Pub Date : 2024-07-03DOI: 10.21294/1814-4861-2024-23-3-64-72
L. Tashireva, A. Kalinchuk, V. Alifanov, E. Grigoryeva, E. S. Andriukhova, N. Krakhmal, N. O. Popova, V. Perelmuter
The relationship between the tumour and the microenvironment is of great interest because it may determine the efficacy of new agents aimed at targeting the anti-tumour immune response, such as immune checkpoint inhibitors (ICI s), which have been used to treat breast cancer. PD -L1 status in immune cells should be examined when prescribing ICI s for breast cancer. This highlights the importance of studying the characteristics of the tumour microenvironment, the main approach being to uncover its heterogeneity. The aim of this study was to investigate the subpopulation composition of PD -L1-positive lymphocytes in the tumour microenvironment, separately in each luminal subtype of BC, and to compare it according to the PD -L1 status of the tumour. Material and Methods. Fifty-two primary tumour samples were obtained from patients with invasive luminal A, luminal B HER2- and luminal B HER2+ subtypes of breast cancer (T1–2N0–1M0). No drug therapy was administered prior to surgery to any patient in this study. Cytotoxic lymphocytes (CTL s), B lymphocytes, T helper lymphocytes, T regulatory lymphocytes and their PD -L1 expression in tumour tissue samples were assessed by flow cytometry, and tumour PD -L1 status was determined by Ventana SP 142 immunohistochemistry. Results. All of the key lymphocyte populations we identified were present in almost all patients. The number of PD -L1-positive Th2 lymphocytes was significantly higher in the luminal A and luminal B HER2- BC samples compared to the luminal B HER2+ cases (р=0.0240 and p=0.0092, respectively). When the proportion of PD -L1-positive cells was calculated, the proportion of PD -L1-positive Th2 lymphocytes and T regulatory lymphocytes was significantly lower in luminal B HER2-compared to luminal A BC. Cytotoxic lymphocytes, Th2 lymphocytes and T-regulatory lymphocytes represented the predominant PD -L1-positive immune cells in the breast cancer microenvironment and were present in higher numbers in PD -L1-positive luminal B HER2-. Conclusions. Different lymphocyte populations, including those expressing PD -L1, can be found in the breast cancer microenvironment and there are differences in their numbers between different luminal breast cancers. This may explain the discordant prognostic and predictive value of the microenvironment in luminal breast cancer when considered as a single molecular subtype.
肿瘤与微环境之间的关系非常值得关注,因为它可能决定以抗肿瘤免疫反应为靶点的新药的疗效,如用于治疗乳腺癌的免疫检查点抑制剂(ICI)。在使用 ICIs 治疗乳腺癌时,应检查免疫细胞中的 PD -L1 状态。这凸显了研究肿瘤微环境特征的重要性,主要方法是揭示肿瘤微环境的异质性。本研究的目的是研究肿瘤微环境中 PD -L1 阳性淋巴细胞的亚群组成,分别针对 BC 的每个管腔亚型,并根据肿瘤的 PD -L1 状态进行比较。材料与方法从侵袭性腔隙 A 型、腔隙 B 型 HER2-和腔隙 B 型 HER2+ 亚型乳腺癌(T1-2N0-1M0)患者身上获取了 52 份原发肿瘤样本。本研究中的所有患者在手术前均未接受药物治疗。通过流式细胞术评估肿瘤组织样本中的细胞毒性淋巴细胞(CTL)、B淋巴细胞、T辅助淋巴细胞、T调节淋巴细胞及其PD -L1表达,并通过Ventana SP 142免疫组化确定肿瘤PD -L1状态。结果显示我们确定的所有关键淋巴细胞群几乎都存在于所有患者体内。与管腔B型HER2+病例相比,管腔A型和管腔B型HER2- BC样本中PD -L1阳性的Th2淋巴细胞数量明显更高(分别为р=0.0240和p=0.0092)。在计算PD -L1阳性细胞的比例时,管腔B型HER2淋巴细胞和T调节淋巴细胞的PD -L1阳性比例明显低于管腔A型BC。细胞毒性淋巴细胞、Th2 淋巴细胞和 T 调节淋巴细胞是乳腺癌微环境中主要的 PD -L1 阳性免疫细胞,在 PD -L1 阳性的管腔 B HER2-中数量较多。结论乳腺癌微环境中存在不同的淋巴细胞群,包括表达 PD -L1 的淋巴细胞群,不同管腔型乳腺癌的淋巴细胞数量存在差异。这可能是管腔型乳腺癌微环境作为单一分子亚型的预后和预测价值不一致的原因。
{"title":"Subpopulation composition of PD-L1-positive lymphocytes in the primary tumour in luminal breast cancer patients","authors":"L. Tashireva, A. Kalinchuk, V. Alifanov, E. Grigoryeva, E. S. Andriukhova, N. Krakhmal, N. O. Popova, V. Perelmuter","doi":"10.21294/1814-4861-2024-23-3-64-72","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-3-64-72","url":null,"abstract":"The relationship between the tumour and the microenvironment is of great interest because it may determine the efficacy of new agents aimed at targeting the anti-tumour immune response, such as immune checkpoint inhibitors (ICI s), which have been used to treat breast cancer. PD -L1 status in immune cells should be examined when prescribing ICI s for breast cancer. This highlights the importance of studying the characteristics of the tumour microenvironment, the main approach being to uncover its heterogeneity. The aim of this study was to investigate the subpopulation composition of PD -L1-positive lymphocytes in the tumour microenvironment, separately in each luminal subtype of BC, and to compare it according to the PD -L1 status of the tumour. Material and Methods. Fifty-two primary tumour samples were obtained from patients with invasive luminal A, luminal B HER2- and luminal B HER2+ subtypes of breast cancer (T1–2N0–1M0). No drug therapy was administered prior to surgery to any patient in this study. Cytotoxic lymphocytes (CTL s), B lymphocytes, T helper lymphocytes, T regulatory lymphocytes and their PD -L1 expression in tumour tissue samples were assessed by flow cytometry, and tumour PD -L1 status was determined by Ventana SP 142 immunohistochemistry. Results. All of the key lymphocyte populations we identified were present in almost all patients. The number of PD -L1-positive Th2 lymphocytes was significantly higher in the luminal A and luminal B HER2- BC samples compared to the luminal B HER2+ cases (р=0.0240 and p=0.0092, respectively). When the proportion of PD -L1-positive cells was calculated, the proportion of PD -L1-positive Th2 lymphocytes and T regulatory lymphocytes was significantly lower in luminal B HER2-compared to luminal A BC. Cytotoxic lymphocytes, Th2 lymphocytes and T-regulatory lymphocytes represented the predominant PD -L1-positive immune cells in the breast cancer microenvironment and were present in higher numbers in PD -L1-positive luminal B HER2-. Conclusions. Different lymphocyte populations, including those expressing PD -L1, can be found in the breast cancer microenvironment and there are differences in their numbers between different luminal breast cancers. This may explain the discordant prognostic and predictive value of the microenvironment in luminal breast cancer when considered as a single molecular subtype.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":"61 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141683138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.21294/1814-4861-2024-23-3-73-85
