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Aim. To assess the efficacy and safety of lenvatinib and pembrolizumab for the treatment of mismatch repair-proficient endometrial cancer (EC) in routine clinical practice in Russia.Materials and methods. This multicenter, retrospective, cohort study included patients with recurrent and metastatic EC from 37 cancer centers in Russia treated between May 2020 and April 2023. Patients with histologically verified EC without microsatellite instability who received ≥1 course of pembrolizumab/lenvatinib therapy were included in the study. The primary endpoint was progression-free survival; the clinical characteristics of the patients were additionally analyzed, the objective response rate and the toxicity profile of therapy were assessed.Results. The study included 100 patients. Median age was 65 (30–83) years. The most common histologic tumor subtype was endometrioid adenocarcinoma (68 %); serous adenocarcinoma was diagnosed in 22 % of cases, other types of tumor – 10 % of cases. All patients had pMMR/microsatellite-stable tumors. The median progression-free survival was 7.75 months (95 % confidence interval 0.7–33.8), and a partial response to therapy was observed in 24 % of patients. Almost half of the patients (44 %) required dose reduction due to adverse events. The most common adverse events included fatigue (n = 26; 26 %), hypertension (n = 20; 20 %), and hypothyroidism (n = 14; 14 %).Conclusion. This study confirms the clinical efficacy of lenvatinib and pembrolizumab in patients with recurrent and metastatic EC without mismatch repair system deficiency (pMMR-tumors) in routine clinical practice.

Objective: to compare the efficacy and toxicity of aflibercept and bevacizumab in combination with fOLfIRI in secondline therapy for patients with metastatic colon cancer.Materials and methods. we performed a retrospective analysis of data on patients with metastatic colon cancer treated in 9 clinics in the Russian federation. The inclusion criteria were as follows: metastatic or locally advanced colon cancer; treatment with bevacizumab or aflibercept plus fOLfIRI in the second-line therapy. The primary outcome measure was progression-free survival (PfS). Secondary outcome measures included objective response rate and incidence of adverse events.Results. A total of 271 patients with metastatic colon cancer who received second-line therapy with bevacizumab (n = 81) or aflibercept (n = 190) between 2014 and 2018 were selected for this study. Study groups were matched for main prognostic signs. The objective response rate was 18.1 % in the bevacizumab group and 20.5 % in the aflibercept group (p = 0.7). The median PfS was 5 months (95 % confidence interval 3.8–6.1) in the aflibercept group and 7 months (95 % confidence interval 0.81–2.1) in the bevacizumab group (hazard ratio 1.4; 95 % confidence interval 0.99–2.1; p = 0.04). multivariate regression analysis demonstrated that the type of the targeted drug independently had no effect on PfS (hazard ratio 1.3; 95 % confidence interval 0.9–1.9; p = 0.2). we observed no statistically significant differences in the incidence of complications of any grades between the groups (58 % vs 72 %, p = 0.1). Patients receiving aflibercept were more likely to develop grade III–Iv arterial hypertension (2 % vs 9.5 %) and diarrhea (0 % vs 5.4 %), whereas thrombotic complications were more common in the bevacizumab group (10 % vs 1.8 %).Conclusion. we observed no significant differences in objective response rate and PfS between patients with metastatic colon cancer receiving bevacizumab or aflibercept in combination with fOLfIRI as second-line therapy. The toxicity profiles were different. Our findings can be used for choosing an optimal targeted drug for second-line treatment.

The principles of specific rehabilitation in females with hormone sensitive breast cancer depending on the type of the antiestrogen hormonotherapy are described. According to the different mechanisms of action of the antiestrogen blockers impact (blocking of estrogen receptors, steroid and nonsteroid aromatase inhibition) programs for rehabilitation depending on the different spectra of antiestrogen therapy side effects were designed.

