Journal of Modern Oncology

Theoretical and practical publication

Journal of Modern Oncology
(Sovremennaya onkologiya) 

The Journal of Modern Oncology (Sovremennaya Onkologiya) is a peer-reviewed, open-access periodical that since 1999 serves the interests of oncologists.

Peer-reviewed theoretical and practical Journal of Modern Oncology is published since 1999 in 5000 copies, volume of about 80 pages of format А4. The journal has been included into the List of periodical scientific and technical publications issued in the Russian Federation where basic scientific results of doctoral thesis should be published. The territory of dissemination of the journal: Russian Federation, countries of Commonwealth of Independent States (CIS) and other foreign countries. 

This periodical publishes papers of scientists and practitioners-oncologists and clinical pharmacologist not only from Russia as well as from the near and far abroad. The journal publishes articles on modern methods of diagnostics and treatment. The journal is issued regularly with periodicity 4 issues a year. At the present time the journal has acquired wide recognition and popularity among specialists.

The journal is disseminated among doctors and researchers working on oncology, modern methods of diagnostics and treatment, officials and specialists of agencies of healthcare of regions of Russian Federation and other foreign countries, Research Institutes; across medical institutions and research centers; into central libraries; by subscription; into all medical libraries.

The "Journal of Modern Oncology" is an open access, peer-reviewed online journal dedicated to providing the very latest information both in clinical and translational research fields related to a wide range of topics in oncology. 

The journal publishes editorial conference updates, original research, reviews, clinical case reports, commentaries, clinical and laboratory observations by Russian and international authors, pertinent to readers in CIS countries and around the world.

The Journal emphasizes vigorous peer-reviewing and accepts papers in Russian and English with most rapid turnaround time possible from submission to publication. Abstracts for all papers are available in both languages.

Special area focus/ journal sections:

  •  Diagnosis of cancer
  •  Tumors of the respiratory system
  •  Ovarian and cervical tumors
  •  Tumors of the digestive tract
  •  Radiation therapy, chemotherapy, targeted therapy of tumors
  •  Quality of life of patients

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Current Issue

Vol 24, No 2 (2022)

CLINICAL ONCOLOGY

Innovations in the therapy of oncohematological diseases
Abstract

On March 26, 2022, the First scientific and practical forum of the biopharmaceutical company Nanolek was held, dedicated to the issues of modern methods for the treatment of lymphoproliferative diseases using innovative targeted drugs, including Bruton tyrosine kinase inhibitor – zanubrutinib. The leading Russian speakers showed the results of new clinical studies in the context of therapy of mantle cell lymphoma, Waldenstrom's disease, marginal zone lymphoma, as well as chronic lymphocytic leukemia. The algorithms for the management of patients, as well as the complex issues concerning the choosing therapy in case of relapses of non-Hodgkin lymphomas and chronic lymphocytic leukemia were discussed.

Journal of Modern Oncology. 2022;24(2):142-148
pages 142-148 views
Creating a story on the pages of a book about diffuse B-large cell lymphoma
Abstract

Within the framework of VI All-Union Congress of Hematologists of Russia and III Congress of Transfusiologists of Russia, the symposium concerning diffuse large B cell lymphoma (DLBCL) was held on April 21. Leading Russian experts discussed current trends in diagnosis, the causes of the failures and successes of the treatment of this heterogeneous disease, the changes that are expected in the very near future. During the symposium, the detailed data concerning the new option for DLBCL therapy – polatuzumab vedotin (immunoconjugate) were also presented. The symposium was supported by Roche.

Journal of Modern Oncology. 2022;24(2):150-157
pages 150-157 views
Modern strategy of treatment of patients with retroperitoneal sarcomas: A review
Stilidi I.S., Nikulin M.P., Kalinin O.E., Abgiarian M.G., Vashakmadze L.V., Fainshtein I.A., Arkhiri P.P., Salimova A.A.
Abstract