A. Glushkov, E. Polenok, L. Gordeeva, P. V. Bayramov, N. E. Verzhbitskaya, A. Antonov, G. Kolpinsky, M. Kostyanko
The study was aimed to determine the interrelations between levels of serum antibodies specific to estradiol and progesterone (IgA1-E2 and IgA1-Pg) and corresponding antiidiotypic antibodies (IgG2-E2 and IgG2-Pg) and tumor Ki67 positive cells in breast cancer patients (BCP). Material and Methods. The content of these antibodies in the blood serum of BCP (522 at the I stage and 578 at the II –IV stages) was studied using non-competitive enzyme immunoassay. Ki67 was determined using immunohistochemical method. Statistical analysis of the results was performed using the Statistica 8.0 software. Results. There were no revealed the desired associations in BCP I stage. Tumors with high levels of Ki67 positive cells (>20,0 %) were found more often in BCP II –IV stages with high serum levels of IgA1-E2 together with IgA1-Pg than in BCP with low levels of these antibodies (68.8 vs 58.0 %, р=0.02). In contrast, tumors with Ki67>20,0 % were revealed less often in BCP with high levels of IgG2-E2 together with IgG2-Pg (49.6 vs 65.2 %, р=0.002). Tumors with high levels of Ki67 positive cells were revealed in 42.9 % BCP I stage and in 77.1 % BCP II –IV stages with high serum levels of IgA1-E2 and IgA1-Pg in combination with low serum levels of IgG2-E2 and IgG2-Pg (p<0.001). There were no such differences between BCP I and II -IV stages with low levels of IgA1-E2 and IgA1-Pg in combination with high levels of IgG2-E2 and IgG2-Pg (46.7 vs 48.2 %, accordingly, р=0.985). Conclusion. Antibodies against E2 and Pg synergistically promoted, but corresponding antiidiotypic antibodies synergistically inhibited the tumors proliferation in BCP. Immunoassay of antibodies and anti-antibodies to steroids is recommended for research of human hormone-dependent neoplasms progression.
本研究旨在确定乳腺癌患者(BCP)血清中雌二醇和孕酮特异性抗体(IgA1-E2和IgA1-Pg)及相应的抗生物素抗体(IgG2-E2和IgG2-Pg)水平与肿瘤Ki67阳性细胞之间的相互关系。材料与方法使用非竞争性酶联免疫测定法研究了 BCP(Ⅰ期 522 例,Ⅱ-Ⅳ期 578 例)血清中这些抗体的含量。Ki67 采用免疫组化法测定。使用 Statistica 8.0 软件对结果进行统计分析。结果在 BCP I 期中没有发现预期的关联。与血清中IgA1-E2和IgA1-Pg水平较低的BCP相比,血清中IgA1-E2和IgA1-Pg水平较高的BCP II-IV期肿瘤中Ki67阳性细胞水平较高(>20.0%)(68.8% vs 58.0%,р=0.02)。相反,Ki67>20.0%的肿瘤在IgG2-E2和IgG2-Pg水平较高的BCP中出现的频率较低(49.6% vs 65.2%,р=0.002)。血清中 IgA1-E2 和 IgA1-Pg 含量高、IgG2-E2 和 IgG2-Pg 含量低的 BCP I 期和 BCP II -IV 期中,分别有 42.9% 和 77.1% 的肿瘤出现高水平的 Ki67 阳性细胞(P<0.001)。IgA1-E2 和 IgA1-Pg 含量低且 IgG2-E2 和 IgG2-Pg 含量高的 BCP I 期和 II -IV 期之间没有这种差异(分别为 46.7% 和 48.2%,р=0.985)。结论E2和Pg抗体能协同促进BCP中肿瘤的增殖,而相应的抗生物素抗体则能协同抑制肿瘤的增殖。建议对类固醇抗体和抗抗体进行免疫测定,以研究人类激素依赖性肿瘤的发展。
{"title":"Antibodies and anti-antibodies specific to estradiol and progesterone and tumor proliferation in breast cancer patients","authors":"A. Glushkov, E. Polenok, L. Gordeeva, P. V. Bayramov, N. E. Verzhbitskaya, A. Antonov, G. Kolpinsky, M. Kostyanko","doi":"10.21294/1814-4861-2024-23-3-73-85","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-3-73-85","url":null,"abstract":"The study was aimed to determine the interrelations between levels of serum antibodies specific to estradiol and progesterone (IgA1-E2 and IgA1-Pg) and corresponding antiidiotypic antibodies (IgG2-E2 and IgG2-Pg) and tumor Ki67 positive cells in breast cancer patients (BCP). Material and Methods. The content of these antibodies in the blood serum of BCP (522 at the I stage and 578 at the II –IV stages) was studied using non-competitive enzyme immunoassay. Ki67 was determined using immunohistochemical method. Statistical analysis of the results was performed using the Statistica 8.0 software. Results. There were no revealed the desired associations in BCP I stage. Tumors with high levels of Ki67 positive cells (>20,0 %) were found more often in BCP II –IV stages with high serum levels of IgA1-E2 together with IgA1-Pg than in BCP with low levels of these antibodies (68.8 vs 58.0 %, р=0.02). In contrast, tumors with Ki67>20,0 % were revealed less often in BCP with high levels of IgG2-E2 together with IgG2-Pg (49.6 vs 65.2 %, р=0.002). Tumors with high levels of Ki67 positive cells were revealed in 42.9 % BCP I stage and in 77.1 % BCP II –IV stages with high serum levels of IgA1-E2 and IgA1-Pg in combination with low serum levels of IgG2-E2 and IgG2-Pg (p<0.001). There were no such differences between BCP I and II -IV stages with low levels of IgA1-E2 and IgA1-Pg in combination with high levels of IgG2-E2 and IgG2-Pg (46.7 vs 48.2 %, accordingly, р=0.985). Conclusion. Antibodies against E2 and Pg synergistically promoted, but corresponding antiidiotypic antibodies synergistically inhibited the tumors proliferation in BCP. Immunoassay of antibodies and anti-antibodies to steroids is recommended for research of human hormone-dependent neoplasms progression.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141682331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-02DOI: 10.21294/1814-4861-2024-23-3-57-63
E. Krasavina, E. Choynzonov, D. Kulbakin, V. O. Tskhai, L. N. Balatskaya
