Background. Multiple options of first line treatment in patients with EGFR mutated NSCLC are registered worldwide and, in particular, in Russia. The individual choice for every patient is still based primarily on personal preference of a particular physician and financial possibilities of the region, since no stratification factors are available. At the same time large randomized trials comparing various options are hardly possible in this narrow biomarker restricted population. The additional information on advantages in particular subgroups obtained via indirect comparison might be an important argument.

Materials and methods. We conducted meta‑analysis of trials studying various approaches in first line EGFR mutated NSCLC cancer.

Results. Our meta‑analysis revealed unequal influence of different treatment approaches on OS according to clinical stratification factors. In females (HR 0.79, 95 % CI 0.63–0.99; p = 0.04), patients younger than 65 y. o. (HR 0.66, 95 % CI 0.52–0.83; p = 0.0004), with exon 21 mutations (HR 0.76, 95 % CI 0.59–0.99; p = 0.04) and ECOG 1 (HR 0.72, 95 % CI 0.59–0.89; p = 0.002) OS benefit can be achieved with 2nd generation TKI. In the rest of patients (males, ECOG 0, ex19 deletions) increase in OS necessitates more aggressive treatment with TKI and chemotherapy combination (HR 0.57, 95 % CI 0.41–0.79; p = 0.0008). No influence on OS was observed for TKI and angiogenesis inhibitors. Interestingly, the observed advantage in OS and PFS was not accompanied by response that did not differ between regimens (OR 1.55, 95 % CI 0.86–2.80; p = 0.14).

Conclusions. We showed the importance of individualized approach in the first line EGFR mutated NSCLC selection. Our results underline the need for the new data on various approaches comparison.

We have reviewed the available publications about circulating tumor markers (CTM) — CYFRA 21‑1, CEА, SCC, NSE and proGRP, in patients with small‑cell (SCLC) and non‑small cell lung cancer (NSCLC). Elevated levels of at least one of them (CEA, CYFRA 21‑1 и SCC) were seen in 100 % of patients with stage III–IV NSCLC. CEA, CYFRA 21‑1 and SCC could have prognostic and predictive value. Their decrease during chemotherapy or immunotherapy correlates with better overall survival. For SCLC the main CTM are NSE and proGRP. Together with CTM for NSCLC these markers could predict correctly histological subtype of lung cancer in 79–97 % of patients. Levels of proGRP after 1, 2 and 3 cycles of chemotherapy in SCLC correlated with response to treatment and were associated with prognosis. Thus, it can be used as an additional response criterion, for example in patients with non‑measurable disease. CTM provide additional easy‑to‑use predictive and prognostic data for patients with lung cancer.

Introduction: targeted anti‑angiogenic drugs are the integral component of systemic therapy for metastatic colorectal cancer. To date, there have been no prospective studies that would directly answer the question of the need to add anti‑ angiogenic agents to chemotherapy for BRAF‑mutated metastatic colorectal cancer. We performed a systematic review and meta‑analysis to evaluate the efficacy of adding anti‑angiogenic therapy to chemotherapy in patients with metastatic colorectal cancer harboring a mutation in the BRAF gene.

Materials and methods: We searched for articles and abstracts in the PubMed, ASCO and ESMO databases, published before September 2020 and containing information on the results of prospective randomized trials comparing the combination of anti‑angiogenic agents (bevacizumab, aflibercept or ramucirumab) in the first‑or second‑line therapy for metastatic colorectal cancer, which indicate the efficacy depending on the presence of mutations in the BRAF gene. The primary endpoint was the risk ratio (RR) for progression or death with a 95 % confidence interval (95 % CI). The meta‑analysis was carried out using the Review Manager, version 5.3.

