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Background. Mycosis fungoides (MF) is classified as an orphan disease. Due to the rarity of pathology, and until recently the absence of an expert group and a specialized reference center for cutaneous lymphomas in Russia, possible treatment options for MF are presented by listing them without recommendations on the preferred indications for one or another option. This creates difficulties in choosing treatment methods and assessing their effectiveness.Aim. To characterize current treatment methods and their results in MF patients who were observed or received consultative and diagnostic care at the National Medical Research Center for Hematology.Materials and methods. The study included 210 patients: 115 with early disease stages and 95 with advanced stages.Results and conclusion. The most common treatment options were for early stages – local therapy, interferon therapy and systemic chemotherapy (CT), for advanced stages – combination therapy with interferon (+ PUVA therapy, methotrexate), interferon monotherapy and systemic CT. The frequency of systemic chemotherapy use in all lines of MF treatment was 21 %. When integrating statistical analysis using the probability of achieving an antitumor response, switching to 2nd line therapy, and accumulated incidence, the negative results of using chemotherapy in the MF treatment were clearly demonstrated.For the first time in Russia, a real practical situation of the applied MF treatment options is presented on our own large sample of patients. As the first line of therapy, the most common options were immunotherapy and phototherapy, however, in 12.4 % of cases, the use of systemic CT was registered, which is unjustified and leads to a decrease in the time to the next line of treatment and an increase in the cumulative incidence of adverse events. As a result of the use of non-chemotherapeutic approaches (interferon, etc.), the 3-year relapse-free survival rate is about 40 %, after chemotherapy – 9.4 %. Secondand third-line therapy provided more varied options, including combination treatment with interferon and methotrexate, as well as gemcitabine monotherapy, targeted therapy with brentuximab vedotin, and epigenetic therapy in the 3rd line. Studies with targeted agents in this patient population have demonstrated improved clinical outcomes, highlighting the need for their early use to achieve the best results.

Article describes results of study of antitumor and antimetastatic action of dipeptide mimetic of the nerve growth factor amide N-monosuccinyl-L-glutamyl-L-lysine (compound GK-1) in comparison with gemcitabine. Two injections of gemcitabine in total dose of 100 mg/kg resulted in significant tumor growth inhibition by 60–61% on 7th, 9th and 15th days of tumor development. Course administration of GK-1 in doses of 10 mk/kg from 2nd to 15th day of tumor development resulted in significant tumor growth inhibition by 57,8 %. Metastasis inhibition index (MII) of gemcitabine was 75,8 %. MII of GK-1 in doses of 10 mg/kg or 30 mg/kg was 44,9 % and 47,7 % accordingly. It was shown that GK-1 in studied range of doses exerts antimetastatic activity.

Introduction. The randomized MPACT study showed that nab-paclitaxel plus gemcitabine results in statistically significantly longer life expectancy. The objective of this retrospective study is to obtain relevant data on the efficacy of this combination in real clinical practice in Russia. Materials and methods. The study included patients with morphologically proven locally advanced or metastatic pancreatic cancer, with a general condition assessed on the ECOG scale between 0-2, which received gemcitabine and nab-paclitaxel. Immediate and long-term treatment outcomes were evaluated. Results. 142 patients, who received treatment from 2009 to 2019 in 17 centers from 11 regions of Russia, were included in the study. Assessment of the objective effect was made in 134 patients. Objective effects were detected in 34 (25.4%) cases. The median time-to-progression was 6.1 months (95% confidence interval (CI) 4.8-7.4), the median length of life was 14.2 months (95% CI 10.6-17.9). An elevated CA19-9 level is the only independent adverse prognostic factor for progression-free survival (RR = 8.0, 95% CI 1.4 -43.8, p = 0.02) according to Cox multivariate regression analysis. The number of previously conducted chemotherapy lines (p = 0.34), ECOG status (p = 0.70), age over 70 years (p = 0.45), serious comorbidity (p = 0.97) did not have a statistically significant effect on progression-free survival. Findings. The gemcitabine and nab-paclitaxel combination has a relatively higher efficacy in advanced pancreatic cancer. The immediate and long-term results of its use in real clinical practice in Russia are consistent with data obtained in the Western countries.

