Vol 16, No 2 (2014)

Articles
Press-release. «Merck Serono» announces new retrospective analysis shows significant clinical benefit in overall survival for metastatic colorectal cancer patients with RAS wild-type tumors receiving Erbitux® plus FOLFIRI
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Abstract
При проведении ретроспективного анализа данных из исследования III фазы CRYSTAL, в ходе которого проводилась оценка статуса мутаций генов RAS в опухоли, выявлены значительные клинические преимущества у пациентов с метастатическим колоректальным раком (мКРР) с «диким» типом генов RAS, получавших Эрбитукс® в сочетании с FOLFIRI, по сравнению с получавшими FOLFIRI отдельно. Не отмечено преимуществ у пациентов с мутациями генов RAS в опухоли, получавших Эрбитукс® в комбинации с FOLFIRI, по сравнению с получавшими FOLFIRI для лечения мКРР, что соотносится с показаниями к применению препарата в Евросоюзе и последними научными данными.
Journal of Modern Oncology. 2014;16(2):5-6
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Press-release. «Sanofi» makes a contribution in improving availability of treatment in women with breast cancer in Russia in accordance with international standards
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Abstract
В течение 4 лет «Санофи» реализует в России масштабную программу помощи пациентам с диагнозом «рак молочной железы» -«Шанс на жизнь». Благодаря программе около 9 тыс. женщин с диагнозом «рак молочной железы» получили лечение по международным стандартам
Journal of Modern Oncology. 2014;16(2):7
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New horizons in skin malignancies treatment
Gamaunov S.V.
Abstract
10th European Association of Dermato Oncology «Advances in Diagnosis and Treatment of Skin Tumors» was held in Vilnius on May, 7-10.More than 700 specialists from 30 countries visited Congress sessions. Multiple aspects concerning oncodermatology, dermatoscopy, epidemiology and tumor biology were observed during 4 days meeting as well as achievements in drug therapy, most recent results of clinical trials and onco-prevention items in dermatology. Several practical sessions for specialists devoted to dermatoscopy and surgical skills attracting laboratory animals were held in line with theoretical seminars and presentations.
Journal of Modern Oncology. 2014;16(2):8-10
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Difficulties in treating patients with breast cancer in Russia: the resolution on the results of the Review Board
Artamonova E.V., Gorbunova V.A., Zhukov N.V., Manzjuk L.V., Manihas A.G., Paltuev P.M., Semiglazov V.F., Semiglazova T.Y., Stenina M.B., Tjuljandin S.A., Chubenko V.A.
Abstract
The leading oncologists' meeting was held on February 7, 2014 in Moscow. Those in attendance discussed treatment approaches ofbreast cancer, and in particular, locally-advanced and metastatic breast cancer. Participants came to the conclusion that patients with breast cancer require long treatment by many different chemotherapeutic agents, including some newer ones available. There are no standard approaches to treat patients with metastatic breast cancer after antracyclines and taxanes. Eribulin is a new chemotherapeutic agent that resulted in overall survival improvement in patients with locally advanced and metastatic breast cancer after antracyclines and taxanes. Eribulin is included in the recommendations of Russian oncological professional societies. It is diffcult to specify now a particular group of patients for the treatment of Eribulin so the experts came to conclusion that Eribulin is recommended to patients with metastatic breast cancer according to its prescription. Based on the previous, doctors concluded that it is necessary to increase provision of the breast cancer patients with chemotherapy agents, to include Eribulin in the privileged lists of medications and to use chemotherapeautic agents consistently as a monotherapy in accordance with the latest recommendations, also to legally approve standards of breast cancer treatment that have real clinical value based on the clinical recommendations from said professional societies. Varying practical questions relative to the safety and efficacy of Eribulin were raised during the doctors meeting.
Journal of Modern Oncology. 2014;16(2):12-16
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The results of Epidemiological HER2 screening program in patients with breast cancer in 2013
Frank G.A., Poddubnaya I.V., Yagudina R.I., Borisov D.A., Koroleva N.I.
Abstract
HER2 overexpression in breast cancer is an extremely unfavorable prognostic factor determining extensive tumor growth, early distant metastases, and resistance to treatment. To predict the disease course, one of the most important diagnostics steps - HER2 testing - is performed in settings of specialized laboratories at medical institutions. This article summarizes the results of Epidemiological HER2 screening program in patients with breast cancer in 2013 in Russian regions: results of HER2 testing have been analyzed and the changes in the identified parameters have been tracked compared with 2012 data.
