Peer-rewieved medical journal for Cancer Urology
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Analysis of survival rates and evaluation of prognostic factors in patients with bone metastases of renal cancer
Background. In patients with bone metastases of renal cell cancer (RCC), the search for new prognostic factors affecting survival rates is necessary. Aim. To analyze survival rates and identify prognostic factors in patients with RCC metastases in the bones. Materials and methods. A retrospective analysis of data of 350 patients with bone metastases of RCC treated at the Moscow City Oncologic Hospital No. 62 and the City Clinical Oncologic Dispensary (Saint Petersburg) from 2006 to 2022 was performed. 117 (33.4 %) patients were classified into the group of intermediate prognosis, 169 (48.3 %) – into the group of poor prognosis. The study investigated clinical and morphologic prognostic factors affecting survival rates in patients with bone metastases of RCC. Statistical analysis was performed using Statistica 10.0 software packages (StatSoft, USA) through construction of Kaplan–Meier curves and survival tables, development of a mathematical model of survival. Results and conclusion. 3-year, 5-year overall survival (OS) of patients with RCC bone metastases was 38 % (95 % confidence interval (CI) 33–44) and 23 % (95 % CI 18–28), respectively, with a median OS of 28.3 months (95 % CI 23.6–32.9) (p <0.001). In single factor analysis, ECOG (Eastern Cooperative Oncology Group) status (p <0.001), Fuhrman tumor differentiation grade (p <0.001), type and number of metastases (p <0.001), metastases to the lung (p = 0.027), liver (p = 0.013) and lymph nodes (p <0.001), IMDC (International Metastatic RCC Database Consortium) prognosis (p <0.001), radiation therapy (p = 0.003) and nephrectomy (p <0.001) affected OS in patients with bone metastases of RCC. In multivariate analysis, ECOG status, Fuhrman tumor differentiation degree, type and number of metastases, radiotherapy and nephrectomy were additional factors affecting OS in patients with RCC bone metastases (p <0.001).
Efficacy of avelumab and axitinib depending on disease burden in patients with metastatic renal cell carcinoma: a subgroup analysis of the RAVE-Renal trial
Background. Immunotherapies and targeted therapies have demonstrated significant efficacy in prospective randomized trials establishing them as the standard of care for patients with metastatic renal cell carcinoma. This analysis, part of the RAVE-Renal real-world study, aimed to evaluate the effectiveness of avelumab plus axitinib based on disease burden and the presence of liver and bone metastases. Materials and methods. The RAVE-Renal trial was a multicenter, ambispective study that included treatment-naïve patients with histologically confirmed metastatic renal cell carcinoma and measurable lesions. Patients were treated with avelumab (800 mg every two weeks) and axitinib (5 mg twice daily). Primary endpoints were median progressionfree survival (PFS) and objective response rate (ORR). Secondary endpoints included median overall survival, 1-year overall survival, and safety. Subgroup analyses evaluated median PFS and ORR in patients with ³2 organ metastases, bone metastases, and liver metastases. Results. A total of 125 patients from 13 centers were enrolled, with median follow-up of 16.1 months and median age of 61 years. Based on IMDC (International Metastatic RCC Database Consortium) risk categories, 35.3 % had favorable, 49 % had intermediate, and 15.7 % had poor prognosis. The overall population demonstrated median PFS of 14.9 months and ORR of 44.3 %. Among patients with ³2 organ metastases, median PFS was 13.0 months, and ORR was 36.7 % (all p >0.05). In those with bone metastases, median PFS was 6.5 months (p = 0.160), and ORR was 23.5 % (p = 0.0148). For patients with liver metastases, median PFS was 17.6 months, and ORR was 45.5 % (all p >0.05). Conclusion. The combination of avelumab and axitinib demonstrated consistent efficacy in patients with advanced disease including those with liver and bone metastases. These findings suggest the regimen’s broad applicability and suitability in real-world clinical practice.
