Vol 15, No 1 (2013)

Articles
Preliminary results of an observational program for estimating the duration of bevacizumab therapy in patients with metastatic colorectal cancer in daily clinical practice
Poddubnaya I.V., Bobrovskaya E.V., Vladimirova L.Y., Gordeev S.S., Davidenko I.S., Emelyanov S.A., Zharkova O.V., Koroleva I.A., Krasilnikova S.Y., Maikoparova S.C., Malysheva T.A., Modestov A.A., Morozov A.N., Stachenko G.B., Strygina E.A., Tlish E.K., Feoktistova P.S., Chichkanova A.S., Sherman N.Z.
Abstract
Objective: to estimate the average duration of therapy with Avastin (bevacizumab) in patients with metastatic colorectal cancer (mCRC) in the daily clinical practice of cancer care facilities in Russia. Methods. The observational program is being implemented on the initiative of the Russian Medical Academy for Postgraduate education RF (Moscow) and it is based on the results of treating patients with mCRC in 24 clinical centers from different regions of the Russian Federation. The observational program includes patients receiving drug treatment for mCRC in accordance with the local standards and guidelines. Program patient enrolment has not been over yet. The paper presents preliminary results. Results. As of March 1, 2013, the program enrolled 117 patients, including 43 with rectal cancer and 74 with colon cancer. At baseline 70 (60%) patients had synchronous distant metastases and 47 (40%) patients developed synchronous distant metastases after primary radical surgery. At the analysis, 112 patients were treated with bevacizumab in combination with different chemotherapy (CT) regimens; 25 patients received more than the 1 line of CT, in 8 of them bevacizumab was discontinued (because of disease progression in 6 cases); 33 (29%) patients were switched to bevacizumab monotherapy during treatment. The effect of CT with simultaneous administration of 7–10 infusions of bevacizumab was preserved in 73% of the patients; 4 and 27% showed complete and partial responses, respectively; stabilization was noted in 42%. Sixty-three (56%) patients received symptomatic therapy. Adverse events were observed in 18 (16%) patients, 13 of them had grade 4 reactions. Conclusion. Targeted therapy with bevacizumab is in considerable use in the health care facilities of the Russian Federation. The addition of bevacizumab to CT does not increase toxicity of CT. The combination of bevacizumab and standard CT regimens can achieve high disease control rates.
Journal of Modern Oncology. 2013;15(1):5-9
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Tendentsii v diagnostike i lechenii zlokachestvennykh gliom (Po materialam Kongressa «Trends in Central Nervous System Malignancies» pri podderzhke EORTC, ESMO, EANO. Praga, 22–23 marta 2013 g.)
Absalyamova O.V.
Abstract
Наиболее распространенной злокачественной глиомой является глиобластома (ГБ). Признанным большинством нейроонкологов стандартом первичного лечения пациентов с ГБ является ее максимально возможное хирургическое удаление. Следующим этапом проводится комбинированная химиолучевая терапия (разовая очаговая доза 2 Гр, суммарная очаговая доза 60 Гр, темозоломид 75 мг/м2) и курсами темозоломид 200 мг/м2 5/28 дней, 6 циклов, а при прогрессировании опухоли – применение лекарственной терапии на основе бевацизумаба. Основные вопросы, встающие перед клиницистами при лечении ГБ: улучшение эффективности терапии 1-й линии, необходимость совершенствования критериев оценки эффективности лечения, подбор оптимальной терапии 2–3-й линии, сохранение качества жизни пациентов, возможность дифференцированного подхода к лечению на основании прогностических факторов.
Journal of Modern Oncology. 2013;15(1):10-11
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Current approach to adjuvant therapy for breast cancer (a review)
Conte P., Guarneri V.
Abstract
The current approaches to therapy for breast cancer (BC) are based on whether the major markers, such as estrogen receptors, progesterone receptors, and HER2-receptors, are present or absent. Scientific update suggests that subdividing BC into more minor, but distinct subgroups will be continued and treatment approaches will be improved. There is no question that screening and early diagnosis are important in improving treatment results and reducing BC mortality; however, there is increasing evidence for the precedence of adjuvant chemotherapy. Clinical trials show that incorporation of trastuzumab in adjuvant treatment regimens for HER2-positive BC improves substantially long-term results and reduces recurrence rates and the likelihood of a fatal outcome. Of particular interest is the fact that the drugs having different modes of action can produce double inhibition of HER2-receptor. Targeted therapy with trastuzumab in particular has changed dramatically the prognosis of the previously absolutely fatal variant of BC. Combination of targeted therapy will bring the era of personalized medicine closer.
