Introduction. Currently, immune and immune-targeted combinations are in the place of mRCC treatment for all prognosis groups, according to the world’s and national recommendations. These changes are associated with the results of pivotal studies, which proved the efficacy and safety of combinations of immuno-targeted or dual immunotherapy. Considering the changes in clinical recommendations, a retrospective analysis was initiated to assess the effectiveness of first-line therapy in patients with metastatic renal cell carcinoma (mRCC) in the Sverdlovsk Regional Oncology Dispensary.

   Results. The study included 950 patients from January 2021 to November 2024. The median follow-up time was 15 months. Most patients (69 %) had an intermediate and poor prognosis. 28.1 % of patients received combination treatment as the first line. The median PFS in the overall subgroup was 10.5 months. 1-year PFS was 46.5 %. The 2-year PFS was 22.2 %. 32 % patients received subsequent antitumor therapy. The ORR was 40 %, disease progression was recorded in 17 % of cases. The highest disease control rate (DCR) was recorded for combinations of nivolumab + ipilimumab, nivolumab + cabozantinib, lenvatinib + pembrolizumab.

   Conclusions. A change in the structure of the first-line therapy for mRCC was revealed towards a decrease in the prescription of monotherapy with tyrosine kinase inhibitors (TKI). The median OS, PFS is currently not reached in combinations group compared with monotherapy TKI. At the same time, one-year PFS tends to increase when using combinations of pembrolizumab + axitinib, pembrolizumab + lenvatinib. The best ORR rates were achieved in the nivolumab + cabozantinib, pembrolizumab + axitinib, pembrolizumab + lenvatinib, ipilimumab + nivolumab groups. A longer follow-up is required to conduct subgroup analyses and obtain PFS and OS data.

   Introduction. Neuroendocrine gastric tumor (gNETs) type 1 associated with chronic autoimmune atrophic gastritis, hypergastrinemia and usually have multifocal lesions and high frequency of local recurrence (~70 % for 2 year). Somatostatin analogs (SA) showed promised data in neoadjuvant setting with 84 % of complete response in meta-analysis.

   The aim of this study was to evaluate efficacy adjuvant treatment with SA for recurrent gNETs type 1.

   Methods. This retrospective, single center study included patients (pts) with recurrent gNETs who received adjuvant treatment with SA. Recruitment of pts was carried from 2012 to February 2024.

   Results. The study included 35 pts, 33 females and 2 males. Endoscopic mucosal resection (EMR) was performed in 34 cases (97.1 %), gastric resection in 1 (2.9 %). The median of previous EMR was 2 (1–6). The most of pts have multifocal lesions – 28 (80 %), the median of lesions is 5. Tumor size >10 mm was observed at 2 cases (5.7 %), the median size – 6 mm. One pts had N+. The median of Ki67 was 3,5 % (1–10 %), 21 (60 %) pts have G2 tumors and 14 (40 %) – G1. All pts received adjuvant therapy with SA, 33 (94.3 %) long-active octreotide 30 mg and 2 (5.7 %) lanreotide 120 mg. The time of SA therapy was <12 months in 23 cases (65.7 %) and ≥ 12 months at 12 (34.3 %). With a median follow-up of 30.5 months, median DFS was not reached (NR) [95 % CI 67-NR]. Adjuvant SA reduced gastrin levels after a year of therapy by ≥50 % from baseline in 13 cases (37.1 %). We compared DFI after previous EMR (DFS 1) and DFS after EMR with adjuvant SA (DFS 2), DFS 2 was significantly higher – not reached (95 % CI, 67 – NR) versus 8.8 months (95 % CI 2.7–14.9, p<0.01). Adjuvant treatment with SA ≥ 12 months was associated with improve DFS – 61 months (95 % CI 26.2–96.2) versus not reached (95 % CI 58.1 – NR, p = 0.05). No cases of death due to disease progression were observed.

   Conclusions. Adjuvant therapy with somatostatin analogs significantly reduced gastrin levels and improved disease-free survival, demonstrating their antiproliferative effect in type 1 gastric neuroendocrine tumors. However, given the favorable prognosis and low risk of regional or distant metastases, the role of these agents in the treatment of gastric NETs requires further clarification in prospective studies.

   Purpose of the study. To assess the informative value of genetic testing for oncogenic mutations in biological samples obtained during the Papanicolaou test for ovarian cancer screening.

   Materials and methods. The study included 336 patients of the main group with verified ovarian cancer, including borderline ovarian tumors. The control group consisted of 226 patients of a similar age without oncological pathology. Patients of the main and control groups were divided into two subgroups depending on the presence of morbid obesity. Biological material from the endocervical canal was collected by brush biopsy. After standard liquid cytological examination, additional genetic testing for mutations in 18 tumor driver genes was performed using the PCR method.

