Kazan medical journalKazan medical journal0368-48142587-9359Eco-Vector780210.17816/KMJ2018-010Research ArticleNeoadjuvant chemoimmunotherapy for inoperable ovarian cancerNerodoG Amordan-anna@yandex.ruZlatnikE Yumordan-anna@yandex.ruNovikovaI Amordan-anna@yandex.ruArdzhaA Yumordan-anna@yandex.ruVerenikinaE Vmordan-anna@yandex.ruNikitinaV Pmordan-anna@yandex.ruKravtsovaO Emordan-anna@yandex.ruBondarenkoE Smordan-anna@yandex.ruZolotarevaE Imordan-anna@yandex.ruRostov Research Institute of Oncology15022018991101606022018Copyright © 2018, Nerodo G.A., Zlatnik E.Y., Novikova I.A., Ardzha A.Y., Verenikina E.V., Nikitina V.P., Kravtsova O.E., Bondarenko E.S., Zolotareva E.I.2018<p><strong>Aim.</strong> To assess the results of neoadjuvant chemoimmunotherapy for patients with inoperable ovarian cancer.</p>
<p><strong>Methods.</strong> The study included 72 patients with stage IIIС-IV ovarian cancer divided into three groups: with neoadjuvant chemotherapy and with neoadjuvant chemoimmunotherapy with intramuscular and intraperitoneal interferon gamma. Direct and immediate results of the treatment were studied and compared to assess the efficacy of treatment. Besides, ploidy determination and cell cycle analysis were performed on the fresh postoperative specimens by DNA flow cytometry. Immune status was evaluated before and after neoadjuvant therapy.</p>
<p><strong>Results.</strong> After neoadjuvant polychemotherapy, in the group of intramuscular interferon gamma high-volume surgery was performed in 81.8% of patients, in the group of intraperitoneal interferon gamma - in 87.5% (p 0.05), and in the control group (without interferon gamma) high-volume surgery was performed in 34.6% of patients. Recurrence rates were found to be 25% in the group of intraperitoneal interferon gamma (р 0.05) vs. 59.09% in the group of intramuscular interferon gamma and 76.9% in the group without interferon gamma. The study revealed a decreased number of aneuploid tumors in the group of intraperitoneal interferon gamma. The analysis of the immune system showed positive dynamics of the immune status in the groups with interferon gamma.</p>
<p><strong>Conclusion.</strong> Use of interferon gamma in the complex with neoadjuvant chemotherapy improves direct results of the treatment and extends the time to recurrence; intraperitoneal and intramuscular interferon gamma is characterized by similar positive immunological changes in some cellular immunity parameters; the number of aneuploid tumors in patients with chemoimmunotherapy is lower than in the control group indicating better disease prognosis.</p>ovarian cancertreatmentchemoimmunotherapyinterferon gammaрак яичниковлечениехимиоиммунотерапияинтерферон гамма[Ferlay J., Soerjomataram I., Ervik M. et al. GLOBOCAN 2012 v 1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11. Lyon, France: International Agency for Research on Cancer. 2013; E359–E386.][Bookman M.A. Optimal primary therapy of ovarian cancer. Ann. Oncol. 2016; 27 (suppl. 1): i58–i62. DOI: 10.1093/annonc/mdw088.][Wenham R.M. Ovarian cancer: a bright future. Cancer Control. 2011; 18: 4–5. DOI: 10.1177/107327481101800101.][Lederman J.A., Raja F.A., Fotopoulou C. et al. Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2013; 24 (suppl. 6): vi24–vi32. DOI: 10.1093/annonc/mdt333.][Prakticheskie rekomendatsii po lekarstvennomu lecheniyu zlokachestvennykh opukholei (RUSSCO). (Practical recommendations on the medical treatment of malignant tumors (RUSSCO).) Ed. by V.M. Moiseenko. Moscow: Obshcherossiiskaya obshchestvennaya organizatsiya «Rossiiskoe obshchestvo klinicheskoi onkologii». 2016; 524 p. (In Russ.)][Shalashnaya E.V., Goroshinskaya I.A., Nerodo G.A. et al. Study of the influence of chemotherapy drugs on the level of endogenous intoxication, intensity of free radical oxidation and membrane apparatus of blood cells of patients with cervical cancer recurrence in vitro experiments. Sibirskii onkologicheskii zhurnal. 2008; (2): 50–54. (In Russ.)][Kit O.I., Zlatnik E.Yu., Nikipelova E.A. et al. Peculiarities of general and local immunity at solitary and synchronous primary-multiple colon cancer. Sovremennye problemy nauki i obrazovaniya. 2012; (5): 38. (In Russ.)][Rukovodstvo po khimioterapii opukholevykh zabolevaniy. (Guidance on chemotherapy for cancer.) Ed. by N.I. Perevodchikova. Moscow: Prakticheskaya meditsina. 2011; 152 p. (In Russ.)][Nerodo G.A., Novikova I.A., Zlatnik E.Yu. et al. Application of ingaron in combination with chemotherapy in patients with stage III–IV ovarian cancer. Fundamental’nye issledovaniya. 2015; (1–8): 1649–1654. (In Russ.)][Shmelev V.A., Lichinitser M.R., Abramov M.E. et al. Innovative antitumor cytokine drug Ingaron. Meditsinskiy alfavit. Diagnosticheskaya radiologiya i onkoterapiya. 2013; 3–4: 60–68. (In Russ.)][Ardzha A.Yu., Przhedetsky Yu.V., Nerodo G.A. et al. Self-organization of the blood serum in patients with extensive ovarian cancers under chemotherapy in combination with ingaron. Mezhdunarodnyi zhurnal eksperimental’nogo obrazovaniya. 2013; (10-2): 226–232. (In Russ.)]