medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-450medsovet-7980Research ArticleИММУНОТЕРАПИЯIMMUNOTHERAPYРезолюция консультационного совета на тему «Место комбинации атезолизумаба и бевацизумаба в качестве адъювантной терапии у пациентов с гепатоцеллюлярным раком с высоким риском рецидива после хирургической резекции или абляции»Advisory board resolution: The role of the adjuvant atezolizumab plus bevacizumab in patients with hepatocellular carcinoma at high risk of recurrence following surgical resection or ablationhttps://orcid.org/0000-0002-6244-4294БредерВ. В.BrederV. V.

Бредер Валерий Владимирович - д.м.н., Президент Общества МОСОП, заведующий отделом лекарственного лечения, НМИЦ онкологии им. Н.Н. Блохина.

115478, Москва, Каширское шоссе, д. 24

Valeriy V. Breder - Dr. Sci. (Med.), Chairman of Interdisciplinary Liver Tumour Society (MOSOP), Head of Department of Anti-cancer Drug Therapy, Blokhin National Medical Research Center of Oncology.

24, Kashirskoye Shosse, Moscow, 115478

vbreder@yandex.ruhttps://orcid.org/0000-0001-9864-3837ПокатаевИ. А.PokataevI. A.

Покатаев Илья Анатольевич - д.м.н., руководитель службы химиотерапевтического лечения.

117152, Москва, Загородное шоссе, д. 18А, стр. 7

Ilya A. Pokataev - Dr. Sci. (Med.), Head of Chemotherapeutic Service, City Clinical Oncology Hospital No. 1.

18A, Bldg. 7, Zagorodnoe Shosse, Moscow, 117152

ipokataev@gmail.comhttps://orcid.org/0000-0002-0342-4007ПеткауВ. В.PetkauV. V.

Петкау Владислав Владимирович - к.м.н., доцент кафедры онкологии и лучевой диагностики, УГМУ; заместитель главного врача по лекарственной терапии, Свердловский ООД.

620028, Екатеринбург, ул. Репина, д. 3; 620036, Екатеринбург, ул. Соболева, 29

Vladislav V. Petkau - Cand. Sci. (Med.), Associate Professor of Department of Oncology and Diagnostic Radiology, Urals State Medical University; Deputy Chief Medical Officer for Pharmaceutical Therapy, Sverdlovsk Regional Oncology Center.

3, Repin St., Ekaterinburg, 620028; 29, Sobolev St., Ekaterinburg, 620036

vpetkau@yandex.ruhttps://orcid.org/0000-0001-5615-7806ФедянинМ. Ю.FedyaninM. Yu.

Федянин Михаил Юрьевич - д.м.н., врач-онколог, руководитель службы химиотерапевтического лечения, ММКЦ «Коммунарка»; старший научный сотрудник, НМИЦ онкологии им. Н.Н. Блохина; заведующий кафедрой онкологии, НМХЦ им. Н.И. Пирогова.

108814, Москва, пос. Коммунарка ул. Сосенский стан, д. 8; 115478, Москва, Каширское шоссе, д. 24; 105203, Москва, ул. Нижняя Первомайская, д. 70

Mikhail Yu. Fedyanin - Dr. Sci. (Med.), Head of Chemotherapeutic Service, Oncologist, Kommunarka Moscow Multidisciplinary Medical Center; Blokhin National Medical Research Center of Oncology; Head of Department of Oncology, National Medical and Surgical Center named after N.I. Pirogov.

8, Sosenskiy Stan St., Kommunarka Settlement, Moscow, 129301; 24, Kashirskoye Shosse, Moscow, 115478; 70, Nizhnyaya Pervomayskaya St., Moscow, 105203

fedianinmu@mail.ruhttps://orcid.org/0000-0002-1834-0981ЛединЕ. В.LedinE. V.

Ледин Евгений Витальевич - к.м.н., врач-химиотерапевт, онколог, руководитель центра химиотерапии, заведующий отделением химиотерапии.

125284, Москва, 2-й Боткинский проезд, д. 5, корп. 4 ГКБ имени Боткина

Evgeniy V. Ledin - Cand. Sci. (Med.), Chemotherapeutist, Oncologist, Head of Chemeotherapy Center, Head of Department of Chemotherapy, MEDSI International Oncology Center.

5, Bldg. 4 of Botkin City Clinical Hospital, 2nd Botkinskiy Proezd, Moscow, 125284

ledin@inbox.ruhttps://orcid.org/0000-0002-5769-0378ЗагайновВ. Е.ZagainovV. E.

Загайнов Владимир Евгеньевич - д.м.н., профессор, главный внештатный трансплантолог Министерства здравоохранения Нижегородской области, заведующий кафедрой хирургических болезней, ПИМУ; врач-онколог, Нижегородский ОКОД.

603005, Нижний Новгород, пл. Минина и Пожарского, д. 10/1; 603093, Нижний Новгород, ул. Деловая, д. 11/1

Vladimir E. Zagainov - Dr. Sci. (Med.), Professor, Chief External Transplantologist of the Ministry of Health for Nizhny Novgorod region, Head of Department of Surgical Diseases, Privolzhsky Research Medical University; Oncologist, Nizhny Novgorod Regional Clinical Oncology Dispensary.

