Role of Post-Neoadjuvant therapy with trastuzumab emtansine in HER2-positive breast cancer

The widespread introduction of anti-HER2 agents has changed the natural course of Her2-positive breast cancer. The use of trastuzumab, and later dual anti-HER2 blockade with pertuzumab, in neoadjuvant regimens significantly increased the chances of complete cure. However, among patients with early and locally advanced forms of Her2-positive cancer, there is a cohort with an extremely unfavorable prognosis – tumors that have not achieved complete pathomorphological regression after neoadjuvant chemotherapy.The presence of a residual tumor in Her2-positive breast cancer has long been only a prognostically unfavorable factor without the potential to influence disease outcome. The results of the international phase III study KATHERINE, which demonstrated the high efficacy of post-adjuvant therapy with trastuzumab emtansine (T-DM1) in this patient cohort, have established a new standard of care. Due to T-DM1 adjuvant therapy, the possibility to significantly improve long-term results determined the predictive characteristics of the morphological response to the choice of treatment tactics, which became an important argument in favor of neoadjuvant therapy in patients with not only locally advanced but also primarily resectable Her2-positive breast cancer, followed by personalization of therapy.This article presents our own experience with post-neoadjuvant therapy with trastuzumab emtansine in a young patient with a residual tumor. The data of the main studies in early Her2-positive breast cancer are summarized

THE ADVANTAGES OF SENTINEL LYMPH NODE BIOPSY OVER FUNCTIONAL NECK DISSECTION (A REVIEW OF LITERATURE)

The paper analyzes the data available in the literature on sentinel lymph node biopsy in patients with oral cancer and shows its advantages over prophylactic neck dissection: less pronounced functional and cosmetic consequences, the possibility of a detailed pathomorphological analysis of removed neck lymph nodes macrospecimens with immunohistochemical studies

Properties of Neutral Charmed Mesons in Proton--Nucleus Interactions at 70 GeV

The results of treatment of data obtained in the SERP-E-184experiment "Investigation of mechanisms of the production of charmed particles in proton-nucleus interactions at 70 GeV and their decays" by irradiating the active target of the SVD-2 facility consisting of carbon, silicon, and lead plates, are presented. After separating a signal from the two-particle decay of neutral charmed mesons and estimating the cross section for charm production at a threshold energy {\sigma}(c\v{c})=7.1 \pm 2.4(stat.) \pm 1.4(syst.) \mub/nucleon, some properties of D mesons are investigated. These include the dependence of the cross section on the target mass number (its A dependence); the behavior of the differential cross sections d{\sigma}/dpt2 and d{\sigma}/dxF; and the dependence of the parameter {\alpha} on the kinematical variables xF, pt2, and plab. The experimental results in question are compared with predictions obtained on the basis of the FRITIOF7.02 code.Comment: 9 pages, 9 figures,3 table

НЕЙРОЭНДОКРИННЫЙ РАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ (ОПИСАНИЕ КЛИНИЧЕСКОГО СЛУЧАЯ)

Neuroendocrine carcinoma of the prostate belongs to the so-called small-cell neuroendocrine carcinomas and amounts to 1–2 % of all prostate malignancies. With allowance made for the low incidence of this pathology, the paper describes a case of high-grade neuroendocrine (small-cell) prostate cancer with an aggressive course.Нейроэндокринный рак предстательной железы (РПЖ) относится к так называемым мелкоклеточным нейроэндокринным формам рака и составляет 1–2 % всех злокачественных опухолей предстательной железы. С учетом низкой встречаемости этой патологии приводится описание низкодифференцированного нейроэндокринного (мелкоклеточного) РПЖ с крайне агрессивным течением

Achievement of complete morphological regression in the use of trastuzumab in patients with inoperable locally advanced Her-2+ breast cancer

Objective: to evaluate the efficiency (morphological tumor complete regression (mCR), a clinical effect) and safety of the use of new anthracycline-free neoajuvant chemotherapy regimens (paclitaxel + vinorelbine and docetaxel + carboplatin) in combination with trastuzumab in patients with Stage IIIa-c breast cancer (BC) and Her-2 hyperexpression.Subjects and methods. The study enrolled 36 Stage IIIa–c BC patients receiving 4–8 cycles of a chemotherapy regimen of paclitaxel (100 mg/m2) + vinorelbine (25 mg/m2) (every 3 weeks) or docetaxel (50 mg/m2) + carboplatin (AUC 5) (every 3 weeks) in combination with trastuzumab.Results. The docetaxel (75 mg/m2) + carboplatin (AUC 5) + trastuzumab regimen demonstrated a high effectiveness with acceptable toxicity. Seventeen (58.8 %) patients achieved mCP. The clinical effect was 83.3 % (4 complete and 11 partial tumor regressions).The paclitaxel (135 mg/m2) + vinorelbine (25 mg/m2) (every 3 weeks) + trastuzumab regimen is efficacious and promising when the doses of the drugs are increased and granulocyte colony-stimulating factor used

Choice of a way to verify space-occupying lesions of the breast at a preoperative stage

Preoperative verification of breast cancer (BC) is a necessary stage of diagnosis. The main method for obtaining materials is fine-needle aspiration biopsy that is of low informative value in a number of cases. Histological biopsy of nonpalpable breast masses extends the verification capabilities of accurate diagnosis and determines the choice and tactics of combination and complex treatments in patients with BC just at a preoperative stage, and, in case of detection of a benign tumor, enables one to abandon sector resection with an urgent histological study

The clinical value of p53 and the parameters of DNA-flow cytofluorometry in combination with clinical and morphological predictors in breast cancer

The determination of mutant p53 and the basic parameters studied by DNA-flow cytofluorometry in combination with other clinical and morphological predictors may be used as additional prognostic criteria individually in each patient with breast cancer

Therapeutic pathomorphism of malignancies: Clinical and morphological criteria. Classifications. Prognostic value of therapeutic pathomorphism in breast cancer and other tumors

Pathomorphism is one of the most important prognostic factors for breast cancer . The paper gives the notion of pathomorphism an d its types and the most commonly used classifications of tumor pathomorphological changes. It also considers the long-term results of neoadjuvant treatment in relation to pathomorphism