Clinical Oncology

[Inhibition of proteasome in cancer therapy]


DECEMBER 05, 2017

Clinical Oncology - 2017;4(04)

[The ubiquitin-proteasome pathway is the most important element in the regulation of intracellular protein metabolism. Its main function is the degradation of the unnecessary proteins either as part of normal metabolic balance or in case of misfolding or part of the deregulation as in cancer cells using proteolytic enzymes. The importance of this pathway has been acknowledge by Nobel prize. In certain diseases as in several malignancies, where the ubiquitin-proteasome pathway is not able to remove the proteins due to dysfunction or accumulation in a high quantity. The unregulated accumulation of proteins could lead to cell death. This phenomenon was proven by the appearance of proteasome-inhibitors targeting mainly myeloma. It should be mentioned that clinical aspects myeloma has been discussed in an excellent review by Mikala and his colleagues in Klinikai Onkológia.]



Further articles in this publication

Clinical Oncology

[Hematopoetic stem cell transplantation for pediatric non-hematological solid tumors]

HAUSER Péter, KRIVÁN Gergely

[High-dose chemotherapy followed by stem cell rescue or allogeneic stem cell transplantation in the treatment of solid tumor with non-hematologic origin applied for more than three decades. High-dose chemotherapy with stem cell rescue is the part of standard fi rst line therapy for several chemosensitive tumors with unfavorable outcome (neuroblastoma, Ewing-sarcoma, medulloblastoma), and also successfully applied in certain therapy-resistant or recurrent solid tumors (germ cell tumors, Wilmstumor). Allogeneic transplantation with reduced intensity conditioning is still not successful in terms of survival in pediatric solid tumors with non-hematological origin. In present paper results of autologus and allogeneic stem cell transplantation in different pediatric solid tumor are discussed.]

Clinical Oncology


A szerkesztők

Clinical Oncology

[Complex therapy of bladder cancer]


[Bladder cancer is the most common malignancy involving the urinary system. Urothelial (formerly called transitional cell) carcinoma is the predominant histologic type in the developed countries, where it accounts for approximately 90 percent of all bladder cancers. The optimal management of nonmuscle invasive urothelial cancer is highly important. For patients with muscle invasive cancer the gold standard treatment is the cystectomy. If the patient unable or unwilling to undergo radical cystectomy with urinary diversion, complete TURBT combined with radiation therapy plus chemotherapy may offer an alternative bladder-sparing approach. Patients with muscle invasive disease and regional lymph node metastasis limited to the pelvis (N1-N3), but without more distant lymph node or visceral metastasis may be treated with six cycles of cisplatin-based chemotherapy followed by cystectomy or a combined-modality approach. In metastatic cases the combination chemotherapy may prolong survival and often provides palliation of symptomatic disease. Checkpoint inhibition immunotherapy has substantial clinical activity in post-chemotherapy patients and is the preferred therapy for patients who have progressed after platinumbased therapy or is not suitable for them.]

Clinical Oncology

[Burnout syndrome - prevention and treatment]

SZY Ágnes

[The defi nition of burnout syndrome was established due to the recognition of changes that practising physicians experienced in their affective state and behaviour as well as the observation of physical symptoms that put their health at risk. Burnout syndrome can be characterised by a triadic set of factors: emotional exhaustion, depersonalisation, and decline of professional achievement. The present article aims to describe burnout syndrome with regard to the fact that similarities and differences between burnout syndrome and affective disorders such as depression must be highlighted. The focus of this article is that health care professionals burnout is multicausal and it is insuffi cient to put only the individual in the spotlight although it is imperative that we attend to the individual fi rst. It is essential to highlight the fact that without changes in the institutional work culture and requirements the prevalence of burnout syndrome can hardly decrease. It is also the aim of this work to provide the practising health care professional with information that they can easily transform into immediate help.]

Clinical Oncology

[Current treatment therapy of prostate cancer]


[Prostate cancer is a frequent and usually slowly progressing malignancy. Promising opportunities and risks to avoid may occur along its diagnosis and treatment. The chance of early detection is high. The localised disease can be cured by radical prostatectomy and radiotherapy with equal probability. The post-prostatectomy biochemical failure may be controlled by radiotherapy. Even oligometastatic tumours can be cured by harmonised local treatment modalities. The survival of metastatic disease can be prolonged by several years. Effi cacy of traditional androgen deprivation may be enhanced with completion by upfront docetaxel chemotherapy or androgen synthesis blocking agents. However, local and systemic treatments are not harmless. Overtreatment as well as undertreatment has to be avoided upon therapy planning.]

