No 8 (2015)

The first representative of a new class of antiemetics - neurokinin-1 receptor antagonists (NK1) - is a selective NKIreceptor blocker -aprepitant (Emend®) and its intravenous form - Emend®IV. This formulation is more convenient to use, since it is given as a single dose intravenously before chemotherapy, has equal efficacy to aprepitant and, in contrast, does not require additional administration or an injection on subsequent days. Fosaprepitant was introduced in all clinical guidelines for the prevention of nausea and vomiting, in combination with 5-HT3 receptor antagonist and dexamethasone during highly- and, in some cases, moderately emetogenic chemotherapy. The drug has a minimum range of side effects.

Is the most significant advance in the treatment of this disease, because it changes the natural course of breast cancer. However, resistance to anti-HER2 drugs is an important clinical problem both at early and advanced stages of disease; therefore, there is a need for new therapeutic approaches. The article presents the clinical data on HER2-targeted drugs that are under development or already in use in clinical practice.

The article presents the results of treatment of 30 patients with cerebral metastases from colorectal cancer. The morphological and radiological patterns of metastatic nodes, surgical options and the frequency of local recurrences, postoperative chemoradiation therapy, as well as the causes of death in this group of patients are discussed.

The article describes a new method of surgical treatment of breast cancer, which includes a modification of the classical radical resection for tumor with localization in the lower quadrants. We observed 90 women living in the city of Perm and the Perm region aged from 25 to 76 years. All women gave written informed consent and underwent breast-conserving surgery by a new method of radical resection for cancer of lateral lower quadrant of the breast (patent № 2509534, 03.20.2014). Immediate and long-term results of the treatment were studied in all patients. In the majority of women (87.80%), early postoperative period was uneventful. The frequency of breast edema as delayed complication did not differ from that of after classic radical resection and was observed in 24.43% of cases. The application of the described technique of radical resection allowed to achieve excellent cosmetic result in 29.92% of cases, good - in 42.63%, satisfactory - in 20.51%, and unsatisfactory - only in 6.94% of the women. For comparison, after the classic resection cosmetic effect is considered as satisfactory and unsatisfactory in half of the cases. The use of the proposed method allows to effectively simulate the breast shape, bypassing tissue defect in the lateral quadrants, compared to the conventional method of radical resection. Furthermore, radicality of surgery is not reduced. Thus, the proposed method of radical resection can significantly improve the aesthetic results of surgical treatment of breast cancer, enhance the quality of life of patients, without affecting the long-term results of treatment.

In Russia, there is an increased incidence of cervical cancer in women of reproductive age. Secondary prevention of cervical cancer includes the identification and treatment of preinvasive forms of the disease, such as dysplasia, cervical intraepithelial neoplasia and carcinoma in situ. Traditional surgical treatment of preinvasive neoplasia does not always lead to the elimination of the virus, which in turn does not allow to completely exclude the risk of recurrence. The article presents the literature data and own authors’ observations on the possibilities of drug therapy in the treatment of neoplasia. It is emphasized that the use of antiviral drugs, immunomodulators, and selective estrogen receptor modulators as part of treatment allows to achieve higher efficiency compared to the use of surgical methods only.

Application of oral vinorelbine (OV) in clinical practice extends the possibility of high effective and safe chemotherapy of malignant tumors. The use of OV seems promising in stage IIIb-IV non-small cell lung cancer, at the phase of maintenance treatment and as a component of adjuvant chemoradiation therapy. In breast cancer, OV can be administered as monotherapy or in combination. Also, its use is possible in first-line treatment of HER2 positive metastatic breast cancer in combination with an anti-HER2 agents. Vinorelbine is effective and safe in elderly patients in case of regular medical monitoring.