Background. The decade-long use of checkpoint inhibitors in real-world clinical practice in Russia allowed to treat hundreds of patients with urothelial malignancies. The AURORA-RU Phase IV observational Russian study was initiated to evaluate the efficacy of atezolizumab in patients with urothelial carcinoma resistant to platinum-based chemotherapy. This article is based on an analysis conducted at a median follow-up of 60.7 months and provides data on treatment efficacy in Russian patients receiving second-line and subsequent lines of systemic therapy. Aim. To evaluate the clinical efficacy of atezolizumab monotherapy in patients with urothelial carcinoma of the upper and lower urinary tract progressing on platinum-based chemotherapy in a real-world clinical setting. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Secondary endpoints included subgroup analyses of efficacy based on the line of therapy (including the subgroup with early progression after neo/adjuvant chemotherapy [NACT/ACT]), age cohort, metastatic sites, and primary tumor location (bladder vs. upper urinary tract). Materials and methods. The study included data from 152 patients with verified muscle-invasive locally advanced and metastatic urothelial carcinoma who received PD-L1 inhibitor (atezolizumab) monotherapy across 13 centers in the Russian Federation between 2019 and 2025. Atezolizumab treatment was administered to patients who progressed on platinum-based chemotherapy. More than half of the patients (55.9 %) were over 65 years of age. The cohort consisted of 75.0 % men and 25.0 % women. The majority of patients (78.3 %) had a primary tumor located in the bladder. PD-L1 inhibitor therapy was administered as second-line treatment in 57.9 % of cases, while one in five patients (21.7 %) received third-line treatment. In 86.8 % of cases, treatment was administered without prior assessment of PD-L1 expression levels. Results. In the overall cohort, the median PFS reached 5.5 months, with 36-month and 48-month PFS rates of 15.9 % and 9.9 %, respectively. The median OS was 12.0 months; 21.9 % of patients survived 3 years, and 14.3 % of patients remained under observation for five years. In patients transitioning to immuno-oncology treatment after rapid progression following NACT/ACT, the median OS was 17.4 months. The median OS for second-line therapy was two-fold higher than for third-line therapy: 13.9 months versus 6.1 months. High treatment efficacy was noted in patients over 70 years of age (median PFS of 8.7 months; median OS of 14.9 months). Conclusion. In real-world practice, PFS and OS rates were comparable to those reported in registration trials and other real-world evidence studies. The lack of PD-L1 expression testing generally did not affect the efficacy of immuno-oncology therapy in patients with urothelial carcinoma.

Background. External beam radiation therapy (eBRt) is one of the primary treatment modalities for patients with prostate cancer. Despite advancements in radiotherapy technology and planning, significant challenges in managing radiation-induced reactions remain. In this regard, the search and development of new drugs to mitigate side effects from radiotherapy is a critical research area. The purpose of the study was to evaluate the effect of synbiotics (VedaBiotic, Phytolysate Gastro, Phytolysate and urological) on the development of radiation-induced bladder and bowel reactions, as well as to study the state of gut microbiota during eBRt in prostate cancer patients. Material and Methods. The study included 15 patients diagnosed with stage t3–4n0M0 prostate cancer (adenocarcinoma) receiving eBRt at Radiotherapy Department of novosibirsk Regional Clinical Oncology Center. From november 2024 to December 2024, patients received 3D conformal radiation therapy delivered to the prostate, seminal vesicles, and pelvic lymph nodes at single doses of 2.5/2.5/1.8 Gy to total doses of 80/80/50 Gy in 28 fractions, respectively. Patients used synbiotics as the dietary supplement during radiation therapy in accordance with the instructions on the label. all patients underwent maximum androgen blockade including chemical castration with lHRH agonists. Results. A survey of patients showed reduction in nocturia to 2–3 episodes per night. there was also a decrease in urination discomfort and the absence of symptoms of flatulence. PCR analysis detected an increase in beneficial bacteria, namely lactobacillus and Bifidobacterium species (lacto-bifidobacteria), and Faecalibacterium prausnitzii, indicating a restoration of a healthy balance in the intestinal microflora. Conclusion. the results obtained show that the inclusion of synbiotics (VedaBiotic, Phytolysate Gastro, Phytolysate and urological) in the diet can reduce dysuric symptoms, flatulence, and help restore intestinal microflora balance in patients receiving eBRt to the prostate, seminal vesicles, and pelvic lymph nodes.

