ОБЗОР ПОДХОДОВ К ИММУНОТЕРАПИИ В ОНКОЛОГИИ

В статье рассматриваются современные представления об иммунной терапии рака — методике лечения онкологических заболеваний, основанной на иммунологических реакциях организма на появление в нем злокачественных клеток. Данная область активно исследуется в клинической практике в последнее десятилетие, и некоторые терапии уже получили одобрение для применения регуляторными органами после многообещающих результатов клинических исследований 3‑й фазы.

Иммунная терапия основана на противоопухолевом иммунном цикле — каскаде процессов, ответственных за реакцию иммунной системы на опухолевые клетки. Задействованные в нем регуляторные механизмы становятся целями для различных терапий, общая цель которых — восстановить полноценное функционирование цикла и достичь элиминации раковых клеток.

В настоящее время наиболее изучены два вида иммунотерапии — чекпойнт-ингибиторы (checkpoint-inhibitors) и адаптивная клеточная терапия. Чекпойнт-ингибиторы увеличивают активность имеющихся в организме иммунокомпетентных клеток, уменьшая ингибирующее влияние опухолевого микроокружения и самих опухолевых клеток, которое позволило им выйти из-под прессинга иммунитета в ходе развития заболевания. Адаптивная клеточная терапия, в свою очередь, позволяет возместить нехватку активных иммунокомпетентных по отношению к опухоли клеток. Механизмы действия определяют различную эффективность терапий как для разных заболеваний, так и для пациентов «внутри» одного диагноза. Для определения эффективности того или другого лечения до его начала у конкретного пациента необходимо использовать последние достижения прецизионной медицины, основанные на поиске новых биомаркеров и их анализа у каждого пациента в отдельности. Такой подход позволит значительно сократить расходы и сохранить драгоценное время для пациента. 

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