Vol 16, No 1 (2014)
- Year: 2014
- Articles: 15
- URL: https://journal-vniispk.ru/1815-1434/issue/view/1485
Articles
Press-release. The resolution of oncologists of the North-West Federal District: screening for female reproductive system cancers is required
Abstract
2 апреля 2014 г. в Санкт-Петербурге состоялся круглый стол, посвященный проблеме онкологических заболеваний женской репродуктивной системы. Его организаторами стали Ассоциация онкологов (АО) Северо-Западного федерального округа (СЗФО) и ФГБУ «НИИ онкологии им. Н.Н.Петрова» Минздрава России. Участники обсудили результаты пилотного проекта скрининга онкологических заболеваний репродуктивной системы у женщин и приняли резолюцию о дальнейшем совершенствовании диагностики рака.
Journal of Modern Oncology. 2014;16(1):5-6
5-6
7-12
Selection of the anti-angiogenesis therapy for the first-line chemotherapy in advanced ovarian cancer
Abstract
Development of first-line cytostatic therapy in ovarian cancer is slow, and as a result, the main research aim today is to study the biology of the disease. Angiogenesis is one of the main factors of the tumor microenvironment, resulting in growth and metastasis. As a result have been investigated the drugs inhibiting angiogenesis. The first drug being studied in phase III trial of the randomized studies was bevacizumab, which demonstrated the significant increase in both progression-free survival and survival in the high risk group. Other antiangiogenics such as pazopanib, nintenanib, also demonstrated high efficacy in patients with ovarian cancer.
Journal of Modern Oncology. 2014;16(1):13-17
13-17
The role of topotecan in prolongation of platinum-free interval in patients with recurrent ovarian cancer
Abstract
Nowadays disseminated ovarian cancer is a chronic disease, in the therapy of which one type of therapy completes the other; in case of recurrent ovarian cancer is important to change the regimens periodically. The choice of cytostatic drugs is quite wide, but in each case the tactic based on a combination of predictive factors, and also is important to take into account the toxicity after treatment. The article discusses the need and value of prolongation of platinum-free interval in relapsed ovarian cancer. In the preliminary assessment the Topotecan could be used as second-line and further-line treatment for recurrent ovarian cancer for platinum reinduction.
Journal of Modern Oncology. 2014;16(1):18-21
18-21
Low-risk persistent trophoblastic disease: results of treatment
Abstract
Purpose: The aim of this study was to investigate diagnostic peculiarities, clinical features and management outcome of patients with low risk persistent gestational trophoblastic disease (PTD). Any study on this theme hasn’t taken place in Russia.Materials and methods: Between 1996 and 2012, 127 women with PTD were commenced at N.N.Blokhin ROSC. If patients developed MTX resistance or toxicity, treatment was altered according to the score system. If the risk of resistance was up to 6 points, patients received dactinomycin; if greater than 6 points, patients received EMA/CO.Results: β-hCG values normalized in 109 (85,8%) of 127 patients with MTX alone, whereas 18 (14,2%) of 127 patients required a change in treatment, because of MTX resistance. 16 patients changed to dactinomycin, of whom 14 achieved normal β-hCG values, and 2 required third-line chemotherapy with EMA/CO. β-hCG values normalized in 2 of 2 patients who changed directly to EMA/CO from MTX. Overall survival was 100% and the relapse rate was 1,6%.Conclusion: In the case of regular follow-up after hydatidiform mole (HM) evacuation, early identification and adequate treatment of PTD the cure rates approach 100%.
Journal of Modern Oncology. 2014;16(1):21-25
21-25
The role of tamoxifen in the therapy of metastatic ovarian cancer
Abstract
Ovarian cancer is one of the most widely spread among women malignant tumors. Despite high sensitivity to anti-cancer chemotherapy (responses are awaited from more than 80% of women, receiving standard therapy with platinum and paclitaxel) recurrence of the disease takes place and the tumor becomes resistant to further therapy. Thus, it becomes necessary to invent new types of non-toxic therapy, taking into consideration biological qualities of the tumor. Tamoxifen therapy has efficacy in previously intensively treated patients with metastatic ovarian cancer, and it has low toxicity as well.