Results: 4 studies met the selection criteria (AVF2107 g, AGITG MAX, VELOR and RAISE), which included data from 120 patients with the BRAF mutation, 65 (54 %) patients received a combination of chemotherapy with an anti‑angiogenic agent, and 55 (46 %) patients received only chemotherapy. The meta‑analysis showed improved progression‑free survival (RR 0.64, 95 % CI 0.4–1.02; p = 0.06; I 2 = 0 %, p for heterogeneity = 0.7; 3 studies) and overall survival (RR 0.51, 95 % CI 0.32–0.82; p = 0.005; I 2 = 0 %, p for heterogeneity = 0.54; 4 studies) in the group treated with anti‑angiogenic agents.

Conclusions: the combination of chemotherapy with anti‑angiogenic agents in the first‑or second‑line therapy improves progression‑free survival and overall survival in patients with BRAF‑mutated metastatic colorectal cancer. Prospective randomized trials in this patient population are needed to determine the optimal first‑line treatment regimen.

Neoadjuvant systemic therapy is an essential component of the comprehensive treatment of primary operable HER2‑positive breast cancer. Therefore, it is extremely important to search for treatment efficacy predictors and optimal system for assessing tumor response to treatment. The study analyzed factors predicting pathological complete response (pCR) in patients with luminal and non‑luminal HER2‑positive tumor subtypes. The morphological assessment of the tumor response to treatment was carried out using the RCB system; additional characteristics of the residual tumor were studied as well. It was shown that a comprehensive assessment involving the use of the RCB system and determination of the Ki ‑ 67 level helps to divide patients into prognostic groups and individualize the adjuvant therapy plan.

Objective. Assessment of the role of positron emission tomography (PET) in the diagnosis and treatment of B‑cell lymphoproliferative disorders (B-LPD) in Russian real‑world clinical practice from 2014 to 2017.

Materials and Methods. The EQUILIBRIUM, a post marketing multicenter study, included 1000 patients aged 21 to 91 years with a verified diagnosis of B‑cell non‑Hodgkin»s lymphoma (B-NHL) or chronic lymphocytic leukemia (CLL) who received at least 4 cycles of rituximab‑containing therapy with Acellbia®. The main method for the assessment of the disease dissemination, the size and location of the lesions was computed tomography, which was used in 76.2 % of patients. PET was performed in 324 (32.4 %) patients: in 152 (47 %) cases during initial diagnosis, PET during treatment in 102 (31 %) patients and — in the vast majority, i. e. 310 (96 %) patients — after completion of induction chemo‑immunotherapy.

Results. According to the results of interim PET, complete remission was achieved in 44 (43 %) of 102 patients, partial remission — in 53 (52 %) cases, stabilization of the disease was observed in 5 (5 %) patients, and no cases of progression among patients who underwent interim PET was detected. The main evidence of the final PET assessment efficacy was the achievement of complete remission (CR) in 235 (75.8 %) cases; partial remission (PR) was observed in only 61 (19.7 %) patients, and disease progression was reported in 14 (4.5 %) of cases. The median follow‑up was 15 months (range from 1 to 42 months). As expected, the median overall survival (OS) as well as the median event‑free survival (EFS) has not been reached for this period of time. There was a statistically significant effect of the results of interim PET on event‑free survival (p = 0.07661) without a significant effect on overall survival (p = 0.69868). The depth of response recorded during the final PET scan turned out to be a prognostically significant factor for both EFS and OS (p = 0.00000).

Conclusion. Positron emission tomography is a modern and effective method for diagnosing and assessing the efficacy of therapy in B‑cell lymphoproliferative disorders, which is used for only 1 / 3 of patients in a real‑world clinical practice. Nevertheless, the role of this method in assessing the effectiveness of therapy is beyond doubt.

Metastatic lesions in muscles appear to be a rare manifestation of malignant neoplasms with an unfavorable prognosis. To date, due to the low incidence of metastases to the ileo‑lumbar muscle, a definite concept of its treatment does not exist. The article describes the clinical case of a 33‑year‑old patient after a combined treatment of colon cancer in 2017 who progressed 5 months after the end of chemotherapy. Pathomorphological examination after ileo‑lumbar muscle lesion removal revealed metastasis of colon cancer adenocarcinoma. The patient underwent IMRT-SIB radiation therapy and chemotherapy with 5‑FU with no signs of progression for 4 months.