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Introduction. Nowadays the standard of care for locally advanced and metastatic urothelial carcinoma (UC) is a combination of platinum-based drugs. However, such a therapy is characterized with high toxicity and selective efficacy. So, the question of the optimal alternative to the first line of therapy and the choice of drugs for the second line of therapy is currently relevant.Immune checkpoint inhibitors have revolutionized the treatment of UC. Nevertheless, despite the fact that initially the drugs of this series showed a fairly high efficacy as a second-line therapy for metastatic UC, at present there is no unambiguous opinion about the correct tactics of their use. There is also no consensus on the predictive value of PD-L1 biomarkers and their significance in determining treatment tactics.Aim. To evaluate the efficacy and tolerability of first-line atezolizumab therapy in 22 patients with unresectable forms of UC.Materials and methods. The experience of the State Clinical Hospital named after D.D. Pletnev on the example of 22 patients with advanced UC who received first-line therapy with atezolizumab 1200 mg intravenously once every 21 days until progression or intolerable toxicity. Efficacy was assessed according to RECIST 1.1 criteria.Results and discussion. Median follow-up 16.3 months. The objective response rate (ORR) is estimated at 72.7%, 95% CI. A complete response according to RECIST 1.1 criteria was observed in 5 patients (22.7%). Median time to first response was 2.2 months (range 1.5-5.7), late responses (at 5 and 5.7 months) required space in 2 patients. Median progression-free survival was 5.2 months (95% CI) in all patients. Median overall survival (OS) 18.5 months (95% CI). Specific application-related events were required in 10 (45.4%) cases. All the side effects were managed by standard symptomatic therapy. The dosage of atezoli-zumab was reduced in 7 (32%) cases. Immune-mediated adverse events were reported in 5 (23%) patients. No patient received systemic non-corticosteroid immunomodulatory agents for immune-mediated events. 2 (9%) patients received corticosteroids.Conclusions. Atezolizumab has shown high efficacy in the first line of treatment for advanced UC.

In recent years, the approach to the treatment of advanced renal cell carcinoma (RCC) has undergone significant changes. The introduction of targeted drugs in the systemic therapy of RCC in the 2000s began with tyrosine kinase inhibitors that replaced cytokines and had a revolutionary effect. Then the therapeutic arsenal was expanded with the introduction of doublets consisting of a combination of immune checkpoint inhibitors or immune checkpoint inhibitors and tyrosine kinase inhibitors. Tyrosine kinase inhibitors continue to represent an effective treatment option for metastatic RCC (mRCC), maintaining their position as first-line therapy in patients with a favorable prognosis. According to the CheckMate study, targeted therapy is highly effective, and the incidence of complications is generally lower than with nivolumab/ipilimumab combination therapy. Unlike dual immunotherapy, sunitinib does not expose patients with a favorable prognosis to undue risk of adverse events, while leaving more options for subsequent lines of therapy, and it's also often more cost-effective. The presented clinical observation is an example of successful monotherapy with sunitinib in a previously untreated mRCC patient with a favorable prognosis. This case is of particular interest due to the lesion of a single kidney and the patient's polymorbidity. Effective targeted therapy in the postoperative period had a positive effect on the quality and life expectancy.