Retroperitoneal sarcomas are rare tumors of non epithelial origin. There are no standards of surgical treatment, chemotherapy or radiation. In 2021 Transatlantic Australasian RPS Working Group published consensus recommendation for diagnosis, treatment and follow-up of retroperitoneal sarcomas patients. The paper presents the main points of the consensus and discusses the surgical aspects of the recommendations, listing the histologic forms excluded from the retroperitoneal tumor group. The main strategy for surgical treatment is emphasized, which includes the necessity to remove retroperitoneal tumors “en bloc” as well as the necessity to consider the histological structure. Preoperative morphological examination of the tumor, specifying the subtype, should become a standard of examination of patients. The role of multidisciplinary advisory councils as a factor influencing the improvement of survival rate is pointed out. The experience of abdominal department interventions on the great vessels in the context of the experience of large surgical centers is presented. Topical issues of tumor non-resectability, chemotherapy and radiation therapy, perioperative management of patients, including the principles of accelerated recovery after surgery (ERAS) are considered. The results of preoperative irradiation of retroperitoneal sarcoma patients (STRASS1) are presented and the protocol of neoadjuvant therapy (STRASS2) is announced.

Journal of Modern Oncology. 2022;24(2):158-163
pages 158-163 views
The role of molecular genetic factors in the development of cholangiocellular cancer: A review
Chulkova S.V., Loginov V.I., Podluzhny D.V., Egorova A.V., Semichev D.G., Gladilina I.A., Kudashkin N.E.
Abstract

This article highlights the main inducers of cholangiocarcinogenesis. Data are presented on the study of gene mutations, the variations of which depending on the localization of biliary cancer may be different (FGFR2 – in intrahepatic PRKACA, PRKACB – cholangiocarcinoma in extrahepatic cholangiocarcinoma). Mutations in the KRAS, TP53, ARIAD1A genes are common in extrahepatic bile duct cancer. Epigenetic events such as DNA hypermethylation, histone modifications, chromatin remodeling, and disturbances in miRNA expression are considered. A number of epigenetic features, such as the presence of a TP53 gene mutation with hypermethylation of p14ARF, DAPK, and/or ASC, correlate with a more aggressive course of the disease. The role of the SOX17 gene in the development of drug resistance is highlighted. The study of molecular genetic features of extrahepatic bile duct cancer is an important aspect in understanding the pathogenesis of this type of tumor, reveals new prognostic and diagnostic markers of the disease. It is possible that in the future, as knowledge is accumulated, this will make it possible to individualize approaches to the treatment of this category of patients.

Journal of Modern Oncology. 2022;24(2):164-168
pages 164-168 views
Recurrent of ovarian cancer with lymph node involvement: surgery or chemotherapy? Retrospective cohort study
Stilidi I.S., Egenov O.A., Nered S.N., Kalinin O.E., Shevchuk A.S., Arkhiri P.P., Suleymanov E.A., Tyulyandina А.S.
Abstract

Aim. To give a comparative analysis of long-term results of treatment of patients after surgical treatment in combination with systemic chemotherapy with a control group of patients who received only second-line chemotherapy without surgical treatment for recurrent ovarian cancer (OC) with lymph node (LN) involvement, as well as the search of prognostic factors that favorably affect progression-free survival (PFS) and overall survival (OS).

Materials and methods. The retrospective analysis included patients under the age of 75 after surgical treatment or after only second-line chemotherapy without surgery for isolated recurrence in the LN or a combined form of recurrence of OC at Blokhin National Medical Research Center of Oncology from 2005 to 2020. All patients had previously received combined treatment for primary OC. Exclusion criteria: absence of LN involvement in the recurrence of OC, primary multiple malignant tumors, relapses of non-epithelial ovarian tumors, the presence of concomitant pathology in the decompensation phase and lack of information about the treatment received for the recurrence of OC and the date of subsequent progression, death or last observation. The primary endpoint of the study is PFS and the secondary endpoint is OS.