Journal of Modern Oncology. 2013;15(1):12-18
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Combined and complex treatment options for patients with operable rectal cancer
Barsukov Y.A., Tkachev S.I., Mamedli Z.Z., Kuzmichev D.V., Aliev В.А., Kim D.F.
Abstract
More than 30-year experience of the department of proctology of Russian N.N.Blokhin Cancer Research Center, which demonstrates the necessity in developing combined treatment for distal rectal cancer is presented in this article. An original treatment scheme has been developed, incorporating radiotherapy (short course 5x5 Gy) with 2 radiosensitizers and systemic cytotoxic therapy with fluorpyrimidines (capecitabine). The developed treatment scheme has acceptable toxicity and can be combined with all types of surgical interventions. A significant reduction in local and distant failures rates can be achieved as well an improvement of disease-free survival. This allows to increase indications to sphincter-sparing treatment by improving ablastics of surgery and provide high level of social rehabilitation.
Journal of Modern Oncology. 2013;15(1):20-26
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Efficacy and safety of pemetrexed maintenance therapy in advanced non-small-cell lung cancer: a review of phase III studies
Kit O.I., Vladimirova L.Y., Sholokhova E.A.
Abstract
In Russia, over 57,000 new cases of malignant tumors of the trachea, bronchi, and lung were diagnosed in 2009, accounting for 19,8% of all cancers in men and 3,9% of all cancers in women. For most patients in Russia, these cancers are detected at a late stage (stage III – 32,4% and stage IV – 36,0%). Administration of maintenance therapy is one strategy to prolong response or the length of stable disease, resulting in improved survival for patients whose disease has not progressed after first-line induction therapy. This review will summarize the results of phase 3 studies of pemetrexed as maintenance therapy in advanced non-small cell lung cancer.
Journal of Modern Oncology. 2013;15(1):27-31
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Non-Hodgkin’s lymphomas of the organ of vision (a review of literature)
Guzenko E.S.
Abstract
Celebrated worldwide increase in the incidence non-Hodgkin's lymphoma, it is higher in the developed world, where increased more than 50% over the past 20 years and exceeds the rate of growth in the incidence of Hodgkin's lymphoma. Non-Hodgkin's lymphoma of the orbit, the eye and adnexa account for 4,1–8% of all extranodal lymphomas, the pathology of particular interest to oncologists and ophthalmologists. In recent years, much attention is paid to the prognosis of extranodal non-Hodgkin's lymphoma. This paper presents the details of the literature on prognosis non-Hodgkins lymphoma eye and adnexa. Analysis has shown that to date, all of the existing prognostic scales do not represent the full prognosis of primary non-Hodgkin's lymphoma eye and adnexa. This question requires a detailed study.
Journal of Modern Oncology. 2013;15(1):32-36
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Diagram of differential diagnostics of stages of ovarian cancer
Antoneeva I.I., Abakumova T.V., Gening T.P., Gening S.O.
Abstract
The diagram of differential diagnostics of stages of ovarian cancer is developed. Survey of 404 patients included ultrasonic research of genitals, an internal, radiological research of lungs for the purpose of detection of the remote metastasises, cytologic, histologic and immunohistochemical research of tumor, and also biochemical indexes of peripheral blood and level of an onkomarker of CA125. It is shown that indexes of level malondialdehyde, activities of a catalase, a glutation-reductase of plasma can be used for the differential diagnosis of III and IV stages. The assessment of cationic proteins level, phagocytic number, activity of myeloperoxidase of neutrophils of peripheral blood will allow to calculate coefficient for differentiation of II and III stages of ovarian cancer. The diagram of additional laboratory researches is developed for differentiation of stages of ovarian cancer on FIGO, and also calculation formula of differentiation coefficient.
