Vol 18, No 1 (2016)


Systemic drug therapy of metastatic pancreatic cancer

Pokataev I.A., Tyulyandin S.A.


The standard treatment for patients with locally advanced and metastatic pancreatic cancer was monochemotherapy using gemcitabine until 2011. For a long time the attempts to create the combinations of gemcitabine and new drugs did not lead to clinically significant increase of these patients life expectancy. Introduction of new chemotherapy regimens into clinical practice such as combination of nab-paclitaxel and FOLFIRINOX was resulted in a clinically significant increase of life expectancy. Characteristics and toxicity range of new chemotherapy regimens allow form selected mode algorithm of chemotherapy regimen for every patient based on his status, comorbidity and complications of tumor process.
Journal of Modern Oncology. 2016;18(1):20-24
pages 20-24 views

The optimization of second-line therapy for metastatic colorectal cancer: new targeted therapy options

Artamonova E.V., Manzyuk L.V.


Advances in the treatment of metastatic colorectal cancer (mCRC) during the past years, largely associated with the wide use of targeted agents and effective chemotherapy regimens in routine clinical practice, as well as with the introduction of the "continuum of care" concept. This concept means a clear planning of the treatment sequence and identifying the optimal combination of the chemotherapy regimen and targeted agent at each setting. Following this approach the role of the 2-nd line setting is dramatically icreasing, and this review aimed to identify the best treatment combination for the mCRC patients at this setting. The optimal treatment sequence for most patients with unresectable metastases is the use of oxaliplatin containing regimen the in 1-st line and switch to FOLFIRI (duplet containing irinotecan and infusion of 5-fluorouracil) in the 2-nd line treatment for metastatic colorectal cancer.Therefore, the choice of the most effective targeted agent in combination with FOLFIRI seems extremely actual. Various targeted biological agents including as anti-EGFR antibodies as well as antiangiogenic agents such as bevacizumab and aflibercept have been studied in various combinations in the 2-nd line setting for mCRC treatment.Anti-EGFR antibodies in 2-nd line treatment increased progression-free survival, but didn’t result in the overall survival increase, while angiogenesis inhibitors were effective in terms of PFS and OS in bevacizumab-naive patients as well as in bevacizumab pretreated patients. Aflibercept was the first targeted agent showed the increase of overall survival as well as progression-free survival and objective response rate in 2-line setting when combined with FOLFIRI in a broad population of mCRC patients.
Journal of Modern Oncology. 2016;18(1):25-31
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Klinicheskie sluchai lecheniya gepatotsellyulyarnogo raka v Rossii. Klinicheskiy sluchay 1 Bolee chem 3-letnyaya stabilizatsiya protsessa gepatotsellyulyarnogo raka na fone dlitel'nogo priema preparata sorafenib

Sheko S.S., Dem'yanova G.A.


В статье представлены клинические случаи применения таргетной терапии препаратом сорафениб для лечения гепатоцеллюлярного рака в России. Опыт российских онкологов не только подтверждает результаты международных клинических исследований, но и наглядно демонстрирует возможности продолжительного приема препарата сорафениб на фоне высокой эффективности и контролируемого профиля безопасности.
Journal of Modern Oncology. 2016;18(1):32-34
pages 32-34 views
pages 34-36 views

BRCA-associated ovarian cancer (the experience of the Chemotherapy Department in N.N.Blokhin Russian Cancer Research Center of the Ministry of Health of Russia)

Khokhlova S.V., Gorbunova V.A., Lyubchenko L.N., Imyanitov E.N.


In recent years, the main scientific directions concerning ovarian cancer have been associated with the attempt to individualize the treatment based on prognostic and predictive molecular biological markers. The damage in BRCA1 and BRCA2 genes is identified in 10-15% of ovarian cancer cases. The main function of BRCA proteins is responsibility for repairing double-strand break in DNA by a mechanism of homologous recombination. The result of BRCA gene dysfunction is BRCA-associated DNA damage repair mechanism. As a result, these tumors can be extremely sensitive to DNA-damaging cytostatic agents - such as platinum-based drugs. Several studies show the better survival rates of patients with BRCA mutations in comparison with sporadic ovarian cancer. The information concerning the course of disease and treatment characteristics of patients with ovarian cancer associated with BRCA1, 2 mutations in the Russian population of patients is extremely limited.
Journal of Modern Oncology. 2016;18(1):37-44
pages 37-44 views

Rare morphological forms of breast cancer: features of surgical approach

Vysotskaya I.V., Letyagin V.P., Kolyadina I.V., Martynova G.V.


