<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/ms2023-209</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-7698</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCH</subject></subj-group></article-categories><title-group><article-title>Формирование программы принятия клинических решений в локальной практике региона: проблемные вопросы, определяющие выбор терапии при прогрессировании рака эндометрия</article-title><trans-title-group xml:lang="en"><trans-title>Organization clinical decision-making programs in the local practice of the region: problematic issues that determine the choice of therapy in the progression of endometrial cancer</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7127-7945</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Горяинова</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Goryainova</surname><given-names>A. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Горяинова Алла Юрьевна, заведующий  координационным отделом лекарственного  обеспечения; ассистент кафедры онкологии с курсом торакальной хирургии факультета повышения квалификации и профессиональной переподготовки специалистов </p><p>350040, Россия, Краснодар, ул. Димитрова, д. 146 </p><p>350063, Россия, Краснодар, ул. Митрофана Седина, д. 4 </p></bio><bio xml:lang="en"><p>Alla Yu. Goryainova, Medical Oncologist, Head of the Drug Supply Coordination Department; Assistant of the Department of Oncology with a course of Thoracic Surgery of the Faculty of Advanced Training and Professional Retraining of Specialists,  </p><p>146, Dimitrov St., Krasnodar, 350040, Russia</p><p>4, Mitrofan Sedin St., Krasnodar, 350063, Russia </p></bio><email xlink:type="simple">mashelueva@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9658-4247</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Леонов</surname><given-names>М. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Leonov</surname><given-names>M. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Леонов Михаил Генрихович, д.м.н., доцент, доцент кафедры онкологии с курсом торакальной хирургии факультета повышения квалификации и профессиональной переподготовки специалистов; главный врач </p><p>350063, Россия, Краснодар, ул. Митрофана Седина, д. 4 </p><p>353915, Россия, Новороссийск, ул. Лейтенанта Шмидта, д. 7</p></bio><bio xml:lang="en"><p>Mikhail G. Leonov, Dr. Sci. (Med.), Associate Professor, Associate Professor of the Department of Oncology with a course of Thoracic Surgery of the Faculty of Advanced Training and Professional Retraining of Specialists;  Head </p><p>4, Mitrofan Sedin St., Krasnodar, 350063, Russia</p><p>7, Lieutenant Schmidt St., Novorossiysk, 353915, Russia </p></bio><email xlink:type="simple">novonko@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8084-8770</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мурашко</surname><given-names>Р. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Murashko</surname><given-names>R. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мурашко Роман Алексеевич, к.м.н., главный врач;доцент кафедры онкологии с курсом торакальной хирургии факультета повышения квалификации и профессиональной переподготовки специалистов </p><p>350040, Россия, Краснодар, ул. Димитрова, д. 146 </p><p>350063, Россия, Краснодар, ул. Митрофана Седина, д. 4 </p></bio><bio xml:lang="en"><p>Roman A. Murashko, Cand. Sci. (Med.), Head; Associate Professor of the Department of Oncology with a course of Thoracic Surgery of the Faculty of  Advanced Training and Professional Retraining of Specialists </p><p>146, Dimitrov St., Krasnodar, 350040, Russia</p><p>4, Mitrofan Sedin St., Krasnodar, 350063, Russia </p></bio><email xlink:type="simple">kkod@kkod.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-4292-0521</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цирульникова</surname><given-names>О. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsirulnikova</surname><given-names>O. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Цирульникова Ольга Сергеевна, заведующая поликлиническим отделением </p><p> 350040, Россия, Краснодар, ул. Димитрова, д. 146 </p></bio><bio xml:lang="en"><p>Olga S. Tsirulnikova, Head of the Outpatient Department </p><p>146, Dimitrov St., Krasnodar, 350040, Russia</p></bio><email xlink:type="simple">osts25@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9064-8617</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чухрай</surname><given-names>О. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Chukhrai</surname><given-names>O. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Чухрай Ольга Юрьевна, заведующая патологоанатомическим отделением </p><p> 350040, Россия, Краснодар, ул. Димитрова, д. 146 </p></bio><bio xml:lang="en"><p>Olga Yu. Chukhrai, Head of the Department of Pathological Anatomy </p><p>146, Dimitrov St., Krasnodar, 350040, Russia</p></bio><email xlink:type="simple">lecabel@rambler.ru</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Клинический онкологический диспансер №1;&#13;
Кубанский государственный медицинский университет<country>Россия</country></aff><aff xml:lang="en">Clinical Oncologic Dispensary No. 1; &#13;
Kuban State Medical University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Кубанский государственный медицинский университет;&#13;
Онкологический диспансер №3<country>Россия</country></aff><aff xml:lang="en">Kuban State Medical University;&#13;
Oncologic Dispensary No. 3<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">Клинический онкологический диспансер №1<country>Россия</country></aff><aff xml:lang="en">Clinical Oncologic Dispensary No. 1<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>30</day><month>07</month><year>2023</year></pub-date><volume>0</volume><issue>11</issue><fpage>142</fpage><lpage>149</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Горяинова А.Ю., Леонов М.Г., Мурашко Р.А., Цирульникова О.С., Чухрай О.Ю., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Горяинова А.Ю., Леонов М.Г., Мурашко Р.А., Цирульникова О.С., Чухрай О.Ю.</copyright-holder><copyright-holder xml:lang="en">Goryainova A.Y., Leonov M.G., Murashko R.A., Tsirulnikova O.S., Chukhrai O.Y.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/7698">https://www.med-sovet.pro/jour/article/view/7698</self-uri><abstract><p>Введение. На сегодняшний день для лечения рака тела матки (РТМ) в распоряжении современных онкологов имеются клинические рекомендации научных сообществ, набор лекарственных опций в которых представлен ограниченным спектром препаратов, изученных в недостаточном объеме (исследования II фазы, не больше 52 пациенток в каждом). Очевиден дефицит информации о клинических рутинных алгоритмах систематизации данных, описывающих молекулярно-биологические особенности опухоли, ее распространенность, характеристики пациенток, существующие модели лечения, и формирующих программу принятия решений при планировании лечения больных РТМ.Цель. Разработать алгоритм маршрутизации больных РТМ на территории Краснодарского края в существующих условиях организации медицинской помощи и кадрового потенциала.Материалы и методы. Анализу подверглась информация из амбулаторных медицинских карт 72 больных РТМ, которым было выдано направление для тестирования на наличие микросателлитной нестабильности (MSI) в опухоли в Клинический онкологический диспансер № 1 (КОД № 1) с 01.01.2021 по 16.11.2022 гг. для определения возможности получения иммуно/иммунотаргетной терапии во второй и последующих линиях лекарственного лечения.