Gam-COVID-Vac (Sputnik V, Gamaleya Research Institute of Epidemiology and Microbiology of Ministry of Health of Russian Federation) is an adenovirus viral vector vaccine for COVID-19 which became the very first vaccine against SARS-CoV-2 registered in Russia and worldwide. The vaccine efficacy and safety in cancer patients is unknown. We present a clinical case of the absence of post-vaccination immunity after the use of Gam-COVID-Vac in a patient with advanced ovarian cancer treated with maintenance targeted and immunotherapy and discuss it in the light of the available evidence base on the effectiveness of other anti-SARS CoV-2 vaccines in cancer patients.

The worldwide implementation of «breakthrough» surgical approaches such as breast-conserving techniques, the development of mammoplasty, as well as new guidelines for performing biopsy of sentinel lymph nodes incentivized the transition to a higher level of quality in breast cancer care. This review summarizes the modern tendencies in audits of main breast cancer surgical treatments based on last experience of few countries demonstrating the low breast cancer mortality and high incidence (lowest breast cancer mortality-to-incidence ratio).

Purpose. To identify major factors affecting the overall survival (OS). To select the cohort of patients with the best prognosis.

Materials and methods. A retrospective analysis included data of 268 patients, 128 men and 140 women, with median age of 59±10,53 (30 to 83) years. For multivariate analysis of survival, patients were selected who underwent pancreaticoduodenectomy (PD) for ductal adenocarcinoma of the pancreatic head.

Results. Our study demonstrated that histologically verified vascular invasion (detected only in 30 % of patients who underwent PD with resection of the major vessels) statistically significantly affected the OS. The increased CA19-9 level over 500 U / L (detected in 32,3 % of cases) is the factor that significantly worsens the OS. Patients with high grade adenocarcinoma have significantly better survival rates compared with patients who have moderately or poorly differentiated adenocarcinoma (p = 0.014; median 26 months, 95 % CI 4.4–47.6 versus median 17 months, 95 % CI 15–19, an median: 13 months, 95 % CI 5–21, respectively). Also, the use of adjuvant chemotherapy has a positive effect on long-term outcomes (p = 0.0001; median 26 months, 95 % CI 21.7–30.3 versus median 13 months, 95 % CI 11.3–14.7).

Conclusion. A well-differentiated tumor and the use of adjuvant chemotherapy significantly increase the OS of patients. Poorly differentiated tumor, CA19-9 level over 500 U / mL and the histologically confirmed vascular invasion significantly worsen the prognosis of these patients.

Objective. Studying the blood levels of type 1 and 2 insulin-like growth factors in patients with squamous cell carcinoma of the tongue and mouth floor mucosa depending on the therapy effect.

Materials and Methods. The study included data from 30 patients with squamous cell carcinoma of the tongue and mouth floor mucosa T3–4N0–1M0 who received chemotherapy cycles together with targeted therapy with cetuximab. Twenty non-cancer donors were examined as well. Depending on the therapy effect, patients were divided into two groups: sensitive and resistant ones.

Results. Initial levels of IGF-1 and IGF-2 in the blood serum of patients prior to chemotherapy and targeted therapy with cetuximab were lower than the levels in donors by 53.5 % and 20.3 %, respectively. After chemotherapy and cetuximab therapy, patients with sensitivity to the treatment showed normalization of IGF-1 and its significant increase compared to the initial levels — by 87 %. Levels of IGF-2 were not statistically significantly different from the initial levels and were 32.5 % lower than in donors. The IGF-1 / IGF-2 coefficient was 58 % higher than the initial value.

Conclusions. Chemotherapy and cetuximab therapy normalized levels of IGF-1 in patients with sensitivity to the treatment which was demonstrated by an increase in IGF-1 up to the normal blood levels in effective treatment.

Introduction. Adrenocortical carcinoma (ACC) is an orphan disease with an unfavorable prognosis. The most effective therapeutic option in the treatment of ACC is EDP plus mitotane combination chemotherapy. However, no studies comparing the efficacy of the EDP regimen with or without mitotane have been published.

Materials and methods. A retrospective analysis of health records of patients with histologically confirmed metastatic ACC, who received at least one chemotherapy cycle with EDP ± mitotane. The study included 73 patients, 49 of which received a combination of EDP and mitotane and 24 were treated with EDP chemotherapy.

Results. The objective response rate was 18,4 % in the EDP + mitotane group versus 4,1 % in the EDP group. Disease control was reported in 25 (51 %) and 13 (54,2 %) patients, respectively. No significant differences were found in progression-free survival (PFS) rates between the EDP and EDP + mitotane groups; the median PFS rate was 6,5 and 6,0 months, respectively. The median overall survival (OS) in the total population was 20,9 months; no significant differences were found between the groups. However, an increase in median PFS was observed in patients who achieved a therapeutic concentration of mitotane. Moreover, the achievement of therapeutic mitotane concentrations was the only factor significantly associated with improved PFS (HR 0.44, p = 0.006). Significant unfavorable prognostic factors associated with lower OS were Ki-67 level in the primary tumor > 20 % (HR 10.5, p = 0.006) and more than 1 site of metastases (HR 3.82, p = 0.02).

Conclusions. This study showed that the addition of mitotane to EDP chemotherapy does not improve the median PFS and OS in the total patient population, however, the achievement of therapeutic mitotane concentrations is significantly associated with improved progression-free survival.