In accordance with WHO recommendations among the epithelial tumors of breast carcinomas made selection of rare histological subtypes. It is diverse, poorly studied and prognostically heterogeneous group of breast cancer. This situation is related to the rarity of their occurrence in the breast cancer population - from several tens to individual cases, which leads to the inability to obtain statistically valid conclusions. This concerns both the clinical and prognostic features and treatment strategy. Optimal control of local approaches in infiltrative ductal and lobular form of breast cancer are well understood, defined the standard surgery and indications for it. Somewhat different is the situation in the case of rare histological types of breast cancer, in which this problem is the subject of research.
Journal of Modern Oncology. 2016;18(1):45-49
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Features of surgical treatment of patients with breast cancer receiving preoperative systemic therapy

Kolyadina I.V., Poddubnaya I.V., Pavlikova O.A., Komov D.V.


Preoperative systemic therapy of breast cancer is one of the most promising and rapidly developing areas of modern oncology. Effective preoperative systemic treatment modifies the subsequent surgical step, contributes to the elimination of subclinical micrometastases and carcinoma sensitivity assessment for this type of therapy. However, the main goal is to achieve complete morphological regression, as a predictor of favorable prognosis of the disease. The proportion of patients who achieved a complete tumor response to preoperative effective systemic therapy is steadily growing, which creates certain difficulties at all steps of surgical treatment due to loss of macroscopic tumor area. Placement of image-detectable marker into the primary tumor and assessment of the status of regional lymph nodes before the start of systemic therapy, preoperative demarcate the residual tumor, planning volume of removed tissue, evaluation of resection margins and clipping the tumor bed for adjuvant radiation therapy with boost is a continuous chain of modern multidisciplinary approach in the treatment of breast cancer, the need to implement in clinical practice becomes apparent.
Journal of Modern Oncology. 2016;18(1):50-54
pages 50-54 views

Long-term effects of pediatric cancer therapy: 35-year clinical experience

Zaeva G.E., Valiev T.T., Gavrilenko T.F., Moiseenko E.I., Medvedovskaya E.G., Mikhailova S.N., Sinyagina Y.V.


Successes in pediatric cancer treatment made us reassesses treatment goals in favor of maximal anti-cancer effect and decrease unfavorable long-term effects of treatment. Anthracycline antibiotics, platin-derived drugs, methotrexate, bleomycine, irradiated therapy - just a few agents course serious long-term effects for child vital organs and systems after anti-cancer treatment. In the current article international and authors experience in generalysis analysis of anti-cancer treatment long-term effects are presented. Authors present different cardiovascular, respiratory, digestive, endocrine, musculoskeletal immune systems disorders in 873 pediatric cancer survivors. Follow up period from 1979 to 2014 revealed second tumors in this cohort. High value data about health index of pediatric cancer survivors generation, which was comparable with general population.
Journal of Modern Oncology. 2016;18(1):55-60
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Outcomes of surgical treatment of advanced gastrointestinal stromal tumors

Abouhaidar O.B., Nered S.N., Arkhiri P.P., Nikulin M.P., Stilidi I.S.


Targeted therapy of imatinib is a standard treatment of patients with metastatic gastrointestinal stromal tumors (GIST). The role of surgical approach in treatment of patients with disseminated GIST is remaining the most important and controversial issues. The retrospective analysis of the treatment of 140 patients with disseminated GIST to assess the efficacy of surgical treatment was carried out. Surgical treatments in combination with targeted therapy were performed in 98 patients and 42 patients were treated using only tyrosine kinase inhibitors.Comparative analysis showed the statistically significant improvement of remote results in the group of patients undergoing surgical operations associated with the effect of therapy using tyrosine kinase inhibitors. Cytoreductive surgery in patients with diffuse progression on imatinib therapy does not improve survival rates.
Journal of Modern Oncology. 2016;18(1):61-66
pages 61-66 views

Insulin-like growth factors in patients with ovarian tumors (results of own research)

Knyazev R.I., Kuznetsov V.V., Bokin I.I., Barinov V.V., Kushlinskiy N.E., Poddubnaya I.V.


