oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2026-25-2-175-182oncotomsk-4210Research ArticleОБЗОРЫREVIEWSПреодолевая барьеры опухоли: синергия фотодинамической терапии и иммунотерапииOvercoming the barriers of the tumor: the synergy of photodynamic therapy and immunotherapyhttps://orcid.org/0000-0001-8797-5932РоманкоЮ. С.RomankoYu. S.

Романко Юрий Сергеевич - доктор медицинских наук, профессор кафедры, ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» Минздрава России; профессор кафедры, Академия постдипломного образования ФГБУ ФНКЦ ФМБА России. SPIN-код: 7703-4911. Researcher ID (WOS): L-5965-2014. Author ID (Scopus): 7801463724

119991, Москва, ул. Трубецкая, 8/2; 125371, Москва, Волоколамское шоссе, 91

Yuri S. Romanko - MD, DSc, Professor, Department, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia; Professor, Department, Academy of Postgraduate Education, FSCC of FMBA of Russia. Researcher ID (WOS): L-5965-2014. Author ID (Scopus): 7801463724.

8/2, Trubetskaya St., Moscow, 119991; 91, Volokolamskoe shosse, Moscow, 125371

romanko_yu_s@staff.sechenov.ruhttps://orcid.org/0000-0001-8506-7455ФилоненкоЕ. В.FilonenkoE. V.

Филоненко Елена Вячеславовна - доктор медицинских наук, профессор, заведующая Центром, МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России; заведующая кафедрой, РТУ МИРЭА. SPIN-код: 6868-9605. Author ID (Scopus): 6701603698.

125284, Москва, 2-й Боткинский пр-д, 3; 119454, Москва, пр-т Вернадского, 78

Elena V. Filonenko - MD, DSc, Professor, Head of the Center, P. Hertsen MORI; Head of the Department, RTU MIREA. Author ID (Scopus): 6701603698.

3, 2nd Botkinsky proezd, Moscow, 125284; 78, Vernadsky Ave., Moscow 119454

https://orcid.org/0000-0002-0909-6278РешетовИ. В.ReshetovI. V.

Решетов Игорь Владимирович - доктор медицинских наук, профессор, академик РАН, директор института, ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» Минздрава России; заведующий кафедрой, Академия постдипломного образования ФГБУ ФНКЦ ФМБА России; научный руководитель факультета, ЧОУВО «Московский университет им. С.Ю. Витте»; консультант, НИЦ «Курчатовский институт». SPIN-код: 3845-6604. Author ID (Scopus): 6701353127

119991, Москва, ул. Трубецкая, 8/2; 125371, Москва, Волоколамское шоссе, 91; 115432, Москва, 2-й Кожуховский пр-д, 12/1; 123182, Москва, площадь Академика Курчатова, 1

8

Igor V. Reshetov - MD, DSc, Professor, Full Member of RAS, Director of the Institute, I.M. Sechenov First Moscow SMU, Ministry of Health of Russia; Head of the Department, Academy of Postgraduate Education, FSCC of FMBA of Russia; Scientific Director of the faculty, S.Y. Witte Moscow University; Сonsultant, Kurchatov Institute. Author ID (Scopus): 6701353127. ORCID: 0000-0002-0909-6278.

/2, Trubetskaya St., Moscow, 119991; 91, Volokolamskoe shosse, Moscow, 125371; 12/1, 2nd Kozhukhovsky proezd, Moscow, 115432; 1, Akademika Kurchatov Square, Moscow, 123182

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России; Академия постдипломного образования ФГБУ ФНКЦ ФМБА РоссииРоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia; Academy of Postgraduate Education, FSCC of FMBA of RussiaRussian FederationМНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России; РТУ МИРЭАРоссияP. Hertsen MORi; RTU MiREARussian FederationФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России; Академия постдипломного образования ФГБУ ФНКЦ ФМБА России; ЧОУВО «Московский университет им. С.Ю. Витте»; НИЦ «Курчатовский институт»РоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia; Academy of Postgraduate Education, FSCC of FMBA of Russia; S.Y. Witte Moscow University; Kurchatov instituteRussian Federation202617052026252175182Copyright © Романко Ю.С., Филоненко Е.В., Решетов И.В., 20262026Романко Ю.С., Филоненко Е.В., Решетов И.В.Romanko Y.S., Filonenko E.V., Reshetov I.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/4210

Цель исследования – изучить эффективность комбинированного лечения злокачественных опухолей, сочетающего фотодинамическую терапию и иммунотерапию.

