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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">oncotomsk</journal-id><journal-title-group><journal-title xml:lang="ru">Сибирский онкологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Siberian journal of oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1814-4861</issn><issn pub-type="epub">2312-3168</issn><publisher><publisher-name>Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21294/1814-4861-2025-24-2-56-67</article-id><article-id custom-type="elpub" pub-id-type="custom">oncotomsk-3536</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ЛАБОРАТОРНЫЕ И ЭКСПЕРИМЕНТАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LABORATORY AND EXPERIMENTAL STUDIES</subject></subj-group></article-categories><title-group><article-title>Влияние иммунотаргетной терапии на показатели иммунной системы у больных раком эндометрия</article-title><trans-title-group xml:lang="en"><trans-title>Influence of immune targeted therapy on immune system parameters in patients with endometrial cancer</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0601-2240</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Стахеева</surname><given-names>М. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Stakheyeva</surname><given-names>M. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Стахеева Марина Николаевна, доктор медицинских наук, ведущий научный сотрудник лаборатории молекулярной онкологии и иммунологии; профессор</p><p>Researcher ID (WOS): C-6184-2012. Author ID (Scopus): 6505941716</p><p>634009, г Томск, пер. Кооперативный, 5</p><p>634050, г Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>Marina N. Stakheyeva, MD, DSc, Leading Researcher, Laboratory of Molecular Oncology and Immunology; Professor</p><p>Researcher ID (WOS): C-6184-2012. Author ID (Scopus): 6505941716</p><p>5, Kooperativny St., Tomsk, 634009 </p><p>2, Moskovsky trakt, Tomsk, 634050 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1205-5976</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ермак</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ermak</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ермак Никита Андреевич, аспирант, лаборант-исследователь лаборатории молекулярной онкологии и иммунологии</p><p>Author ID (Scopus): 57887085900</p><p>634009, г Томск, пер. Кооперативный, 5</p></bio><bio xml:lang="en"><p>Nikita A. Ermak, MD, Postgraduate, Research Assistant, Laboratory of Molecular Oncology and Immunology</p><p>Author ID (Scopus): 57887085900</p><p>5, Kooperativny St., Tomsk, 634009 </p></bio><email xlink:type="simple">virgil1990f@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8212-731X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мальцева</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Maltseva</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мальцева Анастасия Алексеевна, аспирант</p><p>Author ID (Scopus): 57215558396</p><p>634009, г Томск, пер. Кооперативный, 5</p></bio><bio xml:lang="en"><p>Anastasia A. Maltseva, MD, Postgraduate</p><p>Author ID (Scopus): 57215558396</p><p>5, Kooperativny St., Tomsk, 634009 </p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-3734-1126</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ливанос</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Livanos</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ливанос Екатерина Иоаннисовна, студентка 6-го курса </p><p>634050, г Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>Ekaterina I. Livanos, 6th year student </p><p>2, Moskovsky trakt, Tomsk, 634050 </p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6854-8940</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Коломиец</surname><given-names>Л. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kolomiets</surname><given-names>L. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Коломиец Лариса Александровна, доктор медицинских наук, профессор, заведующая отделением гинекологии; профессор кафедры онкологии</p><p>Researcher ID (WOS): C-8573-2012. Author ID (Scopus): 7004921120</p><p>634009, г Томск, пер. Кооперативный, 5</p><p>634050, г Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>Ekaterina I. Livanos, 6th year student; Professor, Department of Oncology</p><p>Researcher ID (WOS): C-8573-2012. Author ID (Scopus): 7004921120</p><p>5, Kooperativny St., Tomsk, 634009 </p><p>2, Moskovsky trakt, Tomsk, 634050 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1526-9013</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чердынцева</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Cherdyntseva</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Чердынцева Надежда Викторовна, доктор биологических наук, профессор, член-корреспондент РАН, заведующая лабораторией молекулярной онкологии и иммунологии; ведущий научный сотрудник</p><p>Researcher ID (WOS): С-7943-2012. Author ID (Scopus): 6603911744</p><p>634009, г Томск, пер. Кооперативный, 5</p></bio><bio xml:lang="en"><p>Nadezhda V. Cherdyntseva, DSc, Professor, Corresponding Member of Russian Academy of Sciences, Head of the Laboratory of Molecular Oncology and Immunology; Senior Researcher</p><p>Researcher ID (WOS): С-7943-2012. Author ID (Scopus): 6603911744</p><p>5, Kooperativny St., Tomsk, 634009</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук ; ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России<country>Россия</country></aff><aff xml:lang="en">Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences ; Siberian State Medical University of the Ministry of Health of Russia<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук<country>Россия</country></aff><aff xml:lang="en">Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России<country>Россия</country></aff><aff xml:lang="en">Siberian State Medical University of the Ministry of Health of Russia<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>17</day><month>05</month><year>2025</year></pub-date><volume>24</volume><issue>2</issue><fpage>56</fpage><lpage>67</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Стахеева М.Н., Ермак Н.А., Мальцева А.А., Ливанос Е.И., Коломиец Л.А., Чердынцева Н.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Стахеева М.Н., Ермак Н.А., Мальцева А.А., Ливанос Е.И., Коломиец Л.А., Чердынцева Н.В.