State of Oncology in Slovakia - NOISK.sk · 2020. 9. 2. · Klenová 1 833 10 Bratislava E-mail:...

State of Oncology in SlovakiaAnnual Report for 2019

Bratislava | 2020

Compiled byNational Oncology Institute

1. Introduction ............................................................................. 11

2. Facilities providing oncology care in Slovakia

2.1. Clinical oncology facilities..................................................... 17

2.2. Specialized oncohematology care centers for adult

(including transplantation program) ...................................... 28

2.3. Pediatric oncology facilities .................................................. 29

2.4. Radiation oncology facilities ................................................. 32

2.5. Palliative care facilities and hospices ..................................... 40

3. Availability of cancer treatment

3.1. Activity report from 2019 ..................................................... 49

3.2. Challenges for 2020 ............................................................. 52

4. Oncology societies

4.1. Slovak Oncology Society ....................................................... 55

4.1.1. Activity report from 2019 ........................................... 56

4.1.2. Challenges for 2020 .................................................... 56

4.1.3. SEKCAMA (SOS SMA).................................................. 57

4.1.4. Geriatric Oncology Section of SOS ............................... 58

4.2. Slovak Society of Chemotherapy ........................................... 60

4.3. Slovak Society of Pediatric Oncologists and Hematologists .... 61

4.4. Slovak Society of Radiation Oncology (SSRO) ........................ 62

CONTENT 5. National Oncology Institute

5.1. Activity report from 2019 ..................................................... 65

5.2. Challenges for 2020 ............................................................. 67

6. Research and development

6.1. Cancer Clinical Trials............................................................. 71

6.2. Translational research .......................................................... 72

6.3. Cooperative groups .............................................................. 72

6.3.1. Slovak Cooperative Oncology Group ............................ 72

6.3.2. Lymphoma Group ...................................................... 73

6.3.3. Slovak Head and Neck Cancer Cooperative Group,

Civic Assoc ................................................................. 74

6.3.4. Working Group for Oncology Nutrition ........................ 75

6.3.5. Slovak Pediatric Leukemia Group ................................ 76

6.4. Experimental oncology in Slovakia ........................................ 77

6.5. Research and development – challenges for 2020 .................. 88

7. Accreditation of study programs and education

7.1. Accreditation of study programs – clinical oncology ............... 91

7.1.1. List of associate professors

and professors of oncology ......................................... 92

7.1.2. List of physicians certified in 2019 ............................... 92

7.1.3. Finished post-graduate, habilitation

and inaugural programs in 2019 ................................. 92

7.2. Accreditation of study programs – pediatric hematology

and oncology ....................................................................... 92

7.3. Accreditation of study programs – radiation oncology............ 93

7.4. Specialization in palliative medicine ...................................... 94

7.5. Education ............................................................................ 95

7.5.1. Domestic expert events supervised by SOS

and SSRO in 2019 ...................................................... 95

7.5.2. Selected international expert events in 2019 ............... 96

7.5.3. Domestic and international expert events

in pediatric oncology in 2019 ...................................... 96

7.5.4. Other opportunities for education .............................. 97

7.6. Challenges for 2020 ............................................................. 99

7.6.1. Planned domestic expert events supervised by SOS

and SSRO in 2020 ...................................................... 99

7.6.2. Planned selected international

expert events in 2020 ............................................... 100

7.6.3. Planned domestic and international expert events

about pediatric oncology in 2020 .............................. 100

8. 8. Publication activity in 2019

8.1. Publications in extenso in foreign journals

with impact factor ............................................................. 103

8.2. Publications in extenso in foreign journals – pediatric

oncology/hematology ........................................................ 104

8.3. Publication activities of BMC SAS

in experimental oncology in 2019 ....................................... 106

9. International cooperation

9.1. Current situation ............................................................... 115

9.2. Challenges for 2020 ........................................................... 116

9.3. International cooperation – pediatric

oncology/hematology ........................................................ 116

10. National Oncology Plan

10.1. Report by Department of Standard Preventive,

Diagnostic and Treatment Procedures, MoH SR ............... 120

10.2. Report by Department of Public Health, Screening

and Prevention, MoH SR ................................................. 121

10.3. Report of the Institute of Research

and Development, MoH SR ............................................. 124

10.4. Missions in Horizon Europe 2021 – 2027 ......................... 126

11. Main problems in oncology in Slovakia

11.1. Main problems in clinical oncology .................................. 129

11.2. Main problems in pediatric oncology ............................... 132

11.3. Main problems in radiation oncology .............................. 132

11.4. Main problems in palliative medicine (PM) in Slovakia ...... 133

12. Current trends in clinical oncology around the world .......... 137

CONTACT ADDRESSES

COMPILERS

Dr. Mária Rečková, PhD.

Director

National Oncology Institute

Klenová 1

833 10 Bratislava

E-mail: [email protected]

Prof. Dr. Michal Mego, D.Sc.

Chief expert of the MoH SR for clinical oncology

Head of Oncology Clinic of the Faculty of

Medicine of Comenius University (FMCU) and

National Cancer Institute


Klenová 1

833 10 Bratislava


CO-AUTHORS

Assoc. Prof. Dr. Vladimír Bella, PhD.

Chief of department

Mammography ward

St. Elizabeth Cancer Institute

Heydukova 10

812 50 Bratislava


Assoc. Prof. Dr. Michal Chovanec, PhD.


Klenová 1

833 10 Bratislava


Dr. Katarína Jakubovitšová

President of Working Group for Oncology

Nutrition


Klenová 1

833 10 Bratislava


Assoc. Prof. Dr. Kállayová Daniela, PhD.,

MPH

Department of Public Health, Screenings and

Prevention

Ministry of Health of the SR

Limbová 2

837 52 Bratislava


St. Elizabeth Cancer Institute

Heydukova 10

812 50 Bratislava


prof. Dr. Róbert Babeľa, PhD., MBA, MSc

(HTA)

Pharmacoeconomist


Klenová 1

833 10 Bratislava

Institute of Medical Specialities

St. Elizabeth’s Healthcare and Social Work

College

Námestie 1. mája 1

810 00 Bratislava


Dr. Juraj Beniak

Chief of department at POKO Poprad

POKO Poprad s.r.o.

Mnoheľova 2

058 01 Poprad


Dr. Branislav Bystrický, PhD., MPH

Chief of department

Dr. Ivica Kvietiková, PhD.

Director

Research and Development Institute


Limbová 2

837 52 Bratislava


Assoc. Prof. Dr. Alexandra Kolenová, PhD.

Chief of Pediatric Oncology Clinic of the

Faculty of Medicine of Comenius University

and Children’s Teaching Hospital with Policlinic

Chief expert of the MoH SR for pediatric

oncology

Supervisor of the study of Pediatric

hematology and oncology

Children’s Hematology and Oncology Clinic

National Institute of Children’s Diseases

Limbová 1

833 40 Bratislava


Katarína Kováčová, MSc.

External collaborator

Research and Development Institute


Limbová 2

Oncology Clinic

Teaching Hospital Trenčín

Legionárska 28

911 01 Trenčín


Assoc. Prof. Dr. Ľuboš Drgoňa, PhD.

President of Lymphoma Group

Chief of Oncohematology Clinic of the Faculty

of Medicine of Comenius University and



Klenová 1

833 10 Bratislava


Assoc. Prof. Dr. Pavol Dubinský, PhD., MHA

Chief expert of the MoH SR for radiation

oncology

East Slovakia Oncology Institute (ESOI)

Rastislavova 43

041 91 Košice


Dr. Klaudia Gočárová, PhD.

Member of the Slovak Head and Neck Cancer

Cooperative Group

837 52 Bratislava


Prof. Dr. Michal Mego, D.Sc.

Chief expert of the MoH SR for clinical

oncology

Chief of Oncology Clinic of the Faculty of

Medicine of Comenius University and National

Cancer Institute


Klenová 1

833 10 Bratislava


Lucia Messingerová, MSc., PhD.

Researcher

Center of Biosciences

Slovak Academy of Sciences

Dúbravská cesta 9

P.O. Box 63

840 05 Bratislava


Prof. Dr. Silvia Pastoreková, D.Sc.

Director

Biomedical Research Center SAS

Institute of Virology

mailto:[email protected]

















Slovak Academy of Sciences

Dúbravská cesta 9

845 05 Bratislava


Dr. Eva Popreňáková, PhD.

Coordinator of Cancer Trials Register


Klenová 1

833 10 Bratislava


Dr. Mária Rečková, PhD.

Director


Klenová 1

833 10 Bratislava


Dr. Barbora Slabá

Internal Medicine Clinic of St. Elizabeth’s

Healthcare and Social Work College and St.

Elizabeth Cancer Institute

St. Elizabeth Cancer Institute, s.r.o.

Heydukova 10

812 50 Bratislava


Dr. Juraj Detvay, PhD., MPH

Chief of department of the Department of

Radiation and Clinical Oncology

Teaching Hospital Nitra

Špitálska 6

950 01 Nitra


Assoc. Prof. Dr. Richard Hrubý, PhD., MBA


Radiation and Clinical Oncology

Svet zdravia Hospital Rimavská Sobota

Šrobárova 1

979 12 Rimavská Sobota


Dr. Vladimír Malec, PhD.

Chief of Oncology Clinic

F. D. Roosevelt Teaching Hospital with

Policlinic in Banská Bystrica

Nám. L. Svobodu

975 17 Banská Bystrica


Assoc. Prof. Dr. Jozef Mardiak, PhD.


Klenová 1

Dr. Daniela Světlovská, PhD.

Chief of Department of Clinical Trials


Klenová 1

833 10 Bratislava


Dr. Andrea Škripeková, PhD.


Clinical Oncology F – Palliative Medicine


Klenová 1

833 10 Bratislava


Prof. Dr. Stanislav Špánik, PhD.

President of SOS (term 2019 – 2023)

Slovak Oncology Society, St. Elizabeth Cancer

Institute

Heydukova 10

812 50 Bratislava


Prof. Dr. Jozef Šuvada, PhD., MPH, MBA

Expert supervisor of national projects: SDTP,

Preventive Care Procedures (PpVP), Health and

Migration

833 10 Bratislava


Dr. Marian Streško, PhD.

Chief of Oncology Clinic

Teaching Hospital Trnava

A. Žarnova 11

917 75 Trnava


Department of SPDTP


Health section

Limbová 2

837 52 Bratislava

E-mail: [email protected],

[email protected]

Assoc. Prof. Dr. Mária Wagnerová, PhD.

Geriatric oncology section of SOS

Slovak Society of Chemotherapy

Department of Clinical Oncology

East Slovakia Oncology Institute, a.s.

Rastislavova 43

041 91 Košice


OTHER CO-AUTHORS – REGIONAL

EXPERTS

Assoc. Prof. Dr. Igor Andrašina, PhD.

Chief of Radiotherapy and Oncology Clinic

East Slovakia Oncology Institute, a.s.

Rastislavova 43

041 91 Košice


















Introduction1.

11

ANNUAL REPORT FOR 2019

and professional media or at conferences, the latest assessment re-port by OECD (Organization for Economic Co-operation and Devel-opment) about the state of health in Slovakia points out that almost a quarter of Slovak adults smoked daily in 2014 and this trend has not decreased in the last decade. The OECD report also states that one in seven adults was obese in Slovakia in 2017 and obesity of ad-olescents is on the rise.

The MoH SR declared the year 2019 “Year of Prevention”. From the point of view of oncological disease prevention, an important posi-tive step was the launch of the first phase of colorectal cancer screen-ing, mammographic breast cancer screening and cytological cervical cancer screening and creation of processes to improve continuity of oncology screening programs in Slovakia. We thank all stakehold-ers, particularly the former Minister of Health Andrea Kalavská, State Secretary Stanislav Špánik, heads of working groups for screening programs, representatives of the Slovak Society of General Practice, but also the National Cancer Institute (NCI), the National Health In-

W e are pleased to bring you complete information about the state of oncology in Slovakia again this year. A list of

hemato-oncology facilities has been added to this Annual Report, as well as a report about the state of individual sections of the Slovak Oncology Society and a report by the Ministry of Health (MoH SR) stakeholders about the activities related to fulfilling the objectives of the National Oncology Program (NOP).

Oncological diseases continue to be in the center of attention not only in Slovakia, but around the world due to the fact that ac-cording to available statistics, they are the second most frequent cause of death and their incidence and prevalence keep increas-ing. Unfortunately, the number of people with a diagnosed onco-logical disease keeps growing all around the world, including Slova-kia. According to the current knowledge, the majority of oncological diseases is basically preventable and even though risk factors such as smoking, obesity, insufficient physical activity or inability to cope with stressful life today are often discussed in both popular

1312

STATE OF ONCOLOGY IN SLOVAKIA ANNUAL REPORT FOR 2019

formation Center (NHIC), patients’ organizations, health insurance companies and the Public Health Authority.

Last year, we were looking for ways to restore the National Oncol-ogy Register (NOR). However, the last published data in the NOR are from 2011 and other available data for the subsequent time period are only forcasts, and not actual results.

In 2019, innovative cancer treatment was still largely inaccessi-ble to Slovak patients. The current system of authorization of treat-ment for the majority of new innovative medicaments does not allow adding them to the categorization list of pharmaceuticals, even if the treatment has proven clinical benefit declared by EMA (Europe-an Medicine Agency) authorization and ESMO (European Society for Medical Oncology) recommendations.

In order to support academic clinical trials in Slovakia, the Facul-ty of Medicine of Pavol Jozef Šafárik University in Košice established SLOVACRIN (national research infrastructure) in 2018. In 2019, four academic clinical trials were funded from the resources of the Na-tional Oncology Program in cooperation with NOI. Two of them focus on pediatric oncology, one on radiation oncology and one on clinical oncology.

The infrastructure to improve research conditions in Slovakia has been defined and unified. The Ministry of Health of the SR issued an order of the Minister of Health of the SR No. 4/2018 in order to ensure higher quality of biomedical research and clinical trials of human products and human medicaments. The authors of this order, which obliges healthcare facilities to establish specialized sections to sup-port biomedical research and clinical trials, could rely on 25 years of

This document offers an overview of the state of oncology in Slo-vakia in 2019, including organized expert conferences, updated ac-creditations in clinical, pediatric, radiation oncology and palliative medicine and publication activities. Like last year, we present a report about the state of experimental oncology and pediatric oncology and we have added information on geriatric oncology. Lastly, we tried to identify the key issues of clinical and pediatric oncology in Slovakia, present the current trends in clinical oncology and summarize the challenges and expectations for 2020.

We wish you a beneficial reading and many joint successes in 2020.

Mária Rečková a Michal Mego

experience of the Department of Clinical Trials of the National Can-cer Institute. Thanks to this new legislation, the number of academic clinical trials has increased, which has created the first precondition to improve accessibility of innovative treatment procedures within clinical trials for patients in Slovakia.

We believe that the creation of the Cancer Trials Register in Janu-ary 2019 will improve the access to innovative treatment procedures within clinical trials for Slovak patients. The Cancer Trials Register lists trials open to patients, is updated monthly and also includes pediatric and radiation oncology trials.

Slovak Cooperative Oncology Group (SCOG) was founded in June 2019 as a working group within the National Oncology Institute. With 27 members, SCOG is a formal association of facilities con-ducting clinical trials. The mission of SCOG is to connect academic sites, other oncology clinical facilities and pharmaceutical and bio-technological companies in order to conduct coordinated oncology research with the final goal to improve cancer patients’ care in Slo-vakia. The group collaborates with renowned foreign professional institutions such as GETUG (Genitourinary Group), a French coop-erative group for research of genitourinary malignancies, and pre-pares to collaborate with CECOG (Central European Cooperative On-cology Group).

A prestigious conference with the longest tradition in Slovakia, Bratislava Oncology Days, took place in September 2019. The expert symposium was opened by an annual report on the state of oncology in Slovakia in 2018 and challenges for 2019, presented by the National Oncology Institute.

Facilities providing oncology care in Slovakia

2.

17


Region Regional/Chief expertNumber of

beds

Number of clinical oncologists

working in oncology

Number of physician’s offices (work commitment (1.0 = full time))

Bratislava region Assoc. Prof. Dr. Jozef Mardiak, PhD. 198 70 30.0

Trnava region Dr. Marian Streško, PhD. 30 17 10.9

Trenčín region Dr. Branislav Bystrický, PhD., MPH 42 15 11.4

Žilina region Assoc. Prof. Dr. Richard Hrubý, PhD., MBA 100 21 14.6

Nitra region Dr. Juraj Detvay, PhD., MPH 88 19 14.3

Banská Bystrica region Dr. Vladimír Malec, PhD. 78 17 10.6

Prešov region Dr. Juraj Beniak 35 18 17.0

Košice region Assoc. Prof. Dr. Igor Andrašina, PhD. 137 25 19.0

Slovakia Prof. Dr. Michal Mego, D.Sc. 708 202 127.80

2.1. Clinical oncology facilities

Overview of oncology facilities network in Slovakia – situation as of December 31, 2019

1918


Location Hospital DepartmentNumber of beds



Bratislava region – regional expert: Assoc. Prof. Dr. Jozef Mardiak, PhD.

BratislavaNational Cancer Institute (NCI)

Department of Clinical Oncology A (Oncology Clinic of the Medical Faculty Comenius University and NCI)

18

Chief of department: Dr. Jozef Šufliarsky, PhD. Dr. Andrej JuríkDr. Michaela KubičkováDr. Tomáš Minárik, PhD.Dr. Michaela Sojáková, PhD.

3.0

Department of Clinical Oncology D(Oncology clinic of the Medical Faculty Comenius University and NCI)

17

Head of clinic: Prof. Dr. Michal Mego, D.Sc.Chief of department: Dr. Zuzana Syčová-Milá Dr. Michal Chovanec, PhD. Dr. Jana Obertová, PhD. Dr. Patrik Palacka, PhD., MPH, MBA, LL.M.Dr. Katarína Rejleková, PhD.

2.0

Department of Clinical Oncology E (Oncology Clinic of the Medical Faculty Comenius University and NCI)

17

Chief of department: Dr. Jozef DolinskýDr. Róbert GodálDr. Silvia JurišováDr. Melinda KračalíkovaDr. Veronika Švabová, PhD.

2.0

Department of Clinical Oncology F – Palliative Medicine (Oncology Clinic of the Medical Faculty Comenius University and NCI)

19

Chief of department: Dr. Andrea Škripeková, PhD.Dr. Ivan DekánekDr. Lucia DzurillováDr. Katarína JakubovitsováDr. Andrea Sysáková

2.0

Department of Clinical Oncology G (Oncology Clinic of the Medical Faculty Comenius University and NCI)

16Chief of department: Dr. Štefan Pörsök, PhD. Dr. Natália PazderováDr. Tomáš Šálek

2.0




Department of Oncohematology I. (Oncohematology Clinic of the Faculty of the Medical Faculty Comenius University and NCI)

15+6TJ

Head of clinic: Assoc. Prof. Dr. Ľuboš Drgoňa, PhD.Chief of department: Dr. Andrej Vranovský, PhD. Dr. Radoslav Greksák, PhD.Dr. Ľudmila HomolováDr. Miriam Ladická

3.0

Department of Oncohe-matology II. (Oncohema-tology Clinic of the Med-ical Faculty Comenius University and NCI)

12

Chief of department: Dr. Eva Mikušková, PhD. Dr. Ľudmila Demitrovičová, PhD.Dr. Vanda MikudováDr. Iveta Oravcová, PhD.

3.0

Department of Clinical Oncology – Outpatient Chemotherapy

0

Chief of department: Dr. Patrik Palacka, PhD., MPH, MBA, LL.M.Dr. Barbora DobiášováDr. Miroslava MalejčíkováDr. Eva Oravcová, PhD.

2.0

BratislavaSt. Elizabeth Cancer Institute

Internal Medicine Clinic of St. Elizabeth’s Healthcare and Social Work College and St. Elizabeth Cancer Institute

41

Head of clinic: prof. Dr. Stanislav Špánik, PhD.Chief of department: Dr. Klaudia Gočárová, PhD.Dr. Jana Boboková Dr. Katarína Krajcsovics, PhD.Dr. Maroš KunderlíkDr. Bela Mrináková, PhD. Dr. Věra Novotná, PhD.Dr. Miriam PorubskáDr. Barbora SlabáDr. Dagmar SorkovskáDr. Bibiana Vertáková Krakovská, PhD. Dr. Marcela Tkáčová, PhD.Dr. Peter Zuzák

1.0

2120





BratislavaSt. Elizabeth Cancer Institute

Internal Medicine Clinic of St. Elizabeth’s Healthcare and Social Work College and St. Elizabeth Cancer Institute – Department of Outpatient Chemotherapy

0

Chief of department: Dr. Milada MikulováAssoc. Prof. Dr. Lýdia Heľpianska, PhD.Dr. Marta ŠkultétyováDr. Vanda Ušáková, PhD.

4.0

Bratislava

University Hospital with Policlinic Milosrdní bratia, s. r. o.


20

Chief of department: Dr. Vladimír Václav Dr. Miriam Drahokoupilová Dr. Maroš FremalDr. Mária Novisedlaková

1.0

BratislavaHospital Ružinov

Department of Clinical Oncology (pulmonary oncology)

17

Chief of department: Dr. Peter Kasan, PhD. Dr. Radka CahajlováDr. Mária Černá, PhD.Dr. Lucia DenkováDr. Lýdia ĎorďayováDr. Maroš MartákDr. Zuzana ŠvihelováDr. Milada Veselá

2.0

Bratislava Hospital Ružinov Clinical Oncology Office 0 Dr. Pavel Vojtko 1.0

BratislavaHospital with Policlinic Antolská

Clinical Oncology Office 0 Dr. Marián Príbelský, PhD. 1.0

Bratislava Policlinic Mytna Clinical Oncology Office 0 Dr. Ľubica Sládkovičová 1.0

Total 198 70 30.0




Trnava region – regional expert: Dr. Marian Streško, PhD.

Trnava Teaching Hospital in Trnava Oncology Clinic 30

Chief of department: Dr. Marián Streško, PhD.Dr. Abdul DammakDr. Monika Dienerová, PhD.Dr. Oľga NadaskáDr. Erika GrmanováDr. Eliška VolochováDr. Viera Skarbová

2.0

Trnava Private clinical oncology office 0 Assoc. Prof. Dr. Eva Kukučková 1.0

Galanta St. Lucas Hospital with Policlinic Galanta, a.s.

0 Dr. Jozef Kováč 1.0

HlohovecHospital with Policlinic, s.r.o. Hlohovec

0 Dr. Marián Kučma 1.0

Piešťany 0Dr. Eva Popracová Dr. Monika Matejková

2.0

Senica 0 Dr. Adrian Nečas 0.4

Skalica Hospital with Policlinic Skalica, a.s.

0Dr. Jana Mišová Dr. Adrian Nečas

1.5

Dunajská Streda

0Dr. Tibor Csoka Dr. Juraj Kubik

2.0

Total 30 17 10.9

*TU – transplantation unit

2322





Trenčín region – regional expert: Dr. Branislav Bystrický, PhD., MPH

Trenčín Teaching Hospital in Trenčín Oncology Clinic 42

Chief of department: Dr. Branislav Bystrický, PhD., MPHDr. Zuzana HatalováDr. Filip Kohútek, PhD.Dr. Alžbeta Kohúteková Dr. Katarína Riedlová Dr. Miroslava Stratená Dr. Viliam Špánik

4

Považská Bystrica

Hospital with Policlinic Považská Bystrica

0 0Dr. Viera Haviarová Dr. Zuzana HunčíkováDr. Andrej Rosík

3

Prievidza 0 0 Dr. Iveta Jančoková 0.8

Bojnice 0 0Dr. Jana BenkovičováDr. Dušan Magdin Dr. Mária Pastorková-Šafariková

0.62

Partizánske 0 0 Dr. Alexandra Szabová 1

Total 42 15 11.4




Nitra region – regional expert: Dr. Juraj Detvay, PhD.

