Vol 17, No 4 (2015)

Articles
FDA approves Opdivo to treat advanced form of kidney cancer
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Abstract
Управление США по санитарному надзору за качеством пищевых продуктов и медикаментов (Food and Drug Administration - FDA) сегодня одобрило препарат Опдиво (ниволумаб) для лечения больных с распространенным (метастатическим) почечно-клеточным раком (форма рака почки), которые получили определенный вариант предшествующей терапии.
Journal of Modern Oncology. 2015;17(4):5
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FDA approves ixazomib in combination with lenalidomide and dexamethasone for multiple myeloma
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Abstract
Управление США по санитарному надзору за качеством пищевых продуктов и медикаментов (Food and Drug Administration - FDA) одобрило препарат иксазомиб (Нинларо) в комбинации с 2 другими агентами для лечения больных множественной миеломой, которые уже получали минимум один курс терапии. Безопасность и эффективность препарата иксазомиб продемонстрированы в международном рандомизированном двойном слепом клиническом исследовании с участием 722 больных множественной миеломой, рефрактерных к 1-3 курсам проводимого ранее лечения.
Journal of Modern Oncology. 2015;17(4):6
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Review of the Event: The role of local biosimilar drugs and original biological drugs in modern cancer treatment
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Abstract
17 ноября 2015 г. в рамках XIX онкологического конгресса состоялся симпозиум компании разработчика и производителя отечественных биоаналогов BIOCAD, посвященный их доказательной базе, опыту и перспективам применения. Обзор подготовлен редактором журнала «Современная Онкология»
Journal of Modern Oncology. 2015;17(4):7-14
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Modern possibilities of targeted therapy in metastatic colorectal cancer
Gorbunova V.A.
Abstract
Colorectal cancer (CRC) is ranked third in the world among malignant tumors in morbidity - more than 1.3 million (1 360 000 in 2012) new cases per year, and fourth in mortality - 694 000 deaths in 2012. CRC medicamentary is very important in case of this disease, and have been applying as in case of adjuvant treatment schemas and in case of metastatic disease treatment. All this allowed us significantly improve the life expectancy of the patients last decade. One of the last achievements in modern drug therapy of metastatic CRC (mCRC) is the existence of new drug - regorafenib. Regorafenib is a multi-kinase inhibitor, blocking VEGFR 1-3 and TIE-2 protein kinases, involving in tumor angiogenesis and inhibiting the growth of new blood vessels. The drug also inhibits oncogenic protein kinases: KIT, RET and RAF-1, BRAF and mutated BRAFV600E which are involved in cell proliferation and survival of cancer cells and effects on platelet-derived growth factor receptors (PDGF-R) and fibroblast growth factor receptor (FGFR) affecting the microenvironment tumor. The results of Phase III CORRECT study concerning regorafenib show the desirability of using the regorafenib as a new therapeutic option for patients with mCRC, previously have been treated for many times and have exhausted all the possibilities of drug therapy.
Journal of Modern Oncology. 2015;17(4):15-21
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Neoadjuvant systemic therapy of HER2-positive breast cancer
Frolova M.A.
Abstract
HER2 overexpression is evaluated in 15-20% of breast tumors and associated with aggressive type of the disease. Introduction of trastuzumab in clinical practice significantly improve the prognosis of patients with metastatic and early HER2-positive breast cancer. However, up to 40% of patients have a resistance to trastuzumab therapy (de novo or acquired resistance). Dual anti-HER2 blockade of trastuzumab in combination with other anti-HER2 targeted agents is more effective then trastuzumab monotherapy. Neoadjuvant systemic therapy has become very useful in early breast cancer and serves as a model for research of new antitumor agents, treatment regimens and predictive biomarkers. In current review the most important recent neoadjuvant trials in HER2-positive breast cancer and their impact on clinical practice are being analysed.
Journal of Modern Oncology. 2015;17(4):22-25
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Comparative evaluation of the efficacy of an incomplete cytoreduction application in combination with systemic therapy and systemic therapy as mono-therapy in patients with metastatic clear-cell renal cell carcinomas
Borisov P.S., Orlova R.V., Shkolnik M.I., Karlov P.A.
Abstract
The introduction of targeted therapy drugs into the practice of oncology urologists has improved the results of treatment of patients with metastatic clear-cell renal cell carcinomas (mCCRCC). Correctly chosen elements of systemic therapy will help specialist to control the course of the metastatic process for more than 2 years. But, sooner or later, the refractoriness will be developed at each stage of systemic treatment therefore it is important to find the existing methods accompanied the systemic therapy. These methods should increase and prolong the targeted drugs action or delay the time before the first targeted drugs prescription. Complex approach in the treatment of metastatic solid tumors is actively used in cancer therapy every day. Cytoreductive nephrectomy and complete cytoreduction(ectomy for metastasis) are widely used in the world practice, demonstrating the improvement of survival rates, while the necessary of incomplete cytoreductive surgical intervention application (iCSI) is a controversial problem in oncological community. However, the success of complex approach in the treatment of metastatic tumors in other locations gives reason to try this method once again in mCCRCC therapy.The aim is to compare the efficacy of complex approach consisted of targeted therapy and iCSI application in comparison with the targeted therapy as mono-therapy in the treatment of metastatic RCC (mRCC). Conclusions: the choice of combined treatment in patients with mCCRCC is proved. Survival rates in the group using combined treatment comparable to control group show the justification of this treatment method application. The study shows the potential efficacy of complex approach application as a therapy in mCCRCC patients. iCSI can also be used as independent treatment method in specific group of patients. This can help to increase the observation period in case of mCCRCC patients of 9 months.The efficacy of targeted therapy drugs application significantly higher in comparison with the immunotherapy usage in more than 2 times (17 and 13 months versus 6 months).
