Neuroendocrine tumors (NET) are fairly heterogenous malignant tumors. The algorithm of choosing a particular type of treatment, including systemic therapy, depends on the degree of differentiation and tumor burden based on the WHO classification (2010) and the guidelines of the European Neuroendocrine Tumor Society (ENETS, 2011). This nosology is relatively rare (the incidence is 2 to 5 per 100 thousand population).

However, over the past 30 years, there has been an increase in the number of NET diseases by 720 % according to the US SEER (Surveillance, Epidemiology, and End Results) register. This article presents the results of the analysis of the clinical and epidemiological characteristics of neuroendocrine gastrointestinal tumors in patients treated in the St. Petersburg City Clinical Oncology Centre.

The aim. To present a clinical case of treatment of a patient with progressive papillary thyroid cancer in the form of metastatic lesion of the left retropharyngeal lymph node with the targeted drug lenvatinib.

Materials and methods. Clinical, laboratory, radiological and pathomorphological data of a 49-year-old male patient with verified papillary thyroid cancer with disease progression after initial treatment in the form of metastatic lesion of the left retropharyngeal lymph node

Results. A 49-year-old man of European origin, in March 2019, underwent surgical treatment in the volume of thyroidectomy with central and left-sided lateral lymph node dissection followed by radioiodintherapy with 3 Gbc activity for papillary cancer of the left thyroid lobe pT1N 1bM0. In October, according to the control examination, the progression of the disease in the form of metastatic lesion of the left retropharyngeal lymph node was registered. Since February 2020, by appointment of the multidisciplinary commission of the NMRC of Oncology n. a. N. N. Petrov (Moscow, Russia), currently, the patient is taking the targeted drug lenvatinib in a daily dose of 24 mg with satisfactory tolerability. According to control examinations, while taking the drug for 18 months, there was a partial response with a decrease in the size of the left retropharyngeal lymph node from 15 to 7 mm according to magnetic resonance imaging and a decrease in the activity (SUV_max) of the accumulation of 18F-glucose from 10.46 to 5.99.

Conclusion. The presented clinical case demonstrates a rare variant of metastasis of papillary thyroid cancer in the left retropharyngeal node and the result of treatment with the targeted drug lenvatinib on the background of taking for 18 months.

Неметастатический кастрационно-резистентный рак предстательной железы (нмКРРПЖ) характеризуется повышением простатспецифического антигена, несмотря на низкий уровень тестостерона при продолжающейся андроген-депривационной терапии или проведенной ранее билатеральной орхиэктомии, без метастазов по методам стандартной радиологической диагностики. Пациенты с нмКРРПЖ находятся в зоне риска метастазирования и появления симптомов рака, что в конечном итоге может привести к смерти от злокачественного новообразования. Пациенты с нмКРРПЖ обычно не имеют выраженных симптомов, чаще всего это люди пожилого возраста, имеющие сопутствующие хронические заболевания, требующие длительной лекарственной терапии. Данные особенности указывают на необходимость своевременного выявления нмКРРПЖ и принятие решения о тактике лечения.

Purpose of the study. To analyze the data on differential gene expression with the isolation of the main signaling pathways in endometrial carcinoma and rare forms of uterine cancer using bioinformation technologies and to determine the effect of the genetic profile on the survival of patients.

Materials and methods. The identification of differentially expressed genes in tumor cells in endometrial carcinoma, as well as their effect on survival, was carried out using the Gene Expression Omnibus database, the Atlas of the cancer genome, DAVID, STRING and the Bioconductor packages, Cytoscape network software. In addition, we analyzed the survival rate of 2756 patients with uterine cancer according to the cancer registry of Rostov and Volgograd regions. Real-time PCR analysis was used to assess the expression of the gene CDKN2A in tumor cells in endometrial carcinoma, clear cell and serous carcinoma of the uterine body, followed by an assessment of the effect of gene expression on patient survival.

