Archive | 2019
ИММУНОТЕРАПИЯ РАКА ЖЕЛУДКА
Abstract
Gastric cancer (GC) takes 5th place among the malignant neoplasms by incidence in the world. Mortality from GC is high, since in most\xa0cases the disease is diagnosed in the late stages, with distant metastases, the five-year survival in GC does not exceed 25–30 %. The\xa0standard for GC therapy is surgery with chemotherapy. There is a high resistance to chemotherapy in the late stages of GC, and this circumstance\xa0requires a fundamentally new therapy. Recently, studies have been actively conducted on the therapy of GC with the immune\xa0control point inhibitors. At the moment, the most studied are monoclonal antibodies against PD-1 (Programmed cell death 1, CD279) / PDL1\xa0(Programmed death-ligand 1, CD274), CTLA-4 (Cytotoxic T-lymphocyte-associated protein 4, CD152). The article discusses the\xa0characteristics of PD-1, PD-L1, CTLA-4 molecules and their significance in suppressing the T-cell response, as well as the antitumor\xa0effect of immune control point inhibitors. The results of clinical studies of GC therapy with monoclonal antibodies against PD-1 / PD-L1,\xa0CTLA-4 were analyzed. The immune control point inhibitors are used as both first-line therapy and subsequent ones. The negative side\xa0of immunotherapy is immune-mediated adverse events that can affect the tissues of the kidneys, heart, gastrointestinal tract, liver, lungs,\xa0skin and endocrine glands. Biomarkers of the effectiveness of the immune control point inhibitors for GC are considered, among which\xa0one can distinguish PD-L1 expression, microsatellite instability, gene expression profile, tumor mutational load and composition of the\xa0intestinal microbiome.