Результаты. В отношении моделей системной терапии больных РТМ было выявлено, что в КОД №1 применяются все опции, перечисленные в клинических рекомендациях. Первую линию системной терапии по поводу распространенной болезни получила 61 пациентка из 72, вторую – 41, третью линию – 19. Иммунотаргетная комбинация проведена пяти пациенткам во второй линии и трем – в третьей. Иммунотерапию пембролизумабом в третьей линии получила одна больная. Анализ факторов, оказывающих влияние на возможности проведения данной терапии, показал важность своевременного генетического тестирования на наличие MSI в опухоли эндометрия, а также связанных с этим организационных вопросов, таких как возможность быстрого получения лечения и обеспечение соответствующего сопровождения пациенток.Выводы. На основе проведенного исследования выявлена низкая осведомленность клиницистов о возможности и необходимости проведения раннего тестирования на наличие MSI в опухоли эндометрия. Необходимость осуществления доставки материала из клиник, имеющих территориальную отдаленность, недостаточный доступ пациенток к консультациям смежных специалистов и низкая комплаентность больных ограничивают введение современных методов терапии больных РТМ. Организация системы тесного профессионального взаимодействия врачей будет способствовать более широкому внедрению новых методов диагностики и лечения больных РТМ.</p></abstract><trans-abstract xml:lang="en"><p>Introduction. For the treatment of uterine body cancer (UBC), modern oncologists have at their disposal clinical recommendations of scientific communities, the set of drug options in which is represented by a limited range of drugs that have not been studied enough (phase II studies, no more than 52 patients in each). There is an obvious lack of information about clinical routine data systematization algorithms that describe the molecular biological features of the tumor, its prevalence, patient characteristics, existing treatment models, and form a decision-making program when planning the treatment of UBC patients.Aim. Тo develop an algorithm for routing patients with UBC on the territory of the Krasnodar Region in the existing conditions for organizing medical care and human resources.Materials and methods. Local observational retrospective study. Sources – medical records. The data were collected by the co-authors of the article in the course of daily clinical activities. Information from the medical records of 72 patients with endometrial cancer who were referred for microsatellite instability (MSI) testing at the Oncological Dispensary of Krasnodar from 01/01/2021 to 11/16/2022 was analyzed to determine the possibility of receiving immuno/immuno-targeted therapy in the second and subsequent lines medicinal treatment.Results. In the Krasnodar Oncological Dispensary all the therapy options specified in the clinical guidelines were used. One line of systemic therapy for a common disease was received by 61 patients out of 72, only 41 patients received the second line, and only 19 patients received the third line. Five patients received the immunotargeted combination in the second line and 3 in the third. One patient received immunotherapy with pembrolizumab in the third line. One patient received immunotherapy with pembrolizumab in the third line. An analysis of the factors influencing the possibility of receiving this therapy showed the importance of timely genetic testing of MSI, as well as related organizational issues, such as the ability to quickly receive treatment and ensure appropriate follow-up of patients.Conclusions. Based on the study, low awareness of clinicians about the possibility and necessity of early testing for the presence of MSI in an endometrial tumor was revealed. The organization of delivery of material from clinics that have a territorial remoteness, insufficient access to patient consultations by related specialists, and low patient compliance limit the introduction of modern methods of therapy for UBC patients. Establishing a system of close professional interaction between physicians will contribute to a wider introduction of new methods of diagnosis and treatment of UBC patients.