Pancreatic ductal adenocarcinoma occupies a leading position in mortality among other malignant neoplasms. The five-year survival of patients is less than 9 %. Risk of a tumor development increases with a mutation in the BRCA gene, however, the effect of this mutation on the clinical course of the disease has been poorly studied and is of certain scientific and practical interest. A review of the world literature on the clinical significance of germline mutations – the risks of malignancy, the choice of treatment tactics – is presented.

The article presents data on 134 breast cancer patients who were diagnosed with lesions of the parasternal, supraclavicular, subclavian and axillary lymph nodes. The effectiveness of surgical or radiation exposure to the supraclavicular/parasternal lymph nodes in their metastatic lesion was analyzed. The survival assessment showed that after 1 year of follow-up, the values of the indicator were almost the same, amounting to 96.3 and 96.4 %, respectively, in groups 1A (surgical treatment) and 1B (radiation therapy). After 3 years, the indicator value was slightly higher in subgroup 1B – 80.4 %, while in group 1A it was 77.8 %, 5-year survival in group 1A was at the level of 33.3 %, in group 1B the indicator value was higher and amounted to 44.6 %, in group 2–78.4 %. At the same time, there were no statistically significant differences in all the terms of the study. We believe that the results of our study are fully consistent with the current trend in the treatment of breast cancer, which can be defined by the phrase ‘the less surgery, the better’. According to our data, surgical removal of metastatically altered supraclavicular and parasternal lymph nodes is inferior to radiation therapy when comparing 5-year overall survival.

Last many years breast cancer on a leading position in the structure of oncological pathology among the female population. Patients with metastatic breast cancer, as well as with the presence of tumors with incipient decay or bleeding, are currently considered as patients for complex palliative systemic treatment. The question of the expediency of performing an operation in such a pathology occurs quite often in the daily practice of an oncologist-surgeon. Of course, such life-threatening conditions as decaying breast tumors, bleeding from them, do not raise doubts about the urgency of providing palliative surgical treatment, which is often it is sanitation mastectomy. However, the need for a surgical stage of treatment in the complex palliative therapy of metastatic breast cancer raises many questions. The possibilities of treating metastatic breast cancer have expanded significantly due to the development of drug therapy regimens, up to treating it as a chronic disease. The success of drug breast cancer treatment gives a chance to prolong the life of patients for many years. Thus, in the process of long-term treatment of these patients, various situations arise that require an individual solution. Based on the results of studies, the authors conclude that the decision to remove the primary breast lesion in such patients should be individualized and based on the opinion of the oncologist-surgeon, chemotherapist and radiation therapist, taking into account the potential risk, as well as the subsequent quality of life. In addition, as it turned out, the surgical stage of treatment in such patients not only improves the subsequent quality of life, but also improves oncological indicators. This article discusses the indications and contraindications for performing palliative surgical treatment of patients with breast cancer, based on world studies and our own experience and a clinical study.

The widespread use of anti-HER2 drugs has fundamentally changed the fate of patients with both early and metastatic HER2-positive breast cancer (BC). The results of clinical studies demonstrate a significant increase in the frequency of achieving complete pathological response (pCR) and, as a consequence, improved survival rates when using the combination of docetaxel + carboplatin + trastuzumab + pertuzumab (TCHP) in neoadjuvant chemotherapy for HER2+ breast cancer, which is reflected in modern domestic and international guidelines. The purpose of this study was to evaluate the effectiveness of the TCHP regimen, as well as to identify independent clinical and morphological factors in achieving pCR. The study included 234 patients with HER2-positive breast cancer of stages II and III who received TCHP regimen in neoadjuvant setting, 233 were operated. The rate of achieving complete pathomorphological response (pCR, RCB 0) was 63 %, in the nonluminal HER2-positive subtype – 76 %, in the luminal HER2-positive subtype – 55 %. Predictors of pCR were the absence of hormonal receptors in the tumor (OR = 1.72; 95 % CI: 1.17–2.54; р = 0,01), as well as a high (>50 %) Ki-67 proliferation index (OR = 1.4; 95 % CI: 1.01–1.98; р = 0,05). The use of granulocyte colony stimulating factor as primary prevention has reduced the risk of febrile neutropenia and mucositis. Further observation of patients will allow us to evaluate the long-term results of neoadjuvant therapy for HER2-positive breast cancer using the TCHP regimen in our population.

Introduction. Despite modern advances in research into the risk of development, immunological control and treatment options for lung cancer (LC), it is the leading cause of death from cancer. Tobacco smoking remains the predominant risk factor for the development of lung cancer, especially one of its aggressive subtypes, squamous cell lung cancer (SCLC). Benzo[a]pyrene, a component of cigarette smoke, promotes the activation of the aryl-hydrocarbon receptor (AhR). AhR regulates the expression of many oncogenes, including PD-L1, the positive status of which is an indication for immunotherapy, one of the main treatment strategies for SCLC. However, to improve the effectiveness of treatment of SCLC, further search for new diagnostic, prognostic and therapeutic markers is necessary. MicroRNAs (miRs), which are highly stable and present in biological fluids, can act as such markers.

