No 8 (2016)

A number of international clinical trials involving Russian oncological centers have justified broad prospects for dual blockade of HER2-positive breast cancer as the metastatic process and during neoadjuvant therapy including anthracyclines and taxanes in combination with pertuzumab and trastuzumab. The antitumor activity of the Russian combined drug «pertuzumab+trastuzumab» (Beyodim) is confirmed by increase in relapse-free and overall survival.

Disseminated melanoma - a malignant neoplasm with high mortality rates in the world. The efficacy of chemotherapy remains low. The discovery of BRAF mutation and subsequent use of BRAF-inhibitors has allowed to significantly improve the outcomes in patients with disseminated melanoma. The use of combination of BRAF-inhibitors and MEK-inhibitors showed higher efficacy than monotherapy.

Currently, possibilities of effective drug treatment of locally advanced and metastatic bladder cancer (mBIC) are rather limited. The main drug of 1st line is cisplatin, the use of which is difficult for half of the patients because of its nephrotoxicity. The question of choice of effective treatment after progression on the 1st line therapy is of particular importance. Currently vinflunine is the only drug with proven efficacy in mBlC patients after progression on cisplatin-containing chemotherapy regimens, and it is recommended for use in Europe and Russia. Characteristic safety profile of vinflunine allows to consider this drug in combination with gemcitabine as a worthy alternative to cisplatin-containing regimens in the 1st-line therapy in the future.

Currently, the actual problem in the treatment of patients with metastatic colorectal cancer is the search for significant prognostic and predictive factors. To date, the results of numerous studies allow to identify a number of such factors, but in most cases, the role of certain clinical and morphological characteristics remains significantly unproven. The article presents the results of univariate and multivariate analyses aimed to identification of significant predictors of survival of patients with metastatic colorectal cancer who have received a second line drug therapy within a framework of prospective study.

The article presents an analysis of the features of the course and survival of 304 patients with body skin melanoma (BSM), who underwent surgical treatment in the Crimean Republican Clinical Oncological Dispensary in the period from 1982 to 2004, depending on the location of tumor and different surgical tactics. The most «vulnerable» age group for the development of DSM included patients 41 to 60 years - 42.1±2.8% (53.9% women, 46.1% men). Assessing the long-term results of surgical treatment of BSM in the overall cohort of patients (n=304), it should be noted that 11.3% of the patients died during the first year, 3-year survival rate was 64.4±28%, 5-year survival rate - 53.8±2.9%, 10-year survival rate - 41.0±2.9%. It has been shown that various localization of BSM does not significantly affect the features of the course, the nature of metastasis and the depth of tumor invasion. Simultaneous lymphadenectomy in the absence of morphological confirmation of melanoma metastases in regional lymph nodes is not justified (diagnosis is not confirmed in 43.4±5.0% of patients). Metastases in regional lymph nodes should be considered as a factor of unfavorable course, which significantly reduces life expectancy and survival of patients. Expectant management of patients after the removal of the primary tumor which consists of a delayed lymph node dissection only in the case of appearance of clinical signs of lymph node metastases does not worsen the survival.

The frequency of development of osteoporosis (OP) in breast cancer (BC) patients of childbearing age is directly related to the application of special treatment. The article analyzes the incidence of OP in BC patients of reproductive age during treatment of BC, the relationship with the severity of pain in OP, the need for timely administration of drugs that prevent the development of OP and lead to a decrease in pain and improvement in the quality of life of women. In order to prevent the development of OP in this category of patients, it is necessary to include «osteoporotic» treatment (with the inclusion of calcium and selenium) in the comprehensive treatment of the primary cancer.

The article presents data on 1098 patients with colorectal cancer with urgent complications (acute intestinal obstruction, intestinal bleeding, perforation, perifocal inflammation), who were treated in the territory of Smolensk and Smolensk region during the period 2001 to 2013 and were entered into database of the regional population-based cancer registry. The main parameters that reflect the relationship between sex, age of the patient, the severity of the general condition, the presence of the main clinical symptoms, co-morbidities and urgent complications of colon cancer, and the time from the development of complications to hospitalization were analyzed. The reasons for the late hospitalization of patients with complicated colorectal cancer were examined.

Exocrine pancreatic insufficiency (EPI) is a common complication of both benign and malignant diseases of the pancreas. In pancreatic cancer (PCa), development of EPI can be determined by various mechanisms, including block of main pancreatic duct and degradation of exocrine part of organ (due to tumor invasion), and mediated by surgical interventions. In most cases, enzyme replacement therapy with pancreatic enzymes can reduce the severity of symptoms of EPI associated with prostate cancer, extend patient’s diet, improve their nutritional status and quality of life. This article presents the clinical guidelines on the use of enzyme replacement therapy in patients with pancreatic cancer, approved by the Russian Society of Clinical Oncology (RUSSCO).