NitraSpecialized Hospital of St. Zoerardus Zobor, Nitra

Clinical oncology 35

Chief of department: Assoc. Prof. Dr. Peter Beržinec, PhD.Dr. Lucia DolákováDr. Gabriela ChowaniecováDr. Helena Kuzmová

2.0

Nitra Teaching Hospital in Nitra Clinical oncology 31Chief of department: Dr. Juraj Detvay, PhD., MPHDr. Jana ĎurkováDr. Rastislav Gura

1.00.40.1

Nitra MedCentrum Dzurila 0 Dr. Rastislav Gura 1.0

Nitra Private oncology office 0 Dr. Anna Rábeková 1.0

Topoľčany Hospital Svet zdravia Topoľčany a.s. 0Dr. Ján Kubiš Dr. Katarína Lepeyová Dr. Anna Urblíková

1.00.20.4

Komárno Komárno Zdrav. s. r. o. 0 Dr. Eva Konkolovská 1.0

Komárno Hospital Komárno Agel 0 MUDr. Oľga Rosinská 1.0

Levice Levice Hospital 0Dr. Blanka Puškárová Dr. Lyudmyla Rudenko Dr. Anna Urblíková

1.01.0

Levice Private oncology office Dr. Anna Urblíková

Nové Zámky Teaching Hospital 22Chief of department: Dr. Pavol DemoDr. Ľudovít Gremeň Dr. Oľga Szegeyová

1.00.21.0

Nové Zámky Private clinical oncology office 0 Dr. Danica Horváthová 1.0

Total 88 19 14.3

2524




Number of physician’s offices (work commitment (1.0 = full time)

Žilina region – regional expert: Assoc. Prof. Dr. Richard Hrubý, PhD., MBA

ŽilinaTeaching Hospital with Policlinic Žilina

Department of Clinical and Radiation Oncology

40

Chief of department: Dr. Dagmar Sudeková * (RO), Dr. Ivan Kudera, Dr. Andrea Šulgan Murínová, Dr. Zuzana Štofová, Dr. Alena Thomková, Dr. Milan Krošlák

2.0

Žilina ONKOMED ZA s.r.o. Clinical Oncology Office 0 Assoc. Prof. Dr. Richard Hrubý, PhD., MBA 1.0

Martin University Hospital Martin Oncology Center 24Dr. Zuzana Špaňová, Dr. Silvia Šulajová,Dr. Dagmar Šuteková, Dr. Katarína Švábová

2.0

Martin ONKO MARTIN s.r.o. Clinical Oncology Office 0 Dr. Anna Naništová 1.0

RužomberokCentral Military Hospital Ružomberok

Clinical and Radiation Oncology Clinic

36Head of department: Dr. Helena ČesákováChief of department: Dr. Roman Podoba, PhD., Dr. Marta Bodorová

3.0

Liptovský Mikuláš Hospital with Policlinic Clinical Oncology Office 0 Dr. Lucia Polečová 1.0

Dolný Kubín MAZURMED s.r.o. Clinical Oncology Office 0 Dr. Darina Mazúrová 1.0

Námestovo MAZURMED s.r.o. Clinical Oncology Office 0 Dr. Darina Mazúrová 0.2

Námestovo Upper Orava Hospital Clinical Oncology Office 0 Dr. Ľudmila Guspanová 0.2

Trstená Upper Orava Hospital Clinical Oncology Office 0 Dr. Ľudmila Guspanová 1.0

Čadca Kysuce Hospital Clinical Oncology Office 0 Dr. Pavol Lamoš 1.0

Čadca Širanec s.r.o. Clinical Oncology Office 0 Dr. lojz Širanec, MPH 1.0

Kysucké Nové Mesto MEDICA-CARE s.r.o. Clinical Oncology Office 0 Dr. Dagmar Krešáková 0.2

Total 100 21 14.6




Banská Bystrica region – regional expert: Dr. Vladimír Malec, PhD.

Banská BystricaF. D. Roosevelt Teaching Hospital with Policlinic Banská Bystrica

Clinical Oncology

58

Chief of department: Dr. Vladimír Malec, PhD.Dr. Emília Fatkulinová Dr. Matej Hrnčár Dr. Soňa Johnová Dr. Radomír Kadleček Dr. Silvia Mrázová Dr. Anna ŠvidraňováDr. Lucia Venglarčíková

4.0

Banská Bystrica Mammacenter of St. Agatha 0Dr. Etela MišurováDr. Eva Pritzová

1.00.2

Banská Bystrica Onkomed 0 Dr. Dagmar Mazalová 1.0

LučenecGeneral Hospital with Policlinic Lučenec, n. o.

0Dr. Vincent Alakša Dr. Jaroslava Machanová

0.21.0

Rimavská Sobota Rimavská Sobota HospitalClinical Oncology

20Chief of department: Assoc. Prof. Dr. Richard Hrubý, PhD., MBADr. Iveta Palkovácsová

1.2

Veľký Krtíš Veľký Krtíš 0 Dr. Anna Bomborová 1.0

Žiar nad Hronom Žiar nad Hronom 0 Dr. Jana Bankovičová 1.0

Total 78 17 10.6

*RO ‒ speciality in radiation oncology

2726





Prešov region – regional expert: Dr. Juraj Beniak

Poprad POKO POPRAD, s.r.o. 0

Chief of department: Dr. Juraj BeniakDr. Tatiana AlbertováDr. Marian KakalejčíkDr. Lenka MedvecováDr. Mária Rečková, PhD.

5.0

PrešovJ. A. Reiman Teaching Hospital with Policlinic Prešov

Clinical oncology 35

Chief of department: Dr. Valéria Tkáčová Dr. Marcela BujňákováDr. Vladimír Goč, PhD.Dr. Lenka KundríkováDr. Michal MilasDr. Jaroslava Lešková

6.0

PrešovJ. A. Reiman Teaching Hospital with Policlinic Prešov

0 Dr. Alena Benedikty 1.0

LevočaGeneral Hospital with Policlinic, Levoča, a.s.

0Dr. Valér Kováč, PhD.Dr. Marcela Uhriková/Bujňáková

1.0

Stará Ľubovňa Hospital with Policlinic Stará Ľubovňa 0 Dr. Martina Turčániová 1.0

Svidník Svidník Hospital 0 Dr. Erika Hnátová 1.0

Sabinov Sabinov 0 Dr. Kohi Wali 1.0

BardejovSt. Jacob Hospital with Policlinic, n.o., Bardejov

0 Dr. Jozef Chovanec 1.0

Total 35 18 17.0




Košice region – regional expert: Assoc. Prof. Dr. Igor Andrašina, PhD.

Košice East Slovakia Oncology Institute, a. s.

Radiotherapy and Oncology Clinic – Department of Clinical Oncology – Outpatient Chemotherapy

0

Head of clinic: Assoc. Prof. Dr. Igor Andrašina, PhD.Chief of department: Dr. Andrea Cipková, MPHDr. Hana Garanová, Dr. Eleonóra Pihúriková Dr. Mária Višňovská, Assoc. Prof. Dr. Mária Wagnerová, PhD., Dr. Monika Žák

5.0


55Dr. Robert Bieľ, Dr. Jana Jankurová Dr. Martin Petrilák, Dr. Zuzana Pribulová, Dr. Renáta Sikrová

1.0

Košice Outpatient care Oncology Office 0 Dr. Veronika Langerová 1.0

Košice Outpatient care Oncology Office 0 Dr. Helena Šarošiová 1.0

Košice Outpatient care Oncology Office Dr. Ingrid Kernová 1.0

Rožňava St. Barbara Hospital with Policlinic POKO* 0 Dr. Zlatica Šimkovičová 1.0

Trebišov Hospital with Policlinic Trebišov a.s. Oncology Office 0 Dr. Alica Malá 1.0

Trebišov Hospital with Policlinic Trebišov a.s.Department of Clinical Oncology

25Chief of department: Dr. Michal Licko, Dr. Bibiana Brezinová, Dr. Peter JarušinskýDr. Martin Michaľanský, Dr. Bibiana Bereš-Žiarna

5.0

MichalovceŠtefan Kukura Hospital with Policlinic Michalovce

Oncology Center 57

Chief expert: Dr. Radovan Barilla, PhD. Chief of department: Dr. Gabriela HermannováDr. Bibiana Brezinová Dr. Bibiana Bereš-Žiarna

1.8

Humenné A. Leňo Hospital with Policlinic POKO* 0 Dr. Svetlana Šarišská 1.0

Vranov n/Topľou Hospital with Policlinic Vranov n/Topľou Oncology Office 0stand-in by clinical oncologist from Trebišov Hospital

0.2

Total 137 25 19

*POKO – polyclinical department of clinical oncology

2928


State of clinical oncology facilities network in 2019

There are 3 specialized institutes (National Cancer Institute (NCI), East Slovakia Oncology Institute (ESOI) and St. Elizabeth Cancer Institute (SECI)), 13 departments of clinical oncology and 2 specialized pulmo-nary oncology facilities currently working as inpatient oncology care in Slovakia. The drawback is their geographic distribution – there is no specialized institute in central Slovakia and the care provided in the specialized facilities is not comprehensive. NCI is the only one to provide follow-up palliative care and only SECI offers a preventive center.

2.2. Specialized oncohematology care centers for adults (including transplantation program)

1. Department of Hematology and Transfusiology of the Faculty

of Medicine Comenius University (FMCU), Slovak Medical Uni-

versity (SMU) and University Hospital Bratislava, Antolská 11,

Bratislava

https://www.unb.sk/klinika-hematologie-a-transfuziolo-gie-lfuk-szu-a-unb/

2. Department of Hematology and Oncohematology of Louis

Pasteur University Hospital, Trieda SNP 1, Košice

http://www.fnlp.sk/index.php?option=com_con-tent&task=view&id=114&Itemid=112

3. Department of Hematology, F. D. Roosevelt Teaching Hospi-

tal with Policlinic Banská Bystrica, Nám. L. Svobodu 1, Banská

Bystrica

https://www.fnspfdr.sk/kliniky-a-oddelenia/hematologicke-od-delenie/

4. Department of Hematology and Transfusiology, Jessenius

Faculty of Medicine (JFMCU) and University Hospital,

Kollárova 2, Martin

https://www.unm.sk/klinika-hematologie-transfuziologie

2.3. Pediatric oncology facilities

Overview of pediatric oncology facilities network in Slovakia – situation as of December 31, 2019

Region Head of clinic/Chief of departmentNumber of

beds


working in oncology


BratislavaAssoc. Prof. Dr. Alexandra Kolenová, PhD.Dr. Andrea HrašnováDr. Júlia Horáková, PhD.

40 13 7.0

Banská BystricaDr. Eva BubanskáDr. Pavel Bician

18 5 1.4

Košice Dr. Natália Galóová 15 4 1.0

Chief expert from January 1, 2019

Slovakia Assoc. Prof. Dr. Alexandra Kolenová, PhD. 196 9.4

https://www.unb.sk/klinika-hematologie-a-transfuziologie-lfuk-szu-a-unb/

https://www.unb.sk/klinika-hematologie-a-transfuziologie-lfuk-szu-a-unb/

http://www.fnlp.sk/index.php?option=com_content&task=view&id=114&Itemid=112

http://www.fnlp.sk/index.php?option=com_content&task=view&id=114&Itemid=112

https://www.fnspfdr.sk/kliniky-a-oddelenia/hematologicke-oddelenie/

https://www.fnspfdr.sk/kliniky-a-oddelenia/hematologicke-oddelenie/

https://www.unm.sk/klinika-hematologie-transfuziologie

3130



Number of pediatric oncologists

BratislavaNational Institute of Children’s Diseases (NICD)

Department of Oncology – younger children(Children’s Hematology and Oncology Clinic of Medical Faculty Comenius University and NICD)

17

Head of clinic: Assoc. Prof. Dr. Alexandra Kolenová, PhD.Dr. Stanislava HederováDr. Martina MikeskováDr. Kristína Husáková

Department of Oncology – older children

17Dr. Andrea HraškováDr. Judita Puškáčová, PhD.Dr. Andrea Močná

Transplantation Unit 6Dr. Júlia HorákováDr. Ivana BoďováDr. Peter Švec

Day Clinic – outpatient chemotherapy

10 Dr. Marilla Džatková

Oncology offices 0

Dr. Daniela SejnováDr. Martina MikeskováDr. Alexandra KolenováDr. Andrea Hrašková

Transplantation Unit office 0Dr. Júlia HorákováDr. Ivana BoďováDr. Peter Švec

Palliative care 0Dr. Mária JasenkováDr. Martina Mikesková



Banská Bystrica Children’s Teaching Hospital

Department of Oncology(Pediatric Oncology and Hematology Clinic of the Slovak Medical University)

18

Head of clinic: Dr. Eva Bubanská, PhD.Dr. Pavel BicianDr. Helena FillováDr. Ivana Fedoráková

Oncology OfficeDr. Terézia StančokováDr. Ivana Fedoráková



Košice Children’s Teaching HospitalDepartment of Pediatric Oncology and Hematology

15Chief of department: Dr. Natália Galoová Dr. Ladislav DeákDr. Viktória Halušková

OncologyOffice

Dr. Igor JenčoDr. Ladislav Deák

3332


Region Regional/Chief expert Number of bedsNumber of radiation oncology specialists and residents

Bratislava region Dr. Martin Chorváth, PhD. 87 29

Trnava region NA* 0 0

Trenčín region NA* 42 a 5

Žilina region Dr. Eva Hajtmanová, PhD. 80 b 18

Nitra region NA* 51 e 10

Banská Bystrica region Dr. Vladimír Malec, PhD. 98 c 13

Prešov region NA* 28 9

Košice region Dr. Iveta Priatelová 112 d 14

Slovakia Assoc. Prof. Dr. Pavol Dubinský, PhD. 498 f 98

a Including 42 beds shared with clinical oncology

b Including 29 beds shared with clinical oncology

c Including 78 beds shared with clinical oncology

d Including 55 beds shared with clinical oncology

e Including 23 beds shared with clinical oncology

f Including 227 beds shared with clinical oncology

2.4. Radiation oncology facilities

Overview of radiation oncology facilities network in Slovakia as of December 31, 2019

Location Institution DepartmentNumber of beds

List of radiation oncologists and residents

Bratislava region – chief expert: Dr. Martin Chorváth, PhD

Bratislava

National Cancer Institute Department of Radiation Oncology 35

Chief of department: Dr. Margita Pobijáková, PhD.Dr. Zuzana DolinskáDr. Marin DžongovDr. Marta Fekete Dr. Alexandra HanicováDr. Andrea HurákováDr. Martina Kolarčíková – Lukačovičová Dr. Mojmír Masár Dr. Andrea Masaryková, PhD. Dr. Martina PohrancováDr. Danijela Šćepanović, PhD.Dr. Ingrid Závacká

St. Elizabeth Cancer Institute, s.r.o.Radiation Oncology Clinic of the SMU and SECI

52

Head of clinic: Dr. Elena Bolješíková, PhD.Chief of department: Dr. Martin Chorváth, PhD.Chief of department: Dr. Pavol LukačkoChief of department: Dr. Zuzana PiňákováDr. Dominika IlčinováDr. Dana KekešiováDr. Barbora KomaníkováDr. Ivana Krajčovičová Dr. Andrea LigačováDr. Martina Malá Dr. Alžbeta MolnárováDr. Branislav SepešiDr. Monika Šandorová Dr. Peter Šiška Dr. Monika ŠvantnerováDr. Martina VorobjovDr. Alena Závodská Dr. Martina Zemanová

*NA ‒ not appointed

3534




Banská Bystrica region – chief expert: Dr. Vladimír Malec, PhD.

Banská BystricaF. D. Roosevelt Teaching Hospital with Policlinic Banská Bystrica

Oncology Clinic of the SMU 581

Head of clinic: Dr. Vladimír Malec., PhD.Dr. Radomír Kadleček, Dr. Dagmar StykováDr. Milan Kuvik, Dr. Marek LafférsDr. Gabriela Rakická, Dr. Andrea Martinková

LučenecGeneral Hospital with Policlinic Lučenec n.o.

Department of Radiation Oncology

201 Chief of department: Dr. Andrea Kašinská

Rimavská SobotaGeneral Hospital Rimavská Sobota, Svet Zdravia a.s.


20

Chief of department: Dr. Richard Hrubý, PhD., MBADr. Beáta Czeneová, Dr. Adela EnglerováDr. Ján Helcman, Dr. Eva Mrázová, MBADr. Iveta Palovácsová



Košice region – regional expert: Dr. Iveta Priatelová

Košice East Slovakia Oncology Institute, a.s.Department of Radiation Oncology

57

Chief of department: Assoc. Prof. Dr. Pavol Dubinský, PhD., MHADr. Lea BalážováDr. Gabriela BarilíkováDr. Katarína BelánováDr. Marián Frívaldský, MPHDr. Jana HerbertováDr. Natália JaníčkováDr. Karol JutkaDr. Martina KováčováDr. Marek MarinčákDr. Daniela NadzonováDr. Iveta PriatelováDr. Daniela Uhrincová

MichalovceŠtefan Kukura Hospital with Policlinic Michalovce, a.s.


551Dr. Gabriela Herman, MPHDr. Jana Spišáková

Note: 1. Overall number of beds assigned to non-surgical cancer treatment



Nitra region – regional expert: not appointed

Komárno Hospital Komárno AGEL s.r.o.Department of Clinical and Radiation Oncology

231

Chief of department: Dr. Pavel Demeter, MBADr. Eva Mrázová, MBADr. Oľga Rosinská

Nitra Teaching Hospital NitraDepartment of Clinical and Radiation Oncology

28

Dr. Helena BarátováDr. Janka Gáliková Dr. Lea MészarosDr. Oľga MiklóssyováDr. Dana NémethováDr. Andrea Rybárová Dr. Margaréta TanyasiováDr. Marta Zacharová

Note.: 1. Overall number of beds assigned to non-surgical cancer treatment



Prešov region – regional expert: not appointed

PrešovJ. A. Reiman Teaching Hospital with Policlinic

Department of Radiation Oncology 28

Chief of department: Dr. Marek Paľo, PhD.Dr. Diana AnadraščíkováDr. Eva BergendyováDr. Lucia ČintalanováDr. Barbara GuldenováDr. Juraj KmecDr. Dorota KolkováDr. Lucia PoništováDr. Viktor Rosenberg, PhD.

3736


Location Institution Department Number of beds List of radiation oncologists and residents

Trenčín region – regional expert: not appointed

Trenčín Teaching Hospital Trenčín Department of Oncology 421

Chief of department: Dr. Branislav Bystrický, PhD.Dr. František CimmermannDr. Filip KohútekDr. Vladimíra KurišováDr. Karol MartinkaDr. Viliam SpanikDr. Silvia Zavřelová

Note: 1. Overall number of beds assigned to non-surgical cancer treatment

Location Institution Department Number of beds List of radiation oncologists and residents

Žilina region – regional expert: Dr. Eva Hajtmanová, PhD.

Martin University Hospital Martin Oncology Center 292

Chief of department: Dr. Eva Hajtmanová, PhD.Dr. Marian ĎuroškaDr. Petronela KáčerováDr. Mária KočišováDr. Ľubica Kostková Dr. Anton Malicher, PhD.

RužomberokCentral Military Hospital Ružomberok – Teaching Hospital

Radiation and Clinical Oncology Clinic 6

Head of clinic: Dr. Helena ČesákováChief of department: Dr. Peter VaněkDr. Marta Bodorová Dr. Kristína ČelkováDr. Miroslava OravcováDr. Michaela ŠvajdováDr. Dana Vráblová

ŽilinaTeaching Hospital with Policlinic Žilina


46

Chief of department: Dr. Dagmar SudekováDr. Alžbeta HorváthováDr. Ivan KecskesDr. Peter Németh Dr. Dáša PazdúrováDr. Roland Pomichal

Note: 2. Overall number of beds assigned to non-surgical cancer treatment and beds in other departments

The departments of radiation oncology with technological equipment

Legend:1. National Cancer Institute (NCI),

Bratislava2. St. Elizabeth Cancer Institute,

Bratislava3. Teaching Hospital, Trenčín4. Teaching Hospital, Nitra5. General Hospital, Komárno6. Teaching Hospital with Policlinic,

Žilina7. University Hospital, Martin

8. Central Military Hospital Ružomberok – Teaching Hospital

9. F. D. Roosevelt Teaching Hospital with Policlinic, Banská Bystrica

10. General Hospital with Policlinic, Lučenec11. General Hospital, Rimavská Sobota12. East Slovakia Oncology Institute13. J. A. Reiman Teaching Hospital with

Policlinic, Prešov14. Štefan Kukura Hospital with Policlinic,

Michalovce

3938


State of radiation oncology facilities network in 2019 Radiation therapy is undergone by 40 – 50% of cancer patients in the course of their disease. The ability to provide adequate radiothera-py (radiation in adequate time and with controlled quality) is based mainly on the availability of technological equipment. The technolog-ical lag in Slovakia has not been resolved yet and compared to other more developed EU countries, the accessibility of adequate radiother-apy in Slovakia is low. The recommended number of linear accelera-tors (LA) for Slovakia according to the Health Economics in Radiation Oncology (HERO) project of the European SocieTy for Radiotherapy and Oncology (ESTRO) is 5 LA per 1 million citizens. A linear acceler-ator which satisfies the requirements of modern radiotherapy must enable volumetric-modulated arc therapy (VMAT), however, it is also acceptable to use older machines equipped for intensity-modulat-ed radiotherapy (IMRT) and image-guided radiation therapy (IGRT).

Every department should have a CT simulator available for planning radiotherapy with the possibility to move as the patient breathes.

In Slovakia, there are 14 departments with adequate technological equipment in the radiation oncology facilities which administer ra-diotherapy (situation as of December 31, 2019):

• LA with VMAT + older machines with IMRT and IGRT: NCI in Bratislava 2 + 1, SECI in Bratislava 1 + 1, Komárno 1, ESOI in Košice 2 + 1, Martin 2, Nitra 1 + 1, Ružomberok 1

• LA: Banská Bystrica 1, Michalovce 1, Prešov 1, Rimavská Sobota 1, Žilina 1

• Cobalt 60: Banská Bystrica 1, Lučenec 1• CT simulators: Komárno, Martin, Nitra, NCI in Bratislava, SECI

in Bratislava, ESOI in Košice.

Technological equipment as of December 31, 2019

Facility kV XRT unitCesium unit

Cobalt unitLinear accelerator

Linear accelerator with MLC

Linear accelerator with IMRT

Linear accelerator with VMAT

XRT simulator

CT simulator

HDR Afterloading unit

F. D. Roosevelt Teaching Hospital with Policlinic Banská Bystrica

× × × ×

National Cancer Institute Bratislava × × × × × ×St. Elizabeth Cancer Institute, s.r.o., Bratislava

× × × × × ×

Facility kV XRT unitCesium unit

Cobalt unitLinear accelerator

Linear accelerator with MLC

Linear accelerator with IMRT

Linear accelerator with VMAT

XRT simulator

CT simulator

HDR Afterloading unit

FORLIFE n.o.General Hospital Komárno

× ×

East Slovakia Oncology Institute a.s., Košice

× × × × ×

General Hospital with Policlinic Lučenec, n.o. × ×University Hospital Martin × ×Štefan Kukura Hospital with Policlinic Michalovce, a.s.

×

Teaching HospitalNitra × × × ×J. A. Reiman Teaching Hospital with Policlinic, Prešov

× × × ×

Hospital and Policlinic, n.o. Rimavská Sobota

× × ×

Central Military Hospital Ružomberok (ÚVN SNP)

× × × ×

Teaching HospitalTrenčín × × × × ×

Teaching Hospital with Policlinic Žilina × × ×

4140


Palliative medicine (PM) is an interdisciplinary medical specialty (like pediatrics, geriatrics, genetics and intensive care) focusing on patients with incurable chronic diseases and the period near the end of life with its symptoms and syndromes.

There are 257 documented beds in long-term palliative care facilities in Slovakia. Of these beds, only 91 are supervised by a specialist in palliative medicine. NCI provides 19 beds for acute palliative care su-pervised by a specialist in PM.

2.5. Palliative care facilities and hospices

Overview of palliative care facilities network in Slovakia as of December 31, 2019

RegionRegional/Chief expert

Number of acute departments of palliative medicine(number of beds)(number of beds with a specialist in PM)

Number of long-term palliative care facilities – residential hospices, departments of palliative care(number of beds)(with a specialist in PM)

Number of mobile hospices / mobile hospices with a specialist in PM

Bratislava region not appointed 1 (19) 3 (39) 2

Trnava region not appointed 0 1 (25) 2

Trenčín region not appointed 0 3 (39) 1

Nitra region not appointed 0 2 (38) 1

Žilina region not appointed 0 2 (35) 0

Banská Bystrica region

not appointed 0 2 (31) 0

Prešov region not appointed 0 2 (44) 0

Košice region not appointed 0 1 (7) 0

SlovakiaDr. Kristína Križanová

1 (19) (19) 12 (257) (91) 5/5


Chief of department or supervisor Contact

Bratislava region – regional expert: not appointed

Bratislava

National Cancer InstituteDepartment of Clinical Oncology F – Palliative Medicine

19Chief of department: Dr. Andrea Škripeková, PhD.

Klenová 1 833 10 BratislavaPhone: +421 2/59 378 418, 633

St. Catherine Labouré Mobile Hospice (Mobilný hospic sv. Kataríny Labouré)

Mobile hospice – Expert supervisor: Dr. Kristína KrižanováSvätovojtešská 40 831 03 BratislavaPhone: +421 905 966 059

St. Francis Hospital and Sanatorium

Hospice 25 Chief of department: Dr. Jana HoozováVlčie hrdlo 49 821 07 BratislavaPhone: +421 2/43 429 306

University Hospital with Policlinic Brothers of Mercy (Milosrdní bratia, s.r.o.),

Hospice 2 Chief of department: Dr. Vladimír VáclavNámestie SNP 10 811 06 BratislavaPhone: +421 2/57 887 100

House Rafael (Dom Rafael)Bratislava

Hospice 12 Chief of department: Dr. Michal Mrocek

Kutlíkova 15 851 02 BratislavaPhone: +421 2/43 191 987, +421 904 344 454

Center Simeon – Mobile Hospice (Simeon centrum)

Mobile hospice –Expert supervisor: Dr. Sabina Šufliarska, PhD.Physician: Dr. Jana BobokováExpert supervisor: Ľubica Kočanová, MSc.

Medená 18 811 02 Bratislava Phone: +421 905 300 124,+421 918 750 397

4342




Trnava region – regional expert: not appointed

TrsticeSt. Elizabeth Health and Social Center Trstice (Zdravotno-sociálne centrum Sv. Alžbety Trstice)

Hospic 25 Chief of department: Dr. Zuzana Vinczeová

925 42 Trstice č. 659Phone: + 421 31/ 77 82 093, +421 31/70 20 250, -251, +421 908 766 758

SkalicaHome Hospice Care, s.r.o. (Domáca hospicová starostlivosť, s.r.o.)

