Журнал «Практична онкологія» Том 4, №2, 2021

Імунотерапія раку — порівняно новий і перспективний метод лікування новоутворень. Одним із центральних напрямків із залучення імунної системи до боротьби з раком стало розуміння антиген-спрямованої цитотоксичності Т-лімфоцитів. Фундаментальні дослідження в цій сфері призвели до винайдення блокаторів контрольних імунних точок, адаптивної Т-клітинної терапії та протиракових вакцин. Потенціювати дію Т-лімфоцитів можуть цитокіни завдяки їх здатності напряму стимулювати ефекторні та стромальні клітини в пухлинних вогнищах та посилювати розпізнавання пухлинних клітин цитотоксичними ефекторними клітинами. Вони були першими в імунотерапії раку і залишаються актуальними досі. На сьогодні імунотерапія є ефективним методом лікування більшості злоякісних новоутворень, серед яких меланома, недрібноклітинний рак легень, рак печінки, шлунка, сечового міхура, шийки матки, деякі типи раку молочної залози, лімфоми тощо. Однак імунотерапія деяких злоякісних пухлин малоефективна, тому активно відбувається розробка нових та удосконалення існуючих засобів імунотерапії, і є сподівання, що показання до її застосування будуть розширюватися. З цією метою у даному огляді розглянуті принципи роботи різних класів імунотерапевтичних протипухлинних засобів, а саме цитокінів, блокаторів контрольних імунних точок, адаптивної Т-клітинної терапії. У роботі висвітлено їх показання, ефективність і токсичність від застосування кожного класу препаратів, а також перспективи у розробці імунотерапевтичних протипухлинних засобів.

Cancer immunotherapy is a relatively new and pro­mising method of treating neoplasms. Understanding the antigen-directed cytotoxicity of T-lymphocytes has become one of the central directions in involving the immune system in the fight against cancer. Basic research in this area has led to the invention of checkpoint inhibitors, adoptive T-cell therapy, and cancer vaccines. Cytokines can enhance the action of T-lymphocytes for their ability to directly stimulate effector and stromal cells in tumor focus and enhance recognition of tumor cells by cytotoxic effector cells. They were the first in cancer immunotherapy and remain relevant to this day. Today, immunotherapy is an effective treatment for most malignant tumors, including melanoma, non-small cell lung cancer, liver, stomach, bladder, cervical cancer, some types of breast cancer, lymphoma, etc. However, immunotherapy of some malignant tumors is ineffective, therefore, the development of new and improvement of existing immunotherapy agents is actively underway, and there is a hope that the indications for its use will expand. For this purpose, this review discusses the principles of action of various classes of immunotherapeutic anticancer agents, namely cytokines, immune checkpoint inhibitors, and adaptive T-cell therapy. The work highlights their indications, efficacy and toxicity from the use of each class of drugs, as well as the prospects for the development of immunotherapeutic anticancer drugs.

імунотерапія раку; цитокіни; блокатори контрольних імунних точок; адаптивна Т-клітинна терапія; огляд

cancer immunotherapy; cytokines; immune checkpoint inhibitors; adaptive T-cell therapy; review

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