Assessment of kidney injury during immune-targeted therapy (pembrolizumab + axitinib) in patients with metastatic renal cell carcinoma and solitary kidney
Aim. To assess the rate and type of kidney injury in the first 28 weeks of pembrolizumab and axitinib therapy after nephrectomy in patients with metastatic renal cell carcinoma and solitary kidney. Materials and methods. The retrospective study included 50 patients who previously underwent nephrectomy due to stage III–IV stage renal cell carcinoma. After nephrectomy prior to the start of antitumor therapy for cancer progression, 84 % of the patients were diagnosed with stage II and higher chronic kidney disease. Results. During antitumor drug treatment, acute kidney injury 14 and 28 weeks after the start of immune-targeted therapy was diagnosed in 4 % and 6 % of patients, respectively. Dynamics of the change in acute kidney injury in 28 weeks were not statistically significant (p = 0.983). Changes in serum creatinine, urea, and glomerular filtration rate were also insignificant. Statistically significant elevation of hemoglobin and hematocrit was observed during the 28 weeks of observation. Hemoglobin level increased from 128.1 g/L before the treatment to its maximal value of 141.7 g/L after the third injection of pembrolizumab (p <0.001). Conclusion. No significant kidney injury was observed during 28 weeks of observation in this single cohort study of patients with metastatic renal cell carcinoma after nephrectomy receiving pembrolizumab and axitinib.
Real-world outcomes of lenvatinib plus pembrolizumab in intermediateand poor-risk metastatic renal cell carcinoma
Background. The combination of lenvatinib and pembrolizumab demonstrated significant efficacy in the phase 3 CLEAR study for metastatic renal cell carcinoma (RCC). However, poor-risk patients represented only a small proportion of the trial population. Aim. This multicenter retrospective cohort study assessed the real-world efficacy and safety of lenvatinib plus pembrolizumab in patients with clear-cell metastatic RCC and intermediate or poor International Metastatic RCC Database Consortium risk. Materials and methods. Outcomes included objective response rate, progression-free survival, overall survival, and safety. Sixty patients were analyzed, with a median age of 56 years. Poor risk was identified in 53 % of patients, and 90 % had metastases to ≥2 organs. Results. Objective response rate was 48.33 %, disease control rate was 86.7 %, and median progression-free survival was 19.0 months. Grade ≥3 adverse events occurred in 25 % of patients, with 33.3 % requiring lenvatinib dose reductions. Conclusion. Lenvatinib plus pembrolizumab demonstrated robust efficacy and a manageable safety profile in a real-world population with advanced disease and poor-risk features, consistent with outcomes reported in clinical trials.
Type 2 diabetes mellitus and non-muscle invasive bladder cancer: characteristics of the epidermal growth factor system components content in blood, urine, and tumor
Background. The incidence of bladder cancer (BC) and type 2 diabetes mellitus (T2DM) are rising consistently worldwide. It is not uncommon for these two pathologies to be found in combination. T2DM is a contributing factor in many cancer types. It is currently understood that the development of non-muscle invasive BC (NMIBC) occurs primarily through the activation of oncogenes that involve the epidermal growth factor (EGF) system. However, the effect of T2DM on the EGF system in the context of NMIBC remains unclear. Aim. To investigate the specific content of the EGF system components in the blood, urine, and tumor tissue of patients with NMIBC with concomitant T2DM. Materials and methods. The participants were divided into the main group – patients with NMIBC and T2DM (n = 11), and the control group – patients with NMIBC without T2DM (n = 11). The comparison group comprised of patients with T2DM only (n = 8). All parameters were evaluated in comparison to those of healthy donors (n = 12). The levels of EGF (Ray Bio, Germany) and its soluble receptor (sEGFR) (RAD Systems, USA) were quantified in blood, urine and 10 % tumor tissue homogenates using standard EIA kits on an automatic analyzer, the Infinite F50 (Tecan Austria GmbH, Austria). Results. In 80 % of control group patients, blood EGF levels increased 2.8-fold compared to donors, while in 20 % they remained unchanged. Blood EGF content in patients with comorbid pathology and the comparison group (T2DM only) was comparable and at the same time 2.1–2.7 times lower than in most patients from the control group. In all BC patients, blood sEGFR concentration was 1.4 times lower than in donors and T2DM patients, but increased in urine: 2.9-fold in BC patients without T2DM and 3.5-fold in BC patients with T2DM. Patients with NMIBC and T2DM had 1.5 times less EGF and 2.0 times less sEGFR than NMIBC patients without T2DM. Conclusion. The patients with NMIBC and T2DM were deficient in EGF (in blood, urine, and tumor tissue) and sEGFR (in blood and tumor tissue), compared to the patients with NMIBC without T2DM who demonstrated increased levels of EGF (in blood, urine, and tumor tissue). The development of NMIBC was associated with an increase in urinary sEGFR concentrations, irrespective of T2DM status.
