Иммунотерапия злокачественных глиом: современное состояние проблемы

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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.

Об авторах

А. А. Пичугин

ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава России; ГАУЗ «Межрегиональный клинико-диагностический центр»

Email: fake@neicon.ru
ORCID iD: 0000-0002-0134-1005

420012 Казань, ул. Бутлерова, 49

420101 Казань, ул. Карбышева, 12А

Россия

Р. Р. Ковязина

Университет герцога Куньшаня

Email: fake@neicon.ru
ORCID iD: 0000-0002-6165-3668

215316 Куньшань, Цзянсу, Дьюк Авеню, 8

Китай

А. А. Трондин

Клиника Сан-Карлос

Email: fake@neicon.ru
ORCID iD: 0000-0002-8046-2533

28040 Мадрид, Calle del Prof Martín Lagos, S/N, Moncloa – Aravaca

Испания

А. Г. Алексеев

ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава России; ГАУЗ «Межрегиональный клинико-диагностический центр»

Email: fake@neicon.ru
ORCID iD: 0000-0003-1227-8918

420012 Казань, ул. Бутлерова, 49

420101 Казань, ул. Карбышева, 12А

Россия

П. Б. Копнин

Научно-исследовательский институт канцерогенеза ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России

Email: fake@neicon.ru
ORCID iD: 0000-0002-2078-4274

115522 Москва, Каширское шоссе, 24

Россия

Т. В. Гессель

ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава России

Email: fake@neicon.ru
ORCID iD: 0009-0003-4348-9141

420012 Казань, ул. Бутлерова, 49

Россия

С. В. Бойчук

ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава России; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России

Автор, ответственный за переписку.
Email: boichuksergei@mail.ru
ORCID iD: 0000-0003-2415-1084

Сергей Васильевич Бойчук

420012 Казань, ул. Бутлерова, 49

125993 Москва, ул. Баррикадная, 2/1, стр. 1

Россия

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