Journal of Modern Oncology

Theoretical and practical publication

Journal of Modern Oncology
(Sovremennaya onkologiya) 

The Journal of Modern Oncology (Sovremennaya Onkologiya) is a peer-reviewed, open-access periodical that since 1999 serves the interests of oncologists.

Peer-reviewed theoretical and practical Journal of Modern Oncology is published since 1999 in 5000 copies, volume of about 80 pages of format А4. The journal has been included into the List of periodical scientific and technical publications issued in the Russian Federation where basic scientific results of doctoral thesis should be published. The territory of dissemination of the journal: Russian Federation, countries of Commonwealth of Independent States (CIS) and other foreign countries. 

This periodical publishes papers of scientists and practitioners-oncologists and clinical pharmacologist not only from Russia as well as from the near and far abroad. The journal publishes articles on modern methods of diagnostics and treatment. The journal is issued regularly with periodicity 4 issues a year. At the present time the journal has acquired wide recognition and popularity among specialists.

The journal is disseminated among doctors and researchers working on oncology, modern methods of diagnostics and treatment, officials and specialists of agencies of healthcare of regions of Russian Federation and other foreign countries, Research Institutes; across medical institutions and research centers; into central libraries; by subscription; into all medical libraries.

The "Journal of Modern Oncology" is an open access, peer-reviewed online journal dedicated to providing the very latest information both in clinical and translational research fields related to a wide range of topics in oncology. 

The journal publishes editorial conference updates, original research, reviews, clinical case reports, commentaries, clinical and laboratory observations by Russian and international authors, pertinent to readers in CIS countries and around the world.

The Journal emphasizes vigorous peer-reviewing and accepts papers in Russian and English with most rapid turnaround time possible from submission to publication. Abstracts for all papers are available in both languages.

Special area focus/ journal sections:

  •  Diagnosis of cancer
  •  Tumors of the respiratory system
  •  Ovarian and cervical tumors
  •  Tumors of the digestive tract
  •  Radiation therapy, chemotherapy, targeted therapy of tumors
  •  Quality of life of patients


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Current Issue

Vol 25, No 1 (2023)


Guidelines for the endoscopic diagnosis, treatment and follow-up of patients with epithelial neoplasms of the colon. 2022
Malikhova O.A., Zavyalov D.V., Kashin S.V., Shishin K.V., Ilyashenko M.G., Kireev S.U., Mikhin A.I., Sidorova A.N., Malikhov A.G.
Journal of Modern Oncology. 2023;25(1):5-14
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Updates in urologic oncology guidelines: prostate cancer: A review
Volkova M.I., Alekseev B.Y., Nosov D.A., Nyushko K.M.

The emergence of new drug therapy regimens and the completion of several large randomized trials led to significant changes in the clinical guidelines of the Ministry of Health of Russia and the practical guidelines of the Russian Society of Clinical Oncology (RUSSCO) for the treatment of urologic oncology diseases. However, different interpretations of some studies by expert panels and requirements for these documents led to a divergence of some statements in these publications. The article presents executive summaries of the updated clinical and practical prostate cancer treatment guidelines.

Journal of Modern Oncology. 2023;25(1):15-20
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Combination of encorafenib and binimetinib in the treatment of patients with BRAF-mutated advanced melanoma. Case report
Orlova K.V., Petenko N.N., Garanina N.V., Demidov L.V.

Background. The need to use BRAF and MEK inhibitors in the treatment of patients with metastatic and/or unresectable BRAF + melanoma in certain clinical situations is beyond doubt nowadays. The medical community need more information about the new combination of targeted therapy approved in Russia, further details on the expected efficacy and tolerability, potential differences from the existing combinations.

Aim. To present of the study results and demonstration of our experience with the new generation of targeted therapy – encorafenib and binimetinib combination – in the treatment of patients with metastatic and/or inoperable BRAF+ melanoma.

Materials and methods. We present the clinical case of BRAF+ advanced melanoma patient with multiple metastases in the liver, spleen, mediastinal and abdominal lymph nodes, stomach and bones who is being treated with encorafenib and binimetinib since 2015 with the treatment efficacy and tolerability described in details, as well as the published data on the efficacy and tolerability of this combination from the pivotal phase III study COLUMBUS.

Results. High immediate and long-term efficacy, satisfactory tolerability of encorafenib and binimetinib combination are presented. Updated data on progression-free and overall survival in the COLUMBUS study confirmed the long-term efficacy of COMBO450 therapy in patients with advanced melanoma with BRAF V600 mutation.

Conclusion. New generation of BRAFi and MEKi combination expands options of systemic therapy for patients with metastatic and/or inoperable BRAF+ melanoma.

Journal of Modern Oncology. 2023;25(1):21-27
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Immunological detection of bone marrow lesions in skin melanoma and its clinical significance: Observational study
Krylovetskaya M.A., Chulkova S.V., Markina I.G., Chernysheva O.A., Komarov I.G., Kolbatskaya O.P., Kupryshina N.A., Logachev A.V., Mikhaylova I.N., Demidov L.V., Tupitsyn N.N.

Background. Melanoma of the skin is characterized by a rapid progression and early metastasis. It has been shown the disseminated tumor cells, which are often found in the bone marrow, has an important prognostic value. The study of disseminated tumor cells in melanoma might be one of the possible additional sources of information about the nature of the disease and potential application points for drug therapy.