Mobile hospice

–Expert supervisor: Dr. Jana MišováHead nurse: Lucia Ovečková. MSc.

Dr. G. Schaefflera 12/2399909 01 SkalicaPhone: +421 948 206 288prevádzka: Ružová ul. 13 909 01 Skalica

Vrbové

Mobile Hospice Vrbové (Mobilný hospic Vrbové)Civic association Touch of Life (Dotyk Života, o.z.)

Mobile hospice

– Expert supervisor: Dr. Barbora Slabá

Pavla Jantauscha 667/11922 03 Vrbové prevádzka:J. Zigmundika 293/1, VrbovéPhone: +421 915 343 721, +421 902 743 610



Nitra region – regional expert: not appointed

PalárikovoHospice of St. Francis from Assisi – Palárikovo

Hospic 23 Chief of department: Dr. Alena Kollárová

Slovenská 11 941 11 PalárikovoPhone: +421 35/6493-411, -657, +421 903 473 146

Nitra

Hospice – House of Peace and Reconciliation of St. Bernadette (Dom pokoja a zmieru u Bernadetky) – Nitra(Spiš Catholic Charity)

Hospice + Mobile hospice

15 Chief of department: Dr. Leona Šóthová

Chrenovská 22 B 949 01 NitraPhone: +421 37/6531-041, -042, -051, +421 902 419 151



Trenčín region – regional expert: not appointed

TrenčínSisters of Mercy Hospice Trenčín (Hospic Milosrdných sestier Trenčín)

Hospic 24 Chief of department: Dr. Jarmila Bunčáková

Súvoz 739911 01 TrenčínPhone: +421 32/74 170 11, +421 918 606 261

PrievidzaSt. Louise Mobile Hospice Prievidza (Sv. Lujza, n.o., Mobilný hospic Prievidza)

Mobile hospice

– Expert supervisor: Dr. Emília Vlčková

Sv. Lujza, n.o.M.R. Štefánika 29 972 51 HandlováPhone: +421 915 715 641,+421 46/54 754 01

Považská Bystrica

Teaching Hospital with Policlinic Považská Bystrica

Department of Palliative Care

15 Chief of department: Dr. Helena Kmecíková Nemocničná 986017 01 Považská BystricaPhone: +421 42/43 042 90



Žilina region – regional expert: not appointed

TrstenáUpper Orava Hospital with Policlinic Trstená (Hornooravská nemoncnica s poliklinikou Trstená)


10 Chief of department: Dr. Dagmar Hritzová Mieru 549/16028 01 TrstenáPhone: +421 43/53 073 90

ČadcaKysuce Hospital with Policlinic Čadca (Kysucká nemocnica s poliklinikou)


25 Chief of department: Dr. Pavel Gašperík

Palárikova 2311022 16 ČadcaPhone: +421 41/460 43 59, +421 41/460 42 72

4544




Banská Bystrica region – regional expert: not appointed

Banská BystricaHospice – House of Mercy of God (Dom Božieho Milosrdenstva) Banská Bystrica

Hospic 16 Dr. Zuzana Otrubová

Tibora Andrašovana 14300/44974 04 Banská BystricaPhone: +421 48/42 04 401, 409, +421 907 885 989

Lučenec Hospice Hestia Lučenec Hospic 15Director: Dr. Jana Miadokováno Expert supervisor

Námestie republiky 15984 01 LučenecPhone: +421 47/43 33 959,+421 907 172 242



Prešov region – regional expert: not appointed

ĽubicaHospice of St. Elizabeth in Ľubica (Hospic sv. Alžbety v Ľubici) (Spiš Catholic Charity)

Hospic 24Director: Dr. Štefan Kuffano Expert supervisor

Sv. Alžbety 1059 71 ĽubicaPhone: +421 52/47 80 900, 901, +421 910 949 669

Bardejov

Mother Theresa Hospice Bardejov and Nursing Care House Bardejov (Hospic Matky Terezy Bardejov a Dom ošetrovateľskej starostlivosti Bardejov) (Spiš Catholic Charity)

Hospic 20Head of hospice: Jozef Krajči, MSc.no Expert supervisor

Pri štadióne 23 Bardejovská nová Ves 085 01 BardejovPhone: +421 911 284 235,+421 54/47 42 662



Košice region – regional expert: not appointed

KošiceHospice – St. Lucas High Specialized Geriatric Institute in Košice n.o., Košice

Hospic 7 Chief of department: Dr. Valéria Tarabová

Strojárenská 13040 01 KošicePhone: +421 55/68 24 111, 320, 348, 424

Availability of cancer treatment

3.

49


has no significant budget impact on public health resources.” The change had a negative impact on several medicaments for rare diseases with low incidence and relatively high prevalence (due to effective treatment), therefore, some diseases such as GIST were excluded from rare dis-eases in the Slovak legislation. On the other hand, a cost-effectiveness report is still not required when a manufacturer submits an orphan drug reimbursement dossier for consideration to the regulator.

The second change in the law was aimed at a quicker introduction of biosimilars into the list of reimbursed medicaments (§16 of the Law No. 363/2019). This change meant that new biosimilars can enter the list of reimbursed medicaments with lower price difference compared to the original molecule (25% off). In terms of state drug policy, the main regulator decided to lower down the price threshold for the in-troduction of biosimilars which was originally set to 30% lower price than the original medicament. Thus, biosimilars would eventually be more expensive than before. For the second and third biosimilar, an additional 5% price reduction is required for each level.

3.1. Activity report in 2019

The legal basis of cancer treatment accessibility, especially the scope of healthcare according to the Law on Provision of Healthcare Reim-bursed from Public Health Insurance No. 577/2004 and Reimburse-ment Law No. 363/2011, did not go through any dramatic changes in Slovakia in 2019 regarding cancer treatment. We may say that, except for the planned amendment mentioned in the last year’s re-port, cancer treatment was relatively stable in terms of drug policy. A new amendment of the Reimbursement Law No. 363/2011 came into effect in 2019 and introduced two changes related to cancer treatment drugs.

The first change was connected to orphan drugs, specifically in the definition of rare disease in the law that defines key requirements for inclusion into the list of reimbursed medicaments. In §7 of the Law No. 363/2011, the word “incidence“ was replaced with the word prevalence, which means that from 2019, “a medicament can be included in the list of reimbursed medicaments if it is indicated to treat rare diseases with prevalence lower than 1:50,000 in the Slovak Republic, and at the same time,

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12 new reimbursement dossiers for new cancer treatment were submitted to the regulator in 2019, of which only two were included in the list of reimbursed medicaments (Table 1). Overall, there were 15 new drugs included in the list in 2019, of which 13 had the status of orphan drug (the 1:50,000 rule) and were submitted to the regu-lator in 2018 (Table 2).

Accessibility of original cancer treatment in categorization for 2019:

Year 2019 (all original cancer drugs) Number

Submitted reimbursement dossiers 12

Approved reimbursement dossiers 2

Denied/suspended reimbursement dossiers 4

Reimbursement dossiers currently under review 6

Repeated submissions of reimbursement dossiers (submissions from previous years, not from 2019)

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Medicaments successfully included in the categorization list in 2019, of which the majority was submitted in 2018:

ATC code Active substanceDate of inclusion in the categorization

L01XC14 Trastuzumab emtansine 03/01/2019 - orphan

L01XC19 Blinatumomab 05/01/2019 - orphan

L01XC24 Daratumumab 09/01/2019

L01XC31 Avelumab 04/01/2019 - orphan

L01XE15 Vemurafenib 08/01/2019 - orphan

L01XE23 Dabrafenib 08/01/2019 - orphan

L01XE25 Trametinib 08/01/2019 - orphan

L01XE26 Cabozantinib 01/01/2019 - orphan

L01XE36 Alectinib 06/01/2019 - orphan

L01XE38 Cobimetinib 08/01/2019 - orphan

L01XE39 Midostaurín 03/01/2019 - orphan

L01XE41 Binimetinib 07/01/2019 - orphan

L01XE46 Encorafenib 07/01/2019 - orphan

L01XX52 Venetoclax 01/01/2019 - orphan

L04AX06 Pomalidomid 12/01/2019

EMA registered drugs in 2018/2019:

ATC codeEMA approval date

Active substance Therapeutic area Designation

L01XE54 10/23/2019 Gilteritinib fumarate AML Orphan

L01XE53 09/18/2019 Larotrectinib sulfate Tumors with NTRK fusion Original

L01XC 06/27/2019 Cemiplimab Spinocelullar Carcinoma Original

L01 05/05/2019 Lorlatinib Non-small Cell Lung Cancer Original

L01XE47 04/01/2019 Dacomitinib monohydrate Non-small Cell Lung Cancer Original

L01XE43 11/21/2018 Brigatinib Non-small Cell Lung Cancer Original

L01XC25 11/21/2018 Mogamulizumab Sezary Syndrome, Mycosis Fungoides Orphan

L01XE50 09/25/2018 Abemaciclib Breast Neoplasms Original

L01XC28 09/20/2018 Durvalumab Non-small Cell Lung Cancer Original

L01XE 09/19/2018 Binimetinib Malignant Melanoma Original

L01XE 09/18/2018 Encorafenib Malignant Melanoma Original

L01X 08/30/2018 Neratinib Breast Neoplasms Original

L01X 08/22/2018 Axicabtagene ciloleucel Folicullar Lymfoma Orphan

L01 08/21/2018 Tisagenlecleucel Precursor B-Cell Lymphoblastic Leukemia, DLBCL Orphan

L01XX 05/22/2018 Rucaparib camsylate Ovarian Neoplasms Original

L01XC05 04/18/2018 Gemtuzumab ozogamicin AML Orphan

Source: AIFP, 2020 Source: IQVIA, 2019; AIFP, 2019 Source: EMA, 2019

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STATE OF ONCOLOGY IN SLOVAKIA

It is very probable that the higher number of included biosimilars was due to terminated patent protection of several original medic-aments as well as lower required price reduction. According to the local healthcare think tank report (INEKO, 2019), of approximately 54 biosimilars registered by EMA, at least 24 were available in the Slovak Republic in the second half of 2019. The last area that start-ed to influence the availability of categorized cancer drugs in Slo-vakia was a review of drug reimbursements, which also introduced changes of out-of-pocket payments (OOP) in some cases. In the case of some molecules such as temozolomide, the OOP was increased for packages with higher strengths to over 60 euros (180 mg) or even to 169 euros (250 mg) per month of treatment. The review had a neg-ative impact also on the OOP for drugs regularly used in intravenous chemotherapy, such as saline solution.

3.2. Challenges for 2020

• Transparent introduction of oncology innovations into standard categorization according to basic principles of HTA (Health Tech-nology Assessment) including adequate consideration of EBM (ev-idence-based medicine) and creation of clear rules for exceptional cases in this area.

• Cooperation to define basic principles of drug policy in oncology based on adequate and long-term investments.

• Launching a process of determining priority diagnoses and areas of oncology via so-called “horizon scanning” for the current and

future periods in cooperation with experts, the Ministry of Health of the SR, payers and the Ministry of Finance of the SR.

• Cooperation to adequately develop data economy in oncology in terms of collection, processing and adequate analysis of all avail-able data, including a complete launch of the National Oncology Register which serves as the basis for operative and strategic de-cisions in this area including cancer screening programs.

Oncology societies 4.

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SOS committee in 2019: President: prof. Dr. Stanislav Špánik, PhD.Vice President: Dr. Branislav Bystrický, PhD., MPHScientific Secretary: Dr. Peter Beržinec, PhD.Treasurer: Dr. Mária Rečková, PhD.

Members: Assoc. Prof. Dr. Igor Andrašina, PhD.Dr. Radovan Barilla, PhD.Assoc. Prof. Dr. Vladimír Bella, PhD.Dr. Juraj BeniakAssoc. Prof. Dr. Pavol Dubinský, PhD., MHADr. Jozef Chovanec, sr.Prof. Dr. Michal Mego, D.ScDr. Tomáš ŠálekDr. Jozef Šufliarsky, PhD.

4.1. Slovak Oncology Society

Slovak Oncology Society (SOS) is not only an association of oncolo-gists, but also physicians of other specialties who directly participate in cancer patients’ care or who are interested in oncology. Slovak On-cology Society is a part of the Slovak Medical Association along with other specialist societies and since April 2017, it has been a member of the European Society for Medical Oncology (ESMO) which unites oncology societies from other European countries based on agree-ments: https://www.esmo.org/membership/esmo-in-your-country. Slovak Oncology Society has thus entered a prestigious European community of oncology societies.

The number of members of the Slovak Oncology Society has until fairly recent times been rising steadily. The SOS had 240 members in 1979, as many as 578 members in 2009, 486 members in 2018 and 476 members in 2019. SOS is led by a committee with 13 members. SOS supervisory board has 3 members. The committee and the supervisory board are elected for 4 years’ term.

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SOS supervisory board in 2019:Chairman: Dr. Milada Mikulová

Members:Assoc. Prof. Dr. Richard Hrubý, PhD., MBADr. Vanda Ušáková, PhD.

4.1.1. Activity report from 2019

1. stabilization and strengthening of membership a. youth activities b. stimuli – promotion of active participation in expert events c. rewards for the best lectures, publications, scientific activities d. promotion of fellowships

2. stabilization of the number of expert events a. organized by SOS directly b. not organized by pharmaceutical companies – supervised by SOS – participation of SOS in the preparation of program c. with grants from pharmaceutical companies i. supervised by a committee member ii. stable number iii. stable date

3. 3. cooperation with international partners a. ESMO

i. representation in the organization ii. active participation in projects and events b. ECRIN – SLOVACRIN – clinical trials

4. cooperation with MoH SR and patients’ organizations a. standard preventive, diagnostic and treatment procedures b. support of meaningful steps c. League Against Cancer (civic association) – educational materials for patients

5. cooperation with Biomedical Research Center SAS (BMC SAS) a. translational research b. iPAAC (Innovative Partnership for Action Against Cancer) Joint Action

4.1.2. Challenges for 2020

1. stabilization and strengthening of membership a. youth activities b. stimuli – promotion of active participation in expert events abroad c. rewards for the best (lectures, publications, scientific activities) d. promotion of domestic and international fellowships – grants e. geriatric oncology section f. cooperation with Society of Pediatric Oncology

2. stabilization of the number of expert events a. organized by SOS directly – priority over other activities b. not organized by pharmaceutical companies, academic – supervised by SOS – participation of SOS in the preparation of program c. with financial grants from pharmaceutical companies i. supervised by a committee member ii. merging of several events into one – stable number of conferences planned one year ahead with a stable date

3. cooperation with international partners a. Czech Oncology Society (COS) i. mutual participation in events ii. joint research and development projects b. ESMO i. representation in the organization ii. active participation in projects and events c. V4 – establish contacts d. ECRIN – SLOVACRIN – clinical trials

4. cooperation with MoH SR, health insurance companies and pa-tients’ organizations

a. standard preventive, diagnostic and treatment procedures – increase member activity b. support of meaningful steps c. activity and cooperation to search for a solution for the

accessibility of standard drugs (original, generic) as well as of innovative treatment

d. cooperation with patients’ organizations

5. intensify cooperation with BMC SAS a. translational research b. iPAAC (Innovative Partnership for Action Against Cancer) Joint Action

Information about the activities of Slovak Oncology Society and ac-tivities in oncology in Slovakia and abroad in general is regularly updated on the SOS website: http://onkologia.sk/

4.1.3. SEKCAMA (SOS SMA)

The Section for Breast Cancer (SEKCAMA SOS SMA) within the Slo-vak Oncology Society (SOS) and the Slovak Medical Association (SMA) was established at a board meeting of SMA in 1996. The section was created on the initiative of Dr. Vladimír Bella, Dr. Dušan Malatin, Dr. Jozef Haľko and Dr. Ľubomír Bohunický, with the huge support of then president of the SOS and SMA, Assoc. Prof. Dr. Ivan Maňka, PhD.

The main objective of the section is to reduce mortality from breast cancer. SEKCAMA SOS SMA wants to achieve this by organizing regu-lar working conferences based on multidisciplinary approach because diagnostics and treatment of breast cancer is a question of multiple

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disciplines. The section would also like to contribute to the reduction of mortality by improving and unifying preventive, diagnostic and treatment procedures according to state-of-the-art knowledge from science and technology.

SEKCAMA SOS SMA committee in 2019:President: Dr. Vladimír Bella, PhD.Vice President: Dr. Martin Sabol, PhD.Scientific Secretary: Dr. Andrea Šimová Treasurer: Dr. Peter Chvalný

Members:Dr. Zoltán JálnyDr. Ľubomír BohunickýAssoc. Prof. Dr. Richard Hrubý, PhD., MBADr. Marián StreškoAssoc. Prof. Dr. Mária Wagnerová, PhD.

SEKCAMA SOS SMA supervisory board in 2019:Chairman: Dr. Milada Mikulová

Members:Dr. Radovan Barilla, PhD.Assoc. Prof. Dr. Elena Bolješíková, PhD.

The section currently has 110 members.

In June 2019, SEKCAMA SOS SMA organized the 24th international conference in Bratislava which welcomed 360 physicians from vari-ous specialties. The main topic of the expert event was a comprehen-sive and detailed look at breast cancer. Lectures at the conference fo-cused on experimental oncology, pathology, prevention, diagnostics, surgical treatment, systemic treatment and radiotherapy of breast cancer, follow-up treatment, complementary and integrative medi-cine and treatment of side effects of conventional therapy. The con-ference fulfilled its purpose – it increased awareness of physicians about malignant breast disease and created a quality platform for discussion about the controversies among specialties.

Information about the activities of SEKCAMA SOS SMA is regularly updated at the website: http://www.sekcama.sk/.

4.1.4. Geriatric Oncology Section of SOS

Geriatric Oncology (GO) section was established within the Slovak Oncology Society in 2010. Its objective is to ensure progress in re-search and practical activities for geriatric patients. The GO section is a member of the International Society of Geriatric Oncology (SIOG) which was founded in 1999. The section is represented in SIOG by its national representative, Assoc. Prof. Dr. Mária Wagnerová, PhD.

Unfortunately, even after several years of effort, there has been no meaningful discussion about geriatric oncology with the Ministry of Health of the SR.

Members of GO section committee in 2019: Assoc. Prof. Dr. Mária Wagnerová, PhD.Assoc. Prof. Dr. Peter Beržinec, PhD.Assoc. Prof. Dr. Vladimír Bella, PhD. Dr. Eva Konkolovská Dr. Valéria Tkáčová

Members of GO section supervisory board in 2019:Dr. Michal Licko Prof. Dr. Michal Mego, D.Sc.Dr. Eva Juskaničová

The most important agenda of the GO section focuses mainly on ed-ucation and support. Two publications were created within the long-term cooperation with SIOG and published in the specialist magazine Geriatric Oncology:• SIOG 10 priorities initiative: First round questionnaire • SIOG 10 priorities initiative: Second round questionnaire As for the area of clinical and radiation oncology, lung cancer and cardio-oncology, Assoc. Prof. Dr. Mária Wagnerová, PhD. has written chapters for 3 important monographs focusing on the topic of geri-atric oncology:• prof. Jurga et al.: Clinical and Radiation Oncology (Klinická a radiačná onkológia)• Dr. Kavcová et al.: Lung Cancer (Karcinóm pľúc)• prof. Mladosievičová et al.: Cardio-oncology (Kardioonkológia) in 2 editions

Within its publishing activities, the GO section prepared two is-sues of specialist magazine Clinical Oncology (Klinická onkológia) 5/2012 and Clinical Oncology 3/2017 with focus on geriatrics and pub-lished several articles about geriatric oncology in the magazine Phar-macotherapy (Farmakoterapia). The section also managed to include this topic in graduate study at the Faculty of Medicine of PJSU and post-graduate study at the Faculty of Medicine of Comenius University.

The GO section plans to broaden its membership (currently 50 members) particularly b seeking younger members. The section also wants to extend its cooperation with the Slovak Oncology Society and Slovak Society of Chemotherapy. The section also plans to organize the 2nd GO conference during Bardejov Oncology Days (Bardejovské onkologické dni) in 2020 and thus follow up on the 1st GO conference from 2015, which also took place during Bardejov Oncology Days and was extremely successful.

Problem-solving perspectives of the GO section• Increase awareness about geriatric oncology, epidemiological sit-

uation and the need for specific approach at the level of the MoH SR, expert societies, network of patient associations and the media (for example via success stories of cured geriatric cancer patients)

• Officially integrate the topic of geriatric oncology to graduate and post-graduate education in faculties of medicine and nursing care

• Solve the shortage of specialists in geriatric oncology by organ-izing special courses (SMU) with financial subsidies, create on-cogeriatric working groups as well as a separate sub-specialty, establish interdisciplinary geriatric oncology centers mainly in

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oncology institutes and teaching hospitals, include comprehen-sive geriatric assessment (CGA) including comorbidity in cancer treatment guidelines

• Problem-solving in geriatric oncology requires a change of clini-cal and sectoral interest, transformation of outdated approaches as well as the structure of the specialty

• Only joint activities in the fight against cancer can be successful

4.2. Slovak Society of Chemotherapy

Slovak Society of Chemotherapy (SSCH) was founded in 1991. The first documents about its establishment within the Slovak Medical Asso-ciation, which unites specialist medical and pharmaceutical societies and regional associations of physicians and pharmacists, were writ-ten in 1993. The founding members were prof. Dr. Vladimír Krčméry, D.Sc. and Dr. Jozef Šufliarsky, PhD. SSCH is a member of two interna-tional institutions – European Federation (FESCI) and International Society of Chemotherapy (ISC). In 2015, prof. Dr. Vladimír Krčméry, D.Sc., was elected to ISC executive committee as the only represent-ative from the former Eastern bloc.

Publication of the specialist magazine Acta Chemotherapeutica also dates back to the foundation of SSCH. So far, SSCH has released 29 volumes. Since 1996, SSCH has been one of the main organizers of an important expert event – Košice Chemotherapy Days (Košické chemoterapeutické dni), which will celebrate their 25th anniversary in 2020 (November 26 – 28, 2020).

The most important agenda of SSCH focuses mainly on education and support. SSCH cooperates with the sub-department of chemotherapy of the Slovak Medical University (SMU) in Bratislava which organizes continuous education of physicians, pharmacists and public health-care professionals, among others, via its annual SMU course in May. The course is focused on new chemotherapeutic agents, antibiotics, antifungals, antivirals, biological treatment of solid tumors and trop-ical diseases. It also welcomed renowned foreign colleagues from the Department of Tropical Diseases of the SMU.

The traditional event Košice Chemotherapy Days also hosts the Confer-ence of Oncology Nurses (Konferencia sestier pracujúcich v onkológii, 15 conferences organized so far) and Patient Seminar (Pacientsky seminár, 15 conferences organized). The agenda includes news in antimicrobial and anti-neoplastic chemotherapy, molecular biology, immunotherapy, radiotherapy, malignant tumors diagnostics and supportive therapy.

Members of SSCH and SOS support education also by their active par-ticipation in important oncological events such as Bratislava Oncolo-gy Days, Medifórum, SEKCAMA, Current Management of Breast Can-cer (Aktuálny manažment karcinómu prsníka), Young Oncologists’ Days (Dni mladých onkológov), Onkofórum, Onkospektrum, Slovak national ATB symposium, Immune Deficiencies Symposium (Sympó-zium poruchy imunity), Bardejov Oncology Days and more. Partici-pants in Bratislava Oncology Days and Košice Chemotherapy Days highly appreciate the cooperation of both associations as main or-ganizers of the events.

SSCH also supports the preparation of medical research grants, such as successfully finished, resolved and published project Strategy of using antifungal prophylaxis and treatment of invasive aspergillo-sis in high-risk immuno-compromised patients in the SR with the use of biomarkers (“Stratégia používania antimykotickej profylaxie a liečby invazívnej aspergilózy u rizikových imunokompromitovaných pacientov v SR s využitím biomarkerov”).

SSCH committee in 2019: President: Assoc. Prof. Dr. Mária Wagnerová, PhD.

Members:Assoc. Prof. Dr. Peter Beržinec, PhD.Assoc. Prof. Dr. Andrea Demitrovičová, PhD.Assoc. Prof. Dr. Ľuboš Drgoňa, PhD.Prof. Dr. Pavol Jarčuška, PhD. Dr. Peter Jonáš Prof. Dr. Vladimír Krčméry, D.Sc.Assoc. Prof. Dr. Jozef Mardiak, PhD.Dr. Jozef Šufliarsky, PhD.(The term of the committee ends in spring 2020 when a new election is going to take place.)

SSCH supervisory board in 2019:Dr. Juraj BeniakDr. Eva Pritzová Dr. Jana Jankurová

SSCH committee plans to broaden its membership (currently almost 100 regular members) particularly by seeking younger members. SSCH plans to organize 2 educational, accredited activities – course of tropical diseases and Košice Chemotherapy Days. SSCH will con-tinue cooperating to prepare more professional activities in Slovakia. In 2020, SSCH plans to publish more issues of the specialist magazine Acta chemotherapeutica, focusing on anti-infective treatment (prof. Dr. Vladimír Krčméry, D.Sc.) and other contributions from the field of oncology (Assoc. Prof. Dr. Mária Wagnerová, PhD.).

The president of the committee, Assoc. Prof. Dr. Mária Wagnerová, PhD., would kindly like to ask, also via this Annual Report, for help searching for organizers of the following years of the prestigious ex-pert event, Košice Chemotherapy Days, and for help with publishing the specialist magazine.

