The methylation of CpG islands in the promoter regions of miRNA genes is an epigenetic modification that plays a decisive role in the breast cancer (BC) initiation and progression. The aim of the study was to investigate the frequency of 5 miRNA genes methylation (miRNA-9–1, miRNA-9–3, miRNA-34b/c, miRNA-193A, miRNA-129-2) in mammary epithelial neoplasms. Methylation-specific polymerase chain reaction (MS-PCR) was used to detect methylated genes. 62 patients took part in this study. It was found that the frequency of all 5 miRNAs genes methylation is significantly higher in tumor tissue than in the adjacent histologically unchanged mammary tissue. The authors also performed a correlation analysis and founded a relationship between the methylation rate of certain miRNA genes with some clinical and molecular characteristics of the tumor. This information on epigenetic disorders of BC complements the “molecular portrait” of the tumor and can be used to diagnose and assess the prognosis.
REVIEWS AND ANALYSIS
Currently, the standard treatment of recurrent gastrointestinal stromal tumors (GIST) is life-long targeted therapy with tyrosine kinase inhibitors. Imatinib is administered as a first-line therapy. Due to the high mutational potential of tumor cells the secondary drug resistance develops in an overwhelming number of patients, which leads to the necessity of switching to second (sunitinib) and third (regorafenib) line therapy. In addition, the role of the surgical method in the complex treatment of advanced GIST has recently been updated. This article gives an example of long-term follow-up and treatment of a patient with recurrent small bowel GIST. The effectiveness of the combined approach in the treatment of this complex category of patients has been demonstrated.
ORIGINAL REPORTS
Currently, in connection with the epidemiological and demographic crises, there is an increase of the incidence of cancer in the population, which leads to significant social and economic losses.
The leading role in the early detection of cancer is assigned to medical organizations that provide primary health care, the diagnostic capabilities of which allow for the timely conduction of various diagnostic and screening programs. Statistical data on the incidence and prevalence of malignant neoplasms are the main basis for the development of measures aimed at reducing morbidity and mortality from malignant neoplasms. At the same time, a critical area is working with a healthy population: carrying out measures for early prevention of oncological diseases on the basis of clinical examination.
58 samples of stimulated bone marrow (39 – oncology patients, 19 healthy donors) obtained for transplantation in cancer patients were analysed and compared to control group (13 bone marrow samples from women with mastopathies). It was noted the significant increase of blast cells in cancer patients compared to donors and control group (p<0.037). Neutrophyl maturation index was higher in stimulated bone marrow (p<0.001) and decrease of lymphocyte percentage (p<0.008) compared to control group: elevation of CD3+ and CD8+ lymphocytes (p<0.0001) as well as decrease of NK-cells CD56+ CD3- and/ or CD16+ CD3-).
There is a major influence of residual tumor on long term survival in advanced ovarian cancer patients. Tumor can directly involve various organs of abdominal cavity. Complex surgical procedures and multiple resections may be necessary in order to achieve complete debulking. However, its rate remains low and sub-optimal debulking is common. Currently, quality of surgical treatment in ovarian cancer is an emerging medical problem. This article is dedicated to review of various approaches to improve quality of care in advanced ovarian cancer including recent local and international initiatives in this field.
Objective. To evaluate efficacy and safety of FOLFIRINOX regimen as induction therapy in borderline resectable and unresectable pancreatic cancer.
Materials and methods. A prospective study included patients with borderline resectable and unresectable pancreatic cancer without distant metastases. Patients received up to 6 courses of induction chemotherapy with FOLFIRINOX regimen (oxaliplatin 85 mg/m2 i. v., irinotecan 180 mg/m2 i. v., calcium folinate 400 mg/m2 i. v., 5‑fluorouracil 400 mg/m2 i. v. bolus and 2 400 mg/m2 i. v. 46‑hours infusion) repeated every 14 days. Patients underwent surgery when radiologic signs of resectability were achieved. Maintenance chemotherapy was prescribed to the patients in cases of unresectability preservation. The primary endpoint was 1‑year progression-free survival.