Bladder cancer (BC) is an important clinical and scientific challenge. In 2013, in Russia, the absolute number of patients with first-ever diagnosis of bladder cancer was 12 992 people. There is an increasing proportion of detection of bladder cancer stage I–II disease patterns: 2003–50.8% in 2013–69.6%, while the number of newly diagnosed patients in III and IV clinical stages remains at 30%. The proportion of individuals who completed the treatment of the number of newly diagnosed patients with bladder cancer in 2013, was as follows: only surgical method — 65.4%, 33.5% combined. Purpose. Improvement of the results of treatment of patients with locally advanced bladder cancer. Materials and methods. The main treatment for muscle-invasive bladder cancer is radical cystectomy. In the combined treatment of bladder cancer chemotherapy is the component that systemic exposure to the tumor, the way of regional and distant metastases. The study included 132 patients with locally advanced bladder cancer who were treated for 2005–2013, divided into four groups: NACT + CE — 27 people (20.5%), CE + ACT — 21 (15.9%), NACT + CE + ACT — 21 (15.9%) only CE — 63 (47.7%). An important component of treatment has been the use of platinum (cisplatin or carboplatin) in Schemes M–VAC and GP. An objective response is possible in 44.7%, and the stabilization process in 40.4% of patients.Results. The clinical effect is evaluated in all patients. In the group of NACT 21% of patients survived for more than 4 years, but did not survive the 5‑year mark. In the group of CE + ACT the indicator achieved only 3‑year survival rate, which amounted to 43%. In the group of CE — none of the patients did not live up to 3 years, with 2‑year survival rate was 30%. In the group of ACT + NCT + CE 3 patients (15%) were alive at the time, passed the threshold of the 5‑year survival rate, there is no progression of cancer.Conclusion. Combined treatment mode NACT + CE + ACT can achieve significantly longer time to tumor progression and better overall survival; the reverse side is to increase the frequency of postoperative complications.

Objective: to improve the results of neoadjuvant chemotherapy (CT) in patients with locally advanced (L A) inoperable breast cancer (BC) at baseline, by using the intensified combination CT at the interval being reduced between the administration of cytostatic dru gs to 2 weeks to give a chance to the patients to be surgically treated.Subjects and methods. The study enrolled 26 patients aged 33 to 75 years with L A BC. Paclitaxel was administered intravenously (IV) over 3 hours at a dose of 175 mg/m2 on day 1, followed by gemcitabine, 2000 mg/m2, given by 30-minute IV infusion on day 1 every 2 w eeks. If the cytostatics were well tolerated and their effect increased, the treatment was continued up to 6 courses.Results. Eighteen (69.2%) out of the 26 patients achieved the objective effect of treatment; of them 17 (65.4%) had a partial remission and 1 (3.8) had a complete remission.The therapeutic pathomorphism of a tumor w as rated in 22 patients; fourth-degree tumor pathomorphism w as found in 2 (9%) patien ts. The follow-up of patients w as 11 to 28 months (median, 20 months). The median time to progression w as not reached in the entire group of patients.Conclusion. A combination of paclitaxel and gemcitabine in intensive dose-dense scheduling has a marked antitumor activity in BC andis characterized by its good tolerability without a pronounced myelosuppressive effect. This therapy regimen may be used as neoadjuvant CT.

The developed chemotherapy (CT) regimen with paclitaxel and gemcitabine with the interval being reduced between the cycles up to 2 weeks can shorten the time of preoperative treatment 1.5-fold and may be further investigated in the neoadjuvant CT for inoperable breast cancer. Intensified CT in the regimen of paclitaxel 175 mg/m2 one day, gemcitabine 2000 mg/m2 one day, docetaxel 70 mg/m2 one day + doxorubi- cin 60 mg/m2 one day + colony-stimulating factors every 2 weeks has a high clinical effectiveness and a satisfactory tolerability.

