Современные достижения в иммунотерапии рака почки

В России среди опухолей мочеполовой системы почечно-клеточный рак занимает 2-е место после злокачественных новообразований предстательной железы. У 25% пациентов на момент установления диагноза обнаруживаются метастазы. Лечение на поздних стадиях почечно-клеточного рака часто является недостаточно эффективным.  Внедрение в клиническую практику современных иммунотерапевтических препаратов, основанных на ингибировании иммунных контрольных точек, изменило прогноз заболевания для многих пациентов с различными злокачественными новообразованиями, в том числе с раком почки. В этой статье мы описали результаты последних клинических испытаний по применению иммунотерапии в лечении рака почки. Наиболее эффективно сочетание препаратов, ингибирующих разные контрольные точки, и комбинации ингибитора контрольной точки с таргетным препаратом. Такой подход, видимо, будет магистральным в терапии почечно-клеточного рака в ближайшей перспективе. Рассмотрены комбинации ингибиторов контрольных точек с лучевой терапией и иммуномодулирующими препаратами, а также роль микроРНК в регуляции экспрессии иммунных контрольных точек, значение и характеристики микробиома в связи с успешностью иммунотерапии рака почки, профили экспрессии генов в качестве биомаркеров иммунного ответа и другие биомаркеры. Лучшее понимание механизмов, ограничивающих эффективность ингибиторов иммунных контрольных точек, позволит улучшить будущее лечение.

иммунотерапия, рак почки, анти-PD-1, анти-PD-L1, анти-CTLA4, ингибиторы контрольных точек иммунного ответа, микроРНК, таргетная терапия

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