Surgical risks in radical cystectomy: experience of a specialized center
Background. Radical cystectomy is the standard treatment for muscle invasive bladder cancer. However, it is associated with a high risk of complications and mortality. Key strategies to reduce these risks include implementation of minimally invasive treatment methods and the Enhanced Recovery After Surgery (ERAS) protocol, as well as identification of factors associated with development of complications. Aim. To analyze 30-day postoperative complications and mortality rates following radical cystectomy taking into account the effect of the ERAS protocol on treatment outcomes. Materials and methods. This retrospective single-center cohort study included surgical treatment outcomes of 455 patients with a confirmed diagnosis of bladder cancer (cTis–4N0–3) who underwent radical cystectomy via either open or laparoscopic approaches. Of these, 344 patients (75.6 %) underwent perioperative rehabilitation following the ERAS principles. The severity of complications was assessed using the Clavien classification as modified by the European Association of Urology. The study protocol was approved by the Biomedical Ethics Committee (No. 32/355 from 23.12.2020). Results. Surgeries in the ERAS group were more frequently performed using minimally invasive techniques (98.5 % vs. 62.2 %; p <0.001), with reduced blood loss and shorter operative times, and were more often accompanied by standard and extended lymphadenectomy (p <0.001). In the ERAS group, ileocecal angle mobilization was performed in 49.4 % of cases, significantly reducing the risk of mechanical and dynamic bowel obstruction by factor of 2.68 (p = 0.006). Median in-hospital time was 9 days shorter in the ERAS group (p <0.001), and overall complication rate was 40.7 % compared to 56.8 % in the standard care group (p = 0.003). Mortality rates did not differ between the groups (1.8 % vs. 2.3 %; p = 1.0). Conclusion. The implementation of the ERAS protocol and minimally invasive techniques in radical cystectomy significantly reduces postoperative complication rates, including the risk of bowel obstruction, shortens hospital stays, and improves overall treatment outcomes.
Perioperative results and quality of life for various methods of urinary diversion after robot-assisted cystectomy
Background. Bladder cancer is one of the leading causes of mortality and morbidity among urologic malignancies. Radical cystectomy remains the “gold standard” of treatment of muscle-invasive and refractory non-muscle invasive forms of the disease. In recent years, robot-assisted radical cystectomy (RARC) has been increasingly adopted as a minimally invasive alternative, offering reduced blood loss and faster recovery times. However, the optimal method of urinary diversion remains a topic of debate. Aim. To compare perioperative outcomes and quality of life indicators in patients who underwent RARC followed by Bricker ileal conduit or Studer neobladder urinary diversion. Materials and methods. A retrospective cohort study was conducted involving 83 patients diagnosed with muscle-invasive bladder cancer who underwent RARC with Bricker ileal conduit (66 patients) or Studer neobladder (17 patients) urinary diversion at the Urology Department of the A.S. Loginov Moscow Clinical Research Center from January 2018 to October 2023. Perioperative indicators included operative time, blood loss volume, and length of stay. Complications were classified using the Clavien–Dindo system, and quality of life was assessed with the European Organization for Research and Treatment of Cancer (EORTC QLQ-BLM30) questionnaire at 6 and 12 months post-surgery. Results. Operative time was longer in the Studer neobladder group (466.18 ± 74.64 minutes) than in the Bricker ileal conduit group (364.92 ± 48.85 minutes; p <0.001). Blood loss volume was also higher in the Studer group (294.12 ± 77.51 mL versus 218.94 ± 105.67 mL; p = 0.002). The rate and severity of complications did not differ between groups (p = 0.78). Six months postoperatively, patients with orthotopic neobladders (Studer) reported higher quality of life scores (p <0.001), but by 12 months, the differences between the groups were no longer significant. Conclusion. RARC with Studer neobladder is associated with longer operative time. Although the difference in blood loss was statistically significant, this difference in the volume of lost blood has no clinical significance. Complication rates do not differ. Patients with Studer neobladders demonstrated higher quality of life at 6 months post-surgery; however, these differences are no longer apparent at 12 months.