Journal of Modern Oncology. 2014;16(2):18-26
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Angiogenesis as a target for cancer therapy
Imyanitov E.N.
Abstract
The ability of a transformed cell to evolve into the tumor lump is believed to require the secretion of angiogenic factors and active orchestrating of capillary development. Tumor angiogenesis is distinct from the normal one: rapidly growing capillaries lack proper tissue organization and connect to each other in a rather stochastic way, leading to abnormal blood flow and intratumoral oedema. Angiogenic inhibitors selectively destroy immature capillaries and thus normalize tumor vascularization. This results in improved delivery of cytotoxic drugs and sensitization of transformed cells to antitumor treatments. Combined administration of cytotoxic and antiangiogenic drugs improves outcomes of cancer therapies.
Journal of Modern Oncology. 2014;16(2):28-33
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High efficiency of lapatinib in combination with capecitabine in patient with metastatic HER2-positive synchronous breast cancer (case study)
Seryakov A.P., Ovchinnikova L.K., Zabelin M.V., Yakubov T.Z., Sidorov D.B., Ovchinnikov M.V.
Abstract
A case report of lapatinib + capecitabin effective treatment in patient with bilateral HER2+ER+ breast cancer progressing on trastuzumab-containing therapy with brain metastases.
Journal of Modern Oncology. 2014;16(2):33-37
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The beginning of the new era of monoclonal antibodies biosimilars use in oncology:current international guidelines and the results of clinical trial of the first Russian rituximab biosimilar in patients with B-cell non-Hodgkin’s lymphoma
Kaplanov K.D., Zaritskey A.Y., Alekseev S.M., Ivanov R.A., Chernyaeva E.V.
Abstract
This article contains the detailed analysis of current approach to non-clinical and clinical development of monoclonal antibody biosimilars which is described in current guidelines of the European Medicines Agency (2012). Requirements of European regulatory authorities regarding evidence, which allows to demonstrate absence or presence of significant differences between biosimilar and original medicinal product are also discussed. There is the first publication of data from international clinical study of the 1st Russian rituximab biosimilar in patients with B-cell non-Hodgkin's lymphoma, which showed no differences with the reference medicinal product MabThera® in terms of efficacy and safety.
Journal of Modern Oncology. 2014;16(2):38-44
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Algorithm of treatment of patients with castrate-resistant prostate cancer: modern concept and perspectives
Alekseev B.Y., Nyushko K.M., Kalpinskiy A.S., Kaprin A.D.
Abstract
Prostate cancer is one of the most actual problems of modern oncourology. Castrate-refractory prostate cancer (CRPC) is extremely he-terogeneous disease and treatment conception should be individualized in every patient. Therapeutic options in CRPC include 2nd line hormonal therapy, chemotherapy, vaccines, target therapy, radiopharmaceuticals, etc. However, clear algorithm of treatment in using of 1st or 2nd line drugs nowadays is absent. In the article modern concept of treatment of patients with CRPC is present, moreover prognostic factors of therapeutic response are analyzed.
Journal of Modern Oncology. 2014;16(2):44-49
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First results of the Russian multicenter epidemiology project on the malignant gliomas
Smolin A.V., Bekyashev A.H., Kobyakov G.L., Sharabura T.M., Mufazalov F.F., Kanischeva N.V., Bumagina V.O.
Abstract
There is no official data on malignant glioma morbidity in Russian Federation. The data absence became the main reason for Russianmulticenter project conduction to research malignant gliomas’ epidemiology. The epidemiology data and glioblastoma treatment approac-hes are presented in the article. Significant variability of 1st line treatment choice both for radiotherapy and combined therapy was confir-med. The current treatment standard (chemoradiotherapy + temozolomid) is received only by one of every four patients with new diagno-sed glioblastoma. Less than half of patients receive 2nd line therapy, which apparently influences on patient’s life duration. More than thirdof patients with recurrent glioblastoma received bevacizumab.
Journal of Modern Oncology. 2014;16(2):50-55
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Radiological diagnostics of colorectal cancer liver metastases and immunohistochemical characteristics after drug treatment
Skipenko T.O., Paltseva E.M., Sekacheva M.I., Bedganian A.L.
