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Background. Small cell lung cancer (SCLC), predominantly due to smoking, is a highly differentiated, rapidly growing epithelial cell carcinoma of high malignancy originating from bronchial neuroendocrine cells. Almost 70% of SCLC patients have metastases at the time of diagnosis, which requires the use of drug therapies, including immunotherapy. Aim. To evaluate the efficacy and safety of immune checkpoint inhibitors in patients with small cell lung cancer. Materials and methods. One hundred and twenty one patients (90 men and 31 women) aged 44 to 84 years were included in the retrospective multicentre non-randomised study. The majority (90.9%) of patients were treated in the 1st line of therapy. IT were administered in the 2nd line and subsequent lines of treatment in 9.1% of patients. Weakened (ECOG 2–3) state at the time of treatment initiation was noted in 30 (24.8%) patients. Results. Progression-free survival in patients with SCLC receiving 1st-line treatment was 5.82 (95% CI 3.92–7.72) months, and 2nd-line and beyond was 6.21 (95% CI 0.76–11.66) months. Survival in patients with small-cell lung cancer receiving 1st-line IT was 8.0 (95% CI 6.18–9.81) months, and 2nd-line or longer was 11.3 months (95% CI 4.31–18.29) months (p=0.108). Objective response was achieved in 43 (35.5%) patients, of whom 38 (34.5%) were on first-line IT and 5 (45.5%) patients were on 2nd or more. iAEs grade 3–4 was observed in only 18 (14.9%) patients. Conclusion. Immunotherapy for SCLC allows achieving high rates of objective response and disease control. This method of treatment is characterized by insignificant number of grade 3–4 immune-mediated adverse events, which indicates an acceptable safety profile.

Background. Alopecia is one of the main side effects of anticancer chemotherapy and has a significant impact on patients’ appearance, quality of life, social adaptation and mental health of cancer patients. Estimated number of new cancer diagnosis increases annually alongside with the proportion of patients receiving chemotherapy. That means an annual increase in the global burden of chemo-induced alopecia and associated negative consequences. The development of various methods for the prevention of alopecia in cancer patients has continued for decades. However, convincing data have been obtained only for the scalp hypothermia method. In this point, the Paxman company’s cooling systems (UK) – the Orbis and Orbis II devices – have been most widely studied. Despite the fact that Orbis devices were approved in Russia more than 10 years ago, since then just a small amount of real clinical practice has been accumulated and questions regarding the effectiveness of scalp hypothermia in patients with variable cancers still remain open. Aim. Analysis of local clinical practice with scalp hypothermia via the Orbis II device for the prevention of alopecia in patients receiving various chemotherapy regimens. Materials and methods. An open, prospective, single-center study included patients with various cancer types who were indicated for chemotherapy. Orbis II device was used for prophylactic hypothermia. The severity of alopecia was assessed according to the CTCAE version 5.0 at baseline and during anticancer therapy. Results. From June 2022 to May 2023, scalp cooling procedures were performed in 51 patients, of them 78% of all procedures were performed in female cancers: breast tumors – 109 (52.2%) procedures, ovarian cancer– 33 (15.8%), and cervix cancer – 22 (10.5%). The effectiveness of scalp hypothermia in preventing of severe alopecia was 73%. Conclusion. Scalp cooling can be considered as an effective method for the prevention of chemotherapy induced alopecia. Further studies are needed to assess larger patient populations to identify favorable and negative factors that affect potency of the hypothermia.

Background. The course of colon cancer (CC) is burdened in many patients with elderly and senile age, the presence of severe comorbidities, and complications of the malignancy. The complex treatment for advanced colon tumors also requires the search for predictors appropriate for routine clinical practice. Aim. To study the prevalence of sarcopenia (SP) in CC and assess the relationship of SP with the immediate treatment outcomes. Materials and methods. A retro-prospective assessment of cachexia and SP according to clinical and radiological criteria and their relationship to postoperative complications was performed in 679 patients. The mean age was 65±10.7 years. Group 1 included 181 patients who received drug therapy for common types of CC. Group 2 included 498 patients who underwent elective colon resections for cancer. The presence of SP was determined by threshold values for skeletal muscle area at the LIII level, averaged to the patient's height squared. To do this, the data from abdominal computed tomography performed for 1 month or less before the start of antitumor treatment were analyzed. The threshold criteria of Prado, Martin, and the European Working Group on Sarcopenia in Older People (EWGSOP2) were compared. Results. The SP prevalence was 64% according to the Prado criteria for stages I–II, 66% for stage III, and 73.4% for stage IV; according to the Martin criteria, 63.1%, 62.3%, and 68%, respectively, and according to the EWGSOP2 criteria 22.7%, 26.9%, and 32%, respectively. In general, SP was noted according to the Prado criteria in 70.2% of men and 61.4% of women, according to the Martin criteria in 55.8% of men and 71.9% of women, and according to the EWGSOP2 criteria in 27% of men and 22.9% of women. Sarcopenic obesity was identified in 10.1% of patients. In group 1, there was a statistically significant correlation (p0.001) between the presence of SP and poor overall survival of patients, with the Martin criteria showing the most significant correlation. In group 2, an equally strong correlation between the presence of SP according to the Prado criteria and postoperative mortality was found. Conclusion. In CC, SP is detected in more than half of patients before the start of antitumor treatment, being an unfavorable prognostic factor for overall survival and a predictor of death after surgical treatment. Timely diagnosis and treatment of SP can improve the CC therapy outcome.

