Despite its relative rarity, vulvar cancer is associated with a high risk of functional and psychosocial impairments that significantly impact patients' quality of life. This article examines current approaches to pre- and post-operative care for women with vulvar cancer, emphasizing the interdisciplinary nature of rehabilitation measures. Key rehabilitation areas are highlighted, including nutritional and psycho-emotional status correction, prevention and treatment of lymphedema and wound complications, and the use of modern physiotherapy methods. Special attention is given to psychosexual health and long-term follow-up. The article emphasizes the limited evidence base and the need for further research to develop unified and clinically validated rehabilitation strategies for this patient population
Aim. To assess the efficacy and safety of lenvatinib plus pembrolizumab for the treatment of mismatch repair-proficient (pMMR) endometrial cancer (EC) in routine clinical practice in Russia.Materials and methods. This multicenter, retrospective, cohort study included 114 patients with recurrent and metastatic EC from 37 cancer centers in Russia treated between December 2020 and November 2024. Patients with histologically verified EC without microsatellite instability were included. The primary endpoint was progression-free survival; the clinical characteristics of the patients were additionally analyzed; the objective response rate and the toxicity profile of therapy were assessed.Results. Median patients’ age was 66.5 (33–83) years. The most common histologic tumor subtype was endometrioid adenocarcinoma (72.8 %); serous adenocarcinoma was diagnosed in 18.4 % of cases, other subtypes – in 8.8 %. The median progression-free survival was 8.15 months (95 % confidence interval 0.4–41.1). Objective response rate was 38.0 %. The median overall survival was not achieved with a median follow-up of 12.23 months. During treatment, dose reduction rate due to adverse events was 50 %. The most frequent adverse events were hypertension (n = 64; 56.1 %), fatigue (n = 45; 39.5 %), and diarrhea (n = 20; 17.5 %).Conclusion. In the conducted study of routine clinical practice in Russian patients with recurrent and metastatic EC without mismatch repair system deficiency (pMMR/MSS), lenvatinib plus pembrolizumab showed good efficacy with a manageable safety profile.
The tissue explant culture (histoculture) is a method that involves maintaining small pieces taken from an organ ex vivo or post mortem in a controlled laboratory setting. Such a technique has a number of advantages: unlike the 2D, organoid, or on-chip cultures, tissue explants preserve the whole complexity of the original tissue in vivo, its structure, extracellular matrix, and the diverse cell populations, including resident immune cells. The explant culture method can be applied to human tissue specimens obtained from biopsies or autopsies, provided that proper ethical protocols are followed. This avoids the difficulties that may arise in translating results obtained on animal models into biomedical research for humans. This advantage makes histocultures especially desirable for studying human pathogenesis in the course of infectious diseases. The disadvantage of the method is the limited lifespan of the cultured tissues; however, a number of approaches allow extending tissue viability to a period sufficient for observing the infection onset and development. Here, we provide a protocol for lung explant maintenance that allows tracing the local effects of infection with SARS-CoV-2 in humans. Further applications of the lung tissues cultured according to this protocol include, but are not limited to, histochemical and immunohistochemical studies and microscopy, FACS, qPCR, and ELISA-based analysis of the conditioned culture media.
Introduction: The systemic therapy of patients with metastatic luminal HER2‑negative breast cancer (mBC) in‑ cludes various options, which can be fundamentally divided into endocrine therapy and chemotherapy. According to the Clinical Guidelines, both international and Russian, the “gold standard” of the 1st line therapy for patients with metastatic luminal HER2‑negative breast cancer (mBC) is a combination of cyclindependent kinase inhib‑ itors 4 / 6 (iCDK4 / 6) with endocrine therapy (ET). However, until recently we did not have complete data on the characteristics of the Russian population of patients with luminal HER2‑breast cancer, their treatment options, and the results of this therapy.Aim: To analyze the patients’ profile and current treatment approaches for patients with luminal HER2 mBC in routine clinical practice in Moscow.Materials and methods: The study was performed as an observational, crosssectional and retrospective study. The data of 2,500 patients from medical institutions in Moscow who received systemic therapy for luminal HER2 mBC in AugustOctober 2021 were analyzed.Results: The largest number of patients received iCDK4 / 6 + ET in the first and second lines: 69.0 % and 52.0 %, respectively. In the first line, 54.6 % of patients received ribociclib, 43.1 % palbociclib and 2.3 % abemaciclib. In the second line, 50.6 % of patients received ribociclib, 47.8 % palbociclib and 1.6 % abemaciclib. As the pretreatment of patients increased, preference was given to other treatment methods, therefore the proportion of combined ET decreased to 34.0 % in the third line and 25.0 % in the fourth and subsequent lines.Conclusion: The data obtained indicate that the appointment of iCDK4 / 6 + ET is made in accordance with the Clinical Guidelines for the treatment of breast cancer of the Ministry of Health of the Russian Federation from 2021 and the preferred firstline treatment option for patients with luminal HER2 mBC in Moscow is combined endocrine therapy.
Background. Currently, women over 65 years of age comprise a quarter of endometrial cancer (EC) patients, but this population remains underrepresented in clinical trials. The combination therapy with lenvatinib plus pembrolizumab has demonstrated a significant improvement in progression-free survival and overall survival in patients with mismatch repair system proficiency (pMMR/MSS) after a single prior treatment line. However, data on the efficacy and safety of this regimen in real-world clinical practice, especially in elderly patients, are limited.Aim. To describe the efficacy and safety of EC therapy with lenvatinib and pembrolizumab in elderly patients.Materials and methods. In this retrospective single-center study conducted at a Moscow hospital (December 2020 – March 2024), we collected data on the efficacy and safety of lenvatinib and pembrolizumab therapy in 26 patients over 65 years of age. Patients with pathologically confirmed EC without evidence of microsatellite instability were included. The primary endpoint of the study was progression-free survival; additionally, we evaluated the clinical characteristics of the patients, analyzed the objective response rate and the incidence of adverse events.Results. The median age was 69 (65–81) years, 23 % of patients were older than 75 years. The performance status of 92.3 % of patients was classified as ECOG 0–1, endometrial adenocarcinoma was the most frequently detected type (61.5 % of cases), serous carcinoma was reported in 10 (38.5 %) patients. The median number of prior treatment lines was 3 (2–6). The objective response rate reached 25 %, and the disease control rate was 75 %. The median progression-free survival was 5.67 (1.4–35.3) months. Adverse events of any grade were noted in 24 (92.3 %) patients. Lenvatinib dose reduction was performed in 76.9 % of cases. The most frequent adverse events were arterial hypertension (in 16 (61.5 %) patients), fatigue (in 5 (19.2 %) patients), and diarrhea (in 3 (11.5 %) patients).Conclusion. In this real-world clinical practice study in Russia involving patients with recurrent and metastatic EC without mismatch repair system deficiency (pMMR/MSS) over 65 years of age who received lenvatinib plus pembrolizumab, the efficacy and safety of the treatment were comparable to those reported in earlier studies, suggesting the feasibility of combination therapy in this population with appropriate attention to performance status and management of adverse events. Additional studies are required to evaluate the efficacy and safety of the combination therapy of lenvatinib and pembrolizumab in patients with a more severe functional status.
