Clinical Oncology - 2016;3(04)

Clinical Oncology

DECEMBER 10, 2016

[Foreword]

A szerkesztők

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HUN 2016;3(04)

Clinical Oncology

DECEMBER 10, 2016

[Reminiscences of a Peer – Remembering Sándor Eckhardt]

KERPEL-FRONIUS Sándor

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HUN 2016;3(04)

Clinical Oncology

DECEMBER 10, 2016

[News from the World]

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HUN 2016;3(04)

Clinical Oncology

DECEMBER 10, 2016

[Side-effects of immunotherapy]

LANDHERR László

[The immune system has an important role in controlling and eradicating cancer cells. Antibody therapy against several negative immunologic regulators (checkpoints) has demonstrated promise in a variety of malignancies. The immune checkpoint blockade with antibodies against cytotoxic T lymphocyte- associated antigen 4 (CTLA-4) and the programmed cell death protein 1 pathway (PD-1/PD-L1) and its ligand have a unique and distinct pattern of adverse events. Immune-related adverse events are most commonly observed in the skin, gastrointestinal tract, liver and the endocrine system. Early recognition and treatment are believed to be important in mitigating severity of such adverse effects.]

HUN 2016;3(04)

Clinical Oncology

DECEMBER 10, 2016

[Chemotherapy of multiple myeloma]

MIKALA Gábor, CEGLÉDI Andrea, CSACSOVSZKI Ottó, SZEMLAKY Zsuzsanna, PETŐ Mónika

[Multiple myeloma is a multifaceted haematological disease, a plasma cell malignancy that may pose an oncological differential diagnostic challenge. The importance of this disease is emphasized by its incidence. Since there are multiple novel therapies available for myeloma patients, decade-long survival in not uncommon; therefore, myeloma patients provide a signifi cant part of the patients referred to hematological clinics. In this review, fi rst the novel diagnostic criteria are introduced, followed by the standard therapeutic approaches for transplant-eligible and ineligible patients. As the disease nearly always relapses, the later line therapies available in this malignancy are presented with a special emphasis on the Hungarian haematological practice.]

HUN 2016;3(04)

Clinical Oncology

DECEMBER 10, 2016

[Long-term central venous access devices in oncology]

PAJKOS Gábor

[Long-term central venous access devices are essential in the management of oncology patients, as they minimize the discomfort caused by frequent venipuncture and cannulation. Indications of application of central venous accesses, possibilities of implantations, immediate and long term complications, they prevention and obviation has been reported based on guidelines and relevant publications. Long term implantable central venous accesses handled by well-trained and exercised team, working with principles of maintenance, these manipulations are effective and safe, therefore suitable in oncological practice.]

HUN 2016;3(04)

Clinical Oncology

DECEMBER 10, 2016

[Individualized treatment of advanced/metastatic adult soft tissue sarcomas]

SZŰCS Zoltan, JONES L. Robin

[Considering the extreme histological heterogeneity of soft tissue sarcomas (STS), their management is an art of its own. Over the last decade the treatment of STSs has been slowly shifting towards a more individualized, histology driven tailored approach. With the availability of novel antineoplastic agents and the differential sensitivity of different subtypes of sarcomas to these drugs, we aim to provide some guidance in terms of optimal sequencing of therapies. Furthermore, we discuss some of the emerging targeted therapies currently evaluated for the palliative treatment of the more common and some of the very rare STS subtypes.]

HUN 2016;3(04)

Clinical Oncology

DECEMBER 10, 2016

[Defi ciency of DNA-repair]

KOPPER László

[The cell uses the DNA to keep those information, which are vital to function properly. It is essential to maintain the integrity of the DNA, the stability of the genome. Since DNA damages, caused by external or internal factors, are continuously produced, DNA-repair mechanisms should be ready to identify and eliminate the damages. Either the repair system is successful and the cell can continue its duty, or, if the damages are unrepaired, the programed cell death (apoptosis) is activated according to the rule, that it is prohibited to transfer genomic/epigenomic damages into the daughter cells. It is true that the severness of the damages are not the same. The most important is the identifi cation and repair of those damages which can make genomic instability increasing the risk of cancer development. This may happen when the repair system is insuffi cient, sometimes due to inherited mutations (e.g. BRCA1 mutations can increase the risk of breast cancer, ovarian cancer etc.). Among the damages the DNA double strand breaks are rather common, and also, that the breaks are intended to be repaired in most cases. However, if such repair fails, the cell, here the cancer cell, due to the overhelming damages will dye. This phenomenon is the synthetic lethality. An example: „cooperation” of inherited BRCA1 mutation and PARP-inhibition, can lead to clinical response using PARP inhibitors, as oliparib. New agents and clinical trials intend to take advantage from synthetic lethality.]

HUN 2016;3(04)

Clinical Oncology

DECEMBER 10, 2016

[Treatment of anemia in cancer patients]

NAGYKÁLNAI Tamás

[Anemia in cancer can be resulted by the underlying malignant disease or related to the chemotherapy. Cancer-related anemia adversely effects quality of life and is associated with reduced survival. Clinical studies demonstrate that blood transfusions, ESAs, and correction of iron defi ciency are therapeutic options for anemic cancer patients.]

HUN 2016;3(04)

Clinical Oncology

DECEMBER 10, 2016

[Biopharmaceuticals]

LÉVAY György

[Biopharmaceuticals represent a new class of very effective medications in the management of debilitating and often life-threatening diseases but the costs of these therapies exceed the costs of regular therapies. Biological medicinal products (i.e. smaller proteins or monoclonal antibodies) are mostly complex macromolecules, produced by microbial or mammalian cell cultures in bioreactors through application of complex process technologies. After patent expiry, the production of compounds with comparable quality features and comparable clinical safety and effi cacy profi les become available, however, the complexity of the macromolecules means they are not equivalent in the sense of small molecule generics. Biologics that are similar to a given licensed reference compound and meet regulatory requirements within this context can be termed as biosimilars. The similarity of the two products must be appropriately proven during the products’ marketing-authorisation procedure. As more and more biosimilar compounds have been approved by regulatory authorities in the EU and US it is expected that these products will bring signifi cant healthcare savings and much greater patient access to these revolutionary therapeutics.]

HUN 2016;3(04)