Aim. To study the frequency of detection of disseminated tumor cells in the bone marrow in melanoma, depending on the clinical and morphological characteristics of the tumor.

Materials and methods. The study included 67 patients with a verified diagnosis of melanoma who were examined and treated at the Blokhin National Medical Research Center of Oncology from 2014 to 2019 years. Male patients accounted for 50.7% (n=34), female patients 49.3% (n=33). The average age of patients: 50.1±1.6 years. Immunological and morphological examination of the bone marrow were perfomed. Morphological examination was performed by two independent morphologists. Disseminated tumor cells were evaluated by flow cytometry among all nucleated cells (Syto41+) based on the expression of the HMB-45 antigen and the absence of expression of the CD45 panleukocyte antigen (FACS Canto II, USA, Kaluza Analysis v2.1). Statistical data processing was performed using the IBM-SPSS Statistics v.21

Results. Morphologically bone marrow damage was not detected in any case. Disseminated tumor cells (CD45-HMB-45+) in the bone marrow of melanoma patients were detected in 62.7% (n=42) of cases by flow cytometry. The frequency of bone marrow damage in the early stages is not lower than in advanced ones (p=0.029). This is clearly seen in the enlarged analysis. The percentage of DTC detection. At stages I and II was 60.0% (6/10) and 84.6% (11/13), respectively, at stages III and IV – 44.4% (8/18) and 65.4% (17/26). In addition, the frequency of detection of disseminated tumor cells in the bone marrow was higher in young patients (p=0.02). There was no correlation between the frequency of bone marrow damage depending on BRAF status.

Conclusion. The connection of disseminated tumor cells with the clinical and morphological characteristics of the melanoma has been established. Melanoma is characterized by frequent bone marrow damage, even in the early stages, in young patients.

Journal of Modern Oncology. 2023;25(1):28-34
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Following in the footsteps of SABCS 2022: top 16 early breast cancer studies that could change our clinical practice: A review
Kolyadina I.V.

A review of the studies presented at the SABCS 2022 conference on the treatment of breast cancer (BC) has been carried out; 16 of the most exciting and significant works reported at oral or poster sessions have been identified. Data from large randomized and population-based studies were presented, including TAM-01 (the role of adjuvant therapy with 5 mg tamoxifen for in situ cancer), six studies on the surgical treatment of early breast cancer, including a meta-analysis to assess the effect of surgery extent on overall survival, a comparison of the results of targeted lymph node dissection and biopsy of sentinel lymph nodes in patients after neoadjuvant systemic therapy, an analysis of the local relapse rate after breast-conserving surgery in patients with multicentric breast cancer, as well as the effect of carrier status of pathogenic variants of mutations in the ATM, BRCA1, BRCA2, CHEK2 and PALB2 genes on the occurrence of cancer of the contralateral breast. Among the systemic therapy studies, the 10-years results of APT trial, Peony trial were presented, as well as the results of the TMC analysis on the various roles of carboplatin addition in neoadjuvant chemotherapy regimens in patients younger and older than 50 years with triple-negative breast cancer, randomized clinical studies on the escalation of adjuvant endocrine therapy in high relapse risk groups (MonarchE and SWOG S1207), as well as new data on cognitive dysfunction after chemotherapy in patients in the RxPONDER trial. Also noteworthy are the reviews of treatment in special clinical situations: the first results of the POSITIVE trial (an assessment of the oncological and obstetric outcomes of interruption of adjuvant endocrine therapy for conception), an analysis of the mortality of males with breast cancer over the past 20 years, as well as an analysis of the methylmalonic acid effect on senile weakness in patients with early breast cancer.

Journal of Modern Oncology. 2023;25(1):35-45
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Following in the footsteps of SABCS 2022: top 12 advanced breast cancer studies that could change our clinical practice: A review
Kolyadina I.V.

A review of the data presented at the SABCS 2022 conference on the treatment of advanced breast cancer (metastatic breast cancer – mBC) was conducted; 12 of the most exciting, creative, and significant randomized and population studies were identified, the results of which were reported at oral or poster sessions. For the first time, new and unique data on the treatment of HR+HER2-negative mBC from the following studies were presented: RIGHT Choice phase II randomized clinical study (combination endocrine therapy with ribociclib versus chemotherapy in aggressive disease, including visceral crisis), PACE study (combination endocrine therapy with palbociclib after disease progression on CDK4/6 inhibitors), and several studies on choosing the optimal treatment strategy for hormone-resistant breast cancer (CAPItello-291, EMERALD, SERENA-2, TROPiCS-02). A clear-cut favorite, trastuzumab deruxtecan, became available in treating pre-treated HER2+ mBC; at the SABCS 2022 conference, new data from a randomized phase III clinical trials (DESTINY-Breast 02 and 03) and two large real-world population analyses from Italy and Japan were presented. Among the studies on advanced triple-negative mBC, noteworthy are the results of two extraordinary phase II clinical studies, DORA and ALICE, which studied the effectiveness and safety of immunotherapy with unusual combinations (with olaparib in the DORA study and with immunomodulatory chemotherapy in the ALICE study).

