[BREAST-CONSERVING SURGERY AFTER NEOADJUVANT THERAPY FOR BREAST CANCER].

In the randomized phase 2 study there was evaluated the efficacy of neoadjuvant endocrine treatment (anastrozole, exemestane) in comparison with chemotherapy (doxorubicin plus paclitaxel). Preoperative endocrine therapy was well tolerated. There was a trend towards higher overall rates of objective response and breast conserving surgery (BCS) among patients with tumors expressing high levels of ER (luminal A) in endocrine therapy group compared with chemotherapy group (43% vs 24%; p = 0,054). In HER2-positive breast cancer patients the addition of trastuzumab to neoadjuvant chemotherapy improved the overall and pathological complete response. Trastuzumab made possible an increasing number of breast conserving surgery (23% vs 13%; p = 0,022). No patient treated with trastuzumab and with chemotherapy had a local recurrence after BCS.

[The role of nanotechnology in creating novel antitumor agents].

Nanobiotechnology, defined as an arm of a nano-system is a rapidly developing area of medicine. Nanomaterials ranging from 1 to 1000 nm in size offer unique advantages of interaction with biological systems on the molecular level. Nanobiotechnologies can be used in definition, diagnosis and treatment of cancer thus leading to the new development of a new discipline--nanooncology. The potential of nanoparticles to be used in in-vivo tumor visualization, biomolecular profiling of tumor growth factors and targeted drug delivery is being studied. These methods stemming from nanotechnology may soon find a broad application in oncology.

[Inflammatory breast carcinoma and prognosticators of efficacy of primary chemotherapy].

The efficacy of primary chemotherapy for inflammatory breast carcinoma (IBC) was studied vis-a-vis certain symptoms characterizing patient's status and biological features of tumor. It was shown that such factors as estrogen (ER) and progesterone (PR) receptor status and malignancy grade of tumor can be used to predict the efficacy. Negative ER/PR status plus high malignancy grade involved higher frequency of complete pathomorphological responses. Worst prognosis was in patients under 35 years of age, with ductal BC and negative ER/PR status of tumor.

[Phase II clinical trial of neoadjuvant hormone therapy in comparison with chemotherapy of patients with breast cancer].

Data are presented on a randomized study (stage II) which was undertaken to assess the efficacy of neoadjuvant chemotherapy (doxorubicin+paclitaxel) vis-a-vis endocrine therapy with aromatase inhibitors (anastrazole or exemestane) in postmenopausal women with ER-positive and/or PgR-positive tumors. Preoperative neoadjuvant chemotherapy was well tolerated and showed similar rates of overall response as compared with the latter regimen.

[Adjuvant chemotherapy with anthracyclines in comparison with the standard combination of CMF in breast cancer with high risk of relapse]. / Antratsiklin-soderzhashchaia ad''iuvantnaia khimioterapiia v sravnenii s klassicheskoi skhemoi CMF u bol'nykh rakom molochnoi zhelezy s vysokim riskom retsidiva.

The effectiveness of adjuvant therapy with adriablastin and doxorubicin for breast cancer has been compared to that of standard CMF. During 1985-1990, the study included 349 patients with T1-2N2M0 and T3N0-2M0 tumors; mean age--46 yrs; mean follow-up--96.7 months. Overall survival rate in the doxorubicin group was 73%, CMF--62%; relapse-free survival--62.1 and 55%, respectively. The absolute difference in overall survival rates (11%) proved barely significant (p = 0.056). However, the difference in overall survival (p < 0.05) after anthracyclines and CMF in patients with tumors T1-2N2M0 and T3N1M0 was significant and in favor of the former. As far as frequency and degree of side-effects is concerned, their patterns were practically identical in both groups, except for the significantly higher frequency of cardiotoxity and complete alopecia in doxorubicin therapy. Cardiotoxic complication rate was significantly reduced from 13.8 to 3.9% by cardioxane treatment.