Gemcitabine is known to exert a therapeutic effect on brain tumors despite the limited permeability of the blood-brain barrier (BBB). In our experimental research single intraperitoneal (i.p.) injection of gemcitabine 25 mg/kg provided increase in median survival of mice with intracranially transplanted Ehrlich carcinoma by 41-89% (p < 0.001). In this experimental model i.p. administration of gemcitabine (permeability of the BBB of less than 10%), carmustine (good permeability of the BBB), cyclophosphamide (poor permeability of the BBB) and cisplatin (doesn't penetrate through the BBB) increased median survival of mice by 88% (p < 0.001), 59% (p = 0.001), 35% (p = 0.005) and 18% (p = 0.302) respectively. Considering strong correlation between antitumor activity of the drugs (carmustine, cyclophosphamide and cisplatin) and their permeability of the BBB, efficacy of gemcitabine in intracranial tumors could be due to its wide range of therapeutic doses.

The study or antitumor effects of dioxadet, cisplatin, melphalan, paclitaxel, mitomycin C, cyclophosphamide and gemcitabine at intraperitoneal (i.p.) and intravenous (i.v.) administration as monochemotherapy and polychemotherapy in a rat model of ascitic ovarian cancer was carried out in 244 female Wistar rats. Ovarian cancer was transplanted i.p. at a number of 1 x 10(7) tumor cells. The drugs were administered once in 48 hours after ovarian cancer transplantation i.p. or i.v. for monotherapy--in maximum tolerated doses, for i.p. polychemotherapy--in half doses from maximum tolerated doses. Antitumor effects of the treatment were estimated in increase in median survival time (MST) compared to control rats who were administered saline i.p. At i.p. administration dioxadet, cisplatin and melphalan increased MST by 79%, 88% and 144%, respectively, while at i.v. administration these drugs didn't affect MST. Mitomycin C and paclitaxel had stronger antitumor action at i.v. administration increasing MST by 152% and 81%, respectively, while at i.p. administration these drugs increased MST by 35 and 45%, respectively. Combinations dioxadet + cisplatin, dioxadet + cyclophosphamide and dioxadet + paclitaxel at i.p. administration increased MST by 305%, 277% and 133%, respectively, and had additive antitumor action compared to mono-effects of these drugs. Gemcitabine and combination dioxadet + gemcitabine at i.p. administration didn't significantly affect survival of rats with ovarian cancer. Intraperitoneal monochemotherapy and polychemotherapy could be more effective in the treatment of peritoneal carcinomatosis from ovarian cancer compared to systemic administration of the drugs.

This paper gives an account of an experimental and clinical application of super-low frequency scanning magnetic field in patients with noninvasive bladder cancer treated with adjuvant intravesical gemcitabine chemotherapy. Treatment of isolated bladder cancer cells incubated with gemcitabine by this physical factor increased the permeability of cell membranes to the chemotherapy drug. This effect was demonstrated by increased fluorescence intensity of cancer cells. Clinical application of this combination therapy technology showed 2,8-fold increase of disease-free survival interval compared to early recurrences in the control group. These results indicate the potential of biophysical mechanisms to increase chemotherapy effectiveness.

Soft tissue sarcomas (STS) comprise a heterogeneous group of rare malignancies from mesenchymal tissues. The biology of STS causes high aggressiveness, poor prognosis due to early development of distant metastases and limited chemotherapeutic options due to tumor resistance. The paper considers the current principles of chemotherapy for early and metastatic disease. Results of own experience of advanced STS patients' treatment are presented and discussed.

