№73. What you need to know practical oncom?

Malignant cells own an unique spectrum of biological characteristics, such as
production of auto proliferative signals, resistance to growth suppressing factors,
loss of apoptotic capacity, unlimited proliferative potential, invasion and metastasis,
genomic instability, secretion of angiogenic factors, induction of peritumoral immune
suppression, aerobic glycolysis etc. These properties are attributed to mutations
in oncogenes and suppressor genes. Recent advances in experimental oncology
attract attention to the existence of intratumoral heterogeneity, novel views on the
mechanisms of tumor metastasis, investigations of tumor-host interactions etc.

Keywords: tumor growth, malignant cells, properties, tumor.

This review discusses the morphological methods of tumors’ investigation in its historical aspect. Practice shows that
the understanding of different technologies increasingly used in pathology is nowadays a very important part for clinical
management. Molecular-genetic information has been incorporated in a diagnostic algorithm for various entities and
is widely used for therapeutic decisions. Special attention is paid to the achievements in molecular pathological tumor
profiling that allows an effective approach to prognostic and/or predictive biomarkers.

Keywords: morphology, methods, prognostic and predictive biomarkers, immunohistochemistry, FISH, ISH.

There are many diagnostic techniques in the clinical practice. Successful detection of disease and the adequate treatment
depend on a competent use of these techniques.
Knowledge and understanding of the principles of all those methods, their diagnostic capabilities and limitations make
the basis for the clinician to prescribe the necessary examination algorithm in a best way.
The main principles and physical basis of modern radiology methods, their possibilities and limitations, as well as the
legal documents defining the radiology procedures conduction are reviewed in the following article.

Keywords: radiology, computed tomography, magnetic resonance imaging, diagnostic algorithm, ultrasound diagnostic, hepatic tumors, lung cancer, oncological patient.

Receiving morphological verification by means of the biopsy is compulsory when oncological pathology is identified
or suspected.The biopsy gives the full confidence in correctness of the diagnosis and planning of further treatment. It is
necessary to remember that any invasive procedure is accompanied by a certain risk, the biopsy – is not an exception. Only
the positive results, that is the final histologic answer have the diagnostic value. The effectiveness of the material studying
by the morphologist, and respectively reliability of histologic answers depends on the equipment of a fence.

Keywords: diagnosis, biopsy techniques

Radiation oncology is a unique clinical specialty that was born on the crossroad
of several scientific fields. In the past several years the growth of this field has rapidly
accelerated, making the mastery of all new clinical information without daily practice
and dedicated learning simply impossible. For this reason, the presence and active participation of a radiation oncologist in the multidisciplinary team that determines
and recommends to cancer patients treatment strategies is obligatory. This will be a constantly recurring leitmotif
in this article, which will be dedicated to various aspects of radiation therapy that any practicing oncologist should be
familiar with.

Keywords: radiation oncology, multidisciplinary team, chemoradiotherapy, trimodality treatment, radiotherapy effect evaluation, combination of radiotherapy and immunotherapy.

The modern approaches to the cancer patient treatment in terms of oncosurgery
development are described in the article. It is noted that the volume of surgeries will
decrease in favor of organ- and tissue-preserving interventions on the basis of high
technologies in the future. Currently, endosurgical technologies are actively being
introduced, having a number of advantages over open operations, but have some
shortcomings either. Trends in surgical treatment of patients are focused on minimizing
the level of lymphatic dissection after the sentinel lymph node verification.

Keywords: cancer, surgical operations, lymph node, metastasis

To select the most optimal treatment strategy for the patient, a practical
oncologist needs to understand and apply basic and proven methods of the
systemic treatment. This paper presents the current data on the systemic treatment
possibilities for unresectable tumors, as well as the information on the systemic
drugs application in the combined and complex treatment of cancer patients.
Last data on improving the survival of the patients receiving adjuvant therapy
were reviewed in the article. The analysis of the palliative systemic treatmenthas
also been made from the point of improved overall survival.

Keywords: chemotherapy, immunotherapy, target therapy, overall survival, treatment guidelines.

In this article we analyze the practice of circular tracheal resection in cases of
primary malignant tumors. Laryngotracheal resections are formed a separate group.
Injection ventilation was used as a part of complex anesthesia. Adjuvant radiation
therapy was performed in most patients. Direct and long-term results are presented,
which makes it possible to recommend circular tracheal resection in the treatment
of primary malignant tumors.

Keywords: adenoid cystic carcinoma of trachea, circular resection of trachea, laryngotracheal resection.

Adrenocortical carcinoma (ACC) is a rare aggressive tumor of the adrenal cortex with high malignant potential.
ACC is characterized by frequent relapses after surgical treatment, resistance to local and systemic therapy in advanced
disease and poor prognosis. At present, a combination of a steroidogenesis inhibitor mitotane and chemotherapeutic
agents of etoposide, doxorubicin and cisplatin is used for treatment of metastatic ACC. A combination of mitotane,
gemcitabine and capecitabine can be used in pretreated ACC patients. However, it is unclear which chemotherapy
regimens are administered in the second and subsequent treatment lines of advanced ACС. This case report is devoted
to the successful application of a combination of docetaxel and mitotane in a 30-year-old patient with metastatic
ACC after three previous chemotherapy regimens.

Keywords: adrenocortical cancer, docetaxel, mitotane

Aim. Objectives of this study were to evaluate the effectiveness, safety, and tolerability of bendamustine/rituximab combination followed by rituximab maintenance therapy for relapsed or refractory (R/R) iNHL patients in the Russian Federation.

Methods. Adult subjects (≥18 yr), diagnosed with R/R iNHL according to local diagnostic standards, were enrolled in this prospective observational study. Overall response rate (ORR) was assessed after 3 (Evaluation 1) and 6–8 (Evaluation 2) 28-day cycles.

These are the results of 102 subjects enrolled between June 2012 and October 2015. Most study subjects were heavily pretreated with a median number of 2 prior lines of therapy before entering the study (range: 1–6). At Evaluation 2, ORR was high (n=58; 69,9%) with 35 (42,2%) subjects achieving CR (confirmed, n=20 [24,1%]; unconfirmed, n=15 [18,1%]) and 23 (27,7%) achieving PR. At follow up (17 mo), neither median OS or PFS had been reached; 2-year OS was 88,9% (95% CI: 79,7–99,0%) and 2-year PFS was 72,5% (95% CI: 61,6–85,3%). 31 of 96 subjects (32,3%) reported≥1 AE. Decreased neutrophil count, decreased white blood cell count, and infections were the most commonly reported AEs.

Keywords: indolent non-Hodgkin’s lymphoma, follicular lymphoma, relapse, bendamustine, rituximab