Journal of Modern Oncology. 2023;25(1):46-54
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The effect of CDK4/6 inhibitors on the overall survival in patients with advanced HR+/HER2- BC in the entire population and in special clinical subgroups of unfavorable prognosis: A review
Grechukhina K.S., Kalugin M.V., Prosvirnov A.A., Sukhova M.V., Zhukova L.G.

An increase in the median progression-free survival when using cyclin-dependent kinase 4/6 inhibitors in combination with aromatase inhibitors led to high expectations from the analysis of the overall survival of patients with HR+/HER2- metastatic breast cancer. Of the three drugs in the group, the final data were obtained in the MONALEESA-2 and PALOMA-2 studies, while a statistically significant difference in median overall survival was achieved only with the use of ribociclib. The review discusses possible factors that could affect the final results of the presented studies. The effect of ribociclib on the value of OS in clinically unfavorable prognostic subgroups (for example, patients with visceral metastases) and on progression-free survival depending on the expression of molecular genetic factors that worsen patient survival (such as Rb, p16, Ki-67, CDKN2A, CCND1, ESR1) was analyzed.The combination of ribociclib and aromatase inhibitors has proven to be an advantage in the treatment of patients with HR+/HER2- metastatic breast cancer in terms of increasing both progression-free survival and overall survival. Efficacy has been proven in subgroups with clinical and molecular adverse prognostic factors.

Journal of Modern Oncology. 2023;25(1):55-62
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Clinical factors of the risk of hyperplastic endometry processes on tamoxifen therapy with breast cancer: Retrospective population study
Golubenko E.O., Savelyeva M.I., Poddubnaya I.V., Korennaya V.V.

Background. One of the main stages of the treatment of breast cancer (BC) is endocrine therapy with tamoxifen or aromatase inhibitors. Five years of adjuvant tamoxifen therapy reduces the risk of disease recurrence by 39%. Tamoxifen was approved by the U.S. Food and Drug Administration in 1977 as a treatment for ER-positive BC. However, sometime after the start of tamoxifen's wide use, reports have been published on its long-term adverse effects. Most common were hot flashes, gynecological symptoms (vaginal dryness, vaginal discharge), depression, forgetfulness, sleep changes, weight gain, and decreased libido. However, more serious adverse events such as venous thromboembolic disease and endometrial hyperplasia or cancer are the most clinically significant. The article presents the results of a retrospective population-based study on assessing hyperplastic processes of the endometrium (HPE) in patients with breast cancer during TAM therapy, conducted in 2017, approved by the Ethics Committee of the Scientific Research of the Russian Medical Academy of Continuing Professional Education.

Aim. To identify clinical factors that may increase the risk of HPE during tamoxifen therapy in patients with a history of breast cancer living in the Moscow region.

Materials and methods. We retrospectively reviewed 230 case histories of patients with breast cancer. Of these, 120 patients who received TAM therapy had the following HPE risk factors: average age, menopausal status, body mass index, and duration of TAM therapy.

Results. It was found that patients with HPE taking TAM were older (p=0.017), more likely to be postmenopausal (p=0.035), overweight (p=0.023), and received TAM for a longer period (p=0.028) than patients without HPE.

Conclusion. The data obtained indicate the need for continuous monitoring by gynecologists of patients with breast cancer taking tamoxifen, paying particular attention to women from high-risk groups, namely older postmenopausal women with high body mass index receiving TAM for more than 1.5–2 years.

Journal of Modern Oncology. 2023;25(1):63-67
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Influence of radiation therapy on the development of complications in single-stage autologous breast reconstruction with a DIEP-flap in breast cancer patients: a retrospective study
Duadze I.S., Kaprin A.D., Zikiryakhodzhaev A.D., Reshetov I.V., Usov F.N., Rasskazova E.A., Sukhotko A.S., Starkova M.V., Bagdasarova D.V., Dzhabrailova D.S., Khakimova S.G.

Breast reconstruction after complex oncological treatment is an urgent issue due to the high incidence of breast cancer.

Aim. To analyze the effect of postoperative radiotherapy on the incidence of fat necrosis in single-stage autologous breast reconstruction with a DIEP flap and to evaluate the number of complications in groups with and without postoperative radiotherapy, as well as to determine the risk factors for complications.

Materials and methods. The medical records of 34 breast cancer patients who underwent one-stage breast reconstruction using a DIEP flap after skin-sparing/subcutaneous mastectomy with and without subsequent radiation therapy were retrospectively studied. The frequency of complications in groups with and without postoperative radiation therapy was assessed.

Results. Complications developed in 22 (64.7%) patients out of 34. Mild complications developed in 6 (17.6%) patients (divergence of the edges of the postoperative wound of the anterior abdominal wall). Complications of moderate severity developed in 12 (35.3%) patients. Severe complications developed in 4 (11.8%) patients. Out of 22 patients, 6 (17.4%) patients developed areas of fat necrosis after remote radiation therapy in the delayed period, 4 (11.8%) patients, without ESWL, also developed fat necrosis of a part of the flap (areas up to 5 cm). Excision of the area of fat necrosis of the flap was performed in 2 (5.9%) cases under local anesthesia, the rest of the areas of fat necrosis were not excised. The percentage of complications was higher in the group of patients with obesity (20.6%), which indicates that obesity is a risk factor for the development of intraoperative and postoperative complications in patients with simultaneous breast reconstruction with a DIEP flap.