We have experimentally investigated the detoxifying and modifying effects of remaxol in the framework of traditional and high-dose chemotherapy in mice with transplanted tumors. The influence of remaxol in comparison with heptral was studied on the toxic and therapeutic action of cytostatic drugs gemzar, lastet (etoposide), and methotrexate during their traditional and high-dose administration in mice with transplanted P388 lympholeukosis. Remaxol demonstrated a detoxifying action with respect to these cytostatic agents, which decreased in the following series: gemzar lastet methotrexate (according to the results of lethality evaluation). Remaxol significantly increased the therapeutic efficacy of gemzar used in both traditional and high-dose regimes. This was manifested by slowing down tumor growth and increasing animal lifetime during combined administration of the drugs. This may be due to the remaxol potentiation of the antitumor effect of gemzar. In combination with lastet and methotrexate, remaxol does not alter their therapeutic efficacy. The detoxifying action of remaxol with respect to these cytostatics is more pronounced than that of heptral.

SHR mice with intracranial transplanted lymphosarcoma LIO-1 received a single intraperitoneal gemcitabine injection in maximal tolerated dose of 25 mg/kg or single maximal tolerated oral dose of lomustine, 50 mg/kg. Compared to control group gemcitabine injection increased the mice lifespan 1.4-fold (p < 0,01) and oral lomustine 1.6-fold (p < 0,01). The median lifespan of the mice receiving both gemcitabine and lomustine in maximal dose underwent a significant 3.3-fold increase (p < 0,01) compared to controls (2.4-fold compared to gemcitabine and 2.1-fold compared to lomustine group). Combined therapy didn't cause an increase of toxicity.

Research during the past decade has shown that epigenetic events have a key role in carcinogenesis and tumour progression. Histone deacetylase inhibitors (HDACi) comprise structurally diverse compounds that are a group of targeted epigenetic anticancer agents. Here we explored the in vitro efficacy of HDACi such as sodium butyrate (BuNa), valproic acid (VaNa) and several novel HDAC inhibitors for the treatment of cancer. Both BuNa and VaNa inhibited cancer cell proliferation in a time--and dose-dependent fashion. In the present study we demonstrated the significant effect of two novel HDACi, Adipo or BuNHOH, able to induce apoptosis of cancer cells, but not of normal line. Since HDAC inhibitors have been proposed as radio--or chemosensitizers in cancer therapy, we have studied the radiosensitizing effect of sodium butyrate on cancer cells. The combination of BuNa and radiation significantly inhibited tumor cell growth. Besides, combining Cisplatin or Gemzar with HDAC inhibitors results in synergistic antiproliferative activity that could be therapeutically exploited. These results suggest that HDACi acts as an antitumor agent and that combining HDAC inhibitors with radio or--chemotherapeutic strategy may provide a novel chemotherapeutic treatment of cancers insensitive to traditional antitumor agents.

During 2008-2011 32 patients with locally advanced and metastatic gastric cancer passed 154 procedures of interventional radiology. Tumors of gastroesophageal junction were revealed in 7 patients, tumors of the fundus--in 15 patients, tumors of the pylorus--in 10 patients. At the time of treatment and hospitalization complicated course was observed in 14 patients. Upon initial treatment 25 patients (78%) manifested metastatic lesions in the liver. As an independent type of treatment interventional radiology was carried out in 20 patients. The combined treatment (surgery + intraarterial regional chemotherapy) was performed in 12 patients. 19 patients underwent chemoembolisation of the tumor (56 procedures in total). All patients had repeated courses of intraarterial regional chemoinfusion at intervals of 4-6 weeks (98 procedures in total). Surgical treatment was performed in terms of 7-16 days after the last course of neoadjuvant regional chemotherapy. A decrease of tumor size by 15% -35% (26% in average) was registered in all patients; a decrease in accumulation of radiopharmaceutical in tumors of the stomach was 18% -27% (20% in average). The results of the application of intraarterial regional chemotherapy (chemoembolisation tumors of the stomach and regional chemoinfusion) demonstrated the possibility of effective influence both on the primary tumor, and on the stages of lymph node metastasis. Also the use of regional neoadjuvant chemotherapy did not complicate the course of the postoperative period even in the group of patients who underwent extensive combined surgical intervention.

