The overview of modern approaches in treatment of triple negative breast cancer

By far the most aggressive subtype of breast cancer is triple negative cancer. The purpose of this review is to analyze current ideas about the pathogenesis, clinical characteristics of different subtypes of triple negative breast cancer, the nature of its metastasis, mechanisms of chemoresistance. The review presents the results of modern regimens of drug therapy of triple negative breast cancer according to the publications of domestic and foreign oncologists. On the basis of various clinical studies, the effectiveness of the use of anthracyclines, taxanes in the dose-dense regime, platinum preparations and other chemotherapy drugs for the treatment of triple-negative cancer has been shown. The presented treatment regimens allow to achieve a complete morphological response in 85% of patients, to increase the rates of relapse-free and overall survival, comparable with other subtypes of breast cancer. The review highlights the possibilities of modern targeted drugs-PARP inhibitors, chk1 inhibitors UCN‑01, immunotherapy possibilities for the treatment of this aggressive subtype of breast cancer.

OPTIMAL TREATMENT STRATEGY FOR PATIENTS WITH PROGRESSIVE SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK

The treatment of common forms of squamous cell carcinoma of the organs located on the head and neck that are not subject to surgical treatment is limited to the use of chemoradiotherapy with platinum derivatives or drug therapy with platinum-containing regimens. With the progression of the disease, ineffective 2‑line cytostatics were prescribed that did not fundamentally change the course of the tumor process. The introduction into clinical practice of drugs of the original mechanism of action has significantly increased the effectiveness of drug therapy during progression after platinum-containing chemotherapy. The article presents two clinical observations that demonstrate the relevance of the strategy of using inhibitors of immune response control points after platinum preparations.

THE EFFECTIVENESS OF COMBINED TREATMENT OF DISSEMINATED MALIGNANT PLEURAL MESOTHELIOMA, A DESCRIPTION OF THE CLINICAL CASE

Modern approach to the individualization of the management of patients based on the careful observation for the minimal manifestations of the disease, prescription of pemetrexed at the first line of therapy, combination with platinum preparations and antiangiogenic targeted preparation bevazisumab allows control the disease at the advanced stage of pleural mezoteliom and support the good active state of patients during the long time.