Vol 1, No 10 (2019): Diagnostics & Cancer Therapy
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6-14 1324
Abstract
The review is devoted to a new class of drugs - inhibitors of cy-clin-dependent kinases. The discovery of the genetic and molecular mechanisms of cell cycle regulation, and as a result, the emergence of CDK4 / 6 inhibitors was a breakthrough in the treatment of ER+ HER2- metastatic breast cancer and changed the paradigm of hormone therapy in this group of patients. We consider the current role of CDK4 / 6 inhibitors in treating patients with hormone-sensitive breast cancer, as well as the prospects for the future use of this class of drugs. The article presents the results of the main registration studies of the FDA-approved inhibitors of CDK4 / 6: palbocyclyb, ribocyclyb, abemocyclib; a comparative analysis of their efficacy and toxicity profile was carried out.
O. V. Absalyamova,
G. L. Kobiakov,
S. L. Gutorov,
E. R. Vetlova,
S. V. Zolotova,
N. V. Arutyunov,
M. V. Inozemtseva,
N. G. Kobiakov
15-21 1344
Abstract
Radiation therapy (RT) plays an important role in treatment of primary and metastatic CNS tumors and some non-neopiastic conditions (arteriovenous malformations, trigeminal neuralgia). Radiation necrosis (RN) is a common adverse effect of RT. Until recently steroid therapy was used as a main treatment regimen for RN. Mechanisms of RN development are not clear; however, it was shown that vascular endothelial growth factor (VEGF) plays a critical role in its formation. A number of surveys showed efficacy of bevacizumab as an anti-VEGF agent in treatment of RN. Radiation necrosis pathogenesis, diagnostics and treatment are summarized in this review.
22-28 400
Abstract
Purpose. The purpose of the study was the creation of Hodgkin’s lymphoma (HL) predictive model in patients at the age of 10-29 years with a multivariant analysis. Material and methods. Data of 203 patients aged from 10 to 29 years were included in the study, there were 106 teenagers 10-17 years old (52 %) and 97 young adults 18-29 years old (48 %). Stage I was diagnosed in 7 patients (3.4 %), stage II - in 81 (39.9 %), stage III - in 55 (27.1 %) and stage IV-in 60 patients (29.6 %). Nodular sclerosis is established in majority of patients (82.8 %). Almost in half of cases (48.3 %) the B-symptoms were noted. Bulky disease was diagnosed in 152 (74.9 %) patients. Patients of 10-17 years were treated according to risk-adapted therapy DAL-HD (38.8 %) and SPbHL (54.3 %). Young adults of 18-29 years received treatment according to the ABVD and BEACOPP regimen (49.4 % and 37.1 %, respectively). To 66 % patients radiation therapy was carried out. Results. 5-year overall survival was 80.5 ± 3.6 %, disease-free survival was 78.8 ± 3.7 %, event-free survival was 65.4 ± 4.2 %; 10-year overall, disease-free and event-free survival were 70.3 ± 5.3 %, 68.1 ± 5.4 % and 61.1 ± 4.6 %, respectively. Nineteen factors underwent the statistical analysis. For predictors with several values the optimum cut-off was defined. Ten factors showed the significant influence on outcomes: the age more than 16 years old (AUC = 0.646; р = 0.0281), stage IV (AUC = 0.716; р = 0.0001), B- and b-symptoms, number of involved zones more than five (AUC = 0.633; р = 0.0202), lung, bone marrow, thymus and pleura injury, tumor volume more than 103.1 cm3/ m2 (AUC = 0.610; р = 0.027). The age of the patient and stage became the most important predictors in Cox hazard model. Thus, present variables in Cox hazard model will correspond to certain numerical and graphic characteristics of survival that allows to estimate risks and to decide on the treatment. Conclusion. Therapy for Hodgkin in teenagers and young adults based on stratification on risk groups depending on un-favoufable risk factors, carrying out multicenter researches will allow achieving the best treatment results and decrease remote consequences in patients at the age of 10-29 years old.
