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1.
Bevacizumab plus chemotherapy in elderly patients with previously untreated metastatic colorectal cancer : single center experience
Janja Ocvirk, Maja Ebert Moltara, Tanja Mesti, Marko Boc, Martina Reberšek, Neva Volk, Jernej Benedik, Zvezdana Hlebanja, 2016, izvirni znanstveni članek

Povzetek: Metastatic colorectal cancer (mCRC) is mainly a disease of elderly, however, geriatric population is underrepresented in clinical trials. Patient registries represent a tool to assess and follow treatment outcomes in this patient population. The aim of the study was with the help of the patients% register to determine the safety and efficacy of bevacizumab plus chemotherapy in elderly patients who had previously untreated metastatic colorectal cancer. Patients and methods. The registry of patients with mCRC was designed to prospectively evaluate the safety and efficacy of bevacizumab-containing chemotherapy as well as selection of patients in routine clinical practice. Patient baseline clinical characteristics, pre-specified bevacizumab-related adverse events, and efficacy data were collected, evaluated and compared according to the age categories. Results. Between January 2008 and December 2010, 210 patients with mCRC (median age 63, male 61.4%) started bevacizumab-containing therapy in the 1st line setting. Majority of the 210 patients received irinotecan-based chemotherapy (68%) as 1st line treatment and 105 patients (50%) received bevacizumab maintenance therapy. Elderly (% 70 years) patients presented 22.9% of all patients and they had worse performance status (PS 1/2, 62.4%) than patients in < 70 years group (PS 1/2, 35.8%). Difference in disease control rate was mainly due to inability to assess response in elderly group (64.6% in elderly and 77.8% in < 70 years group, p = 0.066). The median progression free survival was 10.2 (95% CI, 6.7%16.2) and 11.3 (95% CI, 10.2%12.6) months in elderly and < 70 years group, respectively (p = 0.58). The median overall survival was 18.5 (95% CI, 12.4%28.9) and 27.4 (95% CI, 22.7%31.9) months for elderly and < 70 years group, respectively (p = 0.03). Three-year survival rate was 26% and 37.6% in elderly vs. < 70 years group (p = 0.03). Overall rates of bevacizumab-related adverse events were similar in both groups: proteinuria 21/22 %, hypertension 25/19 %, haemorrhage 2/4 % and thromboembolic events 10/6 %, for elderly and < 70 years group, respectively. Conclusions. In routine clinical practice, the combination of bevacizumab and chemotherapy is effective and welltolerated regimen in elderly patients with metastatic colorectal cancer.
Ključne besede: metastatic colorectal cancer, bevacizumab, chemotherapy, elderly
Objavljeno v DiRROS: 30.04.2024; Ogledov: 141; Prenosov: 36
.pdf Celotno besedilo (620,74 KB)

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Bevacizumab and irinotecan in recurrent malignant glioma, a single institution experience
Tanja Mesti, Maja Ebert Moltara, Marko Boc, Martina Reberšek, Janja Ocvirk, 2015, izvirni znanstveni članek

Povzetek: Treatment options of recurrent malignant gliomas are very limited and with a poor survival benefit. The results from phase II trials suggest that the combination of bevacizumab and irinotecan is beneficial. Patients and methods. The medical documentation of 19 adult patients with recurrent malignant gliomas was retrospectively reviewed. All patients received bevacizumab (10 mg/kg) and irinotecan (340 mg/m2 or 125 mg/m2) every two weeks. Patient clinical characteristics, drug toxicities, response rate, progression free survival (PFS) and overall survival (OS) were evaluated. Results. Between August 2008 and November 2011, 19 patients with recurrent malignant gliomas (median age 44.7, male 73.7%, WHO performance status 0%2) were treated with bevacizumab/irinotecan regimen. Thirteen patients had glioblastoma, 5 anaplastic astrocytoma and 1 anaplastic oligoastrocytoma. With exception of one patient, all patients had initially a standard therapy with primary resection followed by postoperative chemoradiotherapy. Radiological response was confirmed after 3 months in 9 patients (1 complete response, 8 partial responses), seven patients had stable disease and three patients have progressed. The median PFS was 6.8 months (95% confidence interval [CI]: 5.3-8.3) with six-month PFS rate 52.6%. The median OS was 7.7 months (95% CI: 6.6-8.7), while six-month and twelve-month survival rates were 68.4% and 31.6%, respectively. There were 16 cases of hematopoietic toxicity grade (G) 1-2. Non-hematopoietic toxicity was present in 14 cases, all G1-2, except for one patient with proteinuria G3. No grade 4 toxicities, no thromboembolic event and no intracranial hemorrhage were observed. Conclusions. In recurrent malignant gliomas combination of bevacizumab and irinotecan might be an active regimen with acceptable toxicity.
Ključne besede: recurrent malignant glioma, systemic therapy, bevacizumab
Objavljeno v DiRROS: 17.04.2024; Ogledov: 138; Prenosov: 34
.pdf Celotno besedilo (534,06 KB)

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Dnevi internistične onkologije 2024 : inovativna zdravila v onkologiji
2024, zbornik strokovnih ali nerecenziranih znanstvenih prispevkov na konferenci

Objavljeno v DiRROS: 04.04.2024; Ogledov: 198; Prenosov: 70
.pdf Celotno besedilo (9,80 MB)

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Cisplatin-induced non-convulsive posterior reversible encephalopathy syndrome in a 41-year-old woman with metastatic malignant melanoma
Janja Ocvirk, Marko Boc, Martina Reberšek, Tanja Roš-Opaškar, 2009, izvirni znanstveni članek