4.3. Slovak Society of Pediatric Oncologists and Hematolo-gists

The society currently has 39 members.

The main activities of the society• Qualification to enter international clinical trials all around Slo-

vakia• Update of protocols and standard diagnostic and treatment pro-

cedures

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• Funding of difficult diagnostic procedures (molecular diagnostics of subgroups of CNS tumors, genomic analysis of resistant tum-ors, etc.)

• Preparation of joint procedures for treatment abroad

Committee: President: Dr. Judita Puškáčová, PhD.

Members: Dr. Eva Bubanská, PhD.Dr. Ladislav DeákDr. Irina OravkinováDr. Zuzana StriežencováDr. Sabina Šufliarská, PhD.

4.4. Slovak Society of Radiation Oncology (SSRO)

Slovak Society of Radiation Oncology unites professionals involved in treatment by ionizing radiation. It was established in 1990 under the name Society for Radiation Oncology, Radiobiology and Radio-physics (SROBF) as a unit of the Slovak Medical Association. Its name was changed to Slovak Society of Radiation Oncology (SSRO) in 2011. It has over 100 members, mostly radiation oncologists and physicists working at departments of radiation oncology. SSRO has organized bi-annual scientific conferences for its member associations since 2012. Executive board meetings focus mainly on technological pro-

vision of treatment, reimbursement of procedures in radiotherapy, specialty curriculum, education and quality assessment of treatment.

SSRO committee in 2019: President: Assoc. Prof. Dr. Pavol Dubinský, PhD., MHA(term 2019 – 2022)

Members: Jozef Grežďo, MSc. PhD.Dr. Martin Chorváth, PhD.Dr. Martin JasenčákDr. Marek LafférsDr. Pavol LukačkoPeter Muríň, MSc. PhD.

SSRO supervisory board in 2019: Chairman: Dr. Silvia Zavřelová

Members:Ing. Anna Križanová, PhD.Dr. Milan KuvikDr. Monika Šandorová

Information about the activities of the Slovak Society of Radiation Oncology are regularly updated on SSRO website: http://www.radiac-naonkologia.sk/


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colorectal cancer screening as well as methodology of the pathway for the patient within the cervical cancer screening program. During the preparation of the methodologies, NOI has expertly cooperated with all involved experts from Slovakia as well as screening specialists from the National Screening Center and the Institute of Biostatistics and Analyses at the Faculty of Medicine of the Masaryk University in the Czech Republic. All the materials were presented at working groups’ meetings at the MoH SR. NOI in cooperation with relevant experts prepared a primary population economic impact assessment for colorectal cancer screening.

In cooperation with MoH SR and patients’ organizations (League Against Cancer and No to Cancer), NOI has contributed to expert guidance of an awareness campaign coordinated by the MoH SR.

NOI in cooperation with the MoH SR, League Against Cancer and Public Health Authority (PHA) have created information leaflets for all three screening programs, information brochures for cervical can-

5.1. Activity report from 2019

The National Oncology Institute (NOI) was established by the MoH SR under the National Cancer Institute in August 2018 and in this short period of time, it has contributed considerably to primary activities crucial for the fulfillment of the National Oncology Program, mainly focusing on preparation and launching of selected oncology screening programs as well as research, development and education of profes-sionals and the public. The main objective of the NOI is to help fulfil the challenges of the National Oncology Program comprehensively and independently in cooperation with other stakeholders including the MoH SR in 5 areas: epidemiology, research and development, pre-vention and screening, diagnostics and treatment, supportive care.

Regarding prevention and screenings, NOI in cooperation with working groups for screening programs of the MoH SR have creat-ed the invitation letters for breast cancer and cervical cancer screen-ings. NOI also contributed to the methodology of inviting patients to the screening, reporting of procedures and diagnoses of cervical and

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cer and breast cancer screenings and a special information material for colorectal cancer screening.

The NOI website includes an information platform with a special section dedicated to screening with separate parts dedicated to the professionals and to the public.

Regarding oncology research, the Cancer Trials Register in Slova-kia was created within the NOI website in 2019. This register is up-dated monthly based on information from SIDC (Slovak Institute for Disease Control) database and other validation resources from spon-sors of clinical trials in Slovakia. The register is available to both physi-cians and patients (in a simplified form) and informs about the status of cancer trials in Slovakia, which in turns simplifies the access to in-novative treatment procedures within the trials. In 2019, NOI opened two calls for NOI grants intended for short-term international fel-lowships for oncologists and awarded them to three applicants: Dr. Mária Beníčková from the Pediatric oncology and hematology Clinic, Children’s Teaching Hospital with Policlinic in Banská Bystrica, Dr. Katarína Rejleková, PhD. from the National Cancer Institute and Dr. Michaela Švajdová from the Radiation and Clinical Oncology Depart-ment, Radiation and Clinical Oncology Clinic, Central Military Hos-pital Ružomberok. A Scientific Committee for NOI grants was estab-lished to evaluate the applications. The Committee has 7 members at the moment: the Director of NOI, Chief expert for oncology, Chief ex-pert for pediatric oncology, Chief expert for radiation oncology, Pres-ident of the scientific board of the National Cancer Institute (NCI), President of the Slovak Oncology Society and a Nominee of the MoH

SR. The committee meets up after a call is ended and precise regu-lations of its activity, requirements for NOI grant application, calls and results, reports and publications from the fellowships are avail-able at the NOI website: https://www.noisk.sk/lekar/veda-a-vyskum/noi-granty.

In 2019, NCI/NOI and SLOVACRIN signed a cooperation agree-ment. Based on a request by SLOVACRIN, 4 academic clinical trials were supported financially from the funds allocated to the implemen-tation of the National Oncology Program in 2019.

In June 2019, a working group was created within NOI under the name Slovak Cooperative Oncology Group (SCOG) as an official as-sociation of oncology facilities in Slovakia interested in active partic-ipation in clinical trials. The mission of SCOG is to connect academic sites, other oncology clinical facilities and pharmaceutical and bio-technological companies in order to conduct coordinated oncology research in Slovakia with the final goal to improve cancer patients’ care in Slovakia. First cooperation talks have been started with two cooperative oncology groups – GETUG (French Genitourinary Group) and CECOG (Central European Cooperative Oncology Group).

In 2019, NOI continued its active cooperation with the European So-ciety for Medical Oncology (ESMO) and patients’ organizations in order to create educational materials for patients and the public. In cooperation with AIFP and patients’ organizations, NOI contin-uously prepares ESMO Patient Guides for Slovak patients and the public, published on NOI website in the section Patient/Oncological

diseases: https://www.noisk.sk/pacient/onkologicke-ochorenia/pa-cientske-prirucky. NOI also helped to prepare an information leaflet about prevention in oncology created by the League Against Cancer which was distributed in Slovakia on Daffodil Day in April 2019. NOI cooperated with the civic association No to Cancer in their aware-ness campaign about breast cancer screening.

In 2019, NOI created epidemiology outputs of the the National Oncology Registry (NOR) based on the available data from National Health Information Center (NHIC). The outputs are available at NOI website: https://www.noisk.sk/narodny-onkologicky-register/epide-miologia-nadorovych-ochoreni-na-slovensku. The main objective of NOI is to professionally support the restoration of NOR with up-to-date data. At the moment, the last data about the incidence of on-cological diseases available in NOR are from 2011. The topic is com-plex and the main reason why the data are not up-to-date is lack of updated reports to NOR. We consider it vital to implement a simpler manner of reporting with lower administrative burden. The objective is to reduce bureaucracy for physicians who establish an oncological diagnosis and are obliged to report the newly diagnosed oncological disease to the NOR, as well as for other specialists who participate in cancer patients’ care. It is also necessary to ensure adequate commu-nication between NHIC and healthcare providers. NOI with the chief expert for oncology have suggested possible ways to improve report-ing to NOR directly to NHIC employees including a proposal of new job positions which would be responsible for the accuracy and up-to-dateness of reports to NOR.

Regarding epidemiology of oncological diseases and the settings of oncology screening programs, cooperation of NOI and the Institute of Biostatistics and Analyses at the Faculty of Medicine of the Masaryk University in Brno continued.

NOI activities and other important information for professionals and the public are regularly updated on the NOI website www.noisk.sk which also serves as an information platform of the National Oncology Program for healthcare professionals, patients and the public.

NOI staff in 2019:Dr. Mária Rečková, PhD., Directorprof. Dr. Róbert Babeľa, PhD., MBA, MSc (iHTA), PharmacoeconomistDott. David Balla, AnalystAssoc. Prof. Dr. Alexandra Bražinová, PhD., EpidemiologistPatrícia Kubicová, MSc. Specialist officerRoman Novota, AnalystDr. Eva Popreňáková, PhD., Cancer Trials Register CoordinatorDr. Janka Trautenberger-Ricová, Screenings Coordinator


Regarding prevention and screenings, ensure functioning of three oncology screening programs (breast cancer, cervical cancer and colorectal cancer screening) in cooperation with relevant experts (gastroenterology, gynecology, radiology and GP associations) and all

https://www.noisk.sk/lekar/veda-a-vyskum/noi-granty


https://www.noisk.sk/pacient/onkologicke-ochorenia/pacientske-prirucky

https://www.noisk.sk/pacient/onkologicke-ochorenia/pacientske-prirucky

https://www.noisk.sk/narodny-onkologicky-register/epidemiologia-nadorovych-ochoreni-na-slovensku

https://www.noisk.sk/narodny-onkologicky-register/epidemiologia-nadorovych-ochoreni-na-slovensku

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involved stakeholders (MoH SR, health insurance companies, NHIC, Health Care Surveillance Authority (HCSA), Public Health Authority, patients’ organizations):• Coordination, preparation and update of screening programs (SP)• Completing and updating methodologies related to SP at all levels• Primary evaluation of population-based SP• Preparation of population economic impact assessments of SP • Quality assessment in cooperation with involved expert associa-

tions and other entities • Educational activities in cooperation with the MoH SR (mass me-

dia campaign coordinator); health insurance companies; NHIC; expert associations of gastroenterologists, gynecologists, radi-ologists, GPs, oncologists; patients’ organizations; HCSA; Public Health Authority

Regarding diagnostics, treatment, quality of life, survivorship support and palliative care: prepare the concept of oncology care in Slovakia in cooperation with relevant experts and the MoH SR.

Regarding support of cancer research and better accessibility of clin-ical trials for patients:• Ongoing updates of Cancer Trials Register and readjusting data

collection processes at a systemic level• Support of the activity of SCOG with national and international

cooperation • Creation of the concept of clinical oncology research in Slovakia • Awarding NOI grants for short-term international fellowships for

physicians – oncologists in order to access state-of-the-art med-ical knowledge. Calls for 2020 will be opened regularly in January and June. Establishing the tradition of gala awards of NOI grants with a presentation of experience from the fellowships at the an-nual autumn conference Bratislava Oncology Days with partici-pation of professionals from all over Slovakia.

• Ongoing cooperation with MoH SR, SIDC, AIFP, SLOVACRIN, in-ternational cooperative oncology groups

In cooperation with patients’ organizations, preparation and updates of ESMO Patient Guides and other educational materials for patients and the public.

Regarding cancer epidemiology in the framework of cooperation be-tween NOI and NHIC, we consider it crucial to establish the position of NOI in the legislation and to be able to use data collected and pro-cessed by NHIC as effectively as possible.

Research and development

6.

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NOI also participates in adjustment of processes in cooperation with the MoH SR and SIDC so that the data are available systemati-cally and the outputs are even more transparent.

Radiation oncology fights an everyday battle to provide basic inter-ventions with often obsolete technology in the majority of facilities, which is one of the reasons why no prospective study was conducted in this area in 2019. A prospective cohort phase II study was approved under the name NáDej: De-escalation of HPV-associated oropharyn-geal cancer chemoradiotherapy (NáDej: Deeskalácia chemorádioter-apie HPV asociovaného karcinómu orofaryngu) with the administra-tive support of SLOVACRIN funded by the resources of the National Oncology Plan. Three centers are involved so far: East Slovakia On-cology Institute, Central Military Hospital Ružomberok and National Cancer Institute. Any facility equipped with a linear accelerator with VMAT and IGRT can participate in the study.

6.1. Cancer Clinical Trials

The Cancer Trials Register in Slovakia is published on the website of the National Oncology Institute (www.noisk.sk) since January 15, 2019.

Information about the closing or opening of clinical trials is updat-ed monthly. The more detailed section is available for professionals and a simplified section for the lay public.

The Register should raise the awareness of professionals and the public, which should eventually lead to increased recruitment of pa-tients to clinical trials and better accessibility of innovative treatment to cancer patients in Slovakia.

By the end of 2019, the Register included 17 clinical trials open for recruitment, of which 1 pediatric trial and 16 for adult patients; 6 of them were open in the current year. A further 6 trials ended the re-cruitment in the course of 2019.

Of the 17 clinical trials (CT) open for recruitment, 10 CT are Phase III trials, 5 CT are Phase II trials, one CT is a Phase I trial. One CT is a biomedical research and along with three Phase III CT are investi-gator-initiated research sponsored by NCI.

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6.2. Translational research

Translational Research Unit (TRU) is a specialized facility of the 2nd Oncology Clinic of Medical Faculty Comenius University and NCI which focuses on translational research, i.e. the application of find-ings from basic research in clinical practice, as well as retrograde solutions of clinically significant problems in oncology using exper-imental approaches in vitro and in vivo on TRU animal models. For more information, see websites:https://www.fmed.uniba.sk/pracoviska/klinicke-pracoviska/ii-onko-logicka-klinika-lf-uk-a-nou/ https://www.nou.sk/jednotka-translacneho-vyskumu-lfuk-a-nou

In 2019, TRU cooperated with the Institute of Experimental Oncol-ogy of BMC SAS (Biomedical Research Center of the Slovak Academy of Sciences), facilities of Comenius University (UK) and SECI (St. Eliza-beth Cancer Institute), focusing on germ cell testicular tumors, breast cancer, colon cancer, pancreatic cancer and bladder tumors. Regular monthly research meetings took place throughout the year among TRU, BMC, FMCU and other facilities. There has been an intense co-operation with facilities abroad and a biobank has been established at NCI as another unit used to develop the research.

The most important results were achieved in the area of germ cell testicular tumors, mainly regarding the identification of new bio-markers and late toxicity.

Translational research in pediatric oncology: SRDA (Slovak Re-search and Development Agency) grant is under way in cooperation with SAS.

6.3. Cooperative groups

6.3.1. Slovak Cooperative Oncology Group

Slovak Cooperative Oncology Group (SCOG) was founded on June 14, 2019, as a working group within the Slovak Oncology Institute. SCOG currently has 27 members and is a formal association of profession-als working together on conducting academic and industry-initiated cancer clinical trials in the Slovak Republic.

The mission of SCOG is to connect academic sites, other oncology clinical facilities and pharmaceutical and biotechnological companies in order to conduct coordinated oncology research in Slovakia with the final goal to improve cancer patients’ care in Slovakia.

Activity report from 2019SCOG started cooperation with the French Genitourinary Group (GETUG) and Central European Cooperative Oncology Group (CECOG). An agreement was signed by the NOI and SLOVACRIN (national re-search infrastructure) which was founded at the Faculty of Medicine of Pavol Jozef Šafárik University in Košice, Slovakia, in order to sup-port academic clinical trials in Slovakia.

The ideas and projects of SCOG were presented at a meeting with representatives of Association of Innovative Pharmaceutical Indus-try (AIFP).

Further information about the activities of SCOG can be found on NOI website in the section Clinical trials: https://www.noisk.sk/lekar/veda-a-vyskum/slovenska-kooperativna-onkologicka-skupina.

SCOG committee in 2019:Chairman: Dr. Mária Rečková, PhD.Vice chairman: Dr. Branislav Bystrický, PhD. Secretary: Dr. Juraj Beniak

Members:Assoc. Prof. Dr. Igor Andrašina, PhD.Assoc. Prof. Dr. Peter Beržinec, PhD.Assoc. Prof. Dr. Pavol Dubinský, PhD., MPHDr. Jozef ChovanecProf. Dr. Michal Mego, D.Sc.prof. Dr. Stanislav Špánik, PhD.Dr. Jozef Šufliarsky, PhD.Assoc. Prof. Dr. Mária Wagnerová, PhD.

Challenges for 2020• Support of clinical trials infrastructure in Slovakia within SCOG

coordination • Preparation and coordination of joint clinical trials at the national

level• Ongoing cooperation with SLOVACRIN according to current

needs and possibilities of both organizations• Preparation and initiation of international cooperation with

GETUG• Creation of a platform for cooperation with CECOG and other in-

ternational oncology groups

6.3.2. Lymphoma Group

The Lymphoma Group of the Slovak Republic (LySK) is an interdisci-plinary association of physicians, other specialists and paramedical staff involved in research, diagnostics and treatment of lymphop-roliferative disorders. The objectives of LySK include unification of diagnostic criteria and standardization of treatment of malignant lymphomas (ML), implementing new findings in diagnostics and treatment of ML in clinical practice, reporting of patients with ML, cooperation to organize clinical trials focused on ML topics, partici-pation in graduate and post-graduate education of healthcare profes-sionals and education of the public about ML. The first edition of the publication Strategy of Treatment of Malignant Lymphomas was re-leased in 2007. It includes the principles of classification, diagnostics and treatment of malignant lymphomas. The third revised edition of the recommendations was released electronically in 2018 (https://lysk.sk/wp-content/uploads/2018/11/strategia-liecby.pdf ).

One of the other key activities of the association is a register of pa-tients with ML and subsequent analysis of incidence and prevalence trends as well as effectiveness assessment of therapy used in the treat-ment of ML in Slovakia. Slovlymp Project was created to collect and analyze the data about patients with ML in Slovak centers. The Slovak Lymphoma Group has been organizing regular meetings of specialists working in diagnostics and treatment of lymphoproliferative disor-ders, the Lymphoma Forum, since 2004 (www.lyfo.sk). In 2019, the 14th annual specialist conference took place with the main topic: Practical aspects of diagnostics and treatment of malignant lymphomas. The

https://www.fmed.uniba.sk/pracoviska/klinicke-pracoviska/ii-onkologicka-klinika-lf-uk-a-nou/

https://www.fmed.uniba.sk/pracoviska/klinicke-pracoviska/ii-onkologicka-klinika-lf-uk-a-nou/

https://www.nou.sk/jednotka-translacneho-vyskumu-lfuk-a-nou

https://www.noisk.sk/lekar/veda-a-vyskum/slovenska-kooperativna-onkologicka-skupina

https://www.noisk.sk/lekar/veda-a-vyskum/slovenska-kooperativna-onkologicka-skupina

https://lysk.sk/wp-content/uploads/2018/11/strategia-liecby.pdf

https://lysk.sk/wp-content/uploads/2018/11/strategia-liecby.pdf

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association also provides phone consultations and on-line counseling for patients with ML via its website https://lysk.sk/, which is also open for the public interested in the topic of ML. LySK closely cooperates with patients’ organization reuniting patients with ML, lymfom.sk. The group also actively participates in international clinical trials research-ing new medicaments or new types of treatment for patients with ML.

The structure of LySK consists of board of directors and supervisory board

LySK board of directors in 2019:Chairman: Assoc. Prof. Dr. Ľuboš Drgoňa, PhD.

Members:Prof. Dr. Lukáš Plank, PhD. Dr. Milena SurováAssoc. Prof. Dr. Peter Szépe, PhD.Dr. Andrej Vranovský, PhD. Dr. Alexander Wild, PhD.

Supervisory board in 2019:Dr. Tomáš Balhárek, PhD.Dr. Eva KráliováDr. Martin Petrilák

Challenges for 2020 • Regular updates of recommendations for diagnostics and treat-

ment of ML

• Continuation of the SlovLymp project, professionalization of data collection

• Continuation of the project: Prognostically and Predictively Rele-vant Stratification of Large B-cell Lymphomas via FISH Diagnos-tics in Consultation Center for Bioptic Diagnostics of Hemopoie-tic Disorders at the Institute of Pathologic Anatomy of Jessenius Faculty of Medicine Comenius University and University Hospital Martin, publication of the first output of the project

• Continuation of project Monitoring biomarkers (TARC, ctDNA, interim PET/CT) and their predictive and prognostic role in the treatment of Hodgkin lymphoma.

• Analysis of patients with Hodgkin lymphoma treated by consoli-dation therapy

• Organizing 15th annual Lymphoma Forum

6.3.3. Slovak Head and Neck Cancer Cooperative Group, Civic Assoc.

The civic association Slovak Head and Neck Cancer Cooperative Group was founded in April 2018. The objective of this group is multidiscipli-nary cooperation of individual specialists working in the treatment of head and neck cancer.

The association is governed by its member meeting and committee. Committee is a statutory body of the civic association which governs its activities and is accountable to the member meeting. The commit-tee has 5 members elected for a 5-year term.

Association committee in 2019:Chairman: Dr. Patrik Štefanička, PhD., ENT and Head and Neck Clinic, FMCU and University Hospital, BratislavaVice Chairman: Assoc. Prof. Dr. Pavol Dubinský, PhD., MHA, Depart-ment of Radiation Oncology, ESOI, Košice

Members:Dr. Klaudia Gočárová, PhD., Internal Medicine Clinic of St. Elizabeth’s Healthcare and Social Work College and St. Elizabeth Cancer Insti-tute, BratislavaDr. Andrea Ligačová, Radiation Oncology Clinic of SMU and SECI, Bra-tislavaDr. Milan Almáši, PhD., ENT Department, ESOI, Košice

Current situationRegistration of new members is open since January 2019. The asso-ciation currently has 28 regular members. The association also plans to launch its own website. From January 18 to 19, 2019, the first con-ference of the cooperative group with multidisciplinary representa-tion took place under the auspices of the civic association, intended for all physicians and experts working in diagnostics and treatment of patients with head and neck cancer, focusing on interdisciplinary cooperation. The second year of this conference is planned for January 2020 with the goal to strengthen mutual communication and coop-eration among individual specialties. Experienced specialists from the Czech Republic also agreed to participate actively.

Goals and challenges for 2020• Encourage the creation and activity of multidisciplinary teams

within hospitals in order to improve diagnostics and treatment of patients with head and neck cancer

• Continue and develop the cooperation with Czech Head and Neck Cancer Cooperative Group

• Prospectively, become a member of European organizations• Awareness activities for professionals and the public

6.3.4. Working Group for Oncology Nutrition

The life of cancer patients can be prolonged by the possibility of par-enteral feeding in case of digestive failure, either as a result of the disease itself, of the cancer treatment or a combination of both. Home parenteral nutrition (HPN) program is intended for patients in remission of oncological disease and also patients with advanced oncological diseases. However, indication of PN for these patients remains controversial because we do not have defined predictors of benefit in such a heterogeneous group of patients.There are two HPN centers focused on cancer patients at the moment.

HPN Center (Centrum DPV) was created at the National Cancer In-stitute in Bratislava on January 1, 2015. As of December 31, 2018, the center took care of 89 patients. Of all patients, 67 had an advanced oncological disease (75.3%) and 12 were after a successful treatment of oncological disease (24.7%).

https://lysk.sk

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The Center for Home Parenteral Nutrition (Stredisko pre domácu parenterálnu výživu) at St. Elizabeth Cancer Institute in Bratislava was established on May 13, 2019. In 2019, 13 patients were treated in this center. The most frequent reasons for indication of HPN in these patients were malignant bowel obstruction, short bowel syndrome and malabsorption after radiotherapy or surgical procedures.

Creation of nutritional offices remains a challenge for the future. However, this requires a sufficient number of nurses and physicians educated in nutrition who are currently lacking in Slovakia.

6.3.5. Slovak Pediatric Leukemia Group

Slovak Pediatric Leukemia Group (SPLG) unites physicians, profes-sionals and paramedical staff working in research, diagnostics and treatment of leukemia in childhood. The objective of SPLG is to unify diagnostic criteria and standardize treatment of leukemia in child-hood, implement new findings from diagnostics and therapy in clin-ical practice, ensure registration of children with ALL, AML and CML in Pediatric Oncology Register, launch and manage clinical trials for leukemia in childhood.

Slovak Pediatric Leukemia Group has been meeting once or twice a year at a Slovak seminar “Blastshow” since 2010. During this event, the participants analyze each newly diagnosed patient with ALL or AML, relapses of leukemia, transplant patients, death in the induction, re-mission and progression of the disease. Since 2010, the role of SPLG has been to ensure quality assessment and fulfilment of diagnostic and

treatment criteria necessary for the inclusion to international academic clinical trials. ALL and AML diagnostics is centralized (morphology, flow cytometry, cytogenetics, molecular genetics) in Bratislava since 2012.

In 2013, Slovak Pediatric Leukemia Group was accepted by the inter-national AML BFM group led by prof. Dirk Reihardt. It was accepted also by ALL BFM/AEIOP group led by prof. Martin Schrappe in 2016 thanks to cooperation with the Czech Republic, precisely with the Childhood Leu-kemia Investigation Prague laboratory at the Department of Pediatric Hematology and Oncology at University Hospital Motol which examines minimal residual disease within the monitoring of ALL patients. Based on the acceptance of international groups, it is possible to register patients with ALL and AML and treat them within international academic trials.

