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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/ms2025-203</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-9249</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>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCH</subject></subj-group></article-categories><title-group><article-title>Эффективность иммунных препаратов в поддерживающей терапии после радикального химиолучевого лечения рака легкого: результаты реальной клинической практики</article-title><trans-title-group xml:lang="en"><trans-title>Efficacy of immune drugs in maintenance therapy after radical chemoradiation treatment of lung cancer: Results of real clinical practice</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0996-5995</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Султанбаев</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Sultanbaev</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Султанбаев Александр Валерьевич, к.м.н., доцент кафедры педагогики и психологии, Башкирский государственный медицинский университет;заведующий отделом противоопухолевой лекарственной терапии, Республиканский клинический онкологический диспансер; врач-онколог, Республиканский медико-генетический центр;</p><p>450000, Уфа, ул. Ленина, д. 3;450054, Уфа, проспект Октября, д. 73/1; 450076, Уфа, ул. Гафури, д. 74</p></bio><bio xml:lang="en"><p>Alexander V. Sultanbaev, Cand. Sci. (Med.), Associate Professor of the Department of Pedagogy and Psychology, Bashkir State Medical University; Head of the Department of Antitumor Drug Therapy, Republican Clinical Oncology Dispensary; Oncologist, Republican Medical and Genetic Center;</p><p>3, Lenin St., Ufa, 450008;73/1, Oktyabrya Ave., Ufa, 450054; 74, Gafuri St., Ufa, 450076</p></bio><email xlink:type="simple">rkodrb@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7496-0950</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тузанкина</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tuzankina</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Тузанкина Ирина Александровна, д.м.н., профессор, заслуженный деятель науки РФ, главный научный сотрудник лаборатории иммунологии воспаления, Институт иммунологии и физиологии Уральского отделения Российской академии наук; главный детский иммунолог Министерства здравоохранения Свердловской области; врач аллерголог-иммунолог, Областная детская клиническая больница</p><p>620049, Екатеринбург, ул. Первомайская, д. 106;620085, Екатеринбург, ул. С. Дерябиной, д. 32</p></bio><bio xml:lang="en"><p>Irina A. Tuzankina, Dr. Sci. (Med.), Professor, Honored Scientist of the Russian Federation, Chief Researcher at the Laboratory of Immunology of Inflammation, Institute of Immunology and Physiology of the Ural Branch of the Russian Academy of Sciences; Chief Pediatric Immunologist Sverdlovsk Region; Allergologist-Immunologist, Regional Children’s Clinical Hospital</p><p>106, Pervomaiskaya St., Ekaterinburg, 620049;32, S. Deryabina St., Ekaterinburg, 620085</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8340-7962</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Насретдинов</surname><given-names>A. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Nasretdinov</surname><given-names>A. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Насретдинов Айнур Фанутович, врач-онколог, заведующий отделением противоопухолевой лекарственной терапии №2</p><p>450054, Уфа, проспект Октября, д. 73/1</p></bio><bio xml:lang="en"><p>Ainur F. Nasretdinov, Oncologist, Head of the Department of Antitumor Drug Therapy No. 2</p><p>73/1, Oktyabrya Ave., Ufa, 450054</p></bio><email xlink:type="simple">rkodrb@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1185-977X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мусин</surname><given-names>Ш. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Musin</surname><given-names>Sh. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мусин Шамиль Исмагилович, к.м.н., заведующий хирургическим отделением №6, Республиканский клинический онкологический диспансер; доцент кафедры онкологии с курсами онкологии и патологической анатомии Института дополнительного профессионального образования, Башкирский государственный медицинский университет</p><p>450054, Уфа, проспект Октября, д. 73/1;450000, Уфа, ул. Ленина, д. 3</p></bio><bio xml:lang="en"><p>Shamil I. Musin, Cand. Sci. (Med.), Head of Surgical Department No. 6, Republican Clinical Oncology Dispensary; Associate Professor of the Department of Oncology with Courses in Oncology and Pathological Anatomy at the Institute of Additional Professional Education, Bashkir State Medical University</p><p>73/1, Oktyabrya Ave., Ufa, 450054;3, Lenin St., Ufa, 450008</p></bio><email xlink:type="simple">musin_shamil@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5926-0446</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Султанбаева</surname><given-names>Н. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Sultanbaeva</surname><given-names>N. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Султанбаева Надежда Ивановна, врач-онколог отделения противоопухолевой лекарственной терапии №1</p><p>450054, Уфа, проспект Октября, д. 73/1</p></bio><bio xml:lang="en"><p>Nadezda I. Sultanbaeva, Oncologist of the Department of Antitumor Drug Therapy No. 1</p><p>73/1, Oktyabrya Ave., Ufa, 450054</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3734-2779</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Меньшиков</surname><given-names>К. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Menshikov</surname><given-names>K. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Меньшиков Константин Викторович, к.м.н., доцент кафедры онкологии с курсами онкологии и патологической анатомии Института дополнительного профессионального образования, Башкирский государственный медицинский университет; врач-онколог отделения химиотерапии, Республиканский клинический онкологический диспансер; врач-онколог, Республиканский медико-генетический центр</p><p>450000, Уфа, ул. Ленина, д. 3;450054, Уфа, проспект Октября, д. 73/1; 450076, Уфа, ул. Гафури, д. 74</p></bio><bio xml:lang="en"><p>Konstantin V. Menshikov, Cand. Sci. (Med.), Associate Professor of the Department of Oncology with Courses in Oncology and Pathological Anatomy at the Institute of Additional Professional Education, Bashkir State Medical University; Oncologist of the Chemotherapy Department, Republican Clinical Oncology Dispensary;  Oncologist, Republican Medical and Genetic Center</p><p>3, Lenin St., Ufa, 450008;73/1, Oktyabrya Ave., Ufa, 450054; 74, Gafuri St., Ufa, 450076</p></bio><email xlink:type="simple">kmenshikov80@bk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8665-8895</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Меньшикова</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Menshikova</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Меньшикова Ирина Асхатовна, к.м.н., доцент, доцент кафедры биологической химии</p><p>450000, Уфа, ул. Ленина, д. 3</p></bio><bio xml:lang="en"><p>Irina A. Menshikova, Cand. Sci. (Med.), Associate Professor, Associate Professor of the Department of Biological Chemistry</p><p>3, Lenin St., Ufa, 450008</p></bio><email xlink:type="simple">i-menshikova@bk.ru</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8461-9243</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Измайлов</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Izmailov</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Измайлов Адель Альбертович, д.м.н., главный врач</p><p>450054, Уфа, проспект Октября, д. 73/1</p></bio><bio xml:lang="en"><p>Adel A. Izmailov, Dr. Sci. (Med.), Chief Medical Officer</p><p>73/1, Oktyabrya Ave., Ufa, 450054</p></bio><email xlink:type="simple">izmailov75@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1878-4467</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кудлай</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kudlay</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кудлай Дмитрий Анатольевич, чл.корр. РАН, д.м.н., профессор кафедры фармакологии Института фармации, Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет); ведущий научный сотрудник лаборатории персонализированной медицины и молекулярной иммунологии, Государственный научный центр «Институт иммунологии» Федерального медико-биологического агентства; профессор кафедры патологической физиологии, Башкирский государственный медицинский университет;</p><p>119991, Москва, ул. Трубецкая, д. 8, стр. 2;115478, Москва, Каширское шоссе, д. 24;450000, Уфа, ул. Ленина, д. 3</p></bio><bio xml:lang="en"><p>Dmitry A. Kudlay, Corr. Member RAS, Dr. Sci. (Med.), Professor of the Department of Pharmacology at the Institute of Pharmacy, Sechenov First Moscow State Medical University (Sechenov University);  Leading Researcher at the Laboratory of Personalized Medicine and Molecular Immunology, National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia; Professor of the Department of Pathological Physiology, Bashkir State Medical University</p><p>8, Bldg. 2, Trubetskaya St., Moscow, 119991;24, Kashirskoye Shosse, Moscow, 115478;3, Lenin St., Ufa, 450008, Russia</p></bio><email xlink:type="simple">d624254@gmail.com</email><xref ref-type="aff" rid="aff-6"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Республиканский клинический онкологический диспансер; &#13;
Башкирский государственный медицинский университет; &#13;
Республиканский медико-генетический центр</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Republican Clinical Oncology Dispensary; &#13;
Bashkir State Medical University; &#13;
Republican Medical and Genetic Center</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Институт иммунологии и физиологии Уральского отделения Российской академии наук; &#13;
Областная детская клиническая больница</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute of Immunology and Physiology of the Ural Branch of the Russian Academy of Sciences; &#13;
Regional Children’s Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Республиканский клинический онкологический диспансер</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Republican Clinical Oncology Dispensary</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Республиканский клинический онкологический диспансер; &#13;
Башкирский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Republican Clinical Oncology Dispensary; &#13;
Bashkir State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Башкирский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Bashkir State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>Башкирский государственный медицинский университет; &#13;
Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет); &#13;