This review is dedicated to the impact of modern achievements on the definition and diagnostics of castration-resistant prostate cancer (PCa) (CRPC), prognostic factors for its progression, and treatment strategies.It was proven with new sensitive methods of diagnostics that surgical castration (CS) decreases serum testosterone (T) levels to < 20 ng/dL, while achieving T < 20 ng/dL improves outcomes and delays the development of CRPC. Regular assessment of the T level makes it possible to understand whether this androgen is adequately suppressed in the setting of potential progression of CRPC, given that late dosing may lead to an increase in T level. Improved imaging techniques and biomarker analysis enable early detection of disease progression. Prognostically significant risk factors for CRPC progression include Gleason score, the extent of metastatic spread, hereditary characteristics such as gene mutations affecting androgen receptor (AR) amplification or DNA repair deficiency mutations, prostate-specific antigen (PSA) kinetics, and biomarker levels. Today, treatment options for CRPC have gone beyond androgen deprivation therapy (ADT) to include therapy that blocks T-synthesis and/or suppresses its activity through various mechanisms. Future directions include therapies using new biological targets, drug combinations and personalized therapies. It is necessary to assess the possible reasons for the difference in the pharmacodynamics and pharmacokinetics of androgendeprivation drugs, to study the features of the processes of destruction of drugs under the action of endogenous enzymes and resorption in the subcutaneous or muscle depot, which may cause the resistance to therapy.The aim of improved treatment and diagnostic options for PCa is to delay its progression to CRPC and to prolong patient survival. Rethinking of the castration concept and advances in understanding the biology of disease progression make it necessary to revise diagnostic and treatment strategies. ADT is a fundamental vector of treatment, and it should be continued even if some new ways of treatment for CRPC are introduced.

The standards of treatment for metastatic renal cell carcinoma (mRCC) have changed significantly from unsuccessful attempts of radiation and cytostatic therapy to the encouraging results of targeted therapy and specific immunotherapy. Sunitinib has got into the practice in 2006, and now it`s one of the most studied and approved. Sunitinib is one of the first oral targeted drugs for RCC. It affects such receptors as VEGFR1, 2, 3; PDGFR, FGFR, c-KIT, and RET, which take part in the pathologic angiogenesis, tumor growth, and metastasizing. Moreover, sunitinib stimulates the growth and development of lymphatic vessels, that deliver immunocytes to the tumor. The advantage of sunitinib over non-specific immunotherapy has been proven by Motzer et al. The randomized trials COMPARZ, RECORD-3, and SWITCH have confirmed that sunitinib is more effective than several targeted drugs (pazopanib, everolimus, and sorafenib respectively) as the first line of treatment for mRCC. The randomized trial of the 3rd phase CARMENA has demonstrated the importance of sunitinib monotherapy for mRCC of intermediate and poor prognosis. In general, sunitinib has been proven to be an effective first-line drug for mRCC, as it`s evidenced in the comprehensive metaanalysis of real-world data and randomized controlled trials published between 2000 and 2017. Nowadays, despite the success of the immunotherapeutic direction, tyrosine kinase inhibitors, and particularly sunitinib, rightfully remain the standard for mRCC of favourable prognosis, the treatment option for worse prognosis in case of contraindications for other methods of therapy, and it` s also used in subsequent therapy lines.

Introduction: Hormonal therapy is the method of choice in treating disseminated prostate cancer. Chronic androgenic suppression causes a reduction in bone mineral density. The most common complications of bone metastases are pathological fractures, spinal cord compression, pain, etc.Methods: A multicenter study (11 clinics of Russia) assessing the efficacy of Zometa in preventing skeletal complications of bone metastases was conducted in 2004—2005. Zometa was administered intravenously at a dose of 4 mg every 3Р4 weeks with androgenic deprivation. Its objective effect was evaluated in 70 patients. Changes in bone mineral density were evaluated by densitometry.Results: Complete pain relief was achieved in 73% of the patients; after therapy 86% of the patients had 0—1 WHO activity status score, 97% of the patients had no bone complications. The level of bone resorption marker β-Cross-Laps decreased to the normal values in 51% of the patients.Conclusion: The study has provided an evidence of the efficacy of Zometa and the necessity of using this drug in complex therapy for bone metastases of prostate cancer.

