Onkourologiya最新文献

{"title":"Evaluation of heterogeneous factors of low-grade prostate cancer in patients before and after radical prostatectomy","authors":"E. Veliev, D. Goncharuk, E. Sokolov, E. Ivkin, O. Paklina, G. Setdikova","doi":"10.17650/10.17650/1726-9776-2020-16-3-70-79","DOIUrl":"https://doi.org/10.17650/10.17650/1726-9776-2020-16-3-70-79","url":null,"abstract":"Objective: to determine the degree of heterogeneity of prostate cancer Gleason 6 (3 + 3) by assessing: long-term oncological results, mismatch of pre- and postoperative degree of prostate cancer aggressiveness, preoperative clinical component.Materials and methods. 528 patients with clinically localized prostate cancer and Gleason»s preoperative score of 6 (3 + 3). All patients were divided into 3 groups: group 1 (n = 151) — Gleason 6, prostate specific antigen (PSA) density <0.15ng/ml/cm3, ≤4 positive biopsy cores, <50 % lesion of the biopsy cores, group 2 (n = 229) — Gleason 6, PSA <10 ng/ml and group 3 (n = 148) — Gleason 6, PSA >10 ng/ml.Results. Statistically significant differences between group 1 and group 2 were observed only when assessing PSA velocity (p <0.017). The median time to the development of biochemical relapse (BCR) in the study population was 12 (3—77) months. BCR in group 1 was observed in 1.98 % of patients, in group 2 and 3 — 7.86 and 14.19 %, respectively. Statistically significant differences in the time of onset of BCR within 2 years after surgery were found between groups 1 and 2 (p = 0.002) and group 1 and 3 (p = 0.0001). An increase in the degree of malignancy after surgery in group 1 was determined only in 13 % of patients, in group 2 in 27 %, in group 3 in 43 % of patients. The contribution of a greater postoperative degree of malignancy of prostate cancer to the development of BCR in group 1 was 1.32 % (2 out of 3 patients). Thus, in group 1 in the case of true Gleason 6 (3 + 3), the probability of BCR was 0.66 %.Conclusion. PSA velocity before surgery showed a statistical difference between groups 1 and 2. Based on long-term oncological results after surgery, heterogeneous behavior of the tumor is observed among the study groups. Group 1 in comparison with group 2 and 3 showed the lowest frequency of increase in the Gleason score and the likelihood of developing BCR after surgery. These results may be useful in planning an individual patient treatment plan.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67744661","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}

{"title":"Current opportunities of therapy for patients with non-metastatic castration-resistant prostate cancer","authors":"B. Alekseev, K. M. Nushko, P. Kozlova, A. Kaprin, O. I. Mailyan","doi":"10.17650/1726-9776-2020-16-3-190-197","DOIUrl":"https://doi.org/10.17650/1726-9776-2020-16-3-190-197","url":null,"abstract":"Prostate cancer is one of the most common urological malignancies. Improved diagnostic methods and widespread implementation of mandatory prostate specific antigen (PSA) testing in a number of clinics have led to an increase in the number of timely diagnosed cases of localized and locally advanced prostate cancer, as well as to the expansion of indications for radical therapies. Nevertheless, 30 % to 50 % of patients (depending on their risk) develop biochemical relapse after surgery or radiotherapy. Non-metastatic castration-resistant prostate cancer is usually a result of disease progression after radical treatment and long-term androgen-deprivation therapy, which manifests by constant increase in the PSA level along with castrate level of testosterone and no distant metastases according to the results of comprehensive radiological examination. A number of large clinical studies have demonstrated that regular examinations and control of PSA doubling time (main prognostic factor associated with poor disease outcome) are crucial to increase survival and prevent the development of distant metastases.This paper aims to provide an overview of existing literature on the problems associated with diagnosis and treatment of non-metastatic castration-resistant prostate cancer. We have analyzed large randomized studies that demonstrated an increase in the overall survival of patients receiving selective androgen receptor antagonists.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67761386","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}

{"title":"Combination of pembrolizumab and axitinib: a new gold standard in the first-line therapy for metastatic clear-cell renal-cell carcinoma?","authors":"R. Gafanov, A. Dzidzaria, I. B. Kravtsov, S. Fastovets","doi":"10.17650/1726-9776-2020-16-3-29-37","DOIUrl":"https://doi.org/10.17650/1726-9776-2020-16-3-29-37","url":null,"abstract":"The treatment strategy for metastatic renal cell carcinoma (mRCC) has evolved with the emergence of anti-angiogenic drugs, in particular tyrosine kinase inhibitors (TKIs) targeting the vascular endothelial growth factor receptor (VEGFR) and immune checkpoint inhibitors (ICIs). Both treatment options improved patient outcomes and altered the natural history of mRCC. Clinical studies have focused on evaluating combination regimens containing ICI and VEGFR-targeted TKIs. The combination of axitinib with pembrolizumab (KEYNOTE-426) showed better results compared to sunitinib in patients with mRCC who had not previously received systemic therapy. In this article, we discuss the rationale for the combination of ICI and TKI based on preclinical data, as well as the clinical results obtained with the combination of axitinib with pembrolizumab in first-line patients in clinical trials.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67762274","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}