Journal of Modern Oncology. 2014;16(1):26-29
26-29
New aspects of the first-line chemotherapy in colorectal cancer
Abstract
Colorectal cancer (CRC) steadily occupies the third position in the morbidity and mortality in the world. Due to advance in chemotherapy,surgery and the use of multidisciplinary approach in patients with metastatic colorectal cancer (mCRC) the CRC treatment algorithms have changed recently. Depending on the clinical situation there are 4 groups of patients with CRC: resectable group, potentially resectable group, unresectable group of patients who could undergo the intensive treatment, unresectable group of patients with concomitant diseases. It was found, that besides mutations in 2 exone KRAS there is a scope of rare mutations (exons 3 and 4 in KRAS gene and mutation in NRAS gene) which determines the resistance to EGFR inhibitors as well. The PRIME study found that 17% of patients, who were included in to the group without mutations (KRAS WT), according to the old type of test, could have these rare mutations. The target choice in first line therapy in mCRC patients RAS mutant is only bevacizumab. In RAS WT patients as EGFR inhibitors, so bevacizumab can be used. The presence of BRAF mutation is a factor of the negative prognosis in patients with mCRC and is correlated with a reduction in life expectancy. Further research in the field of molecular genetic characteristics of the tumor will help to solve the remaining points and to optimize treatment in different patients` groups.
Journal of Modern Oncology. 2014;16(1):30-35
30-35
The Avastin application in clinical practice in patients with metastatic colorectal cancer: Second interim analysis of the observational AJAX program
Abstract
The article reports the preliminary results of the observation program studying the application of bevacizumab in patients with metastatic colorectal cancer (mCRC) in daily clinical practice in Russian.Methods. The observation program is based on the results of treatment of 250 patients with metastatic colorectal cancer. The observation program included patients receiving bevacizumab from the first-line of chemotherapy. We were analyzing main demographic factors of the group of patients, survey plan before the treatment, the choice of chemotherapy regimens, dosage and reason for cessation of bevacizumab, frequency of drug usage as a supportive care.Results. The program enrolled 250 patients, where 89 (36%) patients were suffering from rectal cancer, 159 (64%) - from colonic cancer and 2 (1%) from multiple primary rectal colonic cancer. At baseline, 137 (35%) patients had synchronous distant metastases. Only in 32 (13%) patients who were enrolled in the program the primary tumor was not removed. The first-line bevacizumab-based supportive therapy was received by 120 (48%) patients. More than one line of chemotherapy was received by 47 (18,8%) patients. The median duration of bevacizumab-based treatment was 6 months. Bevacizumab therapy was discontinued in 115 (46%) patients; the main reasons for the discontinuation of bevacizumab were progression (49 patients, 43%), lack of drugs (29 patients, 25%), refusal of treatment (15 patients, 13%). During the program 48 (19%) patients developed side effects, 21 (43%) patients among them had grade 3 and 4 side effects. The analysis of treatment effects was estimated in 239 patients: 84 (35,1%) patients showed clinical (complete and partial) response. Conclusion. The targeted therapy in clinical facilities of the Russian Federation cannot be used because of scarcity supply and the oncology specialists willingness to realize the optimal therapeutic approaches. For one part, the results show that involving bevacizumab have failed to increase the toxicity of chemotherapy, for the other part the combination of bevacizumab with standard chemotherapy regimens can help to achieve high disease control rates.
Journal of Modern Oncology. 2014;16(1):36-41
36-41
Overcoming immunological tolerance is a way of treating malignant tumors: new perspectives
Abstract
This literature review outlines the current knowledge of the mechanisms of antitumor immunity and the role of one of the new classes of immunomodulators blocking immune regulatory molecules CTLA4, which soon could be used by oncology practitioners in Russia and has already been successfully used for the treatment of disseminated melanoma in Europe and the United States. Ipilimumab is the first drug, which represent the class registered on this indication in Europe and the United States. Fundamentally different mode of action from the cytostatic drugs mode of action is required to find another approach to assessing an objective response to treatment and special attention to the different, sometimes unexpected side effects of chemotherapy.
Journal of Modern Oncology. 2014;16(1):42-47
42-47
Mobilization of hematopoietic stem cells (HSCs) by using Pleriksafor (Mozobail) in combinationwith colony-stimulating factor in patients with previous failure transplant procurement for autotransplantation of HSCs
Abstract
AutoHSCT is an effective treatment for patients with relapsed and refractory lymphomas, multiple myeloma, some solid tumors. For a successful transplantation it is necessary to obtain an adequate quality and quantity transplant. Due to the heavy pretreatment this category of patients receiving a transplant can be a serious problem, which can be solved with the use of the new mobilizing agent inhibitor CXCR4 - plerixafor. In our study, 10 patients, of which 7 were confirmed as «poor mobilizers» were stimulated with colony stimulating factor, together with a plerixafor dose 0,24 mg/kg body weight on day 5 and 6 of stimulation. In 9 of the 10 patients we had obtained an adequate transplant. In all patients before the administration of plerixafor low or intermediate number of CD34+ cells per microliter of peripheral blood was obtained. The patient failed to mobilize with the use of plerixafor mentioned the smallest number of CD34+ cells per microliter in peripheral blood both before and after administration of plerixafor. In 9 patients, the content of CD34+ cells after stimulation with plerixafor increased by 2-4 times.