Transurethral resection (TUR) of the urinary bladder is a gold standard of the treatment of superficial bladder cancer (BC); however, after the above surgical intervention the incidence of relapses is high and ranges from 40 to 90%, as shown by different authors. Adjuvant intravesicular immuno- or chemotherapy reduces the rate of relapses by 30—35%. Thus, the development of new methods for preventing recurrent superficial BC remains an urgent problem today. Photodynamic therapy (PDT) is a promising line in oncology. The study included 196 patients with superficial BC. Following TUR of the bladder 110 patients received adjuvant PDT; a control group comprised 86 patients treated with TUR only. In the PDT group, the incidence of relapses depended on energy density: with the latter of 10, 12, and 15 J/сm2, the incidence of relapses was 31.7, 19.4, and 15.5%, respectively. In the control group, it was 55.1%. Thus, treatment aimed at preventing recurrent superficial BC may be performed by three methods: 1) intravesical immunotherapy, 2) intravesical chemotherapy, and 3) PDT. On the basis of the findings, it is impossible today to define unambiguous indications for either method in the first-line prevention of relapses in the treatment of superficial BC. Adjuvant PDT is a competitive treatment in low and moderate BC risk patients. In the high-risk group, the advantage of BCG therapy is beyond question.

Purpose. Evaluate efficacy and portability of the combination of the drugs Tautax (docetaxel) with a dose of 75mg/m2 1 time per 21 days and prednisolone — 10 mg per 24 h in hormone-refractory prostate cancer (HRPC) patients. Methods. Patients with verified HRPC were included in the study. Patients without being performed orchofuniculectomy were given LHRH analogues during the entire study. The treatment scheme was: tautax 75 mg/m2 1 time per 21 days as 1,5 h infusion + prednisolone — 10 mg per 24 h per os. Dexamethasone 8 mg was introduced intramuscularly as a premedication before tautax infusion prior to 12, 6 and 1 h. Patients with the revealed bone metastases were given zoledronic acid 4 mg 1 time per 28 days. The therapy was has been being performed for 6 months or till disease progression revelation. In case of regression or stabilization of the disease, up to 10 chemotherapy courses were performed. Results. 29 HRPC patients are examined. 178 chemotherapy courses are performed. Partial regression is noted in 8 (28%) patients, stabilization — in 9 (31%), progression - in 8 (28%) patients. PSA level decrease >50% has been observed in 19 (65,5%) patients. Improvement of the life quality was reached in 11 (38%) patients. The decrease in hyperfixation of radiopharmaceutical by osteoscintigraphy ocurred in 14 (48%) patients. Conclusion. Combination of Tautax and prednisolone is an effective treatment regimen of the HRPC patients.

Objective: The morbidity of multiple urological malignances is steadily grown. Incidental prostate cancer in patients with bladder cancer seems to be fairly often. This is one of the reasons of that the question of partial sparing of prostate in patients undergone radical cystoprostatectomy is still discussable. Purpose: The present study is designed to evaluate the incidence of simultaneous prostate and bladder cancer in patients undergoing radical cystoprostatectomy in Moscow Scientific Research Institute of Oncology.Materials and methods: From 1994 to 2005, 113 men (mean age 59,5 years), with no evidence of prostatic malignancy on preoperative clinical and biochemical assessment, underwent cystoprostatectomy for TCC of the bladder in our institute. The bladder was adequately sampled and the entire prostate sectioned at 5-mm intervals and examined histologically, in order to identify unsuspected prostatic cancer (PCa).Results: 10 out of 113 patients (8,8%) were found to have PCa. Four (3,5%) had cr. in situ, five (4,4%) had high grade prostatic intraepithelial neoplasia (PIN). All tumors were clinically significant, except cr. in situ and PIN. Almost all tumors (7,9%) were organ confined (pT2a—T2c), except one (0,9%), which was locale advanced (pT3a). Glaeson score was 2—4 in 5 (26,3%) and 5—7 in 5 (26,3%).Conclusions: Incidental PCa is quite a common finding in cystoprostatectomy specimens of bladder cancer patients. This demands careful and complete excision of the prostate in patients with muscular-invasive bladder cancer.

