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<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/ms2026-264</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-10290</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ИММУНОТЕРАПИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>IMMUNOTHERAPY</subject></subj-group></article-categories><title-group><article-title>Первая отечественная комбинация нурулимаб + пролголимаб: от клинической разработки и экономического анализа до реального применения при диссеминированной меланоме</article-title><trans-title-group xml:lang="en"><trans-title>The first domestic combination of nurulimab + prolgolimab: from clinical development and economic analysis to real-world use in disseminated melanoma</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0619-2205</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жукова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhukova</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Жукова Наталья Владимировна, к.м.н., врач-онколог, заведующий экспертным сектором</p><p>198255, Санкт-Петербург, проспект Ветеранов, д. 56</p><p>Researcher ID AAP-1605-2021</p><p>Scopus Author ID: 55634494300</p></bio><bio xml:lang="en"><p>Natalia V. Zhukova, Cand. Sci. (Med.), Oncologist, Head of the Expert Sector</p><p>56, Veteranov Ave., St Petersburg, 198255</p></bio><email xlink:type="simple">drnvz@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4447-9458</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Орлова</surname><given-names>Р. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Orlova</surname><given-names>R. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Орлова Рашида Вахидовна, главный специалист по клинической онкологии и реабилитации; д.м.н., профессор, заведующий кафедрой онкологии</p><p>198255, Санкт-Петербург, проспект Ветеранов, д. 56</p><p>199034, Санкт-Петербург, Университетская наб., д. 7–9</p></bio><bio xml:lang="en"><p>Rashida V. Orlova, Dr. Sci. (Med.), Professor, Head of the Oncology Department; Chief Specialist in Clinical Oncology and Rehabilitation</p><p>56, Veteranov Ave., St Petersburg, 198255</p><p>7–9, Universitetskaya Emb., St Petersburg, 199034</p></bio><email xlink:type="simple">orlova_rashida@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-6393-7561</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Герк</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Gerk</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Герк Иван Александрович, врач-онколог отделения противоопухолевой лекарственной терапии (химиотерапевтическое) № 11</p><p>198255, Санкт-Петербург, проспект Ветеранов, д. 56</p></bio><bio xml:lang="en"><p>Ivan A. Gerk, Oncologist, Department of Antitumor Drug Therapy (Chemotherapeutic) No. 11</p><p>56, Veteranov Ave., St Petersburg, 198255</p></bio><email xlink:type="simple">dr.ivangerk@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7351-7084</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жукова</surname><given-names>А. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Jukova</surname><given-names>A. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Жукова Анна Егоровна, врач-онколог отделения противоопухолевой лекарственной терапии (химиотерапевтическое) № 13</p><p>198255, Санкт-Петербург, проспект Ветеранов, д. 56</p></bio><bio xml:lang="en"><p>Anna E. Jukova, Oncologist, Department of Antitumor Drug Therapy (Chemotherapeutic) No. 13</p><p>56, Veteranov Ave., St Petersburg, 198255</p></bio><email xlink:type="simple">a.galatonova@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-3344-9022</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Иткин</surname><given-names>И. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Itkin</surname><given-names>I. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Иткин Илья Михайлович, к.м.н., врач-онколог, заведующий отделением противоопухолевой лекарственной терапии (химиотерапевтическим) №11</p><p>198255, Санкт-Петербург, проспект Ветеранов, д. 56</p></bio><bio xml:lang="en"><p>Ilya M. Itkin, Cand. Sci. (Med.), Oncologist, Head of the Department of Antitumor Drug Therapy (Chemotherapeutic) No. 11</p><p>56, Veteranov Ave., St Petersburg, 198255</p></bio><email xlink:type="simple">itkinjunior@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2003-7938</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Авраменко</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Avramenko</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Авраменко Инна Владимировна, врач-онколог, заведующая клинико-аналитическим отделом</p><p>198255, Санкт-Петербург, проспект Ветеранов, д. 56</p></bio><bio xml:lang="en"><p>Inna V. Avramenko, Oncologist, Head of the Clinical and Analytical Department</p><p>56, Veteranov Ave., St Petersburg, 198255</p></bio><email xlink:type="simple">inna_avramenko08@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Городской клинический онкологический диспансер</institution><country>Россия</country></aff><aff xml:lang="en"><institution>City Clinical Oncology Dispensary</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Городской клинический онкологический диспансер; Санкт-Петербургский государственный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>City Clinical Oncology Dispensary; St Petersburg State University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>28</day><month>07</month><year>2026</year></pub-date><volume>0</volume><issue>0</issue><issue-title>Online First</issue-title><elocation-id>10290</elocation-id><permissions><copyright-statement>Copyright &amp;#x00A9; Жукова Н.