The purpose of the treatment of metastatic breast cancer is overall survival improvement, thus the search for new effective regimes of chemotherapy with low toxicity is especially important. Therefore chemotherapy is one of the options for the treatment of metastatic breast cancer, for instance oral vinorelbine has shown consistant efficacy with a low toxicity profile. In this framework, an active and well tolerated oral CT option provides additional benefits for patients such as the possibilty of intake of the treatment at home and allows avoiding an intravenous infusion and alopecia if that is a priority for the patients. According to experts’ opinions vinorelbine is an efficient choice for first line of chemotherapy of metastatic breast cancer along with anthracyclines and taxanes. A meta-analysis of published trials concluded that longer first-line CT duration is associated with a marginally longer OS and a substantially longer PFS. In this context oral vinorelbine may be chosen as a preferable treatment since treament with oral vinorelbine can go on substantianaly longer than treatment with many other drugs. Vinorelbine yielded equal or superiour results to both paclitaxel and docetaxel, when combined with trastuzumab in the HER-2-positive ABC in the HERNATA and TRAVIOTA trials. And finally oral vinorelbine can be used in new metronomic regimens in which drugs are adminstered frequently or continuously. This kind of treatment maintains low, prolonged and pharmacologically active plama concentrations of drugs to avoid toxicity associated with traditional chemotherapy regimens, while achieveing tumor responce. Thus vinorelbine can be used as one of the options of metastatic breast cancer treatment.

This article discusses the mechanisms of the influence of microRNAs on carcinogenesis in breast cancer (breast cancer), their potential role as markers for the early detection, prognosis and effectiveness of breast cancer treatment. Epigenetic mechanisms of regulation of miсroRNA expression and their indirect effect on the pathogenesis of the disease are described.

Background. The diagnostics of neuroendocrine tumors (NET) is complex due to many factors such as the heterogeneity of the tumors themselves, different localization of the tumor process, and the presence of severe hormonal syndromes. A special place in the diagnostic search is given to the study of biochemical markers which are conditionally divided into universal and specific ones.

Materials and methods. Chromogranin A (CGA) is a universal marker that in most cases identifies tumors of a neuroendocrine nature and is characterized by the best combination of diagnostic sensitivity and specificity. Pancreatic polypeptide (PP) and neuron-specific enolase (NSE) are determined in addition to CGA in pancreatic tumors and in low-grade forms of neuroendocrine cancer. Specific markers, serum serotonin and its metabolite in daily urine 5-hydroxyindolacetic acid (5-GIUC), are the generally recognized specific markers for diagnosing of carcinoid syndrome. Other specific markers such as gastrin, insulin, glucagon, and others, are associated with certain hyperfunctional syndromes and are being investigated to confirm their presence. The article presents generalized recommendations for the use of biochemical markers, taking into account the existing clinical signs, syndromes, and types of NETs. To monitor the course of the tumor process and evaluate the effectiveness of treatment in patients with an established diagnosis of NET, it is recommended to determine the biochemical markers with increased basal levels. At the same time, there is a need to standardize the survey timing. For more accurate monitoring and interpretation of data, serial marker studies should be performed with the same test systems used in the same specialized laboratory.

For the first time in Russia a comparative study of chromogranin A (CgA) and chromogranin B (CgB) in neuroendocrine tumors (NETs) of the pancreas was performed. We examined 50 primary patients with pancreatic NETs and 42 healthy people. The determination of CgA and CgB was performed in blood serum using standard enzyme-linked immunoassay test-systems (Chromogranin A NEOLISA, Eurodiagnostica; Human Chromogranin B, USCN). The levels of CgA and CgB in pancreatic NETs significantly differed from the control group. There was found the association between CgA levels and the dissemination of the process, while CgB demonstrated the properties of a marker independent from the tumor dissemination. The diagnostic sensitivity of CgA was 76 %, CgB – 68 %. Complex determination of CgA and CgB enhanced the diagnostic sensitivity to 84 %. Our data indicate the potential usefulness of complex CgA and CgB in the diagnosis of pancreatic NETs.

