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Возможности улучшения результатов лечения первичного рака яичников

https://doi.org/10.21518/2079-701X-2019-19-150-156

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Аннотация

Рак яичников является пятой по частоте причиной смерти женщин от злокачественных опухолей в мире. Несмотря на достигнутый прогресс в лечении, почти у 70% пациентов развивается рецидив заболевания. Стандартным подходом первичного лечения рака яичников является циторедуктивная операция с последующей платино-, таксаносодержащей химиотерапией; у пациентов с IIIC-IV стадией заболевания возможен вариант неоадъювантной химиотерапии с интервальной циторедукцией. В связи с тем, что ангиогенез играет важную роль в росте и метастазировании солидных опухолей, исследования последних лет 
были сосредоточены на антиангиогенной терапии. Наиболее перспективным антиангиогенным препаратом является бевацизумаб – гуманизированное моноклональное антитело IgG, которое ингибирует рецептор фактора роста эндотелия сосудов. Европейское агентство по лекарственным средствам 23 декабря 2011 г. и Управление по контролю за продуктами и лекарствами 13 июня 2018 г. утвердило бевацизумаб в качестве первой линии лечения эпителиального рака яичников, маточной трубы или первичного рака брюшины при III или IV стадии в сочетании с карбоплатином и паклитакселом. На основании поданализов рекомендуемая дозировка бевацизумаба составляет 15 мг/кг каждые 3 недели в течение 22 циклов. Бевацизумаб – хорошо изученный препарат с благоприятным профилем безопасности, более 10 лет использующийся в рутинной клинической практике. Однако все еще продолжается поиск предикторов для выделения категории пациенток, которые получат наибольшую пользу от терапии бевацизумабом, а также ведутся клинические исследования, которые, возможно, в ближайшем будущем позволят расширить терапевтические возможности лечения РЯ за счет появления новых комбинаций бевацизумаба с PARPингибиторами и иммуноонкологическими препаратами. В свете получения зрелых данных клинических исследований выявлен круг наиболее обсуждаемых вопросов, касающихся оптимального применения бевацизумаба у пациенток с РЯ.


Об авторе

С. В. Хохлова
Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова
Россия

д.м.н., заведующая отделением противоопухолевой лекарственной терапии

117997, Россия, Москва, ул. Академика Опарина, д. 4



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Для цитирования:


Хохлова С.В. Возможности улучшения результатов лечения первичного рака яичников. Медицинский Совет. 2019;(19):150-156. https://doi.org/10.21518/2079-701X-2019-19-150-156

For citation:


Khokhlova S.V. Primary ovarian cancer: possibilities for improving treatment outcomes. Meditsinskiy sovet = Medical Council. 2019;(19):150-156. (In Russ.) https://doi.org/10.21518/2079-701X-2019-19-150-156

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ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)