Pavel I. Skopin

Background. Indocyanine green fluorescence mapping enables real-time assessment of both sentinel lymph nodes and superficial lymphatic drainage pathways of the breast. However, variations in their formation and the factors affecting the time to sentinel lymph node (SLN) visualization remain poorly understood. Aim. To describe patterns of superficial breast lymphatic drainage during fluorescence mapping, assess their relationship with tumor location, and identify factors associated with the time to SLN visualization. Materials and methods. This prospective single-center study included 52 patients with morphologically confirmed breast cancer staged as cT1–3N0M0. Indocyanine green was administered subdermally at four periareolar sites. Drainage direction, the number of active periareolar sectors, the pattern of lymphatic vessel formation, time to SLN visualization, anthropometric variables, and breast subcutaneous fat thickness were recorded. Statistical analysis included Spearman’s rank correlation, univariable and multivariable linear regression, and the Fisher–Freeman–Halton exact test. Results. Fluorescence identification of the SLN was successful in 51 (98.08 %) of 52 patients. An axillary drainage pattern was observed in 48 cases (92.31 %), while a combined axillary – parasternal pattern was found in 3 cases (5.77 %). No association between tumor location and drainage direction was detected in this cohort (p = 0.576); the analysis was limited by only three combined patterns across nine tumor-location categories. Two active periareolar sectors were the most frequent finding, occurring in 18 cases (35.29 %). Among 48 evaluated drainage components, the convergent pattern predominated in 23 cases (47.92 %). Mean visualization time was 13.42 ± 2.45 min with SPY Fluorescent Imaging System (SP2000) and 12.40 ± 1.78 min with SPY-PHI (Portable Handheld Imager) (p = 0.114). After adjustment for body mass index and subcutaneous fat thickness, SPY-PHI was associated with a shorter visualization time (B = –1.539; 95 % confidence interval –2.387…–0.691; p 0.001). Conclusion. Indocyanine green fluorescence mapping allows individual patterns of superficial breast lymphatic drainage to be identified. No association between drainage direction and tumor location was detected in this cohort, but the small number of combined patterns precludes a conclusion that no association exists. Higher body mass index was associated with a longer visualization time, whereas SPY-PHI use was associated with a shorter visualization time.

Objective of the review. To evaluate the associations between colorectal cancer and atherosclerosis-related cardiovascular diseases, and to identify common risk factors. Materials and methods. Data for this analysis were collected from peer-reviewed articles published between 2001 and 2024, sourced from platforms such as PubMed, eLIBRARY, CyberLeninka, and other academic resources. This time frame includes key clinical studies pertinent to the subject matter. The search terms included colorectal cancer (CRC), cardiovascular diseases (CVD), complications, risk factors, and prevention. Articles that did not meet the predetermined selection criteria were excluded from the analysis. Results. Patients with CRC exhibit a significantly elevated risk of cardiovascular mortality compared to the general adult population, with this risk increasing with age and overall life expectancy. Notable gender differences in the association between CVD and CRC were observed. Furthermore, individuals at high cardiovascular risk showed an increased probability of developing CRC. There is a high prevalence of traditional atherosclerosis risk factors among patients with malignancies, particularly those with CRC. Conclusion. Assessing the risk of atherosclerotic cardiovascular disease and implementing clinical cardiovascular follow-up following a cancer diagnosis may help mitigate disease burden and extend survival. Addressing common risk factors and encouraging lifestyle modifications can improve patient outcomes.

Objective. To study the relationship between lung cancer and cardiovascular diseases and to identify factors that influence prognosis in patients with both conditions. Materials and methods. Data were collected from peer-reviewed articles published between 2001 and 2024 and sourced from PubMed, eLibrary, CyberLeninka, and other academic platforms. This period encompasses the primary clinical studies addressing the issue. The search terms included lung cancer, cardiovascular diseases, complications, risk factors, and prevention. Results. The global incidence of malignant neoplasms is rising, with lung cancer occupying a predominant position. In the Russian Federation, respiratory and thoracic cancers account for nearly 19% of mortality due to malignancies, with men being affected four times more frequently than women. In lung cancer survivors, complications arising from cardiovascular diseases (CVD) significantly contribute to mortality rates. Among the known predictors of lung cancer in patients with CVD, the level of coronary calcium merits particular attention. Furthermore, cumulative radiation exposure and chronic inflammation may play a role in the pathogenesis of lung cancer in these patients. Numerous modifiable risk factors, notably tobacco smoking, are critical in the development of both lung cancer and CVD. Conclusion. It is recommended that patients with lung cancer undergo screening to assess their cardiovascular risk and related complications. Effective management of smoking behaviors can improve the prognosis for patients with both conditions. Given the significance of the comorbidity with cardiovascular diseases and lung cancer, further large-scale studies focused on the prevention of their complications are warranted.

