The role of nelarabine in the treatment of T-cell acute lymphoblastic leukemia: literature review and own experience

Aim. The analysis of experience of nelarabine use in refractory/relapsed T-cell acute lymphoblastic leukemia (T-ALL) depending on the immunophenotype and the line of therapy. Materials and methods. All the patients with relapsed or refractory T-ALL aged from 0 to 18 years who received treatment with nelarabine as a part of the therapeutic element R6 were included in the study. For all patients a detailed immunological analysis of leukemia cells with discrimination of immunological variants TI, TII, TIII or TIV was performed. Patients administered with nelarabine as a first therapeutic element were referred to the first-line therapy group, other patients were referred to the second-line therapy group. Nelarabine was administered as intravenous infusion at a dose of 650 mg/m2, on days 1-5. Allogeneic hematopoietic stem cells transplantation (allo-HSCT) was considered for all patients. Results. From 2009 to 2017, 54 patients with refractory/relapsed T-ALL were treated with nelarabine. Five-year event-free survival (EFS) and overall survival (OS) was 28% for all patients, cumulative risk of relapse (CIR) was 27%. EFS was significantly higher in nelarabine first-line therapy group in comparison with second-line therapy group (34±8% vs 8±8%, p=0,05). In patients after allo-HSCT EFS, OS and CIR were 51±10%, 50±10% and 39,1±9,5% accordingly. The best results were achieved in patients with TI immunophenotype. No toxicity-related mortality as well as severe neurologic complications or discontinuation of therapy associated with use of nelarabine were reported. Conclusion. The use of nelarabine is an effective strategy for the treatment of relapsed and refractory T-ALL. The best treatment outcomes were obtained in patients with TI immunophenotype and in the first-line therapy group. Optimal dosage regimens can be established during controlled clinical trials

Эпидемиология и естественное течение неметастатического кастрационно-резистентного рака предстательной железы в российской популяции

Aim. 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 were included 200 patients with a documented diagnosis of nmCRPC from 2019 to 2020. Each patient visited twice: start and after 6 months. Of the 200 patients included, 9 were excluded from the analysis presented in this article: 1 patient had no information on inclusi- on criteria, 1 patient did not meet the inclusion criteria, 7 patients did not attend visit 2. Thus, data are presented for 191 patients.Results and conclusion. The median age was 74.3 years (range 55 to 91). 72 % (137/191) had a disability group. The most common comorbidities were hypertension (n = 115) and hypercholesterolemia (n = 56). The median time from the diagnosis of prostate cancer to the development of castration resistance (diagnosis of nmCRPC) was 75 months. Prostate specific antigen (PSA) nadir (0.37 ng/ml on average) was achieved after 15 months of prostate cancer therapy (median time to reach PSA nadir). At the same time, PSA doubling time in most cases (47.6 %; 91/191) was less than 6 months, 18.8 % of persons (36/191) had PSA doubling time for more than 10 months.Цель исследования – изучение клинического и демографического профиля пациентов с неметастатическим кастрационно-резистентным раком предстательной железы (нмКРРПЖ) в России с оценкой времени прогрессирования до стадии M1 и клинических подходов к лечению нмКРРПЖ в условиях повседневной медицинской практики до и после прогрессирования до M1.Материалы и методы. В многоцентровое неинтервенционное эпидемиологическое исследование были включены 200 пациентов с подтвержденным диагнозом нмКРРПЖ в период с 2019 по 2020 г. В рамках исследования проведены 2 визита: в начале и через 6 мес. Из 200 пациентов 9 мужчин были исключены из анализа, представленного в настоящей статье: у 1 пациента отсутствовала информация о критериях включения, 1 пациент не соответствовал критериям включения, 7 пациентов не прошли визит 2. Таким образом, данные представлены для 191 пациента.Результаты и заключение. Средний возраст пациентов – 74,3 (55–91) года. У 72 % (137/191) пациентов имелась группа инвалидности. Наиболее распространенными сопутствующими заболеваниями были гипертензия (n = 115) и гиперхолестеринемия (n = 56). Медиана времени от диагностики рака предстательной железы до развития кастрационной резистентности (постановки диагноза нмКРРПЖ) составила 75 мес. Надир простатического специфичес кого антигена (ПСА) (в среднем 0,37 нг/мл) достигался через 15 мес терапии рака предстательной железы (медиана времени достижения надира ПСА). Время удвоения ПСА в большинстве случаев (47,6 %; 91/191) было менее 6 мес, у 18,8 % (36/191) пациентов зарегистрировано время удвоения ПСА более 10 мес

Weekly topotecan regimen in the treatment of recurrent ovarian cancer: search for alternatives to upholding the quality of life

The main goals of the study were to evaluate the efficacy and safety of intravenous topotecan (Hycamtin) used in a dose of 4 mg/m2 on days 1, 8, and 15 of a 28-day course of therapy in patients with recurrent ovarian cancer. The study revealed a number of benefits from use of topotecan in patients with this diagnosis