The development and introduction into widespread practice of anti-HER2 agents has changed the natural course of HER2-positive breast cancer, significantly increasing the chance of cure in early forms and significantly increasing the life expectancy of patients with metastatic disease. The results of clinical trials indicate a significant increase in the frequency of achieving complete pathological regress and improved survival rates when using the combination of trastuzumab + pertuzumab in neoadjuvant therapy for HER2-positive breast cancer, which is reflected in modern national and international guidelines. However, the use of drugs in real clinical practice is associated with a whole range of factors and may differ from standard recommendations. To understand the situation in the Russian Federation, a survey study ‘Therapy of HER2-positive breast cancer’ was conducted. 50 specialists – heads of drug therapy departments and/or their deputies who are directly involved in the development of a treatment plan for patients, were involved in the survey. It allows to reflect the preferences of leading chemotherapists regarding treatment strategies for patients with HER2-positive breast cancer in Russian Federation. This publication highlights the results of a survey on the prescription of neoadjuvant therapy for primary resectable and locally advanced unresectable HER2-positive breast cancer. Most experts prefer to use combinations with pertuzumab. In real clinical practice, 62% of patients receive dual anti-HER2 therapy. In the future, experts are ready to increase the percentage of prescribing pertuzumab for early HER2-positive breast cancer for more 16–20%. Based on the results of large randomized trials, this should improve long-term outcomes in one of the most aggressive forms of breast cancer.

The article presents the evolution of the development of oncomammoscreening in Russia and in the world, based on mammography and other methods of non-invasive and invasive radiation diagnostics of breast diseases – from screenless analogue mammography to digital technologies, X-ray tomosynthesis, dual-energy contrast mammography, the development of a wide range of other radiation methods for diagnosing diseases breast, based on non-ionizing radiation – ultrasound, magnetic resonance, etc. The stages of improving contrast and non-contrast technologies of interventional radiology in mammology are shown. The historical aspect outlines the formation and improvement of organizational forms of development of the cancer screening system in the country and the world.

Introduction. The efficacy of dose-dense AC in adjuvant chemotherapy of luminal breast cancer (ER+ BC) compared with the standard dosing regimen followed by switching to taxanes has been proven in numerous clinical trials and in a large meta-analysis of the EBCTCG group. However, no study about efficiency of this regimen in neoadjuvant setting has been published.

The aim of the study. To assess the effectiveness of dose-dense regimens of neoadjuvant chemotherapy (NAC) of ER + HER2-BC (4 AC once every 2 weeks (dose dense, ddAC), then 4 courses of Docetaxel once every 3 weeks or 12 weekly injections of Paclitaxel [4D/12P]) and their comparison with the standard ones (AC once every 3 weeks [ACq3w], hereinafter 4D/12P). Primary end points are complete response rate (pCR) and RCB0–I.

Methods. This retrospective study included patients with resectable or locally advanced luminal HER2-negative breast cancer who received NAC from Janu 2017 to Aug 2022. Statistical hypothesis – the dose-dense regimen AC increases the frequency of RCB0–I from 22 to 32% compared to the standard dosing regimen with subsequent switching to taxanes, with a study power of 80%, ά = 0.05, 138 patients should be included in the study. A total of 315 patients were included in the study, of which 147 and 168 patients received dose-dense (ddAC) and standard chemotherapy (ACq3w), respectively. After propensity matching analysis 138 patients in each group were included in the final analysis.

Results. The pCR rate was 18.84% in the ddAC group versus 14.49% in the AC q3w group, the differences were not statistically significant (p = 0.379). The frequency of RCB0–I was higher in the ddAC – group 33.33% versus 21.74% in the AC q3w (p = 0.040). According to the subgroup analysis, rate of RCB0–I was significantly higher in patients younger 50 years, cN0, with the expression of progesterone receptors in ≥ 20%.

Conclusions. This is the first study to compare the efficacy of a ddAC NAC with a standard regimen for ER + HER2-BC. NAC with ddAC is associated with an increase in RCB0–I rate.

