Immune checkpoint inhibitors (ICIs) are widely used in the treatment of malignant tumors, either as monotherapy or in combination with chemotherapy or tyrosine kinase inhibitors (TKIs). Endocrine immune-related adverse events (e-irAEs) are a promising marker of ICI efficacy and patient survival due to their high frequency, early onset, and clear diagnostic criteria.

Objective: To conduct an epidemiological analysis of the development of e-irAEs, identify their predictors, and evaluate their impact on cancer outcomes.

Materials and methods: This retrospective cohort study included adult patients with solid malignant tumors who received their first administration of ICIs (as monotherapy or in combination with chemotherapy or TKIs) at the SBIH Moscow Clinical Scientific and Practical Center named after A. S. Loginov of DHM from June 1, 2016, to December 31, 2022. Overall survival (OS) was followed up until February 1, 2024. Results were considered statistically significant at p < 0.05.

Results: The study included 214 participants with a mean age of 62.6 years (range: 32–91). e-irAEs were reported in 45.3 % of participants, with 6.5 % experiencing two types of e-irAEs. The most common events were primary hypothyroidism (25.7 %), thyrotoxicosis (7.9 %), thyroiditis (7.5 %), secondary adrenal insufficiency (7.5 %), and ICI-induced diabetes mellitus (1.4 %); one patient developed secondary hypothyroidism. 64.2 % of e-irAEs occurred within the first 26 weeks of ICI therapy.

The development of e-irAEs correlated with better 1-year OS (11.52 vs. 10.85 months, log-rank p = 0.027), especially among patients with thyroid-related complications (11.6 vs. 10.82 months, log-rank p = 0.009).

In the subgroup of participants not receiving TKIs, there was a 44 % higher chance of achieving immune stable disease (iSD, p = 0.04) and a 45 % higher chance of clinical benefit (CBR, p = 0.03). e-irAEs occurred more frequently with concomitant use of incretin-based drugs, calcium channel blockers and antihistamines, and less frequently in patients with a derived neutrophil-to-lymphocyte ratio (dNLR) ≥ 3 at baseline and before the second ICI infusion, and a dNLR > 2.2 before the second ICI infusion. e-irAEs grade ≥ 2 were 2.09 times more often recorded in patients ≥ 60 years old. The combination of ICIs and TKIs increased the risk of primary hypothyroidism 2.3-fold (p = 0.035).

Conclusion: The study results indicate a high incidence of e-irAEs. Potential risk factors for their development have been identified. Further validation in prospective studies is required.

Aim: To evaluate the efficacy of olaparib maintenance therapy in real-world clinical practice in patients with BRCA-mutated ovarian cancer.

Objectives: To evaluate progression-free survival (PFS) by olaparib therapy line. To determine the predictive value of the level of the cancer marker CA-125 before therapy. To analyze the incidence of adverse events requiring dose reduction or drug discontinuation.

Materials and Methods: A retrospective analysis included data of 110 patients with Stage I–IV BRCA1 / 2 mutated high-grade serous ovarian cancer, who received olaparib maintenance therapy at the St. Petersburg Municipal Clinical Oncology Dispensary from 2020 to 2024. Patients were stratified into three groups: first-line olaparib (1L, n = 64), olaparib after the first recurrence (AR1, n = 24), and olaparib after two or more recurrences (AR2+ , n = 22). Statistical analysis included Kaplan-Meier survival estimates and multivariate analysis using Cox regression.

Results: The median PFS was not reached in the 1L group. In the AR1 and AR2+ groups, the median PFS was 49 and 20 months, respectively (p < 0.001). An elevated baseline CA-125 level (> 35 U / mL) before initiation of olaparib therapy was associated with a statistically significant 3.2-fold increase in the risk of progression (odds ratio [OR] 3.2; 95 % CI 1.5–6.8; p = 0.003). Toxicities requiring dose adjustment were reported in 14.1 %, 12.5 %, and 13.6 % of patients in the 1L, AR1, and AR2+ groups, respectively.

Conclusions: Olaparib maintenance therapy demonstrated high clinical efficacy and a manageable safety profile in real-world settings, with the greatest benefit observed in the first-line setting. Elevated pre-treatment CA-125 levels (> 35 U / mL) are an unfavorable prognostic marker.