10/1, Minin and Pozharsky Square, Nizhny Novgorod, 603950; 11/1, Delovaya St., Nizhniy Novgorod, 603093

zagainov@gmail.comhttps://orcid.org/0000-0002-3743-393XШаповалС. В.ShapovalS. V.

Шаповал Сергей Владимирович - к.м.н., врач-онколог, старший научный сотрудник отдела интервенционной радиологии и оперативной хирургии.

197758, Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 70

Sergey V. Shapoval - Cand. Sci. (Med.), Oncologist, Senior Research Associate of the Department of Interventional Radiology and Operative Surgery, Granov Russian Research Center for Radiology and Surgical Technologies.

70 Leningradskaya St., Pesochnyy Settlement, St Petersburg, 197758

gotina@yandex.ruhttps://orcid.org/0000-0002-8746-8452ГрановД. А.GranovD. A.

Гранов Дмитрий Анатольевич - академик РАН, д.м.н., профессор, научный руководитель.

197758, Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 70

Dmitriy A. Granov - Academician RAS, Dr. Sci. (Med.), Professor, Scientific Supervisor of the Center, Granov Russian Research Center for Radiology and Surgical Technologies.

70 Leningradskaya St., Pesochnyy Settlement, St Petersburg, 197758

dmitriigranov@gmail.comhttps://orcid.org/0000-0002-3042-6729БалахнинП. В.BalakhninP. V.

Балахнин Павел Васильевич - к.м.н., заведующий отделением рентгенохирургических методов диагностики и лечения, врач по рентгеноэндоваскулярной диагностике и лечению.

197758, Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 68

Pavel V. Balakhnin - Cand. Sci. (Med.), Head of Department of X-ray Surgical Diagnostic Methods and Treatment, Physician for X-ray Endovascular Diagnosis and Treatment, Petrov National Medical Cancer Research Centre.

68, Leningradskaya St., Pesochnyy Settlement, St Petersburg, 197758

balahnin_p@mail.ruhttps://orcid.org/0000-0003-0504-585XКудашкинН. Е.KudashkinN. E.

Кудашкин Николай Евгеньевич - к.м.н., старший научный сотрудник, врач-онколог, инструктор-методист, отделение абдоминальной онкологии №2 (опухолей гепатопанкреатобилиарной зоны).

115478, Москва, Каширское шоссе, д. 24

Nikolay E. Kudashkin - Cand. Sci. (Med.), Senior Research Associate, Oncologist, Instruction Coordinator, Department of Abdominal Oncology No. 2 (Hepato-pancreato-biliary Malignancies), Blokhin National Medical Research Center of Oncology.

24, Kashirskoye Shosse, Moscow, 115478

dr.kudashkin@mail.ruhttps://orcid.org/0000-0002-4587-4153ПогребняковИ. В.PogrebnyakovI. V.

Погребняков Игорь Владимирович - к.м.н., заведующий отделением рентгенохирургических методов диагностики и лечения.

115478, Москва, Каширское шоссе, д. 24

Igor V. Pogrebnyakov - Cand. Sci. (Med.), Head of Department of X-ray Surgical Diagnostic Methods and Treatment, Blokhin National Medical Research Center of Oncology.

24, Kashirskoye Shosse, Moscow, 115478

i.pogr@mail.ruhttps://orcid.org/0000-0002-3241-6460ПоповаН. В.PopovaN. V.

Попова Наталья Викторовна - врач-онколог, онкологическое химиотерапевтическое отделение (противоопухолевой лекарственной терапии) №11.

197022, Санкт-Петербург, 2-я Березовая аллея, д. 3/5

Natalia V. Popova - Oncologist, Oncological Chemotherapeutic (Anti-tumour Drug Therapy) Department No. 11, City Clinical Oncology Center.

3/5, 2-ya Berezovaya Alleya St., Saint Petersburg, 197022

nvpopova@yandex.ruhttps://orcid.org/0000-0002-6775-3678МорозЕ. А.MorozE. A.

Мороз Екатерина Анатольевна - к.м.н., врач-патологоанатом.

115478, Москва, Каширское шоссе, д. 24

Ekaterina A. Moroz - Cand. Sci. (Med.), Anatomopathologist, Blokhin National Medical Research Center of Oncology.

