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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/ms2024-245</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-8398</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>Эволюция лечения распространенного рака шейки матки: от монотерапии цисплатином до иммуноонкологических комбинаций</article-title><trans-title-group xml:lang="en"><trans-title>The evolution of treatment for advanced cervical cancer: from cisplatin monotherapy to immuno-oncology combinations</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 - к.м.н., заведующий отделением противоопухолевой лекарственной терапии №4 отдела лекарственного лечения Научно-исследовательского института клинической онкологии имени академика Н.Н. Трапезникова.</p><p>115478, Москва, Каширское шоссе, д. 24</p></bio><bio xml:lang="en"><p>Alexey A. Rumyantsev - Cand. Sci. (Med.), Head of Cancer Drug Therapy (Chemotherapeutic) Department No. 4, Medication-Based Treatment Unit, 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 contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4481-4164</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Летучих</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Letuchikh</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Летучих Ангелина Николаевна - врач-ординатор отделения противоопухолевой лекарственной терапии №4 отдела лекарственного лечения Научно-исследовательского института клинической онкологии имени академика Н.Н. Трапезникова.</p><p>115478, Москва, Каширское шоссе, д. 24</p></bio><bio xml:lang="en"><p>Angelina N. Letuchikh - Resident Doctor of Cancer Drug Therapy (Chemotherapeutic) Department No. 4, Medication-Based Treatment Unit, Trapeznikov Research Institute of Clinical Oncology.</p><p>24, Kashirskoye Shosse, Moscow, 115478</p></bio><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 имени Н.Н. Блохина</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Blokhin National Medical Research Center of Oncology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>24</day><month>07</month><year>2024</year></pub-date><volume>0</volume><issue>10</issue><fpage>82</fpage><lpage>88</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Румянцев А.А., Летучих А.Н., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Румянцев А.А., Летучих А.Н.</copyright-holder><copyright-holder xml:lang="en">Rumyantsev A.A., Letuchikh A.N.</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/8398">https://www.med-sovet.pro/jour/article/view/8398</self-uri><abstract><p>В России рак шейки матки (РШМ) является одной из наиболее часто встречающихся онкологических патологий. Несмотря на высокую эффективность локальных методов лечения при ранних стадиях заболевания, метастатический рак шейки матки характеризуется неблагоприятным прогнозом. Показатели заболеваемости и смертности за последние 10 лет остаются на стабильно высоком уровне. Основой лечения метастатического РШМ являются комбинации на основе препаратов платины, комбинация паклитаксела и цисплатина или карбоплатина – обязательный компонент лечения диссеминированного РШМ. При этом применение только цитотоксической химиотерапии не позволяет достичь удовлетворительных результатов лечения – ожидаемые показатели продолжительности жизни на этом фоне составляют около 12 мес. Одним из наиболее перспективных направлений лечения метастатического рака шейки матки пациенток является иммунотерапия, в частности назначение пембролизумаба, ингибитора PD-1 – одной из ключевых контрольных точек иммунного ответа. Данная статья посвящена обзору исторических аспектов лечения РШМ и современных возможностей терапии этой онкологической патологии. В статье подробно разобраны результаты исторических и современных исследований по лечению метастатического РШМ. Освещено развитие лекарственного метода лечения при диссеминированном РШМ, а также возможности современной таргетной антиангиогенной терапии, иммунотерапии и данные последних исследований об эффективности совместного назначения препаратов этих классов со стандартной цитотоксической химиотерапией для достижения наилучших результатов лечения. Назначение пембролизумаба, бевацизумаба, таксанов и препаратов платины позволяет достичь медиану ОВ в 43,9 мес. – наилучшего результата лечения метастатического РШМ, когда-либо репортированного в рамках контролируемого клинического исследования.</p></abstract><trans-abstract xml:lang="en"><p>Cervical cancer is one of the most common malignant tumors in Russia. Despite the high cure rates with local treatment approaches (eg, surgery or radiothearapy) at early stages of the disease, metastatic cervical cancer portends an unfavorable prognosis. The incidence and mortality rates over the last 10 years remain at a consistently high level. The backbone of treatment for metastatic cervical cancer is platinum-based combinations – the cytototic combination of paclitaxel and cisplatin (or carboplatin) being a standard-of-care treatment for patients with metastatic disease. However, chemotherapy alone failed to achieve satisfactory long-term treatment outcomes – the expected life expectancy with chemotherapeutic drugs rarely exceeds 12 months. One of the most fruitful directions in the treatment of metastatic cervical cancer to date is immunotherapy – in particular, pembrolizumab, a PD-1 pathway inhibitor – one of the key checkpoints of the immune response control. This review article highlights historical and recent achievements in metastatic cervical cancer treatment. It highlights the development of anticancer medications for advanced or metastatic cervical cancer, including targeted antiangiogenic therapy, immunotherapy, and the latest research data on the effectiveness of combining these classes of drugs with standard cytotoxic chemotherapy to achieve the best treatment outcomes.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рак шейки матки</kwd><kwd>пембролизумаб</kwd><kwd>бевацизумаб</kwd><kwd>таргетная терапия</kwd><kwd>иммунотерапия</kwd><kwd>PD-L1</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cervical cancer</kwd><kwd>pembrolizumab</kwd><kwd>bevacizumab</kwd><kwd>targeted therapy</kwd><kwd>immunotherapy</kwd><kwd>PD-L1</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 АД, Старинский ВВ, Шахзадова АО (ред.). 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