编号 17 (2011)

The review considers the place of capecitabine as an alternative to fluorouracil (5-FU) in the treatment of colorectal cancer (CRC) and gastric cancer (GC). Based on the results of randomized clinical trials, it was concluded that treatment regimens with capecitabine have equal efficacy compared with those based on infusional 5-FU in terms of overall survival in patients with colorectal cancer. At the same time, capecitabine is likely to be even more effective alternative to 5-FU in metastatic GC.

Neuroendocrine tumors have the ability to produce hormones and vasoactive peptides, and their hyperproduction leads to various pathological changes in affected organs. In particular, endocardial fibroelastosis, ie, carcinoid cardiac syndrome (CCS) develops in heart. To date, cardiovascular complications in patients with CCS are one of the leading causes of death, therefore, timely diagnosis and treatment lead to significant improvements in quality of life of patients. This article is dedicated to the current state of cardiac lesions against the background of neuroendocrine tumors. A brief historical note about this problem is presented; the clinical symptoms, biochemical and instrumental methods of diagnosis are described in detail. General principles of treatment of CCS are represented.

The inclusion of bevacizumab (Avastin) in the modern chemotherapy regimens has led to an increase of frequency of achieving objective response, median progression-free survival and overall survival, but at least 40 % of patients did not have the advantages of using this drug. Failure of treatment may be the result of a primary tumor resistance to treatment, as well as acquired resistance. The results of recent studies on search for markers of efficiency of bevacizumab (single nucleotide polymorphism of the VEGF gene, detection of recessive allele of CXCR1 interleukin-8 receptor, VEGFD expression, etc.) are discussed. The data obtained may contribute to a more rational approach to selecting the option of drug therapy.

The article presents the results of an open, prospective clinical trial aimed at assessing the safety and efficacy of Taxacad® and carboplatin in combination chemotherapy of patients with advanced non-small-cell lung cancer. Study patients have received a combination of Taxacad® (175 mg/m2 as a 3-hour intravenous infusion) and carboplatin (at a dose corresponding to AUC = 6). Cycles of chemotherapy were performed with an interval of 21 days. Six cycles of chemotherapy were planned. The study enrolled 88 patients, 78 of which were included in the analysis of the effectiveness of treatment. Enrolled patients have received 1 to 9 courses of chemotherapy according to the planned scheme. The safety profile of drug combinations used corresponded with data obtained in international studies. Grade III-IV anemia was observed in 4,5 % of patients, grade III-IV leukopenia - in 6,8 %, grade III-IV neutropenia - 35,6 %; III-IV grade thrombocytopenia and liver and renal toxicity was not observed. According to the efficacy analysis (n = 78), partial response rate was 25,6 %, stabilization rate - 44,9 %, progression was observed in 29,5 % of patients. The median time to progression was 4,2 months. Data show that the results of the use of generic drugs Carboplatin and Taxacad® manufactured by CJSC BIOCAD are consistent with the literature on efficacy and safety of the original drugs.

After cardiovascular disease, a prostate cancer (PC) is the second cause of death among men in Western countries. In 2009 in the Russian Federation, there were 23 845 cases of new-onset prostate cancer, accounting for 5 % of all malignancies in men. 53,4 % of patients had stage III or IV prostate cancer. From September 2010 to May 2011 (9 months), 42 patients with locally and generalized prostate cancer were observed and treated in clinical oncology clinic № 1 and Department of Urology of Moscow Reaserch Oncological Institute named after P.A. Herzen. Several schemes of hormonal therapy, including surgical castration and various modes of administration of luteinizing hormone-releasing hormone agonist leuprorelin acetate (Eligard), using a Atrigel system were assessed. It was shown that intermittent HT in patients with prostate cancer has benefits.

The article discusses the problem of drug-induced liver injuries due to toxic effects of drugs, dietary supplements and alternative medicine resources. Options of drug-induced liver injuries, principles of diagnosis, treatment and prevention of hepatotoxicity are represented. Physicians awareness has a great importance for the prevention of hepatotoxicity, because the timely cessation of drug allows to avoid more severe liver injury. Investigations of the prophylactic effect of some drugs that have a beneficial effect on liver function, particularly S-adenosyl-L-methionine (ademethionine) and ursodeoxycholic acid, are most promising.