Новые возможности в коррекции микронутриентной недостаточности у больных со злокачественными новообразованиями

The cancer cell metabolism leads to micronutrient deficiency of micronutrient deficiency, especially in patients with advanced disease. Various studies in patients with malignant tumors revealed the deficit of certain amino acids (glycine, arginine, cysteine, asparagine, lysine, methionine), vitamins (C, E, D, group B), and a number of trace elements (zinc, manganese, selenium). However, the problem of micronutrient deficiency, as well as the necessity of its correction in cancer patients are not widely recognized and poorly implemented by oncologists. The clinical studies in patients with terminal stage of hepatocellular carcinoma have shown that the use of food supplements affecting the micronutrient metabolism (e. g. Oncoxin) can improve appetite, quality of life and well-being. Furthermore, the ability to improve the 2 months overall survival in this group of patients by using of Oncoxin was demonstrated. Thus, the rational correction of micronutrient deficiency can have a positive effect on the general condition of patients and treatment results.Метаболизм опухолевых клеток при онкологических заболеваниях является причиной дефицита микронутриентов, особенно при распространенном опухолевом процессе. На сегодняшний день доказано, что у пациентов со злокачественными новообразованиями имеется дефицит отдельных аминокислот (глицин, аргинин, цистеин, аспарагин, лизин, метионин), витаминов (С, Е, D, группы B) и ряда микроэлементов (цинк, марганец, селен). К сожалению, проблеме микронутриентного дефицита и необходимости ее коррекции при онкологических заболеваниях не уделяется должного внимания. В современных исследованиях, в частности, проведенных у больных гепатоцеллюлярной карциномой в терминальной стадии, показано, что использование препаратов, влияющих на микронутриентный метаболизм (например, Онкоксин), позволяет увеличить аппетит, улучшить качество жизни, общее самочувствие и 2-месячную выживаемость. Таким образом, рациональная коррекция определенных микронутриентов может положительно влиять на общее состояние больных, результаты лечения и открывает новые перспективы в коррекции нарушений метаболизма у онкологических больных

Cancer-associated anorexia: Validity and performance overtime of different appetite tools among patients at their first cancer diagnosis

Background & aims: Anorexia is a frequent symptom in cancer and we aimed to assess its prevalence among patients at their first cancer diagnosis by different appetite tools and the relationship between each tool with self-reports of food intake. We also tested whether cancer anorexia influences outcomes independently of reduced food intake or body weight loss (BWL) overtime and whether BWL was associated with complications during anticancer-therapy. Methods: Functional Assessment of Anorexia/Cachexia Therapy (FAACT) score, self-assessment of appetite, Anorexia Questionnaire (AQ) and Visual Analog Scale (VAS) were administered. Percent of food intake was used as a criterion measure of anorexia. We registered BWL and anticancer-therapy complications over 3-month-follow-up. Results: 438 cancer patients from 7 cancer-centers worldwide were included. The prevalence of anorexia was 39.9% by FAACT score, 40.2% by VAS, 40.6% by the self-assessment of appetite and 65.4% by AQ. Low food intake (≤50%) was reported in 28% of patients. All appetite tools correlated with food intake percent (P < 0.0001). We documented a correlation between self-assessment of appetite, FAACT score, VAS and BWL overtime (P < 0.04). The self-assessment of appetite (P = 0.0152) and the FAACT score (P = 0.043) were associated with BWL independently of anticancer therapies. Among patients with BWL, the risk to develop complications was greater with respect to those who maintained a stable or gained body weight (P = 0.03). Conclusions: In our sample of cancer patients, FAACT score and self-assessment of appetite performed well when low food intake was used as a criterion measure, and revealed an association of anorexia with BWL, which was, in turn, related to the development of anticancer-therapy complications

Late onset toxicities associated with the use of CDK 4/6 inhibitors in hormone receptor positive (HR plus ), human epidermal growth factor receptor-2 negative (HER2-) metastatic breast cancer patients : a multidisciplinary, pan-EU position paper regarding their optimal management. The GIOCONDA project

The personalization of therapies in breast cancer has favoured the introduction of new molecular-targeted therapies into clinical practice. Among them, cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitors have acquired increasing importance, with the approval in recent years of palbociclib, ribociclib, and abemaciclib in combination with endocrine therapy. Currently, no guidelines are available to monitor and manage potential long-term toxicities associated with the use of these drugs. A multidisciplinary panel of European oncologists, was supported by a pharmacologist, a hematologist, a hepatologist and a pulmonologist to discuss the management of long-term toxicities, based on the literature review and their clinical experience. The panel provided detailed roadmaps to manage long-term toxicities associated with the use of CDK4/6 inhibitors in clinical practice. Knowing the frequency and characteristics of the toxicity profile associated with each CDK4/6 inhibitor is important in the decision-making process to match the right drug to the right patient

Effectiveness and safety of empegfilgrastim (Extimia®) in patients with solid tumors receiving cytotoxic therapy: final results of the DEFENDOR study

Aim. To evaluate the effectiveness and safety of Extimia® (empegfilgrastim, JSC "BIOCAD") in reducing the frequency, duration of neutropenia, the incidence of febrile neutropenia (FN) and infections caused by FN in patients with solid tumors receiving myelosuppressive therapy. Materials and methods. The paper presents the final results of a multicenter prospective observational post-marketing study of the safety and effectiveness of Extimia® (empegfilgrastim) in patients with solid tumors receiving cytotoxic therapy. For the primary prevention of FN, all patients received empegfilgrastim at 7.5 mg subcutaneously once per course of chemotherapy (CT) 24 hours after the end of CT administration. The primary endpoint included an assessment of the relative dose-intensity (RDI) of the CT courses administered. The endpoints of interest included the assessment of the RDI of CT courses by nosology and CT regimen, the frequency of dose-limiting neutropenia, and the incidence of all adverse events (AEs) in patients who received at least one dose of the study medication, including serious AEs. Results. From February 2021 to December 2022, 3218 patients with various malignancies were included in 41 study centers of the Russian Fede- ration. Of these, 3217 (99.97%) patients received at least one dose of the study drug, and 2663 (82.8%) patients were included in the RDI evaluation population according to the study protocol. The mean age in this group was 56.9 (18–84) years. RDI ≥85% was achieved in 2,415 (90.7%) patients. The mean RDI was 96.2%, with a median of 100%. FN risk factors were present in 1216 (45.7%) patients, with age ≥65 years being the most common risk factor at 761/2663 (28.6%). It should be noted that in patients younger than 65 years, the RDI was 91.5%, and in elderly patients (≥65 years) 88.7%. Dose-limiting neutropenia was reported in 19 (0.7%) patients. There were 74 cases of grade 3–4 AEs (according to CTCAE v.5) in 59 (1.8%) patients. The most common were neutropenia, anemia, and diarrhea in 19 (0.7%), 7 (0.2%), and 6 (0.2%) patients, respectively. Serious AEs were reported in 17 patients (0.5%). Conclusion. Primary prophylaxis of FN with long-acting granulocyte colony-stimulating factor empegfilgrastim effectively maintains RDI in various nosological and therapeutic groups of patients with different CT regimens in real-world clinical practice