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Relevance: Along with other diagnostic methods, all current recommendations and protocols for malignant tumors’ diagnostics and treatment require mandatory molecular genetic testing at the initial diagnosis and in case of disease progression. The discovery of the BRAF gene mutation in skin melanoma allows the treatment with tyrosine kinase inhibitors, so-called BRAF inhibitors. This increases the probability of tumor response by half and opens up new therapeutic options. The study aimed to identify the BRAF V600E gene mutation frequency in patients with stage III-IV melanoma in the Republic of Kazakhstan to determine the need for targeted therapy. Results: 2251 persons are currently registered with melanoma in the Republic of Kazakhstan, with 355 new primary melanoma cases in 2019. Of them, 54% were diagnosed at stages III-IV and were subject to molecular genetic testing. 278 of 2251 patients were sent for BRAF mutations testing. The mutations were detected in 105 (37.7%) patients. Conclusion: The introduction of molecular genetic testing for malignant neoplasms under the Comprehensive Cancer Control Plan framework for 2018-2022 will increase the use of molecular genetic methods in the Republic of Kazakhstan. Molecular genetic testing is an important step in diagnosing melanoma and choosing the appropriate therapy to personalize cancer treatment.

Relevance: Prostate cancer (PC) is one of the most common malignant neoplasms in the male population. The widespread introduction of modern diagnostic methods and the determination of prostate-specific antigen (PSA) levels have increased the number of detected cases of localized and locally advanced PC forms. However, in some patients treated with radical methods and long-term androgen deprivation therapy (ADT), the disease continues to progress in the form of an increase in PSA levels with castration testosterone values and with no distant metastases. Such a course of the disease is referred to as non-metastatic castration-resistant prostate cancer (nmCRPC). Purpose: The article reports the results of a meeting of the Expert Council arranged by the Kazakh Research Institute of Oncology and Radiology on December 25, 2020, on non-metastatic castration-resistant prostate cancer diagnostics and treatment. Results: Large clinical studies highlight the critical importance of controlling the PSA doubling time as the main prognostic factor for an unfavorable outcome to increase patient survival and prevent the development of distant metastases. Based on the results of large randomized studies, experts recommended using new-generation androgen receptor antagonists in combination with ongoing ADT to improve the clinical outcomes in nmCRPC patients at high risk of metastatic progression. The Expert Council was presented with the data of a registration clinical study on darolutamide efficacy and safety. The advantages of introducing this drug into clinical practice to expand the choice of therapeutic options were identified. Personalized adjustment of a treatment regimen will increase the treatment efficacy and ensure higher survival in this category of patients. Conclusion: Increasing survival as the main objective in treating nmCRPC patients requires improved diagnostics through regular controlling of testosterone and PSA levels, calculation of PSA doubling time, and the use of radiological diagnostic methods to rule out distant metastases. The choice of therapy in patients at high risk of metastasis shall consider the patient’s status and the treatment efficacy and safety balance.

Along with other diagnostic methods, all current recommendations and protocols for malignant tumors’ diagnostics and treatment require mandatory molecular genetic testing at the initial diagnosis and in case of disease progression. The discovery of the BRAF gene mutation in skin melanoma allows the treatment with tyrosine kinase inhibitors, so-called BRAF inhibitors. This increases the probability of tumor response by half and opens up new therapeutic options. The study aimed to identify the BRAF V600E gene mutation frequency in patients with stage III-IV melanoma in the Republic of Kazakhstan to determine the need for targeted therapy. Results: 2251 persons are currently registered with melanoma in the Republic of Kazakhstan, with 355 new primary melanoma cases in 2019. Of them, 54% were diagnosed at stages III-IV and were subject to molecular genetic testing. 278 of 2251 patients were sent for BRAF mutations testing. The mutations were detected in 105 (37.7%) patients. Conclusion: The introduction of molecular genetic testing for malignant neoplasms under the Comprehensive Cancer Control Plan framework for 2018-2022 will increase the use of molecular genetic methods in the Republic of Kazakhstan. Molecular genetic testing is an important step in diagnosing melanoma and choosing the appropriate therapy to personalize cancer treatment.

