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Introduction. About 600 new cases of malignant neoplasms of the paranasal sinuses and nasal cavity are detected annually in Russia. To date, there are no randomized trials to determine the optimal treatment algorithm for this group of patients. Data on the use of induction chemotherapy in squamous cell carcinoma of sino-nasal tract are limited to a small series of clinical observations and, often, are retrospective in nature.Aim. Evaluation of the effectiveness of induction chemotherapy in patients with locally advanced squamous cell carcinoma of the paranasal sinuses and nasal cavity.Materials and methods. Since 2012, 22 patients with locally advanced cancer of the paranasal sinuses and nasal cavity have been treated in our center, who underwent 3-component induction chemotherapy according to the TPF protocol. Evaluation of the effectiveness of treatment was carried out according to the criteria of Response evaluation criteria in solid tumors 1.1 (RECIST 1.1). Patients with a decrease in the tumor size by 30 % or more, were followed by radiation therapy in doses of 66–70 Gy. Patients with a residual tumor underwent surgery after the end of chemoradiotherapy.Results. In 21 patients available for analysis, overall response rate after induction chemotherapy was 71 %: complete response was registered in 3 (14 %) patients, partial response in 12 (57 %), stable disease in 4 (19 %). Progression disease after 3 courses of induction chemotherapy was detected in 2 (10 %) patients.Conclusions. Thus, induction chemotherapy in patients with squamous cell carcinoma of sino-nasal tractseems to be a promising direction for investigation, that can significantly improve the long-term results of treatment of this category of patients and help to avoid of disabling surgery in some of them.

Brain metastases (BM) are associated with poor prognosis, short overall survival, and severely compromised quality of life in patients with advanced breast cancer (BC). BM create therapeutic challenges in BC due to the difficulty for the majority of drugs to cross the blood-brain barrier. Hormone-positive HER2-negative breast cancer usually progresses slowly compared to other subtypes and it is the most common subtype among patients with BC. The cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors have rapidly transformed breast cancer treatment landscape within past few years. Integrating CDK4/6 inhibitors in clinical practice significantly improved both progression-free and overall survival in all patient population, including patients with BM. In this article we summarize the results of phase III randomized controlled trials (MONALEESA-2, MONALEESA-3, MONALEESA-7, and Completion-1), suggesting the efficacy of the combination of ribociclib with various endocrine therapies, and present a clinical case discussion of a patient with advanced hormone-positive HER2-negative BC with brain, hepatic and bone metastases treated with combined targeted and endocrine therapy.

Hereditary breast cancer (BC) accounts for about 5-10% of cases. BRCA-associated tumors have been identified as a separate group of malignant neoplasms with distinctive clinical manifestations and specific treatment features. Understanding of biological mechanisms leading to cancer in BRCA1/2 mutation carriers and discovery of potential molecular targets, such as poly (ADP-ribose) polymerase (PARP), involved in base excision repair mechanisms, led to the development of a new class of targeted drugs belonging to the PARP inhibitors group. PARP inhibition leads to the preservation of single-stranded DNA breaks, the arrest of the replication fork, and the realization of the “synthetic lethality” phenomenon due to the inability to repair double-stranded DNA breaks by homologous recombination in cells with mutations in the BRCA1/2 genes. Two randomized trials OlympiAD and EMBRACA evaluated and proved the effectiveness of PARP inhibitors in patients with metastatic BRCA-mutated HER2-negative breast cancer in comparison with standard chemotherapy. At the same time, data on the potential use of PARP inhibitors for the treatment of BRCA-mutated HER2-positive breast cancer patients are extremely limited. This article presents a clinical example of the use of olaparib in a patient with BRCA-mutated HER2-positive metastatic breast cancer.

Cutaneous melanoma is characterized by an aggressive course associated with a tendency to metastasis. For a long time, the prognosis of patients with metastatic melanoma remained extremely poor. However, the introduction of immunooncological drugs into clinical practice has changed the approaches to the treatment of patients with metastatic melanoma, and fundamentally improved the prognosis and quality of life of such patients, which undoubtedly became a breakthrough in the treatment of this pathology. This article presents a clinical case of the treatment with immunological drugs of a patient with metastatic melanoma of the skin with lymph nodes of rare localization with a complete tumor response.

