[Clinical efficacy of rehabilitation measures in patients with melanoma of the skin undergoing immunotherapy]. / Klinicheskaya effektivnost' reabilitatsionnykh meropriyatii u patsientov s melanomoi kozhi, nakhodyashchikhsya na immunoterapii.

BACKGROUND: Currently one of the urgent problems of oncology is he choice of tactics of rehabilitation measure. Despite the long list of known possible side effects from antitumor therapy, most patients do not receive follow-up and preventive interventions necessary to correct clinically significant consequences. OBJECTIVE: Analysis of clinical effectiveness of complex rehabilitation programs in patients with melanoma of skin receiving immunotherapy. MATERIAL AND METHODS: The study included 109 patients with metastatic melanoma, aged 26 to 88 years, who received immunotherapy in the period from 2019 to 2022. The study group (n=54) included patients who received a comprehensive rehabilitation program: physical therapy, nutritional support, general magnetotherapy, psychotherapy sessions without concomitant medications. Patients who did not use rehabilitation programs made up the control group (n=55). The effectiveness of therapy was evaluated in accordance with iRECIST 1.1 criteria. Immuno-mediated toxity of treatment was evaluated according to CTCAE criteria (version 5.0, 2017). To assess the quality of life (QoL), the EORTC QLQ-C30 questionnaire was used. RESULTS: The median follow-up of patients was 20 weeks in the study group, 19 weeks in the control group. Stabilization of the disease was achieved in 21 (38.9%) patients of the study group and 23 (41.8%) patients of the control group; disease progression in both groups was comparable: 10 (18.5%) - in the study group, 12 (21.8%) - in the control group. Adverse events of therapy were detected in 39 (72.2%) patients of the study group, 46 (83.6%) patients of the control group. All registered adverse events according to CTCAE 5.0 criteria were of grade I-II. No serious adverse events of the IV degree were detected during the study period. CONCLUSION: The introduction of comprehensive rehabilitation programs in the treatment of patients with melanoma shows its effectiveness and reduced toxicity of immunotherapy, however, there are a number of important issues that require further resolution.

[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.