Adjuvant endocrine therapy is an integral component of treatment for resectable luminal breast cancer. Tamoxifen or aromatase inhibitors monotherapy has been the standard of practice for many years. However, recent studies have shown that the addition of ovarian suppression statistically significantly increases survival rates in patients at high risk for recurrence and with poor prognosis factors. In this literature review, we summarized recent data regarding the role of ovarian suppression in adjuvant therapy for hormone-positive breast cancer. Suppression of ovarian function was most effective in young patients (< 35 years) in the premenopausal stage when adverse prognostic factors were present (indications for (neo)adjuvant CT, G3, etc.) The authors noted that using of aromatase inhibitors instead of tamoxifen in this subgroup significantly reduced the risk of breast cancer recurrence. Ovarian suppression, especially in combination with aromatase inhibitors, was accompanied by an increase in the incidence of adverse side effects, particularly osteoporosis and bone fractures, which can be reduced by prescribing adequate accompanying therapy with OMA. The optimal duration of ovarian function suppression has also not been determined, but a two-year course seems optimal, given the results of large clinical trials. In the protocols performed, there was no significant effect of temporary ovarian suppression on the likelihood of subsequent pregnancy.

Cytostatic therapy still remains the gold standard for the treatment of inoperable pleural mesothelioma with a life expectancy of about 9–18 months. The article presents the results of the use of immune checkpoint inhibitors in the first treatment line for inoperable malignant pleural mesothelioma and management of immune-related adverse events in an elderly patient.

Relevance. According to the World Health Organization, the most common oncological diseases in childhood are hemoblastoses. In particular, acute leukemia ranks the first in the structure of malignant tumors, non-Hodgkin’s lymphomas – the third, Hodgkin lymphoma – the fifth in children aged 0 to 19 years. There is no convincing evidence of the inheritance of these diseases, but nevertheless, the literature describes cases of the development of the same disease with the same immunophenotype within the same family in mono- or dizygotic twins, which is one of the proofs of the persistence of preleukemic cells and the possibility of their migration from one twin to another during the antenatal development. These data allow us to study the features of oncogenesis in leukemia in twins, in particular monozygotic twins: the timing of tumor development, clinical features and molecular biological characteristics, as well as the response to therapy.

Aim. To study the clinical and molecular-genetic features of hemoblastoses in twins.

Materials and methods. When writing a literature review, we analyzed data in specialized medical databases PubMed, Scopus, Web of Science with the very first descriptions of the manifestations of tumors of the hematopoietic system in monozygotic twins from 1964 to 2023.

Results. In the course of writing this literature review, we confirmed that the genetic component plays a significant role in the development of hemoblastoses. Studies on twins reveal genetic mutations that predispose to the development of malignant blood tumors, which in turn opens up new opportunities for the early diagnosis of hemoblastoses. The twin method allows for comparative clinical trials of different treatment approaches, which help to choose the optimal therapy and improve the prognosis of diseases.

Relevance. Search for electroencephalographic, psychological and neurochemical correlates of anxiety in adolescents with lymphoid tumors (LT).

Material and methods. In 23 adolescents aged 11 to 16 years with LT, receiving chemotherapy according to the programs recommended by group BFM (Berlin – Frankfurt – Munster), an electroencephalographic (EEG), biochemical and psychological study of the level of anxiety was performed using the Spielberger method. The control group included healthy adolescents.

Results. Electroencephalograms in adolescents with LT differed significantly from those typical for this age group in the norm. During the chemotherapy, EEG variants were found that are not characteristic of healthy peers. A significant increase in the level of situational anxiety was revealed, compared with the control group. The level of both situational and personal anxiety correlated with power values in the beta‑1, -2 band (17–21 Hz) in the frontal areas of the cerebral cortex. Relationships were found between neurochemical indicators of stress (VMA) and neurotoxicity (N-ANA) with an increased content of beta‑1 and beta‑2 activity in the central-parietal regions and a deficit in the activity of the alpha frequency band, according to EEG data, and an increase in the level of anxiety.

