[Comprehensive rehabilitation of immune-mediated adverse events in cancer patients receiving checkpoint inhibitor therapy]. / Kompleksnaya reabilitatsiya immunooposredovannykh nezhelatel'nykh yavlenii u patsientov so zlokachestvennymi opukholyami, poluchayushchikh terapiyu ingibitorami kontrol'nykh tochek.

OBJECTIVE: To evaluate adverse events and clinical effectiveness of complex rehabilitation programs in patients with malignant tumors receiving checkpoint inhibitor therapy. MATERIAL AND METHODS: The study included 144 cancer patients who received immunotherapy for the period from 2019 to 2021. Group 1 consisted of 72 patients who received a comprehensive rehabilitation program including physical therapy, diet therapy, psychotherapy, general magnetotherapy. Patients of the second (control) group (n=72) did not receive rehabilitation procedures. Effectiveness of treatment was evaluated according to RECIST 1.1 criteria, safety of treatment - according to CTCAE criteria (version 5.0, 2017). To assess the quality of life (QoL), the Russian version of the EORTC QLQ-C30 questionnaire was used. RESULTS: Mean follow-up period in the first group was 4.5 months, in the control group - 5 months. Disease progression was observed in 35 (48.6%) patients of the main group and 32 (44.4%) patients of the control group. Two (2.8%) patients in the control group demonstrated complete response to therapy. Partial response was established in both groups in 13 patients (18.1%). Stabilization of disease was detected in 24 (33.3%) and 25 (34.7%) patients, respectively. Adverse events were registered in 54 (75.0%) and 60 (83.3%) patients, respectively. Adverse events grade III-IV occurred in 9.7% and 11.1% of patients, respectively. CONCLUSION. I: Mmunotherapy combined with comprehensive rehabilitation program confirms high effectiveness of these drugs. We observed good tolerability of rehabilitation procedures that do not deteriorate the course of the underlying disease. However, there are certain important issues, in particular influence of rehabilitation procedures on tolerability of immunotherapy in patients with cancer.

[Magnetotherapy in patients with malignant tumors receiving immunotherapy]. / Opyt primeneniya reabilitatsionnoi magnitoterapii u patsientov so zlokachestvennymi opukholyami, poluchayushchikh immunoterapiyu.

OBJECTIVE: To analyze the quality of life in patients receiving immunotherapy and overall response rate in case of additional magnetotherapy. MATERIAL AND METHODS: The study included 3 cohorts of patients (n=48) with various disseminated malignancies (melanoma, lung cancer, kidney cancer) who received immunotherapy. In the study groups, all patients additionally took courses of rehabilitation based on magnetotherapy. In the control cohorts, patients underwent courses of immunotherapy without additional magnetic therapy. Treatment efficacy was assessed according to iRECIST 1.1 criteria. The Russian version of the EORTC QLQ-C30 questionnaire was used to study the quality of life. We analyzed adverse events using the CTCAE 5.0 criteria. RESULTS: In patients with melanoma, the most common response to systemic treatment was stabilization (41.7% in the study group and 30.8% in the control group). The objective response rate was higher in the study group (33.3% vs. 23.1%). There was also significant improvement in the quality of life after treatment in the study group (by 23.5%). In the control group, the indicator worsened by 4.8%. Overall health improved by 12.8% in the study group and 10.3% in the control group. In patients with lung cancer, response to systemic treatment with stabilization was achieved in 33.3% of patients in the study group and 20% of patients in the control group. The objective response rate was 33.3% and 20%, respectively. Analysis of the study group revealed improvement of overall health by 9.6% and overall quality of life by 38.6%. In the control group, overall health improved by 4.8% and quality of life remained the same. In patients with kidney cancer, the objective response rate was 40% and 42.9%, respectively. Disease stabilization was achieved in 40% and 28.6% of patients, respectively. Overall health improved by 16.7% and 6.3%, overall quality of life - by 19% and 9.1%, respectively. CONCLUSION: Magnetic therapy during the course of immunotherapy improved the overall quality of life and reduced severity of adverse events. Further study of magnetotherapy as an accompanying rehabilitation technique is required.

[Application of cell technologies to tissue defect closure in oncology].

In vivo and in vitro experiments on the application of cell technologies to tissue defect closure were conducted; autologic mesenchymal stem cells on 3-demensional matrices were used. The authors analyze the results of the application of bioengineering tissue equivalents for the closure of soft tissue and upper airway defects after extensive resections performed in 52 oncological patients. Tissue equivalents with stem cells provide engraftment and long-term graft functioning; they also modify wound surface, thus stimulating wound epithelization. In this study the application of tissue equivalents led to wound healing and functional recovery in 87% of patients.