Results. The final analysis included 214 patients, who were subsequently divided into 2 main groups: the study group consisted of patients (n=123; 57.5%) who underwent repeated cytoreduction + systemic chemotherapy, and the control group included patients (n=91; 42.5%) who received only second-line chemotherapy. In the general population of patients, the median platinum-free interval was 14.0 months. Platinum-sensitive recurrence of OC developed in 88.3% (189/214) of patients, and platinum-resistant recurrence was observed in 11.7% (25/214) of cases. In the study group, complete repeated cytoreduction was achieved in 70.7% (87/123) of patients, and incomplete – in 29.3% (36/123) of patients. All 91 patients in the control group received second-line chemotherapy in the planned volume. The vast majority of patients underwent second-line platinum-containing chemotherapy – 87.9% (188/214) of patients. The median follow-up was 33.0 (range 0.7–174.0) months. Long-term results in the complete cytoreduction group were significantly higher – median PFS and OS were 30.0 months and 87.0 months, respectively, however, in the incomplete cytoreduction group, long-term results were statistically significantly worse: median PFS and OS were 10.0 months and 29.0 months versus 12.0 months and 36.0 months, respectively, in the control group of patients. Surgical treatment in combination with chemotherapy for platinum-resistant recurrence of OC did not improve long-term results of treatment: the median PFS was the same in both groups – 7.0 months, and the median OS was 24.0 months versus 21.0 months in the control group (p=0.372).

Conclusion. Only complete repeated cytoreduction in combination with systemic chemotherapy leads to an improvement in long-term results of treatment compared with incomplete cytoreduction and only second-line systemic chemotherapy. Incomplete repeated cytoreduction, despite combination with systemic chemotherapy, worsens the prognosis and does not improve the results of drug therapy alone in patients with platinum-sensitive recurrence of OC. Combined treatment (surgery + chemotherapy) for platinum-resistant recurrence of OC does not improve long-term results of treatment.

Journal of Modern Oncology. 2022;24(2):170-176
pages 170-176 views
The effect of antioxidant drugs on the self-assessment of clinical symptoms in women during radiation therapy after surgical treatment of endometrial cancer: Placebo-controlled randomized trial
Volchegorskii I.A., Vazhenin A.V., Alekseeva A.P.
Abstract

Aim. Comparative analysis of the effect of methylethylpiridinol (Emoxipine), ethylmethylhydroxypyridine malate (Ethoxidol) and ethylmethylhydroxypyridine succinate (Mexidol) on the self-assessment of nonspecific clinical symptoms in women receiving adjuvant radiation therapy after radical surgical treatment of uterine body cancer.

Materials and methods. A short-term, prospective, simple “blind”, placebo-controlled, randomized study of the effect of 14-day course use of emoxipine (150 mg [0.87 mmol] per day intravenously), ethoxidol (225 mg [0.83 mmol] per day intravenously) and mexidol (225 mg [0.88 mmol] daily intravenously) on the dynamics of self-assessment of nonspecific clinical symptoms in patients during radiotherapy after surgical treatment of endometrial cancer was conducted. Self-assessment of clinical symptoms and quality of life (QOL) was studied using the MDASI questionnaire (M.D. Anderson Symptom Inventory). The emotional complaints were assessed using the Giessen questionnaire.

Results. The 14-day use of Emoxipine, Ethoxidol and Mexidol in almost eqimolar single doses prevented the negative impact of radiation therapy on the self-assessment of clinical symptoms and QOL according to MDASI. This was manifested by a significant decrease in “weakness”, “sadness” and “depression”, as well as the prevention of “nausea” and “appetite disorders” during radiation therapy. At the same time, the emotional coloring of “stomach” and “heart” complaints, “exhaustion” and “pressure of complaints” decreased according to the Giessen questionnaire. The positive effect of Emoxipine, Ethoxidol and Mexidol on the self-assessment of the clinical condition and the emotional coloring of the corresponding complaints was accompanied by an improvement in such components of QOL as “general activity”, “mood”, “ability to work”, “relationships with other people” and “ability to enjoy life”. The studied drugs did not differ in the intensenty of the identified effects.

Conclusion. Emoxipine, Ethoxidol and Mexidol significantly improve the multidimensional self-assessment of the clinical condition of patients receiving radiation therapy after surgical treatment of endometrial cancer. The results obtained allow us to consider Emoxipine, Ethoxidol and Mexidol as equally effective means of maintenance therapy at the stage of postoperative radiation treatment of patients with endometrial cancer.

