Assay were used to assess the concentration of secreted VEGF and cell viability after bevacizumab exposure. Metabolomic studies on cells were performed using High Resolution Magic Angle Spinning Spectroscopy (HR-MAS). RESULTS: mIDH1-U87 cells secrete VEGF (13 ng/mL). Regardless bevacizumab had no cytotoxic effect, even after a 72 h exposure and with doses as high as 1 mg/mL. Yet, HRMAS analysis showed a significant effect of bevacizumab (0.1 mg/mL) on the metabolic phenotype of mIDH1-U87 cells with elevation of 2-hydroxyglutarate and changes in glutamine grou...
Neuroendocrine tumors (NET) belong to the group of rare tumors, though their incidence is increas... more Neuroendocrine tumors (NET) belong to the group of rare tumors, though their incidence is increasing. Diagnosis and treatment vary among groups of different primary origins. NETs of gastrointestinal origin (GEP-NET) are slow growing tumors; however, most patients with GEP-NET are not diagnosed until the metastatic spread of the disease has already occurred. Somatostatin analogues are the mainstream treatments of symptom and tumor growth control in these patients. Other systemic therapies depend on the biologic potential of the tumor. S100B – Tumor marker in cutaneous melanoma Barbara Peric, Ivana Žagar, Srdjan Novakovic, Janez Žgajnar and Marko Hocevar Introduction. An increased level of serum S100B can serve as a marker of metastatic spread in patients with cutaneous melanoma (CM). In patients with elevated S100 B and/or clinical signs of disease progression, a PET-CT scan is a valuable tool for discovering metastases and planning treatment. The aims of this study were to determine...
BACKGROUND The antivascular endothelial growth factor monoclonal antibody bevacizumab with infusi... more BACKGROUND The antivascular endothelial growth factor monoclonal antibody bevacizumab with infusional 5-fluorouracil, leucovorin and irinotecan (FOLFIRI) is a standard first-line treatment option for metastatic colorectal cancer. However, clinical data for capecitabine and irinotecan (XELIRI) with bevacizumab are limited. PATIENTS AND METHODS A retrospective study was conducted on 139 patients with metastatic colorectal cancer to assess the efficacy and safety of first-line bevacizumab in combination with XELIRI or FOLFIRI. Primary endpoints were overall response rate (ORR), disease control rate and radical resection rate. Secondary endpoints included overall survival (OS), progression-free survival (PFS) and safety. RESULTS No significant differences in efficacy were observed between patients administered XELIRI or FOLFIRI with bevacizumab. The ORR, median OS and PFS and recorded adverse events (AEs) were comparable to those previously reported, with no new or unexpected AEs observ...
Considering the histology of malignant gliomas and their response to treatment, they are regarded... more Considering the histology of malignant gliomas and their response to treatment, they are regarded as a heterogenous group of brain tumors. Standard treatment is a combination of irradiation and concomitant chemotherapy with temozolomide. A new approach to the treatment of malignant gliomas is antiangiogenic strategy because these tumors are highly vasculated. Preclinical data show that the growth of these tumors depends on the onset of new blood vessels which is stimulated by various factors, such as VEGF (vascular endothelial growth factor), produced by the tumor itself. Bevacizumab is a humanized monoclonal antibody that binds to VEGF. It has been proved to be efficient the treatment of numerous solid tumors. Moreover, bevacizumab is efficient also in the treatment of glioblastomas, applied as monotherapy or in combination with cytostatics, which has been confirmed by the results of several clinical studies. In addition to its efficiency in the treatment glioblastomas, it has also...
The patients treated with cytostatic drugs may experience many side-effects, among them also skin... more The patients treated with cytostatic drugs may experience many side-effects, among them also skin and mucosal side-effects because skin and mucosal cells rapidly divide and are therefore most sensitive to cytostatics. The most common skin side-effects are hand-foot syndrome, eczema, erythroderma, hyperpigmentation. Skin toxicity of targeted drugs is different with the exception of hand-foot syndrome. EGFR-inhibitors often cause skin toxicity, most frequently acneiform eruption. Xerosis, eczema, fissures, teleangiectasias, nail changes and paronychia can be seen in some cases, rarely hyperpigmentation. Management of the skin toxicity helps patients to overcome cytostatics- and EGFR- inhibitors associated skin toxicity and is of great importance for patients’ compliance. It is generally manageable with standard topical or systemic antibiotics and anti-inflammatory agents; In some cases, it is nevertheless necessary to reduce doses of the drugs. Education of patients prior to beginning...