Malignant tumors of the sinuses and nasal cavity are rare diseases. Squamous cell carcinoma is the most common histological type (55–70 % of tumors of the sinuses and nasal cavity). The frequency of neuroendocrine tumors reaches 5 %. Currently, there is no generally accepted standard for the treatment of neuroendocrine tumors of sinonasal localization. If surgical treatment is associated with a significant deterioration of the quality of life or poor outcomes, chemoradiotherapy can be recommended. This article describes a clinical case of combined treatment of neuroendocrine cancer of the maxillary sinus and brief review of the literature on malignant tumors of the paranasal sinuses and the nasal cavity.

Sinonasal undifferentiated carcinoma is a rare and aggressive tumor with an extremely poor prognosis. In the vast majority of cases, this tumor can not be resected due to its rapid local growth. Correct morphological diagnosis is impossible without a thorough differential diagnosis between sinonasal undifferentiated carcinoma and a number of lowgrade tumors of the nasal cavity and paranasal sinuses. Very few case reports and retrospective studies on sinonasal undifferentiated carcinoma have been published so far. No unified widely accepted guidelines on sinonasal undifferentiated carcinoma treatment are currently available due to the lack of statistically significant data from randomized clinical trials. The optimal treatment strategy should be based on an aggressive multimodal approach involving radical surgery, precision radiation therapy, and intensive chemotherapy. The benefits of systemic targeted therapy for patients with sinonasal undifferentiated carcinoma are still unclear. The best results can be achieved by employing tailored treatment approaches preferably in multidisciplinary cancer centers, where healthcare professionals experienced in managing patients with head and neck tumors can be involved. In this article, we report a case of complete radiological response after induction chemotherapy with docetaxel and doxorubicin and proton radiation therapy for the primary tumor area in a 53‑year-old female patient with non-resectable platinum-resistant sinonasal undifferentiated carcinoma.

Introduction. The gold standard for the treatment of patients with a localized form of pancreatic cancer is radical surgical intervention. It is characterized by a high frequency of postoperative complications and is not performed in patients with a weakened general functional status and the presence of multiple severe concomitant somatic pathology.Purpose. The aim of this study is a assessment of the safety and effectiveness of combined treatment with the inclusion of gemcitabine chemotherapy and HIFU therapy in somatically inoperable patients with localized pancreatic adenocarcinoma of the elderly and senile age.Materials and methods. This study involved 15 patients with stage II (T3N0-1M0) disease aged 60 years and older, with a performance status ECOG 2 and a high operational and anesthetic risk, who received palliative combined treatment on the basis of the P. Hertsen Moscow Oncology Research Institute in the period from 2017 to 2020. HIFU therapy was performed on the HIFU2001 (Shenzhen Huikang Medical Apparatus Co., Ltd.), local treatment sessions were carried out in the amount of 3–8 per course, conducted daily, in the intervals between days of intravenous administration of gemcitabine at a dosage of 1000 mg/m2 (1, 8, 15 days every 4 weeks).Results. Adverse events of systemic drug therapy were observed in 9 (60%) patients, local complications of HIFU therapy — in 6 (37.5%) patients. 6 months after the start of treatment, pain control was achieved in 87.5% of patients, local progression of the disease was detected in 2 (13.3%) cases, and a partial tumor response was determined in 2 patients and stable disease in 11 patients. The median overall survival was 19 months, and the median progression-free survival was 12 months. The overall 1-, 2-, and 3-year survival rate was 80%, 20%, and 13%, respectively, and the 1-year progression-free survival rate was 54%.Conclusions. The results of this study demonstrate the prospects of using a combination of HIFU therapy and gemcitabine monotherapy in somatically inoperable patients with localized pancreatic adenocarcinoma of the elderly and senile age.