A. V. Nazarenko,
S. I. Tkachyov,
S. B. Alieva,
D. S. Romanov,
B. M. Medvedeva,
I. V. Sagaydak,
V. A. Boldyreva,
Yu. B. Bykova,
O. S. Zaychenko,
D. I. Fedoseenko,
S. V. Medvedev
29-34 383
Abstract
Treatment of patients with hepatocellular carcinoma is an urgent problem of modern oncology. Despite the possibility of using various methods of local and systemic exposure and their continuous improvement, the results of treatment of patients with hepatocellular carcinoma in general remain unsatisfactory. Modern radiation therapy can be considered as one of the significant methods of local exposure due to relative efficacy and acceptable tolerability. Implementation of radiation treatment in the mode of stereotactic radiotherapy is a promising direction in the treatment of patients with hepatocellular carcinoma because of the possibility of applying ablative doses with a significant restriction of doses to healthy organs and tissues in a short period of time and the possibilities of combining this method with other variants of specific treatment.
35-40 432
Abstract
It is an observational study of 228 patients with cancer and chemotherapy-induced anaemia (CIA). 192 patients received chemotherapy, 16 patients - hormone therapy, 20 patients - target therapy. In 118 patients with CIA were considered as iron deficiency. 49.1 % of patients with therapy was prescribed by an oncologist, 50.9 % of the therapy was administered by physician of other specialties. 51.7 % of patients received oral iron for the correction of CIA, 42.6 % patients did not receive any therapy of CIA. In 43.2 % of patients, at least one cycle of chemotherapy was postponed due to CIA. The appointment of the 67 patients monotherapy ferric carboxymaltose 500-1000 mg once a week, has allowed 14 days to increase the level of hemoglobin 16.2 [4.0-19.1] g/L.
41-47 541
Abstract
Vinorelbine is one of the standard drugs for the treatment of nonsmall cell lung cancer and is widely used in adjuvant therapy, chemoradiation programs, and in the treatment of common forms of the disease. The developed oral formulation of the drug provides comparable efficacy with much more convenient use. Vinorelbine capsules can be used both in combination with platinum derivatives, and in monotherapy with the possibility of using standard weekly and more frequent metronome dosing regimens. The efficacy and safety of oral vinorelbine has been proven, including for the elderly and debilitated population.
48-53 435
Abstract
Study objective: To assess the ability of endobronchial ultrasonography (EUS) using a guide sheath (EBUS-GS) to diagnose peripheralpulmonary lesions. Method. We devised a technique for EBUS-GS covering a miniature probe, and 183 lesions were evaluated. in this procedure, the probe covered by a guide sheath is introduced into the lesion via the working channel of a bronchoscope. The probe is withdrawn, a brush or biopsy forceps is introduced through the guide sheath into the lesion. Results. 183 of 152 EBUS-GS procedures (83 %) were diagnostic. When using cytological brushes in 45.9 % of cases (84 of 183), with transbronchial biopsy in 81.4 % (149 of 183 cases) [p < 0.001, х2]. The diagnostic yield from EBUS-GS in lesions > 30 mm (27 of 29 lesions, 93.1 %) had a significantly higher diagnostic yield than in lesions < 10 mm (18 of 32 lesions, 56.25 %), [р < 0,001, х2]. in case of 10-20 mm lesions and 20-30 mm [р = 0,87, х2] ones, they were similar. Cases in which the lesion was located in S8 right lung, had a significantly higher diagnostic yield (14 of 14 lesions, 100 %), than when the lesion was located S1-2 left lung (8 of 28 cases, 28.5 %) [р < 0.01, X2]. Moderate bleeding occurred in two patients (2.2 %); pneumothorax in one case (0.5 %), no other complications. Conclusions. EBUS-GS is a effective method for collecting samples from peripheral pulmonary lesions, have the advantage in comparison with another technique.
54-61 530
Abstract
Renal cell carcinoma is highly refractory to conventional chemotherapy. The survival of tumor cell in several cases is assisted by overexpression of immune checkpoint molecules such as PD-L1 to avoid being attacked by the immune system. One of directions of contemporary immunotherapy is the blocking of checkpoint of immunity by antibodies. This part of review consideres meta-analysis of the literature describing PD-1 and its ligands as prognostic markers for choice of therapy for of renal cell carcinoma. The association between PD-L1 and prognosis seems to be more robust than for PD-1 and PD-L2. Soluble forms PD-1 and PD-L1, as markers of non-invasive diagnosis is examined. The characteristic of the drug acting on the PD-1/PD-L1 system is given. in the end the conclusion is about the most effective drugs such as ipilimumab, nivolumab, pembrolizumab and their combinations is made. We also review the current progress in clinical trials, combination of drug therapy with immunotherapy, safety, and future of check point inhibitors PD-1/PD-L1.
ISSN 2078-5631 (Print)
ISSN 2949-2807 (Online)
ISSN 2949-2807 (Online)