Klinická onkologie : casopis Ceské a Slovenské onkologické spolecnosti
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Review
[Immunotherapy of Urothelial Carcinoma of the Bladder - from BCG Vaccines to Targeted Therapy].
Bladder cancer has high prevalence in men and women. Bladder cancer usually originates from urothelium. More than 75% of cases are classified as nonmuscle invasive bladder cancer. ⋯ While local chemoprophylaxis is sufficient in low and middle risk patients, intravesical instillation of Mycobacterium bovis bacillus CalmetteGuerin (BCG) is preferred in high risk bladder cancer. Chemotherapy alone or in combination with locoregional treatment is used in advanced bladder cancer. New immunotherapy modalities have proven their efficacy in several clinical studies in advanced bladder cancer.
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Chimeric antigen receptors are synthetic, genetically modified receptors of T-cells. The introduction of chimeric antigen receptors into autologous patient T-cells can redirect the lymphocytes to specific antigen targets on the surface of malignant cells. ⋯ The individual variables are currently being tested in numerous clinical trials. In this review, I will briefly describe the principle, basic structure and construction of chimeric antigen receptor T-lymphocytes.
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Breakthrough cancer pain has been defined as a transitory increase in pain intensity that occurs despite relatively stable and adequately controlled background pain. More than half of cancer patients with chronic pain suffer by some form of breakthrough cancer pain. ⋯ The principal treatment strategies are optimization of regular analgesic medication combined with effective rescues medication. The new transmucosal forms of fentanyl represent an important improvement in our treatment options.
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In comparison to malignant tumors of vulva, vagina, cervix and uterine corpus, clear morphologic and molecular genetic features of precursor lesions of ovarian carcinoma have not been defined yet. We can see an effort to describe preinvasive lesions to allow dia-gnostics and treatment prior to development of invasive ovarian cancer. This tendency is magnified by the fact that ovarian carcinomas have the highest mortality from all gynecological malignancies. ⋯ Low grade ovarian serous carcinoma, low grade endometrioid, clear cell, mucinous ovarian cancers and Brenner tumors of ovary are categorized as type I ovarian tumors. Highgrade serous carcinoma, undifferentiated carcinomas and malignant mixed mesodermal tumors of the ovary (MMMTs) belong to type II tumors. A potential precursor lesion of highgrade serous ovarian cancer has been defined - serous tubal intraepithelial carcinoma.
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Cheaper drug forms have been administered more and more in the last decade in oncology and in other fields of clinical medicine, too. Their production was enabled by the end of patent protection of the original drugs used previously. ⋯ There are still some unresolved problems associated with their administration. The current knowledge concerning the safety of biosimilars and possible risks associated with their use is summarised in this review.