Induced apoptosis in urinary bladder cancer tumor cells of patients was studied using TUNEL reaction. It was shown that increase in induced apoptosis value had a definite correlation between corresponding features of tumor reaction as a response on Gemcitabine-Cisplatin neoadjuvant chemotherapy application. It was found that evaluation of induced apoptosis in urinary bladder cancer tumor cells using TUNEL method allows forecasting the effectiveness of chemotherapy on the cellular level in patients with this type of cancer.

Antitumor activity of a new cytostatic drug combination of gemcitabine and dioxadet have been studied in 86 female SHR mice transplanted with 5 x 10(6) of ascitic Ehrlich's tumor cells each. All mice received a single injection of gemcitabine, dioxadet on combination 48 hams after tumor cells introduction. In first series, experimental animals received maximal tolerable dose of gemcitabine (25 mg/kg) and one half of dioxadet maximal tolerable dose (2.5 mg/kg). In the second series of experiments, the animals received 5 mg/kg of dioxadet along with the same gemcitabine dose. Effect of drugs was compared using the time to ascites detection, body weight increase, and survival time. Gemcitabine and dioxadet administered separately and in combination inhibited the growth of ascitic Ehrlich's tumor in the mice. In both series of experiments antineoplastic activity of gemcitabine and dioxadet combination was significantly higher in comparison to the control groups receiving these drugs separately. The highest antineoplastic activity of the gemcitabine and dioxadet combination was observed when the maximal tolerable doses of both drugs was applied. However, the tumor cells growth was also significantly inhibited in mice receiving half of dioxadet dose. Synergism of antitumor activity of gemcitabine and dioxadet was not accompanied by appreciable increase in toxicity.

Efficiency of gemcitabine plus lomustine treatment of transplantable lymphosarcoma LIO-1 in mice was significantly higher than that of monotherapy. According to the area under the kinetic curve for tumor growth, antitumor action, for single maximum tolerable dose of gemcitabine 25 mg/kg body, rose 4.6 times (p < or = 0.001), for lomustine 50 mg/kg body,--2.9 times (p < or = 0.01). The combination involved moderately increased toxicity. Lethality rate for gemcitabine+lomustine, 50 mg/kg body each, was as low as one and a half times as compared with gemcitabine therapy alone, 50 mg/kg body, (30 and 20%, respectively). The antitumor action of the combination (50 mg/kg body), was 32 times that of gemcitabine 50 mg/kg body (p < or = 0.001) and lomustine 50 mg/kg body--30 times (p < or = 0.001).

Russian Academy for Further Medical Education, St. Petersburg A clinical-statistical analysis of chemotherapeutic treatment of 198 gynecological cancer patients in an outpatient clinic and 226 ones in a hospital. It was concluded that was no difference in the treatment effectiveness, as well as in the incidence of hematological and non-hematological complications.

Gemicitabine (2',2'-difluorodesoxycitidine) is a relatively new medicinal product from the group of anti-metabolites used as the first line therapy of pancreatic cancer, non-pulmonary cancer, and breast cancer. However, analysis of its toxicity spectrum revealed a large number of adverse events associated with the clinical application of this product. This fact is ascribed to the narrow range of therapeutic usages of this cytostatic preparation (from 25 mg/kg to 27 mg/kg). This paper is designed to summarize the available data on hematological, gastrointestinal, pulmonary, and cardiotoxicity of gemcitabine. They may be useful for the improvement of control over gemcitabine toxicity, correction of its dosage regime, and efficacious prevention of the most serious side effects.

Neoadjuvant intra-arterial oil chemoembolization and adjuvant selective intra-arterial chemoinfusion with gemicitabine was administered to 28 patients with operable exocrine pancreatic cancer. It was well tolerated and not followed by complications which allowed for gastropancreatoduodenal resection to be carried out in all cases. Complete course of combined treatment was given to 23 out of 28 patients (82.1%). As a result, 2-, 3- and 5-year actuarial survival rates were 23.9, 17.4 and 13%, respectively. Long-term survival was recorded among patients without metastases into regional lymph nodes: two of them have survived without relapse for more than 5 years and one died of tumor progression after 4 years of the follow-up.