Relevance: Over the years, lung cancer (LC) remains the leading cause of cancer deaths in Kazakhstan. In 2018, LC was diagnosed in 3741 people in the RK, and 2377 dies from LC. The purpose of this study was to assess the age-gender characteristics of morbidity and mortality from LC in Kazakhstan based on statistical and literature data. Results: The conducted analysis by gender and age showed a consistent and significant increase in LC mortality in the RK, starting from the age of 40-44 years. The highest incidence and mortality were registered in the age groups of 65-69 years and 70+ years. In general, in all age categories, the incidence and mortality in men exceeded the incidence and mortality in women by 4.5–5.3 times. The highest mortality in men and women of all ages was registered in 2009 (34.3‰₀₀ and 6.9‰₀₀, respectively), the lowest – in 2019 (20.8‰₀₀ in men and 4.6‰₀₀ in women). Conclusions: The results of the assessment can be used to improve early diagnosis of LC and in the preparation of national screening programs and regional pilot projects for LC prevention and the identification of risk groups. The use of the results will contribute to increasing the effectiveness of treatment, improving the five-year survival of patients, reducing the level of neglect and mortality from LC.

e22503 Background: Cervical cancer (CC) is the second most common type of cancer for women worldwide. 99% of cases of CC are associated with high-risk human papillomaviruses (HPV HR). Unfortunately, data on the epidemiology of HPV in Kazakhstan are limited, especially in young kazakhstani women. This study was provided to determine the prevalence of HPV HR and the cytological abnormalities in young Kazakhstani women, which will allow strengthening control in the existing CC screening in this age. Methods: 101 women aged 18-30 years were invited to this cross-sectional study. Women were mentally healthy and did not have a positive human papillomaviruses (HPV) history. Cervical samples for HPV were analyzed with using of Cobas 4800 HPV test. Cytological examination of smears with using the Bethesda terminology system and HPV test were conducted at Kazakh Institute of Oncology and Radiology. Results: The mean age of the study group was 21.0±2.8 years (range 18-30 years). Prevalence of HPV was 11,8% (12 cases). HPV 16 and 18 were the most common type in analyzed cases (5,9%). Cytological abnormalities occurred in 19,8% (20 cases). The Mann-Whitney test of the frequency of cytological abnormalities showed that the ASCUS and LSIL was significantly more found in the group up to 25 years. The HSIL was more common in a group of women 25 years and older and accounted for 1.9 % out of 2 cases (p < 0.05). Conclusions: The results of this study confirm the need for HPV vaccination of adolescent girls and improvement of the existing screening through the inclusion of women to screening from 25 years of age. Changing of CC screening through implementation of HPV screening with cytological triage of HPV - positive of women can reduce the burden of CC in young age in KazakhstanPrevalence of high risk HPV and cytological abnormalities in young women in Almaty, Kazakhstan.

Background: The incidence and mortality from prostate cancer in most native Asian populations remain low although a gradual increase is observed over the last years. Methods: The statistical analysis of official data on prostate cancer mortality and morbidity was performed for the whole country and for Pavlodar Region. Results: The increase in the incidence of prostate cancer among the population of Kazakhstan is observed, which may be attributed to the introduction of screening program based on serum PSA. Still, the crude incidence rates in Kazakhstan are below world indices. Over the last few years, the decreasing prostate cancer mortality is observed that might be influenced by early diagnosis. The age-standardized incidence rates show that the majority of prostate cancer cases occur in advanced ages (70 years and older). Conclusion: More research is needed to determine the risk factors for prostate cancer, as well as ethnic and geographical trends for the population of Kazakhstan

e23033 Background: Russia, Belarus and Kazakhstan are countries of the Eurasian Economic Union with upper-middle-income economies. Limited sources of the healthcare system could affect the treatment of individual cancer patients. The data on the treatment outcomes of elderly patients with mRCC are limited in these countries. RENSUR3 registry study assessed real-world data on the use of therapies in mRCC and overall survival (OS) in this population. Methods: Patients from Russia, Belarus and Kazakhstan were included in the retrospective multicenter registry study. To be eligible, patients were required to have mRCC diagnosed from January 2015 to January 2016. Anonymized data were collected through an online registry. The outcomes of interest were OS, patient characteristics and treatment patterns. Results: 1,094 adult mRCC patients were identified. Mean age at diagnosis of mRCC was 62.3 (SD, 11.2) years. 447 (41%) patients were 65 years and older. In total, 595 (54.4%) patients received systemic therapy for metastatic disease. 58% of elderly patients were not treated compared to 37% of younger patients. Cytokines were the most commonly used treatment in elderly patients (115 of 189 patients, 61%) while targeted therapy was more widely used in younger patients (223 of 406, 55%). Median OS was 12.7 months (95% CI 11.3-14.1) and 9.3 months (7.7-9.9) for patients aged < 65 and ≥65 years, respectively (P < 0.0001). Conclusions: More than half of elderly patients received no systemic therapy or had only cytokines for mRCC in Russia, Belarus and Kazakhstan which doubtless negatively affected OS in this population. Novel therapies should be considered as life-saving and a priority in elderly patients.