Determining the frequency of discrepancies in ISUP values for prostate cancer after standard biopsy and radical prostatectomy: multicenter study
Background. Despite the availability of more reliable methods for prostate biopsy, standard transrectal ultrasound-guided systematic biopsy remains widely used in the Russian Federation. However, there is a lack of multicenter studies assessing the frequency of discrepancies between pathology results obtained through radical prostatectomy (RP) and systematic biopsy. Aim. To determine the frequency of changes in the ISUP (International Society of Urological Pathology) group after RP in patients who underwent systematic biopsy for suspected prostate cancer in the Russian Federation male population. Materials and methods. Data from 603 patients who underwent RP in 6 medical institutions were collected, including 539 patients who underwent systematic biopsy. Pathological conclusions were standardized according to the ISUP grading. The frequencies of false positive and false negative results, as well as overand underdiagnosis, were analyzed. Results. Agreement between systematic biopsy and postoperative conclusions was observed in 54.3 % of cases. The overall frequency of lowering the ISUP group was 13.1 %. False positive results were observed in 1 (0.2 %) case. Overdiagnosis of patients with clinically insignificant prostate cancer was 2.4 %, with a decrease in ISUP group from 2 and 3 to 1 in 2.2 % and 0.2 % of cases, respectively. Conversely, ISUP value upgrading was reported in 32.6 % of cases. False negative biopsy results were observed in 5 (0.9 %) cases. Underdiagnosis of patients with clinically significant forms was observed in 18.7 % of cases, with ISUP 1 initially determined after biopsy seen in 82 (15.2 %), 15 (3 %), 2 (0.4 %), and 2 (0.4 %) patients with a verified post-RP malignancy grade of ISUP 2, 3, 4, and 5, respectively. Conclusion. The high frequency of ISUP value deviations after RP compared to systematic biopsy is a serious problem necessitating the optimization of prostate cancer diagnosis and transition to more modern biopsy methods in the Russian Federation.
Background. Prostate cancer is the most common malignant disease in men. Obtaining high quality and diagnostically accurate tissue samples is paramount to the success of prostate cancer research. Collecting unfixed tissues from radical prostatectomy specimens for research purposes is challenging. Prostate cancer often cannot be detected on gross examination, and this tumor is known to be multifocal and heterogeneous making it of interest for interdisciplinary research. Aim. To develop a protocol that will improve the accuracy and quantity of biobanked primary prostate cancer tissue. Materials and methods. The removed unfixed prostate gland was dissected with a blade into two halves along the ureter, the tumor lesion was identified macroscopically, two sections were made: the first was separated into fragments and transferred into cryotubes and transport media for biobanking storage; the second was filled with gel, and frozen sectioning and histological verification of the tumor were performed. Results. Tumor was detected in frozen sections in 78.95 % (30/38) of cases. The mean time from organ removal from the abdominal cavity to macroscopic evaluation was 8–10 minutes, and the total time for histological verification was 30 minutes. The quality control performed on the biobanked material confirms that the developed protocol guarantees that both tumors and normal tissues are represented for further studies. Conclusion. This paper outlines a method for biobanking fresh prostate tissue removed during radical prostatectomy. The advantage of the method is the use of tissue samples both for diagnosis and for further study at the cellular and molecular levels.
Role of darolutamide in intensification of treatment of patients with hormone-sensitive prostate cancer: who needs the triplet combination?
The article presents a review of the results of the ARASENS registration study of darolutamide in combination with androgen-deprivation therapy (ADT) and docetaxel. This is the only triplet registered in Russia for treatment of metastatic hormone-sensitive prostate cancer. Darolutamide-based triplet showed significant benefits in overall survival and progression-free survival compared to hormone and chemotherapy combination in randomized phase III trial ARASENS, as well as better progression-free survival compared to ADT and androgen signal inhibitor duplets in meta-analyses of phase III randomized trials. Patients with de novo metastatic hormone-sensitive prostate cancer and high metastatic load receive the highest clinical benefit from darolutamide in combination with ADT and docetaxel. Darolutamide-based triplet demonstrated good safety profile comparable to duplet combination of ADT and docetaxel.