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рак тела матки</kwd><kwd>иммунотаргетная терапия</kwd><kwd>иммуногистохимическое исследование</kwd><kwd>микросателлитная нестабильность</kwd></kwd-group><kwd-group xml:lang="en"><kwd>uterine cancer</kwd><kwd>endometrial cancer</kwd><kwd>immunotargeted therapy</kwd><kwd>immunohistochemical study</kwd><kwd>microsatellite instability</kwd></kwd-group><funding-group xml:lang="ru"><funding-statement>Данная публикация выпущена при финансовой поддержке ООО «Эйсай».</funding-statement></funding-group><funding-group xml:lang="en"><funding-statement>This paper was published with financial support from Eisai LLC.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. https://doi.org/10.3322/caac.21660.</mixed-citation><mixed-citation xml:lang="en">Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. https://doi.org/10.3322/caac.21660.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Ferlay J., Colombet M., Soerjomataram I., Parkin D.M., Piñeros M., Znaor A., Bray F. Cancer statistics for the year 2020: An overview. Int J Cancer. 2021. https://doi.org/10.1002/ijc.31937.</mixed-citation><mixed-citation xml:lang="en">Ferlay J., Colombet M., Soerjomataram I., Parkin D.M., Piñeros M., Znaor A., Bray F. Cancer statistics for the year 2020: An overview. Int J Cancer. 2021. https://doi.org/10.1002/ijc.31937.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Каприн А.Д., Старинский В.В., Шахзадова А.О. (ред.). Злокачественные новообразования в России в 2021 году (заболеваемость и смертность). М.; 2022. 252 с.</mixed-citation><mixed-citation xml:lang="en">Kaprin A.D., Starinsky V.V., Shakhzadova A.O. (eds.). Malignant neoplasms in Russia in 2021 (morbidity and mortality). Мoscow: P. Hertsen Moscow Oncology Research Institute of Health of the Russian Federation; 2022. 252 р. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Torricelli F., Sauta E., Manicardi V., Mandato V.D., Palicelli A., Ciarrocchi A., Manzotti G. An Innovative Drug Repurposing Approach to Restrain Endometrial Cancer Metastatization. Cells. 2023;12(5):794. https://doi.org/10.3390/cells12050794.</mixed-citation><mixed-citation xml:lang="en">Torricelli F., Sauta E., Manicardi V., Mandato V.D., Palicelli A., Ciarrocchi A., Manzotti G. An Innovative Drug Repurposing Approach to Restrain Endometrial Cancer Metastatization. Cells. 2023;12(5):794. https://doi.org/10.3390/cells12050794.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Mandato V.D., Palicelli A., Torricelli F., Mastrofilippo V., Leone C., Dicarlo V. et al. Should Endometrial Cancer Treatment Be Centralized? Biology (Basel). 2022;11(5):768. https://doi.org/10.3390/biology11050768.</mixed-citation><mixed-citation xml:lang="en">Mandato V.D., Palicelli A., Torricelli F., Mastrofilippo V., Leone C., Dicarlo V. et al. Should Endometrial Cancer Treatment Be Centralized? Biology (Basel). 2022;11(5):768. https://doi.org/10.3390/biology11050768.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Nagao S., Nishio S., Michimae H., Tanabe H., Okada S., Otsuki T. et al. Applicability of the concept of “platinum sensitivity” to recurrent endometrial cancer: the SGSG-012/GOTIC-004/Intergroup study. Gynecol Oncol. 2013;131(3):567–573. https://doi.org/10.1016/j.ygyno.2013.09.021.</mixed-citation><mixed-citation xml:lang="en">Nagao S., Nishio S., Michimae H., Tanabe H., Okada S., Otsuki T. et al. Applicability of the concept of “platinum sensitivity” to recurrent endometrial cancer: the SGSG-012/GOTIC-004/Intergroup study. Gynecol Oncol. 