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Introduction. A combination of antiandrogen and cytostatic drugs was justified in the neoadjuvant therapy of patients with high-risk prostate cancer (HiRPCa) in some clinical trials. The effectiveness of such therapy in each individual case depends on the sensitivity of cancer cells to the applied drugs. It makes possible the development of the new technologies to personalize therapeutic approach. MicroRNAs (miRNAs) are a class of regulatory molecules whose expression is altered in PCa cells and can be associated with the sensitivity/resistance of cancer cells to specific cytostatics, for instance, taxanes.Objective. To identify the potential-marker miRNAs of PCa cells sensitivity to taxanes.Materials and methods. Samples of PCa tissue (n. 56) obtained from patients underwent neo-adjuvant therapy (antiandrogen and taxanes) and radical prostatectomy; PCa cell lines (PC-3, DU-145, LNCap). Total RNAs isolation was carried out using miRNeasy FFPE Kit, LRU-100-50; miRCURY LNA miRNA Focus PCR Panel, All-MIR kits were used for semi-quantitative analysis of potentially marker microRNA molecules using sequential reverse transcription and PCR.Results. The effect of taxanes on PCa cells is associated with up-regulation of miR-106b expression and down-regulation of miR-200c expression in both in vivo and in vitro conditions.Conclusion. MiR-106b and miR-200c miRNAs are involved in the response of PCa cells to taxanes, and therapeutic modification of these molecules in PCa cells may present a potential strategy to increase their sensitivity to taxane-containing therapy. Appropriate innovative technology may be in demand in the treatment of HiRPCa-patients.

Antitumour herbal medicines based on pink periwinkle and yew tree alkaloids are included in combination therapies for many types of cancer. The use of these classes of products may entail cardiotoxic effects leading to life-threatening conditions. The aim of the study was to analyse scientific literature on cardiotoxic effects of anticancer drugs based on yew tree alkaloids (taxanes) and pink periwinkle alkaloids (vinca alkaloids). The results of the analysis demonstrated that the main manifestations of taxane-induced cardiotoxicity were bradycardia, atrioventricular block, atrial and ventricular arrhythmias. Concomitant use of taxanes and anthracycline antibiotics exacerbated cardiotoxic effects of both drug classes. The use of vinca alkaloids was associated with haematological toxicity in the form of neutropenia, while cardiotoxic effect was rarely observed during monotherapy. Raising awareness among oncologists, cardiologists, and other specialists involved in the management of cancer patients about potential cardiac complications of antitumour therapy contributes to early detection of adverse reactions and allows for individual correction of treatment regimens, especially in patients with predisposition to cardiovascular disease.

Molecular and biological features of triple negative breast cancer (TN BC) determine the limited possibilities of systemic therapy and, as a consequence, the more aggressive course of the disease. Taxanes are one of the most effective chemotherapies used in breast cancer therapy. The special form of paclitaxel nab-paclitaxel makes it possible to obtain an objective and a subjective effect, which is especially important in the pre-treated patients. In addition, the drug has a favourable safety profile and a well-controlled toxicity.The article contains a review of the literature on the prospects for the use of nab-paclitaxel in breast cancer, especially in its triple negative version, and a description of the clinical case of therapy with a combination of cisplatin and nab-paclitaxel in a young patient with BRCA-1-associated TN breast cancer.

Gastric cancer has one of the leading positions in the world in the prevalence and mortality among malignant tumors. The results of surgical treatment of locally advanced gastric cancer remain generally poor due to the high rate of relapse after surgery. Currently, perioperative (pre- and postoperative) chemotherapy in combination with surgery is recommended for patients with stage ≥IB resectable gastric cancer. We analyzed the studies devoted to the problem of choosing the optimal regimen of perioperative chemotherapy in locally advanced and oligometastatic gastric cancer. The highest efficacy was observed in the taxan-containing regimen FLOT which allowed to increase the median overall survival up to 50 months in a randomized controlled phase III trial. The use of perioperative chemotherapy with anti-Her2 therapy, immunotherapy or any other biologic drug remains investigational.

For decades taxanes are used as a part of classical schemes for treatment of malignant tumors of various localizations including breast cancer. Peripheral neuropathy is an adverse reaction which impairs both quality of patients’ lives and treatment efficiency. To prevent or reduce the impact of peripheral neuropathy factors contributing to its development and mechanisms that are involved need to be known. This article is a review of the current status of our understanding about the mechanisms underlying the development of taxanes induced peripheral neuropathy.