Fulfilled challenges for 2019• Launch of academic clinical trial for ALL (trial medicament Blina-

tumomab) with the administrative support of SLOVACRIN funded by the resources of the National Oncology Plan

• Reimbursement of minimal residual disease examination for ALL patients from health insurance

• Blastshow Slovakia – March 21, 2019• Publication of the results of SNP arrays analysis

Challenges for 2020• Launch of academic clinical trial for LBL with the administrative

support of SLOVACRIN funded by the resources of the National Oncology Plan

• Implementation of SNP arrays to ALL diagnostics

• Blastshow Slovakia • Update of diagnostics and treatment of AML• Publication of result analysis of relapsed patients with ALL

6.4. Experimental oncology in Slovakia

Current situationThere are currently several university and research facilities in Slo-vakia working with scientific research in experimental oncology, in-cluding the Faculty of Medicine of Comenius University in Bratislava, Jessenius Faculty of Medicine Comenius University in Martin, Faculty of Medicine of Pavol Jozef Šafarik University (PJSU) and Slovak Medi-cal University. Clinical departments at the National Cancer Institute and St. Elizabeth Cancer Institute also participate in research projects in experimental oncology.

Research facilities of the Slovak Academy of Sciences contribute significantly to research in experimental oncology, especially insti-tutes of Biomedical Research Center of the SAS which was created by merging 5 institutes of the SAS and is a member of OECI (Organ-ization of European Cancer Institutes). It represents Slovakia in the project “Health”, which is a project of the European Union iPAAC, In-novative Partnership for Action Against Cancer (https://www.ipaac.eu), which is a continuation of project CANCON and focuses on the improvement of cancer patients’ care. In 2019, an international meet-ing of project partners took place in Biomedical Research Center of the SAS where the partners adopted “Bratislava Statement on pancre-

atic cancer care and the need for strategies to improve clinical effec-tiveness” (http://www.biomedcentrum.sav.sk/medzinarodne-stretnu-tie-zamerane-na-problematiku-rakoviny-pankreasu/).

Biomedical Research Center of the SAS (BMC SAS) has been fo-cusing on research in experimental oncology for a long time, particu-larly on the following research topics, some of them in cooperation with university and clinical partners

Institute of Experimental Oncology BMC SASMolecular mechanisms of oncological diseases, tumor genetics and epigenetics, DNA damage repair and mechanisms of anticancer drug resistance, properties and therapeutic use of stem cells, tumor mi-croenvironment, identification of biomarkers for diagnostics, pre-diction of treatment effectiveness and patient stratification, de-velopment of diagnostic approaches using modern technologies, translation of findings to oncology practice.

Institute of Virology BMC SASMolecular mechanisms of adaptation to hypoxia and acidosis in tu-mor microenvironment, tumor metabolism, mechanisms of metas-tasis, and development of new anticancer strategies.

Institute of Experimental EndocrinologyCommunication between the nervous system and tumor tissue, in-fluence of physical activity and nutrition on health and quality of life of cancer patients within tertiary prevention, contribution of hormo-nal pathways to development and progression of cancer.

https://www.ipaac.eu

https://www.ipaac.eu

http://www.biomedcentrum.sav.sk/medzinarodne-stretnutie-zamerane-na-problematiku-rakoviny-pankreasu/

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Institute for Clinical and Translational ResearchSignaling pathways in tumor cells regulated by ion transport and small molecules (such as hydrogen sulfide).

BMC SAS (and other cooperating facilities) employs several inter-nationally renowned top experts who coordinate and conduct re-

search in experimental and translational oncology (in alphabetic or-der, stating their area of interest and basic scientometric data from Web of Science, All databases, as of January 31, 2020).

Name Area of activityNumber of entries*in Web of Science

Number of referencesin WOS without self-quotes

Hirsch indexacc. to WOS

Assoc. Prof. Ing. Čestmír Altaner, D.Sc. Stem cells, gene therapy 144 2,814 26

Dr. Jozef Bízik, D.Sc.Cell death, invasiveness, tumor immunology

95 1,055 20

Michal Chovanec, MSc. PhD.Chemoresistance, DNA damage and repair, chemoprevention

50 1,086 17

Dr. Jana Jakubíková, PhD.Tumor immunology, resistance, heterogeneity, diagnostics

130 1,897 25

Assoc. Prof. Dr. Karol Kajo, PhD. Carcinogenesis, diagnostics 138 833 17

Lucia Kučerová, MSc. D.Sc. Stem cells, resistance, gene therapy 56 1,699 19

Name Area of activityNumber of entries*in Web of Science

Number of referencesin WOS without self-quotes

Hirsch indexacc. to WOS

Dr. Miroslava Matúšková, PhD. Stem cells, resistance, gene therapy 61 1,216 15

Prof. Dr. Michal Mego, D.Sc.Circulating tumor cells, metastases, testicular cancer, resistance

242 2,037 26

prof. Dr. Jaromír Pastorek, D.Sc.Hypoxia, acidosis, tumor microenvironment, diagnostics, immunotherapy

228 10,569 55

prof. Dr. Silvia Pastoreková, D.Sc.Hypoxia, acidosis, tumor microenvironment, diagnostics, immunotherapy

284 8,424 53

Dr. Ján Sedlák, D.Sc.Tumor immunology, diagnostics, chemoprevention

136 1,993 23

Eliška Švastová, MSc. PhD.Hypoxia, acidosis, tumor microenvironment, metastases

18 1,211 13

Dr. Miriam Zaťovičová, PhD.Immunotherapy, tumor immunology, intercellular communication

49 1,942 17

*Web of Science (WOS) publications, patents, chapters in books and other published outputs

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Projects

International projects

Innovative Partnership for Action Against Cancer (Joint action support-

ed by the European Commission in the framework of the 3rd Health Pro-

gram) www.ipaac.eu

Type of project: EU – 3rd Health Program

Principal investigator: Silvia Pastoreková

Duration of project: April 1, 2018 / March 31, 2021

Trial registration number: HP-JA-2017-801520

The organization is the coordinator of the project:

No

Coordinator: National Institute of Public Health, Slovenia

Number of co-investigating institutions:

23 – Belgium: 1, Bulgaria: 1, Cyprus: 1, Czech Republic: 0, Germany: 1, Spain: 1, Finland: 1, France: 1, Greece: 1, Croatia: 1, Hungary: 1, Ireland: 1, Italy: 1, Lithuania: 1, Moldova: 1, Malta: 1, the Netherlands: 1, Norway: 1, Poland: 1, Portugal: 1, Romania: 1, Serbia: 1, Slovakia: 1, Slovenia: 1

Strategies to strengthen scientific excellence and innovation capacity for

early diagnosis of gastrointestinal cancer http://vision.sav.sk

Type of project: EU – Horizon 2020 – TWINNING

Principal investigator: Alena Gábelová

Duration of project: October 1, 2019 / September 30, 2022

Trial registration number: 857 381


Yes

Coordinator: Biomedical Research Center SAS


4 – Germany: 1, Spain: 1, Greece: 1, Norway: 1

New diagnostic and therapeutic tools against multidrug resistant tumors

Type of project: EU – COST

Principal investigator:Dana Jurkovičová, Biomedical Research Center SAS

Duration of project: September 11, 2018 / September 10, 2022

Trial registration number: CA17104


No

Coordinator: University of Torino, Italy

Cancer Nanomedicine – from bench to bedside

Type of project: EU – COST

Principal investigator:Monika Šramková, Biomedical Research Center SAS


Trial registration number: CA17140


No

Coordinator: University of Lodz, Poland

Molecular Markers for Biological Dosimetry in Radiation Oncology, Can-

cer Risk, Assessment and Optimizing Cancer Therapy

Type of project: IAEA

Principal investigator: Igor Beliaev

Duration of project: September 19, 2017 / July 9, 2021

Trial registration number: IAEA Research Agreement No: 22259/R0

The organization is a coordinator of the project:

No

Coordinator: International Atomic Energy Agency


27 – Argentina: 1, Brazil: 1, Canada: 1, France: 2, United Kingdom: 1, Chile: 1, Indonesia: 2, India: 2, Israel: 3, Japan: 2, Lithuania: 1, Russia: 1, Saudi Arabia: 1, Singapore: 1, Thailand: 2, Ukraine: 1, Uruguay: 1, USA: 2, Vietnam: 1

Targeted combination therapy of colon cancer with therapeutic gene/

drug loaded novel dendritic nanocarriers

Type of project: SAS SK – Turkey

Principal investigator: Miroslava Matúšková


Trial registration number: SAS-TUBITAK 398784


Yes



1 – Turkey: 1

Multiple myeloma intra-clonal heterogeneity: evolution and implications

of targeted therapy

Type of project: EU – ERANET

Principal investigator: Jana Jakubíková

Duration of project: July 1, 2016 / June 30, 2019

Trial registration number: TRS-2015-00000170


Yes



4 – Greece: 2, Israel: 1, Poland: 1

http://www.ipaac.eu

http://vision.sav.sk

8382


Innovative Nanopharmaceuticals: Targeting Breast Cancer Stem Cells

by a Novel Combination of Epigenetic and Anticancer Drugs with Gene

Therapy


Principal investigator: Božena Smolková

Duration of project: January 1, 2017 / December 31, 2019

Trial registration number: ERA-NET EuroNanoMed II


Yes


Number of co-investigating institutions:5 – Spain: 1, Greece: 1, Latvia: 1, Norway: 2

Establishing an algorithm for the early diagnosis and follow-up of pa-

tients with pancreatic neuroendocrine tumors



Duration of project: September 1, 2019 / August 31, 2022

Trial registration number: NExT-0711


No

Coordinator:

Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V., Institute for Biomedical Engineering IBMT; Germany

Number of co-investigating institutions:19 – Germany: 2, Spain: 6, Greece: 6, Latvia: 5

Domestic projects of SRDA (Slovak Research and Development Agency) and MoH SR

(Only stating projects from oncology for which BMC SAS receives grants.)

DNA damage response and preleukemic clones in hematopoietic stem

cells in diagnostics, risk estimation and treatment of pediatric leukemia

Type of project: SRDA

Principal investigator: Igor Beliaev


Trial registration number: APVV-15-0250


Yes



1, Slovakia: 1

Novel synergistic antitumor properties of nuclear retinoid X receptor

(RXR) agonists as a consequence of the conditional RXR-RAR heterod-

imer formation in human breast cancer cells


Principal investigator: Július Brtko




Yes



1, Slovakia: 1

Sulfide signaling as a potential mechanism in cancer treatment


Principal investigator: Soňa Hudecová




Yes



0

Turning cisplatin-resistant testicular germ cell tumors into a curable disease


Principal investigator: Miroslav Chovanec

Duration of project: August 1, 2018 / June 30, 2021



Yes



8 – Germany: 4, United Kingdom: 4

Tumor heterogeneity in multiple myeloma: evolution and clinical rele-

vance






Yes



3, Slovakia: 3

8584


Utilization of the calcium transport blockers as potential chemothera-

peutics in treatment of solid tumors

Typ projektu: APVV

Principal investigator: Oľga Križanová


Trial registration: number: APVV-16-0246


Yes



0

Disclosure of the molecular mechanism of spontaneous tumor regression

followed by the development of novel prognostic tool


Principal investigator: Ján Lakota




Yes



0

Mechanism of the mesenchymal stromal cell-induced tolerance to anti-

tumor treatment and targeted therapeutic intervention in breast cancer

cells


Principal investigator: Svetlana Miklíková




Yes



1, Slovakia: 1

Impact of comorbidity therapy on tumorigenesis and a role of the tumor

microenvironment in this process


Principal investigator: Jaromír Pastorek




Yes



1 – National Cancer Institute (Juraj Pechan)

The role of CA IX in adaptation to tumor microenvironment and in resist-

ance to anticancer therapy: molecular mechanisms and clinical implica-

tions

Typ projektu: APVV

Principal investigator: Silvia Pastoreková




Yes



0

Prognostic biomarker for colorectal carcinoma based on miRNA analysis

and characterization of selected proteins in the circadian context


Principal investigator: Ján Sedlák




Yes



2, Slovakia: 2

Targeting DNA methylation by epigenetic editing and its implementation

in personalized diagnostics and therapy of uveal melanoma



Duration of project: August 1, 2018 / June 30, 2022



Yes



1, Slovakia: 1

Elucidation of novel pro-metastatic functions of tumor-associated car-

bonic anhydrase IX and its cross-talk with pro-inflammatory response


Principal investigator: Eliška Švastová




Yes



0

8786


Micro-RNA expression profiles for discrimination of endometrioid and se-

rous types of endometrial cancer

Type of project: MoH SR

Principal investigator: Ivana Fridrichová

Duration of project: December 1, 2018 / December 31, 2020

Trial registration number: 2018/45-SAV-4


Yes



0

Molecular biomarkers of relapse in seminoma clinical stage I patients


Principal investigator: Miroslav Chovanec

Duration of project: October 1, 2019 / December 21, 2021

Trial registration number: 2019/57-BMCSAV-1


Yes



1, Slovakia: 1

Development of novel diagnostic and predictive high-dimensional immu-

nophenotyping tool for hematological malignancies



Duration of project: November 1, 2019 / December 31, 2021



Yes



0

Role of hydrogen sulfide in cytoskeleton remodelation in colorectal car-

cinoma cells; impact on activity of taxanes


Principal investigator: Oľga Križanová

Duration of project: December 1, 2019 / December 31, 2021



Yes



0

Markers overlapping chemoresistance and metastatic potential in

colorectal cancer - alhedyde dehydrogenase and its clinical relevance


Principal investigator: Miroslava Matúšková

Duration of project: November 1, 2019 / December 31, 2021



Yes



0

Other activities of Biomedical Research Center in research, development, education and popularization in oncology

Cooperation with Cancer Research Foundation (Nadácia Výskum rakoviny, NVR)NVR promotes and supports projects concerning oncology research, cooperation, participation of experts in specialist conferences and public awareness campaigns about the goals and results of oncology research; it also tries to improve the level of education and skills of young scientists in oncology by competitions and grants. Since 2016, it has cooperated with Biomedical Research Center SAS as an indi-vidual legal entity and its activities promote and support the Cancer

Research Center of BMC SAS as well as scientific results of its em-ployees. The foundation also supports the efforts to update laboratory and diagnostic equipment of the institute. NVR in cooperation with BMC SAS organizes annual national cycle of popularization-educa-tion seminars for high school students called Scientific Workshops – Oncology (Vedecké dielne – onkológia).

Scientific Workshops – OncologyBiomedical Research Center SAS in cooperation with Cancer Research Foundation organized the 9th annual popularization-education sem-inars “Scientific Workshops – Oncology” in 2019. The workshops be-gin on World Cancer Day and end on World Cancer Research Day. During this period, post-graduate students and researchers of the Cancer Research Institute of BMC SAS visit high schools all around Slovakia. Their goal is to show future high school graduates that it is possible to participate in cutting-edge research in Slovakia and un-derline the need of cancer prevention at all levels – from avoiding harmful effects of smoking, drinking (especially episodic) and un-healthy diet, to routine check-ups, coping with stress and healthy lifestyle choices.

These projects of BMC SAS fulfill the idea of World Cancer Day, which makes it one of the few active participants representing Slovakia in this movement. In 2019, the main theme of World Cancer Day was “I Am and I Will”, which was also the main topic of lectures of the workshops. 103 individual lectures by renowned researchers (16 lec-turers, 52 lectures) and post-graduate students from Cancer Re-

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search Center BMC SAS (12 lecturers, 51 lectures) took place altogeth-er in two-hour blocks at 35 high schools in all Slovak regions (5 high schools and 1 vocational chemical school in Bratislava region, 4 high schools in Nitra region, 3 high schools in Trnava region, 3 high schools in Trenčín region, 10 high schools in Žilina region, 2 high schools in Banská Bystrica region, 1 high school in Košice region and 6 high schools in Prešov region). The project raised awareness about the top-ic of oncology among young people with the goal to attract talent-ed students to study at faculties of medicine or natural sciences in Slovakia and eventually become future graduate and post-graduate students and work in oncology research.

On June 10 – 13, 2019, Cancer Research Foundation and Cancer Re-search Center BMC SAS organized an international scientific event Genetic Toxicology and Cancer Prevention 2019 (Genetická toxikoló-gia a prevencia rakoviny 2019) in congress center in Smolenice. Ex-perts from Slovakia and Czech Republic presented 32 lectures at the conference and one renowned researcher, Dr. Mária Dušinská, PhD., DSc. came from Norwegian Institute for Air Research, Norway. This regular gathering of Czech and Slovak scientists, researchers and post-graduate students provides space for expert discussion about current scientific issues, exchange of experiences, new ideas and pos-sibilities for future cooperation. The event is also a good opportu-nity for young post-graduate students to present and discuss their own results with experts. The next conference will take place in 2021 (http://www.biomedcentrum.sav.sk/geneticka-toxikologia-a-preven-cia-rakoviny/).

6.5. Research and development – challenges for 2020

• Strengthening the position of Slovak Cooperative Oncology Group (SCOG)

• Coordinated cooperation with SLOVACRIN and other Slovak or-ganizations promoting clinical research

• Creation of the concept of stimulating environment for clinical and pre-clinical oncology research in Slovakia, closely intercon-nected with standard healthcare

• Strengthening international cooperation • Support of education in science and research• Development of research projects for patients after cancer treat-

ment• Establishment of biobank

Accreditation of study programs and education

7.

http://www.biomedcentrum.sav.sk/geneticka-toxikologia-a-prevencia-rakoviny/

http://www.biomedcentrum.sav.sk/geneticka-toxikologia-a-prevencia-rakoviny/

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7.1. Accreditation of study programs – clinical oncology

Specialist supervisor of the program:Prof. Dr. Michal Mego, D.Sc.

Lecturers for theoretical subjects:Silvia Capíková, MSc. et MSc. PhD.Assoc. Prof. Dr. Ľuboš Drgoňa, PhD.Dr. Eva Chandogová, PhD., MPHDr. Peter KasanProf. Dr. Jozef Mardiak, PhD., Prof. Dr. Michal Mego, D.Sc.Assoc. Prof. Dr. Eva Morovicsová, PhD., MPHprof. Dr. Dalibor Ondruš, D.Sc.Assoc. Prof. Dr. Vojtech Ozorovský, PhD.Dr. Tomáš Šálekprof. Dr. Stanislav Špánik, PhD.Dr. Jozef Šufliarsky, PhD.

Lecturers for practical subjects:Assoc. Prof. Dr. Michal Chovanec, PhD.Assoc. Prof. Dr. Ľuboš Drgoňa, PhD. Dr. Peter KasanAssoc. Prof. Dr. Viera Lehotská, PhD.Prof. Dr. Jozef Mardiak, PhD.Prof. Dr. Michal Mego, D.Sc.Dr. Patrik Palacka, PhD., MPH, MBA, LL.M.Dr. Margita Pobijáková, PhD.Dr. Štefan PörsökDr. Jana Obertová, PhD.Dr. Iveta Oravcová, PhD.Dr. Katarina Rejlekova, PhD.Dr. Tomáš ŠálekDr. Jozef Šufliarsky, PhD.Dr. Andrej Vranovský, PhD.

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Examination board

Chairman:Prof. Dr. Michal Mego, D.Sc., FMCU Bratislava

Members:Assoc. Prof. Dr. Ľuboš Drgoňa, PhD., FMCU BratislavaProf. Dr. Jozef Mardiak, PhD., FMCU BratislavaProf. Dr. Michal Mego, D.Sc., FMCU BratislavaProf. Dr. Dalibor Ondruš, D.Sc., FMCU BratislavaDr. Tomáš Šálek, NCI BratislavaProf. Dr. Stanislav Špánik, PhD., FMCU BratislavaDr. Jozef Šufliarsky, PhD., FMCU BratislavaAssoc. Prof. Dr. Mária Wagnerová, PhD., ESOI Košice

7.1.1. List of associate professors and professors of oncology

Assoc. Prof. Dr. Ľuboš Drgoňa, PhD.Assoc. Prof. Dr. Lýdia Heľpianska, PhD.Assoc. Prof. Dr. Michal Chovanec, PhD.Prof. Dr. Jozef Mardiak, PhD.Prof. Dr. Michal Mego, D.Sc.Prof. Dr. Dalibor Ondruš, D.Sc.Assoc. Prof. Mária Wagnerová, PhD.

7.1.2. List of physicians board-certified in 2019

I/2019Dr. Magdaléna JablonickáDr. Natália PazderováDr. Katarína Švábová

II/2019Dr. Róbert Biel

7.1.3. Finished post-graduate, habilitation and inaugural programs in 2019

Assoc. Prof. Dr. Michal Chovanec, PhD.

7.2. Program accreditation – pediatric hematology and oncology

Specialist supervisor of the program: Assoc. Prof. Dr. Alexandra Kolenová, PhD.

Lecturers for theoretical subjects:Assoc. Prof. Dr. Emília Kaiserová, PhD., FMCU BratislavaAssoc. Prof. Dr. Jozef Mardiak, PhD., FMCU BratislavaAssoc. Prof. Dr. Martin Mistrík, PhD., FMCU Bratislava

Lecturers for practical subjects:Assoc. Prof. Dr. Alexandra Kolenová, PhD. Dr. Oksana Fabri Dr. Monika Grešíková Dr. Andrea Hrašková Dr. Judita Puškáčová, PhD. Dr. Daniela Sejnová Dr. Peter Švec

7.3. Accreditation of study programs – radiation oncology

Radiation Oncology Clinic of SMU and SECI provide post-graduate education in radiation oncology. The head of the clinic is Dr. Elena Bolješikova, PhD. and employees are Dr. Monika Šándorová and pro-fessional instructor Maria Knežovičová.

The structure of post-graduate education in EU countries should fol-low the provisions of a document approved by the European Union of Medical Specialists (UEMS). The document includes all aspects of 5-year specialization course and evaluation of understanding. It was published in the Radiotherapy and Oncology magazine in December 2019. The European Union of Medical Specialists has also approved a new curriculum of the specialized course in radiation oncology.

Program accreditation – radiation oncology

Specialist supervisor of the program:Dr. Elena Bolješiková, PhD.

Lecturers for theoretical subjects:Dr. Elena Bolješíková, PhD. Jozef Greždo, MSc. PhD.Assoc. Prof. Dr. Pavol Dubinský, PhD., MHAAssoc. Prof. Dr. Richard Hrubý, PhD., MBADr. Martin Chorváth, PhD., MPHAssoc. Prof. Dr. Gabriel Králik, PhD.Dr. Andrea LigačováDr. Pavol LukačkoDr. Monika Šándorováprof. Dr. Stanislav Špánik, PhD.Dr. Monika ŠvantnerováDr. Martina Vorobjov

Lecturers for practical subjects:Dr. Elena Bolješíková, PhD. Assoc. Prof. Dr. Pavol Dubinský, PhD., MHAJozef Greždo, MSc. PhD.Assoc. Prof. Dr. Richard Hrubý, PhD., MBADr. Martin Chorváth, PhD., MPHAssoc. Prof. Dr. Gabriel Králik, PhD.Dr. Pavol Lukačko

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Dr. Margita Pobijaková, PhD.Dr. Martina Vorobjov Dr. Monika ŠándorováProf. Dr. Stanislav Špánik, PhD.Dr. Monika Švantnerová

Examination board

Chiarman:Dr. Elena Bolješíková, PhD.

Members: Assoc. Prof. Dr. Gabriel Králik, PhD.Dr. Monika Šándorováprof. Dr. Stanislav Špánik, PhD.

List of physicians board-certified in 1/2019:Dr. Marin DžongovDr. Andrea Martinková

7.4. Specialization in palliative medicine

A specialization course in palliative medicine takes place at the Slovak Medical University in Bratislava and the base of education is provided by the Department of Clinical Oncology F – Palliative Medicine at the 2nd Oncology Clinic of the Faculty of Medicine Comenius University and National Cancer Institute. The department had been led by Dr. Kristína Križanová since its establishment until January 1, 2019, when she was replaced by Dr. Andrea Škripeková, PhD.

There are currently 13 physicians certified in palliative care, of which 9 physicians work actively in this field. A further 26 physicians are currently doing the specialization course, of which 10 physicians started in 2019.