Journal of Modern Oncology. 2013;15(1):38-40
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CUP-syndrome: the present view of the problem (a review of literature)
Levitskaya N.V., Lewitzki V., Komarov I.G., Nemtsova M.V., Poddubnaya I.V.
Abstract
Tumors of unknown primary site (CUP-syndrome) – an intriguing clinical phenomenon that each year 5% of patients with newly diagnosed malignancies. The absence of clinical manifestations of the primary tumor, early development, unusual, often multiple metastases – signs of this heterogeneous group of neoplasms. However, there is no consensus whether the CUP-syndrome metastases undetected primary tumor or an independent biological phenomenon with certain genetic and phenotypic characteristics. Identification of major molecular abnormalities that characterize CUP-syndrome, slow progressive. Profile of gene expression and the expression of miRNAs are highly specific tests that can help to identify histogenesis of tumors without primary site.
Journal of Modern Oncology. 2013;15(1):41-45
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Xerostomia: a brief look of the problem
Podvyaznikov S.O.
Abstract
Xerostomia is iatrogenically and non-iatrogenically manifested in patients for a number of reasons and detectable in 12% of the world’s population and its prevalence in the elderly amounts to as much as 25%. Oncologically, xerostomia remains a problem in patients receiving radiotherapy for malignant tumors of the upper respiratory and digestive tracts. The basis for hyposialia prophylaxis is oral hygiene (that is to prevent and treat caries and fungal superinfection). In more complex cases of significant xerostomia, saliva substitutes are used, which give patients instant functional relief.
Journal of Modern Oncology. 2013;15(1):46
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Efficiency of radiotherapy for cancer of the vermilion border of lower lip in terms of balance between quantitative and qualitative results
Garbuzov M.I.
Abstract
Cancer of the vermilion border of the lower lip ranks first among all oral cancers. The real high quantitative parameters during radiotherapy for cancer at this site, in its stages I and II in particular, are comparable to those only in the same stages of skin cancer. This could lead to the incompletely substantiated optimistic point of view that the problem of radiotherapy for cancer of the vermilion border of the lower lip is mostly solved now. The assessment of the results of radiotherapy for Stage III and a fortiori Stage IV is not so optimistic. The paper assesses the results of radiotherapy in 513 patients with malignant tumors of the vermilion border of the lower lip. The radiotherapy was planned and implemented by the author. The central region of the lower lip, the right half, and the left half were affected in 121 (23,2%), 188 (36,6), and 204 (39,8%) patients, respectively. There was exophytic tumor growth in 250 (48,7%) patients, ulcerative and endophytic growth in 193 (37,6%) and 70 (13,7%), respectively. Cancers of different grades occurred in 512 (99,8%) patients, including 509 (99,2%) with squamous cell carcinoma, 3 with high-grade carcinoma, and 1 with fibrosarcoma. Stage I was seen in 175 (34,1%) patients, Stage II in 236 (46,0%), including 221 patients with Stage IIa and 15 with IIb; Stage III was diagnosed in 98 (19,1%) patients, of whom there were 70 patients with Stage IIIa and 28 with Stage IIIb; Stage IV was present in 3 patients who all had regional metastases.
Journal of Modern Oncology. 2013;15(1):48-61
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Pathogenesis and correction of anemic syndrome in lymphoproliferative disorders patients
Romanenko N.A.
Abstract
The paper presents a lecture that considers the major pathogenetic mechanisms of development and the specific features of the course of anemia syndrome in patients with lymphoproliferative diseases (LPD). It gives a classification of chronic anemia and methods of its treatment. Emphasis is placed on the correction of anemia by packed red blood cell transfusion; indications for the latter, its efficiency, and posttransfusion complications are outlined. A case of successful pathogenetic treatment is demonstrated in a female patient with non-Hodgkin’s lymphoma concurrent with Evans’ syndrome. The lecture also details anemia therapy with erythropoiesis-stimulating drugs in patients with LPD and gives the characteristics of different medications, algorithms and indications for their use, efficacy evaluation, and possible side effects. Prognostic factors for the efficacy of epoietins are given in relation to a number of laboratory tests.
Journal of Modern Oncology. 2013;15(1):62-69
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