Selected articles
Articles for label Skřičková Jana are displayed.. Show all articles
Current possibilities and limitations of chemotherapy
05/2020 Prof. MUDr. Jana Skřičková, CSc.
Worldwide, lung cancer is the most commonly diagnosed type of cancer in both men and women (11.6% of the total number of newly diagnosed cancers) and is the most common cause of cancer deaths (1.8 million deaths, i.e. 18.4% of total number of cancer deaths). The basic treatment modalities for lung cancer include surgical treatment, radiotherapy, chemotherapy, targeted treatment and immunotherapy. Combination chemotherapy is a basic and necessary treatment modality for all patients with small cell carcinoma. Chemotherapy also plays an important role in the treatment of non-small cell lung cancer during biological treatment and immunotherapy. It is used in adjuvant, neoadjuvant treatment and it is administered concomitantly with radiotherapy or it can follow it. Palliative chemotherapy, maintenance chemotherapy and metronomic chemotherapy are also important.
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Worldwide, lung cancer is the most commonly diagnosed type of cancer in both men and women (11.6% of the total number of newly diagnosed cancers) and is the most common cause of cancer deaths (1.8 million deaths, i.e. 18.4% of total number of cancer deaths). The basic treatment modalities for lung cancer include surgical treatment, radiotherapy, chemotherapy, targeted treatment and immunotherapy. Combination chemotherapy is a basic and necessary treatment modality for all patients with small cell carcinoma. Chemotherapy also plays an important role in the treatment of non-small cell lung cancer during biological treatment and immunotherapy. It is used in adjuvant, neoadjuvant treatment and it is administered concomitantly with radiotherapy or it can follow it. Palliative chemotherapy, maintenance chemotherapy and metronomic chemotherapy are also important.
Targeted biological treatment of non‑small cell lung cancer
05/2019 Prof. MUDr. Jana Skřičková, CSc.; MUDr. David Petr
In recent years, non-small cell lung carcinoma (NSCLC) treatment has developed rapidly. Biological treatment preparations have improved survival in NSCLC, particularly in non-operable locally advanced and metastatic NSCLC. Substances that target the processes inside tumor cells are particularly useful in adenocarcinomas. At the time of diagnosis, it is necessary to determine the morphological diagnosis as accurately as possible and, if indicated, to perform genetic testing. In our paper we give an overview of the development and possibilities of biological treatment.
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In recent years, non-small cell lung carcinoma (NSCLC) treatment has developed rapidly. Biological treatment preparations have improved survival in NSCLC, particularly in non-operable locally advanced and metastatic NSCLC. Substances that target the processes inside tumor cells are particularly useful in adenocarcinomas. At the time of diagnosis, it is necessary to determine the morphological diagnosis as accurately as possible and, if indicated, to perform genetic testing. In our paper we give an overview of the development and possibilities of biological treatment.
Non‑small cell lung cancer with EGFR mutations
05/2018 Prof. MUDr. Jana Skřičková, CSc., Mgr. Blanka Robešová, Ph.D., MUDr. Ondřej Venclíček, MUDr. Bohdan Kadlec, Ph.D., MUDr. Marcela Tomíšková, MUDr. Lenka Jakubíková, Ph.D., MUDr. Jana Špeldová, MUDr. Zdeněk Merta, CSc.
In the case of non-small cell lung cancer (NSCLC), the existence of somatic mutations in the epidermal growth factor receptor (EGFR) gene and their effect on the sensitivity to the treatment of tyrosine kinase inhibitors (TKI) is known. Mutations occur in the tyrosine kinase domain between EGFR exon 18 and 21, predominantly point deletions and deletions, eventually insertions. In exons 19 and 21, 80-90% of known activating mutations of EGFR are concentrated. The so-called activation mutations include the G719X point mutation in exon 18, the L858R and L861Q point mutations in exon 21 and the deletion in exon 19. Among so-called resistant mutations are the insertions in exon 20, the T790M and S768I point mutations in exon 20, and the D761Y mutation in exon 19. The mutation rate of the EGFR gene in the Caucasian population is 10%. In NSCLC patients experiencing activation mutations for EGFR, the most effective treatment is with tyrosine kinase inhibitors. In our paper, we investigate the activation and resistance mutations of the EGFR gene and provide an overview of the results of first, second and third generation of TKI treatment.
