Objectives. According to literature and experts, prostate cancer (PC), breast cancer (BC), colon cancer (CC), melanoma (MEL) and renal cell carcinoma (RCC) are the most high-cost oncological diseases. The aim of our study was to calculate the charges for each of these nosologies from the point of view of Moscow’s budget and compare them with each other.

Methods. To assess the annual costs of drug therapy in Moscow in patients with PC, BC, CC, MEL and RCC there has been developed an analytical model in MS Excel software, considering the data of Cancer Register, as well as literature sources.

Results. There has been estimated that if the costs of drug therapy for all five of assessed types of cancer are taken as 100 %, then the most costly is BC (41 % of costs), then MEL (20 %), RCC (15 %), CC (13 %) and PC (12 %). There has been also calculated, that if the number of patients with all five types of assessed cancer undergoing drug therapy, we would consider as 100 %, the highest percentage of them is in BC (50 % of all patients), then PC (36 %), CC (9 %), MEL (3 %) and RCC (1 %).

Conclusions. The structure of drug therapy costs in patients with PC, BC, MEL, CC and RCC in Moscow shows that the most expensive is the treatment of patients with melanoma (for 3 % of patients Moscow City Health Department spends 20 % of charges) and RCC (1 % of patients spends 15 % of charges).

Parameters of ploidity and kinetics of cell cycle in bone marrow samples of lymphoma patients were studied by flow cytometry. These parameters were compared to the lymphoma prognostic criteria: disease stage, levels of lactate dehydrogenase, sed rate test, B-symptoms, Bcl-2, Ki-67 etc. Analysis of the results shows, that bone marrow lesions in primary tumors are characterized by a statistically significant increase in Bcl2-expressing cells and percentage of cells in G0-1 stage of the cell cycle, as well as decrease in percentage of cells in G2М and S stages and percentage of cells of the proliferative pool S+G2M, (G2M+S) / G0-1 compared to non-affected hematopoietic cells. Primary and recurrent lymphomas with bone marrow lesions are characterized by significant variability in cell cycle parameters describing proliferative activity of mononuclear cells combined with inefficiency of hematopoiesis. Marker cytokinetic parameters can be used as prognostic criteria for overall and relapse-free survival of patients with lymphomas.

Introduction. Eribulin, an non-taxane microtubule inhibitor, has been registered in Russia for patients with locally advanced or metastatic breast cancer (mBC) who received at least one chemotherapy regimen for a advanced disease, previous therapy should include anthracyclines and taxanes in adjuvant or metastatic setting, except the patients who could not be prescribed these drugs. We present our experience with eribulin in real clinical practice in Moscow and the Moscow Region.

Patients and methods. We conducted a retrospective analysis of the experience with the use of eribulin in Moscow and the Moscow Region in 202 patients with mBC from January 2016 to February 2017 to assess the effectiveness and safety of the drug. All patients received previous therapy with anthracyclines and taxanes for locally advanced and / or metastatic cancer. The average age of patients at the time of inclusion in the analysis was 5 years (28–81). The status of the general condition on the ECOG 0-1 scale was registered in 81.3 % (100 / 123) of patients, the status of ECOG 2-3 in 18.7 % (23 / 123) of patients. The median of the number of courses of chemotherapy with eribulin is 4 (2–17). Patients received eribulin in 1-7 chemotherapy lines for metastatic disease. The average number of affected organs is 2 (1–5).

Results. Complete response (CR) was in 3 (2 %) patients. Partial response (PR) was in 24 (15.7 %) patients, stabilization of the disease – in 89 (58. 2 %). Progression of the disease was recorded in 37 (24.1 %) patients. The median of progression-free survival (PFS) on the therapy was 4.64 (95 % CI 2.97-6.87) months. Stabilization of the disease for more than 6 months was registered in 28 (18.3 %) patients. The most significant toxicity was neutropenia and polyneuropathy (21 patients (10.4 %) and 7 patients (3.5 %), respectively).

Dose reduction due to neutropenia was required by 26 patients (12.9 %). The objective response rate (ORR) depended on the chemotherapy line: in 1-3 lines the efficacy of the treatment was higher: the ORR was 21.6 %, compared to the 4th and subsequent lines – 12.3 %, respectively. With HER2-positive mBC, eribulin showed clinically significant results in combination with trastuzumab.

