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<article article-type="research-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">10.21518/2079-701X-2020-9-121-126</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-5715</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>ОНКОГИНЕКОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ONCOGYNECOLOGY</subject></subj-group></article-categories><title-group><article-title>Молекулярно-направленная терапия диссеминированного рака шейки матки: настоящее и будущее</article-title><trans-title-group xml:lang="en"><trans-title>Molecular-guided therapy for disseminated cervical cancer: present and future</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4443-9974</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Румянцев</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Rumyantsev</surname><given-names>A. А.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Румянцев Алексей Александрович, врач-онколог, онкологическое отделение лекарственных методов лечения (химиотерапевтическое) №2 Научно-исследовательского института клинической онкологии им. академика РАН и РАМН Н.Н. Трапезникова </p><p>115478, Москва, Каширское шоссе, д. 24</p></bio><bio xml:lang="en"><p>Alexey А. Rumyantsev, Oncologist, Oncological Department of Medication-assisted treatment Methods (Chemotherapeutic No. 2) of the N.N. Trapeznikov Research Institute of Clinical Oncology </p><p>24, Kashirskoye Shosse, Moscow, 115478 </p></bio><email xlink:type="simple">alexeymma@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.N. Blokhin National Medical Research Center of Oncology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>28</day><month>07</month><year>2020</year></pub-date><volume>0</volume><issue>9</issue><fpage>121</fpage><lpage>126</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Румянцев А.А., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Румянцев А.А.</copyright-holder><copyright-holder xml:lang="en">Rumyantsev A.А.</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/5715">https://www.med-sovet.pro/jour/article/view/5715</self-uri><abstract><p>Рак шейки матки (РШМ) – один из лидеров по смертности от онкогинекологических заболеваний. Заболеваемость и смертность от него в последние 10 лет находятся на стабильно высоком уровне. В течение длительного времени единственным вариантом лечения распространенного и/или рецидивирующего РШМ была цитотоксическая химиотерапия, но ее результаты оставались крайне неудовлетворительными, а показатель 5-летней общей выживаемости больных составлял около 12%. Данная статья посвящена обзору современных возможностей таргетной и иммунотерапии метастатического и/или рецидивирующего РШМ. С учетом исторической ретроспективы рассмотрены данные последних исследований эффективности применения антиангиогенной терапии: проведен подробный анализ результатов исследования III фазы GOG-240, рассмотрены ключевые эффекты использования бевацизумаба в качестве первоначальной опции терапии РШМ. Изучены данные современной литературы в области иммунотерапии с использованием ингибиторов сигнального пути PD-1/PD-L1 при метастатическом РШМ. Установлено, что у значительного количества пациенток (34–95%) наблюдается повышенная экспрессия PD-L1 в опухолевой ткани, а у 3–6% больных выявляется высокий уровень микросателлитной нестабильности (MSI) в опухоли, что открывает возможности для проведения иммунотерапии при данном заболевании. Проведен обзор проводимых в настоящее время клинических исследований, посвященных применению таргетной и иммунотерапии диссеминированного РШМ, оценены перспективы изменения «ландшафта» лечения этого заболевания. Приведен клинический случай и на его примере рассмотрены возможности современной таргетной и иммунотерапии метастатического РШМ, которые позволили обеспечить длительную выживаемость больной с исходно неблагоприятным прогнозом.</p></abstract><trans-abstract xml:lang="en"><p>Сervical cancer is recognized as one of the leaders in mortality from gynecological oncological diseases. The incidence and mortality from cervical cancer over the past 10 years remained at a consistently high level. For a long time, the only treatment option for metastatic and/or recurrent cervical cancer was cytotoxic chemotherapy, but its results remained extremely unsatisfactory: the 5-year overall survival rate was about 12%. This article is devoted to a review of the current possibilities of targeted and immunotherapy of metastatic and/or recurrent cervical cancer. We reviewed the most recent studies in the field of the effectiveness of antiangiogenic therapy including a critical and detailed analysis of the results of the GOG-240 phase III study. The data of modern literature in the field of immunotherapy using PD-1 / PD-L1 signaling pathway inhibitors in metastatic cervical cancer has been studied. It was found that a significant number of patients (34-95%) showed increased expression of PD-L1 in the tumor tissue, and 3-6% of patients showed a high level of microsatellite instability (MSI) in the tumor, which reveals the possibility of immunotherapy for this disease. We also conducted a review of ongoing clinical studies on the use of targeted and immunotherapy of advanced cervical cancer and the prospects for changing the “landscape” of treatment for this disease were assessed. On the example of a clinical case of treatment of a real patient, the possibilities of modern targeted and immunotherapy of metastatic cancer of the cervix uteri were analyzed, which gave a possibility to ensure long-term survival for the patient with an initially poor prognosis.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рак шейки матки</kwd><kwd>бевацизумаб</kwd><kwd>антиангиогенная терапия</kwd><kwd>таргетная терапия</kwd><kwd>критерии Moore</kwd><kwd>иммунотерапия</kwd><kwd>MSI</kwd><kwd>PD-L1</kwd><kwd>пролголимаб</kwd><kwd>пембролизумаб</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cervical cancer</kwd><kwd>bevacizumab</kwd><kwd>antiangiogenic therapy</kwd><kwd>targeted therapy</kwd><kwd>Moore criteria</kwd><kwd>immunotherapy</kwd><kwd>MSI</kwd><kwd>PD-L1</kwd><kwd>prolgolimab</kwd><kwd>pembrolizumab</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">Каприн А.Д., Старинский В.В., Петрова Г.В. 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