11. Quantitative imaging biomarkers of immune-related adverse events in immune-checkpoint blockade-treated metastatic melanoma patients : a pilot studyNežka Hribernik, Daniel T. Huff, Andrej Studen, Katarina Zevnik, Žan Klaneček, Hamid Emamekhoo, Katja Škalič, Robert Jeraj, Martina Reberšek, 2022, original scientific article Abstract: Purpose: To develop quantitative molecular imaging biomarkers of immune-related adverse event (irAE) development in malignant melanoma (MM) patients receiving immune-checkpoint inhibitors (ICI) imaged with 18F-FDG PET/CT. Methods: 18F-FDG PET/CT images of 58 MM patients treated with anti-PD-1 or anti-CTLA-4 ICI were retrospectively analyzed for indication of irAE. Three target organs, most commonly affected by irAE, were considered: bowel, lung, and thyroid. Patient charts were reviewed to identify which patients experienced irAE, irAE grade, and time to irAE diagnosis. Target organs were segmented using a convolutional neural network (CNN), and novel quantitative imaging biomarkers - SUV percentiles (SUVX%) of 18F-FDG uptake within the target organs - were correlated with the clinical irAE status. Area under the receiver-operating characteristic curve (AUROC) was used to quantify irAE detection performance. Patients who did not experience irAE were used to establish normal ranges for target organ 18F-FDG uptake. Results: A total of 31% (18/58) patients experienced irAE in the three target organs: bowel (n=6), lung (n=5), and thyroid (n=9). Optimal percentiles for identifying irAE were bowel (SUV95%, AUROC=0.79), lung (SUV95%, AUROC=0.98), and thyroid (SUV75%, AUROC=0.88). Optimal cut-offs for irAE detection were bowel (SUV95%>2.7 g/mL), lung (SUV95%>1.7 g/mL), and thyroid (SUV75%>2.1 g/mL). Normal ranges (95% confidence interval) for the SUV percentiles in patients without irAE were bowel [1.74, 2.86 g/mL], lung [0.73, 1.46 g/mL], and thyroid [0.86, 1.99 g/mL]. Conclusions: Increased 18F-FDG uptake within irAE-affected organs provides predictive information about the development of irAE in MM patients receiving ICI and represents a potential quantitative imaging biomarker for irAE. Some irAE can be detected on 18F-FDG PET/CT well before clinical symptoms appear.
Keywords: melanoma, malignant melanoma, immune-checkpoint inhibitors, molecular imaging biomarkers
Published in DiRROS: 07.09.2022; Views: 497; Downloads: 146
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13. Dnevnik zdravljenja z zdravilom regorafenibJanja 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: 761; Downloads: 201
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16. Priporočila za obravnavo bolnikov z rakom debelega črevesa in danke2020, dictionary, encyclopaedia, lexicon, manual, atlas, map Keywords: rak debelega črevesa, rak danke, bolniki, zdravljenje
Published in DiRROS: 18.03.2022; Views: 788; Downloads: 429
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17. Priporočila za obravnavo bolnikov z melanomomMarko Hočevar, Primož Strojan, Janja Ocvirk, Barbara Perić, Olga Blatnik, Boštjan Luzar, Jože Pižem, Marko Boc, Tanja Mesti, Marija Ignjatović, Nežka Hribernik, Katarina Barbara Karner, Tomi Bremec, Tanja Planinšek Ručigaj, 2020, dictionary, encyclopaedia, lexicon, manual, atlas, map Keywords: onkologija, melanomi, maligni melanomi, UV žarki, sončenje, sončne opekline, zaščitne kreme
Published in DiRROS: 18.03.2022; Views: 676; Downloads: 234
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18. Priporočila Onkološkega inštituta za zdravljenje bolnikov z adenokarcinomom želodcaErik Brecelj, Vesna Zadnik, Neva Volk, Mateja Krajc, Ana Blatnik, Ksenija Strojnik, Nina Boc, Yasmin Marianna Hunt, Gorana Gašljević, Jera Jeruc, Srdjan Novaković, Marko Boc, Franc Anderluh, Martina Reberšek, Borut Štabuc, Irena Oblak, Janja Ocvirk, Ana Jeromen, Zvezdana Hlebanja, Tanja Mesti, Marija Ignjatović, Nežka Hribernik, Ibrahim Edhemović, Gašper Pilko, Rok Petrič, Ajra Šečerov Ermenc, Nada Rotovnik-Kozjek, Vaneja Velenik, Sonja Kramer, Maja Ebert Moltara, Jernej Benedik, 2021, professional article Keywords: adenokarcinom želodca, priporočila, prebavni trakt, multidisciplinarno zdravljenje
