Human papillomaviruses and their role in the etiopathogenesis of malignant tumors

01/2017 Jan Laco
Human papillomaviruses, most commonly transmitted by sexual intercourse, are important pathogens, which significantly contribute to the formation of benign mucocutaneous lesions, e.g., squamous cell papillomas, condylomas, and warts, and of malignant tumors of anogenital and head and neck areas. They are the most important risk factors for cervical, vaginal and anal carcinomas, and they also play a role in the development of a subset of vulvar and penile carcinomas. In head and neck area, the are strongly associated with oropharyngeal carcinoma, mostly affecting palatine tonsils and root of tongue, and with a subset of sinonasal carcinomas.

Laboratory aspects of human papillomavirus testing

01/2017 Kateřina Sieglová, Hana Vošmiková, Jan Laco, Ivo Šteiner
Human papillomavirus (HPV) has been known as the main etiological factor of cervical carcinoma al ready in 1983. Since then, HPV is recognized in relation with carcinomas of other organs of anogenital tract and also of the head and neck region. Recently, it became obvious that HPV-associated squamous cell carcinomas differ significantly from the HPV-negative ones - in the epidemiology, biological behavior and prognosis. Therefore, HPV testing of tumor tissue becomes clinically important. The reis a number of methods for HPV detection, with varying requirements for the biological material and also for their sensitivity, validity and cost. According to these differences, it is important to select optimal method for HPV detection.

The role of human papillomavirus in etiopathogenesis of anogenital cancers

01/2017 Ivan Práznovec, Petr Halada, Peter Škapinec, Jiří Špaček
Human papillomavirus is the most common cause of sexually transmitted infections. It is associated with development of anogenital tumours (cervix, vagina, vulva, anus, penis). Out of these cancers cervix has the highest incidence in the Czech Republic. Approximately 40 HPV subtypes affect anogenital area. Prooncogenic proteins E6 and E7 as well as intracellular p53 play an important role in the etiopathogenesis. HPV infection is transmissed mostly through a sexual contact.

Human papillomaviruses in etiopathogenesis of head and neck cancer and its epidemiology

01/2017 Jan Klozar
The incidence of human papillomaviruses (HPV) associated oropharyngeal cancer rapidly increases. HPV positive tumors are different from tobacco induced tumors biologically, epidemiologically and also by its clinical behavior. Patients with HPV positive tumors are significantly less frequently smokers and may have different sexual habits. The existence of two distinct entities of oropharyngeal cancer can in the future influence the clinical decision making, the treatment of HPV positive tumors will probably be deescalated and thus have reduced toxicity. Vaccination of the whole population together with limitation of tobacco consumption could have beneficial effect on the incidence of oropharyngeal cancer.

Treatment of head and neck tumors – prognostic and predictive significance of human papillomavirus

01/2017 Miloslav Pála
Squamous cell carcinomas of the head and neck are a heterogeneous group of malignancies with different pathways for pathogenesis - one mediated by tobacco and alcohol consumption and the other by human papillomavirus (HPV). These HPV-related carcinomas have distinct epidemiological and molecular characteristics and subsequent distinct biological behaviour and clinical outcome as compared with HPV-negative carcinomas. Multiple retrospective studies have shown that patients with HPV-positive oropharyngeal carcinomas are more responsive to treatment and have better prognosis. Current prospective studies are investigating whether appropriate deescalation of treatment can reduce toxicity without compromising outcomes in this group of tumours.

Ten years of human papillomavirus vaccination and gender issue

01/2017 Tomáš Fait
Human papillomaviruses (HPV) are the most important causes of cervical cancer but also other carcinomas and non-malignant lessions especially of women's and men's genital area. But not only. Prevention of HPV infection is the primary prevention of all HPV-associated lessions. Rules of safety sex are very important but HPV could be transfer also by noncoital activities. Ten years ago clinical history of HPV vaccination has started by quadrivalent vaccine. In 2015 it was graduated by nonavalent vaccine. All HPV vaccines are characterized by high efficacy against including types of HPV and also high safety.

Vaccination against human papillomavirus in general practice for children and adolescents

01/2017 Alena Šebková
Preventative health care for wide population is the cornerstone of any developed country healthcare system. Preventive systems are based on local customs and practices, but, at the same time, they develop with new medical knowledge. Prevention is important not only for individuals, their wellbeing and life quality from childhood to old age, but for the society as well, from social, labor and economic perspectives. In addition to preventive checkups and screening tests, vaccination plays an important role, being an effective tool for the prevention of major infectious diseases. Typically, it's highly infectious diseases that are being vaccinated against. The rising incidence of cancer, however, requires us to provide a protection against the onset and irreversible sequelae of cancer too. Therefore, researchers are trying to find options for cancer prevention. In cancer prevention, there are currently several vaccines available, such as vaccines against Hepatitis B and Human Papilloma Virus, as both infections are associated with cancer.

ALK inhibitors in the treatment of patients with NSCLC

01/2017 Libor Havel
Patients with EML4-ALK translocation represent small, but clinically interesting subgroup of patients with non-small cell lung cancer. Since this genetic alteration revealing we are witness of rapid progress in therapy of these patients. ALK (anaplastic lymphoma kinase) inhibitors became a standard therapy in first line treatment, second generation ALK inhibitors are available in clinical practice and higher lines are tested. This article would be a summarisation of recent attitude to ALK inhibitors in NSCLC.

Options sequential therapy in prostate cancer patients

01/2017 Jana Katolická
During past years, there was a significant progress in the threatment of metastatic castration-resistant prostate cancer. We have various drugs available, including those affecting androgenic receptor - enzalutamide and abiraterone, imunotherapeuthic agents - sipuleucel-T, from taxan-based chemotherapeutics we administer docetaxel and cabazitaxel and as a bone tissue targeting radiopharmaceutical, radium-223 is used. Sequentional threatment allow us to significantly prolong the survival of the patients suffering from metastatic castration-resistant prostate cancer.

Breakthrough pain

01/2017 Štěpán Rusín, Petr Jelínek
Breakthrough pain is a transitory flare of strong intensity pain in patients with otherwise well controlled and treated baseline pain. It occurs in any chronic pain, both of cancer and non-cancer type. Its treatment should be part of the treatment of any chronic pain. To solve this kind of pain, each out patient treated for chronic pain should be equipped with suitable rescue medication with rapid onset of action.