Results of the study. The study included 32 patients. The median follow-up was 7.0 months. The one-year progression-free survival was 55.3%. The one-year overall survival of patients in this study was 83.2%. Eight patients (25%) underwent surgery after induction therapy, and in 7 of them it was possible to perform R0 resection. The main manifestations of 3–4 grade toxicity were neutropenia (46.9%), diarrhea (12.5%), and elevation of hepatic transaminases (12.5%).
Conclusions. The FOLFIRINOX regimen showed high potential as induction chemotherapy in pancreatic cancer. The use of this regimen is possible only in patients with good performance status due to its high toxicity.
Continuous red blood cell (RBC) transfusions are the main factor of hemosiderosis development, but many Myelodysplastic syndrome (MDS) patients develop iron overload at an early stage of the disease before the red blood cell (RBC) transfusions begin. Hepsidin is a hormone, produced by hepatocytes. It plays a leading role in iron hemostasis. MDS patients demonstrate elevated serum ferritin and hepcidin concentrations even before the RBC transfusions initiating. After 6 months of follow-up, serum ferritin concentration was increased up to 1278 µg/L without significant hepcidin concentration elevation. After 12 months, serum ferritin continued increasing up to 1898 µg/L with a significant hepcidin level decrease to 92±17 pg/ml. The patients group with a ferritin level above average after 12 months of treatment demonstrated significantly lower 5-year overall survival (OS) compared to the group with ferritin level after 12 months of treatment below 1598 µg/L: 5-year OS 9,1±8,7%; median OS – 1,7 years, median observation time 2,9 years (1,2–5,8) in the first group versus 5-year OS 44,4±17,0%; median OS – 4,5 years, median observation time 4,5 years (2,6–6) in the second one. This study findings demonstrating invert correlation of ferritin/hepcidin serum concentration may give evidence to the fact of functional hepatocytes reserves depletion and increased iron deposition in the liver. Altered hepcidin production may be a reason for the hemosiderosis over-progression that is negative for the patients’ quality of life. Serum hepcidin and ferritin concentrations must be assessed every 3 months for the iron helators could be administrated on time.
Ixabepilone is an epothilone analog, active as a cytotoxic agent due to its ability to stabilize microtubules of tumor cells. Currently ixabepiloneis approved for treatment of metastatic breast cancer in patients previously treated with taxanes and anthracyclines. In this article we analyzed existing data about its efficacy in preoperative and adjuvant treatment settings as well as in systemic therapy of metastatic breast cancer. We discussed a role of ixabepilone in contemporary treatment of this disease.
305 patients with primary malignant tumors of liver and bile-ducts (C22 according to ICD) were registered in Sverdlovsk Region in 2016. Only 123 of them (40.3%) got consultation in Sverdlovsk Regional Oncology Dispensary. Autopsy was performed in 251 cases (91.9% of deceased patients). On the one hand the exceeding of mortality over morbidity point out the failure of cases registration, on the other hand patients with another type of tumors were identified among the registered ones (4.3%). The majority of liver primary tumors are presented by hepatocellular carcinoma (81.6%). It is usually diagnosed at the age of 60 and older (78.2%) and stage IV (47.9%). Specialized anticancer treatment is not enough provided (just in 18.4% cases). It gives an opportunity to increase the median survival up to 18 months comparing with 1.5 months on best supportive care.
CLINICAL NOTES
Comprehensive approach and a highly qualified morphological analysis are important conditions for timely diagnosis and development of tactics of pathogenetic treatment of cancer patients. This clinical case demonstrates a multimodal approach to the differential diagnosis of metastatic cancer. Due to oncological alertness, the clinical data, qualitative morphological study and close cooperation of all participants in a multidisciplinary group a metastasis of the gastric signet-ring cell carcinoma was diagnosed in the cervix, allowing to optimize treatment of the patient.
Now the number of patients receiving immunotherapy with checkpoint inhibitors, including nivolumab, is growing all over the world. At the same time, there is a growing of immune-related adverse events in clinical practice, including rare ones. There is a case report of immune-related encephalopathy (grade 3) at patient with metastatic non-small cell lung cancer after complete response at nivolumab treatment.
ISSN 2587-6813 (Online)