Background. COVID-19 (COrona VIrus Disease 2019) is a serious threat to cancer patients, who are at an increased risk of severe infection complications. Pre-exposure prophylaxis with a combination of monoclonal antibodies, tixagevimab-cilgavimab (Evusheld), has been shown to be effective in preventing COVID-19, reducing hospital admission rate and mortality in immunocompromised individuals. Aim. To describe the experience of using tixagevimab-cilgavimab for pre-exposure prophylaxis of COVID-19 in the Russian population of patients with solid tumors receiving antitumor drug therapies. Materials and methods. The retrospective analysis included case histories of 79 patients (57% females and 43% males) with solid tumors treated at the Moscow City Clinical Oncology Hospital No. 1 from October 2022 to June 2023. All patients received tixagevimab-cilgavimab for COVID-19 pre-exposure prophylaxis. Results. The mean age was 64±11 years (32 to 83 years). Seventy-three percent of patients received cytotoxic therapy, associated with an increased risk of infectious complications, including COVID-19. No immediate or delayed adverse events related to tixagevimab-cilgavimab were reported. During the observation period since the drug injection, 3 (3.8%) new mild cases of COVID-19 were reported. Conclusion. Tixagevimab-cilgavimab (Evusheld) is safe and effective for pre-exposure prophylaxis of COVID-19 in the Russian population of patients with solid tumors receiving antitumor drug therapy.

Nowadays, checkpoint inhibitors are widely used in the treatment of various types of cancer. However, its use is often accompanied by the development of immune-mediated adverse events (IAEs) of various systems and organs. Aim description of the features of the development of encephalitis during the treatment of small cell lung cancer (SCLC) using checkpoint inhibitors. There is a clinical case of a patient, who is receiving immunotherapy, with small cell carcinoma of the upper lobe of the left lung, stage IVA, cT2bN2M1a. The patient sought medical help in connection with complaints of an episode of memory loss, difficulty in remembering new information. Based on the clinical picture and examination data, a limbic encephalitis was diagnosed. Immune-related adverse events might affect any organ during all the period of therapy with checkpoint inhibitors. Physicians shall be aware of the risk of encephalitis development related to this type of anti-cancer therapy.

Immune-mediated adverse events (imAEs) are complications of therapy with immune checkpoint inhibitors, which arise as a result of autoimmune inflammation. The article summarizes systemic (fatigue, fever), cutaneous (rash, itching), gastrointestinal (diarrhea, colitis, hepatitis, pancreatic dysfunction), endocrinological (hypothyroidism, hypophysitis, adrenal insufficiency, diabetes mellitus), pulmonary (pneumonitis, pleuritis), rheumatological (arthralgia), neurological (headache, sensory and motor disorders), renal (acute interstitial nephritis, lupus-like nephritis, granulomatous nephritis, diffuse interstitial nephritis and minimal change disease), hematological (anemia, cytopenia), cardiovascular (myocarditis) and ocular (conjunctivitis, episcleritis, ceratitis, blepharitis and uveitis) imAE. Pathogenetic mechanisms and treatment approaches (in accordance with toxicity grade and clinical recommendations) are discussed. Early symptom recognition, patient education and timely intervention are crucial for imAE correction.

Aim. To assess the association between the carriage of minor allelic variants of 8 genes that encode key enzymes involved in the metabolism of anticancer drugs (DPYD, GSTP1, MTHFR, UGT1A1) and cell repair (XPC, ERCC1, TYMP, NQO1) and the severity of adverse drug events in patients with common gastrointestinal tumors. Tasks. To study the frequency of minor allelic variants of the DPYD, GSTP1, MTHFR, UGT1A1, XPC, ERCC1, TYMP, NQO1 genes; to assess the frequency and severity of adverse drug events of chemotherapy treatment in the study population. Materials and methods. For the period from October 2020 to April 2021, 56 patients (women 29, men 27) with verified malignant tumors of the gastrointestinal tract were included in a prospective clinical study as a part of the RSF grant No. 20-75-10158. The mean age was 62.311.4 years. Colon cancer was detected in 24 patients, tumors of the esophagus and stomach in 19 patients, tumors of pancreas and biliary tract in 13 patients. First-line palliative chemotherapy was given to 27 patients, adjuvant 19 patients, neoadjuvant 10 patients. All patients had not previously received cytotoxic or radiation treatment. Point nucleotide variants of genes DPYD, XPC, GSTP1, MTHFR, ERCC1, UGT1A1, TYMPS, NQO1 were determined by hybridization analysis on biological microchips. Differences in the tolerance of cytotoxic therapy (5-fluorouracil, platinum preparations, irinotecan) depending on the genotype were assessed using Fishers exact test. Results. The average number of chemotherapy courses received was 4.22.6 (112). There was a statistically significant difference in the tolerability of chemotherapy in patients with minor allelic variants of the GSTP1 rs1695 (p=0.03), ERCC1 rs11615 (p=0.01), and UGT1A1 rs8175347 (p=0.003) genes. Conclusion. The use of hybridization analysis on biological microchips to assess allelic variants responsible for the tolerability of cytotoxic therapy is reasonable and requires further prospective assessment.