Purpose: to conduct a preliminary analysis of the safety and effectiveness of hifu-therapy with a lowenergy hifu-2001 device (shenzhen Huikang Medical apparatus Co., ltd) performed concurrently with chemotherapy in pancreatic cancer patients who are not suitable for surgery or chemoradiotherapy.Material and Method. The study included 24 pancreatic cancer patients who were treated at the Hertsen Moscow Oncology Research institute in the period from 2016 to 2019. There were 17 (71 %) women and 7 (29 %) men. The percentage of patients in the elderly group was 79 %. Stage iia pancreatic cancer was diagnosed in 3 (12.5 %) patients, stage ii in 5 (21 %) patients, stage iii in 9 (37.5 %) patients, and stage iv in 7 (29 %) patients. All patients received combination therapy, including systemic chemotherapy and hifu-therapy. Results. The most frequent adverse events of treatment were skin burns (n=6), with third-degree burns occurring in 2 (8.3 %) patients. Local sclerosis of subcutaneous adipose tissue was observed in 4 (17 %) patients; development of asymptomatic pancreatic pseudocysts in the area of hifu exposure was observed in 1 (4 %) patient. Pain control was achieved in 17 (85 %) patients, and local tumor control was achieved in 19 (79.2 %) patients. The follow-up time ranged from 5 to 30 months with a median time of 14.5 months. The median total life expectancy of patients was 16 months, and the median time to progression was 9 months. The overall 6-month survival rate was 100 %. The 1- and 1.5-year survival rates were 75.0 % and 41.7 %, respectively. The 2-year survival rate was 17.2 %. The 6-month and 1-year disease-free survival rates were 62.5 % and 12.5 %, respectively. Conclusion. The short- and long-term outcomes were consistent with those described in other studies, which indicated that a combination of systemic drug therapy and hifu-therapy is an appropriate approach for the treatment of patients with pancreatic cancer.

Combination of neoadjuvant chemoradiotherapy with subsequent total mesorectum excision and 6-months of adjuvant chemotherapy remains a standard approach to treatment of locally advanced rectal cancer (T3 or T4 and / or N1–3; M0) for more than 15 years, which is reflected in practical guidelines of most leading oncological societies. However, recent data suggests possibilities of more individualized treatment conceptions with a potential of further improvement of long-term therapy outcomes and patient’s quality of life. In this paper we present review of results of clinical trials which investigated new approaches to treatment of locally advanced rectal cancer.

The results of the clinical studies have a direct impact on clinical practice. The main criteria for the effectiveness of treatment method are increasing the overall life expectancy and improving its quality. In the treatment of common forms of squamous cell carcinoma of the head and neck, induction chemotherapy can be used, including platinum drugs, preferably in combination with cetuximab. Next immuno-oncological drugs should be prescribed. In the future, in the 1st line of therapy, it is possible to replace cetuximab with pembrolizumab or monotherapy with pembrolizumab, which allows to increase the effectiveness of treatment and reduce its toxicity. The article presents 3 clinical observations that demonstrate the possibility of integration the results of clinical research in practice.

Detailed, systematic review of the world literature data, including all aspects that reflect the impact of the COVID-19 pandemic on the oncological practice was conducted. The information sources were taken from Pubmed, MedLine, Scopus, Web of Science, and RSCI systems. The data from retrospective and prospective clinical trials have been analyzed. This review presents current data on the impact of COVID-19 on cancer patients, mortality and prognosis of cancer patients infected with COVID-19, treatment options for COVID-19, as well as the case report of the cancer patient with rare atypical COVID-19 course of disease. To date, the groups of increased risk of being infected with a new coronavirus have been identified. These groups include cancer patients. Despite the pandemic, treatment of cancer patients must be continued, since the presence of a tumor process does not allow the therapy to be delayed. The world cancer community is actively continuing to develop recommendations for optimal management of cancer patients in the context of the pandemic. The most relevant of them are described in this article.

Although many currently known molecular targets are characterized by organ specificity, they can be found in various types of tumors. Molecular diagnostic techniques can be used to help select patients who are most likely to benefit from target therapy. Case presentation. We describe the case of a 38-year-old patient with advanced gastric cancer with peritoneal dissemination. On december 11, 2014, the patient underwent palliative subtotal gastrectomy followed by 18 cycles of chemotherapy (xelOx) and radiotherapy. On February 2, 2017, percutaneous transhepatic cholangiostomy of the left lobe bile duct was performed. in May 2017, the stent was inserted into the common bile duct due to bile duct stenosis. three months later, disease progression (multiple liver metastases) occurred, and chemotherapy with paclitaxel was given in a weekly schedule. therapy with crizotinib was administered 3 months after determining the alK mutation. the duration of treatment was 8 months with satisfactory tolerability. Conclusion. target therapy with krizotinib seems to be an effective treatment for alK-positive tumors.

