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Iskalni niz: "avtor" (Tanja Čufer) .

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1.
Oral treatment with etoposide in small cell lung cancer - dilemmas and solution
Renata Režonja, Lea Knez, Tanja Čufer, Aleš Mrhar, 2013, pregledni znanstveni članek

Povzetek: Background. Etoposide is a chemotherapeutic agent, widely used for the treatment of various malignancies, including small cell lung cancer (SCLC), an aggressive disease with poor prognosis. Oral etoposide administration exhibits advantages for the quality of life of the patient as well as economic benefits. However, widespread use of oral etoposide is limited by incomplete and variable bioavailability. Variability in bioavailability was observed both within and between patients. This suggests that some patients may experience suboptimal tumor cytotoxicity, whereas other patients may be atrisk for excess toxicity. Conclusions. The article highlights dilemmas as well as solutions regarding oral treatment with etoposide by presenting and analyzing relevant literature data. Numerous studies have shown that bioavailability of etoposide is influenced by genetic, physiological and environmental factors. Several strategies were explored to improve bioavailability and to reduce pharmacokinetic variability of oral etoposide, including desired and undesired drug interactions (e.g. with ketoconazole), development of suitable drug delivery systems, use of more water-soluble prodrug of etoposide, and influence on gastric emptying. In addition to genotype-based dose administration, etoposide is suitable for pharmacokinetically guided dosing, which enables dose adjustments in individual patient. Further, it is established that oral and intravenous schedules of etoposide in SCLC patients do not result in significant differences in treatment outcome, while results of toxicity are inconclusive. To conclude, the main message of the article is that better prediction of the pharmacokinetics of oral etoposide may encourage its wider use in routine clinical practice.
Ključne besede: oral etoposide, bioavailability, pharmacokinetic variability, small cell lung cancer, treatment
Objavljeno v DiRROS: 22.03.2024; Ogledov: 31; Prenosov: 7
.pdf Celotno besedilo (465,72 KB)

2.
Outcome of small cell lung cancer (SCLC) patients with brain metastases in a routine clinical setting
Mirko Lekić, Viljem Kovač, Nadja Triller, Lea Knez, Aleksander Sadikov, Tanja Čufer, 2012, izvirni znanstveni članek

Povzetek: Background. Small cell lung cancer (SCLC) represents approximately 13 tomediansurvival of SCLC patients treated by specific therapy (chemotherapy andžor radiotherapy) with regard to the 18%months in patients treated with standard chemotherapy and radiotherapy. Inpresence or absence of brain metastases at the time of diagnosis. Patients and methods. All SCLC patients have been treated in a routine clinical practice and followed up at theUniversity Clinic Golnik in Slovenia. In the retrospective study the medical files from 2002 to 2007 were review. All patients with cytological or histological confirmed disease and eligible for specific oncological treatment were included in the study. They have been treated according to the guidelines valid at the time. Chemotherapy and regular followed-up were carried out at the University Clinic Golnik and radiotherapy at the Institute of Oncology Ljubljana. Results. We found 251 patients eligible for the study. The median age of them was 65 years, majoritywere male (67%), smokers or ex-smokers (98%), with performance status 0 to 1 (83%). At the time of diagnosis no metastases were found in 64 patients(25.5%) and metastases outside the brain were presented in 153 (61.0%). Brain metastases, confirmedby a CT scan, were present in 34 patients (13.5%), most of them had also metastases at other localisations. (Abstract truncated at 2000 characters)
Ključne besede: pljuča, rak (medicina), drobnocelični rak, metastaze, možgani
Objavljeno v DiRROS: 22.03.2024; Ogledov: 42; Prenosov: 19
.pdf Celotno besedilo (552,38 KB)

3.
Adjuvant treatment of breast cancer patients with trastuzumab
Erika Matos, Tanja Čufer, 2007, pregledni znanstveni članek

