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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medalphabet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский алфавит</journal-title><trans-title-group xml:lang="en"><trans-title>Medical alphabet</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2078-5631</issn><issn pub-type="epub">2949-2807</issn><publisher><publisher-name>ООО «Альфмед»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.33667/2078-5631-2024-7-13-17</article-id><article-id custom-type="elpub" pub-id-type="custom">medalphabet-3661</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ДИАГНОСТИКА И ОНКОТЕРАПИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>DIAGNOSTICS AND ONCOTHERAPY</subject></subj-group></article-categories><title-group><article-title>Роль митомицина в лечении первичного местно-распространенного BRCA1-ассоциированного трижды-негативного рака молочной железы</article-title><trans-title-group xml:lang="en"><trans-title>Mitomycin C in the treatment of early triple-negative locally  advanced BRCA-associated breast cancer</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2773-3111</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Еналдиева</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Enaldieva</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Еналдиева Диана Артуровна - врач-онколог, аспирант научной лаборатории молекулярной онкологии</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Enaldieva Diana А. - oncologist, graduate student, research fellow at the Scientific Laboratory of Molecular Oncology</p><p>St. Petersburg</p></bio><email xlink:type="simple">dianaenaldieva932@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4898-9159</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Криворотько</surname><given-names>П. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Krivorotko</surname><given-names>P. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Криворотько Петр Владимирович - д.м.н., в.н.с., зав. отделением опухолей молочной железы </p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Krivorotko Petr V. - DM Sci (habil.), leading researcher, head of Breast Tumors Dept</p><p>St. Petersburg</p></bio><email xlink:type="simple">dr.krivorotko@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4529-7891</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Имянитов</surname><given-names>Е. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Imyanitov</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Имянитов Евгений Наумович - д.м.н., член-корр. РАН, профессор, зав. научным отделом биологии опухолевого роста; зав. кафедрой общей и молекулярной медицинской генетики</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Imyanitov Evgeniy N. - DM Sci (habil.), corresponding member of Russian Academy of Sciences, professor, chief researcher, leader of Science Dept of Tumor Growth Biology; head of Dept of General and Molecular Medical Genetics</p><p>St. Petersburg</p></bio><email xlink:type="simple">evgeny@imyanitov.spb.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9391-5327</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Донских</surname><given-names>Р. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Donskih</surname><given-names>R. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Донских Роман Владимирович - к.м.н., зам. главного врача по медицинской части  </p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Donskih Roman V. - PhD Med, deputy chief physician for medicine</p><p>St. Petersburg</p></bio><email xlink:type="simple">Rdonskih@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6304-1609</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Соколенко</surname><given-names>А. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Sokolenko</surname><given-names>A. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Соколенко Анна Петровна - к.м.н., старший научный сотрудник отдела биологии опухолевого роста; доцент кафедры общей и молекулярной медицинской генетики</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Sokolenko Anna P. - PhD Med, researcher at Dept of Biology of Tumor Growth; associate professor at Dept of General and Molecular Medical Genetics</p><p>St. Petersburg, </p></bio><email xlink:type="simple">annasokolenko@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Азаова</surname><given-names>В. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Azaova</surname><given-names>V. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Азаова Валерия Олеговна - студент медико-профилактического факультета </p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Azaova Valeria O. -  student of the Medical and Preventive faculty</p><p>St. Petersburg</p></bio><email xlink:type="simple">Azaovavmspb@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2421-3284</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Амиров</surname><given-names>Н. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Amirov</surname><given-names>N. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Амиров Николай Сергеевич - врач-онколог, аспирант отделения опухолей молочной железы</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Amirov Nikolay N. - oncologist, research fellow at Breast Tumors Dept</p><p>St. Petersburg</p></bio><email xlink:type="simple">amirovn17@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6442-0106</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бондарчук</surname><given-names>Я. