Objective: to summarize current trends in the use of abiraterone in the treatment of prostate cancer based on clinical and experimental studies. Material and Methods. We searched and analyzed information in MedLine, Scopus, WoS, and the Russian Science Citation Index (RSCI) databases for the past 10 years. We analyzed information on pharmaceutical, experimental, and clinical studies on current trends in abiraterone use strategies for prostate cancer treatment, based on clinical and experimental studies. Results. Abiraterone-based therapies are being actively studied for the treatment of both hormone-sensitive and castration-resistant prostate cancer. The use of abiraterone-based therapies or irreversible androgen receptor blockers leads to long-term disease control and improved treatment outcomes for prostate cancer patients. Regulation of testosterone levels between castration and supraphysiological levels suppresses the growth of cancer cells (bipolar androgen therapy). Significant limitations in the use of abiraterone-based therapies are associated with their side effects: changes in water-electrolyte balance due to the effect on the level of mineralocorticoids in the blood, and the development of relative or absolute liver and kidney failure. To reduce the dose and/or increase the bioavailability of the drug, two main approaches are used: using the positive effect of food to increase exposure and the development of supergenerics. Current strategies for overcoming resistance to deprivation and chemotherapy include combination therapy using agents with different mechanisms of pharmacological activity, metronomic administration, and the development of new modified antitumor agents that combine a cytotoxic and antiandrogenic component in a single molecule. Pharmacologically active compounds, such as abiraterone, have been developed using organotin compounds, offering dual (multimodal) action and actively inducing apoptosis and inhibiting proliferation in the G2/M phase of the cell cycle (in vitro studies). Conclusion. The combination of these approaches has the potential to be used for personalized treatment of hormonally active malignant tumors in various locations (prostate, breast, etc.).
Background . Immune system is made up of different organs, cells and proteins. a healthy immune system can defeat invading disease-causing germs (or pathogens), such as bacteria, viruses, parasites as well as cancer cells while protecting healthy tissue. White blood cells are the key players in the hematological immune system. Objective . The aim of this research is to detect the radiation therapy effect on the immune system. Material and Methods. Data of 106 cancer patients have been collected from Department of Radiation Oncology, Jinnah Hospital Lahore, Pakistan since January 2018 to September 2022 and compete blood count of these patients is seen regularly before and after therapy. Results . There were 54.2 % female and 45.7 % male patients in the age range of 29–80 years. The 64 % patients were observed with decrease in platelets count, 71.4 % cancer patients had shown a reduction in hemoglobin level and 68.5 % of patients indicated a decline in TLC after the radiation therapy. Conclusion . Conclusions have been drawn from analyzing the data in this research work. Radiation therapy affects the immune system of the patients. Majority of patients have low White Blood Cells Counts after the treatment and also showed low Hemoglobin and Platelets Count.
Background. Pathological complete response (pCR, ypT0N0) after neoadjuvant therapy is regarded as an exceptionally favorable prognostic factor in locally advanced gastric and esophagogastric junction cancer. The incidence of disease progression in this subgroup and the factors that might predict it remain insufficiently studied, and no data are available for the Russian population. Aim: to assess the incidence of disease progression in patients with locally advanced gastric cancer, who achieved pCR after neoadjuvant therapy and to describe the clinical and morphological features of those in whom it occurred. Material and Methods. In a national multicenter retrospective cohort of 195 patients with pCR, who met the inclusion criteria and had adequate follow-up, disease progression was recorded in 11 (5.6 %). The clinical and morphological characteristics of patients with progression were compared with those of sex- and age-matched patients without progression (1:3). Descriptive statistics, Fisher exact test and the Mann–Whitney u test were used. Results. The median time from the start of treatment to progression was 22 months (range 12–48); progression was predominantly systemic (distant metastases 63.6 %, peritoneal carcinomatosis 45.5 %). Across the whole pCR cohort, cancer-specific survival was ~95.5 % at 2 years and ~94.7 % at 3 years. patients with progression somewhat more often had features of a more aggressive tumor course (cT4, a non-intestinal – diffuse or mixed – Lauren type), as well as postoperative complications grade III+, but none of these differences retained significance after correction for multiple comparisons, and none can be regarded as a reliable predictor of progression. Conclusion. Achievement of pCR is associated with an extremely low rate of disease progression and high cancer-specific survival. No reliable predictors of progression have been identified to date. The very small number of progression events does not allow a subgroup requiring adjuvant therapy to be defined and does not justify the routine use of adjuvant therapy (in particular, continued FLOT) in patients who have achieved a complete response.
Aim: to evaluate the efficacy of combined neoadjuvant photodynamic therapy with chlorin e6 and proton therapy for uveal melanoma using ultrasound parameters of intratumor blood flow, densitometric, and morphometric indicators. Material and Methods. A retrospective study included 40 patients (40 eyes) with T2–T4 uveal melanoma. All patients were divided into two groups. Group I (n=19) received proton therapy using pencil beam scanning at a total dose of 49 Gy in 7 fractions. Group II (n=21) received photodynamic therapy with chlorin e6 followed by proton therapy. All patients underwent complex ultrasound examination with color doppler imaging and echodensitometry before treatment and during follow-up. Results. Neoadjuvant photodynamic therapy resulted in earlier and more complete tumor devascularization, showing a much higher number of avascular tumors by the 6th month in group II patients (χ2=12.093; p=0.002). Both groups showed gradual tumor regression and decreased acoustic density, but no statistically significant differences in these parameters between the groups were found. During the first 6 months after treatment, combined treatment resulted in a faster drop in tissue acoustic density measured by echodensitometry than proton therapy alone. Conclusion. Neoadjuvant photodynamic therapy combined with proton therapy produces a pronounced vasculo-occlusive effect that peaks by the 6th month. complex ultrasound examination with color doppler imaging and echodensitometry is an objective tool for assessing tumor regression during organ-preserving treatment.
Smoking not only leads to the development of cancer but also worsens the prognosis of cancer patients. Objective: to study the impact of smoking cessation on the prognosis of patients diagnosed with non-small cell lung cancer (NSCLC) and clear cell renal cell carcinoma (ccRCC), and to compare these results with the efficacy of FDA-approved immune checkpoint inhibitors (ICIs). Material and Methods : a) a cohort of 1.240 patients diagnosed with NSCLC (stages I-IIIA) and 1.025 patients diagnosed with (ccRCC), b) published results of randomized clinical trials (RCTS) examining the efficacy of ICIs. Results . in patients with NSCLC (stages I-IIIa) who quit smoking, the median progression free survival (mPFS) was 21.6 months greater than that in the patients who continued smoking. mPFS achieved in patients who were treated with adjuvant nivolumab (10.8 months) and neoadjuvant pembrolizumab (16.6 months) were inferior of the results of smoking cessation. The 30 % reduction in the risk of progression hazard ratio (HR=0.70) due to smoking cessation was comparable to the 37 % reduction in the risk of progression associated with nivolumab plus chemotherapy and the 24 % reduction associated with neoadjuvant pembrolizumab. in patients with ccRCC who quit smoking 36-month benefit in mPFS in comparison with continuation of smoking, exceed all relevant results from the presented RCTs. a 49 % (HR=51) and 55 % (HR=45) reduction in the risk of overall survival (OS) and progression in ccRCC patients who quit smoking exceed the corresponding results in RCTs: risk reductions due to use of pembrolizumab (HR=0.68), nivolumab plus ipilumab (HR=0.63), and lenvantinib plus pembrolizumab (HR=0.79). The effectiveness of smoking cessation is universal and, unlike ICIs, is not limited to any clinical groups. the absence of adverse side effects also supports smoking cessation.
