This year marks the 10th anniversary of the establishment of the National Medical Research Center for Radiology of the Russian Ministry of Health, the first in the history of cancer clusters in new Russia. What a breakthrough Russian medicine has made today in the field of combating oncological diseases, said Andrey Kaprin, Director General of the Russian Ministry of Health’s Scientific Research Institute of Radiology, Academician of the Russian Academy of Sciences and the Russian Academy of Medical Sciences, Chief Oncologist of the Russian Ministry of Health

Andrey Kaprin
Director General of NMIC of Radiology of the Ministry of Health of the Russian Federation

Our Center was founded in May 2014 by order of the Minister of Health of the Russian Federation. This federal state budgetary institution has united three leading Russian research centers: the P. A. Herzen Moscow Institute of Medical Sciences, the N. A. Lopatkin Research Institute of Urology and Interventional Radiology in Moscow, and the A. F. Tsyba MRSC in Obninsk. And I have the honor to lead this unique institution.
During this time, the name of the association has changed several times, but the essence and meaning of its work remain unchanged — providing medical care in the fields of «oncology» and «radiology» at the highest level.

The idea of creating national research centers was a logical continuation of the policy of modernizing the medical care system in the country. To implement it, a new three-tier structure of oncological care was introduced, which unites oncological medical organizations throughout the country and includes the level of primary specialized medical care, the level of specialized medical care and the level of specialized (including high-tech) medical care. This system has been built over the years, making it possible to organize a vertical system with strong horizontal links. Within this framework, in 2018, four national medical research centers were established in the fields of «oncology» and «radiology», one of which became our NMC of Radiology.

Our task is to provide organizational and methodological assistance to the supervised regions within the framework of the implementation of the federal project «Fight against oncological diseases».

Advantages of the structure

The very scale of the tasks that were set determined the format of the institution to which they were assigned — a large association with centrally implemented management, the presence of a large scientific, human resources and bed capacity. The center also combines the best traditions of the school in surgery, radiology and urology, created by our
great teachers P. A. Herzen, N. A. Lopatkin and A. F. Tsyb. And soon we felt these advantages.

The main advantage is the closed loop of patient routing. Thanks to such a powerful association, the patient has the opportunity to undergo examinations and receive the most up-to—date diagnostics, including radionuclide and molecular genetic, and comprehensive treatment — surgical, radiation, medicinal in various combinations, as well as rehabilitation within the same institution.

Thanks to the merger, we were able to launch the first Russian proton medical complex Prometheus in Obninsk, make the topic of nuclear medicine sound again, introduce the latest technologies for preserving the reproductive function of cancer patients thanks to a bio-bank, rebuild a powerful system of molecular genetic diagnostics in each of the branches, and much more. We perform truly unique surgeries with interdisciplinary and inter-branch teams of surgeons.

In simple terms, the capabilities of all three institutes have become available for scientific research and for the treatment of patients.

Stages of the center’s development

An important stage for us was the assignment of the status of a reference center for pathomophrological, molecular genetic and radiation research methods in 2018, which indicates the recognition of the competence and qualifications of our specialists and services.

Of course, it is worth noting the title of the National Medical Research Center, which is also held by three other centers in the field of oncology and radiology.

In 2020, the NMIC of Radiology was awarded the title of the basic organization in the field of oncology for the member countries of the Union of Independent States. It’s an incredible honor and responsibility. The Center’s specialists regularly travel to the DPR and LPR on an organizational, methodological, humanitarian and scientific mission. With the participation of our specialists, programs for the development of oncological services in the regions have been developed and adjusted, taking into account logistical re-equipment.

Two Vocation Awards, two Prizes of the Government of the Russian Federation in the field of science and technology, and the gratitude of the President of the Russian Federation to the staff of the Center are all stages and milestones in our development.

Many of the achievements of our Center are related to the development of our own radiopharmaceuticals (RFPs).

In 2016, we opened the Center for High-power Brachytherapy at the A. F. Tsyba MRSC, where, in addition to the standard areas of application of this technology, clinical testing of brachytherapy is currently underway in such localities as the mammary gland, inoperable pancreatic tumors, and potentially unresectable liver tumors. And in 2018, the team received an Award from the Government of the Russian Federation for the development and implementation of an RFP based on iodine-125, which made it possible to begin the process of import substitution and treatment with this isotope. At the same time, we opened the most modern department of X-ray radiosurgery, on the basis of which a huge step forward was made.: We have developed a method for using Russian-made radioactive microspheres for the treatment of inoperable liver cancers.

