Background: Immunotherapy-based regimens, such as nivolumab plus ipilimumab (Nivo-Ipi) and avelumab plus axitinib (Ave-Axi), are standard first-line treatments for metastatic clear-cell renal cell carcinoma (mRCC) with intermediate or poor IMDC risk. Comparative real-world evidence for these regimens remains limited.

Methods: This retrospective cohort study included 102 patients with mRCC treated with Nivo-Ipi (n = 51) or AveAxi (n = 51) from 2018 to 2023. Propensity score matching was used to balance baseline characteristics, including IMDC risk and comorbidities. Primary endpoints were the rate of treatment-related adverse events (TRAEs) and progression-free survival (PFS). Secondary endpoints included objective response rate (ORR) and overall survival (OS).

Results: Patient characteristics were balanced across cohorts, with a median age of 63.4 years, 76 % male, and 61 % having chronic cardiovascular diseases. The rate of any grade TRAEs was similar between Nivo-Ipi and Ave-Axi (62.7 % vs. 68.6 %, respectively), as was the rate of grade ≥ 3 TRAEs (11.7 % vs. 17.6 %). Patients treated with Ave-Axi had a significantly extended PFS (15.0 vs 9.7 months; p  0,05). The median OS was not reached.

Conclusions: Nivo-Ipi and Ave-Axi are effective and well-tolerated first-line therapies for mRCC in real-world settings. Ave-Axi was associated with a significantly longer PFS and a numerically higher ORR compared to Nivo-Ipi.

The article presents data from a retrospective study of COVID-19 outcomes in cancer patients from 24 regions of the Russian Federation.

The study included 1,055 patients who had a Coronavirus disease 2019, including 451 (42.7 %) men and 604 (57.3) women. The mean age was 58.7 years (29–90); 108 (10.2 %) patients were diagnosed with various comorbidities. 627 (59.4 %) were receiving antitumor drug therapy at the time of diagnosis of COVID-19, and 332 (31.5 %) received antitumor chemotherapy.

Most patients had asymptomatic or mild COVID-19: asymptomatic in 205 (19.4 %) patients, and mild — in 517 (49.0 %) patients. Moderate / severe COVID-19 was observed in 268 (25.4 %) patients, while severe / critical COVID-19 was diagnosed in 65 (6.2 %). 1204601776 25 (2.4 %) patients died after COVID-19. The average age of cancer patients who died was 66.3 years (31–84). Among the deceased patients, 16 (64.0 %) were women and 9 (36.0 %) were men. To determine the factors increasing the risk of death in cancer patients we performed univariate and multivariate analyses. Conclusions: based on the presented data, the probability of death from COVID-19 was associated with the anti-tumor therapy administered during the disease. This conclusion obliges us to stop antitumor chemotherapy during the COVID-19 disease.

Treatment strategy of advanced unresectable head and neck squamous cell cancer (HNSCC) is limited to induction chemotherapy (ICT) followed by (chemo) radiotherapy (cRT) and concurrent chemoradiotherapy (CCRT). However, the role of ICT remains controversial considering the lack of overall survival benefit.

The aim: to evaluate the role of induction chemotherapy in the treatment of locally advanced HNSCC.

Methods: We performed a retrospective clinical study that included patients (pts) with unresectable stage III–IVa cancer of larynx, oropharynx and hypopharynx.

Results: A total of 176 pts were enrolled, 84 (48 %) received CCRT with cisplatin or carboplatin and 92 (52 %) — ICT followed by cRT. Groups were well balanced by sex, tumor site, T-stage, while in group of ICT there was a significant prevalence of younger pts (p = 0.004) and pts with stage N2–3 (p = 0,03).

The objective response rates (ORR) were 76 % (42 / 55) in CCRT arm (including 53 % (12 / 62) of complete responses) and 72 % (56 / 78) in ICT arm with complete response rate of 15 % (12 / 78). The ORR in ICT arm increased after the completion of CCRT up to 82 % with 53 % (33 / 62) of complete responses. The difference was not statistically significant (p = 0,7).

With a median follow-up duration of 8.7 months median progression-free survival (mPFS) was 7.6 and 9.4 months (Hazard ratio (HR) 0.67, 95 % CI 0.43–1.04); 6month OS was 65.7 % and 92.8 % in CCRT and ICT groups, respectively (HR 0.51, 95 % CI 0.30–0.85, р < 0.01).