Onkologija, 2013
Melanom, če je odkrit dovolj zgodaj, je ozdravljiva bolezen, medtem ko v bolj napredovalih stadij... more Melanom, če je odkrit dovolj zgodaj, je ozdravljiva bolezen, medtem ko v bolj napredovalih stadijih ostaja neozdravljiv. Kirurgija je še vedno osnovni način zdravljenja za lokalno, regionalno in izolirano metastatsko bolezen. Tveganje bolnikov z melanomom, debelejšim od 4 mm, za ponovitev bolezni je 50 %, bolnikov z zajetimi bezgavkami pa 50 do 85 % in je odvisno od števila zajetih bezgavk. Za to, da bi zmanjšali število ponovitev bolezni pri bolnikih z melanomom z velikim tveganjem, jih adjuvantno zdravimo z interferonom α (IFN α). IFN α je učinkovit, če ga uporabimo v visokih odmerkih. Tako zdravljeni bolniki imajo manj ponovitev bolezni in izboljšano 5-letno celokupno preživetje za 24 %. Zdravljenje ima tudi neželene učinke, ki pa so obvladljivi. Ostala zdravila v adjuvantnem zdravljenju niso toliko učinkovita, da bi značilno vplivala na preživetje. Metastatski melanom je neozdravljiva bolezen, kljub zdravljenju je preživetje bolnikov kratko. Različne sheme s kombinacijo tako cit...
Onkologija, 2010
Veliko bolnikom s karcinomom želodca (KŽ) in gastroezofegealnega prehoda (GEP) se bolezen po rese... more Veliko bolnikom s karcinomom želodca (KŽ) in gastroezofegealnega prehoda (GEP) se bolezen po resekciji ponovi. Ponovitve so lokalne ali z oddaljenimi zasevki ali pa gre za kombinacijo obojega. Adjuvantna kemoterapija lahko pri nekaterih vrstah solidnih tumorjev celotno preživetje podaljša predvsem z zmanjšanjem ostanka mikrozasevkov. Vloga adjuvantne kemoterapije pri teh karcinomih ni tako jasna, adjuvantna radiokemoterapija pa značilno podaljša čas brez bolezni in celotno preživetje. Perioperativno zdravljenje s kemoterapijo ECF značilno podaljša preživetje brez bolezni in v celoti. Standardno zdravljenje za bolnike z napredovalim KŽ in GEP je kemoterapija ECF ali njene izpeljanke EOF, ECX in EOX. Učinkovito je tudi zdravljenje s taksani v kombinaciji s 5-FU in cisplatinom (TCF). Z novimi kombinacijami citostatikov in z uvajanjem novih citostatikov se srednje preživetje bolnikov s KŽ in GEP podaljšuje. V zdravljenje metastatskega KŽ in GEP pa prihajajo tudi tarčna zdravila. Določan...
Background. In most cases, metastatic colorectal cancer is incurable; however, the prognosis and ... more Background. In most cases, metastatic colorectal cancer is incurable; however, the prognosis and survival of these patients have significantly improved in the last 6 years. A few years back, the only efficient drug for colorectal carcinoma, 5-fluoruracil, yielded the mean survival of 10 months, whereas today, the survival rates of 20 months or more may be obtained by using new cytostatics. In the last six years, five new drugs were registered for the treatment of metastatic colorectal cancer. These are three cytostatics (capecitabine, irinotecan, oxaliplatin) and two target drugs (cetuximab and bevacizumab). Conclusions. A combined treatment assures a better quality of life, and longer remissions and overall survival. The combination of cytostatics and target drugs improves particularly the mean survival rate, which may be longer than 30 months. These combinations of drugs used together with surgical treatment of lung and liver metastases may result in complete remission. An important research achievement of this year is the determination of KRAS mutations. The KRAS gene is the first biomarker that predicts how well patients will respond to certain combination of treatment.