Background: Addition of anti-PD1 antibodies to chemotherapy (CT) in pts with mGC has become a standard of care. However, there is no consensus on the threshold value of PD-L1 expression in the tumor as a predictor of the effectiveness of this approach (from the opinion that it is possible not to select on expression, to the selection of pts with a CPS ≥ 10). Therefore, we performed systemic review and meta-analysis to evaluate the efficacy of ICT depending on the expression of PD-L1 and compliance with the indicators of clinical benefit in accordance with ESMO-MCBS.

Methods: We conducted a search of all prospective randomized phase III studies in PubMed, ASCO and ESMO congresses for all years before June 2023, with anti-PD1 antibodies and CT with oxaliplatin and fluoropyrimidines in 1st line in pts with Her-2 negative mGC. Primary outcome was hazard ratio (HR) for OS and 95 % confidence interval (CI). Fixed or random effects were used for analysis, depending on heterogeneity. Meta-analysis was conducted by Review Manager Ver. 5.3. When calculating the number of points according to ESMO-MCBS, the median OS in the control group was more than 12 months and a point was added for improving the quality of life.

Results: We identified 6 trials (ATTRACTION-4, CHECKMATE-649, KEYNOTE-859, ORIENT-16, RATIONALE-305 and GEMSTONE-303), which included 5531 pts (CT — 2762 and ICT — 2769). According to the results of the meta-analysis there was a significant improvement in OS (HR 0.8, 95 % CI 0.75–0.86; p < 0.001; I2 = 0 %, p for heterogeneity 0.74) in groups with ICT in ITT population. Statistically significant improvement in overall survival was observed with PD-L1 CPS expression ≥ 5 (OR 0.71, 95 % CI 0.65–0.78; p < 0.001; I2 = 0 %) with ESMO-MCBS grading level of 3 points and RUSSCO — IC and among patients with PD-L1 CPS expression ≥ 10 (OR 0.65, 95 % CI 0.59–0.71; p < 0.001; I2 = 0 %) and ESMO-MCBS grading level of 4 points and RUSSCO — IB.

Conclusions: Addition of anti-PD1 and CT with oxaliplatin and fluoropyrimidines in 1st line in pts with mGC meets the definition of clinical benefit according to the ESMO-MCBS and RUSSCO only by selecting pts with PD-L1 expression CPS ≥ 10.

Radical hysterectomy or trachelectomy remains the main treatment for stage I–II cervical cancer. In case of high and, in some cases, intermediate risk of cancer progression, adjuvant radiotherapy (ART) or chemoradiotherapy (ACRT) is performed after surgery, which increases disease free survival (DFS) and overall (OS) survival. However, the use of radiotherapy is associated with a risk of toxicity including serious late complications: vesicovaginal and rectovaginal fistulas, intestinal and ureteral strictures, radiation-induced tumors. The combination of surgery and radiotherapy increases the risk of toxicity, which dramatically reduces the quality of life of patients; the correction of complications may be ineffective and traumatic.

All these factors necessitate the search for new approaches to the treatment of early-stage cervical cancer, which would ensure greater safety and higher quality of life for patients without long-term complications. One of these approaches is to reduce the need for ART / ACRT, by means of performance of type III / C2 surgery and partial replacement of ART / ACRT with adjuvant chemotherapy (ACT).

Type III / C2 surgery eliminates the need for ART in patients with intermediate risk of disease progression and results in a 5-year OS > 90 % in patients with IB-IIA stage disease.

The high-quality and large-scale studies demonstrated similar effectiveness of ACT compared to ART / ACRT. With no significant differences in OS and DFS, ACT provided a higher quality of life for patients.

ACT is performed only if the quality of preoperative examination and findings as well as the quality of surgery, and conclusive results of pathology tests are undoubted. Further randomized studies are needed to better understand and clarify the indications for AСT.

A systematic review and meta-analysis of 10 studies (2019–2024) evaluating the diagnostic accuracy of artificial intelligence (AI) algorithms for predicting pancreatic cancer (PCa) recurrence was conducted. The pooled sensitivity and specificity estimates were 0.77 [95 % CI: 0.58–0.95] and 0.79 [95 % CI: 0.57–1.00], respectively. Key limitations of the study included high heterogeneity (I² > 98 %), which could be related to the small number of included studies and insufficient standardization of the validation methods.

Background: Artificial intelligence (AI) tools provide new possibilities in predicting the course of pancreatic cancer.