Journal of Modern Oncology. 2022;24(2):177-183
pages 177-183 views
Cabozantinib in the treatment of patients with advanced renal cell carcinoma
Volkova M.I., Turupaev K.A., Kalinin S.A.
Abstract

In recent years, the standards of drug therapy for advanced kidney cancer have undergone significant changes associated with the appearance of the effective immune checkpoint inhibitors, as well as the high affinity second-generation multi-kinase inhibitors. One of the new tyrosine kinase inhibitors associated with the proven antitumor activity and safety in patients with advanced forms of renal cell carcinoma (RCC) is cabozantinib. The standards of drug therapy for advanced renal cancer have significantly changed in recent years with the emergence of effective anti-tumor immune response checkpoint inhibitors and high-affinity second-generation multikinase inhibitors. One of the novel tyrosine kinase inhibitors with proven antitumor activity and safety in patients with advanced renal cell cancer (RCC) is cabozantinib. In the first-line therapy for advanced renal cancer, the combination of cabozantinib with nivolumab became the regimen of choice in patients of all risk groups, according to International Metastatic RCC Database Consortium (IMDC), regardless of the presence of a sarcomatoid component in the tumor based on the results of the randomized phase III CheckMate 9ER clinical trial (n=651), which demonstrated a significant benefit of immune targeted therapy compared to sunitinib in terms of overall survival (OS; median 37.7 and 34.3 months, respectively), progression-free survival (PFS; median 16.6 and 8.3 months, respectively) and objective response rate (ORR; 55.7 and 28.4%, respectively). Cabozantinib monotherapy in the first-line therapy of advanced renal cancer in patients in the intermediate-risk and poor-risk groups is an alternative regimen reserved for patients with contraindications to anti-tumor immune response checkpoint inhibitors. This recommendation is based on the results of the open-label phase II RCT, CABOSUN (n=157), which showed a significant increase in PFS in the cabozantinib group compared to sunitinib (8.6 month vs 5.3 months, respectively). Also, cabozantinib is the drug of choice in papillary RCC due to the proven advantage in terms of PFS over sunitinib (9.0 and 5.6 months, respectively) demonstrated in the SWOG 1500 phase II RCT (n=152). Cabozantinib remains the drug of choice for second-line therapy of RCC resistant to anti-angiogenic therapy, based on the results of the phase III METEOR RCT, in which the drug showed a compelling advantage over everolimus for PFS (7.4 and 3.8 months, respectively) and OS (21.4 and 16.5 months, respectively). The article presents a detailed analysis of these studies.

Journal of Modern Oncology. 2022;24(2):184-190
pages 184-190 views
Combination therapy regimens in the treatment of metastatic renal cell carcinoma: A review
Zukov R.A., Chernyaev D.V., Zulkaidarova A.R.
Abstract

Renal cell carcinoma (RCC) is one of the most common tumor types in urologic oncology practice. Despite the improvement of diagnostics methods, about 1/3 of patients with renal cell carcinoma have distant metastases at presentation resulting in an extremely high death rate. For many years, treatment of advanced forms of RCC was utterly ineffective. Standard chemotherapy regimens with fluoropyrimidines and antitumor antibiotics, cytokine therapy with interleukin-2, and interferon-α only slightly prolonged the life of patients while causing severe toxic side effects and anemia. Attempts to treat the tumor with radiation therapy have also failed and have been used only for symptomatic treatment of distant metastases. The introduction of tyrosine kinase inhibitors (TKIs) in the treatment of metastatic RCC (mRCC) has enabled much more significant results. Thus, a landmark event was the approval of TKIs sunitinib and then sorafenib, pazopanib, axitinib, lenvatinib, cabozantinib, and mammalian target of rapamycin (mTOR) inhibitors: everolimus and temsirolimus. Subsequent combined therapy using bevacizumab with low-dose interferon-α and lenvatinib with everolimus improved recurrence-free survival and objective response rates but contributed to increased toxicity of therapy. The next step in RCC therapy was the approval of the combination of the immuno-oncology agents ipilimumab and nivolumab for the treatment of mRCC by the U.S. Food and Drug Administration in April 2018. Later, combinations of immune checkpoint inhibitors with targeted agents were approved, which increased the life expectancy of patients and reduced the toxicity of antitumor therapy. One of the most effective regimens is the combination of a TKI axitinib or lenvatinib with the PD-1 inhibitor pembrolizumab. This article addresses the current progress in the treatment of patients with mRCC, reviewing the results of completed clinical trials on the use of combination therapy with targeted and immuno-oncology agents.