Journal of Modern Oncology. 2014;16(1):48-52
48-52
Renal involvement in children with non-Hodgkin lymphomas
Abstract
Team approach to the diagnosis of renal involvement in non-Hodgkin lymphomas (NHL) is the task of prime importance for successful treatment. Anatomical features of children kidneys dictate the need for a differentiated approach in the choice of methods of radiodiagnosis of renal pathology. This article contains characteristics of renal involvement in children with non-Hodgkin lymphomas, using the morphoimmunological tumor characteristics and the results of ultrasound investigation (USI), magnetic resonance and X-ray computed tomography. For the first time in the domestic literature is presented semiotics of renal pathology in children with NHL using results of ultrasound and computed tomography.
Journal of Modern Oncology. 2014;16(1):53-59
53-59
High-dose chemotherapy with hematopoietic stem cell rescuein children older than 3 year with medulloblastoma: results of single institution trial
Abstract
Background: Medulloblastoma (MB) is the most common malignant brain tumor in children, comprises about 20% of all pediatric braintumors. Among average risk MB, survival rate has been reached over 80%. However, in high-risk patients it remains poor. In our trial, we aimed to investigate effectiveness of risk-adapted radiotherapy followed by dose-intense chemotherapy with PBSCs rescue.Methods: 30 patients, 14 with AR disease and 16 with HR were enrolled onto our study from 2007 to 2013. After tumor resection, all patients received risk-adapted craniospinal radiotherapy (23.4 Gy for AR MB and 36 Gy for HR MB, with local boost 54 Gy), followed by 4 cycles of high-dose chemotherapy with PBSC rescue. Each cycle consisted of cyclophosphamide (4000 mg/m2 per cycle), cisplaitn (75 mg/m2 per cycle), and vincristine (2 mg /m2 per cycle). Support with PBSCs was administered after each cycle of chemotherapy. The dose of CD34+ cells was 1,27×106/kg per cycle (range 0,2-2,7×106/kg).Results: 28 of the 30 patients completed all 4 cycles of chemotherapy. There were two (6,7%) toxic related deaths during treatment. Both patients have died for bacterial sepsis. All patients had neutropenia after each cycle of chemotherapy; however, febrile neutropenia was observed in 83% of patients. Most of the toxicities that occurred during high-dose chemotherapy was anticipated. All of the 30 patients required platelet and RBCs transfusion. In our study, 3-year PFS for the 14 AR patients was 77,4±11,5%, for HR patients was 66,1±11,4% with median follow up 56,8±5,6 and 39±4,7 months respectively.Discussion: the results showed that dose-intensive chemotherapy improves PFS in patients with HR MB, but it still worse than in AR MB. Based on our results we can say that future trials for MB treatment should consider molecular and biological features of MB.
Journal of Modern Oncology. 2014;16(1):60-64
60-64
Clinical cases of treatment of hepatocellular carcinoma
Abstract
The article presents the clinical cases of sorafenib treatment of hepatocellular carcinoma. The experience of the Russian oncologistsdoes not only confirm the results of the international clinical research, but also demonstrates the possibility of prolonged administration of the drug for more than 3-4 years against a backdrop of high efficiency and controlled security profile.
Journal of Modern Oncology. 2014;16(1):65-69
65-69
The role of cytokines in the chemotherapy of malignant tumors:the practice of cytokines Refnot® and Ingaron® administration in advanced cancer with multiple metastases
Abstract
Nowadays the best results in the treatment of cancer give combination of traditional treatment method and cytokines, which reduce the negative impact of chemotherapy on immunity and the toxicity of several antineoplastic drugs. The ability of cytokines to reduce the drugs toxicity and strengthen immunity is very important in chemotherapy. In addition, in case of combination cytokine therapy helps to overcome the tumor cells resistance to chemotherapy, significantly increasing the effectiveness of the treatment. Thus, the cytokine therapy can effectively be used in the treatment of different types of cancer, even in advanced cancer.
Journal of Modern Oncology. 2014;16(1):70-75
70-75
Radiation therapy as an independent method of treatment in case of carcinoma of floor of mouth
Abstract
The study presents the efficiency of radiotherapy as an independent method of treatment in 158 patients with cancer of floor of mouth. In this group patients did not undergo surgery and chemotherapy due to several reasons. The group of 158 patients included 137 (86,7%) men and 21 (13,3%) women. In 150 (94,9%) patients were morphologically proven squamous cell carcinoma of different histologic grade, in 8 (5,1%) patients - low differentiated carcinoma. 5-year survival rate in this study was dependent on the Stage of the tumor. Follow-up period up to 5 years was achieved in Stage I in 2 (1,3%) patients with cancer of floor of mouth, in Stage II - 40,7% patients achieved the same period, in Stage III - 21,5%, in Stage IV no one achieved 5-year survival rate.
Journal of Modern Oncology. 2014;16(1):76-81
76-81