Государственный научный центр «Институт иммунологии» Федерального медико-биологического агентства</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Bashkir State Medical University; &#13;
Sechenov First Moscow State Medical University (Sechenov University); &#13;
National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>30</day><month>07</month><year>2025</year></pub-date><volume>0</volume><issue>10</issue><fpage>120</fpage><lpage>127</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Султанбаев А.В., Тузанкина И.А., Насретдинов A.Ф., Мусин Ш.И., Султанбаева Н.И., Меньшиков К.В., Меньшикова И.А., Измайлов А.А., Кудлай Д.А., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Султанбаев А.В., Тузанкина И.А., Насретдинов A.Ф., Мусин Ш.И., Султанбаева Н.И., Меньшиков К.В., Меньшикова И.А., Измайлов А.А., Кудлай Д.А.</copyright-holder><copyright-holder xml:lang="en">Sultanbaev A.V., Tuzankina I.A., Nasretdinov A.F., Musin S.I., Sultanbaeva N.I., Menshikov K.V., Menshikova I.A., Izmailov A.A., Kudlay D.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/9249">https://www.med-sovet.pro/jour/article/view/9249</self-uri><abstract><sec><title>Введение</title><p>Введение. Дурвалумаб – первый иммунотерапевтический препарат, доказавший эффективность в качестве консолидирующей терапии после химиолучевого лечения у пациентов с нерезектабельным немелкоклеточным раком легкого (НМРЛ) III стадии. Исследования PACIFIC и PACIFIC-R подтвердили значительное улучшение выживаемости, однако данные реальной практики, включая российские, демонстрируют вариабельность результатов.</p></sec><sec><title>Цель</title><p>Цель. Оценить эффективность дурвалумаба в реальной клинической практике у пациентов с НМРЛ стадий IB-IIIC после радикальной химиолучевой терапии (ХЛТ).</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. Ретроспективный анализ 81 пациента (2021–2024 гг.), получившего дурвалумаб после ХЛТ (60 Гр ± 10%). Средний возраст – 63 года, 78% – курильщики. Гистология: 75% плоскоклеточный рак, 23% аденокарцинома. PD-L1 статус: 22% ≥ 1%, 18% – неизвестен. Оценены выживаемость без прогрессирования (ВБП) и общая выживаемость (ОВ) методом Каплана–Мейера.</p></sec><sec><title>Результаты</title><p>Результаты. В нашем исследовании медиана ВБП достигла 14 мес. (95% ДИ: 12–22), ОВ на 28-м мес. – 52%. Лучшие показатели ВБП у плоскоклеточного рака (19 мес. против 13 мес. при аденокарциноме), но без статистической значимости (p = 0,08). Значимое улучшение ВБП было отмечено при PD-L1+ (ОР = 0,43; p = 0,025), но не ОВ (p = 0,053). ВБП выше при стадиях I–IIIA (22 мес. против 12 мес. при IIIB-IV; p = 0,01), но разницы по ОВ нет. У 15% пациентов – побочные эффекты 3–4-й степени (пневмонит – 4,9%).</p></sec><sec><title>Заключение</title><p>Заключение. Дурвалумаб демонстрирует клинически значимое улучшение ВБП, особенно у пациентов с PD-L1+ и меньшей стадией заболевания. Однако влияние на ОВ требует дальнейшего наблюдения. Результаты согласуются с данными PACIFIC, но подчеркивают важность индивидуальных факторов (гистология, PD-L1, стадия).</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. Durvalumab is the first immunotherapy drug proven effective as consolidation therapy after chemoradiotherapy (CRT) in patients with unresectable stage III non-small cell lung cancer (NSCLC). The PACIFIC and PACIFIC-R trials confirmed significant survival benefits, but real-world data, including from Russian studies, show variability in outcomes.</p></sec><sec><title>Aim</title><p>Aim. To evaluate the effectiveness of durvalumab in real-world clinical practice in patients with stage IB-IIIC NSCLC after definitive CRT.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. A retrospective analysis of 81 patients (2021–2024) who received durvalumab after CRT (60 Gy ± 10%). Median age was 63 years; 78% were smokers. Histology: 75% squamous cell carcinoma, 23% adenocarcinoma. PD-L1 status: 22% ≥ 1%, 18% unknown. Progression-free survival (PFS) and overall survival (OS) were assessed using the Kaplan–Meier method.</p></sec><sec><title>Results</title><p>Results. Median PFS was 14 months (95% CI: 12–22); OS at 28 months was 52%. Better PFS in squamous cell carcinoma (19 vs. 13 months in adenocarcinoma), but not statistically significant (p = 0.08). Significant PFS improvement in PD-L1+ (HR = 0.43; p = 0.025), but not OS (p = 0.053). Higher PFS in stages I–IIIA (22 vs. 12 months in IIIB-IV; p = 0.01), but no OS difference. Grade 3–4 adverse events in 15% (pneumonitis – 4.9%).</p></sec><sec><title>Conclusion</title><p>Conclusion. Durvalumab demonstrates clinically meaningful PFS improvement, especially in PD-L1+ patients and early-stage disease. However, its impact on OS requires further follow-up. Results align with PACIFIC but highlight the importance of individual factors (histology, PD-L1, stage).</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>дурвалумаб</kwd><kwd>химиолучевая терапия</kwd><kwd>НМРЛ</kwd><kwd>региональный опыт</kwd><kwd>PD-L1</kwd><kwd>EGFR</kwd></kwd-group><kwd-group xml:lang="en"><kwd>durvalumab</kwd><kwd>chemoradiotherapy</kwd><kwd>NSCLC</kwd><kwd>regional experience</kwd><kwd>PD-L1</kwd><kwd>EGFR</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">Spigel DR, Faivre-Finn C, Gray JE, Vicente D, Planchard D, Paz-Ares L et al. Five-Year Survival Outcomes From the PACIFIC Trial: Durvalumab After Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer. 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