The purpose of the study was to compare the effectiveness of correction of sound pronunciation in patients after glossectomy without reconstructive surgery and glossectomy with reconstructive surgery. Material and Methods. The study included 56 patients with histologically verified stage III –IV oral cavity and oropharyngeal cancer. All patients were divided into two groups: those undergoing reconstructive surgery after glossectomy and those not undergoing reconstructive surgery after glossectomy. Data on the dynamics of sound pronunciation correction were assessed during the rehabilitation period, as well as 6 and 12 months after completion of speech therapy. The parameters were scored from 0 to 4, where 0 indicated no speech sound disorders, and 4 indicated maximum disorders. Results. All patients showed absolute (4 points) speech sound disorders after surgery. Speech rehabilitation in patients, who underwent reconstructive surgery after glossectomy, resulted in a significant improvement in the pronunciation of posterior lingual sounds: [K], [G], [K’], [G’], whistling (lingual-dental) sounds: [S], [S’], [Z ], [Z’], front-lingual sounds: [T], [Т’], [D], [D’] and hissing sounds: [Sh, [Zh] (p<0.05). In patients, who underwent glossectomy without reconstructive surgery, a statistically significant improvement in sound pronunciation was observed only after correcting posterior lingual hard sounds: [K], [G] (p<0.05). Conclusion. The results obtained highlight the importance of reconstructive surgery after glossectomy to achieve better results of functional restoration and improve the quality of speech function of patients.
本研究的目的是比较不做整形手术和做了整形手术的龟头切除术后患者的发音矫正效果。材料和方法。研究对象包括 56 名经组织学证实的 III - IV 期口腔癌和口咽癌患者。所有患者被分为两组:腺体切除术后接受整形手术的患者和腺体切除术后未接受整形手术的患者。在康复期间以及完成言语治疗 6 个月和 12 个月后,对发音纠正的动态数据进行了评估。各项参数的评分范围为0至4分,0分表示无发音障碍,4分表示最大发音障碍。结果。所有患者术后均出现绝对(4 分)言语发音障碍。对接受了臀部切除整形手术的患者进行言语康复训练后,其舌尖后音的发音得到了明显改善:[K]、[G]、[K']、[G'],啸音(舌齿音):[S]、[S']、[Z ]、[Z'],前舌音:[T]、[Т']、[D]、[D'] 和嘶嘶声:[Sh、[Zh] (P<0.05)。在未进行整形手术的情况下接受了舌骨切除术的患者中,只有在纠正了舌后硬音后,发音才会有统计学意义上的显著改善:[K]、[G](P<0.05)。结论所获得的结果突出表明,为了获得更好的功能恢复效果和改善患者的语言功能质量,在进行龟头切除术后进行重建手术非常重要。
{"title":"Sound pronunciation correction in patients after glossectomy. Сomparative prospective study","authors":"E. Krasavina, E. Choynzonov, D. Kulbakin, V. O. Tskhai, L. N. Balatskaya","doi":"10.21294/1814-4861-2024-23-3-57-63","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-3-57-63","url":null,"abstract":"The purpose of the study was to compare the effectiveness of correction of sound pronunciation in patients after glossectomy without reconstructive surgery and glossectomy with reconstructive surgery. Material and Methods. The study included 56 patients with histologically verified stage III –IV oral cavity and oropharyngeal cancer. All patients were divided into two groups: those undergoing reconstructive surgery after glossectomy and those not undergoing reconstructive surgery after glossectomy. Data on the dynamics of sound pronunciation correction were assessed during the rehabilitation period, as well as 6 and 12 months after completion of speech therapy. The parameters were scored from 0 to 4, where 0 indicated no speech sound disorders, and 4 indicated maximum disorders. Results. All patients showed absolute (4 points) speech sound disorders after surgery. Speech rehabilitation in patients, who underwent reconstructive surgery after glossectomy, resulted in a significant improvement in the pronunciation of posterior lingual sounds: [K], [G], [K’], [G’], whistling (lingual-dental) sounds: [S], [S’], [Z ], [Z’], front-lingual sounds: [T], [Т’], [D], [D’] and hissing sounds: [Sh, [Zh] (p<0.05). In patients, who underwent glossectomy without reconstructive surgery, a statistically significant improvement in sound pronunciation was observed only after correcting posterior lingual hard sounds: [K], [G] (p<0.05). Conclusion. The results obtained highlight the importance of reconstructive surgery after glossectomy to achieve better results of functional restoration and improve the quality of speech function of patients.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":"21 14‐15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141685659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-02DOI: 10.21294/1814-4861-2024-23-3-32-43
A. Orlov, A. S. Nazarov, A. A. Dolgushin, D. Murzaeva, Y. Belyakov, E. A. Oleynik, A. V. Kudziev, Y. Zabrodskaya
Peripheral nerve sheaths tumors (PNST) account for about 8 % of all nervous system cancers. The relapse rate ranges from 17.3 to 26.4 %, showing an upward trend. The causes and provoking factors for the development of relapses of PNST have not been fully studied. Purpose of the study: to establish criteria for predicting recurrence of PNST. Material and Methods. The study included 122 patients who were treated at the Department of Spine and Peripheral Nerve Surgery of A.I. Polenov Russian Research Neurosurgical Institute from 2009 to 2021. Among them, there were 87 (71.3 %) patients with primary PNST and 35 (28.7 %) patients with recurrent PNST. All patients underwent MRI and ENMG both before and after surgery. An immunohistochemical study of Ki67 and SO X10 markers was performed. Results. The majority of relapses occured within 1 year after surgery. In cases with radical removal of PNST, the risk of relapse was: 28.6 % for schwannomas 28.6 %, 37.1 % for neurofibromas and 34.3 % for MP NST 34.3 % (p≥0.05). The risk of developing relapse of PNST was 2.9 times higher in patients aged ≥49 years than in patients aged ≤48 years (p<0.004). The larger the initial size of the tumor, the higher the risk of relapse in the late postoperative period. The risk of developing relapse of MP NST was 8.79 times higher in patients with tumor size of greater than 11.5 cm than in patients with smaller tumor size (p<0.02). The of Ki67 level above 4.85 % in schwannomas and above 5.17 % in neurofibromas can predict relapse of PNST (p<0.05). Loss of SO X10 protein expression was associated with an increase in histological anaplasia of the tumor, which causes a high risk of relapse and an unfavorable clinical course of the disease. Conclusion. Despite radical (total) resection of PNST, the risk of relapse remains high. The pathological type of tumor, its size, levels of SO X10 and Ki67 markers, patient’s age, degree of preoperative neurological deficit and extent of surgery are significant criteria for predicting the development of relapse of PNST.