Sixty hundred and twenty-six case histories of patients with renal-cell carcinoma, who underwent nephrectomy at the Department of Oncourology, P.A. Herzen Moscow Research Oncological Institute, in November 1992 to November 2005, have been restrospectively analyzed.Results. Metastatic lymph nodal lesion was identified in 23 (6.49%) patients of 354 patients with renal-cell carcinoma without distant metastasis, who had undergone regional lymphadenectomy. Metastatic regional lymph nodal lesions were found in 9 (2.54%) patients on preoperative examination (as verified by ultrasound study and computed tomography). Metastatic lymph nodal lesion was intraoperatively suspected in 3 (0.85%) patients. This was revealed in 11 (3.11%) patients after planned histological study.Conclusion. The frequency of metastatic regional lymph nodal lesions is 3.11% in patients with early renal-cell carcinoma with unaltered regional lymph nodes, as shown by preoperative and operative examinations. In renal-cell carcinoma, the probability of metastasis into the regional lymph nodes increases in patients with a more 5-cm renal tumor, in those with non-clear or mixed carcinoma, and or those with a locally advanced tumorous process.

Androcur is one of basic drugs for the hormonal treatment of patients with prostate cancer. A great number of randomized studies showing the efficacy of androcur alone and in combination with other hormonal treatments have been completed. When orally or intramuscularly administered, the drug is well tolerated, showing the equal efficacy. Androcur used before treatment with luteinizing hormone-realizing hormone agonists is effective in inhibiting the «flash» syndrome. A combination of the agent with surgical or medical castration enhances the efficiency of therapy and improves the quality of life, by reducing the incidence of adverse reactions, such as hot flashes and hyperhidrosis. Androcur therapy prior to radical prostatectomy decreases the frequency of positive surgical edge while neoadjuvant therapy used before radiotherapy enhances the efficiency of radiation and reduces the number of local recurrences.

Treatment of complications due to both early and end-stage urological cancers and those resulting from chemo- or radiotherapy is currently a topical problem.Anemia in cancer patients is a complex syndrome that is caused by the disease and may be treatment induced with the blood level of hemoglobin being below the normal physiological range (< 12 g/dl).A great number of causes of anemia are known in urologic cancer patients. These include chemotherapy for disseminated cancer of the testicle, urinary bladder, and prostate; radiotherapy for prostate cancer; concomitant chronic renal failure in renal cancer; metastatic bone marrow involvement in prostate, renal and urinary bladder cancers; hemorrhages in bladder tumors; profuse bleedings from the bladder and rectum in radiation-induced cystitis and rectitis. A reduction in the level of hemoglobin below the normal physiological range affects not only prognosis and quality of life, but also the course of the disease and the efficiency of specific treatment. Detection of anemia in urological cancer patients and its treatment are required to improve the quality of life and the indices of specific treatment.In a malignant process, anemia is generally chronic and frequent blood transfusions substantially increase the risk for adverse reactions (transmission of viral infections, allergic and immunological reactions). The use of recombinant human erythropoietin is an alternative approach that has been recently widely used to correct and prevent anemia in cancer patients.In the past 10 years, numerous prospective and retrospective studies dealing with the treatment of cancer-induced and postcytostatic anemia in patients with solid tumors and lymphoproliferative diseases. They have demonstrated the efficacy of erythropoietin alpha (Eprex®) that considerably increases blood hemoglobin levels and improves life quality indices.

One of the options in the treatment of hormone-refractory prostate cancer is the administration of cytostatic agents. This article addresses the Taxoter — one of the cytostatic agents. Clinical studies discussed in the article have demonstrated the high activity and efficacy of the agent which allows using it in the treatment of hormone-refractory prostate cancer.