Conclusion. During radiotherapy after breast reconstruction with a DIEP flap, the incidence of fat necrosis of the flap was higher. Obesity is a risk of intraoperative and postoperative complications in patients with simultaneous increased breast reconstruction with a DIEP flap, since the incidence of complications was in the group of patients with obesity.

Journal of Modern Oncology. 2023;25(1):68-72
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The role of minimal residual disease in therapy of pediatric acute lymphoblastic leukemia: a prospective cohort study
Korkina Y.S., Valiev T.T.

Background. During last 50 years there was a significant progress in understanding the nature of pediatric acute lymphoblastic leukemia (ALL). There were developed effective chemoradiotherapy regimens, new methods of diagnosis and emerged evaluation of treatment results. Determination of minimal residual disease (MRD) has become the most important factor in the patient’s stratification for risk-adapted treatment in the ALL IC-BFM 2009.

Aim. To evaluate the survival rates of children with ALL according to the ALL IC-BFM 2009 protocol.

Materials and methods. There were 136 people in the study of evaluating the effectiveness of therapy according to the ALL IC-BFM 2009 protocol: 69 boys and 67 girls (ratio 1.03:1). The median age is 4 years and 10 months. The observation period is from 26.01.2010 to 06.11.2022.

Results. High survival rates of children with newly diagnosed ALL are achieved: overall survival (OS) is 91.2%, event-free (EFS) – 82.4%, relapse-free (RFS) – 88.6%. The best results are among patients of the standard risk group: OS, EFS and RFS reach 96.6%. In the intermediate group OS – 96.2%, EFS – 84.8% and RFS – 88.3%. Worse results of survival are in the high risk group: OS – 76.9%, EFS – 65.4% and RFS – 80.7%. Outcome analysis depending on the linear reveals a statistically insignificant difference in survival rates (for B-ALL OS – 92.4%, EFS – 83.1% and RFS – 89.5%, for T-ALL OS – 83.3%, EFS – 77.8% and RFS – 83.3%). It determines the tendency of improving the prognosis of pediatric T-ALL by optimizing the stratification of patients based on the indicators of MRD and the best direction of protocol.

Conclusion. Results of survival rates of patients with ALL confirm high effectiveness of treatment according to the ALL IC-BFM 2009 protocol. MRD level on day 15 makes it possible to stratify patients and choose the optimal risk-adapted therapy.

Journal of Modern Oncology. 2023;25(1):73-77
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Targeted therapy and hematopoietic stem cell transplantation for relapsed/refractory Hodgkin lymphoma in pediatric and adolescent patients: a pilot protocol results
Tsaplina N.S., Valiev T.T., Kirgizov K.I., Varfolomeeva S.R.

Background. Introduction a targeted drugs in a real clinical practice bring a vast improvement of prognosis in patients with relapsed and refractory (r/r) Hodgkin lymphoma (HL). But it is necessary to increase the experience in anti-CD30 monoclonal antibodies in combination with second-line chemotherapy in pediatric oncology/hematology.

Aim. To estimate the effectiveness of chemoimmunotherapy (ViGePD+BV scheme) in pediatric patients with r/r classical HL (cHL).

Materials and methods. From January 2018 to October 2022, 15 patients with r/r cHL received scheme ViGePD+BV. Programmed treatment included autologous stem cell transplantation (auto-SCT) in 11 (73%) patients. The potency assignment of antitumour treatment was performed with positron emission tomography/computed tomogtaphy (PET-CT).

Results. Complete metabolic response (PET-negative status) was achieved in all 15 (100%) patients after 4 inductive courses by ViGePD+BV scheme; 4-year relapse-free survival was 90.9±8.7%.

Conclusion. Our preliminary data of a pilot protocol of study a chemoimmunotherapy effectiveness for r/r cHL with brentuximab vedotin show a high potency of ViGePD+BV scheme in patients with r/r HL.

Journal of Modern Oncology. 2023;25(1):78-81
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Diagnostic significance of CA-62 cancer antigen for early detection and differential diagnosis of non-small cell lung cancer: results of the blind clinical trials
Tcherkassova J.R., Prostyakova A.I., Tsurkan S.A., Suganov N.V., Boroda A.M., Zhilenkova A.V., Pirogova J.N., Sangadzhieva Z.D., Rusanov A.S., Rozhkov A.A., Fatyanova A.S., Nikitina N.M., Bagmet N.N., Sekacheva M.I.

Background. The combination of several diagnostic methods is used to predict treatment outcomes, assess overall survival, and increase the positive predictive value of detecting malignant lung and bronchial tumors.

Aim. To evaluate the diagnostic value of the CLIA-СА-62 chemiluminescence immunoassay reagent kit for the detection of early (Ia–IIb) and advanced (IIIa–c) stages of lung cancer (LC) in a double-blind clinical study and to assess the use of the CA-62 cancer antigen as a supportive decision-making tool in LC diagnosis in patients with suspicious changes on the tomogram or as a tool for pre-screening of LC prior to computed tomography (CT) to increase diagnostic sensitivity in the detection of early (I and II) stages of LC.

