Even early-stage breast cancer is a heterogeneous disease, so the optimal treatment depends on the pathological characteristics of the tumor. The vast majority of breast tumors (80%) are classified as estrogen receptor positive (ER+) with varying degrees of ER expression. The benefit of endocrine therapy is small with low ER staining (1–10%), occurring in less than 2% of all cases of ER+ breast cancer. Genetic analyzes are valuable for administration of adjuvant chemotherapy prior to endocrine therapy in ER+ / HER2– pN0–pN1c breast cancer. But such tests are not yet widely available. In practical work, when planning adjuvant and neoadjuvant therapy for patients with ER+ / HER2– breast cancer, pathological assessment of the expression of ER, PR, Ki‑67, as well as the tumor grade (G) remains important. The use of drugs to overcome resistance to endocrine therapy: PI3-kinase inhibitors (taselisib), CDK 4/6 inhibitors (palbociclib, abemaciclib, ribociklib), mTOR inhibitors (everolimus) can enhance the effect of neoadjuvant and adjuvant endocrine therapy.
This article describes a method for activating lymphocytes isolated from the peripheral blood of melanoma patients and cultured in a medium supplemented with IL‑2 and IL‑15. It was shown that in these terms, lymphocytes have an increased proliferative and activation potential. The combination of cytokines has a positive effect on cytotoxicity, viability and the expression of activation markers (CD38, CD69, CD25, HLA-DR and NKG2D) on NK- and T-lymphocyte, and may be recommended for the culture of lymphocytes in melanoma patients for the purpose of adoptive immunotherapy.
In most cases triple negative breast cancer is characterized by an aggressive course of disease and early development of resistance to chemotherapy. Thereafter, the late-line treatment choice, usually after anthracyclines and taxanes, is problematic due to the limited amount of effective and low-toxic cytostatics. In our opinion, in this situation the use of eribulin which possesses unique antitumor action mechanisms is a good option. An illustrative case of a pronounced antitumor effect of eribulin in metastatic breast cancer with triple negative phenotype resistant to previous lines of chemotherapy is presented.
Neuroblastoma is a complicated systemic malignant process that requires risk-adapted, multimodal therapy. Certainly, the dissemination of the tumor process is an extremely unfavorable prognosis for the patient’s life and health, however, local relapses can be cured successfully. The aim of the article is to demonstrate a rare clinical case of using SBRT in a patient with central nervous system neuroblastoma local relapse in the context of combined modality treatment.
The aim of the study. To evaluate the results of radiation therapy for recurrent prostate cancer after radical prostatectomy.
Methods. The analysis of medical records data of 60 patients with recurrent prostate cancer after radical prostatectomy (RP) was performed.
Results. Biochemical control was achieved in 55 (92.0%) patients, PSA progression – in 3 (5.0%) and generalization – in 2 (3.0%) patients. Grade I–II cystitis developed in 25 patients (42.0%), grade I–II rectitis – in 7 (11.0%), late hemorrhagic cystitis was noted in 4 (7.0%) patients, late hemorrhagic rectitis – in 2 (3.3%) ones.
Сonclusions. Salvage radiation therapy for recurrent prostate cancer after radical prostatectomy is an important treatment method that allows to achieve biochemical control with acceptable toxicity.
The main goal of neoadjuvant chemotherapy (NACT) in aggressive breast cancer (BC) subtypes (triple-negative, HER2-positive) is to achieve complete pathological response (pCR), since it is associated with a significant decrease in the likelihood of recurrence and death. Currently, the standard approach for HER2+ BC stage II–III is NACT with the inclusion of a double anti-HER2 blockade, since this significantly increases the frequency of pCR. To date, it remains unclear whether the intensification of modern anthracycline-taxane-containing regimens of NACT affects the incidence of pCR in different BC subtypes, including HER2-positive, provided that a double anti-HER2 blockade is used.
The aim of our prospective observational study from daily clinical practice was to assess the efficacy (according to the RCB system and the frequency of pCR) and tolerability of dose-dense NACT in stage II–III HER2-positive BC.
Materials and methods. The study included 86 patients, mean age 45 years (26–74 years), in 96.5% of cases, the tumor was represented morphologically by invasive cancer of a nonspecific type, in 53.5% of the tumors had a positive luminal B HER2 phenotype, in 46.5% – non-luminal HER2+. The majority of patients (67.4%) had locally advanced inoperable breast cancer; in 80.2% of cases, metastatic lesions of regional lymph nodes were determined. NACT included anthracyclines and taxanes: four cycles of AC in a dose-dense regimen (once every 2 weeks), then four cycles of docetaxel 75 mg/m2 once every 3 weeks + trastuzumab + pertuzumab.
Results. The frequency of pCR = RCB0 in the entire group was 54.7% (47/86), in locally advanced breast cancer – 55.9%, in operable breast cancer – 51.9%. In the luminal HER2+ subtype, the frequency of pCR was lower than in the non-luminal HER2+ subtype – 43.5% vs 67.5%, however, the differences were statistically insignificant (p = 0.09). The frequency of RCB0–I in ER+ HER2+ subtype was 60.9%, as in ER-HER2+ – 80%. Conclusions. In our study, for the first time, the efficacy of dose-dense NACT in HER2+ breast cancer was assessed; it was shown that the frequency of pCR and RCB0–I correspond to those in standard anthracycline-taxane-containing regimens. In the context of the use of double anti-HER2 blockade, the anthracycline stage, most likely, does not need to be escalated, since this does not lead to an increase in the frequency of complete pathomorphological regressions.
ISSN 2949-2807 (Online)