Возможности иммунотерапии метастатического рака шейки матки

Рак шейки матки (РШМ) остается одним из распространенных опухолевых заболеваний у женщин, составляя 9,8% всех неоплазий у женщин. Управление по санитарному надзору за качеством пищевых продуктов и медикаментов одобрило применение пембролизумаба с антителами, ингибирующими PD-1, для лечения РШМ после клинического испытания KEYNOTE-158. Ингибиторы PD-L1/PD-1 показали многообещающие результаты в отношении ЧОО у пациенток с РШМ. В статье представлен клинический случай лучения пембролизумабом пациентки с метастатическим РШМ с прогрессией после лучевой терапии, эвисцерации органов малого таза. Пациентке было проведено ИГХ-исследование опухолевого материла, выявлено наличие экспрессии PDL1 более 1% по данным анализа с антителом 22С3. Согласно инструкции к препарату Пемброриа® было решено начать системную химиотерапию в следующем режиме: паклитаксел 175 мг/м², карбоплатин AUC5 и пембролизумаб в дозе 200 мг один раз в три недели. После третьего курса проведено контрольное МРТ-исследование. Констатирован частичный ответ по критериям iRECIST. После шестого курса терапии цитостатики отменены, пациентка продолжила монотерапию пембролизумабом по 200 мг раз в три недели. На контрольной МРТ после 10 мес. терапии опухолевый конгломерат в правой запирательной ямке не определяется, констатирован полный ответ. В приведенном наблюдении анти-PD1-терапия метастатического РШМ позволила достичь полной ремиссии заболевания. Отмечено снижение количества нежелательных явлений, улучшение общего состояния пациентки. Таким образом, клиническое наблюдение демонстрирует эффективность терапии пембролизумабом у пациенток с распространенным РШМ.

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