Fibrolamellar carcinonoma (FLC) was described in 1956 as a separate subtype of hepatocellular carcinoma (HCC) that affects young adults without underling liver diseases. Morphologically FLC is characterized as HCC with large cells, gross nucleus and fibrous collagen bands organized into branched net. The mechanisms of FLC development in the absence of major risk factors remained obscured for a considerable amount of time. High-throughput transcriptomic analysis allowed to describe the unique profile of gene expression in FLC and to define the main signaling pathways activated in tumor cells which include mTOR, FGFR и EGFR cascades which can be accounted as potential therapeutic targets for this type of tumors. Whole transcriptome sequencing allowed to identify in the majority of FLC samples the new chimeric transcript DNAJB1-PRKACA which appears due to deletion of the part of chromosome 19 which leads to fusion of two genes. This translocation appears to be driving event in FLC development that governs increase of proliferation, colony formation and tumor stem cells population. Fusion transcript is specific for FLC and can be identified through the number of clinical laboratory methods. It opens the opportunity for use of that fusion in differential diagnostics as FLC marker. Due to kinase activity of DNAJB1-PRKACA protein, it is considered to be prospective target for the development of therapeutic compounds which can inhibit this function. Analysis of transcriptome aberrations in FLC allowed to specify the prognostic signature of 8 genes whose overexpression correlates with poor patient survival after the surgery. In this review we have summarized recent data on FLC molecular pathogenesis and possibilities for the development of new methods for diagnosis and treatment based on these findings.

The article presents a clinical case of “silent” ACTH-secreting pituitary carcinoma with multiple extra- and intracranial metastases. The patient received combined treatment including transsphenoidal removal of the tumor, 18 courses of palliative chemotherapy, 3 courses of stereotactic irradiation for primary tumor, therapy with cabergoline and somatostatin analogues. The patient lived 2 years and 9 months after the primary diagnosis of the tumor was made. There was a decrease in size of the primary tumor after radiotherapy, and chemotherapy resulted in a decrease in the metabolic activity of metastases which increased the life expectancy of the patient.

The article describes modern view on early breast cancer diagnosis in elderly women. The emphasis was made on controversies and problems of breast cancer mammography screening in women older than 75 years. As a result of Moscow breast cancer statistics analysis the authors made a conclusion that breast cancer mammographic screening could be performed in women 75 years or older. Final decision of inclusion or exclusion needs to be accepted individually in each case, and should be made regarding individual comorbidity of patients.

Approximately 70–80% patients with ovarian cancer are diagnosed at advanced stages. Surgical debulking followed by platinum based chemotherapy is a standard frontline treatment for this disease. There is another approach consisted of neoadjuvant chemotherapy followed by a debulking surgery which is on rise. In this article we reviewed the current evidence which highlights the importance of radical surgery aimed to achieve complete or optimal debulking in ovarian cancer patients. We analyzed the results of large randomized clinical trials addressed the issue of efficacy of primary and interval debulking surgery and compared their results to the data about treatment outcomes in leading cancer centers. We drew conclusions about the current role of interval debulking surgery and discussed the ways to improve patient outcomes.

Modern chemotherapy followed by surgery can cure the majority of patients with advanced nonseminomatous germ cell tumors but only half of patients with poor risk according IGCCCG classification. The most challenge is to treat frail patients with highly extensive disease. First cycle of induction chemotherapy associates with high complication rate (severe infections, cytopenia, tumor-lysis syndrome, bleedings, respiratory insufficiency) and mortality. Using of low-dose first cycle (2–3 days of EP regimen) instead of full-dose one can improve poor patient»s status, prevent severe toxicity, allow to start next cycle earlier and does not diminish long-term outcome.

Modern complex and morphological diagnostics are important conditions for optimal therapeutic algorithm development if breast cancer relapse is suspected. This article shows the importance of a multimodal approach to the differential diagnostics of secondary tumor lesions. Modern clinical and radiologic evaluation, interventional technologies, trustworthy morphological investigstion and multidisciplinary teamwork facilitated to make correct diagnosis of sarcoidosis in patient with lesions suspicious for breast cancer relapse and schedule correct treatment.

Background: The treatment for moderate-risk prostate cancer patients include several methods. There are radical prostatectomy, radiotherapy, brachytherapy, cryotherapy, hormone therapy, and dynamic observation. Purpose: The goal of our study was to analyze the results of brachytherapy using I-125 in patients with moderate-risk prostate cancer. Materials and methods: Eighty six patients at the age of 48 to 76 (median 66 years) were included in the analysis. Implantation of iodine-125 sources was performed in all patients. The total dose to the prostate was 145 Gy. PSA monitoring after surgery was performed every 3 months during the first year, then every 6 months for the next 3 years, and then – annually. Survival was estimated using the Kaplan – Meier scale considering such factors as age, the D90 to the prostate, the V100 prostate, preoperative anti-androgen therapy. Quality of life analysis was made using standard IPSS questionnaire. Results: 5‑year results with median follow-up of 60 months without PSA-recurrent, tumor-specific and overall survival were 90.5%, 100% and 95.2%, respectively. The treatment method has an acceptable spectrum of complications. 1st degree urethritis in the category of RTOG within 1 month after the operation developed in 60 (69.3%) patients while in the 6‑month follow-up period the symptoms of dysuria had only 11 (13.3%) patients, which was associated with chronic urinary infection, resistant to antibiotic therapy. 1st degree radiation proctitis within 1 month after the operation developed in 2 (2.1%) patients, and after 6‑month observation period the symptoms of proctitis ceased in all patients. Before the treatment, the number of points on the IPSS scale was 0–7 points – n = 63 (74%), 8–19 points – n = 23 (26%) (median IPSS 5.7). A month later, the number of patients with mild symptomatology increased to 69.3%, 6 months after the end of treatment, the mean IPSS was 10 points. After 12 months, 0–7 points were recorded in 94% of patients. Conclusion: The permanent brachytherapy with I-125 in patients with moderate-risk prognosis showed very good functional and oncological outcomes. This method provides excellent control of the PSA level with median follow-up of 65 months, and at the same time provides high quality of urination for 2–3 years after treatment.

The article presents a pooled experience of the use of eribulin in the real clinical practice of treatment of metastatic breast cancer in Russian oncological institutions. The effectiveness of the drug in monotherapy with HER2‑negative breast cancer was analyzed, groups of patients with most effective use of eribulin were identified depending on the localization of metastases, the most effective lines of therapy. The effectiveness of the drug in combination with trastuzumab in HER2‑positive breast cancer is described, as well as toxic reactions.

Pericarditis in cancer patients occures in the late stage of the disease and in 95% of cases is caused by metastases of lung, breast, gastrointestinal cancer and hemoblastosis. Malignant exudate in the pericardial cavity in half cases leads to tamponade of the heart and death of the patient. The actual goal in modern oncology is to find the most effective and low-toxic treatment of pericardial carcinomatosis and tumor pericarditis. One of the effective methods of treating of this category of patients is intrapericardial immunotherapy with IL-2.

The article presents the results of the meeting of the Advisory board “Modern treatment approaches for advanced renal cell carcinoma”, held on Apr 24, 2017, with the aim to discuss current approaches to inoperable, locally advanced and advanced renal cell carcinoma. To discuss the Russian experience with lenvatinib in the routine clinical practice and get the experts’ opinion on the perspectives directions of lenvatinib study in renal cell carcinoma landscape.