Propensity score matching analysis proved the 6month OS in the ICT + cRT group to be significantly longer than in CCRT group — 97.7 % vs 66.8 %, respectively (HR = 0.28, 95 % CI 0.13–0.62, p  < 0.01).

Conclusions: ICT + сRT resulted in improvement of PFS and OS compared to CCRT in pts with locally advanced HNSCC.

Introduction: The systemic therapy of patients with metastatic luminal HER2‑negative breast cancer (mBC) in‑ cludes various options, which can be fundamentally divided into endocrine therapy and chemotherapy. According to the Clinical Guidelines, both international and Russian, the “gold standard” of the 1st line therapy for patients with metastatic luminal HER2‑negative breast cancer (mBC) is a combination of cyclindependent kinase inhib‑ itors 4 / 6 (iCDK4 / 6) with endocrine therapy (ET). However, until recently we did not have complete data on the characteristics of the Russian population of patients with luminal HER2‑breast cancer, their treatment options, and the results of this therapy.

Aim: To analyze the patients’ profile and current treatment approaches for patients with luminal HER2 mBC in routine clinical practice in Moscow.

Materials and methods: The study was performed as an observational, crosssectional and retrospective study. The data of 2,500 patients from medical institutions in Moscow who received systemic therapy for luminal HER2 mBC in AugustOctober 2021 were analyzed.

Results: The largest number of patients received iCDK4 / 6 + ET in the first and second lines: 69.0 % and 52.0 %, respectively. In the first line, 54.6 % of patients received ribociclib, 43.1 % palbociclib and 2.3 % abemaciclib. In the second line, 50.6 % of patients received ribociclib, 47.8 % palbociclib and 1.6 % abemaciclib. As the pretreatment of patients increased, preference was given to other treatment methods, therefore the proportion of combined ET decreased to 34.0 % in the third line and 25.0 % in the fourth and subsequent lines.

Conclusion: The data obtained indicate that the appointment of iCDK4 / 6 + ET is made in accordance with the Clinical Guidelines for the treatment of breast cancer of the Ministry of Health of the Russian Federation from 2021 and the preferred firstline treatment option for patients with luminal HER2 mBC in Moscow is combined endocrine therapy.

Introduction: progression of advanced epithelial ovarian cancer (EOC) on olaparib may diminish the efficacy of subsequent chemotherapy in recurrent disease setting. However, the impact of progression of EOC during maintenance therapy with olaparib after frontline therapy has not been well studied.

Materials and methods: this retrospective study enrolled patients of BRCA / HRD + FIGO stage III–IV EOC with confirmed progressive disease after frontline treatment treated since 2014 until 2022 who either received (arm A) or not (arm B) olaparib as maintenance therapy. To ensure the balance of the compared groups during the study propensity score matching analysis was conducted (cardinality method using MatchIT package in R) with 1:1 ratio of patients in trial arms. The groups were balanced according to the presence of residual tumor after initial treatment, the duration of platinum-free interval after the frontline therapy, secondary local therapy for recurrent disease, treatment with platinum drugs for relapse and subsequent bevacizumab. The primary endpoint of the study was progression-free survival (PFS).

Results: the initial population consisted of 259 patients, after the matching procedure 76 patients were enrolled in the study. The median age of patients was 48 years in the arm A and 50 years in the arm B (p = 0.989), 12 (32 %) had FIGO stage IV in both arms (p = 1.000), 25 (66 %) patients in both arms had platinum-free interval ≥ 12 months. With a median follow-up of 42.8 mo. (0.6–70.1 months) median PFS was 6.9 (95 % CI 6.2–10.6 months) and 12.2 (95 % CI 9. 6–21.3 months) in arm A and B, respectively (hazard ratio [HR] 2.89; 95 % CI 1.63–5.12; p < 0.001). Median overall survival was 23.2 months. and 68.2 mo., respectively (HR 4.15; 95 % CI 1.62–10.6).

Conclusion: efficacy of subsequent chemotherapy is apparently reduced following progression of BRCA / HRD + EOC on maintenance olaparib therapy in frontline setting. Further trials should assess optimal approaches for these patients.

Background: Routine analysis of KRAS, NRAS, BRAF V600 mutations, as well as MSI and HER2 guides treatment selection in colorectal cancer (CRC). Recent findings from the PRESSING and PARADIGM trials have demonstrated that the negative hyperselection of patients based on the results of comprehensive genomic profiling results in better treatment outcomes following anti-EGFR therapy. Study objective: The study aimed to retrospectively analyze the occurrence of alterations associated with potential resistance in samples from CRC patients treated with anti-EGFR therapy.

