This clinical case report presents the management of a patient with high-volume hormone-sensitive metastatic prostate cancer treated with a combination of darolutamide and androgen deprivation therapy. The treatment choice was driven by significant comorbidities and a high risk of drug–drug interactions, supporting the rationale for selecting a therapy with a favorable safety and interaction profile. The patient achieved a marked clinical benefit, including an undetectable PSA level and partial regression of metastatic lesions. Special attention is given to the clinical relevance of drug–drug interactions and the role of darolutamide in managing elderly patients with polypharmacy.

Achieving remission in testicular germ cell tumors with 5-year survival rates of up to 99% [1, 2] has become possible due to a systemic approach that includes both surgical treatment and systemic platinum-based therapy. However, the low incidence of this pathology in regional medical and preventive institutions, the lack of visibility in the practice of many doctors lead to a delay in diagnosis and lack of quality treatment that meets all the standards of clinical recommendations of the Russian Federation. Untimely treatment by a specialist, diagnostic errors and non-compliance with the standards of medical care in patients with testicular germ cell tumors inevitably reduce survival and worsen the results of subsequent treatment. The aim of the study is to analyze the role of a specialized oncology hospital and a multidisciplinary tumor board in optimizing the diagnosis and treatment of patients with testicular germ cell tumors based on literature data and our own clinical observations.

This article presents a clinical case of successful multi-stage treatment, including combined surgery, for a patient with a locally advanced transverse colon tumor with invasion of the liver, stomach, and duodenum. It also outlines current approaches to the diagnosis and treatment of colon tumors and their complications, including tumors deemed unresectable at the start of antitumor treatment. Modern diagnostic methods, surgical and systemic treatment strategies, and the results of an integrated approach to the treatment of colorectal cancer are discussed. This case demonstrates the challenges in choosing a surgical approach for complex colorectal cancer sites, highlights the importance of timely diagnosis and individualized treatment, the effectiveness of a multidisciplinary approach, and the need for careful postoperative monitoring and early detection and treatment of complications.

Gastrointestinal stromal tumors (GISTs) are a group of rare gastrointestinal neoplasms of mesenchymal origin. Mutations in the C-KIT or PDGFRA genes are key mechanisms for tumor development. The identification of these pathogenetic mechanisms, as well as significant progress in understanding the molecular biology of gastrointestinal stromal tumors, have led to the development of a personalized approach to the treatment of GISTs, which has had a significant impact on improving patient treatment outcomes.

Distal cholangiocarcinoma (DCCA) is a rare malignant neoplasm originating from the epithelial cells of the distal bile ducts and characterized by an unfavorable prognosis. DCCA often occurs without clinical manifestations and manifests itself at the stage of locally advanced or metastatic disease. For patients with early-stage disease and resectable tumors, surgical resection with negative resection margins remains the only effective treatment strategy: the generally accepted standard of surgical treatment is pancreaticoduodenal resection. However, despite the radical surgical intervention, the risk of recurrence and progression of DCCA remains high: in almost 50% of patients, the disease recurs for 5 years after surgery. Therefore, it is advisable to continue optimizing neoadjuvant and adjuvant therapy to reduce the risk of recurrence and improve the overall survival (OS) of this group of patients. In this review, we will present a clinical observation of a patient with DCCA, in a patient with severe concomitant cardiovascular pathology, who underwent radical resection of the common hepatic duct and common bile duct, cholecystectomy, and formation of a Roux-en-Y hepaticojejunostomy.