7.5. Education

7.5.1. Domestic expert events supervised by SOS and SSRO in 2019:

Date Event Location

01/18 – 01/19/20192nd Conference of Slovak Head and Neck Cancer Cooperative Group (2. konferencia Slovenskej kooperatívnej skupiny pre nádory hlavy a krku)

Banská Štiavnica

03/15 – 03/16/2019 13th Expert Conference on Breast Cancer and Gynecology (13. Odborné podujatie na tému karcinóm prsníka a gynekológia)

Lindner Hotel Gallery Central, Bratislava

06/06 – 06/07/201924th SEKCAMA International Conference (24. medzinárodná konferencia SEKCAMA (Sekcia pre karcinóm prsníka)

Holiday Inn, Bratislava

06/21 – 06/22/2019 Banská Bystrica Oncology Days (Banskobystrické onkologické dni) Hotel Kaskády, Sliač-Sielnica

06/14/2019 News from ASCO® (Novinky z ASCO®) Hotel Austria Trend, Bratislava

09/19 – 09/20/201956th Bratislava Oncology Days (56. ročník - Bratislavské onkologické dni), main topic: Immunotherapy of oncological diseases

Holiday Inn, Bratislava

10/03 – 10/05/2019 15th Young Oncologists’ Days (15. ročník Dni mladých onkológov) Hotel Slupka, Tále

10/25 – 10/26/2019 ONKOspektrum 2019 Hotel Kaskády, Sliač-Sielnica

11/08 – 11/09/2019XIII. Current Situation in Lung Cancer Treatment (Aktuálny stav v liečbe karcinómu pľúc) / XVII. Current Issues in the Management of Gastrointestinal Malignancies (Aktuálne problémy v manažmente gastrointestinálnych malignitít)

Hotel Kaskády, Sliač-Sielnica

11/15 – 11/16/2019 News in genitourinary malignancies (Novinky v genitourinárnych malignitách) Hotel Tenis, Zvolen

11/26/2019 Forum Acta Prostatica 2019 SECI Bratislava

11/28 – 11/30/2019 23rd Košice Chemotherapy Days (23. ročník – Košické chemoterapeutické dni) Hotel Yasmin, Košice

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7.5.2. Selected international expert events in 2019:

Date Event Location

01/24 – 01/26/2019 Prague Multidisciplinary Oncology Colloquium Prague, Czech Republic

02/14 – 02/16/2019 ASCO Genitourinary Cancers Symposium San Francisco, USA

02/17 – 02/19/2019 ASCO Gastrointestinal Cancers Symposium San Francisco, USA

03/27 – 03/30/2019 Society of Surgical Oncology Annual Cancer Symposium San Diego, USA

03/29 – 04/12/2019 AACR Annual Meeting Atlanta, USA

04/10 – 04/12/2019 43th Brno Oncology Days Brno, Czech Republic

05/02 – 05/04/2019 ESMO Breast Cancer Conference Berlin, Germany

05/31 – 06/04/2019 ASCO Annual Meeting Chicago, USA

07/03 – 07/06/2019 ESMO World Congress on Gastrointestinal Cancer Barcelona, Spain

09/07 – 09/10/2019 IASLC/WCLC Barcelona, Spain

09/15 – 09/18/2019 ASTRO Annual Meeting Chicago, USA

10/19 – 10/23/2019 ESMO Annual Meeting Munich, Germany

11/06 – 11/08/2019 Chemotherapy Foundation Symposium New York, USA

12/07 – 12/10/2019 ASH Orlando, USA

12/10 – 12/14/2019 San Antonio Breast Cancer Symposium San Antonio, USA

7.5.3. Domestic and international expert events in pediatric oncology in 2019:

Date Event

March 2019 Slovak Conference of Pediatric Hematologists, Oncologists and Transfusiologists

November 2019 Czecho-Slovak Conference

September 2019IInd International Workshop for Central and Eastern Europe, lecturing team from Children’s Hospital of Philadelphia, supervisor Prof. Stephen Hunger

October 2019 SIOP Conference, Lyon, France

December 2019 ASH, Orlando, USA

7.5.4. Other opportunities for education

Master class in Clinical Oncologyapproximately 60 participants, free interactive workshop about clin-ical oncology, overview of oncology lectured by world-renowned ex-perts; participants must send their CV, motivation letter, case study and recommendation from their home supervisor; travel expenses are not reimbursedMore information at: www.eso.net

ESMO Master class approximately 40 participants, focused on clinical researchMore information at: www.esmo.org

Methods in Clinical Cancer Research (previously Flims Protocol Development Workshop) approximately 80 participants, reimbursed workshop focused on clin-ical research in oncology; participants must send their CV, motivation letter, protocol proposal and recommendation from their home su-pervisor; travel expenses are included in registration feeMore information at: https://www.eortc.org/events/, www.esmo.org

Salzburg Oncology Seminar týždňový seminár z onkológie, je potrebné zaslať CV, motivačný list, odporúčanie od nadriadenéhoInformácie na:https://www.aaf-online.org/index.php/omi-salzbu-rg-medical-seminars.html

ESMO fellowshipsapplications can be sent several times per year for fellowships of dif-ferent duration and focusMore information at: www.esmo.org

UICC fellowships applications can be sent several times per year for fellowships of dif-ferent duration and focusMore information at: https://www.uicc.org/what-we-do/capaci-ty-building/fellowships

NOI grant intended for short-term fellowships abroad; calls are open twice a year (January, June), grants are awarded in a competition based on evaluation by an independent scientific committee for NOI grants; applicants must send a motivation letter, CV, recommendation from their home institution and acceptation letter from the receiving in-stitution with specified dates when the fellowship will take placeMore information at: https://www.noisk.sk/lekar/veda-a-vyskum/noi-granty

Education in radiation oncology In 2019, education in radiation oncology took place at the Radiation Oncology Clinic of St. Elizabeth Cancer Institute. The participants of the 8-week-long course practiced radiation techniques for different locations of malignancies, entering radiation volumes in CT sections, image fusions, planning, special radiation techniques such as IM-

http://www.eso.net

http://www.esmo.org

https://www.eortc.org/events/

http://www.esmo.org

https://www.aaf-online.org/index.php/omi-salzburg-medical-seminars.html

https://www.aaf-online.org/index.php/omi-salzburg-medical-seminars.html

http://www.esmo.org

https://www.uicc.org/what-we-do/capacity-building/fellowships

https://www.uicc.org/what-we-do/capacity-building/fellowships



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RT, VMAT, SRS, TBI, and pediatric malignancies in terms of external radiotherapy/brachytherapy. During consultations, the participants could get acquainted with knowledge from radiotherapy, radiobiol-ogy, medical physics and clinical oncology. A Supervision Day (Kon-trolný deň) took place on September 18 and September 25, 2019, which allowed monitoring the specialization course, verifying practical skills, setting methodical guidelines for approximately 20 residents involved in the specialization study and provided 3 professional lec-tures about selected topics from radiation oncology.

List of IAEA/ESTRO courses in 2019 TC project RER/6/036Comprehensive Quality Management in Radiotherapy, 02/18 – 02/21/2019, MoscowCourse on Target Volume Determination – from Imaging to Margins, 06/02 – 06/05/2019, AthensCourse on IMRT and Other Conformal Techniques in Practice,06/02 – 06/06/2019, BudapestCourse on Evidence Based Radiation Oncology, 06/24 – 06/29/2019, MontpellierCourse on Advanced Treatment Planning, 09/22 – 09/26/2019, BudapestCourse on Best Practice in Radiation Oncology – Train the RTT (Radiation Therapists) Trainers – Part II, 10/14 – 10/16/2019, Vienna


7.6.1. Planned domestic expert events supervised by SOS and SSRO in 2020:

Date Event Location

01/24 – 01/25/20203rd Conference of Slovak Head and Neck Cancer Cooperative Group (3. konferencia Slovenskej kooperatívnej skupiny pre nádory hlavy a krku)

Hotel Jánošík, Liptovský Mikuláš

03/13 – 03/14/2020 Lymphoma Forum 2020 Double Tree by Hilton, Bratislava

05/14 – 05/15/2020 SEKCAMA Holiday Inn, Bratislava

05/22 – 05/23/20205th Slovak Society of Radiation Oncology Conference (5. konferencia Slovenskej spoločnosti radiačnej onkológie)

Hotel Yasmin, Košice

06/12/2020 12th News from ASCO 2020 (Novinky z ASCO 2020) Hotel Carlton, Bratislava

06/18 – 06/19/2020 XI. Bardejov Days (Bardejovské dni) Hotel Alexander, Bardejovské kúpele

09/10 – 09/12/2020 16th Annual Young Oncologists’ Days (16. ročník Dni mladých onkológov) Hotel Slovan, Tatranská Lomnica

10/01 – 10/02/2020 57th Bratislava Oncology Days (57. ročník - Bratislavské onkologické dni) Holiday Inn, Bratislava

Date TBA ONKOspektrum Location TBA

11/06 – 11/08/2020

Current Situation in Lung Cancer Treatment (Aktuálny stav v liečbe karcinómu pľúc) / Current Management of Breast Cancer and Gynecological Malignancies (Aktuálny manažment karcinómu prsníka a gynekologických malignít) / Current Issues in the Management of Gastrointestinal Malignancies (Aktuálne problémy v manažmente GI malignít)

Hotel Kaskády, Sliač-Sielnica

11/26 – 11/28/2020 23rd Košice Chemotherapy Days (23. ročník - Košické chemoterapeutické dni) Hotel Yasmin, Košice

Date TBA News in Genitourinary Malignancies (Novinky v genitourinárnych malignitách) Location TBA

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7.6.2. Planned selected international expert events in 2020:

Date Event Location

02/12 – 02/15/2020 ECCO 2020 Vienna

02/13 – 02/15/2020 ASCO GU 2020 San Francisco

03/22 – 03/25/2020 EBMT 2020 Madrid

03/22 – 03/25/2020 EAU 2020 Amsterdam

04/22 – 04/24/2020 Brno Oncology Days 2020 Brno

05/29 – 06/02/2020 ASCO Annual Meeting 2020 Chicago

06/11 – 06/14/2020 EHA Annual Meeting 2020 Frankfurt

09/18 – 09/22/2020 ESMO Annual Meeting 2020 Madrid

12/08 – 12/12/2020 San Antonio Breast Cancer Symposium San Antonio

7.6.3. Planned domestic and international expert events about pediatric oncology in 2020:

Date Event

03/19/2020 Leukemia Group Meeting, Bergamo

03/27/2020 Slovak Conference of Pediatric Hematologists, Oncologists and Transfusiologists, Bratislava

05/04 – 05/08/2020 SIOP Conference, Valencia, Spain

09/21 – 09/22/2020 International Workshop for Central and Eastern Europe, lecturer from USA Amy Brown (Ethical Aspects in Pediatric Oncology)

09/2020 COG, USA

10/14 – 10/18/2020 SIOP 2020: Congress of The International Society of Pediatric Oncology, Canada

10/23 – 10/25/2020 Czecho-Slovak Conference of Pediatric Oncologists and Hematologists, Bardejov

Publication activity in 2019 8.

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8.1. Publications in extenso in foreign journals with impact factor

Summary

Number of publications in extenso

Numbers of ab-stracts at interna-tional conferences

Genitourinary malignancies

13 5

Breast cancer 3 1

Hematological malignancies

1 0

Supportive therapy 4 1

Gynecological malignancies

1 1

Number of publications in foreign journals registered in Pubmed/Medline database

Clinical oncologist*

First/last author

Co-author Total

Drgoňa L 0 5 5

Chovanec M 4 9 13

Mardiak J 2 3 5

Mego M 6 9 15

Rejleková K 1 4 5

Obertová J 0 2 2

Syčová-Milá Z 0 2 2

Palacka P 0 2 2

*Author/co-author of at least 2 papers

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8.2. Publications in extenso in foreign journals – pediatric oncology/hematology

Summary

Number of publications in extenso

Number of abstracts at international conferences

Pediatric oncology/hematology

5 5

Number of publications in foreign journals registered in Pubmed/Medline database

Pediatric oncologist – hematologist*

First/last author

Co-author Total

Kolenová A 3 2 5

Vaská A 1 1 2

Skalická K 1 1 2

Čermák M 1 1 2

Švec P 1 1 2

*Author/co-author of at least 2 papers

Genitourinary malignancies 1. Chovanec M, Cheng L. Molecular characterization of testicular germ cell

tumors: chasing the underlying pathways. Editorial. Future Oncol. 2019 Jan;15(3):227-229

2. Casadei C, Schepisi G, Menna C, Chovanec M, Gurioli G, Gallà V, Altavilla A, Marcellini M, Bellia SR, Lolli C, Mego M, Rosti G, De Giorgi U. Reclassification of good-risk seminoma: prognostic factors, novel biomarkers and implications for clinical management Future Oncol. 2019 Mar 18.

3. Pindak D, Rejlekova K, Tomas M, Aziri R, Rovenska E, Puska-cova J, Mego M. Intraoperative tumor lysis syndrome in a giant teratoma: a case report BMC Surg. 2019 Jun 14;19(1):62. doi: 10.1186/s12893-019-0526-4.

4. Chovanec M, Mardiak J, Mego M. Immune mechanisms and possible immune therapy in testicular germ cell tumours Andrology. 2019 Jun 6. doi: 10.1111/andr.12656.

5. Mego M, Svetlovska D, Chovanec M, Reckova M, Rejlekova K, Obertova J, Palacka P, Sycova-Mila Z, De Giorgi U, Mardiak J. Phase II study of avelumab in multiple relapsed/refractory germ cell cancer Invest New Drugs. 2019 Jun 1. doi: 10.1007/s10637-019-00805-4.

6. Hapakova N, Sestakova Z, Holickova A, Hurbanova L, Miskovs-ka V, Chovanec M, Rejlekova K, Svetlovska D, Kalavska K, Ober-tova J, Palacka P, Sycova-Mila Z, Mardiak J, Chovanec M, Mego M. High Endogenous DNA Damage Levels Predict Hematological Toxicity in Testicular Germ Cell Tumor Patients Treated With First-Line Chemotherapy Clin Genitourin Cancer. 2019 Jun 13.

7. Hires M, Jane E, Mego M, Chovanec M, Kasak P, Tkac J. Glycan

Analysis as Biomarkers for Testicular Cancer Diagnostics (Basel). 2019 Oct 22;9(4). pii: E156.

8. Chovanec M, Kalavska K, Mego M, Cheng L. Liquid biopsy in germ cell tumors: biology and clinical management Expert Rev Mol Diagn. 2019 Oct 29:1-8.

9. Schmidtova S, Kalavska K, Gercakova K, Cierna Z, Miklikova S, Smolkova B, Buocikova V, Miskovska V, Durinikova E, Burikova M, Chovanec M, Matuskova M, Mego M, Kucerova L. Disulfiram Over-comes Cisplatin Resistance in Human Embryonal Carcinoma Cells Cancers (Basel). 2019 Aug 22;11(9). pii: E1224.

Gynecological malignancies 1. Ray-Coquard I, Cibula D, Mirza MR, Reuss A, Ricci C, Colombo N,

Koch H, Goffin F, González-Martin A, Ottevanger PB, Baumann K, Bjørge L, Lesoin A, Burges A, Rosenberg P, Gropp-Meier M, Harrela M, Harter P, Frenel JS, Minarik T, Pisano C, Hasenburg A, Merg-er M, du Bois A; AGO Study Group-led GCIG/ ENGOT Intergroup Consortium. Final results from GCIG/ENGOT/AGOOVAR 12, a randomised placebo-controlled phase III trial of nintedanib combined with chemotherapy for newly diagnosed advanced ovarian cancer Int J Cancer. 2019 Aug 5.

Hematological malignancies 1. Kral Z, Michalka J, Mocikova H, Markova J, Sykorova A, Belada D,

Jungova A, Vokurka S, Lukasova M, Prochazka V, Duras J, Hajek R, Dusek L, Drgona L, Ladicka M, Ballova V, Vranovsky A. Treatment of Relapsed/Refractory Hodgkin Lymphoma: Real-World Data from the Czech Republic and Slovakia J Cancer. 2019 Aug 28;10(21):5041-5048.

Breast cancer 1. Mego M, Karaba M, Minarik G, Benca J, Jurisova S, Sedlackova

T, Manasova D, Kalavska K, Pindak D, Cristofanilli M, Reuben JM, Mardiak J. Circulating tumor cells with epithelial-to-mesenchymal transi-tion phenotypes associated with inferior outcomes in primary breast cancer. Anticancer Res. 2019 Apr;39(4):18291837

2. Zmetakova I, Kalinkova L, Smolkova B, Horvathova Kajabova V, Cierna Z, Danihel L, Bohac M, Sedlackova T, Minarik G, Karaba M, Benca J, Cihova M, Buocikova V, Miklikova S, Mego M, Fridrichova I. A disintegrin and metalloprotease 23 hypermethylation predicts decreased disease-free survival in low-risk breast cancer patients Cancer Sci. 2019 Feb 28.

3. De Giorgi U, Mego M, Scarpi E, Giordano A, Giuliano M, Valero V, Alvarez RH, Ueno NT, Cristofanilli M, Reuben JM. Association be-tween circulating tumor cells and peripheral blood monocytes in metastatic breast cancer Ther Adv Med Oncol. 2019 Aug 14; 11:1758835919866065.

Supportive therapy 1. Albasanz-Puig A, Gudiol C, Parody R, Tebe C, Akova M, Araos R,

Bote A, Brunel AS, Calik S, Drgona L, García E, Hemmati P, Her-rera F, Ibrahim KY, Isler B, Kanj S, Kern W, Maestro de la Calle G, Manzur A, Marin JI, MárquezGómez I, Martín-Dávila P, Mikuls-ka M, Montejo JM, Montero M, Morales HMP, Morales I, Novo A, Oltolini C, Peghin M, Del Pozo JL, Puerta-Alcalde P, Ruiz-Camps I, Sipahi OR, Tilley R, Yáñez L, Gomes MZR, Carratalà J; IRONIC study group. Impact of antibiotic resistance on outcomes of neutropenic cancer patients with Pseudomonas aeruginosa bacteraemia (IRONIC study):

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study protocol of a retrospective multicentre international study BMJ Open. 2019 May 24;9(5):e025744.

2. Ricna D, Lengerova M, Bezdicek M, Kocmanova I, Drgona L, Wein-bergerova B, Mayer J, Racil Z. Detection and identification of fungi in bronchoalveolar lavage fluid from immunocompromised patients using pan-fungal PCR. Folia Microbiol (Praha). 2019 May;64(3):421-428.

3. Cornely OA, Alastruey-Izquierdo A, Arenz D, Chen SCA, Dannaoui E, Hochhegger B, Hoenigl M, Jensen HE, Lagrou K, Lewis RE, Mellinghoff SC, Mer M, Pana ZD, Seidel D, Sheppard DC, Wahba R, Akova M, Alanio A, Al-Hatmi AMS, Arikan-Akdagli S, Badali H, Ben-Ami R, Bonifaz A, Bretagne S, Castagnola E, Chayakulkeer-ee M, Colombo AL, CorzoLeón DE, Drgona L, Groll AH, Guinea J, Heussel CP, Ibrahim AS, Kanj SS, Klimko N, Lackner M, Lamoth F, Lanternier F, Lass-Floerl C, Lee DG, Lehrnbecher T, Lmimouni BE, Mares M, Maschmeyer G, Meis JF, Meletiadis J, Morrissey CO, Nuc-ci M, Oladele R, Pagano L, Pasqualotto A, Patel A, Racil Z, Richard-son M, Roilides E, Ruhnke M, Seyedmousavi S, Sidharthan N, Sin-gh N, Sinko J, Skiada A, Slavin M, Soman R, Spellberg B, Steinbach W, Tan BH, Ullmann AJ, Vehreschild JJ, Vehreschild MJGT, Walsh TJ, White PL, Wiederhold NP, Zaoutis T, Chakrabarti A; Mucormy-cosis ECMM MSG Global Guideline Writing Group. Global guideline for the diagnosis and management of mucormycosis: an initiative of the Eu-ropean Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium Lancet Infect Dis. 2019 Dec;19(12):e405-e421. doi: 10.1016/S14733099(19)30312-3.

8.3. Publication activities of BMC SAS in experimental oncology in 2019

Scientific papers in foreign current content journals with impact factor1. ALTANEROVÁ, Uršula - JAKUBECHOVÁ, J. - BENEJOVÁ, K. -

PRISCAKOVÁ, Petra - PESTA, Martin - PITULE, Pavel - TOPOLČAN, O. - KAUŠITZ, Juraj - ZDURIENČÍKOVÁ, Martina - REPISKÁ, V. - ALTANER, Čestmír. Prodrug suicide gene therapy for cancer tar-geted intracellular by mesenchymal stem cell exosomes. In In-ternational journal of cancer, 2019, vol. 144, no. 4, p. 897-908. (4.982 - IF2018). ISSN 0020-7136.

2. BÁNOVÁ, Radivojka - ZDURIENČÍKOVÁ, Martina - TYČIAKOVÁ, Silvia - BENADA, Oldřich - DUBROVČÁKOVÁ, Mária - LAKOTA, Ján - ŠKULTÉTY, Ľudovít. Silencing of carbonic anhydrase I en-hances the malignant potential of exosomes secreted by pros-tatic tumour cells. In Journal of cellular and molecular medicine, 2019, vol. 23, no. 5, p. 3641-3655. (4.658 - IF2018). ISSN 1582-1838. Avail-able online: <https://onlinelibrary.wiley.com/doi/full/10.1111/jc-mm.14265

3. DEBREOVÁ, Michaela - CSÁDEROVÁ, Lucia - BURÍKOVÁ, Moni-ka - LUKÁČIKOVÁ, Ľubomíra - KAJANOVÁ, Ivana - SEDLÁKOVÁ, Oľga - KÉRY, Martin - KOPÁČEK, Juraj - ZAŤOVIČOVÁ, Miriam - BIZIK, Jozef - PASTOREKOVÁ, Silvia - ŠVASTOVÁ, Eliška. CAIX regulates invadopodia formation through both a pH-dependent mechanism and interplay with actin regulatory proteins. In Inter-national Journal of Molecular Sciences, 2019, vol. 20, no. 11, art. no. 2745.

(4.183 - IF2018). ISSN 1422-0067. Available online: <https://www.mdpi.com/1422-0067/20/11/2745

4. DURDÍK, Matúš - KOŠÍK, Pavol - MARKOVÁ, Eva - SOMSEDÍKOVÁ, Alexandra - GAJDOSECHOVA, Beata - NIKITINA, Ekaterina - HOR-VÁTHOVÁ, Eva - KOZICS, Katarína - DAVIS, Devra - BELYAEV, Igor. Microwaves from mobile phone induce reactive oxygen species but not DNA damage, preleukemic fusion genes and apoptosis in hematopoietic stem/progenitor cells. In Scientific Reports, 2019, vol. 9, art. no. 16182. (4.011 - IF2018). (2019 - Current Contents, WOS, SCOPUS). ISSN 2045-2322. Available online: <https://www.nature.com/articles/s41598-019-52389-x

5. GOLIAŠ, Tereza - KÉRY, Martin - RADENKOVIČ, Silvia - PAPAN-DREOU, Ioanna. Microenvironmental control of glucose metab-olism in tumors by regulation of pyruvate dehydrogenase. In In-ternational journal of cancer, 2019, vol. 144, no. 4, p. 674-686. (4.982 - IF2018). ISSN 0020-7136.

6. HAPAKOVÁ, Nikola - ŠESTÁKOVÁ, Zuzana - HOLÍČKOVÁ, Andrea - HURBANOVÁ, Lenka - MIŠKOVSKÁ, V. - CHOVANEC, Michal - REJLEKOVÁ, Katarína - SVETLOVSKÁ, D. - KAĽAVSKÁ, Katarína - OBERTOVÁ, Jana - PALACKA, Patrik - SYCOVA MILA, Zuzana - MARDIAK, Jozef - CHOVANEC, Miroslav - MEGO, Michal. High Endogenous DNA Damage Levels Predict Hematological Toxicity in Testicular Germ Cell Tumor Patients Treated With First-Line Chemotherapy. In Clinical Genitourinary Cancer, 2019, vol. 17, no. 5, p. e1020-e1025. (2.450 - IF2018). ISSN 1558-7673

7. HUNÁKOVÁ, Ľuba - HORVÁTHOVÁ, Eva - MAJEROVÁ, Karolína - BOBÁL, Pavel - OTEVREL, Jan - BRTKO, Július. Genotoxic effects

of tributyltin and triphenyltin isothiocyanates, cognate RXR lig-ands: comparison in human breast carcinoma MCF 7 and MDA-MB-231 cells. In International Journal of Molecular Sciences, 2019, vol. 20, no. 5, p. 1198. (4.183 - IF2018). ISSN 1422-0067. Available online: <https://www.mdpi.com/1422-0067/20/5/1198

8. HUNÁKOVÁ, Ľuba - HORVÁTHOVÁ, Eva - GRONESOVÁ, Paulína - BOBÁL, Pavel - OTEVREL, Jan - BRTKO, Július. Triorganotin iso-thiocyanates affect migration and immune check-point receptors in human triple-negative breast carcinoma MDA-MB-231 cells. In Anticancer Research, 2019, vol. 39, no. 9, p. 4845-4851. (1.935 - IF2018). ISSN 0250-7005

9. KHARMA, Ammar - MIŠÁK, Anton - GRMAN, Marián - BRE-ZOVÁ, Vlasta - KURAKOVÁ, Lucia - BARÁTH, Peter - JACOB, Claus - CHOVANEC, Miroslav - ONDRIAŠ, Karol - DOMÍNGUEZ-ÁLVA-REZ, Enrique**. Release of reactive selenium species from phthal-ic selenoanhydride in the presence of hydrogen sulfide and glu-tathione with implications for cancer research. In New Journal of Chemistry, 2019, vol. 43, no. 29, p. 11771-11783. (3.069 - IF2018). ISSN 1144-0546. Available online: https://pubs.rsc.org/en/content/arti-clelanding/2019/nj/c9nj02245g#!divAbstract

10. KUBOVČÍKOVÁ, Martina - KONERACKÁ, Martina** - STRBAK, O. - MOLČAN, Matúš - ZÁVIŠOVÁ, Vlasta - ANTAL, Iryna - KHMA-RA, Iryna - LUČANSKÁ, Daša - TOMČO, Ladislav - BARÁTHOVÁ, Monika - ZAŤOVIČOVÁ, Miriam - DOBROTA, D. - PASTOREKOVÁ, Silvia - KOPČANSKÝ, Peter. Poly-L-lysine designed magnetic na-noparticles for combined hyperthermia, magnetic resonance im-aging and cancer cell detection. In Journal of Magnetism and Magnetic

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Materials, 2019, vol. 475, p. 316-326. (2.683 - IF2018). (2019 - Current Contents, WOS, SCOPUS). ISSN 0304-8853.