</copyright-holder><copyright-holder xml:lang="en">Stakheyeva M.N., Ermak N.A., Maltseva A.A., Livanos E.I., Kolomiets L.A., Cherdyntseva N.V.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.siboncoj.ru/jour/article/view/3536">https://www.siboncoj.ru/jour/article/view/3536</self-uri><abstract><p>Введение. Иммунотаргетная терапия (ИТТ), включающая ингибитор контрольных точек иммунного ответа пембролизумаб и таргетный препарат ленватиниб, блокирующий тирозинкиназы рецепторов, является одной из основных стратегий лечения прогрессирующего рака эндометрия (пРЭ) с профици­том системы репарации (pMMR) и отсутствием микросателлитной нестабильности (MSS). Поскольку иммунологические механизмы вовлечены в реализацию терапевтических эффектов пембролизумаба и ленватиниба, то вероятно, что актуальное состояние иммунной системы пациенток оказывает влияние на эффективность ИТТ. Цель исследования - изучить изменение иммунологических показателей в периферической крови, ассоциированных с молекулярно-клеточными механизмами действия пембро­лизумаба и ленватиниба, у больных пРЭ при проведении иммунотаргетной терапии в зависимости от эффективности данного вида лечения. Материал и методы. В исследование вошли 12 пациенток с пРЭ II—IV (T2-4N0-2M0-1) стадии, с профицитом системы репарации (pMMR) и отсутствием микросателлитной нестабильности (MSS), получившие терапию в виде комбинации пембролизумаба и ленватиниба. В зависимости от эффективности ИТТ сформированы 2 группы: с прогрессированием ИТТ в течение 6 мес от начала данной терапии (n=4) и без признаков прогрессирования более 6 мес (n=8). До начала ИТТ, через 2 мес и 6 мес терапии у пациенток методом проточной цитометрии оценивались следующие иммунологические показатели: количество VEGFR+ моноцитов и экспрессия VEGFR на моноцитах, количество PD-1+клеток периферической крови и экспрессия PD-1 на них, популяционная структура лимфоцитов. В качестве контрольной группы выступили 39 пациенток с впервые диагностированным РЭ до начала противоопухолевого лечения. Результаты. Проведение ИТТ сопровождалось значимым изменением количества VEGFR+ моноцитов и экспрессии VEGFR на моноцитах, количества PD-1+клеток периферической крови и экспрессии PD-1 на них, популяционной структуры лимфоцитов. Характер динамики иммунологических показателей связан с эффективностью ИТТ. В точке наступления исхода (момент прогрессирования или последнее наблюдение при длительном ответе на терапию) различие в показателях достигало уровня статистической значимости. При эффективной ИТТ исследуемые параметры приближались к значениям у пациенток с впервые диагностируемым РЭ. Заключение. Динамика показателей иммунной системы у больных пРЭ при проведении терапии пембролизумабом в комбинации с ленватинибом связана с характером ответа на лечение.</p></abstract><trans-abstract xml:lang="en"><p>Immune targeted therapy (ITT) including pembrolizumab, an immune checkpoint inhibitor, and lenvatinib, a targeted drug that blocks receptor tyrosine kinases, is one of the main treatment strategies for advanced endometrial cancer (aEC) patients with proficient mismatch repair (pMMR) and microsatellite stable (MSS). Since immunological mechanisms are involved in the implementation of the therapeutic effects of pembrolizumab and lenvatinib, it is likely that the current state of the patients’ immune system affects the efficacy of ITT. The purpose of the study was to investigate changes in peripheral blood immune parameters depending on the response to therapy in aEC patients who received therapy with pembrolizumab and lenvatinib. Material and Methods. The study included 12 patients with stage II–IV (T2–4N0–2M0–1) aEC with pMMR and MSS, who received therapy with combination of pembrolizumab and lenvatinib. All patients were divided into 2 groups: 1) with disease progression within 6 months of starting ITT (n=4), 2) without signs of progression for more than 6 months (n=8). The immune parameters (the number of VEGFR+ monocytes and VEGFR expression on monocytes, the number of PD-1+ cells in peripheral blood and PD-1 expression on them, the lymphocyte subsets) were evaluated by flow cytometry before starting ITT, 2 and 6 months after therapy. The control group consisted of 39 patients with newly diagnosed EC prior to anticancer therapy. Results. ITT resulted in significant changes in the number of VEGFR+ monocytes and VEGFR expression on monocytes, as well as in the number of PD-1+ cells in peripheral blood and PD-1 expression on them, along with alterations in the lymphocyte subsets. Changes in the immune parameters were related to the response to ITT. At the point of outcome (during disease progression or in the case of long-term response to therapy) the difference in the parameters reached the level of statistical significance. In the case of effective ITT, the immune parameters approached the values observed in control group patients with EC being newly diagnosed. Conclusion. Changes in immune system parameters of aEC patients treated with pembrolizumab in combination with lenvatinib were found to be related to response to therapy.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рак эндометрия</kwd><kwd>иммунотаргетная терапия</kwd><kwd>пембролизумаб</kwd><kwd>ленватиниб</kwd><kwd>иммуно¬логические показатели</kwd><kwd>эффективность противоопухолевого лечения.</kwd></kwd-group><kwd-group xml:lang="en"><kwd>endometrial cancer</kwd><kwd>immune targeted therapy</kwd><kwd>pembrolizumab</kwd><kwd>lenvatinib</kwd><kwd>immunologic parameters</kwd><kwd>antitumor treatment efficacy</kwd></kwd-group><funding-group xml:lang="ru"><funding-statement>Работа выполнена при финансовой поддержке некоммерческой организации «Ассоциация онкологических организаций Сибири и Дальнего Востока».</funding-statement></funding-group><funding-group xml:lang="en"><funding-statement>The study was funded by “Association of Oncological Organizations of Siberia and the Far East” noncommercial organization.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Makker V., Colombo N., Casado Herráez A., Monk B.J., Mackay H., Santin A.D., Miller D.S., Moore R.G., Baron-Hay S., Ray-Coquard I., Ushijima K., Yonemori K., Kim Y.M., Guerra Alia E.M., Sanli U.A., Bird S., Orlowski R., McKenzie J., Okpara C., Barresi G., Lorusso D. 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