Циркулирующие предиктивные маркеры ответа на ингибиторы контрольных точек иммунитета при немелкоклеточном раке легкого

Иммунотерапия ингибиторами контрольных точек иммунитета (ИКТИ) в виде монотерапии или в комбинации с химиотерапией стала одним из ключевых подходов в лечении пациентов с распространенным немелкоклеточным раком легкого (НМРЛ ). Оценка уровня экспрессии PD-L1 (лиганда рецептора запрограммированной клеточной гибели 1) на опухолевых клетках с помощью иммуногистохимического исследования является единственным одобренным методом определения показаний к назначению ИКТИ у этой группы больных. Однако, несмотря на высокий уровень экспрессии данного маркера, до 80 % пациентов не отвечают на терапию в связи с наличием первичной или приобретенной резистентности. Это обусловливает ограниченную эффективность ИКТИ. К тому же у 8–17 % больных НМРЛ с негативной экспрессией PD-L1 наблюдается ответ на данную терапию. Ограничением этого маркера является то, что он не позволяет оценить как внутриопухолевый, так и системный иммунный статус. Необходим поиск дополнительных предиктивных маркеров для повышения точности отбора кандидатов на иммунотерапию, что позволит избежать затрат, потери времени, высокого риска возникновения иммуноопосредованных нежелательных явлений у потенциально не отвечающих на лечение пациентов. Внимание многих исследователей посвящено циркулирующим маркерам в периферической крови как неинвазивной альтернативе биопсии с целью прогнозирования и мониторинга ответа на терапию. Данный обзор посвящен наиболее перспективным иммунологическим маркерам в периферической крови как потенциальным предикторам ответа на ИКТИ у пациентов с распространенным НМРЛ . 

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