2013;131(3):567–573. https://doi.org/10.1016/j.ygyno.2013.09.021.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Mandato V.D., Palicelli A., Torricelli F., Mastrofilippo V., Leone C., Dicarlo V. et al. Should Endometrial Cancer Treatment Be Centralized? Biology (Basel). 2022;11(5):768. https://doi.org/10.3390/biology11050768.</mixed-citation><mixed-citation xml:lang="en">Mandato V.D., Palicelli A., Torricelli F., Mastrofilippo V., Leone C., Dicarlo V. et al. Should Endometrial Cancer Treatment Be Centralized? Biology (Basel). 2022;11(5):768. https://doi.org/10.3390/biology11050768.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Heffernan K., Nikitas F.S., Shukla U., Camejo H.S., Knott C. Previously treated recurrent or advanced endometrial cancer in England: A real-world observational analysis. Gynecol Oncol. 2022;166(2):317–325. https://doi.org/10.3390/biology11050768.</mixed-citation><mixed-citation xml:lang="en">Heffernan K., Nikitas F.S., Shukla U., Camejo H.S., Knott C. Previously treated recurrent or advanced endometrial cancer in England: A real-world observational analysis. Gynecol Oncol. 2022;166(2):317–325. https://doi.org/10.3390/biology11050768.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Kelkar S.S., Prabhu V.S., Zhang J., Corman S., Macahilig C., Rusibamayila N. et al. Treatment patterns and real-world clinical outcomes in patients with advanced endometrial cancer that are non-microsatellite instability high (non-MSI-high) or mismatch repair proficient (pMMR) in the United States. Gynecol Oncol Rep. 2022;42:101026. https://doi.org/10.1016/j.gore.2022.101026.</mixed-citation><mixed-citation xml:lang="en">Kelkar S.S., Prabhu V.S., Zhang J., Corman S., Macahilig C., Rusibamayila N. et al. Treatment patterns and real-world clinical outcomes in patients with advanced endometrial cancer that are non-microsatellite instability high (non-MSI-high) or mismatch repair proficient (pMMR) in the United States. Gynecol Oncol Rep. 2022;42:101026. https://doi.org/10.1016/j.gore.2022.101026.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Mevius A., Karl F., Wacker M., Welte R., Krenzer S., Link T. et al. Real-world treatment of German patients with recurrent and advanced endometrial cancer with a post-platinum treatment: a retrospective claims data analysis. J Cancer Res Clin Oncol. 2023;149(5):1929–1939. https://doi.org/10.1007/s00432-022-04183-y.</mixed-citation><mixed-citation xml:lang="en">Mevius A., Karl F., Wacker M., Welte R., Krenzer S., Link T. et al. Real-world treatment of German patients with recurrent and advanced endometrial cancer with a post-platinum treatment: a retrospective claims data analysis. J Cancer Res Clin Oncol. 2023;149(5):1929–1939. https://doi.org/10.1007/s00432-022-04183-y.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Vistad I., Bjørge L. Advanced endometrial cancer: New medical treatment options on the horizon. Acta Obstet Gynecol Scand. 2023;102(2):128–129. https://doi.org/10.1111/aogs.14499.</mixed-citation><mixed-citation xml:lang="en">Vistad I., Bjørge L. Advanced endometrial cancer: New medical treatment options on the horizon. Acta Obstet Gynecol Scand. 2023;102(2):128–129. https://doi.org/10.1111/aogs.14499.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Paleari L. New Strategies for Endometrial Cancer Detection and Management. Int J Mol Sci. 2023;24(7):6462. https://doi.org/10.3390/ijms24076462.</mixed-citation><mixed-citation xml:lang="en">Paleari L. New Strategies for Endometrial Cancer Detection and Management. Int J Mol Sci. 2023;24(7):6462. https://doi.org/10.3390/ijms24076462.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Restaino S., Paglietti C., Arcieri M., Biasioli A., Della Martina M., Mariuzzi L. et al. Management of Patients Diagnosed with Endometrial Cancer: Comparison of Guidelines. Cancers (Basel). 