Povzetek: Background. Trastuzumab is a monoclone antibody directed against HER2 receptors that are overexpressed in approximately 20% of breast cancer patients. The present paper presents five clinical trials in which trastuzumabwas applied in breast cancer patients in adjuvant setting. The results of all the trials consistently demonstrate a high efficacy of this target drug in the patients with HER2 positive tumours. So far, no formal guidelines for using trastuzumab in adjuvant setting for breast cancer have been approved. The reasons are many: (i) mean observation time in the studies done so far was considerably short; (ii) the drug was used according to different schedules, (iii) the overall time of treatment with trastuzumab was different in each trial, (iv) late side effects of treatment with trastuzumab are inadequately investigated, and (v) nobody can so far say for sure for which HER2 status patients therapy with trastuzumab is really beneficial. Conclusions. Trastuzumab is definitely very helpful in the treatment of the HER2-positive breast cancer patients that are hormone-independent and of anatomically larger tumours; but, what the absolute benefit of trastuzumab therapy in the treatment of small hormone-dependent tumours is remains a mystery. Incidentally, it must be borne in mind that cardiotoxicity, the well known side effect, may put particularly elderly patients at risk of death, thus beating any treatment advantages down. It has also not been yet resolved at what time it would be most appropriate to start with the therapy with trastuzumab, what would be the optimal duration of the therapy and whether trastuzumab is to be administered concurrently with chemotherapy or immediately after it? What is the optimal treatment duration, one or two yearsor only a few months? In addition there is still a question of optimal HER2 status determination and which HER2 status predicts for trastuzumab benefit. (Abstract truncated at 2000 characters)
Objavljeno v DiRROS: 22.02.2024; Ogledov: 168; Prenosov: 26
.pdf Celotno besedilo (3,80 MB)

4.
Clinical utility of serine proteases in breast cancer
Tanja Čufer, 2004, strokovni članek

Povzetek: The serine protease uPA and its inhibitor PAI-1 are involved in the degradation of tumor stroma and basement membrane. The independent prognostic value of serine protease urokinase-type plasminogen activator uPA and its inhibitor PAI-1 in breast cancer has been almost uniformly confirmed in numerous individual studies as well as in a meta-analysis, including 18 data sets of more than 8,000 patients. According to these observations, the risk ofrelapse in node negative patients with low levels of uPA and PAI-1 is less then 10%; these patients could be spared from toxic adjuvant systemic therapy.Clinically relevant and even more important is the information that uPA and its inhibitor PAI-1 may also have a predictive value for response to either hormonal or cytotoxic therapy in early breast cancer. According to our data obtained from altogether 460 operable breast cancer patients, uPA and PAI-1 may have a predictive value for the response to hormone therapy, but notto chemotherapy. The high PAI-1 levels were associated with a higher risk of relapse in the patients without adjuvant systemic therapy (HR 2.14; C.I. 95%= 0.48-9.56; p=0.321) and in the patients treated with chemotherapy (RR 2.48; C.1. 95%=1.35-4.57; p=0.003). However, in the patients treated with adjuvant hormone therapy, either alone or in combination with chemotherapy, the prognosric value of uPA and PAI-1 was diminished. Moreover, high levels ofboth uPA and PAI-1 were associated with a lower risk of relapse (HR 0.79; p=0.693 and HR 0.26 p= 0.204, respectively). On the basis of currently available evidence, serine protease uPA and its inhibitor PAI-1 are certainly the markers that improve a proper selection of candidates for adjuvant systemic therapy and may also be the markers that could facilitate treatment decision in each individual patient, which is of utmost importance.
Objavljeno v DiRROS: 13.02.2024; Ogledov: 114; Prenosov: 26
.pdf Celotno besedilo (108,14 KB)

5.
Electrochemotherapy with cisplatin of breast cancer tumor modules in a male patient
Martina Reberšek, Tanja Čufer, Zvonimir Rudolf, Gregor Serša, 2000, izvirni znanstveni članek

Povzetek: Background. The metastases of breast cancer in a male patient were treated with electrochemotherapy by intratumoral injection of cisplatin. Electrochemotherapy is chemotherapy with the subsequent local application of electric pulses to the tumor nodules in order to increase drug delivery into the cells. Case report. Cutaneous metastases of breast cancer were treated with the intratumoral administration of cisplatin and by 8 electric pulses (1300 V/cm) applied a minute later to each cutaneous metastasis. The treatmentresulted in complete response of two electrochemotherapy treated cutaneous metastases and partial response of the third metastasis. In cutaneous metastases treated with intratumoral administartion of cisplatin without electric pulses, only partial response was obtained. Conclusion. This study confirms that electrochemotherapy with cisplatin is effective in the treatment of breast cancer metastases, too, as it was already proved for electrochemotherapy with bleomycin.
Objavljeno v DiRROS: 25.01.2024; Ogledov: 127; Prenosov: 32
.pdf Celotno besedilo (267,61 KB)

6.
Do we need axillary dissection in early breast cancer?
Tanja Čufer, 2000, objavljeni znanstveni prispevek na konferenci

