Механизмы метастазирования и развития резистентности к терапии при раке молочной железы. Клинический случай эффективности иксабепилона при формировании множественной лекарственной устойчивости гормон-рецепторпозитивного рака молочной железы

Во всем мире метастатический рак молочной железы (РМЖ) занимает лидирующие позиции в структуре смертности среди женщин с онкологическими заболеваниями. При этом, несмотря на улучшение показателей раннего скрининга, а также внедрение в клиническую практику таргетной терапии, контроль метастатического заболевания остается значимой проблемой для клинической онкологии. Повышение стволовости опухоли и эпителиально-мезенхимальный переход в первичной опухоли приводят к пластичности опухолевой клетки. Это выражается в прогрессировании заболевания, резистентности к проводимой терапии и появлению отдаленных метастазов. Многочисленные сигнальные пути, в т. ч. PI3K/APK, STAT3, Wnt, Hedgehog и Notch, играют ключевую роль в поддержании клеточной пластичности при РМЖ. Понимание клеточных механизмов пластичности клеток РМЖ с развитием множественной лекарственной устойчивости является необходимым условием для разработки эффективных терапевтических стратегий против метастатического РМЖ в  поздних линиях терапии. В  статье представлен обзор современных данных о  биологическом механизме метастатического каскада и  резистентности к  терапии. Именно с  позиций пластичности опухолевой клетки и  повышения стволовости опухоли рассмотрена резистентность к  лечению. Проанализирована эффективность иксабепилона в  случае его применения в  поздней линии терапии гормон-рецепторпозитивного РМЖ с множественной лекарственной резистентностью.

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