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Background: The evaluation of treatment outcomes and toxicity in patients with metastatic castration-resistant prostate cancer (mCRPC) treated by enzalutamide or abiraterone after previous docetaxel., Patients and Methods: We analyzed 66 patients with mCRPC treated by enzalutamide (55 patients) or abiraterone (11 patients) after previous therapy with docetaxel. The median follow-up was 31.2 months. Enzalutamide and abiraterone were administered in daily doses of 160 mg and 1,000 mg per day, respectively. The progression free survival (PFS) and overall survival (OS) were estimated by Kaplan-Meier analysis. The prognostic influence of the factors on OS was evaluated by regression analysis., Results: The progression was observed in 55 (83%) patients, and mPFS was 12.1 (95% CI 7.7-16.4) months. In total, 43 patients died, and he median OS was 21.9 (95% CI 12.2-31.7) months. In the regression analysis, we observed statistical favorable influence of the following factors on OS: PSA decrease ≥ 50%, in patients with early decrease of prostatic specific antigen (PSA) ≥ 50% in 3 months after initiation of enzalutamide or abiraterone treatment, in patients with visceral metastatic sites, in patients treated with only one regimen of previous chemotherapy and in those without anemia. We observed the toxicity grades 3-4 in 45.5% and 36.3% patients treated with enzalutamide and abiraterone, respectively., Conclusion: Our analysis demonstrated efficacy and good tolerance in patients with mCRPC treated with enzalutamide and abiraterone after previous docetaxel therapy.

Background: Current standard treatments for patients with metastatic renal cell carcinoma (mRCC) involve tyrosine kinase inhibitors (TKI) that inhibit angiogenesis. Cabozantinib is a multi TKI used for the treatment of mRCC in the first- and second-line setting., Purpose: The aim of this study was the final analysis of treatment outcomes in patients with metastatic renal cell carcinoma (mRCC) treated with cabozantinib after previous targeted therapy., Patients and Methods: A total of 54 patients with mRCC from four oncology centers in the Czech Republic were evaluated retrospectively; the median follow-up was 18.5 months. Cabozantinib was administered in a dose of 60mg/day, a subset of patients received an initial dose of 40mg/day. The treatment was administered until the progression. The Kaplan-Meier analysis was used to calculate progression free survival (PFS) and overall survival (OS). We performed a multivariate analysis of risk factors for treatment outcomes (PFS, OS) by regression analysis. All statistics were evaluated at the significance level α = 0.05., Results: The median PFS in all patients was 9.3 months (95% CI 7.2 - 11.4). The median OS in all patients was 21.9 months (95% CI 15.5 - 28.4). The median PFS in patients with bone metastases was not statistically significantly different compared with patients without bone metastases (9.3 vs 8.7 months, P = 0.53). The median OS in patients with bone metastases was statistically significantly shorter compared with patients without bone metastases (17.7 vs 26.8 months, P = 0.021). A treatment response was observed in 40.7 % of cases, including one complete remission. The regression analysis demonstrated a significant effect on OS in patients with the presence of subsequent treatment (P = 0.001), patients with treatment duration of first line therapy 6 months (P = 0.019) and 12 months (P = 0.003) and in patients without bone metastases (P = 0.021)., Conclusion: Our final analysis of patients with mRCC treated with cabozantinib after previous targeted therapy confirmed its effectiveness.

Aim: The aim of this retrospective study was to compare the efficacy of the sequence docetaxel-cabazitaxel-enzalutamide vs. docetaxel-enzalutamide in patients with metastatic castration-resistant prostate cancer., Patients and Methods: Of the cohort of 35 patients, 11 were treated with the sequence docetaxel-cabazitaxel-enzalutamide and 24 were treated with the sequence docetaxel-enzalutamide. The doses were as follows: docetaxel, 75 mg/m2; cabazitaxel, 25 mg/m2; and enzalutamide, 160 mg/day. Overall survival (OS) was defined as the interval between the initial dose of docetaxel and death or the date of the last control for survivors (censored). OS was assessed using the Kaplan-Meier method, and the two arms were compared using the log-rank test. The significance level for all statistical tests was set at α = 0.05., Results: The median OS of patients treated with the sequence docetaxel-cabazitaxel-enzalutamide was 28.8 months, vs. 24.4 months in patients treated with the sequence docetaxel-enzalutamide. No statistically significance differences in OS were found between the two arms (HR 0.678, 95% CI 0.264-1.744; p = 0.418). Grade 3-4 toxicity was observed for each drug, as follows: docetaxel: fatigue and peripheral neuropathy in six patients, nausea in three patients, and diarrhea and neutropenia in one patient; cabazitaxel: anemia in two patients and neutropenia in one patient; and enzalutamide: anemia in six patients, thrombocytopenia in two patients, and cerebral hemorrhage in one patient., Conclusion: No statistically significant differences in OS were found between the sequences docetaxel-cabazitaxel-enzalutamide and docetaxel-enzalutamide.Key words: prostate cancer - metastasis - chemotherapy - targeted hormonal treatment The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 13. 2. 2017Accepted: 20. 3. 2017.

