Vol 20, No 1 (2018)

Articles
The role of cytoreduction surgery in advanced ovarian cancer (review)
Tandelov R.K., Sel'chuk V.Y., Morkhov K.Y., Nechushkina V.M., Kuznetsov V.V.
Abstract
The published results of primary and interval debulking surgery in advanced epithelial ovarian cancer are discussed. According to meta-analyses and retrospective studies primary cytoreduction without macroscopic residual tumor has the best results. If the size of the largest residual tumor is more than 1 cm, primary debulking provides no benefit. Published randomized trials didn’t prove benefits of primary debulking surgery.
Journal of Modern Oncology. 2018;20(1):5-10
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Nosological structure of patients in oncohematology department at the Loginov Moscow Clinical Scientific Center for 2016 year
Pivnik A.V., Dudina G.A., Petrenko A.A., Tumanova M.V., Stuklov N.I., Leyghton R.A., Nikerova L.I., Dubnitskaya M.G., Mukhin O.V., Kremneva N.V., Fedorova V.S.
Abstract
Relevance. The distribution of patients of the oncohematological department according to the main nosological units reflecting the main hematological diseases of the elderly and senile patients, Hodgkin's lymphoma young patients of and HIV-infected patients of the hematologic profile is shown. These indicators are necessary for statistical processing and profile for doctors of the city and the country. Aim. There are shown diagnostic methods and treatment programs for major hematological diseases of elderly and senile patients, young patients with Hodgkin's lymphoma and HIV-infected patients with hematological malignancies. Materials and methods. Data on 535 persons entered the department 1351 times are summarized. Mortality was 6.1%. Results. Hospitalized: acute leukemias - 22 patients, chronic myeloproliferative diseases - 61, myelodysplastic syndrome - 42, chronic lymphoproliferative diseases - 63, anemia - 22, others - 38 HIV-infected - 45 patients. Conclusion. These nosologies reflect the structure of hematological diseases in the population of elderly and senile patients, the frequency of Hodgkin's lymphoma and the composition of HIV-infected patients. Diagnosis and therapy were carried out in accordance with generally accepted programs with achievement of average results of treatment. Young patients with HIV infection in the stage of secondary diseases suffered mainly from aggressive lymphomas with effective treatment of about 50%.
Journal of Modern Oncology. 2018;20(1):11-16
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Clinical significance of the achievement of MRD-negativity in patients with chronic lymphocytic leukemia
Mirolyubova Y.V., Stadnik E.A.
Abstract
The determination of the minimal residual disease (MRD) in chronic lymphocytic leukemia (CLL) has acquired significance in connection with the success of therapy for this disease. Immunochemotherapy regimens significantly prolonged the life of CLL patients, which was associated with the achievement of MRD-negative remissions. MRD-status has been regarded as a predictor of progression-free survival and an endpoint in clinical studies. The use of new drugs - targeted BCR-signal inhibitors, bcl-2 inhibitors, new monoclonal antibodies and their combinations opened new perspectives for prognostically unfavorable CLL cases. The importance of MRD-negativity in the era of new drugs has become the object of modern research. There were also developing methods for determining MRD in CLL. This article presents data on the effect of MRD-negativity on the survival rates of patients at the current level of the development of therapy, as well as the prospects for the clinical use of the MRD status in the practice of patient management. Furthermore, we present results of an exploratory MRD analysis of a prospective BEN-001 study in Russia (bendamustine-rituximab in the first-line treatment of CLL). MRD status was evaluated in 84 pts. Bone marrow samples were available and evaluated in 81 (96.4%) pts. MRD-negative status after 6 courses of treatment was achieved in 27.4%. Our results in a sample of Russian patients are well aligned with MRD negativity rates from literature.
Journal of Modern Oncology. 2018;20(1):17-22
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Epstein-Barr virus in children with classical Hodgkin’s lymphoma
Botezatu I.V., Valiev T.T., Dushenkina T.E., Smirnova K.V., Ravshanova R.S., Maksimovich D.M., Likhtenstein A.V., Gurtsevich V.E., Popa A.V., Senyuta N.B.
