oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2024-23-1-120-129oncotomsk-2955Research ArticleОБЗОРЫREVIEWSАбскопальный эффект: механизм возникновения и перспективы применения в терапии метастатических форм злокачественных опухолейThe abscopal effect: mechanism of occurrence and prospects of using it in therapy of metastatic cancerhttps://orcid.org/0000-0003-3774-2879ХачатурянА. В.KhachaturyanA. V.

Хачатурян Александр Владимирович - научный сотрудник, Научно-исследовательский институт клинической онкологии им. акад. РАН и РАМН Н.Н. Трапезникова, онкологическое отделение хирургических методов лечения № 4 (онкоурология).

115478, Москва, Каширское шоссе, 24

Alexander V. Khachaturyan - MD, Researcher, N.N. Trapeznikov Research Institute of Clinical Oncology of the Russian Academy of Sciences and Russian Academy of Medical Sciences, Surgical Oncology Department (Urological Oncology), N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russia.

24, Kashirskoye Shosse, Moscow, 115522

centrforward@mail.ruhttps://orcid.org/0000-0003-3947-1267БулычкинП. В.BulychkinP. V.

Булычкин Петр Владиславович - кандидат медицинских наук, старший научный сотрудник отделения радиотерапии НИИ клинической онкологии.

115478, Москва, Каширское шоссе, 24

Petr V. Bulychkin - MD, PhD, Senior Researcher, Department of Radiotherapy, Research Institute of Clinical Oncology, N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russia.

24, Kashirskoye Shosse, Moscow, 115522

ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииРоссияN.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of the RussiaRussian Federation202420032024231120129Copyright © Хачатурян А.В., Булычкин П.В., 20242024Хачатурян А.В., Булычкин П.В.Khachaturyan A.V., Bulychkin P.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/2955

Абскопальный эффект (АЭ) в онкологической практике известен на протяжении 70 лет, однако до последнего времени его клиническая значимость была относительно невелика. Развитие препаратов ингибиторов контрольных точек иммунного ответа привело к активному изучению этого феномена. В настоящее время имеются данные об улучшении выживаемости среди пациентов, у которых регистрировался абскопальный эффект, что открывает новые перспективы лечения онкологических заболеваний различных стадий. В этом обзоре представлены сведения о механизмах абскопального эффекта, экспериментальные и клинические данные, текущие ограничения и возможные перспективы. Цель исследования – изучить современную концепцию возникновения абскопального эффекта, оценить перспективы применения в терапии метастатических форм злокачественных опухолей. Материал и методы исследования. Проведен поиск публикаций в системе Pubmed с 2010 по 2023 г., найдено 286 статей, 72 из них использованы для написания обзора. Результаты. Согласно данным, представленным в этих статьях, в эпоху широкого применения ингибиторов контрольных точек иммунитета (ИКТИ) для терапии злокачественных новообразований абскопальный эффект представляется эффективным терапевтическим подходом, имеющим широкие перспективы применения в лечении пациентов с метастатическими формами рака. Заключение. С появлением иммунной терапии частота АЭ возросла, а одномоментное использование ИКТИ с лучевой терапией (ЛТ) продемонстрировало улучшение выживаемости даже у пациентов с распространенными стадиями заболевания. Требуются дополнительные исследования для создания стандартизированных протоколов лечения, включая определение оптимальной дозы и времени проведения ЛТ, а также эффективности и безопасности комбинированной терапии различными ИКТИ. Кроме того, необходим поиск клинических и лабораторных предикторов АЭ, которые бы могли позволить индивидуализировать подход к лечению.

The abscopal effect in oncology has been known for 70 years, but until recently its clinical significance was rather low. The development of immune response checkpoint inhibitors has led to an active study of this phenomenon. There is now evidence of improved survival among patients, in whom the abscopal effect has been documented, opening new perspectives for the treatment of cancers at different stages. This review presents data on the mechanisms of the abscopal effect, experimental and clinical data, current limitations and possible perspectives. The aim of the study was to investigate the current concept of the abscopal effect occurrence and to evaluate the prospects of using the abscopal effect in therapy of metastatic cancer. Material and Methods. We searched publications in Pubmed system from 2010 to 2023. Of 286 publications, 72 were used for writing the review. Results. In the era of widespread use of immune checkpoint inhibitors (ICIs) for cancer therapy, the abscopal effect appears to be an effective therapeutic approach with broad prospects of application in the treatment of patients with metastatic cancer. Conclusion. The incidence of the abscopal effect has increased with the advent of immune therapy, and the use of ICIs with radiation therapy (RT) has shown improved survival even in patients with advanced disease. More research is needed to establish standardized treatment protocols, including the optimal dose and timing of RT, as well as the efficacy and safety of combination therapy with different classes of ICIs. Further search for clinical and laboratory abscopal effect predictors, which could allow personalized treatment approaches, is required.

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The authors declare that there are no conflicts of interest present.