Обзоры. Рубрика в журнале - Сибирский онкологический журнал
A study to identify novel biomarkers associated with multiple myeloma
Статья научная
Background. Multiple Myeloma (MM) is a plasma cell cancer that affects white blood cells. Plasma cells from the bone marrow grow abnormally, as a consequence of which patients have high amounts of monoclonal immunoglobulin in their blood and urine, poor renal function, and recurring infections due to this condition. Osteolytic bone lesions and immunodeficiency also impact multiple myeloma patients’ longevity and quality of life. The disease accounts for 13 % of all hematological malignancies worldwide, making it the second most common blood cancer. Material and Methods. The studies investigating MM biomarkers from 2000 to 2021 are collected from various databases. “Multiple myeloma”, “biomarkers”, “genetic markers”, “prognostic markers”, “Epidemiology of multiple myeloma”, and “risk factors for multiple myeloma” are the key phrases utilized to gather the articles.
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A systematic review on the association between ovarian and prostate cancer with BRCA1 and BRCA2 gene
Статья научная
Background. BRCA1 and BRCA2 were discussed as the basis of inherited adenocarcinoma and breast and ovarian malignancy. Ovarian cancer is uncommon in women below 40 years of age, and prostate cancer mainly occurs in older men cause 90 % in those above sixty-five. Objective. The main objective of this paper is to investigate the relationship between ovarian and prostate cancer with the BRCA1 and BRCA2 genes. Material and Methods. The ovarian and prostate cancer mechanism is discussed in detail, and their preventive measures with screening techniques are also demonstrated. This systematic review collected the related articles from online databases using the key terms ovarian cancer, prostate cancer, BRCA genes, mutation, polymorphism, carcinoma, sarcoma, and genetic association. Results. Based on the obtained information, it is found that the BRCA genes are highly associated with prostate cancer in men, and in women, it is significantly linked with breast cancer than ovarian cancer. Conclusion. Therefore, early diagnosis and genetic testing for BRCA1&BRCA2 genes in both men and women are necessary. in some cases, these genes might even cause different types of cancer like pancreatic cancers. identifying individuals with tumour-HRD through mutations in the homologous repair pathway and determining this gene expression is essential to improve treatment techniques developed during the previous decade and rapidly make their way into clinical trials practice. However, the safe introduction of these medicines into everyday practice will require a thorough understanding of treatment targets and associated adverse effects.
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Abscopal effect of radiotherapy and hyperthermia: role of exosomes
Статья обзорная
The review presents data on the role of ionizing radiation/hyperthermia as modulating factors in exosome secretion/composition. Tumor-derived exosomes are important participants in the formation of the tumor microenvironment. They modulate the inflammatory response in the tumor, influence the capability of fibroblasts and mesenchymal cells to differentiate into myofibroblasts, trigger the angiogenic process, promote epithelial to mesenchymal transformation of tumor cells and form the pre-metastatic nisches. The review describes the mechanisms of behavior of the recipient tumor cells receiving exosomes from irradiated cells, including activation of Akt signaling, stabilization of MMP9/MMP2, and enhancement of exosome-mediated motility. In vitro models demonstrate the efficacy of exosomes from mesenchymal stem cells (MSC) to modulate both direct and abscopal effects of radiation therapy/hyperthermia. Exosomes derived from MSC are the most attractive carriers for the delivery of proteins, miRNAs, drugs, and metals to the recipient tumor cells. MSC-derived exosomes potentiate the efficacy of both radiotherapy and hyperthermia in vitro studies. However, some important aspects regarding a) the most effective options for administering MSC/MSC exosomes to modulate radiotherapy/hyperthermia; b) radiation dose; c) options of hyperthermia; d) detailed mechanisms of the effect of irradiated MSC-derived exosomes on the tumor microenvironment and cancer cells, still remain poorly understood.
