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Carriers of germline mutations have an increased risk of developing malignant neoplasms. Mutations in the BRCA1/2 gene are the most studied, leading to an increased risk of breast cancer, characterized by early manifestation and aggressive course. The development of screening measures aimed at identifying tumors characteristic of certain mutations will increase the patient’s chances for radical treatment, and therefore lower costs for the treatment of advanced forms of malignant neoplasms. It is important to know the correlation of mutations with the characteristics of their clinical manifestation, the study of this issue will lead to the formation of a medical and economic justification for additional diagnostic procedures.

Introduction. A decrease in nutrition of cancer patients affects all vital functions of the body, which is, according to numerous studies, typical of patients with gastrointestinal disturbances.Materials and methods. The study was set out to investigate the effect of correcting protein-energy malnutrition on the symptoms manifestation, including pain, fatigue, sleep disorder, poor appetite, nausea, vomiting, constipation and diarrhea in patients with generalized forms of gastrointestinal cancer. The study involved questionnaire method applied prior to the study and three months after. Three groups, equivalent in terms of selection criteria, participated in the study. For this purpose, the study participants were given nutridrink compact protein and omega-3 polyunsaturated fatty acid.Results and discussion. This study found out that timely nutritional support contributes toward reducing the negative symptoms of cancer and, when combined with supportive care and pain management, leads to significantly better results in terms of improving quality of life.Conclusion. Timely nutritional support has a positive effect on reducing the negative symptoms associated with cancer (pain, fatigue, sleep disorder, poor appetite, nausea, vomiting, constipation and diarrhea), and, along with supportive care and pain management, improves the quality of life more significantly.

Bladder cancer is globally considered as one of the most aggressive neoplasms. Traditionally, first-line therapy for metastatic urothelial carcinoma has remained unchanged over the past decades and has been based on combinations of cisplatin. Unfortunately, almost all patients eventually progress and die from bladder cancer, despite the initial response associated with cisplatin-based combinations. Immune checkpoint inhibitors are becoming an increasingly widely used therapeutic option in many solid tumors. In bladder cancer, a high level of programmed death-ligand is determined by rapidly progressive and aggressive tumors and unsatisfactory survival rates. Although checkpoint inhibitors are effective in metastatic urothelial bladder cancer, only a small proportion of treated patients receive a clear benefit, while a large number of patients experience significant side effects and toxicity without improving quality of life or surviving. None of the available biomarkers at this point was associated with response rates. There is evidence of an correlation between PD-L1 expression, the efficacy of immune checkpoint inhibitors, and treatment outcomes in patients with bladder cancer. A major paradigm shift in bladder cancer medicine has followed the FDA approval of avelumab, pembrolizumab, durvalumab, atezolizumab, and nivolumab for the treatment of patients with metastatic urothelial carcinoma previously treated with chemotherapy. Combining classical clinicopathological parameters with data obtained via information technology, together with genomic profiling, could be the future of personalized therapy for bladder cancer.

The off-label use of medicines is a routine clinical practice of oncology, especially in malignant-tumour patients with no treatment alternatives left when registered-drug options have been exhausted or standard therapies reveal contraindications. The recent shift from single-gene assays to multigene panels powered by full-exome or -genome sequencing expands the capacity of precision therapy, leading to a wider agnostic off-label use of targeted drugs for detecting a particular molecular genetic disorder. Studies of the off-label drug use in oncology will clarify the feasibility and safety of such prescriptions in patients with rare forms of malignancy when registered therapies have been exhausted or standard treatment reveals contraindications. This article examines the prevalence and landscape of off-label drug use in cancer patients and elaborates on the off-label principle. The paper presents a critical reflection on the off-label use of medicines in oncology.

Descripton of metastatic HER2-positive breast cancer clinical case is introduced, multilineal strategy basing on clinical situation and disease features is justified, justification of the choice of anti-HER2 treatment in every line is made, in compliance with russian and foreigh oncology associations guidelines, along with comparance of rutine treatment results and randomised trials data.