Background. Nowadays there are no any standards of treatment for patients with locally advanced and metastatic breast cancer resistant to treatment with anthracyclines, taxanes and capecitabin. Ixabepilone has proved successful as a single agent for treatment of these patients. Methods. Eribulin was chosen as an alternative strategy. Efficacy criteria were overall and progression-free survival. Cost-effectiveness analysis is performed on the basis of published data and Markov modeling for 1.5 year time horizon. Results. Total expenditures for ixabepilone strategy were 18.2% less than those for eribulin treatment. Administration of ixabepilone instead of eribulin will allow treating additionally up to 222 patients per year. Price elasticity analysis revealed that total expenditures on ixabepilone will be 20% less than on eribulin treatment at a price of ixabepilone equal to 63 000 rubles per 45 mg vial and 21 691.23 rubles per 15 mg vial of ixabepilone. Conclusion. Ixabepilone as a single agent appeared to be economically reasonable as compared to eribulin in case of ineffective pretreatment with taxanes, anthracyclines and capecitabine.

Androgen deprivation therapy (ADT) is used in the treatment of prostate cancer metastatic cancer (PC) since the first description of its hormone dependence in 1941. After receiving the results of a TAX 327 study in 2004, the drug from the taxanes - docetaxel became the main cytostatic agent in the treatment of the castration resistant prostate cancer (CRPC). In a recently publishedstudy CHAARTED it was shown for the first time that the combination of ADT with docetaxel in men with hormone-sensitive metastatic prostate cancer (HSMPC) showed the advantage in the total survival rate by 13.6 months compared to the independent ADT. Similar results were obtained in the STAMPEDE study of men with local-distrubuted and metastatic PC with initial long ADT. A combination of six docetaxel courses with ADT in men starting long-term ADT demonstrated the same advantage by the survival rate parameter compared to the standard ADT by 10 months. Based on the reliability of the treatment results obtained by a new combination of a cytostatic and hormonal product, docetaxel in addition to ADT should be regarded as the basic initial therapy for men with the first identified hormone-sensitive PC, as reflected in the practical recommendations on the treatment of malignant tumours (RUSSCO) 2016 and the recommendations of the European Association of Urologists, 2017.

This article represents data on economic evaluation of treatment with ixabepilone (Ixempra) as a single agent for patients with metastatic breast cancer with ineffective pretreatment with taxanes, anthracyclines and capecitabine. Two health technologies were evaluated: Ixabepilone as a single agent at the 1st day of a 21-day cycle of chemotherapy versus eribulin also as a single agent at the 1st and the 8th days of a 21-day cycle. Cost-effectiveness analysis is performed on the basis of published data and Markov modeling. As a result, ixabepilone as a single agent appeared to be economically reasonable as compared to eribulin as a single agent in case of ineffective pretreatment with taxanes, anthracyclines and capecitabine. Total expenditures for Ixabepilone strategy were 13.6% less than those for eribulin treatment. Furthermore, ixabepilone was found 16% more effective in terms of median progression-free survival, as compared to eribulin as a single agent. Sensitivity analysis has proved the results obtained in the main scenario. Price elasticity analysis revealed the equality of total expenditures on ixabepilone and eribulin treatment at a price of ixabepilone equal to 88 000 rubles per 45 mg vial and 30 298.87 rubles per 15 mg vial of ixabepilone.

Metastatic breast cancer (mBC) continues to be an incurable disease, but modern drug therapy, associated with the steady extension of the arsenal of active cytostatic drugs and the development of new treatment options, provides the long-term control of tumor growth, transforming into chronic pathology. Nab-paclitaxel (nanodispersed albumin-bound paclitaxel) is one of such options. This innovative dosage form provides the active transport of the drug through the vascular endothelium with the creation of the high concentration in the tumor tissue. Clinical trial of nab-paclitaxel compared with traditional taxanes (paclitaxel and docetaxel) have demonstrated high efficiency of a new drug both in the general population and in the selected subgroups of patients, including treated with anthracyclines, patients with invasive disease, damages of the visceral organs, younger patients and others. Nab-paclitaxel proved to act in patients treated with taxanes, the physician can use this drug one again and thus we have another line of therapy. Nab-paclitaxel can be effectively and safely combined with trastuzumab in patients with mBC associated with HER2+. In addition, the drug because of the unique formula does not cause hypersensitivity reactions and differs from traditional taxanes of the variant of application. No need for premedication with dexamethasone let us appoint the drug in patients with comorbid conditions: severe arterial hypertension, diabetes, gastric and duodenal ulcers and others. High safety of nab-paclitaxel was approved in elderly patients as well.

The article tells about the current problems in the treatment of castrate-resistant prostate cancer. An extensive search for more effective treatments resulted in the development of a number of novel drugs which affect the quality of life of patients as well as increase the overall survival rate and time to PSA progression. The article studied the clinical efficacy of first-line cytotoxic chemotherapy with docetaxel. Satisfactory tolerance of docetaxel monotherapy was demonstrated. PSA levels declined > 50% in 43.7% of patients with overall survival up to 16 months.