HRR gene mutations and characteristics of the tumor microenvironment as predictors of response to olaparib therapy in metastatic castration-resistant prostate cancer
Aim. To identify clinical, molecular, genetic, and immunological predictors of response to PARP inhibitor olaparib therapy in patients with metastatic castration-resistant prostate cancer (mCRPC) harboring germline and somatic mutations in homologous recombination repair (HRR) genes. Materials and methods. A prospective analysis was conducted on data from 39 patients with mCRPC and HRR gene mutations (BRCA1/2, ATM, CHEK2, CDK12, among others) receiving оlaparib therapy after prior treatment with androgen receptor signaling inhibitors. Diagnoses were histologically verified according to the current WHO classification (5th edition). Genetic status was determined by next-generation sequencing (NGS). The tumor immune microenvironment was evaluated by immunohistochemical analysis assessing expression of CD4, CD8, CD68, CD163 markers and tumor-infiltrating lymphocyte (TILs) levels. Statistical analysis involved Cox proportional-hazards regression and Kaplan–Meier survival analysis. Results. The BRCA2 mutation was the most frequently detected alteration (61 %), correlating with increased expression of CD163 and decreased CD68 expression. The most significant clinical predictors associated with improved progressionfree survival during оlaparib therapy included BRCA2 mutation positivity, patient age under 64 years, initially metastatic disease presentation, and ≥90 % reduction in prostate-specific antigen levels at 3 months post-treatment initiation. Immunological markers indicative of favorable therapeutic response included elevated levels of M2-polarized macrophages (CD163 ≥30 %) and a high CD163/CD68 ratio (≥2.83). Conversely, robust prior response to еnzalutamide therapy and administration of docetaxel during hormone-sensitive stages significantly worsened the prognosis for olaparib efficacy. Conclusion. Olaparib therapy is effective in patients with HRRm mCRPC, with particularly effectiveness in BRCA2m tumors. Clinical (age, disease dissemination pattern, prostate-specific antigen dynamics), immunological (CD163 expression and CD163/CD68 ratio), and molecular and genetic tumor characteristics should be considered when selecting patients for olaparib treatment, enhancing personalized therapeutic strategies in mCRPC management.
Search for new microRNAs for differential diagnosis of teratomas
Aim. Search for new microRNAs as markers for differential diagnosis of teratoma and live tumor tissues. Materials and methods. In the study, freshly frozen tissue samples obtained after orchifuniculectomy (n = 46) and retroperitoneal lymph node dissection (n = 42) in patients with TGCT diagnosis were analyzed. MicroRNAs were isolated from tissue samples and analyzed using reverse transcription polymerase chain reaction. Results. After studying the Cancer Genome Atlas, microRNA-196a-5p and microRNA-200b-3p with differential expression in tissue samples of different histological types of TGCT were identified. These microRNA are significantly overexpressed in non-seminomas, and their expression levels significantly differ from expression levels in normal tissues and seminomas. The level of microRNA-196b-5p expression in teratomas obtained after retroperitoneal lymph node dissection is significantly higher than in seminomas, and microRNA-200b-3p expression level is significantly higher than in tissues with necrotic changes. ROC analysis has shown 89 % sensitivity and 79 % specificity for microRNA-196b-5p as a diagnostic marker. For microRNA-200b-3p, sensitivity and specificity were 75 and 89 %, respectively. Conclusion. In this study, we have shown for the first time that microRNA-196a-5p and microRNA-200b-3p have high diagnostic potential as markers for identification of various types of TGCTs including teratoma.
Multidisciplinary approach in treatment of a patient with locally advanced renal cancer and critical coronary artery disease: clinical case
Today, the tactics of treating tumor diseases of the urinary tract with concomitant pathology of the cardiovascular system are the subject of active discussion in the scientific community. There is a small number of published clinical cases, and only small retrospective monocentric series. The goal of this clinical case presentation is to help to establish the correct sequence of treatment steps and determine the priority of each medical intervention in this difficult cohort of patients. The article presents the result of successful radical nephrectomy in a patient with papillary renal cell carcinoma pT3aN0M0 one month after coronary artery bypass grafting for multivessel coronary artery disease.
IInverted urothelial papilloma of the bladder with concomitant benign prostate hyperplasia and bladder stones: case report
Inverted urothelial papilloma is a rare non-invasive endophytic urothelial tumor of the bladder accounting for less than 1 % of urothelial neoplasms. Analysis of the available scientific papers shows that a more in-depth study of this nosology is necessary. An analysis of available articles in the PubMed, Scopus, Web of Science databases published between 1997 and 2018 on the topic was performed. The article presents a clinical observation to improve the treatment tactics of patients with inverted urothelial papilloma of the bladder. Based on the examination results, the patient underwent surgical interventions: transurethral laser cystolithotripsy, resection of the bladder lesion and prostatic hyperplasia. Inverted urothelial papilloma of the bladder, although a rare disease, is still periodically encountered in the practice of a urologist and requires further study and observation of the patient with this pathology.