Materials and methods. A blinded clinical study was conducted on 304 clinically verified serum samples, including 141 samples from patients with non-small cell LC (NSCLC), 133 healthy volunteers, and 30 chronic obstructive pulmonary disease patients. Quantification of other well-known tumor markers used in the diagnosis of LC (CEA, CA-125, CA 15-3, CA 19-9, CYFRА 21-1, NSE, and SCC), as well as the CA-62 marker in all serum samples was performed using electrochemiluminescent immunoassay Elecsys CA-125, ELECSYS CA 19-9, ELECSYS CYFRА 21-1 and ELECSYS SCC (COBAS, Roche Diagnostics GmbH, Germany, EU), enzyme-linked immunoassay CA 15-3-ELISA-BEST, CEA-ELISA-BEST, NSE-ELISA-BEST (AO Vector-Best, Russia) and chemiluminescent immunoassay CLIA-СА-62 (JVS Diagnostics, Skolkovo, Moscow, Russia).

Results. CA-62 glycoprotein showed the highest level of expression at stage I NSCLC (12 745 U/mL) compared to other tumor markers studied and remained very high at the later stages of cancer: stage II (11 261 U/mL) and stage III (10 220 U/mL). A comparative analysis of the ROC curves of the most promising tumor markers CEA, CYFRA 21-1, SCC, and CA-62 for the entire NSCLC cohort versus all healthy volunteers and patients with chronic obstructive pulmonary disease showed a significant difference in the area under the curve between CA-62 (AUC 0.981) and other markers: CEA (AUC 0.84)> CYFRA 21-1 (AUC 0.753)>SCC (AUC 0.682). When detecting early stages (I and II) of NSCLC, a comparison of the sensitivity of the studied tumor markers showed the following pattern: CA-62 (92%)>CEA (37%)>CYFRA 21-1 (9%) and SCC (9%)>NSE (4.5%)>CA-125 (3%)>CA 15-3 (1.5%)>CA 19–9 (1%). In contrast to the CEA, CA 15-3, CA-125, NSE, CA 19-9, CYFRA 21-1, and SCC tumor markers, which are expressed proportionally to tumor growth, the epithelial carcinoma marker CA-62 showed the highest diagnostic indicators in the detection of LC early stages (I–II): sensitivity 92.5%, specificity 96.3%, positive predictive value 91.2%, NPV 97%, with 95% accuracy of LC detection with biopsy.

Conclusion. The study results showed that in order to increase the specificity of computed tomography in diagnosing LC in patients with suspicious lesion on the CT scan on the tomogram, the use of the carcinoma-specific marker CA-62 can improve the interpretation of the localized focus visualized and increase the accuracy of differential diagnosis at the early stages of LC to 96%, thus contributing to an increase of the overall survival among patients with lung cancer. Of the entire panel of markers, only glycoprotein CA-62 showed a strong correlation with histology (kappa 0.91) in identifying the malignant process with inconclusive results of low-dose CT (LDCT). In the future, introducing the CA-62 marker to the current system for assessing the LC risk as a pre-screening for LDCT can improve the detection of early LC by reducing false-positive results. Once introduced into existing screening programs, it can help significantly reduce the number of patients who need LDCT, decreasing the workload of LDCT and reducing radiation exposure.

Journal of Modern Oncology. 2023;25(1):82-90
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Determination of sentinel lymph nodes in gynecological cancer using the radiopharmaceutical Sentiscan. A case series
Shevchuk A.S., Krylov A.S., Knyazev R.I., Afanasieva K.V.

Background. Lymphadenectomy in patients with malignant female genital neoplasms is a necessary step of surgical treatment, the implementation of which allows assessing the the metastatic involvement of the removed lymph nodes and determining indications for postoperative treatment. Sentinel lymph node (SLN) biopsy with ultrastaging method appears to be a good alternative to standard regional lymph node removal with similar long-term oncologic outcomes and significantly lower rates of postoperative complications.

Aim. To present the possibility of using a domestic radiopharmaceutical labeled with technetium-99m (Sentiscan) in patients with gynecological cancer.

Materials and methods. A series of clinical cases of the use of Sentiscan during SLN biopsy in three patients suffering from cancer of the uterus and vulva is presented.

Results. 18–24 hours before the operation, 0.4 ml of the prepared solution of radiopharmaceutical 99mTc-Sentiscan with a total activity of 150 MBq was injected into the cervix of the uterus with tumors of the uterine body and into the vulva. After 2 hours, SPECT/CT was performed on the Discovery 670 DR (GE) of the abdomen and pelvis, followed by 3D reconstruction of images for better intraoperative navigation. Intraoperatively, a portable gamma detector Rad Pointer Gamma (Medikor Pharma Ural) was used to identify sentinel lymph nodes. Sentinel lymph nodes were removed in all patients, followed by a control assessment of the gamma radiation level, histological and immunohistochemical studies using panCK, CK18 markers.

Conclusion. Presented clinical cases demonstrated high efficacy of sentinel lymph node mapping using radiopharmaceutical Sentiscan. Further studies are necessary for wide implementation of this technology in clinical practice.

Journal of Modern Oncology. 2023;25(1):91-98
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Characteristics of the receptor phenotype of tumor-associated immune cells of the epithelial-mesenchymal microenvironment of ovarian cancer
Zhurman V.N.