   Results. In morbid obesity, the frequency of oncogenic mutations of driver genes in endocervical scraping samples increased only in borderline ovarian tumors compared to patients without obesity (64 % versus 24,3 %, p = 0,002) and was similar in ovarian cancer (37,3 % versus 30,4 %, p = 0,29). Detection of driver gene mutations in endocervical smear samples with negative Pap test results for cervical cancer and human papillomavirus infection increased the risk of ovarian tumor pathology detection regardless of the presence or absence of obesity, which determines the prospects of additional genetic testing of cervical canal material. Genetic testing of endocervical samples to assess the risk of ovarian cancer can be limited to assessing the mutational status of the TP53, FGFR 2, and CTNNB 1 genes.

   Conclusion. Additional genetic testing to detect mutations in driver genes in endocervical smear samples in women with morbid obesity is effective in screening for borderline ovarian tumors.

   Relevance. Cardiotoxicity of antitumor therapy in children represents the important problem in pediatric oncology. In recent decades, due to the introduction of new treatment methods, there has been a significant increase in the survival rate of children with oncologic diseases, but cardiovascular complications developing during antitumor treatment become a frequent problem and have a serious impact on the quality of life of patients, as well as may increase the risks of lethal outcomes.

   Objective. To review the existing data on cardiotoxicity resulting from the use of antitumor drugs in children, with emphasis on the mechanisms of its development, clinical manifestations, diagnostic methods, approaches to treatment and prevention.

   Materials and Methods. When writing the literature review, data were analyzed in databases PubMed, Scopus, eLIBRARY devoted to the problem of cardiotoxicity of antitumor therapy in children for the period 2013–2024.

   Conclusion. Cardiotoxicity remains an important and underestimated problem in pediatric oncology. Objective assessment of cardiovascular risk before, during and after chemotherapy, timely diagnosis of complications and implementation of cardioprotection methods can significantly improve the quality and duration of life of children with malignant diseases. Further research is needed to develop standardized protocols for screening and prevention of cardiotoxicity in these children.

   Pancreatic cancer (PC) remains one of the most aggressive malignancies with poor prognosis, particularly in locally advanced and metastatic forms. Germline BRCA1/2 mutations, found in approximately 5 % of PC patients, are associated with increased sensitivity to platinum-based chemotherapy (CT) and PARP inhibitor therapy. This article presents a clinical case of successful combined treatment for locally advanced BRCA1-associated PC. The reported case demonstrates the efficacy of a comprehensive approach incorporating platinum-based CT, irreversible electroporation (IRE), pancreatic resection, stereotactic radiotherapy (RT), and PARP inhibitor targeted therapy in BRCA1-associated PC. The study highlights the crucial importance of molecular genetic testing at initial diagnosis for optimal treatment strategy selection. The findings confirm both the efficacy and safety of prolonged olaparib administration, warranting further investigation of this therapeutic approach in clinical trials.

   Introduction. Radiation damage to the bladder is one of the most common complications of radiation therapy for pelvic malignancies.

   Materials and methods. The search, analysis and systematization of relevant publications in databases were carried out. e.Library.ru, cyberleninka.ru, PubMed. 64 articles were selected, which are included in this review.

   Results and discussion. Data on epidemiology, risk factors, pathogenesis, prevention, diagnosis, and treatment of radiation damage to the bladder are presented.

   Conclusions. Hyperbaric oxygenation, intravesical instillation of glycosaminoglycan acid and chondroitin sulfate, as well as transurethral fulguration remain the most effective methods of treating radiation damage to the bladder.

   Breast cancer remains the most prevalent oncological disease among women. Surgical treatment often requires subsequent reconstruction, but implant-based approaches can lead to scar deformities, soft tissue deficiency, and asymmetry. Autologous fat grafting enhanced with stromal vascular fraction represents a promising solution for correcting these complications.

   Objective. This study aimed to evaluate the efficacy of stromal vascular fraction-enriched autologous fat grafting in improving scar quality, correcting tissue defects, and maintaining graft volume in hybrid breast reconstruction.

   Materials and methods. The study enrolled 38 patients with stage I–III breast cancer who were evaluated and treated at University Clinical Hospital No. 4 (Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow). Following surgical intervention (radical mastectomy or breast-conserving surgery with radical resection). Participants were divided into a stromal vascular fraction group (n = 18) and control group (n = 20). Evaluations at 3, 6, and 12 months assessed adipose layer thickness, scar quality using the POSAS scale, and degree of asymmetry correction.