Background: Prostate cancer is one of the most common malignancies in men. Chemotherapy has an important role in the management of prostate cancer, especially for the treatment of castrate resistant prostate cancer (mCRPC). According to recently published studies, chemotherapy can also be used to treat advanced hormone sensitive disease., Aim: The aim of this report is to review the currently available options for chemotherapy of prostate cancer., Results: Docetaxel is a chemotherapeutic agent used for standard treatment of mCRPC as 1st line therapy. In TAX 327 and SWOG 9916 studies reported in 2004, docetaxel, the first cytostatic agent indicated for this disease, prolonged overall survival. As a 2nd line mCRPC treatment, kabazitaxel resulted in longer overall survival than mitoxantrone, according to the results of the TROPIC study. Targeted hormone treatment, radium-223 irradiation, and immunotherapy are other treatment options for patients with mCRPC. Currently, the main focus is to develop an optimal sequence of treatments. Standard androgen deprivation therapy (ADT) is the standard option for patients with advanced hormone sensitive prostate cancer. According to recently published studies (CHAARTED, STAMPEDE), docetaxel with ADT increases overall survival in this group of patients. In the Czech Republic, this option is still off-label. Chemotherapy is not indicated in patients with early prostate cancer after radical prostatectomy or radiotherapy.Key words: prostate cancer - metastasis - chemotherapy - docetaxel - cabazitaxelThe authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 9. 5. 2016Accepted: 6. 6. 2016.

Aim: Enzalutamide and abiraterone represent new therapeutical options in the treatment of metastatic castration-resistant prostate cancer (mCRPC). The aim of the presented study was retrospective analysis of clinical experience and efficacy of enzalutamide or abiraterone in the postchemo indication in patients with mCRPC., Patients and Methods: A total of 32 mCRPC patients were evaluated. All patients received one or more lines of chemotherapy. Twenty-three patients were treated by enzalutamide, nine patients were treated by abiraterone. We defined two parameters: over all survival and progression-free survival., Results: The median follow-up was 6.5 months. A total of 10 patients treated by enzalutamide progressed (43.47%) and eight patients died (34.78%). A total of five patients treated by abiraterone progressed (55.56%) and one patient died (11.11%). We did not observe any statistical difference in over all survival (HR 0.2362, 95% CI 0.0295- 1.8942; p = 0.102) and in progression-free survival (HR 0.9853, 95% CI 0.2934- 3.308; p = 0.939) between enzalutamide and abirateron., Conclusion: Our retrospective study demonstrated similar efficacy of enzalutamide and abiraterone in mCRPC patients previously treated by chemotherapy.

Anal cancer is a relatively rare tumour. In local and locally advanced disease, concomitant chemoradiation based on mitomycin C and 5-fluorouracil, remains golden standard of treatment. However, this treatment is associated with significant morbidity. With the developing of molecular biology, new treatment strategies can be investigated. Epidermal growth factor receptor (EGFR) expression in anal cancer is observed in 55-100% of cases. Some studies demonstrated that KRAS mutations, mechanism marker of resistance to antiEGFR therapy, are rare in anal cancer. This paper presents current view on the possibilities of antiEGFR therapy in locally advanced and metastatic anal cancer.

Rectal adenocarcinoma, in contrast to colorectal carcinoma, is typical of its high local reccurence rate. Radiotherapy is proved to reduce the incidence of recurrences. Neoadjuvant chemoradiotherapy demonstrated better treatment results than adjuvant chemoradiotherapy. Standard cytotoxic agents involved in combination therapy are 5- flurouracil or capecitabin. Epidermal growth factor receptor (EGFR) is supposed to play an important role in cell- cycle regulation, proliferation, differentiation, and surviving of normal epithelial tissues. EGFR overexpression in patients with rectal adenocarcinoma is associated with radioresistance of malignant tissues, lower rates of patological complete response after neoadjuvant chemoradiation and generally poor survival. There are many clinical studies describing combination of neoadjuvant chemoradiotherapy with EGFR inhibitors, however, this regimen has not gained an acceptance as a standard of treatmentment.

Aim: The aim of this retrospective study was to determine the prognostic impact of expression of epidermal growth factor receptor (EGFR) changes during neoadjuvant chemoradiotherapy in patients with locally advanced rectal adenocarcinoma., Material and Methods: One hundred and three patients with locally advanced rectal adenocarcinoma of stage II and III were evaluated. All patients were administered the total dose of 44 --  50.4 Gy. Concomitantly, the patients received capecitabine in the dose 825 mg/ m² in two daily oral administrations or 5- fluorouracil in the dose 200 mg/ m² in continuous infusion. Surgery was indicated at intervals of 4-8 weeks from chemoradiotherapy completion. EGFR expression in the pretreatment biopsies and in resected specimens was assessed with immunohistochemistry., Results: All of 103 patients received radiotherapy without interruption up to the total planned dose. Downstaging was described in 64 patients. Six patients had complete pathologic remission. Recurrence occurred in 49 patients. Local recurrence was found in 22 patients, generalization of disease was reported in 27 patients. A total of 51 patients died. Increased EGFR expression was found in 26 patients. The statistically significantly shorter overall survival (p < 0.001) and disease-free survival (p < 0.001) was found in patients with increased expression of EGFR compared with patients where no increase in the expression of EGFR was observed during neoadjuvant chemoradiotherapy., Conclusions: The overexpression of EGFR during neoadjuvant chemoradiotherapy for locally advanced rectal adenocarcinoma is associated with significant shorter overall survival and disease-free survival.