Abstract
Classical Hodgkin's lymphoma (cHL) is one of the many malignant tumors associated with the Epstein-Barr virus (EBV). It is shown that EBV-positive cases of cHL are distributed with different frequencies among all cases of the disease. The frequency of EBV-positive cases of cHL is influenced by the demographic characteristics of the studied population and other factors. Russia belongs to geographical regions with a low incidence of this form of tumor. The aim of the study was to estimate the humoral response to EBV and the level of viral DNA in the blood plasma of children with cHL and to evaluate the significance of both EBV markers for clinical manifestations of the disease. The data obtained have shown that the level of EBV persistence in children with cHL practically does not differ from that in healthy children, however, the activity of the humoral response to EBV was significantly lower. The study of the composition of the elements of the leukocyte germ, responsible for cellular and humoral immunity, did not make it possible to explain the observed phenomenon. In particular, the number of circulating leukocytes in the patients' blood before the treatment corresponded to normal values, but it turned out to be below the normal values after the treatment. Conversely, the percentage of lymphocytes in patients before treatment turned out to be lower than normal values, but it reached normal values after the treatment. The percentage of neutrophils and monocytes in patients before and after the treatment was almost the same as in healthy individuals. The data obtained suggest that the reduced humoral response in patients with cHL is not associated with the altered composition of the leukocyte germ cells, but due to their reduced functional activity. The search for copies of virus DNA in plasma and oral cavity swabs made it possible to detect them only in some patients before the therapy and to state their complete absence after the treatment. Dynamic observation of the EBV DNA concentration in blood plasma and humoral response to EBV in 3 patients showed increased values viral DNA copies before treatment, and their decrease to zero after successful therapy, while antibody titers remained at the same level and did not reflected the clinical state of patients. It can be assumed that the increased concentration of plasma viral DNA detected in cHD patients can become a marker that allows indirectly estimating the degree of minimal residual disease and the probability of recurrence of the disease.
Journal of Modern Oncology. 2018;20(1):23-28
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The use of low molecular weight heparin Enixum® in the prevention and treatment of thrombosis in oncology
Somonova O.V., Elizarova A.L., Matveeva I.I.
Abstract
Thromboembolic complications often develop in patients with various forms of malignant neoplasms, and the occurrence of thromboses complicates antitumor treatment and worsens the survival rates of patients. In modern studies it has been shown that oncological disease increases the risk of developing thrombotic complications 4-7 times. The leading role in the pathogenesis of thrombotic complications in patients with malignant neoplasms is played by changes in the hemostatic system, caused both by the tumor itself and by treatment methods. At present, low molecular weight heparins are the main drugs in the prevention and treatment of thrombotic complications in cancer patients. Anticoagulant of direct action of domestic production - Enixum® (Pharmfirma Soteks, Russia, registration certificate No. ЛП-002330) in chemical structure is sodium enoxaparin, according to pharmacokinetic and pharmacodynamic properties it corresponds to the original drug - Clexan® (Sanofi Winthrop Industry, France). An open comparative randomized multicenter clinical trial in Russia of the drug Enixum® and Clexan® in patients with a high risk of thrombotic/thromboembolic complications in the postoperative period showed that the efficacy and safety of the Enixum® product is equivalent to the efficacy and safety of the Clexan® drug. The use of Enixum® for the prevention of thrombotic complications in the postoperative period in oncogynecologic patients and in the treatment of acute thromboses and PE during various stages of complex treatment has proved the high efficacy and safety of this low molecular weight heparin.
Journal of Modern Oncology. 2018;20(1):29-34
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Ramucirumab therapy in patients with advanced gastric cancer: discussion of a case series
Orlova R.V., Zhukova L.G., Ganshina I.P., Yukalchuk D.Y., Ponomarenko D.M., Beliak N.P., Gordeeva O.O., Erdniev S.P., Minasyan A.A., Dashkova A.A., Sopiya E.R., Sholokhova E.A., Gurochkin A.B.
