Esophageal cancer is one of the most aggressive malignancies of the gastrointestinal tract, characterized by high malignancy potential and poor prognosis. Surgical treatment is the standard for localized esophageal cancer, but the results of only surgery for locally advanced tumors remain unsatisfactory. The use of neoadjuvant chemotherapy, as well as neoadjuvant chemoradiation therapy, leads to a downstaging of the tumor, improves its resectability and increases an overall and disease‑free survival rates. The method of choice for unresectable esophageal cancer, as in case of refusal or intolerance to surgical treatment, is definitive chemoradiotherapy. Until recently, adjuvant therapy after R0 resection was not carried out, however, there is evidence that the postoperative use of nivolumab, an immune checkpoint inhibitor, significantly improves progression‑free survival in patients with evidence of residual tumor.

This article presents a current review of the treatment for resectable squamous‑cell carcinoma of the esophagus.

Circulating tumor DNA (ctDNA) refers to small fragments of nucleic acid (approximately 166 base pairs) that are not associated with cells or cell fragments and circulate in the bloodstream. Circulating tumor DNA has been proven to be a marker of minimal residual disease (MRD), a tumor process that cannot be detected using routine investigations. Circulating tumor DNA can be used as a marker of MRD because tumor cells secrete their DNA into the blood during necrosis, apoptosis, and functioning (with extracellular vesicles, etc.); therefore, it is possible to detect it and identify MRD. Circulating tumor DNA accounts for 0,01 % to several percent of all circulating extracellular DNA depending on the size of the tumor, its vascularization and biological properties. Currently, much attention is paid to the detection of minimal residual disease after radical surgery for non‑small cell lung cancer (NSCLC), since a number of large studies have shown postoperative plasma ctDNA to be a negative prognostic sign. For example, Chaudhuri et al. showed that 36‑month relapse‑free survival (RFS) in patients with and without postoperative plasma ctDNA was nearly 0 % and 90–99 %, respectively. The status of MRD determined by postoperative plasma ctDNA levels may be potentially used for adjuvant treatment selection in the postoperative period. In the DYNAMIC study, MRD‑positive patients (with postoperative plasma ctDNA) who received adjuvant therapy had an RFS of 22,4 months while those who did not receive adjuvant treatment had an RFS of 9,3 months.

Thus, the status of MRD based on the plasma ctDNA level after radical surgery may allow a personalized treatment approach for patients undergoing radical surgery for non‑small cell lung cancer (NSCLC).

Introduction: The problem of treating patients with unresectable liver metastases of colon cancer is currently far f rom being solved. One possible approach is the use of stereotactic body radiotherapy.

The purpose of this study was to evaluate the immediate and long-term results of stereotactic radiotherapy in patients with colorectal cancer and oligometastatic liver metastases.

Methods: This study was designed as a retro-prospective, open-label, controlled, non-randomized clinical trial. We assessed one-year local control, one-year overall survival, progression-free survival, and toxicity in 60 patients with oligometastatic liver disease from colorectal cancer who underwent stereotactic body radiotherapy, with median dose of 54 Gy.

Results: The median follow-up was 20,1 months. One-year local control (LC) was 73,7 % (95 % CI = 62,7–86,6 %). Oneyear overall survival (OS) was 92,8 % (95 % CI = 86,3–99,9 %), one-year progression-free survival (PFS) was 31,3 % (95 % CI = 21,1–46,4 %) with a median of 8,1 months. Grade ≥ 3 toxicity was not noted. No cases of radiation-induced liver failure were observed. Radiation dose (HR = 0.88, 95 % CI = 0.81–0.95, p = 0.00087), metastasis size (HR = 1.51, 95 % CI = 1.07–2.12, p = 0.01858) and their number (HR = 1.8, 95 % CI = 1.01–3.22, p = 0.04669) are significant risk factors for LC. Metastasis size > 3 cm is a significant risk factor for LC (HR = 5.5, 95 % CI = 1.7–17.9, p = 0.005) and OS (HR = 3.8, 95 % CI = 1.3–11.7, p = 0.02).

