Osteosarcomas are rare tumors with aggressive biology. It is important to refer such patients to a high-volume center, where an accurate diagnosis and optimal treatment are more likely to be performed. In contrast to Ewing's sarcoma, conventional osteosarcomas are believed to be generally resistant to radiation therapy, and the main treatment modalities are surgery and chemotherapy. In this clinical case, we demonstrate the efficacy of combined treatment of osteosarcoma of the femur.Preoperative chemotherapy allowed to evaluate tumor sensitivity to systemic treatment in vivo and optimize adjuvant treatment after R0 resection which allowed to achieve complete clinical response to treatment.
Currently, use of CDK4/6 inhibitors in combination with hormone therapy is approved for treatment of patients with advanced or metastatic breast cancer positive for estrogen and progesterone receptors and negative for human epidermal growth factor receptor 2 (HER2). In this clinical observation, analysis of the effectiveness of treatment of a patient with metastatic breast cancer of luminal A subtype is performed. The 1st line combination therapy was CDK4/6 inhibitors (ribociclib) and hormone therapy with aromatase inhibitors (letrozole) and analogues of gonadotropin-releasing hormone (goserelin) with concurrent bone-modifying denosumab therapy. Effectiveness of antitumor drug therapy administered for 7 months, and toxicity of the regimen were evaluated. Effectiveness of the selected combination treatment regimen was demonstrated and confirmed by clinical data, as well as results of laboratory and instrumental examinations. Adverse effects were controlled and managed with symptomatic therapy which allows to continue treatment using previously selected tactics.
Immunotherapy has improved the results of treatment of patients with metastatic colorectal cancer. According to literature, the most cancericidal effect revealed in a microsatellite instability high (MSI-H) tumors. In our case, PD-1/PD-L1/PD-L2 inhibitors (nivolumab) treatment for locally advanced MSI-H colon carcinoma with liver metastasis in 44-year-old patient resulted in tumor regression, so that R0 surgical procedure became possible. Computed tomography scan and pathology report showed complete response, in primary and metastatic tumors. As a result, this allowed to improve the quality of patient’s life.
Neuroendocrine tumors are rare type of tumors of the gastrointestinal tract. Mostly the patient is diagnosed rather late, the tumors don’t have specific symptoms and there are no sensitive and specific methods of early diagnostics of the disease. Also, to date, the choice of antitumor treatment methods is limited. The article presents a clinical case of effective treatment of a neuroendocrine tumor of the colon with high level of microsatellite instability. After palliative partial colectomy, atypical resection of the liver, female patient with metastatic cancer of the descending colon has been receiving therapy with checkpoint inhibitors (PD-1) which led to long-term stabilization of the process.
Per the majority of authors, melanoma is the most common tumor diagnosed during pregnancy (31 % of all malignant neoplasms). In approximately 1/3 of women melanoma developed in child-bearing age is diagnosed during pregnancy or in the postpartum period. However, only some retrospective studies analyzed the effect of pregnancy on melanoma development, and conclusive data on development, progression and treatment of BRAF-mutant melanoma is lacking. In this subpopulation of patients, BRAF status supposedly can negatively affect disease outcome irrespective of treatment methods.The article presents a clinical case of recurrence of melanoma with the BRAF V600E mutation during pregnancy. The patient underwent lymph node dissection during pregnancy prolongation, after labor she received antitumor drug therapy with МЕК and ВRAF inhibitors. Melanoma recurrence during pregnancy did not worsen treatment outcomes for the mother and embryo.
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