Background: Glioma cells not only secrete high levels of vascular endothelial growth factor (VEGF... more Background: Glioma cells not only secrete high levels of vascular endothelial growth factor (VEGF) but also express VEGF receptors (VEGFR), supporting the existence of an autocrine loop. The direct impact on glioma cells metabolism of drugs targeting the VEGF pathway, such as Bevacizumab (Bev) or VEGFR Tyrosine Kinase Inhibitor (TKI), is poorly known. Material and Methods: U87 cells were treated with Bev or SU1498, a selective VEGFR2 TKI. VEGFR expression was checked with FACS flow cytometry and Quantitative Real-Time PCR. VEGF secretion into the medium was assessed with an ELISA kit. Metabolomic studies on cells were performed using High Resolution Magic Angle Spinning Spectroscopy (HR-MAS). Results: U87 cells secreted VEGF and expressed low level of VEGFR2, but no detectable VEGFR1. Exposure to SU1498, but not Bev, significantly impacted cell proliferation and apoptosis. Metabolomic studies with HR MAS showed that Bev had no significant effect on cell metabolism, while SU1498 indu...
Cetuximab is a chimeric human-murine monoclonal antibody against the epidermal growth factor rece... more Cetuximab is a chimeric human-murine monoclonal antibody against the epidermal growth factor receptor (EGFR). It has shown activities against multiple malignancies in clinical trials. EGFR-inhibitors often cause skin toxicity, most frequently acneiform eruption. Xerosis, eczema, fissures, teleangiectasias, nail changes and paronychia can be seen in some cases, rarely hyperpigmentation. Management of the skin toxicity helps patients to overcome cetuximab-associated skin toxicity and is of great importance for patients’ compliance. It is generally manageable with standard topical or systemic antibiotics and anti-inflammatory agents. Education of patients prior to beginning the therapy and proactive intervention at the first signs of skin toxicity are keys to successful management
Incidenca melanoma v svetu in Sloveniji se vedno narasca, skupaj z njo pa žal tudi umrljivost. V ... more Incidenca melanoma v svetu in Sloveniji se vedno narasca, skupaj z njo pa žal tudi umrljivost. V zadnjem desetletju se je incidenca podvojila. Preživetje se je v zadnjih 20 letih izboljsalo, predvsem zaradi zgodnejsega odkrivanja melanoma in enotnih pristopov v primarnem zdravljenju. Približno 25 % melanomov vznikne v predobstojecem melanocitnem nevusu, vecina pa jih nastane de novo. Dejavnike tveganja za nastanek melanoma delimo na genetske in okoljske, pomembna pa je tudi njihova medsebojna interakcija. Med preventivne ukrepe za preprecevanje melanoma uvrscamo zascito kože pred UV-sevanjem, neuporabo solarijev in redno (samo)pregledovanje kože. Pri prepoznavanju melanoma nam je v pomoc metoda ABCDE: A (asimetrija, angl. asymmetry), B (rob, angl. border), C (barva, angl. colour), D (premer, angl. diameter), E (spreminjanje, angl. evolution). Na melanom posumimo, ko je pigmentna sprememba nesimetricna, z nepravilnimi robovi, sestavljena iz vec barv, v premeru vecja od 6 mm in se spr...
Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine skin cancer with a poor prognosi... more Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine skin cancer with a poor prognosis in advanced stage. The incidence is increasing with some deviations between different geographic regions. The risk factors are advanced age, immunosuppression, and ultraviolet light exposure. There are associations between MCC and polyomavirus infection, but the exact mechanism that leads to carcinogenesis is yet to be fully understood. For localized disease (when feasible), surgery is the recommended treatment, followed by adjuvant radiation or chemoradiation. In the metastatic setting, chemotherapy has been the standard treatment, but durable responses are rare. As tumour oncogenesis is linked to Merkel cell polyomavirus integration and ultraviolet-radiation-induced mutations, there is rationale for treatment with immunotherapy antibodies that target the PD-L1/PD-1 pathway. However, recently published trials with immune checkpoint inhibitors in the first- and second-line showed promi...