The prevention of malignant neoplasms in a healthy population is a priority task of national healthcare systems. Population screening and genetic counselling programmes allow identification of not only precancerous conditions, but also a genetic susceptibility to tumour diseases. Most hereditary cancers are passed on following an autosomal dominant pattern. Timely screening in healthy individuals, who may be potential carriers of mutated genes, facilitates the development of personalized preventive measures. The history of breast and/or ovarian cancer in close relatives is an important factor in early detection of genetic mutations in healthy patients, both women and men. The history of breast, ovarian or prostate cancer in close relatives increases significantly the chances of detecting a germinal mutation in the BRCA1 and BRCA2 genes in a proband. Genes associated with an increased risk of developing pancreatic cancer are BRCA1, BRCA2, CDKN2A, PALB2, PRSS1 and STK11. The most common syndromes of genetic mutations increasing the risk of cancer development include hereditary breast and ovarian cancer syndrome, Lynch syndrome, familial adenomatous polyposis, Peutz—Jeghers syndrome and Lee­Fraumeni syndrome, multiple endocrine neoplasia syndrome.

Background. At the end of 2019, a new coronavirus infection emerged in the People’s Republic of China. On March 11, 2020, the World Health Organization announced the start of the COVID­19 pandemic. During 2018, 2068 patients with malignant neoplasms of the vulva were identified, with the majority of patients aged 75–79 years. Surgical treatment is currently the main treatment method for vulva cancer (VC) patients. According to most authors, surgical treatment is the only method providing good long­term results. One of the approaches to reducing the volume of surgical treatment in such patients is the selective biopsy of the sentinel lymph node (SLN).Aim. To apply the method of SLN biopsy in VC patients with the purpose of reducing the amount of surgical treatment and surgical complications, as well as shortening hospital stay in the context of the COVID­19 pandemic.Materials and methods. This paper presents the results of surgical treatment of 19 patients with malignant neoplasms of the vulva. All the patients were at risk for a complicated course of COVID­19 due to age and concomitant pathologies. In 13 cases, vulvectomy with SLN biopsy was performed. SLN biopsy was performed by radioisotope lymphoscintigraphy.Results and discussion.A decrease in the duration of hospital stay and the absence of surgical complications characteristic of lymphadenectomies were noted.Conclusion. Reducing the duration of hospital stay in the context of the COVID­19 pandemic is an urgent task. The method of SLN biopsy in patients with invasive squamous cell carcinoma of the vulva with T1A — T2 was found to be effective, allowing the amount of surgical treatment to be reduced. Vulvectomy accompanied by SLN biopsy is the surgical treatment of choice in the context of strict anti­epidemiological measures in the COVID­19 pandemic.

Introduction. Breast cancer is the leader in cancer incidence in theRussian Federation. The tumor is considered extremely heterogeneous and the luminal subtypes of breast tumors occupy a special place, since they are considered relatively favorable in therapy and control of the disease.Drug therapy for hormone-positive cancer has undergone significant evolution and new anticancer agents have appeared in the arsenal of the oncologist and have shown promising results compared to classical therapy. The search for predictive markers of the effectiveness of new therapy has become of great importance. This marker turned out to be a mutation in the PIK3CA gene – one of the most frequent genetic disorders in breast cancer cells. According to the literature, the presence of this mutation negatively effects on endocrine therapy for breast tumors.The aim of this study was to analyze the frequency of mutations in the PIK3CA gene among patients with hormone-positive tumors, and the effectiveness of therapy with CDK4/6 inhibitors in this group of patients.Materials and methods. The material for the study of the mutation in the PIK3CA gene was tumor biopsies of 31 patients and clinical data on the response to therapy with CDK4/6 inhibitors and classical hormone therapy.Results and discussion. The results of the work showed a high incidence of the PIK3CA mutation among hormone-positive tumors (45%). The mutation resulted in a decrease in both the median time to progression after radical surgery (from 48.4 ± 7.8 months to 30.1 ± 6.0 months) in patients receiving adjuvant hormone therapy and progression-free survival in patients receiving therapy with CDK4 /6 inhibitors (4.2 months versus 9 months). This confirmed the theory that the PIK3CA mutation negatively affects the outcome of hormone therapy.Conclusions. PIK3CA is an important predictive marker in endocrine therapy for hormone-positive tumors. Its presence not only determines the relatively worse results of treatment, but can also serve as an indication for the appointment of a special series of drugs – inhibitors of this mutation.