24, Kashirskoye Shosse, Moscow, 115478

moroz-kate@yandex.ruНациональный медицинский исследовательский центр онкологии имени Н.Н. БлохинаРоссияBlokhin National Medical Research Center of OncologyRussian FederationГородская клиническая онкологическая больница №1РоссияCity Clinical Oncology Hospital No. 1Russian FederationУральский государственный медицинский университет; Свердловский областной онкологический диспансерРоссияUrals State Medical University; Sverdlovsk Regional Oncology CenterRussian FederationНациональный медицинский исследовательский центр онкологии имени Н.Н. Блохина; Московский многопрофильный клинический центр «Коммунарка»; Национальный медико-хирургический центр имени Н.И. ПироговаРоссияBlokhin National Medical Research Center of Oncology; Kommunarka Moscow Multidisciplinary Medical Center; National Medical and Surgical Center named after N.I. PirogovRussian FederationМеждународный центр онкологии МЕДСИРоссияMEDSI International Oncology CenterRussian FederationПриволжский исследовательский медицинский университет; Нижегородский областной клинический онкологический диспансерРоссияPrivolzhsky Research Medical University; Nizhny Novgorod Regional Clinical Oncology DispensaryRussian FederationРоссийский научный центр радиологии и хирургических технологий имени академика А.М. ГрановаРоссияGranov Russian Research Center for Radiology and Surgical TechnologiesRussian FederationНациональный медицинский исследовательский центр онкологии имени Н.Н. ПетроваРоссияPetrov National Medical Cancer Research CentreRussian FederationГородской клинический онкологический диспансерРоссияCity Clinical Oncology CenterRussian Federation2023170120240222028Copyright © Бредер В.В., Покатаев И.А., Петкау В.В., Федянин М.Ю., Ледин Е.В., Загайнов В.Е., Шаповал С.В., Гранов Д.А., Балахнин П.В., Кудашкин Н.Е., Погребняков И.В., Попова Н.В., Мороз Е.А., 20242024Бредер В.В., Покатаев И.А., Петкау В.В., Федянин М.Ю., Ледин Е.В., Загайнов В.Е., Шаповал С.В., Гранов Д.А., Балахнин П.В., Кудашкин Н.Е., Погребняков И.В., Попова Н.В., Мороз Е.А.Breder V.V., Pokataev I.A., Petkau V.V., Fedyanin M.Y., Ledin E.V., Zagainov V.E., Shapoval S.V., Granov D.A., Balakhnin P.V., Kudashkin N.E., Pogrebnyakov I.V., Popova N.V., Moroz E.A.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/7980ДАТА ЗАСЕДАНИЯ

ДАТА ЗАСЕДАНИЯ: 7 июля 2023 г.

ВОПРОСЫ ПОВЕСТКИ ДНЯ

ВОПРОСЫ ПОВЕСТКИ ДНЯ:

1

1. Место комбинации атезолизумаба и бевацизумаба в качестве адъювантной терапии у пациентов с гепатоцеллюлярным раком (ГЦР) с высоким риском рецидива после хирургической резекции или абляции. Профиль пациента, который получит максимальные преимущества от данной терапии.

2

2. Оценить перспективы тактики лечения пациентов с ранним ГЦР в России.

Рак печени остается глобальной проблемой здравоохранения, и заболеваемость растет во всем мире. Ранняя, точная диагностика и своевременное лечение способствуют повышению общей и безрецидивной выживаемости. Важно, что при выявлении ГЦР на очень ранней и ранней стадии болезни может быть применен весь арсенал методов локального лечения (резекция, абляция и трансплантация печени (ТП)). Сложной и малоизученной проблемой в лечении больных ГЦР являются рецидивы опухолевого процесса после хирургического лечения, абляции. Описано множество факторов, способных предсказать риск рецидива после хирургического лечения: размер опухоли >5 см, >3 очагов, микро- или макрососудистая (Vp1-2) инвазии, низкая степень дифференцировки опухоли (G3-4). На экспертном совете мы попытались выделить наиболее важные факторы риска раннего рецидива, а также определить роль и влияние на клиническую практику результатов первого позитивного клинического исследования, посвященного проблеме раннего ГЦР, IMbrave050: исследование III фазы адъювантной терапии атезолизумабом + бевацизумабом в сравнении с активным наблюдением у пациентов с ГЦР с высоким риском рецидива заболевания после резекции или абляции.

MEETING DATE

MEETING DATE: July 7, 2023

ITEMS ON THE AGENDA

ITEMS ON THE AGENDA:

1

1. The role of the adjuvant atezolizumab plus bevacizumab in patients with hepatocellular carcinoma (HCC) at high risk of recurrence following surgical resection or ablation. Profile of the patient who will benefit the most from this therapy.

2

2. To evaluate the prospects for therapeutic options for patients with early HCC in Russia.

Liver cancer remains a public health concern globally, with an increasing trend in the number of incident cases worldwide. Early, precise diagnosis and timely treatment contribute to the improvement in overall and relapse-free survival. It is important that the entire arsenal of local treatments (resection, ablation and liver transplantation) can be applied in cases when HCC is detected at a very early and early stage of the disease. Tumour recurrence after surgical treatment or ablation is a complex and underexplored problem in the treatment of patients with HCC. Many factors that can predict the risk of relapse after surgical treatment have been described: tumour size >5 cm, >3 foci, micro- or macrovascular (Vp1-2) invasion, poor degree of tumour differentiation (G3-4). Our advisory board tried to identify the most important risk factors for early relapse, and to determine the role and impact of the results of the first positive clinical trial focused on the issue of early HCC, IMbrave050: a phase 3 trial of adjuvant atezolizumab + bevacizumab vs active surveillance in patients with HCC at high risk of disease recurrence following resection or ablatio.

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