Current landscape of personalized and molecular-driven approach to cancer treatment contributes to a rapid growth of novel biomarkers used for a targeted therapy. Amplification or over-expression of HER2 has been shown to play an important role in the development and progression of some cancers. Recent studies have shown that over-expression of HER2 is found in up to 5% of colorectal cancers (CRC). These findings led to active research of therapeutic use of HER2-targeted therapy in a subset of patients with metastatic CRC, especially in patients with wild-type RAS, who progressed on anti-EGFR targeted therapy. According to data from several published studies, the rate of objective responses, progression-free and overall survival in this subset of patients matches or exceeds same rates that are achieved while using BRAF-targeted therapies in BRAF-mutated metastatic CRC patients and immunotherapy used in subjects diagnosed with MSI-H tumors. Currently, there is no conclusive data on potential of HER2-targeted therapy in RAS-mutated CRC patients. In this paper, we report a case of durable objective response obtained on trastuzumab therapy in patient with metastatic CRC, mutation in 12th exon of KRAS gene and over-expression of HER2 in 40% of tumor cells, after progression on several lines of chemotherapy and anti-angiogenic targeted therapy.

The treatment of common forms of squamous cell carcinoma of the organs located on the head and neck that are not subject to surgical treatment is limited to the use of chemoradiotherapy with platinum derivatives or drug therapy with platinum-containing regimens. With the progression of the disease, ineffective 2‑line cytostatics were prescribed that did not fundamentally change the course of the tumor process. The introduction into clinical practice of drugs of the original mechanism of action has significantly increased the effectiveness of drug therapy during progression after platinum-containing chemotherapy. The article presents two clinical observations that demonstrate the relevance of the strategy of using inhibitors of immune response control points after platinum preparations.

Testicular cancer is a rare malignant tumor. In the structure of general cancer incidence, this nosology accounts for about 1–1.5% of cases. Among this pathology, about 90–95% is due to testicular germ cell tumors. Currently, testicular cancer is a potentially treatable solid tumor with a 10-year survival rate of more than 95% upon timely diagnosis and proper treatment. In this regard, early diagnosis and treatment of this pathology is an urgent task today. The article presents a clinical observation of the treatment of a patient with a testicular germ cell tumor. The presented clinical case demonstrates the successful conduct of neoadjuvant chemotherapy and further orchifuniculectomy in the presence of distant metastases namely in case of a non-seminomic form of a testicular germ cell tumor. The approach to treating patients with testicular tumors must be individualized and take into account both the potential gain and the potential risks of the treatment being performed.

The study objective is to provide a rationale for the development of an individual treatment plan for patients with locally advanced squamous cell carcinoma of the larynx, hypopharynx, and oropharynx by selecting different regimens of induction chemotherapy according to biological characteristics of the tumor and functional status of the patient.Materials and methods. We developed an individual treatment plan for a patient with stage IV moderately differentiated oropharyngeal squamous cell carcinoma (cT4N2M0) characterized by extensive local distribution, pronounced clinical symptoms of respiratory failure, and bilateral conglomerates of metastatic lymph nodes. The treatment scheme included paclitaxel (80 mg/m2), carboplatin AUC 2, and ce-tuximab (400 mg/m2 loading dose, then 250 mg/m2). The treatment was initially palliative. The patient received 6 injections once a week.Results. After a six-week course, we observed tumor resorption by more than 50 %, which allowed the second stage of treatment that included radical chemoradiotherapy with cetuximab. After summarizing our own experience, we found that the majority of patients with initially unresectable tumors, but in good overall physical condition responded to docetaxel, cisplatin, 5-fluorouracil (TPF) — based chemotherapy. Approximately half of them had complete tumor resorption, whereas 14.2 % of them had stabilization of the tumor process. Research literature shows that up to 30 % of patients receiving chemoradiotherapy with cisplatin fail to complete the planned treatment due to its toxicity; replacement of cisplatin with carboplatin and 5-fluorouracil results in mucositis and thrombocytopenia. By contrast, chemoradiotherapy with cetuximab significantly increases both 3-year and 5-year survival and demonstrates good tolerability. In patients with .severe nutritional deficiency, concomitant cardiac diseases, polyneuropathy, and impaired liver function, the preference should be given to less toxic treatment regimens.Conclusion. Cetuximab-containing chemotherapy regimens are the most effective treatment option in head and neck squamous cell carcinoma They can be used in patients with different functional status depending on the clinical situation.

The 5-year overall survival rate for stage IV gastric cancer is lower than 10%, despite the development of systemic therapy. Conversion surgery has shown to improve survival outcomes in patients with durable clinical response on chemotherapy. We report a clinical case of a patient, who underwent conversion surgery after pembrolizumab in the third-line setting for stage IV gastric cancer. The patient did not have recurrence for 22 months after conversion surgery.