Among all histological types, serous carcinomas account for up to 85%. Due to pronounced heterogeneity (at the molecular and genetic level) and chemoresistance, difficulties arise in finding active targets for tumor elimination.

Aim. To establish a link between the population composition of tumor-associated immune cells of the microenvironment and the stage of serous ovarian cancer.

Materials and methods. The analysis of the pathologic and anatomical material in 74 patients with serous ovarian cancer was carried out. Monoclonal antibodies were used to determine antigens in the samples: CD3, CD4, CD8, CD11b, CD14 and CD16.

Results. The obtained results of the immunohistochemical study showed that in the composition of the immune cells of the microenvironment, the largest number of cells, at all stages (I–IV) of the oncological process, are represented by macrophages (CD11b+, CD14+), CD3+ lymphocytes are in second place in terms of the number of cells, followed by CD8+ and CD4+ and the smallest number of CD16+ cells.

Conclusion. As a result of the immunohistochemical study, a multidirectional trend was found between the population composition of tumor-associated immune cells of the microenvironment and the stage of serous ovarian cancer. With an increase in the stage of the disease, the number of macrophages (CD11b+, CD14+) and lymphocytes (CD3+, CD16+) decreased regardless of the degree of differentiation of the tumor. With an increase in the tumor stage, the number of CD4+ and CD8+ populations decreased, but in this case, the degree of differentiation played a significant role, i.e. the higher the tumor stage and the lower the degree of differentiation, the fewer cells were detected.

Journal of Modern Oncology. 2023;25(1):99-103
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Molecular-genetic landscape of abdominal and retroperitoneal desmoid fibromatosis: a retrospective study
Turupaev K.A., Budurova M.D., Filippova M.G., Isayev A.A., Gridneva Y.V., Khmelkova D.N., Gayryan M.A., Mironova I.V., Nikulin M.P., Puchkova A.I., Delektorskaya V.V.

Background. Desmoid fibromatosis (DF) is a rare mesenchymal tumor with invasive growth, a high relapse rate, and low incidence (2–4 cases per 1 million people per year). Given the small number of patients with DF and, as a result, the lack of knowledge of this disease, the search for molecular predictors of the disease course and the individualization of treatment and prevention is relevant.

Aim. To study tumor cells' molecular genetic and immunohistochemical profile and determine their clinical significance in patients with abdominal and retroperitoneal DF.

Materials and methods. A comprehensive analysis of clinical and laboratory data of 31 patients with abdominal and retroperitoneal DF, a molecular genetic and morphological study of tumor samples was performed, including next-generation sequencing (NGS) using the Onconetix oncology panel and an immunohistochemical study using antibodies to β-catenin and estrogen and progesterone receptors.

Results. NGS testing showed somatic mutations in 28 (90%) of the 31 tumor samples. Somatic mutations in the CTNNB1 gene were detected in 26 (84%) tumor samples: 21 (68%) patients had c.121A>G (p.Thr41Ala, rs121913412), 3 (10%) patients had c.134C>T (p.Ser45Phe, rs121913409), 1 (3%) patient had c.133T>C (p.Ser45Pro, rs121913407), and 1 (3%) patient had c.122C>T (p.Thr41Ile, rs121913413). Two (6%) patients had mutations in the APC gene: c.4381G>T (p.Glu1461Ter, COSM30779) and c.4634C>A (p.Ser1545Ter, rs863225356). In 3 (9%) patients, no mutations were detected in the studied genes. The immunohistochemical study showed the expression of β-catenin in the cytoplasm and nuclei of tumor cells in 16 (51.6%) samples. Nuclear expression of estrogen and progesterone receptors was detected in 6 (19%) and 1 (3.2%) samples, respectively. Of 10 patients with established relapses, sequencing (NGS) showed a c.121A>G mutation (p.Thr41Ala, rs121913412) in 7; 1 patient had a c.134C>T mutation (p.Ser45Phe, rs121913409), and 2 patients had no mutations in tumor samples.

Conclusion. The combination of factors such as the retroperitoneal DF, the presence of the c.121A>G mutation (p.Thr41Ala, rs121913412) in the CTNNB1 gene, female gender, and young age, can warrant assigning the patient to the group with an unfavorable DF prognosis.

Journal of Modern Oncology. 2023;25(1):104-110
pages 104-110 views
Effective prevention of COVID-19 infection in cancer patients receiving antitumor drug therapy: a regional analysis
Valiachmetova C.K., Siraev E.R., Izmailov A.A.

Background. The results of several multicenter studies indicate a high risk of severe COVID-19 and fatal outcomes in immunocompromised patients, including those with cancer. Effective prevention is critical to saving cancer patients' lives during the pandemic. Additional passive immunization with a combination of monoclonal antibodies to the SARS-CoV-2 S protein in clinical studies showed a significant reduction in the risk of severe disease and death and a decrease in the frequency of hospitalizations. Real clinical practice shows the high efficiency of this approach in patients with oncological diseases receiving immunosuppressive therapy.

Aim. To perform a comparative analysis of prevention effectiveness and COVID-19 severity in patients with solid malignant tumors receiving antitumor drug therapy.

