Radiation therapy is a cancer treatment that causes direct death of cancer cells, however there is a number of reports on anticancer effect of radiotherapy, that may be considered as tumor regression at sites that are outside the irradiated volume, this phenomenon was called as abscopal antitumor effect. The article presents results of the model study of the abscopal antitumor effect. The model of very aggressive ascitic mammary tumor “Ehrlich ascites carcinoma” (EAC) was used for the study. First, one-step bilateral grafting of EAC cells to mice hind extremities was performed, the following step was the formation of tumor contralateral nodes in the hips. In 5 days after the cells transplantation, the right (target) node was locally irradiated with 60Co gamma rays with a dose of 30 Gy. The growth of the left (non-target) and the target tumor nodes was watched during 20 days after irradiation. It was found that local irradiation of the right tumor node with a dose of 30 Gy at an early stage of tumor growth caused inhibition of the left, non-target tumor node growth from 10 to 49% relative to the growth of the tumor nodes in the control group of the tumor bearing mice. In order to reduce the dose burden in this model, the impact of fractionated irradiation with single dose of 10 Gy, to a total dose of 30 Gy on the abscopal effect was studied. The ability of the immune system of the mice with transplanted tumors in both hips and the irradiated target tumor node to respond to an antigenic stimulus was studied. The study results are the following: the immune system of mice, with a transected tumor in both thighs and subsequent gamma-ray irradiation of the target tumor node at a dose of 30 Gy respond to the antigenic stimulus; radiation doses to the target tumor node are crucial in achieving the abscopal effect; the use of complementary therapeutic methods, such as targeted therapy or immunotherapy, will increase the probability of the abscopal effect achieving.
Background. Extramedullary plasmacytoma (EP) of soft tissues, which in most cases affects the organs of the head and neck region, is a relatively rare malignant tumor. Until now, there are no consensus approaches to the diagnosis and treatment of EP. Differentiating EP from other types of non-Hodgkin’s lymphomas is difficult. There are difficulties in the differential diagnosis of EP and carcinomas in the head and neck region. Given the rare occurrence of this nosological form, the frequency of diagnostic errors is quite high, which dictates the need for a thorough description of each head and neck EP case.Objective of the study: analysis of possible difficulties and reasons for incorrect interpretation of diagnostic data, and treatment for head and neck EP.Materials and methods. Clinical and morphoimmunological data of 97 primary patients with B-cell non-Hodgkin’s lymphomas (B-NHLs) of the head-neck region were analyzed.Results. In our cohort we identified 2 tumor cases of a plasma cell nature, which amounted to 2 % among all B-NHLs. In one case, the process was located in the nasal cavity and clinically manifested itself with nosebleeds. The second case is a lesion of the mouth floor, primarily with the ulcer formation. In the first cases, at diagnosis, the immunohistochemistry (IHC) test was performed after patient’s chemotherapy and radiation treatment, which distorted the tumor immunophenotype. In the second cases with extensive process in maxillary sinuses, a complete and very detailed IHC test was carried out; however the data did not allow for a definitive diagnosis. Difficulties apparently arose in the interpretation of CD38 expression – main marker of plasmacytic line cells, as well as due to the unusual morphology.Conclusion. The described diagnostic situations dictate the need for a comprehensive algorithm in the diagnosis of head and neck tumors. It is advisable to perform an extended morpho-immunophenotypic study of the tumor (IHC, immunocytology, flow cytometry, etc.), if a tumor of a plasma cell nature is suspected, a morpho-immunological study of the bone marrow is indicated.
The implementation of innovative methods of drug therapy and biotherapy into clinical practice has significantly changed the treatment tactics for metastatic urothelial cancer. Currently, treatment regimens are successfully supplemented with immunotherapy (immune checkpoint inhibitors) or targeted therapy, and the effectiveness of such combinations can be quite high, but the optimal sequence of different types of drug therapy remains to be established. The development of correct algorithms using reliable biomarkers is necessary to select the correct sequence of prescribing drugs. Until now, the expression of programmed cell death-ligand 1 (PD-L1) and changes in fibroblast growth factor receptors 1–4 (FGFR1–4) have been the fundamental markers for choosing alternative treatment regimens for metastatic urothelial cancer. At the same time, the list of useful and sufficiently informative biomarkers is expanding, and therefore we tried to summarize the available data on the known biological markers for selection of treatment tactics for metastatic urothelial cancer.
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