Conclusion: Stereotactic body radiotherapy is an effective and safe method of providing local control of oligometastatic liver metastases in colorectal cancer as part of a combined treatment approach. Further studies are required to individualize the indications for this treatment method.

Despite the widespread u se of fine-needle aspiration biopsy (FNAB) of uveal melanoma (UM) for prognostic purposes, there are still doubts about the safety of this procedure. No analysis of such data can be found in domestic literature, and foreign authors have published only a few papers on this issue.

The purpose of this study is to analyze the risk of metastasis in patients with UM during FNAB.

Two groups of patients were formed: the main group, where FNAB was performed during brachytherapy (BT) (BT + FNAB) (n = 70), and the control group, where only BT was performed (n = 144).

According to the obtained data, the probability of metastases during a 3‑year follow-up period did not significantly differ between the two groups (p = 0.22 by Fisher's exact test and p = 0.11 by log-rank test when assessing survival using the Kaplan – Meier method), the relative risk (RR) was 1.43 [95 % CI 0.79 to 2.24]. In addition, there was no significant difference in the main clinical outcomes of local treatment associated with worse prognosis: the degree of tumor regression (p = 0.46), extrascleral growth, the need for additional brachytherapy (p = 0.32) or secondary enucleation (p = 0.99).

The absence of a significant difference in patient survival between the BT and BT + FNAB groups opens up prospects for a more extensive use of FNAB in patients with UM for prognostic purposes.

Cowden syndrome is a rare disease characterized by multiple hamartomas and increased breast, thyroid, kidney and uterine neoplasm risk. The lifetime breast cancer risk for patients with Cowden syndrome is 85 %, with an average age of diagnosis between 38 and 46 years. The diagnostic criteria for Cowden syndrome have been established by the International Cowden Consortium (ICC) and the National Comprehensive Cancer Network (NCCN), and are regularly revised, but the diagnosis of Cowden syndrome remains difficult due to the variety of phenotypic and clinical features of the disease. At the same time, the genetic variants associated with Cowden syndrome analysis is not a standard for patients with breast cancer.

Objective: To demonstrate the non‑BRCA hereditary breast cancer detection using whole genome sequencing on the Cowden syndrome clinical case example.

Materials and methods: The article describes a clinical case of a 37‑year‑old female patient with breast cancer, normal intelligence and phenotype, structural abnormalities of the thyroid gland (multinodular goiter). Whole genome sequencing was used to identify clinically significant genetic variants associated with hereditary tumor syndromes.

Clinical case: The article presents a brief literature review on the clinical presentation of Cowden syndrome and indications for its molecular diagnosis. Also, the presented clinical case describes patient R., 37 years old female with breast cancer, who underwent treatment in the City Clinical Oncological Hospital № 1 of the Moscow City Health Department in 2021. The patient was fully examined and enrolled in the whole genome sequencing project under the Order № 69 of Moscow Healthcare Department dated February 1, 2021 «Oncogenetic research organization in Moscow». The results revealed a pathogenic variant in the PTEN gene, previously associated with Cowden syndrome.

Conclusion: The use of whole genome sequencing allows to identify hereditary tumor syndromes, the clinical manifestation of which may be breast cancer.

According to GLOBOCAN, there were about 18 million new cases of cancer and 9.6 million deaths from malignancies worldwide in 2018. Renal cell carcinoma is a malignant tumor characterized by the loss of the VHL gene, which leads to increased angiogenesis. The potential of immuno-oncology and anti-angiogenic drugs has significantly improved outcomes for patients with metastatic renal cell carcinoma. The phase III CheckMate 9ER study compared the efficacy and safety of nivolumab plus cabozantinib versus sunitinib in the first-line treatment of patients with metastatic clear cell renal cell carcinoma. The advantages of nivolumab plus cabozantinib over sunitinib in terms of progression-free survival, overall survival, and objective response rate were generally similar across subgroups based on IMDC risk, PD-L1 expression, and the presence or absence of bone metastases. We present a case report of metastatic renal cell carcinoma. The patient has been on cabozantinib plus nivolumab therapy for 12 months, with a partial response achieved. Treatment was well tolerated; the profile of adverse events was consistent with that in the clinical study.