As of now, vinflunine is the only second-line chemotherapy drug showing an advantage over the best maintenance therapy in a Phase III
randomized study treating patients with urothelial transitional cell carcinoma. Due to the advent of this drug, it was relevant to make a pharmacoeconomic analysis comparing therapy with vinflunine in combination with the best maintenance therapy and the latter only. A budget impact analysis showed that the use of the new drug required additional expenditures. The ICER reflecting the cost of one additional year of life and estimating vinflunine therapy as cost-effective was determined by the results of a cost-effectiveness analysis.

Everolimus is an orally administered inhibitor of the mammalian target of rapamycin (mTOR) recommended for patients with metastatic renal cell carcinoma (mRCC) who progressed on previous vascular endothelial growth factor (VEGF) receptor-tyrosine kinase inhibitor therapy. Efficacy of everolimus in patients who progressed on anti-VEGF monoclonal antibody bevacizumab is unknown. We did a multicenter prospective trial of everolimus in patients with mRCC whose disease had progressed on bevacizumab ± interferon alpha (IFN). Patients with clear-cell mRCC which had progressed on bevacizumab ± IFN received everolimus 10 mg once daily. The primary end point was the proportion of patients remaining progression-free for 56 days, and a two-stage Simon design was used, with 80 % power and an alpha risk of 5 %. This study is registered with ClinicalTrials.gov, number NCT02056587. From December 2011 to October 2013, a total of 37 patients (28 M, 9 F) were enrolled. Median age was 60.5 years (range 41-66), 11 % had Eastern Cooperative Oncology Group Performance Status (ECOG PS) > 2, and Memorial Sloan-Kettering Cancer Center (MSKCC) favorable/intermediate risk was 38/62 %. Five (14 %) patients had a confirmed partial response and 26 (70 %) patients had a stable disease. Median progression-free survival was 11.5 months (95 % CI, 8.8–14.2). Median overall survival was not reached. No grade 3 or 4 treatment-related toxicities were observed. The most common grade 2 adverse events were fatigue (19 %) and pneumonitis (8 %). Everolimus demonstrated a favorable toxicity profile and promising anti-tumor activity as a second-line therapy in metastatic renal cell carcinoma (RCC) patients previously treated with bevacizumab ± IFN.

PET/CT with 18F-fluorocholine, based on an assessment of phosphatidylcholine biodistribution, is an effective method in the diagnosis of biochemical recurrence of prostate cancer. According to results of our study on 71 patients (PSA level 1,775 (0.0245, 56.0975) ng/mL), the sensitivity of two-stage PET/CT with 18F-fluorocholine was 66.7 % (CI 55.3–78 0 %), and specificity – 80 % (CI 44.9–100.0 %), the overall accuracy of the method ranged from 56.7 to 78.5 %. The results show the feasibility of two-staged PET/CT with 18F-fluorocholine in biochemical recurrence of prostate cancer.

To estimate the extent of local tumor spread is a main goal in the diagnosis of prostate cancer (PC). The value of this criterion is that its clinical stage plays a key role in choosing a treatment policy. Overestimation of the clinical stage of cancer leads to the fact that specialists refuse radical and its underestimation gives rise to its recurrence. Our trial defined criteria for the diagnostic efficiency of magnetic resonance imaging (MRI) in 150 PC patients who had undergone radical prostatectomy. The findings were as follows: the diagnostic sensitivity of the method in determining the spread of the cancer beyond the organ was 76.8 %; its diagnostic specificity and accuracy were 80.2 and 78.7 %, respectively. The positive predictive value in detecting the extra-organ spread of the tumor was equal to 76.8 %; the negative predictive value was 80.2 %. A prognostic classification of a risk for locally advanced PS has been developed using the independent clinical and MRI signs found.

The paper provides comparative analysis of cancer specific survival among 202 patients treated with 3D-conformal radiotherapy or radical prostatectomy in N. N. Alexandrov National Cancer Centre of Belarus between 2005–2008. The proportional hazards regression model was used to estimate survival predictors.

The introduction of interstitial radiation sources is the «youngest» of the radical method of treatment of patients with prostate cancer (PC). The high level of efficiency comparable to prostatectomy at a significantly lower rate of complications causes rapid growth of clinical use of brachytherapy (BT). Depending on the radiation source and the mode of administration into the prostate gland are two types BT – high-dose rate (temporary) (HDR-BT) and low-dose rate (permanent) (LDR-BT) brachytherapy. At the heart of these two methods are based on a single principle of direct effect of the quantum gamma radiation on the area of interest. However, the differences between the characteristics of isotopes used and technical aspects of the techniques cause the difference in performance and complication rates for expression HDR-BT and LDR-BT.

Objective: to estimate overall survival (OS) rates in patients with metastatic castration-resistant prostate cancer (mCRPC), who have received currently available drugs and to identify the predictors of OS.

Subjects and methods. The case histories of 112 patients with mCRPC treated at the N.N. Blokhin Russian Cancer Research Center in 2005 to 2014 were retrospectively analyzed. All the patients had received standard regimens based on docetaxel, cabazitaxel, abiraterone acetate in combination with prednisolone.

