Background. The association between body mass index and prognosis in patients with HER2-positive metastatic breast cancer (mBC) is unclear. Purpose – the first purpose of our study was to determine whether BMI is an independent prognostic factor for progression-free survival (PFS) and overall survival (OS) in HER2-positive mBC patients. The second objective was to assess the mutual impact of baseline clinicopathological characteristics on survival outcomes. Materials and Methods. The study group included patients treated at the Sumy Regional Clinical Oncology Center. We considered the underweight patients if their BMI was <18.5 kg/m2, normal weight 18.5–24.9 kg/m2, overweight 25.0–29.9 kg/m2, and obese ≥ 30 kg/m2. The following formula was used for calculations: weight/height2 (kilograms/meter2). Information about the height, weight, and other clinicopathological characteristics of the patient at the time of the start of drug therapy was taken from the primary medical documentation. Pearson’s test and Chi2 test for categorical variables were used to compare baseline clinicopathological characteristics in groups with normal, overweight, and obesity. The Kaplan-Meier method was used to establish the medians of PFS and OS. Cox regression analysis assessed the mutual impact on the survival of various clinicopathological characteristics. The statistical significance threshold was considered P ≤0.05. Results. Seventy-eight patients with HER2-positive mBC were enrolled and categorized according to their BMI in normal weight, overweight, and obese groups. BMI had a different impact on PFS and OS. Median PFS was 14.9, 11.9, and 14.2 months for normal-weight, overweight, and obese patients, respectively. There is no statistically significant difference in PFS between groups (Р = 0.110). Multivariable regression analysis confirmed no impact of BMI on PFS. Nevertheless, metastases in bones and kidneys and the nuclear grade were statistically significant determinants of PFS. Median OS was 26.4, 28.8, and 37.9 months for normal-weight, overweight, and obese patients, respectively. BMI, kidney metastases, and nuclear grade were prognostically significant determinants of OS. Conclusions. BMI is an independent prognostic factor of OS in patients with HER2-positive mBC. Obesity is associated with better OS but does not impact PFS. Metastases in bones and kidneys and the nuclear grade can predict survival outcomes.

Among all malignant neoplasms, lung cancer is the cause of death in approximately every fifth patient. Next-generation sequencing can solve the issue of not only diagnosis but also the further treatment of lung cancer. Aim. The work aims to search, process, generalize and bibliometrically analyze the scientific literature to study the main trends in next-generation sequencing in diagnosing non-small cell lung cancer. Materials and methods. One thousand nine hundred thirty-one literature sources, including information about next-generation sequencing, were published between 2010 and 2023. The data search was carried out in electronic databases Scopus, PubMed, Web of Science, and Google Scholar using keywords: "lung cancer," "next-generation sequencing," "targeted therapy," "genetic mutations," "circulating tumor DNA," and "liquid biopsy." The authors used the bibliometric tools of the Scopus and SciVal databases to analyze the year, source, type of study, subject area, and country of publication. Results and discussion. Next-generation sequencing is gradually becoming the new diagnostic standard. This technology allows to detect biological markers with high accuracy and specificity. Many studies have confirmed the effectiveness of next-generation sequencing for diagnosing lung cancer, assessing response to treatment and sensitivity to drug therapy, and predicting the prognosis of the disease. Lung cancer is one of the most common tumors with a high mutational load. Unique diagnostic panels allow for a short period to examine tumor tissue for a wide range of biological markers. The article aims to investigate the main areas of application of next-generation sequencing in patients with lung cancer and current clinical trials in this field. The bibliometric analysis of the scientific literature consisted of the study of publication activity from 2010 to 2023, the geography of publications, and the identification of scientific journals where the articles about the role of next-generation sequencing were publicized. Conclusions. Next-generation sequencing is widely used in medicine. This method can become one of the leading methods for diagnosing lung cancer because it can accurately identify specific biological markers. Tumor tissue embedded in paraffin blocks and various biological fluids can be used for diagnosis. Next-generation sequencing is effective even in cases where the amount of tumor tissue is limited and other methods cannot identify it. The advantages of the method are confirmed in clinical trials and described in many scientific publications of the leading countries of the world. As a result, next-generation sequencing appears to be an effective method for diagnosing lung cancer and selecting the most appropriate regimen of targeted or immunotherapy. Disadvantages of the method include the high cost in developing countries and the need for appropriate software.