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Bondarchuk</surname><given-names>Ya. Ig.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бондарчук Яна Игоревна - врач-онколог, аспирант отделения опухолей молочной железы</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Bondarchuk Yana Ig. - oncologist, research fellow at Breast Tumors Dept</p><p>St. Petersburg</p></bio><email xlink:type="simple">yana_bondarchuk_2015@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0003-6597-376X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Левченко</surname><given-names>В. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Levcheko</surname><given-names>V. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Левченко Валерий Евгеньевич - аспирант отделения опухолей молочной железы</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Levcheko Valerii E. - research fellow at Breast Tumors Dept</p><p>St. Petersburg</p></bio><email xlink:type="simple">levch.ve@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1346-933X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ульрих</surname><given-names>Д. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Ulrikh</surname><given-names>D. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ульрих Дарья Глебовна - врач-онколог клинико-диагностического отделения; аспирант кафедры онкологии </p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Ulrikh Daria G. - postgraduate student at Dept of Oncology; oncologist of Clinical Diagnostic Dept</p><p>St. Petersburg</p></bio><email xlink:type="simple">dashaulrikh@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0077-9619</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Семиглазов</surname><given-names>В. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Semiglazov</surname><given-names>V. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Семиглазов Владимир Федорович - д.м.н., член-корр. РАН, проф., зав. научным отделением, гл. научный сотрудник научного отделения опухолей  молочной железы</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Semiglazov Vladimir F. - DM Sci (habil.), corresponding member of the Russian Academy of Sciences, professor, chief researcher, leader of Science Dept</p><p>St. Petersburg</p><p> </p></bio><email xlink:type="simple">ssemiglazov@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.N. Petrov National Medical Research Center of Oncology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова»; ФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.N. Petrov National Medical Research Center of Oncology; St. Petersburg State Pediatric Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>St. Petersburg State Pediatric Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет»; ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Northwestern State Medical University named after I.I. Mechnikov; N.N. Petrov National Medical Research Center of Oncology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>09</day><month>05</month><year>2024</year></pub-date><volume>0</volume><issue>7</issue><issue-title>«Диагностика и онкотерапия» (1)</issue-title><fpage>13</fpage><lpage>17</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Еналдиева Д.А., Криворотько П.В., Имянитов Е.Н., Донских Р.В., Соколенко А.П., Азаова В.О., Амиров Н.С., Бондарчук Я.И., Левченко В.Е., Ульрих Д.Г., Семиглазов В.Ф., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Еналдиева Д.А., Криворотько П.В., Имянитов Е.Н., Донских Р.В., Соколенко А.П., Азаова В.О., Амиров Н.С., Бондарчук Я.И., Левченко В.Е., Ульрих Д.Г., Семиглазов В.Ф.</copyright-holder><copyright-holder xml:lang="en">Enaldieva D.A., Krivorotko P.V., Imyanitov E.N., Donskih R.V., Sokolenko A.P., Azaova V.O., Amirov N.N., Bondarchuk Y.I., Levcheko V.E., Ulrikh D.G., Semiglazov V.F.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-alphabet.com/jour/article/view/3661">https://www.med-alphabet.com/jour/article/view/3661</self-uri><abstract><sec><title>Обоснование</title><p>Обоснование. BRCA1-ассоциированный трижды-негативный рак молочной железы (ТНРМЖ) – один из самых агрессивных подтипов РМЖ. В то же время, карциномы, развивающиеся у носительниц мутаций BRCA1, характеризуются крайне высокой чувствительностью к ДНК-повреждающей химиотерапии. Митомицин С отдельно или в сочетании с препаратами платины уже продемонстрировал многообещающие результаты в лечении BRCA-ассоциированного рака яичников (РЯ) и метастатической формы РМЖ. В данной статье мы представляем результаты ретроспективного исследования, направленного на сравнение стандартных неоадъювантных схем химиотерапии (НАХТ) с режимами на основе митомицина при первичном местно-распространенном BRCA1-ассоциированном ТНРМЖ.</p><p>Цель исследования – определить эффективность комбинации митомицина и соединений платины при проведении неоадъювантной терапии у пациентов с первичным местно-распространенным BRCA1-ассоциированном ТНРМЖ.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В исследование включено 89 больных с диагнозом первичный местно-распространённый BRCA1-ассоциированный ТНРМЖ. Пациенты были разделены на три группы в зависимости от проводимой терапии: 1) 4 цикла антрациклина и циклофосфамида с последующими 12 еженедельными введениями паклитаксела (n = 48) (АС + Т), 2) 4 цикла антрациклина и циклофосфамида с последующими 12 еженедельными введениями паклитаксела и карбоплатина (n = 27) (АС + ТCbP), 3) митомицин С плюс препарат платины с последующими 12 еженедельными введениями паклитаксела (n = 14) (МР + Т). Сравнивали частоту достижения полного патоморфологического ответа (pCR).