Prostate cancer (PC) is one of the most common malignancies in males. Hormonal therapy (HT) is the method of choice in treating disseminated PC. LHRH agonists are used for therapy of disseminated and metastatic PC; a number of studies have shown the advantages of adjuvant and neoadjuvant HT for its locally advanced process over radiotherapy (RT) alone and radical prostatectomy (RPE). Diferelin (tryptorelin) that has been used for over 20 years is one of the most studied LHRH agonists. The efficiency of HT with diferelin is comparable with that of bilateral orchiectomy, the quality of life being much higher in the patients receiving this drug. The efficiency of intermittent diferelin HT is shown to be the same as that of continuous HT, by considerably improving the quality of life. Diferelin may be used for evaluation of the hormonal sensitivity of a tumor and for choice of an efficient treatment policy. Comparison of diferelin with other LHRH agonists has yielded comparable results in the trend of prostate-specific antigen levels and testosterone concentrations to decrease.

The paper presents the results of using Vero-Mitomycin in patients with superficial bladder carcinoma (SBC). The study included 23 SBC patients over 18 years of age, with invasion levels of pTa, pT1, and differentiation grades of G1—2, ECOG 0 or 1, who were treated at the Department of Oncourology, P.A. Herzen Moscow Research Oncological Institute. The patients were given 6 intravesicular instillations of Vero-Mitomycin in a single dose of 40 mg. During a follow-up, a recurrence developed in 9 (39.1%) patients, a tumorous process progressed in none patient. There were recurrences at 12—16 months. The acute cystitis syndrome was revealed in 2 patients (after 4 and 6 instillations of the drug). Hematological toxicity was not observed. Thus, Vero-Mitomycin is one of the drugs of choice for the first-line intravesicular chemotherapy in patients with low and moderate risk SBC. Intravesicular chemotherapy with Vero-Mitomycin is an effective and low-toxic preventive method against recurrent SBC.

Интервью с вице-президентом Российского общества онкоурологов (РООУ), врачом-онкологом Московской городской клинической больницы № 57, доктором медицинских наук, профессором Игорем Георгиевичем РУСАКОВЫМ и заведующим отделением онкоурологии ГБУЗ «ГКБ им. Д.Д. Плетнева», кандидатом медицинских наук Сергеем Владимировичем МИШУГИНЫМ.

In recent years several therapeutic options have been developed that significantly improve the survival of patients with metastatic treatment-resistant prostate gland cancer (mCRPC). The presence of several active agents gives oncologists an unprecedented opportunity to adapt their choices to the clinical characteristics of each patient, to each treatment line, but at the same time raises the problem of determining the optimal therapeutic sequence for the individual. Due to evolution of the therapeutic strategy, difficulty of the process of the therapy dynamics evaluation and variability of the clinical disease aspects the multi-disciplinary approach currently acquires the primary importance. This article presents the views and recommendations of the expert of the Interdisciplinary Group (Milan, Italy) on the use of Radium-223 in men with mCRPC.

Our surveillance was performed for 358 patients with locally advanced and disseminated prostate gland cancer who were treated by analogues of LHRH. Patients in group 1 (n = 222) received treatment with a LHRH analogue, and patients in group 2 (n = 136) received treatment with 75 mg Buserelin-depo 3. Experience has shown that the use of the Buserelin-Depot drug results in a regression of the average PSA value: Up to 36.05 ng/ml in 2 months, up to 12.35 ng/ml - in four months, up to 3.3 ng/ml - in six months. The drug ensures a steady decrease in the level of testosterone in the blood serum to the castration level already in a month after the start of treatment, a decrease in prostate gland volume (from 57.3 to 40.45 cc 3 by month 6 of treatment (-29.4%)). A number of patients have experienced a decrease in the need for analgesics and thus an increase in the activity status. The obtained data are comparable to those in the group of patients receiving other analogues of LHRH.

