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Alpelisib – the first PI3K inhibitor in the treatment of hormone‑positive, HER2‑negative breast cancer
05/2021 MUDr. Stanislav Hloušek
Despite all the progress of recent years, hormone therapy is still the main treatment modality in most patients with breast cancer. However, even for this treatment, resistance and disease progression may develop over time then it is necessary to find therapy for the second and higher lines of treatment. A suitable candidate for this situation appears to be alpelisib - an α-specific phosphatidylinositol-3-kinase (PI3K) inhibitor which, in combination with fulvestrant, has been shown to be effective in patients with advanced hormone-dependent, human epidermal growth factor receptor 2-negative (HER2-negative) breast cancer where PI3K catalytic subunit alpha (PIK3CA) mutations have been identified, after disease progression to hormonal therapy, even if cyclin dependent kinase 4/6 (CDK4/6) inhibitors have been used. This efficacy was documented in the SOLAR-1 study in patients after hormonal treatment failure compared to placebo and in the BYLieve study, which enrolled patients after previous progression to CDK4/6 inhibitors.
ENTIRE ARTICLE
Despite all the progress of recent years, hormone therapy is still the main treatment modality in most patients with breast cancer. However, even for this treatment, resistance and disease progression may develop over time then it is necessary to find therapy for the second and higher lines of treatment. A suitable candidate for this situation appears to be alpelisib - an α-specific phosphatidylinositol-3-kinase (PI3K) inhibitor which, in combination with fulvestrant, has been shown to be effective in patients with advanced hormone-dependent, human epidermal growth factor receptor 2-negative (HER2-negative) breast cancer where PI3K catalytic subunit alpha (PIK3CA) mutations have been identified, after disease progression to hormonal therapy, even if cyclin dependent kinase 4/6 (CDK4/6) inhibitors have been used. This efficacy was documented in the SOLAR-1 study in patients after hormonal treatment failure compared to placebo and in the BYLieve study, which enrolled patients after previous progression to CDK4/6 inhibitors.
Combination therapy in locally advanced esophageal cancer, its benefits and risks – case report
03/2020 MUDr. Stanislav Hloušek; doc. MUDr. Milada Zemanová, Ph.D.
The case report presents a patient with locally advanced carcinoma of the distal esophagus, clinical stage IIIB. Due to the stage of the disease a neoadjuvant concomitant chemoradiotherapy was indicated. During the treatment the patient developed complications for which he had to be hospitalized. For the aphagia the patient was provided with parenteral nutrition and nutritional jejunostomy was indicated to adjust nutritional parameters. After improvement of the general condition, the patient was able to undergo a radical procedure, after which the disease remission lasts so far. Thus, the case presents the potential benefits and complications of combination therapy in a patient with locally advanced esophageal cancer.
ENTIRE ARTICLE
The case report presents a patient with locally advanced carcinoma of the distal esophagus, clinical stage IIIB. Due to the stage of the disease a neoadjuvant concomitant chemoradiotherapy was indicated. During the treatment the patient developed complications for which he had to be hospitalized. For the aphagia the patient was provided with parenteral nutrition and nutritional jejunostomy was indicated to adjust nutritional parameters. After improvement of the general condition, the patient was able to undergo a radical procedure, after which the disease remission lasts so far. Thus, the case presents the potential benefits and complications of combination therapy in a patient with locally advanced esophageal cancer.
Stereotactic radiotherapy as an alternative to surgical treatment at the early stage of non‑small cell lung cancer
01/2019 MUDr. Stanislav Hloušek; doc. MUDr. Milada Zemanová, Ph.D.; prof. MUDr. David Feltl, Ph.D., MBA
Case presents a patient with non-small cell lung cancer at clinical stage IA3, who refused surgical removal of the tumor. Instead of surgery, the patient was offered a variant with stereotactic radiotherapy that the patient agreed to and underwent without complications. Partial remission was observed in subsequent CT scans. One year after the therapy the patient is without signs of progression or generalization. The case therefore presents an alternative to standard surgical treatment for patients for whom, for various reasons, this modality is not indicated or preferred.
ENTIRE ARTICLE
Case presents a patient with non-small cell lung cancer at clinical stage IA3, who refused surgical removal of the tumor. Instead of surgery, the patient was offered a variant with stereotactic radiotherapy that the patient agreed to and underwent without complications. Partial remission was observed in subsequent CT scans. One year after the therapy the patient is without signs of progression or generalization. The case therefore presents an alternative to standard surgical treatment for patients for whom, for various reasons, this modality is not indicated or preferred.