Side effects of tyrosine kinase inhibitors in cancer treatment

Zaviralci tirozin-kinaz so multitarčna zdravila, ki prek zaviranja različnih celičnih procesov učinkujejo pri več vrstah rakavih boleznih. Čeprav so stranski učinki ob zaviralcih tirozinskih kinaz v splošnem prenosljivi, pa so lahko tudi resni in povzročajo nemalo preglavic bolnikom, ki prejemajo zdravila dolgotrajno. Pogosto je potrebno zmanjšanje odmerkov ali prehodna ukinitev, redkeje pa se odločimo za trajno prekinitev zdravljenja. Značilni so kožna toksičnost, kardiovaskularni zapleti, težave gastrointestinalnega trakta - predvsem diareja, nepravilno delovanje ščitnice in utrujenost ob zdravljenju rakave bolezni.Tyrosine kinase inhibitors are multicentric drugs that inhibit different cellular processes and are effective in the treatment of many types of cancer. Although the side effects of tyrosine kinase inhibitors are generally tolerable, they may also be serious and cause numerous problems in patients receiving long-term medication. Dosage reductions or transient withdrawal are often required, but only rarely is the treatment permanently discontinued. Typical complications include skin toxicity, cardiovascular complications, problems in the gastrointestinal tract, in particular diarrhoea, thyroid malfunction, and treatment-specific fatigue. The present article lays out the most common side effects of treatment with tyrosine kinase inhibitors

Stranski učinki ob zdravljenju rakavih bolezni z zaviralci tirozinskih kinaz

Tyrosine kinase inhibitors are multicentric drugs that inhibit different cellular processes and are effective in the treatment of many types of cancer. Although the side effects of tyrosine kinase inhibitors are generally tolerable, they may also be serious and cause numerous problems in patients receiving long-term medication. Dosage reductions or transient withdrawal are often required, but only rarely is the treatment permanently discontinued. Typical complications include skin toxicity, cardiovascular complications, problems in the gastrointestinal tract, in particular diarrhoea, thyroid malfunction, and treatment-specific fatigue.Zaviralci tirozin-kinaz so multitarčna zdravila, ki prek zaviranja različnih celičnih procesov učinkujejo pri več vrstah rakavih boleznih. Čeprav so stranski učinki ob zaviralcih tirozinskih kinaz v splošnem prenosljivi, pa so lahko tudi resni in povzročajo nemalo preglavic bolnikom, ki prejemajo zdravila dolgotrajno. Pogosto je potrebno zmanjšanje odmerkov ali prehodna ukinitev, redkeje pa se odločimo za trajno prekinitev zdravljenja. Značilni so kožna toksičnost, kardiovaskularni zapleti, težave gastrointestinalnega trakta - predvsem diareja, nepravilno delovanje ščitnice in utrujenost ob zdravljenju rakave bolezni

Metastatic castration-resistant prostate cancer

V pričujočem prispevku opisujemo zdravila z različnim mehanizmom delovanja: radij-223 (Ra-223), lutecij-177-PSMA-167 (Lu-177-PSMA), zaviralci imunskih nadzornih točk (ZINT) ter zaviralci poli-ADP-riboza polimeraze (PARP), ki so bila v zadnjih letih registrirana s strani ameriške in/ali evropske agencije za zdravila (angl. FDA, EMA) za zdravljenje bolnikov z metastatskim, na kastracijo odpornim rakom prostate (mKORP)

[Breast cancer in young women and pregnancy]

Rak dojke pri mladih bolnicah je redek pojav. Uspešno zdravljenje te bolezni omogoča večini mladih bolnic dolgo preživetje. Pomemben vidik kakovosti življenja je nedvomno ohranjanje plodnosti, posebno ob zavedanju, da je starost žensk ob prvem otroku vse višja. Mlade bolnice je zato treba že ob postavitvi diagnoze seznaniti z možnimi negativnimi vplivi zdravljenja na plodno sposobnost in jim ponuditi možnost svetovanja. Na ginekološko-onkološkem konziliju bolnicam ali paru med drugim predstavimo postopke za shranjevanje genetskega materiala pred pričetkom zdravljenja. V pričujočem prispevku predstavljamo in razpravljamo o novejših spoznanjih, ki povezujejo rak dojke ter nosečnost. Predstavljamo tudi zbrane podatke o nosečnostih pri zelo mladih bolnicah po zdravljenju raka dojke v Sloveniji.Breast cancer in young women is a rare occurrence, and successful treatment of this disease offers long survival to the majority of young female patients. Preserving fertility is an important aspect of the quality of life, in particular if bearing in mind that the age at which women have their first child has been increasing. Therefore, young female patients must be aware of the possible negative effects of treatment on fertility already at diagnosis and should be offered counselling. At the gynaecological oncology consilium, patients or couples are presented the procedures for the storage of genetic material before commencing treatment. In the following article, we present and discuss the newest findings on the association between breast cancer and pregnancy. Moreover, we also present the data collected on pregnancy in very young patients following breast cancer treatment in Slovenia

Establishment of a virtual transborder tumor board for cancer patients in Central and Southeastern Europe : an initiative of the Central European Cooperative Oncology Group (CECOG)

o establish a transborder virtual tumor board (VTB) fostering state-of-the-art management of cancer patients by exchanging knowledge and expertise among oncologists in Central and Southeastern Europe (CEE). Methods: We established and implemented a VTB based on the WebEx platform. This allowed for password-protected and secure upload of patient cases to be presented and discussed among colleagues from various oncology centers scattered throughout CEE in order to arrive at a recommendation for further diagnoses and/or treatment. Results: A total of 73 cases from 16 oncology centers located in 11 CEE countries were uploaded by 22 physicians71 were discussed over the course of 17 virtual meetings between June 2018 and May 2019 and 12 different kinds of malignant diseases were discussed with lung cancer (46.6%), melanoma (19.2%) and bladder cancer (13.6%) being the most commonly presented tumor entities. Of the discussed patients, 93.3% had stage IV disease at the time of presentation, 62.6% received chemotherapy or targeted treatment and 67.1% were treated with immune checkpoint inhibitors (ICPIs). The most common causes for presentation and discussion of patient cases were related to the use of ICPIs (80%). Conclusion: When the need for expertise exceeds locally available resources, web-based VTBs provide a feasible way to discuss patient cases and arrive at conclusions regarding diagnoses and/or treatment across large geographic distances. Moreover, VTBs provide an innovative way for proper, state-of-the-art management of patients with malignant diseases in times of social distancing and the resulting need for restricted interaction during the current SARS-CoV‑2 (severe acute respiratory syndrome coronavirus type 2) pandemic