Published in DiRROS: 16.12.2021; Views: 1109; Downloads: 496
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19. Priporočila Onkološkega inštituta za zdravljenje bolnikov z adenokarcinomom želodca2021, other monographs and other completed works Abstract: V Sloveniji vsako leto zboli zaradi raka želodca okrog 450 bolnikov, od tega ima tri četrtine bolnikov ob postavitvi diagnoze razširjeno ali razsejano bolezen. Zato je pomembno, da imamo razvito sodobno multidisciplinarno zdravljenje. Onkološki inštitut je na poti pridobitve evropske onkološke akreditacije, ki jo podeljuje priznana Evropska organizacija onkoloških inštitutov (OECI), katere član je tudi Onkološki inštitut Ljubljana. Namen tega projekta je razvoj kliničnih poti, ki bodo omogočile celostno obravnavo bolnikov z rakom. Slovenskih priporočil za zdravljenje adenokarcinoma želodca trenutno nimamo, zato smo bili primorani sprejeti te, ki jim bomo sledili na Onkološkem inštitutu. V teh priporočilih, zaradi drugačne narave bolezni, ni zajeto zdravljenje raka ezofagogastričnega stika.
Keywords: rak želodca, adenokarcinom, onkološko zdravljenje, priporočila
Published in DiRROS: 14.09.2021; Views: 1374; Downloads: 366
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20. Idiopathic pulmonary fibrosis in patients with early-stage non-small-cell lung cancer after surgical resectionNežka Hribernik, Igor Požek, Izidor Kern, 2019, original scientific article Abstract: Background. The outcomes of patients with both lung cancer and idiopathic pulmonary fibrosis (IPF) are unfavorable. Therapeutic interventions for lung cancer such as surgery can cause acute exacerbation of IPF (aeIPF). This study aimed to assess the frequency of IPF in a group of patients with early-stage non-small-cell lung cancer (NSCLC) and to report clinical characteristics and outcomes of this cohort of patients. Patients and methods. This observational cohort retrospective study analyzed 641 pathological records of patients after surgical resection of early-stage non-small-cell lung cancer (NSCLC) at University Clinic Golnik from May 2010 to April 2017. Pathological records of NSCLC with coexisting IPF were reviewed. CT scans and biopsy specimens for this group of patients were analyzed by a thoracic radiologist and pathologist, independently. We searched radiological and pathological features of usual interstitial pneumonia (UIP) pattern in this group of patients. We report the clinical characteristics and outcome of this cohort of patients. Results. Out of 641 patients with early-stage NSCLC, only 13 (2.0%) had histologically and radiologically proven coexisting UIP/IPF. Squamous cell carcinoma was the most common type of lung cancer (7/13 patients). The majority of tumors were small size (all being pT1 or pT2), stage I–II (11/13 patients), located in the lower lung lobes (11/13 patients). Almost all patients were current or ex-smokers (11/13 patients). There were two pathologically confirmed fatal cases (15.4%) due to aeIPF in the first two months after radical treatment, one after adjuvant radiotherapy and the other after surgery. Out of 13 patients, one patient had a lung cancer relapse. Conclusions. Frequency of UIP/IPF in surgically treated early stage NSCLC is rather low. Our observational study shows that radical treatment of lung cancer can cause aeIPF with dismal outcome in this group of patients. The standard of care in these mostly elderly patients still remains unresolved.
Keywords: non-small-cell lung cancer, early-stage cancer, idiopathic pulmonary fibrosis, surgery, radiotherapy
Published in DiRROS: 07.10.2020; Views: 1905; Downloads: 853
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