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Query: "author" (Marija Ignjatović) .

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1.
Retrospective analysis of treatment-naive Slovenian patients with metastatic melanoma treated with pembrolizumab : real-world experience
Nežka Hribernik, Marko Boc, Janja Ocvirk, Jasna Knez Arbeiter, Tanja Mesti, Marija Ignjatović, Martina Reberšek, 2020, original scientific article

Abstract: Based on recent data from clinical trials, the immune checkpoint inhibitor pembrolizumab prolongs survival and has a good toxicity profile in patients with advanced or metastatic melanoma. However, the question remains whether these results are transmitted into daily clinical practice. The aim of this study was to assess the efficacy and toxicity of pembrolizumab in treatment-naive patients with metastatic melanoma in everyday clinical practice in Slovenia and compare it to the results from clinical trials. Patients and methods. This observational retrospective cohort study included 138 consecutive metastatic treatment-naive melanoma patients treated with pembrolizumab at the Institute of Oncology Ljubljana in Slovenia, from January 2016 to December 2018. Patient and treatment characteristics were retrospectively collected from hospital data base. Statistical data was obtained using the SPSS software version 22. Survival rate was calculated with the Kaplan-Meier method. Observation period took place between January 2016 and the end of June 2019. Results. The estimated median overall survival (OS) was 25.1 months (95% CI, 14.6%35.6) and the median progressionfree survival (PFS) was 10.7 months (95% CI, 5.9%15.4). Among all patients, 29 (21.0%) achieved complete response, 31 (22.5%) partial response and 23 (16.7%) reached stable disease. The number of organs with metastatic involvement and the level of baseline lactate dehydrogenase (LDH) concentration had significant influence on survival rates. Immune-related adverse events (irAE) were reported in 88 (63%) patients, while grade 3%4 irAE occurred in 12 (8.7%). Due to toxicity, 16 (11.6%) patients discontinued the treatment. Conclusions. Our real-world data from single centre retrospective analysis of treatment-naive metastatic melanoma patients treated with pembrolizumab showed inferior median OS and similar median PFS, compared to the results from clinical trials. However, patients with normal serum levels of LDH and a small number of organs with metastatic involvement had comparable survival outcomes. Toxicity rates of pembrolizumab were quite similar. These results further support the use of pembrolizumab for metastatic treatment-naive melanoma patients.
Keywords: immunotherapy, pembrolizumab, metastatic melanoma, treatment-naive
Published in DiRROS: 11.07.2024; Views: 73; Downloads: 31
.pdf Full text (696,58 KB)

2.
The prognostic and predictive value of human gastrointestinal microbiome and exosomal mRNA expression of PD-L1 and IFNγ for immune checkpoint inhibitors response in metastatic melanoma patients : protocol trial
Ana Erman, Marija Ignjatović, Katja Leskovšek, Simona Miceska, Urša Lampreht Tratar, Maša Omerzel, Veronika Kloboves-Prevodnik, Maja Čemažar, Lidija Kandolf Sekulović, Gorazd Avguštin, Janja Ocvirk, Tanja Mesti, 2023, original scientific article

Abstract: Background: Immunotherapy has been successful in treating advanced melanoma, but a large proportion of patients do not respond to the treatment with immune checkpoint inhibitors (ICIs). Preclinical and small cohort studies suggest gastrointestinal microbiome composition and exosomal mRNA expression of PD-L1 and IFNγ from the primary tumor, stool and body fluids as potential biomarkers for response. Methods: Patients treated with immune checkpoint inhibitors as a first line treatment for metastatic melanoma are recruted to this prospective study. Stool samples are submitted before the start of treatment, at the 12th (+/−2) week and 28th (+/−2) week, and at the occurrence of event (suspected disease progression/hyperprogression, immune-related adverse event (irAE), deterioration). Peripheral venous blood samples are taken additionally at the same time points for cytologic and molecular tests. Histological material from the tumor tissue is obtained before the start of immunotherapy treatment. Primary objectives are to determine whether the human gastrointestinal microbiome (bacterial and viral) and the exosomal mRNA expression of PD-L1 and IFNγ and its dynamics predicts the response to treatment with PD-1 and CTLA-4 inhibitors and its association with the occurrence of irAE. The response is evaluated radiologically with imaging methods in accordance with the irRECIST criteria. Conclusions: This is the first study to combine and investigate multiple potential predictive and prognostic biomarkers and their dynamics in first line ICI in metastatic melanoma patients.
Keywords: gastrointestinal microbiome, mRNA expression of PD-L1 and IFNγ, immune checkpoint inhibitors, metastatic melanoma
Published in DiRROS: 21.03.2024; Views: 230; Downloads: 121
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3.
Sluznični melanom : Mucosal melanoma
Marija Ignjatović, 2023, published scientific conference contribution