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Clinical Oncology

[Metals and cancer]

VETLÉNYI Enikő, RÁCZ Gergely

[We often tend to forget about our environment when looking for the origin of a disease. Inhaled air, drinking water and food, substances in contact with the skin all have an effect on the human body. Metals are indispensable parts of our everyday lives, their mining, processing and use cause a continuous exposure to them. Metal exert their effects on the body in various ways. Many of them are essential for maintaining homeostasis, but excessive or harmful metal intake can lead to health damage, including tumour formation through multiple attack points. Metals substitute each other during different transport processes and in the structure of proteins, they cause oxidative stress and bind to DNA, thereby damaging it. Applying them appropriately, the proapoptotic effect of the metal compounds is brought to the fore, thus becoming a therapeutic tool for tumours. Nowadays, platinum(II) compounds are widely used as chemotherapeutic agents and there are many ongoing studies to fi nd metal compounds with an ideal therapeutic and side-effect profi le. The aims of this article were to draw the attention to the dangers of metals in relation to cancer and to highlight their diverse application possibilities in current and future cancer therapy and diagnostics.]

Clinical Neuroscience

Evaluation of ischemic stroke patients with systemic cancer

UFUK Emre, TASKIN Gunes, IREM Pinar, FURUZAN Kokturk, ESENGUL Liman, ORHAN Yağiz

Purpose - In cancer patients, an ischemic stroke can be seen as both a direct effect of cancer and a complication of treatment. This condition can negatively affect the follow-up and treatment of these patients. For this research, we aimed to evaluate the clinical features, stroke types and etiological features of ischemic stroke patients with histories of cancer or found to have cancer during the aetiological investigation. Materials and methods - We retrospectively evaluated 100 patients (57 males, 43 females) who were hospitalized with acute stroke and determined to have the presence of cancer or a cancer history during the aetiological investigation between 2011 and 2016. All the demographic features, stroke types and localizations, National Institutes of Health Stroke Scale (NIHSS) scores, Rankin Scale scores, durations of cancer and cancer treatments were recorded. Results - The mean age of the patients was 67.07 ± 10.9 years old, the median NIHSS score was 5, and the median Rankin Scale score was 4. While 79% of patients had ischemic stroke risk factors, 21% did not. Atherosclerotic stroke was the most common stroke type (49%, n=49) and cryptogenic strokes were detected in 21% (n=21). In addition, 63% of the patients had chronic cancer (later than 6 months), 31% of the patients had recent cancer histories (less than 6 months), and 29% of the patients had metastases. Among all the malignancies, lung cancer (n=23), gastrointestinal cancer (n=20) and gynaecological-breast cancer (n=16) were the three most common. Moreover, 37% of the patients underwent chemotherapy, 29% underwent radiotherapy, and 88% of the patients had Carotid/Vertebral Doppler USG abnormalities. Conclusion - Similar to what is stated in the literature, an atherosclerotic stroke was the most common type of stroke in the cancer patients. Stroke risk factors were not detected in 21% of the patients, and in the majority of the patients, atherosclerotic changes in the carotid artery were observed in the Doppler examinations. In the aetiology and prognosis of ischemic stroke, it is important to keep in mind the existence of cancer in addition to the classical stroke risk factors.

Clinical Oncology

[Thromboprophylaxis in cancer patients]


[Cancer- and chemotherapy-associated venous thromboembolism (VTE) is a serious complication in patients with malignancies. Most important questions and challenges are summarized in the review and an attempt is made to answer some of them. Epidemiology, causes of thrombophilia and risk factor analysis including thrombogenicity of both tumorous disease and chemotherapy are discussed. The following special risk groups are detailed: (a) postoperative, (b) hospitalized non-surgical patients, (c) ambulatory patients with chemotherapy, (d) tumorous patients without chemotherapy. As conclusion, most important messages of the recent guidelines for preventing and treating cancer-associated thrombosis are discussed.]


[MicroRNAs as a new family of hormones]

BOJCSUK Dóra, SIPOS Lilla, BÁLINT Bálint László

[MicroRNA molecules regulate the translation of mRNAs to proteins. In a study published by Maria A. Cortez and her colleagues in Nature in 2011, the authors suggest that miRNAs, known as biomarkers and translation regulators, could be considered as nucleic acid hormones. In this paper we introduce the characteristics of microRNAs that support their function as hormones.]

Clinical Oncology

[The role of EGFR receptor family in the oncological practice]


[The EGFR receptor family is a set of membrane tirosine kinase receptors with signifi cant homology which are responsible for cellular activation through intracellular signaling due to ligand binding. The four members of the family (EGFR1, EGFR2/HER2/neu, EGFR3/HER3, EGFR4/HER4) earned special interest in tumor biology while becoming one of the most potent targets of anti-cancer therapies. Changes in the receptor expression or in the kinase activity fundamentally modify cellular functions, survival and tumorigenic potential. Moreover, mutations are associated with reduced or altered treatment effi cacy. The basic function and major genetic and biological mechanisms affecting the function of EGFR receptors and related therapies are subjects of this overview.]