ABSTRACT
Introduction & Objectives: The incidence of prostate cancer, both in the world and in the Russian Federation, tends to increase. In the Republic of Bashkortostan in 2021, 699 patients with this diagnosis were registered. 19.6% of patients had stage IV disease at the time of diagnosis. 5818 patients were registered, of which 361 died within a year. The effectiveness of hormonal treatment of common prostate cancer has time limitations, after which there is a development of resistance to castration and progression of the disease. To date, drugs such as kabazitaxel, sipuleucel-T vaccine, abiraterone, enzalutamide and radium-223 have been approved for use in metastatic CRPC. The purpose of the work: analysis of the experience of systemic radiotherapyand Radium - 223 patients with mCRPC in the Republic of Bashkortostan in 2021. Material(s) and Method(s): Analysis of patients who received systemic radiotherapy Radium - 223 in the Republic of Bashkortostan according to medical documentation and research data. In 2021, Radiy-223 radiotherapy was performed on 7 patients diagnosed with mCRPC. Median age 63.14 years. All patients met the criteria for treatment, i.e. had castration-resistant prostate cancer with bone metastases, without visceral metastases. All patients had concomitant pathology from the cardiovascular system, respiratory tract, endocrine system. According to the previous surgical treatment, patients were distributed as follows: orchidectomy - 4, prostatectomy - 1 and 2 patients underwent tumor biopsy. By morphology: Glisson 6 - 2 patients, Glisson 7 - 1, Glisson 8 - 3, Glisson 10 - 1. 4 patients were referred to Xofigo for radiologically confirmed progression, 3 patients were progressingin height at PSA levels. Result(s): 1 patient previously received 1 line of systemic therapy, 5 patients received 2 lines, 1 patient received 3 lines of therapy. 6 patients received all 6 courses of radiotherapy, 1 patient did not complete treatment due to COVID 19. He is expected to complete therapy. All patients are currently alive with no signs of disease progression. Serious side effects were not registered. Conclusion(s): The "therapeutic window" for the prescription of radium-223 is the period before the appearance of visceral metastases and decline of the somatic status. To achieve the maximum benefit from the appointment of radium-223, it is necessary to conduct >=5 cycles of therapy, which is possible in 1-2 treatment lines. It is necessary to select patients carefully for radiotherapy - Radium 223.Copyright © 2022 European Association of Urology. Published by Elsevier B.V.
ABSTRACT
Aim. To evaluate the safety and efficacy of long-term continuous use of Avegra® BIOCAD (international nonproprietary name – INN: bevacizumab) as a targeted therapy in patients with metastatic colorectal cancer in real-world practice. Materials and methods. The paper presents the interim results of a multicenter prospective observational post-approval study of the safety and efficacy of Avegra® BIOCAD (INN: bevacizumab) combined with chemotherapy in patients with metastatic colorectal cancer. Inclusion criteria: histology verified diagnosis of metastatic colorectal cancer;therapy with bevacizumab (by JSC BIOCAD, Russia) to all patients included in the study, as part of real-world clinical practice, at a dose of 5 mg/kg every 2 weeks or 7.5 mg/kg every 3 weeks in combination with standard cytotoxic regimens (FOLFOX 6, XELOX, etc.). The main safety criteria are the incidence of adverse reactions to bevacizumab and the rate of treatment withdrawal due to the development of adverse reactions to bevacizumab. Additional criteria are objective response rate (complete and partial response to therapy), disease control rate (ORR and stable disease), and rate of disease progression. Results. At the time of the interim analysis, 441 patients with metastatic colorectal cancer in 28 research centers of the Russian Federation (Moscow, Saint Petersburg and regional clinics) were included in the study. Median age of patients is 62 (28–87) years. Patients had an ECOG performance status of 0–1, with a median follow-up of 7.3 months. After the therapy, the disease control rate was 79.5%. The median PFS was 8 months (95% CI 7.04 to 9.00). The median OS was not reached. Toxicity associated with bevacizumab manifested predominantly as arterial hypertension (3%), diarrhea (1,1%) and asthenia (0.9%). Nine (2.1%) SARs were observed;three (0.6%) of them (COVID-19, intestinal obstruction, multiple organ failure) resulted in mortality. The obtained results are well consistent with the previously known bevacizumab safety profile characteristics. Conclusion. The interim analysis results confirm the favorable safety profile and high efficacy of Avegra® BIOCAD (INN: bevacizumab) combined with standard cytotoxic regimens (FOLFOX, XELOX, etc.) as first-line therapy in patients with metastatic colorectal cancer. The real-world data for ORR and PFS are comparable with clinical trials results. At the time of the interim analysis publication, the study is ongoing. Final conclusions on the safety and efficacy of bevacizumab (by JSC BIOCAD, Russia), will be made after the study is completed. © 2022 Moscow Polytechnic University. All rights reserved.
ABSTRACT
In a pandemic of a new coronovirus infection, patients with malignant neoplasms fall into a special risk group. A clinical case of COVID-19 infection in a patient receiving chemoradiotherapy is presented. The patient received chemoradiotherapy for esophageal cancer and was suspended due to the development of leukopenia. On the 2nd day after discharge from the hospital, the patient developed symptoms of SARS. According to computed tomography signs of viral pneumonia, according to PCR smear revealed RNA of coronavirus SARS (SARS-CoV-2). The patient underwent antiviral, anticoagulant, antibacterial therapy, hematopoietic stimulants, glucocorticosteroids, and immunosuppressant. Conducted CT control in dynamics. On day 14, an improvement was noted, normalization of body temperature, according to CT data on day 14, the volume of lung damage decreased from 45% to 10%, smears on RARS coronavirus RNA (SARS-CoV-2) on 5.10, 14 days after hospitalization were negative. On the 18th day, the patient was discharged with recovery under the supervision of a therapist and continued antitumor treatment. A clinical case demonstrates a successful recovery from COVID-19 against the background of chemoradiotherapy for esophageal cancer complicated by lymphopenia and leukopenia. В условиях пандемии новой коронавирусной инфекции в особую группу риска попадают пациенты со злокачественными новообразованиями. Представлен клинический случай заражения COVID-19 пациентки, получавшей химиолучевую терапию. Пациентка получала химиолучевое лечение по поводу рака пищевода, которое было приостановлено в связи с развитием лейкопении. На 2-е сут после выписки из стационара у пациентки развились симптомы ОРВИ. По данным компьютерной томографии признаки вирусной пневмонии, по данным ПЦР мазка выявлен РНК коронавируса ТОРС (SARS-CoV-2). Пациентке проводилась противовирусная, антикоагулянтная, антибактериальная терапия, стимуляторы гемопоэза, глюкокортикостероиды, иммунодепрессант. Проводился КТ-контроль в динамике. На 14-е сут отметилось улучшение состояния, нормализация температуры тела, по данным КТ объём поражения лёгких сократился с 45 до 10%, мазки на РНК коронавируса ТОРС (SARS-CoV-2) на 5, 10, 14-е сут с момента госпитализации были отрицательны. На 18-е сут пациентка выписана с выздоровлением под наблюдение терапевта и продолжения противоопухолевого лечения. Клинический случай демонстрирует успешное выздоровление от COVID-19 на фоне осложнённого лимфопенией и лейкопенией химиолучевого лечения рака пищевода.