Background. Lung cancer continues to be a significant health concern globally. Due to the heterogeneity of the disease, using innovative strategies for effective management and treatment of patients is extremely important. Purpose – to characterize the mutational profile of a group of non-small cell lung cancer (NSCLC) patients utilizing a next-generation sequencing technique. Materials and Methods. A total of 42 samples that were fixed in formalin and embedded in paraffin (FFPE) were collected from 42 Ukrainian patients diagnosed with lung cancer who had surgery at the Sumy Regional Clinical Oncology Center. DNA was extracted from FFPE samples using the Omega Bio-tek E.Z.N.A.® FFPE DNA Kit (USA) following the manufacturerʼs instructions. Sequencing was performed on the Illumina NextSeq 550Dx platform (USA) using the Illumina NextSeq 550 Mid-Output Kit. The Cancer Genome Atlas Program (TCGA) database (https://portal.gdc.cancer.gov/) was used for a comparative analysis of the prevalence of genomic mutations in a cohort of Ukrainian and Caucasian patients with NSCLC. Statistical analysis was performed using Stata V.18.0 software (StataCorp, Texas, USA; https://www.stata.com; 2024). The paper belongs to the «description of case series» category which is a type of study recognized by evidence based medicine and does not claim statistical significance of the result. Results. Among the 42 NSCLC samples, 11 (26.19%) carried driver mutations such as EGFR (n=2; L858R), KRAS (n=7; G12C, G12D, G12A and A146S), BRAF (n=1; V600E) and translocation EML4(exon6) – ALK (exon20) (n=1; chr2:42503838 – chr2:29447579). All mutations were mutually exclusive. No NRAS, ROS1, RET, MET, ERBB2, and PIK3CA mutation cases were detected. The number of driver mutations in patients who had never smoked was significantly higher than in former or current smokers (p=0.046). No association was found between age, sex, tumor stage, histology of NSCLC, and driver mutations. Conclusions. Molecular genetic profiling using next-generation sequencing revealed driver mutations in 26.19% of patients with radically treated NSCLC. Most mutations are oncogenic and sensitive to tyrosine kinase inhibitors.

According to GLOBOCAN 2.2 data a million of new cases of lung cancer and 1.8 million of deaths from this pathology were registered in the world in 2020. Every tenth patient with suspected malignancy was diagnosed with lung cancer, and death of every fifth of them was caused by it. Aim. To analyze the trend of the spreading of lung cancer among the population of Sumy region and Ukraine, as well as compare it with global indicators for the period of 2011-2020. Methods. The data from The Global Cancer Statistics (GLOBOCAN) and National Cancer Register of Ukraine were used. GLOBOCAN helped to evaluate global trends, while National Cancer Register of Ukraine helped to evaluate lung cancer statistics among residents of Ukraine and Sumy region. Results. The incidence rate of lung cancer among residents of Sumy region during the observed period was 24% higher than the average rate in Ukraine. Among women population prevalence of lung cancer in Sumy region exceeds the Ukrainian average rate by almost 19%. The incidence rate in the districts in general corresponded to the average indicators in the region. But it is possible to identify areas with the highest incidence rate (Burynskyi, Lebedynskyi, Glukhovskyi), as well as areas with the smallest rate (Seredyna-Budskyi, Trostyanetskyi, Shostkinskyi, Konotopskyi). The indicators of the Burynskyi district exceed the Ukraine nationwide indicators by 2.2 times, and the regional by 1.7 times. According to GLOBOCAN data lung cancer was the most common malignancy in 10 world regions over the past decade: Central and Eastern Europe, Eastern Asia, Southern Europe, North America, Western Europe, Micronesia / Polynesia, Western Asia, Northern Europe, Australia / New Zealand, and Southeast Asia. If we compare 2012 and 2020, a significant reduction in the incidence of lung cancer was observed only in North America. On the contrary, the negative dynamics was observed in Micronesia / Polynesia, and especially by West Asia, where the indicators in 2020 were more than 2 times higher than in 2012. Diagnose of lung cancer in women was mainly recorded in North America, Northern Europe and Australia / New Zealand. In addition, in North America incidence rate for woman were almost the same as in men. In Northern Europe and Australia / New Zealand they were only slightly smaller than in men. The incidence among women in Western Asia, Central and Eastern Europe, on the other hand, is several times lower than among men. In Ukraine, the incidence of lung cancer among women is about 5 times lower than the incidence among men. The incidence rate in Ukraine in 2020 corresponded to the indicators of Eastern Europe (29.5 versus 30.3 per 100 000 population, respectively). There is no significant downward trend in morbidity over the past 10 years. Conclusions. The incidence rate of lung cancer among residents of the Sumy region for the period from 2011 to 2020 significantly exceeded the average Ukrainian indicators. The situation in Ukraine was fully consistent with the data presented in GLOBOCAN for the countries of Eastern Europe. The countries of this region, along with North America, East Asia and Western Europe, occupied the leading positions in the incidence rate of lung cancer among both men and women. Country with the highest prevalence of malignant lung tumors among men is Turkey, while among women is Hungary. The downward trend in the incidence rate was observed only in high-income countries. For developing countries where smoking is still gaining, the peak of the incidence rate has not been reached yet. Ukraine also belongs to such countries.