{"title":"Criteria for predicting the development of recurrent peripheral nerve sheas tumors","authors":"A. Orlov, A. S. Nazarov, A. A. Dolgushin, D. Murzaeva, Y. Belyakov, E. A. Oleynik, A. V. Kudziev, Y. Zabrodskaya","doi":"10.21294/1814-4861-2024-23-3-32-43","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-3-32-43","url":null,"abstract":"Peripheral nerve sheaths tumors (PNST) account for about 8 % of all nervous system cancers. The relapse rate ranges from 17.3 to 26.4 %, showing an upward trend. The causes and provoking factors for the development of relapses of PNST have not been fully studied. Purpose of the study: to establish criteria for predicting recurrence of PNST. Material and Methods. The study included 122 patients who were treated at the Department of Spine and Peripheral Nerve Surgery of A.I. Polenov Russian Research Neurosurgical Institute from 2009 to 2021. Among them, there were 87 (71.3 %) patients with primary PNST and 35 (28.7 %) patients with recurrent PNST. All patients underwent MRI and ENMG both before and after surgery. An immunohistochemical study of Ki67 and SO X10 markers was performed. Results. The majority of relapses occured within 1 year after surgery. In cases with radical removal of PNST, the risk of relapse was: 28.6 % for schwannomas 28.6 %, 37.1 % for neurofibromas and 34.3 % for MP NST 34.3 % (p≥0.05). The risk of developing relapse of PNST was 2.9 times higher in patients aged ≥49 years than in patients aged ≤48 years (p<0.004). The larger the initial size of the tumor, the higher the risk of relapse in the late postoperative period. The risk of developing relapse of MP NST was 8.79 times higher in patients with tumor size of greater than 11.5 cm than in patients with smaller tumor size (p<0.02). The of Ki67 level above 4.85 % in schwannomas and above 5.17 % in neurofibromas can predict relapse of PNST (p<0.05). Loss of SO X10 protein expression was associated with an increase in histological anaplasia of the tumor, which causes a high risk of relapse and an unfavorable clinical course of the disease. Conclusion. Despite radical (total) resection of PNST, the risk of relapse remains high. The pathological type of tumor, its size, levels of SO X10 and Ki67 markers, patient’s age, degree of preoperative neurological deficit and extent of surgery are significant criteria for predicting the development of relapse of PNST.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":"34 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141688059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-02DOI: 10.21294/1814-4861-2024-23-3-44-56
M. Atyukov, I. Zemtsova, A. S. Petrov, O. A. Zhemchugova-Zelenova, P. Yablonskiy
The aim of this study was to evaluate the feasibility and safety of sequential bilateral anatomical lung resections performed via video-assisted thoracic surgery (VATS) or thoracotomy approaches in lung cancer patients, as well as to identify factors affecting the postoperative period. Material and Methods. Of 534 NSCLC patients undergoing anatomical lung resection in Center for Intensive Pulmonology and Thoracic Surgery from 2014 to 2022, 14 patients with consecutive bilateral anatomical lung resections were included in the retrospective study. The patients were divided into two groups depending on a surgical approach used during the first surgery: group I – 5 patients underwent thoracotomy and group II – 9 patients underwent videoassisted thoracic surgery (VATS). The groups were matched for gender, age, smoking, Charlson Comorbidity Index, lung resection, functional status and stage of the disease. Surgical treatment included anatomical lung resection and ipsilateral systematic lymph dissection. Results. There were significant differences in intraoperative blood loss between the groups. Postoperative complications after surgery on the contralateral lung were observed more often in group 1 patients than in group II patents. The overall 5-year survival rates in patients of groups 1 and 2 were 60 % and 86 %, respectively. Respiratory function indicators three months after surgery corresponded to preoperative prognosis, and their decrease did not depend on the surgical approach used. In comparison with patients who underwent standard unilateral lung resection, bilateral anatomical lung resection was not associated with increased number of “major” complications, however, an increase in the frequency of prolonged air discharge was noted (26 % vs 6 %; p<0.05). Conclusion. Sequential bilateral anatomical lung resections are feasible and safe after thorough preoperative assessment of the functional reserves of the cardio-respiratory system. Mini-invasive technologies make it possible to reduce the frequency of complications in the early postoperative period. The use of the VATS approach makes it possible to safely perform anatomical resection of the contralateral lung.