2023;15(4):1091. https://doi.org/10.3390/cancers15041091.</mixed-citation><mixed-citation xml:lang="en">Restaino S., Paglietti C., Arcieri M., Biasioli A., Della Martina M., Mariuzzi L. et al. Management of Patients Diagnosed with Endometrial Cancer: Comparison of Guidelines. Cancers (Basel). 2023;15(4):1091. https://doi.org/10.3390/cancers15041091.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Abdol Manap N., Ng B.K., Phon S.E., Abdul Karim A.K., Lim P.S., Fadhil M. Endometrial Cancer in Pre-Menopausal Women and Younger: Risk Factors and Outcome. Int J Environ Res Public Health. 2022;19(15):9059. https://doi.org/10.3390/ijerph19159059.</mixed-citation><mixed-citation xml:lang="en">Abdol Manap N., Ng B.K., Phon S.E., Abdul Karim A.K., Lim P.S., Fadhil M. Endometrial Cancer in Pre-Menopausal Women and Younger: Risk Factors and Outcome. Int J Environ Res Public Health. 2022;19(15):9059. https://doi.org/10.3390/ijerph19159059.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Boeckstaens S., Dewalheyns S., Heremans R., Vikram R., Timmerman D., Van den Bosch T., Verbakel J.Y. Signs and symptoms associated with uterine cancer in pre- and postmenopausal women. Heliyon. 2020;6(11):e05372. https://doi.org/10.1016/j.heliyon.2020.e05372.</mixed-citation><mixed-citation xml:lang="en">Boeckstaens S., Dewalheyns S., Heremans R., Vikram R., Timmerman D., Van den Bosch T., Verbakel J.Y. Signs and symptoms associated with uterine cancer in pre- and postmenopausal women. Heliyon. 2020;6(11):e05372. https://doi.org/10.1016/j.heliyon.2020.e05372.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Каприн А.Д., Старинский В.В., Шахзадова А.О. (ред.). Состояние онкологической помощи населению России в 2021 году. М.; 2022. 239 с. Режим работы: https://oncology-association.ru/wp-content/uploads/2022/05/sostoyanie-onkologicheskoj-pomoshhi-naseleniyu-rossii-v-2021-godu.pdf.</mixed-citation><mixed-citation xml:lang="en">Kaprin A.D., Starinsky V.V., Shakhzadova A.O. (eds.). The state of cancer care to the population of Russia in 2021. Moscow; 2022. 239 р. (In Russ.) Available at: https://oncology-association.ru/wp-content/uploads/2022/05/sostoyanie-onkologicheskoj-pomoshhi-naseleniyu-rossii-v-2021-godu.pdf.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Neri M., Peiretti M., Melis G.B., Piras B., Vallerino V., Paoletti A.M. et al. Systemic therapy for the treatment of endometrial cancer. Expert Opin Pharmacother. 2019;20(16):2019–2032. https://doi.org/10.1080/14656566.2019.1654996.</mixed-citation><mixed-citation xml:lang="en">Neri M., Peiretti M., Melis G.B., Piras B., Vallerino V., Paoletti A.M. et al. Systemic therapy for the treatment of endometrial cancer. Expert Opin Pharmacother. 2019;20(16):2019–2032. https://doi.org/10.1080/14656566.2019.1654996.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Makker V., Taylor M.H., Aghajanian C., Oaknin A., Mier J., Cohn A.L. et al. Lenvatinib Plus Pembrolizumab in Patients With Advanced Endometrial Cancer. J Clin Oncol. 2020;38(26):2981–2992. https://doi.org/10.1016/j.gore.2021.100840.</mixed-citation><mixed-citation xml:lang="en">Makker V., Taylor M.H., Aghajanian C., Oaknin A., Mier J., Cohn A.L. et al. Lenvatinib Plus Pembrolizumab in Patients With Advanced Endometrial Cancer. J Clin Oncol. 2020;38(26):2981–2992. https://doi.org/10.1016/j.gore.2021.100840.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Нечушкина В. М., Коломиец Л. А., Кравец О. А., Морхов К. Ю., Новикова Е. Г., Новикова О. В. и соавт. Практические рекомендации по лекарственному лечению рака тела матки и сарком матки. Злокачественные опухоли. 