Povzetek: Background. Cisplatin, a widely used antineoplastic agent usually induces peripheral neuropathy, but can rarely also complicate with encephalopathy, with or without seizures. Case report. We report a case of a young patient with metastatic malignant melanoma with signs and symptoms of cisplatin-induced non-convulsive posterior reversible encephalopaty syndrome. Within the days shortly after the first cycle of cisplatin based chemotherapy the patient suffered from nausea, vomitus, headache, severe pain at the site of sub-cutaneous metastases and confusion. She later experienced somnolence, cortical blindness and aphasia, but without epileptic seizures. Conclusions. Cisplatin is an effective chemotherapeutic drug but also very toxic one and physicians using it must also be aware of possible encephalopathy.
Objavljeno v DiRROS: 08.03.2024; Ogledov: 161; Prenosov: 44
.pdf Celotno besedilo (343,74 KB)

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3. limfomska šola, Ljubljana, oktober 2023
Marko Boc, 2023, druge monografije in druga zaključena dela

Objavljeno v DiRROS: 04.01.2024; Ogledov: 264; Prenosov: 137
.pdf Celotno besedilo (16,32 MB)
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Neželeni učinki pri zdravljenju z BRAF in MEK zaviralci : prikaz primera
Alja Drobnič, Marko Boc, 2023, objavljeni znanstveni prispevek na konferenci

Povzetek: Zdravljenje z BRAF in MEK inhibitorji je močno izboljšalo preživetje bolnikov z BRAF mutiranim malignim melanomom. Neželeni stranski učinki ob terapiji z BRAF in MEK inhibitorji so pogosti in lahko vodijo v prekinitev zdravljenja. Pri različnih kombinacijah zdravil so najpogostejši neželeni stranski učinki podobni in so mrzlica, povišana telesna temperatura, kožna toksičnost, hepatotoksičnost, driska, arterijska hipertenzija in artralgije. V nadaljevanju je predstavljen primer bolnice, pri kateri smo morali zaradi resnih neželenih stranskih učinkov prekiniti zdravljenje z BRAF in MEK inhibitorji.
Ključne besede: rak kože, melanom, sistemsko zdravljenje
Objavljeno v DiRROS: 17.05.2023; Ogledov: 368; Prenosov: 141
.pdf Celotno besedilo (111,82 KB)
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9.
Napredovali maligni melanom s prisotno BRAF mutacijo : klinični primer zdravljenja z BRAF in MEK zaviralci
Rozala Arko, Marko Boc, 2023, objavljeni znanstveni prispevek na konferenci

Povzetek: Bolniki z napredovalim malignim melanomom s prisotno BRAF mutacijo tumorskih celic so kandidati za tarčno zdravljenje z BRAF in MEK zaviralci. Pričujoči klinični primer nam predstavi bolnico z napredovalim malignim melanomom s prisotno BRAF mutacijo, ki se je leta 2015 pričela zdraviti z BRAF zaviralcem (vemurafenibom), s katerim je bila dosežena nekajletna remisija bolezni. Ob napredovanju bolezni je bilo uvedeno zdravljenje z zaviralcem imunskih nadzornih točk (ZINT) s pembrolizumabom. Po dveh letih je bilo zdravljenje zaključeno, saj je bila dosežena popolna metabolična in klinična remisija bolezni. V fazi sledenja je bil na novo-ugotovljen solitaren zasevek v možganih, ki je bil odstranjen, ležišče zasevka je bilo obsevano. Uvedeno je bilo zdravljenje s kombinacijo nivolumaba ter ipilimumaba, ki je bilo predčasno ukinjeno zaradi imunsko pogojenih nezaželenih stranskih učinkov. Do sedaj ni dokazanega napredovanja bolezni, vendar je v prihodnosti pričakovati napredovanje v osnovi že napredovale bolezni. Pojavlja se vprašanje nadaljnjega zdravljenja.
Ključne besede: rak kože, melanom, sistemsko zdravljenje
Objavljeno v DiRROS: 17.05.2023; Ogledov: 373; Prenosov: 133
.pdf Celotno besedilo (243,94 KB)
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Sistemsko zdravljenje napredovalega in metastatskega malignega melanoma : tarčno zdravljenje
Marko Boc, 2023, objavljeni znanstveni prispevek na konferenci

Povzetek: Dabrafenib, vemurafenib in encorafenib spadajo med močno potentne in učinkovite tirozin kinazne (TKI) zaviralce pri malignem melanomu z prisotno BRAFV600E mutacijo. So selektivni inhibitorji RAF kinase tipa 1, ki predstavlja ključni del mitogen aktivirajoče protein.kinazne poti (MAPK). BRAFV600E mutacija je prisotna pri cca. 7% vseh rakov, pri malignem melanomu je prisotna v cca. 50% bolnikov. Kot smo navajeni tudi pri drugih tarčnih zdravilih je tudi pri BRAF zaviralcih velika težava pridobljena rezistenca na zdravljenje. Z kombiniranjem BRAF in MEK zaviralcev (trametinib, cobimetinib in binimetinib) lahko to rezistenco do določene mere presežemo in s tem bolnikom z metastatskim malignim melanomom omogočamo še daljša celokupna preživetja (OS) in preživetja brez napredovanja bolezni (PFS).
Ključne besede: rak kože, melanom, sistemsko zdravljenje
Objavljeno v DiRROS: 17.05.2023; Ogledov: 310; Prenosov: 120
.pdf Celotno besedilo (217,12 KB)
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