Ewing sarcoma: Clinical case and literature review
This article presents a clinical case of treatment of a female patient with Ewing Sarcoma of the kidney. Currently, treatment standards haven’t yet been developed due to the rarity of this pathology. We describe our own experience of drug treatment of Ewing sarcoma of the kidney recurrence after surgery.
Combination of lenvatinib and pembrolizumab in treatment of patients with metastatic renal cell carcinoma and factors of poor prognosis
Renal cell carcinoma (RCC) are among the most frequently diagnosed types of cancer in the world. Despite improvements in diagnostics in the recent years, every third patient with RCC is still diagnosed at the metastatic stage, which explains high mortality rates with this pathology. RCC is a heterogeneous disease. At the stage of metastatic process, factors including presence and site of metastases, prior nephrectomy before systemic therapy, and sarcomatoid differentiation based on the pathomorphological study are most important in determining treatment tactics. In the era of cytokine therapy, patients with metastases were treated with cytoreductive nephrectomy as a first step, as demonstrated in the SWOG and EORTC trials. Currently, the National Comprehensive Cancer Network (NCCN) Guidelines, European Society for Medical Oncology (ESMO) Guidelines, and American Urological Association (AUA) Guidelines suggest a more selective approach to cytoreductive nephrectomy in patients with metastatic RCC and selection of patients for surgery according to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) criteria. And for poor prognosis group, preference should be given primarily to dual immune or immune-targeted systemic therapy. Surgical intervention is reserved for patients with not more than 3 factors, with “low metastatic load”, and good performance status. This publication describes a clinical case of successful treatment of a 58-year-old patient with metastatic RCC (T3bN1M1) and poor prognosis according to the IMDC criteria. The patient had no prior history of nephrectomy and presented with a venous tumor thrombus of the right renal vein and the inferior vena cava up to the level of the caval porta, along with metastases to the liver and the 10th thoracic vertebra. The combination of lenvatinib and pembrolizumab was selected as first-line therapy and administered from February 2023 to March 2025 (25 months of treatment). After 3 months of lenvatinib plus pembrolizumab treatment, the tumor thrombus showed reduction (began to be washed by blood), and disease regression was reported in the form of a 60 % reduction in target lesions per the RECIST 1.1 (Response Evaluation Criteria in Solid Tumors) criteria. Most notably, the liver metastasis demonstrated a remarkable decrease from 7 cm to 2 cm (>78 % reduction), which was achieved with the therapy conducted. The tumor of the right kidney exhibited a >50 % size reduction (from 10 cm to 5 cm), accompanied by decreased contrast enhancement in the aortic phase on imaging.
Efficacy of cabozantinib in the 1st line therapy of progressing multiple primary metachronous renal cell carcinomas: clinical observation
In 2023 in Russia, renal cell carcinoma (RCC) was the 7th most common cancer among men and the 12th among women. According to the data of the national cancer register, in approximately 18 % of patients, RCC is diagnosed at a late stage and with distant metastases. Another large group (between 20 and 40 %) are patients who underwent radical surgical treatment at a localized stage but whose disease progressed into metastatic stage. Frequency of bilateral tumor lesions in both kidneys is 2 to 6 % of all RCC cases. In the presented rare clinical observation of a patient with bilateral metachronous metastatic RCC, late metachronous tumor in the contralateral kidney 13 years after diagnosis of the primary tumor, different histological types of the tumors (clear cell and non-clear cell papillary RCC), efficacy of cabozantinib therapy in combination with immunotherapeutic drug nivolumab and as monotherapy is demonstrated. Objective response to treatment was achieved. The patient had intolerable immune-related toxicity – grade III adrenal gland failure – which required nivolumab cessation. Continued therapy with cabozantinib demonstrated satisfactory tolerability with controlled adverse events. Overall duration of response (disease control) to cabozantinib therapy is currently 24 months.
Expanding indications for sodium fumarate anti-hypoxia infusion solution in kidney cancer surgery: literature review
This literature review is devoted to the urgent problem of organ-saving surgery for kidney cancer: hypoxic-ischemic changes in the spared renal tissue and possibilities of their prevention through the use of the succinate-forming drug sodium fumarate 15 %.