Results. In uterine cancer, high expression activity of the genes CDKN2A, L1CAM, ERBB2, PAX8, UBE2C, CLDN4, KIF2C, AURKB, and TNNT1 was found in comparison with normal endometrium. Expression of the gene CDKN 2A sharply increased in serous and clear cell carcinomas and was many times higher than in endometrioid tumors. Overexpression of the gene CDKN2A in serous and clear cell carcinomas is associated with the development of death and lost its independence as a predictor of endometrial adenocarcinoma.

Conclusion. Evaluation of gene expression CDKN 2A is promising for expanding the molecular genetic classification of uterine cancer and predicting the survival of patients with rare forms of uterine cancer.

According to the International Foundation for Research on Cancer, malignant neoplasms of the pancreas are the fourth leading cause of death among all oncological nosologies. Over the past few years, there has been a trend in the form of an increase in the number of newly diagnosed cases of the disease. The disappointing data of pancreatic cancer statistics dictate the conditions for a more intensive study of nature, the search for new possible methods for the early detection and treatment of pancreatic cancer. One of the promising areas is to study the effect of vitamin D and its derivatives on carcinogenesis and prevention of pancreatic cancer. Vitamin D and its derivatives have the ability to regulate growth, differentiation, apoptosis and angiogenesis of cells, thus, the concentration of this substance in blood plasma in patients at risk of developing pancreatic cancer can be used in a set of measures for the early detection of this pathology. One of the morphological features of pancreatic cancer, which determines resistance to chemotherapeutic agents, is the presence of a desmoplastic stroma. Vitamin D is able to influence the functioning of the elements of the desmoplastic stroma of pancreatic cancer, which may contribute to an improved effect of cytotoxic chemotherapy and the formation of an immunogenic response to treatment. One of the pleiotropic effects of vitamin D is in the regulation of the immune system: it may play a role in increasing the sensitivity of tumors to other immunotherapies. These areas are considered promising in the treatment of pancreatic cancer. The purpose of this literature review is to highlight the effect of vitamin D on carcinogenesis, early detection and treatment of pancreatic cancer.

The first radiopharmaceutical drug for the treatment of metastatic castration-resistant prostate cancer, Radium-223, was registered in Russia in 2016. The drug has proven its effectiveness not only in reducing pain in patients with bone metastases, but also in significantly lengthening overall survival, which made it an attractive treatment option for a certain category of patients. This article presents the first results of the use of ‘Xofigo’ in the Primorsky Regional Oncological Centre.

The article analyzes the literature data on organ-preserving and oncoplastic breast resections in cancer. Organ-preserving operations were performed in patients with stage I–IIA, comparing the results of treatment with patients after radical mastectomies. Oncoplastic resections are used to achieve good aesthetic results with operable and locally advanced breast cancer, as well as with such an aesthetically unfavorable localization of the tumor node in the mammary gland, which will obviously lead to unsatisfactory cosmetic results with classical organ-preserving surgery. In recent years, the term extreme oncoplastic resection has appeared, in which the indications for performing organ-preserving operations have expanded, namely, with multicentricity, multifocality and a tumor node size of more than 50 mm, it has become possible to perform oncoplastic resections. These operations improve the quality of life in breast cancer patients and are a method of rehabilitation.

Treatment of bladder cancer is a traditional problem of modern oncology, given the property of this disease to develop in patients of the older age group. For those patients who cannot be offered radical cystectomy because of the anesthetic risks or who refuse it, trimodality therapy, including transurethral resection of the maximum volume and a radical course of chemoradiation therapy, looks like a worthy alternative to radical surgery. This article contains a review of the recent publications on the issue voiced in it, as well as a clinical example of the effectiveness of radiotherapy in a patient with an initially metastatic bladder cancer.

This article reviews different aspects of usage of ixabepilone: from mechanism of action and data of clinical trials to clinical recommendations. We also present our own experience with this drug, which illustrates additional opportunities for extending survival in patient with metastatic breast cancer after seven lines of therapy. Rational usage of all available drugs helps to expand our treatment horizons and prolong lifetime of our patients.