Chemotherapy is important part of the systemic treatment of non-small cell lung cancer (NSCLC). Vinorelbine has proven its effectiveness in adjuvant therapy, as part of chemoradiotherapy programs, and in the treatment of metastatic disease. The oral form of the drug is significantly more convenient to use and can be used not only in standard dosage regimens (both in monotherapy and in combination with platinum derivatives), but also in metronomic therapy, which provides for more frequent administration of vinorelbine in smaller single doses. Oral vinorelbine has been shown to be highly effective and safe in various patient populations, including subgroups of elderly and patients with ECOG2, and can be widely used in various stages of NSCLC treatment.

At present administration of a combination of several immune checkpoint inhibitors (ICT) for the treatment of colorectal cancer (CRC) demonstrates promising results, but clinical trials of that approach are lacking, especially in patients with high microsatellite instability (MSI-H).

Aim. To describe the efficacy of combination of ICT therapy in a female patient with CRC and MSI-H.

Results. A clinical case of a young female patient with transverse colon cancer with T4N 2M1 IV stage is presented. Patient underwent a course of chemotherapy. After disease progression a course of ICT therapy with nivolumab and ipilimumab (four courses) with subsequent 21 course of nivolumab were performed, with positive clinical dynamics. Immune-mediated adverse events included peripheral polyneuropathy (2nd grade), immune-mediated hypothyreosis and immune-mediated arthritis.

Conclusions. Further studies are needed in a subgroup of patients with metastatic CRC with MSI-H to develop treatment approaches utilizing ICT and additional treatment modalities with maximal efficacy.

The purpose of this research was to develop and evaluate the effectiveness of a new way of cytological diagnosis of breast cancer, based on the premise that before aspiration the cyst contents, an ozone-oxygen mixture at a concentration of 5 ug/ml is introduced into the cyst cavity, then the mixture is evacuated with the subsequent introduction of the saline solution in a quantity of 150 % of initial volume. The cytological preparations are made for microscopic examination in order to verify morphologically the diagnosis from the obtained aspirate after centrifugation. The article highlights the results of examination of 67 patients with suspected intracystic breast cancer with usage of traditional and new methods of fine- needle aspiration biopsy. The sensitivity of the traditional method of fine-needle aspiration biopsy in the diagnosis of this pathology according to the results of the research is 81.80 %, the sensitivity of the new method is 97.06 % (p < 0.05), which proves the expedience of usage of a new method in breast cancer detection.

Background. The inflammatory is an integral part of the formation and development of malignant neoplasms, including oral cavity squamous cell carcinoma (OCSCC).

The aim. Identification of the prognostic role of the factors of systemic inflammation in the peripheral blood of patients with OCSCC, as well as the relative indicators: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR), with an assessment of their effect on overall survival (OS) and progression-free survival (PFS).

Materials and methods. A prospective study was included 165 patients with OCSCC. At the initial assessment, all patients underwent counting of peripheral blood parameters: leukocytes, lymphocytes, monocytes, eosinophils, platelets, as well as calculation of NLR, PLR and LMR.

Results. Due to univariate analysis a negative effect on OS is exerted by: the relative number of neutrophils > 61.18 % (HR = 0.66; p = 0.0280), the absolute number of lymphocytes ≤ 2.12 × 109/L (HR = 0.65; p = 0.0025), relative number of monocytes > 9.1 % (HR = 0.67; p = 0.0313), NLR > 2.30 (HR = 0.63; p = 0.0130) and LMR ≤ 3.47 (HR = 0.64; p = 0.0157). The PFS in univariate analysis was significantly negatively influenced by: the level of peripheral blood leukocytes ≤ 5.23 × 109/L (HR = 0.58; p = 0.0492), the absolute number of neutrophils > 2.86 × 109/L (HR = 0.62; p = 0.0386), the relative number of neutrophils > 61.18 % (HR = 0.53; p = 0.0028), the absolute number of lymphocytes ≤ 2.88 × 109/L (HR = 0.55; p = 0.0097), relative lymphocyte number 29.71 % (HR = 0.52; p = 0.0006), absolute number of eosinophils ≤ 0.09 × 109/L (HR = 0.55; p = 0.0244), relative number of monocytes > 6.96 % (HR = 0.58; p = 0.0087), NLR > 1.74 (HR = 0.52; p = 0.0006), PLR > 111.39 (HR = 0.63; p = 0.0196) and LMR ≤ 3.71 (HR = 0.55; p = 0.0019). According to the results of multivariate analysis, a significant negative effect on PFS was exerted by the relative number of monocytes > 6.96 %, and the absolute number of eosinophils in the peripheral blood ≤ 0.09 × 109/L. 

