Magyar onkologia
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Immunotherapy proved to be effective in various forms of cancer but it is in its infancy in colorectal cancer, although the Immunoscore was developed to classify this tumor immunologically. Various forms of immunotherapy were tested in early clinical trials but anti-PD-1 antibodies seem the most promising so far. These studies also revealed that one particular molecular subgroup of colorectal cancer, the microsatellite instable variant, is extremely sensitive for such modality.
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Similarly to other malignancies, immune checkpoint inhibitor therapy is a revolutionary, effective new treatment possibility for lung cancer. In lung cancer carcinogenesis is related mainly to tobacco smoking with high somatic mutation rate and immunogenicity. The PD-1 inhibitor nivolumab and pembrolizumab and the PD-L1 inhibitor atezolizumab is a labelled indication in second line setting in advanced nonsmall cell lung cancer (NSCLC). ⋯ In this selected patient population, progression-free survival has doubled, and overall survival was significantly better in pembrolizumab-treated patients compared to those receiving standard of care. Pembrolizumab treatment became a new first line standard of care in advanced NSCLC. There are numerous ongoing clinical trials in lung cancer with immune checkpoint inhibitors in combination with cytotoxic chemotherapy, targeted agents, or in adjuvant setting.
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The past three decades of immunology research led to a drastic increase in the knowledge of antitumor immune response mechanisms and in parallel to a rapid development in various antitumor immune therapy strategies. This will most probably result in the implementation of immunotherapeutic protocols within the standard anticancer regimens in a very near future. Though, it is obvious that combination of immunotherapy with traditional anticancer treatment modalities will only be legitimate if the combination has at least an additive, or perhaps a synergistic effect. ⋯ It is also known by now that local irradiation due to its out-of-field effects has systemic immune modulatory capacity, too. In the light of all these novel findings the optimal combination between antitumor immunotherapy and radiotherapy has become an increasing option. The first part of the present review summarizes the main antitumor mechanisms that can be influenced by ionizing radiation, and the second part attempts to provide a comprehensive overview of those antitumor immunotherapeutic modalities that are currently being used in combination with radiotherapy in preclinical and/or clinical trials for the treatment of various tumors.
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The phosphatidylinositol-3-kinase/AKT (PI3K/AKT) pathway is commonly deregulated in breast cancer through several mechanisms, including PI3K catalytic subunit alpha (PIK3CA) mutations and loss of phosphatase and tensin homolog (PTEN). The hiperactivated PI3K/AKT signaling can be associated with endocrine or trastuzumab therapy resistance and underscore the impact of targeting the pathway. Our aim was to identify PIK3CA mutations and the mechanisms of PTEN loss and assess their therapeutic consequences in breast cancer patients. ⋯ The PTEN-deficient MCF10A cell line showed increased expression of certain members of the fibroblast growth factor 2 (FGF2)/FGFR1 pathway. We suppose that loss of PTEN enhances the autocrine FGF signaling promoting cell proliferation. FGF-2 and FGFR1 can be potential targets in PTEN deficient breast cancers.
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The purpose of the study is to report the status of Hungarian radiotherapy (RT) based on the assessment of treatment data in years 2012 to 2014, available infrastructure, and RT staffing. Between December 2014 and January 2015, a RT questionnaire including 3 parts (1. treatment data; 2. infrastructure; 3. staffing) was sent out to all Hungarian RT centers (n=12). All RT centers responded to all questions of the survey. 1. ⋯ Brachytherapy and modern teletherapy (e.g. IMRT and IGRT) are underutilized in Hungary compared to other European countries. Implementation of continuous education and practical training programs in leading Hungarian and international RT centers are suggested in an effort to a wider implementation of modern RT techniques in Hungarian RT centers.