Fumarates in the prevention of hypoxic and reperfusion kidney injury: how far is it to surgery? Review of the article “Expanding the indications of antihypoxant infusion solution of sodium fumarate in kidney cancer surgery: literature review”
Review of the effectiveness of nuclear magnetic resonance spectroscopy for prostate cancer diagnosis
Prostate cancer (PCa) is the most common malignant neoplasm among men in Russia and one of the most common worldwide. PCa diagnosis, progression management, and evaluation of prognosis are performed using a combination of examinations: laboratory, instrumental, and various nomograms. The current methods of PCa diagnosis have limited sensitivity and specificity, therefore the search for new diagnostic methods is an important problem. Nuclear magnetic resonance (NMR) spectroscopy is a promising method allowing to detect malignant tumor-associated metabolites in biological liquids. According to some studies, PCa is associated with changes in levels of various metabolites in serum and plasma. This review presents the results of studies reporting on high effectiveness of NMR spectroscopy analysis of serum and plasma for PCa diagnosis.
A modern view on thermoradiotherapy in integrative treatment of prostate cancer
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.
Therapy with a protein-peptide complex from embryonic stem cells as a method of reducing nephrotoxic effect of chemotherapy drug cisplatin
Background. One of the serious complications of chemotherapy with cisplatin is its nephrotoxic effect. Different variants of hydration therapy and thiol-containing drugs are used to prevent deterioration of renal function. However, if high doses of cisplatin are necessary, the effectiveness of therapy is limited, and the use of pharmacological agents is often accompanied by undesirable side effects, which forces the search for alternative ways of therapy. Aim. To study the effectiveness of prevention of nephrotoxic effect of cisplatin using a protein-peptide complex isolated from the pig embryonic brain (EPPC). Materials and methods. The study was conducted on 40 white mongrel male rats in 4 series. In the 1st series, rats were administered one intraperitoneal injection of cisplatin at a dose of 5 mg/kg. In the 2nd series, starting from the next day, an additional 10-day course of EPPC therapy was performed with daily intramuscular administration at a dose of 0.1 mL per rat. In the 3rd series, higher toxicity dose of cisplatin – 7 mg/kg – was used, and in the 4th series, EPPC therapy was used according to the same scheme as in the 2nd series. Severity of the toxic effect of cisplatin therapy was assessed by measuring biochemical parameters of blood and urine characterizing functional state of the kidneys on days 3, 7 and 14, and histological examination of the removed kidneys. Results. When cisplatin was administered at 5 mg/kg dose, all animals survived. In rats of the control series, concentration of creatinine and urea in the blood increased significantly with peak values on day 3, exceeding normal values by 146 % and 214 %, respectively. Glomerular filtration rate decreased by 75 %, and sodium and calcium reabsorption decreased by 72 % and 74 %, respectively. With EPPC therapy, the maximum increase in creatinine and urea concentrations was 100 % and 122 %, respectively, glomerular filtration rate decreased by only 48 %, and sodium and calcium reabsorption decreased by 60 % and 59 %, respectively. In experiments with a highly toxic dose of cisplatin in the control series, 80 % of rats died, and with EPPC therapy, the mortality rate was 50 %. The maximum increase in creatinine and urea concentrations in the control series was 1177 % and 1500 %, respectively, whereas with EPPC therapy it was 707 % and 1150 %, respectively. The decrease in glomerular filtration rate in the control series was 85 %, while with EPPC therapy it was 65 %. Sodium and calcium reabsorption in the control experiments decreased by 81 % for both cations, and in the experimental series by 57 % and 58 %, respectively. Histological examination in control experiments revealed marked glomerulosclerosis with necrotic and dystrophic changes in the renal tubules, and in experiments with 7 mg/kg dose of cisplatin massive interstitial hemorrhages were observed. Histological changes were significantly less pronounced during EPPC therapy. Conclusion. EPPC therapy significantly reduces the nephrotoxic effect of cisplatin, contributing to lower severity of impaired renal function and mortality when using the drug at high doses.
С большой радостью и чувством глубокого уважения хотим сообщить, что 28 июня 2025 г. выдающемуся онкоурологу, блестящему ученому, опытному хирургу и замечательному наставнику доктору медицинских наук, профессору Игорю Георгиевичу Русакову исполнилось 80 лет!
Поздравляем доктора медицинских наук, профессора В. Б. Матвеева с избранием в академики Российской академии наук
Поздравляем доктора медицинских наук, профессора Б. Я. Алексеева с избранием членом-корреспондентом Российской академии наук