Conclusion. The analysis allows us to consider the factors of systemic inflammation recorded in the peripheral blood, as well as the NLR, PLR and LMR can serve as reliable additional factors in predicting the course of OCSCC.

The detection of tumor-like formations in the area of the uterine appendages during dispensary observation in patients who have undergone treatment for malignant neoplasms of the gastrointestinal tract often suggests metastatic lesions of the ovaries (Krukenberg metastasis). It is very important to collect anamnestic data, namely the fact of hereditary burden. It is recognized that one of the main indications for molecular genetic testing for the detection of mutations in the BRCA1, BRCA2 genes is hereditary burden, that is, the presence of a family history of cancer. Oncological burden of personal history, implying the development of polyneoplasias, is less often taken into account by oncologists, although it is one of the most important characteristics of hereditary ovarian cancer. Most often, with BRCA-associated ovarian cancer, breast cancer, pancreatic cancer occurs in the patient herself (polyneoplasia) or in close female and male relatives. The risk of developing stomach cancer is extremely low in patients with mutations in the BRCA1 genes. Stomach cancer is characterized by mutations in other genes. The article presents a rare case of multiple primary metachronous gastric cancer and BRCA1-associated ovarian cancer. In a patient who underwent radical treatment for stomach cancer, after 3 years, a relapse in the region of the esophageal-gastric anastomosis was revealed. Regarding the recurrence, extirpation of the gastric transplant with esophagogastroanastomosis with one-stage reconstruction – colon plastic surgery was performed in a planned manner. 10 years after the second operation, the patient was diagnosed with ovarian cancer. Taking into account the obtained postoperative historesponse for the ovary (serous adenocarcinoma), aggravated family and personal history, the patient underwent a molecular genetic study in order to identify germline mutations in the BRCA1 and BRCA2 genes by the polymerase chain reaction method. For the detection of mutations, a standard diagnostic panel was used, which makes it possible to analyze the mutations most common in the Russian Federation. According to the results of the study, the patient was found to have a 5382insC mutation in the BRCA1 gene. The patient is a candidate for PARP inhibitors, which are widely used as maintenance therapy not only for hereditary ovarian cancer, but also have found application in the treatment of patients with identified somatic mutations in the BRCA1 and BRCA2 genes, which will increase life expectancy and improve treatment results.