Abstract
Background. Gastric cancer is the fifth most common malignancy worldwide with diagnosis often occurring at an advanced stage. For the majority of advanced gastric cancer patients, chemotherapy typically is used as first-line treatment, although many patients will also require second-line treatment. Ramucirumab (Cyramza®, Eli Lilly and Company, Indianapolis, Indiana, USA) recently has received worldwide and United States Food and Drug Administration approval for gastric cancer in the second-line setting. Case reports. A series of five advanced gastric cancer cases is presented, outlining each patient’s diagnosis and treatment. All patients were treated with intravenous ramucirumab (8 mg/kg on days 1 and 15) plus paclitaxel (80 or 100 mg/m2 on days 1, 8, and 15 of a 28-day cycle) after disease progression on or after first-line chemotherapy. Patient outcomes are described including an outline of treatment-related adverse events and quality of life. All patients were able to achieve a clinical response and stable disease. Conclusion. Our case series demonstrates that ramucirumab, in conjunction with paclitaxel, is an effective and well-tolerated treatment option for advanced gastric cancer patients who have disease progression following first-line chemotherapy.
Journal of Modern Oncology. 2018;20(1):35-41
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Dermatomyositis and polymyositis in breast cancer patients: a case reports
Ganshina I.P., Zhukova L.G., Burnevitch E.Z., Gordeeva O.O., Kondratieva O.E.
Abstract
Dermatomyositis and polymyositis are an autoimmune disease which is characterized by proximal skeletal muscle weakness, muscle inflammation and associated with a variety of skin manifestations. Both autoimmune conditions are mainly observed as an independent disease, though an association between dermato- and polymyositis and malignancy were described. Case reports of two patients are presented, in one of which dermatomyositis and breast cancer were manifested simultaneously, in the other - the development of polymyositis preceded the recurrence of the disease after a long-term remission. Also diagnostic and therapeutic options of both conditions are shown.
Journal of Modern Oncology. 2018;20(1):42-44
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Clinical cases of treatment of patients with advanced hepatocellular carcinoma
Petkau V.V., Gladkov O.A., Filatov P.N., Raigorodskii M.V., Tarkhanov A.A., Klimushkin A.V., Nikitina L.Y.
Abstract
The article presents the clinical cases of complex approach to the treatment of patients with advanced hepatocellular carcinoma in everyday clinical practice. The use of targeted therapy with sorafenib and regorafenib lead to the long-term disease control even among the patients with massive liver lesions and among the patients with poor performance status.
Journal of Modern Oncology. 2018;20(1):46-49
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Pre-operative chemoradiation therapy in complex treatment of patients with locally advanced tumors of the thoracic esophagus
Shogenov M.S., Davydov M.M., Allakhverdiyev A.K., Chekini A.K., Filatov A.A., Akhmedov P.I., Serebryanskaya M.V., Korolyeva A.A., Dadyev I.A., Chichikov E.I., Grigorenko V.A., Kozlov N.A., Nazliyev P.B., Malikhova O.A., Tryakin A.A.
Abstract
The objective of this study was to evaluate the preliminary results of the complex treatment of patients with locally advanced tumors of the thoracic esophagus after pre-operative chemordiation therapy. Materials and methods. Men and women (n=26) over 18 years of age with histologically squamous cell carcinoma tumors T3-4aN0-3M0 of the thoracic esophagus were included in our study. In this group of patients we performed pre-operative chemotherapy: paklitaxel 175 mg/м2 first day; cisplatin 75 mg/м2 first day; leucovorin 50 mg 1-3 days; 5-ftoruracil 425 mg/м2 1-3 days or instead of leucovorin and 5-ftoruracil we used capecitabine 1500 mg/м2 1-14 days, every 3 weeks followed by chemoradiation therapy (РОД 2 Gy, СОД 44-46 Gy) with weekly used of chemotherapy. We analyzed the preliminary results of the complex treatment in terms of the severity of toxicity, therapeutic pathomorphosis and reduction in the tumor stage and the number of postoperative complications. R0-resections were performed in 24 (92%) patients. Microscopic manifestations of the tumor in the proximal margin of resection (R1) were detected only in 2 (8%) patients. Therapeutic pathomorphosis was studied in all 26 patients. In the histological study, 8 (31%) patients did not have tumor cells, which was regarded as the complete effect of chemotherapy in the preoperative period. Pathomorphosis of grade 3 was observed in 9 patients, which was 35%. Thus, the used strategy of preoperative chemotherapy and chemoradiotherapy is a promising direction in improving long-term treatment outcomes.