{"title":"Features and outcomes of bilateral anatomical lung resections in patients with lung cancer","authors":"M. Atyukov, I. Zemtsova, A. S. Petrov, O. A. Zhemchugova-Zelenova, P. Yablonskiy","doi":"10.21294/1814-4861-2024-23-3-44-56","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-3-44-56","url":null,"abstract":"The aim of this study was to evaluate the feasibility and safety of sequential bilateral anatomical lung resections performed via video-assisted thoracic surgery (VATS) or thoracotomy approaches in lung cancer patients, as well as to identify factors affecting the postoperative period. Material and Methods. Of 534 NSCLC patients undergoing anatomical lung resection in Center for Intensive Pulmonology and Thoracic Surgery from 2014 to 2022, 14 patients with consecutive bilateral anatomical lung resections were included in the retrospective study. The patients were divided into two groups depending on a surgical approach used during the first surgery: group I – 5 patients underwent thoracotomy and group II – 9 patients underwent videoassisted thoracic surgery (VATS). The groups were matched for gender, age, smoking, Charlson Comorbidity Index, lung resection, functional status and stage of the disease. Surgical treatment included anatomical lung resection and ipsilateral systematic lymph dissection. Results. There were significant differences in intraoperative blood loss between the groups. Postoperative complications after surgery on the contralateral lung were observed more often in group 1 patients than in group II patents. The overall 5-year survival rates in patients of groups 1 and 2 were 60 % and 86 %, respectively. Respiratory function indicators three months after surgery corresponded to preoperative prognosis, and their decrease did not depend on the surgical approach used. In comparison with patients who underwent standard unilateral lung resection, bilateral anatomical lung resection was not associated with increased number of “major” complications, however, an increase in the frequency of prolonged air discharge was noted (26 % vs 6 %; p<0.05). Conclusion. Sequential bilateral anatomical lung resections are feasible and safe after thorough preoperative assessment of the functional reserves of the cardio-respiratory system. Mini-invasive technologies make it possible to reduce the frequency of complications in the early postoperative period. The use of the VATS approach makes it possible to safely perform anatomical resection of the contralateral lung.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":"13 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141685979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21294/1814-4861-2024-23-3-15-31
D. O. Elkhov, A. V. Bukharov, D. A. Erin, V. Derzhavin, E. V. Filonenko, M. D. Aliev, A. Kaprin
Arthroplasty is the most widely used surgical technique for bone tumors of the upper limbs. However, it should be noted that the functional outcomes after endoprosthetic reconstruction for malignant bone tumors of the upper limb does not always satisfy patients and often lead to impaired working capacity of patients, and their disability. The need to improve functional outcomes determines the practical and socio-economic significance of the research. The purpose of the study was to evaluate the impact of a complex of rehabilitation measures on the quality of life of patients after surgery with endoprosthetic reconstruction for malignant bone tumors of the upper limb. Material and Methods. The treatment and rehabilitation outcomes in 146 patients were analyzed. There were 88 (60 %) men and 58 (40 %) women with an average age of 47 years (range, 19–75 years). The tumor was localized in the proximal humerus in 98 (67 %) patients, in the diaphysis in 18 (12 %), in bones that make up the elbow joint in 16 (11 %) and in the distal radius in 14 (9.6 %) patients. Results. Our rehabilitation technique improved functional outcomes after endoprosthetic reconstruction for all tumor localizations. The musculoskeletal Tumor Society (MSTS) score was improved by 10 % (75 vs 65 %) for arthroplasty of the shoulder joint, for the wrist joint by 8 (80 vs 72 %). The rehabilitation technique allowed significant improvement of MSTS score for arthroplasty of the humeral diaphysis and bones making up the elbow joint (from 76 to 95 % and from 68 to 82 %, respectively). Conclusion. Rehabilitation measures play an important role in optimizing quality of life of patients after surgical treatment of bone tumors of the upper limb with arthroplasty, helping to improve functional outcomes.
