Монотерапия ниволумабом у больных метастатическим колоректальным раком: современные подходы к оценке ответа опухоли

Цель исследования ‒ систематический анализ данных современной литературы об эффективности применения ниволумаба в монорежиме у больных метастатическим колоректальным раком (мКРР). Материал и методы. В обзор включены данные клинических исследований за период с 2012 по 2022 г., оценивающих эффективность лечения ниволумабом у больных мКРР. Рассмотрены текущие подходы к оценке опухолевого ответа, включая характер иммунного ответа и критерии ответа. Результаты. Анализ литературы показал, что применение ниволумаба при мКРР имеет значимые клинические преимущества. Продемонстрировано, что монотерапия ниволумабом улучшает показатели выживаемости у пациентов с высокой микросателлитной нестабильностью (MSI) или нарушением механизма репарации неспаренных оснований ДНК (dMMR), которые прогрессировали на фоне стандартной химиотерапии. Многочисленные клинические исследования указывают на развитие атипичных реакций ответа на ниволумаб. Традиционные критерии ответа, такие как RECIST, не всегда адекватно оценивают терапевтическую эффективность ниволумаба у пациентов с мКРР. Заключение. Для повышения эффективности лечения мКРР необходима разработка стандартизированных подходов, основанных на предложенных специфических критериях ответа на иммунотерапию, включая иммунологический Recist, иммунный Recist и иммуномодифицированный RECIST.

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