The study aim was to analyze the literature on the common pathogenetic pathways and risk factors for cardiovascular diseases (CVD) and cancer. Cancer is the second leading cause of death among adults worldwide after CVD. In clinical practice, the comorbidity of cancer and CVD is increasingly being recorded, which undoubtedly increases the mortality risk. CVD is the leading cause of death in patients with breast, prostate, or colorectal cancer. At the same time, individuals with CVD, particularly heart failure, have an increased risk of cancer. Some pathogenic pathways in the development of cancer and CVD are common. There are published data on common genetic mutations between cancer and CVD. Chronic inflammation and oxidative stress play a significant role in the genesis of cancer and CVD. Many chemotherapy agents increase inflammation, aggravating prior CVD or promoting its development. Screening may be appropriate in certain categories of surviving patients, taking into account risk factors and the nature of treatment. It is noteworthy that screening for cancer in individuals with CVD, particularly heart failure, requires further study. In the context of measures to prevent cancer recurrence, comprehensive measures aimed at secondary prevention of comorbid conditions should be developed. Preventive, diagnostic, and therapeutic strategies should be part of multidisciplinary cardio-oncology care aimed at improving outcomes.

Introduction. The increasing need for affordable treatment options for patients with HER2-positive breast cancer necessitates the development of pertuzumab biosimilars to expand access to effective therapies. BCD-178 is a pertuzumab biosimilar that has demonstrated equivalence to reference pertuzumab (RP) based on physicochemical characterization, preclinical in vitro and in vivo and clinical phase I study. The international, multicenter, Phase III clinical trial BCD-178–2/PREFER was conducted to comparatively evaluate the efficacy and safety of BCD-178 and RP in combination with TCHP regimen for neoadjuvant therapy in patients with HER2-positive breast cancer.Objective. To compare the efficacy and safety of the pertuzumab biosimilar BCD-178 and RP when used in a neoadjuvant setting for patients with HER2-positive breast cancer.Methods. The study included female patients aged 18–75 years with histologically confirmed invasive HER2-positive breast cancer and the absence of estrogen receptor (ER) and progesterone receptor (PR) expression. Patients were randomized 1:1 to receive either BCD-178 or RP. The primary endpoint was the proportion of patients achieving a total pathological complete response – tpCR (ypT0/is, ypN 0) based on the conclusion of a central independent review after completion of the neoadjuvant therapy phase.Results. A total of 380 patients were randomized into the study. The proportions of patients achieving tpCR (95 % CI) were not statistically different between the treatment groups (p=0.6521, Cochran–Mantel–Haenszel method). The risk difference (95 % CI) for achieving tpCR between the groups was within the pre-defined equivalence boundaries, demonstrating equivalent efficacy of BCD-178 and RP. The treatment groups were comparable in terms of safety profile, including the incidence of adverse reactions (ARs). The most common (≥10 % of patients) ARs were diarrhea and anemia. The pharmacokinetics and immunogenicity of the drugs were comparable.Conclusions. The study demonstrated comparability between BCD-178 and RP in terms of efficacy, safety, pharmacokinetics, and immunogenicity when used in the neoadjuvant treatment of patients with HER2-positive ER/PR-negative breast cancer.

Introduction. The issue of diagnosing and treating oncological diseases during pregnancy remains highly relevant, as physiological changes may hinder early detection, while therapeutic decision-making is complicated by the need to minimize fetal risks and ensure effective treatment for the mother. This article discusses the specifics of treatment strategy selection, potential risks for both the mother and the fetus, and approaches to minimizing adverse outcomes. The aim of the study is to analyze treatment strategies for oncological diseases during pregnancy, compare treatment effectiveness, and assess the impact on fetal development. Materials and methods. An analysis of current literature was conducted, enabling the systematization of the structure of oncological diseases in pregnant women, treatment options, and potential outcomes. Additionally, a clinical case from the practice of the Republican Oncology Dispensary was examined, illustrating the real-world challenges and solutions in managing such patients. Results. Based on the conducted analysis, it has been established that the management of pregnancy in the context of oncological disease requires a careful balance between therapeutic efficacy and fetal safety. In particular, surgical intervention and chemotherapy are considered permissible after the first trimester, whereas radiotherapy, whenever possible, is postponed until the postpartum period. However, data on the long-term outcomes for the child remain inconclusive: some studies indicate an increased risk of preterm birth and mild cognitive impairments, while others do not reveal significant deviations. Discussion and conclusion. The results obtained confirm that the treatment of cancer during pregnancy requires an individualized approach that takes into account both the stage of the disease and the gestational age. The presented clinical case of a patient with advanced rectal cancer in the third trimester illustrates the feasibility of using XELOX chemotherapy (capecitabine, oxaliplatin) in combination with pregnancy-prolonging measures to improve perinatal outcomes. At the same time, the prognosis for the mother remains dependent on the biological characteristics of the tumor, underscoring the need for further research in this area.

In this study, we've evaluated the myelotoxic effect of treating Walker-256 carcinoma with cytostatics, followed by correction of thrombocytopenia with liposomal and liposome-free mexidol. The study included 60 rats, which, depending on the type of treatment, were divided into 5 groups. We recorded the greatest increase in the number of platelets on the background of liposomal mexidol both on the 3rd and 7th day after the start of chemotherapy. At the end of the monitoring, the myeloprotective effect was 30% higher in the liposomal mexidol compared to its non-liposomal form. CONCLUSION: Activation of thrombocytopoiesis on the background of cytostatic therapy helps to reduce the complications related to the use of chemotherapy.