Objective. Search for microRNAs that could potentially serve as diagnostic markers or therapeutic targets for SCLC. For this purpose, microRNAs were selected whose promoter regions contain AhR binding sites or whose target is PD-L1.

Materials and methods. A biocollection of tumor and conditionally normal lung tissue samples (n = 40) was collected at the thoracic department of the Novosibirsk Clinical Oncology Dispensary. The relative levels of selected miRNAs were examined using real-time reverse transcription-PCR (RT-PCR) technique.

Results. The levels of miR-342 and miR-181a in SCLC tissues were reduced by 3 times relative to conditionally normal tissue. The expression of miR-181a and miR-155 is associated with tumor size (lower levels in tumors larger than 3 cm) and the presence of metastases in the lymph nodes (3- and 2-fold lower levels in cases with metastases). The level of miR-146a decreased by 3 times in patients with metastatic lesions of lymph nodes. A significant relationship between the levels of miR-93, miR-181a and miR-155 and the expression status of PD-L1 was also found.

Conclusions. The expression profile of miR-146a, miR-93, miR-181a and miR-155 differs in SCLC patients depending on PD-L1 status and the presence or absence of lymph node metastases.

Endometrial cancer (EC) is one of the most common cancers with a constantly and steadily growing incidence worldwide. The main reason for EC development, in addition to the female population aging, involves the obesity epidemic and associated hyperinsulinemia. Screening for EC has not been developed. However, endometrial carcinoma (ECa) demonstrates a specific symptomatology and clinical picture, and diagnostic methods are available, sensitive and defined by a certain range of comorbid diseases. These factors allow early ECa diagnosis in 80 %. The methods of treatment are standardized, depending on the stage of RTM and the morphological structure of EC, the age of the patient and allow to achieve 72–76 % of the overall 5-year survival rate. The methods of treatment are standardized, depending on the EC stage, the morphological structure of ECa, and the patient’s age, and allow achieving the 5-year overall survival of 72–76 %. The disease promised a favorable outcome and seemed to be controlled. However, at the end of the last century, researchers started to report the clinical and morphological heterogeneity of ECa, which allowed Ya. V. Bohman to propose a dichotomous division of EC into clinical and pathological variants. Such a division was accepted all over the world and required re-evaluation of the prognostic value of various endometrial adenocarcinoma histotypes depending on the phenotype and hormonogenesis of ECa. Initially, adenosquamous cancer (or endometrioid adenocarcinoma with squamous metaplasia, in the modern classification) was also classified as estrogen-dependent endometrioid adenocarcinoma, and squamous cell endometrial cancer was classified as an unfavorable type with a poor prognosis and without hormonal influence. Interest in the squamous cell component in dimorphic endometrial adenocarcinoma has repeatedly arisen over the past decades due to its unpredictable clinical course. The newest TCGA molecular classification of EC did not clarify the issues, but gave rise to new ones related to the etiology and carcinogenesis of this ECa histotype and its clinical interpretation.

Cervical cancer is the fourth most common cancer in women worldwide and is responsible for over 300 thousand deaths worldwide. The causative agent of cervical cancer is persistent infection with high-risk human papillomavirus subtypes, and viral oncoproteins E 5, E 6, and E 7 interact with human factors to induce and maintain a malignant phenotype. This review describes the mechanisms behind the onset and development of cervical cancer and discusses in detail promising and effective new treatment options for cervical cancer, including immunotherapy, targeted therapy and combination therapy.

Surgical oncology is not a well-defined discipline. The variety of surgical specialties in oncology is due to the variety of tumor localizations. After operations involving the abdominal organs, it is possible to develop dynamic intestinal obstruction, which is referred to as postoperative paresis of the gastrointestinal tract or postoperative ileus (POI). We did not find any information on the frequency of POI in surgical oncology, however, the frequency of POI in the clinic of colorectal surgery is known to be from 10 to 30 % and after gynecological operations from 10 to 15 %. The issue of POI prevention remains relevant. In a systematic review of recommendations aimed at restoring GI function after abdominal surgery, the most commonly recommended interventions were magnesium-based laxatives (48.6 %) and chewing gum (35.1 %), with other recommendations occurring significantly. less often. However, in domestic reviews, only 1 paragraph is devoted to the possibilities of using chewing gum for the prevention of POI in colorectal surgery and obstetric and gynecological practice, with a limited number of references to literary sources. In real clinical practice, chewing gum has been used after surgery to reduce POI since the beginning of the 21st century. The recommendation for the use of chewing gum in the postoperative period after abdominal surgery has now been included in a number of clinical guidelines. The review considers clinical studies, reviews and meta-analyses that have studied the possibility of using chewing gum in the prevention of POI in oncological surgery.