The majority of primary basal cell carcinomas (BCCs) are treated surgically or, in surface lesion... more The majority of primary basal cell carcinomas (BCCs) are treated surgically or, in surface lesions, using non surgical methods. The risk of recurrence increases with tumour size, poorly defined lesion margins, an aggressive histologic sub-type and previous recurrence. In some cases, the tumour can destroy the surrounding tissues (muscles, bones, cartilage etc.) due to long-term absence of treatment or aggressiveness of the tumour (locally advanced form of BCC - IaBCC). In extremely rare cases, BCC spreads also to distant tissues (metastatic BCC - mBCC). In multiple local recurrences or invasion of surrounding/distant structures (laBCC/mBCC), where surgery and/or radiation therapy are not appropriate, it is important to use a multidisciplinary approach in patient management. Abnormal activation of the Hedgehog signalling pathway is responsible for the occurrence of the disease in 90 % of BCCs. By selectively binding to the transmembrane protein SMO (Smoothened Transmembrane Protein),...
Colorectal cancer (CC) is the most common cancer in Slovenia. According to the Cancer Registry of... more Colorectal cancer (CC) is the most common cancer in Slovenia. According to the Cancer Registry of the Republic of Slovenia, a total of 1,450 people were diagnosed with colorectal cancer in Slovenia in 2008(1). The increasing incidence also means increasing morbidity, as in half of the patients, the disease is diagnosed when already at an advanced stage. Metastatic disease is incurable, but the prognosis and the survival of these patients have improved considerably, as in the last decade, with the use of new drugs, namely a combination of cytostatics (capecitabine, irinotecan, oxaliplatin) and target drugs (cetuximab, bevacizumab, panitumumab) we have achieved a median survival of more than 30 months(2). When combining systemic and surgical treatment in patients with liver metastases, in particular if these are solitary metastases, the 5-year survival can exceed 50%. In this paper, we present a case of a patient with primary metastatic rectal carcinoma with metastases in the liver. W...
Oesophageal cancer is a relatively rate tumor with high mortality. It is most frequent in men in ... more Oesophageal cancer is a relatively rate tumor with high mortality. It is most frequent in men in their sixties or seventies. In the past years, a constant increase in the incidence of adenocarcinoma of the distal esophagus and esophagogastric juncture (EGS) has been observed in the West. This can probably be attributed changing lifestyle with increases obesity incidence and gastroesophageal reflux disease. The latest, 7th review of the TNM Classification classifies both – cancer of the esophagus and cancer of the esophagogastric juncture – as oesophageal cancer. In a select group of patients this disease is curable, however the treatment is long, usually combined and with high morbidity that can significantly impact the patient’s quality of life. Due to the specific anatomy, cancer of the esophagus and cancer of the esophagogastric juncture develop metastasis early, and the prognosis is worse compared to other gastrointestinal cancers.
Radiology and Oncology, 2018
INTRODUCTION: Our study was performed to assess the metabolic effects of bevacizumab on the gliom... more INTRODUCTION: Our study was performed to assess the metabolic effects of bevacizumab on the glioma cells carrying the IDH1 mutation, a mutation associated with better prognosis and treatment outcome. Bevacizumab is known to inhibit tumour growth by neutralizing the biological activity of VEGF. However, the direct effects of bevacizumab on tumour cells metabolism remain poorly known. MATERIAL AND METHODS: The immunoassay and MTT Assay were used to assess the concentration of secreted VEGF and cell viability after bevacizumab exposure. Metabolomic studies on cells were performed using High Resolution Magic Angle Spinning Spectroscopy (HR-MAS). RESULTS: mIDH1-U87 cells secrete VEGF (13 ng/mL). Regardless bevacizumab had no cytotoxic effect, even after a 72 h exposure and with doses as high as 1 mg/mL. Yet, HRMAS analysis showed a significant effect of bevacizumab (0.1 mg/mL) on the metabolic phenotype of mIDH1-U87 cells with elevation of 2-hydroxyglutarate and changes in glutamine grou...
