Vol 15, No 2 (2013)

Articles
Breast cancer: from guidelines to personalized oncology
PierFranco C., Valentina G.
Abstract
The review considers the present-day problems and possibilities of targeted therapy for breast cancer (BC) in relation to the biological subtype of a tumor. The emergence of new clinical data on the targeted drugs and their combinations already used in routine practice and new medications from an arsenal of personalized medicine leads to changes in therapeutic approaches. The review gives great attention to the HER2-positive subtype of BC.There is evidence from clinical trials of pertuzumab and T-DM1, which may alter the standard treatment for HER2-positive BC. The review also considers the predictive value of the recurrence index in the luminal subtype and biological characteristics of triple negative BC.
Journal of Modern Oncology. 2013;15(2):5-9
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New possibilities of chemotherapy for anthracyclineand/or taxane-resistant breast cancer
Artamonova E.V., Manzyuk L.V.
Abstract
Patients with metastatic breast cancer previously treated with anthracycline chemotherapy. Effective treatment options for patients with metastatic breast cancer resistant to anthracyclines and taxanes are limited. The review is devoted to chemotherapy-pretreated metastatic breast cancer, reasons of anthracycline-and taxane-resistance development, epothilones’ mechanisms of action The possible reasons for the development of, especially the mechanism of action of epothilones, data on the effects of cytotoxic drugs in intensive-pretreated metastatic breast cancer. Discussed the results of clinical studies of Ixabepilone showing high efficacy in monotherapy or in combination with capecitabine resistance of anthracyclines and taxanes.
Journal of Modern Oncology. 2013;15(2):10-16
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Prognostic value of p53 expression in patients with stage I breast cancer
Kolyadina I.V., Poddubnaya I.V., Van de Velde C.J., Kuppen P.J., Liefers G.J., Dekker-Ensink N.G., Bastiaannet E., Van As-Sajet A., Prinse B., Engels C., Van Vlierberghe R., Komov D.V., Karseladze A.I., Ermilova V.D., Vishnevskaya Y.V., Frank G.A., Banov S.M.
Abstract
The prognostic value of p53 nuclear expression in Stage 1 (T1N0M0) breast cancer was studied in 315 women treated in Russia (at the N.N.Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, and at the Clinic of the Russian Medical Academy of Postgraduate Education) in 1985 to 2009. An immunohistochemical assay for determining the expression of estrogen receptors (ER), progesterone receptors (PR), and HER2 and the nuclear expression of p53 receptors was carried out at the Leiden University Medical Center. p53 nuclear expression was found in 14,7% of cases and statistically significantly correlated (p<0,05) with important prognostic factors, such as age less than 40 years; histologic type of infiltrating ductal cancer; high-grade cancer; ER- and PR-negative status; and HER2 overexpression. Analysis of overall and relapse-free survivals in the entire group of patients revealed no prognostic value (p>0,05) of p53 expression for the risk of further progression and death. It was suggested that the negative impact of p53 expression in the entire group might be compensated for by the positive role of adjuvant systemic therapy. Subgroup analysis showed that the patients with p53-positive tumors who did not receive any adjuvant drug treatment had the worst relapse-free and cancer-specific survival rates (p<0,05); this was not seen in the patients on adjuvant systemic treatment. Thus, p53 nuclear expression is a negative prognostic factor in Stage I breast cancer; adjuvant systemic therapy can appear to compensate for the unfavorable impact of the expression of this marker.
Journal of Modern Oncology. 2013;15(2):17-21
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The concept of resectability in the treatment of colorectal cancer liver metastases: the present notion
Bagmet N.N., Bedzhanyan A.L., Polishchuk L.O., Sekacheva M.I., Shatveryan G.A., Skipenko O.G.