Abstract
More than 50% of patients with colorectal cancer (CRC) suffer from different types of metastatic lesions. Liver resection is the only radicaltreatment option, but R0 resection is possible only in 10-30% of patients. Chemotherapy (CT) with targeted agents allows to increase resectability and improve distant treatment results. Multidisciplinary board approves any treatment options for these patients and its decision is directly dependent on the level and quality of methods of radiological diagnostics (Magnetic Resonance Imaging - MRI, Multispiral Computed Tomography - MSCT).The purpose of the study is to evaluate the significance of diagnostic and immunohistochemical characteristics after drug treatment in the surgical clinic.Materials and methods: 59 patients with colorectal cancer liver metastases were prospectively analyzed during the study. The median age was 57±10,2 years. Primary tumor in rectum was detected in 32,2% (n=19) cases and in colon in 67,8% (n=40) of patients. Synchronous metastases were detected in 78% (n=46) of patients. 35,6% (n=21) of patients had solitary metastases. Location of lesions: right lobe of liver - 44% (n=26), left lobe of liver - 17% (n=10) and bilobar involvement - 39% (n=23). FOLFOX (81,4%) and FOLFIRI (8,5%) were used as induction therapy in combination with targeted agents (44%): bevacizumab (n=14), panitumumab (n=9) and cetuximab (n=3). The amount of treatment courses was 5,8±2,1 (from 2 to 12). MRI and/or MSCT were performed for all patients before CT and after treatment. Efficacy was evaluated using RECIST criteria. Immunohistochemistry (IHC) was performed for 14 patients using antibodies to PML, Bax and BCL-2.Results: 95% of patients responded to the treatment. Metastases regression was achieved in 49,2% (n=29) of cases, disease stabilization in 44% (n=26) and complete response had 1 (1,7%) patient. 3 (5%) of patients experienced disease progression. Presence of «borderline» layer in MSCT/MRI after treatment was detected in 7 (11,9%) cases. Hepatic steatosis (mainly after treatment with irinotecan) was diagnosed in 3 patients and «blue» liver due to sinusoid distension (after oxaliplatin therapy) in 14 patients. 13 (22%) patients had inconsistencies between preoperative and expert evaluation data. False-positive results were received from 3 patients, false-negative from10. Sensitivity of MSCT and MRI was 85% and 89% respectively.Positive expression of PML vs control group ( p =0,01) was detected in patients after bevacizumab treatment using immunohistochemistry. The expression was absent in 9% of untreated patients, but there were no patients with absence of this marker after preoperative combined therapy including targeted anti-VEGF agent (bevacizumab). Increase of expression of antiapoptotic protein Bcl-2 was detected in 79% of patients after CT vs 54% in control group. There were no significant differences from control group ( p =0,1) after bevacizumab therapy.Conclusion: Current CT in combination with targeted agents can change resectability, elevating the amount of surgical patients. Radiological diagnostics and modern immunohistochemical methods play a large role in multidisciplinary strategy.
Journal of Modern Oncology. 2014;16(2):55-59
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Modern technology of radiation therapy: IMRT, VMAT using simultanting integrated boost (SIB) in the complex treatment of squamous cell carcinoma of the anal canal
Tkachev S.I., Glebovskaya V.V., Rasulov A.O., Tsariuk V.F., Aliev V.A., Vodyanik V.V.
Abstract
Increased survival of patients with squamous cell carcinoma of the anal canal due to improved technical equipment radiotherapy separated to oncology clinics. Creating conditions accurately summarizing the planned dose decrease absorption substituted doses to critical structures, reducing unscheduled interruptions in the course of chemoradiotherapy with modern technology conformal radiotherapy (3D CRT, IMRT, VMAT).Radiotherapy with intensity modulated (IMRT) and intensity modulation arches VMAT («Rapid Arc») held respectively at 9 and 5 paintion of squamous cell carcinoma of the anal canal. At the same time the primary tumor and lymph node involvement is further subjected to daily exposure Simula mutant integrated boost (SIB).Application of these technologies allowed: 1) get high oncological result (complete tumor regression in all patients); 2) to reduce the radiation dose to critical organs (small intestine - the average minimum dose, Dose Mean) 34,0 Gy (with IMRT); 37,2 Gy (with 3D CRT); bladder - (Dose Mean) 24,2 Gy (with IMRT); 26,2 Gy (with 3D CRT), respectively; 3) reduce the frequency and intensity of acute radialdamage critical organs: toxic heavy early mucositis (III-IV degree) from the rectum and bladder were observed in any observation. Early proctitis degree I was diagnosed in 4 (28,6% of patients), proctitis Grade II in 5 (35,7%) patients. Early cystitis degree I was diagnosed in 3 (21,4%) patients, cystitis II degree in 6 (42,8%) patients; catarrhal mucosal epithelium of the female genital organs occurred in 8 (57,1%) patients; 1 month after the end of radiotherapy proctitis degree I recorded in 5 (35,7%) and cystitis I degree in 4 (28,6%) patients; 4) reduce the number of patients with forced interruptions termoradiohimioterapii: only 6 patients (42,8%) due to hematological toxicity grade I-II, II degree cystitis made a short break in treatment, the duration of which was 5-8 days; 5) Use simultanting integrated boost (SIB) has led to a reduction in duration of the full course termoradiohimioterapii 7 working days compared to traditional small fraction 3D CRT radiation therapy; 6) the use of space modulated radiotherapy arches (VMAT - «Rapid Arc») has allowed to reduce the time of a session of radiotherapy with IMRT compared with 20-30 minutes to 3-5 minutes.Volume modulated radiation therapy technology using SIB reduce the time the patient’s treatment, the number of complications and achieve complete tumor regression.
