Search

Aim. The aim of the study was to evaluate the ability of pMEL-TCI and pMEL-A0201 DNA-constructs encoding artificial polyepitope melanoma antigens to induce antitumor T cell immune response ex vivo. material and methods. Dendritic cells were obtained from peripheral blood mononuclear cells of HLA-A02:01-positive donors; DCs transfected with target DNA vaccine constructions were co-cultured with autologous T lymphocytes to stimulate anti-tumor effector T cells. Specific activity of ex vivo stimulated PBMC was assessed (1) by their ability to cause lysis of human melanoma Mel Is cells, and (2) by the level of their granzyme-producing activity. A recombinant plasmid encoding the full-length MART-1 melanoma antigen was used as a positive control. results. All DNA vaccine constructions as well as positive control construction were found to be able to stimulate specific anti-tumor immune responses of autologous PBMC ex vivo, and these PBMC were found to induce melanoma Mel Is cells lysis. Both the efficiency of induced cytotoxic responses and the level of granzymes production stimulated with DCs transfected with pMel-A0201 significantly exceeded those stimulated with DCs transfected with either pMel-TCI or with DNA construction encoding the full-length MART-1 protein. The cytotoxicity level correlates with the level of granzyme B production in CD8+ T lymphocytes. conclusion. DNA vaccine constructions encoding artificial polypeptides composed of tumor antigen epitopes can stimulate the antitumor cytotoxic response. This approach can be used as the basis for the development of new methods of immunotherapy for cancer.

Melanoma is one of the most dangerous forms of skin cancer. Aggressive growth with a high risk of distant metastasis is the cause of the high death rate from skin melanoma worldwide. Melanoma that has metastasized beyond the lymph nodes requires more aggressive treatment. The standard treatment modalities including surgery, radiation therapy and chemotherapy are not very effective for most patients. The aggressive nature of this disease sustains an urgent need for more effective treatment methods. Immunotherapy is currently one of the most promising approaches for fighting cancer cells. The review analyses the main immunotherapeutic approaches to melanoma treatment, including therapeutic vaccines based on tumor cells, synthetic peptides and polyepitopic immunogens. Many of these vaccines are currently being studied in various clinical trials.

Background. Currently, the major purpose for pelvic surgery is to conduct a locoregional radical procedure while preserving a good quality of life. When performing periacetabular resections, the acetabulum and the hip joint are the most difficult areas to reconstruct. According to some authors, the acetabulum and hip joint reconstruction with modular endoprostheses for patients with periacetabular tumors would lead to better clinical outcomes. The paper presents our experience using this surgical technique. Methods. Between 2011 and 2015, a total of 23 patients underwent periacetabular resection with the acetabulum and hip joint reconstruction using a modular endoprosthesis. There were 10 (44 %) male and 13 (56 %) female patients aged from 20 to 64 years with a median of 44 years. The histological types were as follows: 12 (52 %) chondrosarcomas, 4 (17 %) giant-cell tumors, 2 (8 %) osteosarcomas and 1 Ewing’s sarcoma, 1 malignant fibrous hystiocytoma, 1 synovial bone sarcoma, 1 solitary metastasis from renal cell and gastric carcinomas. Stage Ib bone sarcoma was diagnosed in 8 patients and stage IIb in 6 patients. Results. In accordance with Enneking classification, type I-II-III resections were performed in 14 (61 %) patients and type II-III-IV resections in 7 (30 %) patients. The median duration of surgery was 320 min (240–520 minutes). The median intraoperative blood loss was 5 200 ml (1 000–20 000 ml). Negative resection margins (R0) were achieved in 20 (87 %) patients. Positive resection margin (R1) was observed in 3 (13 %) patients with G-I chondrosarcoma. The median follow-up was 32 months (3–48 months). Disease progression was diagnosed in 7 (30 %) patients at a follow-up from 6 to 18 months. The functional outcome after surgery was assessed according to the MSTS score, with the median value of 48% (15–78 %). Postoperative complications were diagnosed in 10 (43 %) patients. Conclusion: The use of the modular acetabulum and hip joint replacement systems allows one to achieve favorable functional outcome in the postoperative period and to reduce the time of postoperative rehabilitation.

The purpose of the study was to assess immediate response to preoperative external beam radiotherapy in patients with soft tissue sarcomas. The study comprised 55 patients with primary and recurrent soft tissue sarcomas. All patients underwent external beam radiotherapy at a total dose of 38–44 Gy in 5 fractions of 3 Gy daily, followed by surgery with 10–15 Gy intraoperative radiotherapy. The objective tumor response to preoperative external beam radiotherapy was assessed using RECIST criteria. Partial response to preoperative radiotherapy was achieved in 9.1% of patients and disease stabilization in 90.9% of cases. Grade I pathological tumor response was observed in 25 (46.5 %) patients, grade II tumor response in 19 (34.5 %) patients and grade III tumor response in 11 (20 %) cases. A 3-week interval between radiotherapy and surgery was the most optimal time. Pathological tumor response with RECIST criteria is an additional parameter in assessment of immediate tumor response.

A rare clinical case of squamous cell lung cancer with metastases to the skin of the gluteal region after combined modality treatment has been presented. This case is of interest due to atypical localization of metastases, histological tumor type and disease prognosis.

The efficacy of the chest wall reconstruction with TiNi implants was assessed. Between 2007 and 2014, 21 patients with malignant tumors of the skin, soft tissues, ribs and sternum (sarcomas and metastases) underwent replacement of post-resection chest wall defects using the original Ti-Ni constructions. A total of 28 surgeries were performed including 19 single-stage reconstructions or 2 delayed reconstructions. The average square of the defect was 127 cm2 (40 to 323 cm2). results. Spontaneous breathing was restored on the day of surgery in 27 (96.4 %) cases. Chest carcass recovery was achieved in all cases. The amplitude reduction was observed in 10 (36 %) cases and complete elimination of pathological chest wall flotation was achieved in 18 (64 %) cases. Complications requiring surgery were observed in 3 (11 %) patients. At a long-term follow-up, 10 patients are alive. conclusion. The technique combining the use of TiNi alloy structures and complex autotissue grafts with axial type of blood supply allows chest wall cancer with extensive local spread to be successfully treated.

The review aimed to assess the role of local hyperthermia in combined modality treatment of soft tissue sarcoma. The recent randomized trials have shown significant benefits from local hyperthermia in patients with soft tissue sarcoma. When combined with radiotherapy, hyperthermia has a complementary and additive effect. Extensive researches have also shown that hyperthermia improves the efficacy of many chemotherapeutic agents. Besides the increased effectiveness of radiotherapy and chemotherapy, hyperthermia has many anti-cancer effects and improves treatment results in patients with soft tissue sarcomas.