№86. Основные достижения в онкологии в 2020 году
- E.N. ImyanitovDOI 10.31917/2201001
This paper describes the most remarkable advances in fundamental and translational oncology occurred within the year 2020.
Keywords: Genes, mutations, gene expression, predictive markers.
- F.V. MoiseenkoDOI 10.31917/2201009
A huge amount of data obtained during last 30 years in multiple translational works allowed both to break particular tumor types into subgroups based on molecular markers but also to create pan-tumor subgroups based on particular markers. These evidence suggest the new approach to diagnostic and treatment algorithms should be implemented. Despite the rarity of some molecular markers the possibility of their presence must be kept in mind in order to achieve optimal results in patient’s treatment.
Keywords: malignant tumours, cancer, molecular markers, MSI, TMB, BRAF, NTRK.
- N.М. VolkovDOI 10.31917/2201022
Given that no new immunotherapeutic drugs proved to be at least as effective as approved CTLA-4 and PD-1/PD-L1 inhibitors during last years the focus of further immuno oncology (IO)development has shifted to the research on different drug combinations. Most of new immunotherapeutics are studied in combinations with PD-1/PD-L1 inhibitors. This paper reviews most perspective targets for therapeutic manipulations currently studied in combinations with immune check-point inhibitors, such as Tim-3, LAG-3, TIGIT, OX-40, 4-1BB, STING, TGF-β, as well as some metabolic pathways. Also the principles of individualized biology-tailored approaches to IO drugs combining are discussed.
Keywords: malignant tumors, cancer immunotherapy, immune check-point inhibitors, combinations.
- V.A. ChubenkoDOI 10.31917/2201033
The challenging direction is the combinations of the treatment strategies affecting the various pathogenesis pathways of the malignant neoplasms. In addition to the main mechanism of action (impact on the nucleus or blockade of the cell signalling), the immunological component is included in the basis of the therapeutic effectiveness of the chemotherapy or targeted therapy. In this regard, new approaches with the checkpoint inhibitors make it possible to affect both directly the tumour cells and their microenvironment. Undoubtedly, this leads to the significant control of tumour growth and increased overall survival.
Keywords: Target therapy, chemotherapy, check-point inhibitors, overall survival.
- A.S. ZhabinaDOI 10.31917/2201041
The majority of currently available studies on the use of this circulating tumour DNA (ctDNA) deal with the detection of mutations. The analysis of cfDNA is often discussed in the context of the noninvasive detection of mutations that lead to resistance mechanisms and therapeutic and disease monitoring in cancer patients. Indeed, substantial advances have been made in this area, with the development of methods that reach high sensitivity and can interrogate a large number of genes.
Keywords: cfDNA, mutation, resistance, disease monitoring.
- В.В. Akhmedov, Р.V. Kononets, M.Y. Fedyanin, А.А. Tryakin, М.В. KurbanovaDOI 10.31917/2201048
Surgical treatment is one of the options used in the treatment of patients with intrathoracic germ cell metastases. In this article, the results of surgical treatment of the above-described group of patients are analyzed on a fairly large cohort of patients. A multivariate analysis of the study group of patients was carried out in order to determine the positive and negative prognostic factors affecting the median disease-free and overall survival after surgical treatment. Conclusions are drawn about the effectiveness of surgical removal of intrathoracic metastases in patients with germ cell tumors.
Keywords: surgical treatment of intrathoracic metastases, germ cell tumors.
- J.N. Vinogradova, V.V. Rjabchikova, A.I. Chumachenko, E.V. Karjagina, N.V. Medvedeva, A.S. Luchinin, N.V. Minaeva, T.V. Shnejder, M.M. Hodzhibekova,DOI 10.31917/2201059
The best choice of treatment of patients with primary mediastinal B-cell large lymphoma (PMBCL) is very important, taking into account the results of combined positron emission and computed tomography with 18F-FDG (PET/CT) at various stages of the disease clinical progression.
