Improvement in the diagnosis and treatment of cancer patients, increase in frequency of prevalence and detection of metastatic lesions of the brain make the choice of treatment timely and important. The article presents data on the current prognostic scales for patients with cerebral metastases of solid tumors and the analysis of their features. The features of choice of tactics and strategy of treatment of patients with cerebral metastases of solid tumors depending on various prognostic factors are described. The original version of the rating scale for determining treatment options for patients with metastatic brain lesions is proposed. We suggest to consider oncological, neurological (neurosurgical), somatic (functional) groups of factors to choose the tactics of treatment of patients with brain metastases.

The optimal approach to initial management of advanced ovarian cancer remains controversial. Current guidelines point out the high importance of surgical efforts to achieve complete or optimal cytoreduction and advisability of neoadjuvant chemotherapy as an option for patients with high risk of suboptimal debulking. However, there are no well-established criteria for patient selection for each approach. Here we provide a contemporary review of evidence for the utility of various methods for patient selection (eg, various clinical factors, serum levels of tumor markers, radiological models based on assessment of tumor dissemination pattern by computed tomography (CT), magnetic resonance imaging and positron-emission tomography/CT (PET/CT)). Capacity of these methods to predict surgical outcomes in patients with advanced ovarian cancer was evaluated. A detailed review of diagnostic laparoscopy as an emerging method for precise assessment of tumor resectability in these patients was made. We summarized the experience of dedicated cancer centers in patient selection for interval and primary debulking surgery as well as their experience in various diagnostic methods utilization in this setting.

Objective. To perform literature review of clinical trials reporting on the use of single-agent brentuximab vedotin (BV) 1.8 mg/kg therapy in adult patients with relapsed/refractory (R/R) CD30-positive Hodgkin lymphoma (HL).

Methods. A literature search was performed in Pubmed and eLIBRARY. RU databases to identify all studies published from 1 July 2007 until 1 July 2017. We used the key words “brentuximab vedotin” and “Hodgkin lymphoma” simultaneously. The inclusion criteria required that study population included ≥ 20 adult patients with R/R HL. We included clinical trials, systematic reviews, meta-analysis, pharmacoeconomic studies: total 25 publications met inclusion criteria. Publications were grouped by 3 BV indications in instruction for use: adult patient with relapsed/refractory CD30-positive Hodgkin lymphoma post-autologous stem cell transplantation (postASCT), adult patient with refractory CD30-positive HL after failure of at least 2 prior multiagent chemotherapy regimens in patients who are not candidates for ASCT, adult patient with classical HL at high risk of relapse or progression post-ASCT.

Results. Overall response rate (ORR) and complete rate (CR) were 75% and 34% respectively in adult patients with R/R CD30-positive HL post-ASCT in SGN35–0003 study. In patients with refractory HL after failure of at least 2 prior multiagent chemotherapy regimens who are not candidates for auto-SCT ORR and CR were 40% and 30% respectively. In mixed population ORR were 56-80%, CR – 10-46.5%. In patients with CD30-positive Hodgkin lymphoma at increased risk of relapse or progression following ASCT ORR was not evaluated, median progression-free survival was improved in patients in BV group compared with those in placebo group (42.9 and 24.1 months respectively). Overall survival in both group was similar. In patients with R/R CD30-positive HL the incremental cost-effectiveness ratio per quality-adjusted life year (ICER/QALY) was 6.7 million rub. и 3 million rub. from a Russian and a Scottish healthcare payer respectively. ICER/QALY when BV compared with best supportive care was 9.79 million rubles. In patients who were at risk for HL repapse after ASCT if BV consolidation compared with active surveillance ICER/QALY was 8.86 million rub.

Conclusion. As a result of the literature review, it was found that the response rate, the complete response to BV therapy, and the overall survival and progression-free survival with use of BV in different patient populations differ; in most cases, the result of effectiveness favors BV. The found safety data indicated a good tolerability of the drug. The results of the found pharmacoeconomic studies differ depending on the comparison therapy and the accepted pharmacoeconomic indicator.

The review presents an analysis of current data on the molecular mechanisms of targeted drugs action based on monoclonal antibodies aimed at main signaling pathways that change their activity in squamous cell carcinoma of the tongue and mucosa of the oral cavity. The main cellular signaling pathways and disturbances in their functioning, involved in the pathogenesis of this group of diseases, as well as the mechanisms of action of monoclonal antibodies on the ERBB 1 and 2 receptors (cetuximab, matuzumab, trastuzumab), VEGF ligands (bevacizumab, aflibercept), IGF- receptors (fizitumumab) and MET-receptor ligands (AV299 and AMG102) described in detail. The literature analysis showed that the therapeutic potential of monoclonal antibodies to ERBB-, VEGF-, IGF and MET receptors is far from exhausted, and the effectiveness of such therapy can be improved by the combined action of several antibodies.