Materials and methods. The analysis included 100 vaccinated patients aged 22 to 84 with metastatic or inoperable solid tumors who received cytostatic therapy with or without a targeted agent. The median age was 56.5 years in Group 1 and 57.7 years in Group 2. In both groups, 32 (64%) patients had breast cancer, 10 (20%) had gastric, colon, and rectal cancers, 2 (4%) had lung cancer, 4 (8%), and 6 (12%) had reproductive cancers. In addition, Group 1 included 1 patient each with bladder and brain cancer. All were treated with antitumor drug therapy following clinical guidelines according to tumor localization.

Results. The median number of received treatment lines of patients in Group 1 was 2.2, and 2.38 in Group 2. In Group 1, 42% of patients got infected, and 64% in Group 2. The combination of tixagevimab 150 mg + cilgavimab 150 mg monoclonal antibodies reduced the incidence of COVID-19 infection in any clinical form by 1.5-fold and hospitalizations by 1.3-fold. In Group 1, the rate of mild COVID-19 was higher; in Group 2, a higher risk of severe course was observed. In Group 1, viral pneumonia was 1.6-fold less common than in Group 2. Overall mortality in Group 1 was 6.5-fold lower than in Group 2. In Group 1, no COVID-19-related deaths were registered; in Group 2, the mortality rate was 8% (n=4). Mortality related to underlying disease in Group 2 was 3.5 times higher, and the risk of dying from the malignant tumor progression was 50% higher. In addition, in Group 2, 15% of deaths were related to cardiovascular diseases.

Conclusion. Adding Evusheld to vaccinated patients significantly reduces the burden of COVID-19 infection in individuals with solid neoplasms who are receiving antitumor drug therapy. Patients receiving Evusheld at any stage of the underlying disease are less likely to have COVID-19, including severe infection, which requires hospitalization in an infectious hospital. The reduction in overall mortality in the Evusheld group suggests that COVID-19 affects overall survival in cancer patients. Evusheld reduced the risk of death in cancer patients from any causes: the progression of malignant tumors, COVID-19 infection, and other comorbidities.

Journal of Modern Oncology. 2023;25(1):111-114
pages 111-114 views
Prevention of febrile neutropenia in oncological patients: real-world data
Sapozhnikov K.V., Sorokina I.V., Gusev A.V., Sableva N.A., Sokolova V.D., Tolkacheva D.G., Berezina A.M.

Aim. To assess the effect of febrile neutropenia (FN) prophylaxis with granulocyte colony-stimulating factors (G-CSF) in real-world cancer patients.

Materials and methods. We conducted a statistical analysis of anonymized medical records collected in the Webiomed platform. Before analysis, the cards were validated by clinical experts. Electronic records were extracted according to two principles: mentioning D70 in the diagnosis or mentioning a chemotherapy regimen associated with a high risk of FN (≥20%), requiring the primary prevention of neutropenia. Thus, we obtained two datasets comprising 47.085 (590 patients) and 30.523 (398 patients) records, respectively.

Results. Based on the analysis results, the most common risk factors for FN development were highly hematologically toxic chemotherapy regimens and elderly age – about 50% in the adult population. In both datasets, the number of female patients prevailed (63.7% in dataset 1, 91.2% in dataset 2), so the most common was breast cancer. Less common were cervical cancer, digestive cancer, and lung cancer. Despite the indications for primary prevention of FN, for safety and importance of achieving the planned dose intensity, it was administered in 18.3% of patients in dataset 1 and 2.3% in dataset 2. No FN or G-CSF-related adverse events were reported in patients who received adequate primary prevention.

Conclusion. Some issues related to G-CSF administration in cancer patients were identified. We identified the insufficient provision of patients with primary prevention of FN, which negatively affects survival rates and reduces adherence to antitumor therapy. Real-world data demonstrate the efficacy and safety of FN prevention and planned dose intensity maintance in cytotoxic therapy regimens.

Journal of Modern Oncology. 2023;25(1):115-122
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The possibilities of therapy of patients with metastatic colorectal cancer with BRAF V600E mutation. Clinical cases
Polyanskaya E.M., Fedyanin M.I.

Mutation in the BRAF V600E gene in metastatic colorectal cancer (CRC) occurs in 5–10% of cases and is a significant problem due to the aggressive course and extremely unfavorable prognosis. In recent years, new treatment options for BRAF mutated CRC have been emerging, for example, combinations of BRAF inhibitors, anti-EGFR antibodies with optional addition of MEK inhibitors. The possibility of local treatment methods is also being discussed. Objective: to evaluate the effectiveness of triple targeted therapy in BRAF-mutated metastatic colorectal cancer. On the example of 2 clinical cases of long-term treatment of patients with this molecular subtype, possible treatment options are discussed.

Journal of Modern Oncology. 2023;25(1):123-127
pages 123-127 views
Therapy of chronic pain in cancer patients: Tafalgin use experience. Case report
Ognerubov N.A.

Background. Chronic pain is the most common and severe condition associated with cancer, causing peripheral and central nervous system disorders Inadequate pain control can be destructive and negatively affect patients' quality of life and daily activity. Therefore, developing new drugs for complete pain control during antitumor therapy and palliative care is an urgent problem in modern oncology. One of these directions is the search for selective molecules that interact with μ1-opioid receptors without many side effects of opioids.

Aim. To evaluate the effectiveness of a new selective μ1-opioid analgesic, Tafalgin, in treating chronic pain in a patient with pancreatic cancer.