Journal of Modern Oncology. 2014;16(2):60-65
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Pharmacoeconomic usefulness of the drug Giotrif® (afatinib) in first-line treatment of locally advanced or metastatic non-small cell lung cancer with a mutation of epidermal growth factor receptor (EGFR)
Kolbin A.S., Kurylev A.A., Pavlysh A.V., Proskurin M.A., Balykina Y.Y.
Abstract
Purpose of the study is to perform first line Giotrif® (afatinib) health economic assessment in patients with metastatic NSCLC with EGFR mutations. Markov model and budget impact model were implemented to simulate afatinib monotherapy in treatment of naïve patients versus one of the chemotherapy combinations cisplatin/pemetrexed or cisplatin/docetaxel based on randomized clinical trial results data as inputs. Afatinib was shown to be cost-effective strategy.
Journal of Modern Oncology. 2014;16(2):66-72
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Successful treatment with sorafenib in patients with advanced hepatocellular carcinoma: clinical case
Bisovskaya Y.V., Breder V.V., Medvedeva B.M., Gorbunova V.A.
Abstract
Multi-kinase inhibitor sorafenib is the only one drug which increases life time in patients with advanced hepatocellular carcinoma (HCC). Results from the SHARP trial showed that median progression-free survival was less than 5 months. However, it is possible to achieve strong treatment effect for several years receiving sorafenib. Antiviral treatment in the course of the immune treatment for all patients with chronic hepatitis B (CHB) should follow the recommendations from existing The European Association for the Study of the Liver (EASL) guidelines. It is possible to prescribe constant antiviral therapy (AT) with the nucleosides analogue as a treatment (according to the indication) or for prophylactic purposes (prevention of reactivation of HBV-infection in «inactive HBsAg carriers») to prevent cirrhosis development and to prolong sorafenib therapy. New multi-kinase inhibitor sorafenib was approved for the treatment of advanced HCC in the Russian Federation (RF) in 2006. However, there is not enough information on receiving sorafenib in patients with HCC associated with CHB in the RF. Our clinical case presents long-term treatment (37 months) with sorafenib in the course of the AT in patients with HCC. This example helps us to discuss the features of modern diagnostic and treatment algorithm of HCC, chronic hepatitis B and cirrhosis in its outcome.
Journal of Modern Oncology. 2014;16(2):73-77
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Prognostic significance of dynamics of biochemical markers of neuroendocrine tumors during treatment with biotherapy
Emelianova G.S., Gorbunova V.A., Lubimova N.V., Orel N.F., Markovich A.A., Selchuk V.U.
Abstract
Dynamic of biochemical markers of neuroendocrine tumors (chromogranin A, serotonin, 5-hydroxyindoleacetic acid) are predictive factorsof biotherapy efficacy. We found that 30% decreasing of biochemical markers within 6 months improves median of time to progression for patients with neuroendocrine tumors.
Journal of Modern Oncology. 2014;16(2):77-81
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Second primary cancer in patients with head and neck squamous cell carcinoma (review of the literature)
Agabekyan G.O., Kropotov M.A., Saprina O.A., Stelmakh D.K., Park M.B.
Abstract
The article presents a review of the literature about primary cancers in general and, in particular, cancers of the head and neck. The risk factors, criteria, modern opinion about the problem, especially therapeutic approaches are described in detail.
Journal of Modern Oncology. 2014;16(2):82-86
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