Purpose: To conduct a meta-analysis of the diagnostic accuracy of AI algorithms (sensitivity and specificity) for predicting PCa recurrence and to compare the effectiveness of different types of algorithms. Methods. A systematic literature search was conducted in leading scientific databases, covering publications from 2019 to 2024. The review included studies that applied artificial intelligence tools to predict the risk of pancreatic cancer recurrence. The data search and analysis were conducted in three stages: a primary search of studies using keywords and inclusion criteria; screening of the titles and abstracts to select relevant studies; and a detailed assessment of the full texts of the selected articles.

The data synthesis included an analysis of the performance of the AI models, the types of data used (clinical, genomic, radiological, etc.), and the validation and testing strategies for the proposed algorithms.

A random-effects model was used for the sensitivity and specificity meta-analysis, with the calculation of pooled estimates, 95 % confidence intervals, and heterogeneity indices (I², τ²). A meta-regression was also performed to assess the impact of the algorithm type on sensitivity. Statistical analysis was carried out in R (metafor package) with forest plot visualization.

Results: This systematic review included 10 studies, of which 5 were selected for the meta-analysis. The results demonstrate a pooled sensitivity of 0.77 [95 % CI: 0.58–0.95] and specificity of 0.79 [95 % CI: 0.57–1.00] for AI algorithms in predicting PCa recurrence. In the analysis of individual algorithm types, artificial neural networks (ANNs) showed a pooled sensitivity of 0.87 [0.73–1.01], while support vector machines (SVMs) had a negative impact on sensitivity (coefficient –0.45 [–0.69 to –0.21]). The meta-analysis revealed high heterogeneity of the studies (I² = 98.84 % for sensitivity and I² = 99.42 % for specificity), requiring cautious interpretation of the results.

Conclusion: AI models are promising tools for predicting pancreatic cancer recurrence, but require data standardization and prospective validation in clinical practice.

Aim: To evaluate the economic feasibility of reimbursing healthcare organizations for the costs of pharmacotherapy for anemia associated with malignant neoplasms during the period of antitumor pharmacotherapy and to propose mechanisms for its financial provision through funds from compulsory medical insurance.

Materials and methods: А retrospective economic evaluation was conducted in 13 federal subjects of the Russian Federation, assessing various treatment options for anemia associated with malignant neoplasms in terms of financial expenditures for subsequent medical care delivery. This evaluation determined the effectiveness of anemia treatment based on prevented complications (predictable consequences of progression, including hypoxia, ischemia of organs and tissues, and reduced efficiency of pharmacotherapy), which require insurance coverage through funds from compulsory medical insurance.

Results: The estimated costs for procuring erythropoiesis-stimulating agents range from 597.4 million rubles per year to 668.2 million rubles per year. Due to the savings achieved by eliminating the need for insurance coverage to compensate for the costs of treating anemia associated with malignant neoplasms following anticancer drug therapy (prevented insurance cases), a return on investment of 35.0 % is projected within the first 12 months, and 101.7 % within 36 months.

Conclusions: The introduction of a separate payment method for medical care, which would enable reimbursement of costs for treating anemia associated with malignant neoplasms concurrently with antitumor pharmacotherapy for each administration of erythropoiesis-stimulating agents, is justified by a prognostic calculation indicating full cost recovery for the procurement of such agents over a 3-year observation period.

Retroperitoneal liposarcoma is a rare malignancy with a high recurrence rate. Giant retroperitoneal liposarcoma presents significant challenges for oncologists due to its invasive nature and compression of vital organs. Early diagnosis and complete surgical removal of the tumor are key factors in the successful treatment of this disease. This case demonstrates the complexity of treating a 65‑year‑old woman with a tumor measuring 31 × 26 × 17 cm, weighing 5.9 kg. It highlights the importance of precision and complexity of surgical intervention, as well as the potential of using 3D tumor modeling to calculate tumor volume, intraoperative blood loss, surgical planning, and predict complications.

The Russian consensus on prevention, diagnostic and treatment of gastric cancer was prepared on the initiative of the Moscow clinical scientific center named after A. S. Loginov on the Delphi method. Its aim was to clarify and consolidate the opinions of specialists on the most relevant issues of prevention, diagnosis and treatment of gastric cancer. An interdisciplinary approach was provided by the participation of leading gastroenterologists, oncologists and surgeons.