2022;12(3s2-1):260–275. https://doi.org/10.18027/2224-5057-2022-12-3s2-260-275</mixed-citation><mixed-citation xml:lang="en">Nechushkina V.M., Kolomiets L.A., Kravets O.A., Morkhov K.Yu., Novikova E.G., Novikova O.V. et al. Practical recommendations for the drug treatment of uterine body cancer and uterine sarcoma. Malignant Tumors. 2022;12(3s2-1):260–275. (In Russ.) https://doi.org/10.18027/2224-5057-2022-12-3s2-260-275</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Oaknin A., Bosse T.J., Creutzberg C.L., Giornelli G., Harter P., Joly F. et al. Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2022;33(9):860–877. https://doi.org/10.3390/jcm11226765.</mixed-citation><mixed-citation xml:lang="en">Oaknin A., Bosse T.J., Creutzberg C.L., Giornelli G., Harter P., Joly F. et al. Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2022;33(9):860–877. https://doi.org/10.3390/jcm11226765.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Румянцев А.А. Рациональная последовательность терапии распространенного и метастатического рака эндометрия. Опухоли женской репродуктивной системы. 2022;18(2):119–126. https://doi.org/10.17650/1994-4098-2022-18-2-119-126.</mixed-citation><mixed-citation xml:lang="en">Rumyantsev A.A. Efficient sequence of therapy for advanced and metastatic endometrial cancer. Opuholi Zenskoj Reproduktivnoj Sistemy. 2022;18(2):119–126. (In Russ.) https://doi.org/10.17650/1994-4098-2022-18-2-119-126.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">O’Malley D.M., Bariani G.M., Cassier P.A., Marabelle A., Hansen A.R., De Jesus Acosta A. et al. Рembrolizumab in Patients With Microsatellite Instability – High Advanced Endometrial Cancer: Results From the KEYNOTE-158 Study. J Clin Oncol. 2022;40(7):752–761. https://doi.org/10.1200/JCO.21.01874.</mixed-citation><mixed-citation xml:lang="en">O’Malley D.M., Bariani G.M., Cassier P.A., Marabelle A., Hansen A.R., De Jesus Acosta A. et al. Рembrolizumab in Patients With Microsatellite Instability – High Advanced Endometrial Cancer: Results From the KEYNOTE-158 Study. J Clin Oncol. 2022;40(7):752–761. https://doi.org/10.1200/JCO.21.01874.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Barrios C., de Lima Lopes G., Yusof M.M., Rubagumya F., Rutkowski P., Sengar M. Barriers in access to oncology drugs – a global crisis. Nat Rev Clin Oncol. 2023;20(1):7–15. https://doi.org/10.1038/s41571-022-00700-7.</mixed-citation><mixed-citation xml:lang="en">Barrios C., de Lima Lopes G., Yusof M.M., Rubagumya F., Rutkowski P., Sengar M. Barriers in access to oncology drugs – a global crisis. Nat Rev Clin Oncol. 2023;20(1):7–15. https://doi.org/10.1038/s41571-022-00700-7.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Кислов Н.В., Нестеров П.В., Белоногов С.Б. Практические аспекты применения клинических рекомендаций в онкологии. Медицинские технологии. Оценка и выбор. 2020;(2):43–49. https://doi.org/10.17116/medtech20204002143.</mixed-citation><mixed-citation xml:lang="en">Kislov N.V., Nesterov P.V., Belonogov S.B. Practical aspects of clinical guidelines in oncology. Medical Technologies. Assessment and Choice. 2020;(2):43–49. (In Russ.) https://doi.org/10.17116/medtech20204002143.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Spencer R.J., Rice L.W., Ye C., Woo K., Uppal S. Disparities in the allocation of research funding to gynecologic cancers by Funding to Lethality scores. Gynecol Oncol. 2019;152(1):106–111. https://doi.org/10.1016/j.ygyno.2018.10.021.</mixed-citation><mixed-citation xml:lang="en">Spencer R.J., Rice L.W., Ye C., Woo K., Uppal S. Disparities in the allocation of research funding to gynecologic cancers by Funding to Lethality scores. Gynecol Oncol. 2019;152(1):106–111. https://doi.org/10.1016/j.ygyno.2018.10.021.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Restaino S., Paglietti C., Arcieri M., Biasioli A., Della Martina M., Mariuzzi L. et al. Management of Patients Diagnosed with Endometrial Cancer: Comparison of Guidelines. Cancers (Basel). 