Results. Whatever the treatment option was, three-year OS rate was 32.0 ± 5.44 %; median survival was 24.3 months. The following poor prognostic factors for OS were pain syndrome; an ECOG performance status score of 2; the levels of prostate-specific antigen ≥ 288 ng/ml, lactate dehydrogenase ≥ 450 U/l, alkaline phosphatase ≥ 250 U/l, calcium < 2.28 mmol/l, and hemoglobin < 11.5 g/dl; as well as < 24 months’ duration of a response to hormonal therapy.

Conclusion. The use of standard drug treatment regimen for mCRPC may increase survival in this category of patients to achieve 3-years OV; and the identified factors of OV may aid in choosing treatment policy.

Castration-resistant prostate cancer (CRPC) is one of the most complex and unsolved problems in urologic oncology. The somatostatin analogue octreotide depot made in Russia may be used for its treatment. The paper gives the results of a trial of the efficiency and safety of treatment with octreotide depot 30 mg and dexamethasone in 20 patients aged 58 to 89 years with CRPC during continued androgen deprivation therapy. The duration of the trial was 3 months. A response was assessed from the serum levels of prostate-specific antigen (PCA), the time course of changes in general and biochemical blood test values, the degree of pain syndrome, and improvement in quality of life in a patient. A total response in reducing PSA was obtained in 70 % of the patents; overall, the best results were achieved in the group receiving octreotide before chemotherapy with docetaxel. The tolerability of octreotide deport with dexamethasone was good in all cases; no obvious adverse hematological and clinical reactions were noted.

Serum samples from 226 primary patients with prostate cancer (PC) and a baseline total prostate-specific antigen (t-PSA) of < 30.0 ng/ml were used to investigate f-PSA and [-2]proPSA levels and to calculate f-PSA%, [-2]proPSA%, and prostate health index (PHI). The findings were compared with cancer stage (pTNM) and Gleason grade (Gleason index) in accordance with a postoperative histological report. PHI was shown to have the best differentiating properties (pT2c/pT3a/pT3b; localized indolent PC / localized aggressive PC / locally advanced PC / PC with regional metastases; Gleason score 5-6 / Gleason score 7 (3+4) / Gleason score 7 (4+3).

Penile cancer (PC) is a rare tumor; its annual incidence rate in Russia is 0.18 % per 100,000. Active work is now underway to develop organsparing treatment options for PC when the disease is detected in its early stage. The paper describes a clinical observation of a 79-year-old patient G. with PC who has undergone comfort radiotherapy using waterbox technology for organ-sparing treatment at the Radiology Department, N.N. Blokhin Russian Cancer Research Center. This technology ensures homogeneous therapeutic dose radiation distribution and allows adjustment of the therapeutic dose required for ionizing radiation of the surface tissues of the organ.

Molecular and genetic characterization of the prostate cancer seems to be a very relevant issue for clinical practice with regard to diagnostics, prognosis, treatment selection and assessment of therapy efficacy. A lot of fundamental studies assault the genetic basis of the disease and the differences in the phenotypic traits of prostate tumors. However, the significant gap is seen between the huge amount of studies to genetic characterization of prostate cancer, which often have a limited way to translation into the clinical practice or simply were not conceived to be so, and clinical practice. Substantial difficulties on the way are multifocality of the prostate carcinoma, inter- and intrafocal heterogeneity and abundance of recurrent genetic alterations, the role of which is understudied to date. In this review we have aimed at the providing an overview of the current studies, being the most close to translation in clinical practice. The common applications and problems are discussed.

This paper deals with the analysis of current trends in world cancer science and with a search for ways to intensify the development of Russian oncology. It summarizes the results of the development of cancer science in the last 10 years and formulates main problems and handicaps on the way of its further development in order to make reasoned decisions to reform the system and to create a development strategy for the next decade.

Cytoreductive nephrectomy as an independent option in patients with metastatic renal cell carcinoma (mRCC) cannot be considered as the only effective method, with rare exception, of a few patients with solitary metastases. Cytoreductive nephrectomy is now part of a multimodal approach encompassing surgical treatment and systemic drug therapy. Many retrospective and two prospective studies have demonstrated that it is expedient to perform cytoreductive nephrectomy. Immunotherapy should not be used as preoperatively in the era of cytokine therapy for mRCC due to that fact that it has no impact on primary tumor. In the current targeted therapy era, many investigators have concentrated attention
on the role of neoadjuvant targeted therapy for the treatment of patients with both localized and locally advanced mRCC. The potential benefits of neoadjuvant therapy for localized and locally advanced RCC include to make surgery easier and to increase the possibility of organsparing treatment, by decreasing the stage of primary tumor and the size of tumors. The possible potential advantages of neoadjuvant targeted therapy in patients with mRCC include prompt initiation of necessary systemic therapy; identification of patients with primary refractory tumors; and a preoperative reduction in the stage of primary tumor. Numerous retrospective and some prospective phase II studies have shown that neoadjuvant targeted therapy in patients with localized and locally advanced RCC is possible and tolerable and surgical treatment after neoadjuvant targeted therapy is safe and executable with a low incidence of complications. If neoadjuvant therapy is to be performed, it should be done within 2–4 months before surgery. Sorafenib and sunitinib are now most tested and suitable for neoadjuvant targeted therapy. Sorafenib is a more preferred drug due to its shorter half-life and accordingly to the possibility of discontinuing the drug immediately prior to surgery. Unquestionably, elaboration of precise recommendations for neoadjuvant therapy calls for further larger prospective studies estimating progression and survival rates in high-risk patients with localized and locally advanced RCC and in those with mRCC.