Objective. To evaluate the efficacy and safety of different maintenance therapy regimens in patients with HER2-positive metastatic gastric and gastroesophageal junction cancer.

Materials and methods. This retrospective analysis included data from 186 patients who received trastuzumab in combination with platinum-fluoropyrimidine chemotherapy. During the maintenance phase, patients were divided into two groups: trastuzumab monotherapy and trastuzumab plus fluoropyrimidines.

Results. No significant differences were observed between the groups in overall survival (OS) or progression-free survival (PFS) (OS: 26.0 vs 24.0 months; PFS: 13.5 vs 13.1 months; p>0.05). Combination therapy was associated with a higher incidence of toxicity, including hand–foot syndrome (19.4 % vs 0.8 %) and cardiotoxicity (11.3 % vs 3.2 %).

Conclusion. The continuation of fluoropyrimidines during the maintenance phase does not improve treatment efficacy and increases toxicity. The optimal strategy remains prolonged HER2 blockade with trastuzumab.

Aim of the study – to comprehensively evaluate the impact of postresection syndrome on the tolerability and efficacy of immunotherapy in patients with metastatic gastric cancer and to determine the role of personalized comprehensive rehabilitation in correcting metabolic-nutritional, electrolyte, and psychological impairments in this vulnerable subgroup.

Materials and methods. A prospective randomized study (2021–2025) included 168 patients with histologically confirmed stage IV gastric cancer receiving PD-1 inhibitor immunotherapy (pembrolizumab/nivolumab) in the 3rd-4th line. Patients were randomized into an experimental group (n=82): immunotherapy + comprehensive rehabilitation (nutritional support, H₂/O₂ inhalations, magnetic therapy, psychological correction, electrolyte balance correction); and a control group (n=86): immunotherapy only. Special focus was placed on the subgroup with prior total gastrectomy (n=84).

Results. Gastrectomized patients in the experimental group exhibited a pronounced postresection syndrome: baseline PNI 34.66±2.8 (vs. 38.15±3.5 in non-resected, p=0.0047), hypocalcemia (2.05±0.15 mmol/L), hypomagnesemia (0.61±0.09 mmol/L), and chronic pain (78.6 %). After 6 months, the experimental group demonstrated: maximal PNI increase (+21.54 to 56.20, p<0.001), nitrogen balance normalization (+5.2 g/day, p=0.03), Ca²⁺ elevation (to 2.31 mmol/L) and Mg²⁺ recovery (to 0.87 mmol/L) (p<0.05), and significant EORTC QLQ-C 30 improvement (global QoL +15.2 %, physical functioning +14.8 %, pain reduction –55.6 %, p<0.05). Psychological reasons for therapy discontinuation decreased 3.2-fold (OR=0.31). Confirmed progression (iCPD) among patients with unconfirmed progression (iUPD) at week 8 was significantly lower in the experimental group (45.0 % vs. 72.3 %, p=0.05).

Conclusions. Patients with a history of gastrectomy constitute a vulnerable subgroup with severe postresection malabsorption, electrolyte deficiency, and nutritional decompensation that impair immunotherapy tolerability and potentially reduce efficacy. Comprehensive rehabilitation integrating metabolic, nutritional, physical, and psychological support effectively restores homeostasis, improves quality of life, and promotes disease stabilization. These findings justify the early integration of personalized rehabilitation programs into clinical standards for this patient category.

Gastric cancer still occupies a high place in the world in the structure of morbidity and mortality. In most patients, stomach cancer is locally advanced or metastatic, and therefore the 5-year overall survival rate does not exceed 35 %. The reason is the lack of clinical symptoms at the stage of the localized process and screening in the Russian Federation. The introduction of immunotherapy into clinical practice has radically changed approaches to the treatment of metastatic gastric cancer, which has increased the duration and quality of life of patients. According to the clinical recommendations of gastric cancer used in the third and subsequent lines of treatment, patients in satisfactory general condition are shown to use nivolumab immunotherapy in order to improve patient survival. Nivolumab (regardless of PD-L1 level) has shown excellent overall survival in most studies. The article describes a clinical case of Nivolumab treatment in a patient with disseminated gastric cancer in 3 lines. The article reflects the results of treatment and examination, evaluates the  effectiveness of treatment and makes a conclusion. The article is illustrated with original CT scans.