Povzetek: Background. In the existing paradigm of the invasive breast cancer, the treatment with the axillary lymphnode dissection (ALND) and histologic stagingof the axilla, which is associated with a substantial morbidity, is considered necessary for the treatment decision and local control of disease. However paradigms are changing and, since primary tumor characteristics are increasingly used for treatment decision and since there is a trend towards the broad application of preoperative chemotherapy, ALND is less and less important for the treatment planning. In a small subgroup of patients in whom the information on nodal status is still important it can be obtained accurately by the sentinel lymph node biopsy. For good local control of the disease, ALND can be replaced with irradiation of the axilla with substantially lesser morbidity. Conclusions. Abandoning ALND together with breast conserving surgery is one of the major steps towards less mutilating surgery leading to a better quality of life of breast cancer patients at the end of this millennium.
Objavljeno v DiRROS: 25.01.2024; Ogledov: 133; Prenosov: 27
.pdf Celotno besedilo (214,99 KB)

7.
Improving the quality of life of patients with TCC by sequential chemoradiothrapy
Borut Kragelj, Boris Sedmak, Jožica Červek, Tanja Čufer, 2000, objavljeni povzetek znanstvenega prispevka na konferenci

Objavljeno v DiRROS: 25.01.2024; Ogledov: 142; Prenosov: 33
.pdf Celotno besedilo (94,20 KB)

8.
Preface : 2nd international symposyum on organ sparing treatment in oncology, September 14-16, 2000, Ljubljana, Slovenia
Tanja Čufer, 2000, predgovor, uvodnik, spremna beseda

Objavljeno v DiRROS: 25.01.2024; Ogledov: 131; Prenosov: 29
.pdf Celotno besedilo (30,03 KB)

9.
Combined modality treatment with organ preservation in invasive bladder cancer
Tanja Čufer, 2000, izvirni znanstveni članek

Povzetek: Background. The standard treatment for muscle-invasive bladder cancer is stillradical cystectomy. However despite mutilating surgery half of the patients eventually develop metastatic disease and subsequently die of the disease. In view of these problems, a bladder-sparing approach using multi-modality treatment with transurethral resection (TUR), irradiation and chemotherapy has been tested in this disease. So far, the results published byfive groups, showed that the survival rates of patients treated by multi-modality therapy with a bladder sparing approach, based on the response to initial TUR and chemotherapy or chemoradiotherapy, are comparable to cystectomy series, while also offering a 60% to 70% chance of maintaining a functioning bladder. The probability of survival with bladder preserved was found to be around 40% at 5-years. The best predictor of successful multi-modality treatment with bladder preservation seems to be a complete response to initial therapy and a close cystoscopic surveillance is obligatoryto allow for cystectomy at earliest opportunity, if necessary. Conclusions. Multimodality treatment with selective bladder preservation offers a chance for long term cure and survival equal to radical cystectomy inmuscle invasive bladder cancer, while also offering a chance of maintaining a normally functioning bladder. It is expected, that the identification of biological factors with a predictive value for successful chemoradiation will allow for a better selection of patients who could benefit from this treatmentin future.
Objavljeno v DiRROS: 23.01.2024; Ogledov: 131; Prenosov: 32
.pdf Celotno besedilo (301,39 KB)

10.
Prognostic relevance of urokinase plasminogen activator and its inhibitors in patients with breast cancer
Simona Borštnar, Tanja Čufer, Ivan Vrhovec, Zvonimir Rudolf, 1999, izvirni znanstveni članek

Povzetek: Urokinase plasminogen activator (uPA) and its inhibitors, PAI-1 and PAI-2, play an important role in iritercellular tissue degradation, thus promoting tumor cell invasion into the adjoining structures and metastasizing. Our studywas aimed to assess a possible prognostic value of uPA, PAI-1 and PAI-2 in a retrospective series of 87 patients with breast cancer stage I-III, whosecytosols were stored in the archives of the, Institute of Oncology in Ljubljana. The median follow-up was 35 months. The prognostic value of the established prognostic factors and uPA, PAI-1 and PAI-2 were evaluated by means of univariate statistical analysis and partial multivariate models. The obtained uPA values were very low and did not correlate with the disease free survival, whereas PAI-1 and PAI-2 significantly influenced the time to the first recurrence. Patients with PAI-1 values above 5 ng/mg proteins had statistically significantly worse disease free survival than the patients withlower PAI-1 values (58% vs. 85%). In the case of PAI-2, the situation wasjust the opposite: the patients with PAI-2 values exceeding 6.4 ng/mg proteins had statistically significantly better 3-year disease free survival than the patients with lower values (90% vs. 60%). Both, PAI-1 and PAl-2 retained their independent prognostic value, irrespective of the addition of the established prognostic factors to partial multivariate models, and only with locally advanced disease the prognostic value of PAI-1 was greater than that of PAI-2.
Objavljeno v DiRROS: 22.01.2024; Ogledov: 154; Prenosov: 39
.pdf Celotno besedilo (548,70 KB)

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