Introduction. The randomized MPACT study showed that nab-paclitaxel plus gemcitabine results in statistically significantly longer life expectancy. The objective of this retrospective study is to obtain relevant data on the efficacy of this combination in real clinical practice in Russia. Materials and methods. The study included patients with morphologically proven locally advanced or metastatic pancreatic cancer, with a general condition assessed on the ECOG scale between 0-2, which received gemcitabine and nab-paclitaxel. Immediate and long-term treatment outcomes were evaluated. Results. 142 patients, who received treatment from 2009 to 2019 in 17 centers from 11 regions of Russia, were included in the study. Assessment of the objective effect was made in 134 patients. Objective effects were detected in 34 (25.4%) cases. The median time-to-progression was 6.1 months (95% confidence interval (CI) 4.8-7.4), the median length of life was 14.2 months (95% CI 10.6-17.9). An elevated CA19-9 level is the only independent adverse prognostic factor for progression-free survival (RR = 8.0, 95% CI 1.4 -43.8, p = 0.02) according to Cox multivariate regression analysis. The number of previously conducted chemotherapy lines (p = 0.34), ECOG status (p = 0.70), age over 70 years (p = 0.45), serious comorbidity (p = 0.97) did not have a statistically significant effect on progression-free survival. Findings. The gemcitabine and nab-paclitaxel combination has a relatively higher efficacy in advanced pancreatic cancer. The immediate and long-term results of its use in real clinical practice in Russia are consistent with data obtained in the Western countries.

Objective: to identify factors associated with efficacy of an aflibercept-chemotherapy combination in patients with metastatic colon cancer.Materials and methods. This retrospective multicenter study was conducted in 20 clinics from 15 regions of the Russian Federation. The main efficacy outcome was progression-free survival (PFS). We performed univariate and multivariate analysis to assess the impact of various factors of PFS.Results. Two hundred and fifty-seven patients received aflibercept-containing chemotherapy; of them, 175 participants (68.1 %) received it as a second-line therapy. The objective response rate and median PFS were 18.7% and 5 months (95% confidence interval (CI) 4.2—5.8) respec -tively. The following factors were found to have a positive effect of PFS at multivariate analysis: grade I—II adverse events to aflibercept therapy (hazard ratio (HR) 0.58; 95 % CI 0.38—0.89; p = 0.01), therapy for concomitant diseases (HR 0.47; 95 % CI 0.29—0.76; p = 0.002), and ECOG performance status of 0 (HR 0.53; 95 % CI 0.34—0.81; p = 0.004). Patient with all 3 factors present had median PFS of 9 months, whereas patients without them demonstrated PFS of only 3 months (HR 1.9; 95 % CI 1.5—2.6; p

The article reviews new laser-based methods of treatment of basal cell skin cancer. The results of the treatment of 25 patients with skin cancer were analyzed. The article reviews problems of complicated course of the disease when surgical and X-ray methods of treatment are not enough. We started to apply photodynamic therapy with use of Radahlorin for the enhancement of the results of treatment of recurrent basal cell skin cancer. New method of treatment became rather effective at the treatment of recurrent basal cell skin cancer.

Objectives: discussion of modern treatment options for metastatic breast cancer (MBC), the determining of the optimal treatment for subgroups of patients with poor prognosis.

We present a clinical case with continuous recurrent ventricle tachycardia. Patient, 60, admitted with complaints on heart disorders, periods of unexpected total weakness, repeated episodes of pre-syncopal condition, frequent dizziness, which he has been experiencing for about a year. In the anamnesis patient had diagnosis of intermittent syndrome WPW with paroxysmal antidromic tachycardia, and we performed ablation for additional conducting atrioventricular connection. By results of examination we recommended ablation of arrhythmia substrate with the subsequent solution whether implantation of a cardioverter defibrillator was required. Stimulation and activation mapping was performed. The area of ventricular tachycardia substrate was defined in the septal part of the right ventricle outflow tract, and frequent ventricular ectopic activity – in the area of the anterio-lateral wall of LV outflow tract under the aortal valve. On the basis of radiofrequency impact series we observed ventricular disturbances discontinuation. After the performed operation the patient demonstrated clinical improvement. According to Holter ECG monitoring for jogging of group ventricular activity, and also ventricular tachycardia was not registered.