Breast preserving surgery became a preferable method of treatment for breast cancer now. Adjuvant radiotherapy in breast cancer patients is a standard component of breast-preserving treatment that reduces the recurrence rate and mortality. The risk of cardiotoxicity after radiation therapy for left-sided breast cancer is high. The deep inspiration breath hold technique is used to reduce radiation dose to the heart. The Real-time Position Management, Respiratory Gating (RPM; Varian) system is used to monitor respiratory motion. Audio supporting system as a part of RPM has some technical lacks. The purpose of our research consists in developing video engineering system to control respiratory movements. Use of this system allowed patients to  observe graphical sinusoid of amplitudes inspiration image in time interval. Also such system allowed to achieve shortening of treatment time and decrease psychological and emotional stress of the patients.

The article shows the possibilities of the usage of cytological material for diagnostics of lung cancer at the example of work of an oncological outpatient clinic during one year. Light microscopy was used to study of cytological specimens of various material of 721 patients. The method has allowed to determine the diagnosis of lung cancer in majority of the observed cases with definition of histological type in 89%. When comparing the results of cytology with the final diagnosis the difference of determination of the tumor histological types is less than 1%. The immunocytochemical test is used at the examination of pleural fluid of 40 patients without determined primary locus. The immunocytochemical research has allowed specifying the inhering of the tumor cells to the metastasis from the lung, elevating the precision of the diagnostics to 96%. The cytological material of 62 patients obtained during the bronchoscopic examination, puncture of lymphatic nodules, pleural fluid and sputum with presence of a sufficient quantity of tumor cells (not less than 200) represents appropriate material for molecular-genetic research. The usage of cytological material for search of somatic mutations is justified for oncological patients with locally advanced or disseminated process, whose cytological material is the unique accessible morphological material for research.

Background: Eribulin mesylate was initially approved in 2010 by FDA as a third-line treatment for women with advanced breast cancer (ABC) pretreated with at least two lines of chemotherapy, and then in 2011 it was approved by EMA as a second-line therapy. Patients should have received an anthracycline and a taxane in either the adjuvant or metastatic setting. Since then, several studies have been conducted confirming its efficacy and safety. We report our experience of using eribulin in our centre in a real-life clinical setting.

Materials and methods: 34 patients with ABC were enrolled to receive eribulin. From February 2016 to February 2017, patients were treated with standard doses of eribulin and evaluated for toxicity and responses. All of them had previously received anthracyclines and taxanes in either the adjuvant or metastatic setting. Median age was 60 years (range: 39–79). ECOG performance status was 1 or 2 at the time of enrollment. Median number of cycles of eribulin was 5 (range 2–10). Patients received eribulin from first-line chemotherapy to seventh-line chemotherapy for ABC. Median number of envolved visceral organs was 2 (range 1–4).

Results: There were no complete responses. Partial responses were achieved in 26.4% (9/34), stabilization of the disease in 32.4% (11/34) and progression of the disease in 41.2% (14/34) of patients. The median progression-free survival was 4.09 months (range: 2.6–6.53). Main toxicities (grade 3–4) included peripheral neuropathy and neutropenia. Neuropathy was marked in 14.7% (5/34) and neutropenia in 14.7% (5/34) of patients. Dose reductions were required in 14.7% (5/34) of patients because of neutropenia.

Conclusion: Our experience shows that eribulin has clinical activity as well as satisfactory tolerability in unselected patients in a reallife clinical setting. Thus, in our opinion, eribulin can represent a new option in treatment of ABC patients.

One way to improve the results of treatment of patients with locally advanced triple-negative breast cancer (TNBC) is to find the most effective neoadjuvant chemotherapy regimen. It has been shown that patients (pts) with TNBC with pathological complete regression (pCR) after neoadjuvant chemotherapy have better survival. The aim of the study was to evaluate the efficacy and toxicity of induction chemotherapy regimen, including 2 consequent chemotherapy regimens: рaclitaxel 60 mg/m²  IV weekly plus сarboplatinum AUC2 IV weekly for 9 weeks, then doxorubicin 25 mg/m² IV weekly plus cyclophosphamide 50 mg per os q. i. d. plus capecitabine 500 mg t. i. d for 9 weeks. The study included 45 patients with TNBC, stages IIIA, IIIB, IIIC. Overall response rate was 40/45 (88,9%) with 7/45 (15,6%) of complete responses and 33/45 (73,3%) of partial responses. Forty-four patients underwent surgery. Twenty seven patients (61,4%) achieved pCR. Three-year disease-free survival was 71% and overall survival was 81%. The most common types of toxicity were neutropenia (40% grade 3–4), mucositis (55% grade 1–3) and hand-foot syndrome (65% grade 1–3). Despite relatively high toxicity this alternating multicomponent induction chemotherapy regimen had high efficacy. More than half of patients (61.4%) achieved pCR.

Breast cancer (BC) is the most frequently diagnosed cancer among women. Triple negative breast cancer (TNBC) is a special subtype of BC, representing 15% of all breast cancers, is characterized by the absence of receptors to estrogen, progesterone and expression of HER-2 growth factor. This subtype carries an aggressive course, more frequently affects younger patients, a poor prognosis and a high risk of early recurrence with development of metastases. The heterogeneity of the disease and the absence of well-known molecular targets (hormone receptors and amplification of HER-2/neu) explains the complicity in choosing the optimal therapeutics regimens. Less than 30% of women with metastatic TNBC survive 5 years. There is a major need to develop new effective treatment options for patients with this aggressive subtype of breast cancer, that would lead to improve patient outcome.