Клинико-экономический анализ 1-й и 2-й линий таргетной терапии распространенного почечноклеточного рака

Malignant tumors represent a serious problem for healthcare system. At this time, an annual incidence of cancer rate has increased both in Russia and around the world. Renal cancer has 2 % in the structure of oncological incidence. However, in many countries we can see significant increase in oncological incidence and associated mortality. Renal cell carcinoma (RCC) takes the 2nd place after prostate tumors by the growth rate of these parameters: each year more than 200 thousand people become ill with RCC all over the world. Cytokine therapy with interleukin-2 and/or interferon alpha was the standard treatment of the advanced renal cell carcinoma until 2005. However, method of the target therapy became widespread in the last decade. This method is based on the directional drug effect on tumor cells which increases efficiency and safety of the therapy. The use of targeted therapy drugs led to a significant increase in survival rate in RCC patients. In the present review we observe clinical efficacy of the drugs used in the 1st and 2nd line of RCC treatment as well as pharmacoeconomic aspects of their application.Злокачественные новообразования представляют серьезную проблему для системы здравоохранения. При этом отмечается ежегодный рост заболеваемости раком как в России, так и во всем мире. Рак почки составляет 2 % в структуре онкологической заболеваемости, но во многих странах наблюдается выраженный рост заболеваемости и ассоциированной с ней смертности населения. По темпу прироста этих показателей почечноклеточный рак (ПКР) занимает 2-е место после опухолей предстательной железы – ежегодно в мире ПКР заболевают более 200 тыс. человек. До 2005 г. стандартом лечения распространенного ПКР была цитокиновая терапия с применением препаратов интерлейкина 2 и/или интерферона альфа, однако в последнее десятилетие широкое распространение получил метод таргетной терапии (target – мишень), в основе которого лежит направленное действие лекарственного средства на опухолевые клетки, что повышает эффективность и безопасность терапии. Применение препаратов таргетной терапии позволило добиться значительного увеличения выживаемости пациентов с ПКР. В настоящем обзоре рассмотрены клиническая эффективность препаратов, используемых в 1-й и 2-й линиях терапии ПКР, и фармакоэкономические аспекты их применения

Clinical and economic analysis of the 1st and 2nd target lines

Malignant tumors represent a serious problem for healthcare system. At this time, an annual incidence of cancer rate has increased both in Russia and around the world. Renal cancer has 2 % in the structure of oncological incidence. However, in many countries we can see significant increase in oncological incidence and associated mortality. Renal cell carcinoma (RCC) takes the 2nd place after prostate tumors by the growth rate of these parameters: each year more than 200 thousand people become ill with RCC all over the world. Cytokine therapy with interleukin-2 and/or interferon alpha was the standard treatment of the advanced renal cell carcinoma until 2005. However, method of the target therapy became widespread in the last decade. This method is based on the directional drug effect on tumor cells which increases efficiency and safety of the therapy. The use of targeted therapy drugs led to a significant increase in survival rate in RCC patients. In the present review we observe clinical efficacy of the drugs used in the 1st and 2nd line of RCC treatment as well as pharmacoeconomic aspects of their application

Some numerical studies of exotic shock wave behavior

For shock waves propagating in materials with nonideal equations of state, a variety of nonstandard phenomena can occur. Here, we present numerical studies of two such exotic shock effects: (i) "anomalous" behavior, in the terminology of Zel’dovich and Raizer; and (ii) a search for "acoustic emission instabilities." The motivation is in part the possibility of such phenomena in the implosion of inertial confinement fusion (ICF) pellet materials, whose equations of state are currently far from well known. In shock wave theory, anomalous materials are those whose isentropes have regions of negative curvature (in the plane of pressure versus specific volume) through which the shock adiabatic passes. The existence of such regions is significant because they can interfere with the steepening of compressive pulses into shocks, lead to the formation of rarefactive shock waves, and even cause shocks to "split." A van der Waals fluid with a large heat capacity is one example of a material possessing such anomalous properties. Acoustic emission instability—the second exotic shock mechanism considered—may occur when the slope of the shock adiabatic lies below a critical value. In this phenomenon, perturbations of a two-dimensional planar shock front can render it unstable, and lead to the downstream emission of acoustic waves. In addition to the van der Waals fluid, an equilibrium dissociation model for strong shocks in diatomic hydrogen is shown to fulfill the theoretical criteria for this instability, but its numerical verification has been hard to achieve, suggesting that further study is needed. Both classes of phenomena may be expected to play a role in ICF compression scenarios