Nab-paclitaxel is nanoparticle albumin-bound paclitaxel. Nab-paclitaxel is free from any kind of solvent and thus reduces the risk of hypersensitivity reactions and other side effects, compared with standard taxanes (paclitaxel, docetaxel). There is no need to use premedication with glucocorticoids and antihistamines during nab-paclitaxel application. In addition, several studies have demonstrated that nab-paclitaxel allows achieving a higher drug concentration in tumor. The article deals with the basic studies of nab-paclitaxel application using different doses and introduction regimens in patients with metastatic breast cancer. We show the algorithm for optimal use of nab-paclitaxel in different clinical cases.

Introduction. Triple-negative breast cancer (BC) is very aggressive form of breast malignancies with high levels of dissemination, frequent ecurrence and poor survival rate, as compared to other breast cancer subtypes.Aim of the study – development and introduction of optimized treatment strategy of patients with triple-negative breast cancer into the clinical practice of City Clinical Oncological Dispensary.Materials and methods. The study included 201 patients (21–90 years, mean age 52 years) who were treated in the first departmentof St. Petersburg City Clinical Oncological Dispensary from 2005 to 2011. Stage IА–IIIC invasive breast cancer with triple-negative phenotype according to immunohistochemical study of the tumor material was verified in all the patients before beginning of the treatment. Standard chemotherapy by FAC, CMF and taxane-containing regimen was used as neoadjuvant chemotherapy. The degree of therapeutic pathomorphism was evaluated according to Miller-Payne (2003) classification, which was designed taking into account an overall survival rate of patients, depending on the degree of pathologic tumor regression. Results. We performed evaluation of 3-year relapse-free survival, depending on the degree of pathomorphological regression and histological degree of malignancy. There is a clear dependence of the 3-year relapse-free survival on the degree of histological differentiation of the tumor. We noted an inverse correlation between high degree of histological malignancy with a short relapse-free period. The disease progressed in patients who have a high degree of histological malignancy.Conclusion. The highest efficiency was achieved in patients receiving chemotherapy with the addition of taxanes. It is advantageous to include taxane-containing chemotherapy regimens in the treatment of patients with a high degree of histological malignancy.

Treatment of patients with metastatic breast cancer (BC) with a triple-negative phenotype represents the most difficult challenge for clinicians. The optimal chemotherapy regimens for triple-negative BC (TNBC) have not been determined for a long time. However, in the later periods were found molecular agents of application (6 subtypes of TNBC) for the specific therapeutic agent and were performed many studies and subunit analysis, examined appropriate drugs for TNBC. Cell lines of these subtypes have different anticancer drug sensitivity. The results of further studies of targeted drugs using as monotherapy or in combination with chemotherapy in patients with TNBC, in spite of molecular genetic evidence for their application, have fallen short of expectations, although have shown increase in progression-free survival and overall survival. The development of eribulin (nontaxane microtubule dynamics inhibitor) in 2010 significantly increased the possibility of therapy in patients with locally advanced and metastatic BC who had already received chronic treatment. According to the joint analysis of the randomized phase III EMBRACE trial and Study 301, which included data about 1864 patients, it was demonstrated that eribulin statistically significant improve overall survival compared with other drugs using as monotherapy in the general population and among patients with TNBC [statistically significant differences in overall survival was associated with the subgroup of TNBC in patients who had been treated with eribulin, in comparison with the control arm: 12.9 and 8.2 months, respectively (relative risk 0.74; 95% confidence interval, 0.60 to 0.92, p=0.006)]. This article deals with the own experience of successful and long-term eribulin application in young woman with TN metastatic BC who have had already received chronic treatment.

The article deals with the results of the administration of new cytostatic - eribulin (Halaven). In EMBRACE (Eisai Metastatic Breast Cancer Study Assessing Physician's Choice Versus E7389) phase III clinical study, Halaven had been administrated to 6 patients (between 6 and 35 cycles), at that, partial tumor regression was observed in 3 patients and other 3 patients achieved stabilization. Median progression-free survival (PFS) was 15,3 months and median duration of response (DOR) was 13 months in eribulin group, in group of treatment of physician's choice - median PFS was 5,3 and median DOR was 3,3 months. This article demonstrates 3 clinical cases. The authors concluded that eribulin showed high effectiveness and meaningful improvement in overall survival, maintaining the high quality of life.

Taxanes (paclitaxel and docetaxel) are currently considered to be basic cytostatics in the treatment of all breast cancer (BC) stages. The results of conducted and ongoing clinical trials suggest that incorporation of taxanes into adjuvant and neoadjuvant chemotherapy regimens enhances the efficiency of treatment for operable BC and show it necessary to apply an individual approach depending on prognostic and predictive factors.