Материал и методы

Материал и методы. По данной проблеме был проведен поиск и анализ в базах данных WoS, Scopus, MedLine и РИНЦ, в основном за последние 5 лет. Найдено 843 статьи, посвященные исследованиям комбинированной фотодинамической терапии и иммунотерапии. В обзор включено 60 наиболее релевантных работ.

Результаты

Результаты. Доклинические и клинические данные указывают на перспективность комбинированной фотодинамической терапии, которая способна усиливать иммунный ответ и преодолевать резистентность к ингибиторам PD-L1, разрушая сосуды опухоли и улучшая доставку антител. Фотодинамическая терапия активно исследуется как метод стимуляции противоопухолевого иммунитета, особенно в комбинации с иммунотерапией, превращая «холодные» опухоли в «горячие». Она способствует росту цитотоксических Т-лимфоцитов, подавляет регуляторные Т-лимфоциты и улучшает взаимодействие между опухолевыми и эффекторными клетками, одновременно нарушая регуляторные механизмы. Фотодинамическая терапия также может влиять на экспрессию PD-L1/PD-1. Учитывая хорошую переносимость фотодинамической терапии, ее сочетание с иммунотерапией может повысить эффективность лечения при минимальном увеличении рисков. Исследования показали, что опухолевая мутационная нагрузка и экспрессия PD-L1 могут прогнозировать ответ на лечение при немелкоклеточном раке легкого. У пациентов с аденокарциномой легкого с низкой/умеренной опухолевой мутационной нагрузкой и отрицательным PD-L1 наблюдалось улучшение общей выживаемости, что согласуется с данными о связи опухолевой мутационной нагрузки с ответом на ингибиторы PD-L1. При раке желудка комбинация фотодинамической терапии с блокадой PD-L1 показала эффективность, восстанавливая противоопухолевый иммунитет за счет увеличения инфильтрации цитотоксических Т-лимфоцитов и снижения активности регуляторных Т-лимфоцитов.

Заключение

Заключение. Комбинация фотодинамической терапии и иммунотерапии обладает большим потенциалом, поскольку фотодинамическая терапия уничтожает раковые клетки и стимулирует иммунный ответ, а иммунотерапия дополняет и усиливает этот эффект.

The aim of the study was to study the effectiveness of combination of photodynamic therapy and immunotherapy in cancer treatment.

Material and Methods

Material and Methods. We searched and analyzed 843 publications available from WoS, Scopus, MedLine and RSCI databases over the past 5 years. Out of 843 articles, 60 were included in this review.

Results

Results. Preclinical and clinical data indicate the promise of combined photodynamic therapy, which is able to enhance the immune response and overcome resistance to PD-L1 inhibitors by destroying tumor vessels and improving antibody delivery. Photodynamic therapy is actively being investigated as a method of stimulating antitumor immunity, especially in combination with immunotherapy, turning “cold” tumors into “hot” ones. It promotes the growth of cytotoxic T-lymphocytes, suppresses regulatory T-lymphocytes and improves the interaction between tumor and effector cells, while disrupting regulatory mechanisms. Photodynamic therapy can also affect the expression of PD-L1/PD-1. Given the good tolerability of photodynamic therapy, its combination with immunotherapy can increase the effectiveness of treatment while minimizing the risks. Studies have shown that tumor mutation load and PD-L1 expression can predict treatment response in non-small cell lung cancer. In patients with lung adenocarcinoma with low/ moderate tumor mutation load and negative PD-L1, an improvement in overall survival was observed, which is consistent with data on the association of tumor mutation load with response to PD-L1 inhibitors. In the context of gastric cancer, the combination of photodynamic therapy with PD-L1 blockade has shown efficacy in restoring antitumor immunity by increasing the infiltration of cytotoxic T-lymphocytes and reducing the activity of regulatory T-lymphocytes.

Conclusion

Conclusion. The combination of photodynamic therapy and immunotherapy has great potential, as photodynamic therapy destroys cancer cells and stimulates the immune response, and immunotherapy complements and enhances this effect.

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