Abstract
To treat colorectal cancer liver metastases presents still a challenge and to take tactical decisions requires the participation of a multidisciplinary team of specialists. Despite significant progress in the drug therapy of this disease, the best long-term results can be achieved with hepatectomy. In this connection, one of the key tasks at the present stage is to enhance resectability. The latter is not greater than 10–15% in the 1990s. In the past two decadea, liver resectability for colorectal cancer liver metastases has changed considerably: indications for this operation have been expanded; additional technologies, such as local destruction of foci, have emerged; the concept of preoperative drug therapy has been developed and improved; surgical techniques to stimulate the left liver to grow postresection have been introduced; many problems related to the biological features of a tumor, etc. have been studied. This has made the concept of resectability itself to change from purely technical to complex, involving both technical and oncological components. This change can increase the level of resectability up to 50%. The paper describes the evolution of the concept of resectability in colorectal cancer liver metastases and the present notion accepted at the Consensus Conference of Leading Surgical Hepatologists in 2012.
Journal of Modern Oncology. 2013;15(2):22-25
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Results of preoperative antitumor therapy in combination with bevacizumab and KRAS status during liver resections for colorectal cancer metastases
Sekacheva M.I., Bagmet N.N., Polishchuk L.O., Glazova O.V., Zaklyazminskaya E.V., Skripenko O.G.
Abstract
Whether it is expedient and safe to add bevacizumab to preoperative treatment regimens for colorectal cancer liver metastases has been remained unclear over many years in spite of the duration of its use in this category of patients. In our trial, incorporation of bevacizumab into preoperative therapy was also accompanied by an increase in disease control and a significant reduction in the risk of disease progression during chemotherapy versus other treatment regimens. Comparison with a subgroup of patients treated with oxaliplatin-based regimens without bevacizumab showed that the significance of their difference disappeared; however, a clear trend persisted in favor of bevacizumab addition. KRAS is the only molecular marker used to select patients for therapy with monoclonal antibodies. Our findings also suggest that particular emphasis should be laid on the KRAS status in patients receiving bevacizumab therapy. Random estimation of the KRAS status in the patients who had undergone successful preoperative therapy and liver resection displayed a clear tendency towards the prevalence of the wide-type gene as compared with population-wide data.
Journal of Modern Oncology. 2013;15(2):26-30
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Surgical stading local – cervical cancer incidence
Kargopolova M.V., Maximov S.Y., Berlev I.V., Boyarkina M.P., Meshkova I.E., Khadzhimba A.S., Novikov S.N., Krzhivitsky P.I., Ponomareva O.I., Urmancheeva A.F., Ivanzov A.O., Guseynov K.D., Vishinskaya E.A., Matveeva N.S.
Abstract
The efficiency of laparoscopic par aortic lymphadenectomy to clarify extent of tumor in patients with cervical cancer IB2 – III stages. The obtained data are compared with the results of radiological investigations. Found that the performance of lymph node dissection, followed by morphological study of the preferred embodiment of non-invasive diagnostic tests, given their low predictive value. The results indicate the feasibility of surgical staging by performing diagnostic laparoscopy and para-aortic lymphadenectomy in patients with locally – advanced cervical cancer in order to plan further correction of combined treatment.
Journal of Modern Oncology. 2013;15(2):31-35
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Molecular aspects of the development of genetic syndromes associated with pancreatic neuroendocrine tumors
Mayev I.V., Andreyev D.N., Kucheryavyi Y.A., Dicheva D.T., Andreyeva T.A.
Abstract
The paper provides a literature review of an update on the molecular genetic basis of inherited syndromes associated with the development of pancreatic neuroendocrine tumors, such as type 1 multiple neuroendocrine neoplasia, von Hippel–Lindau disease, type 1 neurofibromatosis, and tuberous sclerosis.
Journal of Modern Oncology. 2013;15(2):36-39
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VEGF inhibitors: a new era in the treatment of metastatic ovarian cancer
Pignata S.
Abstract
O affect angiogenesis is one of the key goals of therapy for ovarian cancer (OC). The advent of targeted drugs that selectively affect neoangiogenesis has been a breakthrough in treating OC in the past decade. By now the only drug validly demonstrating antiangiogenic activity is bevacizumab whose efficacy has been tested in Phases II and III trials of OC. Bevacizumab has been approved by the European Medicines Agency for use in the first-line therapy of OC and in combination with standard chemotherapy to treat platinum-sensitive recurrent OC. This paper gives the results obtained from further clinical trials of bevacizumab, which expand the spectrum of indications of this targeted angiogenesis inhibitor for the treatment of the disease.