Introduction. Hepatocellular carcinoma (HCC) is the most common primary malignant neoplasm of the liver. During the early stages, HCC is asymptomatic, which makes X-ray examination a particularly important diagnostic tool. According to WHO data, the mortality rate from HCC was 782,000 in 2018. HCC is associated with a number of risk factors: a high viral load, liver cirrhosis, detected HBeAg and elevated serum HBsAg levels. Inhibitors of tyrosine kinase receptors increase the overall survival and progression-free survival rates in patients with metastatic HCC. In this article, we conduct an analysis of results of the REFLECT study obtained for Russian patients by the Republican Clinical Oncological Dispensary, Ufa.Materials and methods. The experimental group included 9 patients (52.9%) receiving Lenvatinib. The control group included 8 patients (47.1%)) underwent therapy with Sorafenib at a dose of 800 mg per day 7 (41.17%) patients had a history of chronic hepatitis, of which hepatitis B and chronic hepatitis C was confirmed in 6 and 1 cases, respectively.Results and discussion. Over the period from 2017 up to the present, progression-free survival was observed in three patients (17.6%), of which 2 and 1 received Lenvatinib and Sorafenib, respectively. Overall survival was 10.5 months. The median overall survival rate in the experimental and control groups was 9.8 and 11.2 months, respectively. These parameters are considered comparable, provided that the sample was small.Conclusions. The use of Lenvatinib demonstrated the efficacy comparable to that of Sorafenib in terms of the overall survival rate in patients with inoperable HCC. Lenvatinib allowed statistically and clinically significant improvement in the progression-free survival and time to progression to be achieved.

The establishment of oncology as a discipline in Russia should be considered taking into account the specifics of national history, as well as key historical events. In 2020, Russia celebrates the 75th anniversary of Victory in the Great Patriotic War (World Was II). Russian oncology also celebrates its 75th anniversary. April 30, 1945 is considered the birthday of the Russian oncological service connected with the publication of a historical resolution of the Council of People’s Commissars of the USSR No. 935 “On measures to improve oncological care to population.”In pre-revolutionary Russia, oncological care had the character of a private initiative, rather than a well-organised process. The tsarist government did not bear responsibility for organising the fight against cancer. The Great October Socialist Revolution contributed to the organisation of the fight against malignant neoplasms at the state level, based on the decisions of party congresses and healthcare laws. This created favourable conditions for improving and expanding anticancer care to the population. Soviet scientists-enthusiasts made a significant contribution to the development of oncology in the USSR. The organisation of medical professional societies facilitated the determination of main directions in the development of oncology as a discipline in the country. By the beginning of World War II, oncology in the USSR had acquired the character of an oncological care system, implementing measures aimed at developing and transferring into clinical practice early detection methods and those of treating malignant tumours, as well as their prevention. By the beginning of World War II, this system had comprised a large number of oncological dispensaries, located in almost all the republics of the Soviet Union. However, at that moment, there was still no unity in the creation of practical oncological institutions. Neither was practiced the registration of cancer cases, their account and observation, which measures are necessary for the prevention and early diagnosis of malignant tumours and precancerous diseases.

Introduction. Vulvar cancer belongs to the group of rare neoplasms and accounts for about 4% of all gynecological malignant tumours. One of the important barriers to the spread of the tumour cell population is the lymph nodes. Most oncologists recognize the existence of the so-called sentinel lymph nodes. A proper assessment of the status of this node makes it possible to predict the extent of the spread of cancer, which in turn secures a better surgical treatment outcome.Materials and methods. 87 patients with vulvar malignant neoplasms received surgical treatment in 2015-2018 at the Department of Oncogynecology of the Republican Oncology Center. Vulvectomy was performed on 19 patients with verified vulvar cancer; sentinel lymph node detection was employed. The methods used were the contrast lymphography and indirect intraoperative radioisotope lymphoscintigraphy. This resulted in the minimal number of postoperative complications recorded.Results. The scope of surgical treatment for vulvar cancer was optimized based on sentinel lymph node verification.Conclusions. Detection of sentinel lymph nodes in vulvar cancer is an effective method of planning for the scope of the surgery. Using this method reduces the number of postoperative complications. The reduction of the number of postoperative complications improves the patients’ quality of life.

In the article are the incidence of breast cancer, cervical and ovarian cancer in the Republic of Bashkortostan from 1993 to 2002 and from 2003 to 2012 analyzed. A comparative analysis of the performance of the primary cancer incidence neoplasms of the female reproductive system has done, level patterns the dynamics of disease in different years, depending on age are obtained.

The article covers the data of skin melanoma advancing and of its prevalence rate in the Republic of Bashkortostan. Clinical cases of skin melanoma advancing among residents of the Republic of Bashkortostan are described. Treatment options of the disease are also mentioned. Causes of high skin melanoma advancing in the Republic of Bashkortostan in comparison with the subjects of Volga Federal district are considered in the article.