Cytokinogenetic Therapy as Part of Antitumor Treatment for Pancreatic Cancer
Abstract
Treatment of locally advanced and metastatic pancreatic cancer remains one of the most challenging issues in clinical oncology. Modern chemotherapy drugs do not ensure long-term survival of patients. Th e use of immuno- oncological drugs is also not eff ective enough in the treatment of this pathology. Among the possible immunotherapy options, cytokinogenetic therapy (CGT) drugs are of interest, having proven themselves well in the treatment of a number of solid tumors in combination with cytostatics. Objective: to study the possibility of cytokinogenetic therapy using in the treatment of locally advanced and metastatic pancreatic cancer.
Materials and methods. Th e study included 30 patients aged 58–83 years (median 64±1,2 years) with locally advanced and metastatic PC with a histologically confi rmed diagnosis. Th e examination of patients included an assessment of the Karnofsky status, determination of the level of tumor necrosis factor alpha (TNF-α) in the blood using the enzyme immunoassay method, computed tomography of the chest, abdomen and pelvis with intravenous contrast. Cytokinogenetic therapy drugs were used to treat patients— human recombinant interferon gamma and recombinant tumor necrosis factor- thymosin-α1 according to the scheme developed in the clinic. In 27 patients, treatment was carried out in combination with courses of polychemotherapy, in 3 cases only cytokinogenetic therapy was used due to concomitant pathology and high prevalence of the tumor process. Th e obtained digital material was processed using the Statistica 12.0 soft ware package.
Results. According to computed tomography data using RECIST 1.1 criteria, a partial response was registered in 14 patients, and stabilization of the disease was registered in 16 patients. Th ere were no cases of tumor progression against the background of combined use of CGT and cytostatic therapy if the treatment regimen was followed. Th e average survival time of patients from the moment of disease detection was 15 +, in the group of locally advanced cancer, and 19 + months in patients with metastatic cancer. Carrying out CGT improved the quality of life of patients and was not accompanied by severe toxicity, and did not increase the incidence of adverse events during chemotherapy. As the treatment courses were carried out, there was an increase in the Karnofsky status and an increase in the level of TNFα. A clinical observation of a patient suff ering from metastatic pancreatic cancer with multiple foci in the liver is given as an example of successful use of CGT in combination with cytostatic therapy.
Conclusions. Th e combined use of interferon gamma, recombinant tumor necrosis factor- thymosin-α1 recombinant and cytostatic drugs can be considered as an eff ective treatment option in patients with locally advanced and metastatic prostate cancer.
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