Journal of Modern Oncology. 2015;17(4):26-33
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Current possibilities in diagnosis and treatment of diffuse large B cell lymphoma in children and adolescents: results of Pediatric Hematology and Oncology Research Institute of N.N.Blokhin Russian Cancer Research Center, international experience
Levashov A.S., Kovrigina A.M., Valiev T.T., Belyaeva E.S., Popa A.V., Mentkevich G.L.
Abstract
Background/Objectives. At the present time results of some pediatric protocols (FAB/LMB96 with and without rituximab (±R), B-NHL-BFM90/95, B-NHL-2004m) were published but prognostic significance of markers, such as: non-GCB DLBCL subtype, C-MYC, pSTAT3, BCL2/C-MYC coexpression, C-MYC, BCL2/C-MYC gene rearrangements in childhood DLBCL is unknown. In this article there was presented results of treatment childhood DLBCL according to protocols IDM-NHL-BFM90, B-NHL-BFM95 ± rituximab in view of morpho-immunological tumor’s features.Design/Methods. From 1994 to 2015 fifty one pediatric patients with DLBCL were included in trials IDM-NHL-BFM90, B-NHL-BFM95 ± rituximab. Male/female ratio was 2/1. Median age - 9.9±0.5 years (range from 2 till 16). Stage III-IV were revealed in 29 patients (56.9%), R3-R4-risk group - in 26 (50.9%). GCB/non-GCB DLBCL subtypes were assessed by Hans, Tally and Visco-Young immunohistochemical algorithms. Cutoff values of 40% for MYC, 70% for BCL2, 50% for pSTAT3 were established. MYC gene rearrangement was assessed by FISH using locus-specific MYC (8q24) tricolor breakapart probe, MYC (8q24) SE8 control probe and locus-specific MYC, BCL2, BCL6 dual - color breakapart probes.Results. GCB/non-GCB DLBCL subtypes were revealed in 13 (54.2%) and 11 (45.8%) out of 24 cases; in 10 (41.7%)and 14 (58.3%) out of 24 cases according to Hans algorithm, 10 (43.5%) and 13 (56.5%) out of 23 cases according to Visco-Young algorithm; in 7 (63.6%) and 4 (36.4%) out of 11 cases according to Tally algorithm. There was a trend to determine the difference between GCB/non-GCB subgroups of DLBCL according immunohistochemical algorithms (p=0.058). Ten (62.5%) out of 16 DLBCL samples were positive for MYC, 9 (40.9%) out of 22 - for BCL2, 2 (18.2%) out of 11 - for BCL2/C-MYC coexpression, 1 (9.1%) out of 11 - for pSTAT3. MYC gene rearrangement was revealed in 3 (20%) out of 15 patients. There was determined a statistically significant relationship between MYC expression>70% and MYC gene rearrangement in patients with III - IV stages of disease and R3 - R4 risk group. BCL2 and BCL-6 gene rearrangements were not revealed. Five-year overall survival (OS), event-free survival (EFS) were 90.3±5.3%, a median follow-up was 63.3±7.9 months, relapse-free (RFS) was 100%, a median follow-up was 69.5±7.9 months. There is not revealed any influence of investigated markers on OS, EFS and RFS.Conclusion. Number of patients in this study is not enough to estimate authentic prognostic significance of these markers but high-intensive B-NHL-BFM95 ± rituximab chemotherapy showed good therapeutic effect in our patients. This study will be continued.
Journal of Modern Oncology. 2015;17(4):34-44
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The ability to combine autodermoplasty in the treatment of patients with malignant tumors of the skin extremities (clinical observation)
Vaschenko L.N., Dashkova I.R., Kechedzhieva E.E., Babieva S.M.
Abstract
Basal cell carcinoma of the skin (BCC) is up to 80% of all epithelial non-melanoma skin tumors. With long-term growth of the tumor it spreads gradually to deeper layers, destroying soft tissue and bone. The surgical technique, particularly sparing and functional-sparing treatment, is priorjk and leading method in dealing with locally advanced BCC. Open cutaneous limb defects, after these interventions are the most difficult for surgical closure. Reconstructive plastic surgery is the final stage of surgery for patients with tumors of the skin, where a simple wound closure during the operation without the use of additional plastic material is not possible. Aesthetic and functional aspects of the problem can and should be solved by an individual approach of the choice of the method of skin plastics, depending on the size and location of the primary tumor, as well as the main treatment program. The authors demonstrate the clinical use case of technically simple and accessible way of the reconstruction of extensive defects of the skin of the upper limb with full recovery of its function.
Journal of Modern Oncology. 2015;17(4):45-50
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