Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press99310.17650/1726-9776-2019-15-4-30-38LECTUREЛЕКЦИЯCurrent advances in kidney cancer immunotherapyСовременные достижения в иммунотерапии рака почкиhttps://orcid.org/0000-0003-0083-3005KorotaevaA. A.КоротаеваА. А.
Russian Federation

1 Moskvorechye St., Moscow 115522

Коротаева Александра Алексеевна,  старший научный сотрудник, кандидат медицинский наук

115522 Москва, ул. Москворечье, 1

kor2306@mail.ruhttps://orcid.org/0000-0003-4539-5424ApanovichN. V.АпановичН. В.
Russian Federation

1 Moskvorechye St., Moscow 115522

Апанович Наталья Владимировна, старший научный сотрудник, кандидат медицинский наук

115522 Москва, ул. Москворечье, 1

apanovich81@mail.ruhttps://orcid.org/0000-0001-5188-4094BragaE. A.БрагаЭ. А.
Russian Federation

1 Moskvorechye St., Moscow 115522, 

8 Baltiyskaya St., Moscow 125315

Брага  Элеонора  Александровна, доктор биологических наук, профессор, ведущий научный сотрудник

115522 Москва, ул. Москворечье, 1, 

125315 Москва, ул. Балтийская, 8

eleonora10_45@mail.ruhttps://orcid.org/0000-0001-7748-9527MatveevV. B.МатвеевВ. Б.
Russian Federation

Department of Fundamental Medicine M.V. Lomonosov Moscow State University

24 Kashirskoe Shosse, Moscow 115478, 

Build. 5, 31 Lomonosovskiy Prospekt, Moscow 119192

Матвеев  Всеволод  Борисович, доктор медицинских наук, профессор, член-корреспондент РАН, заведующий урологическим отделением, заместитель директора по научной работе

Факультет фундаментальной медицины ФГБОУ ВО «Московский государственный университета им. М.В. Ломоносова»

115478 Москва, Каширское шоссе, 24, 

119192 Москва, Ломоносовский проспект, 31, корп. 5

vsevolodmatveev@mail.ruhttps://orcid.org/0000-0002-7001-9116KarpukhinA. V.КарпухинА. В.
Russian Federation

1 Moskvorechye St., Moscow 115522

Карпухин  Александр  Васильевич, доктор биологических наук, профессор, заведующий лабораторией

115522 Москва, ул. Москворечье, 1

karpukhin@med-gen.ruN.P. Bochkov Research Centre for Medical GeneticsФГБНУ «Медико-генетический научный центр им. акад. Н.П. Бочкова»Institute of General Pathology and PathophysiologyФГБНУ «Научно-исследовательский институт общей патологии и патофизиологии»N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииM.V. Lomonosov Moscow State UniversityФГБОУ ВО «Московский государственный университета им. М.В. Ломоносова»3012201915430381110201904112019https://oncourology.abvpress.ru/oncur/article/view/993

In Russia, among tumors of the genitourinary system, renal cell carcinoma takes the 2nd place after prostate cancer. In 25 % of patients at the time of diagnosis, metastases are detected. Treatment of advanced stages of renal cell carcinoma is often not effective enough. The introduction into clinical practice of modern immunotherapeutic drugs based on inhibition of immune check points has changed the prognosis of the disease for many patients with various malignant neoplasms, including kidney cancer. In this article, we described the results of recent clinical trials on the use of immunotherapy in the treatment of kidney cancer. The most effective is combination of drugs that inhibit different immune check points, and a combination of a check point inhibitor with a targeted drug. This approach is likely to be a major one in the treatment of renal cell carcinoma in the short term. Combinations of control point inhibitors with radiation therapy and immunomodulatory drugs, the role of miRNAs in the regulation of expression of immune control points, the significance and characteristics of the microbiome in connection with the success of immunotherapy for kidney cancer, gene expression profiles as biomarkers of the immune response, and other biomarkers are considered. A better understanding of the mechanisms that limit the effectiveness of immune control point inhibitors will improve future treatment.

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.

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