11. MAJERNÍK, M. - JENDŽELOVSKÝ, R. - BABINČÁK, Marián - KOŠUTH, Ján - ŠEVC, Juraj - GOMBALOVÁ, Zuzana - JENDŽELOVSKÁ, Zuzana - BURÍKOVÁ, Monika - FEDOROČKO, Peter**. Novel insights into the effect of hyperforin and photo-dynamic therapy with hypericin on chosen angiogenic factors in colorectal micro-tumors created on chorioallantoic membrane. In International Journal of Molecular Sciences, 2019, vol. 20, no. 12, art. no. 3004. (4.183 - IF2018). ISSN 1422-0067. Available online: www.mdpi.com/1422-0067/20/12/3004

12. MAKINISTIAN, Leonardo - MARKOVÁ, Eva - BELYAEV, Igor. A high throughput screening system of coils for ELF magnetic fields ex-periments: proof of concept on the proliferation of cancer cell lines. In BMC Cancer, 2019, vol. 19, art. no. 188. (2.933 - IF2018). ISSN 1471-2407. Available online: https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC6396543/pdf/12885_2019_Article_5376.pdf

13. MEGO, Michal - AGTHOVEN, Ton van - GRONESOVÁ, Paulína - CHOVANEC, Michal - MIŠKOVSKÁ, V. - MARDIAK, Jozef - LOO-IJENGA, Leendert H.J. Clinical utility of plasma miR-371a-3p in germ cell tumors. In Journal of cellular and molecular medicine, 2019, vol. 23, no. 2, p. 1128-1136. (4.658 - IF2018). ISSN 1582-1838. Available online: https://onlinelibrary.wiley.com/doi/full/10.1111/jcmm.14013

14. MILATA, Viktor - SVEDOVÁ, Alexandra - BARBIERIKOVÁ, Zuza-na - HOLUBKOVÁ, Eva - ČIPÁKOVÁ, Ingrid - CHOLUJOVÁ, Dana - JAKUBÍKOVÁ, Jana - PÁNIK, Miroslav - JANTOVÁ, Soňa - BRE-ZOVÁ, Vlasta - ČIPÁK, Ľuboš. Synthesis and anticancer activity

of novel 9-O-substituted berberine derivatives. In International Journal of Molecular Sciences, 2019, vol. 20, no. 9, art.no. 2169. (4.183 - IF2018). ISSN 1422-0067. Available online: www.mdpi.com/1422-0067/20/9/2169

15. OPATTOVÁ, A.** - HORÁK, J. - VODENKOVÁ, Soňa - KOSTOVCIK-OVÁ, Klara - CUMOVÁ, Andrea - MACINGA, Peter - GALANOVÁ, Natalie - REJHOVÁ, Alexandra - VODIČKOVÁ, Ľudmila - KOZICS, Katarína - TURNOVCOVÁ, Karolina - HUCL, Tomas - SLIVA, Daniel - VODIČKA, Pavel**. Ganoderma Lucidum induces oxidative DNA damage and enhances the effect of 5-Fluorouracil in colorectal cancer in vitro and in vivo. In Mutation research-genetic toxicology and environmental mutagenesis, 2019, vol. 845, art.no. 403065. (2.256 - IF2018). ISSN 1383-5718.

16. PLAVÁ, Jana - CIHOVÁ, Marína - BURÍKOVÁ, Monika - MATÚŠK-OVÁ, Miroslava - KUČEROVÁ, Lucia - MIKLÍKOVÁ, Svetlana**. Recent advances in understanding tumor stroma-mediated chemoresistance in breast cancer. In Molecular Cancer, 2019, vol. 18, p. 67. (10.679 - IF2018). ISSN 1476-4598. Available online: https://molecular-cancer.biomedcentral.com/articles/10.1186/s12943-019-0960-z

17. POTURNAYOVÁ, Alexandra - BURÍKOVÁ, Monika - BIZIK, Jozef - HIANIK, Tibor. DNA Aptamers in the Detection of Leukemia Cells by the Thickness Shear Mode Acoustics Method. In ChemPhysChem, 2019, vol. 20, no. 4, p. 545-554. (3.077 - IF2018). ISSN 1439-7641.(APVV-14-0267 : Vývoj progresívnej diagnostickej metódy pre klin-ickú onkológiu založenej na interakcii DNA aptamerov s proteín-mi).

18. REŽUCHOVÁ, Ingeborg - HUDECOVÁ, Soňa - ŠOLTYSOVÁ, Andrea - MATÚŠKOVÁ, Miroslava - ĎURINÍKOVÁ, Erika - CHOVANCOVÁ, Barbora - ZUZCAK, M. - CIHOVÁ, Marína - BURÍKOVÁ, Monika - PENESOVÁ, Adela - LENČEŠOVÁ, Ľubomíra - KRIŽANOVÁ, Oľga**. Type 3 inositol 1,4,5-trisphosphate receptor has antiapoptotic and proliferative role in cancer cells. In Cell Death & Disease, 2019, vol. 10, no. 3, art. 186. (5.959 - IF2018). ISSN 2041-4889. Available online: <https://www.nature.com/articles/s41419-019-1433-4>.

19. SIMUNKOVÁ, Miriama - LAURO, Peter - JOMOVÁ, K. - HUDECOVÁ, Lenka - DANKO, Martin - ALWASEL, Saleh - ALHAZZA, Ibrahim M. - RAJČÁNIOVÁ, Simona - KOZOVSKÁ, Zuzana - KUČEROVÁ, Lucia - MONCOL, Ján - ŠVORC, Ľubomír - VALKO, Marián. Redox-cycling and intercalating properties of novel mixed copper(II) complex-es with non-steroidal anti-inflammatory drugs tolfenamic, me-fenamic and flufenamic acids and phenanthroline functionality: Structure, SOD-mimetic activity, interaction with albumin, DNA damage study and anticancer activity. In Journal of inorganic biochem-istry, 2019, vol. 194, p. 97-113. (3.224 - IF2018). ISSN 0162-0134.

20. SZADVARI, I. - HUDECOVÁ, Soňa - CHOVANCOVÁ, Barbora - MATÚŠKOVÁ, Miroslava - CHOLUJOVÁ, Dana - LENČEŠOVÁ, Ľubomíra - VALERIAN, David - ONDRIAŠ, Karol - BABULA, P. - KRIŽANOVÁ, Oľga. Sodium/calcium exchanger is involved in ap-optosis induced by H2S in tumor cells through decreased levels of intracellular pH. In Nitric Oxide : Biology and Chemistry, 2019, vol. 87, p. 1-9. (3.371 - IF2018). ISSN 1089-8603.

21. ZMETÁKOVÁ, Iveta - KALINKOVÁ, Lenka - SMOLKOVÁ, Bože-na - HORVÁTHOVÁ KAJABOVÁ, Viera - ČIERNA, Zuzana -

DANIHEL, Ľudovít - BOHÁČ, Martin - SEDLÁČKOVÁ, Tatiana - MINÁRIK, Gabriel - KARABA, Marián - BENCA, Juraj - CIHOVÁ, Marína - BUOCIKOVÁ, Verona - MIKLÍKOVÁ, Svetlana - ME-GO, Michal - FRIDRICHOVÁ, Ivana. A disintegrin and metallo-protease 23 hypermethylation predicts decreased disease-free survival in low-risk breast cancer patients. In Cancer Science, 2019, vol. 110, no. 5, p. 1695-1704. (4.751 - IF2018). ISSN 1347-9032. Available online: <https://onlinelibrary.wiley.com/doi/full/10.1111/cas.13985

Scientific papers in domestic current content journals with impact factor22. HUNÁKOVÁ, Ľuba - ZVARÍK, M. - MAJEROVÁ, Karolína - MESTAN-

IK, M. - BELLA, Vladimír - TONHAJZEROVÁ, Ingrid. Cardiovagal regulation and transcutaneous pO2 in breast cancer patients - a pilot study. In Neoplasma, 2019, vol. 66, no. 2, p. 281-287. (1.771 - IF2018). ISSN 0028-2685.(VEGA 2/0092/16 : Biologické účinky prostredia so zníženým množstvom deutéria alebo zvýšeným pH a fyzického cvičenia vo vzť ahu k onkologickým ochoreniam: im-plikácie pre terciárnu prevenciu).

23. KÉRY, Martin - ORAVCOVÁ, Nina - RADENKOVIČ, Silvia - IULIANO, F. - TOMÁŠKOVÁ, Jana - GOLIAŠ, Tereza. Pyruvate dehy-drogenase kinase 1 and carbonic anhydrase IX targeting in hypox-ic tumors. In Neoplasma, 2019, vol. 66, no. 1, p. 63-72. (1.771 - IF2018). ISSN 0028-2685.

24. STROUHALOVÁ, Dana - TOPOROVÁ, Lucia - LASTOVICKOVA, M. - MACEJOVÁ, Dana - BOBÁLOVÁ, Janette - BRTKO, Július. Novel



https://www.ncbi.nlm.nih.gov/pmc/%20articles/PMC6396543/pdf/12885_2019_Article_5376.pdf

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https://www.nature.com/articles/s41419-019-1433-4

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insights into the combined effect of triorganotin compounds and all-trans retinoic acid on expression of selected proteins associat-ed with tumor progression in breast cancer cell line MDA-MB-231: proteomic approach. In General Physiology and Biophysics, 2019, vol. 38, no. 2, p. 135-144. (1.309 - IF2018). ISSN 0231-5882.

25. WACHSMANNOVÁ, Lenka** - ŠTEVURKOVÁ, Viola - ČIERNIKOVÁ, Soňa. Changes in SNAI1 and VIM gene expression in Caco2 cells after co-cultivation with bacteria from colorectal cancer biopsies. In Neoplasma, 2019, vol. 66, no. 2, p. 271-275. (1.771 - IF2018). ISSN 0028-2685

Scientific papers in other foreign journals with impact factor26. FRIDRICHOVÁ, Ivana** - ZMETÁKOVÁ, Iveta. MicroRNAs contrib-

ute to breast cancer invasiveness. In Cells, 2019, vol. 8, art. no. 1361. (5.656 - IF2018). ISSN 2073-4409. Available online: <https://www.mdpi.com/2073-4409/8/11/1361

Scientific papers in other domestic journals without impact factor27. PAULOVÁ, Petronela. Špecifiká vo výžive onkologických pacientov.

In Nutrition news, 2019, vol. 3, no. 1, p. 5-8. ISSN 2585-7711.

Scientific papers in foreign journals with impact factor registered in WOS Core Collection or SCOPUS28. BUGÁROVÁ, Nikola** - ŠPITÁLSKY, Zdenko - MIČUŠÍK, Matej

- BODIK, Michal - ŠIFFALOVIČ, Peter - KONERACKÁ, Martina -

ZÁVIŠOVÁ, Vlasta - KUBOVČÍKOVÁ, Martina - KAJANOVÁ, Ivana - ZAŤOVIČOVÁ, Miriam - PASTOREKOVÁ, Silvia - ŠLOUF, Miroslav - MAJKOVÁ, Eva - OMASTOVÁ, Mária. A multifunctional graphene oxide platform for targeting cancer. In Cancers, 2019, vol. 11, no. 6, art. no. 753, [19] p. (6.162 - IF2018). ISSN 2072-6694.(APVV-14-0120 : Grafenova nanoplatforma na detekciu rakoviny. APVV-15-0641 : Inovatívna MoS2 platforma pre diagnózu a cielenú liečbu rak-oviny).

29. LIŠKOVÁ, Veronika - HUDECOVÁ, Soňa - LENČEŠOVÁ, Ľubomíra - IULIANO, F. - ŠÍROVÁ, Marta - ONDRIAŠ, Karol - PASTOREKOVÁ, Silvia - KRIŽANOVÁ, Oľga**. Type 1 sodium calcium exchanger forms a complex with carbonic anhydrase IX and via reverse mode activity contributes to pH control in hypoxic tumors. In Cancers, 2019, vol. 11, art.no. 1139. (6.162 - IF2018). ISSN 2072-6694

30. MACEJOVÁ, Dana** - PODOBA, Ján - TOPOROVÁ, Lucia - KAJO, Karol - MACHALEKOVA, Katarina - BRTKO, Július. Causal associa-tions of autoimmune thyroiditis and papillary thyroid carcinoma: mRNA expression of selected nuclear receptors and other molec-ular targets. In Oncology Letters, 2019, vol. 18, p. 4270-4277. (1.871 - IF2018). ISSN 1792-1074

31. OBACZ, J. - SOMMEROVA, Lucia - SICARI, Daria - DURECH, Michal - AVRIL, Tony - IULIANO, F. - PASTOREKOVÁ, Silvia - HRSTKA, R. - CHEVET, Eric - DELOM, Frederic - FESSART, Delphine. Extracellu-lar AGR3 regulates breast cancer cells migration via Src signaling. In Oncology Letters, 2019, vol. 18, no. 5, p. 4449-4456. (1.871 - IF2018). ISSN 1792-1074. Available online: <https://www.spandidos-publi-cations.com/10.3892/ol.2019.10849.

32. PASTOREKOVÁ, Silvia - GILLIES, Robert J. The role of carbonic an-hydrase IX in cancer development: links to hypoxia, acidosis, and beyond. In Cancer and Metastasis Reviews, 2019, vol. 38, no. 1-2, p. 65-77. (6.667 - IF2018). ISSN 0167-7659. Available online: https://link.springer.com/article/10.1007/s10555-019-09799-0

33. SCHMIDTOVÁ, Silvia - KAĽAVSKÁ, Katarína - GERČÁKOVÁ, Katarína - ČIERNA, Zuzana - MIKLÍKOVÁ, Svetlana - SMOLKOVÁ, Božena - BUOCIKOVÁ, Verona - MIŠKOVSKÁ, V. - ĎURINÍKOVÁ, Erika - BURÍKOVÁ, Monika - CHOVANEC, Michal - MATÚŠK-OVÁ, Miroslava - MEGO, Michal - KUČEROVÁ, Lucia. Disulfiram overcomes cisplatin resistance in human embryonal carcinoma cells. In Cancers, 2019, vol. 11, art.no. 1224. (6.162 - IF2018). ISSN 2072-6694. Available online: <https://www.mdpi.com/2072-6694/11/9/1224>

Scientific papers in foreign journals without impact registered in WOS Core Collection or SCOPUS34. ALTANER, Čestmír - ALTANEROVÁ, Uršula - JAKUBECHOVÁ, J. In-

tracellular acting tumor cell-targeted chemotherapy by MSC-sui-cide gene exosomes. In Oncotarget, 2019, vol. 10, no. 54, p. 5573-5575. ISSN 1949-2553.

35. POTURNAYOVÁ, Alexandra - DZUBINOVÁ, Ľudmila - BURÍKOVÁ, Monika - BIZIK, Jozef - HIANIK, Tibor. Detection of Breast Cancer Cells Using Acoustics Aptasensor Specific to HER2 Receptors. In Biosensors, 2019, vol. 9, no. 2, art. no. 72. ISSN 2079-6374. Available online: <https://www.mdpi.com/2079-6374/9/2/72>

Scientific papers in domestic journals with impact factor registered in WOS Core Collection or SCOPUS36. MRAVEC, Boris - DUBRAVICKÝ, J. - TIBENSKÝ, Miroslav - HORVÁ-

THOVÁ, Ľubica. Effect of the nervous system on cancer: analysis of clinical studies. In Bratislava Medical Journal, 2019, vol. 120, no. 2, p. 119-123. (0.859 - IF2018). ISSN 0006-9248.

Scientific papers in foreign peer-reviewed anthologies and shorter chapters/essays in foreign scientific monographs or university textbooks37. ALTANER, Čestmír - ALTANEROVÁ, Uršula. Mesenchymal

stem cell exosome-mediated prodrug gene therapy for can-cer. In Suicide Gene Therapy: method and protocols. 1st edition - Humana Press, 2019, p. 75-85. ISBN 978-1-4939-8921-8. ISSN 1064-3745.



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International cooperation 9.

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9.1. Current situation

The 2nd Oncology Clinic at the Faculty of Medicine, Comenius Uni-versity and the National Cancer Institute actively cooperated with renowned international institutions in 2019. The cooperation with University of Texas, MD Anderson Cancer Center in Houston, Tex-as, USA has continued research in the field of circulating tumor cells. Cooperation with Erasmus MC, University Medical Center in Rot-terdam, Netherlands was devoted to testicular germ cell tumors, aim-ing to identify biomarkers and mechanisms of resistance to chemo-therapy. Another international cooperation with Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) in Meldola, Italy continued biomarker research of testicular germ cell tumor bi-omarkers. IRST and Masaryk Cancer Institute in Brno, Czech Re-public have joined an informal working group with National Cancer Institute in Bratislava for conducting investigator-initiated clini-cal trials for testicular germ cell tumors. Cooperation with Indiana University Melvin and Bren Simon Cancer Center, Indiana, USA focused on mechanisms of resistance and late toxicity in testicular

germ cell tumors, as well as urologic surgery. As a result of this col-laboration, a grant proposal to National Institutes of Health, National Cancer Institute in Bethesda, USA, entitled “Disparities in treatment and outcome of germ cell tumors” was submitted, but the funding was not approved. In this proposal, the National Cancer Institute act-ed as the formal leader of the research project. Cooperation with On-tario Cancer Institute, PMH/UHN, Canada is ongoing in the field of biostatistics. As a result of the international cooperation, Slovakia has hosted the foreign experts: Dr. Lawrence Einhorn, distinguished professor of medicine, Dr. Thomas Ulbright,, professor of medicine, Dr. Daren Feldman professor of medicine.A 3-month fellowship at Memorial Sloan Kettering Cancer Center, New York, USA was awarded to Dr. Katarína Rejleková, PhD. and led to initiation of cooperation in super high-risk germ cell tumors research (Assoc. Prof. Dr. Daren Feldman). Another 1-month fellowship took place at University of Texas, MD Anderson Cancer Center in Houston, Texas, USA (Prof. Dr. Michal

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Mego, D.Sc.) within the joint research of breast cancer. Regarding lung cancer and immunotherapy, Slovakia has initiated cooperation with Indiana University Melvin and Bren Simon Cancer Center, Indi-ana, USA, during a 1-month fellowship of Dr. Lenka Medvecová (su-pervisor prof. Dr. Nasser Hanna).Cooperation with centers from the Czech Republic was initiated, par-ticularly with Masaryk Cancer Institute in Brno and Institute of Biostatistics and Analyses at Masaryk Faculty of Medicine in Brno and National Oncology Institute (NOI).Slovak Cooperative Oncology Group (SCOG) started cooperation with the French Genitourinary Group (GETUG) presided by prof. Dr. Karim Fizazi, PhD. and Central European Cooperative Oncology Group (CE-COG) presided by Univ. prof. Dr. Christoph Zielinski.


• Strengthen existing and initiated cooperation with foreign insti-tutions

• Support short-term international fellowships (1 – 3 months) via NOI grants

• Support international foreign projects in order to further estab-lish research and education in oncology, including the participa-tion of foreign experts in Slovak educational events

• Include the principal Slovak oncology conference Bratislava On-cology Days to the ESMO Oncology Meetings Calendar

9.3. International cooperation – pediatric oncology/hematology

Centers for pediatric oncology conducted international collaboration in the following areas in 2019: • Cooperation with Czech Republic (annual conferences with on-

cologists from Czech Republic, diagnostics of minimal residual disease)

• Cooperation with Austria: St. Anna Kinderspital, Vienna, joint solving of complicated patient cases within “tumor board” meet-ings

• Cooperation with Children Hospital of Philadelphia, USA: video-conference once in two months as a “tumor board” meeting; an-nual workshop for young pediatric oncology/hematology fellows

• Cooperation with SIOPe – The European Society for Pediatric On-cology

• Cooperation with I-BFM – International study group for treat-ment of pediatric leukemias and lymphomas

• Cooperation with COG – Children Oncology Group, USA • Cooperation with pediatric oncology and surgery – Paris, France

National Oncology Plan 10.

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vide early and effective diagnostics of asymptomatic diseases.2. Diagnostics and treatment: intended to reduce obstacles for

early diagnostics and treatment and ensure the accessibility of decidedly effective and recommended treatment procedures within standard healthcare, but also fair access to clinical trials for suitable patients.

3. Post-treatment monitoring, follow-up and long-term care: promote the provision of services and resources necessary to sup-port continual physical, mental and social health within a holistic approach to the individual while taking into account rising num-bers of people suffering from an oncological disease.

4. Research and development: support the access to clinical trials and create suitable environment for pre-clinical and clinical re-search including their integration at the national and interna-tional level. It supports continuous education, access to relevant information and their sharing with all stakeholders.

National Oncology Plan (NOP) is a strategic plan with the primary ob-jective to reduce the incidence and mortality of oncological diseases and improve the quality of life of cancer patients by systematic imple-mentation of evidence-based strategies. NOP remains a challenge for the Slovak public and experts mainly in terms of strategic thinking about new needs, partnerships and collective efforts.

NOP objectives are organized more across complex cancer patient care rather than sorted per type of disease, including primary preven-tion. It is not a detailed action plan, rather a strategy plan in complex areas stated as specific goals and evidence-based strategies focusing on the following four areas:

1. Prevention and screening: promote healthy lifestyle and less harmful environment, aiming to reduce the risk of develop-ment of oncological diseases in the Slovak population and pro-

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Update of the National Oncology Program for the following period and preparation of an updated concept of cancer care in Slovakia in cooperation of NOI, MoH SR and relevant experts is a great challenge for 2020.

10.1. Report by Department of Standard Preventive, Diagnostic and Treatment Procedures, MoH SR

In 2018 and 2019, the Department of Standard Preventive, Diagnos-tic and Treatment Procedures (SPDTP) worked hard on the creation of a new National Oncology Plan and proposals (in 2018) and 1st re-view (in 2019) of standard preventive procedures for oncological dis-eases – colon cancer and breast cancer. Population-based screening programs intended for a defined population most affected by both these diseases were created based on evidence-based medicine in terms of prevention and regulations (legislative, legal and interna-tional recommendations). The SPDTP expert project team and expert working groups (consisting of important stakeholders from a wide array of fields in order to set the regulations correctly) in coopera-tion with the World Health Organization and McMaster Universi-ty in Canada monitor scientific literature and best practices in the framework of continuous development and implementation process of standard preventive procedures for oncological diseases.

SPDTP also monitor a set of recommendations by international in-stitutions composed of preventive and clinical recommendations for

new evidence which can cause a change of current recommenda-tions or creation of brand-new standard procedures, procedures for patient safety (reduction or elimination of risks related to screening methods) or implementation of clinical audit. International cooper-ation is important also in terms of identification of the right indi-cators for monitoring of these diseases or risk factors and new in-formation about screenings which should be provided to healthcare professionals as well as target population groups. This is why the Na-tional Oncology Institute (NOI) created several auxiliary methodol-ogies for the implementation of standard preventive procedures for oncological diseases, e.g. for reporting of healthcare procedures re-lated to screening to health insurance companies, the manner of inviting patients to screening or the course of action if the cancer screening shows a positive or negative result. SPDTP in cooperation with experts in social economy and marginalized Romany com-munities (MRC) also prepared a specific approach to invitations to screenings and subsequent management for these groups.

Cooperation of NOI, NHIC, health insurance companies, expert so-cieties, expert working groups and representatives of providers and patients is vital for the correct adjustment of innovations such as population-based screening and subsequent early and effec-tive management of patients with preventable oncological diseas-es in Slovakia. The evaluation report points out the need for mon-itoring and improvement of data processing and validation and, without a doubt, their correct interpretation by specialists in or-der to improve preventive and clinical care. This is only possible if

we cooperate closely with international partners with experience in similar programs, creation and implementation of standard and recommended preventive procedures and correct data collection and evaluation in prevention and healthcare. In 2018 and 2019, the de-partment of SPDTP worked with important partners who helped to prepare the basic principles of creation and implementation of screening programs based on standard procedures with methodolo-gies and ongoing consultations and supervision in order to improve data processing and implementation of patient safety and clinical audit tools. These partners include mainly colleagues from the Czech Republic (prof. Dr. Ladislav Dušek, PhD. and his team from Masaryk University and MoH CZ), World Health Organization (Dr. Bente Mik-kelsen, Dr. Jill Louise Farrington, Dr. Claudia Stein and prof. Neville Calleja) and cooperation in methodology of creation of standard pro-cedures under the guidance of McMaster University in Canada (prof. Dr. Holger Shunemann).

10.2. Report by Department of Public Health, Screening and Prevention, MoH SR

In April 2016, Prof. Dr. Stanislav Špánik, PhD., Chief Expert for Clinical Oncology, became one of the two State Secretaries at the Ministry of Health. In 2016, the Slovak Republic also presided the Council of the EU in the field of healthcare. The main priorities in the health sector were availability of medicaments, antimicrobial resistance, food re-formulation and vaccination.

In May 2017, prevention and healthy lifestyle became a priority. A specialized workshop entitled Future of Cancer Treatment in Slo-vakia raised questions about the future of cancer care in terms of prevention, diagnosis, treatment and follow-up care. State Secretary Stanislav Špánik underlined that this area poses great challenges for our health care, taking into account the statistics according to which cancer is the second most common cause of death in Slovakia after cardiovascular diseases. “Access to state-of-the-art medicaments and adequate therapy is one area that we will focus on, the other is pre-vention. Insured persons in Slovakia have guaranteed routine check-ups reimbursed from public health insurance, but they still do not use this opportunity very much,” Stanislav Špánik said. Experts also dis-cussed the possibilities of cancer treatment and the topic of screen-ing programs in Slovakia. The problem of updating cancer data in the National Oncology Register was also discussed.