The composite quasi-liquid fuels made of different industrial waste become more and more attractive for scientists during last years. Coal-water slurry is one of the popular types of such compositions. Addition of the waste petrochemicals into the slurry allows decrease of the ignition delays of such composite for up to 27%. However, it has a non-trivial effect onto the atomization dynamics of the slurry making the size and velocity distributions of the aerosol more stable during propagation of the aerosol cloud. This, in turn, leads to more predictable ignition and combustion of the aerosol.

The method of pumping water to compensate for fluid withdrawals from an oil formation in order to maintain formation pressure has long established itself as an effective technology and is widely used at oil and gas fields. At the same time, field operator is often faced with the problem of reduction in the intake capacity of injection wells, which may be caused by various complications arising in the near-wellbore area due to a violation of water treatment technology or other factors. This problem is typical for reservoirs with low permeability values, which leads to a decrease in the performance indicators of the formation pressure maintenance system. In order to counter contamination of the bottomhole zone of the well, as a rule, injection of specialized acid compositions for the purpose of cleaning is used. To increase the effectiveness of this procedure, the authors of the article propose to discharge the injection well at the maximum permissible speeds. This event will allow primary cleaning of the bottomhole zone of the formation from moving particles clogging the pore space, and reduce formation pressure in the vicinity of the injection well, which will subsequently improve the intake capacity of the well during treatment with acid compositions. The decrease in formation pressure in the bottomhole zone of the well also has a positive effect on the radius of acid penetration into the formation. The proposed approach has been successfully tested on a number of injection wells at one of «Gazprom Neft» enterprises. The results of pilot operations showed an increase in the quality of cleaning the bottomhole zone of the formation and an increase in the intake capacity of injection wells with subsequent preservation of intake dynamics.

Aim. To compare the impact of cardiac resynchronization therapy (CRT) on survival in patients with ischemic and non-ischemic cardiomyopathy (CMP) in clinical practice. Subjects and methods. The study enrolled 206 patients with NYHA Functional Class II-IV chronic heart failure (CHF) and a left ventricular ejection fraction of ≤35, including 107 patients implanted with CRT devices in combination with continuous drug therapy (DT). Among the 107 patients, 48 were diagnosed as having non-ischemic CMP (NCMP), 59 as coronary heart disease (CHD). The other 99 patients (12 with NCMP and 87 with CHD) were on DT only. Later on the patients from both groups were divided into subgroups according to the treatment policy of CHF: CRT + DT or DT only. The mean follow-up period was 24±18.1 months. Results. The Kaplan-Meier survival analysis revealed that overall survival in the patients on CRT + DT was significantly higher than in those on DT (70 and 49%, respectively; p=0.004). Analysis of the chosen treatment policy in the NCMP subgroup showed no significant differences in survival rates in the patients receiving CRT + DT or DT (74 versus 78%, respectively; p=0.5). At the same time, the survival rates in the CHD patients on CRT + DT were significantly higher than those in the DT subgroup (68 versus 44%; p=0.04). Conclusion. CRT significantly reduces overall mortality in patients with CHF in clinical practice. Our findings indicated that this effect was achieved mainly in patients with CHD, rather than in those with NCMP.

Electrophysical properties of multicomponent heterogeneous systems containing polar liquid phase and electrically active inclusions are investigated while the study of human blood. It was found that the examined biological system has electret properties which are related to accumulation of interphase charges in the presence of inner electric field. Special attention is paid to the analysis of change of structure of water component in plasma near the interfaces. The existence of low-temperature current maximums whose dynamics is the same for all groups of blood and high-temperature current maximums which characterize individual properties of the biofluid in the range of temperatures (20-220) °C has been established. For the first time electrophysical parameters that describe physical properties of human blood thoroughly are determined.

