Иммунотерапия злокачественных глиом: современное состояние проблемы

Злокачественные глиомы являются наиболее распространенными опухолями из клеток глиального ряда головного мозга у взрослых и характеризуются крайне неблагоприятным прогнозом. Терапия злокачественных глиом, как правило, включает максимально радикальное хирургическое удаление опухоли с последующим проведением лучевой терапии и/или химиотерапии.
В обзоре представлены основные клинико-морфологические и молекулярно-генетические характеристики глиом, их прогностическая значимость, а также роль в выборе тактики таргетной терапии с использованием соответствующих ингибиторов тирозинкиназ и моноклональных антител. Особое внимание уделяется современным аспектам в области иммунотерапии злокачественных глиом, таким как активация иммунных клеток и блокирование различных механизмов, используемых опухолью для уклонения от иммунной системы. Одним из наиболее изученных направлений иммунотерапии злокачественных новообразований является применение ингибиторов контрольных точек иммунного ответа. Данные препараты могут быть эффективны в лечении злокачественных глиом, в которых отмечается гиперэкспрессия молекул, оказывающих супрессорное действие на клетки иммунной системы. Еще одним перспективным направлением иммунотерапии является использование генетически модифицированных CAR-T-клеток (CAR – химерный антигенный рецептор), что подразумевает применение модифицированных иммунных клеток, способных распознавать и уничтожать опухолевые клетки. Помимо этого, к перспективным подходам иммунотерапии глиом относят цитокинотерапию и генную терапию, связанную c генным редактированием вирусов для производства онколитических вирусных вакцин. Разрабатываются вакцины, содержащие специфичные для опухолевых клеток антигены, которые могут стимулировать иммунную систему для их распознавания и последующего уничтожения.
Несмотря на перспективность иммунотерапии глиом, многие вышеперечисленные иммунотерапевтические подходы к лечению злокачественных глиом находятся на различных стадиях доклинических и клинических исследований, результаты некоторых из которых многообещающие.

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