Metastatic breast cancer (MBC) is an incurable disease by now. The main goals of treatment are prolongation of life, control of symptoms and preservation/improvement of quality of life. The modern arsenal of antitumor agents when choosing the optimal treatment regimen allows to be guided not only by efficiency and safety values, but also to take into account the ease of using drugs. Thus, the oral form of vinorelbine demonstrates high antitumor efficacy regardless of the subtype of breast cancer and the line of treatment, and also allows the patient to avoid serious toxicity and lead a regular lifestyle. This overview presents the results of the main clinical studies of vinorelbin, with special attention to combinations for the treatment of HER2-positive metastatic breast cancer. A case of successful treatment of a rare pathology – metastatic HER2-positive breast cancer in a man is presented.

Objective. To analyze the results of treatment and prognostic factors of general and relapse-free survival in patients with locally advanced welldifferentiated thyroid cancer who received surgical treatment, radiation therapy, radioiodine therapy and chemotherapy.

Methods. The retrospective study included patients with a verified diagnosis of locally advanced well-differentiated thyroid cancer who received treatment at the National Medical Research Centre of Oncology n. a. N. N. Petrov (Saint Petersburg, Russia). The study endpoints were overall and disease-free survival.

Results. Seventy-six patients were included in the study. The average age of patients was 60.0 (20.3) years, the median age was 62.0 (52.8–73.0) years. 25 (32.9 %) of 76 patients were male. The median overall survival was 109.0 months, and the 5-year overall survival rate was 80 months (95 % CI: 65.6–97.5). The median relapse-free survival was 108.6 months (the lower limit was 95 % CI was 56.7), and the 5-year relapse-free survival rate was 62.1 months (95 % CI: 46.5–83.0).

Conclusion. Analysis of risk factors revealed a statistically significant relationship between tumor invasion into the larynx and chemotherapy. Factors such as the patient’s age and neck lymph node surgery are associated with the risk of recurrence or death.

Nowadays we can see a significant improvement and changes in the treatment of the patients with lung cancer. The current recommendations for the treatment are constantly being changed. New schemes and medicines are coming to the clinical practice. However, there are a group of patients outside of guidelines: patients with ECOG‑2 status, clinically rapidly progressing, with severe anxiety. Such patients are not including in clinical trials. Apparently, it is not quite right to transfer the current standard recommendations for the treatment to this group of patients. This review discusses various aspects related to the choice of a first line treatment in patients with metastatic non-small cell lung cancer in the situation of time absence and luck of molecular status of the patient. Is there a place for the starting with chemotherapy or immunochemotherapy, switching to targeted therapy or immunotherapy in the process of treatment.

Breast cancer currently occupies a leading place in the structure of morbidity and mortality of the female world population. Despite the improvement of methods of diagnosis and treatment of this pathology, more than 2,1 million new cases are detected annually. All these facts make us look for more informative methods of diagnosing breast cancer. The purpose of the study is to evaluate the effectiveness of a new improved algorithm of the diagnosis of one of the rarest forms of intracystic breast cancer. 153 patients with suspected cancer in breast cyst were examined in the study. Compression elastography, shear-wave elastography and fine needle aspiration were included in the standard traditional examination algorithm according to our improved method with using an ozone-oxygen mixture. We have obtained data on lower sensitivity and specificity of the traditional diagnostic complex of examination of patients with suspected intracystic breast cancer in comparison with the improved algorithm.

Relevance. Advances in cancer treatment over the past decades have improved long-term patient survival, but increased the incidence of chemotherapy-associated cardiotoxicity (CTA). The study of quality of life (QOL) indicators is becoming an important and integral subject of management for patients receiving high doses of anticancer therapy. In particular, CTA carries a high burden on the healthcare system and the habitual lifestyle of patients due to a decrease in the functional ability of the body. Due to the increase in the life expectancy of patients with oncological diseases, the issues of maintaining a high QoL are becoming increasingly important.

The aim of the study was to conduct a comprehensive assessment of QoL in patients during neoadjuvant chemotherapy.

Materials and methods. The study included 72 patients with breast cancer who underwent a comprehensive assessment of the cardiovascular system at the National Medical Research Centre for Cardiovascular Surgery n. a. A. N. Bakoulev as a continuous cardiac monitoring during neoadjuvant chemotherapy. To assess the QoL, all patients filled out a standardized questionnaire SF-36, EQ-5D-5L, as well as indicators according to the international Karnovsky and ECOG (Eastern Cooperative Oncology Group) scales. The possible relationship between various indicators of the questionnaire with internationally validated scales, as well as data on the clinical status of patients, were studied.

