This article summarizes the latest data concerning second and later lines treatments of patients with metastatic gastric carcinoma. Different variants of classical chemotherapy as well as targeted therapy (anti-PD checkpoint inhibitors, ramucirumab) significantly improve overall survival. Risk models based on prognostic factors help to select patients with most benefit on second-line treatment.

The article presents clinical cases of successful use of chemotherapy with eribulin in patients with disseminated luminal and triple negative breast cancer.

The article discusses the place of targeted and immunotherapy in the treatment of advanced non-small-cell lung cancer with activating EGFR mutations. According to subgroup analyzes and meta-analysis of randomized clinical trials, inhibitors of immunity control points have no advantage over chemotherapy in this category of patients. One of the important factors explaining the relatively lower efficacy of anti-PD/PD-L1 monoclonal antibodies in EGFRm NSCLC is the low mutation load characteristic for tumors with driver mutations. On the contrary, targeted therapy with tyrosine kinase inhibitors in this population increases survival rate, provides a very high frequency of objective response and is characterized by rapid regression, which is very important in the symptomatic course of the disease and the high prevalence of the tumor process. Thus, tyrosine kinase inhibitors continue to be the standard for the therapy of patients with locally distributed or metastatic NSCLC EGFRm.

The issue of choice of optimal treatment algorithm for localized and locally-advanced prostate cancer remains actual for latest decades. Brachytherapy as monotherapy is an effective method for the treatment of low and intermediate risk. It shows remarkable biochemical recurrence-free survival while avoiding normal tissue toxicity. For the high risk disease brachytherapy is one of the modality combined treatment, includes external beam radiotherapy and androgen deprivation. The further investigations is study of possibility to apply contact radiotherapy for local recurrence. Another issue is to find a cheaper cost of treatment.

The article presents the results of oral use of vinorelbine for the second and third lines of chemotherapy of metastatic breast cancer. Patients received vinorelbine per os 60 mg/m² 1 time per week (1st, 8th, 15th day of treatment), 21 day cycle, with subsequent dose escalation up to 80 mg/m². The disease control (partial response + stabilization) was achieved in 13 of 17 patients. Oral chemotherapy with vinorelbin has a satisfactory profile of toxicity, can be performed in outpatient department, requires minimal maintenance.

The article shows the results of clinical application of a recombinant tumor necrosis factor-alpha-thymosin-alpha1 (TNF-T) and chemotherapy FAC and РА for neoadjuvant treatment of patients with breast cancer of IIB-IIIB stages. In contrast to the standard subcutaneous administration, the authors proposed peritumoral application of TNF-T to maximize the drugs action directly on the tumor and peritumoral tissue. TNF-T 200 000 IU peritumorally on days 1-5 used each chemotharapy course showed significant increase in response rate, including increase in frequency of complete regressions, and decrease in frequency and intensity of chemotherapy complications as well. Morphological examination revealed an increase rate of pathomorphosis grade III-IV, decreased number of microvessels in tumor in comparison with primary tumors. Immune status of patients shows that the proposed method of peritumoral application of recombinant hybrid protein of tumor necrosis factor-alpha-thymosin-alpha1 has an immunocorrective effect because of its effect on T- and B-cell component of the immune system. Besides application of this technique allows to increase 3-year disease-free survival rate by 20 %.

A domestic vena cava filter Korona was implanted into more that one thousand oncologically sick people for preventive treatment of thromboembolism of the pulmonary arteries. And only one patient (0.09 %) got complications which had set in perforation of the IVC wall and into clinically significant cropping out of cava filter s radiates beyond the vein s wall. The reimplantation of the device into the other part of IVC was necessary. After installation of a trap for emboli in IVC the thromboembolism of pulmonary arteries happened to 5 patients (0.5 %). The structural features of the implanted device Korona are being discussed and their data of effectiveness are also compared with the other models of cava filters in the available literature. The achieved results testily to safety and effectiveness of domestically produced model of cava filter.

This article presents the results of surgical treatment of non-small cell lung cancer (NSCLC). Performing lobectomy compared with pneumonectomy increases 5-year survival rate from 39.3 to 59.5 %, and 10-year rate from 31.2 to 45.2 % respectively. The overall 5-year survival rate after surgery with systematic nodal dissection was 55.2 % and 45.5 % for the 10-year survival. Preference for the surgical treatment of NSCLC should be given to lobectomy with the systematic nodal dissection.

As permanent reference points for intraoperative visualization of the recurrent laryngeal nerve, it is recommended to use tracheoesophageal furrows and the lower edge of the cricoid cartilage, taking into account the fact that after excision of the lateral lobe of the thyroid gland into the wound, the distal segment of the nerve is displaced laterally and anteriorly, lying on the lateral surface of the trachea. The location of the lymphatic duct is very variable. The parathyroid glands located on the same horizontal level, have the same shape and are located at the same distance from the median line of the thyroid gland. However, these anatomical structures may change or poorly differentiate with the growth of the thyroid tumor, which contributes to an increase in the number of postoperative complications.