2023;15(4):1091. https://doi.org/10.3390/cancers15041091.</mixed-citation><mixed-citation xml:lang="en">Restaino S., Paglietti C., Arcieri M., Biasioli A., Della Martina M., Mariuzzi L. et al. Management of Patients Diagnosed with Endometrial Cancer: Comparison of Guidelines. Cancers (Basel). 2023;15(4):1091. https://doi.org/10.3390/cancers15041091.</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Сапунова Т.А. Анализ проблем демографической ситуации Краснодарского края. Инновационная экономика: перспективы развития и совершенствования. 2021;(3):161–166. Режим доступа: https://elibrary.ru/contents.asp?id=45797694.</mixed-citation><mixed-citation xml:lang="en">Sapunova T.A. Analysis of the problems of the demographic situation of the Krasnodar territory. Innovatsionnaya Ehkonomika: Perspektivy Razvitiya i Sovershenstvovaniya. 2021;(3):161–166. (In Russ.) Available at: https://elibrary.ru/contents.asp?id=45797694.</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Makker V., Colombo N., Casado Herráez A., Santin A.D., Colomba E., Miller D.S. et al. Lenvatinib plus Pembrolizumab for Advanced Endometrial Cancer. N Engl J Med. 2022;386(5):437–448. https://doi.org/10.1016/j.gore.2022.101002.</mixed-citation><mixed-citation xml:lang="en">Makker V., Colombo N., Casado Herráez A., Santin A.D., Colomba E., Miller D.S. et al. Lenvatinib plus Pembrolizumab for Advanced Endometrial Cancer. N Engl J Med. 2022;386(5):437–448. https://doi.org/10.1016/j.gore.2022.101002.</mixed-citation></citation-alternatives></ref><ref id="cit29"><label>29</label><citation-alternatives><mixed-citation xml:lang="ru">Stinton C., Fraser H., Al-Khudairy L., Court R., Jordan M., Grammatopoulos D., Taylor-Phillips S. Testing for lynch syndrome in people with endometrial cancer using immunohistochemistry and microsatellite instability-based testing strategies – A systematic review of test accuracy. Gynecol Oncol. 2021;160(1):148–160. https://doi.org/10.1016/j.ygyno.2020.10.003.</mixed-citation><mixed-citation xml:lang="en">Stinton C., Fraser H., Al-Khudairy L., Court R., Jordan M., Grammatopoulos D., Taylor-Phillips S. Testing for lynch syndrome in people with endometrial cancer using immunohistochemistry and microsatellite instability-based testing strategies – A systematic review of test accuracy. Gynecol Oncol. 2021;160(1):148–160. https://doi.org/10.1016/j.ygyno.2020.10.003.</mixed-citation></citation-alternatives></ref><ref id="cit30"><label>30</label><citation-alternatives><mixed-citation xml:lang="ru">Duraturo F., Liccardo R., De Rosa M., Izzo P. Genetics, diagnosis and treatment of Lynch syndrome: Old lessons and current challenges. Oncol Lett. 2019;17(3):3048–3054. https://doi.org/10.3892/ol.2019.9945.</mixed-citation><mixed-citation xml:lang="en">Duraturo F., Liccardo R., De Rosa M., Izzo P. Genetics, diagnosis and treatment of Lynch syndrome: Old lessons and current challenges. Oncol Lett. 2019;17(3):3048–3054. https://doi.org/10.3892/ol.2019.9945.</mixed-citation></citation-alternatives></ref><ref id="cit31"><label>31</label><citation-alternatives><mixed-citation xml:lang="ru">Liu L., Habeshian T.S., Zhang J., Peeri N.C., Du M., De Vivo I., Setiawan V.W. Differential trends in rising endometrial cancer incidence by age, race, and ethnicity. JNCI Cancer Spectr. 2023;7(1):pkad001. https://doi.org/10.1093/jncics/pkad001.</mixed-citation><mixed-citation xml:lang="en">Liu L., Habeshian T.S., Zhang J., Peeri N.C., Du M., De Vivo I., Setiawan V.W. Differential trends in rising endometrial cancer incidence by age, race, and ethnicity. JNCI Cancer Spectr. 2023;7(1):pkad001. https://doi.org/10.1093/jncics/pkad001.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