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In the case of non-small cell lung cancer (NSCLC), the existence of somatic mutations in the epidermal growth factor receptor (EGFR) gene and their effect on the sensitivity to the treatment of tyrosine kinase inhibitors (TKI) is known. Mutations occur in the tyrosine kinase domain between EGFR exon 18 and 21, predominantly point deletions and deletions, eventually insertions. In exons 19 and 21, 80-90% of known activating mutations of EGFR are concentrated. The so-called activation mutations include the G719X point mutation in exon 18, the L858R and L861Q point mutations in exon 21 and the deletion in exon 19. Among so-called resistant mutations are the insertions in exon 20, the T790M and S768I point mutations in exon 20, and the D761Y mutation in exon 19. The mutation rate of the EGFR gene in the Caucasian population is 10%. In NSCLC patients experiencing activation mutations for EGFR, the most effective treatment is with tyrosine kinase inhibitors. In our paper, we investigate the activation and resistance mutations of the EGFR gene and provide an overview of the results of first, second and third generation of TKI treatment.
Neuroendocrine neoplasm
05/2018 MUDr. Marcela Tomíšková, MUDr. Lenka Jakubíková, Ph.D., MUDr. Bohdan Kadlec, Ph.D., MUDr. Jana Špeldová, prof. MUDr. Jana Skřičková, CSc.
Neuroendocrine pulmonary neoplasms are a group of rare tumors. Their incidence is 1.35 cases per 100,000 inhabitants. They form a heterogeneous group from well and moderately differentiated carcinoids to very aggressive low differentiated carcinomas. Diagnosis is based on pathomorphology, immunohistochemical examination and neuroendocrine differentiation. Individual types of neuroendocrine pulmonary neoplasms (differ from one another by localization, biological behavior, clinical picture, diagnosis, and treatment approaches. Low differentiated carcinomas (LCNEC, SCLC) are aggressive, sensitive to chemotherapy and radiation but have a poor prognosis. For well and moderately differentiated neuroendocrine pulmonary neoplasms (typical and atypical carcinoid) captured in operable stage, surgical removal of the tumor leads to its complete cure. Analogs of somatostatin receptors, peptide receptor radionuclide therapy or m-TOR inhibitor (mammalian target of rapamycin) represent a new therapeutic potential in treatment of recurrent or inoperable neuroendocrine pulmonary neoplasms grade I and II.
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Neuroendocrine pulmonary neoplasms are a group of rare tumors. Their incidence is 1.35 cases per 100,000 inhabitants. They form a heterogeneous group from well and moderately differentiated carcinoids to very aggressive low differentiated carcinomas. Diagnosis is based on pathomorphology, immunohistochemical examination and neuroendocrine differentiation. Individual types of neuroendocrine pulmonary neoplasms (differ from one another by localization, biological behavior, clinical picture, diagnosis, and treatment approaches. Low differentiated carcinomas (LCNEC, SCLC) are aggressive, sensitive to chemotherapy and radiation but have a poor prognosis. For well and moderately differentiated neuroendocrine pulmonary neoplasms (typical and atypical carcinoid) captured in operable stage, surgical removal of the tumor leads to its complete cure. Analogs of somatostatin receptors, peptide receptor radionuclide therapy or m-TOR inhibitor (mammalian target of rapamycin) represent a new therapeutic potential in treatment of recurrent or inoperable neuroendocrine pulmonary neoplasms grade I and II.
Erlotinib in the treatment of advanced non‑small cell lung cancer – present experience and results in the Czech Republic
04/2018 MUDr. Helena Čoupková, Mgr. Renata Chloupková, Marek Konečný, Mgr. Magda Bařinová, prof. MUDr. Jana Skřičková, CSc., prof. MUDr. Miloš Pešek, CSc., prof. MUDr. Vítězslav Kolek, DrSc., doc. MUDr. František Salajka, CSc., doc. MUDr. Milada Zemanová, CSc., MUDr. Leona Koubková, MUDr. Libor Havel, MUDr. Kateřina Košatová
Erlotinib is an inhibitor of epidermal growth factor receptor (EGFR) tyrosine-kinase activity, a potent drug in non-small-cell lung cancer (NSCLC) treatment. In this paper, we report a population of patients suffering from advanced NSCLC who are being treated with erlotinib in the Czech Republic under the terms of the TULUNG drug registry (excluding the patients from the University Hospital of Ostrava). By October 2nd 2017, 3763 patients were treated with erlotinib in this cohort. The overall response rate (ORR) in the entire group was 8,7 %, the disease control rate was 58,5 %. Survival data were updated on May 21st 2018. Progression-free survival and overall survival were 3,1 months and 7,7 months, respectively. In our evaluation, we noticed a statistically significant difference both in overall survival (OS) and progression free survival (PFS) in patients grouped according to status of EGFR mutation, performance status, gender and smoking habits. Moreover, there was a statistically significant difference in PFS among patients grouped according to treatment line. Based on our results, skin toxicity appears to be a prognostic factor. The efficacy difference in squamous and non-squamous carcinomas was not statistically significant. From the 3763 patients included in the safety analysis, 1592 (42,3 %) experienced therapy-related adverse events, the most common was rash (35,3 %) and diarrhea (16,3 %). Serious adverse events (G3/4) were reported in 13,6 % patients, the most common was rash (9 %) and diarrhea (3 %). Our results confirm the efficacy and safety of the erlotinib therapy in the first and in the following lines of advanced NSCLC.