{"title":"Rehabilitation and quality of life of patients after arthroplasty for malignant bone tumors of the upper limb","authors":"D. O. Elkhov, A. V. Bukharov, D. A. Erin, V. Derzhavin, E. V. Filonenko, M. D. Aliev, A. Kaprin","doi":"10.21294/1814-4861-2024-23-3-15-31","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-3-15-31","url":null,"abstract":"Arthroplasty is the most widely used surgical technique for bone tumors of the upper limbs. However, it should be noted that the functional outcomes after endoprosthetic reconstruction for malignant bone tumors of the upper limb does not always satisfy patients and often lead to impaired working capacity of patients, and their disability. The need to improve functional outcomes determines the practical and socio-economic significance of the research. The purpose of the study was to evaluate the impact of a complex of rehabilitation measures on the quality of life of patients after surgery with endoprosthetic reconstruction for malignant bone tumors of the upper limb. Material and Methods. The treatment and rehabilitation outcomes in 146 patients were analyzed. There were 88 (60 %) men and 58 (40 %) women with an average age of 47 years (range, 19–75 years). The tumor was localized in the proximal humerus in 98 (67 %) patients, in the diaphysis in 18 (12 %), in bones that make up the elbow joint in 16 (11 %) and in the distal radius in 14 (9.6 %) patients. Results. Our rehabilitation technique improved functional outcomes after endoprosthetic reconstruction for all tumor localizations. The musculoskeletal Tumor Society (MSTS) score was improved by 10 % (75 vs 65 %) for arthroplasty of the shoulder joint, for the wrist joint by 8 (80 vs 72 %). The rehabilitation technique allowed significant improvement of MSTS score for arthroplasty of the humeral diaphysis and bones making up the elbow joint (from 76 to 95 % and from 68 to 82 %, respectively). Conclusion. Rehabilitation measures play an important role in optimizing quality of life of patients after surgical treatment of bone tumors of the upper limb with arthroplasty, helping to improve functional outcomes.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":"22 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21294/1814-4861-2024-23-3-5-14
G. A. Kononova, L. D. Zhuikova, O. Ananina, L. A. Kolomiets, L. V. Pikalova, A. S. Zhuikova
Background. The incidence of female reproductive system cancer, including breast, cervical, ovarian and uterine cancers, is steadily increasing, and therefore it is advisable to conduct an epidemiological analysis and assess the quality of medical care. The purpose of the study was to analyze the epidemiological characteristics of reproductive system cancer in females of the Tyva Republic. Material and Methods. The reporting forms № 7 “Cancer incidence in the Tyva Republic” for 2013–2022 were used. Age-standardized incidence rates were calculated using the “Oncostat” program, and cancer care quality was assessed using “Cancer Care Indicators” program. Results. Reproductive system cancer in the Tyva Republic accounted for 46.3 % of all malignant neoplasms in females during 2013–2022. In 2022, breast cancer was the most common cancer (16.2 %) followed by cervical cancer (13.7 %), ovarian cancer (6.7 %), and uterine cancer (4.0 %). During the study period, none of these cancers showed a statistically significant increase in agestandardized incidence rates (AS R). In 2022, age-standardized incidence rates in the Tyva Republic were higher than those in the Siberian Federal District for cervical cancer (27.5 ± 3.7 vs 16.3 ± 0.4 0/0000) and for ovarian cancer (14.1 ± 2.8 vs 12.7 ± 0.3 0/0000), but lower for breast cancer (32.4 ± 4.1 vs 58.7 ± 0.6 0/0000) and uterine cancer (8.6 ± 2.2 vs 19.7 ± 0.4 0/0000). Overall, cancer care quality indicators for reproductive system cancers had improved. Active detection increased from 22.0 to 29.8 %, p=0.039 (in the Siberian Federal District: from 27.6 to 37.2 %, p=0.001). The detection rate at I–II stages increased from 53.7 to 75.2 %, p=0.004 (in the Siberian Federal District: from 63.0 to 71.3 %, p=0.001). The percentage of advanced stages decreased from 37.4 % to 15.5 %, p=0.001 (from 27.4 % to 23.1 % in the Siberian Federal District, p=0.013). The oneyear mortality rates also decreased from 19.0 to 5.4 %, p=0.013 (in the Siberian Federal District: from 11.8 to 8.5 %, р<0.001). The high incidence of cervical cancer, the absence of noticeable optimal changes in the early detection and the high prevalence of HPV infection among the female population of the Tyva Republic indicate the relevance of mass HPV testing as a part of secondary cancer prevention. Conclusion. The high incidence of female reproductive system cancer and the current status of reproductive cancer care in the Republic of Tyva dictate the need to strengthen primary, secondary and tertiary cancer prevention.
{"title":"Reproductive system cancer in females of the Tyva Republic. Epidemiological characteristics","authors":"G. A. Kononova, L. D. Zhuikova, O. Ananina, L. A. Kolomiets, L. V. Pikalova, A. S. Zhuikova","doi":"10.21294/1814-4861-2024-23-3-5-14","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-3-5-14","url":null,"abstract":"Background. The incidence of female reproductive system cancer, including breast, cervical, ovarian and uterine cancers, is steadily increasing, and therefore it is advisable to conduct an epidemiological analysis and assess the quality of medical care. The purpose of the study was to analyze the epidemiological characteristics of reproductive system cancer in females of the Tyva Republic. Material and Methods. The reporting forms № 7 “Cancer incidence in the Tyva Republic” for 2013–2022 were used. Age-standardized incidence rates were calculated using the “Oncostat” program, and cancer care quality was assessed using “Cancer Care Indicators” program. Results. Reproductive system cancer in the Tyva Republic accounted for 46.3 % of all malignant neoplasms in females during 2013–2022. In 2022, breast cancer was the most common cancer (16.2 %) followed by cervical cancer (13.7 %), ovarian cancer (6.7 %), and uterine cancer (4.0 %). During the study period, none of these cancers showed a statistically significant increase in agestandardized incidence rates (AS R). In 2022, age-standardized incidence rates in the Tyva Republic were higher than those in the Siberian Federal District for cervical cancer (27.5 ± 3.7 vs 16.3 ± 0.4 0/0000) and for ovarian cancer (14.1 ± 2.8 vs 12.7 ± 0.3 0/0000), but lower for breast cancer (32.4 ± 4.1 vs 58.7 ± 0.6 0/0000) and uterine cancer (8.6 ± 2.2 vs 19.7 ± 0.4 0/0000). Overall, cancer care quality indicators for reproductive system cancers had improved. Active detection increased from 22.0 to 29.8 %, p=0.039 (in the Siberian Federal District: from 27.6 to 37.2 %, p=0.001). The detection rate at I–II stages increased from 53.7 to 75.2 %, p=0.004 (in the Siberian Federal District: from 63.0 to 71.3 %, p=0.001). The percentage of advanced stages decreased from 37.4 % to 15.5 %, p=0.001 (from 27.4 % to 23.1 % in the Siberian Federal District, p=0.013). The oneyear mortality rates also decreased from 19.0 to 5.4 %, p=0.013 (in the Siberian Federal District: from 11.8 to 8.5 %, р<0.001). The high incidence of cervical cancer, the absence of noticeable optimal changes in the early detection and the high prevalence of HPV infection among the female population of the Tyva Republic indicate the relevance of mass HPV testing as a part of secondary cancer prevention. Conclusion. The high incidence of female reproductive system cancer and the current status of reproductive cancer care in the Republic of Tyva dictate the need to strengthen primary, secondary and tertiary cancer prevention.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":"59 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-12DOI: 10.21294/1814-4861-2024-23-2-139-146
A. Sokolenko, S. V. Poletaeva, A. D. Shestakova, T. Gorodnova, I. V. Berlev, E. N. Imyanitov
Background. Homologous recombination deficiency (HRD) is a valuable molecular marker for predicting response to platinum agents and poly(ADP-ribose)-polymerase (PARP) inhibitors. Germline and somatic alterations in the BRCA1 and BRCA2 genes are the major cause of HRD in ovarian cancer. However, in some cases, tumors arising in carriers of BRCA1 or BRCA2 pathogenic variants do not lose the normal copy of the corresponding gene and are not deficient for homologous recombination. Aim of the study was to present a case of high-grade ovarian carcinoma without HRD phenotype developed in a BRCA2 mutation carrier. Case report. A 48-year-old woman was diagnosed with multiple primaries: HER2-positive high-grade ovarian cancer and colorectal adenocarcinoma. analysis of the coding BRCA1/BRCA2 sequences revealed the germline BRCA2 c.658_659delgt [rs80359604] pathogenic variant. Given the unusual histological features, namely the absence of serous or endometrioid markers and high HER2 expression, we performed additional molecular analysis of the metastatic lesions in the lymph nodes. In all samples, the pattern of chromosomal instability did not match the HRD profile and there was loss of the mutant copy of the BRCA2 gene. Therefore, this tumor lacked the BRCAness phenotype. Conclusion. Tumors arising in HRR gene mutation carriers require additional molecular analysis for a comprehensive assessment of HRD.