Introduction. Radionuclide therapy represents a dynamically developing treatment direction, and the emergence of PSMA-targeted radionuclide therapy is an innovative breakthrough in the treatment of patients with metastatic castration-resistant prostate cancer.Materials and methods. An analytical literature review was conducted based on current publications from the PubMed, e.library.ru, and cyberleninka.ru databases for the period 2016–2024. This review includes results of key phase III clinical trials (ALSYMPCA, VISION, PSMAfore), as well as data from Russian research centers.Results and discussion. Modern advances in radionuclide therapy of prostate cancer are presented, including the use of radium-223, ¹⁷⁷Lu -PSMA-617, and ²²⁵Ac -PSMA-617. Mechanisms of action, indications, clinical trial outcomes, and promising combined strategies with immunotherapy and targeted agents are detailed. Patient profiles for each type of radionuclide therapy are defned.Conclusions. Radium-223 and ¹⁷⁷Lu-PSMA-617 have demonstrated effectiveness in improving overall survival in patients with metastatic castration-resistant prostate cancer. Prospective directions include the use of alpha-emitters, combination approaches, and earlier application of radionuclide therapy in disease progression.

Colorectal cancer (CRC) remains one of the leading causes of cancer morbidity and mortality in Russia. Early diagnosis enables the detection of pathology at preclinical stages, improving prognosis and reducing healthcare costs. The main tool is population-based screening programs, regulated by the Order of the Ministry of Health of the Russian Federation No. 404n (2021), which include fecal occult blood testing. However, discussions persist regarding the clinical significance of the method and the optimal management of high-risk patients. In practice, both qualitative and quantitative tests are used. The former are suitable for individual use, while the latter are more appropriate for large-scale examinations with adjustable cutoff values. Particular attention is given to high-risk cohorts – employees of carcinogenic hazardous industries – who often present not only with colorectal neoplasms but also with upper gastrointestinal tract pathology. For these individuals, the use of modern immunochemical and molecular genetic technologies is considered appropriate.

Objective. To assess the effectiveness and diagnostic value of fecal occult blood tests in the early detection of gastrointestinal pathology in high-risk patients.

Materials and methods. From 2021 to 2025, a total of 1,752 employees of an oil refinery in Yaroslavl were examined. At the first stage, three fecal occult blood tests were used: the quantitative immunochemical test FOB Gold Test (iFOBT), the qualitative immunochemical test NADAL iFOB (NADAL), and the Russian qualitative test IHA-FOB-K-FACTOR. At the second stage, expert colonoscopy and esophagogastroduodenoscopy (EGD) were performed to verify neoplastic lesions.

Results. A comparative analysis of the three noninvasive fecal occult blood tests revealed the highest diagnostic efficiency for the quantitative immunochemical FOB Gold Test (iFOBT), which demonstrated high sensitivity (up to 85.7 %) and a negative predictive value exceeding 91 %. The qualitative NADAL iFOB showed high sensitivity and a strong positive predictive value, making it effective for screening high-risk patient groups. The IHA-FOB-K-FACTOR test showed low specificity and reproducibility, limiting its clinical applicability.

 Conclusion. The quantitative iFOBT format provides objective assessment, adjustable cutoff thresholds, and compliance with international colorectal cancer screening standards. Its use is advisable in large-scale preventive programs and for dynamic monitoring of individuals at increased risk, confirming its optimal balance of diagnostic reliability and practical applicability.

The relevance of improving diagnostic methods, drug and radiation therapy contributes to an increase in the life expectancy of cancer patients including hemoblastosis. At the same time, the number of patients with various complications, including those from the cardiovascular system as a result of antitumor therapy, has increased. The identification of long-term toxic effects of antitumor therapy in patients with hemoblastosis is relevant due to the increased life expectancy of patients after treatment.

Objective: according to the literature, to evaluate the long-term side effects of cardiotoxic effects in patients with hemoblastosis who received antitumor treatment.

Material and methods. When writing a literature review, data were analyzed in specialized medical databases Pubmed, Scopus, Web of Science in patients with hemoblastosis from 1994 to 2024.

Results. Cardiotoxic side effects in patients with hemoblastosis as a result of antitumor therapy may occur in the long term years after treatment. This review is devoted to the analysis of the cardiotoxic effects of various forms of therapy on the heart in adults and children with hemoblastosis in the long-term period after treatment. The causes of side effects on the cardiovascular system are discussed, the molecular, genetic, and biochemical correlates of these disorders are described, and ways to prevent complications are considered. This, in turn, opens up opportunities for early detection and treatment of long-term complications in surviving patients. This will contribute to improving the quality of life of patients.