Abstract: Sluznični melanom je redka bolezen. Za njo najpogosteje zbolijo starejši ljudje, ženske bolj kot moški. Incidence ja relativno stabilna. Ob postavitvi diagnoze ima četrtina bolnikov s sluzničnim melanom napredovalo obliko bolezni, kar je posledica agresivnosti bolezni in ˝skritih˝ lezij s posledično zapoznelo diagnozo. 5-letno preživetje je najnižje v primerjavi z drugimi oblikami melanoma, če izključimo najredkejšo obliko melanoma, primarni leptomeningealni melanom. Biološke lastnosti sluzničnega melanoma se precej razlikujejo od lastnosti kožnega melanoma. Adjuvantno sistemsko zdravljenje je nujno potrebno, zaenkrat ni dovolj podatkov o njem. Kombinirana imunoterapija je terapija izbora zdravljenja metastatske oblike bolezni. Tarčna terapija ima svoje mesto le pri zdravljenju bolnikov z natančno določenimi tarčami (V600 Braf mutacija oz. cKIT mutacija).
Keywords: sluznica, melanom, imunoterapija
Published in DiRROS: 25.05.2023; Views: 585; Downloads: 193
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4.
Sluznični melanom : prikaz primera
Ela Markočič-Rojc, Marija Ignjatović, 2023, published scientific conference contribution

Abstract: Sluznični melanom je redka bolezen. Najpogosteje se pojavi na sluznici področja glave in vratu, genitalnega trakta in anorektalni sluznici. Bolniki imajo ob diagnozi v večjem deležu prisotne regionalne ali oddaljene zasevke (najpogosteje v jetrih in pljučih). Sluznični melanom se od kožnega melanoma razlikuje v biologiji, kliničnem poteku in prognozi. Aktivirajoče mutacije gena c-KIT so prisotne pri večjem številu bolnikov s sluzničnim melanomom. V primeru prisotne c-KIT mutacije pride v poštev tarčno zdravljenje z imatinibom.
Keywords: rak kože, melanom, sistemsko zdravljenje
Published in DiRROS: 18.05.2023; Views: 709; Downloads: 191
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5.
Zdravljenje duktalnega adenokarcinoma pankreasa : prikaz treh primerov
Ela Markočič-Rojc, Marija Ignjatović, 2022, published scientific conference contribution

Abstract: Duktalni adenokarcinom ima slabo preživetje. V zadnjem času ni bistvenih novosti v zdravljenju, ki se razlikuje glede na razširjenost bolezni in molekularne značilnosti tumorja. V prispevku so predstavljeni primeri treh bolnikov z različno napredovalim rakom pankreasa. Prvi je imel mejno resektabilen tumor in smo ga zdravili neoadjuvantno s sistemsko terapijo po shemi FOLFIRINOX, a se je po operaciji izkazalo, da gre za metastatsko bolezen, zato smo uvedli sistemsko zdravljenje po shemi gemcitabin + nabpaklitaksel. Drugi je primer bolnika, ki smo ga zdravili adjuvantno s kemoterapijo z gemcitabinom in kapecitabinom ter radioterapijo. Tretji bolnik pa je bil zdravljen s paliativnim sistemskim zdravljenjem zaradi metastaske bolezni. Po začetnem zdravljenju po shemi FOLFIRINOX smo uvedli vzdrževalno zdravljenje s PARP inhibitorjem, saj je imel mutacijo BRCA.
Keywords: rak trebušne slinavke, sistemsko zdravljenje, rak prebavil
Published in DiRROS: 13.01.2023; Views: 827; Downloads: 199
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6.
Novosti v sistemskem zdravljenju karcinoma pankreasa
Marija Ignjatović, 2022, published scientific conference contribution

Abstract: Rak trebušne slinavke je v 90% primerov pankreatični duktalni adenokarcinom (PDAC). Čeprav ta predstavlja 3% vseh malignomov, je odgovoren za 5% smrti zaradi rakavih bolezni. Je ˝tihi˝rak, zato ga po navadi odkrijemo v napredovali fazi bolezni, ko radikalna operacija ni več možna. Le 25% bolnikov ima ob postavitvi diagnoze potencialno ozdravljivo bolezen. Neoadjuvantna sistemska terapija je indicirana za zdravljenje bolnikov z mejno resektabilnim PDAC. Adjuvantna sistemska terapija se priporoča pri vseh bolnikih, vključno s tumorji stadija 1, ki niso bili zdravljenji z neoadjuvantno sistemsko terapijo in so po resekciji PADC. Paliativna sistemska terapija je edina možnost zdravljenja bolnikov z lokalno napredovalim neresktabilnim in metastatskim PDAC.
Keywords: rak trebušne slinavke, sistemsko zdravljenje, rak prebavil
Published in DiRROS: 13.01.2023; Views: 729; Downloads: 142
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7.
8.
Dnevnik zdravljenja z zdravilom regorafenib
Janja Ocvirk, Martina Reberšek, Neva Volk, Tanja Mesti, Marko Boc, Marija Ignjatović, Nežka Hribernik, 2022, dictionary, encyclopaedia, lexicon, manual, atlas, map

Keywords: kemoterapija, rak debelega črevesa in danke, gastrointestinalni tumorji
Published in DiRROS: 14.07.2022; Views: 912; Downloads: 244
.pdf Full text (2,48 MB)

9.
Melanom v perinatalnem obdobju – prikaz primera : Elektronski vir
Ana Erman, Marija Ignjatović, 2022, published scientific conference contribution

Keywords: melanom, rak kože, kemoterapija
Published in DiRROS: 11.04.2022; Views: 574; Downloads: 213
.pdf Full text (289,97 KB)

10.
Melanom v nosečnosti : Elektronski vir
Marija Ignjatović, 2022, published scientific conference contribution

Keywords: melanom, rak kože, nosečnost
Published in DiRROS: 11.04.2022; Views: 668; Downloads: 188
.pdf Full text (385,21 KB)

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