Conclusions. 1. In adolescents with LT, the tumor process and chemotherapy have a negative impact on the functioning of the central nervous system, which is reflected in the change in the level of ‘anxiety’ and the appearance of pathological forms of activity in the EEG and in the dynamics of neurochemical parameters. 2. An increased level of theta- and beta-activity in the frontotemporal areas of the cerebral cortex in adolescents with LT, which correlates with an increased level of anxiety, may be one of the markers of neurotoxicity.

Background. Currently, the main treatment for T1N0M0 kidney cancer is surgery, mainly in the amount of kidney resection. However, not all patients can be operated on, and most often due to the severity of comorbidity, some patients refuse surgery. In such cases, it becomes necessary to search for an acceptable operation of an alternative method of treatment. Such requirements can be met by stereotactic radiotherapy (SBRT), being a non-invasive method of treating renal cell carcinoma.

Purpose. To determine overall survival (OS), local control, and renal toxicity after treatment of T1N0M0 renal cell carcinoma (RCC) with stereotactic radiotherapy.

Material and methods. Since 2011 to 2022 in the Chelyabinsk Regional Clinical Centre of Oncology and Nuclear Medicine, 50 patients with verified RCC underwent SBRT up to 30–45 Grey in three fractions using the CyberKnife. The mean age of the patients was 69.8 years. Primary tumor was diagnosed in 44 cases, recurrence after previous surgical treatment in 6 cases, including one patient with recurrence of cancer of both kidneys. The average tumor volume was 29.1 cm3 .

Results. Median overall survival was not reached as most patients were alive at the time of the study. Indicators of 1-, 3- and 5-year OS are 94.8%, 87.3% and 75.1%, respectively. In 74.5% of cases, according to the RECIST 1.1 criteria, stabilization of the process was recorded 6 months after STLT, in 21.6% of cases – a partial response, in 3.9% – progression of the process. One-year local control – 98%. Renal toxicity occurred in 26% of patients 6 months after radiation therapy, but within a year, kidney function was restored in these patients.

Conclusions. Stereotactic radiation therapy T1N0M0 of kidney cancer in SOD = 30–45 Grey allows to stabilize the tumor process with sufficiently high results of overall survival and local control with low renal toxicity, respectively, can be used in the treatment of inoperable patients with localized renal cell carcinoma.

Malignant glomus tumor is an extremely rare, aggressive neoplasm, which is contain from modified glomus body’s cells. The correct morphological diagnosis is difficult, and requires careful differential diagnosis between neuroendocrine tumors, pericytic tumors, smooth muscle neoplasms. The literature describes only sporadic clinical observations, a series of cases and the results of a small number of retrospective studies. Due to the rarity of nosology, the optimal treatment strategy for this disease has not been developed. Most cases, surgical treatment is used in a locally common process. Cases of metastasis of a malignant glomus tumor are extremely rare. There is no consensus on the tactics of systemic treatment to date. In this article, we present a clinical case of achieving stabilization of the tumor process after 5 courses of chemotherapy with doxorubicin, ifosfamide in a 49-year-old patient with a malignant glomus tumor of the soft tissues of the left forearm with metastatic lesion of the tissues of the anterior chest wall on the left with spread to the left small pectoral muscle, 3rd rib and pleural cavity, with metastatic lesion lung parenchyma.

Relevance. Endometrial stromal sarcomas are rare tumors that account for about 0.2% of all malignant tumors of the genital tract. It is believed that they are more common in premenopausal women. Endometrial stromal sarcomas are hormone-sensitive tumors. Because of the rarity of this tumor, there are a limited number of reports in the publications concerning the clinical control and the final result of such cases.

Purpose. To study the main pathogenetic, clinical and morphological features of endometrial stromal sarcoma on the example of a clinical case.

Materials and methods. The article presents a clinical case of malignant tumor of the uterus, histologically – endometrial stromal sarcoma.

Results and conclusions. Diagnosis of endometrial stromal sarcoma is difficult; tumor verification requires mandatory histological examination. Difficulties in diagnosis largely determine the low early detection and poor prognosis in patients with endometrial sarcomas.