Conclusions. Our analysis confirms that eribulin has a predictable and manageable safety profile, is an effective drug for the treatment of patients with different subtypes of mBC in a real clinical setting.

Despite significant progress in molecular oncology and immuno-oncology, only 20-30 % of patients with advanced cancer can be cured with modern treatments indicating that new approaches are needed. Further improvements in immunotherapy of cancer are associated with enhanced tumor immunogenicity, induction of inflammatory phenotype and inhibition of immune suppression at the tumor microenvironment level. In this context, high-intensity focused ultrasound (HIFU) ablation have several advantages, particularly it is able to elicits a rapid clinical and immune response, is non-invasive, have low local morbidity, allows repeated sonications, have relative low cost and does not require long hospitalization. In addition to cytoreduction and decreasing of systemic immune suppression, HIFU generates a tumor debris depot acting as vaccine in situ. Immunogenic cell death elicits a CD4+ and CD8+ cytotoxic T-cell response, but several regulatory mechanisms, particularly PD-1L expression, are promoted in response to enhanced immune cells infiltration of heated and distal tumors. This results in low rate of durable and clinically relevant abscopal effects. For these reasons HIFU is currently viewed as a part of strategies targeting multiple steps of cancer immune cycle (TLR agonists, GM-CSF, cytokines, CTLA-4, PD-1 / PD-1L inhibitors, T-cell co-stimulation agonists, adoptive cell therapy etc). Higher rate of abscopal effects and improved survival have been shown in some preclinical studies using thermal ablations in combination with immunotherapy. In this setting, there is an opportunity to use check-point inhibitors in reduced doses. In addition, tumor ablation after non-effective immunotherapy could induce a new cancer antigens spreading, T-cell repertoire changes and enhance tumor responsiveness to treatment. Based on encouraging preclinical data, this exiting approach is currently explored in some ongoing trials aiming to evaluate the optimal treatment sequences and its clinical efficacy.

Delayed breast reconstruction after performing radical mastectomy for cancer is a surgical method of rehabilitation of patients. Breast reconstruction is performed to improve the quality of life of patients with breast cancer. Breast restoration using expander is used in women with a small breast size, as well as in patients who refuse to use patchwork techniques of breast restoration. In P. A. Herzen MORI 27 patients with a diagnosis of breast cancer was performed in delayed breast reconstruction after radical mastectomy.

To achieve symmetry in 51,9 % of cases the operations were also performed on the healthy breast. During the observation period up to 4 years, no signs of progression of the underlying disease were found in this group.

In this review we analyzed results of studies concerning the choice of first and subsequent lines of therapy in patients with metastatic colon cancer. We discussed data of various combinations of monoclonal antibodies with different chemotherapeutic regimens. Also we discussed modern preclinical and clinical trials concerning strategy of choice of targeted therapy sequence in patients with metastatic disease. We considered the impact of various molecular and clinical factors on the effectiveness of drugs and determined their application for therapy choice for colon cancer.

Currently, more and more studies show the effectiveness of anti-PD-1 therapy in tumors with a deficiency of the unpaired DNA nucleotide repair system (MMR). According to various sources in endometrial cancer, the MMR deficit is determined in 20–30 % of cases. This paper presents the experience of successful immunotherapy (anti PD-1) in a patient with metastatic endometrioid adenocarcinoma of the uterus with a deficiency of MMR.

Stomach cancer (SC) (in the structure of morbidity) is one of the most frequent malignant diseases that occurs in the elderly. Systemic chemotherapy showed improved quality of life and survival rate compared with palliative therapy in patients with advanced SC. It has also been shown that elderly patients with SC are able to tolerate and receive effective systemic chemotherapy, as are the younger patients with the same stage of cancer. The only one age limit should not be the only criterion for excluding effective chemotherapy. However, proper patient selection is extremely important to ensure effective safe treatment. The article analyzes the optimal regimens of chemotherapy, taking into account the general condition and geriatric functional status of elderly patients with SC.