Journal of Modern Oncology. 2022;24(2):191-198
pages 191-198 views
Malignant refractory priapism in case of urothelial cancer. Case report
Ognerubov N.A., Antipova T.S.
Abstract

Background. Malignant priapism is a painful lesion and persistent erection of the penis due to metastatic infiltration by a neoplasm. Secondary penile malignancy, as a consequence of metastatic disease, is a rare event. This indicates the progression of the main disease and an unfavorable outcome. Most cases of metastatic penile cancer are from the urogenital region: the prostate – 33%, the urinary bladder – 30%, the kidneys – 8% and gastrointestinal tract – 8%.

Aim. To describe the case of malignant refractory priapism in bladder cancer patient.

Materials and methods. A 49-year-old patient with pT4aN3M0 stage IIIB low-grade bladder cancer received the complex treatment and was under observation. Combined 18F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) using GE Healthcare Optima PET/CT 560 scanner was performed.

Results. The patient with poorly differentiated bladder cancer underwent transurethral resection followed by 3 cycles of neoadjuvant polychemotherapy using Gemzar plus cisplatin scheme. The surgery concerning cystprostatectomy, pelvic lymphadenectomy, urethrectomy and the Bricker operation was performed after the development of relapse. The histological examination of the bladder tissue showed the presence of poorly differentiated urothelial cancer, invading all the layers with invasion into the seminal vesicles and prostate. The lesion in the root of the penis that were growing and associated with the tensive pain was diagnosed 7 months after the surgical treatment. The intensity of these manifestations was increasing within 2 weeks. During the physical examination the penis was enlarged, solid, rigid and painful on palpation. According to 18F-FDG PET/CT study the metastatic penile cancer complicated with priapism was diagnosed.

Conclusion. Malignant priapism is a rare condition. The most often cause of malignant priapism development is urogenital tract tumors, in particular urothelial cancer. Refractory priapism is characterized by the increase of the local manifestations over time. 18F-FDG PET/CT is the method of choice for the diagnosis of malignant priapism.

Journal of Modern Oncology. 2022;24(2):200-203
pages 200-203 views
The third-line therapy for patients with metastatic colorectal cancer: regorafenib or repeated administration of drugs? A review
Rykov I.V., Chubenko V.A.
Abstract

To this date, the treatment of metastatic colorectal cancer involves continuous drug therapy, the so-called "continuum of care" approach in order to control of tumor growth and try to increase life expectancy for patients. The characteristic is the limited availability and insufficient number of third- and subsequent-line therapy. The main options for the treatment of resistant forms of metastatic colorectal cancer in real practice are the alternation of chemotherapy regimens, targeted drugs and the application of regorafenib. The choice of the treatment tactics is influenced by the patient's condition, the previous treatment and the efficacy, the molecular status of the tumor. The correct sequence of use of such approaches is currently not clearly defined and is the subject of many discussions and retrospective studies. The article discusses the main trends in the application of targeted antiangiogenic therapy for this category of patients.

Journal of Modern Oncology. 2022;24(2):204-208
pages 204-208 views
Prospects for the treatment of neurofibromatosis type 1: A review
Mustafin R.N.
Abstract

Neurofibromatosis type 1 (NF1) is an autosomal dominant hereditary tumor syndrome with a prevalence of 1:3000 in human population. About 50% of NF1 cases are sporadic due to newly emerging germline mutations in NF1 gene. Protein product of NF1 is a neurofibromin, which inhibits RAS-RAF-MEK-ERK system. The prevalence of NF1 is increasing as patients are fertile. Therefore, it is important to use rapid diagnostic methods for NF1 mutations in NF1 families for prenatal prophylaxis. Mutations in NF1 gene play roles in sporadic carcinogenesis and in development of cancer resistance to chemotherapy. Specific for NF1 are multiple subcutaneous and cutaneous neurofibromas, age spots, skeletal abnormalities, mental retardation, tumors of the brain and optic nerves. Half of patients with NF1 develop plexiform neurofibromas, which disfigure them or compress vital organs. The difficulty in treating NF1 is due to involvement of immune system, since a large number of degranulating mast cells are found in neurofibromas. Mast cells secrete cytokines that don’t provide a proper anti-tumor immune response, but initiate formation and growth of new neurofibromas. Therefore, long-term administration of ketotiphen was proposed for treatment of NF1 patients. Surgical removal of neurofibromas causes relapses and induction of the growth of new tumors; therefore, it is necessary to develop an effective therapy for NF1. The effectiveness of complex therapy of NF1 with use of ketotiphen, Lydase and Aevit, as well as monotherapy with an ATP-independent inhibitor of mitogen-activated protein kinase, has been described. For widespread clinical implementation of these methods, it is necessary to conduct studies on large sample of patients, as well as to make medicines available for patients. Gene therapy may become promising in the treatment of NF1, which requires identification of the type of mutation in NF1 gene in each individual and the use of specific microRNAs.