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Artificial intelligence in colorectal cancer: a review
Статья научная
The study objective: the study objective is to examine the use of artificial intelligence (AI) in the diagnosis, treatment, and prognosis of Colorectal Cancer (CRC) and discuss the future potential of AI in CRC. Material and Methods. The Web of Science, Scopus, PubMed, Medline, and eLIBRARY databases were used to search for the publications. A study on the application of Artificial Intelligence (AI) to the diagnosis, treatment, and prognosis of Colorectal Cancer (CRC) was discovered in more than 100 sources. In the review, data from 83 articles were incorporated. Results. The review article explores the use of artificial intelligence (AI) in medicine, specifically focusing on its applications in colorectal cancer (CRC). It discusses the stages of AI development for CRC, including molecular understanding, image-based diagnosis, drug design, and individualized treatment. The benefits of AI in medical image analysis are highlighted, improving diagnosis accuracy and inspection quality. Challenges in AI development are addressed, such as data standardization and the interpretability of machine learning algorithms. The potential of AI in treatment decision support, precision medicine, and prognosis prediction is discussed, emphasizing the role of AI in selecting optimal treatments and improving surgical precision. Ethical and regulatory considerations in integrating AI are mentioned, including patient trust, data security, and liability in AI-assisted surgeries. The review emphasizes the importance of an AI standard system, dataset standardization, and integrating clinical knowledge into AI algorithms. Overall, the article provides an overview of the current research on AI in CRC diagnosis, treatment, and prognosis, discussing its benefits, challenges, and future prospects in improving medical outcomes.
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Статья обзорная
Тамоксифен является препаратом выбора при эндокринотерапии гормоноположительного рака молочной железы у женщин в репродуктивном периоде. Метаболическая активность тамоксифена в организме определяется активностью фермента CYP2D6, кодируемого одноименным геном: под действием фермента тамоксифен переходит в метаболически активную форму - эндоксифен. Фармакогенетическое тестирование гена CYP2D6 у пациентов с гормоноположительным раком молочной железы поможет прогнозировать эффективность терапии и оценить риск развития побочных эффектов в целях улучшения отдаленных результатов лечения.
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Chemoradiation therapy for localized colorectal cancer: a view from the outside
Статья научная
Background. Colorectal cancer is among the most lethal and prevalent malignances in the world. The management of localized colorectal cancer is highly debated. Surgical resection of the rectum, such as total mesenteric excision (TME) is usually associated with significant morbidity and mortality. The integration of various chemotherapy options into the standard treatment of localized rectal cancer could potentially enhance the tumor control with a subsequent reduction in the frequency of recurrence, thus improving overall and disease-free survival. Moreover, there are categories of patients for whom surgical treatment is contraindicated and chemotherapy will be more useful for them. Although rectal cancer is predominantly a disease of older patients, current guidelines do not incorporate optimal treatment recommendations for elderly patients with comorbidities; therefore this issue remains a matter of debate. Aim. We aimed to consider alternative approaches to the treatment of localized rectal cancer and the management of selected patients with this diagnosis. Material and Methods. We searched for publications in the Pubmed, eLibrary databases and up-to-date information on the basis of world cancer associations. Conclusions. Comparison of surgery with concurrent chemoradiotherapy for localized rectal cancer showed that in some cases neoadjuvant therapy can be useful and successful, acting as an ideal alternative. However, this approach may be suitable for selected patients who meet certain criteria. In addition, a follow-up care after treatment should include a specific range of diagnostic imaging tests.
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Chitinase-like proteins as promising markers in cancer patients
Статья обзорная
In the present review we collected the main studies regarding the role of chitinase-like proteins (CLPs), belonging to the family of Glyco_18 domain-containing proteins, in different cancers. In humans, 3 chitinaselike proteins have been identified: YKL-40 (CHI3L1), YKL-39 (CHI3L2) and stabilin-1-interacting chitinase-like protein (SI-CLP). CLPs are produced by several types of cells and combine the properties of cytokines and growth factors. The high levels of CLPs were identified in the circulation of the patients with inflammatory diseases and various types of tumors. We highlighted the main known functions of CLPs in normal and pathological conditions, their contribution to metastasis development, angiogenesis, invasion and other processes in cancer, the correlation of the levels of CLPs with tumour progression. Our data also contribute to the understanding of question how CLP could be useful for cancer patient benefit.
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Clostridium difficile ассоциированная диарея
Статья научная
В обзоре литературы по антибиотикоассоциированной диарее показана значимость C. difficile и вырабатываемых ею токсинов А и В. Рассмотрены вопросы, касающиеся эпидемиологии, клинической симптоматики, возможных осложнений этого заболевания, диагностики, а также рациональные подходы к терапии. Антибиотикоассоциированная диарея является серьезным заболеванием и требует тщательных и взвешенных подходов к назначению лечения. Опасность внутрибольничных вспышек этого заболевания с учетом старения населения и массивного использования антибактериальных препаратов в России и других странах делает эту проблему более актуальной.
