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Malignant tumours

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Vol 9, No 1 (2019)
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LETTER TO THE EDITOR

6-9 1994
Abstract

Introduction of possibilities ways of using modern information technologies in the organizational and therapeutic activities of medical organizations of the health care system of the Russian Federation(Russia) is one of the most important tools in implementation of the state policy of providing quality medical care to the population. Information systems (IS) allow to monitor and record data on patients with malignant neoplasms, to reflect diagnosis data, treatment, to present various thematic analytical reports, which increases the data analysis efficiency, diagnostic methods effectiveness, which, in turn, provides possibilities for high‑quality treatment of patients with malignant neoplasms and timely monitoring of their condition.

OWN RESEARCH

10-15 3174
Abstract

Background. Urothelial cancer ranks 7th and 17th of all the malignant tumors in males and females, respectively. Development of new immunotherapeutic drugs provides new possibilities in treatment of such patients, especially the patient population in whom platinum‑based therapy is contraindicated. Administration of immunooncology drugs requires determination of PD-L1, for which various diagnostic systems are used. The question regarding correlation of results of determination of PD-L1 expression remains of concern.

Materials and Methods. The study was performed on 100 samples of surgical and biopsy samples of urothelial cancer. Two clones of 22C3 and SP142 with corresponding detection systems were used for the study. PD-L1 expression was assessed in tumor and immune cells.

Results. The study demonstrated a high correlation of negative PD-L1 tumor status determined using both diagnostic agents (92 % and 97 %) and low correlation of results of positive PD-L1 status (67 % and 43 %).

Conclusions. Thus, if a negative result of PD-L1 status of urothelial cancer is obtained using any of the diagnostic agents studied, repeated test with the other antibody is not required. If positive status is obtained in one test, the patient may have a negative status in the other test, which allows recommending a repeated testing in borderline cases using a test, recommended for the medicinal product untended for treatment.

16-21 813
Abstract

Considering a rise in colon cancer rates, searching for new treatment options remains highly relevant for this patient cohort. Determination of chemokine receptors in tumor tissue may become an additional prognostic tool that can be used for planning adjuvant therapy.

22-28 952
Abstract

Introduction: The search for new molecular targets for chemotherapy of malignancies, particularly pediatric brain tumors, is a relevant issue of modern oncology. MYC expression and amplification is often observed in brain tumors, which is an unfavorable prognostic factor. Many oncogenic processes are regulated by some growth factors including the nerve growth factor (NGF).

Purpose: To study the changes in the number of MYCCand MYCN‑gene copies in MB cells exposed to the NGF.

Material and methods: The impact of the NGF on the number of MYCC‑, MYCN oncogene copies in the primary human medulloblastoma cell culture was assessed using the method of fluorescence in situ hybridization.

Results: Exposure to the NGF was shown to decrease the number of MB cells containing 6, 8 copies of MYCN oncogenes and 3, 8 copies of MYCC oncogene. The NGF was also shown to increase the number of tumor cells that contain a double set of copies of both oncogenes. There was a statistically significant (p<0.0001) negative correlation (r=–0.65) between the average number of MYCC oncogene copies and the NGF cytotoxicity index.

Conclusion: The increased number of oncogene copies reduces the susceptibility of MB cells to the growth factor.

29-37 1150
Abstract

The purpose of the research. To study prognostic significance of indicators of systemic inflammation of peripheral blood and relative indicators: neutrophil‑lymphocytic and platelet‑lymphocytic ratio, the course of squamous cell carcinoma of the oral mucosa and gastric adenocarcinoma.

Materials and methods. Prospective analysis of patients with squamous cell carcinoma of the oral mucosa and disseminated gastric adenocarcinoma was performed. Patients with verified diagnosis, without signs of inflammatory diseases in anamnesis, not receiving antibacterial and immunomodulatory therapy were selected. Overall survival and survival without progression were considered as the main estimated parameters.

Results. The selection criteria were met by 32 patients with disseminated gastric adenocarcinoma and 60 patients with squamous cell carcinoma of the oral mucosa. The prognostic value of relative indicators is determined: overall survival of patients with gastric adenocarcinoma with a low value of the neutrophil‑lymphocytic index is significantly higher than that of the rest of the cohort of patients: 16 months vs. 8 and 7 months (95 % CI (confidence interval) from 12 to 23 months, p=0.0382). Overall survival of patients with low platelet‑lymphocytic index was also higher: 16 months vs. 8 months (95 % CI from 11 to 24 months, р=0,0026). Different relapse‑free survival was noted in the group of patients with squamous cell head and neck cancer: patients with low index value it is 7 months vs. 2 months (95 % CI from 5 to 9 months, p=0.0499).