{"title":"Bladder cancer: treatment after progression. Results of the second retrospective analysis of data on the efficacy of vinflunin in patients with metastatic urothelial cancer in real clinical practice in Russia","authors":"L. Bolotina, I. Zaborskiy, K. Safiullin, E. V. Gurin, L. N. Volodina, E. S. Semyonova, A. A. Gurchev, O. Gladkikh, A. Zhabina, A. Tarasova","doi":"10.17650/1726-9776-2020-16-3-135-142","DOIUrl":"https://doi.org/10.17650/1726-9776-2020-16-3-135-142","url":null,"abstract":"Objective. There is the second generalized analysis of administration of vinflunine in real clinical practice in Russia.Materials and methods. This analysis gathered 15 patients with urothelial carcinoma treated using this medicine in 8 cancer centers in Russia. We assessed efficacy, safety profile of vinflunine in this subset of patients.Results. Clinical efficacy of vinflunine (complete response + partial response + stable disease) was 73.3 %, one patient demonstrated complete response. Median of response duration accounts for 3.8 months. Six-month and 1-year survival rate made up 93.3 %. Adverse events were observed in 53.5 %, with only one episode of neutropenia 4 grade.Conclusion. In our second analysis vinflunine was more effective than in randomized clinical trial and other studies from real practice in Europe. Thus, we confirm expediency to administer of vinflunine for metastatic urothelial carcinoma.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"79 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67760563","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}

{"title":"Islam and urostoma: a modern view through the prism of a religiously traditional legal system","authors":"E. Mamizhev, I. B. Dzhalilov, B. Aslanov, T. K. Kemryugov, S. S. Krestianinov, V. Osetnik, A. A. Kharsov","doi":"10.17650/1726-9776-2020-16-3-205-208","DOIUrl":"https://doi.org/10.17650/1726-9776-2020-16-3-205-208","url":null,"abstract":"Patients who practice Islam often refuse the proposed type of treatment for malignant neoplasms, citing religious reasons. Most fear that complete or partial non-retention of urine, the presence of a urostoma (ileal conduit) will violate their ritual purity and, as a result, their religious duties. The consequence of such refusal of treatment may be a lower quality of life, compared with patients of other faiths. Unfortunately, a low awareness of religious responsibilities among surgeons performing pelvic exentesis, cystectomy, prostatectomy, may prevent a full-fledged discussion of these issues before surgery. The presented review of the literature examined studies, legal aspects, and religious arguments that assist doctors in choosing treatment tactics for patients.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67762569","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}

{"title":"Non-interventional study of treatment approaches in patients with locally advanced prostate cancer who have undergone prostatectomy or radiation therapy (PREVENT)","authors":"V. Matveev, E. I. Kopyl’tsov, P. Borisov","doi":"10.17650/1726-9776-2020-16-3-109-116","DOIUrl":"https://doi.org/10.17650/1726-9776-2020-16-3-109-116","url":null,"abstract":"Background. Prostate cancer (PCa) is the second most common cancer in men. Currently there is no clear understanding of preferences among oncologists in Russia in decision-making process regarding adjuvant ADT in patients with locally advanced PCa with high and very high risk of recurrence after prostatectomy or radiotherapy.Objective: to provide accurate and reliable information regarding the adjuvant endocrine treatment in patients with locally advanced PCa in the Russian routine clinical practice.Materials and methods. This multicentre, non-interventional, prospective observational cohort study included 204 males (mean age 64.9 ± 6.2 years) with locally advanced PCa. The patients were enrolled at 18 sites in Russian Federation. Information on the routine diagnosis-specific examinations, including PSA measurements before, after and during one year after prostatectomy / radiotherapy was collected. Information regarding patient demographics, disease characteristics, management approaches, diagnostic tests and medications received by patients was taken from the medical records.Results. Among patients participated in the study, 64.4 % were treated surgically, and 38.6 % underwent radiotherapy; only 6 patients (4.6 %) underwent radical prostatectomy followed by radiotherapy. Median duration from diagnosis of PCa at the time of enrolment was less than 2.7 months, for 75 % of patients the disease duration did not exceed 7 months. ADT was used in 132 patients. ADT was received by 95.8 % of males treated with radiotherapy without radical prostatectomy and by 46.8 % of those who underwent radical prostatectomy without radiotherapy. Medical or surgical castration was used in 56.4 % of cases, antiandrogens without castration were used by less than 10 % of patients, while 28.2 % of patients received treatment with both castration and antiandrogens and the same number of males underwent only castration. Percentage of patients with PCa progression was 9.3 % for males after radical prostatectomy without radiotherapy and 7.4 % for those who underwent radiotherapy without radical prostatectomy. There were no cases of death due to PCa progression.Conclusion. The results are in alignment with international guidelines and standards. Received data can help to improve management approaches for treatment of Russian patients with high risk locally advanced PCa, particularly giving a basis for a decision on use of ADT.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67760507","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}

