Objective Patients with bone metastases or lesions secondary to solid tumors or multiple myeloma often experience bone complications (skeletal-related events [SREs]-radiation to bone, pathologic fracture, surgery to bone, and spinal cord compression); however, recent data that can be used to assess the value of treatments to prevent SREs across European countries are limited. This study aimed to provide estimates of health resource utilization (HRU) and cost associated with all SRE types in Europe. HRU data were reported previously; cost data are reported herein. Methods Eligible patients from 49 centers across Austria (n = 57), the Czech Republic (n = 59), Finland (n = 60), Greece (n = 59), Portugal (n = 59), and Sweden (n = 62) had bone metastases or lesions secondary to breast, lung, or prostate cancer, or multiple myeloma, and ≥1 index SRE (a SRE preceded by a SRE-free period of ≥ 6.5 months). SRE-related costs were estimated from a payer perspective using health resource utilization data from patient charts (before and after the index SRE diagnosis). Country-specific unit costs were from 2010 and local currencies were converted to 2010 euros. Results The mean costs across countries were €7043, €5242, €11,101, and €11,509 per radiation to bone, pathologic fracture, surgery to bone, and spinal cord compression event, respectively. Purchasing power parity (PPP)-adjusted mean cost ratios were similar in most countries, with the exception of radiation to bone. Limitations The overall burden of SREs may have been under-estimated owing to home visits and evaluations outside the hospital setting not being reported here. Conclusions All SREs were associated with substantial costs. Variation in SRE-associated costs between countries was most likely driven by differences in treatment practices and unit costs.

• Klíčová slova
• Bone metastases, Cost, Europe, Skeletal-related events, Supportive care,
• MeSH
• ekonometrické modely MeSH
• fraktury spontánní ekonomika   etiologie   MeSH
• komprese míchy ekonomika   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory kostí komplikace   ekonomika   sekundární   MeSH
• senioři MeSH
• výdaje na zdravotnictví statistika a číselné údaje   MeSH
• zdravotnické služby ekonomika   statistika a číselné údaje   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND: An integrated analysis of phase III trials in patients with advanced solid tumors demonstrated superiority of denosumab over zoledronic acid in preventing skeletal-related events. A drug's clinical efficacy, however, depends on regular and continued administration (persistence); persistence in Slovak real-life is yet undetermined for denosumab in the oncology indication. PATIENTS AND METHODS: This was a single-arm, prospective, observational, non-interventional study in patients with bone metastases from solid tumors treated with denosumab every 4 weeks in real-world clinical practice in 5 European countries. The results of the 54 patients from Slovakia are presented here. Persistence was defined as denosumab administration at ≤ 35-day intervals over 24 or 48 weeks, respectively. RESULTS: Previous skeletal-related events were found in 5.6% of patients. 84.8% were persistent over 24 weeks and 61.4 % over 48 weeks. The median (95% confidence interval (CI)) time to non-persistence was 306.5 days (Q1 = 151.0; Q3 = 315.0). The most frequent reason for non-persistence was delayed administration of denosumab. There was a trend towards weaker analgesics over time, with > 70% of patients not requiring any analgesics. Serum calcium remained within the normal range throughout the whole study. Adjudicated osteonecrosis of the jaw was not documented in any Slovak patient. CONCLUSION: Most patients received denosumab regularly once every 4 weeks over 24 weeks of treatment. Non-persistence was mainly due to delayed administration. The incidence of adverse drug reactions was in line with expectations from previous studies, osteonecrosis of the jaw did not occur in any of the patients involved in the study.

• Klíčová slova
• bone metastases, denosumab, observational study, persistence, solid tumors,
• MeSH
• denosumab MeSH
• lidé MeSH
• nádory kostí * MeSH
• osteonekróza * MeSH
• prospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• pozorovací studie MeSH
• Geografické názvy
• Slovenská republika MeSH
• Názvy látek
• denosumab MeSH

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• metastázy nádorů MeSH
• nádory kostí diagnóza   etiologie   terapie   MeSH
• nádory štítné žlázy diagnóza   etiologie   terapie   MeSH
• nádory závislé na hormonech diagnóza   terapie   MeSH
• radioizotopy jodu MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• radioizotopy jodu MeSH

In a group of 840 patients with thyroid carcinoma the authors found pulmonary metastases in 123 patients, i. e. in 14.6%. In 78 pulmonary metastases were the only remote ones, in the remainder they were combined also with other remote metastates, almost always bone metastases. Cases of "pure" pulmonary metastases were found in the whole group without a proved relationship to age and histology, with a slight prdominance of men, while in patients with a combination of pulmonary and bone metastases follicular carcinoma predominates and it is found mainly in patients of more advanced age. The biological behaviour of these two groups differs completely, and this should be taken into account in the international TNM classification. When investigating the biological properties of thyroid carcinoma, we evaluated in detail in a recent publication (15) bone metastases. As all remote metastases of thyroid carcinoma are included according to the classification of WHO under the common sign M1 (9), we wanted to compare some factors in the incidence of pulmonary and bone metastases.