The purpose of this study is to assess the dynamics of the incidence of trachea, bronchi, lung cancer in the Omsk Region over a 12year period.

Materials and methods. The analysis of long-term dynamics of morbidity of the population of the Omsk Region with cancer of the trachea, bronchi, lung (RTBL) for the years 2006–2017.

Results. In the structure of cancer incidence in the Omsk Region, the proportion of RTBL was 12.4 % that was higher than the national average (11.0 %; p < 0.001). In dynamics for the period of 2006–2017 morbidity of inhabitants of the region of ZNO of trachea, bronchus, lung did not change (T = 0.15 %; p < 0.001). Incidence of RTBL in the Omsk Region tended to increase in general (from 46.9 to 51.3 ⁰/₀₀₀; p < 0.001) and decrease in standardized (from 25.9 to 24.1 ⁰/₀₀₀; p < 0.001) indicators.

Conclusion. 1. In the Omsk region over a 12-year period, the incidence of RTBL remained stable (long-term average 51.0 ⁰/₀₀₀₀; 95 % CI: 48.4–54.1). 2. The absence of positive changes in the dynamics of morbidity of the population of RTBL in the Omsk Region requires a study of the prevalence of known factors associated with the risk of developing this pathology and the improvement of approaches to primary prevention, taking into account regional characteristics.

Radiotherapy is an integral part of the cancer treatment, including with mediastinum, breast cancer. In this case, cardiovascular complications of the treatment are quite common. The long-term prognosis can be determined not only by the effectiveness of radiotherapy, but also by cardiovascular risks. A feature of cardiotoxicity of radiation therapy is the high probability of its occurrence in the delayed period of 3–30 years after treatment. The article highlights the results of published epidemiological studies of cardiotoxicity of radiotherapy, as well as the available screening algorithms for cardiovascular complications in patients who underwent radiotherapy. Own clinical observation of the early debut of coronary artery disease after combined chemoradiotherapy of diffuse large B-cell non-Hodgkin lymphoma is presented.

Tactics of treating patients with meningeal hemangiopericytoma, or a solitary fibrous tumor of the dura mater remains controversial due to their rarity and heterogeneity of global experience, however, analysis of clinical data indicates that the best results are achieved when performing a total removal of the primary tumor and then following a course of external-beam radiation therapy on surgical bed in adequate total doses.

The most common anatomical localization of neuroendocrine neoplasms (NEN) are the digestive and bronchopulmonary systems, the total proportion of which exceeds 90 % of cases of this group of tumors. In turn, the remaining cases are represented by extremely rare primary neuroendocrine neoplasms of the head and neck, skin, female genital organs, mammary gland, bladder and kidney. Due to the extremely rare observations and the lack of standardized approaches to the diagnosis and treatment of neuroendocrine neoplasms of the kidneys are of significant clinical interest. The true incidence of NENs of the kidney has not yet been established. We carried out a retrospective analysis of patients undergoing treatment in National Medical Research Centre of Oncology n. a. N. N. Blokhin (Moscow, Russia) from 1992 to 2015. According to the results of a sample of patients among registered 12,013 cases of malignant neoplasms of the kidney with NEN of the kidney, the number of morphologically verified cases of NEN of the kidney was 9 cases (0.07 %). Among the patients included in the study group, the main part was represented by highly differentiated neuroendocrine tumors (7 cases; 77.8 %), small cell cancer (1 case; 11.1 %), large cell neuroendocrine cancer (1 case; 11.1 %). The average age of the patients was 51 years (40–63 years; median – 55 years), among which there were 4 women and 5 men. In addition, we conducted an analysis of the clinical, morphological and molecular biological characteristics of tumors with the study and assessment of the grade Ki-67, which was a determining factor in predicting survival and choosing treatment tactics.