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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-2020-20-62-68</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-5936</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>Современные возможности первой линии терапии рака яичников: фокус на поддерживающей терапии</article-title><trans-title-group xml:lang="en"><trans-title>The latest first-line treatment options for ovarian cancer: focus on maintenance therapy</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. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Румянцев Алексей Александрович, кандидат медицинских наук, врач-онколог онкологического отделения лекарственных методов лечения (химиотерапевтического) №2 Научно-исследовательского института клинической онкологии имени Н.Н. Трапезникова, Национальный медицинский исследовательский центр онкологии имени Н.Н. Блохина; лидер группы по лекарственному лечению опухолей женской репродуктивной системы, Институт онкологии Хадасса Москва</p><p>115478, Россия, Москва, Каширское шоссе, д. 24; 121205, Россия, Москва, Большой бульвар, д. 46, стр. 1, Инновационный центр Сколково</p></bio><bio xml:lang="en"><p>Alexey A. Rumyantsev, Cand. of Sci. (Med.), Oncologist, Cancer Drug Therapy (Chemotherapeutic) Department No. 2, Research Institute of Clinical Oncology N.N. Trapeznikova, Blokhin National Medical Research Center of Oncology; Leader of the Female Reproductive System Cancer Drug Therapy Group, Institute of Oncology, Hadassah Medical Moscow</p><p>24, Kashirskoye Shosse, Moscow, 115478, Russia; 46, Bldg. 1, Bolshoi Boulevard, Skolkovo, Moscow, 121205, Russia</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; &#13;
Институт онкологии Хадасса Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Blokhin National Medical Research Center of Oncology; &#13;
Institute of Oncology, Hadassah Medical Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>19</day><month>12</month><year>2020</year></pub-date><volume>0</volume><issue>20</issue><fpage>62</fpage><lpage>68</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.A.</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/5936">https://www.med-sovet.pro/jour/article/view/5936</self-uri><abstract><p>Рак яичников – одна из лидирующих причин смертности от онкологических заболеваний женской репродуктивной системы в России: в 2018 г. 7 616 женщин умерло от этого заболевания. Показатель количества пациенток, состоящих на учете в течение 5 или более лет, в 2018 г. составил всего 3,4%, что, вероятно, соотносится с низкими показателями 5-летней выживаемости. При этом последние 2 года в лечении BRCA-ассоциированного рака яичников, на долю которого приходится до 35% случаев заболевания, произошла революция. Были опубликованы результаты ряда крупных исследований III фазы, посвященных изучению применения ингибиторов PARP при данном подтипе заболевания. Их результаты продемонстрировали выраженное снижение риска прогрессирования заболевания или смерти при применении ингибиторов PARP после первой линии терапии рака яичников. В данной публикации нами проведен сравнительный анализ эффективности различных ингибиторов PARP при BRCA-ассоциированном раке яичников. Показатель снижения относительного риска составил для олапариба, нирапариба и велипариба 70, 60 и 56% соответственно, при этом преимущество применения указанных препаратов отмечено во всех подгруппах пациентов. Проведен сравнительный анализ безопасности различных ингибиторов PARP, оценены риски развития различных токсических явлений на фоне их применения. На основании сопоставления опубликованных данных о профиле их безопасности сделан вывод, что олапариб является наиболее безопасным представителем данного класса, особенно в контексте проведения терапии в амбулаторных условиях. Проанализированы возможные пути оптимизации применения PARP-ингибиторов при диссеминированном раке яичников.</p></abstract><trans-abstract xml:lang="en"><p>Ovarian cancer is one of the leading causes of death from gynecologic cancers in Russia: in 2018, 7616 women died from this disease and the proportion of patients who is under observation for 5 years or more was only 3.4%, which probably indicates very low 5-year survival. At the same time, there was is a tremendous paradigm shift in the treatment of BRCA-associated ovarian cancer. A number of large phase III trials have been published on the use of PARP inhibitors in this subtype of the disease. Their results demonstrated a marked reduction in the risk of disease progression or death with PARP inhibitors after first-line therapy for advanced ovarian cancer. Here we present a comparative analysis of the efficacy of various PARP inhibitors in BRCA-associated ovarian cancer. The relative risk reduction in disease progression or death for olaparib, niraparib and veliparib was 70%, 60% and 56%, respectively and advantage of using these drugs noted in all patient subgroups. Comparative analysis of the safety of various PARP inhibitors was carried out as well, the risks of developing various toxicity were assessed. Based on a comparison of published data on their safety profile, it was concluded that olaparib is the safest drug of this class, especially in the context of therapy on an outpatient basis. Possible ways to optimize the use of PARP inhibitors in disseminated ovarian cancer have been analyzed.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>олапариб</kwd><kwd>нирапариб</kwd><kwd>велипариб</kwd><kwd>рак яичников</kwd><kwd>химиотерапия</kwd><kwd>BRCA</kwd><kwd>поддерживающая терапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>olaparib</kwd><kwd>niraparib</kwd><kwd>veliparib</kwd><kwd>chemotherapy</kwd><kwd>BRCA</kwd><kwd>maintenance therapy</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. (ред.). Злокачественные ново­ образования в России в 2017 году (заболеваемость и смертность). М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России; 2019. 250 с. 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