• MeSH
• adenokarcinom diagnóza   patologie   MeSH
• dospělí MeSH
• karcinom diagnóza   patologie   MeSH
• lidé MeSH
• metastázy nádorů MeSH
• nádory kostí diagnóza   patologie   MeSH
• nádory plic diagnóza   patologie   sekundární   MeSH
• nádory štítné žlázy patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The ARON-2 study (NCT05290038) aimed to assess the real-world efficacy of pembrolizumab in patients recurred or progressed after platinum-based chemotherapy. This retrospective analysis reports the outcomes of urothelial carcinoma (UC) patients with bone metastases (BM). Medical records of patients with documented metastatic UC treated by pembrolizumab as second-line therapy were reviewed from60 institutions in 20 countries. Patients were assessed for Overall Response Rate (ORR), Progression-Free Survival (PFS), and Overall Survival (OS). Univariate and multivariate analyses were used to explore the association of variables of interest with OS and PFS. 881 patients were included; of them, 263 (30%) presented BM. Median follow-up time was 22.7 months. Patients with BM showed both shorter median OS (5.9 months vs 13.1 months, p < 0.001) and PFS (3.5 months, vs 7.3 months, p < 0.001) compared to patients without BM. Patients who received bone targeted agents (BTAs) showed a significantly longer median OS (8.5 months vs 4.6 months, p = 0.003) and PFS (6.1 months vs 3.2 months, p = 0.003), while no survival benefits were observed among patients who received radiation therapy for BM during pembrolizumab treatment compared to those who did not. In multivariate analysis, performance status, concomitant liver metastases, and the lack of use of BTAs were significantly associated with worse OS and PFS. Bone involvement in UC patients treated with pembrolizumab predicts inferior survival. Poor performance status and liver metastases may further worsen outcomes, while the use of BTAs is associated with improved outcomes.

• Klíčová slova
• ARON-2 study, Bone metastases, Immunotherapy, NCT05290038, Pembrolizumab, Real-world data, Survival, Tumor response, Urothelial cancer,
• MeSH
• antitumorózní látky * terapeutické užití   MeSH
• karcinom z přechodných buněk * farmakoterapie   radioterapie   MeSH
• lidé MeSH
• lokální recidiva nádoru MeSH
• nádory jater * farmakoterapie   MeSH
• nádory kostí * farmakoterapie   radioterapie   MeSH
• nádory močového měchýře * patologie   MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antitumorózní látky * MeSH
• pembrolizumab MeSH Prohlížeč

• MeSH
• kosti a kostní tkáň patofyziologie   MeSH
• lidé MeSH
• metastázy nádorů patofyziologie   MeSH
• nádory kostí patofyziologie   sekundární   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• lidé MeSH
• metastázy nádorů MeSH
• nádory kostí * MeSH
• resorpce kosti MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

The authors compared the results of bone scintigraphy and determination of CEA levels in a group consisting of 167 patients suffering from breast cancer with suspect distant metastases. The high agreement (79%) in results of both of examinations increase the diagnostic reliability of distant metastases. In the case of disagreement the bone scanning should be considered as a more sensitive method. The elevated CEA levels at negative or only uncertain bone scintigraphy results most often prove the present of distant metastases outside the skeleton.

• MeSH
• karcinoembryonální antigen analýza   MeSH
• kosti a kostní tkáň diagnostické zobrazování   MeSH
• lidé MeSH
• nádory kostí diagnóza   diagnostické zobrazování   sekundární   MeSH
• nádory prsu * diagnostické zobrazování   MeSH
• radioisotopová scintigrafie MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• karcinoembryonální antigen MeSH

In this article, the authors present their experience with the diagnosis of bone metastases in patients with breast cancer using bone scintigraphy with 99mTc phosphonate and radioimmunological determination of carcinoembryonic antigen (CEA) and tissue polypeptic antigen (TPA). In a group of 395 patients, there was agreement between tumour markers (CEA, TPA) and the results of bone scintigraphy in 331 cases (84%)--negative in 193 cases (49%) and positive (i.e. in terms of bone scintigraphy results and the presence of at least one tumour marker) in 138 cases (35%). On the basis of this good agreement of the results between bone scintigraphy and CEA and TPA levels, the authors recommend the following algorithm in monitoring patients with breast cancer: follow-up of tumour markers at several-month intervals and, any increase in their levels will refer the patient to further examination using imaging techniques including bone scintigraphy.

• MeSH
• karcinoembryonální antigen analýza   MeSH
• kosti a kostní tkáň diagnostické zobrazování   MeSH
• lidé MeSH
• nádorové biomarkery krev   MeSH
• nádory kostí diagnostické zobrazování   sekundární   MeSH
• nádory prsu diagnostické zobrazování   imunologie   MeSH
• technecium 99mTc medronát MeSH
• tomografie emisní počítačová * MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• karcinoembryonální antigen MeSH
• nádorové biomarkery MeSH
• technecium 99mTc medronát MeSH

Gastrointestinal stromal tumors (GISTs) represent rather rare neoplasms. Most GISTs are benign; malignant tumors account for 20- 30% of cases (overall, approximately 10- 30% of GISTs exhibit malignant behavior). GISTs most commonly metastasize to the liver and abdominal cavity. Distant metastases to other sites, especially to the bones, are relatively rare. We report a case of a 62 year old man with metastatic spread of GIST to skull, ribs and both sacroiliac joints manifesting six months after surgical resection of a gastric tumor. Although bone metastases from GISTs are rare and there are only a few reported cases in the literature, this case emphasizes that metastatic disease should always be considered in a patient with gastric GIST and suspicious bone lesions.

• MeSH
• antitumorózní látky terapeutické užití   MeSH
• gastrointestinální stromální tumory patologie   chirurgie   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory kostí sekundární   chirurgie   terapie   MeSH
• prognóza MeSH
• protokoly antitumorózní kombinované chemoterapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH
• Názvy látek
• antitumorózní látky MeSH