Objectives: The aim of this study is to demonstrate the efficacy of the modified technique of radical organ-preserving surgery of invasive cervical cancer (CC) in patients of reproductive age. Methods: This study included 118 patients of reproductive age (34.9 ± 4.8 years) with a morphologically verified diagnosis of invasive CC (T1a-1bNxM0). All patients underwent organ-preserving surgery in the scope of radical trachelectomy. A shape memory mesh implant woven in the form of a stocking from superelastic nickelide titanium thread with subsequent fixation with separate sutures around the perimeter was used to form the uterine closure apparatus and to strengthen the utero-vaginal anastomosis. The mesh implant was made of superelastic thin nickelide titanium threads with a diameter of 60–40 microns on a metal knitting machine. All patients were prospectively followed up for a mean of 120 months. Results: No intraoperative or postoperative complications were revealed when using a shape memory implant made of titanium nickelide during radical trachelectomy to form a locking apparatus and strengthen the anastomosis zone. No cervical stenoses or mesh failures were noted in any case. The 5-year overall and recurrence-free survival rates were 100% and 98%, respectively. Two patients indicated recurrence; it occurred in 3 and 36 months. There were 42 spontaneous pregnancies, and 29 resulted in full-term delivery, whereas 2 and 11 ended in miscarriage and early abortion, respectively. Currently, 18 patients are at different stages of the use of assisted reproductive technologies. Conclusions: The shape memory implant made of titanium nickelide integrates well into the surrounding tissues and successfully imitates the effect of the cervix. The use of this sparing-surgery technique has shown reasonably good results in carrying the pregnancy to term and good reproductive outcomes.

Background. The article presents an overview of literature data on integrative treatment of prostate cancer using local hyperthermia.Aim. To analyze modern Russian and foreign studies on the use of local hyperthermia in integrative treatment of prostate cancer and its long-term treatment results.Materials and methods. The search for relevant sources was performed using the PubMed, eLIBRARY databases (publications from 2008 to 2023 were included) with key words “prostate cancer”, “local hyperthermia”, “radiation therapy”. For analysis of radiobiological aspects, sources published since 2004 were considered.Results. A review of the literature data shows that of all the methods related to physical modifications through radiation, local hyperthermia is considered to be the most promising. Analysis of randomized studies on the use of local hyperthermia in integrative treatment of prostate cancer published by foreign and Russian researchers showed immediate and long-term results demonstrating the positive effect of thermoradiotherapy.Conclusion. The combination of local hyperthermia and radiation therapy seems to be an innovative strategy to improve tumor control and increase the effectiveness of treatment. However, there are currently no data on the use of thermoradiotherapy using new irradiation techniques, such as intensity-modulated radiation therapy (IMRT), volumetric modulated radiation therapy (VMAT) which utilize modern linear accelerators. There is also no consensus on the use of thermoradiomodification in relation to the amount of exposure to the prostate, and therefore further research is required.

Acral melanoma is a rare form of skin melanoma. Subungual melanoma is the most common variant with poor prognosis and difficult diagnosis at the early stages. Surgical treatment of subungual melanoma remains a matter of debate. Standard surgical options include amputation or disarticulation of phalanges proximal to tumor growth. At the same time, some reports show the advantage of function-sparing surgery for melanoma in situ without impairment of surgical quality. We present function-sparing surgery for subungual melanoma in situ.

Aim : to summarize the available literature data on the role of matrix metalloproteinases (MMPs) in angiogenesis, as well as in the development and progression of colorectal cancer (CRC). Material and Methods . A literature search was conducted in the Medline and eliBRARY.RU databases from 1999 to the present using the keywords “angiogenesis + cancer + colon + MMP”. Results. Malignant tumors are characterized by the ability to form new vessels, invade surrounding tissues, and metastasize to distant organs, and this aggressiveness depends on the expression of proteolytic enzymes, including MMPs. in CRC, the levels of MMPs are increased in both tumor tissues and blood plasma; these enzymes are required for extracellular matrix remodelling during angiogenesis, tumor invasion and metastasis. The degree of overexpression of certain MMPs correlates with the stage of CRC, vascularization, VEGF expression and/or prognosis; however, not all researchers agree with these findings. MMPs are synthesized both by tumor cells and, more prominently, stromal cells like tumor-associated macrophages. Alterations in the function of immunocompetent and stromal cells that express and produce MMPs play a key role in both the initiation and progression of CRC. Targeting tumor-associated immunocompetent and stromal cells, their reprogramming, neutralization and/or inhibition of their trafficking may delay the growth and invasion of CRC. inhibition of MMPs may represent one of the stages of antiangiogenic therapy. in addition to suppressing angiogenesis, certain MMP inhibitors stimulate apoptosis, suppress cell proliferation, induce cell cycle arrest, and reduce the expression of antiapoptotic genes of the Bcl family. A wide range of artificial and natural compounds and methods has been proposed as MMP inhibitors. However, despite promising experimental results, clinical trials of MMP inhibitors have been largely disappointing. There is evidence that some MMPs exert antitumor effects, and their blockade may be accompanied by tumor progression. Conclusion . A wide variety of approaches to targeting MMPs, together with the certain inconsistency of available data, may indicate the persisting dissatisfaction of researchers and clinicians with the current solutions to the problem of MMP-mediated angiogenesis in tumor tissues. This also highlights the need for continued investigation into both the effects of MMPs in CRC and the methods for controlling the activity of this enzyme group.