{"title":"An interim analysis of non-interventional study of the epidemiology and natural history of non-metastatic castration-resistant prostate cancer in Russia","authors":"B. Alekseev, K. Nyushko, R. Gafanov, A. Kirichek, Yu. V. Anzhiganova, E. Kopyltsov, Y. Sundui, V. Matveev","doi":"10.17650/1726-9776-2020-16-3-90-101","DOIUrl":"https://doi.org/10.17650/1726-9776-2020-16-3-90-101","url":null,"abstract":"Objective: to study the clinical and demographic profile of patients with non-metatstatic castration-resistant prostate cancer (nmCRPC) and clinical approaches to the treatment of nmCRPC in the context of daily medical practice before and after progression M1 stage.Materials and methods. The multicenter non-interventional epidemiological study is planned to include 200 patients with a documented diagnosis of nmCRPC from 2019 to 2020. The interim report has included data on 108 patients from 13 centers located in different regions of the Russian Federation. The median age of the patients was 73 (55—90) years.Results and conclusion. When the diagnosis of nmCRPC was made, the median prostate specific antigen was 8.23 (0.17—116.9) ng/ml, and the prostate specific antigen doubling time was 6 (1—50) months. When diagnosed nmCRPC, 86 patients (79.6 %) underwent a change of therapy, of which 42 % were prescribed modern regimens containing the new generation non-steroid antiandrogens (apalutamide, enzalutamide).","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67762740","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}

{"title":"Modern prostate cancer biomarkers. Prospects for EN2 in the prostate cancer diagnosis","authors":"A. Tarabayeva, A. B. Zhubanturliyeva, I. M. Okhas","doi":"10.17650/1726-9776-2020-16-3-165-173","DOIUrl":"https://doi.org/10.17650/1726-9776-2020-16-3-165-173","url":null,"abstract":"Prostate cancer is one of the most common forms of malignant neoplasms in men. In this regard, it is relevant to search for diagnostic markers that allow the creation of inexpensive, effective tests for early diagnosis of the disease, predicting the risk of relapse and assessing the effectiveness of the therapy. Existing invasive methods for diagnosing prostate cancer present some difficulties for patients. This article discusses the diagnostic capabilities of tissue biomarkers of prostate cancer obtained by non-invasive methods.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"19 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67761767","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}

{"title":"Combination of nivolumab and ipilimumab in the treatment of disseminated renal cell carcinoma. Realities and prospects","authors":"B. Alekseev, I. Shevchuk","doi":"10.17650/1726-9776-2020-16-3-38-52","DOIUrl":"https://doi.org/10.17650/1726-9776-2020-16-3-38-52","url":null,"abstract":"The use of immunotherapeutic drugs as monotherapy and in various combinations for metastatic renal cell carcinoma has revolutionized the treatment of this disease. Thanks to the breakthrough studies carried out, the standard in the first line of therapy for metastatic renal cell carcinoma is now a combination of checkpoint inhibitors, as well as an immuno-oncological agent with a tyrosine kinase inhibitor.This article presents updated data from the CheckMate 214 study with a minimum follow-up of 42 months. A review of studies on the efficacy of nivolumab in patients with renal cell carcinoma in the first line of therapy with the possibility of adding ipilimumab in case of progression of the disease on the background of monotherapy is carried out, as well as data on the use of a combination of nivolumab and ipilimumab in the second line of treatment.Monotherapy with nivolumab has a certain effectiveness in a specific category of patients, for example, with potential intolerance to ipilim-umab or first-line tyrosine kinase inhibitors, as well as in patients with a favorable prognosis.The combination of drugs nivolumab + ipilimumab is a highly effective treatment option in the first line of therapy with the potential for a sustained response in patients with RCC with an poor and intermediate risk, and in the second and subsequent lines requires further study.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67762436","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}

{"title":"Influence of biopsy cores number performed with targeted prostate biopsy on the likelihood of a positive result in patients with clinically significant prostate cancer","authors":"A. Zyryanov, G. A. Gulin, N. Rubtsova, V. Mager, A. E. Putintsev, S. G. Kuznetsova, D. D. Kuznetsova","doi":"10.17650/1726-9776-2020-16-3-62-69","DOIUrl":"https://doi.org/10.17650/1726-9776-2020-16-3-62-69","url":null,"abstract":"Background. Targeted biopsy is proposed as a method of choice in the algorithm of prostate cancer diagnosis, but not all the features of method has been evaluated.Objective: determine the rational number of targeted biopsy samples in patients with clinically significant prostate cancer.Materials and methods. The magnetic resonance imaging and fusion biopsy data of 156 patients with suspected prostate cancer were retrospectively evaluated.Results and conclusion. In the study statistically significant dependence of the positive histological results in patients with clinically significant prostate cancer from the number of biopsy samples was found. The potential probability of a false negative histological examination with an insufficient number of biopsy samples was noted. These results confirm the latest published data of potential targeted biopsy false in true positive patients after multiparametric magnetic resonance imaging. An increase in the number of biopsy samples in the target lesion reduces the likelihood of false-negative results. The main causes of such discrepancy are some technical laxity and the heterogeneous histological structure of prostate cancer. Increase the number of biopsy cores can reduce the likelihood of false-negative results. ","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67762456","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}