Complete Regression Of Metastases Research Articles

Results of comprehensive treatment of locally advanced oral cancer using regional intra-arterial chemotherapy

Introduction. Head and neck cancers are a significant healthcare and social problem worldwide with an estimated 377,713 new cases and 177,757 deaths registered annually. The incidence of head and neck cancer in Russia is 4.12 per 100,000. Despite all the achievements of current oncology, approximately 50–60 % of patients with locally advanced head and neck cancer develop relapses within the first 2 years after treatment completion.The study objective is to analyze the effectiveness of regional intra-arterial polychemotherapy in the combined and comprehensive treatment of locally advanced oral cancer.Materials and methods. This prospective study included 29 patients with oral squamous cell carcinoma treated and followed-up at N.N. Blokhin National Cancer Research Center between 2017 and 2020. The majority of patients (82.8 %) had stage III–IV disease. We evaluated clinical response to neoadjuvant regional intra-arterial chemotherapy, pathomorphosis of the primary tumor after surgery, treatment toxicity, overall survival, and relapse-free survival.Results. The objective response rate assessed for the primary oral tumor after regional intra-arterial chemotherapy was 100 %; complete regression of the primary tumor was achieved in 82.8 % of patients. More than one-third of participants (35.5 %) had complete regression of metastases in regional lymph nodes. In 73.5 % of patients who had under gone neoadjuvant regional intra-arterial chemotherapy followed by surgery, we observed grade IV therapeutic pathomorphosis of the primary tumor. The 2-year relapse-free survival rate was 100 % in individuals with stage II–III disease and 92.9 ± 6.9 % in patients with stage IV disease.Conclusion. The administration of regional intra-arterial chemotherapy as an induction stage ensures high treatment efficacy and high rate of complete pathomorphological responses. This suggests the opportunity of conservative treatment for patients with locally advanced oral cancer, which is currently considered impossible for such patients. Moreover, this method demonstrated moderate systemic toxicity, which expands the indications for its use and increase treatment compliance.

Tall-cell variant of papillary thyroid carcinoma: literature review and case reports

The tall-cell variant of papillary thyroid carcinoma is a rare malignancy characterized by an aggressive course, low relapse-free survival, early metastasis, and frequent development of radioiodine refractoriness. We report two cases of tall-cell papillary thyroid carcinoma in patients who had disease progression after combination treatment and started to receive lenvatinib. We observed partial and complete regression of metastases in response to lenvatinib. Our findings are consistent with the results of other studies assessing treatment efficacy for disseminated tall-cell papillary thyroid carcinoma.

399P - Melanoma with brain metastases: Experience of immunotherapy in a single center

Background: The effectiveness of conventional chemotherapy (temozolomide, fotemustine, lomustine) alone and its combinations with radiation therapy in patients with melanoma with cerebral metastases does not exceed 7-10%, There is no significant impact on overall survival, which is 2-4 month. Research of immunotherapy (nivolumab, ipilimumab, pembrolizumab) is relevant in melanoma patients with brain metastases in the absence of mutations of the BRAF, or in the case of the progression of the disease while therapy BRAF inhibitors in patients with mutations of the BRAF. Methods: The effect of the various schemes immunotherapy was evaluated in 22 patients with melanoma with brain metastases in Russian N.N. Blokhin Cancer Research Center. Patients received the following treatment options: nivolumab (6 patients), ipilimumab (11 patients), nivolumab + ipilimumab (2 patients), pembrolizumab (3 patients). The immunotherapy was combined with whole brain irradiation in 1 patient (4,5%), in 11 patients (50,0%) – in combination with stereotactic radiotherapy/radiosurgery. Results: Complete regression of brain metastases was achieved in 3 patients (13,6%), partial regression in 2 (9,1%), stabilization in 11 (50,0%). Thus, the tumor control in the brain was observed in 16 patients (72,7%). In 22 patients (100,0%) were also established metastases in other sites (extracranial lesions). Complete regression of metastases in extracranial lesions was achieved in 4 patients (18,2%), partial regression – in 2 (9,1%), stabilization in 13 (59,1%). The median time to disease progression was 5,0 months. The median survival of patients was 10,0 months. Conclusions: The preliminary results of our study show that the application of immunotherapy, including the combination with local control of metastases in the brain in patients with melanoma with brain metastases provides control over the disease in most patients and has a significant advantage with a group of historical control (chemotherapy ± whole brain irradiation). Legal entity responsible for the study: Russian N.N. Blokhin Cancer Research Center. Funding: Russian N.N. Blokhin Cancer Research Center. Disclosure: All authors have declared no conflicts of interest.

DRUG THERAPY OF BREAST CANCER PATIENTS WITH METASTATIC BRAIN LESIONS.