</p></sec><sec><title>Результаты</title><p>Результаты. Частота pCR в группе MP + T составила 10/14 (71 %). У пациенток с BRCA1-ассоциированным РМЖ, которые получали в качестве НАХТ схемы AC + T и AC + TCbP, частота pCR составила 17/48 (35%) и 19/27 (70%), соответственно. Различие в частоте pCR между митомицин-содержащей терапией и стандартной схемой AC + T было статистически достоверным (p = 0.03); частота регрессов была сопоставима с частотой в группе AC + TCbP. В течение 20-месячного периода наблюдения в группе МР + Т рецидивов зарегистрировано не было. Рецидивы были более частыми в группе АС + Т по сравнению с группой АС + ТCbP (16/48 (33%) против 1/27 (4%), р = 0,003, точный критерий Фишера). Профиль токсичности режима, содержащего митомицин, включал гематологические нежелательные явления, наиболее частыми из которых были анемия и лейкопения. По сравнению со стандартными схемами тошнота была значительно менее выражена. Ни один пациент не сообщил об алопеции при использовании данного режима.</p></sec><sec><title>Выводы</title><p>Выводы. Добавление митомицина С к неоадъювантной терапии BRCA1–ассоциированного ТНРМЖ может быть перспективным вариантом лечения этой категории больных и заслуживает дальнейшего изучения</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Rationale</title><p>Rationale. BRCA1 associated triple-negative breast cancer (TNBC) is one of the most aggressive subtypes of breast cancer. At the same time, carcinomas that develop in carriers of BRCA1 mutations are characterized by extremely high sensitivity to DNA-damaging chemotherapy. Mitomycin C alone or in combination with platinum agents has already demonstrated promising results in the treatment of BRCA-associated ovarian cancer (OC) and metastatic breast cancer. In this article, we present the results of a retrospective study aimed at comparing standard neoadjuvant chemotherapy regimens (NACT) with mitomycin-based regimens for primary locally advanced BRCA1-associated TNBC.</p><p>The aim of the study is to determine the effectiveness of the combination of mitomycin and platinum compounds during neoadjuvant therapy in patients with primary locally advanced BRCA1 – associated TNBC.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. The study included 89 patients diagnosed with primary locally advanced BRCA1-associated TNBC. Patients were divided into three groups depending on the therapy: 1) 4 cycles of anthracycline and cyclophosphamide followed by 12 weekly injections of paclitaxel (n = 48) (AC + T), 2) 4 cycles of anthracycline and cyclophosphamide followed by 12 weekly injections of paclitaxel and carboplatin (n = 27) (AC + TCbP), 3) mitomycin C plus platinum followed by 12 weekly injections of paclitaxel (n = 14) (MR + T). Pathological complete response (pCR) rates were compared.</p></sec><sec><title>Results</title><p>Results. The pCR rate in the MP+T group was 10/14 (71%). In patients with BRCA1-associated breast cancer who received AC + T and AC + TCbP regimens as NACT, the pCR rate was 17/48 (35%) and 19/27 (70%), respectively. The difference in pCR rate between mitomycin-containing therapy and the standard AC + T regimen was statistically significant (p = 0.03); the frequency of regressions was comparable to the frequency in the AC + TCbP group. During the 20-month follow-up period, no relapses were observed in the MR + T group. Relapses were more frequent in the AC + T group compared with the AC + TCbP group (16/48 (33%) vs 1/27 (4%), p = 0.003, Fisher’s exact test). The toxicity profile of the mitomycin-containing regimen included hematologic adverse events, the most common of which were anemia and leukopenia. Compared to standard regimens, nausea was significantly less pronounced. No patients reported alopecia with this regimen.</p></sec><sec><title>Conclusions</title><p>Conclusions. The addition of mitomycin C to neoadjuvant therapy for BRCA1-associated TNBC may be a promising treatment option for this category of patients and merits further study.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>мутация BRCA1/2</kwd><kwd>трижды-негативный рак молочной железы</kwd><kwd>препараты платины</kwd><kwd>полный патоморфологический  регресс</kwd><kwd>неоадъювантная химиотерапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>BRCA1/2 mutation</kwd><kwd>triple-negative breast cancer</kwd><kwd>platinum preparations</kwd><kwd>complete pathomorphological regression</kwd><kwd>neoadjuvant &#13;
chemotherapy</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена при финансовой поддержке Российского научного фонда (грант № 22–15–0266).</funding-statement><funding-statement xml:lang="en">This study has been supported by the Russian Science Foundation (grant No 22–15–0266)</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Khosravi-Shahi P. Metastatic triple negative breast cancer: Optimizing treatment options, new and emerging targeted therapies / P. Khosravi-Shahi, L. Cabezón-Gutiérrez, S. Custodio-Cabello // Asia Pac J Clin Oncol.– 2018.– Vol.14 (1).– P. 32–39.</mixed-citation><mixed-citation xml:lang="en">Khosravi-Shahi P. Metastatic triple negative breast cancer: Optimizing treatment options, new and emerging targeted therapies / P. Khosravi-Shahi, L. Cabezón-Gutiérrez, S. 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