Introduction. In 2022, 155,239 new cases of cancer and 84,153 deaths were registered in Ukraine. Among them, lung cancer was diagnosed in 18% of men and 1.4% of women. The study aimed to estimate the incidence of lung cancer in Ukraine and the Sumy region from 2014 to 2023 and to compare it with the indicators of the United States and China. Materials and methods. Data from the National Cancer Registry of Ukraine and the Global Cancer Observatory were used to investigate the incidence of lung cancer in Ukraine and worldwide. Statistical analysis was performed in the Stata V.18.0 software environment. Results. In Ukraine, men are 6.3 times more likely to have lung cancer than women. From 2014 to 2019, the incidence in men remained at a stable level. From 2020 to 2023, a rapid decline in morbidity is observed. Compared to 2019, in 2023, the number of incidents in men in Ukraine decreased by 1.5 times, and in the Sumy region, it decreased by 1.7 times. Lung cancer incidence rates among women in Ukraine from 2014 to 2019 were stable. In Sumy region, there was a trend towards an increase in morbidity. Thus, in 2014, compared to 2019, the number of registered cases increased by 41.2%. However, from 2020 to 2023, the morbidity began to decline sharply. Compared to 2019, in 2023, the incidence of lung cancer among women in Ukraine decreased by 1.4 times and in the Sumy region – by 1.9 times. At the time of diagnosis, 38.5±5.07% of patients in Ukraine and 24.2±2.92% in the Sumy region were diagnosed in advanced stages. The highest incidence without a tendency to decrease or increase is observed among Chinese men (an average of 49.2 per 100,000 population). The incidence is lower among men in the USA and Ukraine (an average of 38.2 and 33.7 per 100,000 population, respectively). Among Ukrainian women, the incidence is 5.7 times and 4.2 times lower than in the USA and China. Conclusions. During the period from 2014 to 2019 in Ukraine, the incidence of lung cancer among men and women was at a stable level. From 2020 to 2023, a decrease in morbidity is observed. In Ukraine and Sumy region, the proportion of newly diagnosed patients with stage IV has increased. Compared to the USA and China, the incidence of lung cancer among men and women in Ukraine is lower.

Tumor-associated macrophages play an essential role in carcinogenesis and metastasis. Our study aimed to evaluate the distribution of M1 and M2 macrophages in tumor islets and stroma and establish the impact on recurrence-free survival and overall survival in patients with surgically resected non-small cell lung cancer (NSCLC). 42 surgically treated NSCLC patients were recruited from the Sumy Regional Clinical Oncology Center. The inclusion criteria were age over 18, stages IA–IIIB of NSCLC, and absence of severe cardiovascular, pulmonary, or autoimmune diseases. Antibodies against CD68+ and CD163+ were used to determine the macrophage phenotype and their distribution in tumor islets and stroma. For each sample, six fields of view with a diameter of 1 mm were analyzed, focusing on the “hot spots” in the tumor stroma and islets. The average values method determined the cut-off value for macrophages M1 and M2. The cut-off values for total macrophages M1 was 28 cells/mm2, macrophages М1 in tumor islets – 18 cells/mm2, macrophages М1 in the stroma – 11 cells/mm2, total macrophages М2 – 38 cells/mm2, macrophages М2 in tumor islets – 13 cells/mm2, macrophages М2 in the stroma – 24 cells/mm2. All data about the clinicopathological characteristics of patients were collected from the medical records. The long-term follow-up period continued for at least 60 months. The difference between the studied groups was assessed using the Student's t-test and the Mann-Witney test. The Cox proportional hazards model was used to assess the impact of several clinicopathological characteristics on patient survival. Most M1 and M2 macrophages accumulated in the stroma (p<0.001). The total number of M1 macrophages was higher in men than women (p=0.0082). Pro-inflammatory macrophages were more prevalent in men than women in both the tumor islets (p=0.0192) and stroma (p=0.0226). Patients with the T1a–2a category had more total M1 macrophages than those with the T2b-4 category (p=0.0486). The tumor stroma also observed this trend (p=0.0205). Current and former smokers had a significantly higher number of M1 macrophages in tumor islets (p=0.0485). In squamous cell carcinomas, the total number of M2 macrophages was higher than in adenocarcinomas (p=0.0343), especially in the tumor stroma (p=0.0006). In conclusion, high M1 macrophage infiltration of tumor islets is associated with better recurrence-free survival. A low total number of M2 macrophages and their low expression in the stroma are associated with better overall survival in surgically treated NSCLC patients.