We studied efficacy of a combination of intraosseous and systemic administration of drugs in patients with invasive cancer of the urinary bladder (UB). A total of 20 patients aged 54-79 years with verified had recurrence, 2 had tumors with continuous growth. T2N0M0 UB carcinoma was diagnosed in 7 patients, T3N0M0--in 12, T6N0M0--in 1 patient. All the patients received systemic chemotherapy with gemzar in a single daily dose 800-1000 mg/m2 on day 1, 7 and 14. On day 2 a single intraosseous 100 mg eloxatin was given. A total of three courses of combined chemotherapy with 4-week interval was used. Intravenous gemzar administration was accompanied with mild leukopenia in 4 patients, moderate leukopenia--in 1, allergic reaction--in 2 patients. This required gemzar discontinuation. No side effects were seen in response to intraosseous administration of eloxatin. The combined chemotherapy produced complete regression of UB cancer in 3 of 18 patients, partial regression--in 12, stabilization--in 3 patients. Neither local nor long-term tumor progression was found. Short-term therapeutic efficacy of combined therapy was 70%. Fifteen patients with partial regression or stabilization have undergone transurethral resection. Duration of a recurrence-free period reached 5 to 72 months (mean 17 months). The neoadjuvant chemotherapy proposed by us allows achievement of a high percentage of regression in patients with invasive UB cancer located in UB cervix and provides concervative surgery including patients over 70 years of age.

Experience of application of preparation Gemzar as a chemotherapy agent for ductal pancreatic adenocarcinoma was analysed. In 28 patients (main group) chemotherapy using Gemzar preparation was conducted, in 30 patients (control group) chemotherapy was not conducted. The trustworthy differences of life span in patients with unresectable tumors in the main and control groups were noted. Difference of the patients life span after performance of radical pancreatic resection was not trustworthy.

The efficacy and tolerability of therapy with gemcitabine plus cisplatin were evaluated in 49 patients with disseminated breast cancer refractory to anthracyclines, docetaxel and capecitabine. Gemcitabine 600-750 mg/m2 and cisplatin 30 mg/m2 were injected intravenously, dropwise, on days 1 and 8 of a 3-week course. Overall response rate was 27%; median response duration - 8.0 months, median mediation time until tumor progression--3.2 months, and median survival time--10.3 months. Untoward side-effects were moderate, reversible and, therefore, did not require dosage to be corrected or cut down.

Meta-analysis has been made to answer the question whether a proven advantage exists of chemotherapy of locally advanced and metastatic cancer of the urinary bladder (UB) with gemcitabine+cisplatin over the scheme M-VAC. The data for 1990-2002 obtained from the data base Medline, library of Cocrane Association, proceedings of the symposia and conferences, publications in domestic periodicals Urologiya, Voprosy Onkologii covered 3477 items on UB cancer. Nine publications were selected which seem to use significant information in terms of evidence-based medicine. The patients were divided into two groups. Group 1 consisted of patients with local and metastatic UB cancer treated with the combination gemcitabine+cisplatin (n = 390). Group 2 patients (n = 499) received chemotherapy with M-VAC. By principles of evidence-based medicine, group 1 patients had more frequent unfavourable outcomes (absence of complete and partial regressions)--50 and 42%, respectively. A decrease in the absolute risk is significant (p < 0.05, chi-square = 5.8). It is 8% in the confidence interval (CI) 4,12. A decrease in the relative risk was 19% (CI 13.7-24.3), odds ratio 1.39 in CI 1.3-1.48. Thus, at present there are no reliable data on advantages of local and metastatic UB cancer treatment with the scheme gemcitabine-cysplatin over standard treatment M-VAC.