{"title":"HRD-negative high-grade carcinoma of the ovary in BRCA2 pathogenic variant carrier","authors":"A. Sokolenko, S. V. Poletaeva, A. D. Shestakova, T. Gorodnova, I. V. Berlev, E. N. Imyanitov","doi":"10.21294/1814-4861-2024-23-2-139-146","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-2-139-146","url":null,"abstract":"Background. Homologous recombination deficiency (HRD) is a valuable molecular marker for predicting response to platinum agents and poly(ADP-ribose)-polymerase (PARP) inhibitors. Germline and somatic alterations in the BRCA1 and BRCA2 genes are the major cause of HRD in ovarian cancer. However, in some cases, tumors arising in carriers of BRCA1 or BRCA2 pathogenic variants do not lose the normal copy of the corresponding gene and are not deficient for homologous recombination. Aim of the study was to present a case of high-grade ovarian carcinoma without HRD phenotype developed in a BRCA2 mutation carrier. Case report. A 48-year-old woman was diagnosed with multiple primaries: HER2-positive high-grade ovarian cancer and colorectal adenocarcinoma. analysis of the coding BRCA1/BRCA2 sequences revealed the germline BRCA2 c.658_659delgt [rs80359604] pathogenic variant. Given the unusual histological features, namely the absence of serous or endometrioid markers and high HER2 expression, we performed additional molecular analysis of the metastatic lesions in the lymph nodes. In all samples, the pattern of chromosomal instability did not match the HRD profile and there was loss of the mutant copy of the BRCA2 gene. Therefore, this tumor lacked the BRCAness phenotype. Conclusion. Tumors arising in HRR gene mutation carriers require additional molecular analysis for a comprehensive assessment of HRD.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":"113 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-12DOI: 10.21294/1814-4861-2024-23-2-26-36
O. Churuksaeva, L. A. Kolomiets, A. L. Chernyshova, A. Villert, M. O. Ochirov, Yu. M. Trushchuk, A. A. Maltseva, L. Tashireva
Background. Determination of the feasibility of performing minimally invasive surgery for invasive cervical cancer and identification of criteria for optimal surgical access that ensures safety, effectiveness, and satisfactory immediate and long-term results remain challenging in gynecological oncology. The aim of the study was to evaluate the immediate and long-term treatment outcomes in patients with invasive cervical cancer who underwent radical hysterectomy via laparotomy compared to those who underwent minimally invasive surgery. Material and methods. Treatment outcomes of 91 patients with invasive carvical cancer were analyzed. The assessment of the objective tumor response to neoadjuvant chemotherapy using the RECIST scale (Response Evaluation Criteria in Solid Tumors) was confirmed by clinical, ultrasound and CT/ MRI findings. The Kaplan-Maier curves and the log-rank criterion were used to compare the time of relapse-free and overall survivals. Statistical analysis and visualization of the analysis results were performed using prism 9.5.1 (GraphPad, USA). Results. The presence of parametrial lymphovascular space invasion and the frequency of lymphadenopathy were comparable for both groups of patients. there were no statistically significant differences in the number of the resected lymph nodes, but there was a statistically significant difference in volume of blood loss and the duration of surgery between the groups (p=0.0001). Every third patient was diagnosed with stage IIIC after surgery (pelvic lymph node lesion). Intraoperative complications were significantly lower in the laparoscopy group than in the laparotomy group (6.7 % vs 13 %). No significant differences in the proportion of relapses of the disease between the groups were found (9.6 % in the laparotomy group vs 11.7 % in the laparoscopy group). There were no significant differences in overall and relapse-free survival between the groups. Conclusion. Minimally invasive surgery is a promising and adequate surgical technique for the treatment of cervical cancer. However, additional studies are needed to determine the indications for these surgeries.