Journal of Modern Oncology. 2018;20(1):50-53
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The effect of derivatives of 3-hydroxypyridine and succinic acids on depressive symptoms, pain intensity and quality of life after surgical treatment of breast cancer
Volchegorskii I.A., Vazhenin A.V., Zyuzina M.S.
Abstract
Aim. A comparative analysis of the impact of derivatives of 3-hydroxypyridine and succinic acids on depressive symptoms, the pain intensity and quality of life after surgical treatment of breast cancer. Materials and methods. A short-term prospective placebo-controlled simple «blind» randomized study of the effect of 14 - day course of application of Emoxipin (150 mg daily intravenously), Reamberin (400.0 ml - 1.5% per day intravenously) and Mexidol (300 mg/day daily intravenously) for severity of depression, the dynamics of postoperative pain and quality of life was conducted. Results. Two-week application of Emoxipin, Reamberin, Mexidol on the background of standard therapy reduces the intensity of nociceptive pain with a simultaneous increase in generic and oncospecific parameters of quality of life in the postoperative period of oncomammologic intervention. Antinociceptive effect of Mexidol and its positive impact on quality of life were accompanied by the development of a significant antidepressant effect. Conclusion. Mexidol, which improved the quality of life due to the parallel development of antinociceptive and antidepressant effects, should be considered the most effective drug in the series of studied derivatives of 3-hydroxypyridine and succinic acid.
Journal of Modern Oncology. 2018;20(1):54-59
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Taxanes induced peripheral neuropathy: mechanism of development and pharmacogenetic factors
Shestakova L.V., Sychev D.A., Poddubnaya I.V.
Abstract
For decades taxanes are used as a part of classical schemes for treatment of malignant tumors of various localizations including breast cancer. Peripheral neuropathy is an adverse reaction which impairs both quality of patients’ lives and treatment efficiency. To prevent or reduce the impact of peripheral neuropathy factors contributing to its development and mechanisms that are involved need to be known. This article is a review of the current status of our understanding about the mechanisms underlying the development of taxanes induced peripheral neuropathy.
Journal of Modern Oncology. 2018;20(1):60-63
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Cost-effectiveness analysis of ixabepilone use in monotherapy in patients with locally advanced and metastatic breast cancer resistant to treatment with anthracyclines, taxanes and capecitabin
Kolbin A.S., Mosikyan A.A., Balykina Y.E., Proskurin M.A.
Abstract
Background. Nowadays there are no any standards of treatment for patients with locally advanced and metastatic breast cancer resistant to treatment with anthracyclines, taxanes and capecitabin. Ixabepilone has proved successful as a single agent for treatment of these patients. Methods. Eribulin was chosen as an alternative strategy. Efficacy criteria were overall and progression-free survival. Cost-effectiveness analysis is performed on the basis of published data and Markov modeling for 1.5 year time horizon. Results. Total expenditures for ixabepilone strategy were 18.2% less than those for eribulin treatment. Administration of ixabepilone instead of eribulin will allow treating additionally up to 222 patients per year. Price elasticity analysis revealed that total expenditures on ixabepilone will be 20% less than on eribulin treatment at a price of ixabepilone equal to 63 000 rubles per 45 mg vial and 21 691.23 rubles per 15 mg vial of ixabepilone. Conclusion. Ixabepilone as a single agent appeared to be economically reasonable as compared to eribulin in case of ineffective pretreatment with taxanes, anthracyclines and capecitabine.
Journal of Modern Oncology. 2018;20(1):64-69
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