Materials and methods. Tafalgin was used to control chronic pain in a 60-year-old patient with stage IV pancreatic cancer, pT2 N0M1, with liver metastases, state after 10 cycles of polychemotherapy, and distal subtotal resection of the pancreas with splenectomy, progression in October 2022, liver metastases; state after 4 cycles of polychemotherapy, severe chronic pain.

Results. The initial pain severity was evaluated using a visual analog scale: 7 points at rest and 9 points on exertion. The patient developed pain during FOLFIRINOX polychemotherapy, for which he received tramadol at a daily dose of 400 mg in combination with paracetamol, with an effect for 1.5 months. The pain severity increased with breakthrough pain. The patient was prescribed long-acting morphine at 60 mg/day, with good effect. However, the patient experienced nausea and vomiting. The morphine dose was reduced to 20 mg, thus resolving side effects and decreasing the effectiveness. Tafalgin was administered at a dose of 4 mg TID. The pain severity decreased to 1–1.2 points. No adverse events were reported. The patient has been receiving the drug for 52 days. His sleep and appetite have improved, physical activity has increased, and no weight loss has been reported.

Conclusion. When switching a patient to Tafalgin, continuous adequate pain control is maintained, not inferior to morphine. Tafalgin is associated with a favorable safety profile.

Journal of Modern Oncology. 2023;25(1):128-132
pages 128-132 views
Effect of transfused donor and autoerythrocytes on the oncological outcomes of surgical treatment in patients with renal cell carcinoma with tumor-related venous thrombosis: observational study
Volkova M.I., Feoktistov P.I., Begaliev A.K., Shin A.R., Matveev V.B., Prikhodchenko A.O.

Background. The only effective treatment for renal cell carcinoma with tumor inferior vena cava (IVC) thrombosis is surgery. Nephrectomy with thrombectomy (NETE) is usually associated with clinically significant blood loss. The role of blood-sparing methods using autoerythrocyte reinfusion device (ARD) or replacement of blood loss with donor erythrocytes (DE) on the outcomes of NETE has not been well studied.

Aim. To study the rate of hemostasis disorders with intraoperative ARD use, as well as the effect of ARD and DE transfusions on specific (SS), relapse-free (RFS), and progression-free (PFS) survival of patients with renal cell carcinoma (RCC) after NETE.

Materials and methods. The observational study included medical data of 507 patients with RCC and tumor IVC thrombosis operated after NETE. The median volume of blood loss was 4000 [2000–6500] mL. In 312 (61.5%) patients, ARD without a leukocyte filter was used to compensate for blood loss (median volume of reinfused autoerythrocytes – AE was 1140 [700; 1900] mL). Transfusion of DE was required in 387 (76.3%) cases; the median number of DE transfused doses was 3 [1; 5]; 475 (93.7%) patients were discharged from the hospital. The median follow-up of all surviving patients was 24 (1–189) months.

Results. Indications for blood transfusions (DE and AE) were directly correlated to the pN (r=0.101; p=0.024) and pT (r=0.091; p=0.040) categories, respectively. The use of AE had no significant effect on the rate of hemostasis disorders and coagulopathic complications compared to other methods of blood loss replacement: 6.8% (21/311) vs 4.7% (9/193), p=0.227; 5.1% (16/311) vs 4.1% (8/193), p=0.394, respectively. ARD had no effect on SS, RFS (after radical surgery), and PFS (after cytoreductive surgery) after NETE. There was a reduction of SS in patients who received DE transfusions compared with those who did not (hazard ratio 0.4; 95% confidence interval 0.1–0.9; p=0.048). The effects of DE transfusions on RFS and PFS were not identified.

Conclusion. Intraoperative ARD use is an effective and safe method of correcting anemia, which does not increase the risk of coagulopathic complications or decrease survival rates. The non-use of the leukocyte filter during AE preparation does not worsen the medium-term oncological results of RCC surgical treatment with tumor IVC thrombosis. The effect of DE transfusion on the survival of RCC patients after NETE requires further research.

Journal of Modern Oncology. 2023;25(1):133-139
pages 133-139 views
Clinical case of complications of immunotherapy – encephalitis
Lyadova M.A., Kuchevskaya O.A., Kulikova E.A.

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.

Journal of Modern Oncology. 2023;25(1):140-144
pages 140-144 views
Improving outcomes for people with a primary malignant brain tumour and their carers through early palliative interventions
Ivanchenko K.A.

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Byrne A, Torrens-Burton A, Sivell S, et al. Early palliative interventions for improving outcomes in people with a primary malignant brain tumour and their carers. Cochrane Database Syst Rev. 2022;1(1):CD013440. DOI: 10.1002/14651858.CD013440.pub2

Journal of Modern Oncology. 2023;25(1):145-145
pages 145-145 views
Can musical interventions benefit patients with cancer?
Razumovskaya E.A.

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Bradt J, Dileo C, Myers-Coffman K, Biondo J. Music interventions for improving psychological and physical outcomes in people with cancer. Cochrane Database Syst Rev. 2021;10(10):CD006911. DOI: 10.1002/14651858.CD006911.pub4

Journal of Modern Oncology. 2023;25(1):146-146
pages 146-146 views

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