The paper is concerned with the data on treatment of 33 patients with advanced ovarian cancer, aged 34-72 (average age of 52.5). Having received numerous regimens of combination chemotherapy, mainly, with cisplatin-containing drugs, sixty-one percent had visceral metastases. Early-onset relapse was in 18.2%, late-onset--12.1% and primary refractory to cisplatin chemotherapy--30%. Hemzar (hemcytabin) + cisplatin + carboplatin treatment was given in 15- or 8-day courses (hemzar--1,000 mg/m2, day 1, 8 and 15 or day 1 and 8; cisplatin m2 or carboplatin AVC5--60 mg/m2, day 1 or 15, day 1 or 8, respectively). A total of 102 cycles of therapy were given and evaluated. Complete response was reported in 2 (6.0%), partial--5 (15.2%), and stabilization--13 (39.4%); significant clinical effect--60.6%. Such side-effects as leukemia stage I-II--63.6%; stage III-IV--3%, neutropenia stage I-II--39.4; stage III-IV--24.2%, thrombocytopenia stage I-II--6%, and asthenia stage I-II--12.1%, stage III-IV--3 patients, did not interfere with treatment. Combination chemotherapy with hemzar + cisplatin + carboplatin was effective and sufficiently tolerable. It is indicated in management of relapse and primary resistance to cisplatin drugs administered for ovarian cancer whenever all other remedies have failed.

A novel method of intra-arterial oily chemoembolization of pancreatic tumor has been developed. It slowed down regional blood flow in tumor dramatically due to injection of gemcitabin-in-oil. As a result, a prolonged contact of tumor with the highly-concentrated chemotherapeutic drug along the microcirculatory bed was assured. Enhanced antitumor effect, unaccompanied by any increase in systemic toxicity, was obtained by intensifying gemcitabin perfusion in the tissue. Tumor vessels had to be contrast-enhanced during the selective angiography of great vessels feeding the pancreas. Diagnostic angiography was performed in 63 patients with locally advanced tumors (T4NxMo) in 1999-2002. A total of 98 intra-arterial oily chemoembolizations (1-11 per patient) were carried out in 32 (51%). One or two-year survival rates in these patients after hemzar were 50 and 15%, respectively. Arterial oily chemoembolization is a safe and potentially effective method for the treatment of pancreatic cancer.

Cycloplatam, a new platinum derivative, evolved at N.S. Kurnakov Institute of General and Inorganic Chemistry in 1982, has been added to the arsenal of Russian cytostatic drugs. Having passed phase I trials, it was approved for treatment of pleural mesothelioma, ovarian carcinoma and multiple myeloma. Leukothrombocytopenia formation indicates toxicity-related limit of dosage. Phase II clinical trials are under way at the Center. They include treatment of solid tumors with cycloplatam alone in urinary bladder tumors, cervical carcinoma and malignant pleurites of various etiology as well as in combination with other cytostatics (carcinoma of the prostate, pleural mesothelioma and urinary bladder tumors). The drug may be recommended both for oral and intracavitary administration; side-effects may include moderate toxicity, chiefly, hematological one.

The effectiveness of different regimens of chemotherapy for advanced pancreatic cancer was compared in 74 cases (1995-1999). 5-fluorouracil (5FU), adriamycin and mitomycin C (FAM) were given to 12 patients, 5FU alone--23, 5FU plus leukovorin--29, and gemcitabine alone--10. Metastases to the liver were detected in 42 (57%) patients. Partial response (40) was registered in: FAM--1 (8%); 5FU--1 (4%); 5FU + leukovorin--3 (10%); gemcitabine--3 (30%). Mean duration (40) was 5.4; 4; 6.1 and 9 months, respectively. Stabilization was recorded in 17 (23%), mean duration--4.4 months; tumor progression--49 (66%). Toxic side-effects of all the regimens were insignificant. Mean survival rates following FAM, 5FU, 5FU + leukovorin were 4.4; 4.2 and 5.6 months, respectively, while that for gemcitabine varied 3-24 months (on average--7.9 months). Survival in patients responsive to chemotherapy was 9.8; remaining patients--4.7 (p (0.05). Chemotherapy for advanced pancreatic carcinoma is a measure of palliation; its use was followed by a 20% increase in survival. Gemcitabine treatment appeared most effective.