References

oncotomsk

Сибирский онкологический журнал

Siberian journal of oncology

1814-48612312-3168

Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences

10.21294/1814-4861-2024-23-6-138-148

oncotomsk-3345

Research Article

ОБЗОРЫ

REVIEWS

Системная терапия анапластического рака щитовидной железы: обзор литературы

Systemic therapy for anaplastic thyroid cancer: a literature review

https://orcid.org/0000-0002-2571-243X

Джелялов

Э. С.

Dzhelialov

E. S.

Джелялов Эрнест Серверович - онколог онкологического отделения № 2 (торако-абдоминальной онкологии и противоопухолевой лекарственной терапии с койками общей хирургии).

198103, Санкт-Петербург, набережная реки Фонтанки, 154

Researcher ID (WOS) KYP-5609-2024, Author ID (Scopus) 57881611400

Ernest S. Dzhelialov - MD, Oncologist, Oncology Department No. 2, Saint Petersburg State University, N.I. Pirogov Clinic of High Medical Technologies.

154, Fontanka river embankment, Saint Petersburg, 198103

Researcher ID (WOS) KYP-5609-2024, Author ID (Scopus) 57881611400

ernest.dzhelialov@gmail.com

https://orcid.org/0000-0002-1903-5081

Слепцов

И. В.

Sleptsov

I. V.

Слепцов Илья Валерьевич - доктор медицинских наук, профессор, главный специалист Клиники по эндокринологии, хирург, эндокринолог, онколог хирургического (эндокринологического) отделения, заведующий кафедрой эндокринной хирургии медицинского института.

198103, Санкт-Петербург, набережная реки Фонтанки, 154

Researcher ID (WOS) F-1670-2019, Author ID (Scopus) 57216017997

Ilya V. Sleptsov - MD, DSc, Professor, Chief Specialist of Endocrinology Clinic, Surgeon, Endocrinologist, Oncologist, Surgical (Endocrinology) Department, Head of Endocrine Surgery Department of Medical Institute, Saint Petersburg State University, N.I. Pirogov Clinic of High Medical Technologies.

154, Fontanka river embankment, Saint Petersburg, 198103

Researcher ID (WOS) F-1670-2019, Author ID (Scopus) 57216017997

https://orcid.org/0000-0002-3001-664X

Черников

Р. А.

Chernikov

R. A.

Черников Роман Анатольевич - доктор медицинских наук, заведующий хирургическим (эндокринологическим) отделением.

198103, Санкт-Петербург, набережная реки Фонтанки, 154

Researcher ID (WOS) AAZ-1549-2021

Roman A. Chernikov - MD, DSc, Head of Surgery (Endocrinology) Department, Saint Petersburg State University, N.I. Pirogov Clinic of High Medical Technologies.

154, Fontanka river embankment, Saint Petersburg, 198103

Researcher ID (WOS) AAZ-1549-2021

https://orcid.org/0000-0001-6594-8845

Тимофеева

Н. И.

Timofeeva

N. I.

Тимофеева Наталья Игоревна - кандидат медицинских наук, онколог хирургического (эндокринологического) отделения.

198103, Санкт-Петербург, набережная реки Фонтанки, 154

Researcher ID (WOS) AAZ-1032-2021, Author ID (Scopus) 57215861367

Natalia I. Timofeeva - MD, PhD, Oncologist, Surgery (Endocrinology) Department, Saint Petersburg State University, N.I. Pirogov Clinic of High Medical Technologies.

154, Fontanka river embankment, Saint Petersburg, 198103

Researcher ID (WOS) AAZ-1032-2021, Author ID (Scopus) 57215861367

https://orcid.org/0000-0002-2274-8170

Белоусов

А. М.

Belousov

A. M.

Белоусов Александр Михайлович - кандидат медицинских наук, заместитель директора по медицинской части (хирургия и онкология).

198103, Санкт-Петербург, набережная реки Фонтанки, 154

Researcher ID (WOS) LDG-6733-2024, Author ID (Scopus) 57218703128

Alexander M. Belousov - MD, PhD, Deputy Director for Medical Affairs (Surgery and Oncology), Saint Petersburg State University, N.I. Pirogov Clinic of High Medical Technologies.

154, Fontanka river embankment, Saint Petersburg, 198103

Researcher ID (WOS) LDG-6733-2024, Author ID (Scopus) 57218703128

ФГБОУ ВО «Санкт-Петербургский государственный университет», Клиника высоких медицинских технологий им. Н.И. ПироговаРоссияSaint Petersburg State University, N.I. Pirogov Clinic of High Medical TechnologiesRussian Federation

2024

11012025

236138148

2025

Джелялов Э.С., Слепцов И.В., Черников Р.А., Тимофеева Н.И., Белоусов А.М.