More recently, thanks to the support of the Government of the Russian Federation and the Ministry of Health of Russia, the first pharmacy in Russia for the manufacture of radiopharmaceuticals for the treatment of patients with oncological and non-oncological diseases was opened at the NMITS of Radiology. This allowed us to make a real breakthrough in the development of nuclear medicine technologies and opened up new perspectives in the treatment of patients suffering from, among other things, metastatic diseases.

In 2023, in Obninsk, we opened an innovative scientific and production complex of GMP-class cellular technologies, one of the key tasks of which is the development and implementation of the latest cell
therapy products for cancer treatment.

Both scientific and clinical work of specialists from all three branches enrich and support each other. In all branches of the Center, we master the latest technologies and develop our own cancer treatment methods. For example, a Center for the Treatment of Carcinomatosis has been established on the basis of the P. A. Herzen Moscow Institute of Medical Sciences. It uses advanced PIPAC technologies, intra—abdominal aerosol chemotherapy, which is performed with minimally invasive access and affects peritoneal metastases. And what is important is that our specialists have invented and patented a special device for dispersing the drug, which also gave us the opportunity to get away from import dependence in the supply of this nozzle.

Two years ago, the ENDOONCO Russian-Japanese center for endoscopic technologies was opened here, which will allow our specialists not only to work on state-of-the-art expert-class equipment, but also to perform high-precision endoscopic examinations of the gastrointestinal tract and treat early and pre-cancers. On the basis of this center, there is a training school for modern methods of diagnosis and treatment of endoscopists from all regions of the country.

It was the PET-CT department at the P. A. Herzen Moscow Institute of Nuclear Medicine that became the first and only one in our country accredited by the European Association of Nuclear Medicine (EANM).

The Lopatkin Research Institute of Urology and Interventional Radiology has a department of pediatric urology, which treats patients from birth to the age of 18. Moreover, all types of surgical intervention are performed here, including with the use of reconstructive traumatology and orthopedic care.
The National Research Medical Center of Radiology has the only department of reconstructive plastic surgery of radiation injuries in the country.

The basic organization of the CIS member States in the field of oncology

Since 2020, the Center has become the basic organization of the CIS member states in the field of oncology. Formally, the purpose of the work of the basic organization is to coordinate research, educational, organizational and methodological support for activities in the areas of oncology in the member states of the Commonwealth of Independent States. In practice, we have signed a lot of cooperation agreements with colleagues from the CIS countries, with whom we are members of the Association of Directors of Institutes of Oncology and Radiology ADIOR, and in addition to joint meetings where we discuss ways to develop oncological services and scientific research in this field, we provide students, residents, and doctors with the opportunity to undergo internships at our branches.. Our best specialists often travel to friendly countries with their master classes to transfer best practices in the field of practical oncology — surgery, endoscopic diagnostics. Twice a week
, everyone (including colleagues from the CIS countries,
as well as Mongolia and China) joins our morning conferences, where we analyze the most interesting cases and observations from our practice. We regularly participate in meetings of the CIS Health Council. Russia is chairing the Council this year.

Implementation of the federal project

Over the past five years, the Russian cancer service has made a powerful breakthrough both scientifically and clinically. Thanks to the support of the Government, the Ministry of Health, and the Federal Assembly of the Russian Federation, Russian scientists and physicians have gained new opportunities to develop and implement the latest technologies for cancer diagnosis and treatment in Russia.
A system of reference centers has been introduced in the country, the role of which is performed by large national and federal centers overseeing regional institutions in the fields of oncology and radiology. For example, the NMC of Radiology of the Ministry of Health of the Russian Federation is a reference center for the direction of pathomorphological, immunohistochemical and radiation research methods. The Center’s Molecular Genetic Service currently performs the full range of relevant research, which makes it possible to diagnose patients and begin treatment in the shortest possible time.

Today, almost every region has organized and implemented a network of outpatient cancer care centers (CAOPS) aimed at increasing the availability of appropriate care to the population. Over the past five years, the implementation of the federal project to combat cancer has already opened more than 552 such centers. Logistical re-equipment of regional dispensaries is taking place everywhere. New buildings, departments, and entire complexes are being built and put into operation. Equipment is being purchased: heavy machinery, expert-class apparatuses, pathomorphological laboratories, operating rooms are being equipped. We regularly travel as part of the Ministry of Health’s delegations to open new facilities.

Telemedicine technologies are actively developing, and the possibilities of remote telemedicine consultations (TMC) using the doctor-to-doctor system are being used to their full potential. In 2023 alone, the NMIC of Radiology conducted more than 17 thousand such TMCs, including those with foreign medical centers. Artificial intelligence technologies are being increasingly introduced into the diagnosis of oncological diseases.