В настоящее исследование за период с 2000 по 2002 г. включено 20 больных: 13 (65%) женщин и 7 (35%) мужчин; из них 17 (85%) пациентов с крупноклеточной В-клеточной лимфомой, 1 больная с беркиттоподобной лимфомой, 2 больных с фолликулярной лимфомой 1-П цитологической степени. Сочетание мабтеры с антрациклиносодержащими комбинациями химиопрепаратов оказалось высокоэффективным и малотоксичным режимом первой линии лечения больных с прогностически неблагоприятными вариантами В-клеточных неходжкинских лимфом. Полученные данные диктуют необходимость дальнейшего изучения эффективности комбинаций R-CHOP и R-CIOP в однородных группах пациентов.

В настоящее время сохраняется тенденция к увеличению заболеваемости злокачественными новообразованиями.Многие вопросы при выборе терапевтической тактики при лимфомах все еще далеки от разрешения. Особенно это относится к пациентам пожилого и старческого возраста ввиду значительно большей выраженности у них токсических эффектов стандартной химиотерапии и менее благоприятным прогнозом по сравнению с более молодыми больными. Отсюда особое внимание привлекает принципиально новый противоопухолевый препарат «Мабтера».В рамках разработки новых методов лечения пожилых больных НХЛ нами было выполнено исследование по изучению эффективности и безопасности мабтеры для терапии рецидивов и рефрактерных форм НХЛ низкой степени злокачественности. Исследование было проведено на базе трех центров РОНЦ им. Н.Н. Блохина РАМН (Москва), Российского научного центра рентгенорадиологии МЗ РФ (Москва), НИИ онкологии им. Н.Н. Петрова (Санкт-Петербург).Анализ эффективности и токсичности монотерапии мабтерой у пожилых больных позволяет сделать следующие выводы - 1. Лечение эффективно, безопасно, легко осуществимо и может широко применяться в амбулаторной практике. 2. Мабтера является препаратом выбора для лечения пожилых пациентов с рецидивами НХЛ низкой степени злокачественнсти, отнесенных по МПИ к группе благоприятного прогноза. 3. Мабтера высокоэффективна при различных экстранодальных проявлениях НХЛ низкой степени злокачественности. 4. Необходимы дальнейшие исследования с целью оптимизации показаний для применения препарата у пожилых больных.

Abstract Background and objectives :The hypothesis of the study was the assumption that the serum levels of soluble ST2 (sST2) and growth differentiation factor (GDF-15) can be predictors of atrial fibrillation (AF) recurrence in long-term period after primary radiofrequency catheter ablation (RFA). Methods Of the 165 patients included in the prospective follow-up, the final analysis included 131 patients whose follow-up duration reached 18 months after the end of the blanking period (3 months after RFA). The median age of patients was 59.0 (50.0; 64.0) years, and 80 (61%) were men. Paroxysmal AF was present in 103 (79%) and persistent AF in 28 (21%) patients. All patients underwent transthoracic and transesophageal echocardiography, and electroanatomic mapping was used to assess the area of low-voltage zones (LVZ). sST2 and GDF-15 levels were determined by ELISA using GDF-15/MIC-1 analytical kits (BioVender, Czech Republic) and Presage ST2 (Critical Diagnostics, USA) before RFA. After RFA, patients had regular follow-up visits at 3-6-9-12-18 months with 12-lead ECG or Holter ECG monitoring and with clinical evaluation. The primary endpoint was the occurrence of the first symptomatic AF recurrence (AFr) lasting > 30 s, recorded on an ECG or during daily ECG monitoring, after a blanking period. Results At the 18-month follow-up, 47 patients (35.9%) had AFr. The groups with and without AFr didn`t differ in the LVZ area. The medians of NT-proBNP, GDF-15 and sST2 also didn`t differ significantly between the groups, but in patients with AFr, the proportion of those with sST2 ≥ 36 ng/ml (the border of the lower and middle terziles) was higher (p = 0.03). According to the one-factor Cox regression analysis, AFr were associated with four factors: AF history ≥ 1 year, early AFr (during the blanking period), left atrial appendage flow velocity (LAAFV)