Nº 7 (2011)

In 2010, therapy for breast cancer was determined by the fundamental biology of the tumor as measured by such prognostic markers of outcome as status of hormone receptors, HER2 expression and incremental molecular typing. These bioassays enlarge traditional staging in determining the risk of relapse, which had previously been the sole determinant for treatment planning. Small tumors with signs of high risk of recurrence require aggressive adjuvant therapy, whereas higher stage tumors with favorable biological characteristics may not require such therapy. Important prospective clinical trials integrating traditional and new markers of risk are currently under way to optimization of individualized treatment of patients with early (operable) breast cancer.

Colon cancer is common cause of morbidity and mortality from malignant tumors. 67.6% of patients have stages I-III colon cancer at the time of diagnosis. Surgical treatment is medically necessary in these patients. The main goal of adjuvant chemotherapy (AHT) in this situation is the eradication of micrometastases and reduction of risk of local recurrence. It is shown that the post-operative chemotherapy in patients with stage III colon cancer lead to improvement of recurrence free survival and overall survival, and it is recommended as standard treatment. In patients with stage II colon cancer, AHT improves survival rates only in the group with risk factors for disease progression. The decision making on choosing of schemes and initiation of AHT should be based on patients risk factors for disease progression, effectiveness and potential complications of planned therapy, and individual characteristics of the patient, such as age and concomitant diseases.

The large randomized phase III E2100, AVADO and RIBBON-1 trials have demonstrated high effectiveness of bevacizumab (Avastin) in first line treatment of advanced breast cancer (BC). This drug was effective as addition to the second line standard chemotherapy for metastatic breast cancer in RIBBON-2 study. Data for the use of this drug in routine clinical practice in patients with unexplained HER2/new and ER / PR-receptor status are limited, although these patients can be considered as candidates for the 1-st line and 2-nd line chemotherapy in combination with bevacizumab, because administration of bevacizumab does not require determining the VEGF (vascular endothelial growth factor) level and VGRF receptors. The article presents the experience of successful clinical use of bevacizumab with and without taxanes, in patients with metastatic breast cancer with unidentified (for one reason or another) HER2/new and ER/PR-receptor status.

The article presents the results of study that based on assessment of median time to progression (MTTP) and overall survival has examined the potentials of different forms of chemoradiotherapy (CRT) in the complex treatment of brain glioblastoma. The study has included 127 patients with glioblastoma multiforme. All patients underwent surgery or biopsy of the tumor, and subsequently, received post-operative radiation therapy (RT) or chemoradiotherapy. Group 1 received only radiotherapy, Group 2 - Lomustin (CCNU) and hydroxycarbamid, and Group 3 - temozolomide (TMZ). On completing of CRT, chemotherapy was continued. A statistically significant increase of MTTP was observed in group of patients receiving combined CRT with TMZ.

The article presents the results of estimation of efficiency of chemotherapy in 160 patients with breast cancer (BC) with lung metastases identified within year since the making primary diagnosis. A comparative study of different chemotherapy regimens noted that the AC + AD combination has advantages in achieving objective response and time to progression (P<0,05). Objective response in patients receiving FAS chemotherapy was 52%, while in patients treated with AD regimen - 64%. High efficacy of monotherapy with docetaxel in patients resistant to anthracyclines allows to use this regimen in the second line chemotherapy for the treatment of breast cancer patients with lung metastases.

The article presents most interesting reports on the treatment of malignant gliomas presented at Society of Neurooncology (SNO) symposium in 2010. Most of the papers on clinical neurooncology concerning the treatment of malignant gliomas were focused on current or completed studies using targeted drugs - bevacizumab, sunitinib, cediranib, silenzitid, nimotuzumab.