Vol 18, No 4 (2016)

Articles
The use of PARP inhibitor - olaparib for the treatment of ovarian cancer in clinical practice
Khokhlova S.V.
Abstract
The treatment of patients with ovarian cancer remained unchanged over the past years: cytoreductive surgery and platinum-based chemotherapy regardless of the histological type of the tumor. A deeper understanding of ovarian cancer biology has paved the way to developing targeted drugs; the most studied are bevacizumab and olaparib (Lynparza) - the first among PARP inhibitors, which has been recently approved in the world and in Russia. Olaparib demonstrated a statistically significant efficacy in the treatment using supportive regimen in patients with recurrent platinum-sensitive ovarian cancer after successful platinum-based chemotherapy and with the presence of BRCA1/2 mutations and all these characteristics would significantly change the course of the disease in this group of patients.
Journal of Modern Oncology. 2016;18(4):13-22
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Fulvestrant in endocrine therapy of recurrent and metastatic breast cancer
Vladimirova L.Y.
Abstract
Hormone therapy of recurrent and metastatic breast cancer has a wide range of drugs possessing different medical effects. However, the main problem is the sequence of endocrine therapy of hormone receptor-positive metastatic BC in the absence of visceral crisis, nowadays. The recommendations of the different professional communities do not contain visible preference in favor of the choice of any specific endocrine therapy or specific treatment sequence. According to the information we have received, at present the optimal treatment path, in the absence of resistance to endocrine therapy and visceral crisis, will be the following: line 1 - fulvestrant 500 mg; line 2 - AIs (for example anastrozole); line 3 - tamoxifen. The choice of the therapy must be based on the characteristics of not only the tumor, but also the patient. One should take into account the age of the patient, the duration of the interval without disease symptoms after adjuvant chemotherapy, the type of the damage and the involvement of internal organs in the process, the presence of concomitant diseases, toxic manifestations of chemotherapy regimens, the price and availability of the drugs.
Journal of Modern Oncology. 2016;18(4):23-26
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Therapy for patients with non-small cell lung cancer in the Russian Federation: EPICLIN-Lung study
Tyulyandin S.A., Imyanitov E.N., Moiseyenko V.M., Ponomarenko D.M., Gurina L.I., Koroleva I.A., Karaseva V.V.
Abstract
The first epidemiological observational EPICLIN-Lung study in Russia is aimed at revealing the true incidence and the type of EGFR mutations in the Russian population of patients with non-small cell lung cancer (NSCLC), the connection with the main epidemiological parameters, the treatment approaches and outcomes in real clinical practice. The study was conducted in 33 oncology centers across 24 Russian regions; the study included 838 patients with histologically confirmed NSCLC. Most patients (63.2%) presented with advanced disease (stage III-IV patients) and Squamous-cell carcinoma (54.3%) and adenocarcinoma (31%) were the most prevalent histology types of NSCLC. Epidemiology of EGFR mutations in this NSCLC cohort was similar to other studies of NSCLC in Caucasian populations. EGFR mutations were identified in 10.1% of NSCLC patients included in this study, most of them were women (69.4%) and associated with adenocarcinoma histologically (58.8%) and 71.8% of these patients were never-smokers. The presence of EGFR mutations in tumor indicated the low risk for progression. The results of EPICLIN-Lung study would contribute to a better understanding of prognostic and predictive factors of NSCLC in Russian populations and that would help to choose the optimal therapy in routine clinical practice.
Journal of Modern Oncology. 2016;18(4):27-33
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Surgical treatment and clinicopathological characteristics of patients with neuroendocrine neoplasms of the stomach
Bokhyan V.Y., Peregorodiev I.N., Delektorskaya V.V., Arkhiri P.P., Stilidi I.S.
Abstract
Neuroendocrine neoplasms of the stomach combine a wide range of tumors with different clinical features and prognosis. They are systematized by three classifications: WHO Classification, clinicopathological classification, TNM classification (UICC, ENETs). The treatment of stomach NENs is still unclear. Surgical method is the main treatment for localized forms and the only one way that can help to achieve a complete cure in patients with NENs. Patients and methods. The results of treatment of 35 patients with gastric NENs who were operated at N.N.Blokhin Russian Cancer Research Center for the period of time from 2001 to 2015 were analyzed. The patients were divided into two groups: well-differentiated tumors (1 and 3 clinicopathological types), poor-differentiated tumors - neuroendocrine cancer. Gender, age of patients, clinical features, type of tumors, locations and number of tumor, stage, time from manifestation to diagnosis, type of surgery, Ki-67 index, five-year survival rate were analyzed. Results. Surgical treatment allows to achieve a good result for the group of patients with well-differentiated tumors of stomach (where EMR is not recommended). The overall five-year survival rate is 79.8%. In the group of patients with NEC of the stomach radical surgery allows you to achieve the best five-year survival compared to palliative (54.8 and 0%, p=0.03, log-rank). Conclusions. The group of patients with well-differentiated neuroendocrine tumors is heterogeneous and requires a more careful and differentiated treatment approach. The main principles for the selection are clinicopathological features and proliferative index. According to our research, the value of Ki-67 to precises determine G1 and G2 is 5%. Surgical treatment allows to achieve the good long-term results for patients with localized NECs of the stomach.
Journal of Modern Oncology. 2016;18(4):34-41
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Molecular genetic features of the head and neck (upper aerodigestive tract) mucosal melanoma
Ignatova A.V.
Abstract
Mucosal melanoma is a rare and aggressive neoplasm of melanocytic origin. To date, in literature only few retrospective series and case reports have been reported on mucosal melanoma. Despite melanoma’s common histological origin,molecular biology of upper aerodigestive tract mucosal melanoma has some specific features compared with those of cutaneous melanomas. Taking into concideration the tremendous number of studies of prognostic molecular markers in cancer, only a few such markers have entered clinical practice in mucosal melanoma. The incidence of activating mutations in the BRAF, C-KIT and N-RAS oncogenes in mucosal melanoma is quite different from cutaneous melanoma: upper aerodigestive tract melanoma is characterized by high incidence of C-KIT and N-RAS mutations, BRAF mutations are uncommon. The most frequently studied markers in upper aerodigestive tract mucosal melanoma and prospectives of targeted therapy are reviewed in this article. A better comprehension of the pathogenesis of disease, in particular its molecular aberrations, can provide important insights into targets for future therapies.
Journal of Modern Oncology. 2016;18(4):42-46
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Nutritional status of children with cancer and hematological malignancies during treatment in FSBI Federal Scientific Clinical Center of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev (screening results)
Vasilyeva E.S., Vashura A.Y., Litvinov D.V.
Abstract
The majority of children during treatment for cancer, have disorders of nutritional status associated both with the presence of main disease and antitumor therapy. This paper deals with the results of the screening study of nutritional status of patients in FSBI Federal Scientific Clinical Center of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev on their primary admission to the Centre and during the treatment. It is shown that the part of the patients on the admission, or even before the special therapy, has disorders of nutritional status. We have determined the increase in the number of children with disorders of nutritional status over time and the persistence of somatic protein pool deficiency during the observation. The results show the necessity of adequate correction of nutritional status in this category of patients.
Journal of Modern Oncology. 2016;18(4):48-52
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