Иммунотерапия в комбинации с химиотерапией при раке молочной железы с тройным негативным фенотипом – первая «таргетная» терапия, но только для «таргетной» популяции

Гречухина К.С., Жукова Л.Г. Иммунотерапия в комбинации с химиотерапией при раке молочной железы с тройным негативным фенотипом – первая «таргетная» терапия, но только для «таргетной» популяции. Современная Онкология. 2019; 21 (3): 33–37. DOI: 10.26442/18151434.2019.3.190655

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Grechukhina K.S., Zhukova L.G. Immunotherapy in combination with chemotherapy in triple-negative breast cancer – the first “target” therapy for the “target” patients’ population. Journal of Modern Oncology. 2019; 21 (3): 33–37. DOI: 10.26442/18151434.2019.3.190655

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Аннотация

До последнего времени единственным вариантом системной терапии при раке молочной железы (РМЖ) с тройным негативным фенотипом (тройной негативный РМЖ – ТНРМЖ) являлась химиотерапия, причем единый стандарт лечения метастатических форм так и не определен, поэтому подход к лечению остается на усмотрение врача и является эмпирическим, заключаясь в искусном подборе различных комбинаций препаратов. ТНРМЖ печально известен как наименее прогностически благоприятный подтип. Отсутствие при данном виде опухоли экспрессии рецепторов эстрогенов, прогестерона и амплификации гена HER2 делало невозможным применение таргетной терапии, определяющей успехи в лечении люминальных и HER2-позитивного подтипов РМЖ. Полученные данные о потенциальной иммуногенности опухоли при ТНРМЖ позволили начать изучение эффективности иммунотерапии и при этом виде рака. Международное клиническое исследование IMpassion130 не только положило основу развития этого направления в лечении ТНРМЖ, но и позволило определить выигрывающую («таргетную») популяцию больных в отношении одной из самых главных целей нашей терапии – общей выживаемости, увеличение которой так важно для пациенток с этим подтипом РМЖ.

Ключевые слова: рак молочной железы, тройной негативный фенотип, иммунотерапия, PD-L1.

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The only option of systemic therapy for triple-negative breast cancer (TNBC) was cytotoxic chemotherapy until recently, moreover the unitary standard of care for metastatic forms was not strictly defined. That is why paradigm of the treatment remains at the discretion of the doctor and it is empirical, consisting of precise combination of drugs. TNBC is infamous as the worst prognostic subtype. The absence of estrogen and progesterone receptors expression and HER2 amplification in this subtype of tumors made the usage of target therapy impossible, which is essential for successful treatment of luminal and HER2 positive breast cancer subtypes. The data about potential immunogenicity of tumor in TNBC launched the investigation of immunotherapy efficacy in this subtype of breast cancer. International clinical trial Impassion130 has not only created the basis in this field of TNBC treatment but also identified and determined the “benefiters”-cohort of patients concerning one of the most important goals – improving overall survival, that is so significant for patients with this subtype of breast cancer.

Key words: breast cancer, triple-negative, immunotherapy, PD-L1.

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Авторы

К.С. Гречухина*, Л.Г. Жукова

ГБУЗ «Московский клинический научный центр им. А.С. Логинова», Москва, Россия
*dr.grechukhina@gmail.com

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Katerina S. Grechukhina*, Ludmila G. Zhukova

Loginov Moscow Clinical Scientific Center, Moscow, Russia
*dr.grechukhina@gmail.com

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