Journal of Modern Oncology. 2022;24(2):209-215
pages 209-215 views
Transthoracic biopsy under the control of computed tomography as a method of differential diagnosis of nodular neoplasms of the lung in outpatient settings: Retrospective cohort study
Perepelevskiy A.N., Stanojevic U.S., Lazarenko V.A., Grebenkin E.N., Sumina O.E.
Abstract

Background. Morphological verification of central and peripheral focal lung neoplasms is a difficult task for modern minimally invasive methods of differential diagnosis. The use of transthoracic trepanobiopsy of lung neoplasms under the control of computed tomography (CT) allows you to obtain informative, histological material and make a correct diagnosis.

Aim. The aim of the study was to determine the possibility and safety of performing transthoracic trepanobiopsy of lung tumors under the control of CT in patients who are on an outpatient appointment in a third-level institution in order to obtain informative histological material.

Materials and methods. From January 2020 to April 2021, 65 patients underwent transthoracic trepanobiopsy of focal lung neoplasms under the control of CT on an outpatient basis in the polyclinic department of the Ostroverkhov Kursk Cancer Research and Clinical Center.

Results. The average time spent on performing a biopsy, with preliminary marking under CT control, was 15.1±4.5 minutes. In 2 (3.1%) cases, the morphological material was uninformative. The informativeness of the performed trepanobiopsies for the verification of the lung tumor process was 96.9%. Complications were observed in 5 (7.6%) patients: pneumothorax – in 4 (6.1%), hemoptysis – in 1 (1.5%). Pneumothorax occurred mainly in patients aged 55–67 years.

Conclusion. The used method of transthoracic lung trepanobiopsy under CT control should be used in outpatient settings of third-level institutions for morphological confirmation of the diagnosis, since it is safe and highly informative for patients, which is confirmed by a low percentage of complications (7.6%) and allows for differential diagnosis of focal lung neoplasms at the pre-hospital stage.

Journal of Modern Oncology. 2022;24(2):216-220
pages 216-220 views
Experience with olaparib in the treatment of BRCA-associated tumors in real clinical practice. Observational study
Sultanbaev A.V., Menshikov K.V., Musin S.I., Nasretdinov A.F., Fatikhova A.A., Izmailov A.A., Lipatov O.N., Ayupov R.T., Sultanbaeva N.I., Menshikova I.A., Serebrennikov G.A.
Abstract

Background. PARP inhibitor olaparib shows encouraging results in the treatment of patients with BRCA-associated tumors. The detection of new tumors associated with abnormalities of the BRCA gene, also can lead to the expansion of PARP inhibitors application. The application of PARP inhibitors improved treatment outcomes for ovarian, breast, prostate and pancreatic cancers in comparison with standard drug therapy regimens, demonstrating the moderate toxicity profile. All this makes olaparib the significant option in planning the tactics of treatment of this category of patients.

Aim. Assess the efficacy of olaparib in real clinical practice conditions in our region and to demonstrate the clinical experience accumulated in the regional clinical oncology dispensary.

Materials and methods. We analyzed the cases of the treatment with olaparib in the Republican Clinical Oncological Dispensary of the Ministry of Health of the Republic of Bashkortostan. The study included 79 patients.

Results. Median progression-free survival reached 12 months and the best response was the stabilization of the disease among patients receiving olaparib. Median progression-free survival was 6 months and the best response was the stabilization of the disease among the patients treated with olaparib during Re-Challenge regimen.

Conclusion. Olaparib applying in real clinical practice demonstrated satisfactory results.

