Aim:Human papilloma viruses (HPVs) are small DNA viruses that have been identified in periodontal pocket as well as gingival sulcus. High risk HPVs are also associated with a subset of head and neck carcinomas. HPV detection in periodontium has previously involved DNA detection. This study attempts to: (a) Detect the presence or absence of high risk HPV in marginal periodontiun by identifying E6/E7 messenger RNA (mRNA) in cells from samples obtained by periodontal pocket scraping. (b) Detect the percentage of HPV E6/E7 mRNA in cells of pocket scrapings, which is responsible for producing oncoproteins E6 and E7.Materials and Methods:Pocket scrapings from the periodontal pockets of eight subjects with generalized chronic periodontitis were taken the detection of presence or absence of E6, E7 mRNA was performed using in situ hybridization and flow cytometry.Results:HPV E6/E7 mRNA was detected in four of the eight samples.Conclusion:Presence of high risk human papillomaviruses in periodontal pockets patients of diagnosed with chronic periodontitis, not suffering from head and neck squamous cell carcinoma in the present day could link periodontitis to HPV related squamous cell carcinoma. Prevalence studies are needed detecting the presence of HPV in marginal periodontium as well as prospective studies of HPV positive periodontitis patients are required to explore this possible link.

The standards of treatment for metastatic renal cell carcinoma (mRCC) have changed significantly from unsuccessful attempts of radiation and cytostatic therapy to the encouraging results of targeted therapy and specific immunotherapy. Sunitinib has got into the practice in 2006, and now it`s one of the most studied and approved. Sunitinib is one of the first oral targeted drugs for RCC. It affects such receptors as VEGFR1, 2, 3; PDGFR, FGFR, c-KIT, and RET, which take part in the pathologic angiogenesis, tumor growth, and metastasizing. Moreover, sunitinib stimulates the growth and development of lymphatic vessels, that deliver immunocytes to the tumor. The advantage of sunitinib over non-specific immunotherapy has been proven by Motzer et al. The randomized trials COMPARZ, RECORD-3, and SWITCH have confirmed that sunitinib is more effective than several targeted drugs (pazopanib, everolimus, and sorafenib respectively) as the first line of treatment for mRCC. The randomized trial of the 3rd phase CARMENA has demonstrated the importance of sunitinib monotherapy for mRCC of intermediate and poor prognosis. In general, sunitinib has been proven to be an effective first-line drug for mRCC, as it`s evidenced in the comprehensive metaanalysis of real-world data and randomized controlled trials published between 2000 and 2017. Nowadays, despite the success of the immunotherapeutic direction, tyrosine kinase inhibitors, and particularly sunitinib, rightfully remain the standard for mRCC of favourable prognosis, the treatment option for worse prognosis in case of contraindications for other methods of therapy, and it` s also used in subsequent therapy lines.

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