В., Орлова Р.В., Герк И.А., Жукова А.Е., Иткин И.М., Авраменко И.В., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Жукова Н.В., Орлова Р.В., Герк И.А., Жукова А.Е., Иткин И.М., Авраменко И.В.</copyright-holder><copyright-holder xml:lang="en">Zhukova N.V., Orlova R.V., Gerk I.V., Jukova A.E., Itkin I.M., Avramenko I.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/10290">https://www.med-sovet.pro/jour/article/view/10290</self-uri><abstract><p>Иммунотерапия ингибиторами контрольных точек существенно изменила прогноз лечения меланомы, однако клинически значимой задачей остается повышение эффективности двойной блокады PD-1/CTLA-4 при одновременном снижении иммуноопосредованной токсичности. В статье представлен систематический обзор данных о первой отечественной фиксированной комбинации ингибиторов иммунных контрольных точек двух классов анти-CTLA-4 + анти-PD-1 нурулимаб + пролголимаб (Нурдати®, BCD-217). Поиск публикаций осуществлялся в информационных ресурсах PubMed/MEDLINE, eLibrary, ClinicalTrials.gov, Кокрейновской библиотеки, а также в материалах профильных онкологических конгрессов. Использовались следующие ключевые слова и их комбинации: нерезектабельная/метастатическая меланома, иммунотерапия, ингибиторы контрольных точек, Нурулимаб, Пролголимаб, Нурдати. На первом этапе было идентифицировано 146 публикаций и информационных источников. После исключения дубликатов и материалов, не соответствующих теме обзора, для скрининга было отобрано 118 источников, из них 54 были включены в качественный анализ. В итоговый обзор вошли публикации и источники, отражающие молекулярные и фармакологические особенности нурулимаба и пролголимаба, результаты клинической разработки BCD-217, данные сравнительной эффективности и безопасности, а также клинико-экономический анализ. Исключены публикации по следующим причинам: несоответствие тематике, отсутствие клинических данных, дублирование результатов, ограниченный доступ к полному тексту. В рандомизированном исследовании III фазы OCTAVA комбинация нурулимаб + пролголимаб статистически значимо превысила монотерапию пролголимабом по медиане выживаемости без прогрессирования при сопоставимой суммарной частоте нежелательных явлений 3–4- й степени. Нурдати представляет собой отечественную инновационную разработку, реализующую принцип низкодозной CTLA-4-блокады при стандартной анти-PD-1-терапии, демонстрирующую устойчивый контроль заболевания у пациента с BRAF-дикого типа акральной меланомой в представленном клиническом случае</p></abstract><trans-abstract xml:lang="en"><p>Immunotherapy with immune checkpoint inhibitors has dramatically shifted the prognosis for outcomes of melanoma treatment. However, enhancing the efficacy of dual blockade immunotherapy targeting PD-1/PD-L1 and CTLA-4 while reducing immune-mediated toxicity remains a clinically significant challenge. This article presents a systematic review of data on the first homegrown fixed-dose combination of dual immune checkpoint inhibitors: anti-CTLA-4 + anti-PD-1 (Nurulimab) + Prolgolimab (Nurdati, BCD-217). We searched articles in the PubMed/MEDLINE, eLIBRARY, ClinicalTrials.gov, Cochrane Library databases, and specialized oncology congress records, using the following keywords in different combinations: unresectable/metastatic melanoma, immunotherapy, checkpoint inhibitors, nurulimab, prolgolimab, Nurdati. A total of 146 articles and information sources were identified at the first stage. After removing duplicates and materials irrelevant to the review topic 118 records were selected for screening, of which 54 were included in the qualitative analysis. The final review included articles and records covering the molecular and pharmacological properties of nurulimab and prolgolimab, the results of the BCD-217 clinical development, comparative efficacy and safety data, and a cost-effectiveness analysis. The excluded articles got the following reasons in favour of exclusion: inappropriateness, lack of clinical data, duplicate results, and limited access to the full text. In the randomized phase III OCTAVA study, the combination of nurulimab plus prolgolimab demonstrated significantly superior efficacy over prolgolimab monotherapy in terms of median progression-free survival (PFS) with comparable cumulative incidence rates of grade 3–4 AEs. Nurdati is a homegrown innovative medicine that is based on a low-dose CTLA-4 blockade and standard anti-PD-1 therapy, demonstrating durable disease control in a patient with BRAF-wild-type acral melanoma in the presented clinical case.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>меланома</kwd><kwd>иммунотерапия</kwd><kwd>ингибиторы иммунных контрольных точек</kwd><kwd>нурулимаб</kwd><kwd>пролголимаб</kwd><kwd>BCD-217</kwd><kwd>OCTAVA</kwd><kwd>anti-CTLA4 + anti-PD1</kwd><kwd>акральная меланома</kwd></kwd-group><kwd-group xml:lang="en"><kwd>melanoma</kwd><kwd>immunotherapy</kwd><kwd>immune checkpoint inhibitors</kwd><kwd>nurulimab</kwd><kwd>prolgolimab</kwd><kwd>BCD-217</kwd><kwd>OCTAVA</kwd><kwd>anti-CTLA4 + anti-PD1</kwd><kwd>acral melanoma</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Larkin J, Chiarion-Sileni V, Gonzalez R, Grob JJ, Cowey CL, Lao CD et al. 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