Materials and methods: Patients with confirmed left-sided CRC treated with anti-EGFR therapy due to the lack of RAS / BRAFV600 mutations as per routine PCR were included in the study. FFPE samples were analyzed via NGS (Solo-test Atlas Pro, 38 genes, MSI). Samples determined as RAS / BRAFV600positive by NGS were validated with PCR.

Results: A total of 111 samples were analyzed via NGS. A total of 172 alterations in 17 genes were found; alterations in any of the genes covered by the panel were found in 96 (86.5 %) samples. The variant allele frequency ranged 1.3–93.0 %. NGS identified 29 (26.1 %) samples with KRAS (n = 24), NRAS (n = 3) or BRAF p. V600E (n = 4) mutations. Confirmatory PCR testing of 16 RAS / BRAF p. V600E-positive samples resulted in 100 % agreement with NGS. Among RAS / BRAFV600negative samples, 10 (9 %) samples harbored other alterations (ERBB2 amplification, n = 3; PIK3CA, n = 2; MSI, n = 1; BRAF class II mutation, n = 1; ERBB3, n = 1). A total of 11 samples harbored more than 1 alterations associated with potential resistance. BRAF class II / III mutations were found in 4 samples, PIK3CA mutations — in 17 (15.3 %) samples (of those, 5 samples harbored mutations in exon 21).

Conclusions: The results of this retrospective analysis demonstrate that a high frequency of false-positive routine PCR results may lead to incorrect indication of anti-EGFR therapy in ~ 26 % cases. Analysis of alterations beyond RAS / BRAFV600 might identify an additional 9 % of patients whose tumors are potentially resistant to anti-EGFR therapy.

Aim: to characterize CD155 expression in primary choroidal melanoma cells and determine its prognostic value for survival.

Material and methods: 68 patients with primary choroidal melanoma were included. The levels and patterns of CD155 expression in tumor tissues were studied using immunohistochemical method. Regression analysis was performed to identify independent factors predicting the course of the disease.

Results: in 51 % of cases, membrane expression of CD155 was registered in choroidal melanoma cells. In the group of tumors with any type of membrane expression of CD155, the signs of poor prognosis were statistically significantly more common. Membrane expression of CD155 was found to be an independent prognostic factor for the development of distant metastases according to multivariate regression analysis (RR 3.7 95 % CI 1.3–10.4, p = 0.005), as well as for death from choroidal melanoma (RR 3.2 95 %CI 1.2–8.3, p = 0.009).

Conclusion: the expression patterns of CD155 in primary choroidal melanoma were studied. It was found that the presence of membrane expression of CD155 was associated with an increased risk of choroid melanoma progression by 3.7 times and death by 3.2 times.

Despite the use of modern treatment methods for gastric cancer (GC), survival rates in locally advanced stages remain unsatisfactory. This necessitates the search for new therapeutic options and potential predictive factors for tailoring treatment approaches. The emergence of new molecular classifications like The Cancer Genome Atlas (TCGA) and the Asian Cancer Research Group (ACRG), leading to the identification of a distinct subset — gastric cancer with high microsatellite instability (MSI-H) caused by mismatch repair deficiency (dMMR), has paved the way for a novel treatment direction: immunotherapy. MSI status and PD-L1 expression are regarded as predictors of immunotherapy efficacy in GC. However, the question of which marker is more accurate or if they should be considered together remains unanswered. Furthermore, the efficacy of checkpoint inhibitor therapy is often attributed to increased PD-L1 expression in microsatellite unstable tumors compared to microsatellite stable ones. The article discusses a case demonstrating the high efficacy of immunochemotherapy, resulting in complete pathomorphological regression of the tumor in a patient with locally advanced gastric cancer and MSI-H status after neoadjuvant immunochemotherapy, despite the absence of PD-L1 expression (CPS-0). The patient has been monitored for 1.5 years post-treatment at the N. N. Blokhin National Medical Research Center of Oncology without signs of progression.

The treatment approach for gestational and non-gestational ovarian choriocarcinoma has several differences, and their differential diagnosis requires special attention. The implementation of molecular-genetic testing which determines the presence of paternal genetic material in the tumor allows for a reliable determination of the origin of ovarian choriocarcinoma. The presented clinical case demonstrates the importance of this method in the differential diagnosis of gestational and non-gestational forms of ovarian choriocarcinoma.