Introduction. An important aspect of cancer treatment today is the concept of immuno-targeted therapy, which requires a deep understanding of the characteristics of immune reactions in the body of a cancer patient. Bone marrow is the central organ of immunopoiesis, therefore, along with the study of tumor characteristics, attention is paid to the bone marrow. The study of the cellular composition of the bone marrow in some types of cancer revealed a number of features of hematopoiesis, which requires further deeper analysis.
Purpose. To study the parameters of hematopoiesis in patients with primary and recurrent ovarian cancer.
Materials and methods. The paper presents data from 68 patients with a verified diagnosis of primary (n = 43) and recurrent (n = 25) ovarian cancer. The study was dominated by serous adenocarcinoma of high grade. Stage I was established in 13.2 % of cases, II – in 5.9 %, III – in 60.3 %, IV – in 20.6 %. The bone marrow was harvested by puncture of the posterior iliac spine (spina iliaca posterior superior). Parameter assessment and myelogram calculation were performed by two physicians, morphologists. The content of myelokaryocytes, indicators of granulocyte, erythroid lineage, the content of lymphocytes, monocytes were analyzed, and myelogram indices were assessed. In all patients microscopy of bone marrow samples excluded metastatic lesions. Statistical data processing was performed using the SPSS Statistics v. 21 package.
Results. The analysis of bone marrow samples from patients with ovarian cancer revealed differences with the norm for both primary and recurrent ovarian cancer. Most punctates were normocellular, but average myelokaryocyte count in both groups was below normal. With recurrent ovarian cancer, a reduced content of promyelocytes and metamyelocytes was noted, whereas with primary cancer, all young forms of neutrophils was below normal. An increase in segmented neutrophils without a change in the percentage of cells of the granulocytic lineage was observed in primary ovarian cancer, and in one third of the samples of bone marrow an increased number lymphocytes and monocytes were noted. With recurrent ovarian cancer lymphocytes were increased in 2/3 of samples, monocyte – in 48 %. A change in the proportion of cells of the erythroid lineage was observed in both recurrent and primary cancers: depletion of the pool of basophilic normoblasts and polychromatophils with an unchanged number of erythrokaryocytes, an increase in oxyphilic forms were noted.
Conclusion. The revealed changes in hematopoiesis in ovarian cancer reflect the aggressive course of high-grade tumors, which can be considered as a result of the systemic influence of the tumor, and the obtained data can serve as the basis for a detailed immunophenotypic study of bone marrow in ovarian cancer.

Pro-tumor inflammation is associated with increased risk of oncologic malignancies development, including lung cancer. Complex tumor microenvironment which is formed during chronic inflammation contributes to tumor growth, progression, angiogenesis and metastasis. Interleukin-1β (IL-1β) is a cytokine, which plays a key role in pro-tumor inflammation development. Increased level of IL-1β in blood is related to poor prognosis of lung cancer and tumor invasiveness. IL-1β binds to its receptor and activates signaling pathways such as MAPK, COX-2 and Nf-κB, which leads to tumor infiltration with immunosuppressive cells and tumor growth promotion. Selective inhibition of IL-1β can improve the effectiveness of immunotherapy and chemotherapy via enhancing of anti-tumor immunity. In this review we observe a crucial role of pro-tumor inflammation and Il-1β in lung cancer pathogenesis.

The article explores a role of brigatinib in a basic strategy of treatment of ALK-positive non-small-cell lung cancer (NSCLC) patients with progressive disease on or with intolerance to crizotinib. Brigatinib, a next-generation anaplastic lymphoma kinase (ALK) inhibitor, at an approved dose of 180 mg once daily (with 7-day lead-in at 90 mg) is associated with extremely high activity against a wide range of ALK mutations. Brigatinib demonstrate improvement in both, long-term efficacy (the median progression-free survival is 16.7 months, the median overall Survival is 34.1 months) and short-term response to treatment. Thus, in ALTA trial Brigatinib at a dose of 180 mg per day (with lead-in) in the 2nd line of targeted therapy, was associated with IRC (independent review committee)-assessed overall objective response rate of 56 % and the median duration of response of 15.7 months. Brigatinib demonstrated a high efficacy against intracranial disease: the rate of objective response in measurable brain metastases was 67 %, the median duration of response was 16.6 months, and the median progression-free survival in the central nervous system was 18.4 months. The safety profiles of brigatinib characterized by predictable and manageable toxicity. Brigatinib demonstrate the same high efficacy and good tolerability in Russian ALK+ NSCLC patients within early access programme. The expected approval of brigatinib for ALK+ NSCLC patients in the Russian Federation in the 2nd line of treatment can significantly expand our capabilities in the fight against this formidable disease.