Results. Significant deterioration in the quality of life of patients receiving neoadjuvant chemotherapy was observed in all analyzed parameters: SF-36, Karnovsky scale, ECOG and EQ 5D-5L decreased sharply, the prevalence of general weakness, shortness of breath and decreased exercise tolerance increased. According to the SF-36, initially low rates were observed in a large number of patients, respectively, 80 and 82 %, at the intermediate and final stages, almost all patients showed a deterioration in condition compared to the outcome (p = 0.0002–0.0001). Predictors of a pronounced negative deviation of QoL indicators are the presence of initial reduced ECOG and Karnovsky scores, as well as the presence of an initial decrease in exercise tolerance, the presence of weakness and shortness of breath.

Conclusion. In the course of continuous cardiac monitoring, we demonstrated a deterioration in all QoL indicators, according to questionnaires and validated international scales during neoadjuvant chemotherapy. The predictors of a pronounced decrease in QoL indicators are the presence of initial reduced ECOG and Karnovsky scale, as well as the presence of an initial decrease in exercise tolerance, the presence of weakness and shortness of breath. The Karnovsky scale and ECOG can be adapted for an objective assessment of QoL indicators during neoadjuvant chemotherapy.

Objective. To evaluate the effectiveness of contrast-enhanced ultrasound in the formation of the protocol of virtual dynamic nephroscintigraphy in patients with type 2 diabetes mellitus.

Materials and methods. All patients were examined according to a single diagnostic algorithm, which included four stages: 1) multiparametric ultrasound examination of the kidneys in the In-mode; 2) Doppler assessment of the state of intrarenal blood flow in this group of patients; 3) carrying out CEUS of the kidneys in accordance with European recommendations for clinical practice on contrast-enhanced ultrasound examination followed by the calculation of virtual dynamic nephroscintigraphy; 4) carrying out dynamic nephroscintigraphy according to standard the methodology as a reference method.

Results. In the course of the study, patients (n = 32) with a clinical diagnosis of type 2 diabetes mellitus of varying severity were examined. All patients were divided into 2 groups of 16 people each, depending on the results of glomerular filtration rate (GFR). The time of maximum accumulation of contrast agent in group 1 (patients with type 2 diabetes and GFR greater than 60 ml/min/1.73 m2) is quantitatively less than in group 2 (patients with type 2 diabetes and GFR 30–44 ml/min/1.73 m2). The half-life of the contrast agent in groups 1 and 2 does not change significantly. When performing virtual dynamic nephroscintigraphy in patients of the 1st and 2nd groups, the results correlating with the reference method – dynamic nephroscintigraphy were obtained.

Conclusion. The method of using contrast-enhanced ultrasound in the formation of the protocol of virtual dynamic nephroscintigraphy in patients with type 2 diabetes mellitus allows us to obtain quantitative indicators of dynamic nephroscintigraphy for subsequent medical conclusions, as well as the possibility of dynamic monitoring of the course of the disease without the use of ionizing research methods.

The purpose of this study. To assess the dynamics of the incidence of malignant neoplasms in the population of the Siberian Federal District.

Materials and methods. In this work, based on the materials of statistical reports (the Form No. 7) of the health authorities of the subjects of the Siberian Federal District and the Russian Federation, an epidemiological analysis was carried out and an assessment of the epidemiological manifestations of morbidity (incidence) of the population with malignant neoplasms for the period from 2008 to 2019 was given.

Results. During the observation period in the population living in the territories of the Siberian Federal District, there was a tendency to increase the incidence of malignant neoplasms (Tpr. = 1.4 %, with an average federal indicator of 1.1 %). The largest increase in intensive indicators of malignant neoplasms incidents was observed in the Republic of Tyva and the Krasnoyarsk Territory (2.4 % and 2.2 %, respectively). Among the male population of the Siberian Federal District, the largest increase in intensive indicators was observed in the Krasnoyarsk Territory and the Republic of Khakassia (2.2 % and 2.1 %, respectively). The highest rate of increase in the incidence of women was observed in the Republic of Tyva (3.3 %). Despite the obvious relevance, the epidemiology and causes of the development of malignant neoplasms in the Siberian Federal District have not been studied enough, which requires scientific justification and improvement of approaches to primary prevention, taking into account regional peculiarities.

Conclusion. In general, in the subjects of the Siberian Federal District from 2008 to 2019, a situation similar to the global trend was revealed, characterized by an increase in the incidence of the population of malignant neoplasms, which is a reflection of insufficient attention to the primary prevention of malignant neoplasms, the peculiarities of the socio-economic situation in the Russian Federation, as well as the lack of proper sanitary and educational work.

Alpelisib is a modern targeted drug for the treatment of patients with hormone receptor-positive HER2-negative metastatic breast cancer with a PIK3CA gene mutation. Blockade of PI3K can significantly increase progression-free survival, however, it is accompanied by adverse events, the most common of which is hyperglycemia. The article presents recommendations for risk estimation, prevention and correction of alpelisibinduced hyperglycemia.