In experimental models it was shown that the family of insulin-like growth factors (IGF), the main representative of which is IGF-1 exerts mitogenic, antiapoptotic and angiogenic activity. It is known that IGF-signaling pathway is involved in the activation cascade of the mitogen-activated protein kinases, resulting in the blocking of apoptosis. Clinical studies confirm the need for the involvement of IGF signaling pathway in the development and progression of ovarian cancer (OC).Subjects and methods. The study included 44 patients with ovarian cancer, 7 patients with borderline and 14 benign ovarian tumors. The ELISA analysis determined the content of insulin-like growth factors type 1 and 2 in tumor tissue and serum of patients with neoplasm of the ovary.Results. In the tissue of ovarian cancer content of IGF-1 were significantly lower than in the tissue of benign tumors. Serum levels of IGF-1 and IGF-2 correlated negatively with the prevalence of OC. Found direct correlation between levels of IGF-1 and IGF-2 in ovarian cancer tissue, and poor direct correlation between serum levels of IGF-1 and IGF-2. The median follow-up period was 14 months and the median time without recurrence was 13.5 months. It is established that two-year disease-free survival is reduced by 40% when low serum levels of IGF-I, and 30% at low levels of IGF-2. In patients with residual tumor size less than 1 cm with high serum levels of IGF-1 (87 ng/ml) two - year disease-free survival was 66.2%, and at low levels of IGF-1 - 25% (p=0.016).Conclusions. The levels of IGF-1 and IGF-2 in tumor tissue and serum in patients with ovarian cancer were decreased in the tumor process. Elevated levels of IGF-I can be considered as a factor of favorable prognosis in patients with ovarian cancer who underwent cytoreductive surgery with residual tumor of less than 1 cm.
Journal of Modern Oncology. 2016;18(1):67-74
pages 67-74 views

Concerning selective neck dissections in oral squamous cell carcinoma

Alymov Y.V., Podvyaznikov S.O., Mudunov A.M.


Background. Incidence of oral cancer in Russia is 4.52 and mortality - 2.44. Head and neck cancer is characterized by the high risk of development of metastases in regional lymph nodes (LN). LN status exerts influence on the treatment plan and appears to be the major predictive factor. Regional metastases result into two-fold decrease of five-year survival. Treatment of metastatic LN is of prime importance.Objective. The aim of this manuscript was to illustrate and summarize publications devoted to selective neck dissections in patients with squamous cell carcinoma of the oral cavity (OC).Results. Classic radical neck dissection is the gold standard of surgical treatment of OC cancer, characterized by regional metastases. However, metastases in neck LN of the IV- and V-th level are rarely present in patients with oral cancer. Therefore, efficiency of less extensive neck surgery is of great interest of up-to-date investigations. It was established, that selective neck dissection increases disease-free survival among patients with cT1-4N0M0 oral cancer in comparison with watchful waiting. Comparison of preventive selective neck dissections with preventive and curative modified neck dissections also indicates, that these methods of surgical treatment have equal efficacy.Conclusion. Selective neck dissection is feasible treatment method of сT1-4N0M0 oral cancer. Nevertheless, comparison studies of preventive selective and modified neck dissections, were characterized by disparate design and high probability of systematic errors. Moreover, another aspect, that must be solved, is the number of LN levels to be dissected during selective neck dissection. Thus, conception of selective neck dissection in patients with clinically negative LN is changing and requires further investigation.
Journal of Modern Oncology. 2016;18(1):75-79
pages 75-79 views

Lanreotide for the treatment of patients with disseminated high-grade neuroendocrine tumors: the experience of application in case of unsatisfactory tolerability of octreotide

Emelyanova G.S., Kuzminov A.E., Orel N.F., Odintsova A.S., Markovich A.A., Kuznetsova A.A., Gorbunova V.A.


Somatostatin analogs plays a key role in the treatment of disseminated well-differentiated functioning and nonfunctioning neuroendocrine tumors (NET). Its ingibit hormonal activity of NET by binding to somatostatin receptors, have antiproliferative effect, increase the median time to progression. Approximately 10% of patients have significant side-effects when used octreotide. Octreotide and lanreotide differ in structure. Intolerance to one drug, it may be assigned to another.
Journal of Modern Oncology. 2016;18(1):80-83
pages 80-83 views

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