medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-9-172-177medsovet-6930Research ArticleКЛИНИЧЕСКОЕ НАБЛЮДЕНИЕCLINICAL OBSERVATIONДлительный контроль за болезнью у пациентки с ALK-позитивным немелкоклеточным раком легкогоLong-term disease control in a patient with ALK-positive non-small cell lung cancerhttps://orcid.org/0000-0003-0329-9696БерезинаГ. И.BerezinaG. I.

Березина Галина Игоревна - ординатор кафедры онкологии факультета дополнительного профессионального образования.

127473, Москва, ул. Делегатская, д. 20, стр. 1.

Galina I. Berezina - Resident of the Oncology Department of the Faculty of Additional Professional Education, Yevdokimov Moscow State University.

20, Bldg.1, Delegatskaya St., Moscow, 1127473.

docgalina369@yandex.ruhttps://orcid.org/0000-0003-4469-502XЛактионовК. К.LaktionovK. K.

Лактионов Константин Константинович – доктор медицинских наук, профессор, заведующий онкологическим отделением лекарственных методов лечения (химиотерапевтическое) №17.

115478, Москва, Каширское шоссе, д. 24.

Konstantin K. Laktionov - Dr. Sci. (Med.), Professor, Head of the Oncological Department of Medicinal Treatment Methods (Chemotherapy) No.17, Blokhin National Medical Research Center of Oncology.

24, Kashirskoe Shosse, Moscow, 115478.

lkoskos@mail.ruhttps://orcid.org/0000-0002-2154-3376РеутоваЕ. В.ReutovaE. V.

Реутова Елена Валерьевна – кандидат медицинских наук, старший научный сотрудник.

115478, Москва, Каширское шоссе, д. 24.

Elena V. Reutova - Cand. Sci. (Med.), Senior Researcher, Blokhin National Medical Research Center of Oncology.

24, Kashirskoe Shosse, Moscow, 115478.

evreutova@rambler.ruhttps://orcid.org/0000-0002-8967-7987АрдзинбаМ. С.ArdzinbaM. S.

Ардзинба Мераб Сергеевич - кандидат медицинских наук, научный сотрудник.

115478, Москва, Каширское шоссе, д. 24.

Merab S. Ardzinba - Cand. Sci. (Med.), Researcher, Blokhin National Medical Research Center of Oncology.

24, Kashirskoe Shosse, Moscow, 115478.

merabii@mail.ruhttps://orcid.org/0000-0002-5570-684XБорисоваТ. Н.BorisovaT. N.

Борисова Татьяна Николаевна - кандидат медицинских наук, старший научный сотрудник.

115478, Москва, Каширское шоссе, д. 24.

Tatiana N. Borisova - Cand. Sci. (Med.), Senior Researcher, Blokhin National Medical Research Center of Oncology.

24, Kashirskoe Shosse, Moscow, 115478.

tborisova111@gmail.comhttps://orcid.org/0000-0001-5130-140XУткинаВ. Л.UtkinaV. L.

Уткина Вероника Львовна - врач-рентгенолог.

115478, Москва, Каширское шоссе, д. 24.

Veronika L. Utkina - Radiologist, Blokhin National Medical Research Center of Oncology.

24, Kashirskoye Shosse, Moscow, 115478.

utkina_veronika@mail.ruМосковский государственный медико-стоматологический университет имени А.И. ЕвдокимоваРоссияYevdokimov Moscow State University of Medicine and DentistryRussian FederationНациональный медицинский исследовательский центр онкологии имени Н.Н. БлохинаРоссияBlokhin National Medical Research Center of OncologyRussian Federation20221906202209172177Copyright © Березина Г.И., Лактионов К.К., Реутова Е.В., Ардзинба М.С., Борисова Т.Н., Уткина В.Л., 20222022Березина Г.И., Лактионов К.К., Реутова Е.В., Ардзинба М.С., Борисова Т.Н., Уткина В.Л.Berezina G.I., Laktionov K.K., Reutova E.V., Ardzinba M.S., Borisova T.N., Utkina V.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6930

Немелкоклеточный рак легкого - очень гетерогенная группа заболеваний. При выборе эффективной тактики ведения пациента онколог ориентируется на распространенность заболевания, морфологическую форму опухоли, а также на ее молекулярно-генетический портрет. Сегодня большинство таргетируемых мутаций рака легкого приходится именно на аденокарциному. Стандартом при выявлении этого типа рака в 2022 г. является определение мутаций генов EGFR (18-21-е экзоны) и BRAF (V600E), транслокаций гена ALK и ROS1, определение PD-LI-статуса независимо от пола, возраста и анамнеза курения. Часто рак легкого выявляется уже на поздних стадиях, однако обнаружение транслокации гена ALK может дать пациенту высокие шансы на большую продолжительность жизни и длительный контроль над заболеванием. В данной статье на примере клинического случая пациентки с ALK-положительной аденокарциномой легкого продемонстрирован мультидисциплинарный подход к ведению онкологических больных, длительный контроль заболевания при применении таргетного препарата 2-го поколения алектиниба, а также варианты терапии при прогрессировании болезни.

Non-small cell lung cancer is a very heterogeneous group of diseases. When choosing an effective patient management strategy, an oncologist focuses on the stage of the disease, the morphological form of the tumor, as well as its molecular genetic markers. Most of the targeted mutations in lung cancer today are in adenocarcinoma. The standard for detecting this type of cancer in 2022 is the determination of mutations in the EGFR genes (18-21 exons) and BRAF (V600E), translocations of the ALK and ROS1 genes, and determination of PD-L1 status regardless of gender, age, and history of smoking. Often, lung cancer is detected in the advanced stages, but the detection of ALK gene translocation can give the patient a high chance of a longer life expectancy and long-term control of the disease. In this article, on the example of a clinical case of a patient with ALK-positive lung adenocarcinoma, a multidisciplinary approach to the management of cancer patients, long-term control of the disease with the use of the second-generation targeted medication alectinib, as well as treatment options for disease progression are demonstrated.

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The authors declare that there are no conflicts of interest present.