An immunohistochemical research with antibodies to the mutant p53 protein and a revelation of the human papilloma virus DNA 16 and 18 types via in situ hybridization at the histological sections of the urothelial carcinoma are realized. The material of 44 patients with the superficial bladder cancer (Ta and T1 stages) and with a presence of the indirect signs of the viral infection was studied. 16 patients were included in the group of high risk recurrence, 13 patients were included in the group of the mean risk, 15 patients were included in the group of the low risk. HPV DNA was revealed in 12 of 44 cases only in patients of the mean and high risk groups (5 and 7 cases, respectively); all the positive results in the high risk group were with the HPV 16 type probe. Evaluation of the p53 protein showed a significant increase of its expression in the mean and high risk groups. p53 protein expression mean value was 23,67% in the low risk group, 36,53% in the mean risk group, 53,43% in the high risk group. Presence of HPV DNA was associated with the high p53 expression in the vast majority of cases.

The paper provides the first interim analysis of a database including information on 806 metastatic kidney cancer patients receiving targeted therapy in the cancer facilities of the Moscow Healthcare Department. It shows a comparative analysis of the periods of first-line targeted therapy with different drugs until progression is established.

The article tells about the current problems in the treatment of castrate-resistant prostate cancer. An extensive search for more effective treatments resulted in the development of a number of novel drugs which affect the quality of life of patients as well as increase the overall survival rate and time to PSA progression. The article studied the clinical efficacy of first-line cytotoxic chemotherapy with docetaxel. Satisfactory tolerance of docetaxel monotherapy was demonstrated. PSA levels declined > 50% in 43.7% of patients with overall survival up to 16 months.

// Ksenia Lezhnina 1,2 , Olga Kovalchuk 3,4 , Alexander A. Zhavoronkov, 2,5,6 , Mikhail B. Korzinkin 1 , Anastasia A. Zabolotneva 7 , Peter V. Shegay 8 , Dmitry G. Sokov 9 , Nurshat M. Gaifullin 10,11 , Igor G. Rusakov 8 , Alexander M. Aliper 1,2 , Sergey A. Roumiantsev 2 , Boris Y. Alekseev 8 , Nikolay M. Borisov 12 and Anton A. Buzdin 1,2,7 1 Pathway Pharmaceuticals, Wan Chai, Hong Kong, Hong Kong SAR 2 Laboratory of Bioinformatics, D. Rogachyov Federal Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia 3 Department of Biological Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4 4 Canada Cancer and Aging Research Laboratories, Lethbridge, AB, Canada 5 Insilico Medicine, Inc, ETC, Johns Hopkins University, Baltimore, MD 6 Faculty of Biological and Medical Physics, Moscow Institute of Physics and Technology 7 Group for Genomic Regulation of Cell Signaling Systems, Shemyakn-Ovchinnikov Institute of Bioorganic Chemistry, Moscow, Russia 8 P.A. Herzen Moscow Oncological Research Institute, Moscow, Russia 9 Moscow 1st Oncological Hospital, Moscow, Russia 10 Lomonosov Moscow State University, Faculty of Fundamental Medicine, Moscow, Russia 11 Russian medical postgraduate academy , Moscow, Russia 12 Laboratory of Systems Biology, A.I. Burnasyan Federal Medical Biophysical Center, Moscow, Russia Correspondence: Anton A. Buzdin, email: // Keywords : Bladder cancer, Intracellular signaling pathway activation, Gene expression, Transcriptome profiling, Molecular markers, AUC Received : August 21, 2014 Accepted : September 15, 2014 Published : September 16, 2014 Abstract We recently proposed a new bioinformatic algorithm called OncoFinder for quantifying the activation of intracellular signaling pathways. It was proved advantageous for minimizing errors of high-throughput gene expression analyses and showed strong potential for identifying new biomarkers. Here, for the first time, we applied OncoFinder for normal and cancerous tissues of the human bladder to identify biomarkers of bladder cancer. Using Illumina HT12v4 microarrays, we profiled gene expression in 17 cancer and seven non-cancerous bladder tissue samples. These experiments were done in two independent laboratories located in Russia and Canada. We calculated pathway activation strength values for the investigated transcriptomes and identified signaling pathways that were regulated differently in bladder cancer (BC) tissues compared with normal controls. We found, for both experimental datasets, 44 signaling pathways that serve as excellent new biomarkers of BC, supported by high area under the curve (AUC) values. We conclude that the OncoFinder approach is highly efficient in finding new biomarkers for cancer. These markers are mathematical functions involving multiple gene products, which distinguishes them from “traditional” expression biomarkers that only assess concentrations of single genes.