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Статья обзорная
Introduction. Colon and rectal cancer (CC, RC) are different entities from a clinical and tumor biological point of view. Up to now, both, CC and RC, are synonymously called “Colorectal Cancer” (CRC). With our experience in basic and clinical research and routine work in this field we now have come to the opinion, that the term “CRC” should definitely be questioned, and if justified, be abandoned. materials/methods. We analyzed the actual available data from the literature and our own results from the Ulm based study group FOgT to proof or reject our hypothesis. results. The following evident differences were recognized: Anatomically, the risk to develop RC is 4× higher than for CC. Molecular changes in carcinogenesis in CC are different from RC. Physical activity helps to prevent CC, not RC. Pathologically there are differences between RC and CC. In addition, there are also major clinical differences between CC and RC, such as in surgical topography and- procedures, multimodal treatment (MMT) approaches (RC in MMT is less sensitive to chemotherapy than CC), and prognostic factors for the spontaneous course and for success of MMT (e.g. TS or DPD). discussion. CC´sand RC´s definitely are different in parameters of causal and formal carcinogenesis, effectivity of primary prevention by physical activity, conventional and molecular pathology.According to our findings we can demand from the preclinical point of view that CC and RC are two different tumor entities in terms of various representative biological characteristics.CC and RC are also differing substantially in many clinical features, as outlined in a separate paper from our group. Conclusion. “CRC” should no longer be used in basic and clinical research and other fields of cancer classification as a single disease entity. CC is not the same as RC. CC might even be divided into right and left CC.
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Menopausal syndrome and its correction for oncogynecological patients
Статья научная
The review presents the problem of climacteric syndrome in reproductive-aged oncogynecological patients after antitumor treatment. A subject about correction of climacteric syndrome using substitutive hormonotherapy and non-hormonal methods (phytotherapy, phytohormones, homeopathy, vitamintherapy, behavior therapy and physical factors) was opened.
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Nivolumab monotherapy in metastatic colorectal cancer: current approaches to response evaluation
Статья научная
Aim of the study: a systematic analysis of the modern literature data on the nivolumab monotherapy efficacy in patients with metastatic colorectal cancer (mCRC). Material and Methods. The review summarizes the results of clinical studies of the nivolumab efficacy in patients with mCRC between 2012 and 2022. The current approaches to assessing the tumor response in patients treated with immune checkpoint inhibitors are considered, including response patterns and criteria. Results. Data analysis showed that the use of nivolumab in mCRC patients had significant clinical benefits. Nivolumab monotherapy was shown to improve survival in patients with high microsatellite instability (MSi) or deficiencies in mismatch repair (dMMR) that progressed during standard chemotherapy. Numerous clinical studies indicate the atypical response to nivolumab. Traditional response criteria, such as RECiST do not always adequately assess the therapeutic efficacy of nivolumab in patients with mCRC. conclusion. To improve the efficacy of mCRC treatment, standardized approaches based on the proposed specific criteria for response to immunotherapy, including immune related RECiST, immune RECiST, and immune-modified RECiST must be developed.
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Predicting the site of distant metastases in breast cancer
Статья научная
Background. Distant organ tumor dissemination is a major cause of breast cancer-related deaths. Breast cancer can metastasize to several organs, and the most frequent metastatic sites include the bones, lungs and liver. There is a question what factors can influence the direction of spread of tumor cells to a particular organ. Material and Methods. We summarized the data available in the world literature on methods for prediction of the localization of distant metastases in breast cancer patients. Results. We divided the factors associated with the localization of distant metastases into two main groups: clinicopathological parameters of breast cancer patients and molecular features of tumor microenvironment and tumor cells (primary tumor and circulating tumor cells) or its derivates - exosomes. From our point of view, the most powerful clinicopathological factor predicting the distant metastasis site is a molecular subtype of primary tumor. We can conclude that luminal (HR+/HER2-) tumors are often characterized by single metastases and bones are the most common metastatic site, while TNBC and HER2-enriched tumors often metastasize to multiple sites, most commonly brain and liver. However, several authors did not reveal these associations in their studies. It likely indicates the existence of other factors that significantly affect the organotropism of metastasis. Numerous studies demonstrate the association of different molecules expressed on tumor cells with organotropic metastasis. However, these data are very fragmentary and rather contradictory. Conclusion. The found associations are common to all participants of metastatic cascade, but remains unclear which factors are essential and crucial in determining the direction of metastasis.