Journal of Modern Oncology. 2022;24(2):221-225
pages 221-225 views
Current treatment aspects of hormone-dependent ERBB2-negative metastatic breast cancer: overall survival outcomes
Snegovoy A.V., Kononenko I.B.
Abstract

This review provides an overall survival analysis in patients with hormone-dependent ERBB2-negative metastatic breast cancer (mBC) treated with CDK4/6 inhibitors combined with endocrine therapy (ET). The results of MONALEESA-2, 3, 7, PALOMA-2, 3, and MONARCH-2, 3 studies are provided.

The emergence of a new class of drugs, CDK4/6 inhibitors, opened the way to revise the treatment algorithm for patients with HR+/HER2- mBC. Currently, in treatment lines 1 and 2, the combination of CDK4/6 inhibitors with ET is preferable. The proven overall survival advantage in treatment lines 1 and 2, and data from an exploratory analysis subgroup, demonstrate the efficacy of ribociclib in combination with ET. The results of the studies confirm the benefits of combination therapy in routine practice to treat HR+/HER2- mBC regardless of the patient's age, menopausal status, ET variant, and disease prevalence.

Journal of Modern Oncology. 2022;24(2):226-233
pages 226-233 views
Sarcopenia, sarcopenic obesity, myosteatosis as factors of poor prognosis in gastrointestinal tract tumors: sistematic review
Lyadov V.K., Dikova T.S., Zatsepina A.Y., Ivashchenko D.V.
Abstract

Background. Gastrointestinal (GI) tract cancer includes a broad spectrum of tumors with generally high prevalence and poor prognosis. Over the past decade sarcopenia (skeletal muscle depletion), myosteatosis, sarcopenic obesity were all shown to have a negative prognostic impact in patients with various malignancies. However, the role of myosteatosis in patients with GI tumors remains controversial.

Aim. To summarize recent literature regarding the impact of myosteatosis on the surgical treatment of patients with GI malignancies.

Materials and methods. PubMed, Cochrane Library and ClinicalTrials.gov databases were searched for relevant original studies published between Jan. 2011 and Dec. 2021. The risk of bias of the included studies was assessed using Newcastle-Ottawa Scale (NOS).

Results. 34 studies comprising 15 295 patients were included. Patients with myosteatosis had significantly poorer overall survival (hazard ratio 0,506, 95% confidence interval 0,431–0,595; p<0,05). There was no significant influence of myosteatosis on recurrence-free survival (hazard ratio 0,658, 95% confidence interval 0,389–1,112; p<0,05). Myosteatosis was significantly associated with the occurrence of major postoperative complications in 6 studies. However, only 3 studies supported the impact of myosteatosis on mortality.

Conclusion. This meta-analysis demonstrates that patients with preoperative myosteatosis have poor long-term survival following treatment for GI malignancy. Therefore, myosteatosis might be used as a prognostic tool. However, more studies with standardized definitions and cut-offs are required.

Journal of Modern Oncology. 2022;24(2):234-241
pages 234-241 views
Current concepts of neuroendocrine cancer of the prostate: a clinical case and review of the literature
Chizh G.A., Tyutrina Y.A., Protsenko S.A., Dzhelialov E.S., Latipova D.H.
Abstract

Prostate cancer (PC) is a heterogeneous group of diseases that differ in their biological nature, clinical manifestations, and prognosis. A special variant among them is a neuroendocrine prostate cancer (NEPC). NEPC is a rare disease with unfavorable prognosis. The majority of patients with different NEPC variants die within 2 years after the diagnosis, despite the performed treatment. The distinctive features of NEPC are the patterns of metastasis in the form of a tendency to involve internal organs and extra regional lymph nodes, lytic bone lesions; high rates (up to 6 months) of clinical and radiological disease progression against the background of androgen-deprivation therapy; expression of serological markers and their high content in peripheral blood. The reasons of the aggressive behavior of NEPC consists in molecular and genetic events in cells, leading to realization of androgen-independent mechanisms of proliferation as a result of the AURKA-mediated neuroendocrine differentiation of tumor cells, early loss of function of p53 and Rb1 oncosuppressors, and low expression of androgen receptors. In every tenth case of NEPC, these molecular changes are response of prostatic adenocarcinoma to androgen-deprivation therapy. The described clinical case demonstrates the differences of biological behavior of these cancer variants and their sensitivity to various variants of drug treatment. Our case also illustrates possible difficulties of differential diagnostics of prostatic adenocarcinoma with various variants of neuroendocrine cancer, especially with adenocarcinoma with foci of neuroendocrine differentiation. The complexity of management of patients with NEPC are exacerbated by insufficient coverage of this problem: the existing data on the management of patients suffering from various variants of NEPC are limited by descriptions of clinical cases, literature reviews and few phases I–II clinical studies. All this makes it necessary to thoroughly study and describe each case of NEPC.

