И. Л. Царев, А. В. Мелерзанов
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引用次数: 1

摘要

本文讨论了肿瘤免疫治疗的现代思想——基于机体对肿瘤细胞出现的免疫反应治疗肿瘤疾病的方法。在过去的十年中,这一领域在临床实践中得到了积极的研究,一些治疗方法在临床试验三期取得了令人鼓舞的结果后,已经被监管机构批准使用。免疫治疗是基于抗肿瘤免疫周期-负责免疫系统对肿瘤细胞反应的级联过程。所涉及的调节机制是各种治疗的目标,总体目标是恢复正常的循环功能,实现消除癌细胞。目前,研究最多的两种免疫疗法——检查点抑制剂和适应性细胞疗法。检查点抑制剂增加了机体免疫细胞的活性,减少了肿瘤微环境和肿瘤细胞自身的抑制作用,使其在疾病发展过程中摆脱了免疫系统的压力。适应性细胞疗法,反过来,允许补偿缺乏对肿瘤细胞的主动免疫。作用机制决定了各种治疗方法对不同疾病的疗效,以及对同一诊断内的患者的疗效。为了在特定患者之前确定其他治疗的有效性,有必要在寻找新的生物标志物和单独分析每个患者的基础上,使用精密医学的最新成果。这种方法将大大降低成本,为患者节省宝贵的时间。
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ОБЗОР ПОДХОДОВ К ИММУНОТЕРАПИИ В ОНКОЛОГИИ
The article discusses modern ideas about the immune therapy of cancer — methods of treatment of oncological diseases based on immunological reactions of the organism to the appearance of malignant cells in it. This area is actively studied in clinical practice in the last decade, and some therapy has already been approved for use by regulators after promising results of clinical trials 3 phase. Immune therapy is based on antitumor immune cycle — the cascade of processes responsible for the immune system’s response to tumor cells. Involved regulatory mechanisms are targets for various therapies, the overall goal is to restore proper functioning of the cycle and to achieve the elimination of cancer cells. Currently, the most studied two types of immune therapy — checkpoint inhibitors and adaptive cell therapy. Checkpoint inhibitors increase the activity of body immune cells, reducing the inhibitory influence of the tumor microenvironment and the tumor cells themselves, which allowed them to get out from under the pressure of the immune system during the development of the disease. Adaptive cell therapy, in turn, allows to compensate the lack of active immune against tumor cells. Mechanisms of action determine the effectiveness of various therapies for different diseases, and for patients inside of one diagnosis. To determine the effectiveness of other treatment prior to a particular patient it is necessary to use the latest achievements in precision medicine, based on the search for new biomarkers and analyzing each patient separately. This approach will significantly reduce costs and save precious time for the patient.
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