ENTIRE ARTICLE
Erlotinib is an inhibitor of epidermal growth factor receptor (EGFR) tyrosine-kinase activity, a potent drug in non-small-cell lung cancer (NSCLC) treatment. In this paper, we report a population of patients suffering from advanced NSCLC who are being treated with erlotinib in the Czech Republic under the terms of the TULUNG drug registry (excluding the patients from the University Hospital of Ostrava). By October 2nd 2017, 3763 patients were treated with erlotinib in this cohort. The overall response rate (ORR) in the entire group was 8,7 %, the disease control rate was 58,5 %. Survival data were updated on May 21st 2018. Progression-free survival and overall survival were 3,1 months and 7,7 months, respectively. In our evaluation, we noticed a statistically significant difference both in overall survival (OS) and progression free survival (PFS) in patients grouped according to status of EGFR mutation, performance status, gender and smoking habits. Moreover, there was a statistically significant difference in PFS among patients grouped according to treatment line. Based on our results, skin toxicity appears to be a prognostic factor. The efficacy difference in squamous and non-squamous carcinomas was not statistically significant. From the 3763 patients included in the safety analysis, 1592 (42,3 %) experienced therapy-related adverse events, the most common was rash (35,3 %) and diarrhea (16,3 %). Serious adverse events (G3/4) were reported in 13,6 % patients, the most common was rash (9 %) and diarrhea (3 %). Our results confirm the efficacy and safety of the erlotinib therapy in the first and in the following lines of advanced NSCLC.
Short nivolumab causing severe fatigue with long‑lasting partial response – a case reports
05/2017 MUDr. Lenka Jakubíková, Ph.D., MUDr. Jana Špeldová, MUDr. Marcela Tomíšková, prof. MUDr. Jana Skřičková, CSc.
The authors of the first part of the article summarize the current therapeutic results of nivolumab in both squamous and non-squamous lung cancer, as well as the safety profile of this type of immunotherapy, including recommendations for prevention and measures for the occurrence of side effects. In particular, adverse events, particularly weakness and exhaustion, were reported in two selected patients who experienced a severe fatigue with the need for permanent discontinuation of treatment immediately after initiation of treatment with nivolumab, but two months after the last dose of immunotherapy, partial healing response that lasted for one year in both patients was observed.
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The authors of the first part of the article summarize the current therapeutic results of nivolumab in both squamous and non-squamous lung cancer, as well as the safety profile of this type of immunotherapy, including recommendations for prevention and measures for the occurrence of side effects. In particular, adverse events, particularly weakness and exhaustion, were reported in two selected patients who experienced a severe fatigue with the need for permanent discontinuation of treatment immediately after initiation of treatment with nivolumab, but two months after the last dose of immunotherapy, partial healing response that lasted for one year in both patients was observed.
Pembrolizumab in the treatment of non‑small‑cell lung carcinoma
03/2017 Prof. MUDr. Jana Skřičková, CSc.
Bronchogenic carcinoma is one of the most common carcinomas of the world. Roughly 85% of all bronchogenic carcinoma is a non-small-cell lung carcinoma (NSCLC). A new approach to its treatment is immunotherapy. This treatment is not directed to the tumor itself, but on the immune system of the patient. Pembrolizumab is a human monoclonal antibody that binds to a PD-1 receptor of programmed cell death and thus blocks its interaction with ligands of PD-L1 and PD-L2. Blocking PD-1 receptor by pembrolizumab prevents binding of the respective ligands and, thus, enhances the T-cell immune response, which may thus be used in the fight against the tumor itself. The article presents the results of studies that demonstrate the effectiveness pembrolizumab in the first and other lines of treatment. It is necessary to know the state of PD-L1 expression in all NSCLC, regardless of histological type, before pembrolizumab can is indicated for any line of treatment.
ENTIRE ARTICLE
Bronchogenic carcinoma is one of the most common carcinomas of the world. Roughly 85% of all bronchogenic carcinoma is a non-small-cell lung carcinoma (NSCLC). A new approach to its treatment is immunotherapy. This treatment is not directed to the tumor itself, but on the immune system of the patient. Pembrolizumab is a human monoclonal antibody that binds to a PD-1 receptor of programmed cell death and thus blocks its interaction with ligands of PD-L1 and PD-L2. Blocking PD-1 receptor by pembrolizumab prevents binding of the respective ligands and, thus, enhances the T-cell immune response, which may thus be used in the fight against the tumor itself. The article presents the results of studies that demonstrate the effectiveness pembrolizumab in the first and other lines of treatment. It is necessary to know the state of PD-L1 expression in all NSCLC, regardless of histological type, before pembrolizumab can is indicated for any line of treatment.