The Blokhin RCRC the effectiveness of various schemes of drug therapy in breast cancer patients with brain metastases was evaluated. When using the schemes with anthracyclines (CAF, AC) among 26 patients objective response in the brain (full and partial regression) was registered in 16 (62%) patients (previously untreated patients). Median survival was 12 months. In the group of patients received monotherapy (30 patients), capecitabine was administered at a dose of 2000 mg/m2/day per os the 1 to 14 days every 3 weeks. Partial effect in the brain was registered in 9 patients (30%). Median survival was 15.1 months. In the combination therapy group (capecitabine + radiotherapy) among 30 patients overall effect in the brain was registered in 4 patients (13%), partial response - 18 (60%). Median survival was 22 months. The effectiveness of chemotherapy scheme gemcitabine and cisplatin in 30 breast cancer patients with metastases in the brain, previously treated with I-III line of chemotherapy and radiation therapy in the area of the brain was evaluated. In 4 cases (13.3%) complete regression of metastases in the brain was achieved. In 12 patients (40.0%) a partial regression of metastases in the brain was achieved. Median survival was 10 months. Twenty-three breast cancer patients with overexpression of Her2/neu, and with metastatic brain lesions received capecitabine + lapatinib. Complete response in the brain was achieved in 2 cases (8.7%), partial regression - in 9 cases (39.1%) and stabilization of the disease - in 10 cases (43.5%). Median overall survival was 16 months. Nine patients with breast cancer with overexpression of Her2/neu, and with metastatic brain lesions received therapy with capecitabine + trastuzumab. In 2 cases (22.2%) complete regression of metastases in the brain was achieved, in 4 cases (44.4%) - partial response, in 2 cases (22.2%) - stabilization. The median overall survival was 15.5 months. Thus, the results of this study have shown high efficiency of drug therapy in the treatment of breast cancer patients with metastases in the brain.

Results of Induction Chemotherapy in Children Older Than 1 Year With a Stage 4 Neuroblastoma Treated With the NB 97 French Society of Pediatric Oncology (SFOP) Protocol

To test the metastatic response rate in stage 4 neuroblastoma, using dose-intensive induction chemotherapy in a multi-institutional setting. From 1998 to 1999, 47 consecutive children were treated according to N7 protocol. Children received cyclophosphamide 140 mg/kg, doxorubicin 75 mg/m(2), and vincristine 0.066 mg/kg (CAV) in cycles 1, 2, 4, and 6, and cisplatinum 200 mg/m(2) and etoposide 600 mg/m(2) (P/VP) in cycles 3, 5, and 7. The International Neuroblastoma Staging system was used with an emphasis on skeletal evaluation by 123-iodine-metaiodobenzylguanidine (MIBG) scintigraphy. A phase II study evaluating the metastasis complete response rate after induction chemotherapy was conducted in patients who had positive metastatic sites on MIBG scans at diagnosis. Forty-six patients were assessable for toxicity. Hematologic toxicity was the main toxicity observed. Neutropenia was more frequent after CAV than after P/VP (P < .001). A higher rate of thrombocytopenia was observed after P/VP (P = .03). Forty patients with positive MIBG were assessable for metastatic response, and complete regression of metastases was achieved in 17 patients (ie, 43%; 95% CI, 27% to 59%). Of all 47 patients, 21 achieved complete metastatic response. The N7 induction chemotherapy protocol was feasible in a multicentric setting. The observed metastasis complete response rate was similar to that obtained in our previous studies and significantly lower than that published in a previous series using the same regimen. In our hands, escalating doses of cyclophosphamide and prolonging conventional chemotherapy with the same drugs failed to improve the metastasis complete response rate.

The Role of Adjunctive Nephrectomy in Patients with Metastatic Renal Cell Carcinoma

The results of therapy for 78 patients with disseminated renal cell carcinoma are evaluated. Symptoms related to the primary tumor were noted in only 28 per cent of the patients and were not difficult to manage in those patients not undergoing nephrectomy. Adjunctive nephrectomy, therefore, is a more appropriate term than palliative nephrectomy when referring to removal of the primary tumor as part of an aggressive combined therapeutic approach. Of patients receiving an adjunctive nephrectomy those with osseous metastases only had a better 1-year survival rate (36 per cent) than those with metastases to other sites (18 per cent). Complete regression of metastases was noted in 12 per cent of patients treated with medroxyprogesterone acetate and adjunctive nephrectomy. The role of adjunctive nephrectomy combined with embolic infarction, hormonal therapy, chemotherapy and/or immunotherapy is discussed.

Complete regression of metastases following chemotherapy.

AbstractDisseminated solid malignancies are seldom controlled for long periods by the use of chemotherapy. Far‐advanced cancer of the colon has rarely been controlled by the use of chemicals. One of the patients in this report with pulmonary metastases is free of disease at the present time and completely rehabilitated. He received multiple regimens of 5‐fluorouracil but has not received drug for the past 4 years. Long‐term control of metastatic embryonal cell carcinoma of the testicle has been reported, and this 7‐year survival without disease was treated with triple chemotherapy. The causes for these complete regressions are considered.