Magyar onkologia最新文献

Stereotactic radiotherapy gains more and more importance in the management of malignant melanoma, owing to technical developments of recent years. This approach might be applied with success in solitary or oligometastatic cases, since the deliverable biological dose is far higher than that of conventional radiotherapy. Beyond chemotherapy of decreasing importance, there is a widening range of new targeted and immunotherapy agents, leading to longer survival times even in disseminated stages. This latter underlines that it is worth to treat metastatic lesions locally, making this strategy part of present clinical routine. The authors summarize relevant literature of strereotactic radiotherapy in malignant melanoma, and describe related concepts such as oligometastases, abscopal effect or the combination of radiosurgery with modern systemic therapies.

While metastases are the most common intraocular malignancies, ocular metastases of renal cell carcinoma are rare. The most frequent primary malignancy of the eye is uveal melanoma. The common ocular localization is the choroid in both cases. The clinical differentiation of choroidal metastasis from renal cell carcinoma and choroidal melanoma malignum is a diagnostic challenge for the ophthalmologist. We present two cases where renal cell carcinoma had metastasized to the choroid. Enucleation was performed in a 61- and a 71-year-old male patient with suspected advanced choroidal malignant melanoma following biomicroscopic and B-scan ultrasonography examination. Histopathological examination confirmed clear-cell renal cell carcinoma in both cases. The clinical and ultrasonographic appearance of clear-cell renal cell carcinoma metastasis may mimic choroidal malignant melanoma, and may only be suspected if a primary renal cell carcinoma is already established.

Skin melanoma became one of the most frequent malignancies of the skin mainly due to the increased exposure to environmental UV irradiation. However, this did not lead to the increase of mortality, mainly due to the efficient early diagnostics as well as to the development of new therapies which were based on the identification of the mutation patterns and understanding of the immunobiology. Molecular markers are important to differentiate malignant tumors from precancerous ones but also routinely available to define prognosis. Immunotherapy can be used in any molecular class of melanoma, while target therapy is only available in case of BRAF mutant form. Meanwhile these novel therapies induce new resistance mechanisms based on the development of acquired genetic alterations. Due to these facts the initial molecular profiling of the resected primary tumors must gradually be replaced by continuous monitoring.

Background: Congenital glioblastoma (cGBM) is a brain tumor very rarely observed in newborns and young infants, and differs in several respects from glioblastoma (GBM) of childhood and adulthood. Our aim was the presentation of a cGBM case with 14 days of postnatal survival at the Pediatric Oncology Center of the Markusovszky University Teaching Hospital in 2004. We investigated formalin-fixed, paraffin-embedded autoptic tumor samples of the newborn by immunohistochemical and molecular genetic (FISH and pyrosequencing) methods. We found polysomy of chromosome 2 and 5' deletion of the ALK gene in the glioma cells by ALK FISH. This result indicates the importance of molecular analyses in the diagnostic evaluation of cGBM, and raises the possibility of a personalized, targeted therapy (crizotinib, alectinib).

Melanoma treatment has been revolutionized during the last decade. Currently first line therapeutic options for advanced melanoma include immunotherapy with anti-PD-1 antibodies (combination of PD-1 and CTLA-4 blockers should be an option in a selected group of patients) or targeted therapy with BRAF and MEK inhibitors in BRAF V600 mutated tumors. This review aims to summarize long-term survival data of immunotherapy in cutaneous melanoma and to show possible directions of development in combined oncological modalities.

The development of the therapy of advanced melanoma resulted in significant improvement of disease outcome; over 6 years of median survival was reached in the CheckMate 067 study. The new therapeutic modalities are already implemented in the clinical practice according to the current guidelines, however some diagnostic and therapeutic questions are still unresolved. We aimed to highlight the topic of therapeutic options for BRAF mutated melanomas, the role of PD-L1 ligand examination, the adequate therapy of oligoprogression, and the current indication of sentinel lymph node biopsy.

One characteristic type of the common somatic mutations causing myeloproliferative neoplasias is the frameshift mutation of the calreticulin gene that leads to proteins of abnormal structure. The pathologic protein induces novel cell biological processes that are fundamental to the onset and maintenance of myeloproliferative diseases. In this review, an insight is provided into these processes, aiding better understanding of the underlining pathobiological processes and eventually to more effective therapy in the future.

We investigated the efficacy and safety of vemurafenib+cobimetinib (V+C) and dabrafenib+trametinib (D+T) based on real-life data. From 2015 and 2018 we have selected 118 BRAF-mutated metastatic melanoma patients, treated with V+C and D+T in our institute. We retrospectively analyzed the overall response rate (ORR), the progression-free survival (PFS), the overall survival (OS) and the adverse events of the therapies. The median follow-up time was 18 months (3-43) with V+C and 12 months (3-43) with D+T. The median PFS was 8 months in the V+C and 8.5 months in the D+T group. Median OS was 18 months in V+C group and 12 months with D+T. The ORR was revealed to be 82% in D+T group and 76% in V+C group. Each combination displayed a slightly different safety profile. In our retrospective analysis both BRAF-MEK inhibitor combination therapies showed favorable efficacy with a slightly different spectrum of toxicity profile.

COVID-19 pandemic affected the diagnosis and management of many diseases, including the most vulnerable group of patients with cancer. In this retrospective survey we evaluated the course of disease of patients treated for melanoma, who got infected with COVID-19 virus between March 2020 and April 2021. 382 patients had been treated for advanced melanoma in our center in this time period. 24 of them had been infected with coronavirus. Six of them suffered in stage III melanoma, the remaining 18 patients had stage IV disease. 14, 5 and 4 of the infected patients had been administered with checkpoint inhibitor, targeted therapy and chemotherapy, respectively. Seven (29%) patients died in COVID-19 infection, in a median of 12 days. None of our patients who had been vaccinated at least one time, had severe symptoms. As a conclusion, the mortality of COVID-19 infection was significantly higher among our melanoma patients compared to the age-standardized mortality rate in Hungary.

Malignant tumors were the leading cause of death in Hungary between 1990 and 2018 according to the central statistical office (www.ksh.hu). While the mortality of cerebrovascular diseases is decreasing, cancer-related mortality is getting worse, despite the improvement of both diagnostic and therapeutic opportunities. The exact number of synchronous double and triple cancers in Hungary is unknown, and their therapeutic pathways are unclear. Currently there is no data available regarding these questions in the National Cancer Registry. In this case report we present the diagnostic and therapeutic algorithm of a patient with a triple malignancy.