Conclusions. The results show the possibility of using immunological microenvironment of the tumor and indices, characterizing the systemic inflammation, for prognosis of gastric adenocarcinoma and squamous cell carcinoma of the oral mucosa.

42-46 2775
Abstract

Local therapy can complement traditional systemic drug therapy for metastatic breast cancer. The objective of the study was to assess toxicity, immediate results of the treatment and to determine the overall survival rate in patients with breast cancer with metastases to the liver, who underwent transarterial chemoembolization (TACE) of the hepatic artery in combination with traditional chemotherapy with taxanes. Sixty patients were divided into 2 groups: 34 patients received combined treatment (systemic chemotherapy with the following TACE (1–2 procedures) with HepaSphere microspheres, lipiodol, doxorubicin 30 mg/m² and 5‑fluorouracil 600 mg/m²), while 26 patients received chemotherapy only. The groups were comparable in terms of their main clinical parameters: age, initial stage, biological subtype, and previous treatment (p>0.05). Median follow‑up period was 17 months. The immediate response to the therapy according to the RECIST criteria in the chemotherapy+TACE group was the following: partial response — 7 (20.6 %), stabilization — 23 (67.6 %), disease progression — 4 (11.8 %). Adverse effects of TACE were manageable. Kaplan‑Meier 3‑year‑survival rate was 63.2 % in the chemotherapy+TACE group versus 43.8 % in the control group (p=0.039). Thus, TACE method can be included to the treatment protocol for the patients with metastatic breast cancer with partial response to chemotherapy or stabilization of the disease progression after chemotherapy for consolidation of the result.

REVIEWS AND ANALYSIS

47-52 845
Abstract

Objective. Analysis of main indicators of the quality of medical care for children with cancer in Ural Federal District.

Materials and methods. The study analyzed operational reports for 2017 obtained from the public health care executive authorities of the 6 Russian Federation Subjects constituting Ural Federal District: Kurgan Oblast, Tyumen Oblast, Sverdlovsk Oblast, Chelyabinsk Oblast, Khanty‑Mansi Autonomous Okrug, and Yamal‑Nenets Autonomous Okrug.

Results. There were 3 paediatric oncology departments. No paediatric oncology departments were available in 3 Subjects (50 %), one Subject (20 %) had no paediatric oncology hospital beds. There were 192 paediatric oncology hospital beds in total (0.7 per 10,000 children aged 0‑17 years). No paediatric oncology hospital beds were available in one Subject (20 %) (Yamal‑Nenets Autonomous Okrug). The average hospital bed occupancy was 343 days a year. The number of physicians providing medical care for children with cancer was 59, and 35 of them (59.3 %, 0.1 per 10,000 children aged 0‑17 years) had a paediatric oncologist certificate. No paediatric oncologists or paediatric oncology hospital beds were available in one Subject (20 %) (Yamal‑Nenets Autonomous Okrug). The 2017 incidence rate in Ural Federal District was 14, the prevalence rate was 147.2 (per 100,000 patients aged 0‑17 years). The mortality rate was 2.5 per 100,000 patients aged 0‑17 years, the one‑year mortality rate was 5 %. There were 46 patients diagnosed through active case finding (12.1 %). A total of 94 patients (24.8 %) were referred to medical centres of Federal subordination. Four primary patients (1 %) left the Russian Federation for treatment.

Conclusion. Apparent registration flaws (low incidence) and the lack of reliable follow‑up data (mortality assessment is difficult) can be overcome by the introduction of electronic registries. Audit of medical records is necessary for reliable assessment of how the general demand in paediatric oncology hospital beds is met and of the percentage of patients referred for treatment to medical centres of Federal subordination. The long‑standing problems of lack of paediatric oncologists and low percentage of patients diagnosed through active case finding should be tackled through reform of the medical education system.

CLINICAL NOTES

53-58 1363
Abstract
Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with limited treatment options in later stages, when the mortality rate due to the disease is as high as 46 %. It has been demonstrated earlier that MCC is an immunogenic tumor, therefore the emergence of immune checkpoint inhibitors has changed the treatment principles for patients with advanced MCC. In this article, we present the initial results of the use of avelumab, an anti‑PD–L1 antibody, in the treatment of patients with metastatic and/or locally advanced MCC as part of the early access program in Russia.


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ISSN 2224-5057 (Print)
ISSN 2587-6813 (Online)