Search

Diabetes mellitus type 2 and malignant diseases are among the most frequent causes of morbidity and mortality worldwide. Number of studies showed that breast carcinoma and other cancers are more frequent and have worse prognosis in patients with diabetes. The mechanisms of effect of type 2 diabetes to frequency and prognosis of breast carcinoma are complex and besides a direct effect of insulin resistance, hyperinsulinemia and hyperglycemia, they include the effect of accompanying obesity and anti-diabetic therapy. One of the anti-diabetic drugs that reduces frequency and improves prognosis of breast carcinoma is metformin. Anticancer effects of metformin are indirect (insulin dependent) and direct (insulin independent). Insulin-dependent and insulin-independent antitumor effect of metformin opens the door for implementation of this drug in therapy and prevention of breast cancer and other malignant diseases even in patients without type 2 diabetes. This paper presents literature data on mechanisms of type 2 diabetes impact to the risk of development and prognosis of breast cancer and the anticancer potential of metformin.

Background: In the second half of the twentieth century, cancer treatment options evolved with more sophisticated selection of targets for cancer therapy, which led to the development of more intelligent drugs directed against these specific targets. One group of pharmaceutical molecules with specific and unique properties against (or for) a welldefined molecular target is monoclonal antibodies (mAbs). The purpose of this study was to show the expenditure of mAbs at the Oncology Institute of Vojvodina from 2007 to 2011. Next, to display the number of patients treated with mAbs and therapy cycles, for each indication. Methods: We used software programs Lirpis and LWM for collecting the data regarding mAbs expenditure from April 2007 to 2011. The comments about the situation in Serbia were given with the review on the FDA approvals. Results: The results showed the increase in number of ampoules dispensed from the pharmacy from 2007 to 2010, and a slight decrease in 2011 for all mAbs. With 4070 vials of rituximab, 195 patients were treated. The average number of therapy cycles was 7.34. With total number of 4341 of trastuzumab, we treated 310 patients, with average number of cycles 12.27. With 1343 ampoules of bevacizumab, we treated 92 patients. The average number of cycles was 6.63. With 7051 ampoules of cetuximab, we treated 94 patients, with average number of therapy cycle of 5.94. Conclusion: Despite proven benefits of mAbs for many other indications according to FDA, in our Institution (based on the indications approved by Republic Institute of Health Insurance), bevacizumab, and cetuximab are used for colorectal cancer, trastuzumab is only used for breast cancer and rituximab for non-Hodgkin lymphoma. The decrease of the number of ampoules dispensed from our pharmacy and the number of patients in 2011 was caused by tightening the criteria indications by Republic Institute of Health Insurance.

Hodgkin lymphoma and anaplastic large cell lymphoma are malignancies that highly express CD30 antigen on the cell surface. Both are generally curable by standard chemotherapy but refractory diseases and relapses are treatment problems. Brentuximab-vedotin is a labeled monoclonal antibody against CD30 and it is approved for the treatment of Hodgkin lymphoma relapsed after autologous stem cell transplantation and for relapsed anaplastic large cell lymphoma. This is the first drug approved for the treatment of Hodgkin lymphoma after 30 years.

Primary breast lymphoma is rare location of this disease. Diffuse large B-cell lymphoma is the most common histological subtype. We presented two cases of primary diffuse large B-cell lymphoma of the breast and reviewed a literature about this topic.

Uveal, especially choroidal melanoma is the most common ocular melanoma. There is no clear evidence that pregnancy impacts its development. Enucleation is generally indicated for advanced tumors. Five-year mortality rate is 53% in patients with large melanomas (>8 mm).