Dzhelialov E.S., Sleptsov I.V., Chernikov R.A., Timofeeva N.I., Belousov A.M.

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/3345

Актуальность. Анапластический рак щитовидной железы - редкое, но агрессивное заболевание с крайне низкой выживаемостью. Совершенствование диагностических и терапевтических возможностей позволило разработать комплексный подход (хирургия + лучевая терапия + возможности системной противоопухолевой терапии), который способствовал улучшению общей выживаемости, что подчеркивает важность участия мультидисциплинарной команды. Однако, несмотря на широкое применение химиотерапии, таргетной терапии и иммунотерапии, результаты лечения пациентов остаются неутешительными. Цель исследования - проанализировать литературу о подходах к системной терапии анапластического рака щитовидной железы, выделить ключевые недостатки существующих методов лечения и определить перспективные направления исследований в данной области. Материал и методы. Поиск литературы для подготовки обзора осуществлен по базам данных Web of science, scopus, Medline, the Cochrane library, РИНЦ. В ходе поиска проанализировано 395 источников, из них отобрано 59 научных публикаций. В обзор включены исследования за период с 1985 по 2024 г. Результаты. Проанализировано текущее состояние системной терапии анапластического рака щитовидной железы. В настоящее время применяются различные методы системной терапии, включая химиотерапию, таргетную терапию и иммунотерапию, а также их комбинации. Химиотерапия остается одним из основных методов лечения, однако ее эффективность ограничена, а токсичность лимитирует ее применение у ослабленных пациентов. Отсутствие чувствительности у пациентов с таргетируемой мутацией и приобретенная резистентность ограничивают возможности таргетной терапии, а недостаточная эффективность и необходимость запаса времени для ожидания реализации эффекта - иммунотерапии. Наиболее оптимальным методом лечения представляется комбинированная терапия (таргетная терапия + иммунотерапия). Заключение. Несмотря на появление новых методов системной терапии, прогноз для пациентов с анапластическим раком щитовидной железы остается неблагоприятным. Дальнейшие исследования в этой области необходимы для разработки более эффективных и безопасных методов лечения. Особое внимание следует уделить изучению молекулярных механизмов развития анапластического рака щитовидной железы и формирования резистентности к системной терапии, поиску новых мишеней для таргетной терапии и совершенствованию комбинированных с иммунотерапией подходов.

Background. Anaplastic thyroid cancer is a rare but aggressive disease with an extremely low survival rate. Improved diagnostic and therapeutic options have enabled the development of a multidisciplinary approach (surgery + radiation therapy + systemic antitumor therapy options) that has improved overall survival, highlighting the importance of a multidisciplinary approach. However, despite the widespread use of chemotherapy, targeted therapy and immunotherapy, patient outcomes remain disappointing. Objective. To analyze literature data on approaches to systemic therapy for anaplastic thyroid cancer, highlight the key disadvantages of existing treatment methods and identify promising areas of research in this area. Material and Methods. The literature search for the review was performed using the following databases: Web of Science, Scopus, Medline, the Cochrane library, and RSCI. During the literature search, 395 sources were analyzed, 59 scientific publications were selected. the review included studies covering the period from 1985 to 2024. Results. This review analyzes the current state of systemic therapy for anaplastic thyroid cancer. Chemotherapy remains one of the main methods of treatment, but its effectiveness is limited, and toxicity limits its use in weakened patients. lack of sensitivity in patients with a target mutation and acquired resistance limit the effectiveness of targeted therapy, and insufficient efficiency and the need for waiting time for the effect to be realized limit the benefits of immunotherapy. Based on the results obtained, the most optimal treatment modality appears to be combination therapy (targeted therapy + immunotherapy). Conclusion. Despite advances in therapy modalities, prognosis for patients remains unfavorable. Further research is necessary to develop more effective and safe treatments. Particular attention should be paid to the study of the molecular mechanisms of the development of anaplastic thyroid cancer and resistance to systemic therapy, the search for new targets for targeted therapy and the improvement of approaches combined with immunotherapy.

анапластический рак щитовидной железыхимиотерапияиммунотерапиятаргетная терапияобзор литературы

anaplastic thyroid cancerchemotherapyimmunotherapytargeted therapyliterature review

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