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Статья научная
The purpose of the study was to generalize information regarding the molecular and biological mechanisms involved in the resistance to endocrine therapy with aromatase inhibitors in patients with luminal breast cancer. material and methods. the literature search was conducted using medline, cochrane library, elibrary and pubmed databases. results. the review highlights the results of international studies on molecular and biological characteristics of breast tumors and their relationship with the effectiveness of hormone therapy. particular attention was paid to the description of modern studies on RoR1 and Bmi-1 proteins and their contribution to the development of tumor resistance to treatment. conclusion. the analysis of the world literature confirms the relevance of studying the molecular and genetic characteristics of tumor tissue in patients with luminal breast cancer. the data obtained were compared to the clinical course and response to hormone therapy in order to standardize them for implementation in everyday practice as the “gold standard of diagnosis”.
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The role of liquid biopsy in the diagnosis of glioblastoma progression
Статья научная
Purpose: to summarize available data on the diagnostic value of various circulating biomarkers for the detection of glioblastoma recurrence. material and methods. a literature search was conducted using pubmed exocarta and silVa databases. results. glioblastoma multiforme (gBm) is the most common glioma in adults with an unfavorable prognosis. treatment of tumor recurrence can improve the survival of patients. Neuroimaging is the standard method of diagnosing brain tumor recurrence. However, a neuroimaging method to clearly distinguish between pseudo progression and tumor progression has not been found to date. current molecular tumor profiling relies heavily on tissue resection or biopsy. tissue profiling has several disadvantages in the central nervous system’s tumors, including the challenge associated with invasive biopsy, the heterogeneous nature of many malignancies where a small biopsy can under represent the mutational profile. liquid biopsy is a promising method in diagnosing malignant tumors. Blood collection is a simple, minimally invasive procedure, but cerebrospinal fluid allows tumor markers to be detected more confidently. However, collection of cerebrospinal fluid is a complex and invasive procedure that can be accompanied by serious complications. conclusion. Biological fluid markers such as circulating tumor cells, extracellular vesicles, cell-free dNa and cell-free RNa allow for the detection of gmB, determination of molecular genetic features of cancer during response to therapy, and early detection of gBm recurrence.
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Treatment of cervical esophageal carcinoma: systematic review and meta-analysis
Статья научная
Objectives. Up to date managing a cervical esophageal carcinoma (CEC) has remained a controversial challenge. The choice of treatment is still uncertain. In the present review we attempted to assess eligibility of surgery in treatment of CEC. Material and Methods. We have enquired particular publication databases and the enquiries yielded 24 contributions matching study selection criteria such as (1) original articles published from 2000 to 2022, (2) primary tumor localization in the cervical esophagus, (3) squamous cell carcinoma,(4) available characteristics of studied groups (age, sex, T, N, M, stage), (5) detailed description of curative procedures (radiation therapy, chemotherapy, surgery), (6) information about overall survival. These publications represented two arms of 14 surgical and 17 non-surgical subgroups to analyze. Individual patient data and parameter estimates have been renewed on the basis of original Kaplan-Meier curves plotted. Results. The analysis revealed a highly heterogeneous (I2=83.76 %; 95 % CI, 71.40-92.16) random effects model. Including a surgical option into treatment of CEC did not affect 3-year overall survival (р=0.665); 46.4 % (95% CI, 37.4-55.6) vs 43.7 % (95 % CI, 35.3-51.6), respectively. Possibilities of surgical and non-surgical modalities employment were discussed. Conclusion. In treatment of CEC CRT and surgery are non-inferior to each other. These modalities are evenly associated with posterior side effects and complications, which adversely affect functional outcomes and survival. The choice of a treatment mode may depend on tumor response to induction therapy. The latter demands further investigations.
