Background. Advances in breast cancer (BC) treatment have led to a large and growing population of survivors. This necessitates a clinical paradigm shift from a sole focus on survival to the comprehensive management of long-term health and quality of life.

Objective. To critically analyze and synthesize current evidence-based data on key aspects of post-treatment BC care, emphasizing the transition from passive surveillance to proactive strategies for rehabilitation and secondary prevention.

Materials and methods. A systematic analysis of data from key randomized clinical trials (RCTs), meta-analyses (Cochrane, EBCTCG), and clinical guidelines (ESMO, NCCN) was conducted. The review covers the efficacy of follow-up protocols, the impact of lifestyle factors, methods for managing endocrine therapy complications, and modern approaches to fertility preservation.

Results. The analysis reveals a scientific consensus on the inefficacy of intensive instrumental screening in asymptomatic patients. Conversely, the role of lifestyle modification is strongly evidenced, with body weight control and regular physical activity being key factors in reducing the risk of recurrence and mortality. Managing long-term complications of endocrine therapy, such as osteoporosis and genitourinary syndrome, requires a proactive approach, including the use of bone-modifying agents (which also possess antitumor effects) and safe methods of local hormonal treatment. The POSITIVE trial represents a breakthrough in oncofertility, proving the safety of temporarily interrupting therapy to pursue pregnancy, which fundamentally changes counseling for young patients.

Conclusion. The modern concept of BC survivorship care demands a shift towards personalized survivorship care plans. These plans must integrate evidence-based surveillance strategies, proactive management of side effects, mandatory screening and correction of psychological distress, and active patient engagement in lifestyle modification. Future research should focus on developing effective models for implementing these comprehensive approaches into routine clinical practice.

Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver, originating from hepatocytes. HCC ranks as the sixth most frequently diagnosed cancer globally and the third leading cause of cancer-related mortality [1]. The management of HCC requires a comprehensive, multidisciplinary approach, which includes locoregional therapies, surgical intervention, liver transplantation, as well as systemic therapy for advanced forms of the disease. Contemporary, comprehensive management of HCC patients is inconceivable without collaboration with gastroenterologists and infectious disease specialists. For many years, the pharmacological treatment of advanced hepatocellular carcinoma posed a significant challenge in clinical oncology. Due to the rapid advancement of oncological therapeutics, several highly effective first-line treatment options are now available for unresectable and advanced HCC. This article reviews the current approach to selecting first-line treatment regimens for unresectable HCC, with a particular focus on the combination immunotherapy of durvalumab and tremelimumab, which has been incorporated into updated clinical guidelines. Furthermore, the practical experience of two clinics of specialized types of medical care (Oncology) in utilizing the tremelimumab and durvalumab combination in the first-line setting is described.

This article presents a clinical case of acute decompensation of chronic heart failure in a patient with chronic myeloid leukemia (CML) during targeted therapy with a tyrosine kinase inhibitor — imatinib.

The patient was admitted to a multidisciplinary clinic with pronounced clinical signs of heart failure (HF). Upon admission to the hospital, blood tests revealed severe pancytopenia and elevated cardio-specific enzymes. According to echocardiography — a low left ventricular ejection fraction (LVEF), decreased global contractility of the left ventricle, and decreased regional contractility of the left ventricle were noted. The condition was interpreted as a type 2 acute myocardial infarction (AMI) due to severe anemia. Intensive therapy was conducted in the intensive care unit, during which a significant positive dynamic was achieved. Follow-up echocardiography showed disappearance of regional wall motion abnormalities and an increase in LVEF according to Simpson (from 30% to 42%). During subsequent follow-up — further increase in LVEF (from 42% to 69%) and resolution of heart failure symptoms were observed. Given the complete regression of clinical symptoms following imatinib withdrawal, heart failure could have been associated with the cardiotoxicity of this drug.

Sarcomatoid carcinoma of the skin is a rare and aggressive variant of cutaneous squamous cell carcinoma characterized by poor differentiation. Due to the limited number of reported cases, there are no standardized approaches to management, making individual case reports particularly valuable. We describe a young patient presenting with a rapidly enlarging giant sarcomatoid carcinoma of the postauricular region with ulceration and bleeding. A combinedmodality treatment, including surgery and chemoimmunotherapy, resulted in complete clinical and radiological disease control, with no evidence of recurrence at follow-up.

Based on current World Health Organization statistics, today there were an estimated 40 million people living with HIV. The specific epidemiological course of HIV infection is represented by a wide range of severe forms of diseases with a predominance of involvement of the central nervous system in the pathological process. Due to the variability of cerebral lesions, there are difficulties in identifying and diagnosing the pathological process, especially when it comes to a tumor process unrelated to HIV infection. A 40-year old man presented with left hemiparesis and headaches. He was diagnosed with human immunodeficiency virus (HIV) in 2020 and does not treat using antiretroviral (ARV) drugs. The CD4⁺ lymphocyte level was 180 cells/μl. The titers of antibodies to T.gondii were 1:400. Brain magnetic resonance imaging (MRI) revealed an intraaxial mass in the basal ganglia region on the right side, with ring-shaped contrast enhancement, restricted diffusion and extensive perifocal edema, small foci of hemorrhages and vascular shunts, and high perfusion levels. The patient underwent a stereotactic biopsy of the brain mass and postoperative pathological report confirmed the diagnosis of a primary neuroepithelial tumor: Glioblastoma, Not Otherwise Specified (NOS, WHO 2021). Correct and timely detection of the nature of brain lesion is necessary to select the correct treatment strategies and, as a result, reduce mortality. The use of multiparametric MRI protocol recommended to the differential diagnosis of brain lesions in patients with HIV infection.

Leptomeningial metastasis of non-small cell lung cancer is a rare and complex clinical case. The lack of randomized clinical trials complicates the process of choosing appropriate treatment methods with the proven efficacy for this cohort of patients and often puts clinicians in a difficult position. Therefore, the search for possible potentially effective treatment options for patients with leptomeningeal metastases is an important direction. Here is a description of a clinical case of a patient with squamous cell lung cancer treatment using intrathecal chemotherapy with etoposide.