The paper considers treatment regimens for metastatic bladder cancer (MBC) and gives the data of trials of the efficiency of using different chemotherapy schemes and regimens in patients with MBC.

A comprehensive fluorescence technique has been developed to study the urinary bladder mucosa in patients with superficial bladder cancer (BC), by using alasense, white light cystoscopy, fluorescence cytoscopy, and local fluorescence spectroscopy in vivo. Quantification of urothelium fluorescence in the red emission foci of 5-ALA-induced protophorphyrin, with the local autofluorescence intensity being borne in mind, has been shown to increase the specificity of photodynamic diagnosis of superficial BC from 70 to 85% (p ≤ 0.05) and the total accuracy of the technique from 80 to 86%.

Leuproprelin acetate (Lucrin-depot) is an efficacious and safe luteinizing hormone-releasing hormone analogue, the efficiency of which has been proven in a number of large clinical studies. The agent exhibits a sustained release, is easy-to-use and well-tolerated, and causes minimal side effects. Lucrin-depot may be recommended for use as alone and in combination with other hormonal agents in patients with prostate cancer if androgenic deprivation is indicated.

Renal carcinoma (RC) is one of ten most common malignancies in adults and an urgent problem of modern oncology. The purpose of the study was to make a molecular genetic analysis of a number of suppressor genes in RC, which was aimed at searching for and characterizing the potential markers of the disease. Two hundred and nine RC samples were examined, of them there were 192 clear-cell carcinomas. VHL gene mutations were detected by single-strand conformation polymorphism and sequence analyses while the methylation of suppressor genes was by the methylation-sensitive polymerase chain reaction. Somatic VHL mutations were determined in 35.4% of cases of clear-cell RC (CCRC). VHL gene disorders were found in 53.7% of patients with Stage 1, which counts in favor of VHL inactivation in early-stage CCRC. The methylation of the VHL, RASSF1, FHIT, and CDH1 genes was identified in 12, 56, 58.4, and 46.4% of primary tumors, respectively; that of at least one gene was in 84.1% of the samples. The hypermethylation of the RASSF1 gene was associated with late stages (p = 0.015) and the presence of metastases (p = 0.036); that of the CDH1 gene was related to the progression, invasion, and dissemination of primary tumors (p = 0.009, 0.039, and 0.002, respectively). The findings show it possible to use an analysis of abnormalities in the VHL gene and the methylation of the RASSF1 and CDH1 genes to develop a system of molecular genetic markers of RC.

Рак предстательной железы (РПЖ) является в настоящее время одним из наиболее распространенных видов злокачественных новообразований в мире. Дальнейшее прогрессирование болезни приводит к потере чувствительности к андрогенным воздействиям, после чего развивается гормонорефрактерная стадия опухолевого процесса (гормонорефрактерный рак предстательной железы - ГРРПЖ). Средняя продолжительность жизни больных РПЖ на этом этапе не превышает 6-12 мес. Лечение ГРРПЖ является сложным и многоэтапным процессом. Эстрацит, сочетая в своем механизме действия цитостатический противоопухолевый эффект и гормональный эффект, с успехом может применяться на всех этапах терапии ГРРПЖ, общий объективный ответ на лечение составляет 40-50%. Благодаря незначительной миелосупрессивной токсичности и синергизму с различными противоопухолевыми агентами эстрамустин является базисным препаратом для проведения различных схем полихимиотерапии. Таким образом, терапия Эстрацитом и комбинированная терапия с его применением являются методами выбора лечения ГРРПЖ.

Resolution on the results of the Meeting of Experts on the treatment of castrate-resistant prostate cancer.