Journal of Modern Oncology. 2022;24(2):242-249
pages 242-249 views
Are oral blood thinners safe and effective for people being treated for cancer?
Abstract

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Lara A Kahale, Charbel F Matar, Ibrahim G Tsolakian, Maram B Hakoum, Maddalena Barba, Victor ED Yosuico, Irene Terrenato, Francesca Sperati, Holger Schünemann, Elie A Akl. Oral anticoagulation in people with cancer who have no therapeutic or prophylactic indication for anticoagulation. Cochrane Database of Systematic Reviews 2021, Issue 10. Art. No.: CD006466. DOI: 10.1002/14651858.CD006466.pub7

Journal of Modern Oncology. 2022;24(2):250-251
pages 250-251 views
Blood thinners for the initial treatment of blood clots in people with cancer
Abstract

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Lara A Kahale, Charbel F Matar, Maram B Hakoum, Ibrahim G Tsolakian, Victor ED Yosuico, Irene Terrenato, Francesca Sperati, Maddalena Barba, Holger Schünemann, Elie A Akl. Anticoagulation for the initial treatment of venous thromboembolism in people with cancer. Cochrane Database of Systematic Reviews 2021, Issue 12. Art. No.: CD006649. DOI:10.1002/14651858.CD006649.pub8

Journal of Modern Oncology. 2022;24(2):252-252
pages 252-252 views
Benefits of capecitabine in hormone receptor-positive compared to hormone receptor-negative breast cancer
Abstract

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Siao-Nge Hoon, Peter K H Lau, Alison M White, Max K Bulsara, Patricia D Banks, Andrew D Redfern. Capecitabine for hormone receptor-positive versus hormone receptor-negative breast cancer. Version published: 26 May 2021. DOI: 10.1002/14651858.CD011220.pub2

Journal of Modern Oncology. 2022;24(2):253-253
pages 253-253 views
Own experience in the treatment of primary refractory Hodgkin's lymphoma. Case report
Gushchina E.E., Vernyuk M.A., Chervontseva A.M., Cherkashina I.V., Khayrullina L.S., Lunin V.V., Fedenko A.A.
Abstract

Despite significant progress made in recent decades in the treatment of classical Hodgkin's lymphoma, in 10–30% of patients develop a refractory course or relapse of the disease. The effectiveness of therapy of the second and subsequent lines is about 50%. A significant breakthrough in the treatment of recurrent/refractory forms of classical Hodgkin's lymphoma has been the introduction of targeted drugs. The inclusion of new drugs in previously standard rescue therapy regimens significantly improves the effectiveness of the therapy. A clinical case of treating a patient with the progression of classical Hodgkin's lymphoma after first-line therapy, the use of brentuximab vedotin in combination with bendamustine as a rescue therapy with the achievement of complete remission, followed by high-dose consolidation with autologous hematopoietic stem cell transplantation is presented.

Journal of Modern Oncology. 2022;24(2):254-258
pages 254-258 views
Risk of discrimination against Russian citizens in providing medical care abroad as a health care trend
Ognerubov N.A., Zelepukin R.V., Poddubnaya I.V.
Abstract

The authors reveal the conditions and factors of health care system development that have emerged to date, indicate their content, and note the role of legal regulation of health care. The influence of aggravation of the international situation is noted, and the resulting risk of national origin discrimination against Russian citizens is addressed. The risk of discrimination against Russian citizens in providing health care abroad is presented as a trend. In this respect, the authors suggest some organizational and human rights measures and directions of support and protection of the rights of Russian citizens.

Journal of Modern Oncology. 2022;24(2):260-263
pages 260-263 views


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