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Биомаркеры при метастатической меланоме кожи: можем ли мы точнее выбирать тактику лечения наших пациентов?

https://doi.org/10.21518/2079-701X-2021-9-48-63

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Аннотация

При наличии возрастающего количества альтернативных эффективных методов лечения пациентов увеличивается потребность в более точной селекции пациентов для проведения терапии (в сравнении, например, с наблюдением после радикального хирургического лечения), выбора оптимального способа терапии  (предсказание первичной резистентности или, напротив, высокой чувствительности), а также критериев для прекращения лечения (полная элиминация опухоли) или смены терапии (молекулярное, т. е. предклиническое и предрадиологическое прогрессирование). Ответы на все эти вопросы мы ищем в разнообразных биомаркерах. Сегодня изучено много клинических маркеров (например, состояние по шкале ECOG или распространенность заболевания), молекулярно-генетических (например, таких, как мутации в генах BRAF, NRAS, NF1, TMB), иммунологических (например, инфильтрация опухоли лимфоцитами и экспрессия PD-L1, PD-L2, PD-1 или других контрольных точек иммунитета на опухолевых клетках и клетках микроокружения), а также факторов, циркулирующих в крови и плазме (например, соотношение клеток крови между собой, циркулирующая опухолевая ДНК или цитокины в периферической крови). В данной работе мы постарались проанализировать накопленные к  настоящему времени сведения и  попытаться соотнести их как с  имеющейся клинической практикой и доступными способами лечения, так и наметить перспективы ближайших исследований в этой области. Имеющиеся сведения, на наш взгляд, могут повлиять на текущую рутинную практику врачей-онкологов и позволят аккуратнее выбирать терапию первой линии для получения от нее максимальной пользы и минимального вреда. Хотя вероятно, что для определения таких биомаркеров потребуется предпринять некоторые организационные усилия для изменения устоявшейся клинической практики.

Об авторах

А. Р. Зарецкий
Российский национальный исследовательский медицинский университет имени Н.И. Пирогова
Россия

Зарецкий Андрей Ростиславович, научный сотрудник отдела молекулярных технологий научно-исследовательского института трансляционной медицины

117997, Москва, ул. Островитянова, д. 1

Scopus Author ID: 57130636900;

SPIN-код: 2891-9533;

Author ID: 882141



Л. В. Демидов
Национальный медицинский исследовательский центр онкологии имени Н.Н. Блохина
Россия

Демидов Лев Вадимович, доктор медицинских наук, профессор, заведующий отделением онкодерматологии

115478, Москва, Каширское шоссе, д. 23

Scopus Author ID: 6602828686;

SPIN-код: 5362-6386;

Author ID: 173317



И. В. Самойленко
Национальный медицинский исследовательский центр онкологии имени Н.Н. Блохина
Россия

Самойленко Игорь Вячеславович, кандидат медицинских наук, старший научный сотрудник отделения онкодерматологии

115478, Москва, Каширское шоссе, д. 23

Scopus Author ID: 57206666589;

SPIN-код: 3691-8923;

Author ID: 520864;



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Рецензия

Для цитирования:


Зарецкий А.Р., Демидов Л.В., Самойленко И.В. Биомаркеры при метастатической меланоме кожи: можем ли мы точнее выбирать тактику лечения наших пациентов? Медицинский Совет. 2021;(9):48-63. https://doi.org/10.21518/2079-701X-2021-9-48-63

For citation:


Zaretsky A.R., Demidov L.V., Samoylenko I.V. Biomarkers in metastatic melanoma of the skin: can we more accurately choose the tactics of treating our patients? Meditsinskiy sovet = Medical Council. 2021;(9):48-63. (In Russ.) https://doi.org/10.21518/2079-701X-2021-9-48-63

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