In March 2018, State Secretary Assoc. Prof. Dr. Andrea Kalavská, PhD. MHA became the new Minister of Health. The issue of disease pre-vention and health promotion came to the forefront. At that time, the Ministry was very intensively preparing standard preventive, diag-nostic and treatment procedures. In May 2018, the Minister of Health presented the priorities of healthcare for the upcoming period to the Prime Minister of the Slovak Republic, including the preparation of the National Oncology Plan. The Minister considered prevention of oncological diseases a priority and, since June 1, 2018, she has estab-lished the Department of Public Health, Screening and Prevention at the Ministry. Under the auspices of the Minister, the “Year of Pre-

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vention 2019” initiative was launched with the objective to improve citizens’ awareness of the importance and possibilities of preventive screening, including cancer screening examinations.

In June 2018, the Ministry presented the proposal of the National Oncology Program for 2018 – 2020. The Ministry focused on the im-plementation of national screening programs for cervical cancer, colorectal cancer and breast cancer. In August 2018, the government approved the National Oncology Program for years 2018 – 2020.

In September 2018, communication activities about the screening programs started in cooperation with health insurance companies and patients’ organizations.

In January 2019, new standard prevention procedures for mammog-raphy screening and colorectal cancer screening came into force. In January 2019, the government approved Action Plans of the Nation-al Oncology Program, including primary prevention and screening. In 2019, the priorities of the Ministry included the fulfillment of the tasks of the National Oncology Program. According to this strategic plan, population-based screening activities aimed at early detection of colorectal cancer, breast and cervical cancer were launched in Slo-vakia. The screening itself was launched gradually from January 2019. The first activity was the first phase of colorectal cancer screening on a sample of 20,000 people aged over 50 who received a screen-ing Fecal Immunochemical Test from their health insurance com-panies. The goal was to achieve at least 50% attendance (there is ap-

proximately 30% attendance at the moment according to data from health insurance companies). The overall response rate in the first stage of colorectal cancer screening was 27% among respondents who had not participated in the preventive screening in the last two years. Next initiated activities focused on breast cancer screening for wom-en aged 50 – 69 and cervical cancer screening for women aged 23+. Coordination of screening programs was under the supervision of the National Oncology Institute (NOI) which is a clinical research and ed-ucational platform established within the National Cancer Institute (NCI) in August 2018. The role of the NOI is to analyze the screening results and fulfill the role of coordinator of the National Oncology Program in the future.

In March 2019, the Ministry of Health of the Slovak Republic, pa-tients’ organizations No to Cancer and Europacolon Slovakia launched a joint communication campaign about the national screening pro-gram for colorectal cancer titled Don't Throw Your Life Away – Take a Preventive Test Today. The Ministry supported the campaign fi-nancially with over 38 thousand euros. The cooperation started with a “Cup of Coffee in a Dummy Colon” in the atrium of the Ministry of Health. The campaign was accompanied by a new song featuring the video "Let’s Talk about Health with a Cup of Coffee." The video fea-tures cured patients who were saved by a screening test for fecal oc-cult blood or an examination at the gastroenterology department of the National Cancer Institute with chief gastroenterologist Dr. Boris Pekárek. The information campaign also included an accompanying educational interactive road show called Don't Throw Your Life Away.

From March 15 to May 11, 2019, the Ministry of Health and patients’ organizations invited people in nine Slovak towns (Košice, Poprad, Prešov, Žilina, Trenčín, Banská Bystrica, Nitra, Trnava and Bratisla-va) to an interactive exhibition “Cup of Coffee in the Colon” where they learned how to stay healthy by taking a fecal occult blood test. In cooperation with League Against Cancer and National Oncology Institute, the Ministry prepared a leaflet called “You Are Entitled to It Too”. The leaflets were distributed as a part of League Against Cancer campaign on Daffodil Day in 2019.

In September 2019, health insurance companies started inviting women aged 50 to 69 to mammography screening. This is an ex-tremely important prevention activity conducted by the govern-ment and health insurance companies. Breast cancer is the most common form of cancer in women. The Ministry in cooperation with experts commissioned 16 mammography centers which meet the European criteria for performing mammography screening. In cooperation with the Slovak national television, the Ministry pre-pared an educational film entitled A Chance to Survive which in-troduced the three most common oncological diseases and the pos-sibilities of their prevention. The film was distributed to 36 health promotion centers within the Regional Public Health Authorities and is also available at the NOI website (https://www.noisk.sk/skri-ning/laicka-verejnost).

Population-based cervical cancer screening program for women aged 23+ was launched in November 2019.

Although population-based screening programs launched in 2019, it is important to underline that many of the program processes are on-ly at the beginning and the response rates will increase step by step. Changes in population health will not occur immediately.

The government launched three screening programs in 2019. Colorec-tal cancer screening started in January, breast cancer screening in September and cervical cancer screening in November. Health in-surance companies started inviting people for screenings thanks to legislative changes effective from June 2019. This is the first instance of population-based screening programs implemented by the gov-ernment.

Oncology is one of the fields which received thorough attention from the Ministry of Health in 2019. We want to thank former Minister of Health Andrea Kalavská and state secretary Stanislav Špánik who created the necessary conditions at the Ministry and supported the implementation of screening programs. In 2017, Slovakia was among the last three countries in the EU that did not have population-based screening programs in place as it was recommended by the Council of Europe in 2003.

In 2020, the Ministry of Health plans to prepare a new strategic ma-terial for the years 2021 – 2030 according to the Europe’s Beating Can-cer Plan and fulfill its role in the context of Government Resolution No. 4/2019, B.1: to submit an update of the National Oncology Plan and an impact assessment of its Action Plans by June 30, 2021.

https://www.noisk.sk/skrining/laicka-verejnost

https://www.noisk.sk/skrining/laicka-verejnost

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10.3. Report of the Institute of Research and Develop-ment, MoH SR

The cooperation of National Oncology Institute (NOI), National Can-cer Institute (NCI)/ Clinical Trials Department (CTD), SLOVACRIN, Ministry of Health of the Slovak Republic (MoH SR)/ Institute of Re-search and Development (IRD) has created a platform for Systemic support of development of biomedical clinical research.

In 2018, the Ministry of Health of the Slovak Republic (MoH SR) sub-stantially contributed to the accession of Slovakia to ECRIN (Europe-an Clinical Research Infrastructure Network) as an observer via na-tional partner SLOVACRIN (Slovak Clinical Research Infrastructure Network), which is coordinated and currently funded by the Faculty of Medicine of Pavol Jozef Šafárik University in Košice. The national representative and Director General of SLOVACRIN is Prof. Daniel Pel-la, PhD., dean of the University. SLOVACRIN is the national research infrastructure linking workplaces focused on academic clinical re-search. Its overall objective is to increase the number of academical-ly-initiated clinical trials in Slovakia and improve their quality by us-ing available capacity and expertise of the participating workplaces with a guarantee of compliance with regulatory, legislative and eth-ical requirements related to the implementation of clinical research. Overall, SLOVACRIN supports all types of clinical research (clinical trials of human products and medicaments, clinical trials of medical devices, validation of treatment methods, observational studies) es-pecially where innovative medicaments and approaches are needed,

such as in the field of oncology or rare diseases. Therefore, Slovak pa-tients have a unique opportunity to get much earlier access to inno-vative methods of treatment as well as to medicaments which are not commonly available. Innovative treatment is often very expensive, so another benefit is significant savings for Slovak health insurance companies. This approach primarily improves the quality of health-care provision, but also the prestige and internationalization of Slo-vak biomedical clinical research.

For this purpose, the MoH SR issued a new legal form (Order of the Minister of Health of the Slovak Republic No. 4/2018) to which SLOVACRIN and the Clinical Trials Department (CTD) of the Nation-al Cancer Institute (NCI) contributed significantly, among others. This legislation specifies conditions for the inclusion of specialized organizational units in order to conduct biomedical research and clinical trials in the organizational system of healthcare facilities. In addition to this order, the MoH SR provided clinical units with a model of a tripartite agreement between the main participants in the clinical trial, thereby facilitating the negotiation of contrac-tual terms with clinical trial sponsors, which have often been very time-consuming and professionally demanding. In April 2019, the MoH SR via IRD in cooperation with SLOVACRIN and NCI / CTD also organized the first certified course for coordinators and heads of de-partments of clinical trials in healthcare facilities and plan to con-tinue these activities in 2020.

Only 3 months after the Order was issued, the number of new or-ganizational units for biomedical research and clinical trials in-

creased by 7 and 12, respectively. Furthermore, the number of ap-proved academic clinical trials in Slovakia increased significantly, specifically from 1 in 2018 to 8 in 2019. From those, 4 academic clinical trials are currently financially subsidized by the MoH SR through the National Oncology Program (NOP) 2018 – 2020 which was approved by the Government of the SR on August 23, 2018. These activities reflect the implementation of the NOP Action Plan No. 5 “Promoting cancer research and improving the accessibility of clinical trials for patients” which includes planned continuity and further development planned for 2020.

In the context of the NOP action plan (approved by the Government of the SR on January 9, 2019), SLOVACRIN in cooperation with the NOI and MoH SR / IRD prepares a Slovak roadmap of clinical work-places focusing on (academic) clinical research in order to reflect im-portant solutions of targeted state support in this area, as well as the implementation of the ESFRI platform (European Strategy Forum on Research Infrastructures).

In 2019, several events promoting the development of science, re-search and innovation in health care took place, including the Inter-national Clinical Trials Day 2019 (Slovak ICTD 2019), organized under the auspices of the MoH SR / IRD under Slovak V4 Presidency. The conference was attended by Prof. Jacques Demotes, Director General of ECRIN, Prof. Daniel Pella, Director General of SLOVACRIN, repre-sentatives of other ECRIN national authorities in the V4 countries, and Eric Steinfelder, Director General of BBMRI (Biobanking and Bi-oMolecular Resources Research Infrastructure) – a pan-European re-

search infrastructure for biobanking, with whom the MoH SR/ IRD discussed a planned accession of the SR to the BBMRI consortium in 2020. This strategy reflects a long-term initiative of the MoH SR / IRD to establish systemic biobanking infrastructure in Slovakia, which is highly relevant also for biomedical clinical research. This approach is in line with the implementation of one of the NOP Action Plan No. 5 activities, specifically to support the development of a biobank at the NCI.

In November 2019, a gala workshop was held on the occasion of the 25th anniversary of the establishment of CTD at the NCI. The main topic of the event was an overview of history and current situation of clinical research in healthcare. Since 2000, more than 1,300 patients have been included in interventional clinical trials thanks to CTD ac-tivities and since 2003, more than 200 interventional clinical trials have been carried out. The CTD department also supports academic clinical research at the NCI, as evidenced by more than 70 publica-tions, 22 of which are devoted to international academic trials, 8 to its own academic trials, 4 to probiotics, whereas other publications were sponsored by the pharmaceutical industry. CTD also helps to safeguard the quality of clinical trials, as evidenced by excellent re-sults of international audits. In 2019, the NCI initiated a cooperation with SLOVACRIN within the framework of academic clinical research through this department, which is also supported by the MoH SR / IRD in the context of the above-mentioned Action Plan No. 5 encom-passed in the NOP 2018 – 2020.

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10.4. Missions in Horizon Europe 2021 – 2027

Five areas of research and innovation missions intended to respond to some of the biggest challenges faced by today’s world were defined during negotiations about the new program Horizon Europe 2021 – 2027 focused on research and innovation. One of these areas is can-cer. The mission is defined as a portfolio of interdisciplinary activities focused on fulfilling a bold, inspiring and measurable objective in a specified timeline with an impact on the society and policy-making, as well as an importance for a significant part of Europe and broad spectrum of the citizens of the EU. The mission board for cancer has 15 members and is presided by professor Walter Ricciardi MD, MPH, MSc. National Oncology Institute cooperates with our representatives in the cancer mission.

Main problems in oncology in Slovakia

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11.1. Main problems in clinical oncology

The annual report maps out the real situation and activities in Slovak oncology in 2019. An important role of oncology in Slovakia is contin-uous quality improvement of healthcare, but also of preventive care with the intention to reduce morbidity and mortality of oncological diseases. The current concept of cancer care must be updated based on current problems and findings. The growing number of people diagnosed with an oncological disease requires the involvement of other specialties within joint effective healthcare and follow-up.

It is necessary to broaden the network of palliative care centers and strengthen the field of geriatric oncology due to population age-ing. Both of these fields are specific. Moreover, it is vital to closely interconnect clinical and pre-clinical research with healthcare in clinical facilities in the form of translational research units which will provide clinical oncologists interested in research activities enough capacity and time. It is important to promote public aware-ness of clinical oncologists working in research. The update of the concept of oncology care and National Oncology Plan requires close

cooperation of all stakeholders, particularly MoH SR, chief experts with their consultants, National Oncology Institute, Slovak Oncology Society committee, but also heads of clinics, Chief of departments of clinical and polyclinical oncology, representatives of other involved expert societies or professional associations and representatives of the field of experimental oncology. The concept of cancer care is close-ly connected to healthcare in terms of accessibility of innovative medical procedures.

However, the current situation in approving treatment which is evidence-based does not give a lot of importance to opinions of pro-fessionals. They have virtually no say in this topic. It is hard to im-agine that the approval process of medicaments reimbursed from public health insurance as exceptions (outside of approved catego-rization) in Slovakia lacks clear rules and transparency. It must be stated that many cases of exceptional reimbursements of medica-ments in Slovakia are considered the standard situation according to treatment recommendations for patients in the EU. Besides systemic

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changes of categorization of medicaments or indications, it is also important to set clear rules when it is possible to de-categorize a less beneficial cancer treatment in favor of broader medical benefit. The main aspect here is the willingness of the principal entities with ex-ecutive power, i.e. the Ministry of Health of the SR, health insurance companies and pharmaceutical companies.

Another option to improve the accessibility of innovative cancer treatment is accessibility of oncology clinical trials (CT). From the point of view of support infrastructure of CT in Slovakia, it is impor-tant to broaden cooperation, strengthen the CT infrastructure and set systematic updates of the Clinical Trials Register. Based on the or-der of the Minister of Health of the SR in 2019, positions for academic CT in hospitals managed by the MoH SR were created. However, clini-cal trials are conducted also in facilities not managed by the Ministry.

Slovak Cooperative Oncology Group was founded with the inten-tion to formally unite facilities which conduct clinical trials or are interested in doing so and support CT at national and international level in a coordinated manner. It is also important for a more effec-tive functioning of CT to create and, if necessary, extend the network of CT coordinators and nurses trained in clinical trials. Therefore, CT coordination in Slovakia could motivate more clinical trials and, at the end of the day, enable Slovak patients’ access to innovative treat-ment procedures within CT.

At the same time, it is important to interconnect clinical and translational research, which has already become a natural and in-dispensable part of clinical trials. The SLOVACRIN organization was established at the Faculty of Medicine of Pavol Jozef Šafárik University

in Košice to support Slovak academic clinical trials. Its main purpose is administrative support of academic clinical trials within national and international cooperation. SLOVACRIN belongs to a broader con-sortium of organizations with a common goal associated in ECRIN.

Another important topic in Slovak oncology which needs to be at-tended to and resolved is updated and correctly assessed and pre-sented data as well as their accessibility to those who can critically assess them. In this context, a legislative base for the position of NOI is necessary, given that one of its tasks is to analyze data from the National Oncology Register and coordinate and evaluate oncology screening programs. Moreover, cooperation and proactive approach of responsible NHIC employees skilled in this complex topic and prop-erly educated is crucial to restore the National Oncology Register (NOR). There is still a considerable time lag between finished and published outputs from NOR. At the moment, only data about inci-dence from 2011 are available in NOR. Predictions up to 2030 can be influenced by a significant error and thus have only limited value. It is necessary for NOR to be managed by experts, all the while having the option of external independent audit which could be the next ef-fective step to restore NOR and later maintain the processes. When NOR was created and started its function, it was managed by experts and established at the National Cancer Institute. It was something Slovakia could be proud of, even set an example for other countries.

The launch of oncology screening programs (SP) is only a small step, but an important one for Slovak citizens. The issue is complex, with many stakeholders and specifics of the situation in Slovakia. Thorough preparation and continuous efforts of all stakeholders to

update the SP are necessary, as well as process checks at all levels, permanent activities focused on education of professionals and the public, including an ongoing campaign in the media. It is possible that some SP might stop in the future if they are not actually needed in the population, which is something we wish for in case of cervical cancer screening. Best practices from other countries shows that this disease has been almost eradicated thanks to successful implementa-tion of vaccination against HPV, which means that the screening pro-gram is no longer necessary. On the other hand, screening programs for other oncological diseases might be extended if needed and if it is possible to implement effective screening methods.

However, in order to maintain functional nation-wide screening programs, they must be supported not only by experts and the pub-lic, but mainly by the state with its political and financial support. The most important factor is sufficient participation of the target population in the SP. Quality assessment of SP can be done via short-term indicators which evaluate the course of SP, including its cov-erage, participation of the invited population, quality of performed examinations, number of relevant pathological findings and their subsequent diagnostic and therapeutic management. Long-term in-dicators include epidemiological parameters, particularly mortality. However, a desired decrease in mortality does not manifest itself im-mediately. It is thus important for the whole society to understand that well-coordinated, well-functioning population-based oncology screening programs have the potential to save many lives and reduce mortality, but also save money needed for complicated cancer treat-ment in late stages of the diseases.

It is necessary to appeal again to increase the attractiveness of the field of oncology to fresh graduates of faculties of medicine and to the current generation of physicians. Again, these are complex steps with a common denominator – creation of the right conditions for professional growth, sufficient remuneration, possibility of edu-cation not only in Slovakia but also abroad, elimination of current obstacles and often inadequate financial burden caused by partici-pation in conferences abroad. Young oncologists must be interested in education and publication abroad. This is the only way to increase the credibility of Slovak oncology. Therefore, it is important to adjust the healthcare system to be effective and to motivate teamwork in which older physicians pass on their knowledge to younger ones and the young ones provide the necessary drive. Multidisciplinary teams with specialists from different fields who can find a common solution also have a great significance. Besides a correctly prepared concept, the next step is its implementation, often connected to political and social understanding. We need a society with the willingness to work, implement innovations in clinical practice, enjoy our successes to-gether and learn from our mistakes. A society which values medical professions and doctors who work in a professional, expert, dignified and sincere manner and thus help create an environment which fa-vors recovery, and if that is not possible, pain relief or decent and re-spectful death.

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11.2. Main problems in pediatric oncology

• Pathological diagnostics of rare tumors, classification of sub-groups (CNS tumors)

• Second opinion on pathological findings• Molecular diagnostics of rare tumors (with adequate internation-

al quality assessment)• Funding of rare disease diagnostics abroad• Second opinion in radiology• Availability of expensive innovative treatment / immunotherapy• Administrative and financial support for academic clinical trials• Inadequate financial remuneration via DRG• Funding of education of physicians (international fellowships)

Challenges for 2020 – pediatric oncology• Preparation of funding models for expensive custom genetic on-

cological diagnostics • Preparation of funding models for expensive innovative cancer

treatment in order to improve its accessibility to patients • Qualification to enter international clinical trials – lymphoblastic

lymphoma, hepatoblastoma, soft tissue sarcomas• International accreditation for pediatric oncology facilities (JACIE

for bone marrow transplantation)• Development of scientific and research activities within interna-

tional cooperation• Qualification for cell therapy of pediatric cancers

11.3. Main problems in radiation oncology

Accessibility of adequate radiotherapy still varies in Slovakia; from the point of view of patients, we can still view the situation as a “post-code lottery”. The main issue is lack of new technologies and obsolete equipment. After repeated notices about the inadequate equipment, the Ministry of Health of the SR opened a tender for technological update of 8 healthcare facilities managed by the Ministry in the sum-mer of 2018. After the project is finished, the facilities will have 24 – 28 linear accelerators (including expected planned activities in the private sector) with VMAT and IGRT and 10 – 11 CT simulators.

We expect the unfavorable situation in this area to improve in the next two years. It is not possible to regulate its development because it is influenced by several unpredictable factors, particularly lengthy tenders for construction works, duration of the construction works themselves, capacities of technology distributors to implement and maintain complex technologies and capacities of individual depart-ments to effectively handle the new technologies and SW solutions up to standard.

Challenges for 2020The provision of radiotherapy for patients in Slovak hospitals poses an immediate challenge. Gradually, by replacing obsolete technology in facilities, it will be possible to provide radiotherapy in a timely man-ner and high quality for each patient. Average reimbursements of ra-diotherapy from health insurance companies must ensure the func-tioning of departments and regular modernization of equipment. It

will be necessary to continually reduce the number of patients treat-ed in the Czech Republic due to lack of advanced technologies, mainly stereotactic radiotherapy.

11.4. Main problems in palliative medicine (PM) in Slovakia

Based on recommendations of European Association for Pallia-tive Care (EAPC) from 2011, 80 to 100 palliative care beds are need-ed for each 1 million citizens (Radbruch, 2011). In 1995, prof. Xavier Gómez-Batiste published a PM implementation project in healthcare for Catalonia. This system was revised every 5 years and the last re-view in 2015 stated that the accessibility of palliative care in Catalonia is provided at 80% at the moment (Gómez-Batiste 2015).

The need for beds in long-term palliative care according to the Cat-alan model represents 100 palliative care beds per 1 million citizens, i.e. Slovakia should have 550 beds available. There are currently 257 beds available in Slovakia and only 91 beds provide specialized medi-cal care with a PM specialist. Approximately 10 acute beds are needed per one million citizens, which means Slovak citizens should be able to use 55 acute palliative care units. The only acute palliative care unit exists in Clinical Oncology Clinic of the National Cancer Institute in Bratislava and has the capacity of 19 beds. The need of mobile pallia-tive units represents approximately 1 mobile palliative unit per dis-trict. Slovakia has 79 districts and 6 available mobile palliative units. Five of them employ a PM specialist.

Implementation programPalliative medicine is not implemented in the Slovak healthcare sys-tem. Available hospices are not reimbursed sufficiently; out-of-pock-et payments are still required, which usually puts a burden on the patient’s financial situation. The approach of the state Slovak health insurance company (Všeobecná zdravotná poisťovňa) to funding and reimbursing expenses of mobile hospices has changed recently. The form of reimbursement should change significantly because the cur-rent scoring system according to Healthcare Procedures Catalog does not take into account specific aspects of palliative care.

Palliative care can be provided in an inpatient or outpatient facility or in a mobile hospice/mobile palliative unit. A palliative patient may need acute care or long-term care focused on nursing care. Acute pal-liative inpatient care should be provided at a department of acute internal medicine in a (community) hospital and is conditioned by the presence of a specialist in palliative medicine. Acute palliative care in Slovakia is not provided to patients in this manner. The only facility providing this type of care is the National Cancer Institute in Bratislava, which has 19 beds at the Department of Clinical Oncology F – Palliative Care. Long-term inpatient care is provided in hospices or (according to new, still not approved palliative care concept) should be provided in departments of long-term palliative care. Outpatient care may be provided in a palliative medicine office or mobile hos-pice/mobile palliative unit.

In 2019, National Cancer Institute proposed an important com-ment during consultation about the minimal healthcare network to extend it by providing palliative medicine offices. However, the

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comment was not accepted and therefore, there are no conditions for contracting palliative medicine offices by health insurance com-panies. However, in 2019, several negotiations took place with the management of the health insurance company, Všeobecná zdravotná poisťovňa, which is viewed as a helpful step towards the accessibility of palliative care. By the end of 2019, the health insurance company Dôvera did not conclude contracts with any palliative medicine office or mobile hospice.

ReferencesGómez-Batiste X et al., 2015. The Catalonia WHO Demonstration Project of

Palliative Care: Results at 25 Years (1990-2015), J Pain Sym Management, http://doi.org/101016/j.painsymman2015.11.029 accessed Feb 23 2019

Radbruch L, Payne S (2011) Standards und Richtlinien für Hospiz- und Pal-liativversorgung in Europa: Teil 2. Weißbuch zu Empfehlungen der Europäis-chen Gesellschaft für Palliative Care (EAPC). Z Palliativmed 2011(12):260 bis 270

Current trends in clinical oncology around the world

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http://doi.org/101016/j.painsymman2015.11.029

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Current trends in clinical oncology around the world can be classified in six basic areas:1. Multidisciplinary approach to decision-making about diagnostic

and therapeutic management.2. Innovations at all levels of diagnostic and therapeutic care as well

as prevention and oncology screenings.3. Personalized treatment – search for “tailored” treatment for each

individual person and its implementation.4. Holistic approach to patient and their environment – under-

standing the individual from biopsychosocial point of view.5. Supportive therapy at each level of care of the sick or recovered

person and their environment. 6. Prevention and screening as the key to reduce morbidity and mor-

tality of oncological diseases.

Medicine is beautiful and fascinating; its objective is to restore bal-ance called health, while keeping in mind the fundamental principle „Primum non nocere“. (First do no harm).

Annual Report for 2019

State of Oncology in Slovakia

compiled by National Oncology Institute


Klenová 1

833 10 Bratislava

Slovak Republic

Phone: +421 2 59 378 429

E-mail: [email protected]: www.noisk.sk

Acknowledgement:

Our gratitude goes to Veronika Maťúšková, MSc.

for translations, and Veronika Maťúšková, MSc.

and Stephen E. Zlatos, Esq. for English text revisions.


http://www.noisk.sk

State of Oncology in Slovakia - NOISK.sk · 2020. 9. 2. · Klenová 1 833 10 Bratislava E-mail:...

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