   Results. The stromal vascular fraction group demonstrated significantly better fat graft retention at 6 months (1.4 ± 0.2 cm versus 1.0 ± 0.2 cm in controls, p < 0.05). No procedure-related complications were observed in either group.

   Conclusion. Our findings indicate that stromal vascular fraction-enriched autologous fat grafting improves long-term reconstruction outcomes, supporting its use as an effective adjuvant technique in breast reconstruction.

   Background. The standard treatment for localized non-small cell lung cancer (NSCLC) is surgery. However, for inoperable patients or patients who refuse surgical treatment, radiation therapy in different fractionation regimens remains an alternative to surgery. Traditional radiation therapy does not provide treatment results similar to those after surgical treatment, but the use of stereotactic body radiation therapy (SBRT) changes this paradigm, allowing results comparable to surgical treatment.

   Purpose. To compare the results of treatment of patients with T1–2N 0M0 stages of NSCLC depending on the treatment performed – surgery, radiation therapy in the traditional fractionation mode, stereotactic radiation therapy, combined treatment.

   Materials and methods. From 2015 to 2021 on the basis of the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine, 195 patients with non-small cell lung cancer stages T1–2N 0M0 were treated. 79 patients underwent surgical treatment, 81 patients underwent radiation therapy, and the combined treatment group included 35 patients. The operation was more often performed as a lobectomy (62 people), atypical resection was performed in 17 cases. Traditional radiation therapy was performed in 66 patients, stereotactic radiation therapy in 15 patients. In the combination treatment group, radiotherapy was given after atypical resection.

   Results. Overall survival (OS), regardless of treatment option, was 102 months. OS rates were high in the surgical and combined treatment groups, while median OS was not reached in the surgery group. In the radiation therapy group, OS was 54 months. Progression-free survival (PFS) was 83 months among all patients. PFS rates are highest with surgical treatment (1-year PFS 96 %), in the radiation therapy group the 1-year PFS was 78 %, in the combined treatment group – 80 %. There was no significant difference in OS and PFS depending on the histological subtype of the tumor. The 1-year OS rates in the radiation therapy (RT) group were comparable: after a radical course of RT in the traditional fractionation regimen – 90 %, after SBRT – 93 %. The 5-year OS rates were significantly different: 41 and 60 %, respectively. In a subgroup analysis of surgical treatment, there was a trend towards increased OS in the atypical resection group compared with lobectomy patients: 5-year OS was 80 and 77 %, respectively.

   Conclusions. Surgical treatment of stages T1–2N 0M0 non-small cell lung cancer should be the main treatment method. For inoperable patients who refuse surgical treatment, SBRT should be preferred to traditional RT.

   A case of multiple sclerosis and rectal cancer is described. The clinical case is of interest to doctors from the point of view of the rarely encountered simultaneous pathology of these two diseases.

   Triple-negative breast cancer (TNBC) remains one of the most aggressive subtypes of breast cancer, associated with a high risk of early recurrence and limited systemic treatment options. Despite advances in neoadjuvant therapy, including platinum-based agents and immune checkpoint inhibitors, the widespread adoption of these approaches is limited by their toxicity, cost, and insufficient data on their combination with dose-dense regimens.

   Study objective. To evaluate the efficacy and safety of empegfilgrastim (a long-acting granulocyte colony-stimulating factor, G-CSF) in maintaining dose intensity during dose-dense neoadjuvant therapy (NAT) in patients with stage II–III triple-negative breast cancer (TNBC).

   Materials and methods. This prospective study enrolled 60 patients who received dose-dense chemotherapy with the ddAC regimen (doxorubicin + cyclophosphamide every 14 days) followed by weekly paclitaxel and carboplatin. Empegfilgrastim was administered once after each ddAC cycle. The primary endpoint was achieving a relative dose intensity (RDI) of ≥ 85 %.

   Results. The target RDI was achieved in 96 % of patients (median values: 100 % for ddAC and 94 % for weekly paclitaxel and carboplatin). Efficacy. A pathological complete response (pCR) was observed in 50 % of patients with localized (initially operable) disease and 43 % of those with locally advanced (initially inoperable) stages. Low residual tumor burden (RCB 0–1) was noted in 63 % of cases. Safety. The safety profile demonstrated a low incidence of severe adverse events (grade III–IV neutropenia: 1.7 %).

   Conclusion. Empegfilgrastim effectively maintains high dose intensity in NAT, leading to a significant pCR rate comparable to that of immunotherapy but with a more favorable safety profile.