Neuroendocrine tumors (NET) belong to the group of rare tumors, though their incidence is increas... more Neuroendocrine tumors (NET) belong to the group of rare tumors, though their incidence is increasing. Diagnosis and treatment vary among groups of different primary origins. NETs of gastrointestinal origin (GEP-NET) are slow growing tumors; however, most patients with GEP-NET are not diagnosed until the metastatic spread of the disease has already occurred. Somatostatin analogues are the mainstream treatments of symptom and tumor growth control in these patients. Other systemic therapies depend on the biologic potential of the tumor. S100B – Tumor marker in cutaneous melanoma Barbara Peric, Ivana Žagar, Srdjan Novakovic, Janez Žgajnar and Marko Hocevar Introduction. An increased level of serum S100B can serve as a marker of metastatic spread in patients with cutaneous melanoma (CM). In patients with elevated S100 B and/or clinical signs of disease progression, a PET-CT scan is a valuable tool for discovering metastases and planning treatment. The aims of this study were to determine...
BACKGROUND The antivascular endothelial growth factor monoclonal antibody bevacizumab with infusi... more BACKGROUND The antivascular endothelial growth factor monoclonal antibody bevacizumab with infusional 5-fluorouracil, leucovorin and irinotecan (FOLFIRI) is a standard first-line treatment option for metastatic colorectal cancer. However, clinical data for capecitabine and irinotecan (XELIRI) with bevacizumab are limited. PATIENTS AND METHODS A retrospective study was conducted on 139 patients with metastatic colorectal cancer to assess the efficacy and safety of first-line bevacizumab in combination with XELIRI or FOLFIRI. Primary endpoints were overall response rate (ORR), disease control rate and radical resection rate. Secondary endpoints included overall survival (OS), progression-free survival (PFS) and safety. RESULTS No significant differences in efficacy were observed between patients administered XELIRI or FOLFIRI with bevacizumab. The ORR, median OS and PFS and recorded adverse events (AEs) were comparable to those previously reported, with no new or unexpected AEs observ...
Considering the histology of malignant gliomas and their response to treatment, they are regarded... more Considering the histology of malignant gliomas and their response to treatment, they are regarded as a heterogenous group of brain tumors. Standard treatment is a combination of irradiation and concomitant chemotherapy with temozolomide. A new approach to the treatment of malignant gliomas is antiangiogenic strategy because these tumors are highly vasculated. Preclinical data show that the growth of these tumors depends on the onset of new blood vessels which is stimulated by various factors, such as VEGF (vascular endothelial growth factor), produced by the tumor itself. Bevacizumab is a humanized monoclonal antibody that binds to VEGF. It has been proved to be efficient the treatment of numerous solid tumors. Moreover, bevacizumab is efficient also in the treatment of glioblastomas, applied as monotherapy or in combination with cytostatics, which has been confirmed by the results of several clinical studies. In addition to its efficiency in the treatment glioblastomas, it has also...
The patients treated with cytostatic drugs may experience many side-effects, among them also skin... more The patients treated with cytostatic drugs may experience many side-effects, among them also skin and mucosal side-effects because skin and mucosal cells rapidly divide and are therefore most sensitive to cytostatics. The most common skin side-effects are hand-foot syndrome, eczema, erythroderma, hyperpigmentation. Skin toxicity of targeted drugs is different with the exception of hand-foot syndrome. EGFR-inhibitors often cause skin toxicity, most frequently acneiform eruption. Xerosis, eczema, fissures, teleangiectasias, nail changes and paronychia can be seen in some cases, rarely hyperpigmentation. Management of the skin toxicity helps patients to overcome cytostatics- and EGFR- inhibitors associated skin toxicity and is of great importance for patients’ compliance. It is generally manageable with standard topical or systemic antibiotics and anti-inflammatory agents; In some cases, it is nevertheless necessary to reduce doses of the drugs. Education of patients prior to beginning...