The aim: Increase the treatment success in patients with PMBCL by the rational use of the drug and radiation therapy.
Materials and methods: We analyzed therapy results of 101 patients with PMBCL who received either only
immunopolychemotherapy (34 patients, R-CHOP or R-DA-EPOCH) or combined treatment with radiation (67 patients.
PET/CT was performed before treatment, after immunopolychemotherapy and combination therapy.
Results: Complete remissions were achieved in 94 (93,1%) patients, including those who received combined treatment in 65 of 67 (97,0%) patients; and with drug therapy only – in 29 of 34 (85,3%) patients (p<0,02). Primary disease progression with subsequent unfavorable outcome was more frequent in the only drug therapy group than in the chemoradiotherapy group (14,7% and 3,0%, respectively, p<0,02). There were no relapses after combined treatment, but in the drug-only group 1 patient had shown a relapse in the mediastinum (p=0,04) after 34 months. The frequency of low efficiency of the first line of immunopolychemotherapy was the same after R-CHOP (20,0%) and R-DA-EPOCH (30,4%), p>0,1. After the first line of immunopolychemotherapy, the absence of metabolic activity (DC1-3) was observed in 48 (76,2%) of 63 examined patients. They are all alive and in remission. 4 from 15 (26,7%) patients with PET-positive results of the study (DC4-5) after immunopolychemotherapy had an unfavorable progress of disease which is significantly worse compared to those of the PET-negative group (100%, p<0,01). 5-year overall, progression-free and relapse-free survival of patients in the whole group was 91,6%, 89,9% and 95,5%; with only drug therapy and combined treatment was: total – 79,6% and 97,0% (p=0,005); nonprogressive – 77,5% and 97.0% (p=0,005); relapse-free – 92,6% and 100% (p>0,1).
Conclusion: Efficiency of first-line immunopolychemotherapy schemes was comparable. Long-term results were better with immunochaemoradiotherapy; the presence of PET-negative data after the first line of immunopolychemotherapy is a favourable prognostic sign. Radiation therapy executed in proper time helps to reduce the systemic cytostatic stress.
Keywords: primary mediastinal B-cell large lymphoma, radiotherapy, PET/CT.
- M.Yu. Fedyanin, E.O. Ignatova, А.А. TryakinDOI 10.31917/2201072
Attempts to classify tumors in order to substantiate the different course of the disease and response to therapy have undergone significant changes over the past decades and have advanced from the creation of prognostic systems based on the clinical and morphological picture to the division into molecular-genetic subtypes. The latter, based on various omics data, should have opened a new era in oncology, dividing tumors not only according to the prognostic course, but also allowing individualized treatment. However, data from clinical trials, at least in colorectal cancer, show conflicting results. This review is devoted to the critical analysis of the applicability of molecular genetic subtyping of colon tumors in clinical practice.
Keywords: colorectal cancer, molecular subtypes, immunotherapy, targeted therapy.
- I.A. Medyanik, A.S. Gordetsov, K.S. Yashin, O.V. Krasnikova, A.P. Frayerman, Z.О. Shenkarev, N.N. KaryakinDOI 10.31917/2201087
Early diagnostics of brain tumors – is an important component of combined therapy for treatment neoplasms. Searching markers of glioma allowing to diagnose tumors at an early stage (before appearance of some changes on MRI and CT scans), to predict their course and to estimate the effectiveness of the performed therapy is a prospective research direction. Now-a-days the properties of microRNK and infrared spectroscopy of blood serum is being studied actively. This review covers results of the performed studies, confirming the possibility of application of such methods as biomarkers of glioma.
Keywords: biomarkers of glioma, microRNK, infrared spectroscopy, early diagnostics, brain tumors.
- DOI 10.31917/2201097
The main directions of scientific, scientific-organizational, pedagogical and social activities of Academician Shamil Khanafievich Gantsev