Neoadjuvant chemotherapy (NACT) for early and locally advanced triple negative breast cancer (TNBC) is a mandatory component of radical treatment. Achieving complete pathomorphological regress determines prognosis of the disease, allows for organ-preserving treatment, and also reduces the risk of recurrence and improves overall survival. Recently, there has been an increase number of studies aimed at intensifying NACT, which is explained by the well-known aggressiveness of this subtype of breast cancer. However, an increase frequency and severity of adverse events, which often offset the improvement in the effect of treatment, led to the emergence of studies aimed at reducing the chemotherapeutic burden of NACT breast cancer without losing its effectiveness. The studied chemotherapy regimens may become new standards for the neoadjuvant stage of complex treatment of resectable breast cancer. This review examines the current standard of systemic treatment for early and locally advanced breast cancer, as well as possible options for de-escalation of drug therapy.

Purpose of the study. To conduct an analysis of the effectiveness in terms of overall and relapse-free survival rates in patients with metastatic skin melanoma and BRAF V600 mutation in the 1st and 2nd lines, depending on the strategy of choosing the sequence of targeted and immune-oncological drugs. To evaluate the effectiveness of the use of checkpoint inhibitors in patients without a driver mutation. To compare the safety profiles of these groups of drugs.

Patients and methods. A retrospective study was conducted to analyze the treatment outcomes of 130 patients who received the first line of therapy for metastatic skin melanoma. Among them, 38 patients received the second line of therapy. The treatment was provided at the Yaroslavl regional oncology hospital from 2016 to 2024. For the analysis of the results in the first line of therapy, 5 groups were defined, depending on the presence of a BRAF mutation and the chosen treatment strategy: Group I: patients with a BRAF mutation and BRAF inhibitors (iBRAF) in monotherapy N= 35 (27 %). Group II: patients with BRAF mutation and iBRAF+ iMEK combination N=21 (16.1 %). Group III: patients with BRAF mutation and anti-PD-1 drugs N=22 (16.9 %). Group IV: patients with wild-type melanoma and anti-PD-1 drugs N =42 (32.3 %). V group: patients with wild-type melanoma with a doublet of anti-PD-1 + anti-CTLA-4 drugs N=10 (7.7 %). To assess OS in the second line in BRAF+ patients, 4 clinical groups were defined according to the options of the therapy performed in this line: I group – iBRAF (26.31 %; n=10); II group – iBRAF + iMEK (10.53 %; n=4); III group – anti-PD-1 (52.63 %; n=20); IV group – combination of immune checkpoint inhibitors (ICI): anti-PD-1 and anti-CTLA-4 (10.53 %; n=4).

Results. When comparing the results obtained in patients with a mutation in the BRAF gene, a statistically significant difference was found in overall and relapse-free survival depending on the choice of first-line drug. The median OS in Group I was 14 months, in Group II 20 months, and in Group III 41.5 months. The median РFS accordingly groups: 7.5 months, 13 months and 28 months. In groups with mMC without BRAF V600 mutation (wild type), OS and PFS rates are higher in case of use of dual immunotherapy: anti-PD-1 and anti-CTLA-4. The median OS in the IV group is 21.5 months, PFS is 15.5 months, OS rates in the V group are 36 months and PFS are 22 months. During the second line, the indicators were higher in the clinical groups with targeted drugs, previously they were preceded by immunotherapy with checkpoint inhibitors. The indicators of m(s) in group I were 19 months old, and in group II, at the time of the study, m(OS) had not been reached. In the groups of patients with immuno-oncological drugs, the indicators are lower, so in the III group 11.2 months, and in the IV-13 months. The m(PFS) indicators are as follows: I group-13 months; II group-14 months; III group-7.8; IV group-8.6.

Conclusion. Immuno-oncology drugs demonstrate efficacy in the treatment of metastatic skin melanoma with and without BRAF mutation (wt). In patients with BRAF+, first-line immunotherapy surpasses targeted therapy in terms of survival rates. In the treatment of BRAF wt, dual immunotherapy is more effective. Second-line targeted therapy shows better results in patients previously treated with immunotherapy. This demonstrates the potential benefit of the sequential use of immuno-oncology and targeted drugs. An analysis of adverse events showed that combination targeted therapy is less likely to cause skin complications compared to BRAF inhibitor monotherapy. In rare cases, a combination of PD-1 and CTLA-4 inhibitors may cause specific immune-mediated complications.

Despite the low incidence of soft tissue sarcomas, providing care to patients with this condition is an important mission of current oncology. The high mortality rate among patients within the first year of diagnosis, as well as the low five-year survival rate, highlight the need for timely diagnosis and the implementation of modern anti-cancer drug therapies that have proven to be highly effective in clinical practice. This article presents a clinical case study of a patient with recurrent dedifferentiated retroperitoneal liposarcoma, evaluating disease progression and prognosis of disease