Vol 18, No 1 (2016)

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.

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.

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.

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.

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.