Journal of Modern Oncology. 2013;15(2):40-44
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Toxicity of trabectedin-based combinations in the treatment of different malignant tumors
Cherkasova M.V., Khokhlova S.V., Limareva S.V., Orel N.F., Gorbounova V.A., Poddubnaya I.V., Lyubimova N.V.
Abstract
Antitumor activity of trabectedin as a monotherapy in different solid tumors (soft tissue sarcoma, ovarian cancer, breast cancer, melanoma) contributed to research trabectedin-based drug combinations. Phase I trials were searching for optimal dose and schedule of administration trabectedin and trabectedin-based combinations. This review considers aspects of clinical applications and toxic profile of trabectedin alone and combinations, including a rare adverse event – rhabdomyolysis and data of own experience.
Journal of Modern Oncology. 2013;15(2):46-52
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Efficiency of denosumab in giant cell tumor of the bone
Semenov N.N.
Abstract
Studies of the mechanisms of giant cell tumor of the bone have confirmed the pivotal role of the RANK-RANKL-OPG (receptor activator of nuclear factor kappa-b – receptor activator of nuclear factor kb ligand – osteopretegerin ligand) system and also shown that stromal cells (spindle-shaped fibroblasts) carry a tumor potential. The paper gives the results of 2 investigations of the novel monoclonal antibody denosumab, an osteoprotegerin analogue, in 199 patients with giant cell tumor of the bone. Both X-ray evaluation and morphological re-examination of the tumor revealed the high efficacy of denosumab, which was attended by normalization of enhanced osteolysis. It was shown that there was a possibility of performing the lower volume of surgery or postponing the latter to a later time in patients with a potentially operable tumor, without causing damage to them.
Journal of Modern Oncology. 2013;15(2):54-56
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Role of vemurafenib in the treatment of disseminated skin melanoma
Demidov L.V., Utyashev I.A., Kharkevich G.Y.
Abstract
Up to date, therapy of disseminated skin melanoma remains a serious issue. In this review authors describe the main features of melanoma epidemiology, general approaches in the systemic therapy of disseminated forms of the disease. Special attention is paid to molecular-genetic mechanisms in the pathogenesis of melanoma. This publication describes the results of novel BRAF-kinase inhibitor targeted drug vemurafenib clinical trials, its safety profile and adverse reactions management. The authors also discuss the further perspectives for vemurafenib use in the therapy of skin melanoma.
Journal of Modern Oncology. 2013;15(2):58-61
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Experience with Hyposalix spray treatment for xerostomia
Afanasyev V.V., Titova O.N., Ordashev K.A., Ugurchiev Y.S.
Abstract
Xerostomia, dry mouth, is a symptom of different diseases of the salivary glands and also a consequence of radio- and chemotherapy for malignant maxillofacial tumors. Xerostomia treatment is a challenge and requires the attention of different specialists: a maxillofacial surgeon, an oncologist, an endocrinologist, and others. Replacement therapy (artificial saliva, various gels) is one of the treatments for xerostomia. The new agent Hyposalix spray has recently emerged in Russia. The performed trial revealed its high efficacy, particularly in xerostomia caused by radio- and chemotherapy for malignant maxillofacial tumors.
Journal of Modern Oncology. 2013;15(2):62-64
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Problem of iron-deficiency anemia in patients with cancers: practice in using iron-containing drugs
Snegovoy A.V.
Abstract
The continuing relevance of anemia in cancer patients is confirmed by the results of recent trials. Decreased hemoglobin levels are shown to lead to not only poorer quality of life, but also to lower survival rates in cancer patients. Today there is evidence that iron deficiency is the most common cause of anemia. This paper considers the mechanisms of iron metabolic disturbances, the diagnosis and treatment of iron deficiency. It gives the results of many clinical trials comparing the efficacy of different iron preparations.
Journal of Modern Oncology. 2013;15(2):65-72
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