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Алопеция в онкологии: практическое значение фундаментальных исследований
Статья научная
Цель исследования - отразить современное представление о частоте, молекулярных механизмах, средствах преодоления алопеции у онкологических пациентов с учетом последних фундаментальных данных о физиологии волосяного фолликула и профиле токсичности противоопухолевых средств. Материал и методы. Проведен поиск доступных литературных источников, опубликованных в базах данных Medline, Pubmed и др. Найдено более 200 работ, посвященных изучению алопеции, из которых 42 были включены в данный обзор. Результаты. Облысение является одним из наиболее частых токсических эффектов лекарственного лечения больных злокачественными новообразованиями. Частота и молекулярный механизм развития алопеции связаны с фармакологическими особенностями схемы лечения, исходным нутритивным и преморбидным фоном пациента, а также предрасполагающими генетическими полиморфизмами, участвующими в лекарственном превращении и выведении. Очаговое или диффузное облысение может явиться и первым признаком злокачественного роста в рамках паранеопластического синдрома, первичного или метастатического поражения кожи волосистой части головы или быть проявлением нутритивной недостаточности. Облысение негативно сказывается на психо-эмоциональном состоянии пациентов, усугубляя депрессивные расстройства, тревожность, снижая самооценку и приверженность лечению. Профилактика или быстрое преодоление алопеции могут существенно повысить качество жизни пациентов. Наибольшую доказательную базу по профилактической эффективности в настоящее время имеет охлаждение кожи головы с помощью электронных охлаждающих шапочек. Заключение. Необходимо продолжать фундаментальные и прикладные исследования по изучению средств профилактики и лечения алопеции у онкологических пациентов.
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Статья научная
Цель исследования - анализ возможных маркеров эффективного противоопухолевого клеточного иммунного ответа. Материал и методы. С помощью ключевых слов: ингибиторы контрольных точек, иммунотерапия, Т-лимфоциты, истощенные Т-лимфоциты, противоопухолевый иммунный ответ - были отобраны обзорные и оригинальные статьи (n=34), опубликованные с 2005 по 2020 г. в международных базах данных PubMed, Web of Science, Elsevier. Результаты. Исследование выявило потенциальные маркеры, отражающие высокую активность адаптивного иммунного ответа, основанного на эффективном распознавании антигенов опухоли через молекулы главного комплекса гистосовместимости (MHC), достаточном количестве Т-лимфоцитов и преобладании Т-цитотоксических клеток, а также на низком уровне экспрессии ингибиторных рецепторов и малых молекул. Свою предиктивную значимость показали наличие полиморфизмов единичных нуклеотидов в генах HLA-I и HLA-II, кодирующих белки MHC-I и MHC-II соответственно, высокий уровень лимфоцитов, среди которых наиболее важно преобладание CD8+ Т-клеток и низкий уровень Т-регуляторных клеток (Т-рег), а также наличие полиморфизмов единичных нуклеотидов в генах, кодирующих FcγR рецепторы Т-лимфоцитов. Также была выявлена диагностическая значимость определения экспрессии ингибиторных рецепторов Т-лимфоцитов - TIM3, LAG3, TIGIT, особенно в комплексе с определением уровня экспрессии PD1. Заключение. Полученные результаты могут быть актуальны для внедрения новых методов оценки функциональной активности Т-клеточного иммунного ответа перед назначением ИКТ, а также для разработки новых диагностических панелей, что может представлять интерес для сотрудников клинико-диагностических лабораторий и исследовательских центров.
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Анализ заболеваемости и смертности от рака почки в России и Санкт-Петербурге
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Представлены данные по заболеваемости и смертности от рака почки (РП) в России и г. Санкт-Петербурге, освещены проблемы диагностики, вопросы подбора оптимальных методов лечения в зависимости от стадии заболевания и возраста пациента. Анализ данных проводился ретроспективно за последние 10 лет. Отмечается стойкий рост заболеваемости РП, который обусловлен активным внедрением методов лучевой диагностики и увеличением продолжительности жизни населения. Таким образом, в России следует ожидать продолжение быстрого прироста заболеваемости раком почки за счет ряда регионов, где только начинается активное внедрение малоинвазивных методов диагностики этого заболевания, а также увеличение доли ранних форм, что делает чрезвычайно актуальным совершенствование органосохраняющего лечения. Морфологическое подтверждение должно обязательно выполняться как у больных с метастатическим процессом, так и у больных с планирующимися аблативными методами лечения и наблюдением.
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