{"title":"Controversies in minimally invasive surgery for invasive cervical cancer","authors":"O. Churuksaeva, L. A. Kolomiets, A. L. Chernyshova, A. Villert, M. O. Ochirov, Yu. M. Trushchuk, A. A. Maltseva, L. Tashireva","doi":"10.21294/1814-4861-2024-23-2-26-36","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-2-26-36","url":null,"abstract":"Background. Determination of the feasibility of performing minimally invasive surgery for invasive cervical cancer and identification of criteria for optimal surgical access that ensures safety, effectiveness, and satisfactory immediate and long-term results remain challenging in gynecological oncology. The aim of the study was to evaluate the immediate and long-term treatment outcomes in patients with invasive cervical cancer who underwent radical hysterectomy via laparotomy compared to those who underwent minimally invasive surgery. Material and methods. Treatment outcomes of 91 patients with invasive carvical cancer were analyzed. The assessment of the objective tumor response to neoadjuvant chemotherapy using the RECIST scale (Response Evaluation Criteria in Solid Tumors) was confirmed by clinical, ultrasound and CT/ MRI findings. The Kaplan-Maier curves and the log-rank criterion were used to compare the time of relapse-free and overall survivals. Statistical analysis and visualization of the analysis results were performed using prism 9.5.1 (GraphPad, USA). Results. The presence of parametrial lymphovascular space invasion and the frequency of lymphadenopathy were comparable for both groups of patients. there were no statistically significant differences in the number of the resected lymph nodes, but there was a statistically significant difference in volume of blood loss and the duration of surgery between the groups (p=0.0001). Every third patient was diagnosed with stage IIIC after surgery (pelvic lymph node lesion). Intraoperative complications were significantly lower in the laparoscopy group than in the laparotomy group (6.7 % vs 13 %). No significant differences in the proportion of relapses of the disease between the groups were found (9.6 % in the laparotomy group vs 11.7 % in the laparoscopy group). There were no significant differences in overall and relapse-free survival between the groups. Conclusion. Minimally invasive surgery is a promising and adequate surgical technique for the treatment of cervical cancer. However, additional studies are needed to determine the indications for these surgeries.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":"117 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-12DOI: 10.21294/1814-4861-2024-23-2-133-138
A. Kazakov, K. Laktionov, V. O. Vorobyeva, K. Sarantseva
Background. The use of the modern targeted drugs in patients with non-small-cell lung cancer (NSCLC) with certain somatic alterations (genetic alterations in EGFR, ALK, ROS1, BRAF, RET genes, etc.) provides a significant increase in overall and disease-free survival with an acceptable toxicity profile. The use of RET inhibitors, such as selpercatinib, has significantly improved prognosis in NSCLC patients with RET gene translocation, since chemotherapy and immunotherapy in this cohort of patients are ineffective options. The RET gene translocation occurs rarely (2–3 % of cases among lung adenocarcinoma), but detection of this genetic alteration with subsequent administration of targeted therapy significantly improves the prognosis of the disease. Case report. We present a clinical case of the efficacy of targeted therapy with selpercatinib in a 60-year-old patient with RET-positive NSCLC. Methods to eliminate toxicity after selpercatinib therapy and therapy response are described. Results. Second-line selpercatinib therapy resulted in partial response in our patient with lung adenocarcinoma and the presence of translocation in RET gene. Adverse effects from targeted therapy were minimized or eliminated by the use of concomitant therapy, temporary cancellation of targeted therapy with subsequent dose reduction and gradual return to full therapeutic doses. Conclusion. This case demonstrates the high significance and importance of genetic testing in patients with lung adenocarcinoma not only for the most common mutations, but also for rarer somatic alterations, such as translocation in the RET gene. Detection of this translocation and subsequent administration of appropriate targeted therapy significantly improves the prognosis of patients.
背景。对于存在某些体细胞改变(表皮生长因子受体、ALK、ROS1、BRAF、RET基因等的遗传改变)的非小细胞肺癌(NSCLC)患者,使用现代靶向药物可显著提高总生存期和无病生存期,且毒性可接受。RET抑制剂(如赛铂替尼)的使用大大改善了RET基因易位的NSCLC患者的预后,因为化疗和免疫疗法在这类患者中是无效的选择。RET基因易位很少发生(占肺腺癌病例的2%-3%),但发现这种基因改变并随后进行靶向治疗,可明显改善疾病的预后。病例报告。我们介绍了一个临床病例,该病例是一名60岁的RET阳性NSCLC患者使用舍帕替尼(selpercatinib)进行靶向治疗的疗效。文中介绍了赛帕替尼治疗后的毒性消除方法和治疗反应。结果我们的患者患有肺腺癌并存在RET基因易位,二线舍帕替尼治疗使其获得了部分应答。通过使用伴随治疗、暂时取消靶向治疗并随后减少剂量以及逐步恢复到完全治疗剂量,靶向治疗的不良反应得以最小化或消除。结论该病例表明,对肺腺癌患者进行基因检测意义重大,不仅要检测最常见的突变,还要检测罕见的体细胞改变,如 RET 基因的易位。检测出这种易位并随后进行适当的靶向治疗,可显著改善患者的预后。
{"title":"Use of selpercatinib in a patient with RET-mutated non-small cell lung cancer: case report","authors":"A. Kazakov, K. Laktionov, V. O. Vorobyeva, K. Sarantseva","doi":"10.21294/1814-4861-2024-23-2-133-138","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-2-133-138","url":null,"abstract":"Background. The use of the modern targeted drugs in patients with non-small-cell lung cancer (NSCLC) with certain somatic alterations (genetic alterations in EGFR, ALK, ROS1, BRAF, RET genes, etc.) provides a significant increase in overall and disease-free survival with an acceptable toxicity profile. The use of RET inhibitors, such as selpercatinib, has significantly improved prognosis in NSCLC patients with RET gene translocation, since chemotherapy and immunotherapy in this cohort of patients are ineffective options. The RET gene translocation occurs rarely (2–3 % of cases among lung adenocarcinoma), but detection of this genetic alteration with subsequent administration of targeted therapy significantly improves the prognosis of the disease. Case report. We present a clinical case of the efficacy of targeted therapy with selpercatinib in a 60-year-old patient with RET-positive NSCLC. Methods to eliminate toxicity after selpercatinib therapy and therapy response are described. Results. Second-line selpercatinib therapy resulted in partial response in our patient with lung adenocarcinoma and the presence of translocation in RET gene. Adverse effects from targeted therapy were minimized or eliminated by the use of concomitant therapy, temporary cancellation of targeted therapy with subsequent dose reduction and gradual return to full therapeutic doses. Conclusion. This case demonstrates the high significance and importance of genetic testing in patients with lung adenocarcinoma not only for the most common mutations, but also for rarer somatic alterations, such as translocation in the RET gene. Detection of this translocation and subsequent administration of appropriate targeted therapy significantly improves the prognosis of patients.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":"107 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}